lista completa de medicamentos recetados disponibles para …...(lista de medicamentos cubiertos)...

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Kaiser Permanente

Lista completa de medicamentos recetados disponibles para 2019 (Lista de medicamentos cubiertos) ATENCIÓN: ESTE DOCUMENTO CONTIENE INFORMACIÓN SOBRE LOS MEDICAMENTOS QUE CUBRIMOS EN ESTE PLAN Esta lista de medicamentos recetados disponibles se actualizó el 1 de octubre de 2019. Para obtener información más reciente o si tiene alguna otra pregunta, llame al número de su región de Kaiser Permanente indicado a continuación, siete días a la semana, de 8 a. m. a 8 p. m., o visite kp.org/seniormedrx. Regiones de Kaiser Permanente

REGIÓN DEL NORTE DE CALIFORNIA Plan Kaiser Permanente Senior Advantage Medicare Medi-Cal North (HMO SNP)

Central de Llamadas de Servicio a los Miembros 1-800-443-0815 (TTY 711)

REGIÓN DE COLORADO Plan Kaiser Permanente Senior Advantage Medicare Medicaid (HMO SNP)

Servicio a los Miembros 1-800-476-2167 (TTY 711)

REGIÓN DE HAWÁI Plan Kaiser Permanente Senior Advantage Medicare Medicaid (HMO SNP)

Servicio a los Miembros 1-800-805-2739 (TTY 711) REGIÓN DE LOS ESTADOS DEL ATLÁNTICO MEDIO (Distritos de Columbia, Maryland y Virginia) Plan Kaiser Permanente Medicare Plus (Cost) Basic con D (AB) y Basic con D (B)


Nota para los miembros actuales: Esta lista de medicamentos recetados disponibles ha cambiado desde el año pasado. Revise este documento para asegurarse de que todavía incluye los medicamentos que está tomando. Cuando en esta lista de medicamentos (lista de medicamentos recetados disponibles) se utilizan los términos “nosotros” o “nuestros/as” o “-nos”, se hace referencia con ellos a Kaiser Permanente. Cuando se habla del “plan” o de “nuestro plan”, se hace referencia al plan Kaiser Permanente Senior Advantage o a Medicare Plus, dependiendo de la región en la que esté inscrito. En este documento se incluye una lista de los medicamentos (lista de medicamentos recetados disponibles) de nuestro plan, la cual está actualizada al 1 de octubre de 2019. Si desea una lista actualizada de medicamentos recetados disponibles, visite nuestro sitio web kp.org/seniormedrx o llámenos. La información de contacto de su región de Kaiser Permanente, junto con la fecha de la última actualización de la lista de medicamentos recetados disponibles, aparece en la portada y la contraportada. Por lo general, tiene que usar las farmacias de la red para utilizar su beneficio de medicamentos recetados. Los beneficios, la lista de medicamentos recetados disponibles, la red de farmacias, los copagos y el coseguro pueden cambiar el 1 de enero de 2019. En California, Hawái, Oregon, Washington, Colorado, Georgia y el Distrito de Columbia, Kaiser Permanente es un plan HMO con un contrato de Medicare. En Maryland, Kaiser Permanente es un plan HMO y un plan Cost que tiene contrato con Medicare. En Virginia, Kaiser Permanente es un plan Cost que tiene un contrato con Medicare. La inscripción en Kaiser Permanente depende de la renovación del contrato. ATENCIÓN: Si habla español, tenemos a su disposición servicios gratuitos de asistencia con el idioma. Por favor llame al número de Servicio a los Miembros que aparece en la portada y la contraportada. ATTENTION: If you speak Spanish, language assistance services, free of charge, are available to you. Please call the Member Services number listed on the front and back covers. .

2019 - Lista completa de medicamentos recetados disponibles del estándar definido de Kaiser Permanente • 1

¿Qué es la lista de medicamentos recetados disponibles de Kaiser Permanente? Una lista de medicamentos recetados disponibles es una lista de los medicamentos cubiertos, seleccionados por Kaiser Permanente junto con un equipo de proveedores de atención médica, que representa las farmacoterapias que se consideran parte necesaria de un programa de tratamiento de calidad. Por lo general, nuestro plan cubrirá los medicamentos que figuran en nuestra lista de medicamentos recetados disponibles, siempre y cuando el medicamento sea necesario desde el punto de vista médico, la receta médica se surta en una farmacia de la red de Kaiser Permanente y se cumplan con otras reglas del plan. Para obtener más información sobre cómo surtir sus recetas médicas, consulte su Evidencia de Cobertura. Nuestro plan cubre todos los medicamentos que se pueden incluir en un plan de medicamentos recetados de Medicare Parte D según los requisitos de Medicare. La información de contacto de su región de Kaiser Permanente, junto con la fecha de la última actualización de la lista de medicamentos recetados disponibles, aparece en la portada y la contraportada. ¿Puede cambiar la lista de medicamentos recetados disponibles? En general, si está tomando un medicamento incluido en nuestra lista de medicamentos recetados disponibles de 2019 y que estaba cubierto a principios de año, no suspenderemos ni reduciremos la cobertura de dicho medicamento durante el año de cobertura de 2019, excepto en casos en los que surja un medicamento genérico nuevo menos caro o que se publique información nueva sobre la seguridad o la eficacia de tal medicamento, o si el medicamento es retirado del mercado. (Ver más adelante para obtener información sobre los cambios que afectan a los miembros que estén tomando actualmente un medicamento). Otros tipos de cambios en la lista de medicamentos

recetados disponibles, tal como la retirada de un medicamento de nuestra lista, no afectarán a los miembros que actualmente estén usando dicho medicamento. Seguirá estando disponible al mismo costo compartido para aquellos miembros que continúen usándolo durante el resto del año de la cobertura. A continuación, se indican los cambios a la lista de medicamentos recetados disponibles que también afectan a los miembros que están actualmente tomando un medicamento: Nuevos medicamentos genéricos Inmediatamente retiraremos de la lista de medicamentos recetados disponibles el medicamento de marca si lo estamos reemplazando con un nuevo medicamento genérico con las mismas o menos restricciones. Además, cuando se agreguen nuevos medicamentos genéricos, podríamos decidir mantener el medicamento de marca en la lista de medicamentos recetados disponibles, pero inmediatamente agregar nuevas restricciones. Si actualmente estuviese tomando dicho medicamento de marca, podríamos no notificarle con anticipación sobre el cambio, pero le daríamos más adelante la información acerca de los cambios específicos que hayamos hecho.

• Si hiciésemos dicho cambio, usted o el profesional que le receta el medicamento, puede solicitarnos hacer una excepción y que continuemos dándole cobertura para el medicamento de marca. La notificación que le demos incluirá también información sobre los pasos que tiene que seguir para solicitar la excepción, y también encontrará información en la sección a continuación: “¿Cómo solicito una excepción a la lista de medicamentos recetados disponibles de Kaiser Permanente?”.

Medicamentos que han sido retirados del mercado Si la Administración de Alimentos y Medicamentos (Food and Drug Administration, FDA) de los Estados Unidos considera que un medicamento de nuestra lista de medicamentos

2 • 2019 - Lista completa de medicamentos recetados disponibles del estándar definido de Kaiser Permanente

recetados disponibles es peligroso o si el fabricante del medicamento lo retira del mercado, retiraremos inmediatamente el medicamento de nuestra lista e informaremos este hecho a los miembros que usan el medicamento. Otros cambios Puede ser que hagamos otros cambios que afecten a los miembros que actualmente estén tomando un medicamento. Por ejemplo, puede ser que agreguemos un medicamento genérico que no sea nuevo en el mercado para reemplazar un medicamento de marca que esté en la lista de medicamentos recetados disponibles, o puede ser que agreguemos nuevas restricciones al medicamento de marca; o podemos hacer cambios con base en nuevas pautas clínicas. Si eliminamos medicamentos de nuestra lista de medicamentos recetados disponibles o agregamos el requisito de autorización previa, tenemos que notificarles a los miembros que se verán afectados por dicho cambio por lo menos 30 días antes de la fecha en que entre en vigor el cambio o cuando el miembro solicite resurtir el medicamento, momento en el cual se le dará al miembro un suministro de 30 días del medicamento. La lista de medicamentos recetados disponibles adjunta está actualizada al 1 de octubre de 2019. Por favor, llámenos si desea obtener información actualizada sobre los medicamentos que cubre nuestro plan. La información de contacto para su región de Kaiser Permanente aparece en la portada y la contraportada. Si a mediados de año se realiza un cambio que no es de mantenimiento en la lista de medicamentos recetados disponibles, detallaremos esto en la Explicación de Beneficios de Medicare Parte D que le enviamos o en la Divulgación de Información publicada en el sitio kp.org/seniormedrx. ¿Cómo uso la lista de medicamentos recetados disponibles? Hay dos maneras de buscar su medicamento en la lista de medicamentos recetados disponibles:

Afección médica La lista de medicamentos recetados disponibles empieza en la página 6. Los medicamentos de esta lista de medicamentos recetados disponibles están agrupados en categorías según el tipo de afección médica para la cual se use el medicamento. Por ejemplo, los medicamentos que se usan para tratar afecciones del corazón figuran en la categoría “Medicamentos cardiovasculares” (Cardiovascular Drugs). Si sabe para qué se usa su medicamento, busque el nombre de la categoría en la lista que comienza en la página 8. Luego, busque en esta categoría el nombre de su medicamento. Listado en orden alfabético Si no está seguro de en qué categoría debe buscar, busque su medicamento en el índice que comienza en la página 68. El índice ofrece una lista en orden alfabético de todos los medicamentos que figuran en este documento. Junto al nombre del medicamento, verá el número de la página donde encontrará información sobre la cobertura. Pase a la página señalada en el índice y busque el nombre de su medicamento en la primera columna de la lista. ¿Qué son los medicamentos genéricos? Nuestro plan cubre los medicamentos de marca y los genéricos. Un medicamento genérico está aprobado por la FDA como un medicamento que contiene el mismo principio activo que el medicamento de marca. Por lo general, los medicamentos genéricos cuestan menos que los de marca. Consulte su Evidencia de Cobertura para obtener más información. ¿Qué son los medicamentos de marca? Los medicamentos de marca son fabricados y vendidos por la compañía farmacéutica que


realizó la investigación y desarrolló el medicamento en un primer lugar. Cuando vence la patente de un medicamento de marca, otras compañías farmacéuticas pueden fabricar y vender la versión genérica del medicamento, aprobada por la Administración de Alimentos y Medicamentos de los Estados Unidos, que contiene el mismo (o los mismos) principio(s) activo(s) a precios más bajos. Consulte su Evidencia de Cobertura para obtener más información. ¿Tiene alguna restricción mi cobertura? Algunos medicamentos cubiertos pueden tener requisitos o límites de cobertura adicionales. Estos requisitos y límites pueden incluir:

• Autorización previa: Es posible que nuestro plan requiera que usted o su proveedor de la red obtenga autorización previa para ciertos medicamentos. Esto significa que necesitará obtener la autorización de nuestro plan antes de surtir sus recetas médicas. Es posible que no cubramos el medicamento si no obtiene la autorización.

Nota: Si su receta médica indica que tiene más de un resurtido, solo puede obtener un resurtido a la vez, a menos que tenga autorización porque estará fuera de nuestra área de servicio por un período prolongado. Para ciertos medicamentos, es posible que limitemos la cantidad de los suministros diarios extendidos (las cantidades que excedan un suministro de 30 días) que pueda recibir. También es posible que le proporcionemos una cantidad limitada de su medicamento recetado si hay escasez de dicho medicamento en el mercado. Para averiguar si su medicamento tiene algún requisito o algún límite adicionales, puede consultar la lista de medicamentos recetados disponibles que empieza en la página 6. También puede visitar nuestro sitio web para obtener más información sobre las

restricciones correspondientes a ciertos medicamentos cubiertos. Hemos publicado un documento en línea que explica nuestra restricción de autorización previa. También puede pedirnos que le enviemos una copia. La información de contacto de su región de Kaiser Permanente, junto con la fecha de la última actualización de la lista de medicamentos recetados disponibles, aparece en la portada y la contraportada. Nos puede pedir que hagamos una excepción de estas restricciones o límites o una lista de otros medicamentos semejantes que pueden usarse para tratar su afección médica. Consulte la sección: “¿Cómo solicito una excepción a la lista de medicamentos recetados disponibles de Kaiser Permanente?” para obtener información sobre cómo solicitar una excepción. ¿Qué sucede si mi medicamento no está en la lista de medicamentos recetados disponibles? Si su medicamento no figura en esta lista de medicamentos recetados disponibles (lista de medicamentos cubiertos), debe consultar primero nuestra Lista completa de medicamentos recetados disponibles para 2019 de Kaiser Permanente en kp.org/seniormedrx, o llamar a nuestro plan al número correspondiente a su región de Kaiser Permanente (que aparece en la portada y la contraportada), y confirmar si su medicamento está cubierto. Nuestro plan cubre todos los medicamentos de Medicare Parte D. En el caso poco frecuente de que su medicamento de venta con receta de Medicare Parte D no esté en nuestra Lista completa de medicamentos recetados disponibles para 2019 de Kaiser Permanente, usted tiene dos opciones:

• Puede pedirle a su proveedor de la red que le recete un medicamento semejante que esté incluido en nuestra lista de medicamentos recetados disponibles.


• Puede pedirnos que hagamos una

excepción y cubramos su medicamento. Consulte en la siguiente sección la información sobre cómo pedir una excepción.

¿Cómo solicito una excepción a la lista de medicamentos recetados disponibles de Kaiser Permanente? Puede pedirnos que hagamos una excepción a nuestras reglas de cobertura. Hay varios tipos de excepciones que puede pedirnos que hagamos.

• Nos puede pedir que cubramos un medicamento aunque no esté incluido en nuestra Lista completa de medicamentos recetados disponibles para 2019 de Kaiser Permanente.

• Nos puede pedir que no apliquemos

restricciones o límites de cobertura en su medicamento. Por ejemplo, si su medicamento requiere autorización previa, puede pedirnos que no apliquemos el requisito de autorización previa para su medicamento de la Parte D.

Por lo general, solo aprobaremos su solicitud de una excepción si los demás medicamentos alternativos incluidos en la lista de medicamentos recetados disponibles del plan o las restricciones adicionales en su utilización no fueran igual de eficaces para tratar su afección o si le causaran efectos médicos adversos. Deberá comunicarse con nosotros para pedirnos una decisión de cobertura inicial para una excepción de la restricción de la lista de medicamentos recetados disponibles o de la utilización. Cuando solicite una excepción de la restricción de la lista de medicamentos recetados disponibles o de la utilización, deberá entregar una declaración de su proveedor de la red que

respalde su solicitud. Por lo general, debemos tomar nuestra decisión en el transcurso de 72 horas después de haber recibido la declaración de respaldo de la persona que recetó su medicamento. Puede pedir una excepción acelerada (rápida) si usted o su proveedor de la red creen que su salud podría verse gravemente afectada si se esperan hasta 72 horas para que se tome una decisión. Si aprobamos su solicitud para acelerar la decisión, debemos tomar una decisión a más tardar 24 horas después de que hayamos recibido una declaración de respaldo de su médico o de otra persona que le haya recetado el medicamento. Tenga en cuenta lo siguiente: Solo puede solicitar una excepción para los medicamentos que los Centros de Servicios de Medicare y Medicaid (Centers for Medicare & Medicaid Services, CMS) consideren medicamentos de venta con receta de Medicare Parte D. No se puede hacer una excepción de los medicamentos que están excluidos de Medicare Parte D. Consulte su Evidencia de Cobertura para obtener más información sobre la solicitud de excepciones, incluidos los procesos de apelaciones. ¿Qué debo hacer antes de hablar con mi proveedor de la red sobre cambiar mis medicamentos o solicitar una excepción? En raras ocasiones es posible que esté usando medicamentos de Medicare Parte D que no estén incluidos en nuestra lista de medicamentos recetados disponibles o que esté usando un medicamento que sí está incluido en nuestra lista, pero que su capacidad para obtenerlo es limitada. Por ejemplo, es posible que necesite nuestra autorización previa para poder surtir su receta médica. Debe hablar con su proveedor de la red para decidir si debe cambiar a un medicamento apropiado que nosotros cubramos o solicitar una excepción a la lista para que cubramos el medicamento que usa. Mientras habla con su proveedor de la red


para determinar cuál sería la mejor forma de proceder en su caso, es posible que cubramos su medicamento, en ciertos casos, durante los primeros 90 días que sea miembro de nuestro plan. Por cada uno de los medicamentos de la Parte D que no están en nuestra lista de medicamentos recetados disponibles, o si tiene posibilidad limitada de surtir sus medicamentos, nosotros le cubriremos un suministro temporal de 30 días. Si su receta médica es por menos tiempo, permitiremos que se hagan varios resurtidos para proporcionarle un suministro de medicamentos para 30 días como máximo. Es posible que cubramos un resurtido adicional, cuando sea necesario desde el punto de vista médico, después de su primer suministro de 30 días. Después de que haya usado estos resurtidos, no cubriremos estos medicamentos aunque haya sido miembro del plan menos de 90 días. Si es usted residente de algún centro de atención a largo plazo y necesita un medicamento que no está en nuestra lista de medicamentos recetados disponibles, o si la posibilidad de surtir sus medicamentos es limitada, pero si ya tiene más de 90 días de ser miembro de nuestro plan, nosotros cubriremos un suministro de emergencia de 31 días de dicho medicamento hasta que consiga la excepción a la lista de medicamentos recetados disponibles. Como miembro activo de nuestro plan, si tiene una estancia con cobertura en un hospital o un centro de atención de enfermería especializada como paciente hospitalizado, los medicamentos que reciba durante su estancia estarán cubiertos conforme a su beneficio médico y no a su cobertura de medicamentos de venta con receta de Medicare Parte D. Cuando se le dé de alta hospitalaria para que regrese a su casa o para que se lo traslade a un nivel de atención de custodia en un centro de atención a largo plazo, es posible que muchos de los medicamentos recetados para pacientes ambulatorios que obtenga en una

farmacia estén cubiertos por la cobertura de la Parte D de Medicare. Debido a que su cobertura de medicamentos es distinta según el contexto en el que se obtiene el medicamento, es posible que un medicamento que haya estado usando y que haya tenido cobertura con su beneficio médico no tenga cobertura con Medicare Parte D (por ejemplo, medicamentos de venta sin receta o medicamentos para la tos). Si esto ocurre, tendrá que pagar el precio total de dicho medicamento, a menos que tenga otra cobertura (por ejemplo, cobertura de grupo patrocinada por su empleador). Para obtener más información Para obtener información más detallada sobre su cobertura de medicamentos recetados de Kaiser Permanente, consulte su Evidencia de Cobertura y los demás documentos del plan. Si tiene alguna pregunta sobre nuestro plan, por favor llámenos. La información de contacto de su región de Kaiser Permanente, junto con la fecha de la última actualización de la lista de medicamentos recetados disponibles, aparece en la portada y la contraportada. Si tiene preguntas generales sobre la cobertura de Medicare para medicamentos recetados, por favor llame a Medicare al 1-800-MEDICARE (1-800-633-4227), las 24 horas del día, los 7 días de la semana. Los usuarios de TTY deben llamar al 1-877-486-2048. O visite http://www.medicare.gov (en inglés).

http://www.medicare.gov/

http://www.medicare.gov/


Lista de medicamentos recetados disponibles de Kaiser Permanente La lista de medicamentos recetados disponibles que se muestra a continuación ofrece información de cobertura sobre algunos de los medicamentos cubiertos por nuestro plan. Si tiene dificultad para encontrar su medicamento en la lista, consulte el índice que comienza en la página 68. La primera columna de la tabla contiene el nombre del medicamento. Los medicamentos de marca aparecen con letras mayúsculas (por ejemplo, ALBENZA) y los genéricos con letras minúsculas y en cursiva (por ejemplo, amoxicilina). La información que se muestra en la columna Requisitos/Límites le indica si nuestro plan tiene algún requisito especial en la cobertura de su medicamento. Ciertas dosis o presentaciones del medicamento pueden estar sujetas a los códigos de administración de utilización que se indican a continuación. HI = Los medicamentos de infusión intravenosa domiciliaria pueden estar cubiertos por nuestro beneficio médico y obtenerse en las farmacias de infusión intravenosa domiciliaria. Si desea más información, consulte su directorio de farmacias o llame a nuestro plan al número de su región de Kaiser Permanente que aparece en la portada y la contraportada. LD = Los medicamentos de distribución limitada solo se pueden obtener en ciertas farmacias especializadas. Si desea más información, consulte su directorio de farmacias o llame a nuestro plan al número de su región de Kaiser Permanente que aparece en la portada y la contraportada. MO = Medicamentos de pedido por correo. Puede pedir en línea el resurtido de ciertos medicamentos recetados por medio de nuestro servicio de pedidos por correo en kp.org/refill (en inglés), o por teléfono o aplicación móvil, lo cual podría reducir los costos de un suministro de tres meses. Comuníquese con nosotros 10 días antes de que se le terminen los medicamentos. Por lo general, deberá recibirlos en el transcurso de 10 días. Si no los recibe, llame al número de teléfono de pedidos por correo correspondiente a su región de Kaiser Permanente, que figura en el cuadro a continuación, o al número de teléfono que aparece en la etiqueta del medicamento recetado para solicitar asistencia. Es posible que otros medicamentos estén disponibles para envío por correo. No todos los medicamentos pueden enviarse por correo; hay restricciones y limitaciones. Si desea más información, visite el sitio kp.org/seniormedrx o llame al número de teléfono de la región correspondiente a continuación. Región

Números de contacto para hacer pedidos por correo (TTY 711)

California

Farmacia de Pedidos por Correo de Kaiser Permanente Norte de California – 1-888-218-6245 De lunes a viernes, de 8 a. m. a 6 p. m.

Colorado

Farmacia de Pedidos por Correo de Kaiser Permanente 1-866-523-6059 De lunes a viernes, de 8 a. m. a 6 p. m.


Hawái

Farmacia de Pedidos por Correo de Kaiser Permanente 808-643-7979 (Oahu y las islas vecinas) De lunes a viernes, de 8:30 a. m. a 5 p. m.

Estados del Atlántico Medio

Centro de resurtido de recetas automatizado del Atlántico Medio de Kaiser Permanente 703-466-4900 o sin costo al 1-800-733-6345 De lunes a viernes, de 7 a. m. a 6 p. m.; sábados, de 8:30 a. m. a 4 p. m.

NDS = Medicamentos con suministro diario no extendido que se entregan en suministros de hasta 30 días para vigilar si se presentan posibles efectos adversos, y para evitar que se desperdicie medicamento.

PA = Los medicamentos con autorización previa pueden estar cubiertos por Medicare Parte D o Medicare Parte B, dependiendo de la manera en que se administran (por ejemplo, por bomba de infusión, nebulizador u otro dispositivo de equipos médicos duraderos), el lugar en donde se administran (por ejemplo, en casa o en un centro de atención a largo plazo) y el tipo de afección médica que se busca tratar con ellos. Es posible que también se requiera autorización previa para los medicamentos en los que el tratamiento de la afección médica es el que determina si el medicamento no está incluido en la Parte D (excluido) o si tiene cobertura.

Al inicio o al final de esta tabla encontrará información sobre el significado de las abreviaturas que aparecen en ella. 8 • 2019 - Lista completa de medicamentos recetados disponibles del estándar definido de Kaiser Permanente

Nombre del medicamento Requisitos/

Límites ANTI-INFECTIVE AGENTS ANTHELMINTICS albendazole tabs NDS ALBENZA TABS NDS BILTRICIDE TABS emverm chew ivermectin tabs praziquantel tabs MO STROMECTOL TABS ANTIBACTERIALS amikacin sulfate soln injection HI amoxicillin caps amoxicillin chew amoxicillin susr amoxicillin tabs amoxicillin-pot clavulanate chew amoxicillin-pot clavulanate er tb12

amoxicillin-pot clavulanate susr amoxicillin-pot clavulanate tabs ampicillin caps ampicillin sodium solr injection 1gm, 125mg HI

ampicillin sodium solr intravenous HI

ampicillin-sulbactam sodium solr injection HI

ARIKAYCE SUSP NDS AUGMENTIN SUSR AVELOX SOLN INTRAVENOUS HI AVELOX TABS AVYCAZ SOLR INTRAVENOUS HI AZACTAM SOLR INJECTION 1gm, 2gm HI

AZITHROMYCIN PACK MO azithromycin solr intravenous HI azithromycin susr 100mg/5ml, 200mg/5ml MO

azithromycin tabs 250mg, 500mg, 600mg MO

aztreonam solr injection HI AZULFIDINE EN-TABS TBEC AZULFIDINE TABS


Límites BACTOCILL IN DEXTROSE SOLN INTRAVENOUS HI

BACTRIM DS TABS MO BACTRIM TABS MO BAXDELA SOLR INTRAVENOUS HI

BAXDELA TABS MO BETHKIS NEBU PA BICILLIN C-R 900/300 SUSP BICILLIN C-R SUSP BICILLIN L-A SUSP cefaclor caps cefaclor er tb12 cefaclor susr cefadroxil caps cefadroxil susr cefadroxil tabs cefazolin sodium solr injection 1gm, 10gm, 500mg HI

cefdinir caps cefdinir susr cefepime hcl solr injection 1gm, 2gm HI

cefixime caps cefixime susr cefotaxime sodium solr injection 1gm, 2gm, 500mg HI

cefotetan disodium solr injection 1gm, 2gm HI

cefoxitin sodium solr injection HI cefoxitin sodium solr intravenous 1gm, 2gm HI

cefpodoxime proxetil susr cefpodoxime proxetil tabs cefprozil susr cefprozil tabs ceftazidime solr injection 1gm, 2gm, 6gm HI

CEFTIN SUSR ceftriaxone sodium solr injection 1gm, 2gm, 250mg, 500mg HI

ceftriaxone sodium solr intravenous 10gm HI

cefuroxime axetil tabs

Al inicio o al final de esta tabla encontrará información sobre el significado de las abreviaturas que aparecen en ella.



Límites cefuroxime sodium solr injection 7.5gm, 750mg HI

cefuroxime sodium solr intravenous HI

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HI

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CUBICIN SOLR INTRAVENOUS HI DALVANCE SOLR INTRAVENOUS HI

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Límites DORIPENEM SOLR INTRAVENOUS HI

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Límites linezolid soln intravenous HI linezolid susr NDS linezolid tabs NDS MAXIPIME SOLR INJECTION 1gm, 2gm HI

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VANCOCIN CAPS NDS




Límites VANCOCIN HCL CAPS NDS vancomycin hcl caps vancomycin hcl intravenous 750mg

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VIBRAMYCIN CAPS MO VIBRAMYCIN SUSR MO VIBRAMYCIN SYRP XENLETA SOLN NDS XENLETA TABS NDS XIFAXAN TABS 200mg, 550mg NDS ZEMDRI SOLN INTRAVENOUS HI ZERBAXA SOLR INTRAVENOUS HI

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Límites CASPOFUNGIN ACETATE SOLR INTRAVENOUS 50mg, 70mg, 50mg, 70mg

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ANTIMYCOBACTERIALS CAPASTAT SULFATE SOLR dapsone tabs 25mg, 100mg MO



Límites ethambutol hcl tabs 100mg, 400mg MO

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Límites PLAQUENIL TABS MO primaquine phosphate tabs QUALAQUIN CAPS NDS quinine sulfate caps NDS SOLOSEC PACK TINDAMAX TABS tinidazole tabs

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Límites nevirapine tabs MO NORVIR CAPS MO NORVIR PACK MO NORVIR SOLN MO NORVIR TABS MO ODEFSEY TABS MO OLYSIO CAPS PA,NDS oseltamivir phosphate caps 30mg, 45mg, 75mg MO

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NDS

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NDS

PEGASYS PROCLICK SOLN 135mcg/0.5ml, 180mcg/0.5ml NDS

PEGASYS SOLN 180mcg/0.5ml, 180mcg/ml NDS

PEGINTRON KIT 50mcg/0.5ml, 80mcg/0.5ml, 120mcg/0.5ml, 150mcg/0.5ml

NDS

PIFELTRO TABS MO PLEGRIDY SOPN NDS PLEGRIDY SOSY NDS PLEGRIDY STARTER PACK SOPN NDS

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PREVYMIS SOLN 240mg/12ml, 480mg/24ml NDS

PREVYMIS TABS 240mg, 480mg NDS

PREZCOBIX TABS MO PREZISTA SUSP MO PREZISTA TABS 75mg, 150mg, 600mg, 800mg MO

RAPIVAB SOLN NDS REBETOL SOLN MO RELENZA DISKHALER AEPB MO RESCRIPTOR TABS 100mg, 200mg MO

RETROVIR CAPS MO



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Límites valacyclovir hcl tabs 1gm, 500mg MO

VALCYTE SOLR NDS VALCYTE TABS NDS valganciclovir hcl solr NDS valganciclovir hcl tabs NDS VALTREX TABS 1gm, 500mg MO VEMLIDY TABS VIDEX EC CPDR 125mg, 200mg, 250mg, 400mg MO

VIDEX SOLR 2gm, 4gm MO VIEKIRA PAK TBPK PA,NDS VIEKIRA XR TB24 PA,NDS VIRACEPT TABS 250mg, 625mg MO

VIRAMUNE SUSP MO VIRAMUNE TABS MO VIRAMUNE XR TB24 100mg, 400mg MO

VIREAD POWD MO VIREAD TABS 150mg MO VIREAD TABS 200mg, 250mg, 300mg MO

VOSEVI TABS PA,NDS XOFLUZA TBPK 20mg, 40mg MO ZEPATIER TABS PA,NDS ZERIT CAPS 15mg, 20mg, 30mg, 40mg MO

ZERIT SOLR MO ZIAGEN SOLN MO ZIAGEN TABS MO zidovudine caps MO zidovudine syrp MO zidovudine tabs MO ZOVIRAX CAPS MO ZOVIRAX SUSP MO ZOVIRAX TABS MO URINARY ANTI-INFECTIVES FURADANTIN SUSP HIPREX TABS MACROBID CAPS MACRODANTIN CAPS methenamine hippurate tabs




Límites MONUROL PACK nitrofurantoin macrocrystal caps nitrofurantoin monohyd macro caps

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KARBINAL ER SUER levocetirizine dihydrochloride soln

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Límites AFINITOR DISPERZ TBSO 2mg, 3mg, 5mg NDS

AFINITOR TABS 2.5mg, 5mg, 7.5mg, 10mg NDS

ALECENSA CAPS NDS ALIMTA SOLR ALIQOPA SOLR NDS ALUNBRIG TABS 30mg, 90mg, 180mg NDS

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AVASTIN SOLN BALVERSA TABS 3mg, 4mg, 5mg NDS

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BRAFTOVI CAPS 50mg, 75mg NDS CABOMETYX TABS 20mg, 40mg, 60mg NDS

CALQUENCE CAPS NDS CAPRELSA TABS 100mg, 300mg LD,NDS

CASODEX TABS CISPLATIN SOLR NDS COMETRIQ (100 MG DAILY DOSE) KIT LD,NDS

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Límites COPIKTRA CAPS 15mg, 25mg NDS COTELLIC TABS NDS CYCLOPHOSPHAMIDE CAPS 25mg, 50mg, 50mg PA

CYRAMZA SOLN 100mg/10ml, 500mg/50ml NDS

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DAURISMO TABS 25mg, 100mg NDS DOCETAXEL (NON-ALCOHOL) SOLN 160mg/8ml, 20mg/ml NDS

DROXIA CAPS ELIGARD KIT ELZONRIS SOLN NDS EMCYT CAPS NDS EMPLICITI SOLR 300mg, 400mg NDS

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EVOMELA SOLR NDS exemestane tabs FARESTON TABS FARYDAK CAPS 10mg, 15mg, 20mg LD,NDS

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GLEEVEC TABS 100mg, 400mg NDS GLEOSTINE CAPS HERCEPTIN HYLECTA SOLN NDS HERCEPTIN SOLR 440mg NDS HERCEPTIN SOLR NDS HEXALEN CAPS NDS HYDREA CAPS hydroxyurea caps


Límites IBRANCE CAPS 75mg, 100mg, 125mg NDS

ICLUSIG TABS 15mg, 45mg LD,NDS IDHIFA TABS 50mg, 100mg NDS imatinib mesylate tabs 100mg, 400mg NDS

IMBRUVICA CAPS 70mg, 140mg NDS

IMBRUVICA TABS 140mg, 280mg, 420mg, 560mg NDS

IMFINZI SOLN 500mg/10ml, 120mg/2.4ml NDS

INFUGEM SOLN NDS INLYTA TABS 1mg, 5mg NDS INREBIC CAPS NDS INTRON A SOLN 10mu/ml, 6000000unit/ml NDS

INTRON A SOLR 10mu, 18mu, 50mu NDS

IRESSA TABS NDS IXEMPRA KIT SOLR NDS JAKAFI TABS 5mg, 10mg, 15mg, 20mg, 25mg NDS

KADCYLA SOLR 100mg, 160mg NDS KANJINTI SOLR NDS KEYTRUDA SOLN NDS KEYTRUDA SOLR NDS KISQALI (200 MG DOSE) TBPK NDS KISQALI (400 MG DOSE) TBPK NDS KISQALI (600 MG DOSE) TBPK NDS KISQALI FEMARA (400 MG DOSE) TBPK NDS

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KYPROLIS SOLR 10mg, 30mg, 60mg NDS

LARTRUVO SOLN 190mg/19ml, 500mg/50ml NDS

LENVIMA (10 MG DAILY DOSE) CPPK LD,NDS





Límites LENVIMA (14 MG DAILY DOSE) CPPK LD,NDS






letrozole tabs LEUKERAN TABS NDS leuprolide acetate kit LIBTAYO SOLN NDS LONSURF TABS NDS LORBRENA TABS 25mg, 100mg NDS

LUMOXITI SOLR NDS LUPANETA PACK KIT LUPRON DEPOT (1-MONTH) KIT

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LYNPARZA CAPS NDS LYNPARZA TABS 100mg, 150mg NDS

LYSODREN TABS NDS MARQIBO SUSP NDS MATULANE CAPS NDS megestrol acetate susp megestrol acetate tabs MEKINIST TABS .5mg, 2mg NDS MEKTOVI TABS NDS mercaptopurine tabs


Límites methotrexate sodium (pf) soln NDS methotrexate sodium soln methotrexate tabs PA MUSTARGEN SOLR MVASI SOLN 400mg/16ml, 100mg/4ml NDS

MYLOTARG SOLR NDS NERLYNX TABS NDS NEXAVAR TABS NDS NILANDRON TABS nilutamide tabs NINLARO CAPS 2.3mg, 3mg, 4mg NDS

NUBEQA TABS NDS ODOMZO CAPS NDS ONIVYDE INJ NDS OPDIVO SOLN 100mg/10ml, 240mg/24ml, 40mg/4ml NDS

PERJETA SOLN NDS PIQRAY (200 MG DAILY DOSE) TBPK NDS

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POLIVY SOLR NDS POMALYST CAPS 1mg, 2mg, 3mg, 4mg NDS

PORTRAZZA SOLN NDS POTELIGEO SOLN NDS PROLEUKIN SOLR NDS PURIXAN SUSP NDS REVLIMID CAPS 2.5mg, 5mg, 10mg, 15mg, 20mg, 25mg NDS

RITUXAN HYCELA SOLN RITUXAN SOLN ROZLYTREK CAPS 100mg, 200mg NDS

RUBRACA TABS 200mg, 250mg, 300mg NDS

RYDAPT CAPS NDS SIKLOS TABS NDS SOLTAMOX SOLN



Límites SPRYCEL TABS 20mg, 50mg, 70mg, 80mg, 100mg, 140mg NDS

STIVARGA TABS NDS SUTENT CAPS 12.5mg, 25mg, 37.5mg, 50mg NDS

SYLATRON KIT SYLVANT SOLR 100mg, 400mg NDS SYNRIBO SOLR NDS TABLOID TABS TAFINLAR CAPS 50mg, 75mg NDS TAGRISSO TABS 40mg, 80mg NDS TALZENNA CAPS .25mg, 1mg NDS tamoxifen citrate tabs TARCEVA TABS 25mg, 100mg, 150mg NDS

TARGRETIN CAPS NDS TASIGNA CAPS 50mg, 150mg, 200mg NDS

TECENTRIQ SOLN 840mg/14ml, 1200mg/20ml NDS

TENIPOSIDE SOLN TEPADINA SOLR NDS THALOMID CAPS 50mg, 100mg, 150mg, 200mg NDS

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TRISENOX SOLN 10mg/10ml NDS TRISENOX SOLN NDS TURALIO CAPS NDS TYKERB TABS NDS UNITUXIN SOLN NDS VANTAS KIT VELCADE SOLR VENCLEXTA STARTING PACK TBPK NDS

VENCLEXTA TABS 10mg, 50mg NDS VENCLEXTA TABS NDS VERZENIO TABS 50mg, 100mg, 150mg, 200mg NDS


Límites VITRAKVI CAPS 25mg, 100mg NDS VITRAKVI SOLN NDS VIZIMPRO TABS 15mg, 30mg, 45mg NDS

VOTRIENT TABS NDS VYXEOS SUSR NDS XALKORI CAPS 200mg, 250mg NDS XATMEP SOLN PA,NDS XOSPATA TABS NDS XPOVIO (100 MG ONCE WEEKLY) TBPK NDS

XPOVIO (60 MG ONCE WEEKLY) TBPK NDS

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XTANDI CAPS NDS YERVOY SOLN YONDELIS SOLR NDS YONSA TABS NDS ZALTRAP SOLN 100mg/4ml, 200mg/8ml NDS

ZEJULA CAPS NDS ZELBORAF TABS NDS ZOLINZA CAPS NDS ZYDELIG TABS 100mg, 150mg NDS ZYKADIA CAPS NDS ZYKADIA TABS NDS ZYTIGA TABS 250mg, 500mg NDS AUTONOMIC DRUGS ANTICHOLINERGIC AGENTS ANORO ELLIPTA AEPB MO ATROVENT HFA AERS MO BEVESPI AEROSPHERE AERO MO CUVPOSA SOLN MO dicyclomine hcl caps MO dicyclomine hcl soln MO dicyclomine hcl tabs MO glycopyrrolate tabs 1mg, 2mg MO INCRUSE ELLIPTA AEPB MO ipratropium bromide soln .02% PA,MO




Límites ipratropium bromide soln .03%, .06% MO

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SPIRIVA RESPIMAT AERS MO STIOLTO RESPIMAT AERS MO TUDORZA PRESSAIR AEPB MO YUPELRI SOLN PA,NDS AUTONOMIC DRUGS, MISCELLANEOUS CHANTIX CONTINUING MONTH PAK TABS MO

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donepezil hcl tbdp 5mg, 10mg MO EVOXAC CAPS MO EXELON PT24 4.6mg/24hr, 9.5mg/24hr, 13.3mg/24hr MO

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Límites galantamine hydrobromide tabs 4mg, 8mg, 12mg MO

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RAZADYNE TABS 4mg, 8mg, 12mg MO

REGONOL SOLN rivastigmine pt24 4.6mg/24hr, 9.5mg/24hr, 13.3mg/24hr MO

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SALAGEN TABS 5mg, 7.5mg MO urecholine tabs 5mg, 10mg, 25mg, 50mg MO

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DANTRIUM CAPS dantrolene sodium caps fexmid tabs PA lorzone tabs 375mg, 750mg NDS metaxall tabs metaxalone tabs methocarbamol tabs



Límites orphenadrine citrate er tb12 SKELAXIN TABS SOMA TABS 250mg, 350mg PA,NDS tizanidine hcl caps tizanidine hcl tabs ZANAFLEX CAPS ZANAFLEX TABS SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS alfuzosin hcl er tb24 MO D.H.E. 45 SOLN NDS DIBENZYLINE CAPS NDS dihydroergotamine mesylate soln 1mg/ml, 4mg/ml NDS

ergoloid mesylates tabs MO FLOMAX CAPS MO MIGRANAL SOLN NDS phenoxybenzamine hcl caps NDS RAPAFLO CAPS 4mg, 8mg MO silodosin caps 4mg, 8mg MO tamsulosin hcl caps MO UROXATRAL TB24 MO SYMPATHOMIMETIC (ADRENERGIC) AGENTS ADVAIR DISKUS AEPB MO ADVAIR HFA AERO MO AIRDUO RESPICLICK 113/14 AEPB MO

AIRDUO RESPICLICK 232/14 AEPB MO

AIRDUO RESPICLICK 55/14 AEPB MO

albuterol sulfate er tb12 4mg, 8mg MO

albuterol sulfate hfa aers 108mcg/act MO

ALBUTEROL SULFATE HFA AERS MO

albuterol sulfate nebu .083%, .5% PA,MO

albuterol sulfate nebu .63mg/3ml, 1.25mg/3ml PA,MO

albuterol sulfate syrp MO albuterol sulfate tabs 2mg, 4mg MO


Límites ARCAPTA NEOHALER CAPS MO AUVI-Q SOAJ .15mg/0.15ml, .1mg/0.1ml, .3mg/0.3ml NDS

BROVANA NEBU PA,MO COMBIVENT RESPIMAT AERS MO epinephrine soaj EPIPEN 2-PAK SOAJ EPIPEN JR 2-PAK SOAJ fluticasone-salmeterol aepb MO ipratropium-albuterol soln PA,MO levalbuterol hcl nebu 1.25mg/0.5ml, .31mg/3ml, .63mg/3ml, 1.25mg/3ml

PA,MO

levalbuterol tartrate aero MO metaproterenol sulfate syrp MO metaproterenol sulfate tabs 10mg, 20mg MO

midodrine hcl tabs 2.5mg, 5mg, 10mg MO

NORTHERA CAPS 100mg, 200mg, 300mg NDS

PERFOROMIST NEBU PA,MO PROAIR HFA AERS MO PROAIR RESPICLICK AEPB MO PROVENTIL HFA AERS MO SEREVENT DISKUS AEPB MO STRIVERDI RESPIMAT AERS MO SYMJEPI SOSY terbutaline sulfate tabs 2.5mg, 5mg MO

UTIBRON NEOHALER CAPS MO VENTOLIN HFA AERS MO wixela inhub aepb MO XOPENEX CONCENTRATE NEBU PA,MO

XOPENEX HFA AERO MO XOPENEX NEBU .31mg/3ml, .63mg/3ml, 1.25mg/3ml PA,MO

BLOOD FORMATION, COAGULATION, AND THROMBOSIS BLOOD FORMATION MODIFIERS BERINERT KIT INTRAVENOUS HI CINRYZE SOLR INTRAVENOUS HI




Límites FIRAZYR SOLN NDS icatibant acetate soln NDS RUCONEST SOLR INTRAVENOUS HI

COAGULANTS AND ANTICOAGULANTS AGGRENOX CP12 MO AGRYLIN CAPS MO AMICAR TABS MO anagrelide hcl caps .5mg, 1mg MO ARIXTRA SOLN 2.5mg/0.5ml NDS ARIXTRA SOLN 5mg/0.4ml, 7.5mg/0.6ml, 10mg/0.8ml NDS

aspirin-dipyridamole er cp12 MO BEVYXXA CAPS 40mg, 80mg MO BRILINTA TABS 60mg, 90mg MO cilostazol tabs 50mg, 100mg MO clopidogrel bisulfate tabs 75mg, 300mg MO

COUMADIN TABS 1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg, 7.5mg, 10mg

MO

EFFIENT TABS 5mg, 10mg MO ELIQUIS STARTER PACK TABS MO

ELIQUIS TABS 2.5mg, 5mg MO enoxaparin sodium soln 30mg/0.3ml, 40mg/0.4ml, 60mg/0.6ml, 80mg/0.8ml, 120mg/0.8ml, 300mg/3ml, 100mg/ml, 150mg/ml

NDS

fondaparinux sodium soln 2.5mg/0.5ml NDS

fondaparinux sodium soln 5mg/0.4ml, 7.5mg/0.6ml, 10mg/0.8ml

NDS

FRAGMIN SOLN 2500unit/0.2ml, 5000unit/0.2ml, 7500unit/0.3ml, 12500unit/0.5ml, 15000unit/0.6ml, 95000unit/3.8ml, 10000unit/ml, 18000unt/0.72ml

NDS

heparin sodium (porcine) soln 1000unit/ml, 5000unit/ml, 10000unit/ml, 20000unit/ml

PA


Límites jantoven tabs 1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg, 7.5mg, 10mg

MO

LOVENOX SOLN 300mg/3ml NDS LOVENOX SOLN 30mg/0.3ml, 40mg/0.4ml, 60mg/0.6ml, 80mg/0.8ml, 120mg/0.8ml, 100mg/ml, 150mg/ml

NDS

LYSTEDA TABS MO pentoxifylline er tbcr MO PLAVIX TABS 75mg, 300mg MO PRADAXA CAPS 110mg, 150mg MO

prasugrel hcl tabs 5mg, 10mg MO SAVAYSA TABS 15mg, 30mg, 60mg MO

tranexamic acid tabs MO warfarin sodium tabs 1mg, 2mg, 2.5mg, 3mg, 4mg, 5mg, 6mg, 10mg

MO

XARELTO STARTER PACK TBPK MO

XARELTO TABS 2.5mg, 10mg, 15mg, 20mg MO

YOSPRALA TBEC MO ZONTIVITY TABS MO HEMATOPOIETIC AGENTS ARANESP (ALBUMIN FREE) SOLN 25mcg/ml, 40mcg/ml, 60mcg/ml, 100mcg/ml, 200mcg/ml, 300mcg/ml

PA,NDS

ARANESP (ALBUMIN FREE) SOSY 60mcg/0.3ml, 150mcg/0.3ml, 25mcg/0.42ml, 10mcg/0.4ml, 40mcg/0.4ml, 200mcg/0.4ml, 100mcg/0.5ml, 300mcg/0.6ml, 500mcg/ml

PA,NDS

CABLIVI KIT NDS DOPTELET TABS NDS EPOGEN SOLN 2000unit/ml, 3000unit/ml, 4000unit/ml, 10000unit/ml, 20000unit/ml

PA,NDS

FULPHILA SOSY NDS GRANIX SOLN 480mcg/1.6ml, 300mcg/ml NDS



Límites GRANIX SOSY 300mcg/0.5ml, 480mcg/0.8ml NDS

LEUKINE SOLR NDS MIRCERA SOSY 30mcg/0.3ml, 50mcg/0.3ml, 75mcg/0.3ml, 100mcg/0.3ml, 150mcg/0.3ml, 200mcg/0.3ml

PA

MULPLETA TABS NDS NEULASTA ONPRO PSKT NDS NEULASTA SOSY NDS NEUPOGEN SOLN 480mcg/1.6ml, 300mcg/ml NDS

NEUPOGEN SOSY 300mcg/0.5ml, 480mcg/0.8ml NDS

NIVESTYM SOLN 480mcg/1.6ml, 300mcg/ml NDS

NIVESTYM SOSY 300mcg/0.5ml, 480mcg/0.8ml NDS

NPLATE SOLR 250mcg, 500mcg NDS

PROCRIT SOLN 2000unit/ml, 3000unit/ml, 4000unit/ml, 10000unit/ml, 20000unit/ml, 40000unit/ml

PA,NDS

PROMACTA PACK NDS PROMACTA TABS 12.5mg, 25mg, 50mg, 75mg NDS

RETACRIT SOLN 2000unit/ml, 3000unit/ml, 4000unit/ml, 10000unit/ml, 40000unit/ml

PA,NDS

TAVALISSE TABS 100mg, 150mg NDS

UDENYCA SOSY NDS ZARXIO SOSY 300mcg/0.5ml, 480mcg/0.8ml NDS

CARDIOVASCULAR DRUGS A-ADRENERGIC BLOCKING AGENTS CARDURA TABS 1mg, 2mg, 4mg, 8mg MO

CARDURA XL TB24 4mg, 8mg MO DEMSER CAPS MO doxazosin mesylate tabs 1mg, 2mg, 4mg, 8mg MO

MINIPRESS CAPS 1mg, 2mg, 5mg MO


Límites prazosin hcl caps 1mg, 2mg, 5mg MO

terazosin hcl caps 1mg, 2mg, 5mg, 10mg MO

ANTILIPEMIC AGENTS ALTOPREV TB24 20mg, 40mg, 60mg MO

ANTARA CAPS 30mg, 90mg MO atorvastatin calcium tabs 10mg, 20mg, 40mg, 80mg MO

cholestyramine light powd MO cholestyramine pack MO colesevelam hcl pack MO colesevelam hcl tabs MO COLESTID PACK MO COLESTID TABS MO colestipol hcl pack MO colestipol hcl tabs MO CRESTOR TABS 5mg, 10mg, 20mg, 40mg MO

EZALLOR SPRINKLE CPSP 5mg, 10mg, 20mg, 40mg MO

ezetimibe tabs MO ezetimibe-simvastatin tabs MO fenofibrate caps 50mg, 150mg MO fenofibrate micronized caps 43mg, 67mg, 130mg, 134mg, 200mg

MO

fenofibrate tabs 40mg, 48mg, 54mg, 120mg, 145mg, 160mg MO

fenofibric acid cpdr 45mg, 135mg MO

fenofibric acid tabs 35mg MO FENOFIBRIC ACID TABS MO FENOGLIDE TABS 40mg, 120mg MO

FIBRICOR TABS 35mg, 105mg MO FLOLIPID SUSP 20mg/5ml, 40mg/5ml MO

fluvastatin sodium caps 20mg, 40mg MO

fluvastatin sodium er tb24 MO gemfibrozil tabs MO




Límites JUXTAPID CAPS 5mg, 10mg, 20mg, 30mg, 40mg, 60mg PA,LD,NDS

KYNAMRO SOSY PA,LD,NDS LESCOL XL TB24 MO LIPITOR TABS 10mg, 20mg, 40mg, 80mg MO

LIPOFEN CAPS 50mg, 150mg MO LIVALO TABS 1mg, 2mg, 4mg MO LOPID TABS MO lovastatin tabs 10mg, 20mg, 40mg MO

LOVAZA CAPS MO niacin er (antihyperlipidemic) tbcr 500mg, 750mg, 1000mg MO

niacor tabs MO NIASPAN TBCR 500mg, 750mg, 1000mg MO

omega-3-acid ethyl esters caps MO PRALUENT SOPN 75mg/ml, 150mg/ml PA,NDS

PRALUENT SOSY 75mg/ml, 150mg/ml PA,NDS

PRAVACHOL TABS 20mg, 40mg, 80mg MO

pravastatin sodium tabs 10mg, 20mg, 40mg, 80mg MO

prevalite pack MO questran light powd MO questran pack MO REPATHA PUSHTRONEX SYSTEM SOCT PA,NDS

REPATHA SOSY PA,NDS REPATHA SURECLICK SOAJ PA,NDS rosuvastatin calcium tabs 5mg, 10mg, 20mg, 40mg MO

simvastatin tabs 5mg, 10mg, 20mg, 40mg, 80mg MO

TRICOR TABS 48mg, 145mg MO TRIGLIDE TABS MO TRILIPIX CPDR 45mg, 135mg MO VASCEPA CAPS .5gm, 1gm MO VYTORIN TABS MO WELCHOL PACK MO WELCHOL TABS MO


Límites ZETIA TABS MO ZOCOR TABS 5mg, 10mg, 20mg, 40mg, 80mg MO

ZYPITAMAG TABS 1mg, 2mg, 4mg MO

BETA-ADRENERGIC BLOCKING AGENTS acebutolol hcl caps 200mg, 400mg MO

atenolol tabs 25mg, 50mg, 100mg MO

atenolol-chlorthalidone tabs MO BETAPACE AF TABS 80mg, 120mg, 160mg MO

betaxolol hcl tabs 10mg, 20mg MO bisoprolol fumarate tabs 5mg, 10mg MO

bisoprolol-hydrochlorothiazide tabs MO

BYSTOLIC TABS 2.5mg, 5mg, 10mg, 20mg MO

carvedilol phosphate er cp24 10mg, 20mg, 40mg, 80mg MO

carvedilol tabs 3.125mg, 6.25mg, 12.5mg, 25mg MO

COREG CR CP24 10mg, 20mg, 40mg, 80mg MO

COREG TABS 3.125mg, 6.25mg, 12.5mg, 25mg MO

CORGARD TABS 20mg, 40mg, 80mg MO

CORZIDE TABS MO DUTOPROL TB24 MO INDERAL LA CP24 60mg, 80mg, 120mg, 160mg MO

INNOPRAN XL CP24 80mg, 120mg MO

labetalol hcl tabs 100mg, 200mg, 300mg MO

LOPRESSOR HCT TABS MO LOPRESSOR TABS MO metoprolol succinate er tb24 25mg, 50mg, 100mg, 200mg MO

metoprolol tartrate tabs 25mg, 50mg, 100mg MO



Límites metoprolol-hydrochlorothiazide tabs MO

nadolol tabs 20mg, 40mg, 80mg MO nadolol-bendroflumethiazide tabs MO

pindolol tabs 5mg, 10mg MO propranolol hcl er cp24 60mg, 80mg, 120mg, 160mg MO

propranolol hcl soln 20mg/5ml, 40mg/5ml MO

propranolol hcl tabs 10mg, 20mg, 40mg, 60mg, 80mg MO

propranolol-hctz tabs MO sorine tabs 80mg, 120mg, 160mg, 240mg MO

sotalol hcl (af) tabs MO sotalol hcl tabs 80mg, 160mg, 240mg MO

SOTYLIZE SOLN MO TENORETIC 100 TABS MO TENORETIC 50 TABS MO TENORMIN TABS 25mg, 50mg, 100mg MO

timolol maleate tabs 5mg, 10mg, 20mg MO

TOPROL XL TB24 25mg, 50mg, 100mg, 200mg MO

ZIAC TABS MO CALCIUM-CHANNEL BLOCKING AGENTS ADALAT CC TB24 30mg, 60mg, 90mg MO

afeditab cr tb24 30mg, 60mg MO amlodipine besy-benazepril hcl caps MO

amlodipine besylate tabs 2.5mg, 5mg, 10mg MO

amlodipine besylate-valsartan tabs MO

amlodipine-atorvastatin tabs MO amlodipine-olmesartan tabs MO amlodipine-valsartan-hctz tabs MO AZOR TABS MO CADUET TABS MO CALAN SR TBCR 120mg, 240mg MO


Límites CALAN TABS 80mg, 120mg MO CARDENE IV SOLN CARDIZEM CD CP24 120mg, 180mg, 240mg, 300mg, 360mg MO

CARDIZEM LA TB24 120mg, 180mg, 240mg, 300mg, 360mg, 420mg

MO

CARDIZEM TABS 30mg, 60mg, 120mg MO

cartia xt cp24 120mg, 180mg, 240mg, 300mg MO

dilt-xr cp24 120mg, 180mg, 240mg MO

diltiazem hcl er beads cp24 360mg, 420mg MO

diltiazem hcl er coated beads cp24 120mg, 180mg, 240mg, 300mg

MO

diltiazem hcl er cp12 60mg, 90mg, 120mg MO

diltiazem hcl tabs 30mg, 60mg, 90mg, 120mg MO

EXFORGE HCT TABS MO EXFORGE TABS MO felodipine er tb24 2.5mg, 5mg, 10mg MO

isradipine caps 2.5mg, 5mg MO LOTREL CAPS MO matzim la tb24 180mg, 240mg, 300mg, 360mg, 420mg MO

nicardipine hcl caps 20mg, 30mg MO nifedipine caps 10mg, 20mg MO nifedipine er osmotic release tb24 30mg, 60mg, 90mg MO

nifedipine er tb24 30mg, 60mg, 90mg MO

nimodipine caps MO nisoldipine er tb24 8.5mg, 17mg, 20mg, 25.5mg, 30mg, 34mg, 40mg

MO

NORVASC TABS 2.5mg, 5mg, 10mg MO

NYMALIZE SOLN MO olmesartan-amlodipine-hctz tabs MO PROCARDIA CAPS MO




Límites PROCARDIA XL TB24 30mg, 60mg, 90mg MO

SULAR TB24 8.5mg, 17mg, 34mg MO

TARKA TBCR MO taztia xt cp24 120mg, 180mg, 240mg, 300mg, 360mg MO

telmisartan-amlodipine tabs MO TIAZAC CP24 120mg, 180mg, 240mg, 300mg, 360mg, 420mg MO

trandolapril-verapamil hcl er tbcr MO TRIBENZOR TABS MO TWYNSTA TABS MO VERAPAMIL HCL ER CP24 100mg, 120mg, 180mg, 200mg, 240mg, 300mg, 360mg

MO

verapamil hcl er tbcr 120mg, 180mg, 240mg MO

verapamil hcl tabs 80mg, 120mg MO verapamil hcl tabs MO VERELAN CP24 120mg, 180mg, 240mg, 360mg MO

VERELAN PM CP24 100mg, 200mg, 300mg MO

CARDIAC DRUGS amiodarone hcl tabs 100mg, 200mg, 400mg MO

CORLANOR TABS 5mg, 7.5mg MO digitek tabs .125mg, .25mg MO digox tabs DIGOXIN SOLN MO digoxin tabs 125mcg, 250mcg MO disopyramide phosphate caps 100mg, 150mg MO

dofetilide caps 125mcg, 250mcg, 500mcg MO

flecainide acetate tabs 50mg, 100mg, 150mg MO

LANOXIN PEDIATRIC SOLN LANOXIN TABS 62.5mcg, 125mcg, 187.5mcg, 250mcg MO

mexiletine hcl caps 150mg, 200mg, 250mg MO

MULTAQ TABS MO


Límites NORPACE CAPS 100mg, 150mg MO

NORPACE CR CP12 100mg, 150mg MO

pacerone tabs 100mg, 200mg, 400mg MO

propafenone hcl er cp12 225mg, 325mg, 425mg MO

propafenone hcl tabs 150mg, 225mg, 300mg MO

quinidine gluconate er tbcr MO QUINIDINE GLUCONATE SOLN quinidine sulfate tabs 200mg, 300mg MO

RANEXA TB12 500mg, 1000mg MO ranolazine er tb12 500mg, 1000mg MO

RYTHMOL SR CP12 225mg, 325mg, 425mg MO

TIKOSYN CAPS 125mcg, 250mcg, 500mcg MO

VYNDAMAX CAPS NDS VYNDAQEL CAPS NDS HYPOTENSIVE AGENTS CATAPRES TABS .1mg, .2mg, .3mg MO

CATAPRES-TTS-1 PTWK MO CATAPRES-TTS-2 PTWK MO CATAPRES-TTS-3 PTWK MO clonidine hcl er tb12 MO clonidine hcl tabs .1mg, .2mg, .3mg MO

clonidine ptwk .1mg/24hr, .2mg/24hr, .3mg/24hr MO

guanfacine hcl tabs 1mg, 2mg MO hydralazine hcl tabs 10mg, 25mg, 50mg, 100mg MO

KAPVAY TB12 MO methyldopa tabs 250mg, 500mg MO methyldopa-hydrochlorothiazide tabs MO

minoxidil tabs 2.5mg, 10mg MO vecamyl tabs NDS RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITORS



Límites ACCUPRIL TABS 5mg, 10mg, 20mg, 40mg MO

ACCURETIC TABS MO ALDACTAZIDE TABS MO ALDACTONE TABS 25mg, 50mg, 100mg MO

aliskiren fumarate tabs 150mg, 300mg MO

ALTACE CAPS 1.25mg, 2.5mg, 5mg, 10mg MO

ATACAND HCT TABS MO ATACAND TABS 4mg, 8mg, 16mg, 32mg MO

AVALIDE TABS MO AVAPRO TABS 75mg, 150mg, 300mg MO

benazepril hcl tabs 5mg, 10mg, 20mg, 40mg MO

benazepril-hydrochlorothiazide tabs MO

BENICAR HCT TABS MO BENICAR TABS 5mg, 20mg, 40mg MO

BYVALSON TABS MO candesartan cilexetil tabs 4mg, 8mg, 16mg, 32mg MO

candesartan cilexetil-hctz tabs MO captopril tabs 12.5mg, 25mg, 50mg, 100mg MO

captopril-hydrochlorothiazide tabs MO

CAROSPIR SUSP MO COZAAR TABS 25mg, 50mg, 100mg MO

DIOVAN HCT TABS MO DIOVAN TABS 40mg, 80mg, 160mg, 320mg MO

EDARBI TABS 40mg, 80mg MO EDARBYCLOR TABS MO enalapril maleate tabs 2.5mg, 5mg, 10mg, 20mg MO

enalapril-hydrochlorothiazide tabs MO

ENTRESTO TABS MO eplerenone tabs 25mg, 50mg MO


Límites eprosartan mesylate tabs MO fosinopril sodium tabs 10mg, 20mg, 40mg MO

fosinopril sodium-hctz tabs MO HYZAAR TABS MO INSPRA TABS 25mg, 50mg MO irbesartan tabs 75mg, 150mg, 300mg MO

irbesartan-hydrochlorothiazide tabs MO

lisinopril tabs 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg MO

lisinopril-hydrochlorothiazide tabs MO

losartan potassium tabs 25mg, 50mg, 100mg MO

losartan potassium-hctz tabs MO LOTENSIN TABS 10mg, 20mg, 40mg MO

MICARDIS HCT TABS MO MICARDIS TABS 20mg, 40mg, 80mg MO

moexipril hcl tabs 7.5mg, 15mg MO moexipril-hydrochlorothiazide tabs MO

olmesartan medoxomil tabs 5mg, 20mg, 40mg MO

olmesartan medoxomil-hctz tabs MO perindopril erbumine tabs 2mg, 4mg, 8mg MO

PRINIVIL TABS 5mg, 10mg, 20mg MO

QBRELIS SOLN MO quinapril hcl tabs 5mg, 10mg, 20mg, 40mg MO

quinapril-hydrochlorothiazide tabs MO

ramipril caps 1.25mg, 2.5mg, 5mg, 10mg MO

spironolactone tabs 25mg, 50mg, 100mg MO

spironolactone-hctz tabs MO TEKTURNA HCT TABS MO TEKTURNA TABS 150mg, 300mg MO




Límites telmisartan tabs 20mg, 40mg, 80mg MO

telmisartan-hctz tabs MO trandolapril tabs 1mg, 2mg, 4mg MO valsartan tabs 40mg, 80mg, 160mg, 320mg MO

valsartan-hydrochlorothiazide tabs MO

VASERETIC TABS MO VASOTEC TABS 2.5mg, 5mg, 10mg, 20mg MO

ZESTORETIC TABS MO ZESTRIL TABS 2.5mg, 5mg, 10mg, 20mg, 30mg, 40mg MO

VASODILATING AGENTS ADCIRCA TABS PA,NDS alyq tabs PA,NDS BIDIL TABS MO CIALIS TABS 2.5mg, 5mg PA,NDS dipyridamole tabs 25mg, 50mg, 75mg MO

GONITRO PACK MO ISORDIL TITRADOSE TABS 5mg, 40mg MO

isosorbide dinitrate er tbcr MO isosorbide dinitrate tabs 5mg, 10mg, 20mg, 30mg MO

isosorbide mononitrate er tb24 30mg, 60mg MO

isosorbide mononitrate er tb24 MO isosorbide mononitrate tabs 10mg, 20mg MO

minitran pt24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr MO

nitro-bid oint MO NITRO-DUR PT24 .3mg/hr, .8mg/hr MO

NITRO-DUR PT24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr MO

nitroglycerin pt24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr MO

nitroglycerin soln MO nitroglycerin subl .3mg, .4mg, .6mg MO


Límites NITROSTAT SUBL .3mg, .4mg, .6mg MO

REVATIO SOLN PA,NDS REVATIO SUSR PA,NDS REVATIO TABS PA,NDS sildenafil citrate susr PA,NDS sildenafil citrate tabs PA,MO,NDS tadalafil (pah) tabs 20mg PA,NDS tadalafil tabs 2.5mg, 5mg PA,NDS CENTRAL NERVOUS SYSTEM AGENTS ALCOHOL DETERRENTS acamprosate calcium tbec MO antabuse tabs 250mg, 500mg MO disulfiram tabs 250mg, 500mg MO ANALGESICS AND ANTIPYRETICS ABSTRAL SUBL 100mcg, 200mcg, 300mcg, 400mcg, 600mcg, 800mcg

PA,NDS

acetaminophen-codeine #3 tabs NDS acetaminophen-codeine soln NDS acetaminophen-codeine tabs NDS ACTIQ LPOP 200mcg PA,NDS ACTIQ LPOP 400mcg, 600mcg, 800mcg, 1200mcg, 1600mcg PA,NDS

allzital tabs APADAZ TABS NDS ARTHROTEC TBEC ARYMO ER TBEA 15mg, 30mg NDS ARYMO ER TBEA NDS ascomp-codeine caps NDS BELBUCA FILM 75mcg, 150mcg, 300mcg, 450mcg, 600mcg, 750mcg, 900mcg

NDS

bupap tabs buprenorphine ptwk 5mcg/hr, 7.5mcg/hr, 10mcg/hr, 15mcg/hr, 20mcg/hr

NDS

butalbital-acetaminophen caps NDS butalbital-acetaminophen tabs butalbital-apap-caff-cod caps NDS butalbital-apap-caffeine caps butalbital-apap-caffeine tabs butalbital-asa-caff-codeine caps NDS



Límites butalbital-aspirin-caffeine caps butorphanol tartrate soln 1mg/ml, 2mg/ml, 10mg/ml NDS

BUTRANS PTWK 5mcg/hr, 7.5mcg/hr, 10mcg/hr, 15mcg/hr, 20mcg/hr

NDS

capital/codeine susp NDS CELEBREX CAPS celecoxib caps codeine sulfate tabs 15mg, 30mg, 60mg NDS

CONZIP CP24 100mg, 200mg, 300mg NDS

DAYPRO TABS DEMEROL SOLN 25mg/0.5ml, 75mg/1.5ml, 100mg/2ml, 25mg/ml, 50mg/ml, 75mg/ml, 100mg/ml

PA,NDS

DEMEROL TABS 50mg, 100mg NDS diclofenac potassium tabs diclofenac sodium er tb24 diclofenac sodium tbec diclofenac-misoprostol tbec diflunisal tabs DILAUDID LIQD NDS DILAUDID SOLN 1mg/ml, 4mg/ml NDS

DILAUDID TABS 2mg, 4mg, 8mg NDS

DOLOPHINE TABS 5mg, 10mg NDS DUEXIS TABS DURAGESIC-100 PT72 NDS DURAGESIC-12 PT72 NDS DURAGESIC-25 PT72 NDS DURAGESIC-50 PT72 NDS DURAGESIC-75 PT72 NDS DURAMORPH SOLN .5mg/ml, 1mg/ml HI,NDS

dvorah tabs EMBEDA CPCR NDS endocet tabs NDS esgic tabs etodolac caps etodolac er tb24


Límites etodolac tabs EXALGO T24A 8mg, 12mg, 16mg, 32mg NDS

FELDENE CAPS 10mg, 20mg NDS fenoprofen calcium caps fenoprofen calcium tabs fentanyl citrate (pf) soct NDS FENTANYL CITRATE (PF) SOLN 1000mcg/20ml, 2500mcg/50ml

NDS

FENTANYL CITRATE (PF) SOLN 500mcg/10ml, 100mcg/2ml, 250mcg/5ml

NDS

fentanyl citrate lpop 200mcg PA,NDS fentanyl citrate lpop 400mcg, 600mcg, 800mcg, 1200mcg, 1600mcg

PA,NDS

fentanyl citrate tabs 100mcg, 200mcg, 400mcg, 600mcg, 800mcg

PA,NDS

fentanyl pt72 12mcg/hr, 25mcg/hr, 37.5mcg/hr, 50mcg/hr, 62.5mcg/hr, 75mcg/hr, 87.5mcg/hr, 100mcg/hr

NDS

FENTORA TABS 100mcg, 200mcg, 400mcg, 600mcg, 800mcg

PA,NDS

fioricet caps fioricet/codeine caps NDS FIORINAL CAPS FIORINAL/CODEINE #3 CAPS NDS flurbiprofen tabs GRALISE STARTER MISC GRALISE TABS hycet soln NDS hydrocodone-acetaminophen soln NDS

hydrocodone-acetaminophen tabs NDS

hydrocodone-ibuprofen tabs NDS hydromorphone hcl er t24a 8mg, 12mg, 16mg, 32mg NDS

hydromorphone hcl liqd NDS




Límites hydromorphone hcl pf soln 50mg/5ml, 10mg/ml NDS

HYDROMORPHONE HCL PF SOLN 2mg/ml, 4mg/ml NDS

HYDROMORPHONE HCL SOLN NDS

hydromorphone hcl tabs 2mg, 4mg, 8mg NDS

HYSINGLA ER T24A 20mg, 30mg, 40mg, 60mg, 80mg, 100mg, 120mg

NDS

ibu tabs ibudone tabs NDS ibuprofen susp ibuprofen tabs ILARIS SOLN NDS INDOCIN SUSP indomethacin caps indomethacin er cpcr INFUMORPH 200 SOLN NDS INFUMORPH 500 SOLN NDS KADIAN CP24 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 80mg, 100mg, 200mg

NDS

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meclofenamate sodium caps mefenamic acid caps meloxicam tabs


Límites meperidine hcl soln 50mg/5ml, 10mg/ml, 25mg/ml, 50mg/ml, 100mg/ml

PA,NDS

meperidine hcl tabs 50mg, 100mg NDS

methadone hcl conc NDS methadone hcl soln 5mg/5ml, 10mg/5ml NDS

METHADONE HCL SOLN NDS methadone hcl tabs 5mg, 10mg NDS MOBIC TABS MORPHABOND ER T12A 15mg, 30mg, 60mg, 100mg NDS

morphine sulfate (concentrate) soln NDS

MORPHINE SULFATE (PF) SOLN 2mg/ml, 4mg/ml, 5mg/ml, 8mg/ml, 10mg/ml

NDS

MORPHINE SULFATE DEVI NDS morphine sulfate er beads cp24 30mg, 45mg, 60mg, 75mg, 90mg, 120mg

NDS

morphine sulfate er cp24 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 80mg, 100mg

NDS

morphine sulfate er tbcr 15mg, 30mg, 60mg, 100mg, 200mg NDS

morphine sulfate soln 10mg/5ml, 20mg/5ml NDS

MORPHINE SULFATE SOLN 150mg/30ml, 5mg/ml, 15mg/ml, 25mg/ml, 50mg/ml

NDS

MORPHINE SULFATE SOLN INJECTION 2mg/ml, 4mg/ml, 8mg/ml, 10mg/ml

HI

MORPHINE SULFATE SOLN INTRAVENOUS HI

MORPHINE SULFATE TABS 15mg, 30mg NDS

MS CONTIN TBCR 15mg, 30mg, 60mg, 100mg, 200mg NDS

nabumetone tabs nalbuphine hcl soln 10mg/ml, 20mg/ml NDS

nalfon tabs



Límites nalocet tabs NDS NAPRELAN TB24 naproxen dr tbec naproxen sodium er tb24 naproxen sodium tabs naproxen susp naproxen tabs norco tabs NDS NUCYNTA ER TB12 50mg, 100mg, 150mg, 200mg, 250mg NDS

NUCYNTA TABS 50mg, 75mg, 100mg NDS

OPANA ER T12A 5mg, 7.5mg, 10mg, 15mg, 20mg, 30mg, 40mg

NDS

OPANA SOLN NDS OPANA TABS 5mg, 10mg NDS oxaprozin tabs OXAYDO TABA 5mg, 7.5mg NDS oxycodone hcl caps NDS oxycodone hcl conc NDS oxycodone hcl er t12a 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg

NDS

oxycodone hcl soln NDS oxycodone hcl tabs 5mg, 10mg, 15mg, 20mg, 30mg NDS

oxycodone-acetaminophen soln NDS oxycodone-acetaminophen tabs NDS oxycodone-aspirin tabs NDS oxycodone-ibuprofen tabs NDS OXYCONTIN T12A 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg

NDS

oxymorphone hcl er tb12 5mg, 7.5mg, 10mg, 15mg, 20mg, 30mg, 40mg

NDS

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panlor tabs pentazocine-naloxone hcl tabs NDS percocet tabs NDS phrenilin forte caps piroxicam caps 10mg, 20mg NDS


Límites primlev tabs NDS profeno tabs QMIIZ ODT TBDP reprexain tabs NDS ROXICODONE TABS 5mg, 15mg, 30mg NDS

ROXYBOND TABA 5mg, 15mg, 30mg NDS

SUBSYS LIQD 100mcg, 200mcg, 400mcg, 600mcg, 800mcg, 1200mcg, 1600mcg

PA,NDS

sulindac tabs SYNALGOS-DC CAPS NDS TALWIN SOLN NDS tencon tabs TIVORBEX CAPS tolmetin sodium caps tolmetin sodium tabs tramadol hcl er (biphasic) tb24 100mg, 200mg, 300mg NDS

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ULTRAM TABS NDS vanatol lq soln vicodin es tabs NDS vicodin hp tabs NDS vicodin tabs NDS VIMOVO TBEC NDS VIVLODEX CAPS XARTEMIS XR TBCR NDS xodol tabs NDS XTAMPZA ER C12A 9mg, 13.5mg, 18mg, 27mg, 36mg NDS




Límites zamicet soln NDS zebutal caps ZIPSOR CAPS ZOHYDRO ER C12A 10mg, 15mg, 20mg, 30mg, 40mg, 50mg

NDS

ZORVOLEX CAPS ANOREXIGENIC AGENTS AND RESPIRATORY AND CEREBRAL STIMULANTS adderall tabs NDS ADDERALL XR CP24 NDS ADHANSIA XR CP24 25mg, 35mg, 45mg, 55mg, 70mg, 85mg

NDS

ADZENYS ER SUER NDS ADZENYS XR-ODT TBED 3.1mg, 6.3mg, 9.4mg, 12.5mg, 15.7mg, 18.8mg

NDS

amphetamine sulfate tabs 5mg, 10mg NDS

amphetamine-dextroamphet er cp24 NDS

amphetamine-dextroamphetamine tabs NDS

APTENSIO XR CP24 10mg, 15mg, 20mg, 30mg, 40mg, 50mg, 60mg

NDS

armodafinil tabs 50mg, 150mg, 200mg, 250mg PA

CONCERTA TBCR 18mg, 27mg, 36mg, 54mg NDS

COTEMPLA XR-ODT TBED 8.6mg, 17.3mg, 25.9mg NDS

DAYTRANA PTCH 10mg/9hr, 15mg/9hr, 20mg/9hr, 30mg/9hr NDS

DESOXYN TABS PA,NDS DEXEDRINE CP24 5mg, 10mg, 15mg NDS

dexedrine tabs 5mg, 10mg NDS dexmethylphenidate hcl er cp24 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg

NDS

dexmethylphenidate hcl tabs 2.5mg, 5mg, 10mg NDS


Límites dextroamphetamine sulfate er cp24 5mg, 10mg, 15mg NDS

dextroamphetamine sulfate tabs 5mg, 10mg NDS

DYANAVEL XR SUER NDS EVEKEO ODT TBDP 5mg, 10mg, 15mg, 20mg NDS

evekeo tabs 5mg, 10mg NDS FOCALIN TABS 2.5mg, 5mg, 10mg NDS

FOCALIN XR CP24 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg

NDS

JORNAY PM CP24 20mg, 40mg, 60mg, 80mg, 100mg NDS

METADATE CD CPCR 10mg, 20mg, 30mg, 40mg, 50mg, 60mg

NDS

metadate er tbcr NDS methamphetamine hcl tabs PA,NDS METHYLIN CHEW 2.5mg, 5mg, 10mg NDS

METHYLIN SOLN 5mg/5ml, 10mg/5ml NDS

methylphenidate hcl chew 2.5mg, 5mg, 10mg NDS

methylphenidate hcl er (cd) cpcr 10mg, 20mg, 30mg, 40mg, 50mg, 60mg

NDS

methylphenidate hcl er (la) cp24 10mg, 20mg, 30mg, 40mg, 60mg

NDS

methylphenidate hcl er tb24 18mg, 27mg, 36mg, 54mg NDS

methylphenidate hcl er tbcr 10mg, 18mg, 20mg, 27mg, 36mg, 54mg, 72mg

NDS

methylphenidate hcl soln 5mg/5ml, 10mg/5ml NDS

methylphenidate hcl tabs 5mg, 10mg, 20mg NDS

modafinil tabs 100mg, 200mg PA,NDS MYDAYIS CP24 NDS NUVIGIL TABS 50mg, 150mg, 200mg, 250mg PA



Límites procentra soln NDS PROVIGIL TABS 100mg, 200mg PA,NDS QUILLICHEW ER CHER 20mg, 30mg, 40mg NDS

QUILLIVANT XR SUSR NDS relexxii tbcr NDS RITALIN LA CP24 10mg, 20mg, 30mg, 40mg, 60mg NDS

RITALIN TABS 5mg, 10mg, 20mg NDS

VYVANSE CAPS 10mg, 20mg, 30mg, 40mg, 50mg, 60mg, 70mg

NDS

VYVANSE CHEW 10mg, 20mg, 30mg, 40mg, 50mg, 60mg NDS

zenzedi tabs 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg, 30mg

NDS

ANTICONVULSANTS APTIOM TABS 200mg, 400mg, 600mg, 800mg MO

BANZEL SUSP MO BANZEL TABS 200mg, 400mg NDS BRIVIACT SOLN NDS BRIVIACT TABS 10mg, 25mg, 50mg, 75mg, 100mg NDS

carbamazepine chew MO carbamazepine er cp12 100mg, 200mg, 300mg MO

carbamazepine er tb12 100mg, 200mg, 400mg MO

carbamazepine susp MO carbamazepine tabs MO CARBATROL CP12 100mg, 200mg, 300mg MO

CELONTIN CAPS MO clobazam susp MO clobazam tabs 10mg, 20mg MO clonazepam tabs .5mg, 1mg, 2mg NDS

clonazepam tbdp .125mg, .25mg, .5mg, 1mg, 2mg NDS

DEPAKENE CAPS MO DEPAKENE SOLN MO


Límites DEPAKOTE ER TB24 250mg, 500mg MO

DEPAKOTE SPRINKLES CSDR MO DEPAKOTE TBEC 125mg, 250mg, 500mg MO

DIACOMIT CAPS 250mg, 500mg NDS

DIACOMIT PACK 250mg, 500mg NDS

DIASTAT ACUDIAL GEL 10mg, 20mg NDS

DIASTAT PEDIATRIC GEL NDS diazepam gel 2.5mg, 10mg, 20mg NDS

dilantin caps 30mg, 100mg MO dilantin infatabs chew MO DILANTIN SUSP MO divalproex sodium csdr MO divalproex sodium er tb24 250mg, 500mg MO

divalproex sodium tbec 125mg, 250mg, 500mg MO

EPIDIOLEX SOLN NDS epitol tabs MO ethosuximide caps MO ethosuximide soln MO felbamate susp MO felbamate tabs 400mg, 600mg MO FELBATOL SUSP FELBATOL TABS FYCOMPA SUSP NDS FYCOMPA TABS gabapentin caps 100mg, 400mg MO gabapentin soln MO gabapentin tabs 600mg, 800mg MO GABITRIL TABS 2mg, 4mg, 12mg, 16mg MO

HORIZANT TBCR 300mg, 600mg MO

KEPPRA SOLN MO KEPPRA TABS 250mg, 500mg, 750mg, 1000mg MO

KEPPRA XR TB24 500mg, 750mg MO




Límites KLONOPIN TABS .5mg, 1mg, 2mg NDS

LAMICTAL CHEW 5mg, 25mg MO LAMICTAL ODT TBDP 25mg, 50mg, 100mg, 200mg MO

LAMICTAL STARTER KIT MO LAMICTAL TABS 25mg, 100mg, 150mg, 200mg MO

LAMICTAL XR KIT MO LAMICTAL XR TB24 25mg, 50mg, 100mg, 200mg, 250mg, 300mg

MO

lamotrigine chew 5mg, 25mg MO lamotrigine er tb24 25mg, 50mg, 100mg, 200mg, 250mg, 300mg MO

lamotrigine starter kit-blue kit MO lamotrigine starter kit-green kit MO lamotrigine starter kit-orange kit MO lamotrigine tabs 25mg, 100mg, 150mg, 200mg MO

lamotrigine tbdp 25mg, 50mg, 100mg, 200mg MO

levetiracetam er tb24 500mg, 750mg MO

levetiracetam soln MO levetiracetam tabs 250mg, 500mg, 750mg, 1000mg MO

LYRICA CAPS 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg

MO

LYRICA SOLN MAGNESIUM SULFATE SOLN INJECTION 50%, 50% HI

MAGNESIUM SULFATE SOLN INTRAVENOUS 40gm/1000ml, 4gm/100ml, 20gm/500ml, 2gm/50ml

HI

MYSOLINE TABS 50mg, 250mg MO NEURONTIN CAPS 100mg, 300mg, 400mg MO

NEURONTIN SOLN MO NEURONTIN TABS 600mg, 800mg MO

ONFI SUSP MO ONFI TABS 10mg, 20mg MO


Límites oxcarbazepine susp MO oxcarbazepine tabs 150mg, 300mg, 600mg MO

OXTELLAR XR TB24 150mg, 300mg, 600mg MO

PEGANONE TABS MO phenytek caps 200mg, 300mg MO phenytoin chew MO phenytoin sodium extended caps 100mg, 200mg, 300mg MO

phenytoin susp MO pregabalin caps 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg

MO

pregabalin soln primidone tabs 50mg, 250mg MO QUDEXY XR CS24 25mg, 50mg, 100mg, 150mg, 200mg MO

roweepra tabs 500mg, 750mg, 1000mg MO

roweepra xr tb24 500mg, 750mg MO SABRIL PACK LD,NDS SABRIL TABS LD,NDS SPRITAM TB3D 250mg, 500mg, 750mg, 1000mg NDS

SYMPAZAN FILM 5mg SYMPAZAN FILM 10mg, 20mg TEGRETOL SUSP MO TEGRETOL TABS MO TEGRETOL-XR TB12 100mg, 200mg, 400mg MO

tiagabine hcl tabs 2mg, 4mg, 12mg, 16mg MO

TOPAMAX SPRINKLE CPSP 15mg, 25mg MO

TOPAMAX TABS 25mg, 50mg, 100mg, 200mg MO

topiramate cpsp 15mg, 25mg MO topiramate er cs24 25mg, 50mg, 100mg, 150mg, 200mg MO

topiramate tabs 25mg, 50mg, 100mg, 200mg MO

TRILEPTAL SUSP MO



Límites TRILEPTAL TABS 150mg, 300mg, 600mg MO

TROKENDI XR CP24 25mg, 50mg, 100mg, 200mg MO

valproic acid caps MO valproic acid soln MO vigabatrin pack LD,NDS vigabatrin tabs LD,NDS vigadrone pack LD,NDS VIMPAT SOLN VIMPAT TABS MO ZARONTIN CAPS MO zarontin soln MO ZONEGRAN CAPS 25mg, 100mg MO

zonisamide caps 25mg, 50mg, 100mg MO

ANTIMIGRAINE AGENTS AIMOVIG SOAJ AJOVY SOSY almotriptan malate tabs AMERGE TABS AXERT TABS cafergot tabs CAMBIA PACK eletriptan hydrobromide tabs EMGALITY SOAJ EMGALITY SOSY 120mg/ml EMGALITY SOSY 100mg/ml NDS ergotamine-caffeine tabs FROVA TABS frovatriptan succinate tabs IMITREX SOLN IMITREX STATDOSE REFILL SOCT

IMITREX STATDOSE SYSTEM SOAJ

IMITREX TABS MAXALT TABS MAXALT-MLT TBDP migergot supp naratriptan hcl tabs ONZETRA XSAIL EXHP


Límites RELPAX TABS rizatriptan benzoate tabs rizatriptan benzoate tbdp sumatriptan soln SUMATRIPTAN SUCCINATE REFILL SOCT

sumatriptan succinate soaj sumatriptan succinate soln sumatriptan succinate sosy sumatriptan succinate tabs sumatriptan-naproxen sodium tabs

TREXIMET TABS ZEMBRACE SYMTOUCH SOAJ zolmitriptan tabs zolmitriptan tbdp ZOMIG SOLN ZOMIG TABS ZOMIG ZMT TBDP ANTIPARKINSONIAN AGENTS amantadine hcl caps MO amantadine hcl syrp MO amantadine hcl tabs MO APOKYN SOCT NDS AZILECT TABS .5mg, 1mg MO benztropine mesylate tabs .5mg, 1mg, 2mg MO

bromocriptine mesylate caps MO bromocriptine mesylate tabs MO cabergoline tabs MO carbidopa tabs MO carbidopa-levodopa er tbcr MO carbidopa-levodopa tabs MO carbidopa-levodopa tbdp MO carbidopa-levodopa-entacapone tabs MO

COMTAN TABS MO DUOPA SUSP LD ELDEPRYL CAPS MO EMSAM PT24 6mg/24hr, 9mg/24hr, 12mg/24hr MO

entacapone tabs MO




Límites GOCOVRI CP24 68.5mg, 137mg NDS

INBRIJA CAPS NDS LODOSYN TABS MO MIRAPEX ER TB24 .375mg, .75mg, 1.5mg, 2.25mg, 3mg, 3.75mg, 4.5mg

MO

MIRAPEX TABS .125mg, .25mg, .5mg, .75mg, 1mg, 1.5mg MO

NEUPRO PT24 1mg/24hr, 2mg/24hr, 3mg/24hr, 4mg/24hr, 6mg/24hr, 8mg/24hr

MO

OSMOLEX ER TB24 129mg, 193mg, 258mg MO

PARLODEL CAPS MO PARLODEL TABS MO pramipexole dihydrochloride er tb24 .375mg, .75mg, 1.5mg, 2.25mg, 3mg, 3.75mg, 4.5mg

MO

pramipexole dihydrochloride tabs .125mg, .25mg, .5mg, .75mg, 1mg, 1.5mg

MO

rasagiline mesylate tabs .5mg, 1mg MO

REQUIP XL TB24 4mg, 6mg, 8mg, 12mg MO

ropinirole hcl er tb24 2mg, 4mg, 6mg, 8mg, 12mg MO

ropinirole hcl tabs .25mg, .5mg, 1mg, 2mg, 3mg, 4mg, 5mg MO

RYTARY CPCR MO selegiline hcl caps MO selegiline hcl tabs MO SINEMET CR TBCR MO SINEMET TABS MO STALEVO 100 TABS MO STALEVO 125 TABS MO STALEVO 150 TABS MO STALEVO 200 TABS MO STALEVO 50 TABS MO STALEVO 75 TABS MO TASMAR TABS MO tolcapone tabs MO trihexyphenidyl hcl soln MO


Límites trihexyphenidyl hcl tabs 2mg, 5mg MO

ZELAPAR TBDP MO ANXIOLYTICS, SEDATIVES, AND HYPNOTICS alprazolam er tb24 .5mg, 1mg, 2mg, 3mg NDS

alprazolam intensol conc NDS alprazolam tabs .25mg, .5mg, 1mg, 2mg NDS

alprazolam tbdp .25mg, .5mg, 1mg, 2mg NDS

AMBIEN CR TBCR 6.25mg, 12.5mg NDS

AMBIEN TABS 5mg, 10mg NDS ATIVAN SOLN 2mg/ml, 4mg/ml NDS ATIVAN TABS .5mg, 1mg, 2mg NDS BELSOMRA TABS buspirone hcl tabs 5mg, 10mg buspirone hcl tabs BUTISOL SODIUM TABS chlordiazepoxide hcl caps 5mg, 10mg, 25mg NDS

clorazepate dipotassium tabs 3.75mg, 7.5mg, 15mg NDS

diazepam intensol conc NDS DIAZEPAM SOAJ NDS diazepam soln 5mg/5ml, 5mg/ml NDS diazepam tabs 2mg, 5mg, 10mg NDS EDLUAR SUBL 5mg, 10mg NDS estazolam tabs 1mg, 2mg NDS eszopiclone tabs 1mg, 2mg, 3mg NDS flurazepam hcl caps 15mg, 30mg NDS

HALCION TABS NDS HETLIOZ CAPS PA,NDS hydroxyzine hcl syrp hydroxyzine hcl tabs hydroxyzine pamoate caps INTERMEZZO SUBL 1.75mg, 3.5mg NDS

lorazepam conc NDS lorazepam intensol conc NDS lorazepam tabs .5mg, 1mg, 2mg NDS



Límites LUNESTA TABS 1mg, 2mg, 3mg NDS

meprobamate tabs midazolam hcl soln 10mg/10ml, 50mg/10ml, 2mg/2ml, 10mg/2ml, 5mg/5ml, 25mg/5ml, 5mg/ml

NDS

midazolam hcl syrp NDS oxazepam caps 10mg, 15mg, 30mg NDS

PHENOBARBITAL ELIX PHENOBARBITAL TABS QUAZEPAM TABS NDS ramelteon tabs RESTORIL CAPS 7.5mg, 15mg, 22.5mg, 30mg NDS

ROZEREM TABS SILENOR TABS SONATA CAPS 5mg, 10mg NDS temazepam caps 7.5mg, 15mg, 22.5mg, 30mg NDS

TRANXENE-T TABS NDS triazolam tabs .125mg, .25mg NDS VALIUM TABS 2mg, 5mg, 10mg NDS VISTARIL CAPS XANAX TABS .25mg, .5mg, 1mg, 2mg NDS

XANAX XR TB24 .5mg, 1mg, 2mg, 3mg NDS

zaleplon caps 5mg, 10mg NDS zolpidem tartrate er tbcr 6.25mg, 12.5mg NDS

zolpidem tartrate subl 1.75mg, 3.5mg NDS

zolpidem tartrate tabs 5mg, 10mg NDS

ZOLPIMIST SOLN NDS CENTRAL NERVOUS SYSTEM AGENTS, MISCELLANEOUS atomoxetine hcl caps 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg

MO

AUSTEDO TABS 6mg, 9mg, 12mg LD,NDS

guanfacine hcl er tb24 1mg, 2mg, 3mg, 4mg MO


Límites INGREZZA CAPS 40mg, 80mg NDS INGREZZA CPPK NDS INTUNIV TB24 1mg, 2mg, 3mg, 4mg MO

memantine hcl er cp24 memantine hcl soln MO memantine hcl tabs 5mg, 10mg MO NAMENDA TABS 5mg, 10mg MO NAMENDA TITRATION PAK TABS MO

NAMENDA XR CP24 7mg, 14mg, 21mg, 28mg MO

NAMENDA XR TITRATION PACK CP24 MO

NAMZARIC C4PK MO NAMZARIC CP24 MO,NDS NUEDEXTA CAPS PA,NDS RADICAVA SOLN NDS RILUTEK TABS NDS riluzole tabs MO,NDS SAVELLA TABS 12.5mg, 25mg, 50mg, 100mg MO

SAVELLA TITRATION PACK MISC MO

STRATTERA CAPS 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg

MO

tetrabenazine tabs 12.5mg, 25mg NDS

TIGLUTIK SUSP NDS XENAZINE TABS 12.5mg, 25mg NDS XYREM SOLN LD,NDS MULTIPLE SCLEROSIS AGENTS AMPYRA TB12 NDS AUBAGIO TABS 7mg, 14mg PA,NDS AVONEX KIT NDS AVONEX PEN AJKT NDS AVONEX PREFILLED PSKT NDS BETASERON KIT NDS COPAXONE SOSY 20mg/ml, 40mg/ml NDS

dalfampridine er tb12 NDS EXTAVIA KIT NDS GILENYA CAPS .25mg, .5mg NDS




Límites glatiramer acetate sosy 20mg/ml, 40mg/ml NDS

glatopa sosy 20mg/ml, 40mg/ml NDS LEMTRADA SOLN NDS MAYZENT STARTER PACK TBPK NDS

MAYZENT TABS .25mg, 2mg NDS OCREVUS SOLN REBIF REBIDOSE SOAJ 22mcg/0.5ml, 44mcg/0.5ml NDS

REBIF REBIDOSE TITRATION PACK SOAJ NDS

REBIF SOSY 22mcg/0.5ml, 44mcg/0.5ml NDS

REBIF TITRATION PACK SOSY NDS TECFIDERA CPDR 120mg, 240mg NDS

TECFIDERA MISC NDS TYSABRI CONC INTRAVENOUS HI

ZINBRYTA SOSY LD,NDS OPIATE ANTAGONISTS BUNAVAIL FILM NDS BUPRENEX SOLN NDS buprenorphine hcl soln NDS buprenorphine hcl subl 2mg, 8mg NDS

buprenorphine hcl-naloxone hcl film NDS

buprenorphine hcl-naloxone hcl subl NDS

EVZIO SOAJ NDS LUCEMYRA TABS NDS naloxone hcl soct naloxone hcl soln naloxone hcl sosy naltrexone hcl tabs NARCAN LIQD SUBLOCADE SOSY 100mg/0.5ml, 300mg/1.5ml NDS

SUBOXONE FILM NDS VIVITROL SUSR NDS ZUBSOLV SUBL NDS PSYCHOTHERAPEUTIC AGENTS


Límites ABILIFY MAINTENA PRSY ABILIFY MAINTENA SRER MO ABILIFY MYCITE TABS 2mg, 5mg, 10mg, 15mg, 20mg, 30mg NDS

ABILIFY TABS 2mg, 5mg, 10mg, 15mg, 20mg, 30mg MO

amitriptyline hcl tabs 10mg, 25mg, 50mg, 75mg, 100mg, 150mg

MO

amoxapine tabs 25mg, 50mg, 100mg, 150mg MO

ANAFRANIL CAPS 25mg, 50mg, 75mg MO

APLENZIN TB24 174mg, 348mg, 522mg MO

aripiprazole soln MO aripiprazole tabs 2mg, 5mg, 10mg, 15mg, 20mg, 30mg MO

aripiprazole tbdp 10mg, 15mg MO ARISTADA INITIO PRSY NDS ARISTADA PRSY 441mg/1.6ml, 662mg/2.4ml, 882mg/3.2ml, 1064mg/3.9ml

NDS

BRISDELLE CAPS MO bupropion hcl er (smoking det) tb12 MO

bupropion hcl er (sr) tb12 100mg, 150mg, 200mg MO

bupropion hcl er (xl) tb24 150mg, 300mg, 450mg MO

bupropion hcl tabs 75mg, 100mg MO CELEXA TABS 10mg, 20mg, 40mg MO

chlordiazepoxide-amitriptyline tabs

chlorpromazine hcl tabs 10mg, 25mg, 50mg, 100mg, 200mg MO

citalopram hydrobromide soln MO citalopram hydrobromide tabs 10mg, 20mg, 40mg MO

clomipramine hcl caps 25mg, 50mg, 75mg MO

clozapine tabs 25mg, 50mg, 100mg, 200mg NDS



Límites clozapine tbdp 12.5mg, 25mg, 100mg, 150mg, 200mg NDS

CLOZARIL TABS 25mg, 100mg NDS compro supp MO CYMBALTA CPEP 20mg, 30mg, 60mg MO

desipramine hcl tabs 10mg, 25mg, 50mg, 75mg, 100mg, 150mg

MO

DESVENLAFAXINE ER TB24 50mg, 100mg MO

desvenlafaxine succinate er tb24 25mg, 50mg, 100mg MO

doxepin hcl caps 10mg, 25mg, 50mg, 75mg, 100mg, 150mg MO

doxepin hcl conc MO duloxetine hcl cpep 20mg, 30mg, 40mg, 60mg MO

EFFEXOR XR CP24 37.5mg, 75mg, 150mg MO

EQUETRO CP12 100mg, 200mg, 300mg MO

escitalopram oxalate soln MO escitalopram oxalate tabs 5mg, 10mg, 20mg MO

FANAPT TABS 1mg, 2mg, 4mg, 6mg, 8mg, 10mg, 12mg MO

FANAPT TITRATION PACK TABS MO

FAZACLO TBDP 12.5mg, 25mg, 100mg, 150mg, 200mg NDS

FETZIMA CP24 20mg, 40mg, 80mg, 120mg MO

FETZIMA TITRATION C4PK MO fluoxetine hcl caps 10mg, 20mg, 40mg MO

fluoxetine hcl cpdr MO fluoxetine hcl soln MO fluoxetine hcl tabs 10mg, 20mg, 60mg MO

FLUOXETINE HCL TABS MO fluphenazine decanoate soln fluphenazine hcl conc MO fluphenazine hcl elix MO fluphenazine hcl soln


Límites fluphenazine hcl tabs 1mg, 2.5mg, 5mg, 10mg MO

fluvoxamine maleate er cp24 100mg, 150mg MO

fluvoxamine maleate tabs 25mg, 50mg, 100mg MO

FORFIVO XL TB24 MO GEODON CAPS 20mg, 40mg, 60mg, 80mg MO

GEODON SOLR HALDOL DECANOATE SOLN HALDOL SOLN haloperidol decanoate soln haloperidol lactate conc MO haloperidol lactate soln haloperidol tabs .5mg, 1mg, 2mg, 5mg, 10mg, 20mg MO

imipramine hcl tabs 10mg, 25mg, 50mg MO

imipramine pamoate caps 75mg, 100mg, 125mg, 150mg MO

INVEGA SUSTENNA SUSY 39mg/0.25ml, 78mg/0.5ml

INVEGA SUSTENNA SUSY 117mg/0.75ml, 234mg/1.5ml, 156mg/ml

NDS

INVEGA TB24 1.5mg, 3mg, 6mg, 9mg MO

INVEGA TRINZA SUSY KHEDEZLA TB24 50mg, 100mg MO LATUDA TABS 20mg, 40mg, 60mg, 80mg, 120mg NDS

LEXAPRO TABS 5mg, 10mg, 20mg MO

lithium carbonate caps 150mg, 300mg, 600mg MO

lithium carbonate er tbcr 300mg, 450mg MO

lithium carbonate tabs MO LITHIUM SOLN MO LITHOBID TBCR MO loxapine succinate caps 5mg, 10mg, 25mg, 50mg MO

maprotiline hcl tabs 25mg, 50mg, 75mg MO




Límites MARPLAN TABS MO mirtazapine tabs 7.5mg, 15mg, 30mg, 45mg MO

mirtazapine tbdp 15mg, 30mg, 45mg MO

molindone hcl tabs 5mg, 10mg, 25mg MO

NARDIL TABS MO nefazodone hcl tabs 50mg, 100mg, 150mg, 200mg, 250mg MO

NORPRAMIN TABS 10mg, 25mg MO

nortriptyline hcl caps 10mg, 25mg, 50mg, 75mg MO

nortriptyline hcl soln MO NUPLAZID CAPS NDS NUPLAZID TABS 10mg, 17mg NDS olanzapine solr olanzapine tabs 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg MO

olanzapine tbdp 5mg, 10mg, 15mg, 20mg MO

olanzapine-fluoxetine hcl caps MO ORAP TABS MO paliperidone er tb24 1.5mg, 3mg, 6mg, 9mg MO

PAMELOR CAPS 10mg, 25mg, 50mg, 75mg MO

PARNATE TABS MO paroxetine hcl er tb24 12.5mg, 25mg, 37.5mg MO

paroxetine hcl tabs 10mg, 20mg MO paroxetine hcl tabs 30mg, 40mg MO paroxetine mesylate caps MO PAXIL CR TB24 12.5mg, 25mg, 37.5mg MO

PAXIL SUSP MO PAXIL TABS 10mg, 20mg, 30mg, 40mg MO

perphenazine tabs 2mg, 4mg, 8mg, 16mg MO

perphenazine-amitriptyline tabs MO PERSERIS PRSY 90mg, 120mg NDS PEXEVA TABS 10mg, 20mg, 30mg, 40mg MO


Límites phenelzine sulfate tabs MO pimozide tabs 1mg, 2mg MO PRISTIQ TB24 25mg, 50mg, 100mg MO

prochlorperazine maleate tabs prochlorperazine supp MO protriptyline hcl tabs 5mg, 10mg MO PROZAC CAPS 10mg, 20mg, 40mg MO

quetiapine fumarate er tb24 50mg, 150mg, 200mg, 300mg, 400mg

MO

quetiapine fumarate tabs 25mg, 50mg, 100mg, 200mg, 300mg, 400mg

MO

REMERON SOLTAB TBDP 15mg, 30mg, 45mg MO

REMERON TABS 15mg, 30mg, 45mg MO

REXULTI TABS .25mg, .5mg, 1mg, 2mg, 3mg, 4mg NDS

RISPERDAL CONSTA SUSR RISPERDAL M-TAB TBDP .5mg, 1mg, 3mg, 4mg MO

RISPERDAL SOLN MO RISPERDAL TABS .25mg, .5mg, 1mg, 2mg, 3mg, 4mg MO

risperidone soln MO risperidone tabs .25mg, .5mg, 1mg, 2mg, 3mg, 4mg MO

risperidone tbdp .25mg, .5mg, 1mg, 2mg, 3mg, 4mg MO

SAPHRIS SUBL 2.5mg, 5mg, 10mg NDS

SARAFEM TABS 10mg, 20mg MO SEROQUEL TABS 25mg, 50mg, 100mg, 200mg, 300mg, 400mg MO

SEROQUEL XR TB24 50mg, 150mg, 200mg, 300mg, 400mg MO

sertraline hcl conc MO sertraline hcl tabs 25mg, 50mg, 100mg MO

SPRAVATO (56 MG DOSE) SOPK NDS



Límites SPRAVATO (84 MG DOSE) SOPK NDS

SURMONTIL CAPS 25mg, 50mg, 100mg MO

SYMBYAX CAPS MO thioridazine hcl tabs 10mg, 25mg, 50mg, 100mg MO

thiothixene caps 1mg, 2mg, 5mg, 10mg MO

tofranil tabs 10mg, 25mg, 50mg MO tranylcypromine sulfate tabs MO trazodone hcl tabs 50mg, 100mg, 150mg MO

trazodone hcl tabs MO trifluoperazine hcl tabs 1mg, 2mg, 5mg, 10mg MO

trimipramine maleate caps 25mg, 50mg, 100mg MO

TRINTELLIX TABS 5mg, 10mg, 20mg MO

venlafaxine hcl er cp24 37.5mg, 75mg, 150mg MO

venlafaxine hcl er tb24 37.5mg, 75mg, 150mg, 225mg MO

venlafaxine hcl tabs 25mg, 37.5mg, 50mg, 75mg, 100mg MO

VERSACLOZ SUSP NDS VIIBRYD STARTER PACK KIT MO VIIBRYD TABS 10mg, 20mg, 40mg MO

VRAYLAR CAPS 1.5mg, 3mg, 4.5mg, 6mg NDS

VRAYLAR CPPK NDS WELLBUTRIN SR TB12 100mg, 150mg, 200mg MO

WELLBUTRIN XL TB24 150mg, 300mg MO

ziprasidone hcl caps 20mg, 40mg, 60mg, 80mg MO

ZOLOFT TABS 25mg, 50mg, 100mg MO

ZYBAN TB12 MO ZYPREXA RELPREVV SUSR ZYPREXA SOLR


Límites ZYPREXA TABS 2.5mg, 5mg, 7.5mg, 10mg, 15mg, 20mg MO

ZYPREXA ZYDIS TBDP 5mg, 10mg, 15mg, 20mg MO

DIABETIC SUPPLIES DIABETIC SUPPLIES ALCOHOL PREP PADS MO BD INSULIN SYRINGE MISC MO BD INSULIN SYRINGE U/F MISC MO

BD PEN NEEDLE ORIGINAL U/F MISC MO

BD SAFETY-LOK INSULIN SYRINGE MISC MO

CURITY GAUZE PADS MO GAUZE PADS PADS MO OMNIPOD STARTER KIT NDS ELECTROLYTIC, CALORIC, AND WATER BALANCE ACIDIFYING AND ALKALINIZING AGENTS potassium citrate er tbcr 15meq, 540mg, 1080mg MO

SODIUM LACTATE SOLN INTRAVENOUS HI

UROCIT-K 10 TBCR MO UROCIT-K 15 TBCR MO UROCIT-K 5 TBCR MO AMMONIA DETOXICANTS BUPHENYL POWD NDS BUPHENYL TABS NDS CARBAGLU TABS LD constulose soln MO enulose soln MO generlac soln MO kristalose pack 10gm, 20gm MO lactulose pack MO lactulose soln MO LITHOSTAT TABS MO RAVICTI LIQD NDS sodium phenylbutyrate powd NDS sodium phenylbutyrate tabs NDS CALORIC AGENTS




Límites AMINOSYN II SOLN INTRAVENOUS HI

AMINOSYN II/ELECTROLYTES SOLN INTRAVENOUS HI

AMINOSYN-HBC SOLN INTRAVENOUS HI

AMINOSYN-PF SOLN INTRAVENOUS HI

AMINOSYN-RF SOLN INTRAVENOUS HI

AMINOSYN/ELECTROLYTES SOLN INTRAVENOUS 8.5% HI

AMINOSYN/ELECTROLYTES SOLN INTRAVENOUS 7% HI

CLINIMIX E/DEXTROSE (2.75/10) SOLN INTRAVENOUS HI





CLINIMIX E/DEXTROSE (5/15) SOLN INTRAVENOUS HI



CLINIMIX/DEXTROSE (2.75/5) SOLN INTRAVENOUS HI





CLINIMIX/DEXTROSE (5/15) SOLN INTRAVENOUS HI




Límites clinisol sf soln intravenous HI DEXTROSE SOLN INTRAVENOUS 5%, 10% HI

FREAMINE HBC SOLN INTRAVENOUS HI

HEPATAMINE SOLN INTRAVENOUS HI

INTRALIPID EMUL INTRAVENOUS 20gm/100ml HI

INTRALIPID EMUL INTRAVENOUS HI

NEPHRAMINE SOLN INTRAVENOUS HI

NUTRILIPID EMUL INTRAVENOUS HI

plenamine soln intravenous HI premasol soln intravenous HI PROCALAMINE SOLN INTRAVENOUS HI

PROSOL SOLN INTRAVENOUS HI TRAVASOL SOLN INTRAVENOUS HI

TROPHAMINE SOLN INTRAVENOUS HI

DIURETICS amiloride hcl tabs MO amiloride-hydrochlorothiazide tabs MO

bumetanide soln bumetanide tabs .5mg, 1mg, 2mg MO

chlorothiazide tabs 250mg, 500mg MO

chlorthalidone tabs 25mg, 50mg MO DIURIL SUSP MO DYAZIDE CAPS MO DYRENIUM CAPS 50mg, 100mg MO

EDECRIN TABS NDS ethacrynic acid tabs MO,NDS furosemide soln 8mg/ml, 10mg/ml MO

furosemide soln injection HI furosemide tabs 20mg, 40mg, 80mg MO



Límites hydrochlorothiazide caps MO hydrochlorothiazide tabs 12.5mg, 25mg, 50mg MO

indapamide tabs 1.25mg, 2.5mg MO JYNARQUE TABS 15mg, 30mg NDS JYNARQUE TBPK NDS LASIX TABS 20mg, 40mg, 80mg MO MAXZIDE TABS MO MAXZIDE-25 TABS MO methyclothiazide tabs MO metolazone tabs 2.5mg, 5mg, 10mg MO

MICROZIDE CAPS MO PALYNZIQ SOSY 10mg/0.5ml, 20mg/ml NDS

SAMSCA TABS 15mg, 30mg NDS SODIUM EDECRIN SOLR INTRAVENOUS HI

torsemide tabs 5mg, 10mg, 20mg, 100mg MO

triamterene-hctz caps MO triamterene-hctz tabs MO ION-REMOVING AGENTS AURYXIA TABS PA,MO FOSRENOL CHEW 500mg, 750mg, 1000mg MO

FOSRENOL PACK 750mg, 1000mg NDS

kionex susp MO lanthanum carbonate chew 500mg, 750mg, 1000mg MO

LOKELMA PACK 5gm, 10gm MO RENAGEL TABS 400mg, 800mg MO RENVELA PACK .8gm, 2.4gm MO RENVELA TABS MO sevelamer carbonate pack .8gm, 2.4gm MO

sevelamer carbonate tabs MO sevelamer hcl tabs 400mg, 800mg MO

sodium polystyrene sulfonate powd MO

sps susp MO VELPHORO CHEW NDS


Límites VELTASSA PACK 8.4gm, 16.8gm, 25.2gm NDS

REPLACEMENT PREPARATIONS calcium acetate (phos binder) caps MO

calcium acetate (phos binder) tabs MO

DEXTROSE-NACL SOLN INTRAVENOUS HI

DEXTROSE 10%/NACL 0.2% ; DEXTROSE 10%/NACL 0.45% HI

DEXTROSE 5%/NACL 0.225% HI IONOSOL-MB IN D5W SOLN INTRAVENOUS HI

ISOLYTE-P IN D5W SOLN INTRAVENOUS HI

ISOLYTE-S SOLN INTRAVENOUS HI

K-TAB TBCR 10meq MO K-TAB TBCR 8meq, 20meq MO KCL IN DEXTROSE-NACL SOLN INTRAVENOUS HI

KCL 0.3%/ D5W / NACL 0.9% HI KCL-LACTATED RINGERS-D5W SOLN INTRAVENOUS HI

KLOR-CON 10 TBCR MO klor-con m10 tbcr MO klor-con m15 tbcr MO klor-con m20 tbcr MO klor-con pack MO klor-con sprinkle cpcr 8meq, 10meq MO

KLOR-CON TBCR MO NORMOSOL-M IN D5W SOLN INTRAVENOUS HI

NORMOSOL-R IN D5W SOLN INTRAVENOUS HI

NORMOSOL-R PH 7.4 SOLN INTRAVENOUS HI

PHOSLYRA SOLN MO PLASMA-LYTE 148 SOLN INTRAVENOUS HI

PLASMA-LYTE A SOLN INTRAVENOUS HI




Límites potassium chloride crys er tbcr 10meq, 20meq MO

potassium chloride er cpcr 8meq, 10meq MO

potassium chloride er tbcr 8meq, 10meq, 20meq MO

POTASSIUM CHLORIDE IN DEXTROSE SOLN INTRAVENOUS

HI

potassium chloride in nacl soln intravenous HI

potassium chloride pack MO potassium chloride soln 10%, 20% MO

POTASSIUM CHLORIDE SOLN INTRAVENOUS 2meq/ml, 10meq/100ml, 20meq/100ml, 40meq/100ml

HI

SODIUM CHLORIDE SOLN INJECTION HI

SODIUM CHLORIDE SOLN INTRAVENOUS .45%, .9%, 3%, 5%

HI

TPN ELECTROLYTES SOLN INTRAVENOUS HI

URICOSURIC AGENTS colchicine-probenecid tabs MO DUZALLO TABS probenecid tabs MO ZURAMPIC TABS MO ENZYMES ENZYMES ADAGEN SOLN ALDURAZYME SOLN CERDELGA CAPS NDS CEREZYME SOLR NDS CREON CPEP MO DOCETAXEL (NON-ALCOHOL) SOLN NDS

ELAPRASE SOLN NDS ELELYSO SOLR NDS ELITEK SOLR FABRAZYME SOLR 5mg, 35mg NDS KANUMA SOLN NDS


Límites LUMIZYME SOLR NDS miglustat caps LD,NDS NAGLAZYME SOLN NDS PALYNZIQ SOSY NDS PANCREAZE CPEP MO PERTZYE CPEP MO PULMOZYME SOLN PA,NDS REVCOVI SOLN NDS STRENSIQ SOLN 18mg/0.45ml, 28mg/0.7ml, 80mg/0.8ml, 40mg/ml

LD,NDS

SUCRAID SOLN LD VIMIZIM SOLN NDS VIOKACE TABS MO VPRIV SOLR NDS ZAVESCA CAPS LD,NDS ZENPEP CPEP MO EYE, EAR, NOSE, AND THROAT (EENT) PREPARATIONS ANTI-INFECTIVES AZASITE SOLN bacitracin oint bacitracin-polymyxin b oint BESIVANCE SUSP bleph-10 soln CETRAXAL SOLN chlorhexidine gluconate soln CILOXAN OINT CILOXAN SOLN ciprofloxacin hcl soln (ophth) CIPROFLOXACIN HCL SOLN (OTIC)

erythromycin oint floxin otic soln gatifloxacin soln gentak oint gentamicin sulfate soln levofloxacin soln MOXEZA SOLN moxifloxacin hcl soln NATACYN SUSP neomycin-bacitracin zn-polymyx oint



Límites neomycin-polymyxin-gramicidin soln

OCUFLOX SOLN ofloxacin soln OTOVEL SOLN periogard soln polymyxin b-trimethoprim soln POLYTRIM SOLN sulfacetamide sodium oint sulfacetamide sodium soln tobramycin soln TOBREX OINT TOBREX SOLN trifluridine soln VIGAMOX SOLN VIROPTIC SOLN ZIRGAN GEL ZYMAXID SOLN ANTI-INFLAMMATORY AGENTS ACULAR LS SOLN MO ACULAR SOLN MO ACUVAIL SOLN MO ALREX SUSP MO bacitra-neomycin-polymyxin-hc oint MO

BECONASE AQ SUSP MO blephamide s.o.p. oint MO BLEPHAMIDE SUSP MO bromfenac sodium (once-daily) soln MO

BROMSITE SOLN MO CIPRO HC SUSP MO CIPRODEX SUSP MO COLY-MYCIN S SUSP MO dexamethasone sodium phosphate soln MO

diclofenac sodium soln MO DUREZOL EMUL MO flac oil MO FLAREX SUSP MO flunisolide soln MO fluocinolone acetonide oil MO fluorometholone susp MO


Límites flurbiprofen sodium soln MO fluticasone propionate susp MO FML FORTE SUSP MO FML LIQUIFILM SUSP MO FML OINT MO hydrocortisone-acetic acid soln MO ILEVRO SUSP MO INVELTYS SUSP MO ketorolac tromethamine soln .4%, .5% MO

LOTEMAX GEL MO LOTEMAX OINT MO LOTEMAX SM GEL MO LOTEMAX SUSP MO loteprednol etabonate susp MO MAXIDEX SUSP MO MAXITROL OINT MO MAXITROL SUSP MO mometasone furoate susp MO NASONEX SUSP MO neomycin-polymyxin-dexameth oint MO

neomycin-polymyxin-dexameth susp MO

neomycin-polymyxin-hc soln MO neomycin-polymyxin-hc susp MO NEVANAC SUSP MO OMNARIS SUSP MO OMNIPRED SUSP MO PRED FORTE SUSP MO PRED MILD SUSP MO PRED-G S.O.P. OINT MO PRED-G SUSP MO prednisolone acetate susp MO prednisolone sodium phosphate soln MO

PROLENSA SOLN MO QNASL AERS MO QNASL CHILDRENS AERS MO RESTASIS EMUL MO sulfacetamide-prednisolone soln MO TOBRADEX OINT MO TOBRADEX ST SUSP MO




Límites TOBRADEX SUSP MO tobramycin-dexamethasone susp MO

triamcinolone acetonide aero MO XHANCE EXHU MO XIIDRA SOLN ZETONNA AERS MO ZYLET SUSP MO ANTIALLERGIC AGENTS ALOCRIL SOLN MO ALOMIDE SOLN MO ASTEPRO SOLN MO azelastine hcl soln .05%, .1%, .15% MO

BEPREVE SOLN MO cromolyn sodium soln MO DYMISTA SUSP MO ELESTAT SOLN MO EMADINE SOLN MO epinastine hcl soln MO LASTACAFT SOLN MO olopatadine hcl soln .1%, .2%, .6% MO

PATADAY SOLN MO PATANASE SOLN MO PATANOL SOLN MO PAZEO SOLN MO ANTIGLAUCOMA AGENTS acetazolamide er cp12 MO acetazolamide tabs 125mg, 250mg MO

ALPHAGAN P SOLN .1%, .15% MO AZOPT SUSP MO BETAGAN SOLN MO betaxolol hcl soln MO BETIMOL SOLN .25%, .5% MO BETOPTIC-S SUSP MO bimatoprost soln MO BRIMONIDINE TARTRATE SOLN .15% MO

brimonidine tartrate soln .2% MO carteolol hcl soln MO COMBIGAN SOLN MO


Límites COSOPT PF SOLN MO COSOPT SOLN MO dorzolamide hcl soln MO dorzolamide hcl-timolol mal pf soln

dorzolamide hcl-timolol mal soln MO ISOPTO CARPINE SOLN 1%, 2%, 4% MO

ISTALOL SOLN MO latanoprost soln MO levobunolol hcl soln MO LUMIGAN SOLN MO methazolamide tabs 25mg, 50mg MO

metipranolol soln MO PHOSPHOLINE IODIDE SOLR MO pilocarpine hcl soln 1%, 2%, 4% MO ROCKLATAN SOLN MO SIMBRINZA SUSP MO TIMOLOL MALEATE SOLG .25%, .5% MO

timolol maleate soln .25%, .5% MO TIMOPTIC OCUDOSE SOLN .25%, .5% MO

TIMOPTIC-XE SOLG .25%, .5% MO TRAVATAN Z SOLN MO TRUSOPT SOLN MO VYZULTA SOLN MO XALATAN SOLN MO XELPROS EMUL MO ZIOPTAN SOLN MO EENT DRUGS, MISCELLANEOUS acetic acid soln MO apraclonidine hcl soln MO ATROPINE SULFATE SOLN MO CYSTARAN SOLN IOPIDINE SOLN 1% MO IOPIDINE SOLN MO LACRISERT INST MO LUCENTIS SOLN .3mg/0.05ml, .5mg/0.05ml NDS

LUCENTIS SOSY .3mg/0.05ml, .5mg/0.05ml NDS



Límites OXERVATE SOLN NDS RHOPRESSA SOLN LOCAL ANESTHETICS lidocaine viscous hcl soln MO proparacaine hcl soln MO GASTROINTESTINAL DRUGS ANTI-INFLAMMATORY AGENTS alosetron hcl tabs .5mg, 1mg NDS APRISO CP24 MO ASACOL HD TBEC MO balsalazide disodium caps MO CANASA SUPP MO colazal caps MO DELZICOL CPDR MO DIPENTUM CAPS NDS GIAZO TABS MO LIALDA TBEC MO LOTRONEX TABS .5mg, 1mg NDS mesalamine cpdr MO mesalamine enem MO mesalamine supp MO mesalamine tbec 1.2gm, 800mg MO PENTASA CPCR 250mg, 500mg MO

ROWASA KIT MO ANTIDIARRHEA AGENTS diphenoxylate-atropine liqd diphenoxylate-atropine tabs LOMOTIL TABS loperamide hcl caps MO MYTESI TBEC MO XERMELO TABS LD,NDS ANTIEMETICS AKYNZEO CAPS PA ANZEMET TABS 50mg, 100mg PA,NDS aprepitant caps PA,NDS BONJESTA TBCR MO CESAMET CAPS PA DICLEGIS TBEC MO doxylamine-pyridoxine tbec MO dronabinol caps 2.5mg, 5mg, 10mg PA


Límites EMEND CAPS 40mg, 80mg, 125mg PA,NDS

EMEND SUSR PA,NDS EMEND TRI-PACK CAPS PA,NDS granisetron hcl tabs PA MARINOL CAPS 2.5mg, 5mg, 10mg PA

meclizine hcl tabs ondansetron hcl soln PA ondansetron hcl tabs 4mg, 8mg, 24mg PA

ondansetron tbdp 4mg, 8mg PA PALONOSETRON HCL SOLN NDS SANCUSO PTCH NDS scopolamine pt72 SYNDROS SOLN PA,NDS TIGAN CAPS PA TRANSDERM-SCOP (1.5 MG) PT72

trimethobenzamide hcl caps PA VARUBI TABS PA,NDS ZOFRAN ODT TBDP 4mg, 8mg PA ZOFRAN SOLN PA ZOFRAN TABS 4mg, 8mg PA ZUPLENZ FILM 4mg, 8mg PA ANTIULCER AGENTS AND ACID SUPPRESSANTS ACIPHEX SPRINKLE CPSP 5mg, 10mg MO

ACIPHEX TBEC MO amoxicill-clarithro-lansopraz misc MO

CARAFATE SUSP MO CARAFATE TABS MO cimetidine hcl soln MO cimetidine tabs 200mg, 300mg, 400mg, 800mg MO

CYTOTEC TABS 100mcg, 200mcg MO

DEXILANT CPDR 30mg, 60mg MO esomeprazole magnesium cpdr 20mg, 40mg MO

ESOMEPRAZOLE STRONTIUM CPDR




Límites famotidine susr MO famotidine tabs 20mg, 40mg MO lansoprazole cpdr 15mg, 30mg MO lansoprazole tbdp 15mg, 30mg MO misoprostol tabs 100mcg, 200mcg MO

NEXIUM CPDR 20mg, 40mg MO NEXIUM PACK 2.5mg, 5mg, 10mg, 20mg, 40mg MO

nizatidine caps 150mg, 300mg MO nizatidine soln MO OMECLAMOX-PAK MISC MO omeprazole cpdr 10mg, 20mg, 40mg MO

omeprazole-sodium bicarbonate caps MO

omeprazole-sodium bicarbonate pack MO

pantoprazole sodium tbec 20mg, 40mg MO

PEPCID SUSR MO pepcid tabs 20mg, 40mg MO PREVACID CPDR 15mg, 30mg MO PREVACID SOLUTAB TBDP 15mg, 30mg MO

PREVPAC MISC MO PRILOSEC PACK 2.5mg, 10mg MO PROTONIX PACK MO PROTONIX TBEC 20mg, 40mg MO PYLERA CAPS MO rabeprazole sodium tbec MO ranitidine hcl caps 150mg, 300mg MO

ranitidine hcl syrp MO ranitidine hcl tabs 150mg, 300mg MO

sucralfate tabs MO ZANTAC TABS MO ZEGERID CAPS MO ZEGERID PACK MO CATHARTICS AND LAXATIVES CLENPIQ SOLN MO COLYTE WITH FLAVOR PACKS SOLR MO


Límites gavilyte-c solr MO gavilyte-g solr MO gavilyte-n with flavor pack solr MO GOLYTELY SOLR MO MOVIPREP SOLR MO NULYTELY WITH FLAVOR PACKS SOLR MO

OSMOPREP TABS MO peg 3350-kcl-na bicarb-nacl solr MO peg 3350/electrolytes solr MO peg-3350/electrolytes solr MO PLENVU SOLR MO polyethylene glycol 3350 powd MO PREPOPIK PACK MO SUPREP BOWEL PREP KIT SOLN MO

trilyte solr MO GI DRUGS, MISCELLANEOUS ACTIGALL CAPS MO AMITIZA CAPS 8mcg, 24mcg MO chenodal tabs MO CHOLBAM CAPS 50mg, 250mg NDS ENTYVIO SOLR NDS GATTEX KIT NDS LINZESS CAPS 72mcg, 145mcg, 290mcg MO

metoclopramide hcl soln MO metoclopramide hcl tabs 5mg, 10mg MO

metoclopramide hcl tbdp 5mg, 10mg MO

MOTEGRITY TABS 1mg, 2mg MO MOVANTIK TABS 12.5mg, 25mg MO

NUTRESTORE PACK MO OCALIVA TABS 5mg, 10mg LD,NDS REGLAN TABS 5mg, 10mg MO RELISTOR SOLN 8mg/0.4ml, 12mg/0.6ml NDS

RELISTOR TABS NDS SYMPROIC TABS MO TRULANCE TABS URSO 250 TABS MO



Límites URSO FORTE TABS MO ursodiol caps MO ursodiol tabs 250mg, 500mg MO VIBERZI TABS 75mg, 100mg NDS HEAVY METAL ANTAGONISTS HEAVY METAL ANTAGONISTS CHEMET CAPS CUPRIMINE CAPS deferasirox tbso 125mg NDS deferasirox tbso 250mg, 500mg NDS DEPEN TITRATABS TABS EXJADE TBSO 125mg NDS EXJADE TBSO 250mg, 500mg NDS FERRIPROX SOLN LD,NDS FERRIPROX TABS 500mg, 1000mg NDS

JADENU SPRINKLE PACK 90mg, 180mg, 360mg NDS

JADENU TABS 90mg, 180mg, 360mg NDS

penicillamine caps NDS SYPRINE CAPS NDS trientine hcl caps NDS HORMONES AND SYNTHETIC SUBSTITUTES ADRENALS BREO ELLIPTA AEPB MO budesonide cpep MO,NDS budesonide er tb24 NDS CORTEF TABS 5mg, 10mg, 20mg MO

cortisone acetate tabs MO decadron tabs 4mg, 6mg PA,MO deltasone tabs PA,MO DEPO-MEDROL SUSP dexamethasone elix MO dexamethasone intensol conc MO dexamethasone tabs .5mg, .75mg, 1mg, 1.5mg, 2mg, 4mg, 6mg

PA,MO

dexamethasone tbpk MO dexpak 13 day tbpk MO EMFLAZA SUSP LD,NDS


Límites EMFLAZA TABS 6mg, 18mg, 30mg, 36mg LD,NDS

ENTOCORT EC CPEP NDS fludrocortisone acetate tabs MO hydrocortisone tabs 5mg, 10mg, 20mg MO

INTRAROSA INST KENALOG SUSP MEDROL TABS 2mg MO MEDROL TABS 4mg, 8mg, 16mg, 32mg MO

MEDROL TBPK MO methylprednisolone tabs 4mg, 8mg, 16mg, 32mg MO

methylprednisolone tbpk MO millipred soln MO millipred tabs MO ORAPRED ODT TBDP 10mg, 15mg, 30mg MO

prednisolone sodium phosphate soln 5mg/5ml, 10mg/5ml, 20mg/5ml, 25mg/5ml

MO

prednisolone sodium phosphate tbdp 10mg, 15mg, 30mg MO

prednisolone soln MO prednisone intensol conc PA,MO prednisone soln PA,MO prednisone tabs 1mg, 2.5mg, 5mg, 10mg, 20mg, 50mg PA,MO

prednisone tbpk RAYOS TBEC 1mg, 2mg, 5mg PA,MO SOLU-CORTEF SOLR SOLU-MEDROL SOLR taperdex 12-day tbpk taperdex 6-day tbpk MO taperdex 7-day tbpk MO TRELEGY ELLIPTA AEPB MO UCERIS TB24 NDS veripred 20 soln MO ANDROGENS ANADROL-50 TABS MO ANDRODERM PT24 2mg/24hr, 4mg/24hr MO




Límites ANDROGEL GEL 20.25mg/1.25gm, 25mg/2.5gm, 40.5mg/2.5gm, 50mg/5gm

MO

ANDROGEL PUMP GEL MO AVEED SOLN MO danazol caps 50mg, 100mg, 200mg MO

depo-testosterone soln 100mg/ml, 200mg/ml MO

FORTESTA GEL MO methitest tabs MO methyltestosterone caps MO oxandrolone tabs 2.5mg, 10mg MO STRIANT MISC MO TESTIM GEL MO testosterone cypionate soln 100mg/ml, 200mg/ml MO

testosterone enanthate soln MO testosterone gel 1%, 1.62%, 20.25mg/1.25gm, 25mg/2.5gm, 40.5mg/2.5gm, 50mg/5gm, 10mg/act

MO

testosterone soln MO VOGELXO GEL MO VOGELXO PUMP GEL MO XYOSTED SOAJ 50mg/0.5ml, 75mg/0.5ml, 100mg/0.5ml MO

CONTRACEPTIVES altavera tabs MO alyacen 1/35 tabs MO amethia lo tabs MO amethia tabs MO apri tabs MO aranelle tabs MO ashlyna tabs MO aubra tabs MO aviane tabs MO balziva tabs MO BEYAZ TABS MO blisovi 24 fe tabs MO blisovi fe 1.5/30 tabs MO blisovi fe 1/20 tabs MO briellyn tabs MO


Límites camila tabs MO camrese lo tabs MO caziant tabs MO cryselle-28 tabs MO cyclafem 1/35 tabs MO cyclafem 7/7/7 tabs MO cyred eq tabs MO deblitane tabs MO delyla tabs MO desogestrel-ethinyl estradiol tabs MO drospiren-eth estrad-levomefol tabs MO

drospirenone-ethinyl estradiol tabs MO

ELLA TABS MO emoquette tabs MO enpresse-28 tabs MO enskyce tabs MO errin tabs MO estarylla tabs MO ethynodiol diac-eth estradiol tabs MO falmina tabs MO fayosim tabs MO femynor tabs MO GENERESS FE CHEW MO gianvi tabs MO gildagia tabs MO hailey 24 fe tabs MO incassia tabs MO introvale tabs MO isibloom tabs MO jasmiel tabs MO JOLIVETTE TABS MO juleber tabs MO junel 1.5/30 tabs MO junel 1/20 tabs MO junel fe 1.5/30 tabs MO junel fe 1/20 tabs MO junel fe 24 tabs MO kaitlib fe chew MO kariva tabs MO kelnor 1/35 tabs MO



Límites kelnor 1/50 tabs MO kimidess tabs MO kurvelo tabs MO larin 1.5/30 tabs MO larin 1/20 tabs MO larin fe 1.5/30 tabs MO larin fe 1/20 tabs MO larissia tabs MO LAYOLIS FE CHEW MO leena tabs MO lessina tabs MO levonest tabs MO levonorg-eth estrad triphasic tabs MO

levonorgest-eth est & eth est tabs MO

levonorgest-eth estrad 91-day tabs MO

levonorgestrel-ethinyl estrad tabs MO

levora 0.15/30 (28) tabs MO LO LOESTRIN FE TABS MO loestrin 1.5/30 (21) tabs MO loestrin 1/20 (21) tabs MO loestrin fe 1.5/30 tabs MO loestrin fe 1/20 tabs MO loryna tabs MO LOSEASONIQUE TABS MO low-ogestrel tabs MO lutera tabs MO lyza tabs MO marlissa tabs MO melodetta 24 fe chew MO mibelas 24 fe chew MO microgestin 1.5/30 tabs MO microgestin 1/20 tabs MO microgestin fe 1.5/30 tabs MO microgestin fe 1/20 tabs MO mili tabs MO MINASTRIN 24 FE CHEW MO MONONESSA TABS MO NATAZIA TABS MO necon 0.5/35 (28) tabs MO


Límites NECON 7/7/7 TABS MO nikki tabs MO nora-be tabs MO norethin ace-eth estrad-fe chew MO norethin ace-eth estrad-fe tabs MO norethin-eth estradiol-fe chew MO norethindrone acet-ethinyl est tabs MO

norethindrone tabs MO norgestim-eth estrad triphasic tabs MO

norgestimate-eth estradiol tabs MO norlyroc tabs MO nortrel 0.5/35 (28) tabs MO nortrel 1/35 (21) tabs MO nortrel 1/35 (28) tabs MO nortrel 7/7/7 tabs MO NUVARING RING MO ocella tabs MO ogestrel tabs MO orsythia tabs MO ORTHO MICRONOR TABS MO ORTHO TRI-CYCLEN (28) TABS MO

ORTHO TRI-CYCLEN LO TABS MO ORTHO-CYCLEN (28) TABS MO ORTHO-NOVUM 1/35 (28) TABS MO

ORTHO-NOVUM 7/7/7 (28) TABS MO

pimtrea tabs MO pirmella 1/35 tabs MO portia-28 tabs MO previfem tabs MO QUARTETTE TABS MO quasense tabs MO reclipsen tabs MO rivelsa tabs MO SAFYRAL TABS MO SEASONIQUE TABS MO setlakin tabs MO sharobel tabs MO sprintec 28 tabs MO




Límites sronyx tabs MO syeda tabs MO tarina 24 fe tabs MO tarina fe 1/20 tabs MO tri-estarylla tabs MO tri-legest fe tabs MO tri-lo-estarylla tabs MO tri-lo-sprintec tabs MO tri-mili tabs MO TRI-NORINYL (28) TABS MO tri-previfem tabs MO tri-sprintec tabs MO tri-vylibra lo tabs MO tri-vylibra tabs MO TRINESSA (28) TABS MO trivora (28) tabs MO tydemy tabs MO velivet tabs MO vestura tabs MO vienva tabs MO vyfemla tabs MO vylibra tabs MO wymzya fe chew MO xulane ptwk MO YASMIN 28 TABS MO YAZ TABS MO zarah tabs MO zenchent tabs MO zovia 1/35e (28) tabs MO zovia 1/50e (28) tabs MO DIABETIC AGENTS acarbose tabs 25mg, 50mg, 100mg MO

ACTOPLUS MET TABS MO ACTOPLUS MET XR TB24 MO ACTOS TABS 15mg, 30mg, 45mg MO

ADLYXIN SOPN MO ADLYXIN STARTER PACK PNKT MO

ADMELOG SOLN MO ADMELOG SOLOSTAR SOPN MO


Límites AFREZZA POWD MO AFREZZA POWD 8 (90) & 12 (90) UNIT NDS

alogliptin benzoate tabs 6.25mg, 12.5mg, 25mg MO

ALOGLIPTIN-METFORMIN HCL TABS MO

alogliptin-pioglitazone tabs MO AMARYL TABS 1mg, 2mg, 4mg MO APIDRA SOLN PA,MO APIDRA SOLOSTAR SOPN MO AVANDIA TABS 2mg, 4mg MO BAQSIMI TWO PACK POWD BASAGLAR KWIKPEN SOPN MO BYDUREON BCISE AUIJ BYDUREON PEN MO BYDUREON SRER BYETTA 10 MCG PEN SOPN MO BYETTA 5 MCG PEN SOPN MO chlorpropamide tabs 100mg, 250mg MO

CYCLOSET TABS MO DUETACT TABS MO FARXIGA TABS 5mg, 10mg MO FIASP FLEXTOUCH SOPN MO FIASP SOLN MO FORTAMET TB24 500mg, 1000mg MO

glimepiride tabs 1mg, 2mg, 4mg MO glipizide er tb24 2.5mg, 5mg, 10mg MO

glipizide tabs 5mg, 10mg MO glipizide-metformin hcl tabs MO GLUCAGEN HYPOKIT SOLR GLUCAGON EMERGENCY KIT GLUCOPHAGE TABS 500mg, 850mg, 1000mg MO

GLUCOPHAGE XR TB24 500mg, 750mg MO

GLUCOTROL TABS 5mg, 10mg MO GLUCOTROL XL TB24 2.5mg, 5mg, 10mg MO

GLUMETZA TB24 500mg, 1000mg NDS



Límites glyburide micronized tabs 1.5mg, 3mg, 6mg MO

glyburide tabs 1.25mg, 2.5mg, 5mg MO

glyburide-metformin tabs MO GLYNASE TABS 1.5mg, 3mg, 6mg MO

GLYSET TABS 25mg, 50mg, 100mg MO

GLYXAMBI TABS MO HUMALOG JUNIOR KWIKPEN SOPN MO

HUMALOG KWIKPEN SOPN 100unit/ml, 200unit/ml MO

HUMALOG MIX 50/50 KWIKPEN SUPN MO

HUMALOG MIX 50/50 SUSP MO HUMALOG MIX 75/25 KWIKPEN SUPN MO

HUMALOG MIX 75/25 SUSP MO HUMALOG SOCT MO HUMALOG SOLN MO HUMULIN 70/30 KWIKPEN SUPN MO

HUMULIN 70/30 SUSP MO HUMULIN N KWIKPEN SUPN MO HUMULIN N SUSP MO HUMULIN R SOLN PA,MO HUMULIN R U-500 (CONCENTRATED) SOLN MO

HUMULIN R U-500 KWIKPEN SOPN MO

insulin lispro soln MO insulin lispro sopn MO INVOKAMET TABS MO INVOKAMET XR TB24 MO INVOKANA TABS 100mg, 300mg MO

JANUMET TABS MO JANUMET XR TB24 MO JANUVIA TABS 25mg, 50mg, 100mg MO

JARDIANCE TABS 10mg, 25mg MO JENTADUETO TABS MO


Límites JENTADUETO XR TB24 MO KAZANO TABS MO KOMBIGLYZE XR TB24 MO KORLYM TABS LD,NDS LANTUS SOLN MO LANTUS SOLOSTAR SOPN MO LEVEMIR FLEXTOUCH SOPN MO LEVEMIR SOLN MO metformin hcl er (mod) tb24 500mg, 1000mg NDS

metformin hcl er (osm) tb24 500mg, 1000mg MO

metformin hcl er tb24 500mg, 750mg MO

metformin hcl tabs 500mg, 850mg, 1000mg MO

miglitol tabs 25mg, 50mg, 100mg MO

nateglinide tabs 60mg, 120mg MO NESINA TABS 6.25mg, 12.5mg, 25mg MO

NOVOLIN 70/30 SUSP MO NOVOLIN N SUSP MO NOVOLIN R SOLN PA,MO NOVOLOG FLEXPEN SOPN MO NOVOLOG MIX 70/30 FLEXPEN SUPN MO

NOVOLOG MIX 70/30 SUSP MO NOVOLOG PENFILL SOCT MO NOVOLOG SOLN PA,MO ONGLYZA TABS 2.5mg, 5mg MO OSENI TABS MO OZEMPIC (0.25 OR 0.5 MG/DOSE) SOPN MO

OZEMPIC (1 MG/DOSE) SOPN MO pioglitazone hcl tabs 15mg, 30mg, 45mg MO

pioglitazone hcl-glimepiride tabs MO pioglitazone hcl-metformin hcl tabs MO

prandin tabs 1mg, 2mg MO PRECOSE TABS 25mg, 50mg, 100mg MO

PROGLYCEM SUSP MO




Límites QTERN TABS MO repaglinide tabs .5mg, 1mg, 2mg MO repaglinide-metformin hcl tabs MO RIOMET SOLN SEGLUROMET TABS SOLIQUA SOPN MO STARLIX TABS 60mg, 120mg MO STEGLATRO TABS 5mg, 15mg MO STEGLUJAN TABS MO SYMLINPEN 120 SOPN MO SYMLINPEN 60 SOPN MO SYNJARDY TABS MO SYNJARDY XR TB24 MO TANZEUM PEN 30mg, 50mg MO tolazamide tabs 250mg, 500mg MO tolbutamide tabs MO TOUJEO MAX SOLOSTAR SOPN MO

TOUJEO SOLOSTAR SOPN MO TRADJENTA TABS MO TRESIBA FLEXTOUCH SOPN 100unit/ml, 200unit/ml MO

TRESIBA SOLN MO TRULICITY SOPN .75mg/0.5ml, 1.5mg/0.5ml MO

VICTOZA SOPN MO XIGDUO XR TB24 MO XULTOPHY SOPN NDS ESTROGENS AND ANTIESTROGENS ACTIVELLA TABS MO ALORA PTTW .025mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr

MO

amabelz tabs MO ANGELIQ TABS MO BIJUVA CAPS MO CLIMARA PRO PTWK MO CLIMARA PTWK 37.5mcg/24hr, .025mg/24hr, .05mg/24hr, .06mg/24hr, .075mg/24hr, .1mg/24hr

MO

clomiphene citrate tabs PA COMBIPATCH PTTW MO


Límites DELESTROGEN OIL depo-estradiol oil DIVIGEL GEL MO dotti pttw .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr

MO

DUAVEE TABS MO ELESTRIN GEL MO estrace crea MO estrace tabs .5mg, 1mg, 2mg MO estradiol crea MO estradiol pttw .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr

MO

estradiol ptwk 37.5mcg/24hr, .025mg/24hr, .05mg/24hr, .06mg/24hr, .075mg/24hr, .1mg/24hr

MO

estradiol tabs 10mcg, .5mg, 1mg, 2mg MO

estradiol valerate oil estradiol-norethindrone acet tabs MO ESTRING RING MO estropipate tabs .75mg, 1.5mg, 3mg MO

EVAMIST SOLN MO EVISTA TABS MO FEMHRT LOW DOSE TABS MO FEMRING RING .05mg/24hr, .1mg/24hr MO

fyavolv tabs MO IMVEXXY MAINTENANCE PACK INST 4mcg, 10mcg MO

IMVEXXY STARTER PACK INST 4mcg, 10mcg MO

jinteli tabs MO LOPREEZA TABS MO menest tabs .3mg, .625mg, 1.25mg MO

MENOSTAR PTWK MO mimvey lo tabs MO mimvey tabs MO



Límites MINIVELLE PTTW .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr

MO

norethindrone-eth estradiol tabs MO OSPHENA TABS MO prefest tabs MO PREMARIN CREA MO PREMARIN SOLR PREMARIN TABS .3mg, .45mg, .625mg, .9mg, 1.25mg MO

PREMPHASE TABS MO PREMPRO TABS MO raloxifene hcl tabs MO VAGIFEM TABS MO VIVELLE-DOT PTTW .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr

MO

yuvafem tabs MO GONADOTROPINS CHORIONIC GONADOTROPIN SOLR PA

NOVAREL SOLR 10000unit PA NOVAREL SOLR PA ORILISSA TABS 150mg, 200mg NDS PREGNYL SOLR PA TRIPTODUR SRER NDS OXYTOCICS MIFEPREX TABS PARATHYROID calcitonin (salmon) soln MO cinacalcet hcl tabs 30mg, 60mg, 90mg PA,MO

FORTEO SOLN PA,NDS FORTICAL SOLN MO MIACALCIN SOLN NATPARA CART 25mcg, 50mcg, 75mcg, 100mcg LD,NDS

SENSIPAR TABS 30mg PA,NDS SENSIPAR TABS 60mg, 90mg PA,NDS TYMLOS SOPN NDS PITUITARY ACTHAR GEL PA,LD,NDS


Límites DDAVP RHINAL TUBE SOLN MO DDAVP SOLN MO DDAVP TABS .1mg, .2mg MO DESMOPRESSIN ACE RHINAL TUBE SOLN MO

desmopressin ace spray refrig soln MO

desmopressin acetate tabs .1mg, .2mg MO

NOCDURNA SUBL 27.7mcg, 55.3mcg MO

NOCTIVA EMUL .83mcg/0.1ml, 1.66mcg/0.1ml MO

STIMATE SOLN MO SYNAREL SOLN MO PROGESTINS aygestin tabs MO CRINONE GEL 4%, 8% PA,MO DEPO-PROVERA SUSP 400mg/ml

DEPO-PROVERA SUSP 150mg/ml

DEPO-SUBQ PROVERA 104 SUSY

MAKENA SOAJ NDS medroxyprogesterone acetate susp

medroxyprogesterone acetate susy

medroxyprogesterone acetate tabs 2.5mg, 5mg, 10mg MO

MEGACE ES SUSP MO megestrol acetate susp MO norethindrone acetate tabs MO progesterone micronized caps 100mg, 200mg MO

PROMETRIUM CAPS 100mg, 200mg MO

PROVERA TABS 2.5mg, 5mg, 10mg MO

SOMATOTROPIN AGONISTS AND ANTAGONISTS EGRIFTA SOLR NDS GENOTROPIN MINIQUICK SOLR .2mg, .4mg, .6mg, .8mg, PA,NDS




Límites 1mg, 1.2mg, 1.4mg, 1.6mg, 1.8mg, 2mg GENOTROPIN SOLR 12mg PA,NDS GENOTROPIN SOLR PA,NDS HUMATROPE SOLR 5mg, 6mg, 12mg, 24mg PA,NDS

INCRELEX SOLN NDS NORDITROPIN FLEXPRO SOLN 5mg/1.5ml, 10mg/1.5ml, 15mg/1.5ml, 30mg/3ml

PA,NDS

NUTROPIN AQ NUSPIN 10 SOLN PA,NDS



octreotide acetate soln OMNITROPE SOLN 5mg/1.5ml, 10mg/1.5ml PA,NDS

OMNITROPE SOLR PA,NDS SAIZEN CLICK.EASY SOLR PA,NDS SAIZEN SOLR 5mg, 8.8mg PA,NDS SAIZENPREP SOLR PA,NDS SANDOSTATIN LAR DEPOT KIT 10mg, 20mg, 30mg NDS

SANDOSTATIN SOLN SEROSTIM SOLR 4mg, 5mg, 6mg PA,NDS

SIGNIFOR LAR SRER 10mg, 20mg, 30mg, 40mg, 60mg NDS

SIGNIFOR SOLN .3mg/ml, .6mg/ml, .9mg/ml NDS

SOMATULINE DEPOT SOLN SOMAVERT SOLR 10mg, 15mg, 20mg, 25mg, 30mg LD,NDS

ZOMACTON SOLR 5mg PA,NDS ZOMACTON SOLR PA,NDS ZORBTIVE SOLR PA,NDS THYROID AND ANTITHYROID AGENTS CYTOMEL TABS 5mcg, 25mcg, 50mcg MO

LEVO-T TABS 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg,

MO


Límites 150mcg, 175mcg, 200mcg, 300mcg LEVOTHYROXINE SODIUM SOLN

levothyroxine sodium tabs 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg

MO

LEVOXYL TABS 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg

MO

liothyronine sodium tabs 5mcg, 25mcg, 50mcg MO

methimazole tabs 5mg, 10mg MO propylthiouracil tabs MO SYNTHROID TABS 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg

MO

tapazole tabs 5mg, 10mg MO THYROLAR-1 TABS THYROLAR-1/2 TABS THYROLAR-1/4 TABS THYROLAR-2 TABS THYROLAR-3 TABS TIROSINT CAPS 13mcg, 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg

MO

TIROSINT-SOL SOLN 13mcg/ml, 25mcg/ml, 50mcg/ml, 75mcg/ml, 88mcg/ml, 100mcg/ml, 112mcg/ml, 125mcg/ml, 137mcg/ml, 150mcg/ml, 175mcg/ml, 200mcg/ml

MO

UNITHROID TABS 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 150mcg, 175mcg, 200mcg, 300mcg

MO



Límites MISCELLANEOUS THERAPEUTIC AGENTS 5-ALPHA REDUCTASE INHIBITORS AVODART CAPS MO dutasteride caps MO dutasteride-tamsulosin hcl caps MO finasteride tabs MO JALYN CAPS MO PROSCAR TABS MO ANTIDOTES acetylcysteine soln 10%, 20% PA,MO KHAPZORY SOLR 175mg, 300mg NDS

leucovorin calcium tabs 5mg, 10mg, 15mg, 25mg MO

VISTOGARD PACK NDS VORAXAZE SOLR NDS ANTIGOUT AGENTS allopurinol tabs 100mg, 300mg MO COLCHICINE CAPS MO colchicine tabs MO COLCRYS TABS MO febuxostat tabs 40mg, 80mg MO MITIGARE CAPS MO ULORIC TABS 40mg, 80mg MO ZYLOPRIM TABS 100mg, 300mg MO

BONE RESORPTION INHIBITORS ACTONEL TABS 5mg, 30mg, 35mg, 150mg MO

alendronate sodium soln MO alendronate sodium tabs 5mg, 10mg, 35mg, 70mg MO

alendronate sodium tabs 40mg MO ATELVIA TBEC MO BINOSTO TBEF MO BONIVA TABS PA,MO etidronate disodium tabs 200mg, 400mg MO

EVENITY SOSY NDS FOSAMAX PLUS D TABS MO FOSAMAX TABS MO ibandronate sodium tabs PA,MO PROLIA SOSY NDS


Límites risedronate sodium tabs 5mg, 30mg, 35mg, 150mg MO

RISEDRONATE SODIUM TBEC MO XGEVA SOLN NDS DISEASE-MODIFYING ANTIRHEUMATIC AGENTS ACTEMRA ACTPEN SOAJ NDS ACTEMRA SOSY NDS ARAVA TABS 10mg, 20mg MO CIMZIA KIT NDS CIMZIA PREFILLED KIT NDS CIMZIA STARTER KIT KIT ENBREL MINI SOCT NDS ENBREL SOLR NDS ENBREL SOSY 25mg/0.5ml, 50mg/ml NDS

ENBREL SURECLICK SOAJ NDS HUMIRA PEDIATRIC CROHNS START PSKT NDS

HUMIRA PEN PNKT 40mg/0.4ml, 40mg/0.8ml NDS

HUMIRA PEN-CD/UC/HS STARTER PNKT 40mg/0.8ml, 80mg/0.8ml

NDS

HUMIRA PEN-PS/UV/ADOL HS START PNKT NDS

HUMIRA PSKT 10mg/0.1ml, 10mg/0.2ml, 20mg/0.2ml, 20mg/0.4ml, 40mg/0.4ml, 40mg/0.8ml

NDS

INFLECTRA SOLR INTRAVENOUS HI

KEVZARA SOAJ 150mg/1.14ml, 200mg/1.14ml NDS

KEVZARA SOSY 150mg/1.14ml, 200mg/1.14ml NDS

KINERET SOSY NDS leflunomide tabs 10mg, 20mg MO OLUMIANT TABS NDS ORENCIA CLICKJECT SOAJ NDS ORENCIA SOLR NDS ORENCIA SOSY 50mg/0.4ml, 87.5mg/0.7ml, 125mg/ml NDS

OTEZLA TABS PA,NDS




Límites OTEZLA TBPK PA,NDS OTREXUP SOAJ RASUVO SOAJ REMICADE SOLR INTRAVENOUS HI

RENFLEXIS SOLR NDS RINVOQ TB24 NDS SIMPONI ARIA SOLN NDS SIMPONI SOAJ 50mg/0.5ml, 100mg/ml NDS

SIMPONI SOSY 50mg/0.5ml, 100mg/ml NDS

XELJANZ TABS 5mg, 10mg NDS XELJANZ XR TB24 NDS IMMUNE SUPPRESSANTS ASTAGRAF XL CP24 .5mg, 1mg PA,MO ASTAGRAF XL CP24 PA azasan tabs 75mg, 100mg PA,MO azathioprine tabs PA,MO BENLYSTA SOAJ BENLYSTA SOLR BENLYSTA SOSY CELLCEPT CAPS PA,MO CELLCEPT SUSR PA,MO CELLCEPT TABS PA,MO cyclosporine caps 25mg, 100mg PA,MO cyclosporine modified caps 25mg, 50mg, 100mg PA,MO

cyclosporine modified soln PA,MO ENVARSUS XR TB24 .75mg, 1mg, 4mg PA,MO

GAMIFANT SOLN 50mg/10ml, 10mg/2ml NDS

gengraf caps 25mg, 50mg, 100mg PA,MO

gengraf soln PA,MO IMURAN TABS PA,MO MAVENCLAD (10 TABS) TBPK NDS MAVENCLAD (4 TABS) TBPK NDS MAVENCLAD (5 TABS) TBPK NDS MAVENCLAD (6 TABS) TBPK NDS MAVENCLAD (7 TABS) TBPK NDS MAVENCLAD (8 TABS) TBPK NDS


Límites MAVENCLAD (9 TABS) TBPK NDS mycophenolate mofetil caps PA,MO mycophenolate mofetil susr PA,MO mycophenolate mofetil tabs PA,MO mycophenolate sodium tbec 180mg, 360mg PA,MO

MYFORTIC TBEC 180mg, 360mg PA,MO

NEORAL CAPS 25mg, 100mg PA,MO NEORAL SOLN PA,MO NULOJIX SOLR NDS PROGRAF CAPS .5mg, 1mg, 5mg PA,MO

PROGRAF PACK .2mg, 1mg PA,NDS PROGRAF SOLN PA,MO RAPAMUNE SOLN PA,MO RAPAMUNE TABS .5mg, 1mg, 2mg PA,MO

SANDIMMUNE CAPS 25mg, 100mg PA,MO

SANDIMMUNE SOLN 50mg/ml PA,MO SANDIMMUNE ORAL SOLN 100mg/ml PA,MO

sirolimus soln PA,MO sirolimus tabs .5mg, 1mg, 2mg PA,MO tacrolimus caps .5mg, 1mg, 5mg PA,MO ZORTRESS TABS .25mg PA,MO ZORTRESS TABS .5mg, .75mg, 1mg PA

MISCELLANEOUS THERAPEUTIC AGENTS ACTIMMUNE SOLN ARCALYST SOLR NDS BOTOX SOLR 100unit, 200unit PA CARNITOR SOLN PA,MO CARNITOR TABS PA,MO CRYSVITA SOLN 10mg/ml, 20mg/ml, 30mg/ml NDS

CYSTADANE POWD LD,NDS CYSTAGON CAPS 50mg, 150mg LD,NDS

DYSPORT SOLR 300unit, 500unit PA

ELMIRON CAPS MO ENDARI PACK NDS



Límites EXONDYS 51 SOLN 500mg/10ml, 100mg/2ml NDS

FIRDAPSE TABS NDS GALAFOLD CAPS NDS HAEGARDA SOLR 2000unit, 3000unit NDS

KEVEYIS TABS NDS KUVAN PACK 100mg, 500mg NDS KUVAN TBSO NDS levocarnitine soln PA,MO LEVOCARNITINE TABS PA,MO MESNEX TABS NDS MYALEPT SOLR NDS NITYR TABS 2mg, 5mg, 10mg NDS ODACTRA SUBL ONPATTRO SOLN NDS ORALAIR SUBL MO ORFADIN CAPS 2mg, 5mg, 10mg, 20mg LD,NDS

ORFADIN SUSP LD,NDS PROCYSBI CPDR 25mg, 75mg NDS RIDAURA CAPS MO RIMSO-50 SOLN RUZURGI TABS NDS SODIUM CHLORIDE SOLN MO SODIUM FLUORIDE TABS MO TAKHZYRO SOLN NDS TEGSEDI SOSY NDS THIOLA EC TBEC 100mg, 300mg NDS

THIOLA TABS MO ULTOMIRIS SOLN NDS XEOMIN SOLR 50unit, 100unit PA XEOMIN SOLR PA,NDS XURIDEN PACK NDS RESPIRATORY TRACT AGENTS ANTI-INFLAMMATORY AGENTS ACCOLATE TABS 10mg, 20mg MO CINQAIR SOLN NDS cromolyn sodium conc MO cromolyn sodium nebu PA,MO FASENRA SOSY GASTROCROM CONC MO


Límites montelukast sodium chew 4mg, 5mg MO

montelukast sodium pack MO montelukast sodium tabs MO NUCALA SOAJ NDS NUCALA SOLR NDS NUCALA SOSY NDS SINGULAIR CHEW 4mg, 5mg MO SINGULAIR PACK MO SINGULAIR TABS MO zafirlukast tabs 10mg, 20mg MO zileuton er tb12 NDS ZYFLO CR TB12 NDS ZYFLO TABS MO CYSTIC FIBROSIS CAYSTON SOLR LD,NDS KALYDECO PACK 25mg, 50mg, 75mg PA,NDS

KALYDECO TABS PA,NDS ORKAMBI PACK NDS ORKAMBI TABS NDS SYMDEKO TBPK NDS TOBI NEBU PA TOBI PODHALER CAPS PULMONARY FIBROSIS ESBRIET CAPS PA,NDS ESBRIET TABS 267mg, 801mg PA,NDS OFEV CAPS 100mg, 150mg NDS RESPIRATORY AGENTS, MISCELLANEOUS ALVESCO AERS 80mcg/act, 160mcg/act MO

ARALAST NP SOLR INTRAVENOUS 500mg, 1000mg

HI

ARMONAIR RESPICLICK 113 AEPB MO



ARNUITY ELLIPTA AEPB 50mcg/act, 100mcg/act, 200mcg/act

MO




Límites ASMANEX (120 METERED DOSES) AEPB MO

ASMANEX (30 METERED DOSES) AEPB 110mcg/inh MO

ASMANEX (30 METERED DOSES) AEPB MO

ASMANEX (60 METERED DOSES) AEPB MO

ASMANEX HFA AERO 100mcg/act, 200mcg/act MO

budesonide susp .25mg/2ml, .5mg/2ml, 1mg/2ml PA,MO

DALIRESP TABS 250mcg, 500mcg MO

DULERA AERO MO FLOVENT DISKUS AEPB 50mcg/blist, 100mcg/blist, 250mcg/blist

MO

FLOVENT HFA AERO 44mcg/act MO

FLOVENT HFA AERO 110mcg/act, 220mcg/act MO

GLASSIA SOLN INTRAVENOUS HI

PROLASTIN-C SOLN INTRAVENOUS HI

PROLASTIN-C SOLR INTRAVENOUS HI

PULMICORT FLEXHALER AEPB 90mcg/act, 180mcg/act MO

PULMICORT SUSP .25mg/2ml, .5mg/2ml, 1mg/2ml PA,MO

QVAR AERS 40mcg/act, 80mcg/act MO

QVAR REDIHALER AERB SYMBICORT AERO MO XOLAIR SOLR NDS XOLAIR SOSY 75mg/0.5ml, 150mg/ml NDS

ZEMAIRA SOLR INTRAVENOUS HI

VASODILATING AGENTS ADEMPAS TABS .5mg, 1mg, 1.5mg, 2mg, 2.5mg PA,NDS

ambrisentan tabs 5mg, 10mg NDS


Límites bosentan tabs 62.5mg, 125mg NDS LETAIRIS TABS 5mg, 10mg NDS OPSUMIT TABS PA,NDS ORENITRAM TBCR .125mg LD,NDS ORENITRAM TBCR .25mg, 1mg, 2.5mg, 5mg LD,NDS

REMODULIN SOLN 20mg/20ml, 50mg/20ml, 100mg/20ml, 200mg/20ml

PA,LD,NDS

TRACLEER TABS 62.5mg, 125mg NDS

TRACLEER TBSO NDS treprostinil soln 20mg/20ml, 50mg/20ml, 100mg/20ml, 200mg/20ml

PA,LD,NDS

TYVASO REFILL SOLN PA,LD TYVASO SOLN PA,LD TYVASO STARTER SOLN PA,LD UPTRAVI TABS 200mcg, 400mcg, 600mcg, 800mcg, 1000mcg, 1200mcg, 1400mcg, 1600mcg

NDS

UPTRAVI TBPK NDS VENTAVIS SOLN 10mcg/ml, 20mcg/ml PA,LD,NDS

SERUMS, TOXOIDS, AND VACCINES SERUMS BIVIGAM SOLN INTRAVENOUS HI CARIMUNE NF SOLR INTRAVENOUS HI

CUTAQUIG SOLN 1.65gm/10ml, 2gm/12ml, 3.3gm/20ml, 4gm/24ml, 8gm/48ml, 1gm/6ml

PA,NDS

CYTOGAM INJ FLEBOGAMMA DIF SOLN INTRAVENOUS 10%, 5gm/100ml, .5gm/10ml, 10gm/200ml, 20gm/400ml, 2.5gm/50ml

HI

GAMASTAN INJ PA GAMASTAN S/D INJ PA GAMMAGARD S/D LESS IGA SOLR INTRAVENOUS 5gm, 10gm

HI



Límites GAMMAGARD SOLN INJECTION HI

GAMMAKED SOLN INJECTION HI GAMMAPLEX SOLN INTRAVENOUS 10gm/200ml HI

GAMMAPLEX SOLN INTRAVENOUS 10gm/100ml, 20gm/200ml, 5gm/50ml

HI

GAMUNEX-C SOLN INJECTION 10gm/100ml, 1gm/10ml, 20gm/200ml, 2.5gm/25ml, 5gm/50ml

HI

HYPERRAB S/D SOLN HYQVIA KIT PA,NDS IMOGAM RABIES-HT SOLN NABI-HB SOLN OCTAGAM SOLN INTRAVENOUS 5gm/100ml, 1gm/20ml, 2gm/20ml, 25gm/500ml

HI

PANZYGA SOLN INTRAVENOUS 10gm/100ml, 1gm/10ml, 20gm/200ml, 2.5gm/25ml, 30gm/300ml, 5gm/50ml

HI

PRIVIGEN SOLN INTRAVENOUS HI

VARIZIG SOLN TOXOIDS DIPHTHERIA-TETANUS TOXOIDS DT SUSP

KINRIX SUSP QUADRACEL SUSP TDVAX SUSP TENIVAC INJ VACCINES ACTHIB SOLR ADACEL SUSP BEXSERO SUSY BOOSTRIX SUSP DAPTACEL SUSP ENGERIX-B SUSP 10mcg/0.5ml, 20mcg/ml PA

GARDASIL 9 SUSP


Límites GARDASIL 9 SUSY HAVRIX SUSP HEPLISAV-B SOLN PA HIBERIX SOLR IMOVAX RABIES INJ INFANRIX SUSP IPOL INJ IXIARO SUSP M-M-R II INJ MENACTRA INJ MENVEO SOLR PEDIARIX SUSP PEDVAX HIB SUSP PROQUAD SUSR RABAVERT SUSR RECOMBIVAX HB SUSP 5mcg/0.5ml, 10mcg/ml, 40mcg/ml

PA

ROTARIX SUSR ROTATEQ SOLN SHINGRIX SUSR TRUMENBA SUSY TWINRIX SUSY TYPHIM VI SOLN VAQTA SUSP VARIVAX INJ VAXCHORA SUSR YF-VAX INJ ZOSTAVAX SUSR SKIN AND MUCOUS MEMBRANE AGENTS ANTI-INFECTIVES (SKIN AND MUCOUS MEMBRANE) ACANYA GEL MO acyclovir crea acyclovir oint AKTIPAK PACK MO AVC VAGINAL CREA BACTROBAN CREA BACTROBAN NASAL OINT BENZACLIN WITH PUMP GEL MO BENZAMYCIN GEL MO BENZOYL PEROXIDE GEL NDS




Límites benzoyl peroxide-erythromycin gel MO

ciclopirox gel ciclopirox olamine crea ciclopirox olamine susp ciclopirox sham ciclopirox soln CLEOCIN CREA CLEOCIN SUPP CLEOCIN-T GEL MO CLEOCIN-T LOTN MO CLEOCIN-T SOLN MO CLEOCIN-T SWAB MO clindacin-p swab MO CLINDAGEL GEL MO clindamycin phos-benzoyl perox gel MO

clindamycin phosphate crea clindamycin phosphate foam MO clindamycin phosphate gel MO clindamycin phosphate lotn MO clindamycin phosphate soln MO clindamycin phosphate swab MO CLINDESSE CREA clotrimazole crea clotrimazole lozg clotrimazole soln clotrimazole-betamethasone crea

clotrimazole-betamethasone lotn DENAVIR CREA DUAC GEL MO econazole nitrate crea ELIMITE CREA ERTACZO CREA ery pads MO ERYGEL GEL MO erythromycin gel MO erythromycin soln MO EURAX CREA EURAX LOTN EVOCLIN FOAM MO


Límites EXELDERM CREA EXELDERM SOLN EXTINA FOAM gentamicin sulfate crea gentamicin sulfate oint gynazole-1 crea JUBLIA SOLN KERYDIN SOLN ketoconazole crea ketoconazole foam ketoconazole sham KLARON LOTN MO lindane sham LOPROX CREA LOPROX SHAM LOTRISONE CREA LULICONAZOLE CREA LUZU CREA mafenide acetate pack malathion lotn MENTAX CREA METROCREAM CREA METROGEL GEL METROGEL-VAGINAL GEL METROLOTION LOTN metronidazole crea metronidazole gel metronidazole lotn miconazole 3 supp mupirocin calcium crea mupirocin oint naftifine hcl crea NAFTIN CREA NAFTIN GEL NATROBA SUSP neuac gel MO NIZORAL SHAM NORITATE CREA nyamyc powd nystatin crea nystatin oint nystatin powd



Límites nystop powd ONEXTON GEL MO ORAVIG TABS ovide lotn oxiconazole nitrate crea OXISTAT CREA OXISTAT LOTN permethrin crea selenium sulfide lotn SILVADENE CREA SILVER SULFADIAZINE CREA SKLICE LOTN SOOLANTRA CREA SSD CREA sulfacetamide sodium (acne) lotn MO SULFAMYLON CREA SULFAMYLON PACK TERAZOL 7 CREA terconazole crea terconazole supp VANDAZOLE GEL XEPI CREA MO XERESE CREA ZOVIRAX CREA ZOVIRAX OINT ANTI-INFLAMMATORY AGENTS (SKIN AND MUCOUS MEMBRANE) ala scalp lotn MO ala-cort crea 1%, 2.5% MO alclometasone dipropionate crea MO alclometasone dipropionate oint MO amcinonide crea MO amcinonide lotn MO amcinonide oint MO anusol-hc crea MO apexicon e crea MO BENZOYL PEROXIDE FORTE- HC LOTN NDS

beser lotn MO betamethasone dipropionate aug crea MO

betamethasone dipropionate aug gel MO


Límites betamethasone dipropionate aug lotn MO

betamethasone dipropionate aug oint MO

betamethasone dipropionate crea MO

betamethasone dipropionate lotn MO betamethasone dipropionate oint MO betamethasone valerate crea MO betamethasone valerate foam MO betamethasone valerate lotn MO betamethasone valerate oint MO BRYHALI LOTN MO calcipotriene-betameth diprop oint MO,NDS

CAPEX SHAM MO clobetasol prop emollient base crea MO

clobetasol propionate crea clobetasol propionate emulsion foam

clobetasol propionate foam MO clobetasol propionate gel MO clobetasol propionate liqd MO clobetasol propionate lotn MO clobetasol propionate oint MO clobetasol propionate sham MO clobetasol propionate soln MO CLOBEX LOTN MO CLOBEX SHAM MO CLOBEX SPRAY LIQD MO clocortolone pivalate pump crea MO clodan sham MO CLODERM CREA MO colocort enem MO CORDRAN TAPE MO CORTISPORIN CREA MO CORTISPORIN OINT MO CUTIVATE LOTN MO DESONATE GEL MO desonide crea MO desonide lotn MO desonide oint MO




Límites DESOWEN CREA MO desowen lotn MO desoximetasone crea .05%, .25% MO

desoximetasone gel MO desoximetasone liqd MO desoximetasone oint .05%, .25% MO diclofenac epolamine ptch PA,MO diclofenac sodium gel 1%, 3% MO diclofenac sodium soln MO diflorasone diacetate crea MO diflorasone diacetate oint MO DIPROLENE AF CREA MO DIPROLENE OINT MO DUOBRII LOTN NDS ELOCON CREA MO ELOCON OINT MO ENSTILAR FOAM MO EUCRISA OINT MO FLECTOR PTCH PA,MO fluocinolone acetonide crea .01%, .025% MO

fluocinolone acetonide oint MO fluocinolone acetonide scalp oil MO fluocinolone acetonide soln MO fluocinonide crea MO fluocinonide emulsified base crea MO

fluocinonide gel MO fluocinonide oint MO fluocinonide soln MO flurandrenolide crea MO flurandrenolide lotn MO flurandrenolide oint MO fluticasone propionate crea MO fluticasone propionate lotn MO fluticasone propionate oint MO halobetasol propionate crea MO HALOBETASOL PROPIONATE FOAM NDS

halobetasol propionate oint MO HALOG CREA MO HALOG OINT MO


Límites hydrocortisone butyrate crea MO hydrocortisone butyrate lotn MO hydrocortisone butyrate oint MO hydrocortisone butyrate soln MO hydrocortisone crea 1%, 2.5% MO hydrocortisone enem MO hydrocortisone lotn MO hydrocortisone oint 1%, 2.5% MO hydrocortisone valerate crea MO hydrocortisone valerate oint MO IMPOYZ CREA MO KENALOG AERS MO LEXETTE FOAM NDS LOCOID LIPOCREAM CREA MO LOCOID LOTN MO LOCOID OINT MO LOCOID SOLN MO LUXIQ FOAM MO micort-hc crea MO mometasone furoate crea MO mometasone furoate oint MO mometasone furoate soln MO neo-synalar crea MO nolix crea nolix lotn MO nystatin-triamcinolone crea MO nystatin-triamcinolone oint MO OLUX FOAM MO OLUX-E FOAM PANDEL CREA MO PENNSAID SOLN MO prednicarbate crea MO prednicarbate oint MO procto-med hc crea MO procto-pak crea MO proctosol hc crea MO proctozone-hc crea MO psorcon crea MO SOLARAZE GEL MO SYNALAR CREA MO TACLONEX OINT NDS TACLONEX SUSP MO



Límites topicort crea .05%, .25% MO topicort gel MO topicort oint .25% MO TOPICORT OINT MO TOPICORT SPRAY LIQD MO triamcinolone acetonide aers MO triamcinolone acetonide crea .025%, .1%, .5% MO

triamcinolone acetonide lotn .025%, .1% MO

triamcinolone acetonide oint .025%, .1%, .5% MO

triamcinolone acetonide pste MO trianex oint MO triderm crea MO TRIDESILON CREA MO UCERIS FOAM MO ULTRAVATE CREA MO ULTRAVATE LOTN NDS ULTRAVATE OINT MO VANOS CREA MO VOLTAREN GEL MO ANTIPRURITICS AND LOCAL ANESTHETICS 7T LIDO GEL PA,MO doxepin hcl crea MO glydo gel MO hydrocortisone ace-pramoxine crea MO

lidocaine hcl soln PA lidocaine hcl urethral/mucosal gel MO

lidocaine oint PA,MO lidocaine ptch PA,MO lidocaine-prilocaine crea PA,MO lidocaine-tetracaine crea PA LIDODERM PTCH PA,MO PLIAGLIS CREA PA PRUDOXIN CREA MO SYNERA PTCH PA texacort soln MO XYLOCAINE SOLN PA ZONALON CREA MO ZTLIDO PTCH PA,MO


Límites CELL STIMULANTS AND PROLIFERANTS ALTRENO LOTN MO ATRALIN GEL PA,MO AVITA CREA PA,MO AVITA GEL PA,MO KEPIVANCE SOLR NDS PANRETIN GEL NDS RETIN-A CREA .025%, .05%, .1% PA,MO

RETIN-A GEL .01%, .025% PA,MO RETIN-A MICRO GEL .04%, .1% PA,MO

RETIN-A MICRO PUMP GEL .04%, .1% PA,MO

RETIN-A MICRO PUMP GEL .08% PA,MO

RETIN-A MICRO PUMP GEL PA,NDS TARGRETIN GEL NDS tretinoin crea .025%, .05%, .1% PA,MO tretinoin gel .01%, .025%, .05% PA,MO tretinoin microsphere gel .04%, .1% PA,MO

tretinoin microsphere pump gel .04%, .1% PA,MO

SKIN AND MUCOUS MEMBRANE AGENTS, MISCELLANEOUS ABSORICA CAPS 10mg, 20mg, 25mg, 30mg, 35mg, 40mg NDS

acitretin caps 10mg, 17.5mg, 25mg NDS

ACZONE GEL MO adapalene crea MO adapalene gel .1%, .3% MO adapalene pads MO adapalene soln NDS adapalene-benzoyl peroxide gel MO ALDARA CREA MO ammonium lactate crea MO ammonium lactate lotn MO amnesteem caps 10mg, 20mg, 40mg NDS

azelaic acid gel MO AZELEX CREA MO calcipotriene crea MO




Límites calcipotriene oint MO calcipotriene soln MO CALCITRIOL OINT MO CARAC CREA MO claravis caps 10mg, 20mg, 30mg, 40mg NDS

clindamycin-tretinoin gel MO CONDYLOX GEL MO COSENTYX (300 MG DOSE) SOSY NDS

COSENTYX SENSOREADY (300 MG) SOAJ NDS

dapsone gel MO DIFFERIN CREA MO DIFFERIN GEL .1%, .3% MO DIFFERIN LOTN MO DOVONEX CREA MO DUPIXENT SOSY 200mg/1.14ml, 300mg/2ml NDS

EFUDEX CREA MO ELIDEL CREA MO EPIDUO FORTE GEL MO EPIDUO GEL MO FABIOR FOAM MO FINACEA FOAM MO FINACEA GEL MO FLUOROPLEX CREA fluorouracil crea .5%, 5% MO fluorouracil soln 2%, 5% MO ILUMYA SOSY NDS imiquimod crea MO IMIQUIMOD PUMP CREA MO isotretinoin caps 10mg, 20mg, 30mg, 40mg NDS

methoxsalen rapid caps MO MIRVASO GEL MO myorisan caps 10mg, 20mg, 30mg, 40mg NDS

ORACEA CPDR OXSORALEN ULTRA CAPS MO PICATO GEL .015%, .05% MO pimecrolimus crea MO plixda pads MO


Límites podofilox soln MO PROTOPIC OINT .03%, .1% MO RECTIV OINT MO REGRANEX GEL NDS RHOFADE CREA MO RYNODERM CREA NDS SANTYL OINT MO SILIQ SOSY NDS SKYRIZI (150 MG DOSE) PSKT SORIATANE CAPS 10mg, 17.5mg, 25mg NDS

SORILUX FOAM MO STELARA SOLN 45mg/0.5ml, 130mg/26ml PA,NDS

STELARA SOSY 45mg/0.5ml, 90mg/ml PA,NDS

tacrolimus oint .03%, .1% MO TALTZ SOAJ NDS TALTZ SOSY NDS tazarotene crea PA,MO TAZORAC CREA .05% PA,MO TAZORAC CREA PA,MO TAZORAC GEL .05%, .1% PA,MO TOLAK CREA TREMFYA SOPN TREMFYA SOSY VALCHLOR GEL NDS VECTICAL OINT MO VEREGEN OINT MO XIMINO CP24 45mg, 90mg, 135mg MO

zenatane caps 10mg, 20mg, 30mg, 40mg NDS

ZIANA GEL MO ZYCLARA PUMP CREA 2.5%, 3.75% MO

SMOOTH MUSCLE RELAXANTS SMOOTH MUSCLE RELAXANTS darifenacin hydrobromide er tb24 7.5mg, 15mg MO

DETROL LA CP24 2mg, 4mg MO DETROL TABS 1mg, 2mg MO



Límites DITROPAN XL TB24 5mg, 10mg, 15mg MO

ENABLEX TB24 7.5mg, 15mg MO flavoxate hcl tabs MO GELNIQUE PUMP GEL MO MYRBETRIQ TB24 25mg, 50mg MO oxybutynin chloride er tb24 5mg, 10mg, 15mg MO

oxybutynin chloride syrp MO oxybutynin chloride tabs MO OXYTROL PTTW MO solifenacin succinate tabs 5mg, 10mg MO

theo-24 cp24 100mg, 200mg, 300mg, 400mg MO

theophylline er tb12 100mg, 200mg, 300mg MO

theophylline er tb24 400mg, 600mg MO

theophylline soln MO tolterodine tartrate er cp24 2mg, 4mg MO

tolterodine tartrate tabs MO TOVIAZ TB24 4mg, 8mg MO trospium chloride er cp24 MO trospium chloride tabs MO VESICARE TABS 5mg, 10mg MO VITAMINS VITAMINS calcitriol caps .25mcg, .5mcg PA,MO calcitriol soln PA,MO doxercalciferol caps .5mcg, 1mcg, 2.5mcg PA,MO

HECTOROL CAPS .5mcg, 1mcg, 2.5mcg PA,MO

paricalcitol caps 1mcg, 2mcg, 4mcg PA,MO

RAYALDEE CPCR NDS ROCALTROL CAPS .25mcg, .5mcg PA,MO

ROCALTROL SOLN PA,MO VP-PNV-DHA CAPS MO ZEMPLAR CAPS 1mcg, 2mcg PA,MO


La información que se muestra en la columna Requisitos/Límites le indica si nuestro plan tiene algún requisito especial en la cobertura de su medicamento. Ciertas dosis o presentaciones del medicamento pueden estar sujetas a los códigos de administración de utilización que se indican a continuación. HI = Los medicamentos de infusión intravenosa domiciliaria pueden estar cubiertos por nuestro beneficio médico y obtenerse en las farmacias de infusión intravenosa domiciliaria. Si desea más información, consulte su directorio de farmacias o llame a nuestro plan al número de su región de Kaiser Permanente que aparece en la portada y la contraportada. LD = Los medicamentos de distribución limitada solo se pueden obtener en ciertas farmacias especializadas. Si desea más información, consulte su directorio de farmacias o llame a nuestro plan al número de su región de Kaiser Permanente que aparece en la portada y la contraportada. MO = Medicamentos de pedido por correo. Puede pedir en línea el resurtido de ciertos medicamentos recetados por medio de nuestro servicio de pedidos por correo en kp.org/refill (en inglés), o por teléfono o aplicación móvil, lo cual podría reducir los costos de un suministro de tres meses. Comuníquese con nosotros 10 días antes de que se le terminen los medicamentos. Por lo general, deberá recibirlos en el transcurso de 10 días. Si no los recibe y necesita un resurtido de urgencia, llame al número de

teléfono de pedidos por correo correspondiente a su región de Kaiser Permanente, que figura en el cuadro en la página 6, o al número de teléfono que aparece en la etiqueta del medicamento recetado para solicitar asistencia. Es posible que otros medicamentos estén disponibles para envío por correo. No todos los medicamentos pueden enviarse por correo; hay restricciones y limitaciones. Si desea más información, visite el sitio kp.org/seniormedrx o llame al número de teléfono de la región correspondiente, que figura en la página 5. NDS = Medicamentos con suministro diario no extendido que se entregan en suministros de hasta 30 días para vigilar si se presentan posibles efectos adversos, y para evitar que se desperdicie medicamento.

PA = Los medicamentos con autorización previa pueden estar cubiertos por Medicare Parte D o Medicare Parte B, dependiendo de la manera en que se administran (por ejemplo, por bomba de infusión, nebulizador u otro dispositivo de equipos médicos duraderos), el lugar en donde se administran (por ejemplo, en casa o en un centro de atención a largo plazo) y el tipo de afección médica que se busca tratar con ellos. Es posible que también se requiera autorización previa para los medicamentos en los que el tratamiento de la condición médica es el que determina si el medicamento no está incluido en la Parte D (excluido) o si tiene cobertura.


Índice de medicamentos

7 7T LIDO GEL ........................................... 64

A abacavir sulfate soln ................................ 12 abacavir sulfate tabs ................................ 12 abacavir sulfate-lamivudine tabs .............. 12 abacavir-lamivudine-zidovudine tabs ....... 12 ABELCET SUSP INTRAVENOUS ........... 11 ABILIFY MAINTENA PRSY ..................... 37 ABILIFY MAINTENA SRER ..................... 37 ABILIFY MYCITE TABS 2mg, 5mg, 10mg,

15mg, 20mg, 30mg .............................. 37 ABILIFY TABS 2mg, 5mg, 10mg, 15mg,

20mg, 30mg ......................................... 37 abiraterone acetate tabs .......................... 15 ABRAXANE SUSR .................................. 15 ABSORICA CAPS 10mg, 20mg, 25mg,

30mg, 35mg, 40mg .............................. 64 ABSTRAL SUBL 100mcg, 200mcg,

300mcg, 400mcg, 600mcg, 800mcg .... 27 acamprosate calcium tbec ....................... 27 ACANYA GEL .......................................... 60 acarbose tabs 25mg, 50mg, 100mg ........ 51 ACCOLATE TABS 10mg, 20mg .............. 58 ACCUPRIL TABS 5mg, 10mg, 20mg, 40mg

............................................................. 26 ACCURETIC TABS ................................. 26 acebutolol hcl caps 200mg, 400mg ......... 23 acetaminophen-codeine #3 tabs .............. 27 acetaminophen-codeine soln ................... 27 acetaminophen-codeine tabs ................... 27 acetazolamide er cp12 ............................. 45 acetazolamide tabs 125mg, 250mg ......... 45 acetic acid soln .................................. 44, 45 acetylcysteine soln 10%, 20% ................. 56 ACIPHEX SPRINKLE CPSP 5mg, 10mg . 46 ACIPHEX TBEC ...................................... 46 acitretin caps 10mg, 17.5mg, 25mg ......... 64 ACTEMRA ACTPEN SOAJ ..................... 56 ACTEMRA SOSY .................................... 56 ACTHAR GEL .......................................... 54 ACTHIB SOLR ......................................... 60 ACTIGALL CAPS .................................... 47

ACTIMMUNE SOLN ................................. 57 ACTIQ LPOP 200mcg .............................. 27 ACTIQ LPOP 400mcg, 600mcg, 800mcg,

1200mcg, 1600mcg .............................. 27 ACTIVELLA TABS ................................... 53 ACTONEL TABS 5mg, 30mg, 35mg, 150mg

............................................................. 56 ACTOPLUS MET TABS ........................... 51 ACTOPLUS MET XR TB24 ...................... 51 ACTOS TABS 15mg, 30mg, 45mg ........... 51 ACULAR LS SOLN .................................. 44 ACULAR SOLN ........................................ 44 ACUVAIL SOLN ....................................... 44 acyclovir caps .......................................... 12 acyclovir crea ........................................... 60 acyclovir oint ............................................ 60 acyclovir sodium soln intravenous ............ 12 acyclovir susp .......................................... 12 acyclovir tabs 400mg, 800mg ................... 12 ACZONE GEL .......................................... 64 ADACEL SUSP ........................................ 60 ADAGEN SOLN ....................................... 43 ADALAT CC TB24 30mg, 60mg, 90mg .... 24 adapalene crea ........................................ 64 adapalene gel .1%, .3% .......................... 64 adapalene pads ....................................... 64 adapalene soln ......................................... 64 adapalene-benzoyl peroxide gel .............. 64 ADCIRCA TABS....................................... 27 adderall tabs ............................................ 31 ADDERALL XR CP24 .............................. 31 adefovir dipivoxil tabs ............................... 12 ADEMPAS TABS .5mg, 1mg, 1.5mg, 2mg,

2.5mg ................................................... 59 ADHANSIA XR CP24 25mg, 35mg, 45mg,

55mg, 70mg, 85mg .............................. 31 ADLYXIN SOPN....................................... 51 ADLYXIN STARTER PACK PNKT ........... 51 ADMELOG SOLN .................................... 51 ADMELOG SOLOSTAR SOPN ................ 51 ADVAIR DISKUS AEPB ........................... 20 ADVAIR HFA AERO ................................ 20 ADZENYS ER SUER ............................... 31 ADZENYS XR-ODT TBED 3.1mg, 6.3mg,

9.4mg, 12.5mg, 15.7mg, 18.8mg .......... 31 afeditab cr tb24 30mg, 60mg .................... 24


AFINITOR DISPERZ TBSO 2mg, 3mg, 5mg ............................................................. 15

AFINITOR TABS 2.5mg, 5mg, 7.5mg, 10mg ............................................................. 15

AFREZZA POWD .................................... 51 AFREZZA POWD 8 (90) & 12 (90) UNIT . 51 AGGRENOX CP12 .................................. 21 AGRYLIN CAPS ...................................... 21 AIMOVIG SOAJ ....................................... 34 AIRDUO RESPICLICK 113/14 AEPB ...... 20 AIRDUO RESPICLICK 232/14 AEPB ...... 20 AIRDUO RESPICLICK 55/14 AEPB ........ 20 AJOVY SOSY .......................................... 34 AKTIPAK PACK ....................................... 60 AKYNZEO CAPS ..................................... 46 ala scalp lotn ............................................ 62 ala-cort crea 1%, 2.5% ............................ 62 albendazole tabs ....................................... 8 ALBENZA TABS ........................................ 8 albuterol sulfate er tb12 4mg, 8mg .......... 20 ALBUTEROL SULFATE HFA AERS ....... 20 albuterol sulfate hfa aers 108mcg/act ...... 20 albuterol sulfate nebu .083%, .5% ........... 20 albuterol sulfate nebu .63mg/3ml,

1.25mg/3ml .......................................... 20 albuterol sulfate syrp ................................ 20 albuterol sulfate tabs 2mg, 4mg ............... 20 alclometasone dipropionate crea ............. 62 alclometasone dipropionate oint .............. 62 ALCOHOL PREP PADS .......................... 40 ALDACTAZIDE TABS .............................. 26 ALDACTONE TABS 25mg, 50mg, 100mg26 ALDARA CREA ....................................... 64 ALDURAZYME SOLN ............................. 43 ALECENSA CAPS ................................... 15 alendronate sodium soln .......................... 56 alendronate sodium tabs 40mg ................ 56 alendronate sodium tabs 5mg, 10mg,

35mg, 70mg ......................................... 56 alfuzosin hcl er tb24 ................................. 20 ALIMTA SOLR ......................................... 15 ALINIA SUSR .......................................... 12 ALINIA TABS ........................................... 12 ALIQOPA SOLR ...................................... 15 aliskiren fumarate tabs 150mg, 300mg .... 26 allopurinol tabs 100mg, 300mg ................ 56 allzital tabs ............................................... 27 almotriptan malate tabs ........................... 34 ALOCRIL SOLN ...................................... 45

alogliptin benzoate tabs 6.25mg, 12.5mg, 25mg .................................................... 51

ALOGLIPTIN-METFORMIN HCL TABS ... 51 alogliptin-pioglitazone tabs ....................... 51 ALOMIDE SOLN ...................................... 45 ALORA

PTTW .025mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr .................................... 53

alosetron hcl tabs .5mg, 1mg ................... 46 ALPHAGAN P SOLN .1%, .15% .............. 45 alprazolam er tb24 .5mg, 1mg, 2mg, 3mg 35 alprazolam intensol conc .......................... 35 alprazolam tabs .25mg, .5mg, 1mg, 2mg . 35 alprazolam tbdp .25mg, .5mg, 1mg, 2mg . 35 ALREX SUSP .......................................... 44 ALTACE CAPS 1.25mg, 2.5mg, 5mg, 10mg

............................................................. 26 altavera tabs ............................................ 49 ALTOPREV TB24 20mg, 40mg, 60mg ..... 22 ALTRENO LOTN...................................... 64 ALUNBRIG TABS 30mg, 90mg, 180mg ... 15 ALUNBRIG TBPK .................................... 15 ALVESCO AERS 80mcg/act, 160mcg/act 58 alyacen 1/35 tabs ..................................... 49 alyq tabs................................................... 27 amabelz tabs ............................................ 53 amantadine hcl caps ................................ 34 amantadine hcl syrp ................................. 34 amantadine hcl tabs ................................. 34 AMARYL TABS 1mg, 2mg, 4mg .............. 51 AMBIEN CR TBCR 6.25mg, 12.5mg ........ 35 AMBIEN TABS 5mg, 10mg ...................... 35 AMBISOME SUSR INTRAVENOUS ........ 11 ambrisentan tabs 5mg, 10mg ................... 59 amcinonide crea ....................................... 62 amcinonide lotn ........................................ 62 amcinonide oint ........................................ 62 AMERGE TABS ....................................... 34 amethia lo tabs ......................................... 49 amethia tabs ............................................ 49 AMICAR TABS ......................................... 21 amikacin sulfate soln injection .................... 8 amiloride hcl tabs ..................................... 41 amiloride-hydrochlorothiazide tabs ........... 41 AMINOSYN II SOLN INTRAVENOUS ...... 41 AMINOSYN II/ELECTROLYTES SOLN

INTRAVENOUS ................................... 41 AMINOSYN/ELECTROLYTES SOLN

INTRAVENOUS 7% ............................. 41


AMINOSYN/ELECTROLYTES SOLN INTRAVENOUS 8.5% .......................... 41

AMINOSYN-HBC SOLN INTRAVENOUS 41 AMINOSYN-PF SOLN INTRAVENOUS .. 41 AMINOSYN-RF SOLN INTRAVENOUS .. 41 amiodarone hcl tabs 100mg, 200mg,

400mg .................................................. 25 AMITIZA CAPS 8mcg, 24mcg ................. 47 amitriptyline hcl tabs 10mg, 25mg, 50mg,

75mg, 100mg, 150mg .......................... 37 amlodipine besy-benazepril hcl caps ....... 24 amlodipine besylate tabs 2.5mg, 5mg,

10mg .................................................... 24 amlodipine besylate-valsartan tabs .......... 24 amlodipine-atorvastatin tabs .................... 24 amlodipine-olmesartan tabs ..................... 24 amlodipine-valsartan-hctz tabs ................ 24 ammonium lactate crea ........................... 64 ammonium lactate lotn ............................. 64 amnesteem caps 10mg, 20mg, 40mg ...... 64 amoxapine tabs 25mg, 50mg, 100mg,

150mg .................................................. 37 amoxicill-clarithro-lansopraz misc ............ 46 amoxicillin caps ......................................... 8 amoxicillin chew ......................................... 8 amoxicillin susr .......................................... 8 amoxicillin tabs .......................................... 8 amoxicillin-pot clavulanate chew ................ 8 amoxicillin-pot clavulanate er tb12 ............. 8 amoxicillin-pot clavulanate susr ................. 8 amoxicillin-pot clavulanate tabs ................. 8 amphetamine sulfate tabs 5mg, 10mg ..... 31 amphetamine-dextroamphet er cp24 ....... 31 amphetamine-dextroamphetamine tabs ... 31 amphotericin b solr intravenous ............... 11 ampicillin caps ........................................... 8 ampicillin sodium solr injection 1gm, 125mg

............................................................... 8 ampicillin sodium solr intravenous ............. 8 ampicillin-sulbactam sodium solr injection . 8 AMPYRA TB12 ........................................ 36 AMRIX CP24 15mg, 30mg ...................... 19 ANADROL-50 TABS ................................ 48 ANAFRANIL CAPS 25mg, 50mg, 75mg .. 37 anagrelide hcl caps .5mg, 1mg ................ 21 anastrozole tabs ...................................... 15 ANCOBON CAPS 250mg, 500mg ........... 11 ANDRODERM PT24 2mg/24hr, 4mg/24hr

............................................................. 48

ANDROGEL GEL 20.25mg/1.25gm, 25mg/2.5gm, 40.5mg/2.5gm, 50mg/5gm ............................................................. 49

ANDROGEL PUMP GEL ......................... 49 ANGELIQ TABS ....................................... 53 ANORO ELLIPTA AEPB .......................... 18 antabuse tabs 250mg, 500mg .................. 27 ANTARA CAPS 30mg, 90mg ................... 22 anusol-hc crea ......................................... 62 ANZEMET TABS 50mg, 100mg ............... 46 APADAZ TABS ........................................ 27 apexicon e crea ........................................ 62 APIDRA SOLN ......................................... 51 APIDRA SOLOSTAR SOPN .................... 51 APLENZIN TB24 174mg, 348mg, 522mg 37 APOKYN SOCT ....................................... 34 apraclonidine hcl soln ............................... 45 aprepitant caps ........................................ 46 apri tabs ................................................... 49 APRISO CP24 ......................................... 46 APTENSIO XR CP24 10mg, 15mg, 20mg,

30mg, 40mg, 50mg, 60mg .................... 31 APTIOM TABS 200mg, 400mg, 600mg,

800mg .................................................. 32 APTIVUS CAPS ....................................... 12 APTIVUS SOLN ....................................... 12 ARALAST NP SOLR INTRAVENOUS

500mg, 1000mg ................................... 58 aranelle tabs ............................................ 49 ARANESP (ALBUMIN FREE) SOLN

25mcg/ml, 40mcg/ml, 60mcg/ml, 100mcg/ml, 200mcg/ml, 300mcg/ml ..... 21

ARAVA TABS 10mg, 20mg ...................... 56 ARCALYST SOLR ................................... 57 ARCAPTA NEOHALER CAPS ................. 20 ARICEPT TABS 5mg, 10mg, 23mg.......... 19 ARIKAYCE SUSP ...................................... 8 ARIMIDEX TABS ..................................... 15 aripiprazole soln ....................................... 37 aripiprazole tabs 2mg, 5mg, 10mg, 15mg,

20mg, 30mg ......................................... 37 aripiprazole tbdp 10mg, 15mg .................. 37 ARISTADA INITIO PRSY ......................... 37 ARISTADA PRSY 441mg/1.6ml,

662mg/2.4ml, 882mg/3.2ml, 1064mg/3.9ml ....................................... 37

ARIXTRA SOLN 2.5mg/0.5ml .................. 21 ARIXTRA SOLN 5mg/0.4ml, 7.5mg/0.6ml,

10mg/0.8ml .......................................... 21


armodafinil tabs 50mg, 150mg, 200mg, 250mg .................................................. 31

ARMONAIR RESPICLICK 113 AEPB ...... 58 ARMONAIR RESPICLICK 232 AEPB ...... 58 ARMONAIR RESPICLICK 55 AEPB ........ 58 ARNUITY ELLIPTA AEPB 50mcg/act,

100mcg/act, 200mcg/act ...................... 58 AROMASIN TABS ................................... 15 ARRANON SOLN .................................... 15 ARTHROTEC TBEC ................................ 27 ARYMO ER TBEA ................................... 27 ARYMO ER TBEA 15mg, 30mg .............. 27 ARZERRA CONC 1000mg/50ml,

100mg/5ml ........................................... 15 ASACOL HD TBEC ................................. 46 ascomp-codeine caps .............................. 27 ashlyna tabs ............................................ 49 ASMANEX (120 METERED DOSES) AEPB

............................................................. 59 ASMANEX (30 METERED DOSES) AEPB

............................................................. 59 ASMANEX (30 METERED DOSES) AEPB

110mcg/inh .......................................... 59 ASMANEX (60 METERED DOSES) AEPB

............................................................. 59 ASMANEX HFA AERO 100mcg/act,

200mcg/act .......................................... 59 aspirin-dipyridamole er cp12 .................... 21 ASTAGRAF XL CP24 .............................. 57 ASTAGRAF XL CP24 .5mg, 1mg ............ 57 ASTEPRO SOLN ..................................... 45 ATACAND HCT TABS ............................. 26 ATACAND TABS 4mg, 8mg, 16mg, 32mg

............................................................. 26 atazanavir sulfate caps 150mg, 200mg,

300mg .................................................. 12 ATELVIA TBEC ....................................... 56 atenolol tabs 25mg, 50mg, 100mg ........... 23 atenolol-chlorthalidone tabs ..................... 23 ATIVAN SOLN 2mg/ml, 4mg/ml ............... 35 ATIVAN TABS .5mg, 1mg, 2mg ............... 35 atomoxetine hcl caps 10mg, 18mg, 25mg,

40mg, 60mg, 80mg, 100mg ................. 36 atorvastatin calcium tabs 10mg, 20mg,

40mg, 80mg ......................................... 22 atovaquone susp ..................................... 12 atovaquone-proguanil hcl tabs ................. 12 ATRALIN GEL ......................................... 64 ATRIPLA TABS ....................................... 12 ATROPINE SULFATE SOLN................... 45

ATROVENT HFA AERS ........................... 18 AUBAGIO TABS 7mg, 14mg .................... 36 aubra tabs ................................................ 49 AUGMENTIN SUSR ................................... 8 AURYXIA TABS ....................................... 42 AUSTEDO TABS 6mg, 9mg, 12mg .......... 36 AUVI-Q

SOAJ .15mg/0.15ml, .1mg/0.1ml, .3mg/0.3ml ....................................................... 20

AVALIDE TABS ....................................... 26 AVANDIA TABS 2mg, 4mg ...................... 51 AVAPRO TABS 75mg, 150mg, 300mg .... 26 AVASTIN SOLN ....................................... 15 AVC VAGINAL CREA .............................. 60 AVEED SOLN .......................................... 49 AVELOX SOLN INTRAVENOUS ............... 8 AVELOX TABS .......................................... 8 aviane tabs ............................................... 49 AVITA CREA ............................................ 64 AVITA GEL .............................................. 64 AVODART CAPS ..................................... 56 AVONEX KIT ........................................... 36 AVONEX PEN AJKT ................................ 36 AVONEX PREFILLED PSKT ................... 36 AVYCAZ SOLR INTRAVENOUS ............... 8 AXERT TABS ........................................... 34 aygestin tabs ............................................ 54 AZACTAM SOLR INJECTION 1gm, 2gm ... 8 azasan tabs 75mg, 100mg ....................... 57 AZASITE SOLN ....................................... 43 azathioprine tabs ...................................... 57 azelaic acid gel ........................................ 64 azelastine hcl soln .05%, .1%, .15%......... 45 AZELEX CREA ........................................ 64 AZILECT TABS .5mg, 1mg ...................... 34 AZITHROMYCIN PACK ............................. 8 azithromycin solr intravenous ..................... 8 azithromycin susr 100mg/5ml, 200mg/5ml . 8 azithromycin tabs 250mg, 500mg, 600mg .. 8 AZOPT SUSP .......................................... 45 AZOR TABS ............................................. 24 aztreonam solr injection ............................. 8 AZULFIDINE EN-TABS TBEC ................... 8 AZULFIDINE TABS .................................... 8

B bacitracin oint ........................................... 43 bacitracin-polymyxin b oint ....................... 43 bacitra-neomycin-polymyxin-hc oint ......... 44 baclofen tabs 5mg, 10mg, 20mg .............. 19


BACTOCILL IN DEXTROSE SOLN INTRAVENOUS ..................................... 8

BACTRIM DS TABS .................................. 8 BACTRIM TABS ........................................ 8 BACTROBAN CREA ............................... 60 BACTROBAN NASAL OINT .................... 60 balsalazide disodium caps ....................... 46 BALVERSA TABS 3mg, 4mg, 5mg .......... 15 balziva tabs .............................................. 49 BANZEL SUSP ........................................ 32 BANZEL TABS 200mg, 400mg ................ 32 BAQSIMI TWO PACK POWD .................. 51 BARACLUDE SOLN ................................ 12 BARACLUDE TABS ................................ 12 BASAGLAR KWIKPEN SOPN ................. 51 BAVENCIO SOLN ................................... 15 BAXDELA SOLR INTRAVENOUS ............. 8 BAXDELA TABS ........................................ 8 BCG VACCINE INJ.................................. 15 BD INSULIN SYRINGE MISC.................. 40 BD INSULIN SYRINGE U/F MISC ........... 40 BD PEN NEEDLE ORIGINAL U/F MISC . 40 BD SAFETY-LOK INSULIN SYRINGE

MISC .................................................... 40 BECONASE AQ SUSP ............................ 44 BELBUCA FILM 75mcg, 150mcg, 300mcg,

450mcg, 600mcg, 750mcg, 900mcg .... 27 BELEODAQ SOLR .................................. 15 BELSOMRA TABS .................................. 35 benazepril hcl tabs 5mg, 10mg, 20mg,

40mg .................................................... 26 benazepril-hydrochlorothiazide tabs ........ 26 BENICAR HCT TABS .............................. 26 BENICAR TABS 5mg, 20mg, 40mg ......... 26 BENLYSTA SOAJ ................................... 57 BENLYSTA SOLR ................................... 57 BENLYSTA SOSY ................................... 57 BENZACLIN WITH PUMP GEL ............... 60 BENZAMYCIN GEL ................................. 60 BENZNIDAZOLE TABS 12.5mg, 100mg . 12 BENZOYL PEROXIDE FORTE- HC LOTN

............................................................. 62 BENZOYL PEROXIDE GEL .................... 60 benzoyl peroxide-erythromycin gel .......... 61 benztropine mesylate tabs .5mg, 1mg, 2mg

............................................................. 34 BEPREVE SOLN ..................................... 45 BERINERT KIT INTRAVENOUS ............ 20 beser lotn ................................................. 62

BESIVANCE SUSP .................................. 43 BESPONSA SOLR ................................... 15 BETAGAN SOLN ..................................... 45 betamethasone dipropionate aug crea ..... 62 betamethasone dipropionate aug gel ....... 62 betamethasone dipropionate aug lotn ...... 62 betamethasone dipropionate aug oint ...... 62 betamethasone dipropionate crea ............ 62 betamethasone dipropionate lotn ............. 62 betamethasone dipropionate oint ............. 62 betamethasone valerate crea ................... 62 betamethasone valerate foam .................. 62 betamethasone valerate lotn .................... 62 betamethasone valerate oint .................... 62 BETAPACE AF TABS 80mg, 120mg,

160mg .................................................. 23 BETASERON KIT .................................... 36 betaxolol hcl soln...................................... 45 betaxolol hcl tabs 10mg, 20mg ................. 23 bethanechol chloride tabs 5mg, 10mg,

25mg, 50mg ......................................... 19 BETHKIS NEBU ......................................... 8 BETIMOL SOLN .25%, .5% ..................... 45 BETOPTIC-S SUSP ................................. 45 BEVESPI AEROSPHERE AERO ............. 18 BEVYXXA CAPS 40mg, 80mg ................. 21 bexarotene caps ...................................... 15 BEXSERO SUSY ..................................... 60 BEYAZ TABS ........................................... 49 bicalutamide tabs ..................................... 15 BICILLIN C-R 900/300 SUSP ..................... 8 BICILLIN C-R SUSP .................................. 8 BICILLIN L-A SUSP ................................... 8 BICNU SOLR ........................................... 15 BIDIL TABS .............................................. 27 BIJUVA CAPS .......................................... 53 BIKTARVY TABS ..................................... 12 BILTRICIDE TABS ..................................... 8 bimatoprost soln ....................................... 45 BINOSTO TBEF ....................................... 56 bisoprolol fumarate tabs 5mg, 10mg ........ 23 bisoprolol-hydrochlorothiazide tabs .......... 23 BIVIGAM SOLN INTRAVENOUS ............. 59 bleph-10 soln ........................................... 43 blephamide s.o.p. oint .............................. 44 BLEPHAMIDE SUSP ............................... 44 BLINCYTO SOLR .................................... 15 blisovi 24 fe tabs ...................................... 49 blisovi fe 1.5/30 tabs ................................ 49


blisovi fe 1/20 tabs ................................... 49 BONIVA TABS ......................................... 56 BONJESTA TBCR ................................... 46 BOOSTRIX SUSP ................................... 60 BORTEZOMIB SOLR .............................. 15 bosentan tabs 62.5mg, 125mg ................ 59 BOSULIF TABS 100mg, 400mg, 500mg . 15 BOTOX SOLR 100unit, 200unit ............... 57 BRAFTOVI CAPS 50mg, 75mg ............... 15 BREO ELLIPTA AEPB ............................. 48 briellyn tabs ............................................. 49 BRILINTA TABS 60mg, 90mg ................. 21 BRIMONIDINE TARTRATE SOLN .15% . 45 brimonidine tartrate soln .2% ................... 45 BRISDELLE CAPS .................................. 37 BRIVIACT SOLN ..................................... 32 BRIVIACT TABS 10mg, 25mg, 50mg,

75mg, 100mg ....................................... 32 bromfenac sodium (once-daily) soln ........ 44 bromocriptine mesylate caps ................... 34 bromocriptine mesylate tabs .................... 34 BROMSITE SOLN ................................... 44 BROVANA NEBU .................................... 20 BRYHALI LOTN ....................................... 62 budesonide cpep ..................................... 48 budesonide er tb24 .................................. 48 budesonide susp .25mg/2ml, .5mg/2ml,

1mg/2ml ............................................... 59 bumetanide soln ...................................... 41 bumetanide tabs .5mg, 1mg, 2mg ........... 41 BUNAVAIL FILM ...................................... 37 bupap tabs ............................................... 27 BUPHENYL POWD ................................. 40 BUPHENYL TABS ................................... 40 BUPRENEX SOLN .................................. 37 buprenorphine hcl soln ............................ 37 buprenorphine hcl subl 2mg, 8mg ............ 37 buprenorphine hcl-naloxone hcl film ........ 37 buprenorphine hcl-naloxone hcl subl ....... 37 buprenorphine ptwk 5mcg/hr, 7.5mcg/hr,

10mcg/hr, 15mcg/hr, 20mcg/hr ............ 27 bupropion hcl er (smoking det) tb12 ........ 37 bupropion hcl er (sr) tb12 100mg, 150mg,

200mg .................................................. 37 bupropion hcl er (xl) tb24 150mg, 300mg,

450mg .................................................. 37 bupropion hcl tabs 75mg, 100mg ............. 37 buspirone hcl tabs ................................... 35 buspirone hcl tabs 5mg, 10mg ................. 35 butalbital-acetaminophen caps ................ 27

butalbital-acetaminophen tabs ................. 27 butalbital-apap-caff-cod caps ................... 27 butalbital-apap-caffeine caps ................... 27 butalbital-apap-caffeine tabs .................... 27 butalbital-asa-caff-codeine caps ............... 27 butalbital-aspirin-caffeine caps ................. 28 BUTISOL SODIUM TABS ........................ 35 butorphanol tartrate soln 1mg/ml, 2mg/ml,

10mg/ml ............................................... 28 BUTRANS PTWK 5mcg/hr, 7.5mcg/hr,

10mcg/hr, 15mcg/hr, 20mcg/hr ............. 28 BYDUREON BCISE AUIJ ........................ 51 BYDUREON PEN .................................... 51 BYDUREON SRER .................................. 51 BYETTA 10 MCG PEN SOPN ................. 51 BYETTA 5 MCG PEN SOPN ................... 51 BYSTOLIC TABS 2.5mg, 5mg, 10mg, 20mg

............................................................. 23 BYVALSON TABS ................................... 26

C cabergoline tabs ....................................... 34 CABLIVI KIT ............................................. 21 CABOMETYX TABS 20mg, 40mg, 60mg . 15 CADUET TABS ........................................ 24 cafergot tabs ............................................ 34 CALAN SR TBCR 120mg, 240mg ............ 24 CALAN TABS 80mg, 120mg .................... 24 calcipotriene crea ..................................... 64 calcipotriene oint ...................................... 65 calcipotriene soln ..................................... 65 calcipotriene-betameth diprop oint ........... 62 calcitonin (salmon) soln ............................ 54 calcitriol caps .25mcg, .5mcg ................... 66 CALCITRIOL OINT .................................. 65 calcitriol soln ............................................ 66 calcium acetate (phos binder) caps .......... 42 calcium acetate (phos binder) tabs .......... 42 CALQUENCE CAPS ................................ 15 CAMBIA PACK ........................................ 34 camila tabs ............................................... 49 camrese lo tabs ........................................ 49 CANASA SUPP ....................................... 46 CANCIDAS SOLR INTRAVENOUS 50mg,

70mg .................................................... 11 candesartan cilexetil tabs 4mg, 8mg, 16mg,

32mg .................................................... 26 candesartan cilexetil-hctz tabs ................. 26 CAPASTAT SULFATE SOLR .................. 11 CAPEX SHAM ......................................... 62


capital/codeine susp ................................ 28 CAPRELSA TABS 100mg, 300mg .......... 15 captopril tabs 12.5mg, 25mg, 50mg, 100mg

............................................................. 26 captopril-hydrochlorothiazide tabs ........... 26 CARAC CREA ......................................... 65 CARAFATE SUSP ................................... 46 CARAFATE TABS ................................... 46 CARBAGLU TABS................................... 40 carbamazepine chew ............................... 32 carbamazepine er cp12 100mg, 200mg,

300mg .................................................. 32 carbamazepine er tb12 100mg, 200mg,

400mg .................................................. 32 carbamazepine susp ................................ 32 carbamazepine tabs ................................ 32 CARBATROL CP12 100mg, 200mg, 300mg

............................................................. 32 carbidopa tabs ......................................... 34 carbidopa-levodopa er tbcr ...................... 34 carbidopa-levodopa tabs ......................... 34 carbidopa-levodopa tbdp ......................... 34 carbidopa-levodopa-entacapone tabs ...... 34 carbinoxamine maleate soln .................... 15 carbinoxamine maleate tabs .................... 15 CARDENE IV SOLN ................................ 24 CARDIZEM CD CP24 120mg, 180mg,

240mg, 300mg, 360mg ........................ 24 CARDIZEM LA TB24 120mg, 180mg,

240mg, 300mg, 360mg, 420mg ........... 24 CARDIZEM TABS 30mg, 60mg, 120mg .. 24 CARDURA TABS 1mg, 2mg, 4mg, 8mg .. 22 CARDURA XL TB24 4mg, 8mg ............... 22 CARIMUNE NF SOLR INTRAVENOUS .. 59 carisoprodol tabs 250mg, 350mg ............. 19 carisoprodol-aspirin tabs .......................... 19 carisoprodol-aspirin-codeine tabs ............ 19 CARNITOR SOLN ................................... 57 CARNITOR TABS.................................... 57 CAROSPIR SUSP ................................... 26 carteolol hcl soln ...................................... 45 cartia xt cp24 120mg, 180mg, 240mg,

300mg .................................................. 24 carvedilol phosphate er cp24 10mg, 20mg,

40mg, 80mg ......................................... 23 carvedilol tabs 3.125mg, 6.25mg, 12.5mg,

25mg .................................................... 23 CASODEX TABS ..................................... 15

CASPOFUNGIN ACETATE SOLR INTRAVENOUS 50mg, 70mg, 50mg, 70mg .................................................... 11

CATAPRES TABS .1mg, .2mg, .3mg ....... 25 CATAPRES-TTS-1 PTWK ....................... 25 CATAPRES-TTS-2 PTWK ....................... 25 CATAPRES-TTS-3 PTWK ....................... 25 CAYSTON SOLR ..................................... 58 caziant tabs .............................................. 49 cefaclor caps .............................................. 8 cefaclor er tb12 .......................................... 8 cefaclor susr ............................................... 8 cefadroxil caps ........................................... 8 cefadroxil susr ............................................ 8 cefadroxil tabs ............................................ 8 cefazolin sodium solr injection 1gm, 10gm,

500mg .................................................... 8 cefdinir caps ............................................... 8 cefdinir susr ................................................ 8 cefepime hcl solr injection 1gm, 2gm ......... 8 cefixime caps ............................................. 8 cefixime susr .............................................. 8 cefotaxime sodium solr injection 1gm, 2gm,

500mg .................................................... 8 cefotetan disodium solr injection 1gm, 2gm 8 cefoxitin sodium solr injection ..................... 8 cefoxitin sodium solr intravenous 1gm, 2gm

............................................................... 8 cefpodoxime proxetil susr .......................... 8 cefpodoxime proxetil tabs .......................... 8 cefprozil susr .............................................. 8 cefprozil tabs .............................................. 8 ceftazidime solr injection 1gm, 2gm, 6gm .. 8 CEFTIN SUSR ........................................... 8 ceftriaxone sodium solr injection 1gm, 2gm,

250mg, 500mg ....................................... 8 ceftriaxone sodium solr intravenous 10gm . 8 cefuroxime axetil tabs ................................ 8 cefuroxime sodium solr injection 7.5gm,

750mg .................................................... 9 cefuroxime sodium solr intravenous ........... 9 CELEBREX CAPS ................................... 28 celecoxib caps ......................................... 28 CELEXA TABS 10mg, 20mg, 40mg ......... 37 CELLCEPT CAPS .................................... 57 CELLCEPT SUSR .................................... 57 CELLCEPT TABS .................................... 57 CELONTIN CAPS .................................... 32 cephalexin caps ......................................... 9


cephalexin susr .......................................... 9 cephalexin tabs .......................................... 9 CERDELGA CAPS .................................. 43 CEREZYME SOLR .................................. 43 CESAMET CAPS .................................... 46 cetirizine hcl soln ..................................... 15 CETRAXAL SOLN ................................... 43 cevimeline hcl caps.................................. 19 CHANTIX CONTINUING MONTH PAK

TABS ................................................... 19 CHANTIX STARTING MONTH PAK TABS

............................................................. 19 CHANTIX TABS .5mg, 1mg ..................... 19 CHEMET CAPS ....................................... 48 chenodal tabs .......................................... 47 chlordiazepoxide hcl caps 5mg, 10mg,

25mg .................................................... 35 chlordiazepoxide-amitriptyline tabs .......... 37 chlorhexidine gluconate soln.................... 43 chloroquine phosphate tabs ..................... 12 chlorothiazide tabs 250mg, 500mg .......... 41 chlorpromazine hcl tabs 10mg, 25mg,

50mg, 100mg, 200mg .......................... 37 chlorpropamide tabs 100mg, 250mg ....... 51 chlorthalidone tabs 25mg, 50mg .............. 41 chlorzoxazone tabs .................................. 19 chlorzoxazone tabs 375mg, 500mg, 750mg

............................................................. 19 CHOLBAM CAPS 50mg, 250mg ............. 47 cholestyramine light powd ....................... 22 cholestyramine pack ................................ 22 CHORIONIC GONADOTROPIN SOLR ... 54 CIALIS TABS 2.5mg, 5mg ....................... 27 ciclopirox gel ............................................ 61 ciclopirox olamine crea ............................ 61 ciclopirox olamine susp ............................ 61 ciclopirox sham ........................................ 61 ciclopirox soln .......................................... 61 cilostazol tabs 50mg, 100mg ................... 21 CILOXAN OINT ....................................... 43 CILOXAN SOLN ...................................... 43 CIMDUO TABS ........................................ 12 cimetidine hcl soln ................................... 46 cimetidine tabs 200mg, 300mg, 400mg,

800mg .................................................. 46 CIMZIA KIT .............................................. 56 CIMZIA PREFILLED KIT ......................... 56 CIMZIA STARTER KIT KIT ...................... 56 cinacalcet hcl tabs 30mg, 60mg, 90mg .... 54 CINQAIR SOLN ....................................... 58

CINRYZE SOLR INTRAVENOUS ............ 20 CIPRO HC SUSP ..................................... 44 CIPRO SUSR ............................................. 9 CIPRO TABS ............................................. 9 CIPRODEX SUSP .................................... 44 ciprofloxacin hcl soln (ophth) ................... 43 CIPROFLOXACIN HCL SOLN (OTIC) ..... 43 ciprofloxacin hcl tabs .................................. 9 ciprofloxacin in d5w soln intravenous ......... 9 ciprofloxacin soln intravenous .................... 9 ciprofloxacin susr ....................................... 9 ciprofloxacin-ciproflox hcl er tb24 ............... 9 CISPLATIN SOLR .................................... 15 citalopram hydrobromide soln .................. 37 citalopram hydrobromide tabs 10mg, 20mg,

40mg .................................................... 37 claravis caps 10mg, 20mg, 30mg, 40mg .. 65 CLARINEX SYRP .................................... 15 CLARINEX TABS ..................................... 15 CLARINEX-D 12 HOUR TB12 ................. 15 clarithromycin er tb24 ................................. 9 clarithromycin susr ..................................... 9 clarithromycin tabs ..................................... 9 clemastine fumarate tabs ......................... 15 CLENPIQ SOLN....................................... 47 CLEOCIN CAPS ........................................ 9 CLEOCIN CREA ...................................... 61 CLEOCIN IN D5W SOLN INTRAVENOUS 9 CLEOCIN PHOSPHATE SOLN INJECTION

............................................................... 9 cleocin solr ................................................. 9 CLEOCIN SUPP ...................................... 61 CLEOCIN-T GEL...................................... 61 CLEOCIN-T LOTN ................................... 61 CLEOCIN-T SOLN ................................... 61 CLEOCIN-T SWAB .................................. 61 CLIMARA PRO PTWK ............................. 53 CLIMARA PTWK

37.5mcg/24hr, .025mg/24hr, .05mg/24hr, .06mg/24hr, .075mg/24hr, .1mg/24hr ... 53

clindacin-p swab ...................................... 61 CLINDAGEL GEL..................................... 61 clindamycin hcl caps .................................. 9 clindamycin palmitate hcl solr ..................... 9 clindamycin phos-benzoyl perox gel......... 61 clindamycin phosphate crea ..................... 61 clindamycin phosphate foam .................... 61 clindamycin phosphate gel ....................... 61 clindamycin phosphate in d5w soln

intravenous ............................................. 9


clindamycin phosphate lotn ..................... 61 clindamycin phosphate soln ................. 9, 61 clindamycin phosphate soln injection

300mg/2ml, 600mg/4ml, 900mg/6ml ...... 9 clindamycin phosphate swab ................... 61 clindamycin-tretinoin gel .......................... 65 CLINDESSE CREA ................................. 61 CLINIMIX E/DEXTROSE (2.75/10) SOLN

INTRAVENOUS ................................... 41 CLINIMIX E/DEXTROSE (2.75/5) SOLN




INTRAVENOUS ................................... 41 CLINIMIX E/DEXTROSE (5/15) SOLN



INTRAVENOUS ................................... 41 CLINIMIX/DEXTROSE (2.75/5) SOLN





INTRAVENOUS ................................... 41 CLINIMIX/DEXTROSE (5/15) SOLN



INTRAVENOUS ................................... 41 clinisol sf soln intravenous ....................... 41 clobazam susp ......................................... 32 clobazam tabs 10mg, 20mg ..................... 32 clobetasol prop emollient base crea ........ 62 clobetasol propionate crea ....................... 62 clobetasol propionate emulsion foam ...... 62 clobetasol propionate foam ...................... 62 clobetasol propionate gel ......................... 62 clobetasol propionate liqd ........................ 62 clobetasol propionate lotn ........................ 62

clobetasol propionate oint ........................ 62 clobetasol propionate sham ..................... 62 clobetasol propionate soln ....................... 62 CLOBEX LOTN ........................................ 62 CLOBEX SHAM ....................................... 62 CLOBEX SPRAY LIQD ............................ 62 clocortolone pivalate pump crea ............... 62 clodan sham ............................................. 62 CLODERM CREA .................................... 62 clomiphene citrate tabs ............................ 53 clomipramine hcl caps 25mg, 50mg, 75mg

............................................................. 37 clonazepam tabs .5mg, 1mg, 2mg ........... 32 clonazepam tbdp .125mg, .25mg, .5mg,

1mg, 2mg ............................................. 32 clonidine hcl er tb12 ................................. 25 clonidine hcl tabs .1mg, .2mg, .3mg ......... 25 clonidine

ptwk .1mg/24hr, .2mg/24hr, .3mg/24hr . 25 clopidogrel bisulfate tabs 75mg, 300mg ... 21 clorazepate dipotassium tabs 3.75mg,

7.5mg, 15mg ........................................ 35 clotrimazole crea ...................................... 61 clotrimazole lozg ...................................... 61 clotrimazole soln ...................................... 61 clotrimazole-betamethasone crea ............ 61 clotrimazole-betamethasone lotn ............. 61 clozapine tabs 25mg, 50mg, 100mg, 200mg

............................................................. 37 clozapine tbdp 12.5mg, 25mg, 100mg,

150mg, 200mg ..................................... 38 CLOZARIL TABS 25mg, 100mg .............. 38 COARTEM TABS ..................................... 12 codeine sulfate tabs 15mg, 30mg, 60mg .. 28 colazal caps ............................................. 46 COLCHICINE CAPS ................................ 56 colchicine tabs ......................................... 56 colchicine-probenecid tabs ....................... 43 COLCRYS TABS ..................................... 56 colesevelam hcl pack ............................... 22 colesevelam hcl tabs ................................ 22 COLESTID PACK .................................... 22 COLESTID TABS ..................................... 22 colestipol hcl pack .................................... 22 colestipol hcl tabs ..................................... 22 colistimethate sodium (cba) solr injection ... 9 colocort enem .......................................... 62 COLY-MYCIN S SUSP ............................ 44 COLYTE WITH FLAVOR PACKS SOLR .. 47


COMBIGAN SOLN .................................. 45 COMBIPATCH PTTW .............................. 53 COMBIVENT RESPIMAT AERS ............. 20 COMBIVIR TABS .................................... 12 COMETRIQ (100 MG DAILY DOSE) KIT 15 COMETRIQ (140 MG DAILY DOSE) KIT 15 COMETRIQ (60 MG DAILY DOSE) KIT .. 15 COMPLERA TABS .................................. 12 compro supp ............................................ 38 COMTAN TABS ....................................... 34 CONCERTA TBCR 18mg, 27mg, 36mg,

54mg .................................................... 31 CONDYLOX GEL .................................... 65 constulose soln ........................................ 40 CONZIP CP24 100mg, 200mg, 300mg .... 28 COPAXONE SOSY 20mg/ml, 40mg/ml ... 36 COPIKTRA CAPS 15mg, 25mg ............... 16 CORDRAN TAPE .................................... 62 COREG CR CP24 10mg, 20mg, 40mg,

80mg .................................................... 23 COREG TABS 3.125mg, 6.25mg, 12.5mg,

25mg .................................................... 23 CORGARD TABS 20mg, 40mg, 80mg .... 23 CORLANOR TABS 5mg, 7.5mg .............. 25 CORTEF TABS 5mg, 10mg, 20mg .......... 48 cortisone acetate tabs .............................. 48 CORTISPORIN CREA ............................. 62 CORTISPORIN OINT .............................. 62 CORZIDE TABS ...................................... 23 COSENTYX (300 MG DOSE) SOSY ....... 65 COSENTYX SENSOREADY (300 MG)

SOAJ ................................................... 65 COSOPT PF SOLN ................................. 45 COSOPT SOLN ....................................... 45 COTELLIC TABS ..................................... 16 COTEMPLA XR-ODT TBED 8.6mg,

17.3mg, 25.9mg ................................... 31 COUMADIN TABS 1mg, 2mg, 2.5mg, 3mg,

4mg, 5mg, 6mg, 7.5mg, 10mg ............. 21 COZAAR TABS 25mg, 50mg, 100mg ...... 26 CREON CPEP ......................................... 43 CRESEMBA CAPS .................................. 11 CRESEMBA SOLR .................................. 11 CRESTOR TABS 5mg, 10mg, 20mg, 40mg

............................................................. 22 CRINONE GEL 4%, 8% .......................... 54 CRIXIVAN CAPS 200mg, 400mg ............ 12 cromolyn sodium conc ............................. 58 cromolyn sodium nebu ............................. 58 cromolyn sodium soln .............................. 45

cryselle-28 tabs ........................................ 49 CRYSVITA SOLN 10mg/ml, 20mg/ml,

30mg/ml ............................................... 57 CUBICIN SOLR INTRAVENOUS ............... 9 CUPRIMINE CAPS .................................. 48 CURITY GAUZE PADS ............................ 40 CUTAQUIG SOLN 1.65gm/10ml, 2gm/12ml,

3.3gm/20ml, 4gm/24ml, 8gm/48ml, 1gm/6ml ............................................... 59

CUTIVATE LOTN ..................................... 62 CUVPOSA SOLN ..................................... 18 cyclafem 1/35 tabs ................................... 49 cyclafem 7/7/7 tabs .................................. 49 cyclobenzaprine hcl er cp24 15mg, 30mg 19 cyclobenzaprine hcl tabs 5mg, 7.5mg,

10mg .................................................... 19 CYCLOPHOSPHAMIDE CAPS 25mg,

50mg, 50mg ......................................... 16 CYCLOSET TABS ................................... 51 cyclosporine caps 25mg, 100mg .............. 57 cyclosporine modified caps 25mg, 50mg,

100mg .................................................. 57 cyclosporine modified soln ....................... 57 CYMBALTA CPEP 20mg, 30mg, 60mg ... 38 cyproheptadine hcl syrp ........................... 15 cyproheptadine hcl tabs ........................... 15 CYRAMZA SOLN 100mg/10ml,

500mg/50ml.......................................... 16 cyred eq tabs ........................................... 49 CYSTADANE POWD ............................... 57 CYSTAGON CAPS 50mg, 150mg ........... 57 CYSTARAN SOLN ................................... 45 CYTOGAM INJ ........................................ 59 CYTOMEL TABS 5mcg, 25mcg, 50mcg .. 55 CYTOTEC TABS 100mcg, 200mcg ......... 46

D D.H.E. 45 SOLN ....................................... 20 DAKLINZA TABS 30mg, 60mg, 90mg ...... 12 dalfampridine er tb12 ............................... 36 DALIRESP TABS 250mcg, 500mcg ......... 59 DALVANCE SOLR INTRAVENOUS .......... 9 danazol caps 50mg, 100mg, 200mg ........ 49 DANTRIUM CAPS ................................... 19 dantrolene sodium caps ........................... 19 dapsone gel ............................................. 65 dapsone tabs 25mg, 100mg ..................... 11 DAPTACEL SUSP ................................... 60 DAPTOMYCIN SOLR INTRAVENOUS

350mg .................................................... 9


daptomycin solr intravenous 500mg .......... 9 DARAPRIM TABS ................................... 12 darifenacin hydrobromide er tb24 7.5mg,

15mg .................................................... 65 DARZALEX SOLN 400mg/20ml, 100mg/5ml

............................................................. 16 DAURISMO TABS 25mg, 100mg ............ 16 DAYPRO TABS ....................................... 28 DAYTRANA PTCH 10mg/9hr, 15mg/9hr,

20mg/9hr, 30mg/9hr ............................. 31 DDAVP RHINAL TUBE SOLN ................. 54 DDAVP SOLN ......................................... 54 DDAVP TABS .1mg, .2mg ....................... 54 deblitane tabs .......................................... 49 decadron tabs 4mg, 6mg ......................... 48 deferasirox tbso 125mg ........................... 48 deferasirox tbso 250mg, 500mg .............. 48 DELESTROGEN OIL ............................... 53 DELSTRIGO TABS.................................. 12 deltasone tabs ......................................... 48 delyla tabs ............................................... 49 DELZICOL CPDR .................................... 46 demeclocycline hcl tabs ............................. 9 DEMEROL SOLN 25mg/0.5ml, 75mg/1.5ml,

100mg/2ml, 25mg/ml, 50mg/ml, 75mg/ml, 100mg/ml ............................................. 28

DEMEROL TABS 50mg, 100mg .............. 28 DEMSER CAPS ...................................... 22 DENAVIR CREA ...................................... 61 DEPAKENE CAPS .................................. 32 DEPAKENE SOLN .................................. 32 DEPAKOTE ER TB24 250mg, 500mg ..... 32 DEPAKOTE SPRINKLES CSDR ............. 32 DEPAKOTE TBEC 125mg, 250mg, 500mg

............................................................. 32 DEPEN TITRATABS TABS ..................... 48 depo-estradiol oil ..................................... 53 DEPO-MEDROL SUSP ........................... 48 DEPO-PROVERA SUSP 150mg/ml ........ 54 DEPO-PROVERA SUSP 400mg/ml ........ 54 DEPO-SUBQ PROVERA 104 SUSY ....... 54 depo-testosterone soln 100mg/ml,

200mg/ml ............................................. 49 DESCOVY TABS ..................................... 12 desipramine hcl tabs 10mg, 25mg, 50mg,

75mg, 100mg, 150mg .......................... 38 desloratadine tabs ................................... 15 desloratadine tbdp ................................... 15

DESMOPRESSIN ACE RHINAL TUBE SOLN ................................................... 54

desmopressin ace spray refrig soln .......... 54 desmopressin acetate tabs .1mg, .2mg .... 54 desogestrel-ethinyl estradiol tabs ............. 49 DESONATE GEL ..................................... 62 desonide crea .......................................... 62 desonide lotn ............................................ 62 desonide oint ............................................ 62 DESOWEN CREA .................................... 63 desowen lotn ............................................ 63 desoximetasone crea .05%, .25% ............ 63 desoximetasone gel ................................. 63 desoximetasone liqd ................................ 63 desoximetasone oint .05%, .25% ............. 63 DESOXYN TABS ..................................... 31 DESVENLAFAXINE ER TB24 50mg,

100mg .................................................. 38 desvenlafaxine succinate er tb24 25mg,

50mg, 100mg ....................................... 38 DETROL LA CP24 2mg, 4mg .................. 65 DETROL TABS 1mg, 2mg ....................... 65 dexamethasone elix ................................. 48 dexamethasone intensol conc .................. 48 dexamethasone sodium phosphate soln .. 44 dexamethasone tabs .5mg, .75mg, 1mg,

1.5mg, 2mg, 4mg, 6mg ......................... 48 dexamethasone tbpk ................................ 48 dexchlorpheniramine maleate soln ........... 15 DEXEDRINE CP24 5mg, 10mg, 15mg ..... 31 dexedrine tabs 5mg, 10mg ....................... 31 DEXILANT CPDR 30mg, 60mg ................ 46 dexmethylphenidate hcl er cp24 5mg,

10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg .................................................... 31

dexmethylphenidate hcl tabs 2.5mg, 5mg, 10mg .................................................... 31

dexpak 13 day tbpk .................................. 48 dextroamphetamine sulfate er cp24 5mg,

10mg, 15mg ......................................... 31 dextroamphetamine sulfate tabs 5mg, 10mg

............................................................. 31 DEXTROSE 10%/NACL 0.2% .................. 42 DEXTROSE 5%/NACL 0.225% ................ 42 DEXTROSE SOLN INTRAVENOUS 5%,

10% ...................................................... 41 DEXTROSE-NACL SOLN INTRAVENOUS

............................................................. 42 DIACOMIT CAPS 250mg, 500mg ............ 32


DIACOMIT PACK 250mg, 500mg ............ 32 DIASTAT ACUDIAL GEL 10mg, 20mg ... 32 DIASTAT PEDIATRIC GEL ..................... 32 diazepam gel 2.5mg, 10mg, 20mg .......... 32 diazepam intensol conc ........................... 35 DIAZEPAM SOAJ .................................... 35 diazepam soln 5mg/5ml, 5mg/ml ............. 35 diazepam tabs 2mg, 5mg, 10mg .............. 35 DIBENZYLINE CAPS .............................. 20 DICLEGIS TBEC ..................................... 46 diclofenac epolamine ptch ....................... 63 diclofenac potassium tabs ....................... 28 diclofenac sodium er tb24 ........................ 28 diclofenac sodium gel 1%, 3% ................ 63 diclofenac sodium soln ...................... 44, 63 diclofenac sodium tbec ............................ 28 diclofenac-misoprostol tbec ..................... 28 dicloxacillin sodium caps ........................... 9 dicyclomine hcl caps ................................ 18 dicyclomine hcl soln ................................. 18 dicyclomine hcl tabs................................. 18 didanosine cpdr 200mg, 250mg, 400mg .. 12 DIFFERIN CREA ..................................... 65 DIFFERIN GEL .1%, .3% ........................ 65 DIFFERIN LOTN ..................................... 65 DIFICID TABS ........................................... 9 diflorasone diacetate crea ........................ 63 diflorasone diacetate oint ......................... 63 DIFLUCAN SUSR .................................... 11 DIFLUCAN TABS .................................... 11 diflunisal tabs ........................................... 28 digitek tabs .125mg, .25mg ...................... 25 digox tabs ................................................ 25 DIGOXIN SOLN ....................................... 25 digoxin tabs 125mcg, 250mcg ................. 25 dihydroergotamine mesylate soln 1mg/ml,

4mg/ml ................................................. 20 dilantin caps 30mg, 100mg ...................... 32 dilantin infatabs chew .............................. 32 DILANTIN SUSP ..................................... 32 DILAUDID LIQD ...................................... 28 DILAUDID SOLN 1mg/ml, 4mg/ml ........... 28 DILAUDID TABS 2mg, 4mg, 8mg ............ 28 diltiazem hcl er beads cp24 360mg, 420mg

............................................................. 24 diltiazem hcl er coated beads cp24 120mg,

180mg, 240mg, 300mg ........................ 24 diltiazem hcl er cp12 60mg, 90mg, 120mg

............................................................. 24

diltiazem hcl tabs 30mg, 60mg, 90mg, 120mg .................................................. 24

dilt-xr cp24 120mg, 180mg, 240mg .......... 24 DIOVAN HCT TABS ................................. 26 DIOVAN TABS 40mg, 80mg, 160mg,

320mg .................................................. 26 DIPENTUM CAPS .................................... 46 diphenoxylate-atropine liqd ...................... 46 diphenoxylate-atropine tabs ..................... 46 DIPHTHERIA-TETANUS TOXOIDS DT

SUSP ................................................... 60 DIPROLENE AF CREA ............................ 63 DIPROLENE OINT ................................... 63 dipyridamole tabs 25mg, 50mg, 75mg ..... 27 disopyramide phosphate caps 100mg,

150mg .................................................. 25 disulfiram tabs 250mg, 500mg ................. 27 DITROPAN XL TB24 5mg, 10mg, 15mg .. 66 DIURIL SUSP .......................................... 41 divalproex sodium csdr ............................ 32 divalproex sodium er tb24 250mg, 500mg32 divalproex sodium tbec 125mg, 250mg,

500mg .................................................. 32 DIVIGEL GEL ........................................... 53 DOCETAXEL (NON-ALCOHOL) SOLN .. 16,

43 DOCETAXEL (NON-ALCOHOL) SOLN

160mg/8ml, 20mg/ml ............................ 16 dofetilide caps 125mcg, 250mcg, 500mcg

............................................................. 25 DOLOPHINE TABS 5mg, 10mg ............... 28 donepezil hcl tabs 5mg, 10mg, 23mg ....... 19 donepezil hcl tbdp 5mg, 10mg ................. 19 DOPTELET TABS .................................... 21 DORIPENEM SOLR INTRAVENOUS ........ 9 DORYX MPC TBEC ................................... 9 DORYX TBEC 50mg, 200mg ..................... 9 dorzolamide hcl soln ................................ 45 dorzolamide hcl-timolol mal pf soln .......... 45 dorzolamide hcl-timolol mal soln .............. 45 dotti

pttw .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr .............. 53

DOVATO TABS ....................................... 12 DOVONEX CREA .................................... 65 doxazosin mesylate tabs 1mg, 2mg, 4mg,

8mg ...................................................... 22 doxepin hcl caps 10mg, 25mg, 50mg,

75mg, 100mg, 150mg........................... 38 doxepin hcl conc ...................................... 38


doxepin hcl crea ...................................... 64 doxercalciferol caps .5mcg, 1mcg, 2.5mcg

............................................................. 66 doxy 100 solr intravenous .......................... 9 doxycycline hyclate caps 50mg, 100mg..... 9 doxycycline hyclate tabs 20mg, 75mg,

100mg, 150mg ....................................... 9 doxycycline hyclate tbec 50mg, 75mg,

100mg, 150mg, 200mg .......................... 9 doxycycline monohydrate caps 50mg,

75mg, 100mg, 150mg ............................ 9 doxycycline monohydrate susr................... 9 doxycycline monohydrate tabs 50mg,

75mg, 100mg, 150mg ............................ 9 doxylamine-pyridoxine tbec ..................... 46 dronabinol caps 2.5mg, 5mg, 10mg ......... 46 drospiren-eth estrad-levomefol tabs ........ 49 drospirenone-ethinyl estradiol tabs .......... 49 DROXIA CAPS ........................................ 16 DUAC GEL .............................................. 61 DUAVEE TABS ....................................... 53 DUETACT TABS ..................................... 51 DUEXIS TABS ......................................... 28 DULERA AERO ....................................... 59 duloxetine hcl cpep 20mg, 30mg, 40mg,

60mg .................................................... 38 DUOBRII LOTN ....................................... 63 DUOPA SUSP ......................................... 34 DUPIXENT SOSY 200mg/1.14ml,

300mg/2ml ........................................... 65 DURAGESIC-100 PT72 ........................... 28 DURAGESIC-12 PT72 ............................. 28 DURAGESIC-25 PT72 ............................. 28 DURAGESIC-50 PT72 ............................. 28 DURAGESIC-75 PT72 ............................. 28 DURAMORPH SOLN .5mg/ml, 1mg/ml ... 28 DUREZOL EMUL .................................... 44 dutasteride caps ...................................... 56 dutasteride-tamsulosin hcl caps ............... 56 DUTOPROL TB24 ................................... 23 DUZALLO TABS ...................................... 43 dvorah tabs .............................................. 28 DYANAVEL XR SUER ............................. 31 DYAZIDE CAPS ...................................... 41 DYMISTA SUSP ...................................... 45 DYRENIUM CAPS 50mg, 100mg ............ 41 DYSPORT SOLR 300unit, 500unit .......... 57

E e.e.s. 400 tabs ........................................... 9 E.E.S. GRANULES SUSR ......................... 9 econazole nitrate crea .............................. 61 EDARBI TABS 40mg, 80mg ..................... 26 EDARBYCLOR TABS .............................. 26 EDECRIN TABS....................................... 41 EDLUAR SUBL 5mg, 10mg ..................... 35 EDURANT TABS ..................................... 12 efavirenz caps 50mg, 200mg ................... 12 efavirenz tabs ........................................... 12 EFFEXOR XR CP24 37.5mg, 75mg, 150mg

............................................................. 38 EFFIENT TABS 5mg, 10mg ..................... 21 EFUDEX CREA ....................................... 65 EGRIFTA SOLR ....................................... 54 ELAPRASE SOLN ................................... 43 ELDEPRYL CAPS .................................... 34 ELELYSO SOLR ...................................... 43 ELESTAT SOLN ...................................... 45 ELESTRIN GEL ....................................... 53 eletriptan hydrobromide tabs .................... 34 ELIDEL CREA .......................................... 65 ELIGARD KIT ........................................... 16 ELIMITE CREA ........................................ 61 ELIQUIS STARTER PACK TABS ............ 21 ELIQUIS TABS 2.5mg, 5mg ..................... 21 ELITEK SOLR .......................................... 43 ELLA TABS .............................................. 49 ELMIRON CAPS ...................................... 57 ELOCON CREA ....................................... 63 ELOCON OINT ........................................ 63 ELZONRIS SOLN .................................... 16 EMADINE SOLN ...................................... 45 EMBEDA CPCR ....................................... 28 EMCYT CAPS .......................................... 16 EMEND CAPS 40mg, 80mg, 125mg ........ 46 EMEND SUSR ......................................... 46 EMEND TRI-PACK CAPS ........................ 46 EMFLAZA SUSP ...................................... 48 EMFLAZA TABS 6mg, 18mg, 30mg, 36mg

............................................................. 48 EMGALITY SOAJ..................................... 34 EMGALITY SOSY 100mg/ml ................... 34 EMGALITY SOSY 120mg/ml ................... 34 emoquette tabs ........................................ 49 EMPLICITI SOLR 300mg, 400mg ............ 16


EMSAM PT24 6mg/24hr, 9mg/24hr, 12mg/24hr ............................................ 34

EMTRIVA CAPS ...................................... 12 EMTRIVA SOLN ...................................... 12 emverm chew ............................................ 8 ENABLEX TB24 7.5mg, 15mg ................. 66 enalapril maleate tabs 2.5mg, 5mg, 10mg,

20mg .................................................... 26 enalapril-hydrochlorothiazide tabs ........... 26 ENBREL MINI SOCT ............................... 56 ENBREL SOLR ....................................... 56 ENBREL SOSY 25mg/0.5ml, 50mg/ml .... 56 ENBREL SURECLICK SOAJ ................... 56 ENDARI PACK ........................................ 57 endocet tabs ............................................ 28 ENGERIX-B SUSP 10mcg/0.5ml, 20mcg/ml

............................................................. 60 enoxaparin sodium soln 30mg/0.3ml,

40mg/0.4ml, 60mg/0.6ml, 80mg/0.8ml, 120mg/0.8ml, 300mg/3ml, 100mg/ml, 150mg/ml ............................................. 21

enpresse-28 tabs ..................................... 49 enskyce tabs ............................................ 49 ENSTILAR FOAM .................................... 63 entacapone tabs ...................................... 34 entecavir tabs .5mg, 1mg ........................ 13 ENTOCORT EC CPEP ............................ 48 ENTRESTO TABS ................................... 26 ENTYVIO SOLR ...................................... 47 enulose soln ............................................ 40 ENVARSUS XR TB24 .75mg, 1mg, 4mg . 57 EPCLUSA TABS ..................................... 13 EPIDIOLEX SOLN ................................... 32 EPIDUO FORTE GEL .............................. 65 EPIDUO GEL ........................................... 65 epinastine hcl soln ................................... 45 epinephrine soaj ...................................... 20 EPIPEN 2-PAK SOAJ .............................. 20 EPIPEN JR 2-PAK SOAJ ........................ 20 epitol tabs ................................................ 32 EPIVIR HBV SOLN .................................. 13 EPIVIR HBV TABS .................................. 13 EPIVIR SOLN .......................................... 13 EPIVIR TABS 150mg, 300mg .................. 13 eplerenone tabs 25mg, 50mg .................. 26 EPOGEN SOLN 2000unit/ml, 3000unit/ml,

4000unit/ml, 10000unit/ml, 20000unit/ml ............................................................. 21

eprosartan mesylate tabs ........................ 26 EPZICOM TABS ...................................... 13

EQUETRO CP12 100mg, 200mg, 300mg 38 ERAXIS SOLR INTRAVENOUS 50mg,

100mg .................................................. 11 ERBITUX SOLN ....................................... 16 ergoloid mesylates tabs ........................... 20 ergotamine-caffeine tabs .......................... 34 ERIVEDGE CAPS .................................... 16 ERLEADA TABS ...................................... 16 erlotinib hcl tabs 25mg, 100mg, 150mg .... 16 errin tabs .................................................. 49 ERTACZO CREA ..................................... 61 ertapenem sodium solr injection ................. 9 ery pads ................................................... 61 ERYGEL GEL .......................................... 61 ERYPED 200 SUSR .................................. 9 ERYPED 400 SUSR .................................. 9 ery-tab tbec ................................................ 9 erythrocin lactobionate solr intravenous ..... 9 erythrocin stearate tabs .............................. 9 erythromycin base cpep ............................. 9 erythromycin base tabs .............................. 9 erythromycin base tbec .............................. 9 erythromycin ethylsuccinate susr ............... 9 erythromycin ethylsuccinate tabs ............... 9 erythromycin gel ....................................... 61 erythromycin oint ...................................... 43 erythromycin soln ..................................... 61 ESBRIET CAPS ....................................... 58 ESBRIET TABS 267mg, 801mg ............... 58 escitalopram oxalate soln ......................... 38 escitalopram oxalate tabs 5mg, 10mg,

20mg .................................................... 38 esgic tabs ................................................. 28 esomeprazole magnesium cpdr 20mg,

40mg .................................................... 46 ESOMEPRAZOLE STRONTIUM CPDR .. 46 estarylla tabs ...................................... 49, 51 estazolam tabs 1mg, 2mg ........................ 35 estrace crea ............................................. 53 estrace tabs .5mg, 1mg, 2mg ................... 53 estradiol crea ........................................... 53 estradiol

pttw .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr .............. 53

estradiol ptwk 37.5mcg/24hr, .025mg/24hr, .05mg/24hr, .06mg/24hr, .075mg/24hr, .1mg/24hr ... 53

estradiol tabs 10mcg, .5mg, 1mg, 2mg .... 53 estradiol valerate oil ................................. 53 estradiol-norethindrone acet tabs ............. 53


ESTRING RING ....................................... 53 estropipate tabs .75mg, 1.5mg, 3mg ....... 53 eszopiclone tabs 1mg, 2mg, 3mg ............ 35 ethacrynic acid tabs ................................. 41 ethambutol hcl tabs 100mg, 400mg ......... 12 ethosuximide caps ................................... 32 ethosuximide soln .................................... 32 ethynodiol diac-eth estradiol tabs ............ 49 etidronate disodium tabs 200mg, 400mg . 56 etodolac caps .......................................... 28 etodolac er tb24 ....................................... 28 etodolac tabs ........................................... 28 EUCRISA OINT ....................................... 63 EURAX CREA ......................................... 61 EURAX LOTN .......................................... 61 EVAMIST SOLN ...................................... 53 EVEKEO ODT TBDP 5mg, 10mg, 15mg,

20mg .................................................... 31 evekeo tabs 5mg, 10mg .......................... 31 EVENITY SOSY ...................................... 56 EVISTA TABS ......................................... 53 EVOCLIN FOAM ..................................... 61 EVOMELA SOLR .................................... 16 EVOTAZ TABS ........................................ 13 EVOXAC CAPS ....................................... 19 EVZIO SOAJ ........................................... 37 EXALGO T24A 8mg, 12mg, 16mg, 32mg 28 EXELDERM CREA .................................. 61 EXELDERM SOLN .................................. 61 EXELON PT24 4.6mg/24hr, 9.5mg/24hr,

13.3mg/24hr ......................................... 19 exemestane tabs ..................................... 16 EXFORGE HCT TABS ............................ 24 EXFORGE TABS ..................................... 24 EXJADE TBSO 125mg ............................ 48 EXJADE TBSO 250mg, 500mg ............... 48 EXONDYS 51 SOLN 500mg/10ml,

100mg/2ml ........................................... 58 EXTAVIA KIT ........................................... 36 EXTINA FOAM ........................................ 61 EZALLOR SPRINKLE CPSP 5mg, 10mg,

20mg, 40mg ......................................... 22 ezetimibe tabs ......................................... 22 ezetimibe-simvastatin tabs ...................... 22

F FABIOR FOAM ........................................ 65 FABRAZYME SOLR 5mg, 35mg ............. 43 falmina tabs ............................................. 49

famciclovir tabs 125mg, 250mg, 500mg ... 13 famotidine susr ......................................... 47 famotidine tabs 20mg, 40mg .................... 47 FANAPT TABS 1mg, 2mg, 4mg, 6mg, 8mg,

10mg, 12mg ......................................... 38 FANAPT TITRATION PACK TABS .......... 38 FARESTON TABS ................................... 16 FARXIGA TABS 5mg, 10mg .................... 51 FARYDAK CAPS 10mg, 15mg, 20mg ...... 16 FASENRA SOSY ..................................... 58 FASLODEX SOLN ................................... 16 fayosim tabs ............................................. 49 FAZACLO TBDP 12.5mg, 25mg, 100mg,

150mg, 200mg ..................................... 38 febuxostat tabs 40mg, 80mg .................... 56 felbamate susp ......................................... 32 felbamate tabs 400mg, 600mg ................. 32 FELBATOL SUSP .................................... 32 FELBATOL TABS .................................... 32 FELDENE CAPS 10mg, 20mg ................. 28 felodipine er tb24 2.5mg, 5mg, 10mg ....... 24 FEMARA TABS ........................................ 16 FEMHRT LOW DOSE TABS .................... 53 FEMRING RING .05mg/24hr, .1mg/24hr .. 53 femynor tabs ............................................ 49 fenofibrate caps 50mg, 150mg ................. 22 fenofibrate micronized caps 43mg, 67mg,

130mg, 134mg, 200mg......................... 22 fenofibrate tabs 40mg, 48mg, 54mg,

120mg, 145mg, 160mg......................... 22 fenofibric acid cpdr 45mg, 135mg ............ 22 FENOFIBRIC ACID TABS........................ 22 fenofibric acid tabs 35mg ......................... 22 FENOGLIDE TABS 40mg, 120mg ........... 22 fenoprofen calcium caps .......................... 28 fenoprofen calcium tabs ........................... 28 fentanyl citrate (pf) soct ............................ 28 FENTANYL CITRATE (PF) SOLN

1000mcg/20ml, 2500mcg/50ml ............ 28 FENTANYL CITRATE (PF) SOLN

500mcg/10ml, 100mcg/2ml, 250mcg/5ml ............................................................. 28

fentanyl citrate lpop 200mcg .................... 28 fentanyl citrate lpop 400mcg, 600mcg,

800mcg, 1200mcg, 1600mcg ............... 28 fentanyl citrate tabs 100mcg, 200mcg,

400mcg, 600mcg, 800mcg ................... 28


fentanyl pt72 12mcg/hr, 25mcg/hr, 37.5mcg/hr, 50mcg/hr, 62.5mcg/hr, 75mcg/hr, 87.5mcg/hr, 100mcg/hr ....... 28

FENTORA TABS 100mcg, 200mcg, 400mcg, 600mcg, 800mcg ................... 28

FERRIPROX SOLN ................................. 48 FERRIPROX TABS 500mg, 1000mg ....... 48 FETZIMA CP24 20mg, 40mg, 80mg, 120mg

............................................................. 38 FETZIMA TITRATION C4PK ................... 38 fexmid tabs .............................................. 19 FIASP FLEXTOUCH SOPN .................... 51 FIASP SOLN ........................................... 51 FIBRICOR TABS 35mg, 105mg .............. 22 FINACEA FOAM ...................................... 65 FINACEA GEL ......................................... 65 finasteride tabs ........................................ 56 fioricet caps ............................................. 28 fioricet/codeine caps ................................ 28 FIORINAL CAPS ..................................... 28 FIORINAL/CODEINE #3 CAPS ............... 28 FIRAZYR SOLN ...................................... 21 FIRDAPSE TABS .................................... 58 FIRMAGON SOLR................................... 16 FIRVANQ SOLR ........................................ 9 flac oil ...................................................... 44 FLAGYL CAPS ........................................ 12 FLAGYL TABS ........................................ 12 FLAREX SUSP ........................................ 44 flavoxate hcl tabs ..................................... 66 FLEBOGAMMA DIF SOLN INTRAVENOUS

10%, 5gm/100ml, .5gm/10ml, 10gm/200ml, 20gm/400ml, 2.5gm/50ml 59

flecainide acetate tabs 50mg, 100mg, 150mg .................................................. 25

FLECTOR PTCH ..................................... 63 FLOLIPID SUSP 20mg/5ml, 40mg/5ml .... 22 FLOMAX CAPS ....................................... 20 FLOVENT DISKUS AEPB 50mcg/blist,

100mcg/blist, 250mcg/blist ................... 59 FLOVENT HFA AERO 110mcg/act,

220mcg/act .......................................... 59 FLOVENT HFA AERO 44mcg/act ........... 59 floxin otic soln .......................................... 43 fluconazole in sodium chloride soln

intravenous .......................................... 11 fluconazole susr ....................................... 11 fluconazole tabs ....................................... 11 flucytosine caps 250mg, 500mg .............. 11 fludrocortisone acetate tabs ..................... 48

FLUMADINE TABS .................................. 13 flunisolide soln ......................................... 44 fluocinolone acetonide crea .01%, .025% 63 fluocinolone acetonide oil ......................... 44 fluocinolone acetonide oint ....................... 63 fluocinolone acetonide scalp oil ................ 63 fluocinolone acetonide soln ...................... 63 fluocinonide crea ...................................... 63 fluocinonide emulsified base crea ............ 63 fluocinonide gel ........................................ 63 fluocinonide oint ....................................... 63 fluocinonide soln ...................................... 63 fluorometholone susp ............................... 44 FLUOROPLEX CREA .............................. 65 fluorouracil crea .5%, 5% ......................... 65 fluorouracil soln 2%, 5% ........................... 65 fluoxetine hcl caps 10mg, 20mg, 40mg .... 38 fluoxetine hcl cpdr .................................... 38 fluoxetine hcl soln..................................... 38 FLUOXETINE HCL TABS ........................ 38 fluoxetine hcl tabs 10mg, 20mg, 60mg ..... 38 fluphenazine decanoate soln .................... 38 fluphenazine hcl conc ............................... 38 fluphenazine hcl elix ................................. 38 fluphenazine hcl soln ................................ 38 fluphenazine hcl tabs 1mg, 2.5mg, 5mg,

10mg .................................................... 38 flurandrenolide crea ................................. 63 flurandrenolide lotn ................................... 63 flurandrenolide oint ................................... 63 flurazepam hcl caps 15mg, 30mg ............ 35 flurbiprofen sodium soln ........................... 44 flurbiprofen tabs ....................................... 28 flutamide caps .......................................... 16 fluticasone propionate crea ...................... 63 fluticasone propionate lotn ....................... 63 fluticasone propionate oint ....................... 63 fluticasone propionate susp...................... 44 fluticasone-salmeterol aepb ..................... 20 fluvastatin sodium caps 20mg, 40mg ....... 22 fluvastatin sodium er tb24 ........................ 22 fluvoxamine maleate er cp24 100mg,

150mg .................................................. 38 fluvoxamine maleate tabs 25mg, 50mg,

100mg .................................................. 38 FML FORTE SUSP .................................. 44 FML LIQUIFILM SUSP ............................. 44 FML OINT ................................................ 44 FOCALIN TABS 2.5mg, 5mg, 10mg......... 31


FOCALIN XR CP24 5mg, 10mg, 15mg, 20mg, 25mg, 30mg, 35mg, 40mg ........ 31

fondaparinux sodium soln 2.5mg/0.5ml ... 21 fondaparinux sodium soln 5mg/0.4ml,

7.5mg/0.6ml, 10mg/0.8ml ..................... 21 FORFIVO XL TB24 .................................. 38 FORTAMET TB24 500mg, 1000mg ......... 51 FORTEO SOLN ....................................... 54 FORTESTA GEL ..................................... 49 FORTICAL SOLN .................................... 54 FOSAMAX PLUS D TABS ....................... 56 FOSAMAX TABS ..................................... 56 fosamprenavir calcium tabs ..................... 13 fosinopril sodium tabs 10mg, 20mg, 40mg

............................................................. 26 fosinopril sodium-hctz tabs ...................... 26 FOSRENOL CHEW 500mg, 750mg,

1000mg ................................................ 42 FOSRENOL PACK 750mg, 1000mg ....... 42 FREAMINE HBC SOLN INTRAVENOUS 41 FROVA TABS .......................................... 34 frovatriptan succinate tabs ....................... 34 FULPHILA SOSY .................................... 21 fulvestrant soln ........................................ 16 FURADANTIN SUSP ............................... 14 furosemide soln 8mg/ml, 10mg/ml ........... 41 furosemide soln injection ......................... 41 furosemide tabs 20mg, 40mg, 80mg ....... 41 FUZEON SOLR ....................................... 13 fyavolv tabs .............................................. 53 FYCOMPA SUSP .................................... 32 FYCOMPA TABS .................................... 32

G gabapentin caps 100mg, 400mg .............. 32 gabapentin soln ....................................... 32 gabapentin tabs 600mg, 800mg .............. 32 GABITRIL TABS 2mg, 4mg, 12mg, 16mg 32 GALAFOLD CAPS ................................... 58 galantamine hydrobromide er cp24 8mg,

16mg, 24mg ......................................... 19 galantamine hydrobromide soln ............... 19 galantamine hydrobromide tabs 4mg, 8mg,

12mg .................................................... 19 GAMASTAN INJ ...................................... 59 GAMASTAN S/D INJ ............................... 59 GAMIFANT SOLN 50mg/10ml, 10mg/2ml 57 GAMMAGARD S/D LESS IGA SOLR

INTRAVENOUS 5gm, 10gm ................ 59

GAMMAGARD SOLN INJECTION ........... 60 GAMMAKED SOLN INJECTION .............. 60 GAMMAPLEX SOLN INTRAVENOUS

10gm/100ml, 20gm/200ml, 5gm/50ml .. 60 GAMMAPLEX SOLN INTRAVENOUS

10gm/200ml.......................................... 60 GAMUNEX-C SOLN INJECTION

10gm/100ml, 1gm/10ml, 20gm/200ml, 2.5gm/25ml, 5gm/50ml ......................... 60

GARDASIL 9 SUSP ................................. 60 GARDASIL 9 SUSY ................................. 60 GASTROCROM CONC ........................... 58 gatifloxacin soln ....................................... 43 GATTEX KIT ............................................ 47 GAUZE PADS PADS ............................... 40 gavilyte-c solr ........................................... 47 gavilyte-g solr ........................................... 47 gavilyte-n with flavor pack solr ................. 47 GAZYVA SOLN ........................................ 16 GELNIQUE PUMP GEL ........................... 66 gemfibrozil tabs ........................................ 22 GENERESS FE CHEW ............................ 49 generlac soln ............................................ 40 gengraf caps 25mg, 50mg, 100mg ........... 57 gengraf soln ............................................. 57 GENOTROPIN MINIQUICK

SOLR .2mg, .4mg, .6mg, .8mg, 1mg, 1.2mg, 1.4mg, 1.6mg, 1.8mg, 2mg ....... 54

GENOTROPIN SOLR .............................. 55 GENOTROPIN SOLR 12mg .................... 55 gentak oint ............................................... 43 gentamicin in saline soln intravenous ......... 9 gentamicin sulfate crea ............................ 61 gentamicin sulfate oint ............................. 61 gentamicin sulfate soln ......................... 9, 43 gentamicin sulfate soln injection ................. 9 GENVOYA TABS ..................................... 13 GEODON CAPS 20mg, 40mg, 60mg, 80mg

............................................................. 38 GEODON SOLR ...................................... 38 gianvi tabs ................................................ 49 GIAZO TABS ........................................... 46 gildagia tabs ............................................. 49 GILENYA CAPS .25mg, .5mg .................. 36 GILOTRIF TABS 20mg, 30mg, 40mg ....... 16 GLASSIA SOLN INTRAVENOUS ............ 59 glatiramer acetate sosy 20mg/ml, 40mg/ml

............................................................. 37 glatopa sosy 20mg/ml, 40mg/ml ............... 37


GLEEVEC TABS 100mg, 400mg ............. 16 GLEOSTINE CAPS ................................. 16 glimepiride tabs 1mg, 2mg, 4mg .............. 51 glipizide er tb24 2.5mg, 5mg, 10mg ......... 51 glipizide tabs 5mg, 10mg ......................... 51 glipizide-metformin hcl tabs ..................... 51 GLUCAGEN HYPOKIT SOLR ................. 51 GLUCAGON EMERGENCY KIT .............. 51 GLUCOPHAGE TABS 500mg, 850mg,

1000mg ................................................ 51 GLUCOPHAGE XR TB24 500mg, 750mg 51 GLUCOTROL TABS 5mg, 10mg ............. 51 GLUCOTROL XL TB24 2.5mg, 5mg, 10mg

............................................................. 51 GLUMETZA TB24 500mg, 1000mg ......... 51 glyburide micronized tabs 1.5mg, 3mg, 6mg

............................................................. 52 glyburide tabs 1.25mg, 2.5mg, 5mg ......... 52 glyburide-metformin tabs ......................... 52 glycopyrrolate tabs 1mg, 2mg .................. 18 glydo gel .................................................. 64 GLYNASE TABS 1.5mg, 3mg, 6mg ......... 52 GLYSET TABS 25mg, 50mg, 100mg ...... 52 GLYXAMBI TABS .................................... 52 GOCOVRI CP24 68.5mg, 137mg ............ 35 GOLYTELY SOLR ................................... 47 GONITRO PACK ..................................... 27 GRALISE STARTER MISC...................... 28 GRALISE TABS ....................................... 28 granisetron hcl tabs ................................. 46 GRANIX SOLN 480mcg/1.6ml, 300mcg/ml

............................................................. 21 GRANIX SOSY 300mcg/0.5ml,

480mcg/0.8ml ...................................... 22 griseofulvin microsize susp ...................... 11 griseofulvin microsize tabs ....................... 11 griseofulvin ultramicrosize tabs ................ 11 GRIS-PEG TABS ..................................... 11 guanfacine hcl er tb24 1mg, 2mg, 3mg,

4mg ...................................................... 36 guanfacine hcl tabs 1mg, 2mg ................. 25 GUANIDINE HCL TABS .......................... 19 gynazole-1 crea ....................................... 61

H HAEGARDA SOLR 2000unit, 3000unit.... 58 hailey 24 fe tabs ...................................... 49 HALCION TABS ...................................... 35 HALDOL DECANOATE SOLN ................ 38 HALDOL SOLN ....................................... 38

halobetasol propionate crea ..................... 63 HALOBETASOL PROPIONATE FOAM ... 63 halobetasol propionate oint ...................... 63 HALOG CREA ......................................... 63 HALOG OINT ........................................... 63 haloperidol decanoate soln ...................... 38 haloperidol lactate conc ........................... 38 haloperidol lactate soln ............................ 38 haloperidol tabs .5mg, 1mg, 2mg, 5mg,

10mg, 20mg ......................................... 38 HARVONI TABS ...................................... 13 HAVRIX SUSP ......................................... 60 HECTOROL CAPS .5mcg, 1mcg, 2.5mcg 66 heparin sodium (porcine) soln 1000unit/ml,

5000unit/ml, 10000unit/ml, 20000unit/ml ............................................................. 21

HEPATAMINE SOLN INTRAVENOUS .... 41 HEPLISAV-B SOLN ................................. 60 HEPSERA TABS...................................... 13 HERCEPTIN HYLECTA SOLN ................ 16 HERCEPTIN SOLR .................................. 16 HERCEPTIN SOLR 440mg ...................... 16 HETLIOZ CAPS ....................................... 35 HEXALEN CAPS...................................... 16 HIBERIX SOLR ........................................ 60 HIPREX TABS ......................................... 14 HORIZANT TBCR 300mg, 600mg ........... 32 HUMALOG JUNIOR KWIKPEN SOPN .... 52 HUMALOG KWIKPEN SOPN 100unit/ml,

200unit/ml ............................................. 52 HUMALOG MIX 50/50 KWIKPEN SUPN . 52 HUMALOG MIX 50/50 SUSP ................... 52 HUMALOG MIX 75/25 KWIKPEN SUPN . 52 HUMALOG MIX 75/25 SUSP ................... 52 HUMALOG SOCT .................................... 52 HUMALOG SOLN .................................... 52 HUMATROPE SOLR 5mg, 6mg, 12mg,

24mg .................................................... 55 HUMIRA PEDIATRIC CROHNS START

PSKT .................................................... 56 HUMIRA PEN PNKT 40mg/0.4ml,

40mg/0.8ml .......................................... 56 HUMIRA PEN-CD/UC/HS STARTER PNKT

40mg/0.8ml, 80mg/0.8ml ...................... 56 HUMIRA PEN-PS/UV/ADOL HS START

PNKT .................................................... 56 HUMIRA PSKT 10mg/0.1ml, 10mg/0.2ml,

20mg/0.2ml, 20mg/0.4ml, 40mg/0.4ml, 40mg/0.8ml .......................................... 56

HUMULIN 70/30 KWIKPEN SUPN .......... 52


HUMULIN 70/30 SUSP ............................ 52 HUMULIN N KWIKPEN SUPN ................ 52 HUMULIN N SUSP .................................. 52 HUMULIN R SOLN .................................. 52 HUMULIN R U-500 (CONCENTRATED)

SOLN ................................................... 52 HUMULIN R U-500 KWIKPEN SOPN...... 52 hycet soln ................................................ 28 hydralazine hcl tabs 10mg, 25mg, 50mg,

100mg .................................................. 25 HYDREA CAPS ....................................... 16 hydrochlorothiazide caps ......................... 42 hydrochlorothiazide tabs 12.5mg, 25mg,

50mg .................................................... 42 hydrocodone-acetaminophen soln ........... 28 hydrocodone-acetaminophen tabs ........... 28 hydrocodone-ibuprofen tabs .................... 28 hydrocortisone ace-pramoxine crea ......... 64 hydrocortisone butyrate crea ................... 63 hydrocortisone butyrate lotn .................... 63 hydrocortisone butyrate oint .................... 63 hydrocortisone butyrate soln .................... 63 hydrocortisone crea 1%, 2.5% ................. 63 hydrocortisone enem ............................... 63 hydrocortisone lotn .................................. 63 hydrocortisone oint 1%, 2.5% .................. 63 hydrocortisone tabs 5mg, 10mg, 20mg .... 48 hydrocortisone valerate crea.................... 63 hydrocortisone valerate oint ..................... 63 hydrocortisone-acetic acid soln ................ 44 hydromorphone hcl er t24a 8mg, 12mg,

16mg, 32mg ......................................... 28 hydromorphone hcl liqd ........................... 28 HYDROMORPHONE HCL PF SOLN

2mg/ml, 4mg/ml ................................... 29 hydromorphone hcl pf soln 50mg/5ml,

10mg/ml ............................................... 29 HYDROMORPHONE HCL SOLN ............ 29 hydromorphone hcl tabs 2mg, 4mg, 8mg . 29 hydroxychloroquine sulfate tabs .............. 12 hydroxyurea caps .................................... 16 hydroxyzine hcl syrp ................................ 35 hydroxyzine hcl tabs ................................ 35 hydroxyzine pamoate caps ...................... 35 HYPERRAB S/D SOLN ........................... 60 HYQVIA KIT ............................................ 60 HYSINGLA ER T24A 20mg, 30mg, 40mg,

60mg, 80mg, 100mg, 120mg ............... 29 HYZAAR TABS ........................................ 26

I ibandronate sodium tabs .......................... 56 IBRANCE CAPS 75mg, 100mg, 125mg ... 16 ibu tabs .................................................... 29 ibudone tabs ............................................ 29 ibuprofen susp ......................................... 29 ibuprofen tabs .............................. 28, 29, 30 icatibant acetate soln ............................... 21 ICLUSIG TABS 15mg, 45mg .................... 16 IDHIFA TABS 50mg, 100mg .................... 16 ILARIS SOLN ........................................... 29 ILEVRO SUSP ......................................... 44 ILUMYA SOSY ......................................... 65 imatinib mesylate tabs 100mg, 400mg ..... 16 IMBRUVICA CAPS 70mg, 140mg ............ 16 IMBRUVICA TABS 140mg, 280mg, 420mg,

560mg .................................................. 16 IMFINZI SOLN 500mg/10ml, 120mg/2.4ml

............................................................. 16 imipenem-cilastatin solr intravenous .......... 9 imipramine hcl tabs 10mg, 25mg, 50mg ... 38 imipramine pamoate caps 75mg, 100mg,

125mg, 150mg ..................................... 38 imiquimod crea ......................................... 65 IMIQUIMOD PUMP CREA ....................... 65 IMITREX SOLN ........................................ 34 IMITREX STATDOSE REFILL SOCT ...... 34 IMITREX STATDOSE SYSTEM SOAJ .... 34 IMITREX TABS ........................................ 34 IMOGAM RABIES-HT SOLN ................... 60 IMOVAX RABIES INJ ............................... 60 IMPAVIDO CAPS ..................................... 12 IMPOYZ CREA ........................................ 63 IMURAN TABS ........................................ 57 IMVEXXY MAINTENANCE PACK INST

4mcg, 10mcg ........................................ 53 IMVEXXY STARTER PACK INST 4mcg,

10mcg .................................................. 53 INBRIJA CAPS ........................................ 35 incassia tabs ............................................ 49 INCRELEX SOLN .................................... 55 INCRUSE ELLIPTA AEPB ....................... 18 indapamide tabs 1.25mg, 2.5mg .............. 42 INDERAL LA CP24 60mg, 80mg, 120mg,

160mg .................................................. 23 INDOCIN SUSP ....................................... 29 indomethacin caps ................................... 29 indomethacin er cpcr ................................ 29


INFANRIX SUSP ..................................... 60 INFLECTRA SOLR INTRAVENOUS ....... 56 INFUGEM SOLN ..................................... 16 INFUMORPH 200 SOLN ......................... 29 INFUMORPH 500 SOLN ......................... 29 INGREZZA CAPS 40mg, 80mg ............... 36 INGREZZA CPPK .................................... 36 INLYTA TABS 1mg, 5mg ......................... 16 INNOPRAN XL CP24 80mg, 120mg ........ 23 INREBIC CAPS ....................................... 16 INSPRA TABS 25mg, 50mg .................... 26 insulin lispro soln ..................................... 52 insulin lispro sopn .................................... 52 INTELENCE TABS 25mg, 100mg, 200mg

............................................................. 13 INTERMEZZO SUBL 1.75mg, 3.5mg ...... 35 INTRALIPID EMUL INTRAVENOUS ....... 41 INTRALIPID EMUL INTRAVENOUS

20gm/100ml ......................................... 41 INTRAROSA INST................................... 48 INTRON A SOLN 10mu/ml, 6000000unit/ml

............................................................. 16 INTRON A SOLR 10mu, 18mu, 50mu ..... 16 introvale tabs ........................................... 49 INTUNIV TB24 1mg, 2mg, 3mg, 4mg ...... 36 INVANZ SOLR INJECTION ....................... 9 INVEGA SUSTENNA SUSY 117mg/0.75ml,

234mg/1.5ml, 156mg/ml....................... 38 INVEGA SUSTENNA SUSY 39mg/0.25ml,

78mg/0.5ml .......................................... 38 INVEGA TB24 1.5mg, 3mg, 6mg, 9mg .... 38 INVEGA TRINZA SUSY .......................... 38 INVELTYS SUSP .................................... 44 INVIRASE CAPS ..................................... 13 INVIRASE TABS ..................................... 13 INVOKAMET TABS ................................. 52 INVOKAMET XR TB24 ............................ 52 INVOKANA TABS 100mg, 300mg ........... 52 IONOSOL-MB IN D5W SOLN

INTRAVENOUS ................................... 42 IOPIDINE SOLN ...................................... 45 IOPIDINE SOLN 1% ................................ 45 IPOL INJ .................................................. 60 ipratropium bromide soln .02% ................ 18 ipratropium bromide soln .03%, .06% ...... 19 ipratropium-albuterol soln ........................ 20 irbesartan tabs 75mg, 150mg, 300mg ..... 26 irbesartan-hydrochlorothiazide tabs ......... 26 IRESSA TABS ......................................... 16 ISENTRESS CHEW 25mg, 100mg .......... 13

ISENTRESS HD TABS ............................ 13 ISENTRESS PACK .................................. 13 ISENTRESS TABS .................................. 13 isibloom tabs ............................................ 49 ISOLYTE-P IN D5W SOLN INTRAVENOUS

............................................................. 42 ISOLYTE-S SOLN INTRAVENOUS ......... 42 isoniazid syrp ........................................... 12 isoniazid tabs 100mg, 300mg ................... 12 ISOPTO CARPINE SOLN 1%, 2%, 4% .... 45 ISORDIL TITRADOSE TABS 5mg, 40mg 27 isosorbide dinitrate er tbcr ........................ 27 isosorbide dinitrate tabs 5mg, 10mg, 20mg,

30mg .................................................... 27 isosorbide mononitrate er tb24 ................. 27 isosorbide mononitrate er tb24 30mg, 60mg

............................................................. 27 isosorbide mononitrate tabs 10mg, 20mg 27 isotretinoin caps 10mg, 20mg, 30mg, 40mg

............................................................. 65 isradipine caps 2.5mg, 5mg ..................... 24 ISTALOL SOLN ....................................... 45 itraconazole caps ..................................... 11 itraconazole soln ...................................... 11 ivermectin tabs ........................................... 8 IXEMPRA KIT SOLR ................................ 16 IXIARO SUSP .......................................... 60

J JADENU SPRINKLE PACK 90mg, 180mg,

360mg .................................................. 48 JADENU TABS 90mg, 180mg, 360mg ..... 48 JAKAFI TABS 5mg, 10mg, 15mg, 20mg,

25mg .................................................... 16 JALYN CAPS ........................................... 56 jantoven tabs 1mg, 2mg, 2.5mg, 3mg, 4mg,

5mg, 6mg, 7.5mg, 10mg ....................... 21 JANUMET TABS ...................................... 52 JANUMET XR TB24 ................................. 52 JANUVIA TABS 25mg, 50mg, 100mg ...... 52 JARDIANCE TABS 10mg, 25mg .............. 52 jasmiel tabs .............................................. 49 JENTADUETO TABS ............................... 52 JENTADUETO XR TB24 .......................... 52 jinteli tabs ................................................. 53 JOLIVETTE TABS .................................... 49 JORNAY PM CP24 20mg, 40mg, 60mg,

80mg, 100mg ....................................... 31 JUBLIA SOLN .......................................... 61 juleber tabs .............................................. 49


JULUCA TABS ........................................ 13 junel 1.5/30 tabs ...................................... 49 junel 1/20 tabs ......................................... 49 junel fe 1.5/30 tabs .................................. 49 junel fe 1/20 tabs ..................................... 49 junel fe 24 tabs ........................................ 49 JUXTAPID CAPS 5mg, 10mg, 20mg, 30mg,

40mg, 60mg ......................................... 23 JYNARQUE TABS 15mg, 30mg .............. 42 JYNARQUE TBPK ................................... 42

K KADCYLA SOLR 100mg, 160mg ............ 16 KADIAN CP24 10mg, 20mg, 30mg, 40mg,

50mg, 60mg, 80mg, 100mg, 200mg .... 29 kaitlib fe chew .......................................... 49 KALETRA SOLN ..................................... 13 KALETRA TABS ...................................... 13 KALYDECO PACK 25mg, 50mg, 75mg ... 58 KALYDECO TABS ................................... 58 KANJINTI SOLR ...................................... 16 KANUMA SOLN ...................................... 43 KAPVAY TB12 ......................................... 25 KARBINAL ER SUER .............................. 15 kariva tabs ............................................... 49 KAZANO TABS ....................................... 52 KCL 0.3%/ D5W / NACL 0.9% ................. 42 KCL IN DEXTROSE-NACL SOLN

INTRAVENOUS ................................... 42 KCL-LACTATED RINGERS-D5W SOLN

INTRAVENOUS ................................... 42 kelnor 1/35 tabs ....................................... 49 kelnor 1/50 tabs ....................................... 50 KENALOG AERS .................................... 63 KENALOG SUSP .................................... 48 KEPIVANCE SOLR ................................. 64 KEPPRA SOLN ....................................... 32 KEPPRA TABS 250mg, 500mg, 750mg,

1000mg ................................................ 32 KEPPRA XR TB24 500mg, 750mg .......... 32 KERYDIN SOLN ...................................... 61 ketoconazole crea ................................... 61 ketoconazole foam................................... 61 ketoconazole sham .................................. 61 ketoconazole tabs .................................... 11 ketoprofen caps ....................................... 29 ketoprofen er cp24 ................................... 29 ketorolac tromethamine soln .4%, .5%..... 44 ketorolac tromethamine tabs.................... 29

KEVEYIS TABS ....................................... 58 KEVZARA SOAJ 150mg/1.14ml,

200mg/1.14ml ....................................... 56 KEVZARA SOSY 150mg/1.14ml,

200mg/1.14ml ....................................... 56 KEYTRUDA SOLN ................................... 16 KEYTRUDA SOLR ................................... 16 KHAPZORY SOLR 175mg, 300mg .......... 56 KHEDEZLA TB24 50mg, 100mg .............. 38 kimidess tabs ........................................... 50 KINERET SOSY....................................... 56 KINRIX SUSP .......................................... 60 kionex susp .............................................. 42 KISQALI (200 MG DOSE) TBPK .............. 16 KISQALI (400 MG DOSE) TBPK .............. 16 KISQALI (600 MG DOSE) TBPK .............. 16 KISQALI FEMARA (400 MG DOSE) TBPK

............................................................. 16 KISQALI FEMARA (600 MG DOSE) TBPK

............................................................. 16 KISQALI FEMARA(200 MG DOSE) TBPK

............................................................. 16 KITABIS PAK NEBU .................................. 9 KLARON LOTN ........................................ 61 KLONOPIN TABS .5mg, 1mg, 2mg.......... 33 KLOR-CON 10 TBCR .............................. 42 klor-con m10 tbcr ..................................... 42 klor-con m15 tbcr ..................................... 42 klor-con m20 tbcr ..................................... 42 klor-con pack ............................................ 42 klor-con sprinkle cpcr 8meq, 10meq......... 42 KLOR-CON TBCR ................................... 42 KOMBIGLYZE XR TB24 .......................... 52 KORLYM TABS ....................................... 52 KRINTAFEL TABS ................................... 12 kristalose pack 10gm, 20gm ..................... 40 K-TAB TBCR 10meq ................................ 42 K-TAB TBCR 8meq, 20meq ..................... 42 kurvelo tabs .............................................. 50 KUVAN PACK 100mg, 500mg ................. 58 KUVAN TBSO .......................................... 58 KYNAMRO SOSY .................................... 23 KYPROLIS SOLR 10mg, 30mg, 60mg ..... 16

L labetalol hcl tabs 100mg, 200mg, 300mg . 23 LACRISERT INST .................................... 45 lactulose pack .......................................... 40 lactulose soln ........................................... 40


LAMICTAL CHEW 5mg, 25mg ................ 33 LAMICTAL ODT TBDP 25mg, 50mg,

100mg, 200mg ..................................... 33 LAMICTAL STARTER KIT ....................... 33 LAMICTAL TABS 25mg, 100mg, 150mg,

200mg .................................................. 33 LAMICTAL XR KIT................................... 33 LAMICTAL XR TB24 25mg, 50mg, 100mg,

200mg, 250mg, 300mg ........................ 33 LAMISIL TABS ........................................ 11 lamivudine soln ........................................ 13 lamivudine tabs 100mg, 150mg, 300mg .. 13 lamivudine-zidovudine tabs ............... 12, 13 lamotrigine chew 5mg, 25mg ................... 33 lamotrigine er tb24 25mg, 50mg, 100mg,

200mg, 250mg, 300mg ........................ 33 lamotrigine starter kit-blue kit ................... 33 lamotrigine starter kit-green kit ................. 33 lamotrigine starter kit-orange kit ............... 33 lamotrigine tabs 25mg, 100mg, 150mg,

200mg .................................................. 33 lamotrigine tbdp 25mg, 50mg, 100mg,

200mg .................................................. 33 LANOXIN PEDIATRIC SOLN .................. 25 LANOXIN TABS 62.5mcg, 125mcg,

187.5mcg, 250mcg .............................. 25 lansoprazole cpdr 15mg, 30mg ................ 47 lansoprazole tbdp 15mg, 30mg ................ 47 lanthanum carbonate chew 500mg, 750mg,

1000mg ................................................ 42 LANTUS SOLN ........................................ 52 LANTUS SOLOSTAR SOPN ................... 52 larin 1.5/30 tabs ....................................... 50 larin 1/20 tabs .......................................... 50 larin fe 1.5/30 tabs ................................... 50 larin fe 1/20 tabs ...................................... 50 larissia tabs .............................................. 50 LARTRUVO SOLN 190mg/19ml,

500mg/50ml ......................................... 16 LASIX TABS 20mg, 40mg, 80mg ............ 42 LASTACAFT SOLN ................................. 45 latanoprost soln ....................................... 45 LATUDA TABS 20mg, 40mg, 60mg, 80mg,

120mg .................................................. 38 LAYOLIS FE CHEW ................................ 50 LAZANDA SOLN 100mcg/act, 300mcg/act,

400mcg/act .......................................... 29 ledipasvir-sofosbuvir tabs ........................ 13 leena tabs ................................................ 50 leflunomide tabs 10mg, 20mg .................. 56

LEMTRADA SOLN ................................... 37 LENVIMA (10 MG DAILY DOSE) CPPK .. 16 LENVIMA (12 MG DAILY DOSE) CPPK .. 16 LENVIMA (14 MG DAILY DOSE) CPPK .. 17 LENVIMA (18 MG DAILY DOSE) CPPK .. 17 LENVIMA (20 MG DAILY DOSE) CPPK .. 17 LENVIMA (24 MG DAILY DOSE) CPPK .. 17 LENVIMA (4 MG DAILY DOSE) CPPK .... 17 LENVIMA (8 MG DAILY DOSE) CPPK .... 17 LESCOL XL TB24 .................................... 23 lessina tabs .............................................. 50 LETAIRIS TABS 5mg, 10mg .................... 59 letrozole tabs ............................................ 17 leucovorin calcium tabs 5mg, 10mg, 15mg,

25mg .................................................... 56 LEUKERAN TABS ................................... 17 LEUKINE SOLR ....................................... 22 leuprolide acetate kit ................................ 17 levalbuterol hcl nebu

1.25mg/0.5ml, .31mg/3ml, .63mg/3ml, 1.25mg/3ml .......................................... 20

levalbuterol tartrate aero .......................... 20 LEVAQUIN TABS....................................... 9 LEVEMIR FLEXTOUCH SOPN ................ 52 LEVEMIR SOLN....................................... 52 levetiracetam er tb24 500mg, 750mg ....... 33 levetiracetam soln .................................... 33 levetiracetam tabs 250mg, 500mg, 750mg,

1000mg ................................................ 33 levobunolol hcl soln .................................. 45 levocarnitine soln ..................................... 58 LEVOCARNITINE TABS .......................... 58 levocetirizine dihydrochloride soln ............ 15 levocetirizine dihydrochloride tabs ........... 15 levofloxacin in d5w soln intravenous .......... 9 levofloxacin soln ................................... 9, 43 levofloxacin soln intravenous ..................... 9 levofloxacin tabs ........................................ 9 levonest tabs ............................................ 50 levonorgest-eth est & eth est tabs ............ 50 levonorgest-eth estrad 91-day tabs .......... 50 levonorgestrel-ethinyl estrad tabs ............ 50 levonorg-eth estrad triphasic tabs ............ 50 levora 0.15/30 (28) tabs ........................... 50 levorphanol tartrate tabs .......................... 29 levorphanol tartrate tabs 2mg ................... 29 LEVO-T TABS 25mcg, 50mcg, 75mcg,

88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg ................................................ 55


LEVOTHYROXINE SODIUM SOLN ........ 55 levothyroxine sodium tabs 25mcg, 50mcg,

75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg, 300mcg ................................. 55

LEVOXYL TABS 25mcg, 50mcg, 75mcg, 88mcg, 100mcg, 112mcg, 125mcg, 137mcg, 150mcg, 175mcg, 200mcg .... 55

LEXAPRO TABS 5mg, 10mg, 20mg ........ 38 LEXETTE FOAM ..................................... 63 LEXIVA SUSP ......................................... 13 LEXIVA TABS .......................................... 13 LIALDA TBEC .......................................... 46 LIBTAYO SOLN ....................................... 17 lidocaine hcl soln ..................................... 64 lidocaine hcl urethral/mucosal gel ............ 64 lidocaine oint ............................................ 64 lidocaine ptch ........................................... 64 lidocaine viscous hcl soln ........................ 46 lidocaine-prilocaine crea .......................... 64 lidocaine-tetracaine crea .......................... 64 LIDODERM PTCH ................................... 64 lindane sham ........................................... 61 linezolid soln intravenous ......................... 10 linezolid susr ............................................ 10 linezolid tabs ............................................ 10 LINZESS CAPS 72mcg, 145mcg, 290mcg

............................................................. 47 liothyronine sodium tabs 5mcg, 25mcg,

50mcg .................................................. 55 LIPITOR TABS 10mg, 20mg, 40mg, 80mg

............................................................. 23 LIPOFEN CAPS 50mg, 150mg ................ 23 lisinopril tabs 2.5mg, 5mg, 10mg, 20mg,

30mg, 40mg ......................................... 26 lisinopril-hydrochlorothiazide tabs ............ 26 lithium carbonate caps 150mg, 300mg,

600mg .................................................. 38 lithium carbonate er tbcr 300mg, 450mg .. 38 lithium carbonate tabs .............................. 38 LITHIUM SOLN ....................................... 38 LITHOBID TBCR ..................................... 38 LITHOSTAT TABS................................... 40 LIVALO TABS 1mg, 2mg, 4mg ................ 23 LO LOESTRIN FE TABS ......................... 50 LOCOID LIPOCREAM CREA .................. 63 LOCOID LOTN ........................................ 63 LOCOID OINT ......................................... 63 LOCOID SOLN ........................................ 63

lodine tabs ................................................ 29 LODOSYN TABS ..................................... 35 loestrin 1.5/30 (21) tabs ........................... 50 loestrin 1/20 (21) tabs .............................. 50 loestrin fe 1.5/30 tabs ............................... 50 loestrin fe 1/20 tabs .................................. 50 LOKELMA PACK 5gm, 10gm ................... 42 LOMOTIL TABS ....................................... 46 LONHALA MAGNAIR REFILL KIT SOLN 19 LONHALA MAGNAIR STARTER KIT SOLN

............................................................. 19 LONSURF TABS...................................... 17 loperamide hcl caps ................................. 46 LOPID TABS ............................................ 23 lopinavir-ritonavir soln .............................. 13 LOPREEZA TABS .................................... 53 LOPRESSOR HCT TABS ........................ 23 LOPRESSOR TABS ................................ 23 LOPROX CREA ....................................... 61 LOPROX SHAM ....................................... 61 lorazepam conc ........................................ 35 lorazepam intensol conc .......................... 35 lorazepam tabs .5mg, 1mg, 2mg .............. 35 LORBRENA TABS 25mg, 100mg ............ 17 lorcet hd tabs ........................................... 29 lorcet plus tabs ......................................... 29 lorcet tabs ................................................ 29 lortab elix .................................................. 29 lortab tabs ................................................ 29 loryna tabs ............................................... 50 lorzone tabs 375mg, 750mg ..................... 19 losartan potassium tabs 25mg, 50mg,

100mg .................................................. 26 losartan potassium-hctz tabs .................... 26 LOSEASONIQUE TABS .......................... 50 LOTEMAX GEL ........................................ 44 LOTEMAX OINT ...................................... 44 LOTEMAX SM GEL ................................. 44 LOTEMAX SUSP ..................................... 44 LOTENSIN TABS 10mg, 20mg, 40mg ..... 26 loteprednol etabonate susp ...................... 44 LOTREL CAPS ........................................ 24 LOTRISONE CREA ................................. 61 LOTRONEX TABS .5mg, 1mg ................. 46 lovastatin tabs 10mg, 20mg, 40mg .......... 23 LOVAZA CAPS ........................................ 23 LOVENOX SOLN 300mg/3ml .................. 21


LOVENOX SOLN 30mg/0.3ml, 40mg/0.4ml, 60mg/0.6ml, 80mg/0.8ml, 120mg/0.8ml, 100mg/ml, 150mg/ml ........................... 21

low-ogestrel tabs ..................................... 50 loxapine succinate caps 5mg, 10mg, 25mg,

50mg .................................................... 38 LUCEMYRA TABS .................................. 37 LUCENTIS

SOLN .3mg/0.05ml, .5mg/0.05ml ......... 45 LUCENTIS

SOSY .3mg/0.05ml, .5mg/0.05ml ......... 45 LULICONAZOLE CREA .......................... 61 LUMIGAN SOLN ..................................... 45 LUMIZYME SOLR ................................... 43 LUMOXITI SOLR ..................................... 17 LUNESTA TABS 1mg, 2mg, 3mg ............ 36 LUPANETA PACK KIT ............................ 17 LUPRON DEPOT (1-MONTH) KIT .......... 17 LUPRON DEPOT (3-MONTH) KIT .......... 17 LUPRON DEPOT (4-MONTH) KIT .......... 17 LUPRON DEPOT (6-MONTH) KIT .......... 17 LUPRON DEPOT-PED (1-MONTH) KIT .. 17 LUPRON DEPOT-PED (3-MONTH) KIT .. 17 lutera tabs ................................................ 50 LUXIQ FOAM .......................................... 63 LUZU CREA ............................................ 61 LYNPARZA CAPS ................................... 17 LYNPARZA TABS 100mg, 150mg ........... 17 LYRICA CAPS 25mg, 50mg, 75mg, 100mg,

150mg, 200mg, 225mg, 300mg ........... 33 LYRICA CR TB24 82.5mg, 165mg, 330mg

............................................................. 29 LYRICA SOLN ......................................... 33 LYSODREN TABS................................... 17 LYSTEDA TABS ...................................... 21 lyza tabs .................................................. 50

M MACROBID CAPS................................... 14 MACRODANTIN CAPS ........................... 14 mafenide acetate pack ............................. 61 MAGNESIUM SULFATE SOLN INJECTION

50%, 50% ............................................ 33 MAGNESIUM SULFATE SOLN

INTRAVENOUS 40gm/1000ml, 4gm/100ml, 20gm/500ml, 2gm/50ml .... 33

MAKENA SOAJ ....................................... 54 MALARONE TABS .................................. 12 malathion lotn .......................................... 61 maprotiline hcl tabs 25mg, 50mg, 75mg .. 38

MARINOL CAPS 2.5mg, 5mg, 10mg ....... 46 marlissa tabs ............................................ 50 MARPLAN TABS ..................................... 39 MARQIBO SUSP ..................................... 17 MATULANE CAPS ................................... 17 matzim la tb24 180mg, 240mg, 300mg,

360mg, 420mg ..................................... 24 MAVENCLAD (10 TABS) TBPK ............... 57 MAVENCLAD (4 TABS) TBPK ................. 57 MAVENCLAD (5 TABS) TBPK ................. 57 MAVENCLAD (6 TABS) TBPK ................. 57 MAVENCLAD (7 TABS) TBPK ................. 57 MAVENCLAD (8 TABS) TBPK ................. 57 MAVENCLAD (9 TABS) TBPK ................. 57 MAVYRET TABS ..................................... 13 MAXALT TABS ........................................ 34 MAXALT-MLT TBDP ................................ 34 MAXIDEX SUSP ...................................... 44 MAXIPIME SOLR INJECTION 1gm, 2gm 10 MAXITROL OINT ..................................... 44 MAXITROL SUSP .................................... 44 MAXZIDE TABS ....................................... 42 MAXZIDE-25 TABS .................................. 42 MAYZENT STARTER PACK TBPK ......... 37 MAYZENT TABS .25mg, 2mg .................. 37 meclizine hcl tabs ..................................... 46 meclofenamate sodium caps .................... 29 MEDROL TABS 2mg ............................... 48 MEDROL TABS 4mg, 8mg, 16mg, 32mg . 48 MEDROL TBPK ....................................... 48 medroxyprogesterone acetate susp ......... 54 medroxyprogesterone acetate susy ......... 54 medroxyprogesterone acetate tabs 2.5mg,

5mg, 10mg ........................................... 54 mefenamic acid caps ............................... 29 mefloquine hcl tabs .................................. 12 MEGACE ES SUSP ................................. 54 megestrol acetate susp ...................... 17, 54 megestrol acetate tabs ............................. 17 MEKINIST TABS .5mg, 2mg .................... 17 MEKTOVI TABS....................................... 17 melodetta 24 fe chew ............................... 50 meloxicam tabs ........................................ 29 memantine hcl er cp24 ............................. 36 memantine hcl soln .................................. 36 memantine hcl tabs 5mg, 10mg ............... 36 MENACTRA INJ....................................... 60 menest tabs .3mg, .625mg, 1.25mg ......... 53 MENOSTAR PTWK ................................. 53 MENTAX CREA ....................................... 61


MENVEO SOLR ...................................... 60 meperidine hcl soln 50mg/5ml, 10mg/ml,

25mg/ml, 50mg/ml, 100mg/ml .............. 29 meperidine hcl tabs 50mg, 100mg ........... 29 meprobamate tabs ................................... 36 MEPRON SUSP ...................................... 12 mercaptopurine tabs ................................ 17 meropenem solr intravenous 1gm, 500mg

............................................................. 10 MERREM SOLR INTRAVENOUS ........... 10 mesalamine cpdr ..................................... 46 mesalamine enem ................................... 46 mesalamine supp .................................... 46 mesalamine tbec 1.2gm, 800mg .............. 46 MESNEX TABS ....................................... 58 MESTINON SYRP ................................... 19 MESTINON TABS ................................... 19 MESTINON TBCR ................................... 19 METADATE CD CPCR 10mg, 20mg, 30mg,

40mg, 50mg, 60mg .............................. 31 metadate er tbcr ...................................... 31 metaproterenol sulfate syrp ..................... 20 metaproterenol sulfate tabs 10mg, 20mg . 20 metaxall tabs ........................................... 19 metaxalone tabs ...................................... 19 metformin hcl er (mod) tb24 500mg,

1000mg ................................................ 52 metformin hcl er (osm) tb24 500mg,

1000mg ................................................ 52 metformin hcl er tb24 500mg, 750mg ...... 52 metformin hcl tabs 500mg, 850mg, 1000mg

............................................................. 52 methadone hcl conc................................. 29 METHADONE HCL SOLN ....................... 29 methadone hcl soln 5mg/5ml, 10mg/5ml . 29 methadone hcl tabs 5mg, 10mg ............... 29 methamphetamine hcl tabs ...................... 31 methazolamide tabs 25mg, 50mg ............ 45 methenamine hippurate tabs ................... 14 methimazole tabs 5mg, 10mg .................. 55 methitest tabs .......................................... 49 methocarbamol tabs ................................ 19 methotrexate sodium (pf) soln ................. 17 methotrexate sodium soln ........................ 17 methotrexate tabs .................................... 17 methoxsalen rapid caps ........................... 65 methscopolamine bromide tabs 2.5mg, 5mg

............................................................. 19 methyclothiazide tabs .............................. 42

methyldopa tabs 250mg, 500mg .............. 25 methyldopa-hydrochlorothiazide tabs ....... 25 METHYLIN CHEW 2.5mg, 5mg, 10mg .... 31 METHYLIN SOLN 5mg/5ml, 10mg/5ml .... 31 methylphenidate hcl chew 2.5mg, 5mg,

10mg .................................................... 31 methylphenidate hcl er (cd) cpcr 10mg,

20mg, 30mg, 40mg, 50mg, 60mg ......... 31 methylphenidate hcl er (la) cp24 10mg,

20mg, 30mg, 40mg, 60mg .................... 31 methylphenidate hcl er tb24 18mg, 27mg,

36mg, 54mg ......................................... 31 methylphenidate hcl er tbcr 10mg, 18mg,

20mg, 27mg, 36mg, 54mg, 72mg ......... 31 methylphenidate hcl soln 5mg/5ml,

10mg/5ml ............................................. 31 methylphenidate hcl tabs 5mg, 10mg, 20mg

............................................................. 31 methylprednisolone tabs 4mg, 8mg, 16mg,

32mg .................................................... 48 methylprednisolone tbpk .......................... 48 methyltestosterone caps .......................... 49 metipranolol soln ...................................... 45 metoclopramide hcl soln .......................... 47 metoclopramide hcl tabs 5mg, 10mg........ 47 metoclopramide hcl tbdp 5mg, 10mg ....... 47 metolazone tabs 2.5mg, 5mg, 10mg ........ 42 metoprolol succinate er tb24 25mg, 50mg,

100mg, 200mg ..................................... 23 metoprolol tartrate tabs 25mg, 50mg,

100mg .................................................. 23 metoprolol-hydrochlorothiazide tabs......... 24 METROCREAM CREA ............................ 61 METROGEL GEL ..................................... 61 METROGEL-VAGINAL GEL .................... 61 METROLOTION LOTN ............................ 61 metronidazole caps .................................. 12 metronidazole crea ................................... 61 metronidazole gel ..................................... 61 metronidazole in nacl soln intravenous .... 12 metronidazole lotn .................................... 61 metronidazole tabs ................................... 12 mexiletine hcl caps 150mg, 200mg, 250mg

............................................................. 25 MIACALCIN SOLN ................................... 54 mibelas 24 fe chew .................................. 50 MICARDIS HCT TABS ............................. 26 MICARDIS TABS 20mg, 40mg, 80mg ...... 26 miconazole 3 supp ................................... 61


micort-hc crea .......................................... 63 microgestin 1.5/30 tabs ............................ 50 microgestin 1/20 tabs ............................... 50 microgestin fe 1.5/30 tabs ........................ 50 microgestin fe 1/20 tabs ........................... 50 MICROZIDE CAPS .................................. 42 midazolam hcl soln 10mg/10ml, 50mg/10ml,

2mg/2ml, 10mg/2ml, 5mg/5ml, 25mg/5ml, 5mg/ml ................................................. 36

midazolam hcl syrp .................................. 36 midodrine hcl tabs 2.5mg, 5mg, 10mg ..... 20 MIFEPREX TABS .................................... 54 migergot supp .......................................... 34 miglitol tabs 25mg, 50mg, 100mg ............ 52 miglustat caps .......................................... 43 MIGRANAL SOLN ................................... 20 mili tabs ............................................. 50, 51 millipred soln ............................................ 48 millipred tabs ........................................... 48 mimvey lo tabs ......................................... 53 mimvey tabs ............................................ 53 MINASTRIN 24 FE CHEW ...................... 50 MINIPRESS CAPS 1mg, 2mg, 5mg ........ 22 minitran

pt24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr ............................................................. 27

MINIVELLE PTTW .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr ........... 54

MINOCIN CAPS 50mg, 100mg ................ 10 minocycline hcl caps 50mg, 75mg, 100mg

............................................................. 10 minocycline hcl er tb24 45mg, 55mg, 65mg,

80mg, 90mg, 105mg, 115mg, 135mg .. 10 minocycline hcl tabs 50mg, 75mg, 100mg 10 minoxidil tabs 2.5mg, 10mg ..................... 25 MIRAPEX ER TB24 .375mg, .75mg, 1.5mg,

2.25mg, 3mg, 3.75mg, 4.5mg .............. 35 MIRAPEX

TABS .125mg, .25mg, .5mg, .75mg, 1mg, 1.5mg ................................................... 35

MIRCERA SOSY 30mcg/0.3ml, 50mcg/0.3ml, 75mcg/0.3ml, 100mcg/0.3ml, 150mcg/0.3ml, 200mcg/0.3ml ...................................... 22

mirtazapine tabs 7.5mg, 15mg, 30mg, 45mg .................................................... 39

mirtazapine tbdp 15mg, 30mg, 45mg ...... 39 MIRVASO GEL ........................................ 65 misoprostol tabs 100mcg, 200mcg .......... 47

MITIGARE CAPS ..................................... 56 M-M-R II INJ ............................................. 60 MOBIC TABS ........................................... 29 modafinil tabs 100mg, 200mg .................. 31 moderiba 1200 dose pack tabs ................ 13 moderiba 800 dose pack tabs .................. 13 moderiba tabs .......................................... 13 moexipril hcl tabs 7.5mg, 15mg ................ 26 moexipril-hydrochlorothiazide tabs ........... 26 molindone hcl tabs 5mg, 10mg, 25mg ...... 39 mometasone furoate crea ........................ 63 mometasone furoate oint ......................... 63 mometasone furoate soln ......................... 63 mometasone furoate susp ........................ 44 mondoxyne nl caps 75mg, 100mg ........... 10 MONONESSA TABS ............................... 50 montelukast sodium chew 4mg, 5mg ....... 58 montelukast sodium pack ......................... 58 montelukast sodium tabs ......................... 58 MONUROL PACK .................................... 15 morgidox caps .......................................... 10 MORPHABOND ER T12A 15mg, 30mg,

60mg, 100mg ....................................... 29 morphine sulfate (concentrate) soln ......... 29 MORPHINE SULFATE (PF) SOLN 2mg/ml,

4mg/ml, 5mg/ml, 8mg/ml, 10mg/ml ....... 29 MORPHINE SULFATE DEVI ................... 29 morphine sulfate er beads cp24 30mg,

45mg, 60mg, 75mg, 90mg, 120mg ....... 29 morphine sulfate er cp24 10mg, 20mg,

30mg, 40mg, 50mg, 60mg, 80mg, 100mg ............................................................. 29

morphine sulfate er tbcr 15mg, 30mg, 60mg, 100mg, 200mg........................... 29

morphine sulfate soln 10mg/5ml, 20mg/5ml ............................................................. 29

MORPHINE SULFATE SOLN 150mg/30ml, 5mg/ml, 15mg/ml, 25mg/ml, 50mg/ml ... 29

MORPHINE SULFATE SOLN INJECTION 2mg/ml, 4mg/ml, 8mg/ml, 10mg/ml ....... 29

MORPHINE SULFATE SOLN INTRAVENOUS ................................... 29

MORPHINE SULFATE TABS 15mg, 30mg ............................................................. 29

MOTEGRITY TABS 1mg, 2mg ................. 47 MOVANTIK TABS 12.5mg, 25mg ............ 47 MOVIPREP SOLR ................................... 47 MOXEZA SOLN ....................................... 43 moxifloxacin hcl in nacl soln intravenous .. 10 moxifloxacin hcl soln ................................ 43


MOXIFLOXACIN HCL SOLN INTRAVENOUS ................................... 10

moxifloxacin hcl tabs ................................ 10 MS CONTIN TBCR 15mg, 30mg, 60mg,

100mg, 200mg ..................................... 29 MULPLETA TABS ................................... 22 MULTAQ TABS ....................................... 25 mupirocin calcium crea ............................ 61 mupirocin oint .......................................... 61 MUSTARGEN SOLR ............................... 17 MVASI SOLN 400mg/16ml, 100mg/4ml ... 17 MYALEPT SOLR ..................................... 58 MYAMBUTOL TABS ................................ 12 MYCAMINE SOLR INTRAVENOUS 50mg,

100mg .................................................. 11 MYCOBUTIN CAPS ................................ 12 mycophenolate mofetil caps .................... 57 mycophenolate mofetil susr ..................... 57 mycophenolate mofetil tabs ..................... 57 mycophenolate sodium tbec 180mg, 360mg

............................................................. 57 MYDAYIS CP24 ...................................... 31 MYFORTIC TBEC 180mg, 360mg ........... 57 MYLOTARG SOLR .................................. 17 myorisan caps 10mg, 20mg, 30mg, 40mg 65 MYRBETRIQ TB24 25mg, 50mg ............. 66 MYSOLINE TABS 50mg, 250mg ............. 33 MYTESI TBEC ......................................... 46

N NABI-HB SOLN ....................................... 60 nabumetone tabs ..................................... 29 nadolol tabs 20mg, 40mg, 80mg .............. 24 nadolol-bendroflumethiazide tabs ............ 24 nafcillin sodium solr ................................. 10 nafcillin sodium solr injection ................... 10 nafcillin sodium solr intravenous .............. 10 naftifine hcl crea ...................................... 61 NAFTIN CREA ......................................... 61 NAFTIN GEL ........................................... 61 NAGLAZYME SOLN ................................ 43 nalbuphine hcl soln 10mg/ml, 20mg/ml .... 29 nalfon tabs ............................................... 29 nalocet tabs ............................................. 30 naloxone hcl soct ..................................... 37 naloxone hcl soln ..................................... 37 naloxone hcl sosy .................................... 37 naltrexone hcl tabs................................... 37 NAMENDA TABS 5mg, 10mg.................. 36

NAMENDA TITRATION PAK TABS ......... 36 NAMENDA XR CP24 7mg, 14mg, 21mg,

28mg .................................................... 36 NAMENDA XR TITRATION PACK CP24 . 36 NAMZARIC C4PK .................................... 36 NAMZARIC CP24 .................................... 36 NAPRELAN TB24 .................................... 30 naproxen dr tbec ...................................... 30 naproxen sodium er tb24 ......................... 30 naproxen sodium tabs ........................ 30, 34 naproxen susp ......................................... 30 naproxen tabs .......................................... 30 naratriptan hcl tabs ................................... 34 NARCAN LIQD ........................................ 37 NARDIL TABS ......................................... 39 NASONEX SUSP ..................................... 44 NATACYN SUSP ..................................... 43 NATAZIA TABS ....................................... 50 nateglinide tabs 60mg, 120mg ................. 52 NATPARA CART 25mcg, 50mcg, 75mcg,

100mcg ................................................ 54 NATROBA SUSP ..................................... 61 NEBUPENT SOLR ................................... 12 necon 0.5/35 (28) tabs ............................. 50 NECON 7/7/7 TABS ................................. 50 nefazodone hcl tabs 50mg, 100mg, 150mg,

200mg, 250mg ..................................... 39 neomycin sulfate tabs .............................. 10 neomycin-bacitracin zn-polymyx oint........ 43 neomycin-polymyxin-dexameth oint ......... 44 neomycin-polymyxin-dexameth susp ....... 44 neomycin-polymyxin-gramicidin soln ........ 44 neomycin-polymyxin-hc soln .................... 44 neomycin-polymyxin-hc susp ................... 44 NEORAL CAPS 25mg, 100mg ................. 57 NEORAL SOLN ....................................... 57 neo-synalar crea ...................................... 63 NEPHRAMINE SOLN INTRAVENOUS .... 41 NERLYNX TABS ...................................... 17 NESINA TABS 6.25mg, 12.5mg, 25mg .... 52 neuac gel ................................................. 61 NEULASTA ONPRO PSKT ...................... 22 NEULASTA SOSY ................................... 22 NEUPOGEN SOLN 480mcg/1.6ml,

300mcg/ml ............................................ 22 NEUPOGEN SOSY 300mcg/0.5ml,

480mcg/0.8ml ....................................... 22


NEUPRO PT24 1mg/24hr, 2mg/24hr, 3mg/24hr, 4mg/24hr, 6mg/24hr, 8mg/24hr .............................................. 35

NEURONTIN CAPS 100mg, 300mg, 400mg ............................................................. 33

NEURONTIN SOLN ................................. 33 NEURONTIN TABS 600mg, 800mg ........ 33 NEVANAC SUSP .................................... 44 nevirapine er tb24 100mg, 400mg ........... 13 nevirapine susp ....................................... 13 nevirapine tabs ........................................ 13 NEXAVAR TABS ..................................... 17 NEXIUM CPDR 20mg, 40mg ................... 47 NEXIUM PACK 2.5mg, 5mg, 10mg, 20mg,

40mg .................................................... 47 niacin er (antihyperlipidemic) tbcr 500mg,

750mg, 1000mg ................................... 23 niacor tabs ............................................... 23 NIASPAN TBCR 500mg, 750mg, 1000mg

............................................................. 23 nicardipine hcl caps 20mg, 30mg ............ 24 NICOTROL INHA .................................... 19 NICOTROL NS SOLN ............................. 19 nifedipine caps 10mg, 20mg .................... 24 nifedipine er osmotic release tb24 30mg,

60mg, 90mg ......................................... 24 nifedipine er tb24 30mg, 60mg, 90mg ..... 24 nikki tabs ................................................. 50 NILANDRON TABS ................................. 17 nilutamide tabs ........................................ 17 nimodipine caps ....................................... 24 NINLARO CAPS 2.3mg, 3mg, 4mg ......... 17 nisoldipine er tb24 8.5mg, 17mg, 20mg,

25.5mg, 30mg, 34mg, 40mg ................ 24 nitro-bid oint ............................................. 27 NITRO-DUR

PT24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr ............................................................. 27

NITRO-DUR PT24 .3mg/hr, .8mg/hr ........ 27 nitrofurantoin macrocrystal caps .............. 15 nitrofurantoin monohyd macro caps ......... 15 nitrofurantoin susp ................................... 15 nitroglycerin

pt24 .1mg/hr, .2mg/hr, .4mg/hr, .6mg/hr ............................................................. 27

nitroglycerin soln ...................................... 27 nitroglycerin subl .3mg, .4mg, .6mg ......... 27 NITROSTAT SUBL .3mg, .4mg, .6mg ..... 27 NITYR TABS 2mg, 5mg, 10mg ................ 58

NIVESTYM SOLN 480mcg/1.6ml, 300mcg/ml ............................................ 22

NIVESTYM SOSY 300mcg/0.5ml, 480mcg/0.8ml ....................................... 22

nizatidine caps 150mg, 300mg ................. 47 nizatidine soln .......................................... 47 NIZORAL SHAM ...................................... 61 NOCDURNA SUBL 27.7mcg, 55.3mcg .... 54 NOCTIVA EMUL .83mcg/0.1ml,

1.66mcg/0.1ml ...................................... 54 nolix crea .................................................. 63 nolix lotn ................................................... 63 nora-be tabs ............................................. 50 norco tabs ................................................ 30 NORDITROPIN FLEXPRO SOLN

5mg/1.5ml, 10mg/1.5ml, 15mg/1.5ml, 30mg/3ml ............................................. 55

norethin ace-eth estrad-fe chew ............... 50 norethin ace-eth estrad-fe tabs ................ 50 norethindrone acetate tabs ...................... 54 norethindrone acet-ethinyl est tabs .......... 50 norethindrone tabs ................................... 50 norethindrone-eth estradiol tabs ............... 54 norethin-eth estradiol-fe chew .................. 50 norgestimate-eth estradiol tabs ................ 50 norgestim-eth estrad triphasic tabs .......... 50 NORITATE CREA .................................... 61 norlyroc tabs ............................................ 50 NORMOSOL-M IN D5W SOLN

INTRAVENOUS ................................... 42 NORMOSOL-R IN D5W SOLN

INTRAVENOUS ................................... 42 NORMOSOL-R PH 7.4 SOLN

INTRAVENOUS ................................... 42 NORPACE CAPS 100mg, 150mg ............ 25 NORPACE CR CP12 100mg, 150mg ....... 25 NORPRAMIN TABS 10mg, 25mg ............ 39 NORTHERA CAPS 100mg, 200mg, 300mg

............................................................. 20 nortrel 0.5/35 (28) tabs ............................. 50 nortrel 1/35 (21) tabs ................................ 50 nortrel 1/35 (28) tabs ................................ 50 nortrel 7/7/7 tabs ...................................... 50 nortriptyline hcl caps 10mg, 25mg, 50mg,

75mg .................................................... 39 nortriptyline hcl soln ................................. 39 NORVASC TABS 2.5mg, 5mg, 10mg ...... 24 NORVIR CAPS ........................................ 13 NORVIR PACK ........................................ 13 NORVIR SOLN ........................................ 13


NORVIR TABS ........................................ 13 NOVAREL SOLR ..................................... 54 NOVAREL SOLR 10000unit .................... 54 NOVOLIN 70/30 SUSP ............................ 52 NOVOLIN N SUSP .................................. 52 NOVOLIN R SOLN .................................. 52 NOVOLOG FLEXPEN SOPN .................. 52 NOVOLOG MIX 70/30 FLEXPEN SUPN . 52 NOVOLOG MIX 70/30 SUSP................... 52 NOVOLOG PENFILL SOCT .................... 52 NOVOLOG SOLN .................................... 52 NOXAFIL SUSP ...................................... 11 NOXAFIL TBEC ....................................... 11 NPLATE SOLR 250mcg, 500mcg ............ 22 NUBEQA TABS ....................................... 17 NUCALA SOAJ ........................................ 58 NUCALA SOLR ....................................... 58 NUCALA SOSY ....................................... 58 NUCYNTA ER TB12 50mg, 100mg, 150mg,

200mg, 250mg ..................................... 30 NUCYNTA TABS 50mg, 75mg, 100mg ... 30 NUEDEXTA CAPS .................................. 36 NULOJIX SOLR ....................................... 57 NULYTELY WITH FLAVOR PACKS SOLR

............................................................. 47 NUPLAZID CAPS .................................... 39 NUPLAZID TABS 10mg, 17mg ................ 39 NUTRESTORE PACK ............................. 47 NUTRILIPID EMUL INTRAVENOUS ....... 41 NUTROPIN AQ NUSPIN 10 SOLN .......... 55 NUTROPIN AQ NUSPIN 20 SOLN .......... 55 NUTROPIN AQ NUSPIN 5 SOLN ............ 55 NUVARING RING .................................... 50 NUVIGIL TABS 50mg, 150mg, 200mg,

250mg .................................................. 31 NUZYRA SOLR ....................................... 10 NUZYRA TABS ....................................... 10 nyamyc powd ........................................... 61 NYMALIZE SOLN .................................... 24 nystatin crea ............................................ 61 nystatin oint ............................................. 61 nystatin powd ........................................... 61 nystatin susp ............................................ 11 nystatin tabs ............................................ 11 nystatin-triamcinolone crea ...................... 63 nystatin-triamcinolone oint ....................... 63 nystop powd ............................................ 62

O OCALIVA TABS 5mg, 10mg .................... 47 ocella tabs ................................................ 50 OCREVUS SOLN..................................... 37 OCTAGAM SOLN INTRAVENOUS

5gm/100ml, 1gm/20ml, 2gm/20ml, 25gm/500ml.......................................... 60

octreotide acetate soln ............................. 55 OCUFLOX SOLN ..................................... 44 ODACTRA SUBL ..................................... 58 ODEFSEY TABS...................................... 13 ODOMZO CAPS ...................................... 17 OFEV CAPS 100mg, 150mg .................... 58 ofloxacin soln ........................................... 44 ofloxacin tabs ........................................... 10 ogestrel tabs ............................................ 50 olanzapine solr ......................................... 39 olanzapine tabs 2.5mg, 5mg, 7.5mg, 10mg,

15mg, 20mg ......................................... 39 olanzapine tbdp 5mg, 10mg, 15mg, 20mg

............................................................. 39 olanzapine-fluoxetine hcl caps ................. 39 olmesartan medoxomil tabs 5mg, 20mg,

40mg .................................................... 26 olmesartan medoxomil-hctz tabs .............. 26 olmesartan-amlodipine-hctz tabs ............. 24 olopatadine hcl soln .1%, .2%, .6% .......... 45 OLUMIANT TABS .................................... 56 OLUX FOAM ............................................ 63 OLUX-E FOAM ........................................ 63 OLYSIO CAPS ......................................... 13 OMECLAMOX-PAK MISC........................ 47 omega-3-acid ethyl esters caps ............... 23 omeprazole cpdr 10mg, 20mg, 40mg ....... 47 omeprazole-sodium bicarbonate caps ...... 47 omeprazole-sodium bicarbonate pack ...... 47 OMNARIS SUSP...................................... 44 OMNIPOD STARTER KIT ........................ 40 OMNIPRED SUSP ................................... 44 OMNITROPE SOLN 5mg/1.5ml,

10mg/1.5ml .......................................... 55 OMNITROPE SOLR ................................. 55 ondansetron hcl soln ................................ 46 ondansetron hcl tabs 4mg, 8mg, 24mg .... 46 ondansetron tbdp 4mg, 8mg .................... 46 ONEXTON GEL ....................................... 62 ONFI SUSP .............................................. 33 ONFI TABS 10mg, 20mg ......................... 33


ONGLYZA TABS 2.5mg, 5mg ................. 52 ONIVYDE INJ .......................................... 17 ONMEL TABS ......................................... 11 ONPATTRO SOLN .................................. 58 ONZETRA XSAIL EXHP .......................... 34 OPANA ER T12A 5mg, 7.5mg, 10mg,

15mg, 20mg, 30mg, 40mg ................... 30 OPANA SOLN ......................................... 30 OPANA TABS 5mg, 10mg ....................... 30 OPDIVO SOLN 100mg/10ml, 240mg/24ml,

40mg/4ml ............................................. 17 OPSUMIT TABS ...................................... 59 ORACEA CPDR ...................................... 65 ORALAIR SUBL ...................................... 58 ORAP TABS ............................................ 39 ORAPRED ODT TBDP 10mg, 15mg, 30mg

............................................................. 48 ORAVIG TABS ........................................ 62 ORBACTIV SOLR ................................... 10 ORENCIA CLICKJECT SOAJ .................. 56 ORENCIA SOLR ..................................... 56 ORENCIA SOSY 50mg/0.4ml,

87.5mg/0.7ml, 125mg/ml...................... 56 ORENITRAM TBCR .125mg .................... 59 ORENITRAM TBCR .25mg, 1mg, 2.5mg,

5mg ...................................................... 59 ORFADIN CAPS 2mg, 5mg, 10mg, 20mg 58 ORFADIN SUSP ...................................... 58 ORILISSA TABS 150mg, 200mg ............. 54 ORKAMBI PACK ..................................... 58 ORKAMBI TABS ...................................... 58 orphenadrine citrate er tb12 ..................... 20 orsythia tabs ............................................ 50 ORTHO MICRONOR TABS..................... 50 ORTHO TRI-CYCLEN (28) TABS ............ 50 ORTHO TRI-CYCLEN LO TABS ............. 50 ORTHO-CYCLEN (28) TABS .................. 50 ORTHO-NOVUM 1/35 (28) TABS ............ 50 ORTHO-NOVUM 7/7/7 (28) TABS ........... 50 oseltamivir phosphate caps 30mg, 45mg,

75mg .................................................... 13 oseltamivir phosphate susr ...................... 13 OSENI TABS ........................................... 52 OSMOLEX ER TB24 129mg, 193mg,

258mg .................................................. 35 OSMOPREP TABS.................................. 47 OSPHENA TABS ..................................... 54 OTEZLA TABS ........................................ 56 OTEZLA TBPK ........................................ 57 OTOVEL SOLN ....................................... 44

OTREXUP SOAJ ..................................... 57 ovide lotn .................................................. 62 oxacillin sodium solr injection 1gm, 2gm,

10gm .................................................... 10 oxandrolone tabs 2.5mg, 10mg ................ 49 oxaprozin tabs .......................................... 30 OXAYDO TABA 5mg, 7.5mg .................... 30 oxazepam caps 10mg, 15mg, 30mg ........ 36 oxcarbazepine susp ................................. 33 oxcarbazepine tabs 150mg, 300mg, 600mg

............................................................. 33 OXERVATE SOLN ................................... 46 oxiconazole nitrate crea ........................... 62 OXISTAT CREA ....................................... 62 OXISTAT LOTN ....................................... 62 OXSORALEN ULTRA CAPS ................... 65 OXTELLAR XR TB24 150mg, 300mg,

600mg .................................................. 33 oxybutynin chloride er tb24 5mg, 10mg,

15mg .................................................... 66 oxybutynin chloride syrp ........................... 66 oxybutynin chloride tabs ........................... 66 oxycodone hcl caps .................................. 30 oxycodone hcl conc .................................. 30 oxycodone hcl er t12a 10mg, 15mg, 20mg,

30mg, 40mg, 60mg, 80mg .................... 30 oxycodone hcl soln ................................... 30 oxycodone hcl tabs 5mg, 10mg, 15mg,

20mg, 30mg ......................................... 30 oxycodone-acetaminophen soln ............... 30 oxycodone-acetaminophen tabs .............. 30 oxycodone-aspirin tabs ............................ 30 oxycodone-ibuprofen tabs ........................ 30 OXYCONTIN T12A 10mg, 15mg, 20mg,

30mg, 40mg, 60mg, 80mg .................... 30 oxymorphone hcl er tb12 5mg, 7.5mg,

10mg, 15mg, 20mg, 30mg, 40mg ......... 30 oxymorphone hcl tabs 5mg, 10mg ........... 30 OXYTROL PTTW ..................................... 66 OZEMPIC (0.25 OR 0.5 MG/DOSE) SOPN

............................................................. 52 OZEMPIC (1 MG/DOSE) SOPN .............. 52

P pacerone tabs 100mg, 200mg, 400mg ..... 25 paliperidone er tb24 1.5mg, 3mg, 6mg, 9mg

............................................................. 39 PALONOSETRON HCL SOLN ................ 46 PALYNZIQ SOSY .............................. 42, 43 PALYNZIQ SOSY 10mg/0.5ml, 20mg/ml . 42


PAMELOR CAPS 10mg, 25mg, 50mg, 75mg .................................................... 39

PANCREAZE CPEP ................................ 43 PANDEL CREA ....................................... 63 panlor tabs ............................................... 30 PANRETIN GEL ...................................... 64 pantoprazole sodium tbec 20mg, 40mg ... 47 PANZYGA SOLN INTRAVENOUS

10gm/100ml, 1gm/10ml, 20gm/200ml, 2.5gm/25ml, 30gm/300ml, 5gm/50ml ... 60

paricalcitol caps 1mcg, 2mcg, 4mcg ........ 66 PARLODEL CAPS ................................... 35 PARLODEL TABS ................................... 35 PARNATE TABS ..................................... 39 paromomycin sulfate caps ....................... 12 paroxetine hcl er tb24 12.5mg, 25mg,

37.5mg ................................................. 39 paroxetine hcl tabs 10mg, 20mg .............. 39 paroxetine hcl tabs 30mg, 40mg .............. 39 paroxetine mesylate caps ........................ 39 paser pack ............................................... 12 PATADAY SOLN ..................................... 45 PATANASE SOLN ................................... 45 PATANOL SOLN ..................................... 45 PAXIL CR TB24 12.5mg, 25mg, 37.5mg . 39 PAXIL SUSP ............................................ 39 PAXIL TABS 10mg, 20mg, 30mg, 40mg .. 39 PAZEO SOLN .......................................... 45 PCE TBEC ............................................... 10 PEDIARIX SUSP ..................................... 60 PEDVAX HIB SUSP ................................ 60 peg 3350/electrolytes solr ........................ 47 peg 3350-kcl-na bicarb-nacl solr .............. 47 peg-3350/electrolytes solr ........................ 47 PEGANONE TABS .................................. 33 PEGASYS PROCLICK SOLN

135mcg/0.5ml, 180mcg/0.5ml .............. 13 PEGASYS SOLN 180mcg/0.5ml,

180mcg/ml ........................................... 13 PEGINTRON KIT 50mcg/0.5ml,

80mcg/0.5ml, 120mcg/0.5ml, 150mcg/0.5ml ...................................... 13

PEG-INTRON REDIPEN KIT 50mcg/0.5ml, 80mcg/0.5ml, 120mcg/0.5ml, 150mcg/0.5ml ...................................... 13

PEG-INTRON REDIPEN PAK 4 KIT 50mcg/0.5ml, 80mcg/0.5ml, 120mcg/0.5ml, 150mcg/0.5ml .............. 13

penicillamine caps ................................... 48

PENICILLIN G POT IN DEXTROSE SOLN INTRAVENOUS ................................... 10

penicillin g potassium solr injection .......... 10 penicillin g procaine susp ......................... 10 penicillin g sodium solr injection ............... 10 penicillin v potassium solr ........................ 10 penicillin v potassium tabs........................ 10 PENNSAID SOLN .................................... 63 PENTAM SOLR ....................................... 12 PENTASA CPCR 250mg, 500mg ............ 46 pentazocine-naloxone hcl tabs ................. 30 pentoxifylline er tbcr ................................. 21 PEPCID SUSR ......................................... 47 pepcid tabs 20mg, 40mg .......................... 47 percocet tabs ........................................... 30 PERFOROMIST NEBU ............................ 20 perindopril erbumine tabs 2mg, 4mg, 8mg

............................................................. 26 periogard soln .......................................... 44 PERJETA SOLN ...................................... 17 permethrin crea ........................................ 62 perphenazine tabs 2mg, 4mg, 8mg, 16mg

............................................................. 39 perphenazine-amitriptyline tabs ............... 39 PERSERIS PRSY 90mg, 120mg ............. 39 PERTZYE CPEP ...................................... 43 PEXEVA TABS 10mg, 20mg, 30mg, 40mg

............................................................. 39 phenadoz supp ........................................ 15 phenelzine sulfate tabs ............................ 39 phenergan supp ....................................... 15 PHENOBARBITAL ELIX .......................... 36 PHENOBARBITAL TABS ......................... 36 phenoxybenzamine hcl caps .................... 20 phenytek caps 200mg, 300mg ................. 33 phenytoin chew ........................................ 33 phenytoin sodium extended caps 100mg,

200mg, 300mg ..................................... 33 phenytoin susp ......................................... 33 PHOSLYRA SOLN ................................... 42 PHOSPHOLINE IODIDE SOLR ............... 45 phrenilin forte caps ................................... 30 PICATO GEL .015%, .05% ..................... 65 PIFELTRO TABS ..................................... 13 pilocarpine hcl soln 1%, 2%, 4% .............. 45 pilocarpine hcl tabs 5mg, 7.5mg ............... 19 pimecrolimus crea .................................... 65 pimozide tabs 1mg, 2mg .......................... 39 pimtrea tabs ............................................. 50


pindolol tabs 5mg, 10mg .......................... 24 pioglitazone hcl tabs 15mg, 30mg, 45mg . 52 pioglitazone hcl-glimepiride tabs .............. 52 pioglitazone hcl-metformin hcl tabs .......... 52 piperacillin sod-tazobactam so solr

intravenous .......................................... 10 PIQRAY (200 MG DAILY DOSE) TBPK .. 17 PIQRAY (250 MG DAILY DOSE) TBPK .. 17 PIQRAY (300 MG DAILY DOSE) TBPK .. 17 pirmella 1/35 tabs .................................... 50 piroxicam caps 10mg, 20mg .................... 30 PLAQUENIL TABS .................................. 12 PLASMA-LYTE 148 SOLN INTRAVENOUS

............................................................. 42 PLASMA-LYTE A SOLN INTRAVENOUS 42 PLAVIX TABS 75mg, 300mg ................... 21 PLEGRIDY SOPN ................................... 13 PLEGRIDY SOSY ................................... 13 PLEGRIDY STARTER PACK SOPN ....... 13 PLEGRIDY STARTER PACK SOSY ....... 13 plenamine soln intravenous ..................... 41 PLENVU SOLR ....................................... 47 PLIAGLIS CREA ...................................... 64 plixda pads .............................................. 65 podofilox soln ........................................... 65 POLIVY SOLR ......................................... 17 polyethylene glycol 3350 powd ................ 47 polymyxin b sulfate solr injection ............. 10 polymyxin b-trimethoprim soln ................. 44 POLYTRIM SOLN ................................... 44 POMALYST CAPS 1mg, 2mg, 3mg, 4mg 17 portia-28 tabs ........................................... 50 PORTRAZZA SOLN ................................ 17 potassium chloride crys er tbcr 10meq,

20meq .................................................. 43 potassium chloride er cpcr 8meq, 10meq 43 potassium chloride er tbcr 8meq, 10meq,

20meq .................................................. 43 POTASSIUM CHLORIDE IN DEXTROSE

SOLN INTRAVENOUS ........................ 43 potassium chloride in nacl soln intravenous

............................................................. 43 potassium chloride pack .......................... 43 potassium chloride soln 10%, 20% .......... 43 POTASSIUM CHLORIDE SOLN

INTRAVENOUS 2meq/ml, 10meq/100ml, 20meq/100ml, 40meq/100ml ................ 43

potassium citrate er tbcr 15meq, 540mg, 1080mg ................................................ 40

POTELIGEO SOLN ................................. 17

PRADAXA CAPS 110mg, 150mg ............ 21 PRALUENT SOPN 75mg/ml, 150mg/ml ... 23 PRALUENT SOSY 75mg/ml, 150mg/ml ... 23 pramipexole dihydrochloride er

tb24 .375mg, .75mg, 1.5mg, 2.25mg, 3mg, 3.75mg, 4.5mg ............................ 35

pramipexole dihydrochloride tabs .125mg, .25mg, .5mg, .75mg, 1mg, 1.5mg ................................................... 35

prandin tabs 1mg, 2mg ............................ 52 prasugrel hcl tabs 5mg, 10mg .................. 21 PRAVACHOL TABS 20mg, 40mg, 80mg . 23 pravastatin sodium tabs 10mg, 20mg,

40mg, 80mg ......................................... 23 praziquantel tabs ........................................ 8 prazosin hcl caps 1mg, 2mg, 5mg ............ 22 PRECOSE TABS 25mg, 50mg, 100mg .... 52 PRED FORTE SUSP ............................... 44 PRED MILD SUSP ................................... 44 PRED-G S.O.P. OINT .............................. 44 PRED-G SUSP ........................................ 44 prednicarbate crea ................................... 63 prednicarbate oint .................................... 63 prednisolone acetate susp ....................... 44 prednisolone sodium phosphate soln . 44, 48 prednisolone sodium phosphate soln

5mg/5ml, 10mg/5ml, 20mg/5ml, 25mg/5ml ............................................. 48

prednisolone sodium phosphate tbdp 10mg, 15mg, 30mg ......................................... 48

prednisolone soln ............................... 44, 48 prednisone intensol conc ......................... 48 prednisone soln ........................................ 48 prednisone tabs 1mg, 2.5mg, 5mg, 10mg,

20mg, 50mg ......................................... 48 prednisone tbpk ....................................... 48 prefest tabs .............................................. 54 pregabalin caps 25mg, 50mg, 75mg,

100mg, 150mg, 200mg, 225mg, 300mg ............................................................. 33

pregabalin soln ......................................... 33 PREGNYL SOLR ..................................... 54 PREMARIN CREA ................................... 54 PREMARIN SOLR ................................... 54 PREMARIN

TABS .3mg, .45mg, .625mg, .9mg, 1.25mg ................................................. 54

premasol soln intravenous ....................... 41 PREMPHASE TABS ................................ 54 PREMPRO TABS..................................... 54


PREPOPIK PACK ................................... 47 PREVACID CPDR 15mg, 30mg .............. 47 PREVACID SOLUTAB TBDP 15mg, 30mg

............................................................. 47 prevalite pack .......................................... 23 previfem tabs ..................................... 50, 51 PREVPAC MISC ..................................... 47 PREVYMIS SOLN 240mg/12ml,

480mg/24ml ......................................... 13 PREVYMIS TABS 240mg, 480mg ........... 13 PREZCOBIX TABS.................................. 13 PREZISTA SUSP .................................... 13 PREZISTA TABS 75mg, 150mg, 600mg,

800mg .................................................. 13 PRIFTIN TABS ........................................ 12 PRILOSEC PACK 2.5mg, 10mg .............. 47 primaquine phosphate tabs ..................... 12 PRIMAXIN IV SOLR INTRAVENOUS...... 10 primidone tabs 50mg, 250mg .................. 33 primlev tabs ............................................. 30 PRINIVIL TABS 5mg, 10mg, 20mg .......... 26 PRISTIQ TB24 25mg, 50mg, 100mg ....... 39 PRIVIGEN SOLN INTRAVENOUS .......... 60 PROAIR HFA AERS ................................ 20 PROAIR RESPICLICK AEPB .................. 20 probenecid tabs ....................................... 43 PROCALAMINE SOLN INTRAVENOUS . 41 PROCARDIA CAPS ................................. 24 PROCARDIA XL TB24 30mg, 60mg, 90mg

............................................................. 25 procentra soln .......................................... 32 prochlorperazine maleate tabs................. 39 prochlorperazine supp ............................. 39 PROCRIT SOLN 2000unit/ml, 3000unit/ml,

4000unit/ml, 10000unit/ml, 20000unit/ml, 40000unit/ml ........................................ 22

procto-med hc crea .................................. 63 procto-pak crea ........................................ 63 proctosol hc crea ..................................... 63 proctozone-hc crea .................................. 63 PROCYSBI CPDR 25mg, 75mg .............. 58 profeno tabs ............................................. 30 progesterone micronized caps 100mg,

200mg .................................................. 54 PROGLYCEM SUSP ............................... 52 PROGRAF CAPS .5mg, 1mg, 5mg ......... 57 PROGRAF PACK .2mg, 1mg .................. 57 PROGRAF SOLN .................................... 57 PROLASTIN-C SOLN INTRAVENOUS ... 59

PROLASTIN-C SOLR INTRAVENOUS .... 59 PROLENSA SOLN ................................... 44 PROLEUKIN SOLR .................................. 17 PROLIA SOSY ......................................... 56 PROMACTA PACK .................................. 22 PROMACTA TABS 12.5mg, 25mg, 50mg,

75mg .................................................... 22 promethazine hcl supp ............................. 15 promethazine hcl syrp .............................. 15 promethazine hcl tabs .............................. 15 promethazine-phenylephrine syrp ............ 15 promethegan supp ................................... 15 PROMETRIUM CAPS 100mg, 200mg ..... 54 propafenone hcl er cp12 225mg, 325mg,

425mg .................................................. 25 propafenone hcl tabs 150mg, 225mg,

300mg .................................................. 25 propantheline bromide tabs ...................... 19 proparacaine hcl soln ............................... 46 propranolol hcl er cp24 60mg, 80mg,

120mg, 160mg ..................................... 24 propranolol hcl soln 20mg/5ml, 40mg/5ml 24 propranolol hcl tabs 10mg, 20mg, 40mg,

60mg, 80mg ......................................... 24 propranolol-hctz tabs ................................ 24 propylthiouracil tabs ................................. 55 PROQUAD SUSR .................................... 60 PROSCAR TABS ..................................... 56 PROSOL SOLN INTRAVENOUS ............. 41 PROTONIX PACK .................................... 47 PROTONIX TBEC 20mg, 40mg ............... 47 PROTOPIC OINT .03%, .1% .................... 65 protriptyline hcl tabs 5mg, 10mg .............. 39 PROVENTIL HFA AERS .......................... 20 PROVERA TABS 2.5mg, 5mg, 10mg ....... 54 PROVIGIL TABS 100mg, 200mg ............. 32 PROZAC CAPS 10mg, 20mg, 40mg ........ 39 PRUDOXIN CREA ................................... 64 psorcon crea ............................................ 63 PULMICORT FLEXHALER AEPB

90mcg/act, 180mcg/act ........................ 59 PULMICORT SUSP .25mg/2ml, .5mg/2ml,

1mg/2ml ............................................... 59 PULMOZYME SOLN ................................ 43 PURIXAN SUSP ...................................... 17 PYLERA CAPS ........................................ 47 pyrazinamide tabs .................................... 12 pyridostigmine bromide er tbcr ................. 19 pyridostigmine bromide soln ..................... 19


pyridostigmine bromide tabs 30mg, 60mg 19

Q QBRELIS SOLN ...................................... 26 QMIIZ ODT TBDP.................................... 30 QNASL AERS .......................................... 44 QNASL CHILDRENS AERS .................... 44 QTERN TABS .......................................... 53 QUADRACEL SUSP ................................ 60 QUALAQUIN CAPS ................................. 12 QUARTETTE TABS ................................. 50 quasense tabs ......................................... 50 QUAZEPAM TABS .................................. 36 QUDEXY XR CS24 25mg, 50mg, 100mg,

150mg, 200mg ..................................... 33 questran light powd.................................. 23 questran pack .......................................... 23 quetiapine fumarate er tb24 50mg, 150mg,

200mg, 300mg, 400mg ........................ 39 quetiapine fumarate tabs 25mg, 50mg,

100mg, 200mg, 300mg, 400mg ........... 39 QUILLICHEW ER CHER 20mg, 30mg,

40mg .................................................... 32 QUILLIVANT XR SUSR ........................... 32 quinapril hcl tabs 5mg, 10mg, 20mg, 40mg

............................................................. 26 quinapril-hydrochlorothiazide tabs ........... 26 quinidine gluconate er tbcr ....................... 25 QUINIDINE GLUCONATE SOLN ............ 25 quinidine sulfate tabs 200mg, 300mg ...... 25 quinine sulfate caps ................................. 12 QVAR AERS 40mcg/act, 80mcg/act ........ 59 QVAR REDIHALER AERB ...................... 59

R RABAVERT SUSR .................................. 60 rabeprazole sodium tbec ......................... 47 RADICAVA SOLN ................................... 36 raloxifene hcl tabs .................................... 54 ramelteon tabs ......................................... 36 ramipril caps 1.25mg, 2.5mg, 5mg, 10mg 26 RANEXA TB12 500mg, 1000mg .............. 25 ranitidine hcl caps 150mg, 300mg ........... 47 ranitidine hcl syrp ..................................... 47 ranitidine hcl tabs 150mg, 300mg ............ 47 ranolazine er tb12 500mg, 1000mg ......... 25 RAPAFLO CAPS 4mg, 8mg .................... 20 RAPAMUNE SOLN.................................. 57 RAPAMUNE TABS .5mg, 1mg, 2mg ....... 57

RAPIVAB SOLN ....................................... 13 rasagiline mesylate tabs .5mg, 1mg ......... 35 RASUVO SOAJ ....................................... 57 RAVICTI LIQD ......................................... 40 RAYALDEE CPCR ................................... 66 RAYOS TBEC 1mg, 2mg, 5mg ................ 48 RAZADYNE ER CP24 8mg, 16mg, 24mg 19 RAZADYNE TABS 4mg, 8mg, 12mg........ 19 REBETOL SOLN...................................... 13 REBIF REBIDOSE SOAJ 22mcg/0.5ml,

44mcg/0.5ml ......................................... 37 REBIF REBIDOSE TITRATION PACK

SOAJ .................................................... 37 REBIF SOSY 22mcg/0.5ml, 44mcg/0.5ml 37 REBIF TITRATION PACK SOSY ............. 37 reclipsen tabs ........................................... 50 RECOMBIVAX HB SUSP 5mcg/0.5ml,

10mcg/ml, 40mcg/ml ............................ 60 RECTIV OINT .......................................... 65 REGLAN TABS 5mg, 10mg ..................... 47 REGONOL SOLN .................................... 19 REGRANEX GEL ..................................... 65 RELENZA DISKHALER AEPB ................. 13 relexxii tbcr ............................................... 32 RELISTOR SOLN 8mg/0.4ml, 12mg/0.6ml

............................................................. 47 RELISTOR TABS ..................................... 47 RELPAX TABS ........................................ 34 REMERON SOLTAB TBDP 15mg, 30mg,

45mg .................................................... 39 REMERON TABS 15mg, 30mg, 45mg ..... 39 REMICADE SOLR INTRAVENOUS ......... 57 REMODULIN SOLN 20mg/20ml,

50mg/20ml, 100mg/20ml, 200mg/20ml 59 RENAGEL TABS 400mg, 800mg ............. 42 RENFLEXIS SOLR .................................. 57 RENVELA PACK .8gm, 2.4gm ................. 42 RENVELA TABS ...................................... 42 repaglinide tabs .5mg, 1mg, 2mg ............. 53 repaglinide-metformin hcl tabs ................. 53 REPATHA PUSHTRONEX SYSTEM SOCT

............................................................. 23 REPATHA SOSY ..................................... 23 REPATHA SURECLICK SOAJ ................ 23 reprexain tabs .......................................... 30 REQUIP XL TB24 4mg, 6mg, 8mg, 12mg 35 RESCRIPTOR TABS 100mg, 200mg ....... 13 RESTASIS EMUL .................................... 44 RESTORIL CAPS 7.5mg, 15mg, 22.5mg,

30mg .................................................... 36


RETACRIT SOLN 2000unit/ml, 3000unit/ml, 4000unit/ml, 10000unit/ml, 40000unit/ml ............................................................. 22

RETIN-A CREA .025%, .05%, .1% .......... 64 RETIN-A GEL .01%, .025% .................... 64 RETIN-A MICRO GEL .04%, .1% ........... 64 RETIN-A MICRO PUMP GEL .................. 64 RETIN-A MICRO PUMP GEL .04%, .1% 64 RETIN-A MICRO PUMP GEL .08% ........ 64 RETROVIR CAPS ................................... 13 RETROVIR SOLN ................................... 14 RETROVIR SYRP ................................... 14 REVATIO SOLN ...................................... 27 REVATIO SUSR ...................................... 27 REVATIO TABS ...................................... 27 REVCOVI SOLN ...................................... 43 REVLIMID CAPS 2.5mg, 5mg, 10mg,

15mg, 20mg, 25mg .............................. 17 REXULTI TABS .25mg, .5mg, 1mg, 2mg,

3mg, 4mg ............................................. 39 REYATAZ CAPS 150mg, 200mg, 300mg 14 REYATAZ PACK ..................................... 14 RHOFADE CREA .................................... 65 RHOPRESSA SOLN ............................... 46 ribasphere caps ....................................... 14 ribasphere ribapak tabs 400mg, 600mg... 14 ribasphere ribapak tbpk ........................... 14 ribasphere tabs 200mg, 400mg, 600mg .. 14 ribavirin caps ........................................... 14 ribavirin tabs ............................................ 14 RIDAURA CAPS ...................................... 58 rifabutin caps ........................................... 12 RIFADIN CAPS ....................................... 12 rifamate caps ........................................... 12 rifampin caps 150mg, 300mg................... 12 rifampin solr intravenous .......................... 12 RIFATER TABS ....................................... 12 RILUTEK TABS ....................................... 36 riluzole tabs ............................................. 36 rimantadine hcl tabs................................. 14 RIMSO-50 SOLN ..................................... 58 RINVOQ TB24 ......................................... 57 RIOMET SOLN ........................................ 53 risedronate sodium tabs 5mg, 30mg, 35mg,

150mg .................................................. 56 RISEDRONATE SODIUM TBEC ............. 56 RISPERDAL CONSTA SUSR .................. 39 RISPERDAL M-TAB TBDP .5mg, 1mg,

3mg, 4mg ............................................. 39

RISPERDAL SOLN .................................. 39 RISPERDAL TABS .25mg, .5mg, 1mg,

2mg, 3mg, 4mg .................................... 39 risperidone soln ........................................ 39 risperidone tabs .25mg, .5mg, 1mg, 2mg,

3mg, 4mg ............................................. 39 risperidone tbdp .25mg, .5mg, 1mg, 2mg,

3mg, 4mg ............................................. 39 RITALIN LA CP24 10mg, 20mg, 30mg,

40mg, 60mg ......................................... 32 RITALIN TABS 5mg, 10mg, 20mg ........... 32 ritonavir tabs ............................................ 14 RITUXAN HYCELA SOLN ....................... 17 RITUXAN SOLN....................................... 17 rivastigmine pt24 4.6mg/24hr, 9.5mg/24hr,

13.3mg/24hr ......................................... 19 rivastigmine tartrate caps 1.5mg, 3mg,

4.5mg, 6mg .......................................... 19 rivelsa tabs ............................................... 50 rizatriptan benzoate tabs .......................... 34 rizatriptan benzoate tbdp .......................... 34 ROBINUL TABS ....................................... 19 ROBINUL-FORTE TABS ......................... 19 ROCALTROL CAPS .25mcg, .5mcg ........ 66 ROCALTROL SOLN ................................ 66 ROCKLATAN SOLN ................................ 45 ropinirole hcl er tb24 2mg, 4mg, 6mg, 8mg,

12mg .................................................... 35 ropinirole hcl tabs .25mg, .5mg, 1mg, 2mg,

3mg, 4mg, 5mg .................................... 35 rosuvastatin calcium tabs 5mg, 10mg,

20mg, 40mg ......................................... 23 ROTARIX SUSR ...................................... 60 ROTATEQ SOLN ..................................... 60 ROWASA KIT .......................................... 46 roweepra tabs 500mg, 750mg, 1000mg ... 33 roweepra xr tb24 500mg, 750mg ............. 33 ROXICODONE TABS 5mg, 15mg, 30mg . 30 ROXYBOND TABA 5mg, 15mg, 30mg ..... 30 ROZEREM TABS ..................................... 36 ROZLYTREK CAPS 100mg, 200mg ........ 17 RUBRACA TABS 200mg, 250mg, 300mg 17 RUCONEST SOLR INTRAVENOUS ........ 21 RUZURGI TABS ...................................... 58 ryclora soln ............................................... 15 RYDAPT CAPS ........................................ 17 RYNODERM CREA ................................. 65 RYTARY CPCR ....................................... 35


RYTHMOL SR CP12 225mg, 325mg, 425mg .................................................. 25

ryvent tabs ............................................... 15

S SABRIL PACK ......................................... 33 SABRIL TABS ......................................... 33 SAFYRAL TABS ...................................... 50 SAIZEN CLICK.EASY SOLR ................... 55 SAIZEN SOLR 5mg, 8.8mg ..................... 55 SAIZENPREP SOLR ............................... 55 SALAGEN TABS 5mg, 7.5mg .................. 19 SAMSCA TABS 15mg, 30mg .................. 42 SANCUSO PTCH .................................... 46 SANDIMMUNE CAPS 25mg, 100mg ....... 57 SANDIMMUNE ORAL SOLN 100mg/ml .. 57 SANDIMMUNE SOLN 50mg/ml ............... 57 SANDOSTATIN LAR DEPOT KIT 10mg,

20mg, 30mg ......................................... 55 SANDOSTATIN SOLN ............................ 55 SANTYL OINT ......................................... 65 SAPHRIS SUBL 2.5mg, 5mg, 10mg ........ 39 SARAFEM TABS 10mg, 20mg ................ 39 SAVAYSA TABS 15mg, 30mg, 60mg ...... 21 SAVELLA TABS 12.5mg, 25mg, 50mg,

100mg .................................................. 36 SAVELLA TITRATION PACK MISC ........ 36 scopolamine pt72 .................................... 46 SEASONIQUE TABS ............................... 50 SEEBRI NEOHALER CAPS .................... 19 SEGLUROMET TABS ............................. 53 selegiline hcl caps ................................... 35 selegiline hcl tabs .................................... 35 selenium sulfide lotn ................................ 62 SELZENTRY SOLN ................................. 14 SELZENTRY TABS 25mg, 75mg, 150mg,

300mg .................................................. 14 SEMPREX-D CAPS ................................. 15 SENSIPAR TABS 30mg .......................... 54 SENSIPAR TABS 60mg, 90mg ............... 54 SEREVENT DISKUS AEPB .................... 20 SEROQUEL TABS 25mg, 50mg, 100mg,

200mg, 300mg, 400mg ........................ 39 SEROQUEL XR TB24 50mg, 150mg,

200mg, 300mg, 400mg ........................ 39 SEROSTIM SOLR 4mg, 5mg, 6mg ......... 55 sertraline hcl conc .................................... 39 sertraline hcl tabs 25mg, 50mg, 100mg ... 39 setlakin tabs ............................................. 50 sevelamer carbonate pack .8gm, 2.4gm .. 42

sevelamer carbonate tabs ........................ 42 sevelamer hcl tabs 400mg, 800mg .......... 42 SEYSARA TABS 60mg, 100mg, 150mg .. 10 sharobel tabs ........................................... 50 SHINGRIX SUSR ..................................... 60 SIGNIFOR LAR SRER 10mg, 20mg, 30mg,

40mg, 60mg ......................................... 55 SIGNIFOR

SOLN .3mg/ml, .6mg/ml, .9mg/ml ......... 55 SIKLOS TABS .......................................... 17 sildenafil citrate susr ................................. 27 sildenafil citrate tabs ................................. 27 SILENOR TABS ....................................... 36 SILIQ SOSY ............................................. 65 silodosin caps 4mg, 8mg .......................... 20 SILVADENE CREA .................................. 62 SILVER SULFADIAZINE CREA ............... 62 SIMBRINZA SUSP ................................... 45 SIMPONI ARIA SOLN .............................. 57 SIMPONI SOAJ 50mg/0.5ml, 100mg/ml .. 57 SIMPONI SOSY 50mg/0.5ml, 100mg/ml .. 57 simvastatin tabs 5mg, 10mg, 20mg, 40mg,

80mg .................................................... 23 SINEMET CR TBCR ................................ 35 SINEMET TABS ....................................... 35 SINGULAIR CHEW 4mg, 5mg ................. 58 SINGULAIR PACK ................................... 58 SINGULAIR TABS ................................... 58 sirolimus soln ........................................... 57 sirolimus tabs .5mg, 1mg, 2mg ................ 57 SIRTURO TABS....................................... 12 SIVEXTRO SOLR INTRAVENOUS.......... 10 SIVEXTRO TABS..................................... 10 SKELAXIN TABS ..................................... 20 SKLICE LOTN .......................................... 62 SKYRIZI (150 MG DOSE) PSKT .............. 65 SODIUM CHLORIDE SOLN ............... 43, 58 SODIUM CHLORIDE SOLN INJECTION . 43 SODIUM CHLORIDE SOLN

INTRAVENOUS .45%, .9%, 3%, 5% .... 43 SODIUM EDECRIN SOLR INTRAVENOUS

............................................................. 42 SODIUM FLUORIDE TABS ..................... 58 SODIUM LACTATE SOLN INTRAVENOUS

............................................................. 40 sodium phenylbutyrate powd .................... 40 sodium phenylbutyrate tabs ..................... 40 sodium polystyrene sulfonate powd ......... 42 sofosbuvir-velpatasvir tabs ....................... 14 SOLARAZE GEL ...................................... 63


solifenacin succinate tabs 5mg, 10mg ..... 66 SOLIQUA SOPN ..................................... 53 SOLODYN TB24 55mg, 65mg, 80mg,

105mg, 115mg ..................................... 10 SOLOSEC PACK .................................... 12 soloxide tbec ............................................ 10 SOLTAMOX SOLN .................................. 17 SOLU-CORTEF SOLR ............................ 48 SOLU-MEDROL SOLR ............................ 48 SOMA TABS 250mg, 350mg ................... 20 SOMATULINE DEPOT SOLN ................. 55 SOMAVERT SOLR 10mg, 15mg, 20mg,

25mg, 30mg ......................................... 55 SONATA CAPS 5mg, 10mg .................... 36 SOOLANTRA CREA ................................ 62 SORIATANE CAPS 10mg, 17.5mg, 25mg

............................................................. 65 SORILUX FOAM ..................................... 65 sorine tabs 80mg, 120mg, 160mg, 240mg

............................................................. 24 sotalol hcl (af) tabs................................... 24 sotalol hcl tabs 80mg, 160mg, 240mg ..... 24 SOTYLIZE SOLN .................................... 24 SOVALDI TABS ....................................... 14 SPIRIVA HANDIHALER CAPS ................ 19 SPIRIVA RESPIMAT AERS..................... 19 SPIRIVA RESPIMAT AERS 2.5mcg/act .. 19 spironolactone tabs 25mg, 50mg, 100mg 26 spironolactone-hctz tabs .......................... 26 SPORANOX CAPS.................................. 11 SPORANOX SOLN.................................. 11 SPRAVATO (56 MG DOSE) SOPK ......... 39 SPRAVATO (84 MG DOSE) SOPK ......... 40 sprintec 28 tabs ....................................... 50 SPRITAM TB3D 250mg, 500mg, 750mg,

1000mg ................................................ 33 SPRYCEL TABS 20mg, 50mg, 70mg,

80mg, 100mg, 140mg .......................... 18 sps susp .................................................. 42 sronyx tabs .............................................. 51 SSD CREA .............................................. 62 STALEVO 100 TABS ............................... 35 STALEVO 125 TABS ............................... 35 STALEVO 150 TABS ............................... 35 STALEVO 200 TABS ............................... 35 STALEVO 50 TABS ................................. 35 STALEVO 75 TABS ................................. 35 STARLIX TABS 60mg, 120mg ................. 53

stavudine caps 15mg, 20mg, 30mg, 40mg ............................................................. 14

STEGLATRO TABS 5mg, 15mg .............. 53 STEGLUJAN TABS .................................. 53 STELARA SOLN 45mg/0.5ml, 130mg/26ml

............................................................. 65 STELARA SOSY 45mg/0.5ml, 90mg/ml ... 65 STIMATE SOLN ....................................... 54 STIOLTO RESPIMAT AERS .................... 19 STIVARGA TABS..................................... 18 STRATTERA CAPS 10mg, 18mg, 25mg,

40mg, 60mg, 80mg, 100mg .................. 36 STRENSIQ SOLN 18mg/0.45ml,

28mg/0.7ml, 80mg/0.8ml, 40mg/ml ...... 43 streptomycin sulfate solr .......................... 10 STRIANT MISC ........................................ 49 STRIBILD TABS....................................... 14 STRIVERDI RESPIMAT AERS ................ 20 STROMECTOL TABS ................................ 8 SUBLOCADE SOSY 100mg/0.5ml,

300mg/1.5ml......................................... 37 SUBOXONE FILM .................................... 37 SUBSYS LIQD 100mcg, 200mcg, 400mcg,

600mcg, 800mcg, 1200mcg, 1600mcg . 30 SUCRAID SOLN ...................................... 43 sucralfate tabs .......................................... 47 SULAR TB24 8.5mg, 17mg, 34mg ........... 25 sulfacetamide sodium (acne) lotn ............. 62 sulfacetamide sodium oint ........................ 44 sulfacetamide sodium soln ....................... 44 sulfacetamide-prednisolone soln .............. 44 sulfadiazine tabs ...................................... 10 sulfamethoxazole-trimethoprim susp ........ 10 sulfamethoxazole-trimethoprim tabs......... 10 SULFAMYLON CREA .............................. 62 SULFAMYLON PACK .............................. 62 sulfasalazine tabs..................................... 10 sulfasalazine tbec..................................... 10 sulindac tabs ............................................ 30 sumatriptan soln ....................................... 34 SUMATRIPTAN SUCCINATE REFILL

SOCT ................................................... 34 sumatriptan succinate soaj ....................... 34 sumatriptan succinate soln ....................... 34 sumatriptan succinate sosy ...................... 34 sumatriptan succinate tabs ...................... 34 sumatriptan-naproxen sodium tabs .......... 34 SUPRAX CAPS ....................................... 10 suprax chew ............................................. 10


suprax susr 200mg/5ml ........................... 10 SUPRAX SUSR 500mg/5ml .................... 10 SUPREP BOWEL PREP KIT SOLN ........ 47 SURMONTIL CAPS 25mg, 50mg, 100mg 40 SUSTIVA CAPS 50mg, 200mg ................ 14 SUSTIVA TABS ....................................... 14 SUTENT CAPS 12.5mg, 25mg, 37.5mg,

50mg .................................................... 18 syeda tabs ............................................... 51 SYLATRON KIT ....................................... 18 SYLVANT SOLR 100mg, 400mg ............. 18 SYMBICORT AERO ................................ 59 SYMBYAX CAPS .................................... 40 SYMDEKO TBPK .................................... 58 SYMFI LO TABS ..................................... 14 SYMFI TABS ........................................... 14 SYMJEPI SOSY ...................................... 20 SYMLINPEN 120 SOPN .......................... 53 SYMLINPEN 60 SOPN ............................ 53 SYMPAZAN FILM 10mg, 20mg ............... 33 SYMPAZAN FILM 5mg ............................ 33 SYMPROIC TABS ................................... 47 SYMTUZA TABS ..................................... 14 SYNAGIS SOLN 50mg/0.5ml, 100mg/ml . 14 SYNALAR CREA ..................................... 63 SYNALGOS-DC CAPS ............................ 30 SYNAREL SOLN ..................................... 54 SYNDROS SOLN .................................... 46 SYNERA PTCH ....................................... 64 SYNERCID SOLR ................................... 10 SYNJARDY TABS ................................... 53 SYNJARDY XR TB24 .............................. 53 SYNRIBO SOLR ...................................... 18 SYNTHROID TABS 25mcg, 50mcg, 75mcg,


SYPRINE CAPS ...................................... 48

T TABLOID TABS ....................................... 18 TACLONEX OINT .................................... 63 TACLONEX SUSP................................... 63 tacrolimus caps .5mg, 1mg, 5mg ............. 57 tacrolimus oint .03%, .1% ........................ 65 tadalafil (pah) tabs 20mg ......................... 27 tadalafil tabs 2.5mg, 5mg ......................... 27 TAFINLAR CAPS 50mg, 75mg ................ 18 TAGRISSO TABS 40mg, 80mg ............... 18 TAKHZYRO SOLN .................................. 58

TALTZ SOAJ ............................................ 65 TALTZ SOSY ........................................... 65 TALWIN SOLN ......................................... 30 TALZENNA CAPS .25mg, 1mg ................ 18 TAMIFLU CAPS 30mg, 45mg, 75mg ....... 14 TAMIFLU SUSR ....................................... 14 tamoxifen citrate tabs ............................... 18 tamsulosin hcl caps ............................ 20, 56 TANZEUM PEN 30mg, 50mg .................. 53 tapazole tabs 5mg, 10mg ......................... 55 taperdex 12-day tbpk ............................... 48 taperdex 6-day tbpk ................................. 48 taperdex 7-day tbpk ................................. 48 TARCEVA TABS 25mg, 100mg, 150mg .. 18 targadox tabs ........................................... 10 TARGRETIN CAPS .................................. 18 TARGRETIN GEL .................................... 64 tarina 24 fe tabs ....................................... 51 tarina fe 1/20 tabs .................................... 51 TARKA TBCR .......................................... 25 TASIGNA CAPS 50mg, 150mg, 200mg ... 18 TASMAR TABS ........................................ 35 TAVALISSE TABS 100mg, 150mg .......... 22 tazarotene crea ........................................ 65 tazicef solr injection 1gm, 2gm, 6gm ........ 10 TAZORAC CREA ..................................... 65 TAZORAC CREA .05% ............................ 65 TAZORAC GEL .05%, .1% ...................... 65 taztia xt cp24 120mg, 180mg, 240mg,

300mg, 360mg ..................................... 25 TDVAX SUSP .......................................... 60 TECENTRIQ SOLN 840mg/14ml,

1200mg/20ml........................................ 18 TECFIDERA CPDR 120mg, 240mg ......... 37 TECFIDERA MISC ................................... 37 TECHNIVIE TABS .................................... 14 TEFLARO SOLR INTRAVENOUS 400mg,

600mg .................................................. 10 TEGRETOL SUSP ................................... 33 TEGRETOL TABS ................................... 33 TEGRETOL-XR TB12 100mg, 200mg,

400mg .................................................. 33 TEGSEDI SOSY ...................................... 58 TEKTURNA HCT TABS ........................... 26 TEKTURNA TABS 150mg, 300mg ........... 26 telmisartan tabs 20mg, 40mg, 80mg ........ 27 telmisartan-amlodipine tabs ..................... 25 telmisartan-hctz tabs ................................ 27 temazepam caps 7.5mg, 15mg, 22.5mg,

30mg .................................................... 36


tencon tabs .............................................. 30 TENIPOSIDE SOLN ................................ 18 TENIVAC INJ ........................................... 60 tenofovir disoproxil fumarate tabs ............ 14 TENORETIC 100 TABS ........................... 24 TENORETIC 50 TABS ............................. 24 TENORMIN TABS 25mg, 50mg, 100mg .. 24 TEPADINA SOLR .................................... 18 TERAZOL 7 CREA .................................. 62 terazosin hcl caps 1mg, 2mg, 5mg, 10mg 22 terbinafine hcl tabs................................... 11 terbutaline sulfate tabs 2.5mg, 5mg ......... 20 terconazole crea ...................................... 62 terconazole supp ..................................... 62 TESTIM GEL ........................................... 49 testosterone cypionate soln 100mg/ml,

200mg/ml ............................................. 49 testosterone enanthate soln .................... 49 testosterone gel 1%, 1.62%,

20.25mg/1.25gm, 25mg/2.5gm, 40.5mg/2.5gm, 50mg/5gm, 10mg/act ... 49

testosterone soln ..................................... 49 tetrabenazine tabs 12.5mg, 25mg ........... 36 tetracycline hcl caps 250mg, 500mg ........ 10 texacort soln ............................................ 64 THALOMID CAPS 50mg, 100mg, 150mg,

200mg .................................................. 18 theo-24 cp24 100mg, 200mg, 300mg,

400mg .................................................. 66 theophylline er tb12 100mg, 200mg, 300mg

............................................................. 66 theophylline er tb24 400mg, 600mg ......... 66 theophylline soln ...................................... 66 THIOLA EC TBEC 100mg, 300mg .......... 58 THIOLA TABS ......................................... 58 thioridazine hcl tabs 10mg, 25mg, 50mg,

100mg .................................................. 40 thiotepa solr ............................................. 18 thiothixene caps 1mg, 2mg, 5mg, 10mg .. 40 THYROLAR-1 TABS ................................ 55 THYROLAR-1/2 TABS ............................. 55 THYROLAR-1/4 TABS ............................. 55 THYROLAR-2 TABS ................................ 55 THYROLAR-3 TABS ................................ 55 tiagabine hcl tabs 2mg, 4mg, 12mg, 16mg

............................................................. 33 TIAZAC CP24 120mg, 180mg, 240mg,

300mg, 360mg, 420mg ........................ 25 TIBSOVO TABS ...................................... 18

TIGAN CAPS ........................................... 46 tigecycline solr intravenous ...................... 10 TIGLUTIK SUSP ...................................... 36 TIKOSYN CAPS 125mcg, 250mcg, 500mcg

............................................................. 25 TIMOLOL MALEATE SOLG .25%, .5% .... 45 timolol maleate soln .25%, .5% ................ 45 timolol maleate tabs 5mg, 10mg, 20mg .... 24 TIMOPTIC OCUDOSE SOLN .25%, .5% . 45 TIMOPTIC-XE SOLG .25%, .5% .............. 45 TINDAMAX TABS .................................... 12 tinidazole tabs .......................................... 12 TIROSINT CAPS 13mcg, 25mcg, 50mcg,


TIVICAY TABS 10mg, 25mg, 50mg ......... 14 TIVORBEX CAPS .................................... 30 tizanidine hcl caps .................................... 20 tizanidine hcl tabs..................................... 20 TOBI NEBU .............................................. 58 TOBI PODHALER CAPS ......................... 58 TOBRADEX OINT .................................... 44 TOBRADEX ST SUSP ............................. 44 TOBRADEX SUSP ................................... 45 tobramycin nebu ...................................... 10 tobramycin soln ........................................ 44 tobramycin sulfate soln injection 80mg/2ml,

10mg/ml ............................................... 10 tobramycin-dexamethasone susp ............ 45 TOBREX OINT ......................................... 44 TOBREX SOLN ....................................... 44 tofranil tabs 10mg, 25mg, 50mg ............... 40 TOLAK CREA .......................................... 65 tolazamide tabs 250mg, 500mg ............... 53 tolbutamide tabs ....................................... 53 tolcapone tabs .......................................... 35 tolmetin sodium caps ............................... 30 tolmetin sodium tabs ................................ 30 TOLSURA CAPS ..................................... 11 tolterodine tartrate er cp24 2mg, 4mg ...... 66 tolterodine tartrate tabs ............................ 66 TOPAMAX SPRINKLE CPSP 15mg, 25mg

............................................................. 33 TOPAMAX TABS 25mg, 50mg, 100mg,

200mg .................................................. 33 topicort crea .05%, .25% .......................... 64 topicort gel ............................................... 64 TOPICORT OINT ..................................... 64


topicort oint .25% ..................................... 64 TOPICORT SPRAY LIQD ........................ 64 topiramate cpsp 15mg, 25mg .................. 33 topiramate er cs24 25mg, 50mg, 100mg,

150mg, 200mg ..................................... 33 topiramate tabs 25mg, 50mg, 100mg,

200mg .................................................. 33 TOPROL XL TB24 25mg, 50mg, 100mg,

200mg .................................................. 24 toremifene citrate tabs ............................. 18 torsemide tabs 5mg, 10mg, 20mg, 100mg

............................................................. 42 TOUJEO MAX SOLOSTAR SOPN .......... 53 TOUJEO SOLOSTAR SOPN................... 53 TOVIAZ TB24 4mg, 8mg ......................... 66 TPN ELECTROLYTES SOLN

INTRAVENOUS ................................... 43 TRACLEER TABS 62.5mg, 125mg ......... 59 TRACLEER TBSO ................................... 59 TRADJENTA TABS ................................. 53 tramadol hcl er (biphasic) tb24 100mg,

200mg, 300mg ..................................... 30 tramadol hcl er cp24 100mg, 150mg,

200mg, 300mg ..................................... 30 tramadol hcl er tb24 100mg, 200mg, 300mg

............................................................. 30 tramadol hcl tabs ..................................... 30 tramadol-acetaminophen tabs ................. 30 trandolapril tabs 1mg, 2mg, 4mg ............. 27 trandolapril-verapamil hcl er tbcr .............. 25 tranexamic acid tabs ................................ 21 TRANSDERM-SCOP (1.5 MG) PT72 ...... 46 TRANXENE-T TABS ............................... 36 tranylcypromine sulfate tabs .................... 40 TRAVASOL SOLN INTRAVENOUS ........ 41 TRAVATAN Z SOLN ................................ 45 trazodone hcl tabs ................................... 40 trazodone hcl tabs 50mg, 100mg, 150mg 40 TRECATOR TABS................................... 12 TRELEGY ELLIPTA AEPB ...................... 48 TRELSTAR MIXJECT SUSR ................... 18 TREMFYA SOPN .................................... 65 TREMFYA SOSY .................................... 65 treprostinil soln 20mg/20ml, 50mg/20ml,

100mg/20ml, 200mg/20ml .................... 59 TRESIBA FLEXTOUCH SOPN 100unit/ml,

200unit/ml ............................................ 53 TRESIBA SOLN ...................................... 53 tretinoin caps ........................................... 18 tretinoin crea .025%, .05%, .1% ............... 64

tretinoin gel .01%, .025%, .05% .............. 64 tretinoin microsphere gel .04%, .1% ........ 64 tretinoin microsphere pump gel .04%, .1%

............................................................. 64 trexall tabs 5mg, 7.5mg, 10mg, 15mg ...... 18 TREXIMET TABS ..................................... 34 trezix caps ................................................ 30 triamcinolone acetonide aero ................... 45 triamcinolone acetonide aers ................... 64 triamcinolone acetonide

crea .025%, .1%, .5% ........................... 64 triamcinolone acetonide lotn .025%, .1% . 64 triamcinolone acetonide

oint .025%, .1%, .5% ............................ 64 triamcinolone acetonide pste .................... 64 triamterene-hctz caps ............................... 42 triamterene-hctz tabs ............................... 42 trianex oint ............................................... 64 triazolam tabs .125mg, .25mg .................. 36 TRIBENZOR TABS .................................. 25 TRICOR TABS 48mg, 145mg .................. 23 triderm crea .............................................. 64 TRIDESILON CREA ................................. 64 trientine hcl caps ...................................... 48 tri-estarylla tabs ........................................ 51 trifluoperazine hcl tabs 1mg, 2mg, 5mg,

10mg .................................................... 40 trifluridine soln .......................................... 44 TRIGLIDE TABS ...................................... 23 trihexyphenidyl hcl soln ............................ 35 trihexyphenidyl hcl tabs 2mg, 5mg ........... 35 tri-legest fe tabs ....................................... 51 TRILEPTAL SUSP ................................... 33 TRILEPTAL TABS 150mg, 300mg, 600mg

............................................................. 34 TRILIPIX CPDR 45mg, 135mg ................. 23 tri-lo-estarylla tabs .................................... 51 tri-lo-sprintec tabs..................................... 51 trilyte solr .................................................. 47 trimethobenzamide hcl caps ..................... 46 trimethoprim tabs ............................... 10, 15 tri-mili tabs ................................................ 51 trimipramine maleate caps 25mg, 50mg,

100mg .................................................. 40 TRINESSA (28) TABS ............................. 51 TRI-NORINYL (28) TABS......................... 51 TRINTELLIX TABS 5mg, 10mg, 20mg ..... 40 tri-previfem tabs ....................................... 51 TRIPTODUR SRER ................................. 54 TRISENOX SOLN .................................... 18


TRISENOX SOLN 10mg/10ml ................. 18 tri-sprintec tabs ........................................ 51 TRIUMEQ TABS ...................................... 14 trivora (28) tabs ....................................... 51 tri-vylibra lo tabs ...................................... 51 tri-vylibra tabs .......................................... 51 TRIZIVIR TABS ....................................... 14 TROKENDI XR CP24 25mg, 50mg, 100mg,

200mg .................................................. 34 TROPHAMINE SOLN INTRAVENOUS ... 41 trospium chloride er cp24 ........................ 66 trospium chloride tabs .............................. 66 TRULANCE TABS ................................... 47 TRULICITY SOPN .75mg/0.5ml,

1.5mg/0.5ml ......................................... 53 TRUMENBA SUSY .................................. 60 TRUSOPT SOLN ..................................... 45 TRUVADA TABS ..................................... 14 TRUVADA TABS 200-300 MG ................ 14 TUDORZA PRESSAIR AEPB .................. 19 TURALIO CAPS ...................................... 18 TWINRIX SUSY ....................................... 60 TWYNSTA TABS ..................................... 25 TYBOST TABS ........................................ 14 tydemy tabs ............................................. 51 TYGACIL SOLR INTRAVENOUS ............ 10 TYKERB TABS ........................................ 18 tylenol with codeine #3 tabs ..................... 30 tylenol with codeine #4 tabs ..................... 30 TYMLOS SOPN ....................................... 54 TYPHIM VI SOLN .................................... 60 TYSABRI CONC INTRAVENOUS ........... 37 TYVASO REFILL SOLN .......................... 59 TYVASO SOLN ....................................... 59 TYVASO STARTER SOLN ...................... 59

U UCERIS FOAM ........................................ 64 UCERIS TB24 ......................................... 48 UDENYCA SOSY .................................... 22 ULORIC TABS 40mg, 80mg .................... 56 ULTOMIRIS SOLN .................................. 58 ULTRACET TABS ................................... 30 ULTRAM ER TB24 100mg, 200mg, 300mg

............................................................. 30 ULTRAM TABS ....................................... 30 ULTRAVATE CREA ................................. 64 ULTRAVATE LOTN ................................. 64 ULTRAVATE OINT .................................. 64

UNASYN SOLR INJECTION .................... 10 UNITHROID TABS 25mcg, 50mcg, 75mcg,

88mcg, 100mcg, 112mcg, 125mcg, 150mcg, 175mcg, 200mcg, 300mcg ..... 55

UNITUXIN SOLN ..................................... 18 UPTRAVI TABS 200mcg, 400mcg, 600mcg,

800mcg, 1000mcg, 1200mcg, 1400mcg, 1600mcg .............................................. 59

UPTRAVI TBPK ....................................... 59 urecholine tabs 5mg, 10mg, 25mg, 50mg 19 UROCIT-K 10 TBCR ................................ 40 UROCIT-K 15 TBCR ................................ 40 UROCIT-K 5 TBCR .................................. 40 UROXATRAL TB24 .................................. 20 URSO 250 TABS ..................................... 47 URSO FORTE TABS ............................... 48 ursodiol caps ............................................ 48 ursodiol tabs 250mg, 500mg .................... 48 UTIBRON NEOHALER CAPS .................. 20

V VABOMERE SOLR INTRAVENOUS ....... 10 VAGIFEM TABS....................................... 54 valacyclovir hcl tabs 1gm, 500mg ............ 14 VALCHLOR GEL...................................... 65 VALCYTE SOLR ...................................... 14 VALCYTE TABS ...................................... 14 valganciclovir hcl solr ............................... 14 valganciclovir hcl tabs .............................. 14 VALIUM TABS 2mg, 5mg, 10mg .............. 36 valproic acid caps..................................... 34 valproic acid soln...................................... 34 valsartan tabs 40mg, 80mg, 160mg, 320mg

............................................................. 27 valsartan-hydrochlorothiazide tabs ........... 27 VALTREX TABS 1gm, 500mg .................. 14 vanatol lq soln .......................................... 30 VANCOCIN CAPS ................................... 10 VANCOCIN HCL CAPS ........................... 11 vancomycin hcl caps ................................ 11 VANCOMYCIN HCL INTRAVENOUS

250MG ................................................. 11 vancomycin hcl intravenous 750mg ......... 11 vancomycin hcl solr intravenous 1gm,

10gm, 500mg ....................................... 11 VANDAZOLE GEL ................................... 62 VANOS CREA ......................................... 64 VANTAS KIT ............................................ 18 VAQTA SUSP .......................................... 60


VARIVAX INJ ........................................... 60 VARIZIG SOLN ....................................... 60 VARUBI TABS ......................................... 46 VASCEPA CAPS .5gm, 1gm ................... 23 VASERETIC TABS .................................. 27 VASOTEC TABS 2.5mg, 5mg, 10mg, 20mg

............................................................. 27 VAXCHORA SUSR.................................. 60 vecamyl tabs ............................................ 25 VECTICAL OINT ..................................... 65 VELCADE SOLR ..................................... 18 velivet tabs ............................................... 51 VELPHORO CHEW ................................. 42 VELTASSA PACK 8.4gm, 16.8gm, 25.2gm

............................................................. 42 VEMLIDY TABS ...................................... 14 VENCLEXTA STARTING PACK TBPK ... 18 VENCLEXTA TABS ................................. 18 VENCLEXTA TABS 10mg, 50mg ............ 18 venlafaxine hcl er cp24 37.5mg, 75mg,

150mg .................................................. 40 venlafaxine hcl er tb24 37.5mg, 75mg,

150mg, 225mg ..................................... 40 venlafaxine hcl tabs 25mg, 37.5mg, 50mg,

75mg, 100mg ....................................... 40 VENTAVIS SOLN 10mcg/ml, 20mcg/ml .. 59 VENTOLIN HFA AERS ............................ 20 VERAPAMIL HCL ER CP24 100mg,

120mg, 180mg, 200mg, 240mg, 300mg, 360mg .................................................. 25

verapamil hcl er tbcr 120mg, 180mg, 240mg ............................................................. 25

verapamil hcl tabs .................................... 25 verapamil hcl tabs 80mg, 120mg ............. 25 VEREGEN OINT ..................................... 65 VERELAN CP24 120mg, 180mg, 240mg,

360mg .................................................. 25 VERELAN PM CP24 100mg, 200mg,

300mg .................................................. 25 veripred 20 soln ....................................... 48 VERSACLOZ SUSP ................................ 40 VERZENIO TABS 50mg, 100mg, 150mg,

200mg .................................................. 18 VESICARE TABS 5mg, 10mg ................. 66 vestura tabs ............................................. 51 VFEND IV SOLR INTRAVENOUS ........... 11 VFEND SUSR ......................................... 11 VFEND TABS 50mg, 200mg ................... 11 VIBERZI TABS 75mg, 100mg.................. 48 VIBRAMYCIN CAPS ................................ 11

VIBRAMYCIN SUSR ................................ 11 VIBRAMYCIN SYRP ................................ 11 vicodin es tabs ......................................... 30 vicodin hp tabs ......................................... 30 vicodin tabs .............................................. 30 VICTOZA SOPN ...................................... 53 VIDEX EC CPDR 125mg, 200mg, 250mg,

400mg .................................................. 14 VIDEX SOLR 2gm, 4gm ........................... 14 VIEKIRA PAK TBPK ................................ 14 VIEKIRA XR TB24 ................................... 14 vienva tabs ............................................... 51 vigabatrin pack ......................................... 34 vigabatrin tabs .......................................... 34 vigadrone pack ......................................... 34 VIGAMOX SOLN...................................... 44 VIIBRYD STARTER PACK KIT ................ 40 VIIBRYD TABS 10mg, 20mg, 40mg ......... 40 VIMIZIM SOLN ......................................... 43 VIMOVO TBEC ........................................ 30 VIMPAT SOLN ......................................... 34 VIMPAT TABS ......................................... 34 VIOKACE TABS ....................................... 43 VIRACEPT TABS 250mg, 625mg ............ 14 VIRAMUNE SUSP ................................... 14 VIRAMUNE TABS .................................... 14 VIRAMUNE XR TB24 100mg, 400mg ...... 14 VIREAD POWD ....................................... 14 VIREAD TABS 150mg ............................. 14 VIREAD TABS 200mg, 250mg, 300mg .... 14 VIROPTIC SOLN ..................................... 44 VISTARIL CAPS ...................................... 36 VISTOGARD PACK ................................. 56 VITRAKVI CAPS 25mg, 100mg ............... 18 VITRAKVI SOLN ...................................... 18 VIVELLE-DOT

PTTW .025mg/24hr, .0375mg/24hr, .05mg/24hr, .075mg/24hr, .1mg/24hr ........... 54

VIVITROL SUSR ...................................... 37 VIVLODEX CAPS .................................... 30 VIZIMPRO TABS 15mg, 30mg, 45mg ...... 18 VOGELXO GEL ....................................... 49 VOGELXO PUMP GEL ............................ 49 VOLTAREN GEL...................................... 64 VORAXAZE SOLR ................................... 56 voriconazole solr intravenous ................... 11 voriconazole susr ..................................... 11 voriconazole tabs ..................................... 11 VOSEVI TABS ......................................... 14 VOTRIENT TABS ..................................... 18


VP-PNV-DHA CAPS ................................ 66 VPRIV SOLR ........................................... 43 VRAYLAR CAPS 1.5mg, 3mg, 4.5mg, 6mg

............................................................. 40 VRAYLAR CPPK ..................................... 40 vyfemla tabs ............................................ 51 vylibra tabs .............................................. 51 VYNDAMAX CAPS .................................. 25 VYNDAQEL CAPS .................................. 25 VYTORIN TABS ...................................... 23 VYVANSE CAPS 10mg, 20mg, 30mg,

40mg, 50mg, 60mg, 70mg ................... 32 VYVANSE CHEW 10mg, 20mg, 30mg,

40mg, 50mg, 60mg .............................. 32 VYXEOS SUSR ....................................... 18 VYZULTA SOLN ...................................... 45

W warfarin sodium tabs 1mg, 2mg, 2.5mg,

3mg, 4mg, 5mg, 6mg, 10mg ................ 21 WELCHOL PACK .................................... 23 WELCHOL TABS .................................... 23 WELLBUTRIN SR TB12 100mg, 150mg,

200mg .................................................. 40 WELLBUTRIN XL TB24 150mg, 300mg .. 40 wixela inhub aepb .................................... 20 wymzya fe chew ...................................... 51

X XALATAN SOLN ..................................... 45 XALKORI CAPS 200mg, 250mg .............. 18 XANAX TABS .25mg, .5mg, 1mg, 2mg.... 36 XANAX XR TB24 .5mg, 1mg, 2mg, 3mg . 36 XARELTO STARTER PACK TBPK ......... 21 XARELTO TABS 2.5mg, 10mg, 15mg,

20mg .................................................... 21 XARTEMIS XR TBCR .............................. 30 XATMEP SOLN ....................................... 18 XELJANZ TABS 5mg, 10mg .................... 57 XELJANZ XR TB24 ................................. 57 XELPROS EMUL ..................................... 45 XENAZINE TABS 12.5mg, 25mg ............. 36 XENLETA SOLN ..................................... 11 XENLETA TABS ...................................... 11 XEOMIN SOLR ........................................ 58 XEOMIN SOLR 50unit, 100unit ............... 58 XEPI CREA ............................................. 62 XERESE CREA ....................................... 62

XERMELO TABS ..................................... 46 XGEVA SOLN .......................................... 56 XHANCE EXHU ....................................... 45 XIFAXAN TABS 200mg, 550mg ............... 11 XIGDUO XR TB24 ................................... 53 XIIDRA SOLN .......................................... 45 XIMINO CP24 45mg, 90mg, 135mg ......... 65 xodol tabs ................................................. 30 XOFLUZA TBPK 20mg, 40mg ................. 14 XOLAIR SOLR ......................................... 59 XOLAIR SOSY 75mg/0.5ml, 150mg/ml .... 59 XOPENEX CONCENTRATE NEBU ......... 20 XOPENEX HFA AERO ............................ 20 XOPENEX NEBU .31mg/3ml, .63mg/3ml,

1.25mg/3ml .......................................... 20 XOSPATA TABS ...................................... 18 XPOVIO (100 MG ONCE WEEKLY) TBPK

............................................................. 18 XPOVIO (60 MG ONCE WEEKLY) TBPK 18 XPOVIO (80 MG ONCE WEEKLY) TBPK 18 XPOVIO (80 MG TWICE WEEKLY) TBPK

............................................................. 18 XTAMPZA ER C12A 9mg, 13.5mg, 18mg,

27mg, 36mg ......................................... 30 XTANDI CAPS ......................................... 18 xulane ptwk .............................................. 51 XULTOPHY SOPN ................................... 53 XURIDEN PACK ...................................... 58 XYLOCAINE SOLN .................................. 64 XYOSTED SOAJ 50mg/0.5ml, 75mg/0.5ml,

100mg/0.5ml......................................... 49 XYREM SOLN ......................................... 36 XYZAL SOLN ........................................... 15

Y YASMIN 28 TABS .................................... 51 YAZ TABS ................................................ 51 YERVOY SOLN ....................................... 18 YF-VAX INJ .............................................. 60 YONDELIS SOLR .................................... 18 YONSA TABS .......................................... 18 YOSPRALA TBEC ................................... 21 YUPELRI SOLN ....................................... 19 yuvafem tabs ............................................ 54

Z zafirlukast tabs 10mg, 20mg .................... 58 zaleplon caps 5mg, 10mg ........................ 36


ZALTRAP SOLN 100mg/4ml, 200mg/8ml 18 zamicet soln ............................................. 31 ZANAFLEX CAPS ................................... 20 ZANAFLEX TABS .................................... 20 ZANTAC TABS ........................................ 47 zarah tabs ................................................ 51 ZARONTIN CAPS.................................... 34 zarontin soln ............................................ 34 ZARXIO SOSY 300mcg/0.5ml,

480mcg/0.8ml ...................................... 22 ZAVESCA CAPS ..................................... 43 zebutal caps ............................................ 31 ZEGERID CAPS ...................................... 47 ZEGERID PACK ...................................... 47 ZEJULA CAPS ........................................ 18 ZELAPAR TBDP ...................................... 35 ZELBORAF TABS ................................... 18 ZEMAIRA SOLR INTRAVENOUS ........... 59 ZEMBRACE SYMTOUCH SOAJ ............. 34 ZEMDRI SOLN INTRAVENOUS ............. 11 ZEMPLAR CAPS 1mcg, 2mcg ................. 66 zenatane caps 10mg, 20mg, 30mg, 40mg

............................................................. 65 zenchent tabs .......................................... 51 ZENPEP CPEP ....................................... 43 zenzedi tabs 2.5mg, 5mg, 7.5mg, 10mg,

15mg, 20mg, 30mg .............................. 32 ZEPATIER TABS ..................................... 14 ZERBAXA SOLR INTRAVENOUS .......... 11 ZERIT CAPS 15mg, 20mg, 30mg, 40mg . 14 ZERIT SOLR ........................................... 14 ZESTORETIC TABS ................................ 27 ZESTRIL TABS 2.5mg, 5mg, 10mg, 20mg,

30mg, 40mg ......................................... 27 ZETIA TABS ............................................ 23 ZETONNA AERS ..................................... 45 ZIAC TABS .............................................. 24 ZIAGEN SOLN ........................................ 14 ZIAGEN TABS ......................................... 14 ZIANA GEL .............................................. 65 zidovudine caps ....................................... 14 zidovudine syrp ........................................ 14 zidovudine tabs .................................. 13, 14 zileuton er tb12 ........................................ 58 ZINBRYTA SOSY .................................... 37 ZIOPTAN SOLN ...................................... 45 ziprasidone hcl caps 20mg, 40mg, 60mg,

80mg .................................................... 40 ZIPSOR CAPS ........................................ 31 ZIRGAN GEL ........................................... 44

ZITHROMAX PACK ................................. 11 ZITHROMAX SOLR INTRAVENOUS ....... 11 ZITHROMAX SUSR 100mg/5ml,

200mg/5ml ........................................... 11 ZITHROMAX TABS 250mg, 500mg, 600mg

............................................................. 11 ZITHROMAX TRI-PAK TABS ................... 11 ZITHROMAX Z-PAK TABS ...................... 11 ZMAX SUSR ............................................ 11 ZOCOR TABS 5mg, 10mg, 20mg, 40mg,

80mg .................................................... 23 ZOFRAN ODT TBDP 4mg, 8mg .............. 46 ZOFRAN SOLN ....................................... 46 ZOFRAN TABS 4mg, 8mg ....................... 46 ZOHYDRO ER C12A 10mg, 15mg, 20mg,

30mg, 40mg, 50mg .............................. 31 ZOLINZA CAPS ....................................... 18 zolmitriptan tabs ....................................... 34 zolmitriptan tbdp ....................................... 34 ZOLOFT TABS 25mg, 50mg, 100mg ....... 40 zolpidem tartrate er tbcr 6.25mg, 12.5mg . 36 zolpidem tartrate subl 1.75mg, 3.5mg ...... 36 zolpidem tartrate tabs 5mg, 10mg ............ 36 ZOLPIMIST SOLN ................................... 36 ZOMACTON SOLR .................................. 55 ZOMACTON SOLR 5mg .......................... 55 ZOMIG SOLN .......................................... 34 ZOMIG TABS ........................................... 34 ZOMIG ZMT TBDP .................................. 34 ZONALON CREA ..................................... 64 ZONEGRAN CAPS 25mg, 100mg ........... 34 zonisamide caps 25mg, 50mg, 100mg ..... 34 ZONTIVITY TABS .................................... 21 ZORBTIVE SOLR .................................... 55 ZORTRESS TABS .25mg ........................ 57 ZORTRESS TABS .5mg, .75mg, 1mg ...... 57 ZORVOLEX CAPS ................................... 31 ZOSTAVAX SUSR ................................... 60 ZOSYN SOLN INTRAVENOUS ............... 11 ZOSYN SOLR INTRAVENOUS ............... 11 zovia 1/35e (28) tabs ................................ 51 zovia 1/50e (28) tabs ................................ 51 ZOVIRAX CAPS....................................... 14 ZOVIRAX CREA ...................................... 62 ZOVIRAX OINT ........................................ 62 ZOVIRAX SUSP....................................... 14 ZOVIRAX TABS ....................................... 14 ZTLIDO PTCH ......................................... 64 ZUBSOLV SUBL ...................................... 37 ZUPLENZ FILM 4mg, 8mg ....................... 46


ZURAMPIC TABS.................................... 43 ZYBAN TB12 ........................................... 40 ZYCLARA PUMP CREA 2.5%, 3.75% ..... 65 ZYDELIG TABS 100mg, 150mg .............. 18 ZYFLO CR TB12 ..................................... 58 ZYFLO TABS ........................................... 58 ZYKADIA CAPS ...................................... 18 ZYKADIA TABS ....................................... 18 ZYLET SUSP ........................................... 45 ZYLOPRIM TABS 100mg, 300mg ........... 56 ZYMAXID SOLN ...................................... 44 ZYPITAMAG TABS 1mg, 2mg, 4mg ........ 23

ZYPREXA RELPREVV SUSR ................. 40 ZYPREXA SOLR...................................... 40 ZYPREXA TABS 2.5mg, 5mg, 7.5mg,

10mg, 15mg, 20mg .............................. 40 ZYPREXA ZYDIS TBDP 5mg, 10mg, 15mg,

20mg .................................................... 40 ZYTIGA TABS 250mg, 500mg ................. 18 ZYVOX SOLN INTRAVENOUS

200mg/100ml, 600mg/300ml ................ 11 ZYVOX SUSR .......................................... 11 ZYVOX TABS .......................................... 11

60899009

Aviso de no discriminación Kaiser Permanente cumple con las leyes federales de derechos civiles y no discrimina por raza, color, país de origen, edad, discapacidad o sexo. Kaiser Permanente no excluye a las personas ni las trata de forma diferente debido a su raza, color, país de origen, discapacidad o sexo. Además, nosotros:

• proporcionamos ayuda y servicios sin costo a las personas con discapacidades para que puedan comunicarse de manera eficaz con nosotros, como: ♦ intérpretes de lenguaje de señas calificados ♦ información por escrito en otros formatos, como letra grande, audio y formatos

electrónicos accesibles • proporcionamos servicios de idiomas sin costo a las personas cuya lengua materna no sea

el inglés, como: ♦ intérpretes calificados ♦ información por escrito en otros idiomas

Si necesita estos servicios, llame a Servicio a los Miembros (Member Services) al 1-800-443-0815 (línea TTY 711), de 8 a. m. a 8 p. m., los siete días de la semana.

Si usted cree que Kaiser Permanente no proporcionó estos servicios o discriminó de alguna forma ya sea por raza, color, país de origen, edad, discapacidad o sexo, puede presentar una queja por escrito con nuestro coordinador de derechos civiles en One Kaiser Plaza, 12th Floor, Suite 1223, Oakland, CA 94612 o llamar a Servicio a los Miembros al número que aparece arriba. Puede presentar una queja por correo o por teléfono. Si necesita ayuda para presentar una queja, nuestro coordinador de derechos civiles está disponible para ayudarle. También puede presentar una queja informal en la Oficina de Derechos Civiles (Civil Rights Office) del Departamento de Salud y Servicios Humanos de los Estados Unidos (U.S. Department of Health and Human Services) de forma electrónica a través del Portal de Quejas de la Oficina de Derechos Civiles que está disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, por correo en: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, o por teléfono al: 1-800-368-1019, 800-537-7697 (línea TDD). Los formularios de quejas informales están disponibles en http://www.hhs.gov/ocr/office/file/index.html.

http://www.hhs.gov/ocr/office/file/index.html

60897108 CA

Multi-language Interpreter Services English ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-800-443-0815 (TTY: 711).

Spanish ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-443-0815 (TTY: 711).

Chinese 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-443-0815 （TTY：711）。

Vietnamese CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-800-443-0815 (TTY: 711).

Tagalog PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-443-0815 (TTY: 711).

Korean 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

1-800-443-0815 (TTY: 711)번으로 전화해 주십시오.

Armenian ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 1-800-443-0815 (TTY (հեռատիպ)՝ 711):

Russian ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-443-0815 (телетайп: 711).

Japanese 注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-800-443-0815（TTY:711）まで、お電話にてご連絡ください。

Hmong LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-800-443-0815 (TTY: 711).

Thai เรยีน: ถ้าคุณพดูภาษาไทยคุณสามารถใชบ้รกิารช่วยเหลอืทางภาษาไดฟ้ร ี โทร 1-800-443-0815 (TTY: 711).

Farsi ی م فراھم شمای برا گانیرا بصورتی زبان التیتسھ د،یکنی م گفتگو فارسی زبان بھ اگر: توجھ .دیریبگ تماس (TTY: 711) 0815-443-800-1 با. باشد

Arabic - ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم

).711- ھاتف الصم والبكم:(رقم 1-800-443-0815

Aviso contra la discriminación Kaiser Permanente cumple con las leyes federales sobre derechos civiles aplicables y no discrimina por raza, color, país de origen, edad, discapacidad o sexo. Kaiser Permanente no excluye a las personas ni las trata de manera diferente debido a su raza, color, país de origen, edad, discapacidad o sexo. Además:

● Ofrecemos servicios y ayudas sin costo a las personas con discapacidades para que se comuniquen �� con nosotros, tales como: ♦ Intérpretes �� del lenguaje de signos. ♦ Información escrita en otros formatos, tales como impresiones en letra grande, audio y formatos

electrónicos accesibles. ● Ofrecemos servicios lingüísticos sin costo a las personas cuyo idioma principal no es el inglés, tales

como: ♦ Intérpretes �� ♦ Información escrita en otros idiomas.

Si necesita estos servicios, llame a Servicio a los Miembros al 1-800-476-2167 (TTY 711),de 8 a. m. a 8 p. m., siete días a la semana.

Si considera que Kaiser Permanente ha fallado a la hora de ofrecer estos servicios o lo ha discriminado de algún modo por su raza, color, país de origen, edad, discapacidad o sexo, puede presentar una queja formal ante nuestro Coordinador de Derechos Civiles escribiendo a 2500 South Havana, Aurora, CO 80014 o llamando a Servicio a los Miembros al número que aparece arriba. Puede presentar una queja formal por correo postal o por teléfono. Si necesita ayuda para presentar una queja formal, nuestro Coordinador de Derechos Civiles está disponible para ayudarlo. También puede presentar electrónicamente una queja formal de violación de los derechos civiles ante la �� de Derechos Civiles del Departamento de Salud y Servicios Humanos de Estados Unidos, a través del Portal de Quejas Formales de la �� de Derechos Civiles, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o por correo postal o teléfono: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD). Los formularios de quejas están disponibles en http://www��.

61102709_COSP


https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

H0630_17022 accepted 2017MLI






Korean

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

1-800-476-2167 (TTY: 711)번으로 전화해 주십시오.



Amharic ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-800-476-2167 (መስማት ለተሳናቸው: 711).

German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-476-2167 (TTY: 711).

French ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-476-2167 (ATS : 711).

Farsi

ی م فراھم شمای برا گانیرا بصورتی زبان التیتسھ د،یکنی م گفتگو فارسی زبان بھ اگر: توجھ . دیریبگ تماس (TTY: 711) 2167-476-800-1 با. باشد

Arabic

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم ).117- (رقم ھاتف الصم والبكم: 7612-674-008-1

Yoruba AKIYESI: Ti o ba nso ede Yoruba ofe ni iranlowo lori ede wa fun yin o. E pe ero ibanisoro yi 1-800-476-2167 (TTY: 711).

Cushite-Oromo XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-800-476-2167 (TTY: 711).

KAH2711

Notice of nondiscrimination Kaiser Permanente complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kaiser Permanente does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. We also:

• Provide no cost aids and services to people with disabilities to communicateeffectively with us, such as:♦ Qualified sign language interpreters.♦ Written information in other formats, such as large print, audio, and accessible

electronic formats.• Provide no cost language services to people whose primary language is not English,

such as:♦ Qualified interpreters.♦ Information written in other languages.

If you need these services, call Member Services at 1-800-805-2739 (TTY 711), 8 a.m. to 8 p.m., seven days a week.

If you believe that Kaiser Permanente has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with our Civil Rights Coordinator by writing to 711 Kapiolani Blvd, Honolulu, HI 96813 or calling Member Services at the number listed above. You can file a grievance by mail or phone. If you need help filing a grievance, our Civil Rights Coordinator is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.

H1230_2017MLI accepted






Korean

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

1-800-805-2739 (TTY: 711)번으로 전화해 주십시오.


Lao

ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ ້ າພາສາ ລາວ, ການບໍ ລິ ການຊ່ວຍເຫືຼອດ້ານພາສາ, ໂດຍບໍ່ ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-800-805-2739 (TTY: 711).

Ilocano PAKDAAR: Nu saritaem ti Ilocano, ti serbisyo para ti baddang ti lengguahe nga awanan bayadna, ket sidadaan para kenyam. Awagan ti 1-800-805-2739 (TTY: 711).

Samoan MO LOU SILAFIA: Afai e te tautala Gagana fa'a Sāmoa, o loo iai auaunaga fesoasoan, e fai fua e leai se totogi, mo oe, Telefoni mai: 1-800-805-2739 (TTY: 711).

Marshallese LALE: Ñe kwōj kōnono Kajin Ṃajōḷ, kwomaroñ bōk jerbal in jipañ ilo kajin ṇe aṃ ejjeḷọk wōṇāān. Kaalọk 1-800-805-2739 (TTY: 711)

Trukese MEI AUCHEA: Ika iei foosun fonuomw: Foosun Chuuk, iwe en mei tongeni omw kopwe angei aninisin chiakku, ese kamo. Kori 1-800-805-2739 (TTY: 711).

Hawaiian E NĀNĀ MAI: Inā hoʻopuka ʻoe i ka ʻōlelo hoʻokomo ʻōlelo, loaʻa ke kōkua manuahi iā ʻoe. E kelepona iā 1-800-805-2739 (TTY: 711).

Pohnpeian Ni songen mwohmw ohte, komw pahn sohte anahne kawehwe mesen nting me koatoantoal kan ahpw wasa me ntingie Lokaiahn Pohnpei komw kalangan oh ntingidieng ni lokaiahn Pohnpei. Call 1-800-805-2739 (TTY: 711).

Bisayan ATENSYON: Kung nagsulti ka og Cebuano, aduna kay magamit nga mga serbisyo sa tabang sa lengguwahe, nga walay bayad. Tawag sa 1-800-805-2739 (TTY: 711).

Tongan FAKATOKANGA’I: Kapau ‘oku ke Lea-Fakatonga, ko e kau tokoni fakatonu lea ‘oku nau fai atu ha tokoni ta’etotongi, pea teke lava ‘o ma’u ia. Telefoni mai 1-800-805-2739 (TTY: 711).

Aviso de no discriminación Kaiser Permanente cumple las leyes de derechos civiles federales correspondientes y no discrimina por motivos de raza, color, país de origen, edad, discapacidad o sexo. Kaiser Permanente no excluye a las personas ni las trata diferente debido a su raza, color, país de origen, edad, discapacidad o sexo. Además:

• Proporcionamos ayuda y servicios sin costo a personas con discapacidades para que se comuniquen eficazmente con nosotros, como:

♦ intérpretes calificados de lenguaje de señas

♦ información por escrito en otros formatos, como letra grande, audio y formatos electrónicos accesibles

• Proporcionamos servicios de idiomas sin costo a las personas cuya lengua materna no sea el inglés, como:

♦ intérpretes calificados

♦ información por escrito en otros idiomas Si necesita estos servicios, llame a Servicio a los Miembros al 1-888-777-5536 (línea TTY 711), de 8 a. m. a 8 p. m., los siete días de la semana.

Si considera que Kaiser Permanente no le proporcionó estos servicios o que lo discriminaron de alguna otra forma por su raza, color, país de origen, edad, discapacidad o sexo, puede presentar una queja con nuestro coordinador de derechos civiles escribiendo a 2101 East Jefferson Street, Rockville, MD 20852 o llamando a Servicio a los Miembros al número que se mencionó anteriormente. Puede presentar una queja por correo o por teléfono. Si necesita ayuda para presentar una queja, nuestro Coordinador de Derechos Civiles está disponible para ayudarle. También puede presentar una queja de derechos civiles de forma electrónica ante la Oficina de Derechos Civiles (Civil Rights Office) en el Departamento de Salud y Servicios Humanos de los Estados Unidos (U.S. Department of Health and Human Services) mediante el portal de quejas formales de la Oficina de Derechos Civiles, en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o por correo postal o por teléfono a: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, 1-800-368-1019, 1-800-537-7697 (línea TDD). Los formularios de quejas están disponibles en http://www.hhs.gov/ocr/office/file/index.html (en inglés).

61104712


Multi-language Interpreter Services

English ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-888-777-5536 (TTY: 711).


Chinese 1-888-777-5536

TTY 711



Korean : , .

1-888-777-5536 (TTY: 711) .


Japanese

1-888-777-5536 TTY:711

Thai 1-888-777-5536 (TTY: 711).

Hindi :

1-888-777-5536 (TTY: 711)

Amharic : 1-888-777-5536 ( : 711).

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Farsi رایگ ان برای شما فراھم می : اگر بھ زبان فارسی گفتگو می کنید، تسھیالت زبانی بصورت

باشد. با (TTY: 711) 5536-777-888-1 تماس بگیری Arabic

: إذا كنت تتحدث اذكر اللغة، فإن خدم ملحوظة ت المساعدة اللغویة تتوافر لك بالم ا ن . اتصل برقم جا 5536-777-888-1 (رقم ھاتف الصم والبكم : -711).

German ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-888-777-5536 (TTY: 711).

French ATTENTION : Si vous parlez français, des services d aide linguistique vous sont proposés gratuitement. Appelez le 1-888-777-5536 (ATS : 711).

Yoruba AKIYESI: Ti o ba nso ede Yoruba ofe ni iranlowo lori ede wa fun yin o. E pe ero ibanisoro yi 1-888-777-5536 (TTY: 711).

Portuguese ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-888-777-5536 (TTY: 711).

Italian ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-888-777-5536 (TTY: 711).

Bengali , ,

1-888-777-5536 (TTY: 711)

Urdu خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال کریں

1-888-777-5536 (TTY: 711). French Creole ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-888-777-5536 (TTY: 711).

Gujarati . : , :

1-888-777-5536 (TTY: 711).

60958708 10/2019

Esta lista de medicamentos recetados disponibles se actualizó el 1 de octubre de 2019. Para obtener información más reciente o si tiene alguna otra pregunta, llame al número de su región de Kaiser Permanente indicado a continuación, siete días a la semana, de 8 a. m. a 8 p. m., o visite kp.org/seniormedrx.

Regiones de Kaiser Permanente

REGIÓN DEL NORTE DE CALIFORNIA Kaiser Foundation Health Plan, Inc. 393 E. Walnut St. Pasadena, CA 91188-8514 Plan Kaiser Permanente Senior Advantage Medicare Medi-Cal North (HMO SNP)

Central de Llamadas de Servicio a los Miembros 1-800-443-0815 (TTY 711)

REGIÓN DE COLORADO Kaiser Foundation Health Plan of Colorado 10350 E. Dakota Ave. Denver, CO 80247 Plan Kaiser Permanente Senior Advantage Medicare Medicaid (HMO SNP)


kp.org/seniormedrx Please recycle.

REGIÓN DE HAWÁI Kaiser Foundation Health Plan, Inc. 711 Kapiolani Blvd. Tower Suite 400 Honolulu, HI 96813 Plan Kaiser Permanente Senior Advantage Medicare Medicaid (HMO SNP)


REGIÓN DE LOS ESTADOS DEL ATLÁNTICO MEDIO (Distritos de Columbia, Maryland y Virginia) Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. 2101 East Jefferson St. Rockville, MD 20852 Plan Kaiser Permanente Medicare Plus (Cost) Basic con D (AB) y Basic con D (B)


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