Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 00904530909 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 00904530920 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 00904557720 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 45802013326 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 45802089726 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Childrens Ibuprofen Suspension 100 MG/5ML Oral 45802089734 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 24385036126 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 24385036134 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 24385037226 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 24385090526 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 24385090534 INFLAMMATORY* Agents (NSAIDs)*** GNP Childrens Ibuprofen Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 46122011026 INFLAMMATORY* Agents (NSAIDs)*** GoodSense Ibuprofen Childrens Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 00113016626 INFLAMMATORY* Agents (NSAIDs)*** GoodSense Ibuprofen Childrens Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 00113066026 INFLAMMATORY* Agents (NSAIDs)*** GoodSense Ibuprofen Childrens Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 00113068526 INFLAMMATORY* Agents (NSAIDs)*** GoodSense Ibuprofen Childrens Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 00113089726 INFLAMMATORY* Agents (NSAIDs)*** GoodSense Ibuprofen Childrens Suspension 100 *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory MG/5ML Oral 00113089734 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113051771 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113060452 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113060462 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113060471 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113060478 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory GoodSense Ibuprofen TABLET 200 MG Oral 00113060490 INFLAMMATORY* Agents (NSAIDs)*** HM Ibuprofen Childrens Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 62011001001 INFLAMMATORY* Agents (NSAIDs)*** HM Ibuprofen Childrens Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 62011001101 INFLAMMATORY* Agents (NSAIDs)*** HM Ibuprofen Childrens Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 62011003001 INFLAMMATORY* Agents (NSAIDs)***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS HM Ibuprofen Childrens Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 62011021401 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory IBU-200 Tablet 200 MG Oral 00904791451 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory IBU-200 Tablet 200 MG Oral 00904791459 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory IBU-200 Tablet 200 MG Oral 00904791480 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 00472176094 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 00472176098 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 00472176194 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 00472176394 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 00472176494 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 45802014026 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 51672213001 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 51672213008 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 69230030811 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000018101 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000025901 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000026201 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000026301 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000026302 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Childrens Suspension 100 MG/5ML Oral 70000026401 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904674780 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791251 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791259 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791461 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791524 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791540 INFLAMMATORY* Agents (NSAIDs)*** *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791551 INFLAMMATORY* Agents (NSAIDs)***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Ibuprofen Tablet 200 MG Oral 00904791559 INFLAMMATORY* Agents (NSAIDs)*** SM Childrens Ibuprofen Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 49348022934 INFLAMMATORY* Agents (NSAIDs)*** SM Childrens Ibuprofen Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 49348022937 INFLAMMATORY* Agents (NSAIDs)*** SM Childrens Ibuprofen Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 49348049934 INFLAMMATORY* Agents (NSAIDs)*** SM Childrens Ibuprofen Suspension 100 MG/5ML *ANALGESICS - ANTI- *Nonsteroidal Anti-inflammatory Oral 49348050034 INFLAMMATORY* Agents (NSAIDs)*** Back & Body Extra Strength TABLET 500-32.5 MG Oral 70000012701 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Back & Body Extra Strength TABLET 500-32.5 MG Oral 70000012702 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** GNP Headache Relief Extra Str TABLET 250-250-65 MG Oral 46122038278 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** GoodSense Migraine Formula TABLET 250-250-65 MG Oral 00113037462 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Headache Relief TABLET 250-250-65 MG Oral 70000014601 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Headache Relief TABLET 250-250-65 MG Oral 70000025801 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Migraine Relief TABLET 250-250-65 MG Oral 70000024701 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Tension Headache Tablet 500-65 MG Oral 70000015901 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** Tension Headache Tablet 500-65 MG Oral 70000015902 *ANALGESICS - NonNarcotic* *Analgesic Combinations*** 8 Hour Arthritis Pain Reliever Tablet Extended Release 650 MG Oral 70000018002 *ANALGESICS - NonNarcotic* *Analgesics Other*** 8 Hour Arthritis Pain Reliever Tablet Extended Release 650 MG Oral 70000018003 *ANALGESICS - NonNarcotic* *Analgesics Other*** 8 Hour Pain Relief Tablet Extended Release 650 MG Oral 36800021778 *ANALGESICS - NonNarcotic* *Analgesics Other*** 8HR Muscle Aches & Pain Tablet Extended Release 650 MG Oral 70000030601 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 325 MG Rectal 00713016401 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 325 MG Rectal 00713016412 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 325 MG Rectal 00713016450 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 650 MG Rectal 00713016501 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 650 MG Rectal 00713016512 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acephen Suppository 650 MG Rectal 00713016550 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Childrens Suspension 160 MG/5ML Oral 00904676620 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Childrens Suspension 160 MG/5ML Oral 45802020126 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Childrens Suspension 160 MG/5ML Oral 45802020326 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Childrens Tablet Chewable 160 MG Oral 70000031001 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904672024 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904672040 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904672051 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904672059 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Acetaminophen Extra Strength Tablet 500 MG Oral 00904672060 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904672080 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904673059 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904673060 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904673061 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904673080 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 00904674959 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 49483034110 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 49483034150 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 70000037301 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 70000037302 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 70000037303 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 70000037304 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Extra Strength Tablet 500 MG Oral 70000037305 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Infants Suspension 160 MG/5ML Oral 00536121277 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 160 MG/5ML Oral 00121065700 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 160 MG/5ML Oral 00121065705 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 160 MG/5ML Oral 00904673870 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 160 MG/5ML Oral 66689005401 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 160 MG/5ML Oral 66689005499 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 325 MG/10.15ML Oral 00121131400 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 325 MG/10.15ML Oral 00121131411 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 325 MG/10.15ML Oral 00904673971 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 325 MG/10.15ML Oral 66689005501 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 325 MG/10.15ML Oral 66689005599 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 650 MG/20.3ML Oral 00121197100 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 650 MG/20.3ML Oral 00121197121 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 650 MG/20.3ML Oral 00904682076 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 650 MG/20.3ML Oral 66689005601 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Solution 650 MG/20.3ML Oral 66689005699 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Suppository 120 MG Rectal 45802073230 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Suppository 120 MG Rectal 45802073233 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Suppository 650 MG Rectal 45802073030 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Suppository 650 MG Rectal 45802073032 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Suppository 650 MG Rectal 45802073033 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 00536116401 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 00904671950 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 00904671960 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Acetaminophen Tablet 325 MG Oral 00904671980 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 00904677361 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 49483034001 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 49483034010 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 51645070301 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 51645070310 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 63739044001 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 325 MG Oral 70000037401 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 00536117201 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 00536117210 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 51645070501 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 51645070510 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 51645070601 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 51645070610 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 70000031202 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 70000041001 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet 500 MG Oral 70000041002 *ANALGESICS - NonNarcotic* *Analgesics Other*** Acetaminophen Tablet Chewable 160 MG Oral 70000030901 *ANALGESICS - NonNarcotic* *Analgesics Other*** Arthritis Pain Relief Tablet Extended Release 650 MG Oral 36800054462 *ANALGESICS - NonNarcotic* *Analgesics Other*** Arthritis Pain Relief Tablet Extended Release 650 MG Oral 36800054471 *ANALGESICS - NonNarcotic* *Analgesics Other*** Arthritis Pain Relief Tablet Extended Release 650 MG Oral 36800054478 *ANALGESICS - NonNarcotic* *Analgesics Other*** Arthritis Pain Relief Tablet Extended Release 650 MG Oral 36800096647 *ANALGESICS - NonNarcotic* *Analgesics Other*** Arthritis Pain Relief Tablet Extended Release 650 MG Oral 51660033301 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Acetaminophen Suspension 160 MG/5ML Oral 00121178100 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Acetaminophen Suspension 160 MG/5ML Oral 00121178105 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Acetaminophen Suspension 160 MG/5ML Oral 68094001559 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Acetaminophen Suspension 160 MG/5ML Oral 68094001561 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Acetaminophen Suspension 160 MG/5ML Oral 68094001562 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Silapap Liquid 160 MG/5ML Oral 54838014440 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Silapap Liquid 160 MG/5ML Oral 54838014470 *ANALGESICS - NonNarcotic* *Analgesics Other*** Childrens Silapap Liquid 160 MG/5ML Oral 54838014480 *ANALGESICS - NonNarcotic* *Analgesics Other*** Extra Strength Pain Relief Tablet 500 MG Oral 36800004662 *ANALGESICS - NonNarcotic* *Analgesics Other*** Extra Strength Pain Relief Tablet 500 MG Oral 36800004671 *ANALGESICS - NonNarcotic* *Analgesics Other*** Extra Strength Pain Relief Tablet 500 MG Oral 36800004678 *ANALGESICS - NonNarcotic* *Analgesics Other*** Extra Strength Pain Relief Tablet 500 MG Oral 36800004683 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Adults SUPPOSITORY 650 MG Rectal 51672211704 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Childrens Suppository 120 MG Rectal 51672211502 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Childrens Suppository 120 MG Rectal 51672211504 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Infants SUPPOSITORY 80 MG Rectal 51672211402 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Infants SUPPOSITORY 80 MG Rectal 51672211404 *ANALGESICS - NonNarcotic* *Analgesics Other*** FeverAll Junior Strength Suppository 325 MG Rectal 51672211602 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS FeverAll Junior Strength Suppository 325 MG Rectal 51672211604 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP 8 Hour Pain Reliever Tablet Extended Release 650 MG Oral 46122006271 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Acetaminophen Tablet 325 MG Oral 46122043078 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain & Fever Childrens Suspension 160 MG/5ML Oral 46122032226 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Extra Strength Tablet 500 MG Oral 24385014571 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Extra Strength Tablet 500 MG Oral 24385048447 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Extra Strength Tablet 500 MG Oral 24385048471 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Extra Strength Tablet 500 MG Oral 24385048478 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Extra Strength Tablet 500 MG Oral 24385048490 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Tablet 325 MG Oral 46122024778 *ANALGESICS - NonNarcotic* *Analgesics Other*** GNP Pain Relief Tablet 325 MG Oral 46122039078 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Arthritis Pain Tablet Extended Release 650 MG Oral 00113054462 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Arthritis Pain Tablet Extended Release 650 MG Oral 00113054471 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Arthritis Pain Tablet Extended Release 650 MG Oral 00113054478 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Child Suspension 160 MG/5ML Oral 00113002026 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Child Suspension 160 MG/5ML Oral 00113021226 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Child Suspension 160 MG/5ML Oral 00113895926 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Infants Suspension 160 MG/5ML Oral 00113016110 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Infants Suspension 160 MG/5ML Oral 00113059010 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain & Fever Infants Suspension 160 MG/5ML Oral 00113094610 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113002562 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113002571 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113022771 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113048452 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113048462 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113048471 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113048478 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Extra St Tablet 500 MG Oral 00113048490 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS GoodSense Pain Relief Tablet 325 MG Oral 00113040378 *ANALGESICS - NonNarcotic* *Analgesics Other*** GoodSense Pain Relief Tablet Extended Release 650 MG Oral 00113021771 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Acetaminophen Childrens Tablet Chewable 160 MG Oral 62011033901 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Arthritis Pain Relief Tablet Extended Release 650 MG Oral 62011002601 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Arthritis Pain Relief Tablet Extended Release 650 MG Oral 62011033701 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Pain & Fever Childrens Suspension 160 MG/5ML Oral 62011018301 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Pain & Fever Childrens Suspension 160 MG/5ML Oral 62011024601 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Pain & Fever Childrens Suspension 160 MG/5ML Oral 62011024701 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Pain & Fever Infants Suspension 160 MG/5ML Oral 62011000101 *ANALGESICS - NonNarcotic* *Analgesics Other***

HM Pain Relief Extra Strength Tablet 500 MG Oral 62011002301 *ANALGESICS - NonNarcotic* *Analgesics Other***

HM Pain Relief Extra Strength Tablet 500 MG Oral 62011002302 *ANALGESICS - NonNarcotic* *Analgesics Other***

HM Pain Relief Extra Strength Tablet 500 MG Oral 62011002303 *ANALGESICS - NonNarcotic* *Analgesics Other***

HM Pain Relief Extra Strength Tablet 500 MG Oral 62011002701 *ANALGESICS - NonNarcotic* *Analgesics Other*** HM Pain Reliever Tablet 325 MG Oral 62011003201 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Arthritis Pain Tablet Extended Release 650 MG Oral 00904576960 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Capsule 500 MG Oral 00904198760 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Childrens Suspension 160 MG/5ML Oral 00904653620 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Childrens Tablet Chewable 80 MG Oral 00904579146 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Liquid 160 MG/5ML Oral 00904198500 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Liquid 160 MG/5ML Oral 00904198516 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Liquid 160 MG/5ML Oral 00904198520 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 325 MG Oral 00904198251 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 325 MG Oral 00904198259 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 325 MG Oral 00904198260 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 325 MG Oral 00904198261 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 325 MG Oral 00904198280 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 500 MG Oral 00904198340 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 500 MG Oral 00904198860 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet 500 MG Oral 00904198880 *ANALGESICS - NonNarcotic* *Analgesics Other*** Mapap Tablet Chewable 80 MG Oral 00904525646 *ANALGESICS - NonNarcotic* *Analgesics Other***

Pain & Fever Childrens Solution 160 MG/5ML Oral 00536012285 *ANALGESICS - NonNarcotic* *Analgesics Other***

Pain & Fever Childrens Solution 160 MG/5ML Oral 00536012297 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Childrens Suspension 160 MG/5ML Oral 36800020226 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Childrens Suspension 160 MG/5ML Oral 36800039726 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Childrens Suspension 160 MG/5ML Oral 36800095926 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Pain & Fever Childrens Suspension 160 MG/5ML Oral 70000030501 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Childrens Suspension 160 MG/5ML Oral 70000048101 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Childrens Tablet Chewable 80 MG Oral 00536101407 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Extra Strength Tablet 500 MG Oral 00536323101 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Extra Strength Tablet 500 MG Oral 00536323110 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Tablet 325 MG Oral 00536322201 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain & Fever Tablet 325 MG Oral 00536322210 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Childrens Suspension 160 MG/5ML Oral 36800010526 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Childrens Suspension 160 MG/5ML Oral 36800013026 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Childrens Suspension 160 MG/5ML Oral 36800017526 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800022771 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800022778 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800048462 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800048471 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800048478 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Extra Strength Tablet 500 MG Oral 36800048490 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Tablet 325 MG Oral 36800040378 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Tablet 500 MG Oral 36800040572 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pain Relief Tablet 500 MG Oral 36800040578 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pharbetol Extra Strength Tablet 500 MG Oral 16103037608 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pharbetol Tablet 325 MG Oral 16103035307 *ANALGESICS - NonNarcotic* *Analgesics Other*** Pharbetol Tablet 325 MG Oral 16103035308 *ANALGESICS - NonNarcotic* *Analgesics Other*** QC Acetaminophen 8 Hours Tablet Extended Release 650 MG Oral 63868009150 *ANALGESICS - NonNarcotic* *Analgesics Other*** QC Arthritis Pain Relief Tablet Extended Release 650 MG Oral 63868008901 *ANALGESICS - NonNarcotic* *Analgesics Other*** QC Arthritis Pain Relief Tablet Extended Release 650 MG Oral 63868008950 *ANALGESICS - NonNarcotic* *Analgesics Other***

QC Non-Aspirin Extra Strength Tablet 500 MG Oral 63868050350 *ANALGESICS - NonNarcotic* *Analgesics Other***

QC Non-Aspirin Extra Strength Tablet 500 MG Oral 63868050701 *ANALGESICS - NonNarcotic* *Analgesics Other***

QC Non-Aspirin Extra Strength Tablet 500 MG Oral 63868098710 *ANALGESICS - NonNarcotic* *Analgesics Other*** QC Pain Relief Childrens Suspension 160 MG/5ML Oral 63868017418 *ANALGESICS - NonNarcotic* *Analgesics Other***

QC Pain Relief Extra Strength Tablet 500 MG Oral 63868008405 *ANALGESICS - NonNarcotic* *Analgesics Other***

QC Pain Relief Extra Strength Tablet 500 MG Oral 63868008450 *ANALGESICS - NonNarcotic* *Analgesics Other*** QC Pain Relief Tablet 325 MG Oral 63868008210 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM 8 Hour Pain Relief Tablet Extended Release 650 MG Oral 49348092410 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Arthritis Pain Relief Tablet Extended Release 650 MG Oral 49348092110 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain & Fever Childrens Suspension 160 MG/5ML Oral 49348009334 *ANALGESICS - NonNarcotic* *Analgesics Other***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS SM Pain & Fever Childrens Suspension 160 MG/5ML Oral 49348011934 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain & Fever Childrens Suspension 160 MG/5ML Oral 49348012334 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain & Fever Childrens Suspension 160 MG/5ML Oral 49348032534 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever CAPSULE 500 MG ORAL 49348011610 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348004209 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348004210 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348004214 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348073009 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348073010 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Ex St Tablet 500 MG Oral 49348099810 *ANALGESICS - NonNarcotic* *Analgesics Other*** SM Pain Reliever Tablet 325 MG Oral 49348097316 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Extra Strength Tablet 500 MG Oral 62107005001 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Extra Strength Tablet 500 MG Oral 62107005010 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Extra Strength Tablet 500 MG Oral 62107005101 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Extra Strength Tablet 500 MG Oral 62107005110 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Tablet 325 MG Oral 62107005201 *ANALGESICS - NonNarcotic* *Analgesics Other*** Tactinal Tablet 325 MG Oral 62107005210 *ANALGESICS - NonNarcotic* *Analgesics Other*** Adult Aspirin Regimen Tablet Delayed Release 81 MG Oral 70000017801 *ANALGESICS - NonNarcotic* *Salicylates*** Adult Aspirin Regimen Tablet Delayed Release 81 MG Oral 70000021801 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin 81 Tablet Delayed Release 81 MG Oral 62107002726 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin 81 Tablet Delayed Release 81 MG Oral 62107002732 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Adult Low Dose Tablet Delayed Release 81 MG Oral 36800002712 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 325 MG Oral 00904201360 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 325 MG Oral 00904671260 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 325 MG Oral 00904678480 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 325 MG Oral 16103035711 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 81 MG Oral 63739052201 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin EC Tablet Delayed Release 81 MG Oral 63739052210 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Chewable 81 MG Oral 00904628889 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Chewable 81 MG Oral 00904679480 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Chewable 81 MG Oral 00904679489 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Chewable 81 MG Oral 36800046768 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Chewable 81 MG Oral 49483033463 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 00536123441 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 00904671318 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 00904675180 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 00904678370 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 49483038710 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 49483038712 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 49483048110 *ANALGESICS - NonNarcotic* *Salicylates***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Aspirin Low Dose Tablet Delayed Release 81 MG Oral 49483048112 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Low Dose Tablet Delayed Release 81 MG Oral 70000042801 *ANALGESICS - NonNarcotic* *Salicylates***

Aspirin Low Strength Tablet Chewable 81 MG Oral 63739043401 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin SUPPOSITORY 300 MG Rectal 00574703412 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin SUPPOSITORY 600 MG Rectal 00574703612 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 00536105301 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 00536105429 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 00536330501 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 00536330510 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 16103036508 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet 325 MG Oral 51645071610 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 00536100836 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 00904404073 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 16103036605 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 16103036611 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 70000017001 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 70000041901 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 70000042001 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Chewable 81 MG Oral 70000042002 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 325 MG Oral 00536123201 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 81 MG Oral 00536100410 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 81 MG Oral 00536100441 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 81 MG Oral 00536114941 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 81 MG Oral 16103035609 *ANALGESICS - NonNarcotic* *Salicylates*** Aspirin Tablet Delayed Release 81 MG Oral 16103035611 *ANALGESICS - NonNarcotic* *Salicylates*** Aspir-Low Tablet Delayed Release 81 MG Oral 00904770418 *ANALGESICS - NonNarcotic* *Salicylates*** Aspir-Low Tablet Delayed Release 81 MG Oral 00904770480 *ANALGESICS - NonNarcotic* *Salicylates*** Childrens Aspirin Low Strength Tablet Chewable 81 MG Oral 62107002636 *ANALGESICS - NonNarcotic* *Salicylates*** GNP Adult Aspirin Low Strength Tablet Chewable 81 MG Oral 24385027868 *ANALGESICS - NonNarcotic* *Salicylates*** GNP Aspirin Low Dose Tablet Delayed Release 81 MG Oral 46122018076 *ANALGESICS - NonNarcotic* *Salicylates*** GNP Aspirin Low Dose Tablet Delayed Release 81 MG Oral 46122018087 *ANALGESICS - NonNarcotic* *Salicylates*** GNP Aspirin TABLET 325 MG ORAL 46122029278 *ANALGESICS - NonNarcotic* *Salicylates***

GNP Aspirin Tablet Delayed Release 81 MG Oral 46122018248 *ANALGESICS - NonNarcotic* *Salicylates***

GNP Aspirin Tablet Delayed Release 81 MG Oral 46122026248 *ANALGESICS - NonNarcotic* *Salicylates*** GoodSense Aspirin Adult Low St Tablet Chewable 81 MG Oral 00113025968 *ANALGESICS - NonNarcotic* *Salicylates*** GoodSense Aspirin TABLET 325 MG Oral 00113041678 *ANALGESICS - NonNarcotic* *Salicylates***

GoodSense Aspirin Tablet Chewable 81 MG Oral 00113027408 *ANALGESICS - NonNarcotic* *Salicylates***

GoodSense Aspirin Tablet Chewable 81 MG Oral 00113046708 *ANALGESICS - NonNarcotic* *Salicylates***

GoodSense Aspirin Tablet Chewable 81 MG Oral 00113046768 *ANALGESICS - NonNarcotic* *Salicylates***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS HM Aspirin EC Low Dose Tablet Delayed Release 81 MG Oral 62011000301 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin EC Low Dose Tablet Delayed Release 81 MG Oral 62011001901 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin EC Low Dose Tablet Delayed Release 81 MG Oral 62011001902 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin TABLET 325 MG Oral 62011002001 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin TABLET 325 MG Oral 62011002003 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin Tablet Chewable 81 MG Oral 62011002101 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin Tablet Chewable 81 MG Oral 62011002801 *ANALGESICS - NonNarcotic* *Salicylates*** HM Aspirin Tablet Chewable 81 MG Oral 62011021201 *ANALGESICS - NonNarcotic* *Salicylates***

QC Aspirin Low Dose Tablet Chewable 81 MG Oral 63868024036 *ANALGESICS - NonNarcotic* *Salicylates*** QC Aspirin Low Dose Tablet Delayed Release 81 MG Oral 63868036320 *ANALGESICS - NonNarcotic* *Salicylates*** QC Aspirin Low Dose Tablet Delayed Release 81 MG Oral 63868036336 *ANALGESICS - NonNarcotic* *Salicylates*** QC Aspirin Low Dose Tablet Delayed Release 81 MG Oral 63868037305 *ANALGESICS - NonNarcotic* *Salicylates*** QC Aspirin TABLET 325 MG ORAL 63868035210 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin Adult Low Strength Tablet Chewable 81 MG Oral 49348049807 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin Adult Low Strength TABLET DELAYED RELEASE 81 MG ORAL 49348098015 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin Adult Low Strength TABLET DELAYED RELEASE 81 MG ORAL 49348098023 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin Adult Low Strength TABLET DELAYED RELEASE 81 MG ORAL 49348098053 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin Adult Low Strength TABLET DELAYED RELEASE 81 MG ORAL 49348098115 *ANALGESICS - NonNarcotic* *Salicylates***

SM Aspirin Low Dose Tablet Chewable 81 MG Oral 49348075707 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin TABLET 325 MG ORAL 49348000110 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin TABLET 325 MG ORAL 49348000114 *ANALGESICS - NonNarcotic* *Salicylates*** SM Aspirin TABLET 325 MG ORAL 49348000123 *ANALGESICS - NonNarcotic* *Salicylates***

SM Childrens Aspirin Tablet Chewable 81 MG Oral 49348019107 *ANALGESICS - NonNarcotic* *Salicylates*** Almacone Double Strength Suspension 400-400- 40 MG/5ML Oral 00536001583 *ANTACIDS* *Antacid & Simethicone***

Almacone Suspension 200-200-20 MG/5ML Oral 00536002583 *ANTACIDS* *Antacid & Simethicone***

Almacone Suspension 200-200-20 MG/5ML Oral 00536118583 *ANTACIDS* *Antacid & Simethicone*** Antacid Anti-Gas Max Strength Suspension 400- 400-40 MG/5ML Oral 00113058840 *ANTACIDS* *Antacid & Simethicone*** Antacid Fast Relief Suspension 200-200-20 MG/5ML Oral 36800085140 *ANTACIDS* *Antacid & Simethicone*** Antacid Maximum Strength Suspension 400-400- 40 MG/5ML Oral 37205053540 *ANTACIDS* *Antacid & Simethicone*** Antacid Plus Anti-Gas Fast Act Suspension 200- 200-20 MG/5ML Oral 36800035740 *ANTACIDS* *Antacid & Simethicone*** Antacid Plus Anti-Gas Relief Suspension 200-200- 20 MG/5ML Oral 00113035740 *ANTACIDS* *Antacid & Simethicone***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Antacid Plus Anti-Gas Relief Suspension 400-400- 40 MG/5ML Oral 00113034040 *ANTACIDS* *Antacid & Simethicone*** Antacid Suspension 200-200-20 MG/5ML Oral 00113085140 *ANTACIDS* *Antacid & Simethicone*** GNP Antacid & Anti-Gas Suspension 400-400-40 MG/5ML Oral 46122043140 *ANTACIDS* *Antacid & Simethicone*** GNP Antacid & Anti-Gas Suspension 400-400-40 MG/5ML Oral 46122043240 *ANTACIDS* *Antacid & Simethicone*** GNP Antacid Anti-Gas Suspension 200-200-20 MG/5ML Oral 24385035640 *ANTACIDS* *Antacid & Simethicone*** GNP Antacid Regular Strength Suspension 200- 200-20 MG/5ML Oral 46122043340 *ANTACIDS* *Antacid & Simethicone*** GNP MaSanti Regular Strength Suspension 200- 200-20 MG/5ML Oral 24385035740 *ANTACIDS* *Antacid & Simethicone*** HM Advanced Antacid Max St Suspension 400- 400-40 MG/5ML Oral 62011012201 *ANTACIDS* *Antacid & Simethicone*** HM Antacid Anti-Gas Ex St Suspension 400-400-40 MG/5ML Oral 62011014901 *ANTACIDS* *Antacid & Simethicone***

HM Antacid Suspension 200-200-20 MG/5ML Oral 62011029201 *ANTACIDS* *Antacid & Simethicone*** HM Antacid/Antigas Suspension 200-200-20 MG/5ML Oral 62011014801 *ANTACIDS* *Antacid & Simethicone*** Mag-Al Plus Liquid 200-200-20 MG/5ML Oral 00121176130 *ANTACIDS* *Antacid & Simethicone*** Mi-Acid Maximum Strength Suspension 400-400- 40 MG/5ML Oral 00904000514 *ANTACIDS* *Antacid & Simethicone*** Mi-Acid Maximum Strength Suspension 400-400- 40 MG/5ML Oral 00904675514 *ANTACIDS* *Antacid & Simethicone*** Mi-Acid Suspension 200-200-20 MG/5ML Oral 00904000414 *ANTACIDS* *Antacid & Simethicone*** Mintox Regular Strength Suspension 200-200-20 MG/5ML Oral 00904676414 *ANTACIDS* *Antacid & Simethicone*** Mintox Suspension 200-200-20 MG/5ML Oral 00904572114 *ANTACIDS* *Antacid & Simethicone***

QC Antacid Suspension 200-200-20 MG/5ML Oral 63868069457 *ANTACIDS* *Antacid & Simethicone*** QC Antacid/Anti-Gas Suspension 200-200-20 MG/5ML Oral 63868071257 *ANTACIDS* *Antacid & Simethicone*** Rulox Suspension 200-200-20 MG/5ML Oral 00536194583 *ANTACIDS* *Antacid & Simethicone*** SM Antacid Advanced Suspension 200-200-20 MG/5ML Oral 49348015339 *ANTACIDS* *Antacid & Simethicone*** SM Antacid Anti-Gas Ex St Suspension 400-400-40 MG/5ML Oral 49348003539 *ANTACIDS* *Antacid & Simethicone*** SM Antacid Maximum Strength Suspension 400- 400-40 MG/5ML Oral 49348030339 *ANTACIDS* *Antacid & Simethicone*** SM Antacid Maximum Strength Suspension 400- 400-40 MG/5ML Oral 49348074439 *ANTACIDS* *Antacid & Simethicone*** SM Antacid/Antigas Suspension 200-200-20 MG/5ML Oral 49348001939 *ANTACIDS* *Antacid & Simethicone*** Acid Gone Suspension 95-358 MG/15ML Oral 00904772714 *ANTACIDS* *Antacid Combinations*** Aluminum Hydroxide Gel SUSPENSION 320 MG/5ML Oral 00536009185 *ANTACIDS* *Antacids - Aluminum Salts*** Sodium Bicarbonate Tablet 650 MG Oral 00536104710 *ANTACIDS* *Antacids - Bicarbonate*** Sodium Bicarbonate Tablet 650 MG Oral 64980029410 *ANTACIDS* *Antacids - Bicarbonate*** Antacid Calcium Tablet Chewable 500 MG Oral 00536104815 *ANTACIDS* *Antacids - Calcium Salts*** Antacid Calcium Tablet Chewable 500 MG Oral 68084098832 *ANTACIDS* *Antacids - Calcium Salts*** Antacid Tablet Chewable 500 MG Oral 00113048547 *ANTACIDS* *Antacids - Calcium Salts***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Antacid Tablet Chewable 500 MG Oral 37205020047 *ANTACIDS* *Antacids - Calcium Salts*** Calcium Antacid Tablet Chewable 500 MG Oral 00904641292 *ANTACIDS* *Antacids - Calcium Salts*** Calcium Antacid Tablet Chewable 500 MG Oral 36800048547 *ANTACIDS* *Antacids - Calcium Salts*** Calcium Antacid Tablet Chewable 500 MG Oral 51645073515 *ANTACIDS* *Antacids - Calcium Salts*** Calcium Antacid Ultra Max St Tablet Chewable 1000 MG Oral 00113059523 *ANTACIDS* *Antacids - Calcium Salts*** Cal-Gest Antacid Tablet Chewable 500 MG Oral 00536100715 *ANTACIDS* *Antacids - Calcium Salts*** QC Antacid Tablet Chewable 500 MG Oral 63868004715 *ANTACIDS* *Antacids - Calcium Salts*** Magnesium Oxide Tablet 400 MG Oral 57629050012 *ANTACIDS* *Antacids - Magnesium Salts*** Magnesium Oxide Tablet 400 MG Oral 69543021712 *ANTACIDS* *Antacids - Magnesium Salts*** Magnesium Oxide Tablet 420 MG Oral 00603021321 *ANTACIDS* *Antacids - Magnesium Salts*** Magnesium Oxide Tablet 420 MG Oral 54738097401 *ANTACIDS* *Antacids - Magnesium Salts*** SM Glucose TABLET CHEWABLE 4-6 GM-MG ORAL 49348091301 *ANTIDIABETICS* *Diabetic Other - Combinations*** Glucose Tablet Chewable 4 GM Oral 00904671015 *ANTIDIABETICS* *Diabetic Other*** HumuLIN 70/30 KwikPen Suspension Pen-injector (70-30) 100 UNIT/ML Subcutaneous 00002880359 *ANTIDIABETICS* *Human Insulin*** HumuLIN 70/30 Suspension (70-30) 100 UNIT/ML Subcutaneous 00002871501 *ANTIDIABETICS* *Human Insulin*** HumuLIN 70/30 Suspension (70-30) 100 UNIT/ML Subcutaneous 00002871517 *ANTIDIABETICS* *Human Insulin*** HumuLIN N KwikPen Suspension Pen-injector 100 UNIT/ML Subcutaneous 00002880501 *ANTIDIABETICS* *Human Insulin*** HumuLIN N KwikPen Suspension Pen-injector 100 UNIT/ML Subcutaneous 00002880559 *ANTIDIABETICS* *Human Insulin*** HumuLIN N Suspension 100 UNIT/ML Subcutaneous 00002831501 *ANTIDIABETICS* *Human Insulin*** HumuLIN N Suspension 100 UNIT/ML Subcutaneous 00002831517 *ANTIDIABETICS* *Human Insulin*** HumuLIN R Solution 100 UNIT/ML Injection 00002821501 *ANTIDIABETICS* *Human Insulin*** HumuLIN R Solution 100 UNIT/ML Injection 00002821517 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 FlexPen Relion Suspension Pen- Injector (70-30) 100 UNIT/ML Subcutaneous 00169300712 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 FlexPen Relion Suspension Pen- Injector (70-30) 100 UNIT/ML Subcutaneous 00169300725 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 FlexPen Suspension Pen-Injector (70-30) 100 UNIT/ML Subcutaneous 00169300701 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 FlexPen Suspension Pen-Injector (70-30) 100 UNIT/ML Subcutaneous 00169300715 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 ReliOn SUSPENSION (70-30) 100 UNIT/ML Subcutaneous 00169183702 *ANTIDIABETICS* *Human Insulin*** NovoLIN 70/30 Suspension (70-30) 100 UNIT/ML Subcutaneous 00169183711 *ANTIDIABETICS* *Human Insulin*** NovoLIN N ReliOn SUSPENSION 100 UNIT/ML Subcutaneous 00169183402 *ANTIDIABETICS* *Human Insulin*** NovoLIN N Suspension 100 UNIT/ML Subcutaneous 00169183411 *ANTIDIABETICS* *Human Insulin*** NovoLIN R ReliOn SOLUTION 100 UNIT/ML INJECTION 00169183302 *ANTIDIABETICS* *Human Insulin*** NovoLIN R Solution 100 UNIT/ML Injection 00169183311 *ANTIDIABETICS* *Human Insulin*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Bismatrol Suspension 262 MG/15ML Oral 00904131309 AGENTS* Misc.*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Bismatrol Tablet Chewable 262 MG Oral 00904131546 AGENTS* Misc.***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Peptic Relief Suspension 262 MG/15ML Oral 00536181059 AGENTS* Misc.*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Peptic Relief Tablet Chewable 262 MG Oral 00536102107 AGENTS* Misc.*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Pink Bismuth Tablet Chewable 262 MG Oral 37205072065 AGENTS* Misc.*** SM Stomach Relief Suspension 525 MG/30ML *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Oral 49348001441 AGENTS* Misc.*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - SM Stomach Relief Tablet Chewable 262 MG Oral 49348095344 AGENTS* Misc.*** *ANTIDIARRHEAL/PROBIOTIC *Antidiarrheal/Probiotic Agents - Stomach Relief Suspension 262 MG/15ML Oral 36800030234 AGENTS* Misc.*** Bismatrol Suspension 262 MG/15ML Oral 00904131309 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Bismatrol Tablet Chewable 262 MG Oral 00904131546 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Peptic Relief Suspension 262 MG/15ML Oral 00536181059 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Peptic Relief Tablet Chewable 262 MG Oral 00536102107 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Pink Bismuth Tablet Chewable 262 MG Oral 37205072065 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** SM Stomach Relief Suspension 525 MG/30ML Oral 49348001441 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.***

SM Stomach Relief Tablet Chewable 262 MG Oral 49348095344 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Stomach Relief Suspension 262 MG/15ML Oral 36800030234 *ANTIDIARRHEALS* *Antidiarrheal Agents - Misc.*** Anti-Diarrheal Liquid 1 MG/7.5ML Oral 70000041801 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 00113022453 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 00113022462 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 00904772512 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 00904772524 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 36800022462 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 37205037053 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Anti-Diarrheal Tablet 2 MG Oral 37205037067 *ANTIDIARRHEALS* *Antiperistaltic Agents*** GNP Anti-Diarrheal Tablet 2 MG Oral 24385055467 *ANTIDIARRHEALS* *Antiperistaltic Agents*** GNP Loperamide HCl SUSPENSION 1 MG/7.5ML ORAL 46122011126 *ANTIDIARRHEALS* *Antiperistaltic Agents*** HM Anti-Diarrheal Tablet 2 MG Oral 62011015001 *ANTIDIARRHEALS* *Antiperistaltic Agents*** HM Anti-Diarrheal Tablet 2 MG Oral 62011015002 *ANTIDIARRHEALS* *Antiperistaltic Agents*** HM Anti-Diarrheal Tablet 2 MG Oral 62011015003 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Loperamide HCl Liquid 1 MG/5ML Oral 50383061804 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Loperamide HCl Suspension 1 MG/7.5ML Oral 00113064526 *ANTIDIARRHEALS* *Antiperistaltic Agents*** SM Anti-Diarrheal Tablet 2 MG Oral 49348052902 *ANTIDIARRHEALS* *Antiperistaltic Agents*** SM Anti-Diarrheal Tablet 2 MG Oral 49348052904 *ANTIDIARRHEALS* *Antiperistaltic Agents*** SM Anti-Diarrheal Tablet 2 MG Oral 49348052908 *ANTIDIARRHEALS* *Antiperistaltic Agents*** SM Anti-Diarrheal Tablet 2 MG Oral 49348052934 *ANTIDIARRHEALS* *Antiperistaltic Agents*** Driminate Tablet 50 MG Oral 00904205112 *ANTIEMETICS* *Antiemetics - Anticholinergic*** Driminate Tablet 50 MG Oral 00904205159 *ANTIEMETICS* *Antiemetics - Anticholinergic*** SM Motion Sickness TABLET 50 MG Oral 70677002201 *ANTIEMETICS* *Antiemetics - Anticholinergic*** Aller-Chlor Tablet 4 MG Oral 00536100601 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Aller-Chlor Tablet 4 MG Oral 00536100610 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Aller-Chlor Tablet 4 MG Oral 00536100635 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Relief Tablet 4 MG Oral 70000016001 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Relief Tablet 4 MG Oral 70000016002 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Tablet 4 MG Oral 00904001224 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Tablet 4 MG Oral 00904001259 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Tablet 4 MG Oral 36800046362 *ANTIHISTAMINES* *Antihistamines - Alkylamines***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Allergy-Time TABLET 4 MG ORAL 49483024210 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** HM Allergy Relief TABLET 4 MG Oral 62011005901 *ANTIHISTAMINES* *Antihistamines - Alkylamines*** Allergy Childrens Liquid 12.5 MG/5ML Oral 63868082354 *ANTIHISTAMINES* *Antihistamines - Ethanolamines***

Allergy Relief Childrens Liquid 12.5 MG/5ML Oral 36800037926 *ANTIHISTAMINES* *Antihistamines - Ethanolamines***

Allergy Relief Childrens Liquid 12.5 MG/5ML Oral 36800037934 *ANTIHISTAMINES* *Antihistamines - Ethanolamines***

Allergy Relief Childrens Liquid 12.5 MG/5ML Oral 70000024501 *ANTIHISTAMINES* *Antihistamines - Ethanolamines***

Allergy Relief Childrens Liquid 12.5 MG/5ML Oral 70000024502 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Relief Tablet 25 MG Oral 00113047953 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Relief Tablet 25 MG Oral 70000013601 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Relief Tablet 25 MG Oral 70000013602 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Relief Tablet 25 MG Oral 70000013603 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Tablet 25 MG Oral 36800047962 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Tablet 25 MG Oral 36800047967 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Tablet 25 MG Oral 36800047978 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Allergy Tablet 25 MG Oral 36800047979 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Banophen Capsule 50 MG Oral 00904530760 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Banophen Capsule 50 MG Oral 00904530780 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Banophen Liquid 12.5 MG/5ML Oral 00904122800 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Banophen Liquid 12.5 MG/5ML Oral 00904517416 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Banophen Tablet 25 MG Oral 00904555159 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Diphenhist Liquid 12.5 MG/5ML Oral 00536077085 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** Diphenhist Tablet 25 MG Oral 00536101601 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** DiphenhydrAMINE HCl Capsule 50 MG Oral 42806064901 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** DiphenhydrAMINE HCl Capsule 50 MG Oral 42806064910 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** DiphenhydrAMINE HCl Liquid 12.5 MG/5ML Oral 00904674070 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** DiphenhydrAMINE HCl Liquid 12.5 MG/5ML Oral 00904674172 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** DiphenhydrAMINE HCl Tablet 25 MG Oral 00536121429 *ANTIHISTAMINES* *Antihistamines - Ethanolamines***

Dye-Free Allergy Relief Liquid 12.5 MG/5ML Oral 70000024601 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** GNP Allergy Antihistamine Liquid 12.5 MG/5ML Oral 46122036126 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** HM Allergy Relief Childrens Liquid 12.5 MG/5ML Oral 62011028401 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** HM Allergy Relief Tablet 25 MG Oral 62011031001 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** HM Allergy Relief Tablet 25 MG Oral 62011031601 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** HM Allergy Tablet 25 MG Oral 62011005803 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** SM Allergy Relief Liquid 12.5 MG/5ML Oral 49348004534 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** SM Allergy Relief Liquid 12.5 MG/5ML Oral 49348004537 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** SM Allergy Relief Tablet 25 MG Oral 70677000301 *ANTIHISTAMINES* *Antihistamines - Ethanolamines*** 24HR Allergy Relief Tablet 180 MG Oral 70000036101 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** 24HR Allergy Relief Tablet 180 MG Oral 70000036102 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** 24HR Allergy Relief Tablet 180 MG Oral 70000036103 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** 24HR Allergy Relief Tablet 180 MG Oral 70000036104 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

All Day Allergy Childrens Solution 5 MG/5ML Oral 36800018926 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

All Day Allergy Childrens Solution 5 MG/5ML Oral 36800097426 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

All Day Allergy Childrens Solution 5 MG/5ML Oral 70000018601 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS

All Day Allergy Childrens Solution 5 MG/5ML Oral 70000021401 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

All Day Allergy Childrens Solution 5 MG/5ML Oral 70000021501 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045813 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045839 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045847 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045866 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045887 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 36800045895 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 70000038001 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 70000038002 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 70000038003 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** All Day Allergy Tablet 10 MG Oral 70000038004 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

All-Day Allergy Childrens Solution 5 MG/5ML Oral 36800047526 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Childrens Syrup 5 MG/5ML Oral 70000012501 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Non-Drowsy Tablet 10 MG Oral 00536109201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Childrens Solution 1 MG/ML Oral 69230031611 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 00113061239 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 36800061246 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 36800061265 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 36800061276 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 36800061287 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052601 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052605 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052611 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052631 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052653 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 51660052660 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 69230031201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 69230031203 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 69230031230 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 69230031701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 69230031703 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 70000021301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 70000021302 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 70000021303 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 10 MG Oral 70000021304 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 180 MG Oral 69230020201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 180 MG Oral 69230020230 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 180 MG Oral 69230030001 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 180 MG Oral 69230030005 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 180 MG Oral 69230030030 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Relief Tablet 5 MG Oral 70000036201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Tablet 10 MG Oral 00904572872 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Tablet 10 MG Oral 00904572887 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Allergy Tablet 10 MG Oral 00904572889 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Allergy Child Solution 5 MG/5ML Oral 00904676520 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Allergy Child Solution 5 MG/5ML Oral 51672210208 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Cetirizine HCl Childrens Alrgy Solution 1 MG/ML Oral 51672208808 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00378363701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00378363705 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671740 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671741 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671743 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671746 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671760 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671761 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671772 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 00904671786 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16571040210 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16571040250 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714027102 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714027103 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714079901 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714079902 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714079903 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 16714079904 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 43598081112 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 43598081115 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 45802091939 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 45802091987 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 51079059701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 51079059720 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 51660093901 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 51660093930 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 51660093990 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 55111069990 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 60505263301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 10 MG Oral 60505263308 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 5 MG Oral 00378363501 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 5 MG Oral 16571040110 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Cetirizine HCl Tablet 5 MG Oral 60505263201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Childrens Loratadine Solution 5 MG/5ML Oral 54838055840 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Childrens Loratadine Syrup 5 MG/5ML Oral 51672207308 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Childrens Loratadine Syrup 5 MG/5ML Oral 51672208508 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Childrens Suspension 30 MG/5ML Oral 00472052794 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 00378078205 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 00378078293 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 00904671110 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 00904671146 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 00904697860 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 16714089901 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 16714089902 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 36800057113 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 45802057178 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 55111078401 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 180 MG Oral 55111078430 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 60 MG Oral 00378078105 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Fexofenadine HCl Tablet 60 MG Oral 00378078191 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Fexofenadine HCl Tablet 60 MG Oral 45802042578 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP All Day Allergy Childrens Solution 5 MG/5ML Oral 46122002026 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP All Day Allergy Childrens Solution 5 MG/5ML Oral 46122010126 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP All Day Allergy Tablet 10 MG Oral 24385099865 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP All Day Allergy Tablet 10 MG Oral 24385099874 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP All Day Allergy Tablet 10 MG Oral 24385099875 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Allergy Relief Tablet 180 MG Oral 46122004075 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Loratadine Childrens Solution 5 MG/5ML Oral 46122042326 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Loratadine SYRUP 5 MG/5ML ORAL 24385053126 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Loratadine Tablet 10 MG Oral 24385047152 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Loratadine Tablet 10 MG Oral 24385047178 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GNP Loratadine Tablet 10 MG Oral 24385047199 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense All Day Allergy Solution 5 MG/5ML Oral 00113018926 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense All Day Allergy Tablet 10 MG Oral 00113945813 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense All Day Allergy Tablet 10 MG Oral 00113945839 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense All Day Allergy Tablet 10 MG Oral 00113945866 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense Aller-Ease Tablet 180 MG Oral 00113057122 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense Aller-Ease Tablet 180 MG Oral 00113057139 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** GoodSense Aller-Ease Tablet 180 MG Oral 00113057195 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM All Day Allergy Childrens Solution 5 MG/5ML Oral 62011032301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM All Day Allergy Tablet 10 MG Oral 62011005201 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM All Day Allergy Tablet 10 MG Oral 62011031301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM All Day Allergy Tablet 10 MG Oral 62011031303 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Cetirizine HCl Childrens Solution 5 MG/5ML Oral 62011009301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Cetirizine HCl Tablet 10 MG Oral 62011030701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Fexofenadine HCl Tablet 180 MG Oral 62011023301 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Fexofenadine HCl Tablet 180 MG Oral 62011031501 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Fexofenadine HCl Tablet 180 MG Oral 62011031502 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Fexofenadine HCl Tablet 60 MG Oral 62011031401 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Childrens SYRUP 5 MG/5ML Oral 62011018101 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Childrens SYRUP 5 MG/5ML Oral 62011030501 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Childrens SYRUP 5 MG/5ML Oral 62011034801 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011024801 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011024803 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011024804 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011024805 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011025801 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011025802 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011025803 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** HM Loratadine Tablet 10 MG Oral 62011025804 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Levocetirizine Dihydrochloride Tablet 5 MG Oral 00536114492 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Levocetirizine Dihydrochloride Tablet 5 MG Oral 43598073530 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Levocetirizine Dihydrochloride Tablet 5 MG Oral 43598073590 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Loratadine Childrens Solution 5 MG/5ML Oral 00904623420 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 00121084910 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 00121084940 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 00904676720 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 36800009208 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 51672209208 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Childrens Syrup 5 MG/5ML Oral 51672213108 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00781507701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00904685207 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00904685260 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00904685261 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00904685272 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 00904685289 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 16714089801 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 16714089802 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 16714089803 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 45802065065 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 45802065078 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 45802065087 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 50268048915 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 60505014701 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Loratadine Tablet 10 MG Oral 60505014708 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** QC Fexofenadine Hydrochloride Tablet 180 MG Oral 63868014130 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** QC Loratadine Allergy Relief Tablet 10 MG Oral 63868015110 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** QC Loratadine Allergy Relief Tablet 10 MG Oral 63868015130 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM All Day Allergy Childrens Solution 5 MG/5ML Oral 49348032634 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM All Day Allergy Childrens Solution 5 MG/5ML Oral 49348093434 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM All Day Allergy Tablet 10 MG Oral 49348098446 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Allergy Childrens Syrup 5 MG/5ML Oral 70677002901 *ANTIHISTAMINES* *Antihistamines - Non-Sedating***

SM Childrens Loratadine SYRUP 5 MG/5ML ORAL 49348033334 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Fexofenadine HCl Tablet 180 MG Oral 49348096856 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Loratadine SYRUP 5 MG/5ML ORAL 49348063634 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Loratadine Tablet 10 MG Oral 49348011213 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Loratadine Tablet 10 MG Oral 49348081845 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** SM Loratadine Tablet 10 MG Oral 49348081856 *ANTIHISTAMINES* *Antihistamines - Non-Sedating*** Lactic Acid Solution 38779056508 *CHEMICALS* *Acids*** Sodium Hydroxide Pellet 51927123700 *CHEMICALS* *Bases*** Hydroxocobalamin Powder 38779253303 *CHEMICALS* *Bulk Chemicals - Hy's*** Propylene Glycol Liquid 38779051008 *CHEMICALS* *Bulk Chemicals - Pr's*** Psyllium Husk Powder 51552106107 *CHEMICALS* *Bulk Chemicals - Ps's*** Pyridoxal-5-Phosphate Powder 38779155604 *CHEMICALS* *Bulk Chemicals - Py's*** Stevia Extract Powder 38779193004 *CHEMICALS* *Bulk Chemicals - St's*** Dimethyl Sulfoxide Solution 38779061401 *CHEMICALS* *Liquids*** Citric Acid Anhydrous POWDER 38779006801 *CHEMICALS* *Solids*** Silica GEL 51927900900 *CHEMICALS* *Solids*** Aftera Tablet 1.5 MG Oral 51285010388 *CONTRACEPTIVES* *Emergency Contraceptives*** EContra EZ TABLET 1.5 MG ORAL 50102011101 *CONTRACEPTIVES* *Emergency Contraceptives*** EContra EZ TABLET 1.5 MG ORAL 50102011112 *CONTRACEPTIVES* *Emergency Contraceptives*** EContra One-Step TABLET 1.5 MG Oral 50102021111 *CONTRACEPTIVES* *Emergency Contraceptives***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Levonorgestrel Tablet 1.5 MG Oral 00536114263 *CONTRACEPTIVES* *Emergency Contraceptives*** My Choice Tablet 1.5 MG Oral 62756072060 *CONTRACEPTIVES* *Emergency Contraceptives*** My Way Tablet 1.5 MG Oral 68180085211 *CONTRACEPTIVES* *Emergency Contraceptives*** My Way Tablet 1.5 MG Oral 68180085212 *CONTRACEPTIVES* *Emergency Contraceptives*** New Day Tablet 1.5 MG Oral 16714080901 *CONTRACEPTIVES* *Emergency Contraceptives*** Opcicon One-Step TABLET 1.5 MG ORAL 62756071860 *CONTRACEPTIVES* *Emergency Contraceptives*** Option 2 TABLET 1.5 MG ORAL 00113200312 *CONTRACEPTIVES* *Emergency Contraceptives*** Take Action Tablet 1.5 MG Oral 51285010088 *CONTRACEPTIVES* *Emergency Contraceptives*** Take Action Tablet 1.5 MG Oral 69536020088 *CONTRACEPTIVES* *Emergency Contraceptives*** Cough DM Childrens Suspension Extended Release 30 MG/5ML Oral 70000019501 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** Cough DM Suspension Extended Release 30 MG/5ML Oral 00904631256 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** Cough DM Suspension Extended Release 30 MG/5ML Oral 70000018701 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** Cough DM Suspension Extended Release 30 MG/5ML Oral 70000030201 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** Dextromethorphan Polistirex ER Suspension Extended Release 30 MG/5ML Oral 45802043321 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** GoodSense Cough DM Childrens Suspension Extended Release 30 MG/5ML Oral 00113095828 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** GoodSense Cough DM Suspension Extended Release 30 MG/5ML Oral 00113038428 *COUGH/COLD/ALLERGY* *Antitussive - Nonnarcotic*** Cough/Chest Congestion DM Syrup 10-100 MG/5ML Oral 00536118497 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Extra Action Cough Syrup 10-100 MG/5ML Oral 00536118485 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** GNP Mucus Relief DM Tablet 20-400 MG Oral 24385002671 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** GNP Tussin DM Liquid 100-10 MG/5ML Oral 24385035926 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** GNP Tussin DM Liquid 100-10 MG/5ML Oral 24385035934 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Mucinex DM Tablet Extended Release 12 Hour 30- 600 MG Oral 63824005632 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Mucinex Fast-Max DM Max Liquid 20-400 MG/20ML Oral 63824001966 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Mucus & Cough Relief Childrens Liquid 5-100 MG/5ML Oral 70000013101 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Mucus Relief DM Max Tablet Extended Release 12 Hour 60-1200 MG Oral 00536121388 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Mucus Relief DM Tablet Extended Release 12 Hour 30-600 MG Oral 00536116134 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** MucusRelief DM Cough Tablet 20-400 MG Oral 00904681652 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Robafen DM Cgh/Chest Congest Liquid 10-100 MG/5ML Oral 00904646420 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Robafen DM Cough Liquid 10-100 MG/5ML Oral 00904675816 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Robafen DM Cough Liquid 10-100 MG/5ML Oral 00904675859 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Robafen DM Cough Liquid 10-100 MG/5ML Oral 00904675920 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Robafen DM Syrup 100-10 MG/5ML Oral 00904005316 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Siltussin DM DAS Liquid 100-10 MG/5ML Oral 54838013340 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Siltussin-DM Alcohol Free SYRUP 100-10 MG/5ML ORAL 54838020940 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Siltussin-DM Alcohol Free SYRUP 100-10 MG/5ML ORAL 54838020970 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Siltussin-DM Alcohol Free SYRUP 100-10 MG/5ML ORAL 54838020980 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS SM Chest Congestion Relief DM Tablet 20-400 MG Oral 49348072809 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Mucus Relief Cough Children Liquid 5-100 MG/5ML Oral 49348082834 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Tussin Cough/Chest Congest Syrup 100-10 MG/5ML Oral 49348086134 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Tussin Cough/Chest Congest Syrup 100-10 MG/5ML Oral 49348086137 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Tussin DM SYRUP 100-10 MG/5ML ORAL 49348001734 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Tussin DM SYRUP 100-10 MG/5ML ORAL 49348001737 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** SM Tussin DM SYRUP 100-10 MG/5ML ORAL 49348001739 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tusnel Diabetic Liquid 10-100 MG/5ML Oral 54859050504 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tussin DM Cough + Chest Liquid 10-100 MG/5ML Oral 70000031901 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tussin DM Cough + Chest Liquid 10-100 MG/5ML Oral 70000031902 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tussin DM Max Adult Liquid 5-100 MG/5ML Oral 70000038701 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tussin DM Syrup 100-10 MG/5ML Oral 00113035926 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** Tussin DM Syrup 100-10 MG/5ML Oral 00113035934 *COUGH/COLD/ALLERGY* *Antitussive-Expectorant*** GNP Tussin CF Cough & Cold SYRUP 5-10-100 *Antitussive-Expectorants- MG/5ML ORAL 24385090434 *COUGH/COLD/ALLERGY* Decongestant*** Robafen CF Multi-Symptom Cold Liquid 5-10-100 *Antitussive-Expectorants- MG/5ML Oral 00904653720 *COUGH/COLD/ALLERGY* Decongestant*** All Day Allergy D Tablet Extended Release 12 Hour 5-120 MG Oral 36800017662 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 00113017653 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 00113017662 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 00904583112 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Allergy Relief D-24 Tablet Extended Release 24 Hour 10-240 MG Oral 70000016201 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Allergy Relief/Nasal Decongest Tablet Extended Release 24 Hour 10-240 MG Oral 51660072415 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Allergy Relief-D Tablet Extended Release 24 Hour 10-240 MG Oral 52544023912 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Allergy Relief-D Tablet Extended Release 24 Hour 10-240 MG Oral 52544023954 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Aprodine Tablet 2.5-60 MG Oral 00904025024 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Cetirizine-Pseudoephedrine ER Tablet Extended Release 12 Hour 5-120 MG Oral 45802072153 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Cetirizine-Pseudoephedrine ER Tablet Extended Release 12 Hour 5-120 MG Oral 45802072162 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Childrens Cold & Allergy ELIXIR 1-2.5 MG/5ML Oral 00113090626 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Childrens Cold & Allergy ELIXIR 1-2.5 MG/5ML Oral 36800090626 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine***

Cold & Allergy Childrens Elixir 1-2.5 MG/5ML Oral 70000018801 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Dimaphen Childrens Elixir 1-2.5 MG/5ML Oral 00904646220 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** GNP All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 24385017553 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS GNP All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 24385017562 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** GNP Cold/Allergy Childrens ELIXIR 1-2.5 MG/5ML ORAL 24385051726 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** GNP Loratadine-D 12HR Tablet Extended Release 12 Hour 5-120 MG Oral 46122010952 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** GNP Loratadine-D 24 Hour Tablet Extended Release 24 Hour 10-240 MG Oral 46122020622 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** HM Allergy Complete-D Tablet Extended Release 12 Hour 5-120 MG Oral 62011005501 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** HM Allergy Relief/Nasal Decong Tablet Extended Release 24 Hour 10-240 MG Oral 62011007101 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Loratadine-D 12HR Tablet Extended Release 12 Hour 5-120 MG Oral 45802012246 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Loratadine-D 12HR Tablet Extended Release 12 Hour 5-120 MG Oral 45802012260 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Loratadine-D 12HR Tablet Extended Release 12 Hour 5-120 MG Oral 45802012265 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Loratadine-D 24HR Tablet Extended Release 24 Hour 10-240 MG Oral 00904583315 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** Loratadine-D 24HR Tablet Extended Release 24 Hour 10-240 MG Oral 00904583348 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** SM All Day Allergy-D Tablet Extended Release 12 Hour 5-120 MG Oral 49348085104 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** SM Cold & Allergy Childrens Elixir 1-2.5 MG/5ML Oral 49348077734 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** SM Lorata-dine D Tablet Extended Release 24 Hour 10-240 MG Oral 49348054301 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** SM Lorata-dine D Tablet Extended Release 24 Hour 10-240 MG Oral 49348054357 *COUGH/COLD/ALLERGY* *Decongestant & Antihistamine*** GNP Mucus Relief PE TABLET 10-400 MG ORAL 24385092571 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** Mucus Relief D Tablet Extended Release 12 Hour 60-600 MG Oral 00536120521 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** Mucus Relief D Tablet Extended Release 12 Hour 60-600 MG Oral 00536120536 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** MucusRelief Sinus TABLET 10-400 MG ORAL 00904579246 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** MucusRelief Sinus TABLET 10-400 MG ORAL 00904579252 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** SM Chest Congestion Relief PE TABLET 10-400 MG ORAL 49348077409 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** SM Mucus Relief D Tablet Extended Release 12 Hour 60-600 MG Oral 49348011348 *COUGH/COLD/ALLERGY* *Decongestant w/ Expectorant*** Cough Syrup Syrup 100 MG/5ML Oral 00536082585 *COUGH/COLD/ALLERGY* *Expectorants*** Cough Syrup Syrup 100 MG/5ML Oral 00536109597 *COUGH/COLD/ALLERGY* *Expectorants***

Diabetic Siltussin DAS-Na Liquid 100 MG/5ML Oral 54838013840 *COUGH/COLD/ALLERGY* *Expectorants*** GNP Mucus ER Tablet Extended Release 12 Hour 1200 MG Oral 46122041774 *COUGH/COLD/ALLERGY* *Expectorants*** GNP Tussin Mucus & Chest Cong Liquid 100 MG/5ML Oral 46122029926 *COUGH/COLD/ALLERGY* *Expectorants*** GNP Tussin Mucus & Chest Cong Liquid 100 MG/5ML Oral 46122029934 *COUGH/COLD/ALLERGY* *Expectorants*** GuaiFENesin Tablet 400 MG Oral 00904681546 *COUGH/COLD/ALLERGY* *Expectorants*** GuaiFENesin Tablet 400 MG Oral 00904681552 *COUGH/COLD/ALLERGY* *Expectorants***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS HM Chest Congestion Relief Tablet 400 MG Oral 62011006001 *COUGH/COLD/ALLERGY* *Expectorants*** HM Mucus ER Tablet Extended Release 12 Hour 1200 MG Oral 62011029901 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus & Chest Congestion Liquid 100 MG/5ML Oral 00536118285 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus & Chest Congestion Liquid 100 MG/5ML Oral 00536118297 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus Relief ER Tablet Extended Release 12 Hour 600 MG Oral 00904671839 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus Relief Max St Tablet Extended Release 12 Hour 1200 MG Oral 70000047902 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus Relief Tablet 400 MG Oral 00904623252 *COUGH/COLD/ALLERGY* *Expectorants*** Mucus Relief Tablet Extended Release 12 Hour 600 MG Oral 00536116361 *COUGH/COLD/ALLERGY* *Expectorants*** QC Medifin 400 Tablet 400 MG Oral 63868099850 *COUGH/COLD/ALLERGY* *Expectorants*** QC Mucus Relief ER Tablet Extended Release 12 Hour 1200 MG Oral 63868039014 *COUGH/COLD/ALLERGY* *Expectorants*** Robafen Mucus/Chest Congestion Liquid 200 MG/10ML Oral 00904676320 *COUGH/COLD/ALLERGY* *Expectorants*** Robafen Syrup 100 MG/5ML Oral 00904006116 *COUGH/COLD/ALLERGY* *Expectorants*** Robafen Syrup 100 MG/5ML Oral 00904676316 *COUGH/COLD/ALLERGY* *Expectorants*** Siltussin SA Syrup 100 MG/5ML Oral 54838011740 *COUGH/COLD/ALLERGY* *Expectorants*** Siltussin SA Syrup 100 MG/5ML Oral 54838011770 *COUGH/COLD/ALLERGY* *Expectorants*** Siltussin SA Syrup 100 MG/5ML Oral 54838011780 *COUGH/COLD/ALLERGY* *Expectorants*** SM Chest Congestion Relief Tablet 400 MG Oral 49348072909 *COUGH/COLD/ALLERGY* *Expectorants*** SM Mucus Relief Max Strength Tablet Extended Release 12 Hour 1200 MG Oral 70677005001 *COUGH/COLD/ALLERGY* *Expectorants*** Tussin Mucus+Chest Congestion Liquid 100 MG/5ML Oral 70000029901 *COUGH/COLD/ALLERGY* *Expectorants*** Tussin Mucus+Chest Congestion Liquid 100 MG/5ML Oral 70000029902 *COUGH/COLD/ALLERGY* *Expectorants*** Tussin Mucus+Chest Congestion Syrup 100 MG/5ML Oral 00113006126 *COUGH/COLD/ALLERGY* *Expectorants*** *Non-Narc Antitussive-Decongestant- Brotapp DM Liquid 15-1-5 MG/5ML Oral 54838013640 *COUGH/COLD/ALLERGY* Antihistamine*** *Non-Narc Antitussive-Decongestant- Brotapp DM Liquid 15-1-5 MG/5ML Oral 54838013670 *COUGH/COLD/ALLERGY* Antihistamine*** Cold & Cough Childrens Liquid 2.5-1-5 MG/5ML *Non-Narc Antitussive-Decongestant- Oral 70000018901 *COUGH/COLD/ALLERGY* Antihistamine*** Dimaphen DM Cold/Cough Liquid 2.5-1-5 *Non-Narc Antitussive-Decongestant- MG/5ML Oral 00904646320 *COUGH/COLD/ALLERGY* Antihistamine*** *Non-Narc Antitussive-Decongestant- EndaCof-DM Liquid 2.5-1-5 MG/5ML Oral 68047014316 *COUGH/COLD/ALLERGY* Antihistamine*** GNP Cold/Cough Childrens Liquid 2.5-1-5 *Non-Narc Antitussive-Decongestant- MG/5ML Oral 24385051926 *COUGH/COLD/ALLERGY* Antihistamine*** Acne Medication 10 Gel 10 % External 00536105656 *DERMATOLOGICALS* *Acne Products*** Acne Medication 5 Gel 5 % External 00536105556 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 10 % External 45802030801 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 10 % External 45802030896 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 10 % External 54162001902 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 10 % External 68752021060 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 5 % External 45802021696 *DERMATOLOGICALS* *Acne Products*** Benzoyl Peroxide Gel 5 % External 68752020560 *DERMATOLOGICALS* *Acne Products***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS BP Gel Gel 5 % External 24470090960 *DERMATOLOGICALS* *Acne Products***

Clean & Clear Persa-Gel Max St Gel 10 % External 08137003405 *DERMATOLOGICALS* *Acne Products*** Differin Gel 0.1 % External 00299492030 *DERMATOLOGICALS* *Acne Products*** Differin Gel 0.1 % External 00299492045 *DERMATOLOGICALS* *Acne Products*** KP Benzoyl Peroxide Gel 10 % External 00179870360 *DERMATOLOGICALS* *Acne Products*** KP Benzoyl Peroxide Gel 5 % External 00179870260 *DERMATOLOGICALS* *Acne Products***

Triple Antibiotic Ointment 3.5-400-5000 External 45802014301 *DERMATOLOGICALS* *Antibiotic Mixtures Topical***

Triple Antibiotic Ointment 3.5-400-5000 External 51672212001 *DERMATOLOGICALS* *Antibiotic Mixtures Topical***

Triple Antibiotic Ointment 3.5-400-5000 External 51672212002 *DERMATOLOGICALS* *Antibiotic Mixtures Topical*** Bacitracin Ointment 500 UNIT/GM External 00713028031 *DERMATOLOGICALS* *Antibiotics - Topical*** Bacitracin Ointment 500 UNIT/GM External 37205027510 *DERMATOLOGICALS* *Antibiotics - Topical*** Bacitracin Ointment 500 UNIT/GM External 45802006001 *DERMATOLOGICALS* *Antibiotics - Topical*** Bacitracin Ointment 500 UNIT/GM External 45802006003 *DERMATOLOGICALS* *Antibiotics - Topical*** Bacitracin Zinc Ointment 500 UNIT/GM External 51672207501 *DERMATOLOGICALS* *Antibiotics - Topical*** GNP Bacitracin Zinc Ointment 500 UNIT/GM External 24385006003 *DERMATOLOGICALS* *Antibiotics - Topical*** HM Bacitracin Zinc Ointment 500 UNIT/GM External 62011009401 *DERMATOLOGICALS* *Antibiotics - Topical*** SM Antibiotic Ointment 500 UNIT/GM External 49348015472 *DERMATOLOGICALS* *Antibiotics - Topical*** *Antifungals - Topical Castellani Paint Modified Liquid 1.5 % External 00884289301 *DERMATOLOGICALS* Combinations*** *Antifungals - Topical Castellani Paint Modified Liquid 1.5 % External 00884299301 *DERMATOLOGICALS* Combinations*** Antifungal Cream 1 % External 00904072236 *DERMATOLOGICALS* *Antifungals - Topical*** Anti-Fungal Powder 1 % External 00536515026 *DERMATOLOGICALS* *Antifungals - Topical*** GNP Terbinafine Hydrochloride CREAM 1 % EXTERNAL 24385052403 *DERMATOLOGICALS* *Antifungals - Topical*** GNP Terbinafine Hydrochloride CREAM 1 % EXTERNAL 24385052405 *DERMATOLOGICALS* *Antifungals - Topical*** QC Tolnaftate Cream 1 % External 63868010446 *DERMATOLOGICALS* *Antifungals - Topical*** SM Antifungal Tolnaftate Cream 1 % External 49348015529 *DERMATOLOGICALS* *Antifungals - Topical*** SM Athletes Foot CREAM 1 % EXTERNAL 49348079072 *DERMATOLOGICALS* *Antifungals - Topical*** Terbinafine HCl Cream 1 % External 00536111728 *DERMATOLOGICALS* *Antifungals - Topical*** Terbinafine HCl Cream 1 % External 51672208001 *DERMATOLOGICALS* *Antifungals - Topical*** Terbinafine HCl Cream 1 % External 51672208002 *DERMATOLOGICALS* *Antifungals - Topical*** Tolnaftate Cream 1 % External 51672202001 *DERMATOLOGICALS* *Antifungals - Topical*** Tolnaftate Cream 1 % External 51672202002 *DERMATOLOGICALS* *Antifungals - Topical*** Tolnaftate Powder 1 % External 00904072645 *DERMATOLOGICALS* *Antifungals - Topical*** Docosanol Cream 10 % External 00591298135 *DERMATOLOGICALS* *Antivirals - Topical*** Alum Sulfate-Ca Acetate Packet External 51224016212 *DERMATOLOGICALS* *Astringents*** Hypercare SOLUTION 15 % EXTERNAL 58980015511 *DERMATOLOGICALS* *Astringents*** Hypercare SOLUTION 15 % EXTERNAL 58980015520 *DERMATOLOGICALS* *Astringents*** Zinc Oxide Ointment 20 % External 00168006202 *DERMATOLOGICALS* *Astringents*** Zinc Oxide Ointment 20 % External 00168006231 *DERMATOLOGICALS* *Astringents*** Zinc Oxide Ointment 20 % External 00536570025 *DERMATOLOGICALS* *Astringents*** Zinc Oxide Ointment 20 % External 00536570028 *DERMATOLOGICALS* *Astringents*** Hydrocortisone Acetate Ointment 1 % External 70000048901 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Cream 1 % External 00472034356 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Cream 1 % External 45802043803 *DERMATOLOGICALS* *Corticosteroids - Topical***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Hydrocortisone Cream 1 % External 45802043805 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Max St Cream 1 % External 51672206902 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Ointment 1 % External 00168018131 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Ointment 1 % External 45802027603 *DERMATOLOGICALS* *Corticosteroids - Topical*** Hydrocortisone Ointment 1 % External 51672201802 *DERMATOLOGICALS* *Corticosteroids - Topical*** *Imidazole-Related Antifungals - Antifungal Cream 2 % External 00472073542 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Antifungal Cream 2 % External 00472073556 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Anti-Fungal Cream 1 % External 00472035056 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 00904782231 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 00904782236 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 45802043401 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 45802043411 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 51672200201 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Clotrimazole Cream 1 % External 51672200202 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - GNP Athletes Foot Cream 1 % External 24385020503 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Miconazole Nitrate Cream 2 % External 00536113428 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Miconazole Nitrate Cream 2 % External 51672200101 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - Miconazole Nitrate Cream 2 % External 51672200102 *DERMATOLOGICALS* Topical*** *Imidazole-Related Antifungals - SM Antifungal Clotrimazole Cream 1 % External 49348027972 *DERMATOLOGICALS* Topical*** Cutter Backwoods Aerosol External 71121096280 *DERMATOLOGICALS* *Insect Repellents*** Cutter Backwoods Aerosol External 71121096283 *DERMATOLOGICALS* *Insect Repellents*** Cutter Backwoods Dry Aerosol External 71121096435 *DERMATOLOGICALS* *Insect Repellents*** Cutter Backwoods Liquid External 71121096284 *DERMATOLOGICALS* *Insect Repellents*** Cutter Lemon Eucalyptus Liquid External 71121096014 *DERMATOLOGICALS* *Insect Repellents*** Cutter Skinsations Liquid 7 % External 16500054010 *DERMATOLOGICALS* *Insect Repellents*** CVS Insect Repellent Aerosol 15 % External 50428002097 *DERMATOLOGICALS* *Insect Repellents*** CVS Total Home Insect Repel Aerosol 30 % External 50428032153 *DERMATOLOGICALS* *Insect Repellents*** Natrapel 12-Hour Tick/Insect Aerosol 20 % External 44224006878 *DERMATOLOGICALS* *Insect Repellents*** OFF Active Aerosol 15 % External 46500001810 *DERMATOLOGICALS* *Insect Repellents*** OFF Active Aerosol 15 % External 46500021957 *DERMATOLOGICALS* *Insect Repellents*** OFF Active Aerosol 15 % External 46500073020 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Aerosol External 46500001842 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Aerosol External 46500001859 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Aerosol External 46500022930 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Liquid External 46500021845 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Liquid External 46500072925 *DERMATOLOGICALS* *Insect Repellents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS OFF Deep Woods Sportsmen Liquid 98.25 % External 46500001849 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Sportsmen Liquid External 46500071787 *DERMATOLOGICALS* *Insect Repellents*** OFF Deep Woods Sportsmen Liquid External 46500081846 *DERMATOLOGICALS* *Insect Repellents*** OFF Smooth & Dry Aerosol 15 % External 46500071037 *DERMATOLOGICALS* *Insect Repellents*** Repel 100 Liquid 98.11 % External 11423000402 *DERMATOLOGICALS* *Insect Repellents*** Repel 100 Liquid 98.11 % External 11423094098 *DERMATOLOGICALS* *Insect Repellents*** Repel 100 Liquid 98.11 % External 11423094108 *DERMATOLOGICALS* *Insect Repellents*** Repel Hunters Formula Aerosol External 11423094139 *DERMATOLOGICALS* *Insect Repellents*** Repel Lemon Eucalyptus Aerosol External 11423094109 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Aerosol External 11423094137 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Dry Aerosol External 11423094133 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Max Aerosol 40 % External 11423000338 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Max Liquid 40 % External 11423094095 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Max Liquid 40 % External 11423094101 *DERMATOLOGICALS* *Insect Repellents*** Repel Sportsmen Max LOTION 40 % EXTERNAL 11423094079 *DERMATOLOGICALS* *Insect Repellents*** Ultrathon Insect Repellent 8 Aerosol 25 % External 51131067777 *DERMATOLOGICALS* *Insect Repellents*** Arthritis Pain Relieving Cream 0.075 % External 00536111825 *DERMATOLOGICALS* *Local Anesthetics - Topical*** GNP Lidocaine Pain Relief Patch 4 % External 46122045021 *DERMATOLOGICALS* *Local Anesthetics - Topical*** Lidocaine Pain Relief Patch 4 % External 00536120215 *DERMATOLOGICALS* *Local Anesthetics - Topical*** Lidocaine Pain Relief Patch 4 % External 70000036601 *DERMATOLOGICALS* *Local Anesthetics - Topical*** Pain Relieving Cream 4 % External 00536113920 *DERMATOLOGICALS* *Local Anesthetics - Topical*** Pain Relieving Cream 4 % External 00536113928 *DERMATOLOGICALS* *Local Anesthetics - Topical***

GNP Lice Treatment Shampoo 0.33-4 % External 24385011603 *DERMATOLOGICALS* *Scabicide Combinations*** Lice Killing Maximum Strength Shampoo 0.33-4 % External 00113086626 *DERMATOLOGICALS* *Scabicide Combinations*** Lice Killing Maximum Strength Shampoo 0.33-4 % External 00904252820 *DERMATOLOGICALS* *Scabicide Combinations*** SM Lice Killing Max Strength Shampoo 0.33-4 % External 49348044334 *DERMATOLOGICALS* *Scabicide Combinations*** VanaLice Gel 0.3-3.5 % External 58809065008 *DERMATOLOGICALS* *Scabicide Combinations*** GNP Lice Treatment Liquid 1 % External 46122010846 *DERMATOLOGICALS* *Scabicides & Pediculicides*** HM Lice Treatment Liquid 1 % External 62011025501 *DERMATOLOGICALS* *Scabicides & Pediculicides*** Lice Treatment LOTION 1 % External 36800095526 *DERMATOLOGICALS* *Scabicides & Pediculicides*** HM Hydrocortisone Plus CREAM 1 % EXTERNAL 62011009601 *DERMATOLOGICALS* *Topical Steroid Combinations*** HM Hydrocortisone-Aloe Max St CREAM 1 % EXTERNAL 62011009501 *DERMATOLOGICALS* *Topical Steroid Combinations*** HM Gas Relief Infants Drops Suspension 20 MG/0.3ML Oral 62011018701 *GASTROINTESTINAL AGENTS - MISC.* *Antiflatulents*** Mi-Acid Gas Relief TABLET CHEWABLE 80 MG ORAL 00904506860 *GASTROINTESTINAL AGENTS - MISC.* *Antiflatulents*** SM Gas Relief Tablet Chewable 125 MG Oral 49348086348 *GASTROINTESTINAL AGENTS - MISC.* *Antiflatulents*** SM Gas Relief TABLET CHEWABLE 80 MG Oral 49348018810 *GASTROINTESTINAL AGENTS - MISC.* *Antiflatulents*** *GENITOURINARY AGENTS - Potassium Citrate POWDER 51927140600 MISCELLANEOUS* *Citrates*** Potassium Citrate-Citric Acid Solution 1100-334 *GENITOURINARY AGENTS - MG/5ML Oral 00121067616 MISCELLANEOUS* *Citrates*** Sod Citrate-Citric Acid Solution 500-334 MG/5ML *GENITOURINARY AGENTS - Oral 00121059516 MISCELLANEOUS* *Citrates*** *GENITOURINARY AGENTS - Sodium Citrate CRYSTALS 38779054308 MISCELLANEOUS* *Citrates***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *GENITOURINARY AGENTS - Tricitrates Solution 550-500-334 MG/5ML Oral 00121067716 MISCELLANEOUS* *Citrates*** Vitamin B-12 Tablet 100 MCG Oral 00904113213 *HEMATOPOIETIC AGENTS* *Cobalamins*** Vitamin B-12 Tablet 1000 MCG Oral 10006070022 *HEMATOPOIETIC AGENTS* *Cobalamins*** Vitamin B-12 Tablet 1000 MCG Oral 54629058605 *HEMATOPOIETIC AGENTS* *Cobalamins*** Vitamin B-12 Tablet 500 MCG Oral 50268085415 *HEMATOPOIETIC AGENTS* *Cobalamins*** Vitamin B-12 Tablet 500 MCG Oral 51645091301 *HEMATOPOIETIC AGENTS* *Cobalamins*** Vitamin B-12 Tablet 500 MCG Oral 54629058501 *HEMATOPOIETIC AGENTS* *Cobalamins*** Folic Acid Tablet 400 MCG Oral 54629065002 *HEMATOPOIETIC AGENTS* *Folic Acid/Folates*** Ferate TABLET 240 (27 Fe) MG Oral 00904640360 *HEMATOPOIETIC AGENTS* *Iron*** Fer-In-Sol Solution 75 (15 Fe) MG/ML Oral 00087074002 *HEMATOPOIETIC AGENTS* *Iron*** FeroSul Tablet 325 (65 Fe) MG Oral 00904759082 *HEMATOPOIETIC AGENTS* *Iron***

Ferrous Gluconate TABLET 324 (37.5 Fe) MG ORAL 00904213761 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Gluconate Tablet 324 (38 Fe) MG Oral 00574050801 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Gluconate Tablet 324 (38 Fe) MG Oral 00574050810 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Gluconate Tablet 324 (38 Fe) MG Oral 00574050811 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Elixir 220 (44 Fe) MG/5ML Oral 54838000180 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Solution 75 (15 Fe) MG/ML Oral 50383062750 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Solution 75 (15 Fe) MG/ML Oral 54838001150 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 00536100901 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 00904759160 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 00904759161 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 00904759180 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 00904759182 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 49483006301 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 49483006310 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 49483006410 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 57664007001 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 57664007010 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 57664007101 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet 325 (65 Fe) MG Oral 57664007110 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet Delayed Release 324 (65 Fe) MG Oral 00574060801 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet Delayed Release 324 (65 Fe) MG Oral 00574060810 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet Delayed Release 324 (65 Fe) MG Oral 00574060811 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet Delayed Release 325 (65 Fe) MG Oral 00245010801 *HEMATOPOIETIC AGENTS* *Iron*** Ferrous Sulfate Tablet Delayed Release 325 (65 Fe) MG Oral 00245010811 *HEMATOPOIETIC AGENTS* *Iron*** FerrouSul Tablet 325 (65 Fe) MG Oral 62107004401 *HEMATOPOIETIC AGENTS* *Iron*** iFerex 150 Capsule 150 MG Oral 63044020301 *HEMATOPOIETIC AGENTS* *Iron*** iFerex 150 Capsule 150 MG Oral 63044020361 *HEMATOPOIETIC AGENTS* *Iron*** GNP Nighttime Sleep Aid TABLET 25 MG Oral 24385043126 *HYPNOTICS* *Antihistamine Hypnotics*** GNP Nighttime Sleep Aid TABLET 25 MG Oral 24385043178 *HYPNOTICS* *Antihistamine Hypnotics*** HM Sleep Aid Tablet 25 MG Oral 62011034401 *HYPNOTICS* *Antihistamine Hypnotics*** Night Time Sleep Aid TABLET 25 MG Oral 63868061132 *HYPNOTICS* *Antihistamine Hypnotics*** Nighttime Sleep Aid Tablet 25 MG Oral 00113043162 *HYPNOTICS* *Antihistamine Hypnotics*** Nighttime Sleep Aid Tablet 25 MG Oral 36800043162 *HYPNOTICS* *Antihistamine Hypnotics*** Nighttime Sleep Aid Tablet 25 MG Oral 36800043167 *HYPNOTICS* *Antihistamine Hypnotics***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS

Sleep Aid (DiphenhydrAMINE) Tablet 25 MG Oral 70000024401 *HYPNOTICS* *Antihistamine Hypnotics*** Sleep Aid Capsule 25 MG Oral 70000024201 *HYPNOTICS* *Antihistamine Hypnotics*** Sleep Aid Tablet 25 MG Oral 70000024901 *HYPNOTICS* *Antihistamine Hypnotics*** Sleep Tabs TABLET 25 MG Oral 00904427451 *HYPNOTICS* *Antihistamine Hypnotics*** Fiber Laxative Tablet 625 MG Oral 36800047775 *LAXATIVES* *Bulk Laxatives*** Fiber Laxative Tablet 625 MG Oral 37205021375 *LAXATIVES* *Bulk Laxatives*** Fiber Tablet 625 MG Oral 00904250091 *LAXATIVES* *Bulk Laxatives*** Fiber-Lax Tablet 625 MG Oral 00536430605 *LAXATIVES* *Bulk Laxatives*** Fiber-Lax Tablet 625 MG Oral 00536430608 *LAXATIVES* *Bulk Laxatives*** Fiber-Lax Tablet 625 MG Oral 00536430611 *LAXATIVES* *Bulk Laxatives*** GNP Fiber-Caps Tablet 625 MG Oral 24385012576 *LAXATIVES* *Bulk Laxatives*** GNP Natural Fiber Powder 28.3 % Oral 24385029950 *LAXATIVES* *Bulk Laxatives*** HM Fiber TABLET 500 MG ORAL 62011013401 *LAXATIVES* *Bulk Laxatives*** Natural Fiber Therapy Powder 28.3 % Oral 00904520065 *LAXATIVES* *Bulk Laxatives*** Natural Fiber Therapy Powder 28.3 % Oral 00904520066 *LAXATIVES* *Bulk Laxatives*** Natural Fiber Therapy Powder 48.57 % Oral 00904519965 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 28.3 % Oral 00536444554 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 28.3 % Oral 00536444589 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 58.6 % Oral 00536187516 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 58.6 % Oral 00536187579 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 58.6 % Oral 00536188116 *LAXATIVES* *Bulk Laxatives*** Reguloid Powder 58.6 % Oral 00536188179 *LAXATIVES* *Bulk Laxatives*** SM Fiber Laxative TABLET 500 MG ORAL 49348054110 *LAXATIVES* *Bulk Laxatives*** SM Fiber Powder Powder 25 % Oral 10939081444 *LAXATIVES* *Bulk Laxatives*** ClearLax Powder 17 GM/SCOOP Oral 36800030601 *LAXATIVES* *Laxatives - Miscellaneous*** ClearLax Powder 17 GM/SCOOP Oral 36800030602 *LAXATIVES* *Laxatives - Miscellaneous*** ClearLax Powder 17 GM/SCOOP Oral 36800030603 *LAXATIVES* *Laxatives - Miscellaneous*** GaviLAX Powder 17 GM/SCOOP Oral 43386031208 *LAXATIVES* *Laxatives - Miscellaneous*** GaviLAX Powder 17 GM/SCOOP Oral 43386031214 *LAXATIVES* *Laxatives - Miscellaneous*** GlycoLax Powder 17 GM/SCOOP Oral 62175019015 *LAXATIVES* *Laxatives - Miscellaneous*** GlycoLax Powder 17 GM/SCOOP Oral 62175019031 *LAXATIVES* *Laxatives - Miscellaneous*** GNP ClearLax Powder 17 GM/SCOOP Oral 46122001433 *LAXATIVES* *Laxatives - Miscellaneous*** GNP ClearLax Powder 17 GM/SCOOP Oral 46122001471 *LAXATIVES* *Laxatives - Miscellaneous***

GoodSense ClearLax Powder 17 GM/SCOOP Oral 00113030602 *LAXATIVES* *Laxatives - Miscellaneous***

GoodSense ClearLax Powder 17 GM/SCOOP Oral 00113030603 *LAXATIVES* *Laxatives - Miscellaneous*** HM ClearLax Powder 17 GM/SCOOP Oral 62011015304 *LAXATIVES* *Laxatives - Miscellaneous*** HM ClearLax Powder 17 GM/SCOOP Oral 62011028701 *LAXATIVES* *Laxatives - Miscellaneous*** HM ClearLax Powder 17 GM/SCOOP Oral 62011028702 *LAXATIVES* *Laxatives - Miscellaneous*** Pedia-Lax Suppository 1 GM Rectal 00132008112 *LAXATIVES* *Laxatives - Miscellaneous*** PEG 3350 Powder 17 GM/SCOOP Oral 00536105224 *LAXATIVES* *Laxatives - Miscellaneous*** PEG 3350 Powder 17 GM/SCOOP Oral 00536105227 *LAXATIVES* *Laxatives - Miscellaneous*** PEG 3350 Powder 17 GM/SCOOP Oral 00536105284 *LAXATIVES* *Laxatives - Miscellaneous*** Polyethylene Glycol 3350 Powder 17 GM/SCOOP Oral 11534018028 *LAXATIVES* *Laxatives - Miscellaneous*** Polyethylene Glycol 3350 Powder 17 GM/SCOOP Oral 11534018050 *LAXATIVES* *Laxatives - Miscellaneous*** Polyethylene Glycol 3350 Powder 17 GM/SCOOP Oral 45802086801 *LAXATIVES* *Laxatives - Miscellaneous*** Polyethylene Glycol 3350 Powder 17 GM/SCOOP Oral 45802086802 *LAXATIVES* *Laxatives - Miscellaneous***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Polyethylene Glycol 3350 Powder 17 GM/SCOOP Oral 45802086803 *LAXATIVES* *Laxatives - Miscellaneous*** QC Natura-LAX Powder 17 GM/SCOOP Oral 63868000214 *LAXATIVES* *Laxatives - Miscellaneous*** SM ClearLax Powder 17 GM/SCOOP Oral 49348089350 *LAXATIVES* *Laxatives - Miscellaneous*** DOK Plus Tablet 50-8.6 MG Oral 00904672360 *LAXATIVES* *Laxatives & DSS*** GNP Stool Softener/Laxative Tablet 8.6-50 MG Oral 46122034478 *LAXATIVES* *Laxatives & DSS*** HM Senna-S Tablet 8.6-50 MG Oral 62011029001 *LAXATIVES* *Laxatives & DSS*** QC Stool Softener Pls Laxative Tablet 8.6-50 MG Oral 63868013510 *LAXATIVES* *Laxatives & DSS*** QC Stool Softener Pls Laxative Tablet 8.6-50 MG Oral 63868013760 *LAXATIVES* *Laxatives & DSS*** Senexon-S Tablet 8.6-50 MG Oral 00536116901 *LAXATIVES* *Laxatives & DSS*** Senexon-S Tablet 8.6-50 MG Oral 00536116910 *LAXATIVES* *Laxatives & DSS*** Senexon-S Tablet 8.6-50 MG Oral 00536408601 *LAXATIVES* *Laxatives & DSS*** Senexon-S Tablet 8.6-50 MG Oral 00536408610 *LAXATIVES* *Laxatives & DSS*** Senna Plus Tablet 8.6-50 MG Oral 00904633961 *LAXATIVES* *Laxatives & DSS*** Senna Plus Tablet 8.6-50 MG Oral 00904672461 *LAXATIVES* *Laxatives & DSS*** Senna Plus Tablet 8.6-50 MG Oral 51645085001 *LAXATIVES* *Laxatives & DSS*** Senna Plus Tablet 8.6-50 MG Oral 51645085010 *LAXATIVES* *Laxatives & DSS*** Sennosides-Docusate Sodium Tablet 8.6-50 MG Oral 63739043201 *LAXATIVES* *Laxatives & DSS*** SM Senna-S Tablet 8.6-50 MG Oral 70677004201 *LAXATIVES* *Laxatives & DSS*** Enema Enema 7-19 GM/118ML Rectal 00536741551 *LAXATIVES* *Saline Laxative Mixtures*** Enema Enema 7-19 GM/118ML Rectal 00904632078 *LAXATIVES* *Saline Laxative Mixtures*** Enema Ready-To-Use Enema 7-19 GM/118ML Rectal 70000010801 *LAXATIVES* *Saline Laxative Mixtures*** Fleet Enema Enema 7-19 GM/118ML Rectal 00132020142 *LAXATIVES* *Saline Laxative Mixtures*** Fleet Pediatric Enema 3.5-9.5 GM/59ML Rectal 00132020220 *LAXATIVES* *Saline Laxative Mixtures*** GNP Enema Enema Rectal 46122036428 *LAXATIVES* *Saline Laxative Mixtures*** HM Enema Enema 7-19 GM/118ML Rectal 62011027101 *LAXATIVES* *Saline Laxative Mixtures*** QC Enema Enema 16-6 GM/133ML Rectal 63868038045 *LAXATIVES* *Saline Laxative Mixtures*** QC Enema Enema 16-6 GM/133ML Rectal 63868038090 *LAXATIVES* *Saline Laxative Mixtures*** SM Enema Enema 7-19 GM/118ML Rectal 49348018614 *LAXATIVES* *Saline Laxative Mixtures*** SM Enema Enema 7-19 GM/118ML Rectal 49348018620 *LAXATIVES* *Saline Laxative Mixtures*** GNP Milk of Magnesia Suspension 1200 MG/15ML Oral 24385033240 *LAXATIVES* *Saline Laxatives*** GNP Milk of Magnesia Suspension 1200 MG/15ML Oral 46122043740 *LAXATIVES* *Saline Laxatives*** HM Milk of Magnesia Suspension 1200 MG/15ML Oral 62011012301 *LAXATIVES* *Saline Laxatives*** HM Milk of Magnesia Suspension 1200 MG/15ML Oral 62011012401 *LAXATIVES* *Saline Laxatives***

Milk of Magnesia Suspension 1200 MG/15ML Oral 00113033240 *LAXATIVES* *Saline Laxatives***

Milk of Magnesia Suspension 1200 MG/15ML Oral 00113039640 *LAXATIVES* *Saline Laxatives***

Milk of Magnesia Suspension 1200 MG/15ML Oral 00904675714 *LAXATIVES* *Saline Laxatives***

Milk of Magnesia Suspension 1200 MG/15ML Oral 36800039640 *LAXATIVES* *Saline Laxatives***

Milk of Magnesia Suspension 1200 MG/15ML Oral 70000048401 *LAXATIVES* *Saline Laxatives***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Milk of Magnesia Suspension 400 MG/5ML Oral 00904078814 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 400 MG/5ML Oral 37205083340 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 400 MG/5ML Oral 66689005399 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 7.75 % Oral 00113094940 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 7.75 % Oral 00121043130 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 7.75 % Oral 00536247085 *LAXATIVES* *Saline Laxatives*** Milk of Magnesia Suspension 7.75 % Oral 00904078914 *LAXATIVES* *Saline Laxatives*** QC Milk of Magnesia Suspension 400 MG/5ML Oral 63868031012 *LAXATIVES* *Saline Laxatives*** SM Magnesium Citrate Solution 1.745 GM/30ML Oral 70677005101 *LAXATIVES* *Saline Laxatives*** SM Milk of Magnesia Suspension 1200 MG/15ML Oral 49348030539 *LAXATIVES* *Saline Laxatives*** SM Milk of Magnesia Suspension 1200 MG/15ML Oral 49348030739 *LAXATIVES* *Saline Laxatives*** SM Milk of Magnesia Suspension 1200 MG/15ML Oral 49348030839 *LAXATIVES* *Saline Laxatives*** SM Milk of Magnesia Suspension 400 MG/5ML Oral 49348068039 *LAXATIVES* *Saline Laxatives*** SM Milk of Magnesia Suspension 400 MG/5ML Oral 49348068839 *LAXATIVES* *Saline Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010901 *LAXATIVES* *Stimulant Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010905 *LAXATIVES* *Stimulant Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010908 *LAXATIVES* *Stimulant Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010910 *LAXATIVES* *Stimulant Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010912 *LAXATIVES* *Stimulant Laxatives*** Bisac-Evac Suppository 10 MG Rectal 00713010950 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 00904674817 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 00904674860 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 00904674880 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 00904792760 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 00904792780 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl EC Tablet Delayed Release 5 MG Oral 37205012863 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl Suppository 10 MG Rectal 00574705012 *LAXATIVES* *Stimulant Laxatives*** Bisacodyl Suppository 10 MG Rectal 00574705050 *LAXATIVES* *Stimulant Laxatives*** Biscolax Suppository 10 MG Rectal 00904505812 *LAXATIVES* *Stimulant Laxatives*** Biscolax Suppository 10 MG Rectal 00904505860 *LAXATIVES* *Stimulant Laxatives*** Ducodyl Tablet Delayed Release 5 MG Oral 62107003001 *LAXATIVES* *Stimulant Laxatives*** Ducodyl Tablet Delayed Release 5 MG Oral 62107003010 *LAXATIVES* *Stimulant Laxatives*** Fleet Bisacodyl ENEMA 10 MG/30ML Rectal 00132070336 *LAXATIVES* *Stimulant Laxatives***

GNP Bisa-Lax Tablet Delayed Release 5 MG Oral 24385090378 *LAXATIVES* *Stimulant Laxatives***

GNP Laxative Tablet Delayed Release 5 MG Oral 24385090363 *LAXATIVES* *Stimulant Laxatives*** GNP Senna Lax Tablet 8.6 MG Oral 46122039678 *LAXATIVES* *Stimulant Laxatives*** HM Laxative Tablet Delayed Release 5 MG Oral 62011027701 *LAXATIVES* *Stimulant Laxatives*** HM Laxative Tablet Delayed Release 5 MG Oral 62011027703 *LAXATIVES* *Stimulant Laxatives*** HM Senna Tablet 8.6 MG Oral 62011028901 *LAXATIVES* *Stimulant Laxatives*** HM Senna Tablet 8.6 MG Oral 62011036301 *LAXATIVES* *Stimulant Laxatives*** Laxative Max Str Tablet 25 MG Oral 70000038601 *LAXATIVES* *Stimulant Laxatives*** Laxative Suppository 10 MG Rectal 00536135501 *LAXATIVES* *Stimulant Laxatives*** Laxative Suppository 10 MG Rectal 00536135512 *LAXATIVES* *Stimulant Laxatives***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS QC Natural Vegetable Laxative TABLET 8.6 MG ORAL 63868025710 *LAXATIVES* *Stimulant Laxatives*** Senna Laxative Tablet 8.6 MG Oral 36800078601 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 00904643480 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 00904672559 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 00904672580 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 51645085101 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 51645085110 *LAXATIVES* *Stimulant Laxatives*** Senna Tablet 8.6 MG Oral 51645085199 *LAXATIVES* *Stimulant Laxatives*** Senna-Lax Tablet 8.6 MG Oral 00904652261 *LAXATIVES* *Stimulant Laxatives*** Senna-Tabs Tablet 8.6 MG Oral 16103036308 *LAXATIVES* *Stimulant Laxatives*** Senna-Tabs Tablet 8.6 MG Oral 16103036311 *LAXATIVES* *Stimulant Laxatives*** Senno TABLET 8.6 MG Oral 62107003101 *LAXATIVES* *Stimulant Laxatives*** Senokot Tablet 8.6 MG Oral 67618030010 *LAXATIVES* *Stimulant Laxatives*** Senokot Tablet 8.6 MG Oral 67618030020 *LAXATIVES* *Stimulant Laxatives*** Senokot Tablet 8.6 MG Oral 67618030050 *LAXATIVES* *Stimulant Laxatives*** SM Gentle Laxative Tablet Delayed Release 5 MG Oral 49348003205 *LAXATIVES* *Stimulant Laxatives*** Stimulant Laxative Tablet Delayed Release 5 MG Oral 00536338101 *LAXATIVES* *Stimulant Laxatives*** Stimulant Laxative Tablet Delayed Release 5 MG Oral 00536338110 *LAXATIVES* *Stimulant Laxatives*** Docu Liquid 50 MG/5ML Oral 50383077111 *LAXATIVES* *Surfactant Laxatives*** Docu Liquid 50 MG/5ML Oral 50383077116 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Capsule 100 MG Oral 45802048678 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Capsule 100 MG Oral 60687012901 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Capsule 100 MG Oral 60687012911 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Capsule 100 MG Oral 63739047840 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Capsule 100 MG Oral 63739047848 *LAXATIVES* *Surfactant Laxatives*** Docusate Sodium Liquid 50 MG/5ML Oral 00121054410 *LAXATIVES* *Surfactant Laxatives*** Docusil Capsule 100 MG Oral 62107003301 *LAXATIVES* *Surfactant Laxatives*** Docusil Capsule 100 MG Oral 62107003310 *LAXATIVES* *Surfactant Laxatives*** DOK Capsule 100 MG Oral 00904645561 *LAXATIVES* *Surfactant Laxatives*** DOK Capsule 100 MG Oral 00904645760 *LAXATIVES* *Surfactant Laxatives*** DOK Capsule 100 MG Oral 00904645780 *LAXATIVES* *Surfactant Laxatives*** DOK Tablet 100 MG Oral 00904586960 *LAXATIVES* *Surfactant Laxatives*** DOK Tablet 100 MG Oral 00904675060 *LAXATIVES* *Surfactant Laxatives*** Enemeez Mini Enema 283 MG/5ML Rectal 17433987603 *LAXATIVES* *Surfactant Laxatives*** Enemeez Plus ENEMA 20-283 MG Rectal 17433987703 *LAXATIVES* *Surfactant Laxatives*** GNP Stool Softener Capsule 100 MG Oral 46122023172 *LAXATIVES* *Surfactant Laxatives*** GNP Stool Softener Capsule 100 MG Oral 46122045178 *LAXATIVES* *Surfactant Laxatives*** HM Stool Softener Capsule 100 MG Oral 62011022401 *LAXATIVES* *Surfactant Laxatives*** HM Stool Softener Tablet 100 MG Oral 62011028601 *LAXATIVES* *Surfactant Laxatives*** Silace Liquid 150 MG/15ML Oral 54838011680 *LAXATIVES* *Surfactant Laxatives*** SM Stool Softener Capsule 100 MG Oral 49348012105 *LAXATIVES* *Surfactant Laxatives*** SM Stool Softener Capsule 100 MG Oral 49348048310 *LAXATIVES* *Surfactant Laxatives*** SM Stool Softener Capsule 100 MG Oral 49348048319 *LAXATIVES* *Surfactant Laxatives*** SM Stool Softener Capsule 100 MG Oral 70677003401 *LAXATIVES* *Surfactant Laxatives*** Stool Softener Capsule 100 MG Oral 00113048672 *LAXATIVES* *Surfactant Laxatives*** Stool Softener Capsule 100 MG Oral 00536106210 *LAXATIVES* *Surfactant Laxatives*** Stool Softener Capsule 100 MG Oral 00536106229 *LAXATIVES* *Surfactant Laxatives*** Stool Softener Capsule 250 MG Oral 00536106410 *LAXATIVES* *Surfactant Laxatives*** Os-Cal Extra D3 Tablet 500-600 MG-UNIT Oral 00088165125 *MINERALS & ELECTROLYTES* *Calcium Combinations***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Os-Cal Extra D3 Tablet 500-600 MG-UNIT Oral 00088165149 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oysco 500+D Tablet 500-200 MG-UNIT Oral 00536781708 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oysco 500+D Tablet 500-200 MG-UNIT Oral 00536781710 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/D Tablet 500-200 MG-UNIT Oral 00904546052 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/D Tablet 500-200 MG-UNIT Oral 00904546072 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/D Tablet 500-200 MG-UNIT Oral 00904546080 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/D Tablet 500-200 MG-UNIT Oral 00904546092 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/D Tablet 500-200 MG-UNIT Oral 62107007506 *MINERALS & ELECTROLYTES* *Calcium Combinations*** Oyster Shell Calcium/Vitamin D TABLET 500-200 MG-UNIT ORAL 16103036111 *MINERALS & ELECTROLYTES* *Calcium Combinations***

Calcium Carbonate Tablet 1500 (600 Ca) MG Oral 00904323252 *MINERALS & ELECTROLYTES* *Calcium***

Calcium Carbonate Tablet 1500 (600 Ca) MG Oral 00904323261 *MINERALS & ELECTROLYTES* *Calcium***

Calcium Carbonate Tablet 1500 (600 Ca) MG Oral 00904323292 *MINERALS & ELECTROLYTES* *Calcium*** Oysco 500 Tablet 500 MG Oral 00536410602 *MINERALS & ELECTROLYTES* *Calcium*** Oysco 500 Tablet 500 MG Oral 00536410608 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 00904188352 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 00904188361 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 00904188372 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 00904188380 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 00904188392 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 16103036011 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 16103036099 *MINERALS & ELECTROLYTES* *Calcium*** Oyster Shell Calcium Tablet 500 MG Oral 80681000400 *MINERALS & ELECTROLYTES* *Calcium*** Pedialyte Freezer Pops Solution Oral 00074024501 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Pedialyte Singles Solution Oral 00074549820 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Pedialyte Solution Oral 00074024001 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Pedialyte Solution Oral 00074517530 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Pedialyte Solution Oral 00074647032 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Pedialyte Solution Oral 00074647132 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** SM Pediatric Electrolyte Solution Oral 49348016162 *MINERALS & ELECTROLYTES* *Electrolytes Oral*** Floriva Liquid 0.25-400 MG-UNIT/ML Oral 52796017250 *MINERALS & ELECTROLYTES* *Fluoride Combinations*** Sodium Fluoride Tablet Chewable 0.55 (0.25 F) MG Oral 59088010473 *MINERALS & ELECTROLYTES* *Fluoride*** Sodium Fluoride Tablet Chewable 1.1 (0.5 F) MG Oral 59088010573 *MINERALS & ELECTROLYTES* *Fluoride*** Sodium Fluoride Tablet Chewable 2.2 (1 F) MG Oral 59088010673 *MINERALS & ELECTROLYTES* *Fluoride*** Mag64 Tablet Delayed Release 64 MG Oral 68585000575 *MINERALS & ELECTROLYTES* *Magnesium***

Magnesium Oxide Tablet 400 (241.3 Mg) MG Oral 10135058362 *MINERALS & ELECTROLYTES* *Magnesium*** Magnesium Oxide Tablet 420 (252 Mg) MG Oral 10006070049 *MINERALS & ELECTROLYTES* *Magnesium*** Magnesium Oxide TABLET 500 MG ORAL 00904423960 *MINERALS & ELECTROLYTES* *Magnesium*** Magnesium Tablet 250 MG Oral 37205035178 *MINERALS & ELECTROLYTES* *Magnesium*** K-Phos-Neutral Tablet 155-852-130 MG Oral 00486112501 *MINERALS & ELECTROLYTES* *Phosphate*** Sodium Chloride Tablet 1 GM Oral 69367022001 *MINERALS & ELECTROLYTES* *Sodium***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS B Complex CAPSULE ORAL 00536478701 *MULTIVITAMINS* *B-Complex Vitamins*** B Complex Vitamins CAPSULE ORAL 54629056102 *MULTIVITAMINS* *B-Complex Vitamins*** B-Complex/B-12 Tablet Oral 00904418160 *MULTIVITAMINS* *B-Complex Vitamins*** Stress Formula/Zinc Tablet Oral 00904272752 *MULTIVITAMINS* *B-Complex w/ C & E + Zn*** Vita-Bee/C Tablet Oral 00536103601 *MULTIVITAMINS* *B-Complex w/ C & Folic Acid*** Superplex-T Tablet Oral 00904225360 *MULTIVITAMINS* *B-Complex w/ C*** Total B/C Tablet Oral 00904026013 *MULTIVITAMINS* *B-Complex w/ C*** Nephplex Rx TABLET ORAL 59528031701 *MULTIVITAMINS* *B-Complex w/ C-Zn & Folic Acid*** Stress Formula/Iron TABLET ORAL 00904026352 *MULTIVITAMINS* *Multiple Vitamins w/ Iron*** Tab-A-Vite/Iron Tablet Oral 00904053160 *MULTIVITAMINS* *Multiple Vitamins w/ Iron*** CertaVite Senior/Antioxidant Tablet Oral 00904548652 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** CertaVite Senior/Antioxidant Tablet Oral 00904548689 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** CertaVite/Antioxidants Tablet Oral 00904264113 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** CertaVite/Antioxidants Tablet Oral 00904264146 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** CertaVite/Antioxidants Tablet Oral 00904264172 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** DEKAs Plus Capsule Oral 68176000011 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** DEKAs Plus TABLET CHEWABLE ORAL 68176000015 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** ICaps MV Tablet Oral 00065804083 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Ocuvite-Lutein Tablet Oral 24208038760 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Oncovite Tablet Oral 00178055001 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Prosight Tablet Oral 00904773518 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Prosight Tablet Oral 00904773552 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Tab-A-Vite Tablet Oral 00904053046 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Tab-A-Vite Tablet Oral 00904053060 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Tab-A-Vite Tablet Oral 00904053080 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Thera M Plus Tablet Oral 00904549261 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Thera-M Tablet Oral 00904549213 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Thera-M Tablet Oral 00904549280 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** Vitamins/Minerals TABLET ORAL 00904504260 *MULTIVITAMINS* *Multiple Vitamins w/ Minerals*** DEKAs Essential Capsule Oral 68176000012 *MULTIVITAMINS* *Multivitamins*** DEKAs Essential Liquid Oral 68176000013 *MULTIVITAMINS* *Multivitamins*** Multivitamin Tablet Oral 80681002000 *MULTIVITAMINS* *Multivitamins*** Tab-A-Vite/Beta Carotene Tablet Oral 00904053061 *MULTIVITAMINS* *Multivitamins*** Thera Tablet Oral 00904053913 *MULTIVITAMINS* *Multivitamins*** Thera Tablet Oral 00904053961 *MULTIVITAMINS* *Multivitamins*** Thera Tablet Oral 00904053980 *MULTIVITAMINS* *Multivitamins*** Poly-Vi-Flor/Iron SUSPENSION 0.25-7 MG/ML ORAL 23594060050 *MULTIVITAMINS* *Ped Multi Vitamins w/Fl & FE*** Poly-Vi-Flor/Iron TABLET CHEWABLE 0.5-10 MG ORAL 23594010030 *MULTIVITAMINS* *Ped Multi Vitamins w/Fl & FE***

Quflora FE Pediatric Liquid 0.25-9.5 MG/ML Oral 15370010250 *MULTIVITAMINS* *Ped Multi Vitamins w/Fl & FE*** *Ped Multiple Vitamins w/ Minerals & AquADEKs Liquid Oral 58914021460 *MULTIVITAMINS* C*** *Ped Multiple Vitamins w/ DEKAs Plus Liquid Oral 68176000010 *MULTIVITAMINS* Minerals*** Multivitamin/Fluoride Tablet Chewable 0.25 MG Oral 59088010759 *MULTIVITAMINS* *Ped MV w/ Fluoride*** Multivitamin/Fluoride Tablet Chewable 0.5 MG Oral 59088010859 *MULTIVITAMINS* *Ped MV w/ Fluoride***

Multivitamin/Fluoride Tablet Chewable 1 MG Oral 59088010959 *MULTIVITAMINS* *Ped MV w/ Fluoride*** Poly-Vi-Flor SUSPENSION 0.25 MG/ML ORAL 23594050050 *MULTIVITAMINS* *Ped MV w/ Fluoride***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Poly-Vi-Flor TABLET CHEWABLE 0.25 MG ORAL 23594020030 *MULTIVITAMINS* *Ped MV w/ Fluoride*** Poly-Vi-Flor TABLET CHEWABLE 0.5 MG ORAL 23594030030 *MULTIVITAMINS* *Ped MV w/ Fluoride*** Poly-Vi-Flor TABLET CHEWABLE 1 MG ORAL 23594040030 *MULTIVITAMINS* *Ped MV w/ Fluoride***

Animal Shapes/Iron Tablet Chewable 18 MG Oral 00904053660 *MULTIVITAMINS* *Ped MV w/ Iron***

Animal Shapes/Iron Tablet Chewable 18 MG Oral 00904053670 *MULTIVITAMINS* *Ped MV w/ Iron*** *Ped Vitamins ACD & FA w/ Tri-Vi-Flor SUSPENSION 0.25 MG/ML ORAL 23594070050 *MULTIVITAMINS* Fluoride*** *Ped Vitamins ACD & FA w/ Tri-Vi-Flor SUSPENSION 0.5 MG/ML ORAL 23594080050 *MULTIVITAMINS* Fluoride*** *Pediatric Multiple Vitamins w/ C & Animal Shapes Tablet Chewable with C & FA Oral 00904262160 *MULTIVITAMINS* FA*** *Pediatric Multiple Vitamins w/ C & Animal Shapes Tablet Chewable with C & FA Oral 00904262170 *MULTIVITAMINS* FA*** Poly-Vi-Sol Solution 50 MG/ML Oral 00087040203 *MULTIVITAMINS* *Pediatric Multiple Vitamins w/ C*** Tri-Vi-Sol A/C/D Solution 250-50-10 Oral 00087040303 *MULTIVITAMINS* *Pediatric Vitamins A & D w/ C*** Concept DHA CAPSULE 53.5-38-1 MG ORAL 52747062130 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Concept OB CAPSULE 130-92.4-1 MG ORAL 52747062030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Elite-OB TABLET 50-1.25 MG Oral 13811002710 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** EnBrace HR CAPSULE ORAL 64661065030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Folivane-OB CAPSULE 130-92.4-1 MG ORAL 13811053530 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** GNP PreNatal Tablet 28-0.8 MG Oral 46122009878 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Marnatal-F CAPSULE 60-1 MG ORAL 00682157001 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Nestabs TABLET 32-1 MG Oral 50967021990 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** OB Complete One Capsule 50-1-476 MG Oral 68025004430 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** OB Complete Petite CAPSULE 35-5-1-200 MG ORAL 68025005930 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** OB Complete Premier TABLET 30-20-1 MG ORAL 68025004330 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** OB Complete TABLET 50-1.25 MG ORAL 68025001010 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** O-Cal FA Tablet 27-1 MG Oral 00813931601 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Prenatal TABLET 27-1 MG ORAL 39328010610 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Prenatal Vitamin Plus Low Iron TABLET 27-1 MG ORAL 63044015001 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Prenatal Vitamin Plus Low Iron TABLET 27-1 MG ORAL 63044015005 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Prenate Elite TABLET 20-0.6-0.4 MG ORAL 75854031430 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** PrePLUS TABLET 27-1 MG Oral 69543025810 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** PrePLUS TABLET 27-1 MG Oral 69543025850 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** PreTAB Tablet 29-1 MG Oral 69543025910 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Provida OB CAPSULE 20-20-1.25 MG ORAL 52747050430 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Select-OB TABLET CHEWABLE 29-0.6-0.4 MG ORAL 00642012090 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Select-OB TABLET CHEWABLE 29-1 MG ORAL 00642007790 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Se-Natal 19 TABLET 29-1 MG ORAL 13925011601 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Se-Natal 19 TABLET CHEWABLE 29-1 MG ORAL 13925011701 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Taron-C DHA CAPSULE 53.5-38-1 MG ORAL 13811053630 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** TriCare Tablet Oral 67112010100 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Virt-Nate DHA CAPSULE 28-1-200 MG ORAL 69543037030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Vitafol Gummies TABLET CHEWABLE 3.33-0.333- 34.8 MG ORAL 00642012590 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Vitafol-Nano TABLET 18-0.6-0.4 MG ORAL 00642009430 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Vitafol-OB TABLET ORAL 00642007912 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Vol-Plus Tablet 27-1 MG Oral 13811051910 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Vol-Plus Tablet 27-1 MG Oral 13811051950 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** VP-PNV-DHA Capsule 28-1-215.8 MG Oral 69543022330 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA***

Zatean-Pn Plus CAPSULE 28-0.6-0.4-340 MG ORAL 13811058230 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA*** Nestabs One CAPSULE 38-1-225 MG Oral 50967041030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** PNV-DHA CAPSULE 27-0.6-0.4-300 MG ORAL 42192032130 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate DHA CAPSULE 18-0.6-0.4-300 MG ORAL 75854031230 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate Enhance CAPSULE 28-0.6-0.4-400 MG ORAL 75854030930 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate Essential CAPSULE 18-0.6-0.4-300 MG ORAL 75854031330 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate Mini CAPSULE 18-0.6-0.4-350 MG ORAL 75854031530 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate Pixie CAPSULE 10-0.6-0.4-200 MG ORAL 75854031630 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate Restore CAPSULE 27-0.6-0.4-400 MG ORAL 75854030830 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** TriStart DHA CAPSULE 31-0.6-0.4-200 MG ORAL 15370025030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Vitafol Ultra CAPSULE 29-0.6-0.4-200 MG Oral 00642009330 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Vitafol-One Capsule 29-1-200 MG Oral 00642007030 *MULTIVITAMINS* *Prenatal MV & Min w/FE-FA-DHA*** Prenate TABLET CHEWABLE 0.6-0.4 MG ORAL 75854030630 *MULTIVITAMINS* *Prenatal MV & Minerals w/FA*** Prenate AM TABLET 1 MG ORAL 75854030730 *MULTIVITAMINS* *Prenatal Vitamins*** *NASAL AGENTS - SYSTEMIC AND Nasal Moisturizing Spray SOLUTION 0.65 % Nasal 70030013173 TOPICAL* *Nasal Agents - Misc.*** *NASAL AGENTS - SYSTEMIC AND Saline Mist Spray Solution 0.65 % Nasal 45802035758 TOPICAL* *Nasal Agents - Misc.*** *NASAL AGENTS - SYSTEMIC AND Saline Nasal Spray Solution 0.65 % Nasal 32953068965 TOPICAL* *Nasal Agents - Misc.*** Cromolyn Sodium Aerosol Solution 5.2 MG/ACT *NASAL AGENTS - SYSTEMIC AND Nasal 57782039726 TOPICAL* *Nasal Mast Cell Stabilizers*** *NASAL AGENTS - SYSTEMIC AND Budesonide SUSPENSION 32 MCG/ACT Nasal 00536111248 TOPICAL* *Nasal Steroids*** GNP Budesonide Nasal Spray SUSPENSION 32 *NASAL AGENTS - SYSTEMIC AND MCG/ACT Nasal 46122038976 TOPICAL* *Nasal Steroids*** *NASAL AGENTS - SYSTEMIC AND Childrens Silfedrine Liquid 15 MG/5ML Oral 54838010440 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Childrens Silfedrine Liquid 15 MG/5ML Oral 54838010470 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND GNP Nasal Decongestant Tablet 30 MG Oral 24385043262 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND GNP Nasal Decongestant Tablet 30 MG Oral 46122042862 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND HM Nasal Decongestant TABLET 30 MG Oral 62011031201 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND HM Nasal Decongestant TABLET 30 MG Oral 62011031202 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND HM Nasal Decongestant TABLET 30 MG Oral 62011031203 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Max St TABLET 30 MG Oral 70000013501 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Max St TABLET 30 MG Oral 70000013502 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Max St Tablet 10 MG Oral 00113009423 TOPICAL* *Systemic Decongestants***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Max St Tablet 10 MG Oral 00113009468 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Max St Tablet 10 MG Oral 00113009489 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 36800009423 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 36800009447 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 36800009468 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 36800009489 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 70000012601 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant PE Tablet 10 MG Oral 70000012602 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Syrup 30 MG/5ML Oral 00536185085 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Tablet 30 MG Oral 36800043262 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Tablet 30 MG Oral 36800043267 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Pseudoephedrine HCl Tablet 30 MG Oral 45802043262 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND SM Nasal Decongestant Max St Tablet 30 MG Oral 70677000501 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND SM Nasal Decongestant Max St Tablet 30 MG Oral 70677000502 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND SudoGest Maximum Strength Tablet 30 MG Oral 00904633724 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND Sudogest PE Tablet 10 MG Oral 00904573349 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND SudoGest Tablet 30 MG Oral 00904505324 TOPICAL* *Systemic Decongestants*** *NASAL AGENTS - SYSTEMIC AND SudoGest Tablet 30 MG Oral 00904505359 TOPICAL* *Systemic Decongestants*** 12 Hour Nasal Decongestant Solution 0.05 % *NASAL AGENTS - SYSTEMIC AND Nasal 00904676130 TOPICAL* *Topical Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Decongestant Spray Solution 0.05 % Nasal 00904571135 TOPICAL* *Topical Decongestants*** *NASAL AGENTS - SYSTEMIC AND Nasal Spray 12 Hour Solution 0.05 % Nasal 36800030410 TOPICAL* *Topical Decongestants*** *NASAL AGENTS - SYSTEMIC AND SM Nasal Spray 12 Hour Solution 0.05 % Nasal 49348002827 TOPICAL* *Topical Decongestants*** *Artificial Tear and Lubricant FreshKote PF Solution 2.7-2 % Ophthalmic 71776000110 *OPHTHALMIC AGENTS* Combinations*** GenTeal Tears Moderate PF Solution 0.1-0.3 % *Artificial Tear and Lubricant Ophthalmic 00065806301 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant GenTeal Tears Solution 0.1-0.3 % Ophthalmic 00065041880 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant GenTeal Tears Solution 0.1-0.3 % Ophthalmic 00065041881 *OPHTHALMIC AGENTS* Combinations***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS HM Dry Eye Relief Solution 0.2-0.2-1 % *Artificial Tear and Lubricant Ophthalmic 62011019601 *OPHTHALMIC AGENTS* Combinations*** Lubricating Eye Drops Solution 0.4-0.3 % *Artificial Tear and Lubricant Ophthalmic 00536121994 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Puralube Ointment 85-15 % Ophthalmic 00574402535 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Lacri-Lube Ointment Ophthalmic 00023031204 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Lacri-Lube Ointment Ophthalmic 00023031207 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Optive PF Solution 0.5-0.9 % Ophthalmic 00023341630 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Optive PF Solution 0.5-0.9 % Ophthalmic 00023341660 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Optive Solution 0.5-0.9 % Ophthalmic 00023324015 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh P.M. Ointment Ophthalmic 00023024004 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Relieva Solution 0.5-0.9 % Ophthalmic 00023663010 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Solution 1.4-0.6 % Ophthalmic 00023050601 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Refresh Solution 1.4-0.6 % Ophthalmic 00023050650 *OPHTHALMIC AGENTS* Combinations*** Systane Preservative Free Solution 0.4-0.3 % *Artificial Tear and Lubricant Ophthalmic 00065043133 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Solution 0.4-0.3 % Ophthalmic 00065042915 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Solution 0.4-0.3 % Ophthalmic 00065042921 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Solution 0.4-0.3 % Ophthalmic 00065042930 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Ultra PF Solution 0.4-0.3 % Ophthalmic 00065143205 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Ultra PF Solution 0.4-0.3 % Ophthalmic 00065143206 *OPHTHALMIC AGENTS* Combinations*** *Artificial Tear and Lubricant Systane Ultra Solution 0.4-0.3 % Ophthalmic 00065143105 *OPHTHALMIC AGENTS* Combinations*** GenTeal Severe Gel 0.3 % Ophthalmic 00078042957 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants***

HM Lubricating Plus SOLUTION 0.5 % Ophthalmic 62011020301 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** LiquiTears Solution 1.4 % Ophthalmic 00904649235 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Polyvinyl Alcohol Solution 1.4 % Ophthalmic 59390019613 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Refresh Celluvisc GEL 1 % Ophthalmic 00023455430 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Refresh Plus Solution 0.5 % Ophthalmic 00023040330 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Systane Complete Solution 0.6 % Ophthalmic 00065048110 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Systane Complete Solution 0.6 % Ophthalmic 00065048111 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Systane Complete Solution 0.6 % Ophthalmic 00065048155 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Systane Overnight Therapy GEL 0.3 % OPHTHALMIC 00065047401 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Tears Again Solution 1.4 % Ophthalmic 54799090415 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Theratears PF Solution 0.25 % Ophthalmic 58790000032 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Theratears Solution 0.25 % Ophthalmic 58790000115 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Theratears Solution 0.25 % Ophthalmic 58790000130 *OPHTHALMIC AGENTS* *Artificial Tears and Lubricants*** Alaway Childrens Allergy Solution 0.025 % Ophthalmic 24208060105 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Alaway Solution 0.025 % Ophthalmic 24208060110 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Pataday Solution 0.1 % Ophthalmic 00065427401 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Pataday Solution 0.2 % Ophthalmic 00065815001 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Pataday Solution 0.2 % Ophthalmic 00065815003 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Zaditor Solution 0.025 % Ophthalmic 00065401105 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** Zaditor Solution 0.025 % Ophthalmic 00065401106 *OPHTHALMIC AGENTS* *Ophthalmic Antiallergic*** *Ophthalmic Hyperosmolar Muro 128 OINTMENT 5 % OPHTHALMIC 24208038555 *OPHTHALMIC AGENTS* Products*** *Ophthalmic Hyperosmolar Muro 128 OINTMENT 5 % OPHTHALMIC 24208038556 *OPHTHALMIC AGENTS* Products*** *Ophthalmic Hyperosmolar Muro 128 Solution 2 % Ophthalmic 24208027615 *OPHTHALMIC AGENTS* Products*** *Ophthalmic Hyperosmolar Muro 128 SOLUTION 5 % OPHTHALMIC 24208027715 *OPHTHALMIC AGENTS* Products*** Ear Drops Earwax Aid Solution 6.5 % Otic 57896033905 *OTIC AGENTS* *Otic Agents - Miscellaneous*** GNP Earwax Removal Drops Solution 6.5 % Otic 46122055705 *OTIC AGENTS* *Otic Agents - Miscellaneous***

GoodSense Ear Wax Removal Solution 6.5 % Otic 50804010407 *OTIC AGENTS* *Otic Agents - Miscellaneous*** Murine Ear Solution 6.5 % Otic 78112073623 *OTIC AGENTS* *Otic Agents - Miscellaneous*** Murine Ear Wax Removal System Solution 6.5 % Otic 78112073621 *OTIC AGENTS* *Otic Agents - Miscellaneous*** *Pediatric Multiple Vitamins & *Pediatric Multiple Vitamins & Floriva TABLET CHEWABLE 0.25 MG ORAL 52796017390 Minerals w/ Fluoride*** Minerals w/ Fluoride*** *Pediatric Multiple Vitamins & *Pediatric Multiple Vitamins & Floriva TABLET CHEWABLE 1 MG ORAL 52796017790 Minerals w/ Fluoride*** Minerals w/ Fluoride*** Methylparaben POWDER 38779143904 *PHARMACEUTICAL ADJUVANTS* *Antimicrobial Agents*** Propylparaben POWDER 51927116400 *PHARMACEUTICAL ADJUVANTS* *Antimicrobial Agents*** Methylcellulose Powder 38779008505 *PHARMACEUTICAL ADJUVANTS* *External Vehicle Ingredients*** Suspendol-S Liquid 00574030716 *PHARMACEUTICAL ADJUVANTS* *External Vehicles*** Cherry Syrup Oral 00395266216 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Ora-Blend SF Suspension Oral 00574031216 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Ora-Blend Suspension Oral 00574031116 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Ora-Plus Liquid Oral 00574030316 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Ora-Sweet SF Syrup Oral 00574030216 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Ora-Sweet Syrup Oral 00574030416 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Simple Syrup Syrup Oral 00395266116 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Simple Syrup Syrup Oral 38779177908 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** SyrSpend SF Liquid Oral 51552107905 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** SyrSpend SF Liquid Oral 51552116709 *PHARMACEUTICAL ADJUVANTS* *Oral Vehicles*** Lactose Monohydrate Powder 38779031608 *PHARMACEUTICAL ADJUVANTS* *Pharmaceutical Excipients*** Sodium Benzoate POWDER 38779055108 *PHARMACEUTICAL ADJUVANTS* *Pharmaceutical Excipients*** Polybase Ointment External 00574030916 *PHARMACEUTICAL ADJUVANTS* *Semi Solid Vehicles*** *Prenatal MV & Minerals w/FA *Prenatal MV & Minerals w/FA Prenate TABLET CHEWABLE 0.6-0.4 MG ORAL 75854030630 without Iron*** without Iron*** *PSYCHOTHERAPEUTIC AND GNP Nicotine Mini Lozenge 2 MG Mouth/Throat 46122025415 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GNP Nicotine Mini Lozenge 2 MG Mouth/Throat 46122025460 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** GNP Nicotine Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 46122035274 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS GNP Nicotine Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 46122035474 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GNP Nicotine Polacrilex GUM 2 MG Mouth/Throat 46122017125 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GNP Nicotine Polacrilex Gum 4 MG Mouth/Throat 46122017460 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GNP Nicotine Polacrilex Gum 4 MG Mouth/Throat 46122028660 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** GNP Nicotine Polacrilex Lozenge 2 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 46122017608 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** GNP Nicotine Polacrilex Lozenge 4 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 46122025515 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** GNP Nicotine Polacrilex Lozenge 4 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 46122025560 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 2 MG Mouth/Throat 00113002971 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 2 MG Mouth/Throat 00113045660 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 4 MG Mouth/Throat 00113017060 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 4 MG Mouth/Throat 00113017071 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 4 MG Mouth/Throat 00113053260 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Gum 4 MG Mouth/Throat 00113053278 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Lozenge 2 MG Mouth/Throat 00113073402 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Lozenge 4 MG Mouth/Throat 00113087305 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Lozenge 4 MG Mouth/Throat 00113087306 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND GoodSense Nicotine Lozenge 4 MG Mouth/Throat 00113095702 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011017201 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011035001 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011017301 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011035101 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011005001 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 62011034901 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND HM Nicotine Polacrilex Gum 2 MG Mouth/Throat 62011004702 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND HM Nicotine Polacrilex Gum 4 MG Mouth/Throat 62011017001 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** HM Nicotine Polacrilex Lozenge 2 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 62011004801 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS HM Nicotine Polacrilex Lozenge 2 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 62011019901 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Mini Lozenge 2 MG Mouth/Throat 00536123981 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Mini Lozenge 4 MG Mouth/Throat 00536124181 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 14 MG/24HR Transdermal 00536589553 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 14 MG/24HR Transdermal 00536589571 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 14 MG/24HR Transdermal 00536589588 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 14 MG/24HR Transdermal 43598044770 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 14 MG/24HR Transdermal 43598044774 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 00536589653 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 00536589671 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 00536589688 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 43598044828 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 43598044870 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 43598044874 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 21 MG/24HR Transdermal 46122035374 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 7 MG/24HR Transdermal 00536589453 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 7 MG/24HR Transdermal 00536589488 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 7 MG/24HR Transdermal 43598044670 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Patch 24 Hour 7 MG/24HR Transdermal 43598044674 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00113020625 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536136206 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536136223 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536136234 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536302906 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536302923 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536302934 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536311201 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536311237 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536338601 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 00536340401 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 36800002925 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 36800020625 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 36800035278 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 36800045678 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 45802020625 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 70000034501 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 70000034601 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 70000034701 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 70000034801 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 2 MG Mouth/Throat 70000034802 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00113042225 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536137206 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536137223 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536137234 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536303006 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536303023 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536311301 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536311337 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536338701 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 00536340501 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800017025 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800017071 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800042271 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800053260 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800053278 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 36800085478 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 45802000125 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 70000034101 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 70000034201 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 70000034301 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 70000034401 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Gum 4 MG Mouth/Throat 70000034402 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 36800034405 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 45802008901 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 45802008902 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 45802034403 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 45802034405 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 2 MG Mouth/Throat 70000011701 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 36800053905 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 36800087305 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 45802087305 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 45802095701 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 45802095702 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND Nicotine Polacrilex Lozenge 4 MG Mouth/Throat 70000012100 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 1 Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 00536110888 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 1 Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011501 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 1 Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011502 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 1 Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000051202 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Nicotine Step 2 Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 00536110788 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 2 Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011401 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 2 Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011402 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 2 Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000051102 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 3 Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 00536110688 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 3 Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011301 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 3 Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000011302 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Nicotine Step 3 Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 70000051001 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Gum 4 MG Mouth/Throat 49348069236 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Gum 4 MG Mouth/Throat 49348078810 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Lozenge 2 MG Mouth/Throat 49348085216 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** SM Nicotine Patch 24 Hour 14 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 49348014546 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** SM Nicotine Patch 24 Hour 21 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 49348014446 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** SM Nicotine Patch 24 Hour 7 MG/24HR *PSYCHOTHERAPEUTIC AND Transdermal 49348014646 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 2 MG Mouth/Throat 49348057308 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 2 MG Mouth/Throat 49348057336 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 2 MG Mouth/Throat 49348069136 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 2 MG Mouth/Throat 49348078710 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 4 MG Mouth/Throat 49348057208 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** *PSYCHOTHERAPEUTIC AND SM Nicotine Polacrilex Gum 4 MG Mouth/Throat 49348057236 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** SM Nicotine Polacrilex Lozenge 4 MG *PSYCHOTHERAPEUTIC AND Mouth/Throat 49348085316 NEUROLOGICAL AGENTS - MISC.* *Smoking Deterrents*** Acid Reducer Maximum Strength Tablet 20 MG Oral 36800019402 *ULCER DRUGS* *H-2 Antagonists*** Acid Reducer Tablet 10 MG Oral 00113014165 *ULCER DRUGS* *H-2 Antagonists*** Acid Reducer Tablet 10 MG Oral 37205061465 *ULCER DRUGS* *H-2 Antagonists*** Famotidine Tablet 10 MG Oral 00093274865 *ULCER DRUGS* *H-2 Antagonists*** Famotidine Tablet 10 MG Oral 00093274892 *ULCER DRUGS* *H-2 Antagonists*** Famotidine Tablet 10 MG Oral 00093274894 *ULCER DRUGS* *H-2 Antagonists*** GNP Acid Reducer Max St TABLET 20 MG ORAL 24385038571 *ULCER DRUGS* *H-2 Antagonists*** GNP Heartburn Relief TABLET 200 MG ORAL 24385011165 *ULCER DRUGS* *H-2 Antagonists*** Heartburn Relief Max St TABLET 20 MG ORAL 00904578017 *ULCER DRUGS* *H-2 Antagonists*** Heartburn Relief TABLET 10 MG ORAL 00904552952 *ULCER DRUGS* *H-2 Antagonists***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Heartburn Relief TABLET 10 MG ORAL 00904552987 *ULCER DRUGS* *H-2 Antagonists*** HM Famotidine TABLET 10 MG ORAL 62011014201 *ULCER DRUGS* *H-2 Antagonists*** SM Acid Reducer Max St TABLET 20 MG ORAL 49348081709 *ULCER DRUGS* *H-2 Antagonists*** SM Acid Reducer TABLET 10 MG Oral 49348012812 *ULCER DRUGS* *H-2 Antagonists*** SM Acid Reducer TABLET 10 MG Oral 49348012813 *ULCER DRUGS* *H-2 Antagonists*** SM Acid Reducer TABLET 10 MG Oral 49348012844 *ULCER DRUGS* *H-2 Antagonists*** SM Acid Reducer TABLET 200 MG ORAL 49348024644 *ULCER DRUGS* *H-2 Antagonists*** Esomeprazole Magnesium Capsule Delayed Release 20 MG Oral 70000003201 *ULCER DRUGS* *Proton Pump Inhibitors*** Esomeprazole Magnesium Capsule Delayed Release 20 MG Oral 70000003202 *ULCER DRUGS* *Proton Pump Inhibitors*** Esomeprazole Magnesium Capsule Delayed Release 20 MG Oral 70000003203 *ULCER DRUGS* *Proton Pump Inhibitors*** Heartburn Treatment 24 Hour Capsule Delayed Release 15 MG Oral 00536103413 *ULCER DRUGS* *Proton Pump Inhibitors*** Lansoprazole Capsule Delayed Release 15 MG Oral 00536123613 *ULCER DRUGS* *Proton Pump Inhibitors*** SM Lansoprazole Capsule Delayed Release 15 MG Oral 49348030161 *ULCER DRUGS* *Proton Pump Inhibitors*** Oxytrol For Women Patch Twice Weekly 3.9 *Urinary Antispasmodic - MG/24HR Transdermal 00023963708 *URINARY ANTISPASMODICS* Antimuscarinic (Anticholinergic)*** Oxytrol For Women Patch Twice Weekly 3.9 *Urinary Antispasmodic - MG/24HR Transdermal 00023963708 *URINARY ANTISPASMODICS* Antimuscarinics (Antichol)***(new) Clotrimazole Cream 1 % Vaginal 51672200306 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** GNP Miconazole 7 CREAM 2 % VAGINAL 24385059029 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** Miconazole 7 Cream 2 % Vaginal 00904773445 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** Miconazole 7 SUPPOSITORY 100 MG VAGINAL 00472173607 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** Miconazole Nitrate Cream 2 % Vaginal 00472073063 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** Miconazole Nitrate Cream 2 % Vaginal 51672203506 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals***

Miconazole Nitrate Suppository 100 MG Vaginal 00713019757 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** SM Miconazole 7 CREAM 2 % VAGINAL 49348053077 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** SM Miconazole 7 CREAM 2 % VAGINAL 49348087277 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals***

SM Miconazole 7 SUPPOSITORY 100 MG VAGINAL 49348083361 *VAGINAL PRODUCTS* *Imidazole-Related Antifungals*** Biotin Capsule 5 MG Oral 74312013430 *VITAMINS* *Biotin*** Biotin Maximum Strength CAPSULE 5000 MCG ORAL 40985027116 *VITAMINS* *Biotin*** Biotin Tablet 5 MG Oral 10542009512 *VITAMINS* *Biotin*** Meribin Capsule 5 MG Oral 00394013012 *VITAMINS* *Biotin*** Vitamin A Capsule 3 MG (10000 UT) Oral 00904208560 *VITAMINS* *Vitamin A*** GNP Vitamin B-1 TABLET 100 MG ORAL 87701040729 *VITAMINS* *Vitamin B-1***

Niacin ER Capsule Extended Release 500 MG Oral 00904063160 *VITAMINS* *Vitamin B-3*** Niacin ER Tablet Extended Release 500 MG Oral 00904434260 *VITAMINS* *Vitamin B-3*** Niacin Tablet 500 MG Oral 00904227260 *VITAMINS* *Vitamin B-3*** Niacin Tablet 500 MG Oral 00904227280 *VITAMINS* *Vitamin B-3*** Niacinamide Tablet 500 MG Oral 00904420260 *VITAMINS* *Vitamin B-3*** Vitamin B-6 Tablet 100 MG Oral 00904051860 *VITAMINS* *Vitamin B-6*** Vitamin B-6 Tablet 100 MG Oral 51645091001 *VITAMINS* *Vitamin B-6*** Vitamin B-6 Tablet 100 MG Oral 74312000650 *VITAMINS* *Vitamin B-6*** Vitamin B-6 Tablet 25 MG Oral 00536440601 *VITAMINS* *Vitamin B-6*** Vitamin B6 Tablet 50 MG Oral 10006073017 *VITAMINS* *Vitamin B-6***

Last Updated 08/25/20

Common Covered Over-the-Counter Products DRUG NAME NDC CATEGORY CLASS Vitamin B-6 Tablet 50 MG Oral 00904052060 *VITAMINS* *Vitamin B-6*** Vitamin B-6 Tablet 50 MG Oral 10006073016 *VITAMINS* *Vitamin B-6*** Vitamin C Tablet 250 MG Oral 00904052260 *VITAMINS* *Vitamin C*** Ergocalciferol Solution 200 MCG/ML Oral 69543023460 *VITAMINS* *Vitamin D*** Vitamin D Liquid 10 MCG/ML Oral 50383091750 *VITAMINS* *Vitamin D*** Vitamin D Tablet 25 MCG (1000 UT) Oral 00536333401 *VITAMINS* *Vitamin D*** Vitamin D3 Capsule 50 MCG (2000 UT) Oral 00536379001 *VITAMINS* *Vitamin D*** Vitamin D3 Capsule 50 MCG (2000 UT) Oral 80681000900 *VITAMINS* *Vitamin D*** Vitamin D3 Super Strength Tablet 50 MCG (2000 UT) Oral 54629041120 *VITAMINS* *Vitamin D*** Vitamin D3 Tablet 25 MCG (1000 UT) Oral 00904582460 *VITAMINS* *Vitamin D*** Vitamin D3 Tablet 25 MCG (1000 UT) Oral 51645091999 *VITAMINS* *Vitamin D*** Vitamin D3 Tablet 25 MCG (1000 UT) Oral 80681016900 *VITAMINS* *Vitamin D*** Aqua-E Liquid 75 UNIT/ML Oral 68176000017 *VITAMINS* *Vitamin E***

Last Updated 08/25/20