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UHC PA Community and State Quantity Limit List

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Quantity Limits Quantity Max Daily Dose Period Quantity Period Days Period Fills GPI DESCRIPTION Maximum (MDD) Edit (PQE) Edit Edit 97703040004300 *ALCOHOL SWABS*** 10 34000003101810 *AMLODIPINE BESYLATE ORAL SUSP 1 MG/ML (CMPD KIT) (BASE EQ)* 10 88501000002000 *ARTIFICIAL SALIVA - SOLUTION*** 120 Maximum quantity 86202000004200 *ARTIFICIAL TEAR OPHTH OINTMENT*** of 7 per 26 days. 33200020002065 *ATENOLOL ORAL SOLN 10 MG/ML (COMPOUND KIT)** 20 33200020002055 *ATENOLOL ORAL SOLN 2 MG/ML (COMPOUND KIT)** 50 33200020001810 *ATENOLOL ORAL SUSPENSION 1 MG/ML (CMPD KIT)** 200 78110000000100 *B-COMPLEX VITAMIN CAP** 1 Maximum quantity 78133000000920 *B-COMPLEX W/ C & FOLIC ACID LIQUID 0.9 MG/5ML*** of 237 per 26 days. 78133000000325 *B-COMPLEX W/ C & FOLIC ACID TAB 0.8 MG*** 1 78133000000330 *B-COMPLEX W/ C & FOLIC ACID TAB 1 MG*** 1 Maximum quantity 88350010006400 *BENZOCAINE DENTAL LIQUID 20% KIT*** of 1 per 26 days. 90050010006410 *BENZOYL PEROXIDE WASH 2.5% & BENZOYL PEROXIDE LOT 10% KIT** 1 47300005100100 *BIFIDOBACTERIUM BIFIDUM CAP** 2 97202007100900 *BLOOD GLUCOSE CALIBRATION - LIQUID*** 0.04 Maximum quantity 97202011006200 *BLOOD GLUCOSE METER DISPOSABLE DEVICE WITH TEST STRIPS*** of 1 per 999 days. Maximum quantity 97202010006200 *BLOOD GLUCOSE MONITORING DEVICES*** of 1 per 365 days. Maximum quantity 97202010006410 *BLOOD GLUCOSE MONITORING KIT W/ DEVICE*** of 1 per 365 days. Maximum quantity 97202010006400 *BLOOD GLUCOSE MONITORING KIT*** of 1 per 365 days. Maximum quantity 97750010006200 *BLOOD PRESSURE MONITORING - DEVICE*** of 1 per 999 days. Maximum quantity 9025990212B120 *CALCIPOTRIENE CR 0.005% & DIMETHICONE CR 5% THERAPY PACK*** of 1 per 26 days. 79109903450340 *CALCIUM CARB-VIT D W/ MINERALS TABS 600 MG-200 UNIT*** 5 79109903450355 *CALCIUM CARB-VIT D W/ MINERALS TABS 600 MG-800 UNIT*** 2 Maximum quantity 6610990420B120 *CELECOXIB CAP 200 MG & METH SAL-MEN-CAPSAICIN LIQD THER PK* of 1 per 26 days. Maximum quantity 9097990318B120 *CHLORHEXIDINE SOL 4% & MUPIROCIN OINT 2% & DIMETH CR 5% PK* of 1 per 26 days. Maximum quantity 90150030406450 *CICLOPIROX OLAMINE SUSP 0.77% (BASE EQUIV) & CLEANSER KIT** of 1 per 26 days. 56700020002000 *CITRIC ACID-GLUCONOLACTONE-MAGNESIUM CARBONATE SOLN** 180 Maximum quantity 90059903586412 *CLINDAMYCIN 1% GEL-BENZOYL PEROX 2.5% GEL-MOISTURIZER KIT* of 1 per 26 days. Maximum quantity 90059902636420 *CLINDAMYCIN PHOSPHATE GEL 1% & MOISTURIZER KIT*** of 1 per 26 days. 97401000000000 *CONDOMS - MALE*** 2 Maximum quantity 25050010005320 *COPPER IUD** of 1 per 999 days. 75100050601810 *CYCLOBENZAPRINE HCL W/ MSM ORAL SUSP 1 MG/ML (CMPD KIT)** 30 80509903100920 *DHA-EPA-GLA LIQUID 174-558-60 MG/15ML*** 15 Maximum quantity 97402010005400 *DIAPHRAGM ARC-SPRING*** of 2 per 180 days. Maximum quantity 97402000005400 *DIAPHRAGMS*** of 2 per 180 days. Maximum quantity 66109904356430 *DICLOFENAC SOD TAB DR 75 MG & LIDO-MEN-METHYL SAL PTCH KIT* of 1 per 26 days. Maximum quantity 9037990232B120 *DICLOFENAC SODIUM GEL 3% & SILICONE TAPE THERAPY PACK*** of 1 per 26 days. Maximum quantity 66100007256430 *DICLOFENAC SODIUM TAB DR 50 MG & LINIMENT TOPICAL LIQ KIT** of 1 per 26 days. Maximum quantity 66100007256440 *DICLOFENAC SODIUM TAB DR 75 MG & LINIMENT TOPICAL LIQ KIT** of 1 per 26 days. Maximum quantity 90219904386420 *DICLOFENAC SOLN 1.5% & METHYL SAL-MENTH-CAPSAICIN LIQ KIT** of 240 per 26 days. Maximum quantity 90219904376420 *DICLOFENAC TD SOLN 1.5% & CAMP-LIDO-METHYL SAL PATCH KIT*** of 1 per 26 days. 9021990224B120 *DICLOFENAC TD SOLN 1.5% & CANNABINOIDS SUBLINGUAL LIQ PACK* 16 Maximum quantity 90972540003200 *DIETHYLTOLUAMIDE (DEET) AEROSOL*** 184 of 368 per 26 days. Maximum quantity 90972540003200 *DIETHYLTOLUAMIDE (DEET) AEROSOL*** 170 of 340 per 26 days. Maximum quantity 90972540003200 *DIETHYLTOLUAMIDE (DEET) AEROSOL*** 71 of 142 per 26 days. Maximum quantity 90972540003200 *DIETHYLTOLUAMIDE (DEET) AEROSOL*** 113 of 226 per 26 days. Maximum quantity 90972540000900 *DIETHYLTOLUAMIDE (DEET) LIQUID*** 177 of 354 per 26 days. Maximum quantity 90979904203720 *DIMETHICONE-ZINC OXIDE-VITAMIN A-VITAMIN D CREAM 1-10%*** of 480 per 67 days. Maximum quantity 4399750329C420 *DM-GG LIQD & DOXYLAMINE-DM LIQD DAY/NIGHT THER PACK** of 236 per 26 days. Maximum quantity 4399750321C520 *DM-GG SOLN & CHLORPHENIRAMINE-DM SOLN DAY/NIGHT THER PACK** of 236 per 26 days. 04000020556420 *DOXYCYCLINE HYCLATE CAP 1 X 100 MG W/ CLEANSER KIT* 0.04 04000020556410 *DOXYCYCLINE HYCLATE CAP 1 X 50 MG W/ CLEANSER KIT* 0.04 04000020556440 *DOXYCYCLINE HYCLATE CAP 2 X 100 MG W/ CLEANSER KIT* 0.04 20109902220740 *DUST MITE MIXED EXT SL TAB 12 SQ-HDM*** 1 90650000003700 *EMOLLIENT - CREAM** 15.14 90650000004100 *EMOLLIENT - LOTION** 15.14 90650000004200 *EMOLLIENT - OINTMENT** 15.14 Maximum quantity 38900040006420 *EPINEPHRINE INJ KIT 1 MG/ML (1:1000)** of 2 per 26 days. Maximum quantity 49270025106420 *ESOMEPRAZOLE MAG DR CAP 20 MG AND SWALLOWING SPRAY KIT** of 1 per 26 days. Maximum quantity 24994004303720 *ESTRADIOL-ESTRIOL-TESTOST-PROGEST MICRO CREAM (CMPD KIT)*** of 30 per 26 days. Maximum quantity 24990002053720 *ESTRIOL-ESTRADIOL CREAM (CMPD KIT)*** of 30 per 26 days. Maximum quantity 24993002753720 *ESTRIOL-PROGESTERONE MICRO CREAM 4-20 MG/GM (CMPD KIT)*** of 30 per 26 days. Maximum quantity 66100008606440 *ETODOLAC TAB 400 MG & LINIMENT TOPICAL LIQUID KIT** of 1 per 26 days. 82995006350330 *FE CARBONYL-FE GLUCONATE-FA-VIT B12-VIT C-DSS TAB 90-1 MG** 1 Maximum quantity 9055990242B120 *FLUOCINONIDE CREAM 0.1% & SILICONE TAPE THERAPY PACK*** of 1 per 26 days. Maximum quantity 6254990340B130 *GABAPENTIN CAP 300 MG & LIDO CR 4.12% &SILICONE SHEET THPK* of 1 per 26 days. Maximum quantity 6254990225B115 *GABAPENTIN CAP 300 MG & LIDOCAINE CREAM 4.12% THER PACK*** of 1 per 26 days. Maximum quantity 6254990225B120 *GABAPENTIN CAP 300 MG & LIDOCAINE PATCH 5% THERAPY PACK*** of 1 per 26 days. 72600030001810 *GABAPENTIN ORAL SUSP 25 MG/ML (CMPD KIT)** 144 Maximum quantity 20109905200720 *GRASS MIXED POLLEN EXT SL TAB 100 IR (INDEX OF REACTIVITY)* of 9 per 135 days. 20109905200730 *GRASS MIXED POLLEN EXT SL TAB 300 IR (INDEX OF REACTIVITY)* 1 Maximum quantity 2010990520B120 *GRASS MIXED POLLEN SL TAB THERPAK 100 (3) IR & 300 (6) IR* of 9 per 135 days. Maximum quantity 99870010000970 *HOMEOPATHIC PRODUCTS - TOPICAL LIQUID** of 10 per 26 days. Maximum quantity 97102000000000 *HUMIDIFIERS*** of 1 per 999 days. Maximum quantity 42500030002900 *HYPROMELLOSE NASAL POWDER** of 1 per 26 days. Maximum quantity 90210045003760 *IBUPROFEN CREAM 10% (COMPOUNDING KIT)** of 60 per 26 days. Maximum quantity 66100020006450 *IBUPROFEN TAB 600 MG & SWALLOWING SPRAY KIT*** of 1 per 26 days. Maximum quantity 66100020506430 *IBUPROFEN TAB 800 MG & LINIMENT TOPICAL LIQUID KIT** of 1 per 26 days. Maximum quantity 82992008350920 *IRON POLYSACCH-SENNA-C-E-B6- B12-IF-FA LIQ 165-2 MG/5ML*** of 120 per 26 days. Maximum quantity 97403000000000 *IUD'S*** of 1 per 999 days. Maximum quantity 90219903503740 *KETOPROFEN-LIDOCAINE HCL-GABAPENT CRM 20-2-10% (CMPD KIT)** of 240 per 26 days. Maximum quantity 90219903483700 *KETOPROFEN-LIDOCAINE-GABAPENTIN CREAM 20-2-10% (CMPD KIT)** of 240 per 26 days. 47300020600100 *LACTOBACILLUS RHAMNOSUS (GG) CAP** 1 Maximum quantity 97202027006300 *LANCET DEVICES*** of 1 per 365 days. Maximum quantity 97202030006400 *LANCETS KIT*** of 1 per 365 days. 97202030006300 *LANCETS MISC.*** 10 97202025006300 *LANCETS*** 10 Maximum quantity 49270040001820 *LANSOPRAZOLE SUSP 3 MG/ML (COMPOUND KIT)** of 300 per 26 days. 80309903350920 *LEVOCARNITINE-B5-TAURINE LIQD 1000-10-150 MG/15ML*** 45 25990003406420 *LEVONORGEST-ETH ESTRAD TAB 0.1 MG-20 MCG & FA TAB 1 MG KIT* 1 9085990208B120 *LIDOCAINE 5% PATCH & EMOLLIENT CREAM THERAPY PACK*** 1 Maximum quantity 90859902896430 *LIDOCAINE OINTMENT 5% & TRANSPARENT DRESSING KIT*** of 1 per 24 days. Maximum quantity 90859902096420 *LIDOCAINE PATCH 5% & ADHESIVE SHEET KIT*** of 1 per 24 days. Maximum quantity 9085990211B130 *LIDOCAINE PATCH 5% & SILICONE SHEET THERAPY PACK*** of 60 per 26 days. Maximum quantity 9085990382B120 *LIDOCAINE-PRILOCAINE CR 2.5-2.5% & BENZALK FOAM THER PACK** of 1 per 26 days. Maximum quantity 90859903796420 *LIDOCAINE-PRILOCAINE CR 2.5-2.5% &TRANSPARENT DRESSING KIT* of 1 per 26 days. 81250060000130 *L-METHYLFOLATE CAP 15 MG** 1 81259904400320 *L-METHYLFOLATE-ALGAE-B12-ACETYLCYST TAB 6-90.314-2-600MG*** 1 81259904500130 *L-METHYLFOLATE-ALGAE-VIT B12-B6 CAP 3-90.314-2-35 MG*** 2 81259904550120 *L-METHYLFOL-B12-B6-ALPHA LIPOIC AC CAP 3.75-1-25-300 MG*** 2 Maximum quantity 66100052606425 *MELOXICAM TAB 15 MG & LINIMENT TOPICAL LIQUID KIT** of 1 per 26 days. Maximum quantity 52500030206420 *MESALAMINE RECTAL ENEMA 4 GM & CLEANSER WIPE KIT** of 12 per 72 days. 53992005200322 *METHENAMINE-HYOS-METH BLUE-SOD PHOS-PHEN SAL TAB 81.6 MG*** 4 Maximum quantity 33200030102070 *METOPROLOL TARTRATE ORAL SOLN 10 MG/ML (COMPOUND KIT)** of 900 per 72 days. 60201025001830 *MIDAZOLAM SUSP 1 MG/ML (COMPOUND KIT)** 20 Maximum quantity 88500000009400 *MISC THROAT PRODUCTS - SWABS** of 75 per 26 days. Maximum quantity 97700000000000 *MISC. DEVICES** of 1 per 90 days. 79850050000300 *MULTIPLE MINERALS W/ VITAMINS TAB** 8 78200000003000 *MULTIPLE VITAMIN PACK** 1 Maximum quantity 78210000000300 *MULTIPLE VITAMINS W/ IRON TAB** 1 of 100 per 77 days. 78313010001230 *MULTIPLE VITAMINS W/ MINERALS & FA SYRUP 1 MG/15ML*** 1 78310000000500 *MULTIPLE VITAMINS W/ MINERALS CHEW TAB** 2 78310000000300 *MULTIPLE VITAMINS W/ MINERALS TAB** 1 Maximum quantity 66100055606430 *NABUMETONE TAB 500 MG & LINIMENT
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  • Vaginal Administration of Contraceptives

    Vaginal Administration of Contraceptives

    Scientia Pharmaceutica Review Vaginal Administration of Contraceptives Esmat Jalalvandi 1,*, Hafez Jafari 2 , Christiani A. Amorim 3 , Denise Freitas Siqueira Petri 4 , Lei Nie 5,* and Amin Shavandi 2,* 1 School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK 2 BioMatter Unit, École Polytechnique de Bruxelles, Université Libre de Bruxelles, Avenue F.D. Roosevelt, 50-CP 165/61, 1050 Brussels, Belgium; [email protected] 3 Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, 1200 Brussels, Belgium; [email protected] 4 Fundamental Chemistry Department, Institute of Chemistry, University of São Paulo, Av. Prof. Lineu Prestes 748, São Paulo 05508-000, Brazil; [email protected] 5 College of Life Sciences, Xinyang Normal University, Xinyang 464000, China * Correspondence: [email protected] (E.J.); [email protected] (L.N.); [email protected] (A.S.); Tel.: +32-2-650-3681 (A.S.) Abstract: While contraceptive drugs have enabled many people to decide when they want to have a baby, more than 100 million unintended pregnancies each year in the world may indicate the contraceptive requirement of many people has not been well addressed yet. The vagina is a well- established and practical route for the delivery of various pharmacological molecules, including contraceptives. This review aims to present an overview of different contraceptive methods focusing on the vaginal route of delivery for contraceptives, including current developments, discussing the potentials and limitations of the modern methods, designs, and how well each method performs for delivering the contraceptives and preventing pregnancy.
  • Safety Data Sheet

    Safety Data Sheet

    First issue: September 17, 2009 Revision date: October 27, 2014 SDS No. 007.636 Version: 5 SAFETY DATA SHEET In accordance with OSHA’s Hazard Communication Standard 29 CFR §1910.1200 SECTION 1: IDENTIFICATION OF THE SUBSTANCE/MIXTURE AND OF THE COMPANY/UNDERTAKING 1.1. Product identifier: Absorbine® Veterinary Liniment Gel 1.2. Relevant identified uses of the substance or mixture and uses advised against Topical Analgesic 1.3. Details of the supplier of the safety data sheet Manufacturer/Supplier: W. F. Young, Inc. 302 Benton Drive East Longmeadow, MA 01028 Telephone number for information: 413 526 9999 E-mail: [email protected] 1.4. Emergency telephone number 413 526 9999 SECTION 2: HAZARDS IDENTIFICATION 2.1. Classification of the mixture F, Xn, Xi R10, 22, 43 2.2. Label elements Flammable Keep out of the reach of children Harmful if swallowed May product an allergic reaction 2.3. Other hazards Inhalation of vapors can cause anesthetic effect. Page 1 of 8 First issue: September 17, 2009 Revision date: October 27, 2014 SDS No. 007.636 Version: 5 SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS 3.2. Mixtures Hazardous ingredients information Component CAS Nr. EINECS / Amount DSD DSD ELINCS (%) Hazard R-Phrases Symbol Ethanola,denatured 64-17-5 200-578-6 40 - 70 F R11 Menthol 89-78-1 201-939-0 4 Choroxylenol 88-04-0 201-793-8 0.5 Xi R43 Spearmint Oil 8008-79-5 Not classified 0.5-1.0 Xi R43 Propylene Glycola 57-55-6 200-338-0 1 - 5 Other Components: Remaining components of this alcoholic mixture are proprietary, non-hazardous and/or are present at concentrations below reportable limits.
  • Report 752 by Category Description

    Report 752 by Category Description

    PAs by Category Description Sorted by Descending Count Date Range: 04/01/2006 through 06/30/2006 Number Number Category of Category of Description PAs Description PAs Cetirizine HCl 792 Ziprasidone HCl 43 Duloxetine HCl 784 Norelgestromin-Ethinyl Estradiol 42 Methylphenidate HCl 646 Nicotine 41 Venlafaxine HCl 620 Levofloxacin 41 Atomoxetine HCl 472 Carisoprodol 41 Quetiapine Fumarate 430 Albuterol 40 Gabapentin 422 Amylase-Lipase-Protease 40 Nutritional Supplements 378 Famotidine 40 Montelukast Sodium 326 Levothyroxine Sodium 39 Zolpidem Tartrate 288 Enoxaparin Sodium 37 Amphetamine-Dextroamphetamine 286 Norgestimate-Ethinyl Estradiol (Triphasic) 37 Aripiprazole 271 Tretinoin 37 Desloratadine 191 Modafinil 36 Fexofenadine HCl 188 Pioglitazone HCl 36 Topiramate 186 Citalopram Hydrobromide 36 Polyethylene Glycol 3350 182 Budesonide (Inhalation) 36 Fentanyl 175 Epoetin Alfa 33 Eszopiclone 174 Etanercept 33 Esomeprazole Magnesium 172 Botulinum Toxin Type A 32 Celecoxib 157 Somatropin 31 Pregabalin 148 Metformin HCl 31 Escitalopram Oxalate 142 Oxycodone w/ Acetaminophen 31 Sertraline HCl 135 Morphine Sulfate 30 Risperidone 127 Levetiracetam 30 Bupropion HCl 118 Clonazepam 30 Tiotropium Bromide Monohydrate 112 Phenobarbital 30 Oxycodone HCl 110 Drospirenone-Ethinyl Estradiol 29 Ezetimibe 105 Rosiglitazone Maleate 29 Clopidogrel Bisulfate 103 Valsartan 29 Ondansetron HCl 97 Memantine HCl 28 Olanzapine 93 Sumatriptan Succinate 28 Temazepam 92 Buprenorphine HCl 28 Oxcarbazepine 82 B-Complex w/ C & Folic Acid 28 Rabeprazole Sodium 74 Ranitidine
  • Oral Contraceptives

    Oral Contraceptives

    ORAL CONTRACEPTIVES STRENGTH DRUG ESTROGEN PROGESTIN (ESTROGEN/PROGESTIN) MONOPHASIC Aviane 28, Lessina, Lutera, Orsythia, Ethinyl estradiol Levonorgestrel 20mcg/0.1mg Sronyx† Beyaz*, YAZ Ethinyl estradiol Drospirenone 20mcg/3mg [Gianvi, Loryna, Vestura]† Brevicon, Modicon Ethinyl estradiol Norethindrone 35mcg/0.5mg [Necon 0.5/35, Nortrel 0.5/35]† Desogen Ethinyl estradiol Desogestrel 30mcg/0.15mg [Apri, Emoquette, Reclipsen, Solia]† Femcon Fe, Ovcon 35 Ethinyl estradiol Norethindrone 35mcg/0.4mg [Balziva, Briellyn, Philith, Vyfemla Zenchent, Zenchent Fe]† Loestrin 21 1/20, Loestrin Fe 1/20, Ethinyl estradiol Norethindrone acetate 20mcg/1mg Loestrin 24 Fe, Minastrin 24 Fe [Gildess Fe 1/20, Junel 1/20, Junel Fe 1/20, Larin 1/20, Larin Fe 1/20, Microgestin 1/20, Microgestin Fe 1/20]† Loestrin 21 1.5/30, Loestrin Fe 1.5/30 Ethinyl estradiol Norethindrone acetate 30mcg/1.5mg [Gildess Fe 1.5/30, Junel 1.5/30, Junel Fe 1.5/30, Microgestin 1.5/30, Microgestin Fe 1.5/30]† Lo/Ovral Ethinyl estradiol Norgestrel 30mcg/0.3mg [Cryselle, Low-Ogestrel]† Lybrel Ethinyl estradiol Levonorgestrel 20mcg/0.09mg [Amethyst]† [Altavera, Levora, Marlissa, Portia]† Ethinyl estradiol Levonorgestrel 30mcg/0.15mg Norinyl 1/35, Ortho-Novum 1/35 Ethinyl estradiol Norethindrone 35mcg/1mg [Alyacen 1/35, Cyclafem 1/35, Dasetta 1/35, Necon 1/35, Nortrel 1/35]† Necon 1/50, Norinyl 1/50 Mestranol Norethindrone 50mcg/1mg Ogestrel 0.5/50† Ethinyl estradiol Norgestrel 50mcg/0.5mg Ortho-Cyclen Ethinyl estradiol Norgestimate 35mcg/0.25mg [MonoNessa, Previfem, Sprintec]† Ovcon