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Preferred Drug List Molina Healthcare of New York, Inc.

2017

*Molina mandates the use of generic drugs, if available. Brand names listed are for reference only. THIS LIST IS SUBJECT TO CHANGE. You can get more information and updates to this document on our website at www.molinahealthcare.com

MCD_CO_ESIPREFDRUGQ3_0817_08/27/2017 6025633NY0417 Table of Contents

Anti - Infectives...... 3 Antineoplastic / Immunosuppressant Drugs ...... 12 Autonomic / Cns Drugs, Neurology / Psych ...... 17 Cardiovascular, Hypertension / Lipids...... 34 Dermatologicals/Topical Therapy...... 41 Diagnostics / Miscellaneous Agents ...... 56 Ear, Nose / Throat Medications...... 64 Endocrine/Diabetes ...... 66 Gastroenterology ...... 107 Immunology, Vaccines / Biotechnology...... 118 Musculoskeletal / Rheumatology ...... 121 Obstetrics / Gynecology...... 122 Ophthalmology...... 127 Respiratory And Allergy ...... 131 Urologicals ...... 146 Vitamins, Hematinics / Electrolytes...... 148 Index...... 176

1 List of Abbreviations

Brand: Brand

Generic: Generic

NC: NC

NF: NF

OTC: Over the Counter. An OTC drug is a non-prescription drug.

PA: Prior Authorization. The Plan requires you or your physician to get prior authorization for certain drugs. This means that you will need to get approval before you fill your prescriptions. If you don’t get approval, we may not cover the drug.

QL: Quantity Limit. For certain drugs, the Plan limits the amount of the drug that we will cover.

ST: Step Therapy. In some cases, the Plan requires you to first try certain drugs to treat your medical condition before we will cover another drug for that condition. For example, if Drug A and Drug B both treat your medical condition, we may not cover Drug B unless you try Drug A first. If Drug A does not work for you, we will then cover Drug B.

2 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC Anti - Infectives LAMISIL ORAL Brand GRANULES IN Antifungal Agents PACKET amphotericin b Generic MICONAZOLE Brand AMPHOTERICIN B Brand MYCAMINE Brand (BULK) NOXAFIL ORAL Brand CANCIDAS Brand NYSTATIN Brand clotrimazole mucous Generic (BULK) POWDER membrane 1 BILLION UNIT, CRESEMBA Brand 10 BILLION UNIT, 15 BILLION UNIT, FLUCONAZOLE Brand 150 MILLION (BULK) UNIT, 2 BILLION fluconazole in Generic UNIT, 5 BILLION dextrose(iso-o) UNIT, 50 MILLION UNIT, 500 fluconazole in nacl Generic MILLION UNIT (iso-osm) nystatin oral Generic fluconazole oral Generic suspension for SODIUM Brand reconstitution CAPRYLATE fluconazole oral Generic SPORANOX ORAL Brand tablet 100 mg, 200 SOLUTION mg, 50 mg TERBINAFINE Brand fluconazole oral Generic QL (BULK) tablet 150 mg terbinafine hcl oral Generic flucytosine Generic voriconazole Generic FLUCYTOSINE Brand VORICONAZOLE Brand (BULK) (BULK) griseofulvin Generic Antivirals microsize abacavir Generic griseofulvin Generic ultramicrosize abacavir-lamivudine Generic Generic QL abacavir- Generic lamivudine- ITRACONAZOLE Brand zidovudine (BULK) ACYCLOVIR Brand Brand (BULK) (BULK) POWDER ketoconazole oral Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 3 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC acyclovir oral Generic EVOTAZ Brand capsule famciclovir Generic QL acyclovir oral Generic foscarnet Generic suspension 200 mg/5 ml FUZEON Brand SUBCUTANEOUS acyclovir oral tablet Generic RECON SOLN acyclovir sodium Generic ganciclovir sodium Generic intravenous recon soln GENVOYA Brand ACYCLOVIR, Brand IDOXURIDINE Brand MICRONIZED INTELENCE Brand (BULK) INVIRASE Brand adefovir Generic ISENTRESS Brand amantadine hcl Generic KALETRA Brand AMANTADINE Brand HCL (BULK) lamivudine Generic APTIVUS Brand lamivudine- Generic zidovudine ATRIPLA Brand LEXIVA Brand BARACLUDE Brand ORAL SOLUTION lopinavir-ritonavir Generic cidofovir Generic moderiba Generic PA COMPLERA Brand moderiba dose pack Generic PA CRIXIVAN ORAL Brand nevirapine Generic CAPSULE 200 MG, NORVIR Brand 400 MG ODEFSEY Brand DESCOVY Brand oseltamivir Generic QL didanosine Generic PREZCOBIX Brand EDURANT Brand PREZISTA Brand EMTRIVA Brand RAPIVAB Brand entecavir Generic RELENZA Brand QL EPIVIR HBV Brand DISKHALER ORAL SOLUTION RESCRIPTOR Brand EPIVIR ORAL Brand SOLUTION RETROVIR Brand INTRAVENOUS EPZICOM Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 4 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC REYATAZ ORAL Brand VIDEX 2 GRAM Brand CAPSULE 150 MG, PEDIATRIC 200 MG, 300 MG VIRACEPT ORAL Brand REYATAZ ORAL Brand TABLET POWDER IN VIREAD Brand PACKET ZEPATIER Brand PA; QL ribasphere Generic PA ZIAGEN ORAL Brand ribasphere ribapak Generic PA SOLUTION ribavirin inhalation Generic zidovudine Generic ribavirin oral Generic PA capsule Cephalosporins ribavirin oral tablet Generic PA AVYCAZ Brand 200 mg cefaclor oral capsule Generic rimantadine Generic cefaclor oral Generic SELZENTRY Brand PA suspension for reconstitution 125 stavudine Generic mg/5 ml, 250 mg/5 STRIBILD Brand ml, 375 mg/5 ml SUSTIVA Brand cefaclor oral tablet Generic extended release 12 SYNAGIS Brand PA hr TAMIFLU ORAL Brand QL cefadroxil oral Generic SUSPENSION FOR capsule RECONSTITUTIO N cefadroxil oral Generic suspension for TECHNIVIE Brand PA; QL reconstitution 250 TIVICAY Brand mg/5 ml, 500 mg/5 ml TRIUMEQ Brand cefadroxil oral tablet Generic TRIZIVIR Brand cefazolin Generic TRUVADA Brand cefazolin in dextrose Generic TYZEKA Brand (iso-os) intravenous valacyclovir Generic QL piggyback 1 gram/50 ml, 2 gram/50 ml VALACYCLOVIR Brand (BULK) cefdinir Generic valganciclovir Generic cefditoren pivoxil Generic VEMLIDY Brand cefepime Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 5 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC cefepime in Generic AZITHROMYCIN Brand dextrose,iso-osm (BULK) cefixime Generic clarithromycin Generic cefotaxime Generic CLARITHROMYCI Brand N (BULK) cefotetan Generic e.e.s. 400 oral tablet Generic cefoxitin Generic E.E.S. GRANULES Brand cefoxitin in dextrose, Generic iso-osm ERYPED 200 Brand cefpodoxime Generic ERYPED 400 Brand cefprozil Generic ery-tab oral Generic tablet,delayed ceftazidime Generic release (dr/ec) 250 CEFTAZIDIME Brand mg, 333 mg (BULK) ERY-TAB ORAL Brand ceftibuten Generic TABLET,DELAYE ceftriaxone in Generic D RELEASE dextrose,iso-os (DR/EC) 500 MG ceftriaxone injection Generic erythrocin (as Generic recon soln 1 gram, stearate) oral tablet 10 gram, 2 gram, 250 mg 250 mg, 500 mg ERYTHROMYCIN Brand ceftriaxone Generic (BULK) intravenous ERYTHROMYCIN Brand cefuroxime axetil Generic ESTOLATE oral tablet (BULK) cefuroxime sodium Generic ERYTHROMYCIN Brand injection recon soln ETHYLSUCCINAT 750 mg E cefuroxime sodium Generic erythromycin Generic intravenous ethylsuccinate oral suspension for cefuroxime-dextrose Generic reconstitution (iso-osm) erythromycin Generic cephalexin Generic ethylsuccinate oral ZERBAXA Brand tablet Erythromycins / Other Macrolides erythromycin oral Generic capsule,delayed azithromycin Generic release(dr/ec)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 6 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC erythromycin oral Generic CHLORAMPHENI Brand tablet COL (BULK) erythromycin- Generic CHLORAMPHENI Brand sulfisoxazole COL PALMITATE Miscellaneous Antiinfectives chloramphenicol sod Generic succinate ALBENDAZOLE Brand (BULK) CHLOROQUINE Brand PHOSPHATE ALBENZA Brand chloroquine Generic ALINIA Brand phosphate oral AMIKACIN Brand cleocin intravenous Generic (BULK) solution 300 mg/2 ml amikacin injection Generic clindamycin hcl Generic solution 1,000 mg/4 ml, 500 mg/2 ml CLINDAMYCIN Brand HCL (BULK) AMIKACIN Brand SULFATE (BULK) clindamycin in 5 % Generic dextrose AMINOSALICYLI Brand C ACID (BULK) clindamycin Generic palmitate hcl atovaquone Generic CLINDAMYCIN Brand atovaquone- Generic PHOSPHATE proguanil CLINDAMYCIN Brand aztreonam Generic PHOSPHATE baciim Generic (BULK) bacitracin (bulk) Generic clindamycin Generic powder 5 million phosphate injection unit clindamycin Generic BACITRACIN Brand phosphate (BULK) POWDER intravenous 65 UNIT/MG CLIOQUINOL Brand bacitracin Generic CLOFAZIMINE Brand intramuscular (BULK) BACITRACIN, Brand COARTEM Brand MICRONIZED (BULK) COLISTIMETHAT Brand E SODIUM (BULK) BILTRICIDE Brand colistin Generic CAYSTON Brand QL (colistimethate na) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 7 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC COLISTIN Brand IMPAVIDO Brand SULFATE (BULK) IODOQUINOL Brand CUBICIN RF Brand (BULK) CYCLOSERINE Brand isoniazid Generic (BULK) ISONIAZID Brand DALVANCE Brand (BULK) dapsone Generic IVERMECTIN Brand DAPSONE (BULK) Brand ivermectin oral Generic daptomycin Generic KANAMYCIN Brand (BULK) DARAPRIM Brand PA LINCOMYCIN Brand EMVERM Brand lincomycin injection Generic ethambutol Generic linezolid intravenous Generic FURAZOLIDONE Brand (BULK) linezolid oral Generic PA GENTAMICIN Brand linezolid-0.9% Generic (BULK) sodium chloride gentamicin in nacl Generic MEBENDAZOLE Brand (iso-osm) mefloquine Generic intravenous piggyback 100 meropenem Generic mg/100 ml, 60 mg/50 MEROPENEM- Brand ml, 70 mg/50 ml, 80 0.9% SODIUM mg/100 ml, 80 mg/50 CHLORIDE ml, 90 mg/100 ml metro i.v. Generic gentamicin injection Generic METRONIDAZOL Brand gentamicin sulfate Generic E (BULK) (ped) (pf) METRONIDAZOL Brand gentamicin sulfate Generic E BENZOATE (pf) intravenous (BULK) solution 100 mg/10 ml metronidazole in Generic nacl (iso-os) HYDROXYCHLOR Brand OQUINE metronidazole oral Generic hydroxychloroquine Generic NEBUPENT Brand QL oral neomycin Generic imipenem-cilastatin Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 8 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC NEOMYCIN Brand tinidazole Generic SULFATE (BULK) TINIDAZOLE Brand NICLOSAMIDE Brand (BULK) (BULK) TOBRAMYCIN Brand ORBACTIV Brand (BULK) paromomycin Generic tobramycin in 0.225 Generic QL % nacl PAROMOMYCIN Brand SULFATE (BULK) tobramycin in 0.9 % Generic nacl POLYMYXIN B Brand SULF,MICRON.(B tobramycin sulfate Generic ULK) TOBRAMYCIN Brand polymyxin b sulfate Generic SULFATE (BULK) PRAZIQUANTEL Brand TYGACIL Brand (BULK) XIFAXAN Brand QL PRIFTIN Brand ZYVOX Brand PYRANTEL Brand INTRAVENOUS PAMOATE (BULK) PARENTERAL SOLUTION 200 pyrazinamide Generic MG/100 ML PYRIMETHAMINE Brand Penicillins QUINACRINE Brand (BULK) AMOXICILLIN Brand (BULK) QUININE HCL Brand DIHYDRATE amoxicillin oral Generic (BULK) capsule quinine sulfate Generic amoxicillin oral Generic suspension for QUININE Brand reconstitution SULFATE (BULK) amoxicillin oral Generic rifabutin Generic tablet rifampin Generic amoxicillin oral Generic RIFAMPIN (BULK) Brand tablet,chewable 125 mg, 250 mg SIRTURO Brand amoxicillin-pot Generic SIVEXTRO Brand clavulanate INTRAVENOUS ampicillin Generic STREPTOMYCIN Brand ampicillin sodium Generic THIABENDAZOLE Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 9 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ampicillin-sulbactam Generic Generic (mixture) AUGMENTIN Brand ORAL ciprofloxacin hcl Generic SUSPENSION FOR oral RECONSTITUTIO ciprofloxacin in 5 % Generic N 125-31.25 MG/5 dextrose ML ciprofloxacin lactate Generic dicloxacillin Generic LEVOFLOXACIN Brand nafcillin Generic (BULK) nafcillin in dextrose Generic levofloxacin in d5w Generic iso-osm levofloxacin Generic oxacillin Generic intravenous oxacillin in Generic levofloxacin oral Generic dextrose(iso-osm) moxifloxacin Generic penicillin g Generic potassium MOXIFLOXACIN- Brand SOD.ACE,SUL- penicillin g procaine Generic WATER penicillin g sodium Generic ofloxacin oral Generic penicillin v Generic potassium Sulfa's / Related Agents pfizerpen-g Generic SULFACETAMIDE Brand piperacillin- Generic SULFADIAZINE Brand tazobactam sulfadiazine oral Generic intravenous recon soln 2.25 gram, SULFAMETHOXA Brand 3.375 gram, 4.5 ZOLE (BULK) gram, 40.5 gram sulfamethoxazole- Generic trimethoprim Quinolones SULFAPYRIDINE Brand AVELOX IN NACL Brand (ISO-OSMOTIC) sulfatrim Generic CIPRO ORAL Brand SULFISOXAZOLE Brand SUSPENSION,MIC Tetracyclines ROCAPSULE RECON avidoxy Generic ciprofloxacin Generic demeclocycline Generic CIPROFLOXACIN Brand doxy-100 Generic (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 10 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC DOXYCYCLINE Brand methenamine Generic HYCLATE (BULK) hippurate doxycycline hyclate Generic methenamine Generic intravenous mandelate doxycycline hyclate Generic METHENAMINE Brand oral capsule MANDELATE (BULK) doxycycline hyclate Generic oral tablet 100 mg, methylene blue Generic 20 mg (antidote) doxycycline hyclate Generic NALIDIXIC ACID Brand oral tablet,delayed NITROFURAN Brand release (dr/ec) MACROCRYSTAL doxycycline Generic (BULK) monohydrate oral NITROFURANTOI Brand capsule N doxycycline Generic nitrofurantoin Generic monohydrate oral macrocrystal suspension for reconstitution nitrofurantoin Generic monohyd/m-cryst doxycycline Generic monohydrate oral nitrofurantoin oral Generic tablet trimethoprim Generic MINOCYCLINE Brand TRIMETHOPRIM Brand minocycline oral Generic (BULK) mondoxyne nl Generic TRIMETHOPRIM, Brand MICRO (BULK) morgidox Generic ocudox Generic Vancomycin OXYTETRACYCLI Brand VANCOMYCIN Brand NE (BULK) (BULK) tetracycline Generic VANCOMYCIN IN Brand 0.9% SODIUM CL TETRACYCLINE Brand INTRAVENOUS (BULK) PIGGYBACK TETRACYCLINE Brand HCL (BULK) Urinary Tract Agents METHENAMINE Brand (BULK) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 11 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC VANCOMYCIN IN Brand levoleucovorin Generic 0.9% SODIUM CL intravenous recon INTRAVENOUS soln 50 mg SOLUTION 1.5 levoleucovorin Generic GRAM/250 ML, 1.5 intravenous solution GRAM/500 ML, 1.75 GRAM/250 mesna Generic ML, 750 MG/150 MESNEX ORAL Brand ML VISTOGARD Brand VANCOMYCIN IN Brand DEXTROSE 5 % XGEVA Brand INTRAVENOUS Antineoplastic / Immunosuppressant PIGGYBACK 1 GRAM/200 ML, Drugs 500 MG/100 ML ABRAXANE Brand vancomycin Generic ADCETRIS Brand intravenous adriamycin Generic vancomycin oral Generic capsule adrucil Generic Antineoplastic / Immunosuppressant AFINITOR Brand PA Drugs AFINITOR Brand PA DISPERZ Adjunctive Agents ALIMTA Brand amifostine Generic crystalline ALKERAN ORAL Brand calcium folinate Generic anastrozole Generic (leucovorin) ANASTROZOLE Brand dexrazoxane hcl Generic (BULK) ELITEK Brand ARRANON Brand KEPIVANCE Brand ARSENIC Brand TRIOXIDE (BULK) leucovorin calcium Generic ARZERRA Brand LEUCOVORIN Brand CALCIUM (BULK) AVASTIN Brand LEVOLEUCOVORI Brand azacitidine Generic N INTRAVENOUS AZASAN Brand RECON SOLN 175 azathioprine Generic MG AZATHIOPRINE Brand (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 12 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC azathioprine sodium Generic cyclosporine Generic intravenous BENDEKA Brand cyclosporine Generic bexarotene Generic modified BEXXAR Brand cyclosporine oral Generic DOSIMETRIC capsule bicalutamide Generic cytarabine Generic BICNU Brand cytarabine (pf) Generic bleo 15k Generic dacarbazine Generic bleomycin Generic dactinomycin Generic BLINCYTO Brand DARZALEX Brand BOSULIF Brand PA; QL daunorubicin Generic BUSULFEX Brand DAUNOXOME Brand capecitabine Generic decitabine Generic CAPRELSA Brand PA; QL DEPOCYT (PF) Brand carboplatin Generic docetaxel Generic CELLCEPT Brand doxorubicin Generic INTRAVENOUS doxorubicin, peg- Generic cerubidine Generic liposomal CHLORAMBUCIL Brand DROXIA Brand cisplatin Generic ELIGARD Brand PA cladribine Generic ELIGARD (3 Brand PA CLOLAR Brand MONTH) COTELLIC Brand PA; QL ELIGARD (4 Brand PA CYCLOPHOSPHA Brand MONTH) MIDE (BULK) ELIGARD (6 Brand PA cyclophosphamide Generic MONTH) intravenous ELSPAR Brand CYCLOPHOSPHA Brand EMCYT Brand MIDE ORAL epirubicin Generic CAPSULE ERBITUX Brand PA cyclophosphamide Generic oral tablet ETOPOPHOS Brand CYCLOSPORINE Brand etoposide Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 13 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ETOPOSIDE Brand Generic PA; QL (BULK) IMBRUVICA Brand PA; QL exemestane Generic INLYTA Brand PA; QL FARESTON Brand IRESSA Brand PA; QL FASLODEX Brand irinotecan Generic floxuridine Generic ISTODAX Brand FLOXURIDINE Brand IXEMPRA Brand (BULK) JAKAFI Brand PA; QL fludarabine Generic KADCYLA Brand PA FLUOROURACIL Brand (BULK) KEYTRUDA Brand fluorouracil Generic KYPROLIS Brand intravenous LARTRUVO Brand flutamide Generic LENVIMA Brand PA FOLOTYN Brand letrozole Generic GAZYVA Brand LETROZOLE Brand gemcitabine Generic (BULK) gengraf Generic LEUKERAN Brand GILOTRIF Brand PA; QL LEUPROLIDE Brand (BULK) GLEOSTINE Brand leuprolide Generic HALAVEN Brand subcutaneous kit hecoria Generic LEVAMISOLE Brand HERCEPTIN Brand PA (BULK) HEXALEN Brand lipodox Generic HYCAMTIN ORAL Brand LOMUSTINE Brand hydroxyurea Generic LONSURF Brand PA HYDROXYUREA Brand LUPRON DEPOT Brand PA (BULK) (3 MONTH) INTRAMUSCULA IBRANCE Brand PA; QL R SYRINGE KIT ICLUSIG Brand ST; QL 11.25 MG idarubicin Generic ifosfamide Generic ifosfamide-mesna Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 14 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC LUPRON DEPOT Brand PA MITOTANE Brand INTRAMUSCULA (BULK) R SYRINGE KIT mitoxantrone Generic 3.75 MG MUSTARGEN Brand LUPRON DEPOT- Brand PA PED mycophenolate Generic mofetil LUPRON DEPOT- Brand PA PED (3 MONTH) mycophenolate Generic mofetil hcl LYNPARZA Brand PA mycophenolate Generic LYSODREN Brand sodium MARQIBO Brand MYLERAN Brand MATULANE Brand NEORAL Brand MECHLORETHAM Brand NEXAVAR Brand PA; QL INE (BULK) nilutamide Generic MEGESTROL Brand ACETATE,MICRO NINLARO Brand PA; QL (BULK) NULOJIX Brand megestrol oral Generic octreotide acetate Generic suspension 400 mg/10 ml (10 ml), ONCASPAR Brand 400 mg/10 ml (40 ONIVYDE Brand mg/ml), 625 mg/5 ml OPDIVO Brand megestrol oral tablet Generic oxaliplatin Generic MEKINIST Brand PA; QL paclitaxel Generic melphalan hcl Generic pentostatin Generic mercaptopurine Generic PERJETA Brand PA MERCAPTOPURIN Brand E (BULK) PHOTOFRIN Brand METHOTREXATE Brand POMALYST Brand (BULK) PROGRAF Brand methotrexate sodium Generic INTRAVENOUS methotrexate sodium Generic PURIXAN Brand (pf) RAPAMUNE Brand mitomycin Generic ORAL SOLUTION MITOMYCIN Brand REVLIMID Brand PA (BULK) RITUXAN Brand PA; ST

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 15 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC RUBRACA Brand PA; QL TEMODAR Brand INTRAVENOUS SANDIMMUNE Brand temozolomide Generic PA SANDOSTATIN Brand LAR DEPOT TENIPOSIDE Brand SIGNIFOR Brand PA THALOMID Brand PA SIMULECT Brand THIOGUANINE Brand (BULK) sirolimus Generic thiotepa Generic SIROLIMUS Brand (BULK) THIOTEPA Brand (BULK) SODIUM IODIDE Brand (BULK) toposar Generic SPRYCEL Brand PA; QL topotecan Generic STIVARGA Brand PA; QL TORISEL Brand SUTENT Brand PA; QL TREANDA Brand SYLVANT Brand tretinoin Generic (chemotherapy) TABLOID Brand TREXALL Brand TACROLIMUS Brand ANHYDROUS TRISENOX Brand (BULK) TYKERB Brand PA; QL TACROLIMUS Brand UNITUXIN Brand MICRONIZED (BULK) VALSTAR Brand tacrolimus oral Generic VANTAS Brand TAFINLAR Brand PA; QL VECTIBIX Brand PA TAGRISSO Brand PA; QL VELCADE Brand tamoxifen Generic VENCLEXTA Brand PA TAMOXIFEN Brand VENCLEXTA Brand PA; QL (BULK) STARTING PACK TARCEVA Brand PA; QL vinblastine Generic TARGRETIN Brand vincasar pfs Generic TOPICAL vincristine Generic TASIGNA Brand PA; QL vinorelbine Generic TECENTRIQ Brand VOTRIENT Brand PA; QL XOFIGO Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 16 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC YERVOY Brand CLONAZEPAM Brand (BULK) YONDELIS Brand diazepam rectal Generic ZANOSAR Brand DILANTIN Brand ZELBORAF Brand PA; QL DILANTIN Brand ZEVALIN (Y-90) Brand EXTENDED ZOLADEX Brand DILANTIN Brand ZOLINZA Brand INFATABS ZORTRESS Brand DILANTIN-125 Brand ZYDELIG Brand PA; QL divalproex Generic ZYKADIA Brand PA; QL epitol Generic ZYTIGA Brand PA; ST; QL ethosuximide Generic Autonomic / Cns Drugs, Neurology / ETHOSUXIMIDE Brand Psych (BULK) Anticonvulsants felbamate Generic fosphenytoin Generic BANZEL Brand GABAPENTIN Brand CARBAMAZEPIN Brand (BULK) E (BULK) gabapentin oral Generic carbamazepine oral Generic capsule capsule, er multiphase 12 hr gabapentin oral Generic carbamazepine oral Generic solution suspension 100 mg/5 gabapentin oral Generic ml tablet 600 mg, 800 mg carbamazepine oral Generic tablet GABITRIL ORAL Brand TABLET 12 MG, 16 carbamazepine oral Generic MG tablet extended release 12 hr LAMOTRIGINE Brand (BULK) carbamazepine oral Generic tablet,chewable lamotrigine oral Generic tablet CELONTIN ORAL Brand CAPSULE 300 MG lamotrigine oral Generic tablet disintegrating, clonazepam Generic dose pk

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 17 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC lamotrigine oral Generic PHENYTOIN Brand tablet extended SODIUM (BULK) release 24hr phenytoin sodium Generic lamotrigine oral Generic extended tablet, chewable POTIGA Brand dispersible primidone Generic lamotrigine oral Generic tablet,disintegrating PRIMIDONE Brand (BULK) lamotrigine oral Generic tablets,dose pack 25 roweepra Generic mg (35) SABRIL Brand levetiracetam Generic TEGRETOL ORAL Brand LEVETIRACETAM Brand SUSPENSION (BULK) TEGRETOL ORAL Brand levetiracetam in nacl Generic TABLET (iso-os) TEGRETOL XR Brand LYRICA Brand ST tiagabine Generic ONFI ORAL Brand topiragen Generic SUSPENSION TOPIRAMATE Brand ONFI ORAL Brand (BULK) TABLET 10 MG, 20 MG topiramate oral Generic capsule, sprinkle oxcarbazepine Generic topiramate oral Generic PEGANONE Brand tablet phenobarbital Generic valproate sodium Generic PHENOBARBITAL Brand VALPROATE Brand (BULK) SODIUM (BULK) phenobarbital Generic valproic acid Generic sodium injection solution valproic acid (as Generic sodium salt) oral PHENYTOIN Brand solution (BULK) VALPROIC ACID Brand phenytoin oral Generic (BULK) suspension VIMPAT Brand phenytoin oral Generic INTRAVENOUS tablet,chewable phenytoin sodium Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 18 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC VIMPAT ORAL Brand DIHYDROERGOT Brand SOLUTION AMINE MESYLT(BULK) VIMPAT ORAL Brand TABLET Generic QL nasal ZARONTIN Brand Brand zonisamide Generic TARTRATE Antiparkinsonism Agents (BULK) APOKYN Brand ergotamine-caffeine Generic benztropine Generic frovatriptan Generic QL Generic isometh-dichloral- Generic acetaminophn BROMOCRIPTINE Brand (BULK) isomethepten-caf- Generic acetaminophen carbidopa Generic Brand CARBIDOPA Brand MUCATE (BULK) (BULK) Brand carbidopa-levodopa Generic (BULK) carbidopa-levodopa- Generic migergot Generic entacapone migragesic ida Generic entacapone Generic naratriptan Generic QL LEVODOPA Brand (BULK) nodolor Generic pramipexole Generic rizatriptan Generic QL rasagiline Generic sumatriptan Generic QL ropinirole Generic SUMATRIPTAN Brand (BULK) selegiline hcl Generic SUMATRIPTAN Brand SELEGILINE HCL Brand SUCCINATE (BULK) (BULK) tolcapone Generic sumatriptan Generic QL trihexyphenidyl Generic succinate oral Migraine / Cluster Headache sumatriptan Generic QL Therapy succinate subcutaneous almotriptan malate Generic QL cartridge dihydroergotamine Generic injection You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 19 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC sumatriptan Generic QL tetrabenazine Generic PA succinate TYSABRI Brand PA subcutaneous pen injector Muscle Relaxants / Antispasmodic sumatriptan Generic QL Therapy succinate anectine Generic subcutaneous solution atracurium Generic sumatriptan Generic QL baclofen Generic succinate BACLOFEN Brand subcutaneous (BULK) syringe 6 mg/0.5 ml chlorzoxazone Generic zolmitriptan Generic QL cisatracurium Generic ZOMIG NASAL Brand QL CYCLOBENZAPRI Brand Miscellaneous Neurological Therapy NE (BULK) AMPYRA Brand PA oral Generic donepezil oral tablet Generic tablet 10 mg, 5 mg dantrolene Generic donepezil oral tablet Generic ST DANTROLENE Brand 23 mg (BULK) donepezil oral Generic EDROPHONIUM Brand tablet,disintegrating CHLORIDE galantamine Generic (BULK) GILENYA Brand PA enlon Generic glatopa Generic PA; QL GABLOFEN Brand LEMTRADA Brand PA LIORESAL Brand memantine oral Generic MESTINON ORAL Brand solution SYRUP memantine oral Generic metaxall Generic tablet metaxalone Generic NUEDEXTA Brand PA methocarbamol Generic rivastigmine Generic METHOCARBAM Brand rivastigmine tartrate Generic OL (BULK) SPINRAZA (PF) Brand PA Brand METHYLSULF TECFIDERA Brand PA (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 20 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC neostigmine Generic acetaminophen-caff- Generic methylsulfate dihydrocod oral injection tablet neostigmine Generic acetaminophen- Generic PA methylsulfate codeine oral solution intravenous solution 120 mg-12 mg /5 ml (5 ml), 120-12 mg/5 ORPHENADRINE Brand ml, 300 mg-30 mg CITRATE /12.5 ml orphenadrine citrate Generic acetaminophen- Generic PA; QL injection codeine oral tablet orphenadrine citrate Generic alagesic lq Generic oral alfentanil Generic PA orphenadrine Generic compound-ds ascomp with codeine Generic PA pancuronium Generic aspirin-caffeine- Generic PA dihydrocodein PROSTIGMIN Brand astramorph-pf Generic PA pyridostigmine Generic injection solution 1 bromide mg/ml PYRIDOSTIGMINE Brand BUPRENORPHINE Brand BROMIDE (BULK) HCL (BULK) regonol Generic buprenorphine hcl Generic PA revonto Generic injection rocuronium Generic buprenorphine hcl Generic intravenous solution sublingual SUCCINYLCHOLI Brand butalbital compound Generic PA NE CL (BULK) w/codeine Generic butalbital- Generic PA TIZANIDINE Brand acetaminop-caf-cod (BULK) butalbital- Generic vecuronium bromide Generic acetaminophen butalbital- Generic Narcotic Analgesics acetaminophen-caff acetaminophen-caff- Generic PA butalbital-aspirin- Generic dihydrocod oral caffeine oral capsule capsule capacet Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 21 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CODEINE Brand hydrocodone- Generic PA PHOSPHATE acetaminophen oral (BULK) solution codeine sulfate oral Generic PA; QL hydrocodone- Generic PA tablet acetaminophen oral tablet 10-300 mg, codeine-butalbital- Generic PA 10-325 mg, 10-500 asa-caff mg, 10-650 mg, 10- diskets Generic PA 660 mg, 10-750 mg, duramorph (pf) Generic PA 2.5-325 mg, 5-300 mg, 5-325 mg, 5-500 endocet oral tablet Generic QL mg, 7.5-300 mg, 7.5- 10-325 mg, 2.5-325 325 mg, 7.5-500 mg, mg, 5-325 mg, 7.5- 7.5-650 mg, 7.5-750 325 mg mg endodan Generic QL hydrocodone- Generic PA FENTANYL Brand ibuprofen (BULK) HYDROMORPHO Brand fentanyl citrate Generic PA; QL NE (BULK) FENTANYL Brand hydromorphone (pf) Generic PA CITRATE (BULK) hydromorphone Generic PA fentanyl citrate (pf) Generic PA injection solution injection hydromorphone Generic PA fentanyl citrate (pf) Generic PA injection syringe 1 intravenous syringe mg/ml, 2 mg/ml, 4 100 mcg/2 ml (50 mg/ml mcg/ml) hydromorphone oral Generic PA fentanyl citrate- Generic liquid 0.9%nacl (pf) hydromorphone oral Generic PA; QL intravenous solution tablet 5 mcg/ml hydromorphone oral Generic PA; QL fentanyl transdermal Generic PA; QL tablet extended patch 72 hour 100 release 24 hr mcg/hr, 12 mcg/hr, 25 mcg/hr, 50 hydromorphone Generic PA mcg/hr, 75 mcg/hr rectal HYDROCODONE Brand ibuprofen-oxycodone Generic PA; QL BITARTRATE levorphanol tartrate Generic PA (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 22 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC LEVORPHANOL Brand morphine (pf) Generic PA TARTRATE injection solution 0.5 (BULK) mg/ml, 1 mg/ml lorcet (hydrocodone) Generic PA morphine (pf) Generic PA intravenous patient lorcet hd Generic PA control.analgesia lorcet plus oral Generic PA soln tablet 7.5-325 mg morphine Generic PA lortab 10-325 Generic PA concentrate oral lortab 5-325 Generic PA solution lortab 7.5-325 Generic PA morphine injection Generic PA solution margesic Generic morphine injection Generic PA marten-tab Generic syringe 10 mg/ml, 2 MEPERIDINE Brand mg/ml, 4 mg/ml, 5 (BULK) mg/ml, 8 mg/ml METHADONE Brand morphine Generic PA (BULK) intravenous cartridge 10 mg/ml, methadone injection Generic PA 15 mg/ml, 2 mg/ml, 4 methadone oral Generic PA mg/ml concentrate morphine Generic PA methadone oral Generic PA intravenous pt solution controlled analgesia syring methadone oral Generic PA tablet morphine Generic PA intravenous solution methadone oral Generic PA 10 mg/ml, 100 mg/4 tablet,soluble ml, 25 mg/ml, 250 methadose oral Generic PA mg/10 ml, 50 mg/ml concentrate morphine Generic PA methadose oral Generic PA intravenous syringe tablet,soluble 2 mg/ml, 4 mg/ml MORPHINE Brand morphine oral Generic PA; QL (BULK) capsule, er multiphase 24 hr morphine (pf) in 0.9 Generic % nacl intravenous morphine oral Generic PA; QL syringe 0.5 mg/ml capsule,extend.relea se pellets

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 23 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC morphine oral Generic PA reprexain Generic PA solution roxicet oral tablet Generic PA; QL morphine oral tablet Generic PA; QL sufentanil citrate Generic PA morphine oral tablet Generic PA; QL SUFENTANIL Brand extended release CITRATE (BULK) morphine rectal Generic PA tencon Generic OXYCODONE Brand trezix oral capsule Generic (BULK) 356.4-30-16 mg oxycodone oral Generic PA; QL verdrocet Generic PA capsule vicodin Generic PA oxycodone oral Generic PA concentrate vicodin es Generic PA oxycodone oral Generic PA vicodin hp Generic PA solution xolox Generic QL oxycodone oral Generic QL xylon 10 Generic PA tablet 10 mg, 20 mg zamicet Generic PA oxycodone oral Generic PA; QL tablet 15 mg, 30 mg, zebutal oral capsule Generic 5 mg 50-325-40 mg oxycodone- Generic PA; QL Non-Narcotic Analgesics acetaminophen oral 8 hour pain reliever Generic OTC capsule acephen Generic OTC oxycodone- Generic PA acetaminophen oral acetadryl Generic OTC solution aceta-gesic Generic OTC oxycodone- Generic PA; QL ACETAMINOPHE Brand acetaminophen oral N (BULK) tablet 10-325 mg, 2.5-325 mg, 5-325 acetaminophen extra Generic OTC mg, 7.5-325 mg, 7.5- strength 500 mg acetaminophen oral Generic OTC oxycodone- Generic QL drops,suspension acetaminophen oral acetaminophen oral Generic OTC tablet 10-650 mg elixir oxycodone-aspirin Generic PA; QL acetaminophen oral Generic OTC oxymorphone Generic PA; QL liquid 500 mg/5 ml promacet Generic acetaminophen oral Generic OTC solution You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 24 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC acetaminophen oral Generic OTC aspirin oral Generic OTC suspension 160 mg/5 tablet,delayed ml release (dr/ec) 650 mg acetaminophen oral Generic OTC tablet aspirin oral Generic tablet,delayed acetaminophen oral Generic OTC release (dr/ec) 975 tablet extended mg release aspirin rectal Generic OTC acetaminophen oral Generic OTC tablet,disintegrating aspirin, buffered Generic OTC 80 mg aspir-low Generic OTC; QL acetaminophen pm Generic OTC aspir-trin Generic OTC; QL extra str athenol Generic OTC acetaminophen Generic OTC rectal bayer advanced Generic OTC; QL added strength Generic OTC betatemp Generic OTC headache relief bufferin Generic OTC added strength pain Generic OTC buprenorphine- Generic reliever naloxone adult low dose Generic OTC; QL BUTORPHANOL Brand aspirin TARTRATE advil oral tablet 100 Generic OTC; QL (BULK) mg butorphanol tartrate Generic PA advil oral Generic OTC; QL injection tablet,chewable butorphanol tartrate Generic PA; QL arthritis pain relief Generic OTC nasal (acetam) celecoxib Generic ST aspir-81 Generic OTC; QL CELECOXIB Brand ASPIRIN (BULK) Brand (BULK) aspirin low dose Generic OTC; QL child non-aspirin Generic OTC quick melts aspirin oral tablet Generic OTC; QL child pain rel-fever Generic OTC aspirin oral Generic OTC; QL reducer tablet,chewable children's Generic OTC aspirin oral Generic OTC; QL acetaminophen oral tablet,delayed suspension 160 mg/5 release (dr/ec) 325 ml (5 ml) mg, 500 mg, 81 mg

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 25 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC children's advil Generic OTC CHOLIN AND MG Brand SALICYLATE(BUL children's aspirin Generic OTC; QL K) children's easy-melts Generic OTC choline,magnesium Generic children's ibuprofen Generic OTC salicylate children's mapap Generic OTC (pf) Generic children's medi- Generic OTC epidural solution profen 5,000 mcg/10 ml children's medi-tabs Generic OTC cold relief oral Generic OTC tablet children's non- Generic OTC aspirin oral elixir diclofenac potassium Generic children's non- Generic OTC DICLOFENAC Brand aspirin oral SODIUM (BULK) suspension diclofenac sodium Generic children's non- Generic OTC oral aspirin oral diclofenac sodium Generic QL tablet,chewable topical drops children's non- Generic OTC diclofenac sodium Generic PA; ST; QL aspirin pain topical gel 1 % children's pain relief Generic OTC diclofenac- Generic children's pain Generic OTC misoprostol reliever oral diflunisal Generic tablet,disintegrating diphenhydramine- Generic OTC children's pain-fever Generic OTC acetaminophen relief oral liquid dologesic (w- Generic children's pain-fever Generic OTC phenyltoloxamine) relief oral e.c. prin Generic OTC; QL suspension eazzze the pain Generic OTC children's pain-fever Generic OTC relief oral ecotrin Generic OTC; QL tablet,chewable ecotrin low strength Generic OTC; QL children's profen ib Generic OTC ed-apap Generic OTC children's q-pap Generic OTC enteric coated Generic OTC; QL children's silapap Generic OTC aspirin children's tactinal Generic OTC etodolac Generic ETODOLAC Brand (BULK) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 26 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ex-strength medi- Generic OTC ibuprofen oral tablet Generic OTC; QL tabs pm 100 mg, 200 mg extra strength bayer Generic OTC; QL ibuprofen oral tablet Generic 400 mg, 600 mg, 800 extraprin Generic OTC mg fenoprofen oral Generic INDOMETHACIN Brand tablet (BULK) fever reducer Generic OTC indomethacin oral Generic fever reducer an Generic OTC indomethacin Generic pain reliever sodium feverall rectal Generic OTC infant fever reducer- Generic OTC suppository 120 mg, pain relf 325 mg, 650 mg infant's advil Generic OTC flurbiprofen Generic infant's ibuprofen Generic OTC FLURBIPROFEN Brand (BULK) infant's medi-profen Generic OTC GLUCOSAMINE Brand infant's motrin Generic OTC SU 2KCL (BULK) infants' pain and Generic OTC GLUCOSAMINE Brand fever SULFATE infants' pain relief Generic OTC NACL(BULK) infant's pain relief Generic OTC headache formula Generic OTC added str infant's pain reliever Generic OTC headache pm Generic OTC infants profenib Generic OTC headache relief (asa- Generic OTC i-prin Generic OTC; QL acet-caf) jr str non-aspirin Generic OTC ibu-drops Generic OTC quick melts IBUPROFEN Brand jr. acetaminophen Generic OTC (BULK) jr. str non-aspirin Generic OTC ibuprofen ib Generic OTC; QL pain ibuprofen jr strength Generic OTC; QL jr. strength pain Generic OTC reliever ibuprofen lysine (pf) Generic junior mapap Generic OTC ibuprofen oral Generic OTC; QL capsule KETOPROFEN Brand (BULK) ibuprofen oral Generic OTC suspension ketoprofen oral Generic capsule You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 27 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ketoprofen oral Generic MECLOFENAMAT Brand capsule,ext rel. E pellets 24 hr 200 mg meclofenamate oral Generic KETOPROFEN, Brand medi-profen Generic OTC; QL MICRONIZED (BULK) medi-tabs Generic OTC KETOROLAC Brand medi-tabs pm Generic OTC (BULK) mefenamic acid Generic ketorolac injection Generic MEFENAMIC Brand ketorolac Generic ACID (BULK) intramuscular meloxicam Generic ketorolac oral Generic MELOXICAM Brand klofensaid ii Generic ST; QL (BULK) lite coat aspirin Generic OTC; QL migraine formula Generic OTC little remedies fever Generic OTC migraine pain Generic OTC and pain reliever mapap Generic OTC migraine relief Generic OTC (acetaminophen) miniprin Generic OTC; QL oral capsule nabumetone Generic mapap Generic OTC (acetaminophen) NABUMETONE, Brand oral liquid MICRONIZED (BULK) mapap Generic OTC (acetaminophen) nalbuphine Generic PA oral suspension NALBUPHINE Brand mapap Generic OTC (BULK) (acetaminophen) naloxone Generic oral tablet naltrexone Generic mapap Generic OTC (acetaminophen) NALTREXONE Brand oral tablet,chewable HCL (BULK) mapap arthritis pain Generic OTC NALTREXONE Brand HCL mapap extra Generic OTC DIHYDRATE(BUL strength K) mapap infants' Generic OTC NAPRO Brand mapap pm Generic OTC naproxen Generic masophen Generic OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 28 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC NAPROXEN Brand pain relief oral Generic OTC (BULK) capsule 500 mg NAPROXEN Brand pain relief oral Generic OTC SODIUM liquid naproxen sodium Generic pain relief oral Generic OTC oral tablet 275 mg, tablet 550 mg pain relief oral Generic OTC naproxen sodium Generic tablet extended oral tablet, er release multiphase 24 hr pain relief pm Generic OTC night time pain Generic OTC pain relief pm rapid Generic OTC medicine release non-aspirin 8 hour Generic OTC pain relief regular Generic OTC non-aspirin Generic OTC strength childrens pain reliever Generic OTC non-aspirin extra Generic OTC (acetam-aspirin) strength pain reliever extra Generic OTC non-aspirin jr Generic OTC strength strength pain reliever jr Generic OTC non-aspirin oral Generic OTC strength tablet pain reliever oral Generic OTC non-aspirin oral Generic OTC capsule tablet,chewable 80 pain reliever oral Generic OTC mg tablet 325 mg non-aspirin pain Generic OTC pain reliever plus Generic OTC relief oral tablet 500 mg pain-off Generic OTC non-aspirin pain Generic OTC pamprin max Generic OTC relief pm pediacare fever Generic OTC non-aspirin pm Generic OTC reducer nortemp Generic OTC percogesic Generic OTC oxaprozin Generic percogesic extra Generic OTC strength pain and fever Generic OTC pharbetol Generic OTC pain relief Generic OTC (acetamin-asp-caf) piroxicam Generic pain relief adult Generic OTC PIROXICAM Brand (BULK) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 29 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PRIALT Brand tylophen Generic OTC provil Generic OTC; QL VIVITROL Brand PA q-pap extra strength Generic OTC wal-profen Generic OTC; QL q-pap oral drops Generic OTC zflex Generic q-pap oral liquid Generic OTC zgesic Generic q-pap oral tablet Generic OTC Psychotherapeutic Drugs 325 mg alprazolam Generic rhinoflex-650 Generic ALPRAZOLAM Brand salsalate Generic (BULK) SALSALATE Brand alprazolam intensol Generic (BULK) Generic severe allergy Generic OTC AMITRIPTYLINE Brand shake that ache Generic OTC (BULK) silapap Generic OTC amitriptyline- Generic SUBOXONE Brand chlordiazepoxide SULINDAC Brand Generic sulindac oral Generic oral Generic solution super pain relief Generic OTC aripiprazole oral Generic QL tactinal Generic OTC tablet tactinal extra Generic OTC aripiprazole oral Generic QL strength tablet,disintegrating tolmetin Generic ARISTADA Brand TRAMADOL Brand armodafinil Generic PA HYDROCHLORID E (BULK) budeprion sr oral Generic QL tablet extended tramadol oral tablet Generic PA release 12 hr 150 mg tramadol oral tablet Generic PA BUPROPION Brand extended release 24 (BULK) hr bupropion hcl oral Generic tramadol oral tablet, Generic PA tablet er multiphase 24 hr bupropion hcl oral Generic QL tramadol- Generic PA tablet extended acetaminophen release 12 hr tri-buffered aspirin Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 30 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC bupropion hcl oral Generic QL desvenlafaxine Generic QL tablet extended succinate oral tablet release 24 hr extended release 24 hr 100 mg, 50 mg Generic desvenlafaxine Generic BUSPIRONE Brand succinate oral tablet (BULK) extended release 24 BUTALBITAL Brand hr 25 mg (BULK) dexedrine Generic PA CHLORAL Brand Generic HYDRATE (BULK) dexmethylphenidate Generic PA chlordiazepoxide hcl Generic dextroamphetamine Generic PA Generic dextroamphetamine- Generic PA CHLORPROMAZI Brand amphetamine NE (BULK) DIAZEPAM Brand citalopram oral Generic (BULK) solution diazepam injection Generic citalopram oral Generic QL tablet diazepam intensol Generic Generic diazepam oral Generic solution CLOMIPRAMINE Brand (BULK) diazepam oral tablet Generic clonidine hcl oral Generic PA; ST diphenhydramine hcl Generic OTC tablet extended oral tablet 50 mg release 12 hr doxapram Generic clorazepate Generic Brand dipotassium doxepin oral Generic oral tablet Generic DOXYLAMINE Brand clozapine oral Generic SUCCINATE tablet,disintegrating (BULK) 100 mg, 12.5 mg, 25 mg duloxetine oral Generic QL capsule,delayed CLOZARIL Brand release(dr/ec) 20 Brand mg, 30 mg, 60 mg desipramine oral Generic duloxetine oral Generic capsule,delayed release(dr/ec) 40 mg

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 31 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC Generic Brand (BULK) ERGOLOID Brand (BULK) haloperidol Generic decanoate escitalopram oxalate Generic oral solution HALOPERIDOL Brand DECANOATE escitalopram oxalate Generic QL (BULK) oral tablet haloperidol lactate Generic estazolam Generic QL Brand flumazenil Generic (BULK) FLUOXETINE Brand imipramine hcl Generic (BULK) imipramine pamoate Generic fluoxetine oral Generic QL capsule lithium carbonate Generic fluoxetine oral Generic QL LITHIUM Brand capsule,delayed CARBONATE release(dr/ec) (BULK) fluoxetine oral Generic lithium citrate oral Generic solution solution 8 meq/5 ml fluoxetine oral tablet Generic QL lorazepam Generic 10 mg LORAZEPAM Brand fluoxetine oral tablet Generic (BULK) 20 mg lorazepam intensol Generic Generic succinate Generic decanoate Generic FLUPHENAZINE Brand DECANOATE medi-sleep Generic OTC (BULK) OIL metadate er Generic PA fluphenazine hcl Generic methamphetamine Generic PA flurazepam Generic QL METHYLPHENID Brand fluvoxamine Generic QL ATE oral Generic PA; ST methylphenidate Generic PA tablet extended oral release 24 hr MIDAZOLAM Brand guanidine Generic (BULK) haloperidol Generic midazolam (pf) Generic injection cartridge

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 32 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC midazolam (pf) Generic pimozide Generic injection syringe procentra Generic PA midazolam injection Generic Brand midazolam oral Generic (BULK) syrup 2 mg/ml Generic Generic quazepam Generic QL MIRTAZAPINE Brand Generic QL (BULK) RISPERDAL Brand modafinil Generic PA CONSTA molindone Generic oral Generic nighttime sleep-aid Generic OTC solution (doxylamn) risperidone oral Generic QL Generic tablet NORTRIPTYLINE Brand risperidone oral Generic (BULK) tablet,disintegrating 0.25 mg Generic intramuscular risperidone oral Generic QL tablet,disintegrating olanzapine oral Generic QL 0.5 mg, 1 mg, 2 mg, olanzapine- Generic 3 mg, 4 mg fluoxetine ROZEREM Brand ST; QL oxazepam Generic seconal sodium Generic QL Generic QL SERTRALINE Brand paroxetine hcl oral Generic QL (BULK) tablet sertraline oral Generic paroxetine hcl oral Generic QL concentrate tablet extended sertraline oral tablet Generic QL release 24 hr sleep aid Generic OTC PENTOBARBITAL Brand (doxylamine) SODIUM (BULK) STRATTERA Brand PA; ST Generic temazepam Generic QL perphenazine- Generic amitriptyline Generic phenelzine Generic THIORIDAZINE Brand (BULK) PHENELZINE Brand (BULK) thiothixene Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 33 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC tranylcypromine Generic lidocaine in 5 % Generic dextrose (pf) Generic intravenous TRAZODONE Brand parenteral solution 4 (BULK) mg/ml (0.4 %), 8 triazolam Generic QL mg/ml (0.8 %) Generic mexiletine Generic Generic MEXILETINE Brand (BULK) ultra sleep Generic OTC (doxylamine succ) pacerone oral tablet Generic 100 mg, 200 mg, 400 venlafaxine Generic QL mg VYVANSE ORAL Brand PA; ST; QL PROCAINAMIDE Brand CAPSULE procainamide Generic wal-som Generic OTC injection (doxylamine) Generic XYREM Brand PA gluconate Generic zaleplon Generic QL quinidine sulfate Generic zenzedi oral tablet Generic PA 10 mg, 5 mg QUINIDINE Brand SULFATE (BULK) hcl Generic QL sorine Generic zolpidem Generic QL af Generic Cardiovascular, Hypertension / sotalol oral Generic Lipids SOTYLIZE Brand Antiarrhythmic Agents Antihypertensive Therapy adenosine Generic intravenous solution Generic amiodarone Generic ACEBUTOLOL Brand (BULK) dofetilide Generic afeditab cr Generic flecainide Generic amiloride Generic ibutilide fumarate Generic amiloride- Generic lidocaine (pf) in Generic hydrochlorothiazide d7.5w amlodipine Generic lidocaine (pf) Generic intravenous

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 34 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC AMLODIPINE Brand cartia xt Generic BESYLATE Generic (BULK) chlorothiazide Generic amlodipine- Generic benazepril chlorothiazide Generic sodium amlodipine- Generic olmesartan chlorthalidone oral Generic tablet 25 mg, 50 mg amlodipine- Generic valsartan clonidine Generic QL amlodipine- Generic clonidine (pf) Generic valsartan-hcthiazid epidural solution 1,000 mcg/10 ml Generic (100 mcg/ml) ATENOLOL Brand CLONIDINE HCL Brand (BULK) (BULK) atenolol- Generic clonidine hcl oral Generic chlorthalidone tablet benazepril Generic clorpres oral tablet Generic BENAZEPRIL HCL Brand 0.1-15 mg, 0.2-15 (BULK) mg benazepril- Generic CYCLANDELATE Brand hydrochlorothiazide DEMSER Brand BETAHISTINE Brand dilt-cd Generic (BULK) DILTIAZEM HCL Brand oral Generic diltiazem hcl Generic fumarate Generic intravenous bisoprolol- Generic diltiazem hcl oral Generic hydrochlorothiazide dilt-xr Generic bumetanide Generic diltzac er Generic candesartan Generic Generic QL candesartan- Generic hydrochlorothiazid DUTOPROL Brand ST captopril Generic enalapril maleate Generic CAPTOPRIL Brand ENALAPRIL Brand (BULK) MALEATE (BULK) captopril- Generic enalaprilat Generic hydrochlorothiazide intravenous solution You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 35 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC enalapril- Generic irbesartan Generic hydrochlorothiazide irbesartan- Generic eplerenone Generic hydrochlorothiazide epoprostenol Generic PA isradipine Generic (glycine) Brand eprosartan Generic (BULK) esmolol intravenous Generic labetalol Generic solution intravenous solution ethacrynate sodium Generic labetalol Generic intravenous syringe ethacrynic acid Generic 20 mg/4 ml (5 felodipine Generic mg/ml) fosinopril Generic labetalol oral Generic fosinopril- Generic lisinopril Generic hydrochlorothiazide LISINOPRIL Brand FUROSEMIDE Brand (BULK) (BULK) lisinopril- Generic furosemide injection Generic hydrochlorothiazide furosemide oral Generic losartan Generic solution 10 mg/ml, losartan- Generic 40 mg/5 ml (8 hydrochlorothiazide mg/ml) MANNITOL Brand furosemide oral Generic (BULK) tablet mannitol 10 % Generic Brand (BULK) mannitol 20 % Generic Brand mannitol 25 % Generic intravenous solution guanfacine oral Generic tablet mannitol 5 % Generic hydralazine Generic matzim la Generic HYDRALAZINE Brand methyclothiazide Generic HCL (BULK) Generic hydrochlorothiazide Generic methyldopa- Generic HYDROCHLOROT Brand hydrochlorothiazide HIAZIDE (BULK) methyldopate Generic indapamide Generic metolazone Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 36 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC succinate Generic olmesartan- Generic hydrochlorothiazide metoprolol ta- Generic hydrochlorothiaz osmitrol 15 % Generic metoprolol tartrate Generic osmitrol 20 % Generic METOPROLOL Brand PAPAVERINE Brand TARTRATE (BULK) (BULK) papaverine injection Generic MINOXIDIL Brand solution (BULK) papaverine oral Generic minoxidil oral Generic perindopril Generic moexipril Generic erbumine moexipril- Generic Generic hydrochlorothiazide PHENOXYBENZA Brand Generic MINE (BULK) NADOLOL (BULK) Brand Brand nadolol- Generic phentolamine Generic bendroflumethiazide injection recon soln nicardipine Generic Generic intravenous solution oral Generic nicardipine oral Generic Generic nifedical xl Generic PROPRANOLOL Brand NIFEDIPINE Brand (BULK) (BULK) propranolol- Generic nifedipine oral tablet Generic hydrochlorothiazid extended release quinapril Generic nifedipine oral tablet Generic quinapril- Generic extended release hydrochlorothiazide 24hr ramipril Generic nimodipine Generic REMODULIN Brand PA nisoldipine Generic reserpine Generic NYLIDRIN (BULK) Brand RESERPINE Brand olmesartan Generic (BULK) olmesartan- Generic SODIUM NITRITE Brand amlodipin-hcthiazid (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 37 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC spironolactone Generic valsartan- Generic hydrochlorothiazide SPIRONOLACTON Brand E (BULK) veletri Generic PA SPIRONOLACTON Brand verapamil Generic E MICRO (BULK) VERAPAMIL Brand spironolacton- Generic (BULK) hydrochlorothiaz Cardiac Glycosides taztia xt Generic digitek Generic telmisartan Generic digox Generic telmisartan- Generic amlodipine digoxin injection Generic telmisartan- Generic digoxin oral solution Generic hydrochlorothiazid 50 mcg/ml Generic QL digoxin oral tablet Generic Brand LANOXIN Brand MALEATE (BULK) LANOXIN Brand timolol maleate oral Generic PEDIATRIC Brand Coagulation Therapy (BULK) AMICAR Brand torsemide Generic AMINOCAPROIC Brand intravenous solution ACID (BULK) 20 mg/2 ml (10 mg/ml) aminocaproic acid Generic intravenous torsemide oral Generic aminocaproic acid Generic trandolapril Generic oral solution trandolapril- Generic aminocaproic acid Generic verapamil oral tablet 500 mg TRIAMTERENE Brand ARGATROBAN IN Brand triamterene- Generic NACL (ISO-OS) hydrochlorothiazid aspirin-dipyridamole Generic TRICHLORMETHI Brand AVITENE Brand AZIDE (BULK) TOPICAL SHEET UPTRAVI Brand 70 X 70 MM valsartan Generic bivalirudin Generic BRILINTA Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 38 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CEPROTIN (BLUE Brand heparin (porcine) Generic BAR) injection syringe 5,000 unit/ml CEPROTIN Brand (GREEN BAR) heparin flush Generic cilostazol Generic heparin Generic flush(porcine)- clopidogrel Generic 0.9nacl COAGADEX Brand heparin lock Generic COUMADIN Brand heparin lock flush Generic DICUMAROL Brand heparin lock flush Generic (BULK) (porcine) DIPYRIDAMOLE Brand intravenous syringe (BULK) 100 unit/ml dipyridamole oral Generic heparin Generic ELIQUIS Brand PA lockflush(porcine)(pf ) ENDO AVITENE Brand TOPICAL SHEET 5 heparin(porcine) in Generic MM 0.45% nacl intravenous enoxaparin Generic parenteral solution eptifibatide Generic 25,000 unit/250 ml, 25,000 unit/500 ml fondaparinux Generic heparin, porcine (pf) Generic hep flush-10 (pf) Generic injection HEPARIN Brand heparin, porcine (pf) Generic (PORCINE) intravenous solution (BULK) 100 unit/ml (1 ml) heparin (porcine) in Generic heparin, porcine (pf) Generic 5 % dex intravenous syringe heparin (porcine) in Generic 1 unit/ml, 100 nacl (pf) intravenous unit/ml parenteral solution jantoven Generic 1,000 unit/500 ml, 2,000 unit/1,000 ml MEPHYTON Brand heparin (porcine) Generic monoject prefill (pf) Generic injection cartridge monoject prefill Generic heparin (porcine) Generic advanced (pf) injection solution NPLATE Brand PA pentoxifylline Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 39 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PENTOXIFYLLINE Brand fenofibrate Generic (BULK) micronized PHYTONADIONE Brand fenofibrate Generic (BULK) nanocrystallized PRADAXA Brand PA fenofibrate oral Generic tablet protamine Generic fenofibric acid Generic PROTAMINE Brand SULFATE (BULK) fenofibric acid Generic (choline) RIASTAP Brand fluvastatin Generic QL TRANEXAMIC Brand ACID (BULK) GEMFIBROZIL Brand tranexamic acid Generic gemfibrozil oral Generic intravenous JUXTAPID Brand PA; QL vitamin k Generic lovastatin Generic QL VITAMIN K1 Brand NIACIN (BULK) Brand vitamin k1 injection Generic niacin (inositol Generic OTC warfarin Generic niacinate) oral capsule 500 mg WARFARIN Brand (BULK) niacin (inositol Generic OTC niacinate) oral tablet XARELTO Brand PA niacin (niacinamide) Generic OTC Lipid/Cholesterol Lowering Agents niacin oral capsule, Generic OTC amlodipine- Generic QL extended release atorvastatin niacin oral tablet Generic OTC atorvastatin Generic QL niacin oral tablet Generic CHOLESTYRAMI Brand extended release 24 NE (BULK) hr cholestyramine (with Generic niacin oral tablet Generic OTC sugar) extended release 250 cholestyramine light Generic mg, 500 mg, 750 mg colestipol Generic NIACINAMIDE Brand (BULK) POWDER endur-acin oral Generic OTC tablet extended niacinamide oral Generic OTC release 250 mg tablet ezetimibe Generic ST omega-3 acid ethyl Generic PA esters You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 40 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC pravastatin Generic QL Generic bitartrate-nacl prevalite Generic intravenous solution rosuvastatin Generic QL 4 mg/250 ml (16 simvastatin Generic QL mcg/ml) SIMVASTATIN Brand hcl Generic (BULK) injection slo-niacin oral tablet Generic OTC POTASSIUM Brand extended release 500 PERCHLORATE mg (BULK) VASCEPA Brand PA sodium nitroprusside Generic ZETIA Brand ST Nitrates Miscellaneous Cardiovascular ISOSORBIDE Brand (BULK) Agents isosorbide dinitrate Generic cardioplegic soln Generic oral CORLANOR Brand PA isosorbide Generic Generic mononitrate dobutamine in d5w Generic nitro-bid Generic intravenous nitroglycerin in 5 % Generic parenteral solution dextrose 1,000 mg/250 ml (4,000 mcg/ml), 250 nitroglycerin Generic mg/250 ml (1 intravenous mg/ml), 500 mg/250 nitroglycerin oral Generic ml (2,000 mcg/ml) nitroglycerin Generic in 5 % Generic sublingual dextrose nitroglycerin Generic dopamine Generic transdermal patch intravenous solution 24 hour ENTRESTO Brand PA; QL nitroglycerin Generic milrinone Generic translingual milrinone in 5 % Generic nitro-time Generic dextrose Dermatologicals/Topical Therapy norepinephrine Generic bitartrate Antipsoriatic / Antiseborrheic acitretin Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 41 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ANTHRALIN Brand thermazene Generic (BULK) Keratolytics calcipotriene Generic latrix xm Generic CALCIPOTRIENE Brand (BULK) PODOPHYLLUM Brand RESIN calcipotriene- Generic betamethasone POTASSIUM Brand HYDROXIDE calcitrene Generic (BULK) PELLET calcitriol topical Generic RESORCINOL Brand CHLOROXINE Brand (BULK) (BULK) salacyn Generic COAL TAR Brand SALICYLIC ACID Brand COAL TAR Brand (BULK) POWDER (BULK) salicylic acid er- Generic COAL TAR Brand ceramides (CRUDE) TAR salicylic acid topical Generic drithocreme hp Generic cream hydrocortisone- Generic salicylic acid topical Generic pramoxine topical cream,extended release seb-prev Generic salicylic acid topical Generic SELENIUM Brand film forming liquid SULFIDE (BULK) w/appl selenium sulfide Generic salicylic acid topical Generic topical lotion film-forming soln er selenium sulfide Generic w/ appl topical shampoo salicylic acid topical Generic 2.25 % foam sulfacetamide Generic salicylic acid topical Generic sodium topical gel Burn Therapy salicylic acid topical Generic silver sulfadiazine Generic liquid 26 % SILVER Brand salicylic acid topical Generic SULFADIAZINE lotion (BULK) salicylic acid topical Generic ssd Generic lotion,extended release

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 42 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC salicylic acid topical Generic analgesic (trolamine Generic OTC shampoo salicyl) salvax Generic analgesic creme Generic OTC SODIUM Brand analgesic grx balm Generic OTC HYDROXIDE topical ointment SODIUM Brand anti-itch Generic OTC HYDROXIDE (diphenhydramine) (BULK) PELLET anti-itch Generic OTC SULFUR (BULK) Brand (menthol/camphor) SULFUR Brand anti-itch(diphenhyd) Generic OTC SUBLIMED with zinc (BULK) arthricream rub Generic OTC Miscellaneous Dermatologicals arthritis Generic OTC absorbine pain Generic OTC arthritis pain Generic OTC relieving relief(capsaic) al 12 Generic OTC asper-flex Generic OTC ALLANTOIN Brand avo cream Generic (BULK) banophen anti-itch Generic OTC allergy cream Generic OTC (diphenhyd, zn) benadryl itch Generic OTC stopping topical gel allergy cream Generic OTC (diphenhydramin) bengay ultra Generic OTC strength topical allergy relief spray Generic OTC adhesive ALOE VERA LEAF Brand patch,medicated GEL XTR (BULK) BENZALKONIUM Brand ALUMINUM Brand CHLORIDE ACETATE (BULK) BENZOIC ACID Brand ALUMINUM Brand POWDER CHLORIDE blue gel Generic OTC (BULK) bp-50% urea Generic amlactin topical Generic OTC lotion bumm balm Generic OTC ammonium lactate Generic OTC CALAMINE Brand (BULK) AMMONIUM Brand LACTATE (BULK) cameo oil Generic OTC CAMPHOR Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 43 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CANTHARIDIN Brand COLEMAN Brand OTC (BULK) SKINSMART INSECT REP CAPSAICIN Brand COLEMAN Brand OTC capsaicin topical Generic OTC SPORTSMEN adhesive INSECT REPEL patch,medicated cool and heat Generic OTC capsaicin topical Generic OTC cream 0.025 %, 0.1 cool heat (m- Generic OTC % salicylate-menth) capsicum Generic OTC CUTTER Brand OTC BACKWOODS CAPSICUM Brand OLEORESIN CUTTER Brand OTC (BULK) BACKWOODS DRY captracin Generic CUTTER LEMON Brand OTC capzasin-hp Generic OTC EUCALYPTUS carb-o-philic topical Generic CUTTER Brand OTC cream 40 % NATURAL celacyn Generic INSECT cem-urea Generic REPELLNT CHLORHEXIDINE Brand CUTTER Brand OTC GLUCONATE NATURAL REPELLENT2 cold and hot extra Generic OTC strength CUTTER Brand OTC SKINSATIONS cold and hot pain Generic OTC relief dermacerin Generic OTC cold and hot therapy Generic OTC dermadrox topical Generic OTC balm ointment COLEMAN 100 Brand OTC dermamed Generic OTC MAX INSECT (aluminum REPEL hydroxide) COLEMAN Brand OTC dermasarra Generic OTC BOTANICALS diaper rash relief Generic OTC INSECT diaper rash topical Generic OTC COLEMAN HIGH- Brand OTC ointment DRY INSECT DICHLORACETIC Brand REPEL ACID (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 44 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC diclofenac sodium Generic PA; QL imiquimod Generic topical gel 3 % IMIQUIMOD Brand diphenhydramine hcl Generic OTC (BULK) topical INSECT Brand OTC doxepin topical Generic REPELLENT (DEET) eletone Generic INSECT Brand OTC emulsion sb Generic REPELLENT fluorouracil topical Generic (PICARIDIN) cream 5 % IODOFORM Brand fluorouracil topical Generic (BULK) solution itch relief Generic OTC FREEDOM Brand (diphenhydramine) DERMA-D itch relief topical Generic OTC geri-hydrolac Generic OTC cream gordon's vite a Generic OTC johnson's baby oil Generic OTC GUAIACOL Brand lactic acid Generic high potency Generic OTC lactic acid (bulk) Generic capsaicin lactic acid e Generic hpr Generic latrix Generic hpr plus Generic luxamend Generic hpr plus hydrogel Generic mac Generic hydrocerin (with Generic OTC mapo bath Generic OTC petrolatum) mb hydrogel Generic HYDROQUINONE Brand (BULK) mb hydrogel Generic CRYSTALS (cyclomethicone) hypercare topical Generic men-phor Generic OTC solution MENTHOL Brand ice blue gel Generic OTC menthol topical Generic OTC ice gel Generic OTC METHOXSALEN Brand ICHTHAMMOL Brand methoxsalen oral Generic (BULK) LIQUID mineral freez Generic OTC icy hot (menthol) Generic OTC topical adhesive mineral oil light Generic OTC patch,medicated topical

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 45 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC minerin topical Generic OTC pain relieving Generic OTC cream (menthol) mobisyl Generic OTC pain relieving (m- Generic OTC sal-men-cam) moisturizing Generic OTC pain relieving cream Generic OTC moisturizing cream Generic OTC PHENOL Brand MONOBENZONE Brand (BULK) PHENOL (BULK) Brand CRYSTALS MONOCHLOROA Brand CETIC ACID podofilox Generic (BULK) pr cream Generic MONSEL'S Brand PROPYLENE Brand muscle relief Generic OTC GLYCOL (BULK) muscle rub (with Generic OTC pruclair Generic camphor) prudoxin Generic muscle rub topical Generic OTC prumyx Generic cream 15-10 % prutect Generic muscle rub ultra- Generic OTC strength RADIAGEL Brand NATRAPEL Brand OTC rea lo 39 Generic nivatopic plus Generic rea lo 40 Generic nutraderm Generic OTC recedo Generic OFF ACTIVE Brand OTC REGRANEX Brand QL OFF DEEP Brand OTC remeven Generic WOODS REPEL 100 Brand OTC OFF DEEP Brand OTC REPEL FAMILY Brand OTC WOODS DRY REPEL HUNTER'S Brand OTC OFF Brand OTC FAMILYCARE REPEL Brand OTC (WITH DEET) SPORTSMEN DRY pain relief Generic REPEL Brand OTC (capsaicin) SPORTSMEN MAX pain relief (menthol) Generic OTC REPEL TICK Brand OTC DEFENSE pain relief Generic OTC (trolamine sal) risabal-ph Generic OTC pain relief cream Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 46 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC salonpas topical Generic OTC TITANIUM Brand adhesive DIOXIDE (BULK) patch,medicated POWDER SILVER NITRATE Brand TOTAL HOME Brand OTC INSECT silver nitrate Generic REPELLENT applicators tri-chlor Generic silver nitrate topical Generic TRICHLOROACET Brand SILVER PROTEIN Brand IC ACID MILD trixaicin Generic OTC sinelee topical Generic adhesive TROLAMINE Brand patch,medicated (BULK) 0.0375-5 % trolamine salicylate Generic OTC skin treatment Generic OTC tru-micin topical Generic OTC SODIUM Brand lotion HYALURONATE ultracin t Generic OTC (BULK) umecta topical foam Generic sonafine Generic UREA (BULK) Brand sp antipruritic Generic POWDER sp scar management Generic urea (with Generic sports pain relief rub Generic OTC lactic,salicy acid) sports rub pain Generic OTC urea 50% Generic relieving urea nail stick Generic sportscreme Generic OTC urea topical cream Generic TACROLIMUS Brand 39 %, 40 %, 45 %, (BULK) 47 %, 50 % tacrolimus topical Generic ST; QL urea topical foam Generic therapeutic blue Generic OTC urea topical gel Generic therapeutic Generic OTC urea topical lotion Generic moisturizing 40 %, 45 % thritex Generic OTC urea topical nail film Generic suspension tiger balm topical Generic OTC adhesive urea-hyaluronate Generic patch,medicated sodium tiger balm topical Generic OTC ure-k Generic ointment You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 47 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC UVADEX Brand amnesteem Generic VALCHLOR Brand avar topical cleanser Generic VASELINE WHITE Brand avita topical cream Generic PA PETROLEUM AZELAIC ACID Brand wal-dryl Generic OTC (BULK) FLAKES (diphenhydramine) 100 %, 88 % wal-dryl Generic OTC benzepro topical Generic OTC (diphenhydramine- foam zn) topical cream benzepro topical Generic x-viate Generic towelette ZINC OXIDE Brand BENZOYL Brand (BULK) PEROXIDE (BULK) zinc oxide topical Generic OTC ointment benzoyl peroxide Generic OTC topical cleanser 10 zostrix Generic OTC %, 3 %, 5 %, 6 %, 9 zostrix-hp Generic OTC % Therapy For Acne benzoyl peroxide Generic topical cleanser 7 % acne cleansing bar Generic OTC benzoyl peroxide Generic acne control Generic OTC topical foam cleanser benzoyl peroxide Generic OTC acne foaming wash Generic OTC topical gel 10 %, 2.5 acne medication Generic OTC %, 5 % topical gel 10 % benzoyl peroxide Generic OTC acne treatment Generic OTC topical lotion (benzoyl perox) bp Generic OTC acne vanishing Generic OTC bp 10-1 Generic acne-clear Generic OTC bp foam Generic OTC adapalene topical Generic bp wash acne Generic OTC cream treatment adapalene topical Generic bp wash topical Generic OTC gel cleanser 10 %, 5 % adapalene topical Generic bpo Generic gel with pump bpo creamy wash Generic OTC advanced exfoliating Generic OTC pack cleanser

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 48 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC bpo-10 Generic OTC persa-gel Generic OTC bpo-5 Generic OTC RETINOIC ACID Brand claravis Generic rosadan topical Generic cream claris clarifying Generic wash rosadan topical gel Generic cleansing wash Generic rosula cleansing Generic topical cleanser cloths clindacin etz topical Generic se 10-5 ss Generic swab se bpo Generic clindacin p Generic ss 10-2 Generic clindamycin Generic sss 10-5 Generic phosphate topical sulfacetamide Generic clindamycin-benzoyl Generic sodium-sulfur peroxide sulfacetamide sod- Generic clindamycin- Generic PA sulfur-urea topical tretinoin cleanser creamy acne face Generic OTC sulfacetamide- Generic ery pads Generic sulfur-cleansr23 erygel Generic sulfacleanse 8-4 Generic erythromycin with Generic sulfact na-sul- Generic ethanol avobnz-otn-ocsa erythromycin- Generic targeted acne spot Generic OTC benzoyl peroxide treatment foaming acne face Generic OTC TAZORAC Brand PA wash TRETINOIN Brand invisible acne Generic OTC tretinoin Generic PA metronidazole Generic microspheres topical tretinoin topical Generic PA myorisan Generic virti-sulf Generic neuac Generic zenatane Generic panoxyl topical bar Generic OTC zencia Generic panoxyl topical Generic OTC cleanser Topical Anesthetics panoxyl-4 Generic OTC BENZOCAINE Brand (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 49 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC BENZOCAINE Brand lidocaine hcl Generic MICRONIZED injection syringe 10 (BULK) mg/ml (1 %) bupivacaine Generic lidocaine hcl Generic laryngotracheal BUPIVACAINE Brand (BULK) lidocaine hcl mucous Generic QL membrane jelly bupivacaine (pf) Generic injection solution lidocaine hcl mucous Generic QL membrane jelly in bupivacaine- Generic applicator epinephrine lidocaine hcl mucous Generic bupivacaine- Generic membrane solution 4 epinephrine (pf) % (40 mg/ml) carbocaine (pf) Generic lidocaine hcl topical Generic injection solution 15 cream 3 % mg/ml (1.5 %) lidocaine hcl topical Generic CHLOROBUTANO Brand lotion L lidocaine hcl- Generic chloroprocaine (pf) Generic hydrocortison ac cocaine Generic topical COCAINE (BULK) Brand lidocaine topical Generic PA dermacinrx prizopak Generic adhesive patch,medicated DIBUCAINE HCL Brand (BULK) lidocaine topical Generic QL ointment DYCLONINE HCL Brand (BULK) lidocaine viscous Generic ethyl chloride Generic lidocaine- Generic epinephrine glydo Generic QL lidocaine-prilocaine Generic QL LIDOCAINE Brand topical cream (BULK) lidocaine-prilocaine Generic lidocaine (pf) Generic topical kit injection solution lido-k Generic LIDOCAINE HCL Brand (BULK) lidopin topical Generic cream 3 % lidocaine hcl Generic injection solution lidopril Generic lorenza patch Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 50 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC lta pre-attached Generic zeruvia Generic marcaine (pf) Generic Topical Antibacterials injection solution 0.75 % (7.5 mg/ml) antibiotic Generic OTC (bacitracin zinc) polocaine injection Generic solution 1 % (10 bacitracin topical Generic OTC mg/ml) bacitracin zinc Generic OTC polocaine-mpf Generic BACITRACIN ZN Brand PRILOCAINE Brand MICRONIZED(BU (BULK) LK) PROCAINE Brand bacitraycin plus Generic OTC (BULK) topical ointment 500 unit/gram provenza patch Generic dermazene Generic relador pak Generic gentamicin topical Generic relador pak plus Generic GLYCOLIC ACID Brand ropivacaine (pf) Generic injection solution GLYCOLIC ACID Brand (BULK) ROPIVACAINE Brand HCL (BULK) hydrocortisone- Generic iodoquinol-aloe sensorcaine Generic injection solution 0.5 iodoquinol-hc Generic % (5 mg/ml) lugols topical Generic sensorcaine/epineph Generic mafenide acetate Generic rine MAFENIDE Brand sensorcaine-mpf Generic ACETATE (BULK) injection solution 0.5 % (5 mg/ml) mupirocin Generic synvexia patch Generic MUPIROCIN Brand (BULK) TETRACAINE Brand (BULK) mupirocin calcium Generic TETRACAINE Brand NITROFURAZONE Brand HCL (BULK) (BULK) tetracaine hcl (pf) Generic POVIDONE- Brand injection IODINE (BULK) xylocaine dental- Generic sulfacetamide Generic epinephrine sodium (acne) SULFAMYLON Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 51 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC TRICLOSAN Brand CLOTRIMAZOLE Brand (BULK) (BULK) Topical Antifungals clotrimazole topical Generic OTC af Generic OTC clotrimazole- Generic betamethasone aloe vesta antifungal Generic OTC (micon) critic-aid clear af Generic OTC antifungal Generic OTC desenex spray Generic OTC (clotrimazole) desenex topical Generic OTC antifungal Generic OTC powder (tolnaftate) ECONAZOLE Brand antifungal cream Generic OTC econazole topical Generic antifungal spray Generic OTC foot and sneaker Generic OTC anti-fungal topical Generic OTC foot odor control Generic OTC powder formula 3 Generic OTC athlete's foot Generic OTC fungoid tincture Generic OTC athlete's foot Generic OTC topical tincture (clotrimazole) fungoid-d Generic OTC athlete's foot Generic OTC (terbinafine) inzo antifungal Generic OTC athlete's foot Generic OTC itch relief Generic OTC (tolnaftate) (clotrimazole) athletic foot cream Generic OTC jock itch Generic OTC azolen tincture Generic OTC jock itch Generic OTC (clotrimazole) baza antifungal Generic OTC jock itch Generic OTC blis-to-sol Generic OTC (terbinafine) (tolnaftate) ketoconazole topical Generic CHLOROXYLENO Brand L (BULK) ketodan Generic ciclodan Generic ketodan kit Generic ciclopirox Generic lamisil af Generic OTC CICLOPIROX Brand lamisil at topical Generic OTC OLAMINE cream ciclopirox-ure- Generic lotrimin af powder Generic OTC camph-menth-euc medi-first anti- Generic OTC fungal

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 52 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC micatin Generic OTC tolnaftate topical Generic OTC cream MICONAZOLE Brand NITRATE tolnaftate topical Generic OTC solution miconazole nitrate Generic OTC topical cream TRIACETIN Brand miconazorb af Generic OTC triple paste af Generic OTC micro-guard Generic OTC UNDECYLENIC Brand ACID (BULK) naftifine Generic zeasorb Generic OTC nuzole Generic OTC (miconazole) nyamyc Generic ZINC Brand nyata Generic UNDECYLENATE nystatin topical Generic Topical Antivirals nystatin- Generic ABREVA Brand OTC triamcinolone acyclovir topical Generic PA; QL nystop Generic ZOVIRAX Brand PA; QL odor control foot- Generic OTC TOPICAL CREAM sneaker Topical Corticosteroids oxiconazole Generic ala-cort topical Generic pedi-dri Generic cream 2.5 % podactin Generic OTC alclometasone Generic remedy antifungal Generic OTC amcinonide Generic remedy phytoplex Generic OTC anti-itch (hc) topical Generic OTC antifungal topical cream powder anti-itch (hc) topical Generic OTC ringworm Generic OTC ointment secura antifungal Generic OTC apexicon e Generic terbinafine hcl Generic OTC beta-hc Generic OTC topical BETAMETHASON Brand tinactin topical Generic OTC E DIPROPION aerosol powder (BULK) tinactin topical Generic OTC betamethasone Generic powder dipropionate tolnaftate topical Generic OTC betamethasone Generic aerosol powder valerate

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 53 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC BETAMETHASON Brand FLUOCINOLONE Brand E VALERATE ACETONIDE (BULK) (BULK) betamethasone, Generic fluocinolone and Generic augmented shower cap clobetasol Generic QL fluocinonide Generic QL CLOBETASOL Brand FLUOCINONIDE, Brand PROPIONATE MICRONIZED(BU (BULK) LK) clobetasol-emollient Generic QL fluocinonide-e Generic QL clodan Generic QL flurandrenolide Generic cormax scalp Generic QL FLUTICASONE Brand PROP, MICRO corticool Generic OTC (BULK) cortisone Generic OTC FLUTICASONE Brand (hydrocortisone) PROPIONATE cortisone + cooling Generic OTC (BULK) relief fluticasone topical Generic cortizone-10 topical Generic OTC halobetasol Generic cream propionate cortizone-10 topical Generic OTC halonate Generic gel halonate pac Generic cortizone-10 topical Generic OTC ointment HYDROCORTISO Brand NE (BULK) dermarest eczema Generic OTC (hydrocort) hydrocortisone acet- Generic aloe vera topical gel dermasilkrx sds Generic HYDROCORTISO Brand desonide Generic NE ACETATE DESONIDE, Brand (BULK) MICRONIZED hydrocortisone Generic OTC (BULK) acetate topical desoximetasone Generic cream diflorasone Generic hydrocortisone Generic OTC eczema anti-itch Generic OTC acetate topical ointment fluocinolone Generic hydrocortisone Generic butyrate

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 54 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC hydrocortisone Generic prednicarbate Generic butyr-emollient recort plus Generic OTC hydrocortisone plus Generic OTC scalacort Generic hydrocortisone Generic OTC scalp relief topical Generic OTC topical cream 0.5 %, solution 1 % scalpicin anti-itch Generic OTC hydrocortisone Generic topical cream 2.5 % soothing care Generic OTC (hydrocortisone) hydrocortisone Generic OTC topical lotion 1 % TRIAMCINOLONE Brand ACETONIDE hydrocortisone Generic (BULK) topical lotion 2.5 % triamcinolone Generic hydrocortisone Generic OTC acetonide topical topical ointment 0.5 aerosol %, 1 % triamcinolone Generic hydrocortisone Generic acetonide topical topical ointment 2.5 cream % triamcinolone Generic hydrocortisone Generic OTC acetonide topical topical packet lotion hydrocortisone Generic triamcinolone Generic valerate acetonide topical hydrocortisone-aloe Generic OTC ointment 0.025 %, vera 0.1 %, 0.5 % hydrocortisone-min Generic trianex Generic oil-wht pet triderm topical Generic hydrocream Generic OTC cream hydroskin Generic OTC Topical Enzymes hydroskin with aloe Generic OTC COLLAGENASE Brand medi-cortisone Generic OTC CLOS HIST. (BULK) MOMETASONE Brand FUROATE (BULK) SANTYL Brand mometasone topical Generic vasolex Generic neosporin anti-itch Generic OTC Topical Scabicides / Pediculicides noble formula hc Generic OTC complete lice Generic OTC topical cream treatment

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 55 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC lice bedding spray Generic OTC PHENTERMINE Brand HCL (BULK) lice complete kit 1-2- Generic OTC 3 Antidotes lice cream rinse Generic OTC acetylcysteine Generic lice killing Generic OTC intravenous lice killing Generic OTC EDETATE Brand (permethrin) DISODIUM (BULK) lice pyrinyl shampoo Generic OTC PRALIDOXIME Brand lice solution Generic OTC CHLORIDE lice treatment Generic OTC (BULK) topical liquid 1 % PROTOPAM Brand lice treatment Generic OTC CHLORIDE topical shampoo Enzymes lindane Generic BROMELAINS Brand malathion Generic (BULK) pediculicide 11 Generic OTC CHYMOTRYPSIN Brand PERMETHRIN Brand COENZYME Q10 Brand (BULK) (BULK) permethrin topical Generic Irrigating Solutions cream lactated ringers Generic permethrin topical Generic OTC irrigation liquid neomycin-polymyxin Generic pyrethrin lice Generic OTC b gu treatment m ringers irrigation Generic PYRITHIONE Brand tis-u-sol pentalyte Generic ZINC (BULK) rid complete lice Generic OTC Miscellaneous Agents elim kit topical 2-DEOXY-D- Brand rid lice killing Generic OTC GLUCOSE (BULK) spinosad Generic 2- Brand METHOXYESTRA Diagnostics / Miscellaneous Agents DIOL (BULK) Anorexiants 3,5- Brand DIIODOTHYRONI DIETHYLPROPIO Brand NE (BULK) N HCL (BULK) ACACIA (BULK) Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 56 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC acamprosate Generic BARIUM Brand SULFATE (BULK) ACD Brand BENZYL Brand acetic acid irrigation Generic ALCOHOL ACETYL-L- Brand BENZYL Brand CARNITINE BENZOATE ADAGEN Brand (BULK) ALANINE (BULK) Brand BETA 1,3 Brand ALBUMIN, Brand GLUCAN (BULK) BOVINE (BULK) BETADEX (BULK) Brand alendronate oral Generic QL BETAINE HCL Brand tablet 40 mg (BULK) ALGINIC ACID Brand BISMUTH Brand (BULK) CITRATE ALPHA LIPOIC Brand BROMHEXINE Brand ACID (BULK) Brand POWDER 100 % (BULK) ALUMINUM Brand BUPHENYL ORAL Brand CHLOROHYDRAT TABLET E (BULK) bupivacaine- Generic ALUMINUM Brand dextrose-water(pf) SULFATE (BULK) BUTYLATED Brand ammonium Generic HYDROXYTOLUE molybdate NE POWDER AMMONIUM Brand CAFFEINE (BULK) Brand SULFATE (BULK) caffeine citrate Generic anagrelide Generic CAFFEINE Brand ANISINDIONE Brand CITRATE (BULK) (BULK) CALCITRIOL- Brand ANTICOAG Brand ALMOND OIL CITRATE PHOS (BULK) DEXTROSE CALCIUM Brand ANTIMONY Brand LEVULINATE TRICHLORIDE DIHY (BULK) (BULK) CARBAGLU Brand APLIGRAF Brand ARALAST NP Brand PA

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 57 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CESIUM Brand d5 %-0.45 % sodium Generic CHLORIDE chloride (BULK) deferoxamine Generic CETYL Brand delflex-lc/1.5% Generic MYRISTOLEATE dextrose (BULK) delflex-lc/2.5% Generic cevimeline Generic dextrose CHEMET Brand delflex-lc/4.25% Generic CHLOROALLYL Brand dextrose METHENAM CL DEOXYCHOLIC Brand (BULK) ACID (BULK) CHLOROFORM Brand DESOXIMETASON Brand CHROMIUM Brand E, MICRO (BULK) PICOLINATE dex4 glucose bits Generic OTC (BULK) dex4 glucose oral Generic OTC CHRYSIN Brand gel CITRIC ACID Brand dex4 glucose oral Generic OTC (BULK) tablet,chewable citric acid Generic DEXTROSE Brand anhydrous (bulk) (BULK) POWDER CLEMIZOLE HCL Brand dextrose 10 % and Generic (BULK) 0.2 % nacl compound 347 Generic dextrose 10 % in Generic COUMARIN Brand water (d10w) CREATINE Brand dextrose 20 % in Generic MONOHYDRATE water (d20w) (BULK) dextrose 25 % in Generic cryoserv Generic water (d25w) CYSTEAMINE Brand dextrose 30 % in Generic HCL (BULK) water (d30w) d10 %-0.45 % Generic dextrose 40 % in Generic sodium chloride water (d40w) d2.5 %-0.45 % Generic dextrose 5 % in Generic sodium chloride ringers d5 % and 0.9 % Generic dextrose 5 % in Generic sodium chloride water (d5w)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 58 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC dextrose 5 %- Generic DMSA (BULK) Brand lactated ringers ENFAMIL Brand PA; OTC dextrose 5%-0.2 % Generic GLUCOSE sod chloride enfamil water Generic PA; OTC dextrose 5%-0.3 % Generic ethanol (ethyl Generic sod.chloride alcohol) dextrose 50 % in Generic ETHOXY ETHOXY Brand water (d50w) ETHANOL dextrose 70 % in Generic REAGENT water (d70w) ETHOXYDIGLYC Brand DICHLORALPHEN Brand OL (BULK) AZONE (BULK) ETHYL OLEATE Brand DIETHANOLAMIN Brand (BULK) E (BULK) etidronate disodium Generic DIETHYLENE Brand etomidate Generic GLYCOL MONOETHYL ET ETOMIDATE Brand (BULK) DIINDOLYLMETH Brand ANE (BULK) EXJADE Brand diluent for Generic FERRIC SULFATE Brand epoprostenol/flola (BULK) DIMERCAPTOPRO Brand FERRIPROX Brand PANESULFONATE forane Generic SOD formadon Generic DIMETHYL Brand SULFOXIDE formaldehyde Generic (BULK) forma-ray Generic DIMETHYLACET Brand gerber good start Generic PA; OTC AMIDE (BULK) glucose DINITROCHLORO Brand gerber good start Generic PA; OTC BENZENE (BULK) water DIPHENCYPRONE Brand gluco burst Generic OTC (BULK) GLUCOSAMINE Brand disulfiram Generic (BULK) DISULFIRAM Brand glucose Generic OTC (BULK) glucose bits Generic OTC DMPS Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 59 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC glucose gel Generic OTC isopropyl alcohol Generic OTC solution 91 %, 99 % GLUTAMINE Brand ISOPROPYL Brand GLUTARALDEHY Brand MYRISTATE DE JADENU Brand GLUTATHIONE Brand (BULK) ketamine injection Generic GLUTOL GEL Brand PA; OTC kionex Generic GLYCOSAMINOG Brand kionex (with Generic LYCANS,MIXED( sorbitol) BULK) KOJIC ACID Brand GLYCYRRHIZIC Brand L-ALANINE Brand ACID (BULK) L-CARNITINE Brand GRAMICIDIN D Brand LEUCINE Brand GRISEOFULVIN Brand (BULK) LEVOCARNITINE Brand HISTAMINE Brand levocarnitine (with Generic PHOSPHATE sugar) (BULK) levocarnitine Generic HYDRAZINE Brand intravenous SULFATE (BULK) levocarnitine oral Generic HYDROGEN Brand tablet PEROXIDE LIPOIC ACID Brand (BULK) MAGNESIUM Brand INCRELEX Brand PA ASPART DIHYD INDOLE-3- Brand (BULK) CARBINOL MALIC ACID Brand (BULK) (BULK) insta-glucose Generic OTC MECAMYLAMINE Brand IODINE (BULK) Brand HCL (BULK) GRANULES MECLOFENOXAT Brand IOPANOIC ACID Brand E HCL (BULK) (BULK) MECOBALAMIN Brand isoflurane Generic (BULK) ISOPROPYL Brand OTC MELATONIN Brand ALCOHOL (BULK) SOLUTION 50 % MENADIONE Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 60 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC MEQUINOL Brand PENTYLENETETR Brand (BULK) AZOL METHACHOLINE Brand PHENINDIONE Brand CHLORIDE (BULK) (BULK) PHENOL (BULK) Brand METHYLPARABE Brand LIQUID N (BULK) PHENYLMERCUR Brand METHYLSULFON Brand IC NITRATE YLMETHANE (BULK) (BULK) POWDER PHOSPHATIDYL Brand Generic SERINE (BULK) POWDER 40 % mineral oil heavy Generic OTC PHOSPHATIDYLC Brand mineral oil light Generic OTC HOLINE (BULK) MOLYBDENUM Brand hcl oral Generic (BULK) POTASH, Brand monoject 0.9% Generic SULFURATED sodium chloride POTASSIUM Brand monoject prefill Generic CITRATE M- advanced ns HYD(BULK) monoject prefill Generic POTASSIUM Brand saline flush SORBATE morrhuate sodium Generic PREGNENOLONE Brand MURI-LUBE Brand PREGNENOLONE, Brand N-ACETYL- Brand MICRONIZED(BU ALPHA-D- LK) GLUCOSAMINE PREZATIDE Brand NH4 Brand COPPER (BULK) TETRATHIOMOL PROLASTIN-C Brand PA; ST YBDATE (BULK) propofol intravenous Generic OCTANOIC ACID Brand emulsion (BULK) PYRUVIC ACID Brand ora-sweet Generic OTC (BULK) ORFADIN Brand QUERCETIN Brand PARACHLOROPH Brand DIHYDRATE ENOL (BULK) (BULK) PEG 3350-GRX Brand RAVICTI Brand

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 61 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC RENVELA Brand SODIUM Brand DESOXYCHOLAT resource thickenup Generic PA; OTC E (BULK) oral powder sodium ferric Generic riluzole Generic gluconat-sucrose risedronate oral Generic QL SODIUM Brand tablet 30 mg METABISULFITE ROCK CANDY Brand OTC (BULK) SEROTONIN HCL Brand GRANULES (BULK) sodium Generic sevelamer carbonate Generic phenylbutyrate sevoflurane Generic SODIUM Brand PHENYLBUTYRA similac sterilized Generic PA; OTC TE (BULK) water sodium polystyrene Generic SOD PHOS Brand sulfonate oral DIBASIC, HEPT (BULK) sodium polystyrene Generic sulfonate rectal SODIUM Brand enema 30 gram/120 ACETATE ml TRIHYDRATE GRANULES SODIUM Brand STEARYL sodium benzoate-sod Generic FUMARATE phenylacet (BULK) SODIUM Brand sodium succinate Generic BUTYRATE (BULK) SODIUM Brand SULFATE (BULK) SODIUM Brand CACODYLATE SODIUM Brand TETRADECYL sodium chloride 0.9 Generic SULF (BULK) % injection solution SODIUM Brand sodium chloride 0.9 Generic THIOSULFATE % injection syringe (BULK) sodium chloride 0.9 Generic CRYSTALS % intravenous sodium thiosulfate Generic sodium chloride Generic intravenous solution irrigation 1 gram/10 ml (100 mg/ml), 12.5 gram/50 ml (250 mg/ml) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 62 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC sojourn Generic ZINC SULFATE Brand HEPTAHYDRAT(B SOLIRIS Brand ULK) SORBIC ACID Brand zoledronic acid- Generic PA sorbitol solution 70 Generic mannitol-water % intravenous solution sps (with sorbitol) Generic Miscellaneous Devices SQUARIC ACID Brand alcohol, rubbing Generic OTC DIBUTYLEST.(BU LK) dy-o-derm Generic OTC SULFADIAZINE Brand INSTACLEAN Brand OTC SODIUM (BULK) ISOPROPYL Brand OTC syrex sodium Generic ALCOHOL chloride 0.9% SOLUTION 70 % terrell Generic Neutraceuticals THEOBROMINE Brand BOSWELLIA Brand (BULK) SERRATA XT (BULK) POWDER THYROGEN Brand 65 % TRICITRASOL Brand CHONDROITIN Brand TRIMEPRAZINE Brand SULF A SOD TARTRATE (BULK) POWDER (BULK) 100 % TRIOXSALEN Brand EPIGALLOCATEC Brand (BULK) HIN GALLATE(BULK) TRYPSIN Brand GINKGO BILOBA Brand VELTASSA Brand (BULK) water for injection, Generic MILK THISTLE Brand sterile (BULK) water for irrigation, Generic PANAX GINSENG Brand sterile ROOT (BULK) XANTHAN GUM Brand RAUWOLFIA Brand XIAFLEX Brand SERPENTINA (BULK) XURIDEN Brand Brand Pharmaceutical Adjuvants ZEMAIRA Brand PA; ST almond oil, sweet Generic (bulk)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 63 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC BITTER MELON Brand NICOTINE Brand EXTRACT (BULK) POLACRILEX (BULK) CELLULOSE Brand (BULK) POWDER nicotine transdermal Generic OTC patch 24 hour 14 ethyl acetate Generic mg/24 hr, 21 mg/24 EUCALYPTUS Brand hr, 7 mg/24 hr FLAVOR nicotine transdermal Generic OTC FLAVOR Brand PA; OTC patch, td daily, PACKETS sequential MAGNESIUM Brand NICOTROL Brand MALATE NICOTROL NS Brand PHENOLSULFONI Brand nts step 1 Generic OTC C ACID (BULK) quit 2 buccal gum Generic OTC PROPYL Brand GALLATE (BULK) QUIT 2 BUCCAL Brand OTC LOZENGE Smoking Deterrents quit 4 buccal gum Generic OTC buproban Generic QUIT 4 BUCCAL Brand OTC bupropion hcl Generic LOZENGE (smoking deter) stop smoking aid Generic OTC CHANTIX Brand CONTINUING Ear, Nose / Throat Medications MONTH BOX Miscellaneous Agents CHANTIX ORAL Brand TABLET 0.5 MG 12 hour nasal spray Generic OTC CHANTIX Brand 4 way Generic OTC STARTING afrin no Generic OTC MONTH BOX drip(oxymetazolin) NICODERM CQ Brand OTC altamist Generic OTC nicorelief Generic OTC anefrin Generic OTC NICORETTE Brand OTC anti-itch medicated Generic OTC nicotine (polacrilex) Generic OTC ayr saline nasal Generic OTC buccal gum aerosol,spray NICOTINE Brand OTC ayr saline nasal Generic OTC (POLACRILEX) drops BUCCAL LOZENGE azelastine nasal Generic QL aerosol,spray

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 64 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC azelastine nasal Generic nasal spray Generic OTC spray,non-aerosol () baby ayr saline Generic OTC nasal spray (sodium Generic OTC chloride) BACTROBAN Brand NASAL nasal spray 12 hour Generic OTC nasal mist BECLOMETHASO Brand NE DIPROP nasal spray 12 hour Generic OTC (BULK) sinus CETYLPYRIDINIU Brand nasal spray long Generic OTC M CHLORIDE acting children's saline Generic OTC nasal spray x-moist Generic OTC nasal spray natural herb Generic OTC chlorhexidine Generic no drip Generic OTC gluconate mucous membrane no drip nasal relief Generic OTC cough drops mucous Generic OTC nose drops Generic OTC membrane lozenge nrs nasal relief Generic OTC 10 mg nu way Generic OTC DEBACTEROL Brand ocean nasal Generic OTC deep sea nasal Generic OTC olopatadine nasal Generic QL dristan long lasting Generic OTC oralone Generic ephrine Generic OTC original nasal spray Generic OTC FIRST-BXN Brand oxymetazoline Generic OTC FIRST- Brand MOUTHWASH OXYMETAZOLIN Brand BLM E (BULK) ipratropium bromide Generic QL periogard Generic nasal saline mist Generic OTC little remedies Generic OTC saline nasal Generic OTC mucinex sinus-max Generic OTC saline nose Generic OTC nasal decongestant Generic OTC sea soft nasal mist Generic OTC (oxymetazl) severe congestion Generic OTC nasal four Generic OTC sinus nasal spray Generic OTC nasal moisturizing Generic OTC sinus relief Generic OTC nasal relief Generic OTC (oxymetazoline)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 65 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SODIUM Brand hydrocortisone- Generic BENZOATE acetic acid (BULK) ofloxacin otic Generic triamcinolone Generic oticin hc (bak free) Generic acetonide dental oto-end 10 Generic vicks Generic OTC qlearquil(oxymetazol otomax-hc Generic ine) otozin Generic vicks sinex 12-hour Generic OTC pramoxine-hc Generic vicks sinex ultra fine Generic OTC treagan otic Generic mist 12 wal-four Generic OTC Otic Steroid / Antibiotic XYLOMETAZOLI Brand neomycin- Generic NE (BULK) polymyxin-hc otic Miscellaneous Otic Preparations Endocrine/Diabetes acetasol hc Generic Adrenal Hormones acetic acid otic Generic ACTHAR H.P. Brand PA acetic acid- Generic a-hydrocort Generic aluminum acetate ALDOSTERONE Brand aero otic hc Generic (BULK) POWDER 97.5 % antipyrine- Generic benzocaine BETAMETHASON Brand E aurodex Generic ACET,MICRO(BUL auroguard Generic K) CARBAMIDE Brand betamethasone Generic PEROXIDE acet,sod phos (BULK) BETAMETHASON Brand ciprofloxacin hcl Generic E SOD PHOS otic (BULK) cortane-b aqueous Generic CORTICOTROPIN Brand cortane-b otic Generic cortisone Generic exotic-hc Generic CORTISONE Brand (BULK) floxin otic drops Generic cosyntropin injection Generic fluocinolone Generic acetonide oil

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 66 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC deltasone oral tablet Generic methylprednisolone Generic 20 mg sodium succ injection recon soln DESOXYCORTICO Brand 125 mg, 40 mg STERONE AC (BULK) methylprednisolone Generic sodium succ dexamethasone Generic intravenous DEXAMETHASON Brand METHYLPREDNIS Brand E AC, MICRO OLONE, MIC (BULK) (BULK) DEXAMETHASON Brand millipred dp Generic E ACETATE (BULK) millipred oral tablet Generic dexamethasone Generic PREDNISOLONE Brand intensol (BULK) DEXAMETHASON Brand PREDNISOLONE Brand E ISONIC (BULK) AC, MICRO (BULK) DEXAMETHASON Brand E SOD PHOS prednisolone oral Generic (BULK) solution 15 mg/5 ml dexamethasone Generic PREDNISOLONE Brand sodium phos (pf) SOD PHOS (BULK) dexamethasone Generic prednisolone sodium Generic sodium phosphate phosphate oral injection solution 10 mg/5 ml, 15 mg/5 ml (3 DEXAMETHASON Brand mg/ml), 20 mg/5 ml E,MICRONIZED(B (4 mg/ml), 25 mg/5 ULK) ml (5 mg/ml), 5 mg fludrocortisone Generic base/5 ml (6.7 mg/5 FLUDROCORTISO Brand ml) NE (BULK) prednisolone sodium Generic hydrocortisone oral Generic phosphate oral tablet,disintegrating METHYLPREDNIS Brand OLON PREDNISOLONE, Brand AC,MIC(BULK) MICRO (BULK) methylprednisolone Generic PREDNISONE Brand methylprednisolone Generic prednisone intensol Generic acetate

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 67 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PREDNISONE Brand 3M NEXCARE Brand OTC MICRONIZED DURAPORE (BULK) acarbose Generic prednisone oral Generic ACCU-CHEK Brand OTC TRIAMCIN Brand FASTCLIX DIACET, MICRO ACCU-CHEK Brand OTC (BULK) SAFE-T-PRO TRIAMCINOLONE Brand ACCU-CHEK Brand OTC (BULK) SAFE-T-PRO PLUS triamcinolone Generic ACCU-CHEK Brand OTC acetonide injection SOFTCLIX TRIAMCINOLONE Brand LANCETS DIACETATE ACD-A Brand (BULK) ACE AEROSOL Brand veripred 20 Generic CLOUD Antithyroid Agents ENHANCER METHIMAZOLE Brand ACETEST Brand OTC (BULK) ACTICOAT 7 Brand methimazole oral Generic DRESSING tablet 10 mg, 5 mg TOPICAL BANDAGE 4 X 5 " POTASSIUM Brand IODIDE (BULK) ACTI-LANCE Brand OTC CRYSTALS LANCETS 23 GAUGE POTASSIUM Brand IODIDE (BULK) acti-lance lancets 28 Generic OTC GRANULES gauge propylthiouracil Generic ACTIVE CATH Brand OTC PROPYLTHIOURA Brand ACTIVE LIFE 1-PC Brand OTC CIL (BULK) STOMA CAP Diabetes Therapy ACTIVE LIFE Brand OTC CONVEX 1ST TIER UNIFINE Brand OTC UROSTOMY PENTIPS NEEDLE 29 GAUGE X 1/2" ACTIVE LIFE Brand OTC CUT-TO-FIT 1ST TIER UNILET Brand OTC CLOSED COMFORTOUCH 28 GAUGE ACTIVE LIFE Brand OTC DRAINABLE POUCH You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 68 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ACTIVE LIFE Brand OTC ADHESIVE TAPE Brand OTC UROSTOMY TOPICAL TAPE 1/2 POUCH 1 3/4 " (9") X 5 "-YARD ACTOPLUS MET Brand ST; QL ADJUSTABLE Brand OTC XR LANCING DEVICE ADAPT BARRIER Brand OTC ADULT BRIEF - Brand OTC RING 1 3/16 " EXTRA LARGE ADAPT BARRIER Brand OTC ADVANCED Brand OTC STRIPS LANCING DEVICE ADAPT CONVEX Brand OTC ADVANCED Brand OTC BARRIER RINGS TRAVEL LANCETS 30 ADAPT Brand OTC GAUGE LUBRICATING DEODORANT ADVOCATE Brand OTC LANCET 30 ADAPT OSTOMY Brand OTC GAUGE PASTE ADVOCATE Brand OTC ADAPT STOMA Brand OTC LANCING DEVICE POWDER ADVOCATE PEN Brand OTC ADD-A-FOLEY Brand OTC NEEDLE NEEDLE CATH-MONO-FLO 29 GAUGE X 1/2" DRNG ADVOCATE Brand OTC ADD-A-FOLEY Brand OTC RAPID-SAFE CATH-PRE-FILL LANCING SYRN ADVOCATE Brand ADD-A-FOLEY Brand OTC SYRINGES TRAY SYRINGE 1 ML 30 ADHESIVE Brand OTC GAUGE X 5/16 BANDAGE AEROCHAMBER Brand TOPICAL PLUS FLOW-VU,S BANDAGE , 1 ", 3 MSK X 4 ", 3/4 ", 3/4 X 3 " AEROCHAMBER Brand PLUS Z STAT MD ADHESIVE Brand OTC MSK BARRIERS AEROCHAMBER Brand ADHESIVE Brand OTC WITH GAUZE PAD FLOWSIGNAL TOPICAL BANDAGE 2.375 X AEROTRACH Brand 4 " PLUS

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 69 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC AEROVENT PLUS Brand AQUACEL EXTRA Brand OTC TOPICAL AIMSCO Brand OTC BANDAGE 2 X 2 " AIRZONE PEAK Brand OTC AQUACEL FOAM Brand OTC FLOW METER TOPICAL ALCOHOL PREP Brand OTC BANDAGE 7 X 7 " PADS AQUACEL-AG Brand OTC ALCOHOL SWABS Brand OTC TOPICAL ALCOHOL WIPES Brand OTC BANDAGE 1.2-3.5 X 4 %-" ALGISITE M Brand OTC TOPICAL ARGYLE Brand BANDAGE 4 X 4 " ARGYLE TROCAR Brand OTC ALL PURPOSE Brand OTC 8 FR CLOTH TAPE ARTHRITIS Brand OTC TOPICAL TAPE 1 HEATWRAPS X 10 "-YARD ASSESS FULL Brand OTC ALLERGY Brand OTC RANGE PEAK SYRINGE METER SYRINGE 1 ML 27 ASSURA 2PC Brand OTC GAUGE, 1 ML 28 DRAINABLE GAUGE ASSURA 2PC Brand OTC ALLEVYN Brand OTC IRRIGATION TOPICAL SLEEVE BANDAGE 8 X 8 " ASSURA AC Brand OTC ALLKARE Brand OTC BASEPLATE PROTECT BARRIER WIPES ASSURA CONVEX Brand OTC SKIN BARRIER ALTERNATE SITE Brand OTC LANCET ASSURA CONVEX Brand OTC SKIN BARRIER ALTERNATE SITE Brand OTC FLA 1/2 " LANCING DEVICE ASSURA CONVEX Brand OTC AMERIGEL Brand OTC UROPOUCH DRESSING ASSURA Brand OTC ANTIBACTERIAL Brand OTC EASICLOSE MINI BANDAGES POUCH TOPICAL BANDAGE ASSURA Brand OTC EASICLOSE WIDE AQUA LANCE Brand OTC MAXI LANCING DEVICE

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 70 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ASSURA EXTRA Brand OTC ASTHMAMENTOR Brand OTC CONVEX POUCH PEAK FLOW METER ASSURA IRRIG Brand OTC FCE PLT 1/2-2 1/4 ASTHMAPACK Brand CHILDREN'S ASSURA LIGHT Brand OTC EASICLOSE ATN BRIEF Brand OTC DRAINAB ATTENDS Brand OTC ASSURA NON- Brand OTC DISPOSABLE CONVEX UNDERPADS DRAINABLE AURORA SUPER Brand OTC ASSURA OSTOMY Brand OTC THIN LANCETS BELT AUTOJECT 2 Brand OTC ASSURA Brand OTC INJECTION PEDIATRIC DEVICE POUCH AUTO-LANCET Brand OTC ASSURA Brand OTC MINI PEDIATRIC SKIN AUTOLET Brand OTC BARRIER IMPRESSION ASSURA POUCH Brand OTC LANC DEV ASSURA WOUND Brand OTC AUTOLET Brand OTC MANAGER 1/2-2 LANCING DEVICE 3/4 AUTOLET PLUS Brand OTC ASSURANCE Brand OTC LANCING DEVICE WOMENS AUTOPEN 2 TO 32 Brand OTC UNDERWEAR S-M UNITS ASSURE Brand OTC AVOGEL Brand OTC HAEMOLANCE DRESSING PLUS 1.2 MM TOPICAL ASSURE ID Brand BANDAGE 4 X 4 " INSULIN SAFETY BABY BASICS XX Brand OTC SYRINGE 1 ML 29 LARGE DIAPER GAUGE X 1/2" BABY Brand OTC ASSURE LANCE Brand OTC THERMOMETER 25 GAUGE BANDAGES Brand OTC ASSURE LANCE Brand OTC TOPICAL PLUS 21 GAUGE BANDAGE 3/4 " ASTHMA CHECK Brand OTC METER

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 71 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC BAND-AID Brand OTC BARD Brand OTC FLEXIBLE UNIVERSAL FABRIC FOLEY CATH TRAY BARD CENTER Brand OTC ENTRY CLOSE BARD URETHRAL Brand OTC SYSTEM CATHETER TRAY TRAY 16 FR BARD COUDE TIP Brand OTC CATHETER 12 FR BARDEX ALL- Brand OTC SILICONE FOLEY BARD DELUXE Brand OTC CATH 14 FR FABRIC LEG STRAPS BARDEX CLOSED Brand OTC SYSTEM CATH BARD Brand OTC TRAY EXTENSION TUBING/CONNEC BARDEX Brand OTC T URETHRAL CATHETERTRAY BARD FEMALE Brand OTC INTERMITTENT BARDIA Brand OTC CATH URINARY DRAINAGE BAG BARD INFECT Brand OTC CONT TRAY-NO BASAGLAR Brand CATH KWIKPEN BARD INFECTION Brand OTC BASAL Brand OTC CONTROL BAG THERMOMETER, ELECTRONIC BARD LATEX LEG Brand OTC STRAPS BASICS FOR KIDS Brand OTC BARD LEG BAG Brand OTC BD ALCOHOL Brand OTC HOLDER SWABS BARD LEG BAG Brand OTC BD LANCET Brand OTC STRAPS/FABRIC DEVICE BARD Brand OTC BD MAGNI-GUIDE Brand OTC LUBRICATH SYRINGE FOLEY TRAY MAGNIFI BARD PLASTIC Brand OTC BD Brand OTC TUBING/ADAPTE MICROTAINER R LANCET 30 GAUGE BARD RUBBER Brand OTC UTILITY BD ULTRA FINE Brand OTC CATHETER 8 FR LANCETS

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 72 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC BEDSIDE Brand OTC BLOOD Brand OTC DRAINAGE PRESSURE TEST COLLECT SYSTM KIT-MEDIUM BELTED SHIELDS Brand OTC BORDERED Brand OTC GAUZE TOPICAL BELTED Brand OTC BANDAGE 4 X 4 " UNDERGARMENT S BOXERS FOR Brand OTC MEN BELTLESS Brand OTC UNDERGARMENT BREATHERITE Brand S VALVED MDI CHAMBER BEN-E-FIT BRIEFS Brand OTC BREEZERS Brand OTC BIATAIN Brand OTC ADULT BRIEF ADHESIVE FOAM DRESSING BRIEFS, ADULT- Brand OTC TOPICAL EXTRA LARGE BANDAGE 7 X 7 " BULLSEYE MINI Brand OTC BIOBRANE Brand OTC SAFETY GLOVES MEDIUM LANCETS 21 GAUGE BLADDER Brand OTC CONTROL PAD BURNS-SCALDS- Brand OTC ABRASIONS BLADDER Brand OTC CONTROL PADS BUTTERFLY Brand OTC FOR WOMEN CLOSURES BLENDERM Brand OTC BYDUREON Brand PA; QL SURGICAL BYETTA Brand PA; QL TOPICAL TAPE 1/2 X 5 "-YARD CALALGIN-GRX Brand OTC DRESSING BLISTER CARE Brand OTC TOPICAL BLISTER RELIEF Brand OTC BANDAGE 2 X 2 " BANDAGES CALLUS Brand OTC BLOOD Brand OTC CUSHION PRESSURE KIT CALLUS PADS Brand OTC BLOOD Brand OTC CAMO Brand OTC PRESSURE KIT BANDAGES MED AND LRG CANE Brand OTC BLOOD Brand OTC PRESSURE TEST CAREFINE PEN Brand OTC KIT-LARGE NEEDLE NEEDLE 31 GAUGE X 1/4" You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 73 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CAREONE THIN Brand OTC CENTERPOINTLO Brand OTC LANCET CK STOMA IRRIGAT 1 3/4 " CARETOUCH Brand OTC LANCING DEVICE CENTERPOINTLO Brand OTC CK UROSTOMY CARETOUCH PEN Brand OTC POUCH 1 1/2 ", 1 NEEDLE NEEDLE 3/4 " 31 GAUGE X 3/16" CERTAINTY Brand OTC CARETOUCH Brand OTC REGULAR TWIST LANCET CHEK-STIX Brand OTC; QL CARRASYN Brand CONTROL HYDROGEL WOUND DRESS CHEMO Brand OTC TRANSFER PIN CAYA Brand CONTOURED CHEMSTRIP 10 Brand OTC; QL MD CENTERPOINTLO Brand OTC CK CLOSED CHEMSTRIP 10/SG Brand OTC; QL POUCH 1 3/4 " CHEMSTRIP 2 GP Brand OTC; QL CENTERPOINTLO Brand OTC CHEMSTRIP 50B Brand OTC; QL CK DRAIN FILTER 1 3/4 ", 2 3/4 " CHEMSTRIP 7 Brand OTC; QL CENTERPOINTLO Brand OTC CHEMSTRIP 9 Brand OTC; QL CK DRAINABLE CHEMSTRIP K Brand OTC; QL MINI 1 3/4 " CLEAR Brand OTC CENTERPOINTLO Brand OTC BANDAGES CK DRAINABLE POUC 1 3/4 " CLEAR STRIPS Brand OTC TOPICAL CENTERPOINTLO Brand OTC BANDAGE CK FLEXTEND SKIN 1 1/4 " CLEAR Brand OTC WATERPROOF CENTERPOINTLO Brand OTC STRIPS TOPICAL CK FLEXWEAR BANDAGE 1 " CONVE 1/2 " CLEVER CHEK Brand OTC CENTERPOINTLO Brand OTC LANCETS CK SOFTFLEX SKIN 1 3/4 " CLEVER CHOICE Brand CHAMBER-LRG CENTERPOINTLO Brand OTC MASK CK STOMA CAP 1 3/4 "

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 74 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CLICKFINE Brand OTC COMFEEL PLUS Brand OTC NEEDLE 31 ULCER DRESSING GAUGE X 1/4" TOPICAL BANDAGE 4 X 4 " CLINITEST Brand OTC REAGENT COMFEEL Brand OTC PURILON CLOSED-END Brand OTC POUCH COMFEEL Brand OTC SEASORB CLOTH FIRST AID Brand OTC TOPICAL TAPE BANDAGE 4 X 4 " CLOTH TAPE Brand OTC COMFEEL ULCER Brand OTC COAGUCHEK Brand OTC CARE DRESSING LANCETS TOPICAL COBAN SELF- Brand OTC BANDAGE 4 X 4 " ADHERENT COMFORT EZ PEN Brand OTC WRAP TOPICAL NEEDLES BANDAGE 1 X 5 "- NEEDLE 31 YARD GAUGE X 5/16" COLOPLAST Brand OTC COMFORT Brand OTC BARRIER RING LANCETS 3/8 " COMFORT- Brand OTC COLOPLAST Brand OTC STRETCH IRRIGATION SET TRAINING PANTS KIT COMPACT SPACE Brand COLOPLAST Brand OTC CHAMBER PASTE PASTE CONDOMS-PREM Brand OTC COLOPLAST SKIN Brand OTC LUBRICATED BARRIER WAFER CONFORM Brand OTC 4 X 4 " TOPICAL COLOR LANCETS Brand OTC BANDAGE 1 X 5 "- COMBIDERM Brand OTC YARD ACD DRESSING CONTOUR I Brand OTC TOPICAL STOMA CAP BANDAGE 5 1/4 X CONVATEC Brand OTC 5 1/4 " NIGHT COMBINE ABD Brand OTC DRAINAGE COMBISTIX Brand OTC; QL TUBING REAGENT CONVEEN DRIP Brand OTC COLLECTOR

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 75 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC COOL MIST Brand OTC CURITY 8000 Brand OTC HUMIDIFIER 1 URINE MTR FLY GALLON TRAY TRAY 16 FR COOLMAGIC Brand OTC CURITY Brand OTC TOPICAL ABDOMINAL PAD BANDAGE 6 X 8 " TOPICAL BANDAGE 5 X 9 " COPA Brand OTC HYDROPHILIC CURITY Brand OTC FOAM ALCOHOL SWABS CORN CUSHION Brand OTC CURITY BEDSIDE Brand OTC DRAINAGE BAG COSMETIC BALLS Brand OTC CURITY BEDSIDE Brand OTC COSMETIC PUFFS Brand OTC DRAINAGE SET COTTON BALLS Brand OTC CURITY Brand OTC COTTON SNAP Brand OTC BEDSIDE-MONO- PANTS FLO DRANGE COTTON Brand OTC CURITY COVER Brand OTC SQUARES TOPICAL SPONGE COTTON SWABS Brand OTC 4 X 4 " COTTON, Brand OTC CURITY FOLEY Brand OTC STERILE CATHETER KIT CPL DRAINABLE Brand OTC CURITY Brand POUCH 1 3/4 ", 2 IODOFORM 3/4 " PACKING STRIP TOPICAL CRUTCH Brand OTC BANDAGE 1/4 X 5 CRUTCH TIPS Brand OTC "-YARD CURASOL Brand OTC CURITY Brand OTC HYDROGEL PREMIUM DRESSING CATHETER TRAY TRAY 16 FR CURASOL Brand OTC WOUND CURITY Brand OTC DRESSING ULTRAMER 2- WAY CATHETER CURI-STRIP Brand OTC 16 FR WOUND CLOSURES CURITY Brand OTC TOPICAL STRIP UNIVERSAL - NO 1/8 X 3 " DRAINAGE TRAY 16 FR

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 76 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC CURITY Brand OTC DELUXE ARM Brand OTC URETERAL BLOOD DRAIN SET PRESSURE MON CURITY URETH Brand OTC DELUXE Brand OTC CATH CLOSED INSTANT EAR SYSTM THERMOMETER CURITY URETH Brand OTC DEPEND Brand OTC CATH OPEN PROTECTION SZ SYSTEM S-M CURITY Brand OTC DEPEND REAL Brand OTC URETHRAL FIT BRIEF MEN S- CATHETER M CURITY URINE Brand OTC DEPEND Brand OTC METER SILHOUETTE WOMEN S/M CUTIEPANTS Brand OTC TRAINING PANTS DEPEND Brand OTC UNDERWEAR CUTIES BABY Brand OTC FOR WOMEN S-M DIAPERS DERMACEA NON- Brand OTC CYTOSAFE Brand OTC WOVEN TOPICAL DISPENSING PIN SPONGE 4 X 4 " DAVOL Brand OTC DERMACEA Brand OTC COMPLETE STRETCH FOLEY TOPICAL DAVOL FOLEY Brand OTC BANDAGE 2 X 4 "- CATH INSERT YARD TRAY DERMACEA Brand OTC DAVOL Brand OTC TOPICAL IRRIGATION BANDAGE 3.4 X SYRINGE 3.6 "-YARD DAVOL SILICONE Brand OTC DERMADRESS Brand OTC FOLEY TOPICAL CATHETER 16 FR BANDAGE 4 X 4 " DAVOL URINARY Brand OTC DERMAGAUZE Brand OTC DRAINAGE BAG DERMAGINATE Brand OTC DAY AND NIGHT Brand OTC TOPICAL BRIEF,MEDIUM BANDAGE 4 X 4 " DAY, PLUS PAD Brand OTC DERMAGRAN Brand OTC HYDROGEL DRESSING You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 77 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC DERMALEVIN Brand OTC DIAZOXIDE Brand TOPICAL (BULK) BANDAGE 4 X 4 " DIGITAL Brand OTC DERMASYN Brand OTC THERMOMETER TOPICAL GEL DISPOSABLE Brand OTC DIAPERS, UNISEX Brand OTC BRIEF SIZE 3 DISPOSABLE Brand OTC DIAPERS-DISP- Brand OTC GLOVES POLYETHYLENE PACKAGE BACK DISPOSABLE Brand OTC DIASCREEN 10 Brand OTC; QL LATEX-FREE GLOVES DIASCREEN 1B Brand OTC; QL REAGENT DISPOZ-A-BAG Brand OTC LEG BAG SMALL DIASCREEN 1G Brand OTC; QL REAGENT DOVER Brand OTC CATHETER DIASCREEN 1K Brand OTC; QL REAGENT DOVER COATED Brand LATEX FOLEY DIASCREEN 2GK Brand OTC; QL REAGENT DOVER Brand OTC PEDIATRIC DIASCREEN 2GP Brand OTC; QL URINE METER DIASCREEN 3 Brand OTC; QL DOVER TEXAS Brand OTC REAGENT MALE EXTERNAL DIASCREEN 4NL Brand OTC; QL CATH REAGENT DOVER URI- Brand OTC DIASCREEN 4OBL Brand OTC; QL DRAIN DELUXE REAGENT LEG BAG DIASCREEN 4PH Brand OTC; QL DOVER URI- Brand OTC DIASCREEN 5 Brand OTC; QL DRAIN MALE EXT REAGENT CATH DIASCREEN 7 Brand OTC; QL DOVER URINARY Brand OTC REAGENT LEG BAG DIASCREEN 8 Brand OTC; QL DRAINABLE Brand OTC REAGENT FECAL COLLECTOR DIASCREEN 9 Brand OTC; QL REAGENT DRAINABLE Brand OTC POUCH CLAMP DIASTIX Brand OTC; QL

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 78 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC DRAINABLE Brand OTC EAKIN COHESIVE Brand OTC POUCH CLOSURE SLIMS DROPLET Brand OTC EAKIN COHESIVE Brand OTC LANCETS WAFER 4 X 4 " DROPLET Brand OTC EASIVENT Brand LANCING DEVICE HOLDING CHAMBER DROPLET PEN Brand OTC NEEDLE NEEDLE EASY CLICK Brand OTC 29 GAUGE X 3/8" LANCING DEVICE DRY COMFORT Brand OTC EASY COMFORT Brand INSULIN DRY COMFORT Brand OTC SYRINGE EXTRA BRIEFS SYRINGE 1 ML 30 DUODERM CGF Brand OTC GAUGE X 5/16 DRESSING EASY COMFORT Brand OTC TOPICAL LANCETS BANDAGE 6 X 8 " EASY COMFORT Brand OTC DUODERM CGF Brand OTC PEN NEEDLES EXTRA THIN NEEDLE 31 TOPICAL GAUGE X 3/16" BANDAGE 6 X 6 " EASY MINI EJECT Brand OTC DUODERM Brand OTC LANCING DEVICE HYDROACTIVE TOPICAL PASTE EASY TOUCH Brand OTC ALCOHOL PREP DUOLOCK Brand OTC PADS CURVED TAIL CLOSURE EASY TOUCH Brand OTC FLIPLOCK DURAHESIVE Brand OTC SYRINGE MOLDABLE SYRINGE 1 ML 26 CONVEX GAUGE X 3/8" DURAPORE Brand OTC EASY TOUCH Brand OTC SURGICAL FLURINGE TOPICAL TAPE 1/2 FLIPLOCK X 10 "-YARD SYRINGE 1 ML 25 DURASORB Brand OTC GAUGE X 5/8" UNDERPAD PAD EASY TOUCH Brand OTC 23 X 24 " FLURINGE EAKIN COHESIVE Brand OTC SHEATHLOCK SEALS SYRINGE 1 ML 25 GAUGE X 1"

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 79 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC EASY TOUCH Brand OTC ELIMINATOR Brand OTC FLURINGE ODOR SPRAY SYRINGE 1 ML 25 EMBRACE Brand OTC GAUGE X 5/8" LANCETS EASY TOUCH Brand ENTRUST PLUS Brand OTC INSULIN SAFETY SUPER SYR SYRINGE 0.5 UNDERPADS ML 29 GAUGE X 1/2" ENTRUST PLUS Brand OTC UNDERGARMENT EASY TOUCH Brand S INSULIN SYRINGE ENTRUST PLUS Brand OTC SYRINGE 1 ML 31 UNDERWEAR GAUGE X 5/16 ESTEEM Brand OTC EASY TOUCH Brand OTC DRAINABLE LANCING DEVICE POUCH 13/16-2 3/4 " (12") EASY TOUCH Brand OTC TUBERCULIN ESTEEM Brand OTC FLIPLOCK SYNERGY SYRINGE 1 ML 26 ESTEEM Brand OTC GAUGE X 5/8" SYNERGY EASY TOUCH Brand OTC CLOSED POUCH 1 TUBERCULIN 3/8 " SHEATHLK ESTEEM Brand OTC SYRINGE 1 ML 25 SYNERGY GAUGE X 5/8" DRAINABLE ELASTIC Brand OTC POUCH 1 3/8 " BANDAGE (12") TOPICAL EXACTA-MED Brand OTC BANDAGE 3 " ENTERAL ELASTO-GEL Brand OTC DISPENSER CAST-SPLINT EXCEL SYRINGE Brand OTC PADDING TOPICAL EXCILON Brand OTC BANDAGE 12 X 12 TOPICAL SPONGE " 4 X 4 " ELASTO-GEL Brand OTC EXEL Brand CIRCLE HYPODERMIC DRESSING NEEDLES NEEDLE 27 ELASTO-GEL Brand OTC GAUGE X 1/2" FACE DRESSING

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 80 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC EXTENSION Brand OTC FEMALE Brand OTC TUBING W- URINARY POUCH CONNECTOR FEMCAP Brand EXTERNAL Brand OTC VAGINAL DEVICE CATHETER, 22 MM MALE 31 MM TO FEVER FLASH Brand OTC 35 MM THERMOMETER EXUDERM RCD Brand OTC FIFTY50 SAFETY Brand OTC TOPICAL SEAL LANCETS 30 BANDAGE 6 X 6 " GAUGE EXUDERM SATIN Brand OTC FILTER CLOSED Brand OTC DRESSING MINI-POUCH 1 " TOPICAL BANDAGE 4 X 4 " FILTRODOR Brand OTC POUCH FILTER EXUDERM Brand OTC ULTRA FINE 30 Brand OTC UNIVERSAL EXU-DRY Brand OTC LANCETS WOUND DRESSING FINGERSTIX Brand OTC TOPICAL LANCETS BANDAGE 2 X 3 ", FIRST AID CLOTH Brand OTC 4 X 6 " TAPE EYE PAD Brand OTC FIRST AID HURT- Brand OTC EYE PATCH Brand OTC FREE WRAP e-z ject lancets 26 Generic OTC FIRST AID PAPER Brand OTC gauge TAPE EZ SMART Brand OTC FIRST CHOICE Brand OTC LANCETS LANCETS THIN E-Z SPACER Brand FITTED BRIEFS Brand OTC MEDIUM FABRIC STRIP Brand OTC EXTRA LARGE FLEXIBLE Brand OTC FABRIC FANTASY Brand OTC BANDAGES FAST READ Brand OTC TOPICAL THERMOMETER BANDAGE 2 X 3 ", 3/4 X 3 " FC2 FEMALE Brand OTC CONDOM FLEXIBLE FOAM Brand OTC FECAL Brand OTC FLEXICHAMBER Brand COLLECTOR

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 81 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC FLEXIFLO Brand OTC FREESTYLE Brand OTC FEEDING TUBE CONTROL FLEXIFLO Brand OTC FREESTYLE Brand OTC GRAVITY FLASH SYSTEM FEEDING SET FREESTYLE Brand OTC FLEXIFLO Brand FREEDOM QUANTUM PUMP FREESTYLE Brand OTC SET FREEDOM LITE FLEXIFLO TOP- Brand OTC FREESTYLE Brand OTC FILL BAG INSULINX FLEXIFLO/PREAT Brand OTC FREESTYLE Brand OTC; QL TACHED INSULINX STRIP FLEXI-SEAL FMS Brand OTC FREESTYLE Brand OTC; QL FLEXI-TRAK Brand OTC INSULINX TEST ANCHORING STRIPS DEVICE FREESTYLE Brand OTC FLEXTEND SKIN Brand OTC LANCETS BARRIER WAFER FREESTYLE LITE Brand OTC 4 X 4 " METER FLEXZAN Brand OTC FREESTYLE LITE Brand OTC; QL WOUND STRIPS DRESSING TOPICAL FREESTYLE Brand BANDAGE 2 X 3 " NAVIGATOR GLUC SENS FLOW-EZE Brand VENTED NEEDLE FREESTYLE Brand PRECISION FOLEY Brand OTC SYRINGE 1 ML 30 CATHETER 14 FR GAUGE X 5/16 FOLEY Brand OTC FREESTYLE Brand OTC CATHETER TRAY SIDEKICK II TRAY 16 FR FREESTYLE Brand OTC FORA LANCING Brand OTC SYSTEM KIT DEVICE FREESTYLE TEST Brand OTC; QL FOREHEAD Brand OTC THERMOMETER FREESTYLE Brand OTC UNISTIK 2 FOUNTAIN Brand OTC SYRINGE

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 82 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC GAUZE Brand OTC GLUCOSOURCE Brand OTC BANDAGE GLYBURIDE Brand TOPICAL BANDAGE , 2 X glyburide Generic 2.5 "-YARD, 3 X micronized 147 ", 4 1/2 X 4 "- glyburide oral Generic YARD, 4 X 4 " glyburide-metformin Generic gauze roll Generic OTC GMATE LANCETS Brand OTC GEL CORN Brand OTC PROTECTORS GMATE LANCING Brand OTC DEVICE GEL TOE Brand OTC PROTECTOR GOODNITES TRU- Brand OTC FIT LINERS GEL TOE Brand OTC SPACERS GOODNITES Brand OTC UNDERPANTS GELPAD TOPICAL Brand OTC SMALL-MED BANDAGE 4 X 4 " GRX WOUND GEL Brand OTC GENTLE TAPE Brand OTC TOPICAL GUARD MALE Brand OTC BANDAGE 1 X 2.2 GUARDS FOR Brand OTC "-YARD MEN GENTLECATH 12- Brand OTC HANDICARE Brand OTC 16 FR-" GARMENT LINER glimepiride Generic HARMONIE Brand OTC glipizide Generic UNDERPAD GLIPIZIDE (BULK) Brand HEALTHMIST Brand OTC glipizide-metformin Generic HEALTHY Brand OTC ACCENTS GLUCAGEN Brand AUTOLET HYPOKIT HEALTHY Brand OTC GLUCAGON Brand ACCENTS EMERGENCY KIT UNIFINE PENTIP (HUMAN) NEEDLE 29 GLUCOCOM Brand OTC GAUGE X 1/2" LANCETS 28 HEALTHY Brand OTC GAUGE, 33 ACCENTS UNILET GAUGE LANCET GLUCOLET 2 Brand OTC HEARING AID Brand OTC AUTOMATIC BATTERIES LANCING

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 83 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC HEAT THERAPY Brand OTC HUMAPEN Brand LUXURA HD HEATING PADS Brand OTC HUMIDIFIERS Brand OTC heatwraps back and Generic OTC hip pads HUMULIN 70/30 Brand HEAVY DUTY Brand OTC HUMULIN 70/30 Brand FABRIC STRIPS PEN HEMA- Brand OTC; QL HUMULIN N Brand COMBISTIX HUMULIN N PEN Brand HOLLIHESIVE Brand OTC HUMULIN R U-100 Brand SKIN BARRIER HUMULIN R U-500 Brand HOLLISTER Brand OTC (CONC) KWIKPEN REPLACEMENT FILTERS HUMULIN R U-500 Brand (CONCENTRATED huber safety needles Generic ) (disp.) HURRICAINE Brand OTC HUGGIES LITTLE Brand OTC LUER-LOCK DIS MOVERS CAP HUGGIES LITTLE Brand OTC HYDROCOL II Brand OTC SNUGGLERS HYDROCOLLOID Brand OTC HUGGIES Brand OTC DRESSING OVERNITES TOPICAL HUGGIES PURE Brand OTC BANDAGE 4 X 4 " AND NATURAL HYPO- Brand OTC SIZE5 ALLERGENIC HUGO ROLLING Brand OTC BANDAGES WALKER HYPOLANCE AST Brand OTC HUMALOG Brand LANCING HUMALOG Brand ILE-SORB Brand OTC KWIKPEN ORIGINAL HUMALOG MIX Brand INCARE INVIEW Brand OTC 50-50 CATHETER 36 MM HUMALOG MIX Brand IN-CHECK NASAL Brand OTC 50-50 KWIKPEN WITH MASK HUMALOG MIX Brand IN-CHECK ORAL Brand OTC 75-25 FLOW METER HUMALOG MIX Brand INCONTROL BP Brand OTC 75-25 KWIKPEN MONITOR You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 84 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC INCONTROL Brand OTC IRRIGATION Brand OTC LANCING DEVICE SLEEVE INCONTROL PEN Brand OTC IV PREP WIPES Brand OTC NEEDLE NEEDLE J AND J NON- Brand OTC 29 GAUGE X 1/2" STICK PADS INCONTROL Brand OTC MEDIUM SUPER THIN JANUMET Brand ST; QL LANCETS JANUMET XR Brand ST; QL INCONTROL Brand OTC ULTRA THIN JANUVIA Brand ST; QL LANCETS KALTOSTAT Brand OTC INJECT EASE Brand OTC FORTEX LANCETS 28 KALTOSTAT Brand OTC GAUGE ROPE INJECT-EASE Brand OTC KANGAROO Brand OTC INJECT-EASE Brand OTC BURETTE/PUMP AUTOMATIC SET INJECTOR KANGAROO Brand OTC INS Brand ENTERAL-FEED- SYRINGE/NEEDLE IRRIG KT 0.5 ML 27 G KANGAROO Brand OTC INSPIRACHAMBE Brand EPUMP SET R KANGAROO EZ Brand OTC INSTANT EAR Brand OTC CAP BAG THERMOMETER KANGAROO Brand OTC insulin syringe- Generic FEEDING TUBE needle u-100 syringe 10-36 FR-" 1 ml 30 gauge x 3/8" KANGAROO Brand OTC INSULIN Brand GRAVITY SET SYRINGES KANGAROO Brand OTC (DISPOSABLE) PUMP INSUPEN NEEDLE Brand OTC EXTENSION SET 29 GAUGE X 1/2" KANGAROO Brand OTC INVACARE Brand OTC RIGID LANCETS CONTAINER PUMP INVOKAMET Brand ST; QL KARAYA 5 Brand OTC INVOKANA Brand ST; QL CLOSED POUCH - TAPE 1 1/2 " You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 85 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC KARAYA 5 Brand OTC KINNEY BRAND Brand OTC DRAINABLE LANCETS POUCH 1 " KLING ROLLS Brand OTC KARAYA PASTE Brand OTC LABSTIX Brand OTC; QL KARAYA Brand OTC REAGENT POWDER LAMB'S WOOL Brand OTC KENDALL PAPER Brand OTC LANCETS , 30 Brand OTC TAPE GAUGE KENDALL Brand OTC LANCETS,THIN , Brand OTC TOPICAL GEL 28 GAUGE KENGUARD Brand OTC LANCING DEVICE Brand OTC URINARY DRAIN BAG LANCING Brand OTC SYSTEM KENLINE ADD-A- Brand OTC FOLEY TRAY LANZO LANCING Brand OTC 30CC DEVICE KERLIX TOPICAL Brand OTC LIFESHIELD Brand SPONGE BLUNT CANNULA NEEDLE KETO-DIASTIX Brand OTC; QL LINEN FRESH Brand OTC KETONE URINE Brand OTC; QL TEST LISCO TOPICAL Brand OTC SPONGE 2 X 2 " KETOSTIX Brand OTC; QL LITE TOUCH Brand OTC KID PANTS FOR Brand OTC LANCING DEVICE GIRLS LITEAIRE MDI Brand KIMONO Brand OTC CHAMBER CONDOMS(NON- LUBRICATED) LITETOUCH- Brand SMALL MASK KIMONO MAXX Brand OTC CONDOMS LITTLE Brand OTC DARLINGS 2T-3T KIMONO Brand OTC MICROTHIN LITTLE ONES Brand OTC AQUA LUBE CON CLOSED-END POUCH 1 1/4 " KIMONO Brand OTC MICROTHIN LITTLE ONES Brand OTC CONDOMS DRAINABLE POUCH , 1 3/4 " KIMONO Brand OTC TEXTURED CONDOMS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 86 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC LITTLE ONES Brand OTC MAXICARE Brand OTC FLEXIBLE SKIN 1 BELTED 1/4 " UNDERGARMENT LITTLE ONES Brand OTC MAXICARE Brand OTC SKIN BARRIER UNDERPADS PAD 30 X 30 " LITTLE ONES Brand OTC UROSTOMY MAXI-COMFORT Brand POUCH INSULIN SYRINGE LOOP OSTOMY Brand OTC SYRINGE 1/2 ML BRIDGE STERILE 28 GAUGE X 1/2" LO-PROFILE Brand OTC MEDICAL Brand OTC UROSTOMY ADHESIVE POUCH 1 " MEDIHONEY Brand OTC LUER LOCK Brand OTC (CAL ALGINATE- SYRINGE HONEY) TOPICAL SYRINGE 30 ML BANDAGE 2 X 2 " LUVS SIZE 6 Brand OTC MEDI-LANCE Brand OTC M9 CLEANER- Brand OTC LANCETS DECRYSTALLIZE MEDIPORE Brand OTC R MEDIPORE H Brand OTC MAGELLAN Brand TOPICAL TAPE 3 INSULIN SAFETY X 10 "-YARD SYRNG SYRINGE 1 ML 29 GAUGE X MEDISENSE THIN Brand OTC 1/2" LANCETS MAGELLAN Brand MEDLANCE PLUS Brand OTC SYRINGE LANCETS 25 SYRINGE 0.5 ML GAUGE 30 GAUGE X 5/16", MEDLANCE PLUS Brand OTC 1 ML 27 GAUGE X SPECIAL BLADE 1/2" MEDTRONIC Brand OTC MAGNA-PORT Brand OTC REMOTE GASTROSTOMY CONTROL TUBE 26 FR MESH PANTS Brand OTC MASTISOL Brand OTC LIQUID METFORMIN Brand ADHESIVE (BULK) MASTISOL Brand OTC metformin oral Generic STERTIP LIQUID tablet

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 87 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC metformin oral Generic MINI ULTRA- Brand OTC tablet extended THIN II release 24 hr MINIMED QUICK- Brand OTC metformin oral Generic ST SERTER-MMT 395 tablet extended MIRASORB Brand OTC release 24hr MONOJECT Brand OTC metformin oral Generic ST ALLERGY TRAY tablet,er DETACH gast.retention 24 hr MONOJECT Brand OTC MICRO THIN Brand OTC ALLERGY TRAY LANCETS TRAY 0.5 ML 28 X MICROCHAMBER Brand 1/2", 1 ML 28 X 1/2" MICRODERM 1 " Brand OTC MONOJECT Brand MICRODERM Brand OTC BLOOD PLUS 1 " COLLECTION MICROFOAM Brand OTC NEEDLE 20 SURGICAL GAUGE X 1" TOPICAL TAPE 1 MONOJECT Brand OTC X 5 1/2 "-YARD BLUNT MICROHESIVE Brand OTC CANNULAS STOMA PASTE NEEDLE 15 MICROLET Brand OTC GAUGE X 1 1/2" LANCET MONOJECT Brand MICROLIFE PEAK Brand OTC CONTROL FLOW METER SYRINGE LUER MICROPORE Brand OTC MONOJECT Brand SURGICAL FILTER NEEDLE TOPICAL TAPE 1/2 MONOJECT Brand X 10 "-YARD HYPODERMIC MICROSPACER Brand NEEDLES NEEDLE 18 MICROSPONGE Brand OTC GAUGE X 1" miglitol Generic MONOJECT Brand MINI LANCING Brand OTC INSULIN DEVICE SYRINGE SYRINGE 1 ML MINI TRANSFER Brand OTC PIN

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 88 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC MONOJECT Brand MOUTHPIECE Brand OTC MAGELLAN MPM FOAM Brand OTC SYRINGE DRESSING SYRINGE 1 ML 25 TOPICAL GAUGE X 1", 3 ML BANDAGE 4 X 4 " 20 GAUGE X 1" MULTI-DRAW Brand MONOJECT Brand NEEDLE NEEDLE MEDICATION 20 GAUGE X 1" TRANSF NDL MULTI-LANCET Brand OTC MONOJECT Brand DEVICE PHARMACY TRAY REG TIP MULTISTIX Brand OTC; QL MONOJECT REG Brand OTC MULTISTIX 10 SG Brand OTC; QL TIP NON-STERILE MULTISTIX 5 Brand OTC; QL SYRINGE 12 ML MULTISTIX 7 Brand OTC; QL MONOJECT Brand OTC SAFETY MULTISTIX 8 SG Brand OTC; QL SYRINGES MULTISTIX 9 Brand OTC; QL SYRINGE 3 ML 21 GAUGE X 1" MULTISTIX 9 SG Brand OTC; QL MONOJECT Brand OTC MYGLUCOHEALT Brand OTC SYRINGE H LANCETS CATHETER nateglinide Generic MONOJECT Brand OTC NATURA CLOSED Brand OTC SYRINGE LUER POUCH 1 1/4 " LOK SYRINGE 35 ML NATURA Brand OTC DRAINABLE MONOJECT Brand OTC POUCH 1 3/4 " SYRINGE (12") REGULAR LUER NATURA Brand OTC MONOJECT TB Brand OTC DURAHESIVE MONOJECT TB Brand SKIN BARRIER 1 LUER LOK 3/4 " MONOJECT TIP Brand OTC NATURA Brand OTC CAPS/FLEX/LUER STOMAHESIVE SKN BARRIER 1 MONOLET Brand OTC 3/4 " LANCETS NATURAL CARE Brand OTC MONOLET THIN Brand OTC BANDAGES LANCETS

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 89 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC NEEDLES, HUBER Brand NEXCARE Brand OTC DISPOSABLE GENTLE PAPER TAPE NEOTHRIVE Brand OTC SYRINGE 60 ML NIGHT DRAIN Brand OTC ADAPTER NESSI SPACER Brand OTC NITRILE EXAM Brand OTC NEW Brand OTC GLOVES GENERATION NON-ADHERENT Brand OTC NEW IMAGE Brand OTC BANDAGE CLOSED MINI- TOPICAL POUCH 1 3/4 " BANDAGE 2 X 3 " NEW IMAGE Brand OTC NON-STICK PAD Brand OTC CLOSED POUCH 2 TOPICAL 1/4 ", 2 3/4 " BANDAGE 3 X 4 " NEW IMAGE Brand OTC NO-STING SKIN- Brand OTC DRAIN MINI- PREP POUCH 1 3/4 " NOVA SAFETY Brand OTC NEW IMAGE Brand OTC LANCETS 28 DRAINABLE GAUGE POUCH 1 3/4 " NOVA SUREFLEX Brand OTC NEW IMAGE Brand OTC LANCETS FLEXTEND BARRIER FLA 1 NOVAMAX PLUS Brand OTC; QL 3/4 " KETONE NEW IMAGE Brand OTC NOVOFINE 32 Brand OTC FLEXWEAR FLAT NOVOFINE Brand OTC 1 3/4 " AUTOCOVER NEW IMAGE Brand OTC NOVOFINE PLUS Brand OTC IRRIGATOR SLEEVE 1 3/4 " NOVOLOG Brand FLEXPEN NEW IMAGE Brand OTC OSTOMY KIT 2 1/4 NOVOLOG MIX Brand " (12 ") 70-30 NEW IMAGE SKIN Brand OTC NOVOLOG MIX Brand BARRIER- 70-30 FLEXPEN FLANGE NOVOPEN 3 Brand OTC NEW IMAGE Brand OTC PENMATE UROSTOMY NOVOPEN JR Brand OTC POUCH 1 3/4 " (9")

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 90 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC NOVOTWIST Brand OTC ONETOUCH Brand OTC NEEDLE 30 ULTRASOFT GAUGE X 1/3" LANCETS NU-FIT BRIEF Brand OTC ONETOUCH Brand OTC; QL MEDIUM VERIO NUTRIPORT Brand ONETOUCH Brand OTC BALLOON VERIO IQ METER O.A.D. Brand OTC ONETOUCH Brand OTC VERIO MID ON CALL LANCET Brand OTC CONTROL ON CALL Brand OTC ONETOUCH Brand OTC LANCING DEVICE VERIO SYNC ON CALL PLUS Brand OTC ON-THE-GO Brand OTC LANCET LANCETS ON CALL PLUS Brand OTC OPTICHAMBER Brand LANCING DEVICE ADULT MASK- ONE WAY Brand OTC LARGE VALVED OPTICHAMBER Brand MOUTHPIECE DIAMOND VHC ONETOUCH Brand OTC OPTICLUDE EYE Brand OTC DELICA LANCETS PATCH JUNIOR 30 GAUGE OPTIFOAM Brand OTC ONETOUCH Brand OTC TOPICAL FINEPOINT BANDAGE 4 X 4 " LANCETS OPTIONS LINERS Brand OTC ONETOUCH Brand OTC SURESOFT OPTIONS PADS Brand OTC LANCING DEV OPTIONS ULTRA Brand OTC ONETOUCH Brand OTC THINS ULTRA CONTROL ORAL Brand OTC ONETOUCH Brand OTC; QL THERMOMETER ULTRA TEST ORTHO Brand ONETOUCH Brand OTC DIAPHRAGM ULTRA2 ALL-FLEX 65 ONETOUCH Brand OTC OSTOMY BELT Brand OTC ULTRALINK LARGE ONETOUCH Brand OTC OSTOMY PASTE Brand OTC ULTRAMINI

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 91 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC OSTOMY Brand OTC PENTIPS NEEDLE Brand OTC SUPPLIES 29 GAUGE X 1/2" OVER NITES Brand OTC PER-FIT BRIEFS Brand OTC OVERNIGHT Brand OTC PER-FIT Brand OTC UNDERWEAR UNDERWEAR SMALL-MED PERSONAL BEST Brand OTC PAIN FREE TAPE Brand OTC FULL RANGE PAIN FREE WRAP Brand OTC PERSONAL Brand OTC CONFIDENCE PAMPERS UNISEX Brand OTC BRIEFS BABY-DRY personal confidence Generic OTC PANDA MASK Brand OTC liners PANT LINERS, Brand OTC PERSONAL Brand OTC LARGE CONFIDENCE PANT LINERS, Brand OTC PADS LARGE PLUS PERSONAL Brand OTC PANTY LINERS Brand OTC CONFIDENCE PANTY SHIELDS Brand OTC UNDERWEAR PAPER TAPE Brand OTC PETROLATUM Brand OTC GAUZE TOPICAL PARAGARD T Brand BANDAGE 3 X 18 380A " PATROL PUMP Brand PIKO 1 Brand OTC SET pioglitazone Generic QL PEAK AIR PEAK Brand OTC FLOW METER pioglitazone- Generic QL glimepiride PEDIATRIC Brand OTC PANDA MASK pioglitazone- Generic QL metformin PEDIATRIC Brand OTC SMALL MASK PLASTIC STRIPS Brand OTC TOPICAL PEN NEEDLE Brand OTC BANDAGE 3/4 X 3 NEEDLE 29 " GAUGE X 1/2" PLASTIC SWABS Brand OTC PEN NEEDLE, Brand OTC DIABETIC POCKET Brand NEEDLE 29 CHAMBER GAUGE X 1/2" POCKET PEAK Brand OTC FLOW METER

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 92 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC POISE PADS Brand OTC PREMIER Brand OTC DRAINABLE POISE Brand OTC MINI-POUCH 2 1/2 PANTILINERS " (9") POLY HUB Brand PREMIER Brand OTC NEEDLE NEEDLE DRAINABLE 18 GAUGE X 1" POUCH 2 1/2 " POUCH CLAMP Brand OTC PREMIER LOCK N Brand OTC POUCHKINS Brand OTC ROLL 1 " DRAINABLE PREMIER Brand OTC POUCH 2 " UROSTOMY POUCHKINS Brand OTC POUCH 1 " OSTOMY SYSTEM PREMIUM BABY Brand OTC POUCHKINS PED Brand OTC DIAPERS OSTOMY BELT PREMIUM Brand OTC POUCHKINS SKIN Brand OTC COMFORT- BARRIER STRETCH POUCHKINS Brand OTC PREMIUM Brand OTC UROSTOMY DRAINABLE POUCH POUCH/KARAYA PRECISION 200 Brand OTC 1 " CATHETER TRAY PREMIUM Brand OTC PRECISION PCX Brand OTC; QL NITRILE GLOVES PLUS TEST PREMIUM SKIN Brand OTC PRECISION PCX Brand OTC; QL BARRIER TEST PREMIUM Brand OTC PRECISION POINT Brand OTC; QL TRAINING PANTS OF CARE TEST PRESSURE Brand OTC PRECISION Q-I-D Brand OTC; QL ACTIVATED TEST LANCETS 21 GAUGE PRECISION XTRA Brand OTC MONITOR PREVAIL ADJUST Brand OTC UNDERWEAR SM- PRECISION XTRA Brand OTC; QL MD TEST PREVAIL Brand OTC PREMIER CLOSED Brand OTC BLADDER MINI-POUCH 5/8-2 CONTROL PAD 1/8 " (7")

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 93 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PREVAIL Brand OTC PREVAIL Brand OTC BLADDER PAD PURSEREADY EXTRA PREVAIL SIMPLY Brand OTC PREVAIL BOXERS Brand OTC STRETCH FIT PREVAIL Brand OTC PREVAIL Brand OTC BREEZERS 360 SMOOTH FIT PREVAIL BRIEF Brand OTC PREVAIL Brand OTC BARIATRIC STRETCH FIT PREVAIL BRIEF Brand OTC PREVAIL SUPER Brand OTC EXTRA LARGE PLUS PREVAIL Brand OTC PREVAIL Brand OTC CLASSIC FIT UNDERWEAR UNDERWEAR PRIMEAIRE Brand PREVAIL CURVE Brand OTC PRO COMFORT Brand OTC PREVAIL EXTRA Brand OTC LANCET 30 UNDERWEAR GAUGE PREVAIL FULL Brand OTC PRO COMFORT Brand OTC COVERAGE PEN NEEDLE UNDRWEAR NEEDLE 32 GAUGE X 1/4" PREVAIL Brand OTC GUARDS FOR PRO SPORTS Brand OTC MEN TAPE PREVAIL MALE Brand OTC PROBE COVERS Brand OTC GUARD PROCARE Brand OTC PREVAIL PADS Brand OTC PROTECTIVE UNDERWEAR PREVAIL PANT Brand OTC LINER PROCHAMBER Brand PREVAIL PANTY Brand OTC PRODIGY COUNT- Brand OTC LINER A-DOSE PREVAIL PER-FIT Brand OTC PRODIGY Brand INSULIN PREVAIL PER-FIT Brand OTC SYRINGE 360 SYRINGE 1 ML 28 PREVAIL PM Brand OTC GAUGE X 1/2" BRIEF MEDIUM PRODIGY Brand OTC PREVAIL Brand OTC LANCETS 26 PROTECTIVE GAUGE UNDERWEAR

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 94 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PRODIGY Brand OTC relion glucose Generic OTC LANCING DEVICE RELION NEEDLES Brand OTC PRODIGY TWIST Brand OTC RELION PEN Brand OTC TOP LANCET NEEDLES PROGLYCEM Brand RELION THIN Brand OTC PROTECTIVE Brand OTC LANCETS BARRIER FILM RELION ULTRA Brand OTC WIPES THIN PLUS PROTECTIVE Brand OTC LANCETS PADS RENEW Brand OTC PROTECTIVE Brand OTC ADVANCED UNDERWEAR MICRO-LANCETS SMALL-MED repaglinide Generic PURE COTTON Brand OTC repaglinide- Generic QL PURPLE NITRILE Brand OTC metformin GLOVES RESTON MEDIUM Brand OTC PURSEREADY Brand OTC SUPPORT PAD UNDERWEAR RESTORE Brand OTC FOR WOMEN CALCIUM Q-TIPS/SINGLE- Brand OTC ALGINATE TIP APPLICATOR TOPICAL BANDAGE 2 X 2 " QUICK READ Brand OTC DIGITAL RESTORE EXTRA Brand OTC THERMOMETER THIN DRESSING TOPICAL QUICK RESPONSE Brand OTC BANDAGE 4 X 4 " BP MONITOR- LARG RESTORE FOAM Brand DRESSING RECTAL Brand OTC SILVER TOPICAL THERMOMETER BANDAGE 4 X 4 " RELIAMED Brand OTC RESTORE Brand OTC LANCET 28 HYDROGEL GAUGE GAUZE RELIAMED MINI Brand OTC RESTORE Brand OTC LANCING DEVICE HYDROGEL RELIAMED Brand OTC GAUZE SPONGE SAFETY SEAL RESTORE TRIO Brand OTC LANCETS 28 TOPICAL GAUGE BANDAGE 4 X 5 " You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 95 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC RETRACTED Brand OTC scar treatment Generic OTC PENIS POUCH topical sheet 1.5 x 2.75 " RIGHTEST GD500 Brand OTC LANCING DEVICE SCAR Brand OTC TREATMENT RIGHTEST GL300 Brand OTC TOPICAL SHEET LANCETS 1.5 X 3 " RIOMET Brand ST SELECT BRIEFS Brand OTC RITEFLO Brand SELECT Brand OTC AEROCHAMBER DISPOSABLE ROB-NEL Brand OTC BRIEFS URETHRAL SELECT KIDS Brand OTC CATHETER 10-16 BRIEFS FR-" SELECT Brand OTC ROLLED Brand OTC UNDERPADS ABSORBENT COTTON SELECT Brand OTC UNDERWEAR RONDIC Brand OTC SELF ADHERENT Brand OTC SAFE-CLIP Brand OTC WRAP TOPICAL NEEDLE BANDAGE 1 X 2.2 STORAGE DEV "-YARD SAFESNAP Brand SELF-ADHERING Brand OTC INSULIN BANDAGE SYRINGE TOPICAL SYRINGE 0.3 ML BANDAGE 3 " 30 GAUGE X 5/16" SELF-CATHETER, Brand SAFESNAP Brand OTC FEMALE 14 FR SYRINGE SYRINGE 3 ML SELF-CATHETER, Brand OTC FEMALE 8 FR SAFETY Brand OTC LANCETS 21 SELFGRIP Brand OTC GAUGE TOPICAL BANDAGE 4 " SAFETY SEAL Brand OTC LANCETS 28 SELF-GRIP Brand OTC GAUGE TOPICAL TAPE SAFETY-LET Brand OTC SELF-TAKING Brand OTC LANCETS BLOOD PRESSURE SAF-GEL Brand OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 96 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SENSURA Brand OTC SKIN GEL Brand OTC EASICLOSE WIDE PROTECT OUTLET DRESSING WIPE SERENITY TENA Brand OTC SKIN PREP WIPES Brand OTC PADS SKINTEGRITY Brand OTC SHEER BANDAGE Brand OTC HYDROGEL TOPICAL SLEEP Brand OTC BANDAGE COMFORTS SHEER STRIPS Brand OTC SLEEP OVERS Brand OTC ASSORTED PANTS SHIELDS Brand OTC SLEEP PANTS Brand OTC SIDESTREAM Brand OTC SLIP-ON Brand OTC PEDIATRIC FACE UNDERGARMENT MASK SMART SENSE Brand OTC SILICONE MASK - Brand LANCETS 26 INFANT GAUGE, 33 SIL-SERTER Brand OTC GAUGE SILVASORB Brand OTC SMARTDIABETES Brand OTC CAVITY VANTAGE SILVASORB Brand OTC SMARTEST Brand OTC DRESSING LANCET TOPICAL SOF-SET Brand OTC BANDAGE 2 X 2 " ADHESIVE SIMPLICITY Brand OTC PATCH ADULT FLAT SOFT CLOTH Brand OTC FOLD XL TOPICAL SIMPLICITY Brand OTC BANDAGE 2.375 X ADULT POLY 4 " MEDIUM SOFT TOUCH Brand OTC SIMPLICITY Brand OTC LANCETS CONTOURED SOFTFLEX SKIN Brand OTC LINER BARRIER RING SIMPLICITY PAD Brand OTC SOFT-SERTER Brand OTC SINGLE-LET Brand OTC INFUSION PUMP ATT SKIN CLOSURE Brand OTC STRIPS TOPICAL SOFT-TIP Brand OTC STRIP THERMOMETER

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 97 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SOLOSITE Brand OTC STOMAHESIVE Brand OTC WOUND GEL PROTECTIVE SOLUS V2 Brand OTC STOMAHESIVE Brand OTC LANCETS SKIN BARRIER , 1 3/4 " SOLUS V2 Brand OTC LANCING DEVICE STRATASORB Brand OTC COMPOSITE SORBSAN Brand OTC WOUND TOPICAL WOUND BANDAGE 4 X 14 DRESSING " SORESPOT Brand OTC STRETCH GAUZE Brand OTC SPORTS TAPE Brand OTC BANDAGE STA-PUT Brand OTC TOPICAL UNDERPAD BANDAGE 2 X 4.1 "-YARD STERILANCE TL Brand OTC 30 GAUGE STRONG STRIPS Brand OTC TOPICAL STERILE NITRILE Brand OTC BANDAGE 1 X 3 " GLOVE SUPER STRIP Brand OTC STERILE PADS Brand OTC BANDAGES TOPICAL BANDAGE 2 X 2 " SUPER THIN Brand OTC LANCETS 30 STERILE TWO- Brand GAUGE FER NEEDLE NEEDLE 16 X 1/2 " SUPREME Brand OTC DIAPERS SIZE 6 STERI-STRIP Brand OTC DRESSING SURE CARE Brand OTC PROTECTIVE STERI-STRIP SKIN Brand OTC UNDERWEAR CLOSURES TOPICAL STRIP SURE COMFORT Brand OTC 1/8 X 3 " ALCOHOL PREP PADS STOMA CAP- Brand OTC ADHESIVE- SURE COMFORT Brand OTC FILTER LANCETS 28 GAUGE STOMA CONE- Brand OTC CONNECTOR SURE COMFORT Brand OTC REPL UNIT LANCING PEN STOMA Brand OTC SURE COMFORT Brand OTC LUBRICANT PEN NEEDLE NEEDLE 29 GAUGE X 1/2" You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 98 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SURECARE PAD Brand OTC SUR-FIT NATURA Brand OTC 17 X 24 " DRAINABLE POUCH 1 1/4 " SURECHOICE Brand OTC BLADDER SUR-FIT NATURA Brand OTC CONTROL DURAHESIVE 4 " SURECHOICE Brand OTC SUR-FIT NATURA Brand OTC PANTILINER FLANGE CAP SURE-FINE PEN Brand OTC SUR-FIT NATURA Brand OTC NEEDLES HIGH OUTPUT 1 NEEDLE 29 3/4 ", 2 3/4 " GAUGE X 1/2" SUR-FIT NATURA Brand OTC SUREFLEX Brand OTC IRRIG LANCING DEVICE FACEPLATE 1 3/4 " SURE-JECT Brand INSULIN SUR-FIT NATURA Brand OTC SYRINGE LOW-PRESSURE SYRINGE 1 ML 28 SUR-FIT NATURA Brand OTC GAUGE X 1/2" MINI-POUCH 1 1/4 SURE-LANCE 28 Brand OTC ", 2 1/4 " GAUGE SUR-FIT NATURA Brand OTC SURE-PEN Brand OTC STOMAHESIVE 1 LANCING DEVICE 1/4 " SURE-PREP Brand OTC SUR-FIT NATURA Brand OTC ALCOHOL PREP UROSTOMY PADS POUCH 1 1/4 " SUREPRESS HIGH Brand OTC SUR-FIT-ACTIVE Brand OTC COMPRESSION LIFE TAIL CLOS SURE-TOUCH Brand OTC SURGICAL Brand OTC LANCET DRESSING EXTR PROTCT SUR-FIT NATURA Brand OTC ADAPTOR SURGUARD2 Brand SAFETY NEEDLE SUR-FIT NATURA Brand OTC 18 GAUGE X 1" CLOSED POUCH 1 1/2 " SYMLINPEN 120 Brand PA; QL SUR-FIT NATURA Brand OTC SYMLINPEN 60 Brand PA; QL CONVEX INSERTS SYRINGE WITH Brand OTC 3/4 " NEEDLE SYRINGE 1 ML 25 GAUGE X 1" You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 99 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC TECHLITE Brand OTC TENA SERENITY Brand OTC LANCETS 25 TENA STRETCH Brand OTC GAUGE ULTRA TECHLITE PEN Brand OTC TENDERSORB Brand OTC NEEDLE NEEDLE UNDERPAD PAD 32 GAUGE X 5/32" TENDERWRAP Brand OTC TEGADERM Brand OTC UNNA BOOT HYDROCOLLOID THIN TOPICAL TENSOR TOPICAL Brand OTC BANDAGE 4 X 4 BANDAGE 2 X 5 "- 3/4 " YARD TEGADERM Brand OTC TERUMO Brand OTC HYDROCOLLOID ALLERGY TOPICAL SYRINGE BANDAGE 4 X 4 TERUMO Brand OTC 3/4 " HYPODERMIC TEGAGEN HG Brand OTC NEEDLE/SYRIN TOPICAL SYRINGE 5 ML 21 BANDAGE 4 X 4 " GAUGE X 1 1/2" TEGAGEN HI Brand OTC TERUMO INSULIN Brand TOPICAL SYRINGE BANDAGE 4 X 4 " SYRINGE 0.3 ML 30 X 3/8" TELCARE Brand OTC LANCETS TERUMO Brand OTC SYRINGE TELFA AMD Brand OTC SYRINGE 3 ML 23 TELFA CLEAR Brand OTC X 1" WOUND THERMACARE Brand OTC DRESSING KNEE/ELBOW TOPICAL BANDAGE 3 X 3 " THERMOMETER Brand OTC COVERS TELFA Brand OTC OUCHLESS NON- THERMOMETER Brand OTC ADHERENT PROBE COVERS TOPICAL THERMOPHORE Brand OTC BANDAGE 4 X 3 " MAXHEAT TENA PANTS Brand OTC THERMOPHORE Brand OTC SUPER LARGE PACK STANDARD TENA Brand OTC THERMOSCAN Brand OTC PROTECTIVE THERMOMETER UNDERWEAR

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 100 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC thinpro insulin Generic TRUEPLUS Brand syringe syringe 0.3 INSULIN ml 29 gauge x 1/2" SYRINGE 1/2 ML 28 GAUGE X 1/2" THINPRO Brand INSULIN TRUEPLUS Brand OTC; QL SYRINGE KETONE SYRINGE 0.3 ML TRUEPLUS Brand OTC 31 X 3/8" LANCETS 28 tolazamide Generic GAUGE tolbutamide Generic TRUEPLUS PEN Brand OTC NEEDLE NEEDLE TOOMEY Brand 29 GAUGE X 1/2" SYRINGE TRUSTEX Brand OTC TOOTHETTE Brand OTC LUBRICATED TOPCARE ULTRA Brand CONDOMS COMFORT TRUSTEX-RIA Brand OTC SYRINGE 0.3 ML LUB/SPERMICIDE 29 GAUGE X 1/2" TRUZONE PEAK Brand TOPCARE Brand OTC FLOW METER UNIVERSAL1 LANCET TUBERCULIN Brand OTC SYRINGE TOUCH-TROL Brand SYRINGE 1 ML, 1 TRAINING PANTS Brand OTC ML 27 X 1/2" 2T-3T TUBERCULIN- Brand OTC TRANQUILITY Brand OTC ALLERGY PREMIUM SYRINGES UNDERWEAR TUGABOOS Brand OTC TRANQUILITY Brand OTC DIAPERS TOPLINER PADS TUGABOOS Brand OTC TRANSFER PIN Brand OTC OVERNIGHTS TRANSPORE Brand OTC TUGABOOS Brand OTC SURGICAL TRAINING PANTS TOPICAL TAPE 1/2 ULTICARE Brand X 10 "-YARD INSULIN TRUEDRAW Brand OTC SYRINGE LANCING DEVICE SYRINGE 1 ML 31 GAUGE X 1/4"

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 101 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ULTICARE Brand ULTRALANCE Brand OTC SYRINGE 1 ML 30 LANCETS 26 GAUGE X 1/2" GAUGE ULTI-LANCE KIT Brand OTC ULTRA-LIGHT Brand OTC ROLLATOR ULTILET Brand OTC ALCOHOL SWAB ULTRA-SOFT Brand OTC GLOVES ULTILET BASIC Brand OTC LANCETS ULTRA-THIN II Brand INSULIN ULTILET CLASSIC Brand OTC SYRINGE LANCETS SYRINGE 0.5 ML ULTILET INSULIN Brand 29 GAUGE X 1/2" SYRINGE UNDERGARMENT Brand OTC SYRINGE 1 ML 29 EXTRA GAUGE ABSORBENT ULTILET Brand OTC UNDERJAMS Brand OTC LANCETS 28 SMALL-MEDIUM GAUGE UNDERPADS PAD Brand OTC ULTILET PEN Brand OTC , 30 X 36 " NEEDLE NEEDLE 29 GAUGE UNDERPADS Brand OTC REGULAR PAD ULTILET SAFETY Brand OTC LANCETS UNDERWEAR Brand OTC ultra comfort insulin Generic UNDERWEAR Brand OTC syringe syringe 1 ml FOR MEN 28 gauge UNIFINE PENTIPS Brand OTC ULTRA COMFORT Brand NEEDLE 29 INSULIN GAUGE X 1/2" SYRINGE UNIFINE PENTIPS Brand OTC SYRINGE 1/2 ML PLUS NEEDLE 31 28 GAUGE X 1/2" GAUGE X 5/16" ULTRA THIN Brand OTC UNIGARD Brand OTC LANCETS 28 INCONTINENT GAUGE PAD ULTRA THIN Brand OTC UNILET Brand OTC PLUS LANCETS COMFORTOUCH ULTRA TLC Brand OTC LANCET 26 LANCETS GAUGE ULTRA-FLEX Brand OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 102 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC UNILET Brand OTC URISTIX Brand OTC; QL EXCELITE II REAGENT LANCET URO MINICAP Brand OTC UNILET Brand OTC UROCARE Brand OTC EXCELITE URINARY DRAIN LANCET BOTTLE UNILET GP Brand OTC UROSTOMY Brand OTC LANCET DRAIN TUBE UNILET LANCET Brand OTC ADAPTER 28 GAUGE UROSTOMY Brand OTC UNISTIK 2 Brand OTC MICRO-POUCH DEVICE UROSTOMY Brand OTC UNISTIK 3 Brand OTC MULTI-CHAMBER POUCH UNISTIK 3 EXTRA Brand OTC LANCET UROSTOMY Brand OTC NIGHT BAG UNISTIK CZT Brand OTC LANCET 23 UROSTOMY Brand OTC GAUGE POUCH 1 3/4 " (9") UNISTIK SAFETY Brand OTC VANISHPOINT Brand OTC 30 GAUGE TUBERCULIN SYRINGE UNISTIK TOUCH Brand OTC SYRINGE 1 ML 27 LANCETS 23 X 1/2" GAUGE VAPORIZER Brand OTC UNIVERSAL 1 Brand OTC INHALANT LANCETS 26 GAUGE VAPORIZERS Brand OTC UNNA-FLEX Brand OTC VASELINE Brand OTC ELASTIC UNNA PETROLATUM BOOT TOPICAL GAUZE TOPICAL BANDAGE 3 X 10 BANDAGE "-YARD VENTED Brand OTC UP AND UP BABY Brand OTC URINARY LEG DIAPER BAG URETHRAL Brand OTC VERSALON Brand OTC CATHETER TOPICAL SPONGE 2 X 2 " URINARY LEG Brand OTC MEDIUM BAG VERSIVA XC Brand OTC TOPICAL URISTIX 4 Brand OTC; QL BANDAGE 3 X 3 " You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 103 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC VGO 20 Brand VORTEX Brand HOLDING VGO 30 Brand CHAMBER VGO 40 Brand VORTEX VHC Brand VICKS DIGITAL Brand OTC FROG MASK- THERMOMETER CHILD VICKS Brand OTC VORTEX VHC Brand HUMIDIFIER LADYBUG MASK- VICKS WARM Brand OTC TODDLR MIST WARM STEAM Brand OTC HUMIDIFIER VAPORIZER VIGILON Brand OTC WATCHHALER Brand PRIMARY WATER BOTTLE- Brand OTC WOUND FOUNTAIN DRESSING SYRINGE TOPICAL BANDAGE 4 X 4 " WATER SHIELD Brand OTC BANDAGES VINYL Brand OTC CATHETER 14-6 WATERPROOF Brand OTC FR-" STRONG STRIPS VINYL GLOVES Brand OTC WEBCOL Brand OTC VISI-FLOW Brand OTC WELL Brand OTC IRRIGATION BEGINNINGS SLEEVE 1 1/2 " DIAPERS VISI-FLOW Brand OTC WELL Brand OTC IRRIGATION BEGINNINGS STARTER 45 MM SLEEP PANTS VISI-FLOW Brand OTC WELL Brand OTC IRRIGATOR- BEGINNINGS STOMA CONE TRAINING PANTS VISI-FLOW Brand OTC WINGS CHOICE Brand OTC SLEEVE TAIL ADULT BRIEF CLOSURES WINGS CHOICE Brand OTC VISI-FLOW Brand OTC PLUS ADULT STOMA CONE BRIEFS VISTEC X-RAY Brand OTC WINGS CHOICE Brand OTC DETECT TOPICAL PLUS YOUTH SPONGE 4 X 4 " BRIEFS

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 104 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC WINGS CLASSIC Brand OTC 7-KETO DHEA Brand ADULT BRIEFS ALDURAZYME Brand WINGS CLASSIC Brand OTC androxy Generic ADULT BRIEFS X- L Generic QL WINGS FLUFF Brand OTC calcitonin (salmon) Generic AND POLYMER calcitriol Generic WINGS MAXIMA Brand OTC intravenous solution UNDERPADS 1 mcg/ml WINGS Brand OTC calcitriol oral Generic UNDERPAD CERDELGA Brand WINGS XXL Brand OTC CHOR Brand ADULT BRIEF GONADOTROPIN, WOMEN'S Brand OTC HUM (BULK) ADVANCED BP CLOMIPHENE Brand MONITOR CITRATE (BULK) WOMEN'S Brand OTC DANAZOL Brand UNDERWEAR danazol oral Generic WONDERPANTS Brand OTC DEHYDROEPIAN Brand WOUND Brand OTC DROSTERONE DRAINAGE (MICRO) COLLECTOR DESMOPRESSIN Brand WOUN'DRES Brand OTC HYDROGEL desmopressin Generic WOUND DRESS injection XEROFLO GAUZE Brand OTC desmopressin nasal Generic DRESSING solution TOPICAL desmopressin nasal Generic BANDAGE 2 X 2 " spray,non-aerosol XEROFORM Brand desmopressin oral Generic XEROFORM Brand doxercalciferol Generic PETROLATUM OVERWRAP ELAPRASE Brand TOPICAL ELELYSO Brand ST BANDAGE 1 X 8 " FABRAZYME Brand Y-PORT Brand OTC CONNECTOR FLUOXYMESTER Brand ONE (BULK) Miscellaneous Hormones

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 105 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC fortical Generic STIMATE Brand KANUMA Brand STRENSIQ Brand KUVAN ORAL Brand PA TESTOPEL Brand PA TABLET,SOLUBL TESTOSTERONE Brand E (BULK) LUMIZYME Brand TESTOSTERONE Brand METHITEST Brand CYP, MICRO (BULK) METHYLTESTOST Brand ERONE (BULK) TESTOSTERONE Brand CYPIONATE methyltestosterone Generic (BULK) oral capsule TESTOSTERONE Brand METHYLTESTOST Brand ENANTHATE ERONE,MICRO(B (BULK) ULK) TESTOSTERONE Brand MYOZYME Brand MICRONIZED NAGLAZYME Brand (BULK) NANDROLONE Brand TESTOSTERONE Brand DECANOATE PROPIONATE (BULK) (BULK) NATPARA Brand PA testosterone Generic PA oxandrolone Generic transdermal gel in metered-dose pump OXANDROLONE Brand 12.5 mg/ 1.25 gram (BULK) (1 %) pamidronate Generic testosterone Generic PA paricalcitol Generic transdermal gel in intravenous packet paricalcitol oral Generic TETRAHYDROBIO Brand PTERIN DI-HCL SAMSCA Brand PA; QL vasopressin Generic SENSIPAR Brand PA VPRIV Brand SOMAVERT Brand ZAVESCA Brand STANOZOLOL Brand (BULK) zoledronic acid Generic STANOZOLOL Brand ZOMETA Brand MICRONIZED INTRAVENOUS (BULK) SOLUTION 4 MG/100 ML You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 106 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC Thyroid Hormones unithroid Generic ARMOUR Brand westhroid oral tablet Generic THYROID 130 mg, 16.25 mg, 195 mg, 32.5 mg, LEVOTHYROXINE Brand 48.75 mg, 65 mg, (BULK) 97.5 mg levothyroxine Generic intravenous recon Gastroenterology soln 200 mcg, 500 Antidiarrheals / Antispasmodics mcg anaspaz Generic levothyroxine oral Generic anti-diarrhea Generic OTC levoxyl oral tablet Generic 100 mcg, 112 mcg, anti-diarrheal Generic OTC 125 mcg, 137 mcg, anti-diarrheal Generic OTC 150 mcg, 175 mcg, (loperamide) oral 200 mcg, 25 mcg, 50 capsule mcg, 75 mcg, 88 mcg anti-diarrheal Generic OTC liothyronine Generic (loperamide) oral LIOTHYRONINE Brand liquid 1 mg/5 ml (BULK) anti-diarrheal Generic OTC nature-throid Generic (loperamide) oral tablet np thyroid Generic injection Generic PCCA T3 SODIUM Brand solution DILUTION atropine injection Generic PCCA T4 SODIUM Brand syringe 0.05 mg/ml, DILUTION 0.1 mg/ml PROTIRELIN Brand ATTAPULGITE Brand (BULK) b-donna Generic SYNTHROID Brand BELLADONNA Brand THYROID (BULK) Brand ALK LEAF EXT THYROID, PORK Brand (BULK) (BULK) belladonna Generic PA THYROLAR-1 Brand alkaloids-opium THYROLAR-1/2 Brand BELLADONNA Brand TINCTURE THYROLAR-1/4 Brand (BULK) THYROLAR-2 Brand belladonna-opium Generic PA THYROLAR-3 Brand bismatrol Generic OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 107 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC bismuth Generic OTC glycopyrrolate Generic injection bismuth maximum Generic OTC strength glycopyrrolate oral Generic BISMUTH Brand HOMATROPINE Brand SUBGALLATE METHYLBROM (BULK) (BULK) BISMUTH Brand hyoscyamine sulfate Generic SUBSALICYLATE HYOSCYAMINE Brand (BULK) SULFATE (BULK) chlordiazepoxide- Generic hyosyne Generic clidinium ISOPROPAMIDE Brand CLIDINIUM Brand IODIDE BROMIDE (BULK) kaopectate (bismuth Generic OTC diamode Generic OTC subsalicy) oral diarrhea relief Generic OTC suspension (bismuth subs) kaopectate ex str Generic OTC DICYCLOMINE Brand (bismuth ss) (BULK) kao-tin (bismuth Generic OTC dicyclomine Generic subsalicylat) intramuscular kola-pectin ds Generic OTC dicyclomine oral Generic k-pec antidiarrheal Generic OTC capsule (bism sub) dicyclomine oral Generic loperamide Generic OTC solution LOPERAMIDE Brand dicyclomine oral Generic (BULK) tablet medi-bismuth Generic OTC digestive relief oral Generic OTC tablet me-pb-hyos Generic diotame Generic OTC METHSCOPOLAM Brand INE diphenoxylate- Generic atropine METHSCOPOLAM Brand INE NITRATE ed-spaz Generic (BULK) geri-pectate Generic OTC opium tincture Generic GLYCOPYRROLA Brand oscimin Generic TE (BULK) oscimin sl Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 108 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC oscimin sr Generic almacone oral Generic OTC suspension paregoric Generic almacone-2 Generic OTC peptic relief Generic OTC alophen Generic OTC pepto-bismol to-go Generic OTC alosetron Generic phenohytro Generic ALOXI Brand QL pink bismuth Generic OTC aluminum hydroxide Generic OTC PROPANTHELINE Brand gel (BULK) ALUMINUM Brand soothe (bismuth Generic OTC HYDROXIDE GEL subsalicylate) (BULK) POWDER soothe regular Generic OTC ambizine Generic OTC strength antacid (calcium Generic OTC stomach relief max Generic OTC carb-mag hyd) oral strength tablet,chewable 550- stomach relief oral Generic OTC 110 mg suspension 262 antacid anti-gas Generic OTC mg/15 ml antacid anti-gas Generic OTC stomach relief oral Generic OTC double str tablet antacid exst (mag Generic OTC stomach relief oral Generic OTC carb-al hyd) tablet,chewable antacid extra- Generic OTC symax fastabs Generic strength oral symax-sl Generic suspension 400-400- symax-sr Generic 40 mg/5 ml antacid m Generic OTC Miscellaneous Gastrointestinal Agents antacid maximum Generic OTC strength 5- Brand AMINOSALICYLI antacid plus anti-gas Generic OTC C ACID antacid regular Generic OTC acid gone antacid Generic OTC strength acid gone antacid Generic OTC antacid supreme Generic OTC e.strength antacid tablet Generic OTC advanced antacid- Generic OTC antigas AKYNZEO Brand QL

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 109 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC antacid ultra Generic OTC citrucel Generic OTC strength oral clearlax Generic OTC tablet,chewable 1,177 mg colocort Generic antacid-simethicone Generic OTC col-rite Generic OTC antacid-simethicone Generic OTC comfort gel Generic OTC ds comfort gel extra Generic OTC anti-gas ultra Generic OTC strength strength compro Generic anucort-hc Generic constulose Generic anu-med Generic OTC CORTIFOAM Brand Brand CREON Brand (BULK) cromolyn oral Generic aprepitant Generic QL CYSTADANE Brand APRISO Brand DIMENHYDRINAT Brand balsalazide Generic E (BULK) bicarsim forte Generic OTC dimenhydrinate Generic bisac-evac Generic OTC injection solution BISACODYL Brand dimenhydrinate oral Generic OTC bisacodyl rectal Generic OTC diocto Generic OTC bisa-lax Generic OTC dioctyl Generic OTC biscolax Generic OTC DIPHENIDOL Brand (BULK) budesonide oral Generic doc-q-lace Generic OTC calcium Generic OTC polycarbophil doc-q-lax Generic OTC CANASA Brand docu Generic OTC CHENODAL Brand PA docu soft Generic OTC children's pepto Generic OTC docuprene Generic OTC children's soothe Generic OTC docusate calcium Generic OTC chocolate laxative Generic OTC DOCUSATE Brand SODIUM CHOLBAM ORAL Brand PA CAPSULE 250 MG DOCUSATE Brand SODIUM (BULK) CHOLBAM ORAL Brand PA; QL CAPSULE 50 MG

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 110 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC docusate sodium Generic OTC evac-u-gen Generic OTC oral capsule (sennosides) docusate sodium Generic OTC fiber Generic OTC oral liquid fiber (calcium Generic OTC docusate sodium Generic OTC polycarbophil) oral tablet fiber (psyllium husk) Generic OTC docusil Generic OTC fiber (psyllium Generic OTC dok Generic OTC husk/sugar) dok plus Generic OTC fiber (with Generic OTC aspartame) dramamine less Generic OTC drowsy fiber laxative (ca Generic OTC polycarbo) dramamine oral Generic OTC tablet fiber laxative Generic OTC (husk/sugar) driminate Generic OTC fiber laxative Generic OTC dronabinol Generic (methylcellulo) DROPERIDOL Brand fiber laxative Generic OTC droperidol injection Generic (psyllium husk) solution fiber laxative Generic OTC dss Generic OTC (psyllium) s/f ducodyl Generic OTC fiber smooth Generic OTC dulcolax stool Generic OTC fiber smooth Generic OTC softener (dss) (sucrose) EMEND Brand QL fiber supplement Generic OTC INTRAVENOUS (inulin) EMEND ORAL Brand QL fiber therapy (ca Generic OTC CAPSULE 125 MG, polycarboph) 40 MG fiber therapy (m- Generic OTC EMEND ORAL Brand QL cell/sugar) SUSPENSION FOR fiber therapy (m- Generic OTC RECONSTITUTIO cellulose) N fiber therapy Generic OTC enema Generic OTC (psyllium seed) enema disposable Generic OTC fiber therapy Generic OTC ENTYVIO Brand PA laxative (husk) enulose Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 111 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC fiber therapy sugar Generic OTC geri-mox antacid- Generic OTC free antigas fiber-tabs Generic OTC glycolax oral Generic OTC powder flanax antacid Generic OTC granisetron (pf) Generic fleet enema Generic OTC granisetron hcl Generic fleet laxative Generic OTC intravenous foaming antacid Generic OTC granisetron hcl oral Generic QL foaming antacid Generic OTC granisol Generic QL extra strength grx hicort 25 Generic OTC gas free extra Generic OTC strength hc-1% hemorrhoid Generic OTC gas relief extra Generic OTC healthylax Generic OTC strength oral heartburn antacid Generic OTC tablet,chewable heartburn relief Generic OTC gas relief oral Generic OTC capsule 125 mg hemmorex-hc Generic gas relief oral Generic OTC hemorrhoidal Generic OTC drops,suspension suppository gas relief oral Generic OTC hemril-30 Generic tablet,chewable 80 hydrochloric acid Generic mg (bulk) liquid 37 % gas relief ultra Generic OTC hydrocortisone Generic strength acetate rectal gavilax oral powder Generic OTC hydrocortisone Generic gavilyte-c Generic rectal gavilyte-g Generic hydrocortisone Generic topical cream with gavilyte-h and Generic perineal applicator bisacodyl hydrocortisone- Generic gavilyte-n Generic pramox-e-pram#1 generlac Generic hydrocortisone- Generic gentle laxative Generic OTC pramoxine rectal gentlelax Generic OTC infants gas relief Generic OTC geri-kot Generic OTC INFLECTRA Brand PA; ST geri-lanta Generic OTC kao-tin (docusate Generic OTC calcium) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 112 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC KARAYA GUM Brand lidocaine hcl- Generic (BULK) hydrocortison ac rectal kit konsyl (sugar) Generic OTC lidocaine- Generic konsyl fiber Generic OTC hydrocortisone-aloe konsyl sugar-free Generic OTC LINZESS Brand konsyl sugar-free Generic OTC liquid antacid oral Generic OTC (aspartame) oral suspension 200-200- powder 20 mg/5 ml konsyl-d Generic OTC maalox maximum Generic OTC lactulose Generic strength laxa clear Generic OTC mag-al plus Generic OTC laxacin Generic OTC mag-al plus extra Generic OTC laxative (bisacodyl) Generic OTC strength laxative (sennosides) Generic OTC magnesium oral Generic OTC oral tablet 15 mg, tablet 250 mg 17.2 mg MAGNESIUM Brand laxative (sennosides) Generic OTC SULFATE (BULK) oral tablet,chewable CRYSTALS laxative feminine Generic OTC major-prep Generic OTC (phenylephrine-fat) laxative maximum Generic OTC strength masanti double Generic OTC strength laxative peg 3350 Generic OTC oral powder Brand laxative pills Generic OTC meclizine oral tablet Generic OTC 12.5 mg, 25 mg laxative pills regular Generic OTC meclizine oral Generic OTC laxative plus stool Generic OTC tablet,chewable softener medi-lax Generic OTC laxative-senna Generic OTC medi-laxx Generic OTC L-GLUTAMIC Brand ACID medi-meclizine Generic OTC lidocaine hcl- Generic medi-mucil Generic OTC hydrocortison ac medi-natural Generic OTC rectal cream 3-0.5 % medi-natural senna- Generic OTC stool MESALAMINE Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 113 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC mesalamine rectal Generic move it along Generic OTC mesalamine with Generic mytab gas Generic OTC cleansing wipe mytab gas maximum Generic OTC metamucil fiber Generic OTC strength singles natural fiber laxative Generic OTC METOCLOPRAMI Brand natural fiber laxative Generic OTC DE (BULK) (sugar) oral powder metoclopramide hcl Generic 3.4 gram/12 gram, 3.4 gram/7 gram mi-acid Generic OTC natural fiber laxative Generic OTC mi-acid gas relief Generic OTC smooth milk of magnesia Generic OTC natural fiber laxative Generic OTC milk of magnesia Generic OTC therapy concentrated natural fiber Generic OTC mineral oil extra Generic OTC laxative(aspart) oral heavy powder mineral oil oral Generic OTC natural fiber Generic OTC mineral oil rectal Generic OTC supplement mintox Generic OTC natural laxative Generic OTC mintox maximum Generic OTC natural veg Generic OTC strength laxative(sennosid) mintox plus Generic OTC natural vegetable Generic OTC miralax oral powder Generic OTC natural vegetable Generic OTC in packet (psyllium) motion relief Generic OTC natural vegetable Generic OTC (meclizine) powder motion sickness Generic OTC OCALIVA Brand PA; QL motion sickness Generic OTC ondansetron Generic QL (meclizine) ONDANSETRON Brand motion sickness Generic OTC HCL (BULK) relief ondansetron hcl (pf) Generic motion sickness Generic OTC ondansetron hcl Generic relief ii intravenous motion sickness Generic OTC ondansetron hcl oral Generic QL relief(mecliz) oral saline laxative Generic OTC motion-time Generic OTC oral liquid You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 114 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PANCREATIN Brand procto-med hc Generic pancrelipase 5000 Generic procto-pak Generic PAPAIN (BULK) Brand proctosol hc topical Generic p-col rite Generic OTC proctozone-hc Generic pediatric enema Generic OTC promolaxin Generic OTC peg 3350- Generic psyllium husk oral Generic OTC electrolytes capsule 0.52 gram peg3350 Generic OTC purelax Generic OTC peg-3350 with flavor Generic ready-to-use enema Generic OTC packs (min oil) peg-electrolyte soln Generic rectacort-hc Generic peg-prep Generic RECTIV Brand PENTASA Brand reguloid Generic OTC perdiem overnight Generic OTC reguloid, sugar free Generic OTC relief RELISTOR Brand peri-colace Generic OTC SUBCUTANEOUS phosphate laxative Generic OTC ri-gel Generic OTC oral liquid ri-gel ii Generic OTC polyethylene glycol Generic OTC riginic Generic OTC 3350 oral ri-mox Generic OTC powderlax Generic OTC ri-mox plus Generic OTC pramcort Generic sarna sensitive Generic OTC PRAMOXINE Brand SCOPOLAMINE Brand pramoxine topical Generic OTC HBR (BULK) Generic senexon Generic OTC prochlorperazine Generic senexon-s Generic OTC edisylate senna lax Generic OTC PROCHLORPERA Brand ZINE senna laxative oral Generic OTC EDISYLT(BULK) tablet 25 mg PROCHLORPERA Brand senna laxative-stool Generic OTC ZINE MALEATE softener prochlorperazine Generic senna oral capsule Generic OTC maleate oral

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 115 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC senna oral syrup 8.8 Generic OTC SUCRAID Brand mg/5 ml sulfasalazine Generic senna oral tablet Generic OTC SULFASALAZINE Brand senna plus Generic OTC (BULK) senna with docusate Generic OTC supreme antacid Generic OTC sodium surfak Generic OTC senna-extra Generic OTC the magic bullet Generic OTC senna-s Generic OTC travel sickness Generic OTC senna-time s Generic OTC travel sickness Generic OTC senno Generic OTC (meclizine) sennosides-docusate Generic OTC trilyte with flavor Generic sodium packets sen-o-tab Generic OTC TRIMETHOBENZA Brand MIDE (BULK) silace Generic OTC trimethobenzamide Generic SIMETHICONE Brand intramuscular simethicone oral Generic OTC solution smoothlax Generic OTC trimethobenzamide Generic SODIUM Brand oral BICARBONATE tums ultra oral Generic OTC (BULK) tablet,chewable sodium bicarbonate Generic OTC 1,177 mg oral UCERIS ORAL Brand SODIUM Brand ursodiol Generic PHOSPHATE,DIBA URSODIOL Brand SIC(BULK) (BULK) POWDER vegetable laxative Generic OTC sof-lax Generic OTC VIBERZI Brand soluble fiber Generic OTC VIOKACE Brand stimulant laxative Generic OTC plus wal-dram Generic OTC stool softener Generic OTC wal-mucil fiber Generic OTC stool softener- Generic OTC wal-mucil fiber Generic OTC laxative (aspartame) stool softener- Generic OTC wal-mucil fiber Generic OTC stimulant laxat (sugar) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 116 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC wal-mucil natural Generic OTC esomeprazole Generic fiber lax sodium woman's laxative Generic OTC FAMOTIDINE Brand (BULK) women's gentle Generic OTC laxative(bisac) famotidine (pf) Generic women's laxative Generic OTC famotidine (pf)-nacl Generic (bisacodyl) (iso-os) women's stool Generic OTC famotidine Generic softener intravenous Ulcer Therapy famotidine oral Generic suspension acid control Generic OTC; QL (ranitidine) oral famotidine oral Generic OTC; QL tablet 150 mg tablet 10 mg, 20 mg acid controller Generic OTC; QL famotidine oral Generic tablet 40 mg acid reducer Generic OTC; QL (cimetidine) FIRST- Brand LANSOPRAZOLE acid reducer Generic OTC; QL (famotidine) FIRST- Brand OMEPRAZOLE acid reducer Generic OTC; QL (ranitidine) heartburn Generic OTC; QL prevention acid relief Generic OTC; QL (cimetidine) heartburn relief Generic OTC; QL (cimetidine) amoxicil- Generic QL clarithromy- heartburn relief Generic OTC; QL lansopraz (famotidine) CARAFATE ORAL Brand heartburn relief Generic OTC; QL SUSPENSION (ranitidine) CIMETIDINE Brand heartburn relief 24 Generic OTC; QL (BULK) hour cimetidine hcl oral Generic LANSOPRAZOLE Brand (BULK) cimetidine oral Generic OTC; QL tablet 200 mg lansoprazole oral Generic OTC; QL capsule,delayed cimetidine oral Generic release(dr/ec) 15 mg tablet 300 mg, 400 mg, 800 mg lansoprazole oral Generic QL capsule,delayed esomeprazole Generic QL release(dr/ec) 30 mg magnesium You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 117 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC misoprostol Generic PREVACID 24HR Brand ST; OTC; QL MISOPROSTOL Brand PRILOSEC OTC Brand ST; OTC (BULK) rabeprazole Generic NEXIUM 24HR Brand OTC; QL RANITIDINE HCL Brand ORAL (BULK) CAPSULE,DELAY ED ranitidine hcl Generic RELEASE(DR/EC) injection NEXIUM 24HR Brand OTC ranitidine hcl oral Generic ORAL capsule TABLET,DELAYE ranitidine hcl oral Generic D RELEASE syrup (DR/EC) ranitidine hcl oral Generic OTC; QL nizatidine Generic tablet 150 mg, 75 mg OMEPRAZOLE Brand ranitidine hcl oral Generic (BULK) tablet 300 mg omeprazole Generic OTC SUCRALFATE Brand magnesium (BULK) omeprazole oral Generic QL sucralfate oral tablet Generic capsule,delayed release(dr/ec) tagamet hb Generic OTC; QL omeprazole oral Generic OTC; QL wal-zan 150 Generic OTC; QL tablet,delayed wal-zan 75 Generic OTC; QL release (dr/ec) zantac maximum Generic OTC; QL omeprazole-sodium Generic PA; ST; QL strength bicarbonate oral capsule 40-1.1 mg- ZEGERID OTC Brand PA; ST; OTC; gram QL omeprazole-sodium Generic PA; ST; QL Immunology, Vaccines / bicarbonate oral Biotechnology packet 20-1,680 mg Biotechnology Drugs omeprazole-sodium Generic PA; ST bicarbonate oral ACTIMMUNE Brand packet 40-1,680 mg ALFERON N Brand pantoprazole Generic ARCALYST Brand PA intravenous AVONEX (WITH Brand PA; QL pantoprazole oral Generic QL ALBUMIN) pepcid ac oral tablet Generic OTC; QL 20 mg You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 118 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC AVONEX Brand PA; QL SERMORELIN Brand INTRAMUSCULA ACETATE (BULK) R PEN INJECTOR SYLATRON Brand KIT SYLATRON 4- Brand AVONEX Brand PA; QL PACK INTRAMUSCULA SUBCUTANEOUS R SYRINGE KIT 200 MCG, 300 AVONEX Brand PA; QL MCG INTRAMUSCULA TEV-TROPIN Brand PA R SYRINGE KIT ZARXIO Brand PA; ST EGRIFTA Brand PA EXTAVIA Brand PA; QL Vaccines / Miscellaneous Immunologicals GRANIX Brand PA; ST AFLURIA 2013- Brand INFERGEN Brand 2014 INTRON A Brand AFLURIA 2013- Brand INJECTION 2014 (PF) LEUKINE Brand AFLURIA 2014- Brand MOZOBIL Brand 2015 NEULASTA Brand PA; QL AFLURIA 2014- Brand 2015 (PF) NEUMEGA Brand AFLURIA 2015- Brand NEUPOGEN Brand PA; ST 2016 OMNITROPE Brand PA AFLURIA 2015- Brand PEGASYS Brand PA; QL 2016 (PF) PEGASYS Brand PA; QL AFLURIA 2016- Brand CONVENIENCE 2017 PACK AFLURIA 2016- Brand PEGASYS Brand PA; QL 2017 (PF) PROCLICK AFLURIA QUAD Brand PROCRIT Brand PA 2016-2017 (PF) PROLEUKIN Brand BOTOX Brand REBIF (WITH Brand PA; QL FLUAD 2016-2017 Brand ALBUMIN) (65 YR UP)(PF) REBIF REBIDOSE Brand PA; QL FLUARIX 2013- Brand 2014 (PF) REBIF TITRATION Brand PA; QL PACK FLUARIX 2014- Brand 2015 (PF) You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 119 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC FLUARIX QUAD Brand FLUVIRIN 2014- Brand 2014-2015 (PF) 2015 FLUARIX QUAD Brand FLUVIRIN 2014- Brand 2015-2016 (PF) 2015 (PF) FLUARIX QUAD Brand FLUVIRIN 2015- Brand 2016-2017 (PF) 2016 FLUBLOK 2016- Brand FLUVIRIN 2015- Brand 2017 (PF) 2016 (PF) FLUCELVAX Brand FLUVIRIN 2016- Brand QUAD 2016-2017 2017 (PF) FLUVIRIN 2016- Brand FLULAVAL 2013- Brand 2017 (PF) 2014 FLUZONE 2013- Brand FLULAVAL 2014- Brand 2014 2015 FLUZONE 2013- Brand FLULAVAL QUAD Brand 2014 (PF) 2013-2014 FLUZONE 2014- Brand FLULAVAL QUAD Brand 2015 2014-2015 FLUZONE 2014- Brand FLULAVAL QUAD Brand 2015 (PF) 2014-2015 (PF) FLUZONE 2015- Brand FLULAVAL QUAD Brand 2016 2015-2016 FLUZONE HIGH- Brand FLULAVAL QUAD Brand DOSE 2013-14 (PF) 2016-2017 FLUZONE HIGH- Brand FLULAVAL QUAD Brand DOSE 2014-15 (PF) 2016-2017 (PF) FLUZONE HIGH- Brand FLUMIST 2013- Brand DOSE 2015-16 (PF) 2014 FLUZONE HIGH- Brand FLUMIST QUAD Brand DOSE 2016-17 (PF) 2014-2015 FLUZONE Brand FLUMIST QUAD Brand INTRADERM 2015-2016 2013-14 (PF) FLUVIRIN 2013- Brand FLUZONE Brand 2014 INTRADERM 2014-15 (PF) FLUVIRIN 2013- Brand 2014 (PF)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 120 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC FLUZONE Brand GAMUNEX-C Brand PA INTRADERM HIZENTRA Brand PA QUAD 2015-16 METHYLPYRAZO Brand FLUZONE Brand LE INTRADERM QUAD 2016-17 PNEUMOVAX 23 Brand FLUZONE PEDI Brand PREVNAR 13 (PF) Brand 2013-2014 (PF) PRIVIGEN Brand PA FLUZONE QUAD Brand PROVENGE Brand 2013-2014 (PF) ZOSTAVAX (PF) Brand FLUZONE QUAD Brand 2014-2015 Musculoskeletal / Rheumatology FLUZONE QUAD Brand Gout Therapy 2014-2015 (PF) allopurinol Generic FLUZONE QUAD Brand 2015-2016 ALLOPURINOL Brand (BULK) FLUZONE QUAD Brand 2015-2016 (PF) allopurinol sodium Generic FLUZONE QUAD Brand aloprim Generic 2016-2017 COLCHICINE Brand FLUZONE QUAD Brand COLCRYS Brand 2016-2017 (PF) KRYSTEXXA Brand PA FLUZONE QUAD Brand PEDI 2013-14 (PF) MITIGARE Brand FLUZONE QUAD Brand probenecid Generic PEDI 2014-15 (PF) probenecid- Generic FLUZONE QUAD Brand colchicine PEDI 2015-16 (PF) ULORIC Brand ST FLUZONE QUAD Brand Osteoporosis Therapy PEDI 2016-17 (PF) alendronate oral Generic QL fomepizole Generic solution GAMASTAN S/D Brand alendronate oral Generic QL GAMMAGARD Brand PA tablet 10 mg, 35 mg, LIQUID 5 mg, 70 mg GAMMAGARD Brand PA ibandronate Generic PA S/D intravenous GAMUNEX Brand PA ibandronate oral Generic QL You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 121 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC raloxifene Generic SAVELLA Brand ST; QL risedronate oral Generic QL Obstetrics / Gynecology tablet 150 mg, 35 mg, 5 mg Estrogens / Progestins risedronate oral Generic QL amabelz Generic tablet,delayed camila Generic release (dr/ec) covaryx Generic Other Rheumatologicals covaryx h.s. Generic ACTEMRA Brand PA; ST INTRAVENOUS CRINONE Brand SOLUTION 200 VAGINAL GEL 4 MG/10 ML (20 % MG/ML), 80 MG/4 deblitane Generic ML (20 MG/ML) DEPO-PROVERA Brand ACTEMRA Brand PA; ST INTRAMUSCULA SUBCUTANEOUS R SOLUTION BENLYSTA Brand eemt Generic DEPEN Brand eemt hs Generic TITRATABS errin Generic ENBREL Brand PA; ST; QL ESTRADIOL Brand ENBREL Brand PA; ST; QL (BULK) SURECLICK ESTRADIOL Brand GOLD SODIUM Brand BENZOATE THIOMALATE (BULK) (BULK) ESTRADIOL Brand HUMIRA Brand PA; ST; QL CYPIONATE HUMIRA Brand PA; ST; QL (BULK) PEDIATRIC ESTRADIOL Brand CROHN'S START HEMIHYD,MICRO HUMIRA PEN Brand PA; ST; QL (BULK) leflunomide Generic QL ESTRADIOL Brand MICRONIZED OTEZLA Brand PA; ST (BULK) OTEZLA Brand PA; ST estradiol oral Generic STARTER estradiol Generic QL PENICILLAMINE( Brand transdermal D-) estradiol valerate Generic RIDAURA Brand You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 122 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ESTRADIOL Brand mimvey Generic VALERATE mimvey lo Generic (BULK) nora-be Generic estradiol- Generic norethindrone acet NORETHINDRON Brand E (BULK) estrogens- Generic methyltestosterone norethindrone Generic (contraceptive) ESTRONE Brand norethindrone Generic ESTRONE (BULK) Brand acetate estropipate Generic NORETHINDRON Brand ETHINYL Brand E ACETATE ESTRADIOL (BULK) (BULK) norethindrone ac-eth Generic fyavolv Generic estradiol oral tablet 0.5-2.5 mg-mcg, 1-5 heather Generic mg-mcg HYDROXYPROGE Brand norlyroc Generic STERONE CAPR(BULK) PROGESTERONE Brand (BULK) hydroxyprogesterone Generic caproate progesterone Generic micronized jencycla Generic PROGESTERONE Brand jevantique lo Generic MICRONIZED jinteli Generic (BULK) jolivette Generic sharobel Generic lopreeza Generic yuvafem Generic lyza Generic Miscellaneous Ob/Gyn MAKENA Brand PA 3 day vaginal Generic OTC MEDROXYPROGE Brand 3-day vaginal Generic OTC ST, AC MICRO(BULK) clindamycin Generic phosphate vaginal medroxyprogesteron Generic QL e intramuscular clotrimazole vaginal Generic OTC medroxyprogesteron Generic clotrimazole-3 Generic OTC e oral CONCEPTROL Brand OTC MENEST Brand fem ph Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 123 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC gynol ii Generic OTC vaginal Generic OTC contraceptive foam Generic vagistat-3 Generic OTC ISOXSUPRINE Brand HCL (BULK) vandazole Generic metronidazole Generic VCF Brand OTC vaginal CONTRACEPTIVE GEL miconazole 7 Generic OTC xulane Generic miconazole nitrate Generic OTC vaginal comb Oral Contraceptives / Related pack,prefill appl, Agents cream altavera (28) Generic miconazole nitrate Generic OTC vaginal cream alyacen 1/35 (28) Generic miconazole nitrate Generic OTC alyacen 7/7/7 (28) Generic vaginal kit 1,200-2 amethia Generic mg-% amethia lo Generic miconazole nitrate Generic OTC vaginal suppository amethyst Generic miconazole-3 Generic OTC apri Generic vaginal kit aranelle (28) Generic miconazole-3 Generic ashlyna Generic vaginal suppository aubra Generic MIRENA Brand aviane Generic NEXPLANON Brand azurette (28) Generic NUVARING Brand balziva (28) Generic SULFANILAMIDE Brand bekyree (28) Generic SULFATHIAZOLE Brand (BULK) blisovi 24 fe Generic terconazole Generic blisovi fe 1.5/30 (28) Generic TODAY Brand OTC blisovi fe 1/20 (28) Generic CONTRACEPTIVE briellyn Generic SPONGE camrese Generic tranexamic acid oral Generic camrese lo Generic VAGINAL Brand OTC CONTRACEPTIVE caziant (28) Generic FILM chateal Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 124 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC cryselle (28) Generic gildess 24 fe Generic cyclafem 1/35 (28) Generic gildess fe 1.5/30 (28) Generic cyclafem 7/7/7 (28) Generic gildess fe 1/20 (28) Generic cyred Generic introvale Generic dasetta 1/35 (28) Generic jolessa Generic dasetta 7/7/7 (28) Generic juleber Generic daysee Generic junel 1.5/30 (21) Generic delyla (28) Generic junel 1/20 (21) Generic desog- Generic junel fe 1.5/30 (28) Generic e.estradiol/e.estradio junel fe 1/20 (28) Generic l junel fe 24 Generic desogestrel-ethinyl Generic estradiol kaitlib fe Generic drospirenone- Generic kariva (28) Generic e.estradiol-lm.fa kelnor 1/35 (28) Generic drospirenone-ethinyl Generic kimidess (28) Generic estradiol kurvelo Generic econtra ez Generic OTC; QL l norgest/e.estradiol- Generic elinest Generic e.estrad ELLA Brand QL larin 1.5/30 (21) Generic emoquette Generic larin 1/20 (21) Generic enpresse Generic larin 24 fe Generic enskyce Generic larin fe 1.5/30 (28) Generic estarylla Generic larin fe 1/20 (28) Generic ethynodiol diac-eth Generic larissia Generic estradiol layolis fe Generic fallback solo Generic OTC; QL leena 28 Generic falmina (28) Generic lessina Generic femynor Generic levonest (28) Generic gianvi (28) Generic levonorgestrel Generic QL gildagia Generic levonorgestrel- Generic gildess 1.5/30 (21) Generic ethinyl estrad gildess 1/20 (21) Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 125 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC levonorg-eth estrad Generic norethindrone- Generic triphasic e.estradiol-iron oral tablet levora-28 Generic norgestimate-ethinyl Generic lomedia 24 fe Generic estradiol loryna (28) Generic nortrel 0.5/35 (28) Generic low-ogestrel (28) Generic nortrel 1/35 (21) Generic lutera (28) Generic nortrel 7/7/7 (28) Generic marlissa Generic ocella Generic microgestin 1.5/30 Generic ogestrel (28) Generic (21) opcicon one-step Generic OTC; QL microgestin 1/20 Generic (21) option 2 Generic OTC; QL microgestin fe 1.5/30 Generic orsythia Generic (28) philith Generic microgestin fe 1/20 Generic pimtrea (28) Generic (28) pirmella Generic mono-linyah Generic PLAN B ONE- Brand OTC; QL mononessa (28) Generic STEP my way Generic QL portia Generic myzilra Generic previfem Generic necon 0.5/35 (28) Generic quasense Generic necon 1/35 (28) Generic rajani Generic necon 1/50 (28) Generic react Generic OTC; QL necon 10/11 (28) Generic reclipsen (28) Generic necon 7/7/7 (28) Generic setlakin Generic next choice one dose Generic OTC; QL sprintec (28) Generic nikki (28) Generic sronyx Generic noreth-ethinyl Generic syeda Generic estradiol-iron TAKE ACTION Brand OTC; QL norethindrone ac-eth Generic estradiol oral tablet tarina fe 1/20 (28) Generic 1-20 mg-mcg tilia fe Generic tri-estarylla Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 126 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC tri-legest fe Generic Ophthalmology tri-linyah Generic Antibiotics tri-lo-estarylla Generic ak-poly-bac Generic tri-lo-marzia Generic bacitracin Generic tri-lo-sprintec Generic ophthalmic trinessa (28) Generic bacitracin- Generic polymyxin b trinessa lo Generic ophthalmic tri-previfem (28) Generic ciprofloxacin hcl Generic tri-sprintec (28) Generic ophthalmic trivora (28) Generic erythromycin Generic ophthalmic velivet triphasic Generic regimen (28) garamycin Generic ophthalmic drops vestura (28) Generic gatifloxacin Generic vienva Generic gentak ophthalmic Generic viorele (28) Generic ointment vyfemla (28) Generic gentamicin Generic wera (28) Generic ophthalmic wymzya fe Generic levofloxacin Generic ophthalmic zarah Generic NATACYN Brand zenchent (28) Generic neomycin- Generic zenchent fe Generic bacitracin- zeosa Generic polymyxin zovia 1/35e (28) Generic neomycin- Generic zovia 1/50e (28) Generic polymyxin- gramicidin Oxytocics neo-polycin Generic HEMABATE Brand ofloxacin ophthalmic Generic methergine Generic polycin Generic methylergonovine Generic polymyxin b sulf- Generic OXYTOCIN Brand trimethoprim (BULK) tobramycin Generic oxytocin injection Generic solution Antivirals You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 127 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC trifluridine Generic Brand CHLORIDE TRIFLURIDINE Brand (BULK) (BULK) PILOCARPINE Brand VIDARABINE Brand HCL (BULK) (BULK) pilocarpine hcl Generic VIDARABINE Brand ophthalmic drops 1 MONOHYDRATE %, 2 %, 4 % (BULK) PILOCARPINE Brand Beta-Blockers NITRATE (BULK) betaxolol ophthalmic Generic Miscellaneous Ophthalmologics Generic acuicyn Generic Generic advanced eye relief Generic OTC ophthalmic drops 0.5 % akorn balanced salt Generic Generic altacaine Generic timolol maleate Generic altachlore Generic OTC ophthalmic altafluor Generic Cholinesterase Inhibitor Miotics altalube Generic OTC PHOSPHOLINE Brand artificial tears Generic OTC IODIDE (petro/min) Cycloplegic Mydriatics artificial tears (pf) Generic OTC ATROPINE Brand artificial tears Generic OTC (BULK) (polyvin alc) atropine ophthalmic Generic artificial Generic OTC atropine-care Generic tears(dext70-hypro) cyclopentolate Generic artificial Generic OTC tears(glycerin-peg) CYCLOPENTOLA Brand TE (BULK) artificial Generic OTC tears(hypromellose) homatropaire Generic artificial tears(pg- Generic OTC homatropine hbr Generic hypm-glyc) TROPICAMIDE Brand artificial Generic OTC tropicamide Generic tears(pvalch-povid) ophthalmic azelastine Generic Direct Acting Miotics ophthalmic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 128 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC balanced salt Generic JETREA (PF) Brand bion tears (pf) Generic OTC KETOTIFEN Brand FUMARATE BORIC ACID Brand (BULK) BORIC ACID Brand liquitears Generic OTC (BULK) lubricant eye (polyv Generic OTC bss Generic alcohol) cromolyn Generic lubricant eye drops Generic OTC ophthalmic (glyc-pg) CYSTARAN Brand lubricant eye Generic OTC DAPIPRAZOLE Brand ophthalmic ointment (BULK) 56.8-41.5 %, 57.3- dry eye relief Generic OTC 42.5 %, 83-15 % epinastine Generic lubricant Generic OTC eye(dextran70- tears Generic OTC hypml) EYLEA Brand PA lubrifresh pm Generic OTC flucaine Generic LUCENTIS Brand PA FLUORESCEIN Brand moisture drops Generic OTC (BULK) natural balance Generic OTC fluorescein- Generic benoxinate natural tears (pf) Generic OTC fluorescein- Generic nature's tears Generic OTC proparacaine (hypromellose) flurox Generic ocucoat Generic for sty relief Generic OTC olopatadine Generic ophthalmic gonak Generic OTC polyvinyl alcohol Generic OTC goniosoft Generic OTC POLYVINYL Brand goniotaire Generic OTC ALCOHOL (BULK) goniovisc Generic OTC proparacaine Generic HYALURONIDAS Brand PROPARACAINE Brand E, BOVINE (BULK) (BULK) puralube Generic OTC HYDROXYETHYL Brand METHACRYLATE, pure and gentle eye Generic OTC BULK RESTASIS Brand PA; QL

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 129 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC RESTASIS Brand PA; QL DEMECARIUM Brand MULTIDOSE BROMIDE (BULK) sochlor Generic OTC Generic sodium chloride Generic OTC dorzolamide-timolol Generic ophthalmic Generic PA tears again Generic OTC miostat Generic tears again (pva) Generic OTC Generic tears pure Generic OTC salicylate tetcaine Generic Generic PA (benzalkonium) tetracaine hcl Generic tetracaine hcl (pf) Generic Steroid-Antibiotic Combinations ophthalmic neomycin- Generic Non-Steroidal Anti-Inflammatory bacitracin-poly-hc Agents neomycin-polymyxin Generic b-dexameth bromfenac Generic neomycin- Generic diclofenac sodium Generic polymyxin-hc ophthalmic ophthalmic flurbiprofen sodium Generic neo-polycin hc Generic ketorolac Generic tobramycin- Generic ophthalmic dexamethasone Oral Drugs For Steroids Generic dexamethasone Generic ACETAZOLAMID Brand sodium phosphate E (BULK) ophthalmic acetazolamide Generic fluorometholone Generic sodium OZURDEX Brand METHAZOLAMID Brand prednisolone acetate Generic E prednisolone sodium Generic oral Generic phosphate Other Glaucoma Drugs ophthalmic Generic PA Steroid-Sulfonamide Combinations ophthalmic sulfacetamide- Generic Brand prednisolone (BULK) Sulfonamides You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 130 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SULFACETAMIDE Brand acta-tabs pe Generic OTC SOD, MONO actidom dmx Generic OTC (BULK) adrenalin injection Generic SULFACETAMIDE Brand SODIUM adt robitussin peak Generic OTC cld dm max sulfacetamide Generic sodium ophthalmic adult cough formula Generic OTC dm max Sympathomimetics adult robitussin Generic OTC ALPHAGAN P Brand lingering cld OPHTHALMIC DROPS 0.1 % adult robitussin m-s Generic OTC cold Generic adult robitussin peak Generic OTC Generic cold dm BRIMONIDINE Brand adult robitussin peak Generic OTC TARTRATE cold m-s (BULK) adult tussin chest Generic OTC Vasoconstrictor Decongestants congestion altafrin Generic OTC adult tussin cough Generic OTC eye drops Generic OTC congest dm eye drops allergy Generic OTC adult tussin dm Generic OTC relief adult tussin multi- Generic OTC Generic symp cold PHENYLEPHRINE Brand adult wal-tussin Generic OTC HCL (BULK) adult wal-tussin dm Generic OTC phenylephrine hcl Generic max ophthalmic alavert Generic OTC; QL TETRAHYDROZO Brand alavert d-12 allergy- Generic OTC; QL LINE sinus Respiratory And Allergy aler-cap Generic OTC Antihistamine / Antiallergenic aler-tab Generic OTC Agents alka-seltzer plus Generic OTC 12 hour cold relief Generic OTC allergy 12 hour Generic OTC alka-seltzer plus Generic OTC decongestant mucus-conges 30pse-150gfn-15dm Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 131 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC all day allergy Generic OTC; QL allergy and Generic OTC; QL () oral congestion relief capsule oral tablet extended release 12 hr all day allergy Generic OTC; QL (cetirizine) oral allergy and sinus Generic OTC tablet relief all day allergy Generic OTC; QL allergy complete-d Generic OTC; QL (cetirizine) oral allergy d-12 Generic OTC; QL tablet,chewable allergy medication Generic OTC all day allergy-d Generic OTC; QL allergy medicine Generic OTC ALLEGRA Brand OTC; QL oral liquid ALLERGY allergy medicine Generic OTC ALLEGRA-D 12 Brand OTC; QL oral tablet HOUR allergy multi- Generic OTC ALLEGRA-D 24 Brand OTC; QL symptom HOUR allergy relief Generic OTC; QL aller-chlor Generic OTC (cetirizine) oral allerclear Generic OTC; QL capsule allerclear d-12hr Generic OTC; QL allergy relief Generic OTC (cetirizine) oral allerclear d-24hr Generic OTC; QL solution aller-ease oral tablet Generic OTC; QL allergy relief Generic OTC; QL allerfed cold and Generic OTC (cetirizine) oral allergy tablet aller-fex Generic OTC; QL allergy relief Generic OTC aller-g-time Generic OTC (clemastine) allergy Generic OTC allergy relief Generic OTC; QL (chlorpheniramine) (fexofenadine) allergy Generic OTC allergy relief Generic OTC (diphenhydramine) (loratadine) oral oral capsule solution allergy Generic OTC allergy relief Generic OTC; QL (diphenhydramine) (loratadine) oral oral tablet tablet allergy 4-hour Generic OTC allergy relief Generic OTC; QL (loratadine) oral tablet,disintegrating allergy relief d Generic OTC; QL You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 132 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC allergy relief d-24 Generic OTC; QL antitussive dm Generic OTC allergy relief multi- Generic OTC ap-hist dm Generic OTC symptom aprodine Generic OTC allergy Generic OTC arbinoxa Generic relief(chlorpheniram n) banophen allergy Generic OTC allergy Generic OTC banophen oral Generic OTC relief(diphenhydrami capsule n) banophen oral tablet Generic OTC allergy relief,nasal Generic OTC; QL benzonatate Generic decongest bidex Generic OTC allergy relief-d Generic OTC; QL (cetirizine) biobron sf Generic OTC allergy relief-d Generic OTC; QL biocotron Generic OTC (loratadine) biogil Generic OTC allergy relief- Generic OTC; QL bionel Generic OTC d(fexofenadine) brohist d Generic OTC allergy sinus pe Generic OTC BROMPHENIRAM Brand allergy-congestion Generic OTC; QL INE MALEATE relief-d oral tablet (BULK) extended release 24 hr brompheniramine- Generic OTC pseudoeph-dm oral allergy-d Generic OTC syrup allergy-time Generic OTC brompheniramin- Generic OTC allerhist-1 Generic OTC phenylephrin-dm aller-tec Generic OTC; QL broncotron ped oral Generic OTC liquid aller-tec d Generic OTC; QL brotapp Generic OTC allfen Generic OTC brotapp dm Generic OTC allfen dm Generic OTC carbinoxamine Generic ambi 10peh-4cpm Generic OTC maleate ambi 40pse-400gfn- Generic OTC centergy Generic 20dm centergy dm Generic ambi 60pse-400gfn Generic OTC cetiri-d Generic OTC; QL ambi 60pse-4cpm Generic OTC cetirizine oral Generic OTC ambitussin ac Generic solution

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 133 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC cetirizine oral tablet Generic OTC; QL child multi-symptom Generic OTC cold/cough cetirizine oral Generic OTC; QL tablet,chewable child triaminic cold- Generic OTC allergy cetirizine- Generic OTC; QL child wal-tap cold- Generic OTC allergy cheracol d Generic OTC child wal-tussin Generic OTC cheratussin ac Generic cough relief cheratussin dac Generic children night time Generic OTC chest congestion Generic OTC cold-cough relief children's allegra Generic OTC chest congestion Generic OTC allergy oral relief + dm suspension chest congestion Generic OTC children's allegra Generic OTC; QL relief d allergy oral chest congestion Generic OTC tablet,disintegrating relief pe children's allergy Generic OTC chest congestion- Generic OTC (diphenhyd) oral cough relief elixir chest-sinus Generic OTC children's allergy Generic OTC congestion relief (diphenhyd) oral liquid child allergy Generic OTC relf(cetirizine) oral children's allergy Generic OTC solution (diphenhyd) oral tablet,disintegrating child allergy relief Generic OTC (diphen) children's allergy Generic OTC complete child chest Generic OTC congestion + cough children's allergy Generic OTC medicine child delsym Generic OTC cough+chest dm children's allergy Generic OTC relief(lor) child mucinex chest Generic OTC congestion children's aller-tec Generic OTC child mucus relief Generic OTC children's benadryl Generic OTC cough allergy oral tablet,chewable child mucus relief Generic OTC expectorant children's cetirizine Generic OTC oral solution

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 134 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC children's cetirizine Generic OTC; QL children's wal-zyr Generic OTC; QL oral tablet,chewable oral tablet,chewable children's chest Generic OTC child's all day Generic OTC congestion allergy(cetir) CHILDREN'S Brand OTC; QL child's benadryl-d Generic OTC CLARITIN ORAL allergy-sin TABLET,CHEWAB childs triacting cold- Generic OTC LE cough children's cold and Generic OTC chlorhist Generic OTC cough (pe) CHLORPHENIRA Brand children's cold- Generic OTC MINE MALEATE allergy (pe) chlorpheniramine Generic OTC children's complete Generic OTC maleate oral tablet allergy chlorpheniramine Generic OTC children's cough Generic OTC maleate oral tablet children's dibromm Generic OTC extended release cold-allerg chlortabs Generic OTC children's dibromm Generic OTC CLARITIN Brand OTC dm cold-cou REDITABS ORAL children's dimetapp Generic OTC TABLET,DISINTE cold-flu GRATING 5 MG children's flu relief Generic OTC CLEMASTINE Brand children's mucinex Generic OTC clemastine oral Generic cough syrup childrens plus cold Generic OTC clemastine oral Generic OTC tablet 1.34 mg children's plus flu Generic OTC clemastine oral Generic childrens plus multi- Generic OTC tablet 2.68 mg symp cold codeine-guaifenesin Generic children's silfedrine Generic OTC codituss dm Generic OTC children's sudafed pe Generic OTC cough cold and allergy Generic OTC children's wal-dryl Generic OTC cold and allergy Generic OTC allergy (bromphen-pe) children's wal-zyr Generic OTC cold and allergy pe Generic OTC oral solution cold and cough Generic OTC (diphenhydr-pe)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 135 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC cold and cough (pe- Generic OTC cough control dm Generic OTC dm) cough control dm Generic OTC cold and cough (pe- Generic OTC max dm-gg-acet) cough formula dm Generic OTC cold and cough dm Generic OTC cough relief Generic OTC cold and cough Generic OTC cough suppressant- Generic OTC elixir expectorant cold and flu severe Generic OTC cough syrup Generic OTC cold head congestion Generic OTC cough syrup dm Generic OTC nighttime coughtab Generic OTC cold head congestion Generic OTC sever day Generic cold multi-symptom Generic OTC CYPROHEPTADIN Brand E (BULK) cold relief m/s Generic OTC day/night day time pe Generic OTC cold-flu relief oral Generic OTC dayhist allergy Generic OTC liquid 5-10-325 daytime Generic OTC mg/15 ml daytime and Generic OTC complete allergy Generic OTC nighttime cold medicine oral tablet daytime cold-flu Generic OTC complete allergy Generic OTC oral capsule daytime cold-flu Generic OTC relief (pe) complete allergy Generic OTC oral liquid day-time cough Generic OTC congestac Generic OTC daytime mucus relief Generic OTC dm cough and cold Generic OTC mucus relief cf day-time oral Generic OTC capsule 30-15-325 cough and cold oral Generic OTC mg liquid delsym cough-chest Generic OTC cough and cold oral Generic OTC congest dm tablet desgen dm oral Generic OTC cough control Generic OTC liquid 5-10-100 mg/5 (dextromethorph) ml cough control Generic OTC despec dm-g Generic OTC (guaifenesin) despec eda cough- Generic OTC cough control cf (pe) Generic OTC cold drops You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 136 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC despec-dm Generic OTC DIPHENHYDRAMI Brand (phenyleph-dm- NE (BULK) guaif) oral liquid 5- diphenhydramine hcl Generic 10-100 mg/5 ml injection solution 50 despec-tab oral Generic OTC mg/ml tablet 40-400 mg diphenhydramine hcl Generic DEXTROMETHOR Brand injection syringe PHAN HBR diphenhydramine hcl Generic OTC (BULK) POWDER oral capsule dextromethorphan- Generic OTC diphenhydramine hcl Generic OTC guaifenesin oral oral elixir syrup diphenhydramine hcl Generic OTC dextromethorphan- Generic OTC oral liquid guaifenesin oral tablet diphenhydramine hcl Generic OTC oral syrup diabetic siltussin Generic OTC das-na diphenhydramine hcl Generic OTC oral tablet 25 mg diabetic siltussin-dm Generic OTC dm max Generic OTC diabetic siltussin-dm Generic OTC max str dometuss-dmx Generic OTC diabetic tussin dm Generic OTC double-tussin dm Generic OTC diabetic tussin ex Generic OTC dristan cold Generic OTC diabetic tussin max Generic OTC ed a-hist Generic OTC st ed a-hist pse Generic OTC dimaphen (pe) Generic OTC ed bron gp Generic OTC dimaphen dm Generic OTC ed chlorped jr Generic OTC dimetapp cold- Generic OTC ed-chlortan Generic OTC congestion effervescent cold Generic OTC dimetapp dm cold- Generic OTC relief plus cough (pe) endacof - dm Generic OTC diphedryl allergy Generic OTC endacof-c Generic diphedryl oral Generic OTC capsule endacon Generic OTC diphedryl oral tablet Generic OTC entre-cough Generic OTC diphenhist Generic OTC entre-hist pse Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 137 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC EPINEPHRINE Brand g-tron ped oral Generic OTC (BULK) drops EPINEPHRINE Brand guaiasorb dm Generic OTC BITARTRATE guaiatussin ac Generic EPINEPHRINE Brand GUAIFENESIN Brand HCL (BULK) (BULK) epinephrine hcl (pf) Generic guaifenesin ac Generic EPINEPHRINE Brand QL guaifenesin dac Generic INJECTION AUTO- INJECTOR 0.15 guaifenesin oral Generic OTC MG/0.3 ML, 0.3 liquid MG/0.3 ML guaifenesin oral Generic OTC epinephrine Generic tablet injection solution guaifenesin oral Generic OTC epinephrine Generic tablet extended injection syringe 0.1 release 12hr 600 mg mg/ml guaifenesin-dm Generic OTC exefen dmx Generic OTC hist-pse Generic OTC exefen-ir Generic OTC hydrocodone- Generic expectorant oral Generic OTC chlorpheniramine liquid hydrocodone-cpm- Generic fenesin dm ir oral Generic OTC pseudoephed tablet 20-400 mg hydrocodone- Generic fenesin ir Generic OTC homatropine oral syrup 5-1.5 mg/5 ml fenesin pe ir Generic OTC hydrocodone- Generic fexofenadine oral Generic OTC; QL homatropine oral tablet 180 mg, 60 mg tablet flu relief therapy Generic OTC hydromet Generic daytime Brand g tussin ac Generic HCL (BULK) geri-dryl Generic OTC hydroxyzine hcl Generic geri-tussin Generic OTC intramuscular geri-tussin dm Generic OTC hydroxyzine hcl oral Generic solution 10 mg/5 ml glenmax peb dm Generic OTC hydroxyzine hcl oral Generic g-tron Generic OTC tablet

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 138 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC hydroxyzine Generic m-clear wc Generic pamoate medicidin-d Generic OTC HYDROXYZINE Brand medifin expectorant Generic OTC PAMOATE (BULK) mucus rlf intense cough Generic OTC medi-phedrine oral Generic OTC reliever oral liquid tablet 30-200 mg/5 ml medi-phedryl Generic OTC iophen c-nr Generic medi-tussin Generic OTC iophen dm-nr Generic OTC medi-tussin dm Generic OTC iophen-nr Generic OTC medi-tussin dm Generic OTC kidkare cough/cold Generic OTC diabetic levocetirizine oral Generic m-end dm Generic OTC solution m-end wc Generic levocetirizine oral Generic QL tablet m-hist dm Generic OTC liquibid d-r Generic OTC mucaphed Generic OTC lohist - d Generic OTC mucinex allergy Generic OTC; QL lohist peb dm Generic OTC mucinex d Generic OTC lohist-dm Generic OTC mucinex d maximum Generic OTC strength lohist-peb Generic OTC mucinex dm oral Generic OTC loradamed Generic OTC; QL tablet extended lorata-d Generic OTC; QL release 12 hr 30-600 mg loratadine oral Generic OTC solution mucinex fast-max Generic OTC cold-flu-thrt oral loratadine oral Generic OTC; QL tablet tablet mucinex fast-max dm Generic OTC loratadine oral Generic OTC; QL max tablet,disintegrating mucinex fast-max Generic OTC loratadine-d Generic OTC; QL severe cold oral lortuss ex oral syrup Generic tablet mapap cold formula Generic OTC mucinex oral tablet Generic OTC mapap sinus max Generic OTC extended release strength (pe) 12hr 600 mg maxiphen Generic OTC mucosa Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 139 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC mucosa dm Generic OTC nasal decongestant Generic OTC (pseudoeph) oral mucus and cough Generic OTC liquid relief nasal decongestant Generic OTC mucus dm Generic OTC (pseudoeph) oral mucus dm max Generic OTC tablet mucus relief Generic OTC nasal decongestant Generic OTC mucus relief cough Generic OTC (pseudoeph) oral tablet extended mucus relief d Generic OTC release (phenylephrine) neo-tuss Generic OTC mucus relief d Generic OTC (pseudoephed) oral night time cold oral Generic OTC tablet tablet mucus relief dm Generic OTC nightime sleep Generic OTC mucus relief dm max Generic OTC nighttime allergy Generic OTC relief mucus relief er oral Generic OTC tablet extended nighttime cough- Generic OTC release cold mucus relief er oral Generic OTC nighttime sleep aid Generic OTC tablet extended (diphen) oral release 12hr 600 mg capsule 50 mg mucus relief pe Generic OTC nighttime sleep aid Generic OTC (diphen) oral tablet mucus relief plus Generic OTC nohist-lq Generic OTC mucus relief sinus Generic OTC non-aspirin flu oral Generic OTC multi-symptom cold Generic OTC tablet 30-15-500 mg (pe) non-aspirin severe Generic OTC multi-symptom cold Generic OTC congest m-s (pe-cpm) non-drowsy allergy Generic OTC; QL multi-symptom cold Generic OTC daytime non-drying sinus Generic OTC oral capsule multi-symptom cold Generic OTC night time organ-i nr Generic OTC nasal decongestant Generic OTC ormir Generic OTC (pe) oral tablet 10 pain relief allergy Generic OTC mg sinus pain relief cold Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 140 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC pain reliever flu Generic OTC - Generic phenyleph-codeine palgic Generic promethegan Generic pcm la Generic PSEUDOEPHEDRI Brand pedia relief cough- Generic OTC NE HCL (BULK) cold pseudoephedrine hcl Generic OTC pedia relief infant Generic OTC oral liquid nasal pseudoephedrine hcl Generic OTC pediacare multi- Generic OTC oral tablet symptom cold PYRILAMINE Brand pediatric cough and Generic OTC MALEATE cold oral liquid 1- 15-5 mg/5 ml q-dryl Generic OTC pe-guai Generic q-tapp Generic OTC pharbechlor Generic OTC q-tapp dm Generic OTC pharbedryl Generic OTC q-tussin Generic OTC phenadoz Generic q-tussin dm Generic OTC phenergan rectal Generic quenalin Generic OTC phenylhistine dh Generic refenesen Generic OTC poly-tussin Generic refenesen dm Generic OTC poly-tussin d Generic refenesen pe Generic OTC pres gen Generic OTC relcof c Generic PROMETHAZINE Brand relcof dm Generic OTC (BULK) rescon-gg Generic OTC promethazine Generic rest simply nighttime Generic OTC injection solution sleep promethazine oral Generic restfully sleep Generic OTC promethazine rectal Generic ritifed Generic OTC promethazine vc Generic ri-tussin Generic OTC promethazine vc- Generic ri-tussin dm Generic OTC codeine robafen Generic OTC promethazine- Generic codeine robafen cf Generic OTC (phenylephrine) promethazine-dm Generic robafen cough Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 141 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC robafen dm Generic OTC sinus and allergy Generic OTC non-drowsy robafen dm cough Generic OTC sinus and allergy pe Generic OTC robafen dm cough- Generic OTC chest congest sinus congestion and Generic OTC pain robitussin cold-flu Generic OTC day sinus congestion- Generic OTC pain(chlorph) robitussin cough and Generic OTC cold cf sinus congest-pain Generic OTC day-night robitussin cough- Generic OTC chest cong dm oral sinus decongestant Generic OTC capsule (pe) robitussin cough- Generic OTC sinus headache Generic OTC chest cong dm oral degongestant liquid 10-200 mg/5 sinus headache pe Generic OTC ml sinus pain relief Generic OTC robitussin pediatric Generic OTC sinus pain-pressure Generic OTC r-tanna Generic (pe) rydex Generic sinus pe Generic OTC rynex dm Generic OTC decongestant rynex pe Generic OTC sinus relief (non- Generic OTC drowsy) rynex pse Generic OTC sinus-allergy Generic OTC scot-tussin dm Generic OTC (phenylephrine) scot-tussin Generic OTC sleep aid Generic OTC expectorant (diphenhydramine) severe cold Generic OTC oral capsule 50 mg severe cold multi- Generic OTC sleep aid Generic OTC symptom (diphenhydramine) siladryl sa Generic OTC oral tablet silphen cough Generic OTC sleep ii Generic OTC siltussin dm das Generic OTC sleep-tabs Generic OTC siltussin sa Generic OTC sorbugen nr Generic OTC siltussin-dm Generic OTC sudogest Generic OTC simply sleep Generic OTC sudogest 12-hour Generic OTC sinus 12 hour Generic OTC sudogest cold and Generic OTC allergy You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 142 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC sudogest pe Generic OTC tussin Generic OTC sudogest sinus and Generic OTC tussin cf Generic OTC allergy tussin cf (pe-dm- Generic OTC suphedrin Generic OTC guaif) suphedrine Generic OTC tussin cf max Generic OTC suphedrine 12 hour Generic OTC tussin chest Generic OTC congestion suphedrine pe Generic OTC tussin cold- Generic OTC suphedrine pe cold Generic OTC congestion and allergy tussin cough (dm Generic OTC suphedrine pe sinus Generic OTC only) headache tussin cough dm Generic OTC supress dx Generic OTC tussin cough-chest Generic OTC tab tussin Generic OTC congestion tab tussin dm Generic OTC tussin dm clear Generic OTC tavist-1 Generic OTC tussin dm cough Generic OTC tg 10peh-380gfn- Generic OTC tussin dm cough and Generic OTC 15dm chest tl-dmx Generic OTC tussin dm max Generic OTC tl-hist dm Generic OTC tussin dm oral syrup Generic OTC total allergy Generic OTC 10-100 mg/5 ml medicine tussin dm oral tablet Generic OTC TRIPELENNAMIN Brand tussin honey Generic OTC E (BULK) tussin long-acting Generic OTC TRIPROLIDINE Brand HCL (BULK) tussin maximum Generic OTC strength trymine cg Generic tussin maximum Generic OTC tusnel c Generic strength cough tusnel diabetic Generic OTC tussin pe oral liquid Generic OTC tusnel pediatric oral Generic OTC tussinmax Generic OTC drops tussi-pres oral liquid Generic OTC tussi pres-b oral Generic OTC liquid 4-10-20 mg/5 unisom sleepgels Generic OTC ml valu-tapp Generic OTC tussigon Generic vazobid-pd Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 143 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC vicks dayquil cold- Generic OTC wal-phed pe sinus Generic OTC flu relief and allergy vicks dayquil cough Generic OTC wal-som Generic OTC (diphenhydramine) vicks nature fusion Generic OTC oral capsule vicks nature fusion Generic OTC wal-tap dm Generic OTC cough wal-tussin cough Generic OTC vicks qlearquil Generic OTC; QL allergy wal-tussin cough Generic OTC and cold cf vicks qlearquil Generic OTC nighttime rlf wal-tussin dm Generic OTC virdec Generic OTC wal-tussin max Generic OTC strength cough virtussin ac Generic wal-zyr (cetirizine) Generic OTC; QL virtussin dac Generic oral capsule wal-act d cold and Generic OTC wal-zyr (cetirizine) Generic OTC allergy oral solution wal-dryl allergy Generic OTC wal-zyr (cetirizine) Generic OTC; QL wal-dryl-d allergy Generic OTC oral tablet and sinus wal-zyr d Generic OTC; QL wal-fex allergy Generic OTC; QL ZODRYL AC 40 Brand wal-fex d 12 hour Generic OTC; QL ZODRYL DEC 30 Brand wal-fex d 24 hour Generic OTC; QL zyncof oral tablet Generic OTC wal-finate Generic OTC Pulmonary Agents wal-finate-d Generic OTC acetylcysteine Generic wal-itin d Generic OTC; QL ACETYLCYSTEIN Brand wal-itin d 12 hour Generic OTC; QL E (BULK) wal-itin oral Generic OTC ADEMPAS Brand PA solution ALBUTEROL Brand wal-itin oral tablet Generic OTC; QL SULFATE (BULK) wal-itin oral Generic OTC; QL albuterol sulfate Generic tablet,disintegrating inhalation solution wal-phed Generic OTC for nebulization wal-phed 12 hour Generic OTC albuterol sulfate oral Generic wal-phed pe Generic OTC AMINOPHYLLINE Brand (BULK)

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 144 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC aminophylline Generic FLUNISOLIDE Brand intravenous (BULK) ANORO ELLIPTA Brand QL flunisolide nasal Generic QL spray,non-aerosol ATROVENT HFA Brand QL 25 mcg (0.025 %) BEVESPI Brand QL fluticasone nasal Generic QL AEROSPHERE Brand BUDESONIDE Brand FUMARATE (BULK) (BULK) budesonide Generic QL IPRATROPIUM Brand inhalation BROMIDE (BULK) budesonide nasal Generic QL ipratropium bromide Generic BUDESONIDE, Brand inhalation MICRONIZED ipratropium- Generic QL (BULK) albuterol caffeine-sodium Generic ISOPROTERENOL Brand benzoate HCL (BULK) CINRYZE Brand PA KALBITOR Brand PA COMBIVENT Brand QL KALYDECO Brand PA; QL RESPIMAT LETAIRIS Brand PA; ST CROMOLYN Brand levalbuterol hcl Generic cromolyn inhalation Generic LEVALBUTEROL Brand cromolyn nasal Generic OTC HCL (BULK) difil-g 400 Generic METAPROTEREN Brand DULERA Brand PA; QL OL DYPHYLLINE Brand metaproterenol oral Generic (BULK) mometasone nasal Generic QL HCL Brand montelukast Generic (BULK) MONTELUKAST Brand EPHEDRINE Brand (BULK) SULFATE (BULK) nasal allergy Generic OTC ephedrine sulfate Generic symptom control injection solution NUCALA Brand PA; QL ESBRIET Brand PA; QL OFEV Brand PA; QL FIRAZYR Brand PA OPSUMIT Brand PA; ST

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 145 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ORKAMBI Brand PA; QL theophylline oral Generic solution PERFOROMIST Brand QL theophylline oral Generic PULMICORT Brand QL tablet extended FLEXHALER release 12 hr pulmosal Generic theophylline oral Generic PULMOZYME Brand tablet extended QVAR Brand QL release 24 hr RACEPINEPHRIN Brand TRACLEER Brand PA E (BULK) triamcinolone Generic QL SEREVENT Brand QL acetonide nasal DISKUS TUDORZA Brand QL Generic PA PRESSAIR intravenous TYVASO Brand PA; ST sildenafil oral Generic PA; QL TYVASO REFILL Brand PA; ST sodium chloride Generic KIT inhalation TYVASO Brand PA; ST SYMBICORT Brand PA; QL STARTER KIT Brand VENTAVIS Brand PA terbutaline oral Generic VENTOLIN HFA Brand QL terbutaline Generic XOLAIR Brand PA; QL subcutaneous zafirlukast Generic theochron Generic Urologicals THEOPHYLLINE Brand Anticholinergics / Antispasmodics (BULK) darifenacin Generic theophylline in Generic dextrose 5 % flavoxate Generic intravenous OXYBUTYNIN Brand parenteral solution CHLORIDE 200 mg/100 ml, 200 mg/50 ml, 400 oxybutynin chloride Generic mg/250 ml, 400 oral mg/500 ml, 800 tolterodine Generic mg/250 ml trospium Generic theophylline oral Generic elixir Benign Prostatic Hyperplasia(Bph) Therapy

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 146 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC Generic K-PHOS NO 2 Brand dutasteride Generic ST K-PHOS Brand ORIGINAL dutasteride- Generic ST methen-sod phos- Generic meth blue-hyos FINASTERIDE Brand (BULK) METHIONINE Brand (BULK) finasteride oral Generic tablet 5 mg PENTOSAN Brand POLYSULFATE tamsulosin Generic NA (BULK) Cholinergic Stimulants phosphasal Generic bethanechol chloride Generic pot,sodium citrate- Generic BETHANECHOL Brand citric acid CHLORIDE potassium citrate Generic (BULK) potassium citrate- Generic Miscellaneous Urologicals citric acid alprostadil Generic RENACIDIN Brand ALPROSTADIL Brand SILDENAFIL Brand (BULK) (BULK) AMMONIUM Brand sodium citrate-citric Generic CHLORIDE acid (BULK) tricitrates Generic azuphen mb Generic ur n-c Generic CYSTAGON Brand uramit mb Generic cytra k crystals Generic uretron d-s Generic cytra-2 Generic urimar-t Generic cytra-3 Generic urin ds Generic cytra-k Generic uro-458 Generic ELMIRON Brand uro-blue Generic GLYCINE Brand urogesic-blue Generic glycine irrigation Generic uro-l Generic glycine urologic Generic urolet mb Generic hyolev mb Generic uro-mp Generic hyophen Generic urophen mb Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 147 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC uryl Generic calcium 500 + d Generic OTC oral tablet 500 ustell Generic mg(1,250mg) -200 utira-c Generic unit virtrate-2 Generic calcium 500 with d Generic OTC virtrate-3 Generic calcium 600 + d(3) Generic OTC virtrate-k Generic oral capsule calcium 600 + d(3) Generic OTC Urinary Anesthetics oral tablet 600 PHENAZOPYRIDI Brand mg(1,500mg) -200 NE (BULK) unit, 600 mg(1,500mg) -400 phenazopyridine Generic unit oral tablet 100 mg, 200 mg calcium 600 with Generic OTC vitamin d3 oral Vitamins, Hematinics / Electrolytes capsule Electrolytes calcium 600 with Generic OTC alcalak Generic OTC vitamin d3 oral tablet,chewable antacid (calcium Generic OTC carbonate) calcium acetate oral Generic capsule antacid ext str Generic OTC (calcium carb) calcium acetate oral Generic tablet 667 mg antacid extra- Generic OTC strength oral calcium antacid oral Generic OTC tablet,chewable 168 tablet,chewable 200 mg calcium (420 mg calcium (500 mg), 300 mg (750 mg), 300 mg (750 mg) mg), 320 mg calcium (750 mg), 430 mg antacid ultra Generic OTC calcium (1,000 mg) strength oral tablet,chewable 400 calcium antacid Generic OTC mg calcium (1,000 ultra max st mg) CALCIUM Brand calci-chew Generic OTC CARBONATE (BULK) calcionate Generic OTC calcium carbonate Generic OTC calcitrate Generic OTC oral suspension

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 148 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC calcium carbonate Generic OTC calcium citrate + d Generic OTC oral tablet 260 mg calcium citrate oral Generic OTC calcium (648 mg), tablet 500 mg calcium (1,250 mg), 600 mg calcium citrate- Generic OTC calcium (1,500 mg) vitamin d3 oral tablet 200 mg calcium carbonate Generic OTC calcium -250 unit, oral tablet,chewable 200-125 mg-unit, 200 mg calcium (500 250 mg calcium- 200 mg), 300 mg (750 unit, 315-250 mg- mg), 400 mg calcium unit (1,000 mg), 500 mg calcium (1,250 mg) CALCIUM Brand GLUBIONATE calcium carbonate- Generic OTC (BULK) vitamin d3 oral capsule 600 CALCIUM Brand mg(1,500mg) -400 GLUCON unit MONOHYD (BULK) calcium carbonate- Generic OTC vitamin d3 oral calcium gluconate Generic tablet 250-125 mg- intravenous unit, 500 calcium gluconate Generic OTC mg(1,250mg) -125 oral tablet 45 mg unit, 500 (500 mg), 60 mg mg(1,250mg) -400 (650 mg) unit, 500mg (1,250mg) -600 unit, calcium lactate oral Generic OTC 600 mg(1,500mg) - tablet 650 mg, 84 mg 400 unit, 600 (648 mg) mg(1,500mg) -800 CALCIUM Brand unit PHOSPHATE calcium carbonate- Generic OTC (BULK) vitamin d3 oral CALCIUM Brand tablet,chewable SACCHARATE CALCIUM Brand CALCIUM Brand CHLORIDE SULFATE (BULK) cal-gest antacid Generic OTC calcium chloride Generic intravenous chromium chloride Generic CALCIUM Brand citrus calcium Generic OTC CITRATE (BULK) copper chloride Generic calcium citrate + Generic OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 149 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC effer-k oral tablet, Generic MAGNESIUM Brand effervescent 25 meq GLUCONATE eliphos Generic magnesium Generic OTC gluconate oral tablet flavor chews antacid Generic OTC 27 mg (500 mg), hi-cal plus vit d Generic OTC 27.5 mg (500 mg) high potency Generic OTC MAGNESIUM Brand calcium GLYCINATE k-effervescent Generic (BULK) POWDER 15 % klor-con Generic magnesium oral Generic OTC klor-con 10 Generic tablet 200 mg klor-con 8 Generic MAGNESIUM Brand klor-con m10 Generic OXIDE (BULK) klor-con m15 Generic magnesium oxide Generic OTC oral capsule 500 mg klor-con m20 Generic magnesium oxide Generic OTC klor-con sprinkle Generic oral tablet klor-con/ef Generic magnesium sulfate in Generic k-phos-neutral Generic water k-sol Generic magnesium sulfate Generic injection k-tab oral tablet Generic extended release 8 manganese chloride Generic meq MANGANESE Brand lactated ringers Generic CHLORIDE intravenous (BULK) laxative dietary Generic OTC MANGANESE Brand supplement GLUCONATE (BULK) lugols oral Generic manganese sulfate Generic mag 64 Generic OTC intravenous mag-delay Generic OTC mgo Generic OTC mag-g Generic OTC MULTITRACE-4 Brand MAGNESIUM Brand MULTITRACE-4 Brand CHLORIDE CONCENTRATE (BULK) multitrace-4 Generic magnesium chloride Generic pediatric injection

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 150 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC MULTITRACE-5 Brand POTASSIUM Brand CONCENTRATE BROMIDE (BULK) POWDER nutrilyte Generic potassium chlorid- Generic nutrilyte ii Generic d5-0.45%nacl oralyte Generic OTC potassium chloride Generic oysco 500/d oral Generic OTC POTASSIUM Brand tablet CHLORIDE oysco d Generic OTC (BULK) oysco-500 Generic OTC potassium chloride Generic oyster shell calcium Generic OTC in 0.9%nacl intravenous oyster shell calcium Generic OTC parenteral solution 500 20 meq/l, 40 meq/l oyster shell calcium- Generic OTC potassium chloride Generic vit d3 oral tablet 500 in 5 % dex mg(1,250mg) -200 intravenous unit, 500 parenteral solution mg(1,250mg) -400 20 meq/l, 30 meq/l, unit 40 meq/l oystercal-d Generic OTC potassium chloride Generic pedialyte oral Generic OTC in lr-d5 solution potassium chloride- Generic pedialyte singles Generic OTC 0.45 % nacl pediatric electrolyte Generic OTC potassium chloride- Generic oral solution d5-0.2%nacl pediatric freezer Generic OTC potassium chloride- Generic pops d5-0.3%nacl intravenous phos-nak Generic OTC parenteral solution phospha 250 neutral Generic 20 meq/l potassium acetate Generic potassium chloride- Generic d5-0.9%nacl potassium bicarb Generic and chloride POTASSIUM Brand PERMANGANATE potassium bicarb- Generic citric acid potassium phosphate Generic m-/d-basic POTASSIUM Brand BROMIDE (BULK) CRYSTALS You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 151 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC POTASSIUM Brand tums ultra oral Generic OTC PHOSPHATE,DIB tablet,chewable 400 (BULK) POWDER mg calcium (1,000 mg) PROVIMIN Brand PA; OTC virt-phos 250 neutral Generic ringers intravenous Generic ZINC ACETATE Brand selenium Generic DIHYDRATE intravenous (BULK) SELENOMETHION Brand CRYSTALS INE (BULK) zinc chloride Generic smooth antacid Generic OTC ZINC CHLORIDE Brand SODIUM Brand (BULK) POWDER ACETATE ZINC SULFATE Brand sodium acetate Generic (BULK) POWDER intravenous 100 % sodium bicarbonate Generic zinc sulfate Generic intravenous intravenous SODIUM Brand Miscellaneous Nutrition Products CHLORIDE (BULK) ACERFLEX Brand PA; OTC sodium chloride 0.45 Generic ACETYLCARNITI Brand % intravenous NE (BULK) sodium chloride 3 % Generic ADVANTAGE Brand PA; OTC WITH IRON sodium chloride 5 % Generic ALFAMINO Brand PA; OTC sodium chloride Generic JUNIOR intravenous amino acids 15 % Generic sodium chloride oral Generic OTC ARGININE (L- Brand sodium chloride Generic OTC ARGININE) tablet,soluble (BULK) sodium lactate Generic ARGININE HCL(L- Brand intravenous ARGININE)(BULK sodium phosphate Generic ) strong iodine oral Generic balanced nutritional Generic PA; OTC super calcium Generic OTC BCAD 1 Brand PA; OTC benecalorie Generic PA; OTC beneprotein oral Generic PA; OTC powder You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 152 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC beneprotein oral Generic PA; OTC CHOLINE Brand powder in packet BITARTRATE (BULK) biotect plus Generic PA; OTC compleat pediatric Generic PA; OTC BOOST BREEZE Brand PA; OTC oral liquid NUTRITIONAL compleat pediatric Generic PA; OTC boost high protein Generic PA; OTC reduced cal oral liquid compleat-modified Generic PA; OTC boost kid essentials Generic PA; OTC oral liquid 0.03-1 complete amino acid Generic PA; OTC gram-kcal/ml mix BOOST KID Brand PA; OTC complete nutrition Generic PA; OTC ESSENTIALS complete nutrition Generic PA; OTC ORAL LIQUID plus 0.04-1.5 GRAM- KCAL/ML COMPLEX Brand PA; OTC ESSENTIAL BOOST KID Brand PA; OTC ESSENTIALS W- CYCLINEX-1 Brand PA; OTC FIBER CYCLINEX-2 Brand PA; OTC boost oral liquid Generic PA; OTC cysteine (l-cysteine) Generic 0.04 gram- 1 kcal/ml intravenous solution boost plus oral Generic PA; OTC CYSTEINE HCL(L- Brand liquid 0.06 gram- CYSTEINE)(BULK 1.5 kcal/ml ) BOOST PUDDING Brand PA; OTC DUOCAL Brand PA; OTC BOOST VHC Brand PA; OTC EAA Brand PA; OTC BREAKFAST Brand PA; OTC SUPPLEMENT ESSENTIALS EDETATE Brand bright beginnings Generic PA; OTC CALCIUM soy DISODIUM(BULK) CAMINO PRO 15 Brand PA; OTC ELECARE Brand PA; OTC PKU ELECARE INFANT Brand PA; OTC carnation l/f inst Generic PA; OTC FORMULA breakfast ELECARE JR Brand PA; OTC carnation l/f, vhc, Generic PA; OTC electrolyte-48 in d5w Generic inst break ENFAGROW Brand PA; OTC CHOLESTEROL Brand TODDLR (BULK) TRANSITION SOY

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 153 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC enfamil a.r. lipil Generic PA; OTC ENSURE CLEAR Brand PA; OTC enfamil a.r. oral Generic PA; OTC ensure compact Generic PA; OTC powder ENSURE Brand PA; OTC enfamil enfacare Generic PA; OTC COMPLETE oral liquid ENSURE ENLIVE Brand PA; OTC ENFAMIL Brand PA; OTC ensure high protein Generic PA; OTC ENFACARE ORAL oral powder POWDER ensure high protein- Generic PA; OTC ENFAMIL Brand PA; OTC muscle GENTLEASE LIPIL LIQUID ENSURE MUSCLE Brand PA; OTC HEALTH ENFAMIL Brand PA; OTC GENTLEASE ensure oral liquid Generic PA; OTC ORAL LIQUID ENSURE ORAL Brand PA; OTC ENFAMIL Brand PA; OTC POWDER GENTLEASE ENSURE Brand PA; OTC ORAL POWDER ORIGINAL ORAL ENFAMIL INFANT Brand PA; OTC LIQUID 0.04-1.05 GRAM-KCAL/ML ENFAMIL LIPIL Brand PA; OTC NURSETTE ENSURE PLUS Brand PA; OTC ENFAMIL Brand PA; OTC ENSURE Brand PA; OTC NEWBORN PUDDING enfamil premium Generic PA; OTC EO28 SPLASH Brand PA; OTC lipil ORAL LIQUID 0.025-1 GRAM- ENFAMIL Brand PA; OTC KCAL/ML PROSOBEE LIPIL ORAL LIQUID freamine iii 10 % Generic ENFAPORT Brand PA; OTC GA GEL Brand PA; OTC ENFAPORT LIPIL Brand PA; OTC GA POWDER Brand PA; OTC ensure active clear Generic PA; OTC GERBER GOOD Brand PA; OTC START GENTLE ensure active heart Generic PA; OTC health GERBER GOOD Brand PA; OTC START ensure active light Generic PA; OTC PREMATURE 24 ENSURE ACTIVE Brand PA; OTC ORAL LIQUID 3- MUSCLE HEALTH 5.2 GRAM/100 KCAL ensure active Generic PA; OTC protein-muscle You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 154 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC GERBER GOOD Brand PA; OTC good start oral Generic PA; OTC START SOY liquid GERBER Brand PA; OTC GOOD START Brand PA; OTC GRADUATES SUPREME DHA GENTLE AND ARA ORAL CONCENTRATE GERBER Brand PA; OTC GRADUATES good start supreme Generic PA; OTC PROTECT dha and ara oral powder GERBER Brand PA; OTC GRADUATES SOY GOOD START Brand PA; OTC SUPREME DHA GERBER GS Brand PA; OTC AND ARA ORAL GENTLE - SUSPENSION SUPPLEMENT GOOD START Brand PA; OTC GLUCERNA Brand PA; OTC SUPREME NAT ADVANCE CULTURE GLUCERNA Brand PA; OTC GOOD START Brand PA; OTC HUNGER SMART SUPREME ORAL GLUCERNA Brand PA; OTC LIQUID THERAPEUTIC HCU COOLER Brand PA; OTC NUTRITION hcu express powder Generic PA; OTC GLUTARADE Brand PA; OTC JUNIOR HCU GEL Brand PA; OTC POWDER GLUTAREX-1 Brand PA; OTC HCU LOPHLEX Brand PA; OTC GLUTAREX-2 Brand PA; OTC HCY 1 POWDER Brand PA; OTC GLYCOSADE Brand PA; OTC HCY 2 Brand PA; OTC GLYTACTIN 20PE Brand PA; OTC BETTERMILK high-protein Generic PA; OTC LITE nutritional shake glytrol Generic PA; OTC HISTIDINE HCL(L- Brand HISTID)(BULK) GLYTROL WITH Brand PA; OTC PREBIO1 HOM 2 Brand PA; OTC GOOD START 2 Brand PA; OTC HOMINEX-1 Brand PA; OTC SUPREME HOMINEX-2 Brand PA; OTC GOOD START Brand PA; OTC immulife Generic PA; OTC ORAL CONCENTRATE IMPACT 1 CAL Brand PA; OTC IMPACT 1.5 Brand PA; OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 155 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC impact advanced Generic PA; OTC JUVEN Brand PA; OTC recovery oral liquid KETONEX-1 Brand PA; OTC 0.08-1.4 gram- kcal/ml KETONEX-2 Brand PA; OTC IMPACT Brand PA; OTC KETOVOLVE Brand PA; OTC ADVANCED ORAL POWDER RECOVERY ORAL 14.5 GRAM-712 LIQUID 0.1 KCAL/100 GRAM GRAM-1.12 K-PAX ORAL Brand PA; OTC KCAL/ML POWDER IMPACT Brand PA; OTC LACTOBACILL.A Brand GLUTAMINE CIDOPHILUS IMPACT PEPTIDE Brand PA; OTC (BULK) POWDER 1.5 CAL LANAFLEX Brand PA; OTC IMPACT/FIBER Brand PA; OTC L-ASPARTIC ACID Brand IMUPLUS Brand PA; OTC L-CITRULLINE Brand infant formula with Generic PA; OTC LEU-FREE Brand PA; OTC iron oral powder COOLER INOSITOL (BULK) Brand lipistart Generic PA; OTC intralipid Generic liquacel oral liquid Generic PA; OTC intravenous emulsion 20 % liquid nutrition Generic PA; OTC ISOLEUCINE Brand liquid nutrition plus Generic PA; OTC (BULK) L-ISOLEUCINE Brand ISOMIL Brand PA; OTC LMD POWDER Brand PA; OTC ADVANCE LOPHLEX Brand PA; OTC ISOMIL DF Brand PA; OTC L-THREONINE Brand ISOMIL/IRON Brand PA; OTC LYSINE HCL Brand ISOSOURCE 1.5 Brand PA; OTC (BULK) CAL mct procal Generic PA; OTC isosource hn Generic PA; OTC mct pro-cal Generic PA; OTC I-VALEX-1 Brand PA; OTC METHIONAID Brand PA; OTC I-VALEX-2 Brand PA; OTC MMA-PA Brand PA; OTC JEVITY 1 CAL Brand PA; OTC COOLER15 JEVITY 1.2 CAL Brand PA; OTC MMA-PA Brand PA; OTC JEVITY 1.5 CAL Brand PA; OTC EXPRESS

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 156 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC MMA-PA GEL Brand PA; OTC niacin flush free oral Generic OTC capsule 400 mg MONOGEN ORAL Brand PA; OTC niacin (500 mg) POWDER NICOTINAMIDE Brand MSUD 2 Brand PA; OTC ADEN.DINUC.RED MSUD AID Brand PA; OTC NA2 MSUD ANALOG Brand PA; OTC NICOTINAMIDE Brand MSUD COOLER Brand PA; OTC ADENINE DINUC. MSUD EXPRESS Brand PA; OTC novasource renal Generic PA; OTC COOLER novasource renal 2 Generic PA; OTC msud express15 Generic PA; OTC cal MSUD GEL Brand PA; OTC nutrafit Generic PA; OTC POWDER nutrafit plus Generic PA; OTC MSUD LOPHLEX Brand PA; OTC nutrament Generic PA; OTC MSUD Brand PA; OTC NUTRAMIGEN AA Brand PA; OTC MAXAMAID LIPIL MSUD Brand PA; OTC NUTRAMIGEN Brand PA; OTC MAXAMUM DHA-ARA NEOCATE JUNIOR Brand PA; OTC NUTRAMIGEN Brand PA; OTC NEOCATE JUNIOR Brand PA; OTC LIPIL WITH NUTRAMIGEN Brand PA; OTC PREBIOTICS TODDLER ORAL POWDER 16 ENFLORA-LGG GRAM-459 NUTRAMIGEN Brand PA; OTC KCAL/100 GRAM, WITH ENFLORA 16 GRAM-478 LGG KCAL/100 GRAM nutren 1.0 oral Generic PA; OTC NEOCATE NUTRA Brand PA; OTC nutren 1.0 with fiber Generic PA; OTC NEOCATE Brand PA; OTC SPLASH nutren junior Generic PA; OTC NEPRO Brand PA; OTC nutren junior fiber Generic PA; OTC NEPRO CARB Brand PA; OTC NUTREN Brand PA; OTC STEADY PULMONARY niacin (inositol Generic OTC NUTRIHEP ORAL Brand PA; OTC niacinate) oral LIQUID 0.16-1.5 capsule 400 mg GRAM-KCAL/ML niacin (500 mg) nutrition plus Generic PA; OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 157 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC nutritional drink mix Generic PA; OTC PEDIASURE Brand PA; OTC ENTERAL nutritional drink Generic PA; OTC plus PEDIASURE Brand PA; OTC ENTERAL NUTRITIONAL Brand PA; OTC W/FIBER 1.0 SHAKE (DIAB. FORM) PEDIASURE ORAL Brand PA; OTC LIQUID 0.06-1.5 nutritional shake Generic PA; OTC GRAM-KCAL/ML oral liquid pediasure peptide Generic PA; OTC NUTRITIONAL Brand PA; OTC 1.0 cal SHAKE ORAL LIQUID 0.04-0.93 PEDIASURE Brand PA; OTC GRAM-KCAL/ML, PEPTIDE 1.5 CAL 0.04-1.05 GRAM- PEDIASURE Brand PA; OTC KCAL/ML SIDEKICKS nutritional shake Generic PA; OTC pediatric balanced Generic PA; OTC plus oral liquid nutrition NUTRITIONAL Brand PA; OTC PEPDITE JUNIOR Brand PA; OTC SHAKE PLUS ORAL LIQUID PEPTAMEN 1.5 Brand PA; OTC 0.05-1.5 GRAM- ORAL LIQUID KCAL/ML 0.068 GRAM- 1.5 KCAL/ML nutritional Generic PA; OTC supplement oral PEPTAMEN AF Brand PA; OTC liquid peptamen junior Generic PA; OTC nutritional Generic PA; OTC fiber supplement plus oral PEPTAMEN ORAL Brand PA; OTC liquid LIQUID 0.04 OA 1 POWDER Brand PA; OTC GRAM- 1 KCAL/ML OA2 POWDER Brand PA; OTC PERATIVE Brand PA; OTC ORNITHINE Brand PERIFLEX Brand PA; OTC OS 2 Brand PA; OTC ADVANCE OSMOLITE 1 CAL Brand PA; OTC PERIFLEX Brand PA; OTC OSMOLITE 1.2 Brand PA; OTC INFANT CAL PERIFLEX JUNIOR Brand PA; OTC OSMOLITE 1.5 Brand PA; OTC PFD 2 Brand PA; OTC CAL PFD TODDLER Brand PA; OTC OXEPA Brand PA; OTC PHENEX-1 Brand PA; OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 158 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC PHENEX-2 Brand PA; OTC procel singles Generic PA; OTC PHENYLADE 40 Brand PA; OTC PRODUCT 3232A Brand PA; OTC PHENYLADE 60 Brand PA; OTC PROMOD Brand PA; OTC PROTEIN PHENYLADE Brand PA; OTC DRINK MIX PROMOTE Brand PA; OTC PHENYLADE Brand PA; OTC PROMOTE WITH Brand PA; OTC ESSENTIAL FIBER PHENYLADE RTD Brand PA; OTC PROPIMEX-1 Brand PA; OTC PKU 10 PROPIMEX-2 Brand PA; OTC PHENYLALANINE Brand PROSOBEE Brand PA; OTC , L- (BULK) prosource no carb Generic PA; OTC PHENYL-FREE 1 Brand PA; OTC PROSOURCE Brand PA; OTC PHLEXY-10 Brand PA; OTC ORAL LIQUID DRINK MIX POWDER prosource oral Generic PA; OTC powder phlexy-vits Generic PA; OTC pro-stat awc Generic PA; OTC PIVOT 1.5 CAL Brand PA; OTC PRO-STAT Brand PA; OTC PKU 2 Brand PA; OTC PROFILE PKU 3 Brand PA; OTC PRO-STAT SUGAR Brand PA; OTC PKU COOLER 10 Brand PA; OTC FREE PKU COOLER 15 Brand PA; OTC protein oral powder Generic PA; OTC PKU COOLER 20 Brand PA; OTC PROTEINEX-18 Brand PA; OTC PKU LOPHLEX Brand PA; OTC PULMOCARE Brand PA; OTC POLYCOSE Brand PA; OTC PURAMINO DHA- Brand PA; OTC ARA ORAL PORTAGEN ORAL Brand PA; OTC POWDER 2.8-5.3- POWDER 10.3 GRAM/100 premasol 10 % Generic KCAL PREMIUM Brand PA; OTC PURAMINO Brand PA; OTC INFANT TODDLER FORMULA ra pediatric nutrition Generic PA; OTC pre-protein oral Generic PA; OTC drink liquid RENA START Brand PA; OTC probalance Generic PA; OTC renalcal Generic PA; OTC procel Generic PA; OTC replete Generic PA; OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 159 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC replete fiber Generic PA; OTC similac alimentum Generic PA; OTC replete-fiber Generic PA; OTC SIMILAC EXPERT Brand PA; OTC CARE resource 2.0 Generic PA; OTC ALIMENTUM resource breeze Generic PA; OTC SIMILAC EXPERT Brand PA; OTC resource glutasolve Generic PA; OTC CARE NEOSURE resource just for kids Generic PA; OTC SIMILAC EXPERT Brand PA; OTC w/fiber CARE ORAL RESOURCE WITH Brand PA; OTC LIQUID FIBER SIMILAC FOR Brand PA; OTC SACCHARIN Brand SPIT-UP ORAL LIQUID 2.14-5.4-11 scandical Generic PA; OTC GRAM/100 KCAL scandishake (lactose Generic PA; OTC SIMILAC FOR Brand PA; OTC free) SPIT-UP ORAL SCANDISHAKE Brand PA; OTC POWDER ORAL PACKET SIMILAC HUMAN Brand PA; OTC scandishake oral Generic PA; OTC MILK FORTIFIER powder ORAL LIQUID IN PACKET 0.349-6.85 SERINE (BULK) Brand GRAM-KCAL/5 SIMILAC Brand PA; OTC ML ADVANCE ORAL SIMILAC HUMAN Brand PA; OTC LIQUID MILK FORTIFIER SIMILAC Brand PA; OTC ORAL POWDER IN ADVANCE ORAL PACKET POWDER IN SIMILAC LOW- Brand PA; OTC PACKET IRON SIMILAC Brand PA; OTC SIMILAC PM Brand PA; OTC ADVANCE ORAL SUSPENSION SIMILAC PRO- Brand PA; OTC ADVANCE NON- SIMILAC Brand PA; OTC GMO ORAL ADVANCE LIQUID ORGANIC ORAL LIQUID SIMILAC Brand PA; OTC SENSITIVE similac advance Generic PA; OTC organic oral powder similac sensitive fuss Generic PA; OTC and gas oral SIMILAC Brand PA; OTC concentrate 2.1-5.4- ADVANCE WITH 11.1 gram/100 kcal IRON You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 160 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC SIMILAC Brand PA; OTC TYREX-2 Brand PA; OTC SENSITIVE FUSS TYROS 1 Brand PA; OTC AND GAS ORAL LIQUID TYROS 2 Brand PA; OTC SIMILAC Brand PA; OTC Brand SENSITIVE FUSS (BULK) AND GAS ORAL UBIQUINOL Brand POWDER (BULK) POWDER SIMILAC Brand PA; OTC 32 % SENSITIVE UCD 2 Brand PA; OTC ISOMIL SOY UCD ANAMIX Brand PA; OTC SIMILAC SOY Brand PA; OTC JUNIOR ISOMIL VALINE Brand SIMILAC SPECIAL Brand PA; OTC CARE 24 VITAL 1.0 CAL Brand PA; OTC SIMILAC SPECIAL Brand PA; OTC VITAL 1.5 CAL Brand PA; OTC CARE 30 VITAL AF 1.2 CAL Brand PA; OTC SIMILAC Brand PA; OTC VITAL HIGH Brand PA; OTC SUPPLEMENTATI PROTEIN ON VIVONEX Brand PA; OTC SIMILAC TOTAL Brand PA; OTC PEDIATRIC ORAL COMFORT POWDER IN SOL CARB Brand OTC PACKET SUPLENA CARB Brand PA; OTC VIVONEX PLUS Brand PA; OTC STEADY ORAL POWDER IN PACKET THREONINE Brand (BULK) vivonex rtf Generic PA; OTC TOLEREX ORAL Brand PA; OTC VIVONEX T.E.N. Brand PA; OTC POWDER IN ORAL POWDER IN PACKET PACKET travasol 10 % Generic WND 2 Brand PA; OTC TWOCAL HN Brand PA; OTC XLEU ANALOG Brand PA; OTC tyr cooler oral liquid Generic PA; OTC XLEU Brand PA; OTC MAXAMAID TYR EXPRESS20 Brand PA; OTC XLYS- XTRP Brand PA; OTC TYR GEL Brand PA; OTC ANALOG POWDER XLYS, XTRP Brand PA; OTC TYREX-1 Brand PA; OTC MAXAMAID You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 161 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC XLYS, XTRP Brand PA; OTC antioxidant formula Generic OTC MAXAMUM antioxidant vitamins Generic OTC XMET ANALOG Brand PA; OTC apatate forte Generic OTC XMET Brand PA; OTC ascorbate calcium Generic OTC MAXAMUM ASCORBIC ACID Brand XMTVI ANALOG Brand PA; OTC (BULK) POWDER xmtvi maxamaid Generic PA; OTC ascorbic acid Generic xmtvi maxamum Generic PA; OTC (vitamin c) injection XPHE Brand PA; OTC ascorbic acid Generic OTC MAXAMAID (vitamin c) oral tablet 250 mg, 500 xphe maxamum oral Generic PA; OTC mg powder ascorbic acid Generic OTC XPHE MAXAMUM Brand PA; OTC (vitamin c) oral ORAL POWDER IN tablet,chewable PACKET ascorbic acid with Generic OTC XPHE, XTRP Brand PA; OTC rose hips MAXAMAID b complete Generic OTC XPHE, XTYR Brand PA; OTC ANALOG b complex 100 Generic injection XPTM ANALOG Brand PA; OTC b complex oral Generic OTC XTRACAL PLUS Brand PA; OTC b complex-vitamin Generic OTC ZINC PICOLINATE Brand b12 (BULK) b complex-vitamin c- Generic OTC Vitamins / Hematinics folic acid a thru z advanced Generic OTC b-12 kit Generic formula b-50 complex oral Generic OTC a thru z high potency Generic OTC tablet extended a thru z select oral Generic OTC release tablet balance b-50 Generic OTC acerola c-500 Generic OTC balanced b-100 Generic OTC adults' daily formula Generic OTC complex advanced am-pm Generic balanced b-100 oral Generic OTC tablet 0.4 mg, 100 animal chews Generic OTC mg animal shape Generic OTC vitamins You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 162 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC balanced b-50 oral Generic OTC calciferol Generic OTC tablet calcium 600 + Generic OTC bal-care dha Generic minerals b-complex with Generic OTC calcium carbonate- Generic OTC vitamin c oral tablet vit d3-min b-complex with Generic OTC calcium for women Generic OTC vitamin c oral tablet CALCIUM Brand extended release PANTOTHENATE bee-zee Generic OTC calcium plus Generic OTC BETA CAROTENE Brand calcium pnv Generic (BULK) calcium soft chew Generic OTC biosupp Generic OTC oral tablet,chewable BIOTIN (BULK) Brand 500-100-40 mg-unit- mcg, 500-200-40 BIOTIN ORAL Brand OTC mg-unit-mcg CAPSULE 1 MG, 10,000 MCG calcium-folic acid- Generic vitamin d biotin oral capsule Generic OTC 2,500 mcg, 5 mg calcium-vitamin d3- Generic OTC vitamin k oral biotin oral tablet 1 Generic OTC tablet,chewable 500- mg, 300 mcg, 800 200-40 mg-unit-mcg, mcg 500-400-40 mg-unit- BIOTIN ORAL Brand OTC mcg, 500-500-40 TABLET 10 MG, 5 mg-unit-mcg MG cavan-ec sod dha Generic biovol Generic OTC centamin Generic OTC bp vit 3 plus Generic centavite a-z Generic OTC c 500 timed released Generic OTC complete-mineral c complex Generic OTC central-vite oral Generic OTC c-1000 oral tablet Generic OTC tablet 18-400 mg- mcg c-1000 with rose Generic OTC hips central-vite select Generic OTC c-500 oral tablet Generic OTC central-vite women's Generic OTC under 50 c-500 oral Generic OTC tablet,chewable centratex Generic calcidol Generic OTC centravites 50 plus Generic OTC oral tablet

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 163 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC centrum women Generic OTC childs chew vite Generic OTC century Generic OTC child's chewable Generic OTC vitamins/iron oral century mature oral Generic OTC tablet,chewable tablet childs/iron Generic OTC century ultimate Generic OTC women's oral tablet choice-ob + dha Generic 18-400 mg-mcg choice-tabs Generic cerovite Generic OTC CHOLECALCIFER Brand cerovite advanced Generic OTC OL (VIT formula D3)(BULK) LIQUID 2,400 cerovite jr Generic OTC UNIT/ML cerovite senior Generic OTC CHOLECALCIFER Brand certa plus Generic OTC OL (VIT certavite-antioxid Generic OTC D3)(BULK) (iron gluc) oral POWDER liquid 9 mg iron/15 cholecalciferol Generic OTC ml (vitamin d3) oral certavite-antioxidant Generic OTC capsule 10,000 unit, 5,000 unit, 50,000 chewable multi Generic OTC unit vitamin cholecalciferol Generic OTC chewable multivit- Generic (vitamin d3) oral a,b,d,e,k,zn drops 400 unit/ml, chewable-vite Generic OTC 5,000 unit/ml chewable-vite with Generic OTC cholecalciferol Generic OTC iron (vitamin d3) oral tablet 1,000 unit, child vitamin with Generic OTC 2,000 unit, 5,000 minerals unit children's chewable Generic OTC cholecalciferol Generic OTC vitamin (vitamin d3) oral children's chewable Generic OTC tablet,chewable w/minerals 1,000 unit children's iron Generic OTC ciferex Generic children's multivit Generic OTC classic prenatal Generic OTC w/extra c c-nate dha Generic children's vitamin d Generic OTC compete Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 164 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC complete Generic OTC daily vitamin Generic OTC multivitamin oral formula tablet daily vitamin Generic OTC complete Generic OTC formula-iron multivitamin-mineral daily vitamin with Generic OTC oral tablet iron complete natal dha Generic daily vitamin with Generic OTC complete senior oral Generic OTC iron and ca tablet daily vites/iron Generic OTC completenate Generic daily-vite Generic OTC complex b-100 oral Generic OTC delta d3 Generic OTC tablet extended release dexferrum Generic corvita Generic dexpanthenol Generic corvita 150 Generic DEXPANTHENOL Brand (BULK) POWDER CYANOCOBALA Brand MIN (VITAMIN B- dialyvite Generic 12) dialyvite 800 Generic OTC cyanocobalamin Generic dialyvite vitamin d Generic OTC (vitamin b-12) injection dino-life Generic OTC CYTO B7 Brand OTC dino-life with extra c Generic OTC d3-2000 Generic OTC dino-life with iron- Generic OTC zinc daily multiple for Generic OTC men dothelle dha Generic daily multiple oral Generic OTC d-vi-sol Generic OTC tablet , 18-400 mg- d-vita Generic OTC mcg eldertonic Generic OTC daily multivitamin Generic OTC with iron elite-ob Generic daily multivitamin- Generic OTC elite-ob 400 Generic minerals ellis tonic Generic OTC daily multi- Generic OTC ERGOCALCIFERO Brand vitamins/iron L (VITAMIN D2) daily teen multi- Generic OTC ergocalciferol Generic vitamin (vitamin d2) oral daily value Generic OTC capsule You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 165 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC ergocalciferol Generic OTC ferrocite plus Generic (vitamin d2) oral ferrogels forte Generic drops ferro-time Generic OTC ergocalciferol Generic OTC (vitamin d2) oral FERROUS Brand tablet 400 unit FUMARATE (BULK) essentia Generic OTC ferrous fumarate Generic OTC essential daily Generic OTC oral tablet 324 mg eye health plus Generic OTC (106 mg iron) lutein ferrous gluconate Generic OTC ezfe 200 Generic OTC FERROUS Brand fabb Generic GLUCONATE (BULK) farbee with c Generic OTC ferrous sulfate oral Generic OTC fe 90 plus Generic drops fe c plus Generic ferrous sulfate oral Generic OTC feosol oral tablet Generic OTC elixir 325 mg (65 mg iron) ferrous sulfate oral Generic OTC ferate Generic OTC liquid fer-iron Generic OTC ferrous sulfate oral Generic OTC ferocon Generic solution ferosul Generic OTC ferrous sulfate oral Generic OTC tablet ferraplus 90 Generic ferrous sulfate oral Generic OTC ferretts Generic OTC tablet,delayed ferrex 150 Generic OTC release (dr/ec) ferrex 150 plus Generic OTC FERROUS Brand SULFATE, DRIED FERRIC Brand (BULK) AMMONIUM CITRATE (BULK) ferrousul Generic OTC FERRIC Brand ferus Generic OTC SUBSULFATE fluor-a-day (with Generic (BULK) xylitol) SOLUTION fluoritab oral Generic ferric x-150 Generic OTC tablet,chewable ferrocite Generic OTC focalgin 90 dha Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 166 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC focalgin ca Generic gummi bear Generic OTC multivitamin focalgin dss Generic gummy swirls Generic OTC folbecal Generic hair vitamins Generic OTC folbee Generic hair,skin and nails Generic OTC folbee plus oral Generic oral tablet tablet 5 mg halls defense Generic OTC folcal dha Generic HARD NAIL Brand OTC folcaps omega-3 Generic (asparto-gly) healthy eyes Generic OTC FOLIC ACID Brand healthy eyes Generic OTC (BULK) supervision folic acid injection Generic hematinic plus Generic vit/minerals folic acid oral tablet Generic 1 mg hematinic/folic acid Generic folic acid oral tablet Generic OTC hematogen Generic 400 mcg, 800 mcg hematogen fa Generic folic acid-vit b6-vit Generic hematogen forte Generic b12 oral tablet 2.2- 25-0.5 mg hemenatal ob Generic folinatal plus b Generic hemenatal ob + dha Generic folivane-f Generic hemetab Generic folivane-ob Generic high potency iron Generic OTC folivane-plus Generic honey bears Generic OTC folivane-prx dha nf Generic honey bears with Generic OTC iron-zinc folplex 2.2 Generic hydroxocobalamin Generic fosfree Generic OTC HYDROXOCOBAL Brand fruit c Generic OTC AMIN (BULK) fruit c-500 Generic OTC icaps areds oral Generic OTC fruity chews Generic OTC capsule full spectrum b- Generic OTC icaps plus Generic OTC vitamin c iferex 150 Generic OTC geravim Generic OTC inatal advance Generic geriaton Generic OTC inatal ultra Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 167 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC infanate plus Generic macnatal cn dha Generic infed Generic maximum daily Generic OTC multivitamin iron (dried) Generic OTC MEGA BIOTIN Brand OTC iron chews Generic OTC mega Generic OTC iron fum,ag-c-b12- Generic multiple/chelated fa-ca-succ mineral iron high potency Generic OTC men's daily formula Generic OTC iron oral tablet 325 Generic OTC oral tablet 0.4 mg mg (65 mg iron) men's daily multivit- Generic OTC iron oral tablet Generic OTC mineral extended release 159 men's multi-vitamin Generic OTC mg (45 mg iron) men's one daily oral Generic OTC i-vite Generic OTC tablet i-vite protect Generic OTC MERIBIN Brand OTC kid's vitamins + Generic OTC METHYLTETRAH Brand extra c YDROFOL CA kids vitamins + iron Generic OTC (BULK) kid's vitamins + iron Generic OTC milltrium senior Generic OTC kid's vitamins oral Generic OTC multi complete with Generic OTC tablet,chewable iron kobee Generic OTC multi-day with iron Generic OTC kpn oral tablet Generic OTC multi-delyn Generic OTC LEVOMEFOLATE Brand multi-delyn with iron Generic OTC CALCIUM (BULK) multigen folic Generic little animals Generic OTC multigen plus Generic little animals-iron Generic OTC multilex Generic OTC oral tablet,chewable multilex-t and m Generic OTC lozi-flur Generic multiple vitamin, Generic OTC ludent fluoride Generic womens LUTEIN (BULK) Brand multiple vitamin- Generic OTC POWDER minerals lysiplex plus oral Generic OTC multi-vit with Generic liquid fluoride-iron m.v.i. adult Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 168 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC multivital platinum Generic OTC obstetrix dha Generic oral tablet ocutabs Generic OTC multivitamin Generic OTC omnicap Generic OTC multivitamin 50 plus Generic OTC once daily Generic OTC multi-vitamin Generic OTC one daily 50 plus Generic OTC hp/minerals one daily Generic OTC multivitamin with Generic calcium/iron fluoride one daily complete Generic OTC multi-vitamin with Generic fluoride oral drops one daily energy Generic OTC oral tablet multivitamin with Generic OTC iron one daily essential Generic OTC oral tablet , 0.4 mg multivitamin with Generic OTC minerals oral liquid one daily for men Generic OTC multivitamins with Generic one daily for women Generic OTC fluoride one daily maximum Generic OTC multi-vite 50 and Generic OTC one daily maximum Generic OTC over (with ca) mvc-fluoride Generic one daily multi-vit Generic OTC myferon 150 Generic OTC w-mineral mynatal Generic one daily Generic OTC multivitamin oral mynatal advance Generic tablet mynatal plus Generic one daily multivit- Generic OTC mynatal-z Generic iron(folic) mynate 90 plus Generic one daily oral tablet Generic OTC , 0.4-600 mg-mcg mynephrocaps Generic one daily plus iron Generic OTC my-vitalife Generic OTC one daily plus Generic OTC natal-v rx Generic minerals natalvirt 90 dha Generic one daily women's Generic OTC natalvirt ca Generic one daily womens 50 Generic OTC natalvirt flt Generic plus nephplex rx Generic one daily women's Generic OTC nephro-vite rx Generic health newgen Generic one-a-day essential Generic OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 169 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC one-a-day maximum Generic OTC pr natal 430 Generic formula pr natal 430 ec Generic one-a-day teen Generic OTC prefol-dha Generic advantage prena1 Generic opti-vitamins Generic OTC prena1 chew Generic ortho d Generic prena1 chew Generic oyster shell calcium- Generic OTC (quatrefolic) vit d2 prena1 pearl Generic PANTHENOL Brand (BULK) prena1 plus Generic pnv 29-1 Generic prena1 true Generic pnv ob+dha Generic prenaissance Generic pnv-dha Generic prenaissance 90 dha Generic pnv-dha + docusate Generic prenaissance Generic balance pnv-ferrous Generic fumarate-docu-fa prenaissance dha Generic pnv-first Generic prenaissance Generic harmony dha pnv-omega Generic prenaissance next Generic pnv-select Generic prenaissance plus Generic pnv-total Generic prenaissance Generic pnv-vp-u Generic promise polysaccharide iron Generic OTC prenaplus Generic poly-vita Generic OTC prenatabs fa Generic poly-vita (iron) Generic OTC prenatabs rx Generic poly-vitamin Generic OTC prenatal 19 Generic OTC poly-vitamin with Generic OTC prenatal ad Generic iron prenatal formula Generic OTC polyvitamin/iron Generic OTC oral tablet 28 mg poly-vitamins Generic OTC iron- 800 mcg POTASSIUM Brand prenatal low iron Generic PHOSPH, MONO prenatal Generic OTC (BULK) multivitamins pr natal 400 Generic prenatal one daily Generic OTC pr natal 400 ec Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 170 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC prenatal oral tablet Generic OTC rena-vite rx Generic 28 mg iron- 800 mcg reno caps Generic prenatal plus Generic replesta Generic OTC (calcium carb) RIBOFLAVIN Brand prenatal plus with Generic (VITAMIN B2) iron (ca) RIBOFLAVIN 5- Brand prenatal tablet Generic OTC PHOSPHATE prenatal vitamin Generic OTC SODIUM oral tablet , 27 mg rulavite dha Generic iron- 0.8 mg, 28 mg iron- 800 mcg se-natal 19 Generic prenatal vitamin Generic se-natal 19 (with Generic plus low iron docusate) prenatal vits96-iron Generic OTC sentry Generic OTC fum-folic se-tan dha Generic prenatal-u Generic se-tan plus Generic preplus Generic setonet Generic pretab Generic setonet-ec Generic PROFERRIN- Brand slow release iron Generic OTC FORTE oral tablet extended purevit dualfe plus Generic release 142 mg (45 mg iron), 143 mg PYRIDOXAL-5 Brand (45 mg iron), 159 PHOSPHATE mg (45 mg iron), (BULK) 160 mg (50 mg PYRIDOXINE Brand iron), 250 mg (50 (BULK) mg iron), 47.5 mg iron pyridoxine (vitamin Generic b6) injection SODIUM Brand FLUORIDE pyridoxine (vitamin Generic OTC (BULK) b6) oral tablet 100 mg, 25 mg, 250 mg, sodium fluoride oral Generic 50 mg drops quintabs-m iron free Generic OTC sodium fluoride oral Generic tablet,chewable relnate dha Generic soothing pureway-c Generic OTC renal caps Generic spectravite Generic OTC rena-vite Generic OTC

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 171 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC spectravite advanced Generic OTC super multivitamin Generic OTC formula oral tablet super quints Generic OTC 18-400 mg-mcg super quints b-50 Generic OTC spectravite senior Generic OTC oral tablet super thera vite m Generic OTC spectravite senior w- Generic OTC superplex-t Generic OTC lycopene support Generic OTC spectravite ultra Generic OTC tab a vite oral tablet Generic OTC women 18-0.4 mg stress 500 plus zinc Generic OTC tab-a-vite Generic OTC stress b plus zinc Generic OTC tab-a-vite/iron Generic OTC stress b with zinc Generic OTC tab-a-vite-minerals Generic OTC stress formula Generic OTC taron forte Generic stress formula Generic OTC taron-bc Generic advanced taron-c dha Generic stress formula plus Generic OTC iron taron-prex prenatal- Generic dha stress formula with Generic OTC iron thera m plus (ferrous Generic OTC fumarat) stress formula with Generic OTC iron(sulf) thera vitamin Generic OTC stress formula with Generic OTC thera-d Generic OTC zinc theralogix Generic OTC stresstabs with zinc Generic OTC companion strovite plus Generic thera-m Generic OTC super b complex- Generic OTC therapeutic Generic vitamin c formula/hematinics super b maxi Generic OTC therapeutic liquid Generic OTC complex therapeutic m + Generic OTC super b/c Generic OTC beta-carotene super b-50 complex Generic OTC therapeutic-m Generic OTC super b-50 complex Generic OTC therapeutic-m Generic OTC plus vitamin/minerals oral tablet 27-0.4 mg super multiple oral Generic OTC tablet thera-tabs Generic OTC thera-tabs m Generic OTC You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 172 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC theratrum complete Generic OTC tri-tabs dha Generic 50 plus triveen-duo dha Generic theratrum complete Generic OTC triveen-one Generic 50 plus/lut triveen-prx rnf Generic therems Generic OTC tri-vit with fluoride Generic therems-m Generic OTC and iron THIAMINE HCL Brand tri-vita Generic OTC (BULK) tri-vitamin Generic OTC thiamine hcl Generic (vitamin b1) tri-vitamin with Generic injection fluoride thiamine hcl Generic OTC trust natal dha Generic (vitamin b1) oral ultimate ob dha Generic tablet 100 mg, 250 mg, 50 mg ultimatecare one Generic thrivite-19 Generic ultimatecare one nf Generic tl gard rx Generic ultra b-100 complex Generic OTC oral tablet tl g-fol os Generic unicomplex-m Generic OTC tl icon Generic v-c forte Generic tl-care dha Generic vemavite-prx-2 Generic tl-fluorivite Generic vena-bal dha Generic tl-hem 150 Generic venatal-fa Generic tl-select Generic VENOFER Brand total b/c Generic OTC vic-forte Generic triadvance Generic vinacal Generic tricon Generic vinate care Generic trigels-f forte Generic vinate dha Generic trinatal gt Generic vinate gt Generic trinatal rx 1 Generic vinate ii Generic trinatal ultra Generic vinate m Generic trinate Generic vinate one Generic triphrocaps Generic vinate pn care Generic triple vitamin with Generic fluoride vinate ultra Generic

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 173 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC virt-advance Generic VITAMIN A Brand PALMITATE virt-bal dha Generic VITAMIN A Brand virt-bal dha plus Generic PALMITATE virt-c dha Generic (BULK) LIQUID virt-care one Generic 1,700,000 UNIT/GRAM, virt-gard Generic 18,000 UNIT/ML virt-nate Generic vitamin b complex Generic OTC virt-nate dha Generic vitamin b complex Generic OTC virt-pn Generic with c virt-pn dha Generic vitamin b-1 Generic OTC virt-pn plus Generic vitamin b-1 Generic OTC (mononitrate) virt-select Generic vitamin b-6 oral Generic OTC virt-vite Generic tablet virt-vite gt Generic vitamin c cough Generic OTC vision formula (with Generic OTC drops lutein) vitamin c oral Generic OTC vit 3 Generic capsule, extended release vit b complex-folic Generic OTC acid oral tablet vitamin c oral Generic OTC lozenge VIT E ACID Brand SUCCINATE vitamin c oral Generic OTC (BULK) powder vitabee/c Generic OTC vitamin c oral syrup Generic OTC vita-c Generic OTC vitamin c oral tablet Generic OTC VITAFOL-OB Brand vitamin c oral tablet Generic OTC extended release vitafol-pn (ud) Generic vitamin c oral Generic OTC vitalee Generic OTC tablet,chewable 250 vitalets oral Generic OTC mg, 500 mg tablet,chewable vitamin c with rose Generic OTC VITAMAX Brand hips oral tablet 500 mg vitamin a Generic OTC vitamin c with rose Generic OTC VITAMIN A Brand hips oral tablet ACETATE (BULK) extended release You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 174 Drug Name Tier PA/Step/QLL Drug Name Tier PA/Step/QLL s/OTC s/OTC vitamin d3 oral Generic OTC vp-heme one Generic capsule 1,000 unit, vp-vite rx Generic 2,000 unit, 400 unit wee care Generic OTC vitamin d3 oral Generic OTC tablet 400 unit women's daily Generic OTC formula vitamin d3 oral Generic OTC tablet,chewable women's one daily Generic OTC VITAMIN E (DL, Brand yelets Generic OTC ACETATE) zatean-ch Generic (BULK) zatean-pn Generic VITAMIN E Brand ACETATE (BULK) zatean-pn dha Generic LIQUID zatean-pn plus Generic VITAMIN E Brand zavara Generic ACETATE (BULK) POWDER 50 % ZEAXANTHIN Brand (BULK) vitamins a,c,d and Generic fluoride zingiber Generic vitamins and Generic OTC zolate Generic minerals zoo chews Generic OTC vitamins b complex Generic OTC oral capsule vitamins for hair Generic OTC oral tablet vitrum senior oral Generic OTC tablet vol-care rx Generic vol-nate Generic vol-plus Generic vol-tab rx Generic vp-ch plus Generic vp-ch-pnv Generic vp-era ob plus Generic vp-ggr-b6 Generic vp-heme ob Generic vp-heme ob + dha Generic You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 175 Index

1 ACCU-CHEK SAFE-T-PRO acid reducer (cimetidine)....118 12 hour cold relief ...... 133 ...... 69 acid reducer (famotidine) ...118 12 hour decongestant...... 133 ACCU-CHEK SAFE-T-PRO acid reducer (ranitidine) .....118 12 hour nasal spray...... 65 PLUS ...... 69 acid relief (cimetidine) ...... 118 1ST TIER UNIFINE PENTIPS ACCU-CHEK SOFTCLIX acitretin ...... 42 ...... 69 LANCETS...... 69 acne cleansing bar...... 48 1ST TIER UNILET ACD...... 57 acne control cleanser ...... 48 COMFORTOUCH ...... 69 ACD-A ...... 69 acne foaming wash ...... 48 2 ACE AEROSOL CLOUD acne medication ...... 48 2-DEOXY-D-GLUCOSE ENHANCER ...... 69 acne treatment (benzoyl perox) (BULK) ...... 57 acebutolol ...... 35 ...... 48 2-METHOXYESTRADIOL ACEBUTOLOL (BULK).....35 acne vanishing ...... 48 (BULK) ...... 57 acephen...... 24 acne-clear...... 48 3 ACERFLEX ...... 154 acta-tabs pe ...... 133 3 day vaginal ...... 125 acerola c-500 ...... 164 ACTEMRA...... 123 3,5-DIIODOTHYRONINE acetadryl ...... 24 ACTHAR H.P...... 67 (BULK) ...... 57 aceta-gesic ...... 24 ACTICOAT 7 DRESSING ..69 30pse-150gfn-15dm ...... 133 acetaminophen...... 25 actidom dmx ...... 133 3-day vaginal ...... 125 ACETAMINOPHEN (BULK) acti-lance lancets ...... 69 3M NEXCARE DURAPORE ...... 24 ACTI-LANCE LANCETS ...69 ...... 69 acetaminophen extra strength ACTIMMUNE ...... 120 4 ...... 24 ACTIVE CATH...... 69 4 way ...... 65 acetaminophen pm extra str..25 ACTIVE LIFE 1-PC STOMA 5 acetaminophen-caff- CAP ...... 69 5-AMINOSALICYLIC ACID dihydrocod...... 21 ACTIVE LIFE CONVEX ...... 110 acetaminophen-codeine...... 21 UROSTOMY...... 69 7 acetasol hc ...... 67 ACTIVE LIFE CUT-TO-FIT 7-KETO DHEA...... 106 acetazolamide ...... 131 CLOSED...... 69 8 ACETAZOLAMIDE (BULK) ACTIVE LIFE DRAINABLE 8 hour pain reliever ...... 24 ...... 131 POUCH...... 69 A acetazolamide sodium ...... 131 ACTIVE LIFE UROSTOMY a thru z advanced formula ..164 ACETEST ...... 69 POUCH...... 69 a thru z high potency ...... 164 acetic acid ...... 57, 67 ACTOPLUS MET XR ...... 69 a thru z select...... 164 acetic acid-aluminum acetate67 acuicyn...... 130 abacavir ...... 3 ACETYLCARNITINE acyclovir ...... 4, 54 abacavir-lamivudine...... 3 (BULK) ...... 154 ACYCLOVIR (BULK) ...... 3 abacavir-lamivudine- ACETYLCHOLINE acyclovir sodium ...... 4 zidovudine ...... 3 CHLORIDE (BULK) .....130 ACYCLOVIR, MICRONIZED ABRAXANE...... 12 acetylcysteine ...... 57, 146 (BULK)...... 4 ABREVA ...... 54 ACETYLCYSTEINE (BULK) ADAGEN ...... 57 absorbine pain relieving ...... 43 ...... 146 adapalene ...... 48, 49 ACACIA (BULK)...... 57 ACETYL-L-CARNITINE....57 ADAPT BARRIER RING....69 acamprosate...... 57 acid control (ranitidine) ...... 118 ADAPT BARRIER STRIPS 69 acarbose...... 69 acid controller...... 118 ADAPT CONVEX BARRIER ACCU-CHEK FASTCLIX ..69 acid gone antacid ...... 110 RINGS ...... 70 acid gone antacid e.strength110 You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 176 ADAPT LUBRICATING adults' daily formula ...... 164 AIRZONE PEAK FLOW DEODORANT...... 70 advanced am-pm...... 164 METER...... 70 ADAPT OSTOMY PASTE .70 advanced antacid-antigas....110 akorn balanced salt ...... 130 ADAPT STOMA POWDER 70 advanced exfoliating cleanser ak-poly-bac...... 129 ADCETRIS ...... 12 ...... 49 AKYNZEO...... 110 ADD-A-FOLEY CATH- advanced eye relief...... 130 al 12 ...... 43 MONO-FLO DRNG ...... 70 ADVANCED LANCING ala-cort...... 54 ADD-A-FOLEY CATH-PRE- DEVICE ...... 70 alagesic lq ...... 21 FILL SYRN...... 70 ADVANCED TRAVEL ALANINE (BULK)...... 57 ADD-A-FOLEY TRAY...... 70 LANCETS...... 70 alavert ...... 133 added strength headache relief ADVANTAGE WITH IRON alavert d-12 allergy-sinus ...133 ...... 25 ...... 154 ALBENDAZOLE (BULK) ....7 added strength pain reliever .25 advil...... 25 ALBENZA ...... 7 adefovir...... 4 ADVOCATE LANCET ...... 70 ALBUMIN, BOVINE (BULK) ADEMPAS...... 146 ADVOCATE LANCING ...... 57 adenosine...... 34 DEVICE ...... 70 albuterol sulfate ...... 146 ADHESIVE BANDAGE .....70 ADVOCATE PEN NEEDLE ALBUTEROL SULFATE ADHESIVE BARRIERS .....70 ...... 70 (BULK)...... 146 ADHESIVE GAUZE PAD ..70 ADVOCATE RAPID-SAFE alcalak...... 149 ADHESIVE TAPE...... 70 LANCING...... 70 alclometasone ...... 54 ADJUSTABLE LANCING ADVOCATE SYRINGES ...70 ALCOHOL PREP PADS .....70 DEVICE ...... 70 aero otic hc ...... 67 ALCOHOL SWABS ...... 70 adrenalin...... 133 AEROCHAMBER PLUS ALCOHOL WIPES ...... 70 adriamycin...... 12 FLOW-VU,S MSK...... 70 alcohol, rubbing...... 64 adrucil...... 12 AEROCHAMBER PLUS Z ALDOSTERONE (BULK) ..67 adt robitussin peak cld dm max STAT MD MSK...... 70 ALDURAZYME ...... 106 ...... 133 AEROCHAMBER WITH alendronate ...... 57, 123 ADULT BRIEF - EXTRA FLOWSIGNAL...... 70 aler-cap ...... 133 LARGE...... 70 AEROTRACH PLUS...... 70 aler-tab...... 133 adult cough formula dm max AEROVENT PLUS...... 70 ALFAMINO JUNIOR...... 154 ...... 133 af 52 alfentanil ...... 21 adult low dose aspirin...... 25 afeditab cr...... 35 ALFERON N...... 120 adult robitussin lingering cld AFINITOR ...... 12 alfuzosin ...... 148 ...... 133 AFINITOR DISPERZ ...... 12 ALGINIC ACID (BULK) ....57 adult robitussin m-s cold ....133 AFLURIA 2013-2014 ...... 121 ALGISITE M...... 71 adult robitussin peak cold dm AFLURIA 2013-2014 (PF) 121 ALIMTA...... 12 ...... 133 AFLURIA 2014-2015 ...... 121 ALINIA ...... 7 adult robitussin peak cold m-s AFLURIA 2014-2015 (PF) 121 alka-seltzer plus allergy...... 133 ...... 133 AFLURIA 2015-2016 ...... 121 alka-seltzer plus mucus-conges adult tussin chest congestion AFLURIA 2015-2016 (PF) 121 ...... 133 ...... 133 AFLURIA 2016-2017 ...... 121 ALKERAN ...... 12 adult tussin cough congest dm AFLURIA 2016-2017 (PF) 121 all day allergy (cetirizine)...133 ...... 133 AFLURIA QUAD 2016-2017 all day allergy-d...... 133 adult tussin dm ...... 133 (PF)...... 121 ALL PURPOSE CLOTH adult tussin multi-symp cold afrin no drip(oxymetazolin)..65 TAPE ...... 71 ...... 133 a-hydrocort ...... 67 ALLANTOIN (BULK) ...... 43 adult wal-tussin ...... 133 AIMSCO ...... 70 ALLEGRA ALLERGY...... 133 adult wal-tussin dm max ....133 ALLEGRA-D 12 HOUR....133

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 177 ALLEGRA-D 24 HOUR....133 allergy-time ...... 134 ALUMINUM aller-chlor ...... 133 allerhist-1...... 134 CHLOROHYDRATE allerclear...... 133 aller-tec...... 134 (BULK)...... 57 allerclear d-12hr ...... 133 aller-tec d...... 135 aluminum hydroxide gel.....110 allerclear d-24hr ...... 133 ALLEVYN ...... 71 ALUMINUM HYDROXIDE aller-ease...... 133 allfen...... 135 GEL (BULK)...... 110 allerfed cold and allergy.....133 allfen dm...... 135 ALUMINUM SULFATE aller-fex ...... 133 ALLKARE PROTECT (BULK)...... 57 aller-g-time...... 133 BARRIER WIPES...... 71 alyacen 1/35 (28) ...... 126 allergy (chlorpheniramine).134 allopurinol ...... 123 alyacen 7/7/7 (28) ...... 126 allergy (diphenhydramine) .134 ALLOPURINOL (BULK) .123 amabelz...... 124 allergy 4-hour ...... 134 allopurinol sodium...... 123 amantadine hcl...... 4 allergy and congestion relief almacone...... 110 AMANTADINE HCL (BULK) ...... 134 almacone-2 ...... 110 ...... 4 allergy and sinus relief ...... 134 almond oil, sweet (bulk)...... 64 ambi 10peh-4cpm ...... 135 allergy complete-d...... 134 almotriptan malate...... 19 ambi 40pse-400gfn-20dm...135 allergy cream (diphenhyd, zn) ALOE VERA LEAF GEL ambi 60pse-400gfn ...... 135 ...... 43 XTR (BULK) ...... 43 ambi 60pse-4cpm...... 135 allergy cream aloe vesta antifungal (micon)52 ambitussin ac ...... 135 (diphenhydramin)...... 43 alophen ...... 110 ambizine ...... 110 allergy d-12 ...... 134 aloprim...... 123 amcinonide ...... 54 allergy medication...... 134 alosetron ...... 110 AMERIGEL DRESSING.....71 allergy medicine ...... 134 ALOXI...... 110 amethia ...... 126 allergy multi-symptom ...... 134 ALPHA LIPOIC ACID amethia lo ...... 126 allergy relief (cetirizine).....134 (BULK) ...... 57 amethyst...... 126 allergy relief (clemastine)...134 ALPHAGAN P...... 132 AMICAR ...... 39 allergy relief (fexofenadine) alprazolam ...... 30 amifostine crystalline...... 12 ...... 134 ALPRAZOLAM (BULK) ....30 amikacin ...... 7 allergy relief (loratadine)....134 alprazolam intensol...... 30 AMIKACIN (BULK) ...... 7 allergy relief d ...... 134 alprostadil ...... 148 AMIKACIN SULFATE allergy relief d-24...... 134 ALPROSTADIL (BULK) ..148 (BULK)...... 7 allergy relief multi-symptom altacaine...... 130 amiloride...... 35 ...... 134 altachlore ...... 130 amiloride-hydrochlorothiazide allergy relief spray...... 43 altafluor ...... 130 ...... 35 allergy relief(chlorpheniramn) altafrin ...... 132 amino acids 15 %...... 154 ...... 134 altalube ...... 130 aminocaproic acid...... 39 allergy relief(diphenhydramin) altamist ...... 65 AMINOCAPROIC ACID ...... 134 altavera (28)...... 126 (BULK)...... 39 allergy relief,nasal decongest ALTERNATE SITE LANCET aminophylline ...... 146 ...... 134 ...... 71 AMINOPHYLLINE (BULK) allergy relief-d (cetirizine) .134 ALTERNATE SITE ...... 146 allergy relief-d (loratadine) 134 LANCING DEVICE ...... 71 AMINOSALICYLIC ACID allergy relief-d(fexofenadine) ALUMINUM ACETATE (BULK)...... 7 ...... 134 (BULK) ...... 43 amiodarone ...... 34 allergy sinus pe...... 134 ALUMINUM CHLORIDE amitriptyline ...... 30 ALLERGY SYRINGE...... 71 (BULK) ...... 43 AMITRIPTYLINE (BULK).30 allergy-congestion relief-d .134 amitriptyline-chlordiazepoxide allergy-d ...... 134 ...... 30

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 178 amlactin ...... 43 antacid anti-gas...... 111 ap-hist dm ...... 135 amlodipine...... 35 antacid anti-gas double str..111 APLIGRAF...... 58 AMLODIPINE BESYLATE antacid exst (mag carb-al hyd) APOKYN ...... 19 (BULK) ...... 35 ...... 111 APOMORPHINE (BULK).111 amlodipine-atorvastatin...... 40 antacid ext str (calcium carb) apraclonidine ...... 132 amlodipine-benazepril...... 35 ...... 150 aprepitant ...... 111 amlodipine-olmesartan...... 35 antacid extra-strength .111, 150 apri...... 126 amlodipine-valsartan ...... 35 antacid m ...... 111 APRISO...... 111 amlodipine-valsartan-hcthiazid antacid maximum strength .111 aprodine ...... 135 ...... 35 antacid plus anti-gas ...... 111 APTIVUS ...... 4 AMMONIUM CHLORIDE antacid regular strength ...... 111 AQUA LANCE LANCING (BULK) ...... 149 antacid supreme...... 111 DEVICE ...... 71 ammonium lactate ...... 43 antacid tablet...... 111 AQUACEL EXTRA...... 71 AMMONIUM LACTATE antacid ultra strength ..111, 150 AQUACEL FOAM ...... 71 (BULK) ...... 43 antacid-simethicone...... 111 AQUACEL-AG...... 71 ammonium molybdate...... 58 antacid-simethicone ds ...... 111 ARALAST NP...... 58 AMMONIUM SULFATE ANTHRALIN (BULK) ...... 42 aranelle (28)...... 126 (BULK) ...... 58 ANTIBACTERIAL arbinoxa ...... 135 amnesteem...... 49 BANDAGES ...... 71 ARCALYST ...... 120 amoxapine ...... 30 antibiotic (bacitracin zinc)....52 ARGATROBAN IN NACL amoxicil-clarithromy-lansopraz ANTICOAG CITRATE PHOS (ISO-OS)...... 39 ...... 118 DEXTROSE ...... 58 ARGININE (L-ARGININE) amoxicillin...... 9 anti-diarrhea...... 108 (BULK)...... 154 AMOXICILLIN (BULK)...... 9 anti-diarrheal ...... 108 ARGININE HCL(L- amoxicillin-pot clavulanate ..10 anti-diarrheal (loperamide) 108, ARGININE)(BULK)...... 154 amphotericin b...... 3 109 ARGYLE...... 71 AMPHOTERICIN B (BULK)3 anti-fungal ...... 52 ARGYLE TROCAR...... 71 ampicillin...... 10 antifungal (clotrimazole) ...... 52 aripiprazole ...... 30, 31 ampicillin sodium...... 10 antifungal (tolnaftate) ...... 52 ARISTADA...... 31 ampicillin-sulbactam ...... 10 antifungal cream ...... 52 armodafinil ...... 31 AMPYRA...... 20 antifungal spray ...... 52 ARMOUR THYROID...... 108 anagrelide ...... 58 anti-gas ultra strength ...... 111 ARRANON ...... 12 analgesic (trolamine salicyl).43 anti-itch (diphenhydramine) .44 ARSENIC TRIOXIDE analgesic creme ...... 43 anti-itch (hc) ...... 54 (BULK)...... 12 analgesic grx balm...... 43 anti-itch (menthol/camphor).44 arthricream rub ...... 44 anaspaz ...... 108 anti-itch medicated ...... 65 arthritis...... 44 anastrozole...... 12 anti-itch(diphenhyd) with zinc ARTHRITIS HEATWRAPS71 ANASTROZOLE (BULK) ..12 ...... 44 arthritis pain relief (acetam) .25 androxy...... 106 ANTIMONY TRICHLORIDE arthritis pain relief(capsaic)..44 anectine...... 20 (BULK) ...... 58 artificial tears (petro/min)...130 anefrin...... 65 antioxidant formula ...... 164 artificial tears (pf) ...... 130 animal chews ...... 164 antioxidant vitamins ...... 164 artificial tears (polyvin alc) 130 animal shape vitamins ...... 164 antipyrine-benzocaine ...... 67 artificial tears(dext70-hypro) ANISINDIONE (BULK) .....58 antitussive dm...... 135 ...... 130 ANORO ELLIPTA ...... 146 anucort-hc...... 111 artificial tears(glycerin-peg) antacid (calcium carb-mag anu-med...... 111 ...... 130 hyd)...... 111 apatate forte ...... 164 artificial tears(hypromellose) antacid (calcium carbonate)149 apexicon e...... 54 ...... 130

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 179 artificial tears(pg-hypm-glyc) ASSURA OSTOMY BELT .72 AURORA SUPER THIN ...... 130 ASSURA PEDIATRIC LANCETS ...... 72 artificial tears(pvalch-povid) POUCH ...... 72 AUTOJECT 2 INJECTION ...... 130 ASSURA PEDIATRIC SKIN DEVICE ...... 72 ARZERRA ...... 12 BARRIER...... 72 AUTO-LANCET MINI...... 72 ascomp with codeine ...... 21 ASSURA POUCH...... 72 AUTOLET IMPRESSION ascorbate calcium ...... 164 ASSURA WOUND LANC DEV ...... 72 ASCORBIC ACID (BULK) MANAGER 1/2-2 3/4 ...... 72 AUTOLET LANCING ...... 164 ASSURANCE WOMENS DEVICE ...... 72 ascorbic acid (vitamin c) ....164 UNDERWEAR S-M ...... 72 AUTOLET PLUS LANCING ascorbic acid with rose hips164 ASSURE HAEMOLANCE DEVICE ...... 72 ashlyna...... 126 PLUS ...... 72 AUTOPEN 2 TO 32 UNITS 72 asper-flex...... 44 ASSURE ID INSULIN avar ...... 49 aspir-81...... 25 SAFETY...... 72 AVASTIN...... 12 aspirin...... 25 ASSURE LANCE ...... 72 AVELOX IN NACL (ISO- ASPIRIN (BULK)...... 25 ASSURE LANCE PLUS...... 72 OSMOTIC)...... 10 aspirin low dose...... 25 ASTHMA CHECK METER 72 aviane...... 126 aspirin, buffered ...... 25 ASTHMAMENTOR PEAK avidoxy ...... 11 aspirin-caffeine-dihydrocodein FLOW METER ...... 72 avita ...... 49 ...... 21 ASTHMAPACK AVITENE...... 39 aspirin-dipyridamole ...... 39 CHILDREN'S...... 72 avo cream...... 44 aspir-low...... 25 astramorph-pf ...... 21 AVOGEL DRESSING ...... 72 aspir-trin ...... 25 atenolol ...... 35 AVONEX ...... 120 ASSESS FULL RANGE ATENOLOL (BULK) ...... 35 AVONEX (WITH ALBUMIN) PEAK METER...... 71 atenolol-chlorthalidone...... 35 ...... 120 ASSURA 2PC DRAINABLE athenol ...... 25 AVYCAZ ...... 5 ...... 71 athlete's foot...... 52 ayr saline...... 65 ASSURA 2PC IRRIGATION athlete's foot (clotrimazole) ..52 azacitidine...... 12 SLEEVE...... 71 athlete's foot (terbinafine).....52 AZASAN...... 12 ASSURA AC BASEPLATE 71 athlete's foot (tolnaftate)...... 52 azathioprine ...... 13 ASSURA CONVEX SKIN athletic foot cream ...... 52 AZATHIOPRINE (BULK) ..13 BARRIER...... 71 ATN BRIEF ...... 72 azathioprine sodium...... 13 ASSURA CONVEX SKIN atorvastatin ...... 40 AZELAIC ACID (BULK)....49 BARRIER FLA...... 71 atovaquone...... 7 azelastine ...... 65, 130 ASSURA CONVEX atovaquone-proguanil...... 7 azithromycin ...... 6 UROPOUCH...... 71 atracurium...... 20 AZITHROMYCIN (BULK)...6 ASSURA EASICLOSE MINI ATRIPLA ...... 4 azolen tincture ...... 52 POUCH ...... 71 atropine...... 109, 129 aztreonam ...... 7 ASSURA EASICLOSE WIDE ATROPINE (BULK)...... 129 azuphen mb...... 149 MAXI ...... 71 atropine-care...... 129 azurette (28)...... 126 ASSURA EXTRA CONVEX ATROVENT HFA ...... 146 B POUCH ...... 71 ATTAPULGITE...... 109 b complete ...... 164 ASSURA IRRIG FCE PLT ATTENDS DISPOSABLE b complex ...... 164 1/2-2 1/4 ...... 71 UNDERPADS...... 72 b complex 100 ...... 164 ASSURA LIGHT aubra ...... 126 b complex-vitamin b12...... 164 EASICLOSE DRAINAB .72 AUGMENTIN...... 10 b complex-vitamin c-folic acid ASSURA NON-CONVEX aurodex ...... 67 ...... 164 DRAINABLE...... 72 auroguard...... 67 b-12 kit...... 164

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 180 b-50 complex...... 164 BARD INFECTION bee-zee...... 165 baby ayr saline...... 65 CONTROL BAG...... 73 bekyree (28)...... 126 BABY BASICS XX LARGE BARD LATEX LEG STRAPS BELLADONNA ALK LEAF DIAPER ...... 72 ...... 73 EXT (BULK)...... 109 BABY THERMOMETER ...72 BARD LEG BAG HOLDER73 belladonna alkaloids-opium109 baciim...... 7 BARD LEG BAG BELLADONNA TINCTURE bacitracin ...... 7, 52, 129 STRAPS/FABRIC...... 73 (BULK)...... 109 bacitracin (bulk) ...... 7 BARD LUBRICATH FOLEY belladonna-opium ...... 109 BACITRACIN (BULK)...... 7 TRAY ...... 73 BELTED SHIELDS ...... 73 bacitracin zinc ...... 52 BARD PLASTIC BELTED BACITRACIN ZN TUBING/ADAPTER ...... 73 UNDERGARMENTS ...... 74 MICRONIZED(BULK) ...52 BARD RUBBER UTILITY BELTLESS BACITRACIN, CATHETER ...... 73 UNDERGARMENTS ...... 74 MICRONIZED (BULK) ....7 BARD UNIVERSAL FOLEY benadryl itch stopping ...... 44 bacitracin-polymyxin b ...... 129 CATH TRAY ...... 73 benazepril ...... 35 bacitraycin plus ...... 52 BARD URETHRAL BENAZEPRIL HCL (BULK) baclofen ...... 20 CATHETER TRAY ...... 73 ...... 35 BACLOFEN (BULK) ...... 20 BARDEX ALL-SILICONE benazepril-hydrochlorothiazide BACTROBAN NASAL...... 65 FOLEY CATH ...... 73 ...... 35 balance b-50 ...... 165 BARDEX CLOSED SYSTEM BENDEKA ...... 13 balanced b-100 ...... 165 CATH TRAY ...... 73 benecalorie...... 154 balanced b-100 complex.....165 BARDEX URETHRAL BEN-E-FIT BRIEFS ...... 74 balanced b-50 ...... 165 CATHETERTRAY ...... 73 beneprotein ...... 154 balanced nutritional ...... 154 BARDIA URINARY bengay ultra strength ...... 44 balanced salt ...... 130 DRAINAGE BAG...... 73 BENLYSTA ...... 123 bal-care dha ...... 165 BARIUM SULFATE (BULK) BENZALKONIUM balsalazide ...... 111 ...... 58 CHLORIDE...... 44 balziva (28)...... 126 BASAGLAR KWIKPEN.....73 benzepro ...... 49 BANDAGES ...... 72 BASAL THERMOMETER, BENZOCAINE (BULK) ...... 50 BAND-AID FLEXIBLE ELECTRONIC ...... 73 BENZOCAINE FABRIC ...... 72 BASICS FOR KIDS...... 73 MICRONIZED (BULK) ..50 banophen ...... 135 bayer advanced...... 25 BENZOIC ACID ...... 44 banophen allergy ...... 135 baza antifungal ...... 52 benzonatate ...... 135 banophen anti-itch...... 44 BCAD 1...... 154 benzoyl peroxide ...... 49 BANZEL ...... 17 b-complex with vitamin c...165 BENZOYL PEROXIDE BARACLUDE ...... 4 BD ALCOHOL SWABS...... 73 (BULK)...... 49 BARD CENTER ENTRY BD LANCET DEVICE...... 73 benztropine ...... 19 CLOSE SYSTEM ...... 73 BD MAGNI-GUIDE BENZYL ALCOHOL ...... 58 BARD COUDE TIP SYRINGE MAGNIFI...... 73 BENZYL BENZOATE CATHETER...... 73 BD MICROTAINER (BULK)...... 58 BARD DELUXE FABRIC LANCET ...... 73 BETA 1,3 GLUCAN (BULK) LEG STRAPS ...... 73 BD ULTRA FINE LANCETS ...... 58 BARD EXTENSION ...... 73 BETA CAROTENE (BULK) TUBING/CONNECT...... 73 b-donna...... 109 ...... 165 BARD FEMALE BECLOMETHASONE BETADEX (BULK)...... 58 INTERMITTENT CATH.73 DIPROP (BULK) ...... 65 beta-hc ...... 54 BARD INFECT CONT BEDSIDE DRAINAGE BETAHISTINE (BULK)...... 35 TRAY-NO CATH...... 73 COLLECT SYSTM...... 73 BETAINE HCL (BULK) .....58

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 181 BETAMETHASONE BISMUTH CITRATE ...... 58 BORDERED GAUZE ...... 74 ACET,MICRO(BULK)....67 bismuth maximum strength 109 BORIC ACID ...... 130 betamethasone acet,sod phos67 BISMUTH SUBGALLATE BORIC ACID (BULK)...... 130 BETAMETHASONE (BULK) ...... 109 BOSULIF ...... 13 DIPROPION (BULK)...... 54 BISMUTH BOSWELLIA SERRATA XT betamethasone dipropionate.54 SUBSALICYLATE (BULK)...... 64 BETAMETHASONE SOD (BULK) ...... 109 BOTOX ...... 121 PHOS (BULK) ...... 67 bisoprolol fumarate...... 35 BOXERS FOR MEN...... 74 betamethasone valerate ...... 54 bisoprolol-hydrochlorothiazide bp ...... 49 BETAMETHASONE ...... 35 bp 10-1...... 49 VALERATE (BULK) ...... 54 BITTER MELON EXTRACT bp foam...... 49 betamethasone, augmented...54 (BULK) ...... 64 bp vit 3 plus ...... 165 betatemp ...... 25 bivalirudin ...... 39 bp wash...... 49 betaxolol...... 35, 129 BLADDER CONTROL PAD bp wash acne treatment ...... 49 bethanechol chloride ...... 148 ...... 74 bp-50% urea...... 44 BETHANECHOL CHLORIDE BLADDER CONTROL PADS bpo ...... 49 (BULK) ...... 148 FOR WOMEN...... 74 bpo creamy wash pack...... 49 BEVESPI AEROSPHERE.146 BLENDERM SURGICAL...74 bpo-10...... 49 bexarotene ...... 13 bleo 15k ...... 13 bpo-5...... 49 BEXXAR DOSIMETRIC....13 bleomycin ...... 13 BREAKFAST ESSENTIALS BIATAIN ADHESIVE FOAM BLINCYTO...... 13 ...... 155 DRESSING ...... 74 blisovi 24 fe...... 126 BREATHERITE VALVED bicalutamide ...... 13 blisovi fe 1.5/30 (28) ...... 126 MDI CHAMBER...... 74 bicarsim forte...... 111 blisovi fe 1/20 (28) ...... 126 BREEZERS ADULT BRIEF BICNU ...... 13 BLISTER CARE ...... 74 ...... 74 bidex...... 135 BLISTER RELIEF BRIEFS, ADULT-EXTRA BILTRICIDE...... 7 BANDAGES ...... 74 LARGE...... 74 bimatoprost...... 132 blis-to-sol (tolnaftate) ...... 52 briellyn...... 126 BIOBRANE GLOVES BLOOD PRESSURE KIT....74 bright beginnings soy ...... 155 MEDIUM ...... 74 BLOOD PRESSURE KIT BRILINTA ...... 39 biobron sf...... 135 MED AND LRG ...... 74 brimonidine...... 132 biocotron...... 135 BLOOD PRESSURE TEST BRIMONIDINE TARTRATE biogil...... 135 KIT-LARGE...... 74 (BULK)...... 132 bion tears (pf) ...... 130 BLOOD PRESSURE TEST brohist d...... 135 bionel...... 135 KIT-MEDIUM ...... 74 BROMELAINS (BULK)...... 57 biosupp ...... 165 blue gel ...... 44 bromfenac ...... 131 biotect plus ...... 154 boost ...... 155 BROMHEXINE ...... 58 biotin...... 165 BOOST BREEZE bromocriptine ...... 19 BIOTIN ...... 165 NUTRITIONAL...... 154 BROMOCRIPTINE (BULK) BIOTIN (BULK)...... 165 boost high protein...... 154 ...... 19 biovol...... 165 boost kid essentials...... 154 BROMPHENIRAMINE bisac-evac...... 111 BOOST KID ESSENTIALS MALEATE (BULK) ...... 135 bisacodyl...... 111 ...... 155 brompheniramine-pseudoeph- BISACODYL...... 111 BOOST KID ESSENTIALS dm...... 135 bisa-lax ...... 111 W-FIBER...... 155 brompheniramin-phenylephrin- biscolax...... 111 boost plus...... 155 dm...... 135 bismatrol...... 109 BOOST PUDDING...... 155 broncotron ped...... 135 bismuth...... 109 BOOST VHC ...... 155 brotapp...... 135

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 182 brotapp dm...... 135 BUTYLATED calcium carbonate-vitamin d3 bss...... 130 HYDROXYTOLUENE....58 ...... 150, 151 budeprion sr...... 31 BYDUREON...... 74 calcium chloride ...... 151 budesonide...... 111, 146 BYETTA ...... 74 CALCIUM CHLORIDE BUDESONIDE (BULK)....146 C (BULK)...... 151 BUDESONIDE, c 500 timed released ...... 165 calcium citrate ...... 151 MICRONIZED (BULK) 146 c complex ...... 165 CALCIUM CITRATE bufferin...... 25 c-1000...... 165 (BULK)...... 151 BUFLOMEDIL (BULK)...... 58 c-1000 with rose hips ...... 165 calcium citrate + ...... 151 BULLSEYE MINI SAFETY c-500...... 165 calcium citrate + d ...... 151 LANCETS...... 74 cabergoline ...... 106 calcium citrate-vitamin d3..151 bumetanide ...... 35 CAFFEINE (BULK) ...... 58 calcium folinate (leucovorin)12 bumm balm...... 44 caffeine citrate ...... 58 calcium for women ...... 165 BUPHENYL...... 58 CAFFEINE CITRATE CALCIUM GLUBIONATE bupivacaine...... 50 (BULK) ...... 58 (BULK)...... 151 BUPIVACAINE (BULK) ....50 caffeine-sodium benzoate...146 CALCIUM GLUCON bupivacaine (pf)...... 50 CALALGIN-GRX DRESSING MONOHYD (BULK).....151 bupivacaine-dextrose-water(pf) ...... 74 calcium gluconate...... 151 ...... 58 CALAMINE (BULK) ...... 44 calcium lactate ...... 151 bupivacaine-epinephrine ...... 50 calci-chew...... 150 CALCIUM LEVULINATE bupivacaine-epinephrine (pf)50 calcidol ...... 165 DIHY (BULK)...... 58 buprenorphine hcl...... 21 calciferol...... 165 CALCIUM BUPRENORPHINE HCL calcionate...... 150 PANTOTHENATE ...... 165 (BULK) ...... 21 calcipotriene ...... 42 CALCIUM PHOSPHATE buprenorphine-naloxone...... 25 CALCIPOTRIENE (BULK) 42 (BULK)...... 151 buproban...... 65 calcipotriene-betamethasone 42 calcium plus...... 165 BUPROPION (BULK)...... 31 calcitonin (salmon) ...... 106 calcium pnv ...... 165 bupropion hcl...... 31 calcitrate ...... 150 calcium polycarbophil ...... 111 bupropion hcl (smoking deter) calcitrene ...... 42 CALCIUM SACCHARATE ...... 65 calcitriol...... 42, 106 ...... 151 BURNS-SCALDS- CALCITRIOL-ALMOND OIL calcium soft chew ...... 165 ABRASIONS ...... 74 (BULK) ...... 58 CALCIUM SULFATE ...... 151 buspirone ...... 31 calcium 500 + d ...... 150 calcium-folic acid-vitamin d BUSPIRONE (BULK) ...... 31 calcium 500 with d ...... 150 ...... 165 BUSULFEX ...... 13 calcium 600 + d(3) ...... 150 calcium-vitamin d3-vitamin k BUTALBITAL (BULK) ...... 31 calcium 600 + minerals ...... 165 ...... 165 butalbital compound w/codeine calcium 600 with vitamin d3 cal-gest antacid ...... 151 ...... 21 ...... 150 CALLUS CUSHION...... 74 butalbital-acetaminop-caf-cod calcium acetate ...... 150 CALLUS PADS ...... 74 ...... 21 calcium antacid...... 150 cameo oil ...... 44 butalbital-acetaminophen .....22 calcium antacid ultra max st camila ...... 124 butalbital-acetaminophen-caff ...... 150 CAMINO PRO 15 PKU .....155 ...... 22 calcium carbonate...... 150 CAMO BANDAGES ...... 74 butalbital-aspirin-caffeine ....22 CALCIUM CARBONATE CAMPHOR ...... 44 butorphanol tartrate ...... 25 (BULK) ...... 150 camrese ...... 126 BUTORPHANOL calcium carbonate-vit d3-min camrese lo...... 126 TARTRATE (BULK) ...... 25 ...... 165 CANASA...... 111 BUTTERFLY CLOSURES .74 CANCIDAS...... 3

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 183 candesartan...... 35 CARRASYN HYDROGEL CENTERPOINTLOCK candesartan-hydrochlorothiazid WOUND DRESS ...... 75 DRAIN FILTER...... 75 ...... 35 carteolol ...... 129 CENTERPOINTLOCK CANE...... 74 cartia xt...... 35 DRAINABLE MINI...... 75 CANTHARIDIN (BULK) ...44 carvedilol ...... 35 CENTERPOINTLOCK capacet...... 22 cavan-ec sod dha ...... 165 DRAINABLE POUC ...... 75 capecitabine...... 13 CAYA CONTOURED...... 75 CENTERPOINTLOCK CAPRELSA ...... 13 CAYSTON ...... 7 FLEXTEND SKIN ...... 75 capsaicin...... 44 caziant (28)...... 126 CENTERPOINTLOCK CAPSAICIN...... 44 cefaclor ...... 5 FLEXWEAR CONVE...... 75 capsicum...... 44 cefadroxil...... 5 CENTERPOINTLOCK CAPSICUM OLEORESIN cefazolin ...... 5 SOFTFLEX SKIN ...... 75 (BULK) ...... 44 cefazolin in dextrose (iso-os) .5 CENTERPOINTLOCK captopril...... 35 cefdinir...... 5 STOMA CAP ...... 75 CAPTOPRIL (BULK)...... 35 cefditoren pivoxil ...... 5 CENTERPOINTLOCK captopril-hydrochlorothiazide cefepime ...... 5 STOMA IRRIGAT...... 75 ...... 35 cefepime in dextrose,iso-osm.6 CENTERPOINTLOCK captracin ...... 44 cefixime...... 6 UROSTOMY POUCH .....75 capzasin-hp...... 44 cefotaxime ...... 6 central-vite...... 165 CARAFATE...... 118 cefotetan ...... 6 central-vite select...... 166 CARBACHOL (BULK).....132 cefoxitin...... 6 central-vite women's under 50 CARBAGLU...... 58 cefoxitin in dextrose, iso-osm 6 ...... 166 carbamazepine...... 17 cefpodoxime ...... 6 centratex ...... 166 CARBAMAZEPINE (BULK) cefprozil...... 6 centravites 50 plus ...... 166 ...... 17 ceftazidime ...... 6 centrum women ...... 166 CARBAMIDE PEROXIDE CEFTAZIDIME (BULK)...... 6 century ...... 166 (BULK) ...... 67 ceftibuten...... 6 century mature ...... 166 carbidopa ...... 19 ceftriaxone...... 6 century ultimate women's ...166 CARBIDOPA (BULK) ...... 19 ceftriaxone in dextrose,iso-os.6 cephalexin...... 6 carbidopa-levodopa ...... 19 cefuroxime axetil...... 6 CEPROTIN (BLUE BAR) ...39 carbidopa-levodopa- cefuroxime sodium...... 6 CEPROTIN (GREEN BAR) 39 entacapone...... 19 cefuroxime-dextrose (iso-osm) CERDELGA...... 106 carbinoxamine maleate...... 135 ...... 6 cerovite ...... 166 carbocaine (pf)...... 50 celacyn...... 44 cerovite advanced formula .166 carb-o-philic ...... 44 celecoxib...... 25 cerovite jr...... 166 carboplatin...... 13 CELECOXIB (BULK)...... 25 cerovite senior ...... 166 cardioplegic soln ...... 41 CELLCEPT INTRAVENOUS certa plus...... 166 CAREFINE PEN NEEDLE .74 ...... 13 CERTAINTY REGULAR....75 CAREONE THIN LANCET74 CELLULOSE (BULK)...... 64 certavite-antioxid (iron gluc) CARETOUCH LANCING CELONTIN...... 17 ...... 166 DEVICE ...... 75 cem-urea ...... 44 certavite-antioxidant ...... 166 CARETOUCH PEN NEEDLE centamin ...... 165 cerubidine ...... 13 ...... 75 centavite a-z complete-mineral CESIUM CHLORIDE CARETOUCH TWIST ...... 165 (BULK)...... 58 LANCET ...... 75 centergy ...... 135 cetiri-d...... 135 carnation l/f inst breakfast ..155 centergy dm ...... 135 cetirizine ...... 135 carnation l/f, vhc, inst break CENTERPOINTLOCK cetirizine-pseudoephedrine.135 ...... 155 CLOSED POUCH...... 75

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 184 CETYL MYRISTOLEATE child mucus relief expectorant children's mucinex cough ...136 (BULK) ...... 58 ...... 136 children's multivit w/extra c166 CETYLPYRIDINIUM child multi-symptom children's non-aspirin...... 26 CHLORIDE...... 65 cold/cough ...... 136 children's non-aspirin pain....26 cevimeline ...... 58 child non-aspirin quick melts26 children's pain relief ...... 26 CHANTIX...... 65 child pain rel-fever reducer ..26 children's pain reliever...... 26 CHANTIX CONTINUING child triaminic cold-allergy 136 children's pain-fever relief....26 MONTH BOX...... 65 child vitamin with minerals 166 children's pepto...... 111 CHANTIX STARTING child wal-tap cold-allergy...136 childrens plus cold...... 137 MONTH BOX...... 65 child wal-tussin cough relief children's plus flu...... 137 chateal...... 126 ...... 136 childrens plus multi-symp cold CHEK-STIX CONTROL.....75 children night time cold-cough ...... 137 CHEMET ...... 58 ...... 136 children's profen ib ...... 26 CHEMO TRANSFER PIN...75 children's acetaminophen .....26 children's q-pap...... 26 CHEMSTRIP 10 MD...... 75 children's advil...... 26 children's saline nasal spray..65 CHEMSTRIP 10/SG ...... 75 children's allegra allergy.....136 children's silapap ...... 26 CHEMSTRIP 2 GP ...... 75 children's allergy (diphenhyd) children's silfedrine...... 137 CHEMSTRIP 50B...... 75 ...... 136 children's soothe ...... 111 CHEMSTRIP 7 ...... 75 children's allergy complete.136 children's sudafed pe cough137 CHEMSTRIP 9 ...... 75 children's allergy medicine.136 children's tactinal ...... 26 CHEMSTRIP K...... 75 children's allergy relief(lor) 136 children's vitamin d...... 166 CHENODAL...... 111 children's aller-tec ...... 136 children's wal-dryl allergy ..137 cheracol d ...... 135 children's aspirin...... 26 children's wal-zyr...... 137 cheratussin ac ...... 135 children's benadryl allergy .136 child's all day allergy(cetir) 137 cheratussin dac ...... 135 children's cetirizine...... 136 child's benadryl-d allergy-sin chest congestion relief...... 135 children's chest congestion .136 ...... 137 chest congestion relief + dm children's chewable vitamin166 childs chew vite ...... 166 ...... 135 children's chewable w/minerals child's chewable vitamins/iron chest congestion relief d.....135 ...... 166 ...... 166 chest congestion relief pe ...135 CHILDREN'S CLARITIN .136 childs triacting cold-cough .137 chest congestion-cough relief children's cold and cough (pe) childs/iron ...... 166 ...... 135 ...... 136 CHLORAL HYDRATE chest-sinus congestion relief children's cold-allergy (pe).136 (BULK)...... 31 ...... 135 children's complete allergy.136 CHLORAMBUCIL ...... 13 chewable multi vitamin ...... 166 children's cough...... 136 CHLORAMPHENICOL chewable multivit-a,b,d,e,k,zn children's dibromm cold-allerg (BULK)...... 7 ...... 166 ...... 136 CHLORAMPHENICOL chewable-vite ...... 166 children's dibromm dm cold- PALMITATE ...... 7 chewable-vite with iron...... 166 cou ...... 136 chloramphenicol sod succinate child allergy relf(cetirizine) 135 children's dimetapp cold-flu ...... 7 child allergy relief (diphen) 136 ...... 136 chlordiazepoxide hcl...... 31 child chest congestion + cough children's easy-melts ...... 26 chlordiazepoxide-clidinium 109 ...... 136 children's flu relief...... 136 chlorhexidine gluconate...... 66 child delsym cough+chest dm children's ibuprofen ...... 26 CHLORHEXIDINE ...... 136 children's iron ...... 166 GLUCONATE...... 44 child mucinex chest congestion children's mapap...... 26 chlorhist ...... 137 ...... 136 children's medi-profen...... 26 child mucus relief cough ....136 children's medi-tabs...... 26

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 185 CHLOROALLYL CHROMIUM PICOLINATE cleocin...... 7 METHENAM CL (BULK) (BULK) ...... 58 CLEVER CHEK LANCETS75 ...... 58 CHRYSIN ...... 58 CLEVER CHOICE CHLOROBUTANOL ...... 50 CHYMOTRYPSIN ...... 57 CHAMBER-LRG MASK 75 CHLOROFORM ...... 58 ciclodan ...... 53 CLICKFINE ...... 75 chloroprocaine (pf)...... 50 ciclopirox...... 53 CLIDINIUM BROMIDE chloroquine phosphate...... 7 CICLOPIROX OLAMINE...53 (BULK)...... 109 CHLOROQUINE ciclopirox-ure-camph-menth- clindacin etz...... 49 PHOSPHATE...... 7 euc ...... 53 clindacin p ...... 49 chlorothiazide...... 35 cidofovir ...... 4 clindamycin hcl ...... 7 chlorothiazide sodium ...... 35 ciferex...... 167 CLINDAMYCIN HCL CHLOROXINE (BULK) .....42 cilostazol...... 39 (BULK)...... 7 CHLOROXYLENOL (BULK) cimetidine ...... 118 clindamycin in 5 % dextrose ..7 ...... 53 CIMETIDINE (BULK) ...... 118 clindamycin palmitate hcl...... 7 chlorpheniramine maleate ..137 cimetidine hcl ...... 118 clindamycin phosphate ....7, 49, CHLORPHENIRAMINE CINRYZE...... 146 125 MALEATE...... 137 CIPRO ...... 10 CLINDAMYCIN chlorpromazine...... 31 ciprofloxacin...... 10 PHOSPHATE...... 7 CHLORPROMAZINE CIPROFLOXACIN (BULK)10 CLINDAMYCIN (BULK) ...... 31 ciprofloxacin (mixture)...... 10 PHOSPHATE (BULK) ...... 7 chlortabs ...... 137 ciprofloxacin hcl.....10, 67, 129 clindamycin-benzoyl peroxide chlorthalidone...... 35 ciprofloxacin in 5 % dextrose ...... 49 chlorzoxazone...... 20 ...... 10 clindamycin-tretinoin ...... 49 chocolate laxative...... 111 ciprofloxacin lactate ...... 10 CLINITEST REAGENT ...... 75 choice-ob + dha ...... 166 cisatracurium ...... 20 CLIOQUINOL ...... 7 choice-tabs...... 166 cisplatin ...... 13 clobetasol...... 54 CHOLBAM...... 111 citalopram...... 31 CLOBETASOL CHOLECALCIFEROL (VIT CITRIC ACID (BULK)...... 58 PROPIONATE (BULK)...54 D3)(BULK) ...... 166 citric acid anhydrous (bulk)..58 clobetasol-emollient ...... 54 cholecalciferol (vitamin d3) citrucel...... 111 clodan ...... 54 ...... 166, 167 citrus calcium ...... 151 CLOFAZIMINE (BULK) ...... 7 CHOLESTEROL (BULK).155 cladribine...... 13 CLOLAR ...... 13 CHOLESTYRAMINE claravis...... 49 CLOMIPHENE CITRATE (BULK) ...... 40 claris clarifying wash...... 49 (BULK)...... 106 cholestyramine (with sugar) .40 clarithromycin ...... 6 clomipramine...... 31 cholestyramine light ...... 40 CLARITHROMYCIN (BULK) CLOMIPRAMINE (BULK).31 CHOLIN AND MG ...... 6 clonazepam ...... 17 SALICYLATE(BULK)....26 CLARITIN REDITABS.....137 CLONAZEPAM (BULK) ....17 CHOLINE BITARTRATE classic prenatal ...... 167 clonidine ...... 35 (BULK) ...... 155 cleansing wash...... 49 clonidine (pf) ...... 26, 35 choline,magnesium salicylate CLEAR BANDAGES ...... 75 clonidine hcl ...... 31, 35 ...... 26 CLEAR STRIPS...... 75 CLONIDINE HCL (BULK).35 CHONDROITIN SULF A CLEAR WATERPROOF clopidogrel...... 39 SOD (BULK) ...... 64 STRIPS...... 75 clorazepate dipotassium...... 31 CHOR GONADOTROPIN, clearlax ...... 111 clorpres ...... 36 HUM (BULK)...... 106 clemastine...... 137 CLOSED-END POUCH ...... 76 chromium chloride ...... 151 CLEMASTINE...... 137 CLOTH FIRST AID TAPE..76 CLEMIZOLE HCL (BULK) 58 CLOTH TAPE...... 76

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 186 clotrimazole...... 3, 53, 125 cold-flu relief...... 137 COMPACT SPACE CLOTRIMAZOLE (BULK) 53 COLEMAN 100 MAX CHAMBER ...... 76 clotrimazole-3...... 125 INSECT REPEL...... 44 compete...... 167 clotrimazole-betamethasone.53 COLEMAN BOTANICALS compleat pediatric ...... 155 clozapine...... 31 INSECT...... 44 compleat pediatric reduced cal CLOZARIL ...... 31 COLEMAN HIGH-DRY ...... 155 c-nate dha ...... 167 INSECT REPEL...... 44 compleat-modified...... 155 COAGADEX ...... 39 COLEMAN SKINSMART COMPLERA ...... 4 COAGUCHEK LANCETS..76 INSECT REP...... 44 complete allergy ...... 137, 138 COAL TAR...... 42 COLEMAN SPORTSMEN complete allergy medicine..137 COAL TAR (BULK) ...... 42 INSECT REPEL...... 45 complete amino acid mix....155 COAL TAR (CRUDE)...... 42 colestipol ...... 40 complete lice treatment...... 56 COARTEM ...... 7 COLISTIMETHATE complete multivitamin...... 167 COBAN SELF-ADHERENT SODIUM (BULK)...... 7 complete multivitamin-mineral WRAP ...... 76 colistin (colistimethate na) .....8 ...... 167 cocaine...... 50 COLISTIN SULFATE complete natal dha...... 167 COCAINE (BULK)...... 50 (BULK) ...... 8 complete nutrition...... 155 CODEINE PHOSPHATE COLLAGENASE CLOS complete nutrition plus ...... 155 (BULK) ...... 22 HIST. (BULK)...... 56 complete senior...... 167 codeine sulfate...... 22 colocort...... 111 completenate...... 167 codeine-butalbital-asa-caff...22 COLOPLAST BARRIER complex b-100...... 167 codeine-guaifenesin...... 137 RING ...... 76 COMPLEX ESSENTIAL...155 codituss dm...... 137 COLOPLAST IRRIGATION compound 347 ...... 59 COENZYME Q10 (BULK) .57 SET...... 76 compro...... 111 COLCHICINE...... 123 COLOPLAST PASTE...... 76 CONCEPTROL...... 125 COLCRYS ...... 123 COLOPLAST SKIN CONDOMS-PREM cold and allergy ...... 137 BARRIER...... 76 LUBRICATED...... 76 cold and allergy (bromphen-pe) COLOR LANCETS ...... 76 CONFORM ...... 76 ...... 137 col-rite ...... 111 congestac ...... 138 cold and allergy pe ...... 137 COMBIDERM ACD constulose ...... 111 cold and cough (diphenhydr- DRESSING ...... 76 CONTOUR I STOMA CAP.76 pe)...... 137 COMBINE ABD ...... 76 CONVATEC NIGHT cold and cough (pe-dm)...... 137 COMBISTIX REAGENT ....76 DRAINAGE TUBING .....76 cold and cough (pe-dm-gg- COMBIVENT RESPIMAT146 CONVEEN DRIP acet) ...... 137 COMFEEL PLUS ULCER COLLECTOR...... 76 cold and cough dm ...... 137 DRESSING ...... 76 cool and heat...... 45 cold and cough elixir...... 137 COMFEEL PURILON...... 76 cool heat (m-salicylate-menth) cold and flu severe...... 137 COMFEEL SEASORB ...... 76 ...... 45 cold and hot extra strength ...44 COMFEEL ULCER CARE COOL MIST HUMIDIFIER 1 cold and hot pain relief...... 44 DRESSING ...... 76 GALLON...... 76 cold and hot therapy balm ....44 COMFORT EZ PEN COOLMAGIC...... 76 cold head congestion nighttime NEEDLES ...... 76 COPA HYDROPHILIC ...... 137 comfort gel ...... 111 FOAM...... 77 cold head congestion sever day comfort gel extra strength...111 copper chloride ...... 151 ...... 137 COMFORT LANCETS...... 76 CORLANOR ...... 41 cold multi-symptom ...... 137 COMFORT-STRETCH cormax ...... 54 cold relief...... 26 TRAINING PANTS...... 76 CORN CUSHION ...... 77 cold relief m/s day/night.....137 cortane-b ...... 67

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 187 cortane-b aqueous...... 67 CRINONE ...... 124 CUTIEPANTS TRAINING corticool...... 54 critic-aid clear af...... 53 PANTS ...... 78 CORTICOTROPIN...... 67 CRIXIVAN ...... 4 CUTIES BABY DIAPERS ..78 CORTIFOAM ...... 111 cromolyn...... 111, 130, 147 CUTTER BACKWOODS....45 cortisone ...... 67 CROMOLYN ...... 147 CUTTER BACKWOODS CORTISONE (BULK)...... 67 CRUTCH...... 77 DRY...... 45 cortisone (hydrocortisone)....54 CRUTCH TIPS...... 77 CUTTER LEMON cortisone + cooling relief .....54 cryoserv ...... 59 EUCALYPTUS ...... 45 cortizone-10...... 54 cryselle (28)...... 126 CUTTER NATURAL INSECT corvita...... 167 CUBICIN RF...... 8 REPELLNT ...... 45 corvita 150...... 167 CURASOL HYDROGEL CUTTER NATURAL COSMETIC BALLS ...... 77 DRESSING ...... 77 REPELLENT2...... 45 COSMETIC PUFFS...... 77 CURASOL WOUND CUTTER SKINSATIONS ...45 cosyntropin...... 67 DRESSING ...... 77 cyanocobalamin (vitamin b-12) COTELLIC...... 13 CURI-STRIP WOUND ...... 167 COTTON BALLS...... 77 CLOSURES...... 77 CYANOCOBALAMIN COTTON SNAP PANTS.....77 CURITY 8000 URINE MTR (VITAMIN B-12) ...... 167 COTTON SQUARES ...... 77 FLY TRAY...... 77 cyclafem 1/35 (28)...... 126 COTTON SWABS...... 77 CURITY ABDOMINAL PAD cyclafem 7/7/7 (28)...... 126 COTTON, STERILE...... 77 ...... 77 CYCLANDELATE ...... 36 cough and cold ...... 138 CURITY ALCOHOL SWABS CYCLINEX-1...... 155 cough and cold mucus relief cf ...... 77 CYCLINEX-2...... 155 ...... 138 CURITY BEDSIDE cyclobenzaprine...... 20 cough control DRAINAGE BAG...... 77 CYCLOBENZAPRINE (dextromethorph)...... 138 CURITY BEDSIDE (BULK)...... 20 cough control (guaifenesin) 138 DRAINAGE SET...... 77 cyclopentolate...... 129 cough control cf (pe) ...... 138 CURITY BEDSIDE-MONO- CYCLOPENTOLATE cough control dm...... 138 FLO DRANGE...... 77 (BULK)...... 129 cough control dm max...... 138 CURITY COVER...... 77 cyclophosphamide ...... 13 cough drops ...... 66 CURITY FOLEY CATHETER CYCLOPHOSPHAMIDE ....13 cough formula dm ...... 138 KIT ...... 77 CYCLOPHOSPHAMIDE cough relief...... 138 CURITY IODOFORM (BULK)...... 13 cough suppressant-expectorant PACKING STRIP ...... 77 CYCLOSERINE (BULK)...... 8 ...... 138 CURITY PREMIUM cyclosporine...... 13 cough syrup ...... 138 CATHETER TRAY ...... 77 CYCLOSPORINE...... 13 cough syrup dm ...... 138 CURITY ULTRAMER 2- cyclosporine modified ...... 13 coughtab ...... 138 WAY CATHETER...... 77 cyproheptadine ...... 138 COUMADIN...... 39 CURITY UNIVERSAL - NO CYPROHEPTADINE (BULK) COUMARIN ...... 59 DRAINAGE ...... 77 ...... 138 covaryx ...... 124 CURITY URETERAL DRAIN cyred ...... 126 covaryx h.s...... 124 SET...... 77 CYSTADANE...... 111 CPL DRAINABLE POUCH 77 CURITY URETH CATH CYSTAGON ...... 149 creamy acne face ...... 49 CLOSED SYSTM ...... 77 CYSTARAN...... 130 CREATINE CURITY URETH CATH CYSTEAMINE HCL (BULK) MONOHYDRATE (BULK) OPEN SYSTEM...... 78 ...... 59 ...... 59 CURITY URETHRAL cysteine (l-cysteine)...... 155 CREON ...... 111 CATHETER ...... 78 CYSTEINE HCL(L- CRESEMBA ...... 3 CURITY URINE METER ...78 CYSTEINE)(BULK)...... 155

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 188 cytarabine ...... 13 dasetta 1/35 (28) ...... 126 demeclocycline ...... 11 cytarabine (pf) ...... 13 dasetta 7/7/7 (28) ...... 126 DEMSER...... 36 CYTO B7 ...... 167 daunorubicin...... 13 DEOXYCHOLIC ACID CYTOSAFE DISPENSING DAUNOXOME...... 13 (BULK)...... 59 PIN ...... 78 DAVOL COMPLETE FOLEY DEPEN TITRATABS ...... 123 cytra k crystals...... 149 ...... 78 DEPEND PROTECTION SZ cytra-2...... 149 DAVOL FOLEY CATH S-M...... 78 cytra-3...... 149 INSERT TRAY ...... 78 DEPEND REAL FIT BRIEF cytra-k...... 149 DAVOL IRRIGATION MEN S-M ...... 78 D SYRINGE...... 78 DEPEND SILHOUETTE d10 %-0.45 % sodium chloride DAVOL SILICONE FOLEY WOMEN S/M...... 78 ...... 59 CATHETER ...... 78 DEPEND UNDERWEAR d2.5 %-0.45 % sodium DAVOL URINARY FOR WOMEN S-M...... 78 chloride...... 59 DRAINAGE BAG...... 78 DEPOCYT (PF)...... 13 d3-2000...... 167 DAY AND NIGHT DEPO-PROVERA...... 124 d5 % and 0.9 % sodium BRIEF,MEDIUM...... 78 DERMACEA...... 78 chloride...... 59 day time pe ...... 138 DERMACEA NON-WOVEN d5 %-0.45 % sodium chloride DAY, PLUS PAD...... 78 ...... 78 ...... 59 dayhist allergy ...... 138 DERMACEA STRETCH.....78 dacarbazine...... 13 daysee ...... 126 dermacerin ...... 45 dactinomycin ...... 13 daytime ...... 138 dermacinrx prizopak...... 50 daily multiple...... 167 day-time...... 138 DERMADRESS ...... 78 daily multiple for men ...... 167 daytime and nighttime cold 138 dermadrox...... 45 daily multivitamin with iron daytime cold-flu ...... 138 DERMAGAUZE ...... 78 ...... 167 daytime cold-flu relief (pe).138 DERMAGINATE...... 78 daily multivitamin-minerals167 day-time cough...... 138 DERMAGRAN HYDROGEL daily multi-vitamins/iron....167 daytime mucus relief dm ....138 DRESSING...... 78 daily teen multi-vitamin .....167 DEBACTEROL...... 66 DERMALEVIN...... 78 daily value ...... 167 deblitane ...... 124 dermamed (aluminum daily vitamin formula ...... 167 decitabine...... 13 hydroxide)...... 45 daily vitamin formula-iron .167 deep sea nasal ...... 66 dermarest eczema (hydrocort) daily vitamin with iron ...... 167 deferoxamine...... 59 ...... 54 daily vitamin with iron and ca DEHYDROEPIANDROSTER dermasarra ...... 45 ...... 167 ONE (MICRO)...... 107 dermasilkrx sds...... 55 daily vites/iron...... 167 delflex-lc/1.5% dextrose...... 59 DERMASYN...... 78 daily-vite...... 167 delflex-lc/2.5% dextrose...... 59 dermazene...... 52 DALVANCE...... 8 delflex-lc/4.25% dextrose.....59 DESCOVY ...... 4 danazol ...... 107 delsym cough-chest congest desenex ...... 53 DANAZOL...... 106 dm...... 138 desenex spray...... 53 dantrolene...... 20 delta d3 ...... 167 desgen dm...... 138 DANTROLENE (BULK) ....20 deltasone...... 67 desipramine...... 31 DAPIPRAZOLE (BULK)..130 DELUXE ARM BLOOD DESIPRAMINE ...... 31 dapsone...... 8 PRESSURE MON...... 78 desmopressin ...... 107 DAPSONE (BULK)...... 8 DELUXE INSTANT EAR DESMOPRESSIN ...... 107 daptomycin...... 8 THERMOMETER...... 78 desog-e.estradiol/e.estradiol DARAPRIM...... 8 delyla (28)...... 126 ...... 126 darifenacin...... 148 desogestrel-ethinyl estradiol DARZALEX ...... 13 (BULK) ...... 132 ...... 126

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 189 desonide...... 55 DEXTROSE (BULK)...... 59 DIASCREEN 1K REAGENT DESONIDE, MICRONIZED dextrose 10 % and 0.2 % nacl ...... 79 (BULK) ...... 55 ...... 59 DIASCREEN 2GK desoximetasone ...... 55 dextrose 10 % in water (d10w) REAGENT ...... 79 DESOXIMETASONE, ...... 59 DIASCREEN 2GP...... 79 MICRO (BULK) ...... 59 dextrose 20 % in water (d20w) DIASCREEN 3 REAGENT.79 DESOXYCORTICOSTERON ...... 59 DIASCREEN 4NL REAGENT E AC (BULK) ...... 67 dextrose 25 % in water (d25w) ...... 79 despec dm-g...... 138 ...... 59 DIASCREEN 4OBL despec eda cough-cold drops dextrose 30 % in water (d30w) REAGENT ...... 79 ...... 138 ...... 59 DIASCREEN 4PH...... 79 despec-dm (phenyleph-dm- dextrose 40 % in water (d40w) DIASCREEN 5 REAGENT.79 guaif) ...... 138 ...... 59 DIASCREEN 7 REAGENT.79 despec-tab...... 138 dextrose 5 % in ringers...... 59 DIASCREEN 8 REAGENT.79 desvenlafaxine succinate ...... 31 dextrose 5 % in water (d5w).59 DIASCREEN 9 REAGENT.79 dex4 glucose...... 59 dextrose 5 %-lactated ringers59 DIASTIX ...... 79 dex4 glucose bits ...... 59 dextrose 5%-0.2 % sod diazepam...... 17, 31 dexamethasone ...... 67 chloride...... 59 DIAZEPAM (BULK)...... 31 DEXAMETHASONE AC, dextrose 5%-0.3 % diazepam intensol ...... 31 MICRO (BULK) ...... 67 sod.chloride ...... 59 DIAZOXIDE (BULK)...... 79 DEXAMETHASONE dextrose 50 % in water (d50w) DIBUCAINE HCL (BULK).50 ACETATE (BULK) ...... 67 ...... 59 DICHLORACETIC ACID dexamethasone intensol...... 68 dextrose 70 % in water (d70w) (BULK)...... 45 DEXAMETHASONE ISONIC ...... 59 DICHLORALPHENAZONE (BULK) ...... 68 diabetic siltussin das-na...... 138 (BULK)...... 59 DEXAMETHASONE SOD diabetic siltussin-dm...... 138 diclofenac potassium ...... 26 PHOS (BULK) ...... 68 diabetic siltussin-dm max str diclofenac sodium...26, 45, 131 dexamethasone sodium phos ...... 138 DICLOFENAC SODIUM (pf)...... 68 diabetic tussin dm...... 138 (BULK)...... 26 dexamethasone sodium diabetic tussin ex ...... 139 diclofenac-misoprostol ...... 26 phosphate...... 68, 132 diabetic tussin max st ...... 139 dicloxacillin ...... 10 DEXAMETHASONE,MICRO dialyvite...... 167 DICUMAROL (BULK) ...... 39 NIZED(BULK) ...... 68 dialyvite 800 ...... 167 dicyclomine ...... 109 dexedrine ...... 31 dialyvite vitamin d...... 167 DICYCLOMINE (BULK)..109 dexferrum ...... 167 diamode ...... 109 didanosine...... 4 dexmedetomidine ...... 31 diaper rash ...... 45 DIETHANOLAMINE (BULK) dexmethylphenidate ...... 31 diaper rash relief...... 45 ...... 59 dexpanthenol ...... 167 DIAPERS, UNISEX SIZE 3 79 DIETHYLENE GLYCOL DEXPANTHENOL (BULK) DIAPERS-DISP- MONOETHYL ET...... 59 ...... 167 POLYETHYLENE BACK DIETHYLPROPION HCL dexrazoxane hcl...... 12 ...... 79 (BULK)...... 57 dextroamphetamine ...... 31 diarrhea relief (bismuth subs) difil-g 400 ...... 147 dextroamphetamine- ...... 109 diflorasone ...... 55 amphetamine ...... 31 DIASCREEN 10...... 79 diflunisal ...... 26 DEXTROMETHORPHAN DIASCREEN 1B REAGENT digestive relief ...... 109 HBR (BULK) ...... 138 ...... 79 DIGITAL THERMOMETER dextromethorphan-guaifenesin DIASCREEN 1G REAGENT ...... 79 ...... 138 ...... 79 digitek ...... 38

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 190 digox...... 38 diphenhydramine hcl .....32, 45, DOVER CATHETER ...... 79 digoxin...... 38, 39 139 DOVER COATED LATEX dihydroergotamine ...... 19 diphenhydramine- FOLEY ...... 79 DIHYDROERGOTAMINE acetaminophen...... 26 DOVER PEDIATRIC URINE MESYLT(BULK) ...... 19 DIPHENIDOL (BULK) .....112 METER...... 79 DIINDOLYLMETHANE diphenoxylate-atropine...... 109 DOVER TEXAS MALE (BULK) ...... 59 dipyridamole...... 39 EXTERNAL CATH ...... 79 DILANTIN...... 17 DIPYRIDAMOLE (BULK).39 DOVER URI-DRAIN DILANTIN EXTENDED ....17 diskets...... 22 DELUXE LEG BAG...... 79 DILANTIN INFATABS ...... 17 DISPOSABLE BRIEF ...... 79 DOVER URI-DRAIN MALE DILANTIN-125 ...... 17 DISPOSABLE GLOVES.....79 EXT CATH ...... 79 dilt-cd ...... 36 DISPOSABLE LATEX-FREE DOVER URINARY LEG diltiazem hcl ...... 36 GLOVES ...... 79 BAG...... 79 DILTIAZEM HCL ...... 36 DISPOZ-A-BAG LEG BAG doxapram ...... 32 dilt-xr...... 36 SMALL ...... 79 doxazosin...... 36 diltzac er ...... 36 disulfiram...... 60 doxepin ...... 32, 45 diluent for epoprostenol/flola DISULFIRAM (BULK)...... 60 DOXEPIN...... 32 ...... 59 divalproex...... 17 doxercalciferol...... 107 dimaphen (pe)...... 139 dm max...... 139 doxorubicin...... 13 dimaphen dm...... 139 DMPS ...... 60 doxorubicin, peg-liposomal..13 dimenhydrinate...... 112 DMSA (BULK)...... 60 doxy-100...... 11 DIMENHYDRINATE dobutamine ...... 41 doxycycline hyclate ...... 11 (BULK) ...... 112 dobutamine in d5w ...... 41 DOXYCYCLINE HYCLATE DIMERCAPTOPROPANESU docetaxel...... 13 (BULK)...... 11 LFONATE SOD...... 60 doc-q-lace ...... 112 doxycycline monohydrate ....11 dimetapp cold-congestion ..139 doc-q-lax...... 112 DOXYLAMINE SUCCINATE dimetapp dm cold-cough (pe) docu ...... 112 (BULK)...... 32 ...... 139 docu soft ...... 112 DRAINABLE FECAL DIMETHYL SULFOXIDE docuprene ...... 112 COLLECTOR...... 79 (BULK) ...... 60 docusate calcium ...... 112 DRAINABLE POUCH DIMETHYLACETAMIDE docusate sodium ...... 112 CLAMP ...... 79 (BULK) ...... 60 DOCUSATE SODIUM...... 112 DRAINABLE POUCH DINITROCHLOROBENZEN DOCUSATE SODIUM CLOSURE...... 79 E (BULK)...... 60 (BULK) ...... 112 dramamine ...... 112 dino-life ...... 167 docusil ...... 112 dramamine less drowsy ...... 112 dino-life with extra c ...... 167 dofetilide...... 34 driminate...... 112 dino-life with iron-zinc...... 167 dok...... 112 dristan cold ...... 139 diocto...... 112 dok plus ...... 112 dristan long lasting ...... 66 dioctyl...... 112 dologesic (w- drithocreme hp...... 42 diotame...... 109 phenyltoloxamine)...... 26 dronabinol...... 112 diphedryl...... 139 dometuss-dmx ...... 139 droperidol ...... 112 diphedryl allergy ...... 139 donepezil ...... 20 DROPERIDOL...... 112 DIPHENCYPRONE (BULK) dopamine ...... 41 DROPLET LANCETS ...... 79 ...... 60 dopamine in 5 % dextrose ....41 DROPLET LANCING diphenhist ...... 139 dorzolamide...... 132 DEVICE ...... 80 DIPHENHYDRAMINE dorzolamide-timolol ...... 132 DROPLET PEN NEEDLE ...80 (BULK) ...... 139 dothelle dha ...... 167 drospirenone-e.estradiol-lm.fa double-tussin dm ...... 139 ...... 126

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 191 drospirenone-ethinyl estradiol EASY COMFORT INSULIN ed-spaz...... 109 ...... 126 SYRINGE...... 80 EDURANT ...... 4 DROXIA ...... 13 EASY COMFORT LANCETS eemt ...... 124 DRY COMFORT ...... 80 ...... 80 eemt hs...... 124 DRY COMFORT EXTRA EASY COMFORT PEN effer-k ...... 151 BRIEFS ...... 80 NEEDLES ...... 80 effervescent cold relief plus139 dry eye relief...... 130 EASY MINI EJECT EGRIFTA ...... 120 dss...... 112 LANCING DEVICE ...... 80 ELAPRASE...... 107 ducodyl...... 112 EASY TOUCH ALCOHOL ELASTIC BANDAGE ...... 81 dulcolax stool softener (dss) PREP PADS ...... 80 ELASTO-GEL CAST-SPLINT ...... 112 EASY TOUCH FLIPLOCK PADDING ...... 81 DULERA...... 147 SYRINGE...... 80 ELASTO-GEL CIRCLE duloxetine...... 32 EASY TOUCH FLURINGE 80 DRESSING...... 81 DUOCAL ...... 155 EASY TOUCH FLURINGE ELASTO-GEL FACE DUODERM CGF DRESSING FLIPLOCK...... 80 DRESSING...... 81 ...... 80 EASY TOUCH FLURINGE eldertonic ...... 168 DUODERM CGF EXTRA SHEATHLOCK ...... 80 ELECARE ...... 155 THIN ...... 80 EASY TOUCH INSULIN ELECARE INFANT DUODERM HYDROACTIVE SAFETY SYR ...... 81 FORMULA...... 155 ...... 80 EASY TOUCH INSULIN ELECARE JR...... 155 DUOLOCK CURVED TAIL SYRINGE...... 81 electrolyte-48 in d5w...... 155 CLOSURE...... 80 EASY TOUCH LANCING ELELYSO ...... 107 DURAHESIVE MOLDABLE DEVICE ...... 81 eletone...... 45 CONVEX ...... 80 EASY TOUCH ELIGARD...... 13 duramorph (pf) ...... 22 TUBERCULIN FLIPLOCK ELIGARD (3 MONTH) ...... 13 DURAPORE SURGICAL ...80 ...... 81 ELIGARD (4 MONTH) ...... 13 DURASORB UNDERPAD .80 EASY TOUCH ELIGARD (6 MONTH) ...... 13 dutasteride ...... 148 TUBERCULIN ELIMINATOR ODOR dutasteride-tamsulosin...... 148 SHEATHLK...... 81 SPRAY ...... 81 DUTOPROL...... 36 eazzze the pain...... 26 elinest...... 126 d-vi-sol ...... 167 econazole...... 53 eliphos...... 151 d-vita...... 167 ECONAZOLE...... 53 ELIQUIS...... 39 DYCLONINE HCL (BULK) econtra ez...... 126 ELITEK ...... 12 ...... 50 ecotrin...... 27 elite-ob...... 168 dy-o-derm...... 64 ecotrin low strength ...... 27 elite-ob 400...... 168 DYPHYLLINE (BULK)....147 eczema anti-itch...... 55 ELLA...... 126 E ed a-hist ...... 139 ellis tonic ...... 168 e.c. prin...... 26 ed a-hist pse...... 139 ELMIRON...... 149 e.e.s. 400...... 6 ed bron gp...... 139 ELSPAR ...... 13 E.E.S. GRANULES ...... 6 ed chlorped jr...... 139 EMBRACE LANCETS...... 81 EAA SUPPLEMENT...... 155 ed-apap ...... 27 EMCYT ...... 13 EAKIN COHESIVE...... 80 ed-chlortan...... 139 EMEND...... 112 EAKIN COHESIVE SEALS80 EDETATE CALCIUM emoquette ...... 126 EAKIN COHESIVE SLIMS 80 DISODIUM(BULK) ...... 155 EMTRIVA...... 4 EASIVENT HOLDING EDETATE DISODIUM emulsion sb...... 45 CHAMBER ...... 80 (BULK) ...... 57 EMVERM...... 8 EASY CLICK LANCING EDROPHONIUM CHLORIDE enalapril maleate...... 36 DEVICE ...... 80 (BULK) ...... 20

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 192 ENALAPRIL MALEATE ensure active protein-muscle EPIVIR HBV...... 4 (BULK) ...... 36 ...... 156 eplerenone...... 36 enalaprilat ...... 36 ENSURE CLEAR ...... 156 epoprostenol (glycine) ...... 36 enalapril-hydrochlorothiazide ensure compact ...... 156 eprosartan ...... 36 ...... 36 ENSURE COMPLETE ...... 156 eptifibatide...... 39 ENBREL ...... 123 ENSURE ENLIVE...... 156 EPZICOM...... 4 ENBREL SURECLICK .....123 ensure high protein ...... 156 ERBITUX...... 14 endacof - dm...... 139 ensure high protein-muscle 156 ergocalciferol (vitamin d2) .168 endacof-c ...... 139 ENSURE MUSCLE HEALTH ERGOCALCIFEROL endacon...... 139 ...... 156 (VITAMIN D2) ...... 168 ENDO AVITENE ...... 39 ENSURE ORIGINAL ...... 156 ergoloid...... 32 endocet ...... 22 ENSURE PLUS...... 156 ERGOLOID (BULK) ...... 32 endodan ...... 22 ENSURE PUDDING ...... 156 ERGOTAMINE TARTRATE endur-acin...... 40 entacapone...... 19 (BULK)...... 19 enema ...... 112 entecavir ...... 4 ergotamine-caffeine...... 19 enema disposable...... 112 enteric coated aspirin...... 27 errin...... 124 ENFAGROW TODDLR entre-cough...... 139 ery pads...... 49 TRANSITION SOY...... 155 entre-hist pse...... 139 erygel ...... 49 enfamil a.r...... 155 ENTRESTO...... 41 ERYPED 200...... 6 enfamil a.r. lipil ...... 155 ENTRUST PLUS SUPER ERYPED 400...... 6 enfamil enfacare ...... 155 UNDERPADS...... 81 ery-tab...... 6 ENFAMIL ENFACARE....155 ENTRUST PLUS ERY-TAB...... 6 ENFAMIL GENTLEASE..156 UNDERGARMENTS ...... 81 erythrocin (as stearate) ...... 6 ENFAMIL GENTLEASE ENTRUST PLUS erythromycin...... 6, 7, 129 LIPIL LIQUID ...... 156 UNDERWEAR ...... 81 ERYTHROMYCIN (BULK) .6 ENFAMIL GLUCOSE...... 60 ENTYVIO ...... 112 ERYTHROMYCIN ENFAMIL INFANT ...... 156 enulose...... 112 ESTOLATE (BULK) ...... 6 ENFAMIL LIPIL NURSETTE EO28 SPLASH...... 156 erythromycin ethylsuccinate...6 ...... 156 EPHEDRINE HCL (BULK) ERYTHROMYCIN ENFAMIL NEWBORN.....156 ...... 147 ETHYLSUCCINATE...... 6 enfamil premium lipil...... 156 ephedrine sulfate...... 147 erythromycin with ethanol....49 ENFAMIL PROSOBEE LIPIL EPHEDRINE SULFATE erythromycin-benzoyl peroxide ...... 156 (BULK) ...... 147 ...... 49 enfamil water...... 60 ephrine...... 66 erythromycin-sulfisoxazole ....7 ENFAPORT ...... 156 EPIGALLOCATECHIN ESBRIET...... 147 ENFAPORT LIPIL ...... 156 GALLATE(BULK)...... 64 escitalopram oxalate ...... 32 enlon...... 20 epinastine...... 130 esmolol ...... 36 enoxaparin ...... 39 epinephrine ...... 139 esomeprazole magnesium...118 enpresse ...... 126 EPINEPHRINE ...... 139 esomeprazole sodium ...... 118 enskyce...... 126 EPINEPHRINE (BULK)....139 essentia ...... 168 ensure ...... 156 EPINEPHRINE essential daily ...... 168 ENSURE ...... 156 BITARTRATE ...... 139 estarylla...... 126 ensure active clear ...... 156 EPINEPHRINE HCL (BULK) estazolam ...... 32 ensure active heart health ...156 ...... 139 ESTEEM DRAINABLE ensure active light...... 156 epinephrine hcl (pf) ...... 139 POUCH...... 81 ENSURE ACTIVE MUSCLE epirubicin...... 13 ESTEEM SYNERGY...... 81 HEALTH...... 156 epitol...... 17 ESTEEM SYNERGY EPIVIR ...... 4 CLOSED POUCH ...... 81

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 193 ESTEEM SYNERGY EUCALYPTUS FLAVOR...64 famciclovir...... 4 DRAINABLE POUCH ....81 evac-u-gen (sennosides) .....112 famotidine...... 119 estradiol ...... 124 EVOTAZ...... 4 FAMOTIDINE (BULK).....118 ESTRADIOL (BULK) ...... 124 EXACTA-MED ENTERAL famotidine (pf)...... 118 ESTRADIOL BENZOATE DISPENSER...... 81 famotidine (pf)-nacl (iso-os) (BULK) ...... 124 EXCEL SYRINGE...... 81 ...... 119 ESTRADIOL CYPIONATE EXCILON ...... 81 FANTASY...... 82 (BULK) ...... 124 exefen dmx ...... 139 farbee with c ...... 168 ESTRADIOL exefen-ir...... 139 FARESTON ...... 14 HEMIHYD,MICRO EXEL HYPODERMIC FASLODEX ...... 14 (BULK) ...... 124 NEEDLES ...... 81 FAST READ ESTRADIOL MICRONIZED exemestane ...... 14 THERMOMETER...... 82 (BULK) ...... 124 EXJADE...... 60 FC2 FEMALE CONDOM ...82 estradiol valerate ...... 124 exotic-hc ...... 67 fe 90 plus ...... 168 ESTRADIOL VALERATE expectorant ...... 139 fe c plus...... 168 (BULK) ...... 124 ex-strength medi-tabs pm .....27 FECAL COLLECTOR...... 82 estradiol-norethindrone acet EXTAVIA ...... 120 felbamate ...... 17 ...... 124 EXTENSION TUBING W- felodipine...... 36 estrogens-methyltestosterone CONNECTOR...... 82 fem ph...... 125 ...... 124 EXTERNAL CATHETER, FEMALE URINARY POUCH ESTRONE...... 124 MALE...... 82 ...... 82 ESTRONE (BULK) ...... 124 extra strength bayer ...... 27 FEMCAP ...... 82 estropipate ...... 124 extraprin...... 27 femynor...... 126 ethacrynate sodium...... 36 EXUDERM RCD...... 82 fenesin dm ir ...... 139 ethacrynic acid...... 36 EXUDERM SATIN fenesin ir ...... 140 ethambutol...... 8 DRESSING ...... 82 fenesin pe ir ...... 140 ethanol (ethyl alcohol)...... 60 EXUDERM ULTRA...... 82 fenofibrate...... 40 ETHINYL ESTRADIOL EXU-DRY WOUND fenofibrate micronized...... 40 (BULK) ...... 124 DRESSING ...... 82 fenofibrate nanocrystallized .40 ethosuximide ...... 17 eye drop tears...... 130 fenofibric acid...... 40 ETHOSUXIMIDE (BULK) .17 eye drops...... 132 fenofibric acid (choline) ...... 41 ETHOXY ETHOXY eye drops allergy relief ...... 132 fenoprofen...... 27 ETHANOL REAGENT ...60 eye health plus lutein...... 168 fentanyl ...... 22 ETHOXYDIGLYCOL EYE PAD ...... 82 FENTANYL (BULK) ...... 22 (BULK) ...... 60 EYE PATCH ...... 82 fentanyl citrate ...... 22 ethyl acetate...... 64 EYLEA...... 130 FENTANYL CITRATE ethyl chloride...... 50 e-z ject lancets ...... 82 (BULK)...... 22 ETHYL OLEATE (BULK)..60 EZ SMART LANCETS ...... 82 fentanyl citrate (pf) ...... 22 ethynodiol diac-eth estradiol E-Z SPACER...... 82 fentanyl citrate-0.9%nacl (pf) ...... 126 ezetimibe ...... 40 ...... 22 etidronate disodium...... 60 ezfe 200 ...... 168 feosol ...... 168 etodolac ...... 27 F ferate ...... 168 ETODOLAC (BULK)...... 27 fabb...... 168 fer-iron...... 168 etomidate ...... 60 FABRAZYME ...... 107 ferocon...... 168 ETOMIDATE (BULK)...... 60 FABRIC STRIP EXTRA ferosul ...... 168 ETOPOPHOS...... 14 LARGE...... 82 ferraplus 90...... 168 etoposide...... 14 fallback solo ...... 126 ferretts...... 168 ETOPOSIDE (BULK)...... 14 falmina (28) ...... 126 ferrex 150...... 168

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 194 ferrex 150 plus...... 168 fiber therapy (ca polycarboph) FLEXIFLO GRAVITY FERRIC AMMONIUM ...... 113 FEEDING SET...... 83 CITRATE (BULK) ...... 168 fiber therapy (m-cell/sugar) 113 FLEXIFLO QUANTUM FERRIC SUBSULFATE fiber therapy (m-cellulose) .113 PUMP SET ...... 83 (BULK) ...... 168 fiber therapy (psyllium seed) FLEXIFLO TOP-FILL BAG83 FERRIC SULFATE (BULK) ...... 113 FLEXIFLO/PREATTACHED ...... 60 fiber therapy laxative (husk) ...... 83 ferric x-150...... 168 ...... 113 FLEXI-SEAL FMS ...... 83 FERRIPROX...... 60 fiber therapy sugar free...... 113 FLEXI-TRAK ANCHORING ferrocite ...... 168 fiber-tabs...... 113 DEVICE ...... 83 ferrocite plus...... 168 FIFTY50 SAFETY SEAL FLEXTEND SKIN BARRIER ferrogels forte ...... 168 LANCETS...... 82 ...... 83 ferro-time...... 168 FILTER CLOSED MINI- FLEXZAN WOUND ferrous fumarate ...... 168 POUCH ...... 82 DRESSING...... 83 FERROUS FUMARATE FILTRODOR POUCH FLOW-EZE VENTED (BULK) ...... 168 FILTER ...... 82 NEEDLE...... 83 ferrous gluconate...... 168 finasteride ...... 148 floxin...... 67 FERROUS GLUCONATE FINASTERIDE (BULK)....148 floxuridine ...... 14 (BULK) ...... 168 FINE 30 UNIVERSAL FLOXURIDINE (BULK).....14 ferrous sulfate...... 168 LANCETS...... 82 flu relief therapy daytime ...140 FERROUS SULFATE, DRIED FINGERSTIX LANCETS....82 FLUAD 2016-2017 (65 YR (BULK) ...... 169 FIRAZYR...... 147 UP)(PF)...... 121 ferrousul ...... 169 FIRST AID CLOTH TAPE..82 FLUARIX 2013-2014 (PF) 121 ferus...... 169 FIRST AID HURT-FREE FLUARIX 2014-2015 (PF) 121 FEVER FLASH WRAP ...... 82 FLUARIX QUAD 2014-2015 THERMOMETER ...... 82 FIRST AID PAPER TAPE ..82 (PF)...... 121 fever reducer...... 27 FIRST CHOICE LANCETS FLUARIX QUAD 2015-2016 fever reducer an pain reliever THIN ...... 82 (PF)...... 121 ...... 27 FIRST-BXN ...... 66 FLUARIX QUAD 2016-2017 feverall...... 27 FIRST-LANSOPRAZOLE 119 (PF)...... 121 fexofenadine...... 140 FIRST-MOUTHWASH BLM FLUBLOK 2016-2017 (PF) fiber ...... 112 ...... 66 ...... 121 fiber (calcium polycarbophil) FIRST-OMEPRAZOLE.....119 flucaine ...... 130 ...... 112 FITTED BRIEFS MEDIUM 82 FLUCELVAX QUAD 2016- fiber (psyllium husk) ...... 112 flanax antacid ...... 113 2017 (PF) ...... 121 fiber (psyllium husk/sugar) 112 flavor chews antacid...... 151 fluconazole ...... 3 fiber (with aspartame) ...... 112 FLAVOR PACKETS ...... 64 FLUCONAZOLE (BULK) ....3 fiber laxative (ca polycarbo) flavoxate ...... 148 fluconazole in dextrose(iso-o) 3 ...... 112 flecainide ...... 34 fluconazole in nacl (iso-osm) .3 fiber laxative (husk/sugar)..112 fleet enema ...... 113 flucytosine ...... 3 fiber laxative (methylcellulo) fleet laxative ...... 113 FLUCYTOSINE (BULK) ...... 3 ...... 113 FLEXIBLE FABRIC fludarabine...... 14 fiber laxative (psyllium husk) BANDAGES ...... 82 fludrocortisone...... 68 ...... 113 FLEXIBLE FOAM...... 82 FLUDROCORTISONE fiber laxative (psyllium) s/f 113 FLEXICHAMBER...... 82 (BULK)...... 68 fiber smooth...... 113 FLEXIFLO FEEDING TUBE FLULAVAL 2013-2014.....121 fiber smooth (sucrose)...... 113 ...... 83 FLULAVAL 2014-2015.....121 fiber supplement (inulin)....113

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 195 FLULAVAL QUAD 2013- FLURBIPROFEN (BULK)..27 FLUZONE QUAD 2014-2015 2014...... 121 flurbiprofen sodium...... 131 ...... 122 FLULAVAL QUAD 2014- flurox ...... 130 FLUZONE QUAD 2014-2015 2015...... 121 flutamide...... 14 (PF)...... 122 FLULAVAL QUAD 2014- fluticasone ...... 55, 147 FLUZONE QUAD 2015-2016 2015 (PF)...... 121 FLUTICASONE PROP, ...... 122 FLULAVAL QUAD 2015- MICRO (BULK) ...... 55 FLUZONE QUAD 2015-2016 2016...... 121 FLUTICASONE (PF)...... 122 FLULAVAL QUAD 2016- PROPIONATE (BULK)...55 FLUZONE QUAD 2016-2017 2017...... 121 fluvastatin ...... 41 ...... 122 FLULAVAL QUAD 2016- FLUVIRIN 2013-2014...... 121 FLUZONE QUAD 2016-2017 2017 (PF)...... 121 FLUVIRIN 2013-2014 (PF) (PF)...... 122 flumazenil...... 32 ...... 121 FLUZONE QUAD PEDI FLUMIST 2013-2014 ...... 121 FLUVIRIN 2014-2015...... 121 2013-14 (PF)...... 122 FLUMIST QUAD 2014-2015 FLUVIRIN 2014-2015 (PF) FLUZONE QUAD PEDI ...... 121 ...... 122 2014-15 (PF)...... 122 FLUMIST QUAD 2015-2016 FLUVIRIN 2015-2016...... 122 FLUZONE QUAD PEDI ...... 121 FLUVIRIN 2015-2016 (PF) 2015-16 (PF)...... 122 flunisolide...... 147 ...... 122 FLUZONE QUAD PEDI FLUNISOLIDE (BULK) ...147 FLUVIRIN 2016-2017...... 122 2016-17 (PF)...... 122 fluocinolone...... 55 FLUVIRIN 2016-2017 (PF) foaming acne face wash...... 49 FLUOCINOLONE ...... 122 foaming antacid ...... 113 ACETONIDE (BULK) ....55 fluvoxamine...... 32 foaming antacid extra strength fluocinolone acetonide oil ....67 FLUZONE 2013-2014 ...... 122 ...... 113 fluocinolone and shower cap 55 FLUZONE 2013-2014 (PF)122 focalgin 90 dha ...... 169 fluocinonide...... 55 FLUZONE 2014-2015 ...... 122 focalgin ca ...... 169 FLUOCINONIDE, FLUZONE 2014-2015 (PF)122 focalgin dss...... 169 MICRONIZED(BULK) ...55 FLUZONE 2015-2016 ...... 122 folbecal ...... 169 fluocinonide-e...... 55 FLUZONE HIGH-DOSE folbee ...... 169 fluor-a-day (with xylitol)....169 2013-14 (PF)...... 122 folbee plus ...... 169 FLUORESCEIN (BULK) ..130 FLUZONE HIGH-DOSE folcal dha ...... 169 fluorescein-benoxinate ...... 130 2014-15 (PF)...... 122 folcaps omega-3 (asparto-gly) fluorescein-proparacaine ....130 FLUZONE HIGH-DOSE ...... 169 fluoritab ...... 169 2015-16 (PF)...... 122 FOLEY CATHETER ...... 83 fluorometholone ...... 132 FLUZONE HIGH-DOSE FOLEY CATHETER TRAY83 fluorouracil ...... 14, 45 2016-17 (PF)...... 122 folic acid ...... 169 FLUOROURACIL (BULK) 14 FLUZONE INTRADERM FOLIC ACID (BULK) ...... 169 fluoxetine...... 32 2013-14 (PF)...... 122 folic acid-vit b6-vit b12 ...... 169 FLUOXETINE (BULK) ...... 32 FLUZONE INTRADERM folinatal plus b ...... 169 FLUOXYMESTERONE 2014-15 (PF)...... 122 folivane-f ...... 169 (BULK) ...... 107 FLUZONE INTRADERM folivane-ob...... 169 fluphenazine decanoate ...... 32 QUAD 2015-16 ...... 122 folivane-plus ...... 169 FLUPHENAZINE FLUZONE INTRADERM folivane-prx dha nf ...... 169 DECANOATE (BULK)...32 QUAD 2016-17 ...... 122 FOLOTYN ...... 14 fluphenazine hcl ...... 32 FLUZONE PEDI 2013-2014 folplex 2.2...... 169 flurandrenolide ...... 55 (PF)...... 122 fomepizole ...... 122 flurazepam...... 32 FLUZONE QUAD 2013-2014 fondaparinux...... 39 flurbiprofen...... 27 (PF)...... 122 foot and sneaker...... 53

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 196 foot odor control...... 53 FURAZOLIDONE (BULK)...8 gentamicin sulfate (pf)...... 8 for sty relief ...... 130 furosemide...... 36 gentle laxative...... 113 FORA LANCING DEVICE 83 FUROSEMIDE (BULK)...... 36 GENTLE TAPE...... 84 forane...... 60 FUZEON ...... 4 GENTLECATH...... 84 FOREHEAD fyavolv...... 124 gentlelax ...... 113 THERMOMETER ...... 83 G GENVOYA ...... 4 formadon ...... 60 g tussin ac ...... 140 geravim ...... 169 formaldehyde...... 60 GA GEL ...... 156 GERBER GOOD START forma-ray...... 60 GA POWDER ...... 156 GENTLE...... 156 FORMOTEROL FUMARATE gabapentin ...... 17 gerber good start glucose...... 60 (BULK) ...... 147 GABAPENTIN (BULK)...... 17 GERBER GOOD START formula 3 ...... 53 GABITRIL ...... 18 PREMATURE 24...... 156 fortical ...... 107 GABLOFEN...... 20 GERBER GOOD START foscarnet ...... 4 galantamine ...... 20 SOY ...... 156 fosfree...... 169 GAMASTAN S/D ...... 122 gerber good start water ...... 60 fosinopril ...... 36 GAMMAGARD LIQUID ..122 GERBER GRADUATES fosinopril-hydrochlorothiazide GAMMAGARD S/D...... 122 GENTLE...... 156 ...... 36 GAMUNEX...... 122 GERBER GRADUATES fosphenytoin...... 17 GAMUNEX-C...... 122 PROTECT ...... 156 FOUNTAIN SYRINGE ...... 83 ganciclovir sodium ...... 4 GERBER GRADUATES SOY freamine iii 10 % ...... 156 garamycin ...... 129 ...... 157 FREEDOM DERMA-D ...... 45 gas free extra strength...... 113 GERBER GS GENTLE - FREESTYLE CONTROL....83 gas relief ...... 113 SUPPLEMENT ...... 157 FREESTYLE FLASH gas relief extra strength ...... 113 geriaton ...... 169 SYSTEM ...... 83 gas relief ultra strength ...... 113 geri-dryl ...... 140 FREESTYLE FREEDOM ...83 gatifloxacin...... 129 geri-hydrolac...... 45 FREESTYLE FREEDOM GAUZE BANDAGE...... 84 geri-kot ...... 113 LITE ...... 83 gauze roll ...... 84 geri-lanta...... 113 FREESTYLE INSULINX....83 gavilax ...... 113 geri-mox antacid-antigas ....113 FREESTYLE INSULINX gavilyte-c...... 113 geri-pectate ...... 109 TEST STRIPS ...... 83 gavilyte-g...... 113 geri-tussin ...... 140 FREESTYLE LANCETS.....83 gavilyte-h and bisacodyl.....113 geri-tussin dm ...... 140 FREESTYLE LITE METER83 gavilyte-n...... 113 gianvi (28) ...... 126 FREESTYLE LITE STRIPS 83 GAZYVA ...... 14 gildagia ...... 126 FREESTYLE NAVIGATOR GEL CORN PROTECTORS84 gildess 1.5/30 (21) ...... 126 GLUC SENS ...... 83 GEL TOE PROTECTOR .....84 gildess 1/20 (21) ...... 127 FREESTYLE PRECISION..83 GEL TOE SPACERS ...... 84 gildess 24 fe...... 127 FREESTYLE SIDEKICK II 83 GELPAD ...... 84 gildess fe 1.5/30 (28) ...... 127 FREESTYLE SYSTEM KIT83 gemcitabine ...... 14 gildess fe 1/20 (28) ...... 127 FREESTYLE TEST ...... 83 gemfibrozil ...... 41 GILENYA ...... 20 FREESTYLE UNISTIK 2....83 GEMFIBROZIL ...... 41 GILOTRIF...... 14 frovatriptan...... 19 generlac ...... 113 GINKGO BILOBA (BULK)64 fruit c ...... 169 gengraf...... 14 glatopa ...... 20 fruit c-500...... 169 gentak ...... 129 glenmax peb dm ...... 140 fruity chews...... 169 gentamicin ...... 8, 52, 129 GLEOSTINE ...... 14 full spectrum b-vitamin c ...169 GENTAMICIN (BULK) ...... 8 glimepiride...... 84 fungoid tincture ...... 53 gentamicin in nacl (iso-osm) ..8 glipizide ...... 84 fungoid-d ...... 53 gentamicin sulfate (ped) (pf) ..8 GLIPIZIDE (BULK) ...... 84

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 197 glipizide-metformin...... 84 GLYTACTIN 20PE guaifenesin dac ...... 140 GLUCAGEN HYPOKIT .....84 BETTERMILK LITE.....157 guaifenesin-dm ...... 140 GLUCAGON EMERGENCY glytrol ...... 157 GUANABENZ (BULK)...... 36 KIT (HUMAN) ...... 84 GLYTROL WITH PREBIO1 GUANETHIDINE...... 36 GLUCERNA ADVANCE..157 ...... 157 guanfacine...... 32, 36 GLUCERNA HUNGER GMATE LANCETS...... 84 guanidine ...... 32 SMART ...... 157 GMATE LANCING DEVICE GUARD MALE...... 84 GLUCERNA THERAPEUTIC ...... 84 GUARDS FOR MEN ...... 84 NUTRITION ...... 157 GOLD SODIUM gummi bear multivitamin ...169 gluco burst ...... 60 THIOMALATE (BULK)123 gummy swirls ...... 169 GLUCOCOM LANCETS....84 gonak ...... 130 gynol ii...... 125 GLUCOLET 2 AUTOMATIC goniosoft...... 130 H LANCING...... 84 goniotaire...... 130 hair vitamins ...... 169 GLUCOSAMINE (BULK) ..60 goniovisc ...... 131 hair,skin and nails...... 169 GLUCOSAMINE SU 2KCL good start ...... 157 HALAVEN...... 14 (BULK) ...... 27 GOOD START...... 157 halls defense ...... 169 GLUCOSAMINE SULFATE GOOD START 2 SUPREME halobetasol propionate...... 55 NACL(BULK) ...... 27 ...... 157 halonate...... 55 glucose...... 60 GOOD START SUPREME157 halonate pac ...... 55 glucose bits...... 60 good start supreme dha and ara haloperidol...... 32 glucose gel...... 60 ...... 157 HALOPERIDOL (BULK)....32 GLUCOSOURCE ...... 84 GOOD START SUPREME ...... 32 GLUTAMINE ...... 60 DHA AND ARA ...... 157 HALOPERIDOL GLUTARADE JUNIOR ....157 GOOD START SUPREME DECANOATE (BULK) ...32 GLUTARALDEHYDE...... 60 NAT CULTURE ...... 157 haloperidol lactate ...... 32 GLUTAREX-1...... 157 GOODNITES TRU-FIT HANDICARE GARMENT GLUTAREX-2...... 157 LINERS...... 84 LINER ...... 84 GLUTATHIONE (BULK)...60 GOODNITES UNDERPANTS HARD NAIL ...... 169 GLUTOL GEL ...... 60 SMALL-MED ...... 84 HARMONIE UNDERPAD..84 glyburide...... 84 gordon's vite a...... 45 hc-1% hemorrhoid ...... 113 GLYBURIDE...... 84 GRAMICIDIN D...... 60 HCU COOLER...... 157 glyburide micronized...... 84 granisetron (pf)...... 113 hcu express powder ...... 157 glyburide-metformin ...... 84 granisetron hcl ...... 113 HCU GEL POWDER...... 157 glycine ...... 149 granisol ...... 113 HCU LOPHLEX ...... 157 GLYCINE ...... 149 GRANIX ...... 120 HCY 1 POWDER...... 157 glycine urologic...... 149 GRISEOFULVIN (BULK) ..60 HCY 2...... 157 glycolax ...... 113 griseofulvin microsize ...... 3 headache formula added str ..27 GLYCOLIC ACID...... 52 griseofulvin ultramicrosize.....3 headache pm ...... 27 GLYCOLIC ACID (BULK) 52 grx hicort 25 ...... 113 headache relief (asa-acet-caf) glycopyrrolate...... 109 GRX WOUND GEL ...... 84 ...... 27 GLYCOPYRROLATE g-tron ...... 140 HEALTHMIST...... 84 (BULK) ...... 109 g-tron ped ...... 140 HEALTHY ACCENTS GLYCOSADE...... 157 GUAIACOL ...... 45 AUTOLET...... 84 GLYCOSAMINOGLYCANS, guaiasorb dm ...... 140 HEALTHY ACCENTS MIXED(BULK) ...... 60 guaiatussin ac ...... 140 UNIFINE PENTIP...... 84 GLYCYRRHIZIC ACID guaifenesin...... 140 HEALTHY ACCENTS (BULK) ...... 60 GUAIFENESIN (BULK)...140 UNILET LANCET...... 84 glydo...... 50 guaifenesin ac...... 140 healthy eyes ...... 169

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 198 healthy eyes supervision.....169 heparin(porcine) in 0.45% nacl HUMALOG MIX 50-50 healthylax ...... 113 ...... 40 KWIKPEN...... 85 HEARING AID BATTERIES heparin, porcine (pf) ...... 40 HUMALOG MIX 75-25...... 85 ...... 84 HERCEPTIN...... 14 HUMALOG MIX 75-25 heartburn antacid ...... 113 HEXALEN ...... 14 KWIKPEN...... 85 heartburn prevention ...... 119 hi-cal plus vit d...... 151 HUMAPEN LUXURA HD..85 heartburn relief ...... 114 high potency calcium...... 151 HUMIDIFIERS ...... 85 heartburn relief (cimetidine) high potency capsaicin ...... 45 HUMIRA...... 123 ...... 119 high potency iron...... 169 HUMIRA PEDIATRIC heartburn relief (famotidine) high-protein nutritional shake CROHN'S START...... 123 ...... 119 ...... 157 HUMIRA PEN ...... 123 heartburn relief (ranitidine) 119 HISTAMINE PHOSPHATE HUMULIN 70/30 ...... 85 heartburn relief 24 hour...... 119 (BULK) ...... 60 HUMULIN 70/30 PEN...... 85 HEAT THERAPY...... 85 HISTIDINE HCL(L- HUMULIN N ...... 85 heather ...... 124 HISTID)(BULK)...... 157 HUMULIN N PEN...... 85 HEATING PADS...... 85 hist-pse...... 140 HUMULIN R U-100 ...... 85 heatwraps back and hip pads 85 HIZENTRA...... 122 HUMULIN R U-500 (CONC) HEAVY DUTY FABRIC HOLLIHESIVE SKIN KWIKPEN...... 85 STRIPS...... 85 BARRIER...... 85 HUMULIN R U-500 hecoria ...... 14 HOLLISTER (CONCENTRATED) ...... 85 HEMABATE...... 128 REPLACEMENT FILTERS HURRICAINE LUER-LOCK HEMA-COMBISTIX...... 85 ...... 85 DIS CAP...... 85 hematinic plus vit/minerals 169 HOM 2...... 157 HYALURONIDASE, hematinic/folic acid ...... 169 homatropaire...... 129 BOVINE (BULK) ...... 131 hematogen ...... 169 homatropine hbr ...... 129 HYCAMTIN...... 14 hematogen fa ...... 169 HOMATROPINE hydralazine ...... 36 hematogen forte...... 169 METHYLBROM (BULK) HYDRALAZINE HCL hemenatal ob ...... 169 ...... 109 (BULK)...... 36 hemenatal ob + dha ...... 169 HOMINEX-1...... 157 HYDRAZINE SULFATE hemetab ...... 169 HOMINEX-2...... 157 (BULK)...... 60 hemmorex-hc...... 114 honey bears...... 169 hydrocerin (with petrolatum)45 hemorrhoidal suppository...114 honey bears with iron-zinc .170 hydrochloric acid (bulk) .....114 hemril-30 ...... 114 hpr...... 45 hydrochlorothiazide...... 36 hep flush-10 (pf)...... 39 hpr plus...... 45 HYDROCHLOROTHIAZIDE heparin (porcine) ...... 39 hpr plus hydrogel...... 45 (BULK)...... 36 HEPARIN (PORCINE) huber safety needles (disp.) ..85 HYDROCODONE (BULK) ...... 39 HUGGIES LITTLE MOVERS BITARTRATE (BULK)...22 heparin (porcine) in 5 % dex 39 ...... 85 hydrocodone-acetaminophen22 heparin (porcine) in nacl (pf)39 HUGGIES LITTLE hydrocodone-chlorpheniramine heparin flush...... 39 SNUGGLERS ...... 85 ...... 140 heparin flush(porcine)-0.9nacl HUGGIES OVERNITES .....85 hydrocodone-cpm- ...... 39 HUGGIES PURE AND pseudoephed ...... 140 heparin lock ...... 39 NATURAL SIZE5 ...... 85 hydrocodone-homatropine..140 heparin lock flush ...... 39 HUGO ROLLING WALKER hydrocodone-ibuprofen ...... 22 heparin lock flush (porcine) .40 ...... 85 HYDROCOL II ...... 85 heparin lockflush(porcine)(pf) HUMALOG...... 85 HYDROCOLLOID ...... 40 HUMALOG KWIKPEN ...... 85 DRESSING...... 85 HUMALOG MIX 50-50 ...... 85 hydrocortisone ...... 55, 68, 114

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 199 HYDROCORTISONE HYDROXYUREA (BULK) 14 imiquimod...... 45 (BULK) ...... 55 hydroxyzine hcl ...... 140 IMIQUIMOD (BULK)...... 46 hydrocortisone acet-aloe vera HYDROXYZINE HCL immulife ...... 157 ...... 55 (BULK) ...... 140 IMPACT 1 CAL...... 157 hydrocortisone acetate..55, 114 hydroxyzine pamoate ...... 140 IMPACT 1.5 ...... 157 HYDROCORTISONE HYDROXYZINE PAMOATE impact advanced recovery ..157 ACETATE (BULK) ...... 55 (BULK) ...... 140 IMPACT ADVANCED hydrocortisone butyrate...... 55 hyolev mb...... 149 RECOVERY...... 158 hydrocortisone butyr-emollient hyophen ...... 149 IMPACT GLUTAMINE ....158 ...... 55 hyoscyamine sulfate ...... 109 IMPACT PEPTIDE 1.5 CAL hydrocortisone plus ...... 55 HYOSCYAMINE SULFATE ...... 158 hydrocortisone valerate ...... 55 (BULK) ...... 109 IMPACT/FIBER...... 158 hydrocortisone-acetic acid....67 hyosyne...... 109 IMPAVIDO ...... 8 hydrocortisone-aloe vera...... 55 hypercare ...... 45 IMUPLUS...... 158 hydrocortisone-iodoquinol-aloe HYPO-ALLERGENIC inatal advance ...... 170 ...... 52 BANDAGES ...... 85 inatal ultra...... 170 hydrocortisone-min oil-wht pet HYPOLANCE AST INCARE INVIEW ...... 55 LANCING...... 85 CATHETER ...... 85 hydrocortisone-pramox-e- I IN-CHECK NASAL WITH pram#1...... 114 ibandronate ...... 123 MASK...... 85 hydrocortisone-pramoxine ..42, IBRANCE ...... 14 IN-CHECK ORAL FLOW 114 ibu-drops...... 27 METER...... 86 hydrocream...... 56 ibuprofen ...... 27 INCONTROL BP MONITOR HYDROGEN PEROXIDE IBUPROFEN (BULK) ...... 27 ...... 86 (BULK) ...... 61 ibuprofen ib ...... 27 INCONTROL LANCING hydromet...... 140 ibuprofen jr strength ...... 27 DEVICE ...... 86 hydromorphone ...... 22, 23 ibuprofen lysine (pf)...... 27 INCONTROL PEN NEEDLE HYDROMORPHONE ibuprofen-oxycodone...... 23 ...... 86 (BULK) ...... 22 ibutilide fumarate ...... 34 INCONTROL SUPER THIN hydromorphone (pf) ...... 22 icaps areds ...... 170 LANCETS ...... 86 HYDROQUINONE (BULK) icaps plus ...... 170 INCONTROL ULTRA THIN ...... 45 ice blue gel...... 45 LANCETS ...... 86 hydroskin...... 56 ice gel ...... 45 INCRELEX ...... 61 hydroskin with aloe ...... 56 ICHTHAMMOL (BULK)....45 indapamide ...... 36 hydroxocobalamin...... 170 ICLUSIG ...... 14 INDOLE-3-CARBINOL HYDROXOCOBALAMIN icy hot (menthol) ...... 45 (BULK)...... 61 (BULK) ...... 170 idarubicin...... 14 indomethacin ...... 27 hydroxychloroquine ...... 8 IDOXURIDINE...... 4 INDOMETHACIN (BULK) 27 HYDROXYCHLOROQUINE iferex 150...... 170 indomethacin sodium...... 27 ...... 8 ifosfamide...... 14 infanate plus...... 170 HYDROXYETHYL ifosfamide-mesna ...... 14 infant fever reducer-pain relf27 METHACRYLATE,BULK ILE-SORB ORIGINAL...... 85 infant formula with iron...... 158 ...... 131 imatinib...... 14 infant's advil...... 27 HYDROXYPROGESTERON IMBRUVICA ...... 14 infants gas relief ...... 114 E CAPR(BULK) ...... 124 imipenem-cilastatin ...... 8 infant's ibuprofen ...... 27 hydroxyprogesterone caproate IMIPRAMINE (BULK) ...... 32 infant's medi-profen...... 27 ...... 124 imipramine hcl...... 32 infant's motrin...... 27 hydroxyurea...... 14 imipramine pamoate ...... 32 infants' pain and fever...... 27

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 200 infants' pain relief...... 27 IPRATROPIUM BROMIDE itch relief (clotrimazole) ...... 53 infant's pain relief...... 27 (BULK) ...... 147 itch relief (diphenhydramine) infant's pain reliever ...... 27 ipratropium-albuterol...... 147 ...... 46 infants profenib ...... 27 i-prin ...... 27 itraconazole...... 3 infed...... 170 irbesartan ...... 36 ITRACONAZOLE (BULK)...3 INFERGEN ...... 120 irbesartan-hydrochlorothiazide IV PREP WIPES ...... 86 INFLECTRA...... 114 ...... 36 I-VALEX-1...... 158 INJECT EASE LANCETS ..86 IRESSA ...... 14 I-VALEX-2...... 158 INJECT-EASE ...... 86 irinotecan...... 14 ivermectin ...... 8 INJECT-EASE AUTOMATIC iron...... 170 IVERMECTIN ...... 8 INJECTOR...... 86 iron (dried)...... 170 i-vite...... 170 INLYTA...... 14 iron chews...... 170 i-vite protect...... 170 INOSITOL (BULK)...... 158 iron fum,ag-c-b12-fa-ca-succ IXEMPRA ...... 14 INS SYRINGE/NEEDLE 0.5 ...... 170 J ML 27 G...... 86 iron high potency...... 170 J AND J NON-STICK PADS INSECT REPELLENT IRRIGATION SLEEVE...... 86 MEDIUM ...... 86 (DEET)...... 46 ISENTRESS ...... 4 JADENU...... 61 INSECT REPELLENT isoflurane...... 61 JAKAFI ...... 14 (PICARIDIN)...... 46 ISOLEUCINE (BULK)...... 158 jantoven ...... 40 INSPIRACHAMBER ...... 86 isometh-dichloral- JANUMET ...... 86 INSTACLEAN...... 64 acetaminophn...... 19 JANUMET XR...... 86 insta-glucose...... 61 isomethepten-caf- JANUVIA...... 86 INSTANT EAR acetaminophen...... 19 jencycla...... 124 THERMOMETER ...... 86 ISOMETHEPTENE MUCATE JETREA (PF)...... 131 insulin syringe-needle u-100 86 (BULK) ...... 19 jevantique lo ...... 124 INSULIN SYRINGES ISOMIL ADVANCE...... 158 JEVITY 1 CAL...... 158 (DISPOSABLE)...... 86 ISOMIL DF ...... 158 JEVITY 1.2 CAL...... 158 INSUPEN...... 86 ISOMIL/IRON ...... 158 JEVITY 1.5 CAL...... 158 INTELENCE...... 4 isoniazid...... 8 jinteli...... 124 intense cough reliever...... 140 ISONIAZID (BULK) ...... 8 jock itch ...... 53 intralipid ...... 158 ISOPROPAMIDE IODIDE109 jock itch (clotrimazole)...... 53 INTRON A...... 120 isopropyl alcohol ...... 61 jock itch (terbinafine) ...... 53 introvale...... 127 ISOPROPYL ALCOHOL ...61, johnson's baby oil ...... 46 INVACARE LANCETS ...... 86 64 jolessa ...... 127 INVIRASE ...... 4 ISOPROPYL MYRISTATE 61 jolivette...... 124 invisible acne...... 49 ISOPROTERENOL HCL jr str non-aspirin quick melts 27 INVOKAMET...... 86 (BULK) ...... 147 jr. acetaminophen ...... 28 INVOKANA ...... 86 ISOSORBIDE (BULK)...... 42 jr. str non-aspirin pain...... 28 inzo antifungal...... 53 isosorbide dinitrate ...... 42 jr. strength pain reliever...... 28 IODINE (BULK)...... 61 isosorbide mononitrate ...... 42 juleber ...... 127 IODOFORM (BULK)...... 46 ISOSOURCE 1.5 CAL...... 158 junel 1.5/30 (21) ...... 127 IODOQUINOL (BULK)...... 8 isosource hn...... 158 junel 1/20 (21) ...... 127 iodoquinol-hc ...... 52 isoxsuprine...... 125 junel fe 1.5/30 (28) ...... 127 IOPANOIC ACID (BULK) .61 ISOXSUPRINE HCL (BULK) junel fe 1/20 (28) ...... 127 iophen c-nr...... 140 ...... 125 junel fe 24 ...... 127 iophen dm-nr ...... 140 isradipine ...... 36 junior mapap...... 28 iophen-nr ...... 140 ISTODAX ...... 14 JUVEN ...... 158 ipratropium bromide.....66, 147 itch relief...... 46 JUXTAPID ...... 41

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 201 K KEPIVANCE ...... 12 klor-con m10 ...... 152 KADCYLA ...... 14 KERLIX ...... 87 klor-con m15 ...... 152 kaitlib fe...... 127 ketamine ...... 61 klor-con m20 ...... 152 KALBITOR...... 147 ketoconazole...... 3, 53 klor-con sprinkle...... 152 KALETRA ...... 4 KETOCONAZOLE (BULK) .3 klor-con/ef ...... 152 KALTOSTAT FORTEX...... 86 ketodan ...... 53 kobee...... 170 KALTOSTAT ROPE ...... 86 ketodan kit ...... 53 KOJIC ACID ...... 61 KALYDECO...... 147 KETO-DIASTIX...... 87 kola-pectin ds...... 110 KANAMYCIN (BULK) ...... 8 KETONE URINE TEST ...... 87 konsyl (sugar) ...... 114 KANGAROO KETONEX-1...... 158 konsyl fiber...... 114 BURETTE/PUMP SET....86 KETONEX-2...... 158 konsyl sugar-free ...... 114 KANGAROO ENTERAL- ketoprofen...... 28 konsyl sugar-free (aspartame) FEED-IRRIG KT ...... 86 KETOPROFEN (BULK) .....28 ...... 114 KANGAROO EPUMP SET.86 KETOPROFEN, konsyl-d ...... 114 KANGAROO EZ CAP BAG MICRONIZED (BULK) ..28 K-PAX...... 158 ...... 86 ketorolac ...... 28, 131 k-pec antidiarrheal (bism sub) KANGAROO FEEDING KETOROLAC (BULK) ...... 28 ...... 110 TUBE ...... 86 KETOSTIX ...... 87 K-PHOS NO 2...... 149 KANGAROO GRAVITY SET KETOTIFEN FUMARATE K-PHOS ORIGINAL ...... 149 ...... 86 (BULK) ...... 131 k-phos-neutral...... 152 KANGAROO PUMP KETOVOLVE...... 158 kpn ...... 170 EXTENSION SET ...... 86 KEYTRUDA...... 14 KRYSTEXXA...... 123 KANGAROO RIGID KID PANTS FOR GIRLS....87 k-sol ...... 152 CONTAINER PUMP...... 87 kidkare cough/cold ...... 140 k-tab...... 152 KANUMA...... 107 kid's vitamins...... 170 kurvelo...... 127 kaopectate (bismuth subsalicy) kid's vitamins + extra c...... 170 KUVAN...... 107 ...... 109 kids vitamins + iron...... 170 KYPROLIS...... 14 kaopectate ex str (bismuth ss) kid's vitamins + iron ...... 170 L ...... 110 kimidess (28) ...... 127 l norgest/e.estradiol-e.estrad kao-tin (bismuth subsalicylat) KIMONO CONDOMS(NON- ...... 127 ...... 110 LUBRICATED) ...... 87 labetalol ...... 36 kao-tin (docusate calcium) .114 KIMONO MAXX CONDOMS LABETALOL (BULK) ...... 36 KARAYA 5 CLOSED ...... 87 LABSTIX REAGENT...... 87 POUCH - TAPE...... 87 KIMONO MICROTHIN lactated ringers...... 57, 152 KARAYA 5 DRAINABLE AQUA LUBE CON...... 87 lactic acid...... 46 POUCH ...... 87 KIMONO MICROTHIN lactic acid (bulk) ...... 46 KARAYA GUM (BULK)..114 CONDOMS...... 87 lactic acid e ...... 46 KARAYA PASTE...... 87 KIMONO TEXTURED LACTOBACILL.ACIDOPHIL KARAYA POWDER...... 87 CONDOMS...... 87 US (BULK) ...... 158 kariva (28) ...... 127 KINNEY BRAND LANCETS lactulose...... 114 k-effervescent ...... 151 ...... 87 L-ALANINE...... 61 kelnor 1/35 (28)...... 127 kionex ...... 61 LAMB'S WOOL...... 87 KENDALL...... 87 kionex (with sorbitol) ...... 61 LAMISIL...... 3 KENDALL PAPER TAPE...87 KLING ROLLS...... 87 lamisil af ...... 53 KENGUARD URINARY klofensaid ii ...... 28 lamisil at ...... 53 DRAIN BAG...... 87 klor-con ...... 151 lamivudine ...... 4 KENLINE ADD-A-FOLEY klor-con 10 ...... 151 lamivudine-zidovudine...... 4 TRAY 30CC...... 87 klor-con 8 ...... 151 lamotrigine...... 18

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 202 LAMOTRIGINE (BULK) ...18 leucovorin calcium ...... 12 lice killing...... 56 LANAFLEX...... 158 LEUCOVORIN CALCIUM lice killing (permethrin)...... 56 LANCETS...... 87 (BULK) ...... 12 lice pyrinyl shampoo ...... 56 LANCETS,THIN ...... 87 LEU-FREE COOLER ...... 158 lice solution ...... 56 LANCING DEVICE ...... 87 LEUKERAN ...... 14 lice treatment ...... 56 LANCING SYSTEM ...... 87 LEUKINE...... 120 lidocaine ...... 51 LANOXIN...... 39 leuprolide...... 14 lidocaine (pf) in d7.5w ...... 34 LANOXIN PEDIATRIC...... 39 LEUPROLIDE (BULK)...... 14 LIDOCAINE (BULK)...... 50 lansoprazole...... 119 levalbuterol hcl ...... 147 lidocaine (pf) ...... 34, 51 LANSOPRAZOLE (BULK) LEVALBUTEROL HCL lidocaine hcl...... 51 ...... 119 (BULK) ...... 147 LIDOCAINE HCL (BULK).51 LANZO LANCING DEVICE LEVAMISOLE (BULK)...... 14 lidocaine hcl-hydrocortison ac ...... 87 levetiracetam ...... 18 ...... 51, 114 larin 1.5/30 (21)...... 127 LEVETIRACETAM (BULK) lidocaine in 5 % dextrose (pf) larin 1/20 (21)...... 127 ...... 18 ...... 34 larin 24 fe ...... 127 levetiracetam in nacl (iso-os)18 lidocaine viscous ...... 51 larin fe 1.5/30 (28)...... 127 levobunolol...... 129 lidocaine-epinephrine ...... 51 larin fe 1/20 (28)...... 127 levocarnitine ...... 61 lidocaine-hydrocortisone-aloe larissia...... 127 LEVOCARNITINE...... 61 ...... 114 LARTRUVO ...... 14 levocarnitine (with sugar).....61 lidocaine-prilocaine ...... 51 L-ASPARTIC ACID...... 158 levocetirizine ...... 140 lido-k...... 51 latanoprost ...... 132 LEVODOPA (BULK)...... 19 lidopin...... 51 latrix ...... 46 levofloxacin...... 10, 129 lidopril ...... 51 latrix xm ...... 42 LEVOFLOXACIN (BULK).10 LIFESHIELD BLUNT laxa clear ...... 114 levofloxacin in d5w...... 10 CANNULA...... 87 laxacin ...... 114 levoleucovorin ...... 12 lincomycin ...... 8 laxative (bisacodyl) ...... 114 LEVOLEUCOVORIN ...... 12 LINCOMYCIN...... 8 laxative (sennosides) ...... 114 LEVOMEFOLATE lindane ...... 56 laxative dietary supplement 152 CALCIUM (BULK)...... 170 LINEN FRESH...... 87 laxative feminine...... 114 levonest (28)...... 127 linezolid ...... 8 laxative maximum strength 114 levonorgestrel ...... 127 linezolid-0.9% sodium chloride laxative peg 3350 ...... 114 levonorgestrel-ethinyl estrad ...... 8 laxative pills ...... 114 ...... 127 LINZESS ...... 114 laxative pills regular ...... 114 levonorg-eth estrad triphasic LIORESAL...... 20 laxative plus stool softener.114 ...... 127 liothyronine...... 108 laxative-senna...... 114 levora-28...... 127 LIOTHYRONINE (BULK)108 layolis fe ...... 127 levorphanol tartrate...... 23 lipistart...... 158 L-CARNITINE...... 61 LEVORPHANOL lipodox...... 14 L-CITRULLINE...... 158 TARTRATE (BULK)...... 23 LIPOIC ACID ...... 61 leena 28 ...... 127 levothyroxine...... 108 liquacel ...... 158 leflunomide...... 123 LEVOTHYROXINE (BULK) liquibid d-r...... 140 LEMTRADA...... 20 ...... 108 liquid antacid ...... 114 LENVIMA ...... 14 levoxyl...... 108 liquid nutrition...... 158 lessina...... 127 LEXIVA ...... 4 liquid nutrition plus ...... 158 LETAIRIS ...... 147 L-GLUTAMIC ACID ...... 114 liquitears ...... 131 letrozole...... 14 lice bedding spray...... 56 LISCO...... 87 LETROZOLE (BULK) ...... 14 lice complete kit 1-2-3...... 56 lisinopril...... 36 LEUCINE...... 61 lice cream rinse...... 56 LISINOPRIL (BULK)...... 37

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 203 lisinopril-hydrochlorothiazide loratadine...... 141 LYSINE HCL (BULK) ...... 158 ...... 37 loratadine-d...... 141 lysiplex plus...... 170 L-ISOLEUCINE...... 158 lorazepam ...... 32 LYSODREN...... 15 lite coat aspirin ...... 28 LORAZEPAM (BULK)...... 33 lyza ...... 124 LITE TOUCH LANCING lorazepam intensol...... 33 M DEVICE ...... 87 lorcet (hydrocodone) ...... 23 m.v.i. adult...... 170 LITEAIRE MDI CHAMBER lorcet hd...... 23 M9 CLEANER- ...... 87 lorcet plus ...... 23 DECRYSTALLIZER ...... 88 LITETOUCH-SMALL MASK lorenza patch...... 51 maalox maximum strength .114 ...... 87 lortab 10-325 ...... 23 mac ...... 46 lithium carbonate...... 32 lortab 5-325 ...... 23 macnatal cn dha ...... 170 LITHIUM CARBONATE lortab 7.5-325 ...... 23 mafenide acetate ...... 52 (BULK) ...... 32 lortuss ex...... 141 MAFENIDE ACETATE lithium citrate ...... 32 loryna (28) ...... 127 (BULK)...... 52 little animals ...... 170 losartan ...... 37 mag 64 ...... 152 little animals-iron ...... 170 losartan-hydrochlorothiazide 37 mag-al plus ...... 114 LITTLE DARLINGS 2T-3T 88 lotrimin af powder ...... 53 mag-al plus extra strength ..114 LITTLE ONES CLOSED- lovastatin ...... 41 mag-delay ...... 152 END POUCH ...... 88 low-ogestrel (28) ...... 127 MAGELLAN INSULIN LITTLE ONES DRAINABLE loxapine succinate ...... 33 SAFETY SYRNG ...... 88 POUCH ...... 88 lozi-flur...... 170 MAGELLAN SYRINGE .....88 LITTLE ONES FLEXIBLE lta pre-attached ...... 51 mag-g...... 152 SKIN...... 88 L-THREONINE ...... 158 MAGNA-PORT LITTLE ONES SKIN lubricant eye ...... 131 GASTROSTOMY TUBE.88 BARRIER...... 88 lubricant eye (polyv alcohol) magnesium...... 115, 152 LITTLE ONES UROSTOMY ...... 131 MAGNESIUM ASPART POUCH ...... 88 lubricant eye drops (glyc-pg) DIHYD (BULK)...... 61 little remedies ...... 66 ...... 131 magnesium chloride...... 152 little remedies fever and pain28 lubricant eye(dextran70- MAGNESIUM CHLORIDE LMD POWDER ...... 158 hypml) ...... 131 (BULK)...... 152 lohist - d...... 140 lubrifresh pm ...... 131 magnesium gluconate ...... 152 lohist peb dm ...... 140 LUCENTIS...... 131 MAGNESIUM GLUCONATE lohist-dm...... 140 ludent fluoride ...... 170 ...... 152 lohist-peb...... 140 LUER LOCK SYRINGE .....88 MAGNESIUM GLYCINATE lomedia 24 fe...... 127 lugols ...... 52, 152 (BULK)...... 152 LOMUSTINE...... 14 LUMIZYME ...... 107 MAGNESIUM MALATE....64 LONSURF...... 14 LUPRON DEPOT ...... 15 magnesium oxide...... 152 LOOP OSTOMY BRIDGE LUPRON DEPOT (3 MAGNESIUM OXIDE STERILE...... 88 MONTH)...... 15 (BULK)...... 152 loperamide...... 110 LUPRON DEPOT-PED ...... 15 magnesium sulfate ...... 152 LOPERAMIDE (BULK)....110 LUPRON DEPOT-PED (3 MAGNESIUM SULFATE LOPHLEX...... 158 MONTH)...... 15 (BULK)...... 115 lopinavir-ritonavir ...... 4 LUTEIN (BULK)...... 170 magnesium sulfate in water 152 lopreeza ...... 124 lutera (28) ...... 127 major-prep (phenylephrine-fat) LO-PROFILE UROSTOMY LUVS SIZE 6 ...... 88 ...... 115 POUCH ...... 88 luxamend ...... 46 MAKENA...... 124 loradamed...... 141 LYNPARZA...... 15 malathion ...... 56 lorata-d ...... 141 LYRICA ...... 18 MALIC ACID (BULK)...... 61

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 204 manganese chloride ...... 152 MECAMYLAMINE HCL MEDTRONIC REMOTE MANGANESE CHLORIDE (BULK) ...... 61 CONTROL ...... 89 (BULK) ...... 152 MECHLORETHAMINE mefenamic acid...... 28 MANGANESE GLUCONATE (BULK) ...... 15 MEFENAMIC ACID (BULK) (BULK) ...... 152 meclizine ...... 115 ...... 28 manganese sulfate ...... 152 MECLIZINE ...... 115 mefloquine...... 8 MANNITOL (BULK)...... 37 meclofenamate...... 28 MEGA BIOTIN...... 170 mannitol 10 % ...... 37 MECLOFENAMATE ...... 28 mega multiple/chelated mineral mannitol 20 % ...... 37 MECLOFENOXATE HCL ...... 170 mannitol 25 % ...... 37 (BULK) ...... 61 megestrol ...... 15 mannitol 5 % ...... 37 MECOBALAMIN (BULK) .61 MEGESTROL mapap (acetaminophen) ...... 28 medi-bismuth...... 110 ACETATE,MICRO mapap arthritis pain...... 28 MEDICAL ADHESIVE...... 88 (BULK)...... 15 mapap cold formula...... 141 medicidin-d...... 141 MEKINIST ...... 15 mapap extra strength ...... 28 medi-cortisone...... 56 MELATONIN (BULK)...... 61 mapap infants'...... 28 medifin expectorant mucus rlf meloxicam ...... 28 mapap pm ...... 28 ...... 141 MELOXICAM (BULK)...... 28 mapap sinus max strength (pe) medi-first anti-fungal...... 53 melphalan hcl...... 15 ...... 141 MEDIHONEY (CAL memantine ...... 20 mapo bath ...... 46 ALGINATE-HONEY) .....88 MENADIONE...... 61 maprotiline ...... 33 MEDI-LANCE LANCETS ..88 m-end dm...... 141 marcaine (pf) ...... 51 medi-lax...... 115 m-end wc ...... 141 margesic ...... 23 medi-laxx...... 115 MENEST ...... 124 marlissa...... 127 medi-meclizine ...... 115 men-phor...... 46 MARQIBO...... 15 medi-mucil...... 115 men's daily formula ...... 170 marten-tab...... 23 medi-natural...... 115 men's daily multivit-mineral masanti double strength...... 115 medi-natural senna-stool ....115 ...... 170 masophen...... 28 medi-phedrine...... 141 men's multi-vitamin...... 170 MASTISOL LIQUID medi-phedryl ...... 141 men's one daily ...... 170 ADHESIVE...... 88 MEDIPORE...... 88 menthol ...... 46 MASTISOL STERTIP ...... 88 MEDIPORE H...... 88 MENTHOL...... 46 MATULANE ...... 15 medi-profen ...... 28 me-pb-hyos ...... 110 matzim la...... 37 MEDISENSE THIN MEPERIDINE (BULK) ...... 23 MAXICARE BELTED LANCETS...... 88 MEPHYTON...... 40 UNDERGARMENT ...... 88 medi-sleep ...... 33 MEQUINOL (BULK) ...... 61 MAXICARE UNDERPADS88 medi-tabs ...... 28 mercaptopurine ...... 15 MAXI-COMFORT INSULIN medi-tabs pm ...... 28 MERCAPTOPURINE (BULK) SYRINGE...... 88 medi-tussin ...... 141 ...... 15 maximum daily multivitamin medi-tussin dm ...... 141 MERIBIN ...... 170 ...... 170 medi-tussin dm diabetic...... 141 meropenem ...... 8 maxiphen ...... 141 MEDLANCE PLUS MEROPENEM-0.9% mb hydrogel...... 46 LANCETS...... 88 SODIUM CHLORIDE ...... 8 mb hydrogel (cyclomethicone) MEDLANCE PLUS SPECIAL mesalamine ...... 115 ...... 46 BLADE...... 88 MESALAMINE ...... 115 m-clear wc...... 141 MEDROXYPROGEST, AC mesalamine with cleansing mct procal...... 158 MICRO(BULK) ...... 124 wipe ...... 115 mct pro-cal...... 158 medroxyprogesterone ...... 124 MESH PANTS ...... 89 MEBENDAZOLE...... 8 mesna...... 12

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 205 MESNEX ...... 12 methylene blue (antidote).....11 micatin ...... 53 MESTINON ...... 21 methylergonovine...... 128 MICONAZOLE...... 3 metadate er ...... 33 METHYLPARABEN (BULK) miconazole 7...... 125 metamucil fiber singles ...... 115 ...... 61 miconazole nitrate ...... 53, 125 metaproterenol...... 147 methylphenidate ...... 33 MICONAZOLE NITRATE..53 METAPROTERENOL...... 147 METHYLPHENIDATE...... 33 miconazole-3 ...... 125 metaxall ...... 21 METHYLPREDNISOLON miconazorb af ...... 53 metaxalone ...... 21 AC,MIC(BULK) ...... 68 MICRO THIN LANCETS ...89 metformin...... 89 methylprednisolone ...... 68 MICROCHAMBER ...... 89 METFORMIN (BULK) ...... 89 methylprednisolone acetate ..68 MICRODERM ...... 89 METHACHOLINE methylprednisolone sodium MICRODERM PLUS...... 89 CHLORIDE (BULK) ...... 61 succ...... 68 MICROFOAM SURGICAL 89 methadone ...... 23 METHYLPREDNISOLONE, microgestin 1.5/30 (21) ...... 127 METHADONE (BULK)...... 23 MIC (BULK)...... 68 microgestin 1/20 (21) ...... 127 methadose...... 23 METHYLPYRAZOLE ...... 123 microgestin fe 1.5/30 (28) ..127 methamphetamine ...... 33 METHYLSULFONYLMETH microgestin fe 1/20 (28) .....127 methazolamide ...... 132 ANE (BULK) ...... 61 micro-guard ...... 53 METHAZOLAMIDE...... 132 methyltestosterone...... 107 MICROHESIVE STOMA METHENAMINE (BULK) .11 METHYLTESTOSTERONE PASTE...... 89 methenamine hippurate ...... 11 (BULK) ...... 107 MICROLET LANCET...... 89 methenamine mandelate...... 11 METHYLTESTOSTERONE, MICROLIFE PEAK FLOW METHENAMINE MICRO(BULK) ...... 107 METER...... 89 MANDELATE (BULK) ..11 METHYLTETRAHYDROFO MICROPORE SURGICAL..89 methen-sod phos-meth blue- L CA (BULK) ...... 170 MICROSPACER...... 89 hyos ...... 149 METHYSERGIDE (BULK) 19 MICROSPONGE ...... 89 methergine...... 128 metipranolol...... 129 midazolam ...... 33 methimazole ...... 69 METOCLOPRAMIDE MIDAZOLAM (BULK)...... 33 METHIMAZOLE (BULK)..69 (BULK) ...... 115 midazolam (pf) ...... 33 METHIONAID ...... 158 metoclopramide hcl ...... 115 midodrine...... 61 METHIONINE (BULK) ....149 metolazone...... 37 migergot...... 19 METHITEST...... 107 metoprolol succinate...... 37 miglitol ...... 89 methocarbamol ...... 21 metoprolol ta-hydrochlorothiaz migragesic ida...... 19 METHOCARBAMOL ...... 37 migraine formula ...... 28 (BULK) ...... 21 metoprolol tartrate ...... 37 migraine pain reliever...... 28 METHOTREXATE (BULK) METOPROLOL TARTRATE migraine relief ...... 28 ...... 15 (BULK) ...... 37 milk of magnesia ...... 115 methotrexate sodium ...... 15 metro i.v...... 8 milk of magnesia concentrated methotrexate sodium (pf) .....15 metronidazole ...... 8, 49, 125 ...... 115 methoxsalen...... 46 METRONIDAZOLE (BULK)8 MILK THISTLE (BULK) ....64 METHOXSALEN...... 46 METRONIDAZOLE millipred ...... 68 METHSCOPOLAMINE ....110 BENZOATE (BULK) ...... 8 millipred dp ...... 68 METHSCOPOLAMINE metronidazole in nacl (iso-os) 8 milltrium senior ...... 170 NITRATE (BULK) ...... 110 mexiletine ...... 34 milrinone...... 41 methyclothiazide ...... 37 MEXILETINE (BULK) ...... 34 milrinone in 5 % dextrose.....41 methyldopa...... 37 mgo...... 152 mimvey...... 125 methyldopa- m-hist dm...... 141 mimvey lo...... 125 hydrochlorothiazide...... 37 mi-acid...... 115 mineral freez...... 46 methyldopate ...... 37 mi-acid gas relief...... 115 mineral oil...... 115

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 206 mineral oil extra heavy...... 115 mondoxyne nl ...... 11 MONOJECT TIP mineral oil heavy...... 61 MONOBENZONE (BULK).46 CAPS/FLEX/LUER ...... 90 mineral oil light ...... 46, 61 MONOCHLOROACETIC MONOLET LANCETS...... 90 minerin ...... 46 ACID (BULK)...... 46 MONOLET THIN LANCETS MINI LANCING DEVICE ..89 MONOGEN...... 158 ...... 90 MINI TRANSFER PIN...... 89 monoject 0.9% sodium mono-linyah...... 127 MINI ULTRA-THIN II...... 89 chloride...... 61 mononessa (28)...... 127 MINIMED QUICK-SERTER- MONOJECT ALLERGY MONSEL'S...... 46 MMT 395 ...... 89 TRAY ...... 89 montelukast...... 147 miniprin ...... 28 MONOJECT ALLERGY MONTELUKAST (BULK)147 minocycline ...... 11 TRAY DETACH...... 89 morgidox...... 11 MINOCYCLINE...... 11 MONOJECT BLOOD morphine...... 23, 24 minoxidil ...... 37 COLLECTION...... 89 MORPHINE (BULK)...... 23 MINOXIDIL (BULK)...... 37 MONOJECT BLUNT morphine (pf)...... 23 mintox...... 115 CANNULAS ...... 89 morphine (pf) in 0.9 % nacl..23 mintox maximum strength .115 MONOJECT CONTROL morphine concentrate ...... 23 mintox plus...... 115 SYRINGE LUER ...... 89 morrhuate sodium...... 62 miostat ...... 132 MONOJECT FILTER motion relief (meclizine) ....115 miralax...... 115 NEEDLE ...... 89 motion sickness ...... 115 MIRASORB...... 89 MONOJECT HYPODERMIC motion sickness (meclizine) MIRENA ...... 125 NEEDLES ...... 90 ...... 115 mirtazapine...... 33 MONOJECT INSULIN motion sickness relief ...... 115 MIRTAZAPINE (BULK) ....33 SYRINGE...... 90 motion sickness relief ii...... 115 misoprostol...... 119 MONOJECT MAGELLAN motion sickness relief(mecliz) MISOPROSTOL (BULK) .119 SYRINGE...... 90 ...... 115 MITIGARE ...... 123 MONOJECT MEDICATION motion-time ...... 115 mitomycin...... 15 TRANSF NDL ...... 90 MOUTHPIECE ...... 90 MITOMYCIN (BULK)...... 15 MONOJECT PHARMACY move it along ...... 115 MITOTANE (BULK) ...... 15 TRAY REG TIP ...... 90 moxifloxacin...... 10 mitoxantrone...... 15 monoject prefill (pf) ...... 40 MOXIFLOXACIN- MMA-PA COOLER15 ...... 158 monoject prefill advanced (pf) SOD.ACE,SUL-WATER.10 MMA-PA EXPRESS ...... 158 ...... 40 MOZOBIL...... 120 MMA-PA GEL...... 158 monoject prefill advanced ns61 MPM FOAM DRESSING....90 mobisyl...... 46 monoject prefill saline flush.62 MSUD 2...... 159 modafinil ...... 33 MONOJECT REG TIP NON- MSUD AID ...... 159 moderiba...... 4 STERILE...... 90 MSUD ANALOG...... 159 moderiba dose pack...... 4 MONOJECT SAFETY MSUD COOLER...... 159 moexipril ...... 37 SYRINGES ...... 90 MSUD EXPRESS COOLER moexipril-hydrochlorothiazide MONOJECT SYRINGE ...... 159 ...... 37 CATHETER ...... 90 msud express15 ...... 159 moisture drops...... 131 MONOJECT SYRINGE MSUD GEL POWDER...... 159 moisturizing...... 46 LUER LOK ...... 90 MSUD LOPHLEX ...... 159 moisturizing cream...... 46 MONOJECT SYRINGE MSUD MAXAMAID...... 159 molindone...... 33 REGULAR LUER...... 90 MSUD MAXAMUM ...... 159 MOLYBDENUM (BULK) ..61 MONOJECT TB...... 90 mucaphed...... 141 mometasone...... 56, 147 MONOJECT TB LUER LOK mucinex ...... 141 MOMETASONE FUROATE ...... 90 mucinex allergy ...... 141 (BULK) ...... 56 mucinex d ...... 141

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 207 mucinex d maximum strength multi-symptom cold daytime mytab gas...... 115 ...... 141 ...... 142 mytab gas maximum strength mucinex dm...... 141 multi-symptom cold night time ...... 115 mucinex fast-max cold-flu-thrt ...... 142 my-vitalife ...... 171 ...... 141 MULTITRACE-4...... 152 myzilra...... 127 mucinex fast-max dm max .141 MULTITRACE-4 N mucinex fast-max severe cold CONCENTRATE...... 152 nabumetone...... 28 ...... 141 multitrace-4 pediatric ...... 152 NABUMETONE, mucinex sinus-max...... 66 MULTITRACE-5 MICRONIZED (BULK) ..28 mucosa...... 141 CONCENTRATE...... 152 N-ACETYL-ALPHA-D- mucosa dm...... 141 multi-vit with fluoride-iron 171 GLUCOSAMINE ...... 62 mucus and cough relief ...... 141 multivital platinum ...... 171 nadolol ...... 37 mucus dm ...... 141 multivitamin ...... 171 NADOLOL (BULK) ...... 37 mucus dm max ...... 141 multivitamin 50 plus...... 171 nadolol-bendroflumethiazide37 mucus relief...... 141 multi-vitamin hp/minerals ..171 nafcillin...... 10 mucus relief cough ...... 141 multivitamin with fluoride..171 nafcillin in dextrose iso-osm 10 mucus relief d (phenylephrine) multi-vitamin with fluoride 171 naftifine...... 53 ...... 141 multivitamin with iron...... 171 NAGLAZYME...... 107 mucus relief d (pseudoephed) multivitamin with minerals 171 nalbuphine ...... 28 ...... 141 multivitamins with fluoride 171 NALBUPHINE (BULK) ...... 29 mucus relief dm...... 141 multi-vite 50 and over ...... 171 NALIDIXIC ACID...... 11 mucus relief dm max ...... 141 mupirocin...... 52 naloxone ...... 29 mucus relief er...... 141 MUPIROCIN (BULK)...... 52 naltrexone ...... 29 mucus relief pe ...... 142 mupirocin calcium...... 52 NALTREXONE HCL (BULK) mucus relief plus ...... 142 MURI-LUBE...... 62 ...... 29 mucus relief sinus...... 142 muscle relief ...... 46 NALTREXONE HCL multi complete with iron ....170 muscle rub ...... 46 DIHYDRATE(BULK) .....29 multi-day with iron...... 170 muscle rub (with camphor)...46 NANDROLONE multi-delyn ...... 170 muscle rub ultra-strength...... 46 DECANOATE (BULK) .107 multi-delyn with iron...... 171 MUSTARGEN ...... 15 naphazoline...... 132 MULTI-DRAW NEEDLE ...90 mvc-fluoride ...... 171 NAPRO...... 29 multigen folic ...... 171 my way ...... 127 naproxen ...... 29 multigen plus...... 171 MYCAMINE...... 3 NAPROXEN (BULK)...... 29 MULTI-LANCET DEVICE 90 mycophenolate mofetil ...... 15 naproxen sodium ...... 29 multilex...... 171 mycophenolate mofetil hcl ...15 NAPROXEN SODIUM...... 29 multilex-t and m ...... 171 mycophenolate sodium...... 15 naratriptan...... 19 multiple vitamin, womens ..171 myferon 150 ...... 171 nasal allergy symptom control multiple vitamin-minerals ..171 MYGLUCOHEALTH ...... 147 MULTISTIX ...... 90 LANCETS...... 90 nasal decongestant (oxymetazl) MULTISTIX 10 SG ...... 90 MYLERAN ...... 15 ...... 66 MULTISTIX 5 ...... 90 mynatal ...... 171 nasal decongestant (pe)...... 142 MULTISTIX 7 ...... 90 mynatal advance ...... 171 nasal decongestant MULTISTIX 8 SG ...... 90 mynatal plus ...... 171 (pseudoeph) ...... 142 MULTISTIX 9 ...... 90 mynatal-z...... 171 nasal four ...... 66 MULTISTIX 9 SG ...... 90 mynate 90 plus...... 171 nasal moisturizing...... 66 multi-symptom cold (pe)....142 mynephrocaps...... 171 nasal relief ...... 66 multi-symptom cold (pe-cpm) myorisan ...... 49 nasal spray (oxymetazoline) .66 ...... 142 MYOZYME ...... 107

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 208 nasal spray (sodium chloride) necon 0.5/35 (28)...... 127 NEW IMAGE CLOSED ...... 66 necon 1/35 (28)...... 127 POUCH...... 91 nasal spray 12 hour...... 66 necon 1/50 (28)...... 127 NEW IMAGE DRAIN MINI- nasal spray 12 hour sinus .....66 necon 10/11 (28)...... 127 POUCH...... 91 nasal spray long acting ...... 66 necon 7/7/7 (28)...... 127 NEW IMAGE DRAINABLE nasal spray x-moist...... 66 NEEDLES, HUBER POUCH...... 91 NATACYN ...... 129 DISPOSABLE...... 91 NEW IMAGE FLEXTEND natal-v rx ...... 171 NEOCATE JUNIOR ...... 159 BARRIER FLA ...... 91 natalvirt 90 dha...... 171 NEOCATE JUNIOR WITH NEW IMAGE FLEXWEAR natalvirt ca...... 171 PREBIOTICS ...... 159 FLAT ...... 91 natalvirt flt...... 171 NEOCATE NUTRA...... 159 NEW IMAGE IRRIGATOR nateglinide ...... 90 NEOCATE SPLASH ...... 159 SLEEVE ...... 91 NATPARA...... 107 neomycin ...... 9 NEW IMAGE OSTOMY KIT NATRAPEL...... 46 NEOMYCIN SULFATE ...... 91 NATURA CLOSED POUCH (BULK) ...... 9 NEW IMAGE SKIN ...... 90 neomycin-bacitracin-poly-hc BARRIER-FLANGE...... 91 NATURA DRAINABLE ...... 132 NEW IMAGE UROSTOMY POUCH ...... 90 neomycin-bacitracin- POUCH...... 91 NATURA DURAHESIVE polymyxin...... 129 newgen...... 171 SKIN BARRIER ...... 91 neomycin-polymyxin b gu....57 NEXAVAR...... 15 NATURA STOMAHESIVE neomycin-polymyxin b- NEXCARE GENTLE PAPER SKN BARRIER...... 91 dexameth ...... 132 TAPE ...... 91 natural balance...... 131 neomycin-polymyxin- NEXIUM 24HR...... 119 NATURAL CARE gramicidin...... 129 NEXPLANON...... 125 BANDAGES ...... 91 neomycin-polymyxin-hc .....67, next choice one dose...... 127 natural fiber laxative...... 115 132 NH4 natural fiber laxative (sugar) neo-polycin...... 129 TETRATHIOMOLYBDAT ...... 115 neo-polycin hc ...... 132 E (BULK) ...... 62 natural fiber laxative smooth NEORAL...... 15 niacin ...... 41 ...... 115 neosporin anti-itch...... 56 NIACIN (BULK)...... 41 natural fiber laxative therapy NEOSTIGMINE niacin (inositol niacinate) ....41, ...... 116 METHYLSULF (BULK).21 159 natural fiber laxative(aspart) neostigmine methylsulfate....21 niacin (niacinamide) ...... 41 ...... 116 NEOTHRIVE ...... 91 niacin flush free ...... 159 natural fiber supplement.....116 neo-tuss...... 142 niacinamide...... 41 natural herb...... 66 nephplex rx...... 171 NIACINAMIDE (BULK) ....41 natural laxative ...... 116 nephro-vite rx ...... 171 nicardipine ...... 37 natural tears (pf) ...... 131 NEPRO...... 159 NICLOSAMIDE (BULK) ...... 9 natural veg laxative(sennosid) NEPRO CARB STEADY ..159 NICODERM CQ ...... 65 ...... 116 NESSI SPACER...... 91 nicorelief...... 65 natural vegetable ...... 116 neuac...... 50 NICORETTE...... 65 natural vegetable (psyllium) NEULASTA...... 120 NICOTINAMIDE ...... 116 NEUMEGA...... 120 ADEN.DINUC.REDNA2 natural vegetable powder ...116 NEUPOGEN ...... 120 ...... 159 nature's tears (hypromellose) nevirapine ...... 4 NICOTINAMIDE ADENINE ...... 131 NEW GENERATION ...... 91 DINUC...... 159 nature-throid...... 108 NEW IMAGE CLOSED nicotine ...... 65 NEBUPENT...... 9 MINI-POUCH...... 91 nicotine (polacrilex)...... 65

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 209 NICOTINE (POLACRILEX) non-aspirin...... 29 novasource renal...... 159 ...... 65 non-aspirin 8 hour ...... 29 novasource renal 2 cal ...... 159 NICOTINE POLACRILEX non-aspirin childrens ...... 29 NOVOFINE 32...... 91 (BULK) ...... 65 non-aspirin extra strength.....29 NOVOFINE AUTOCOVER 91 NICOTROL...... 65 non-aspirin flu ...... 142 NOVOFINE PLUS...... 91 NICOTROL NS...... 65 non-aspirin jr strength ...... 29 NOVOLOG FLEXPEN...... 91 nifedical xl...... 37 non-aspirin pain relief ...... 29 NOVOLOG MIX 70-30 ...... 92 nifedipine...... 37 non-aspirin pain relief pm ....29 NOVOLOG MIX 70-30 NIFEDIPINE (BULK) ...... 37 non-aspirin pm...... 29 FLEXPEN...... 92 NIGHT DRAIN ADAPTER 91 non-aspirin severe congest m-s NOVOPEN 3 PENMATE ....92 night time cold...... 142 ...... 142 NOVOPEN JR...... 92 night time pain medicine ...... 29 non-drowsy allergy...... 142 NOVOTWIST ...... 92 nightime sleep ...... 142 non-drying sinus ...... 142 NOXAFIL...... 3 nighttime allergy relief ...... 142 NON-STICK PAD ...... 91 np thyroid...... 108 nighttime cough-cold...... 142 nora-be...... 125 NPLATE...... 40 nighttime sleep aid (diphen) norepinephrine bitartrate ...... 41 nrs nasal relief...... 66 ...... 142 norepinephrine bitartrate-nacl nts step 1...... 65 nighttime sleep-aid (doxylamn) ...... 41 nu way ...... 66 ...... 33 noreth-ethinyl estradiol-iron NUCALA ...... 147 nikki (28)...... 127 ...... 127 NUEDEXTA ...... 20 nilutamide...... 15 NORETHINDRONE (BULK) NU-FIT BRIEF MEDIUM ...92 nimodipine...... 37 ...... 125 NULOJIX ...... 15 NINLARO...... 15 norethindrone (contraceptive) nutraderm...... 46 nisoldipine ...... 37 ...... 125 nutrafit ...... 159 NITRILE EXAM GLOVES.91 norethindrone acetate ...... 125 nutrafit plus...... 159 nitro-bid...... 42 NORETHINDRONE nutrament...... 159 NITROFURAN ACETATE (BULK) ...... 125 NUTRAMIGEN AA LIPIL159 MACROCRYSTAL norethindrone ac-eth estradiol NUTRAMIGEN DHA-ARA (BULK) ...... 11 ...... 125, 128 ...... 159 nitrofurantoin...... 11 norethindrone-e.estradiol-iron NUTRAMIGEN LIPIL ...... 159 NITROFURANTOIN...... 11 ...... 128 NUTRAMIGEN TODDLER nitrofurantoin macrocrystal..11 norgestimate-ethinyl estradiol ENFLORA-LGG ...... 159 nitrofurantoin monohyd/m- ...... 128 NUTRAMIGEN WITH cryst ...... 11 norlyroc ...... 125 ENFLORA LGG ...... 159 NITROFURAZONE (BULK) nortemp...... 29 nutren 1.0...... 159 ...... 52 nortrel 0.5/35 (28)...... 128 nutren 1.0 with fiber ...... 159 nitroglycerin ...... 42 nortrel 1/35 (21)...... 128 nutren junior ...... 159 nitroglycerin in 5 % dextrose42 nortrel 7/7/7 (28) ...... 128 nutren junior fiber...... 159 nitro-time...... 42 nortriptyline...... 33 NUTREN PULMONARY..159 nivatopic plus ...... 46 NORTRIPTYLINE (BULK) 33 NUTRIHEP ...... 159 nizatidine ...... 119 NORVIR...... 4 nutrilyte...... 152 no drip ...... 66 nose drops...... 66 nutrilyte ii ...... 152 no drip nasal relief...... 66 NO-STING SKIN-PREP...... 91 NUTRIPORT BALLOON....92 noble formula hc...... 56 NOVA SAFETY LANCETS91 nutrition plus...... 159 nodolor ...... 19 NOVA SUREFLEX nutritional drink mix...... 159 nohist-lq...... 142 LANCETS...... 91 nutritional drink plus ...... 160 NON-ADHERENT NOVAMAX PLUS KETONE nutritional shake ...... 160 BANDAGE ...... 91 ...... 91 NUTRITIONAL SHAKE...160

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 210 NUTRITIONAL SHAKE omeprazole ...... 119 ONETOUCH DELICA (DIAB. FORM) ...... 160 OMEPRAZOLE (BULK)...119 LANCETS ...... 92 nutritional shake plus ...... 160 omeprazole magnesium...... 119 ONETOUCH FINEPOINT NUTRITIONAL SHAKE omeprazole-sodium LANCETS ...... 92 PLUS ...... 160 bicarbonate ...... 119 ONETOUCH SURESOFT nutritional supplement...... 160 omnicap ...... 171 LANCING DEV...... 92 nutritional supplement plus 160 OMNITROPE...... 120 ONETOUCH ULTRA NUVARING...... 125 ON CALL LANCET...... 92 CONTROL ...... 92 nuzole ...... 53 ON CALL LANCING ONETOUCH ULTRA TEST nyamyc ...... 53 DEVICE ...... 92 ...... 92 nyata ...... 53 ON CALL PLUS LANCET .92 ONETOUCH ULTRA2...... 92 NYLIDRIN (BULK)...... 37 ON CALL PLUS LANCING ONETOUCH ULTRALINK 92 nystatin ...... 3, 53 DEVICE ...... 92 ONETOUCH ULTRAMINI.92 NYSTATIN (BULK) ...... 3 ONCASPAR...... 15 ONETOUCH ULTRASOFT nystatin-triamcinolone...... 53 once daily ...... 171 LANCETS ...... 92 nystop ...... 53 ondansetron ...... 116 ONETOUCH VERIO...... 92 O ondansetron hcl...... 116 ONETOUCH VERIO IQ O.A.D...... 92 ONDANSETRON HCL METER...... 92 OA 1 POWDER ...... 160 (BULK) ...... 116 ONETOUCH VERIO MID OA2 POWDER ...... 160 ondansetron hcl (pf)...... 116 CONTROL ...... 92 obstetrix dha ...... 171 one daily ...... 172 ONETOUCH VERIO SYNC OCALIVA...... 116 one daily 50 plus...... 171 ...... 92 ocean nasal ...... 66 one daily calcium/iron ...... 171 ONFI...... 18 ocella ...... 128 one daily complete...... 171 ONIVYDE...... 15 OCTANOIC ACID (BULK) 62 one daily energy ...... 171 ON-THE-GO LANCETS .....92 octreotide acetate...... 15 one daily essential ...... 171 opcicon one-step...... 128 ocucoat ...... 131 one daily for men...... 171 OPDIVO...... 15 ocudox ...... 11 one daily for women...... 171 opium tincture...... 110 ocutabs...... 171 one daily maximum...... 171 OPSUMIT...... 147 ODEFSEY...... 4 one daily maximum (with ca) OPTICHAMBER ADULT odor control foot-sneaker .....53 ...... 171 MASK-LARGE...... 92 OFEV ...... 147 one daily multi-vit w-mineral OPTICHAMBER DIAMOND OFF ACTIVE...... 46 ...... 171 VHC...... 92 OFF DEEP WOODS...... 46 one daily multivitamin...... 171 OPTICLUDE EYE PATCH OFF DEEP WOODS DRY ..46 one daily multivit-iron(folic) JUNIOR...... 92 OFF FAMILYCARE (WITH ...... 172 OPTIFOAM...... 92 DEET) ...... 46 one daily plus iron ...... 172 option 2...... 128 ofloxacin...... 10, 67, 129 one daily plus minerals...... 172 OPTIONS LINERS ...... 92 ogestrel (28)...... 128 one daily women's ...... 172 OPTIONS PADS...... 92 olanzapine...... 33 one daily womens 50 plus ..172 OPTIONS ULTRA THINS ..92 olanzapine-fluoxetine...... 33 one daily women's health ...172 opti-vitamins...... 172 olmesartan ...... 37 ONE WAY VALVED oral saline laxative...... 116 olmesartan-amlodipin- MOUTHPIECE ...... 92 ORAL THERMOMETER....93 hcthiazid ...... 37 one-a-day essential ...... 172 oralone ...... 66 olmesartan- one-a-day maximum formula oralyte ...... 152 hydrochlorothiazide...... 37 ...... 172 ora-sweet...... 62 olopatadine ...... 66, 131 one-a-day teen advantage ...172 ORBACTIV...... 9 omega-3 acid ethyl esters .....41 ORFADIN ...... 62

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 211 organ-i nr...... 142 OXYBUTYNIN CHLORIDE pain reliever plus ...... 30 original nasal spray...... 66 ...... 148 pain relieving (menthol) ...... 47 ORKAMBI...... 147 oxycodone ...... 24 pain relieving (m-sal-men- ormir...... 142 OXYCODONE (BULK) ...... 24 cam) ...... 47 ORNITHINE ...... 160 oxycodone-acetaminophen...24 pain relieving cream ...... 47 orphenadrine citrate...... 21 oxycodone-aspirin ...... 24 pain-off ...... 30 ORPHENADRINE CITRATE oxymetazoline ...... 66 palgic ...... 142 ...... 21 OXYMETAZOLINE (BULK) paliperidone ...... 33 orphenadrine compound-ds..21 ...... 66 pamidronate ...... 107 orsythia...... 128 oxymorphone...... 24 PAMPERS UNISEX BABY- ortho d ...... 172 OXYTETRACYCLINE DRY...... 93 ORTHO DIAPHRAGM ALL- (BULK) ...... 11 pamprin max...... 30 FLEX 65...... 93 oxytocin...... 129 PANAX GINSENG ROOT OS 2...... 160 OXYTOCIN (BULK)...... 129 (BULK)...... 64 oscimin ...... 110 oysco 500/d...... 152 PANCREATIN...... 116 oscimin sl...... 110 oysco d...... 152 pancrelipase 5000 ...... 116 oscimin sr ...... 110 oysco-500 ...... 152 pancuronium ...... 21 oseltamivir...... 4 oyster shell calcium ...... 152 PANDA MASK...... 93 osmitrol 15 % ...... 37 oyster shell calcium 500 .....153 panoxyl ...... 50 osmitrol 20 % ...... 37 oyster shell calcium-vit d2 .172 panoxyl-4...... 50 OSMOLITE 1 CAL...... 160 oyster shell calcium-vit d3 .153 PANT LINERS, LARGE .....93 OSMOLITE 1.2 CAL...... 160 oystercal-d ...... 153 PANT LINERS, LARGE OSMOLITE 1.5 CAL...... 160 OZURDEX...... 132 PLUS ...... 93 OSTOMY BELT LARGE....93 P PANTHENOL (BULK)...... 172 OSTOMY PASTE...... 93 pacerone...... 34 pantoprazole ...... 119 OSTOMY SUPPLIES...... 93 paclitaxel ...... 15 PANTY LINERS...... 93 OTEZLA ...... 123 pain and fever ...... 29 PANTY SHIELDS ...... 93 OTEZLA STARTER...... 123 PAIN FREE TAPE...... 93 PAPAIN (BULK) ...... 116 oticin hc (bak free) ...... 67 PAIN FREE WRAP ...... 93 papaverine...... 37 oto-end 10...... 67 pain relief...... 29 PAPAVERINE (BULK)...... 37 otomax-hc...... 67 pain relief (acetamin-asp-caf) PAPER TAPE...... 93 otozin...... 67 ...... 29 PARACHLOROPHENOL OVER NITES...... 93 pain relief (capsaicin) ...... 46 (BULK)...... 62 OVERNIGHT UNDERWEAR pain relief (menthol)...... 46 PARAGARD T 380A...... 93 SMALL-MED ...... 93 pain relief (trolamine sal) .....46 paregoric ...... 110 oxacillin...... 10 pain relief adult...... 29 paricalcitol ...... 107 oxacillin in dextrose(iso-osm) pain relief allergy sinus ...... 142 paromomycin...... 9 ...... 10 pain relief cold...... 142 PAROMOMYCIN SULFATE oxaliplatin...... 15 pain relief cream...... 46 (BULK)...... 9 oxandrolone...... 107 pain relief pm...... 29 paroxetine hcl ...... 33 OXANDROLONE (BULK) pain relief pm rapid release ..29 PATROL PUMP SET...... 93 ...... 107 pain relief regular strength ...29 PCCA T3 SODIUM oxaprozin...... 29 pain reliever...... 29 DILUTION ...... 108 oxazepam...... 33 pain reliever (acetam-aspirin) PCCA T4 SODIUM oxcarbazepine...... 18 ...... 29 DILUTION ...... 108 OXEPA...... 160 pain reliever extra strength ...29 pcm la ...... 142 oxiconazole...... 53 pain reliever flu ...... 142 p-col rite...... 116 oxybutynin chloride...... 148 pain reliever jr strength...... 29

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 212 PEAK AIR PEAK FLOW PENTIPS ...... 93 PFD TODDLER ...... 160 METER ...... 93 PENTOBARBITAL SODIUM pfizerpen-g...... 10 pedia relief cough-cold...... 142 (BULK) ...... 33 pharbechlor ...... 142 pedia relief infant nasal ...... 142 PENTOSAN POLYSULFATE pharbedryl...... 142 pediacare fever reducer ...... 30 NA (BULK)...... 149 pharbetol ...... 30 pediacare multi-symptom cold pentostatin ...... 15 phenadoz...... 142 ...... 142 pentoxifylline...... 40 phenazopyridine ...... 149 pedialyte ...... 153 PENTOXIFYLLINE (BULK) PHENAZOPYRIDINE pedialyte singles ...... 153 ...... 40 (BULK)...... 149 PEDIASURE...... 160 PENTYLENETETRAZOL ..62 phenelzine...... 33 PEDIASURE ENTERAL...160 pepcid ac...... 119 PHENELZINE (BULK) ...... 33 PEDIASURE ENTERAL PEPDITE JUNIOR...... 160 phenergan ...... 142 W/FIBER 1.0...... 160 PEPTAMEN...... 160 PHENEX-1 ...... 161 pediasure peptide 1.0 cal ....160 PEPTAMEN 1.5...... 160 PHENEX-2 ...... 161 PEDIASURE PEPTIDE 1.5 PEPTAMEN AF...... 160 PHENINDIONE (BULK) ....62 CAL...... 160 peptamen junior fiber ...... 160 phenobarbital ...... 18 PEDIASURE SIDEKICKS 160 peptic relief...... 110 PHENOBARBITAL (BULK) pediatric balanced nutrition 160 pepto-bismol to-go ...... 110 ...... 18 pediatric cough and cold ....142 PERATIVE...... 160 phenobarbital sodium ...... 18 pediatric electrolyte ...... 153 percogesic...... 30 phenohytro...... 110 pediatric enema ...... 116 percogesic extra strength...... 30 PHENOL ...... 47 pediatric freezer pops ...... 153 perdiem overnight relief .....116 PHENOL (BULK)...... 47, 62 PEDIATRIC PANDA MASK PER-FIT BRIEFS...... 93 PHENOLSULFONIC ACID ...... 93 PER-FIT UNDERWEAR.....93 (BULK)...... 64 PEDIATRIC SMALL MASK PERFOROMIST ...... 147 phenoxybenzamine ...... 37 ...... 93 peri-colace ...... 116 PHENOXYBENZAMINE pediculicide 11 ...... 56 PERIFLEX ADVANCE.....160 (BULK)...... 38 pedi-dri ...... 53 PERIFLEX INFANT...... 160 PHENTERMINE HCL peg 3350-electrolytes ...... 116 PERIFLEX JUNIOR ...... 160 (BULK)...... 57 PEG 3350-GRX...... 62 perindopril erbumine ...... 37 phentolamine ...... 38 peg3350 ...... 116 periogard...... 66 PHENTOLAMINE...... 38 peg-3350 with flavor packs 116 PERJETA ...... 15 PHENYLADE 40 ...... 161 PEGANONE ...... 18 permethrin ...... 56 PHENYLADE 60 ...... 161 PEGASYS ...... 120 PERMETHRIN (BULK)...... 56 PHENYLADE DRINK MIX PEGASYS CONVENIENCE perphenazine...... 33 ...... 161 PACK ...... 120 perphenazine-amitriptyline...33 PHENYLADE ESSENTIAL PEGASYS PROCLICK .....120 persa-gel ...... 50 ...... 161 peg-electrolyte soln ...... 116 PERSONAL BEST FULL PHENYLADE RTD PKU 10 peg-prep...... 116 RANGE ...... 93 ...... 161 pe-guai...... 142 PERSONAL CONFIDENCE PHENYLALANINE, L- PEN NEEDLE...... 93 BRIEFS ...... 93 (BULK)...... 161 PEN NEEDLE, DIABETIC .93 personal confidence liners ....93 phenylephrine hcl ...... 41, 132 PENICILLAMINE(D-) ...... 123 PERSONAL CONFIDENCE PHENYLEPHRINE HCL penicillin g potassium...... 10 PADS...... 93 (BULK)...... 132 penicillin g procaine ...... 10 PERSONAL CONFIDENCE PHENYL-FREE 1 ...... 161 penicillin g sodium ...... 10 UNDERWEAR ...... 93 phenylhistine dh...... 142 penicillin v potassium...... 10 PETROLATUM GAUZE.....93 PHENYLMERCURIC PENTASA...... 116 PFD 2...... 160 NITRATE (BULK) ...... 62

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 213 phenytoin...... 18 PLASTIC SWABS...... 94 pot,sodium citrate-citric acid PHENYTOIN (BULK) ...... 18 PNEUMOVAX 23 ...... 123 ...... 149 phenytoin sodium ...... 18 pnv 29-1...... 172 POTASH, SULFURATED...62 PHENYTOIN SODIUM pnv ob+dha...... 172 potassium acetate...... 153 (BULK) ...... 18 pnv-dha...... 172 potassium bicarb and chloride phenytoin sodium extended..18 pnv-dha + docusate...... 172 ...... 153 philith ...... 128 pnv-ferrous fumarate-docu-fa potassium bicarb-citric acid153 PHLEXY-10 DRINK MIX ...... 172 POTASSIUM BROMIDE POWDER...... 161 pnv-first ...... 172 (BULK)...... 153 phlexy-vits...... 161 pnv-omega...... 172 potassium chlorid-d5- phos-nak ...... 153 pnv-select...... 172 0.45%nacl ...... 153 phospha 250 neutral ...... 153 pnv-total...... 172 potassium chloride...... 153 phosphasal ...... 149 pnv-vp-u ...... 172 POTASSIUM CHLORIDE phosphate laxative...... 116 POCKET CHAMBER...... 94 (BULK)...... 153 PHOSPHATIDYL SERINE POCKET PEAK FLOW potassium chloride in 0.9%nacl (BULK) ...... 62 METER ...... 94 ...... 153 PHOSPHATIDYLCHOLINE podactin ...... 53 potassium chloride in 5 % dex (BULK) ...... 62 podofilox ...... 47 ...... 153 PHOSPHOLINE IODIDE..129 PODOPHYLLUM RESIN ...42 potassium chloride in lr-d5.153 PHOTOFRIN ...... 15 POISE PADS...... 94 potassium chloride-0.45 % nacl physostigmine salicylate ....132 POISE PANTILINERS ...... 94 ...... 153 PHYTONADIONE (BULK) 40 polocaine ...... 51 potassium chloride-d5- PIKO 1...... 93 polocaine-mpf...... 51 0.2%nacl ...... 153 pilocarpine hcl ...... 62, 130 POLY HUB NEEDLE...... 94 potassium chloride-d5- PILOCARPINE HCL (BULK) polycin...... 129 0.3%nacl ...... 153 ...... 130 POLYCOSE ...... 161 potassium chloride-d5- PILOCARPINE NITRATE polyethylene glycol 3350 ...116 0.9%nacl ...... 153 (BULK) ...... 130 POLYMYXIN B potassium citrate...... 149 pimozide...... 33 SULF,MICRON.(BULK)...9 POTASSIUM CITRATE M- pimtrea (28)...... 128 polymyxin b sulfate ...... 9 HYD(BULK)...... 62 pindolol...... 38 polymyxin b sulf-trimethoprim potassium citrate-citric acid149 pink bismuth...... 110 ...... 129 POTASSIUM HYDROXIDE pioglitazone ...... 93 polysaccharide iron...... 172 (BULK)...... 43 pioglitazone-glimepiride ...... 93 poly-tussin ...... 142 POTASSIUM IODIDE pioglitazone-metformin...... 93 poly-tussin d ...... 142 (BULK)...... 69 piperacillin-tazobactam ...... 10 polyvinyl alcohol...... 131 POTASSIUM pirmella...... 128 POLYVINYL ALCOHOL PERCHLORATE (BULK) piroxicam...... 30 (BULK) ...... 131 ...... 42 PIROXICAM (BULK)...... 30 poly-vita...... 172 POTASSIUM PIVOT 1.5 CAL ...... 161 poly-vita (iron) ...... 172 PERMANGANATE ...... 153 PKU 2...... 161 poly-vitamin ...... 172 POTASSIUM PHOSPH, PKU 3...... 161 poly-vitamin with iron...... 172 MONO (BULK) ...... 172 PKU COOLER 10...... 161 polyvitamin/iron ...... 172 potassium phosphate m-/d- PKU COOLER 15...... 161 poly-vitamins...... 172 basic...... 153 PKU COOLER 20...... 161 POMALYST ...... 15 POTASSIUM PKU LOPHLEX...... 161 PORTAGEN...... 161 PHOSPHATE,DIB (BULK) PLAN B ONE-STEP...... 128 portia...... 128 ...... 153 PLASTIC STRIPS ...... 94 POTASSIUM SORBATE ....62

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 214 POTIGA ...... 18 PREDNISOLONE SOD PHOS prenaissance dha...... 172 POUCH CLAMP ...... 94 (BULK) ...... 68 prenaissance harmony dha..172 POUCHKINS DRAINABLE prednisolone sodium phosphate prenaissance next...... 172 POUCH ...... 94 ...... 68, 132 prenaissance plus ...... 172 POUCHKINS OSTOMY PREDNISOLONE, MICRO prenaissance promise...... 173 SYSTEM ...... 94 (BULK) ...... 68 prenaplus...... 173 POUCHKINS PED OSTOMY prednisone ...... 68 prenatabs fa...... 173 BELT...... 94 PREDNISONE ...... 68 prenatabs rx ...... 173 POUCHKINS SKIN prednisone intensol...... 68 prenatal ...... 173 BARRIER...... 94 PREDNISONE prenatal 19 ...... 173 POUCHKINS UROSTOMY MICRONIZED (BULK) ..68 prenatal ad ...... 173 POUCH ...... 94 prefol-dha ...... 172 prenatal formula...... 173 POVIDONE-IODINE (BULK) PREGNENOLONE...... 62 prenatal low iron...... 173 ...... 52 PREGNENOLONE, prenatal multivitamins ...... 173 powderlax...... 116 MICRONIZED(BULK) ...62 prenatal one daily ...... 173 pr cream...... 47 premasol 10 %...... 161 prenatal plus (calcium carb)173 pr natal 400...... 172 PREMIER CLOSED MINI- prenatal plus with iron (ca).173 pr natal 400 ec ...... 172 POUCH ...... 94 prenatal tablet ...... 173 pr natal 430...... 172 PREMIER DRAINABLE prenatal vitamin ...... 173 pr natal 430 ec ...... 172 MINI-POUCH...... 94 prenatal vitamin plus low iron PRADAXA...... 40 PREMIER DRAINABLE ...... 173 PRALIDOXIME CHLORIDE POUCH ...... 94 prenatal vits96-iron fum-folic (BULK) ...... 57 PREMIER LOCK N ROLL .94 ...... 173 pramcort ...... 116 PREMIER UROSTOMY prenatal-u...... 173 pramipexole...... 19 POUCH ...... 94 preplus ...... 173 pramoxine...... 116 PREMIUM BABY DIAPERS pre-protein ...... 161 PRAMOXINE ...... 116 ...... 94 pres gen...... 143 pramoxine-hc...... 67 PREMIUM COMFORT- PRESSURE ACTIVATED pravastatin ...... 41 STRETCH ...... 94 LANCETS ...... 95 PRAZIQUANTEL (BULK)...9 PREMIUM DRAINABLE pretab ...... 173 prazosin ...... 38 POUCH/KARAYA ...... 94 PREVACID 24HR...... 119 PRECISION 200 CATHETER PREMIUM INFANT PREVAIL ADJUST TRAY...... 94 FORMULA ...... 161 UNDERWEAR SM-MD..95 PRECISION PCX PLUS TEST PREMIUM NITRILE PREVAIL BLADDER ...... 94 GLOVES ...... 94 CONTROL PAD ...... 95 PRECISION PCX TEST...... 94 PREMIUM SKIN BARRIER PREVAIL BLADDER PAD PRECISION POINT OF ...... 94 EXTRA...... 95 CARE TEST...... 94 PREMIUM TRAINING PREVAIL BOXERS ...... 95 PRECISION Q-I-D TEST....94 PANTS ...... 94 PREVAIL BREEZERS 360 .95 PRECISION XTRA prena1 ...... 172 PREVAIL BRIEF MONITOR ...... 94 prena1 chew...... 172 BARIATRIC...... 95 PRECISION XTRA TEST...94 prena1 chew (quatrefolic)...172 PREVAIL BRIEF EXTRA prednicarbate ...... 56 prena1 pearl ...... 172 LARGE...... 95 prednisolone ...... 68 prena1 plus ...... 172 PREVAIL CLASSIC FIT PREDNISOLONE (BULK) .68 prena1 true...... 172 UNDERWEAR...... 95 PREDNISOLONE AC, prenaissance...... 172 PREVAIL CURVE...... 95 MICRO (BULK) ...... 68 prenaissance 90 dha...... 172 PREVAIL EXTRA prednisolone acetate ...... 132 prenaissance balance ...... 172 UNDERWEAR...... 95

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 215 PREVAIL FULL COVERAGE PROCARE PROTECTIVE promethazine-phenyleph- UNDRWEAR...... 95 UNDERWEAR ...... 95 codeine...... 143 PREVAIL GUARDS FOR procel...... 161 promethegan ...... 143 MEN...... 95 procel singles...... 161 PROMOD PROTEIN ...... 161 PREVAIL MALE GUARD .95 procentra...... 33 promolaxin...... 116 PREVAIL PADS...... 95 PROCHAMBER ...... 95 PROMOTE...... 161 PREVAIL PANT LINER.....95 prochlorperazine...... 116 PROMOTE WITH FIBER .161 PREVAIL PANTY LINER..95 prochlorperazine edisylate..116 propafenone ...... 34 PREVAIL PER-FIT ...... 95 PROCHLORPERAZINE PROPANTHELINE (BULK) PREVAIL PER-FIT 360 ...... 95 EDISYLT(BULK)...... 116 ...... 110 PREVAIL PM BRIEF prochlorperazine maleate ...116 proparacaine ...... 131 MEDIUM ...... 95 PROCHLORPERAZINE PROPARACAINE (BULK) PREVAIL PROTECTIVE MALEATE...... 116 ...... 131 UNDERWEAR ...... 95 PROCRIT ...... 120 PROPIMEX-1...... 161 PREVAIL PURSEREADY..95 procto-med hc...... 116 PROPIMEX-2...... 161 PREVAIL SIMPLY procto-pak...... 116 propofol ...... 62 STRETCH FIT ...... 95 proctosol hc ...... 116 propranolol ...... 38 PREVAIL SMOOTH FIT ....95 proctozone-hc ...... 116 PROPRANOLOL (BULK) ..38 PREVAIL STRETCH FIT ...95 PRODIGY COUNT-A-DOSE propranolol-hydrochlorothiazid PREVAIL SUPER PLUS.....95 ...... 96 ...... 38 PREVAIL UNDERWEAR ..95 PRODIGY INSULIN PROPYL GALLATE (BULK) prevalite...... 41 SYRINGE...... 96 ...... 65 previfem ...... 128 PRODIGY LANCETS ...... 96 PROPYLENE GLYCOL PREVNAR 13 (PF) ...... 123 PRODIGY LANCING (BULK)...... 47 PREZATIDE COPPER DEVICE ...... 96 propylthiouracil ...... 69 (BULK) ...... 62 PRODIGY TWIST TOP PROPYLTHIOURACIL PREZCOBIX...... 4 LANCET ...... 96 (BULK)...... 69 PREZISTA ...... 4 PRODUCT 3232A ...... 161 PROSOBEE...... 161 PRIALT...... 30 PROFERRIN-FORTE...... 173 prosource ...... 161 PRIFTIN...... 9 PROGESTERONE (BULK) PROSOURCE...... 161 PRILOCAINE (BULK)...... 51 ...... 125 prosource no carb ...... 161 PRILOSEC OTC...... 119 progesterone micronized ....125 pro-stat awc ...... 161 PRIMEAIRE ...... 95 PROGESTERONE PRO-STAT PROFILE...... 161 primidone ...... 18 MICRONIZED (BULK) 125 PRO-STAT SUGAR FREE161 PRIMIDONE (BULK) ...... 18 PROGLYCEM ...... 96 PROSTIGMIN...... 21 PRIVIGEN ...... 123 PROGRAF...... 15 protamine...... 40 PRO COMFORT LANCET.95 PROLASTIN-C...... 62 PROTAMINE SULFATE PRO COMFORT PEN PROLEUKIN ...... 120 (BULK)...... 40 NEEDLE ...... 95 promacet ...... 24 PROTECTIVE BARRIER PRO SPORTS TAPE ...... 95 PROMAZINE (BULK) ...... 33 FILM WIPES...... 96 probalance ...... 161 promethazine ...... 143 PROTECTIVE PADS ...... 96 PROBE COVERS ...... 95 PROMETHAZINE (BULK) PROTECTIVE probenecid ...... 123 ...... 143 UNDERWEAR SMALL- probenecid-colchicine ...... 123 promethazine vc ...... 143 MED ...... 96 procainamide ...... 34 promethazine vc-codeine....143 protein...... 161 PROCAINAMIDE ...... 34 promethazine-codeine ...... 143 PROTEINEX-18...... 161 PROCAINE (BULK) ...... 51 promethazine-dm...... 143 PROTIRELIN (BULK) ...... 108 PROTOPAM CHLORIDE ...57

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 216 protriptyline...... 33 Q ranitidine hcl...... 120 PROVENGE...... 123 q-dryl ...... 143 RANITIDINE HCL (BULK) provenza patch...... 51 q-pap...... 30 ...... 120 provil ...... 30 q-pap extra strength ...... 30 RAPAMUNE...... 16 PROVIMIN ...... 153 q-tapp...... 143 RAPIVAB...... 4 pruclair ...... 47 q-tapp dm...... 143 rasagiline...... 19 prudoxin ...... 47 Q-TIPS/SINGLE-TIP RAUWOLFIA SERPENTINA prumyx ...... 47 APPLICATOR ...... 96 (BULK)...... 64 prutect...... 47 q-tussin ...... 143 RAVICTI...... 62 pseudoephedrine hcl...... 143 q-tussin dm ...... 143 rea lo 39 ...... 47 PSEUDOEPHEDRINE HCL quasense...... 128 rea lo 40 ...... 47 (BULK) ...... 143 quazepam...... 33 react ...... 128 psyllium husk ...... 116 quenalin ...... 143 ready-to-use enema (min oil) PULMICORT FLEXHALER QUERCETIN DIHYDRATE ...... 117 ...... 147 (BULK) ...... 62 REBIF (WITH ALBUMIN) PULMOCARE ...... 161 quetiapine ...... 33 ...... 120 pulmosal ...... 147 QUICK READ DIGITAL REBIF REBIDOSE ...... 120 PULMOZYME...... 147 THERMOMETER...... 96 REBIF TITRATION PACK puralube...... 131 QUICK RESPONSE BP ...... 120 PURAMINO DHA-ARA ...161 MONITOR-LARG ...... 96 recedo ...... 47 PURAMINO TODDLER...161 QUINACRINE (BULK)...... 9 reclipsen (28) ...... 128 pure and gentle eye...... 131 quinapril...... 38 recort plus ...... 56 PURE COTTON ...... 96 quinapril-hydrochlorothiazide rectacort-hc ...... 117 purelax...... 116 ...... 38 RECTAL THERMOMETER purevit dualfe plus...... 173 quinidine gluconate ...... 34 ...... 96 PURIXAN ...... 16 quinidine sulfate ...... 35 RECTIV...... 117 PURPLE NITRILE GLOVES QUINIDINE SULFATE refenesen...... 143 ...... 96 (BULK) ...... 35 refenesen dm...... 143 PURSEREADY QUININE HCL DIHYDRATE refenesen pe ...... 143 UNDERWEAR FOR (BULK) ...... 9 regonol...... 21 WOMEN ...... 96 quinine sulfate ...... 9 REGRANEX ...... 47 PYRANTEL PAMOATE QUININE SULFATE (BULK) reguloid...... 117 (BULK) ...... 9 ...... 9 reguloid, sugar free...... 117 pyrazinamide ...... 9 quintabs-m iron free ...... 173 relador pak ...... 51 pyrethrin lice treatment m ....57 quit 2...... 65 relador pak plus ...... 51 pyridostigmine bromide ...... 21 QUIT 2 ...... 65 relcof c ...... 143 PYRIDOSTIGMINE quit 4...... 65 relcof dm...... 143 BROMIDE (BULK)...... 21 QUIT 4 ...... 65 RELENZA DISKHALER ...... 4 PYRIDOXAL-5 PHOSPHATE QVAR...... 147 RELIAMED LANCET...... 96 (BULK) ...... 173 R RELIAMED MINI LANCING PYRIDOXINE (BULK).....173 ra pediatric nutrition drink..161 DEVICE ...... 96 pyridoxine (vitamin b6)...... 173 rabeprazole ...... 120 RELIAMED SAFETY SEAL PYRILAMINE MALEATE143 RACEPINEPHRINE (BULK) LANCETS ...... 96 PYRIMETHAMINE ...... 9 ...... 147 relion glucose...... 96 PYRITHIONE ZINC (BULK) RADIAGEL...... 47 RELION NEEDLES...... 96 ...... 57 rajani...... 128 RELION PEN NEEDLES ....96 PYRUVIC ACID (BULK)...62 raloxifene...... 123 RELION THIN LANCETS..96 ramipril ...... 38

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 217 RELION ULTRA THIN PLUS RESTON MEDIUM RIOMET...... 97 LANCETS...... 96 SUPPORT PAD ...... 96 risabal-ph ...... 47 RELISTOR...... 117 RESTORE CALCIUM risedronate ...... 62, 123 relnate dha ...... 173 ALGINATE...... 96 RISPERDAL CONSTA ...... 33 remedy antifungal...... 53 RESTORE EXTRA THIN risperidone ...... 33, 34 remedy phytoplex antifungal 53 DRESSING ...... 96 RITEFLO AEROCHAMBER remeven ...... 47 RESTORE FOAM ...... 97 REMODULIN...... 38 DRESSING SILVER ...... 97 ritifed ...... 143 RENA START ...... 161 RESTORE HYDROGEL ri-tussin...... 143 RENACIDIN...... 149 GAUZE ...... 97 ri-tussin dm...... 143 renal caps...... 173 RESTORE HYDROGEL RITUXAN ...... 16 renalcal ...... 162 GAUZE SPONGE...... 97 rivastigmine ...... 20 rena-vite...... 173 RESTORE TRIO...... 97 rivastigmine tartrate...... 20 rena-vite rx ...... 173 RETINOIC ACID...... 50 rizatriptan...... 19 RENEW ADVANCED RETRACTED PENIS POUCH robafen...... 143 MICRO-LANCETS ...... 96 ...... 97 robafen cf (phenylephrine) .143 reno caps...... 173 RETROVIR...... 4 robafen cough ...... 143 RENVELA ...... 62 REVLIMID ...... 16 robafen dm...... 143 repaglinide...... 96 revonto...... 21 robafen dm cough ...... 143 repaglinide-metformin...... 96 REYATAZ ...... 5 robafen dm cough-chest REPEL 100...... 47 rhinoflex-650...... 30 congest...... 143 REPEL FAMILY ...... 47 RIASTAP ...... 40 robitussin cold-flu day...... 143 REPEL HUNTER'S ...... 47 ribasphere ...... 5 robitussin cough and cold cf REPEL SPORTSMEN DRY 47 ribasphere ribapak ...... 5 ...... 143 REPEL SPORTSMEN MAX ribavirin ...... 5 robitussin cough-chest cong ...... 47 RIBOFLAVIN (VITAMIN dm...... 143 REPEL TICK DEFENSE.....47 B2)...... 173 robitussin pediatric ...... 143 replesta ...... 173 RIBOFLAVIN 5- ROB-NEL URETHRAL replete...... 162 PHOSPHATE SODIUM 173 CATHETER ...... 97 replete fiber ...... 162 rid complete lice elim kit...... 57 ROCK CANDY...... 62 replete-fiber ...... 162 rid lice killing ...... 57 rocuronium ...... 21 reprexain...... 24 RIDAURA...... 123 ROLLED ABSORBENT rescon-gg ...... 143 rifabutin ...... 9 COTTON...... 97 RESCRIPTOR...... 4 rifampin ...... 9 RONDIC...... 97 reserpine ...... 38 RIFAMPIN (BULK) ...... 9 ropinirole ...... 19 RESERPINE (BULK)...... 38 ri-gel ...... 117 ropivacaine (pf) ...... 51 RESORCINOL (BULK) ...... 43 ri-gel ii ...... 117 ROPIVACAINE HCL (BULK) resource 2.0 ...... 162 RIGHTEST GD500 ...... 51 resource breeze...... 162 LANCING DEVICE ...... 97 rosadan...... 50 resource glutasolve...... 162 RIGHTEST GL300 LANCETS rosula cleansing cloths...... 50 resource just for kids w/fiber ...... 97 rosuvastatin...... 41 ...... 162 riginic...... 117 roweepra ...... 18 resource thickenup...... 62 riluzole...... 62 roxicet...... 24 RESOURCE WITH FIBER162 rimantadine...... 5 ROZEREM ...... 34 rest simply nighttime sleep.143 ri-mox ...... 117 r-tanna...... 143 RESTASIS ...... 131 ri-mox plus ...... 117 RUBRACA...... 16 RESTASIS MULTIDOSE .131 ringers...... 57, 153 rulavite dha ...... 173 restfully sleep ...... 143 ringworm ...... 53 rydex ...... 143

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 218 rynex dm...... 143 sea soft nasal mist...... 66 sensorcaine ...... 51 rynex pe...... 143 seb-prev ...... 42 sensorcaine/epinephrine ...... 51 rynex pse ...... 143 seconal sodium ...... 34 sensorcaine-mpf...... 51 S secura antifungal...... 54 SENSURA EASICLOSE SABRIL...... 18 SELECT BRIEFS...... 97 WIDE OUTLET ...... 98 SACCHARIN...... 162 SELECT DISPOSABLE sentry ...... 173 SAFE-CLIP NEEDLE BRIEFS ...... 97 SERENITY TENA PADS....98 STORAGE DEV ...... 97 SELECT KIDS BRIEFS ...... 97 SEREVENT DISKUS ...... 147 SAFESNAP INSULIN SELECT UNDERPADS ...... 97 SERINE (BULK)...... 162 SYRINGE...... 97 SELECT UNDERWEAR.....97 SERMORELIN ACETATE SAFESNAP SYRINGE ...... 97 selegiline hcl...... 19 (BULK)...... 120 SAFETY LANCETS...... 97 SELEGILINE HCL (BULK)19 SEROTONIN HCL (BULK) 62 SAFETY SEAL LANCETS.97 selenium...... 153 sertraline ...... 34 SAFETY-LET LANCETS ...97 selenium sulfide...... 42 SERTRALINE (BULK) ...... 34 SAF-GEL ...... 97 SELENIUM SULFIDE se-tan dha...... 173 salacyn...... 43 (BULK) ...... 42 se-tan plus...... 173 salicylic acid...... 43 SELENOMETHIONINE setlakin...... 128 SALICYLIC ACID (BULK) 43 (BULK) ...... 153 setonet...... 173 salicylic acid er-ceramides ...43 SELF ADHERENT WRAP..97 setonet-ec...... 173 saline mist...... 66 SELF-ADHERING sevelamer carbonate ...... 62 saline nasal ...... 66 BANDAGE ...... 97 severe allergy...... 30 saline nose ...... 66 SELF-CATHETER, FEMALE severe cold ...... 144 salonpas ...... 47 ...... 98 severe cold multi-symptom 144 salsalate ...... 30 SELFGRIP...... 98 severe congestion...... 66 SALSALATE (BULK) ...... 30 SELF-GRIP ...... 98 sevoflurane ...... 62 salvax...... 43 SELF-TAKING BLOOD shake that ache...... 30 SAMSCA ...... 107 PRESSURE ...... 98 sharobel...... 125 SANDIMMUNE ...... 16 SELZENTRY ...... 5 SHEER BANDAGE...... 98 SANDOSTATIN LAR se-natal 19...... 173 SHEER STRIPS ASSORTED DEPOT...... 16 se-natal 19 (with docusate).173 ...... 98 SANTYL ...... 56 senexon...... 117 SHIELDS...... 98 sarna sensitive ...... 117 senexon-s...... 117 SIDESTREAM PEDIATRIC SAVELLA...... 124 senna...... 117 FACE MASK ...... 98 scalacort...... 56 senna lax...... 117 SIGNIFOR...... 16 scalp relief ...... 56 senna laxative ...... 117 silace ...... 117 scalpicin anti-itch ...... 56 senna laxative-stool softener siladryl sa...... 144 scandical ...... 162 ...... 117 silapap...... 30 scandishake...... 162 senna plus ...... 117 sildenafil ...... 147 SCANDISHAKE...... 162 senna with docusate sodium SILDENAFIL (BULK) ...... 149 scandishake (lactose free)...162 ...... 117 SILICONE MASK - INFANT scar treatment ...... 97 senna-extra...... 117 ...... 98 SCAR TREATMENT ...... 97 senna-s...... 117 silphen cough...... 144 SCOPOLAMINE HBR senna-time s...... 117 SIL-SERTER...... 98 (BULK) ...... 117 senno...... 117 siltussin dm das...... 144 scot-tussin dm...... 144 sennosides-docusate sodium siltussin sa...... 144 scot-tussin expectorant ...... 144 ...... 117 siltussin-dm...... 144 se 10-5 ss ...... 50 sen-o-tab ...... 117 SILVASORB CAVITY...... 98 se bpo...... 50 SENSIPAR ...... 107 SILVASORB DRESSING ...98

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 219 silver nitrate...... 47 SIMPLICITY ADULT POLY SLEEP OVERS PANTS...... 98 SILVER NITRATE...... 47 MEDIUM ...... 98 SLEEP PANTS...... 98 silver nitrate applicators ...... 47 SIMPLICITY CONTOURED sleep-tabs ...... 144 SILVER PROTEIN MILD...47 LINER ...... 98 SLIP-ON UNDERGARMENT silver sulfadiazine...... 42 SIMPLICITY PAD...... 98 ...... 98 SILVER SULFADIAZINE simply sleep...... 144 slo-niacin ...... 41 (BULK) ...... 42 SIMULECT...... 16 slow release iron ...... 174 simethicone...... 117 simvastatin...... 41 SMART SENSE LANCETS 98 SIMETHICONE...... 117 SIMVASTATIN (BULK) ....41 SMARTDIABETES SIMILAC ADVANCE...... 162 sinelee...... 47 VANTAGE...... 98 similac advance organic .....162 SINGLE-LET ...... 98 SMARTEST LANCET ...... 98 SIMILAC ADVANCE sinus 12 hour ...... 144 smooth antacid...... 153 ORGANIC...... 162 sinus and allergy non-drowsy smoothlax ...... 117 SIMILAC ADVANCE WITH ...... 144 sochlor ...... 131 IRON ...... 162 sinus and allergy pe ...... 144 SOD PHOS DIBASIC, HEPT similac alimentum ...... 162 sinus congestion and pain...144 (BULK)...... 62 SIMILAC EXPERT CARE 162 sinus congestion-pain(chlorph) sodium acetate ...... 154 SIMILAC EXPERT CARE ...... 144 SODIUM ACETATE ...... 154 ALIMENTUM ...... 162 sinus congest-pain day-night SODIUM ACETATE SIMILAC EXPERT CARE ...... 144 TRIHYDRATE...... 63 NEOSURE ...... 162 sinus decongestant (pe) ...... 144 SODIUM BENZOATE SIMILAC FOR SPIT-UP...162 sinus headache degongestant (BULK)...... 66 SIMILAC HUMAN MILK ...... 144 sodium benzoate-sod FORTIFIER...... 162 sinus headache pe ...... 144 phenylacet...... 63 SIMILAC LOW-IRON ...... 162 sinus nasal spray...... 66 sodium bicarbonate.....117, 154 SIMILAC PM...... 162 sinus pain relief ...... 144 SODIUM BICARBONATE SIMILAC PRO-ADVANCE sinus pain-pressure (pe)...... 144 (BULK)...... 117 NON-GMO...... 162 sinus pe decongestant ...... 144 SODIUM BUTYRATE SIMILAC SENSITIVE ...... 162 sinus relief (non-drowsy)....144 (BULK)...... 63 similac sensitive fuss and gas sinus relief (oxymetazoline) .66 SODIUM CACODYLATE ..63 ...... 163 sinus-allergy (phenylephrine) SODIUM CAPRYLATE...... 3 SIMILAC SENSITIVE FUSS ...... 144 sodium chloride ...63, 131, 147, AND GAS ...... 163 sirolimus ...... 16 154 SIMILAC SENSITIVE SIROLIMUS (BULK)...... 16 SODIUM CHLORIDE ISOMIL SOY ...... 163 SIRTURO...... 9 (BULK)...... 154 SIMILAC SOY ISOMIL....163 SIVEXTRO ...... 9 sodium chloride 0.45 %...... 154 SIMILAC SPECIAL CARE 24 SKIN CLOSURE STRIPS ...98 sodium chloride 0.9 %...... 63 ...... 163 SKIN GEL PROTECT sodium chloride 3 %...... 154 SIMILAC SPECIAL CARE 30 DRESSING WIPE...... 98 sodium chloride 5 %...... 154 ...... 163 SKIN PREP WIPES ...... 98 sodium citrate-citric acid ....149 similac sterilized water...... 62 skin treatment ...... 47 SODIUM SIMILAC SKINTEGRITY HYDROGEL DESOXYCHOLATE SUPPLEMENTATION..163 ...... 98 (BULK)...... 63 SIMILAC TOTAL sleep aid (diphenhydramine) sodium ferric gluconat-sucrose COMFORT...... 163 ...... 144 ...... 63 SIMPLICITY ADULT FLAT sleep aid (doxylamine) ...... 34 sodium fluoride...... 174 FOLD XL ...... 98 SLEEP COMFORTS...... 98 SODIUM FLUORIDE sleep ii...... 144 (BULK)...... 174

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 220 SODIUM HYALURONATE SOLUS V2 LANCETS ...... 99 SQUARIC ACID (BULK) ...... 47 SOLUS V2 LANCING DIBUTYLEST.(BULK)...63 SODIUM HYDROXIDE .....43 DEVICE ...... 99 sronyx ...... 128 SODIUM HYDROXIDE SOMAVERT...... 107 ss 10-2...... 50 (BULK) ...... 43 sonafine ...... 47 ssd...... 42 SODIUM IODIDE (BULK).16 soothe (bismuth subsalicylate) sss 10-5 ...... 50 sodium lactate...... 154 ...... 110 STANOZOLOL (BULK) ...107 SODIUM METABISULFITE soothe regular strength ...... 110 STANOZOLOL (BULK) ...... 63 soothing care (hydrocortisone) MICRONIZED (BULK) 107 SODIUM NITRITE (BULK) ...... 56 STA-PUT UNDERPAD...... 99 ...... 38 soothing pureway-c ...... 174 stavudine...... 5 sodium nitroprusside ...... 42 SORBIC ACID...... 63 STERILANCE TL...... 99 sodium phenylbutyrate ...... 63 sorbitol...... 63 STERILE NITRILE GLOVE SODIUM SORBSAN WOUND ...... 99 PHENYLBUTYRATE DRESSING ...... 99 STERILE PADS...... 99 (BULK) ...... 63 sorbugen nr...... 144 STERILE TWO-FER sodium phosphate...... 154 SORESPOT...... 99 NEEDLE...... 99 SODIUM sorine ...... 35 STERI-STRIP DRESSING ..99 PHOSPHATE,DIBASIC(B sotalol ...... 35 STERI-STRIP SKIN ULK) ...... 117 sotalol af ...... 35 CLOSURES...... 99 sodium polystyrene sulfonate SOTYLIZE...... 35 STIMATE...... 107 ...... 63 sp antipruritic...... 47 stimulant laxative plus...... 117 SODIUM STEARYL sp scar management...... 47 STIVARGA...... 16 FUMARATE (BULK) .....63 spectravite...... 174 STOMA CAP-ADHESIVE- sodium succinate ...... 63 spectravite advanced formula FILTER...... 99 SODIUM SULFATE (BULK) ...... 174 STOMA CONE- ...... 63 spectravite senior...... 174 CONNECTOR REPL UNIT SODIUM TETRADECYL spectravite senior w-lycopene ...... 99 SULF (BULK)...... 63 ...... 174 STOMA LUBRICANT ...... 99 sodium thiosulfate ...... 63 spectravite ultra women...... 174 stomach relief ...... 110 SODIUM THIOSULFATE spinosad...... 57 stomach relief max strength110 (BULK) ...... 63 SPINRAZA (PF) ...... 20 STOMAHESIVE sof-lax...... 117 spironolactone ...... 38 PROTECTIVE...... 99 SOF-SET ADHESIVE SPIRONOLACTONE (BULK) STOMAHESIVE SKIN PATCH...... 98 ...... 38 BARRIER...... 99 SOFT CLOTH...... 99 SPIRONOLACTONE MICRO stool softener ...... 117 SOFT TOUCH LANCETS ..99 (BULK) ...... 38 stool softener-laxative ...... 117 SOFTFLEX SKIN BARRIER spironolacton-hydrochlorothiaz stool softener-stimulant laxat RING ...... 99 ...... 38 ...... 117 SOFT-SERTER INFUSION SPORANOX ...... 3 stop smoking aid...... 65 PUMP ATT ...... 99 sports pain relief rub...... 47 STRATASORB COMPOSITE SOFT-TIP THERMOMETER sports rub pain relieving...... 47 WOUND...... 99 ...... 99 SPORTS TAPE ...... 99 STRATTERA...... 34 sojourn...... 63 sportscreme...... 47 STRENSIQ ...... 107 SOL CARB ...... 163 sprintec (28)...... 128 STREPTOMYCIN ...... 9 SOLIRIS...... 63 SPRYCEL ...... 16 stress 500 plus zinc...... 174 SOLOSITE WOUND GEL..99 sps (with sorbitol)...... 63 stress b plus zinc...... 174 soluble fiber...... 117 stress b with zinc ...... 174

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 221 stress formula ...... 174 SULFAMETHOXAZOLE SUPLENA CARB STEADY stress formula advanced .....174 (BULK) ...... 10 ...... 163 stress formula plus iron ...... 174 sulfamethoxazole-trimethoprim support ...... 174 stress formula with iron...... 174 ...... 10 supreme antacid ...... 117 stress formula with iron(sulf) SULFAMYLON...... 52 SUPREME DIAPERS SIZE 6 ...... 174 SULFANILAMIDE...... 125 ...... 99 stress formula with zinc...... 174 SULFAPYRIDINE...... 10 supress dx ...... 144 stresstabs with zinc...... 174 sulfasalazine ...... 117 SURE CARE PROTECTIVE STRETCH GAUZE SULFASALAZINE (BULK) UNDERWEAR...... 100 BANDAGE ...... 99 ...... 117 SURE COMFORT ALCOHOL STRIBILD...... 5 SULFATHIAZOLE (BULK) PREP PADS ...... 100 strong iodine...... 154 ...... 125 SURE COMFORT LANCETS STRONG STRIPS...... 99 sulfatrim...... 10 ...... 100 strovite plus ...... 174 SULFISOXAZOLE...... 11 SURE COMFORT LANCING SUBOXONE ...... 30 SULFUR (BULK) ...... 43 PEN...... 100 SUCCINYLCHOLINE CL SULFUR SUBLIMED SURE COMFORT PEN (BULK) ...... 21 (BULK) ...... 43 NEEDLE...... 100 SUCRAID ...... 117 sulindac...... 30 SURECARE ...... 100 sucralfate ...... 120 SULINDAC...... 30 SURECHOICE BLADDER SUCRALFATE (BULK)....120 sumatriptan ...... 19 CONTROL ...... 100 sudogest...... 144 SUMATRIPTAN (BULK)...20 SURECHOICE PANTILINER sudogest 12-hour ...... 144 sumatriptan succinate ...... 20 ...... 100 sudogest cold and allergy ...144 SUMATRIPTAN SURE-FINE PEN NEEDLES sudogest pe ...... 144 SUCCINATE (BULK).....20 ...... 100 sudogest sinus and allergy..144 super b complex-vitamin c .174 SUREFLEX LANCING sufentanil citrate ...... 24 super b maxi complex...... 174 DEVICE ...... 100 SUFENTANIL CITRATE super b/c ...... 174 SURE-JECT INSULIN (BULK) ...... 24 super b-50 complex ...... 174 SYRINGE...... 100 SULFACETAMIDE...... 10 super b-50 complex plus.....174 SURE-LANCE ...... 100 SULFACETAMIDE SOD, super calcium...... 154 SURE-PEN LANCING MONO (BULK) ...... 132 super multiple...... 174 DEVICE ...... 100 sulfacetamide sodium...42, 132 super multivitamin...... 174 SURE-PREP ALCOHOL SULFACETAMIDE SODIUM super pain relief ...... 30 PREP PADS ...... 100 ...... 132 super quints...... 174 SUREPRESS HIGH sulfacetamide sodium (acne) 52 super quints b-50 ...... 174 COMPRESSION ...... 100 sulfacetamide sodium-sulfur 50 SUPER STRIP BANDAGES SURE-TOUCH LANCET..100 sulfacetamide sod-sulfur-urea ...... 99 surfak ...... 117 ...... 50 super thera vite m ...... 174 SUR-FIT NATURA sulfacetamide-prednisolone 132 SUPER THIN LANCETS....99 ADAPTOR ...... 100 sulfacetamide-sulfur-cleansr23 superplex-t...... 174 SUR-FIT NATURA CLOSED ...... 50 suphedrin ...... 144 POUCH...... 100 sulfacleanse 8-4...... 50 suphedrine ...... 144 SUR-FIT NATURA CONVEX sulfact na-sul-avobnz-otn-ocsa suphedrine 12 hour ...... 144 INSERTS...... 100 ...... 50 suphedrine pe...... 144 SUR-FIT NATURA sulfadiazine...... 10 suphedrine pe cold and allergy DRAINABLE POUCH ..100 SULFADIAZINE...... 10 ...... 144 SUR-FIT NATURA SULFADIAZINE SODIUM suphedrine pe sinus headache DURAHESIVE...... 100 (BULK) ...... 63 ...... 144

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 222 SUR-FIT NATURA FLANGE TACROLIMUS TELFA OUCHLESS NON- CAP ...... 100 ANHYDROUS (BULK) ..16 ADHERENT...... 101 SUR-FIT NATURA HIGH TACROLIMUS telmisartan ...... 38 OUTPUT ...... 100 MICRONIZED (BULK) ..16 telmisartan-amlodipine ...... 38 SUR-FIT NATURA IRRIG tactinal ...... 30 telmisartan-hydrochlorothiazid FACEPLATE ...... 100 tactinal extra strength ...... 30 ...... 38 SUR-FIT NATURA LOW- TAFINLAR ...... 16 temazepam...... 34 PRESSURE...... 100 tagamet hb ...... 120 TEMODAR ...... 16 SUR-FIT NATURA MINI- TAGRISSO ...... 16 temozolomide ...... 16 POUCH ...... 100 TAKE ACTION ...... 128 TENA PANTS SUPER SUR-FIT NATURA TAMIFLU ...... 5 LARGE...... 101 STOMAHESIVE...... 100 tamoxifen...... 16 TENA PROTECTIVE SUR-FIT NATURA TAMOXIFEN (BULK)...... 16 UNDERWEAR...... 101 UROSTOMY POUCH...101 tamsulosin...... 148 TENA SERENITY ...... 101 SUR-FIT-ACTIVE LIFE TAIL TARCEVA ...... 16 TENA STRETCH ULTRA 101 CLOS...... 101 targeted acne spot treatment .50 tencon ...... 24 SURGICAL DRESSING TARGRETIN ...... 16 TENDERSORB UNDERPAD EXTR PROTCT ...... 101 tarina fe 1/20 (28) ...... 128 ...... 101 SURGUARD2 SAFETY....101 taron forte ...... 174 TENDERWRAP UNNA SUSTIVA...... 5 taron-bc...... 174 BOOT ...... 101 SUTENT...... 16 taron-c dha...... 174 TENIPOSIDE ...... 16 syeda...... 128 taron-prex prenatal-dha ...... 175 TENSOR...... 101 SYLATRON...... 120 TASIGNA ...... 16 terazosin...... 38 SYLATRON 4-PACK...... 121 tavist-1...... 144 TERBINAFINE (BULK) ...... 3 SYLVANT ...... 16 TAZORAC ...... 50 terbinafine hcl...... 3, 54 symax fastabs ...... 110 taztia xt ...... 38 terbutaline ...... 148 symax-sl ...... 110 tears again...... 131 TERBUTALINE...... 147 symax-sr ...... 110 tears again (pva) ...... 131 terconazole...... 125 SYMBICORT...... 147 tears pure ...... 131 terrell...... 63 SYMLINPEN 120...... 101 TECENTRIQ...... 16 TERUMO ALLERGY SYMLINPEN 60...... 101 TECFIDERA...... 20 SYRINGE...... 101 SYNAGIS...... 5 TECHLITE LANCETS...... 101 TERUMO HYPODERMIC SYNTHROID...... 108 TECHLITE PEN NEEDLE 101 NEEDLE/SYRIN ...... 101 synvexia patch ...... 51 TECHNIVIE...... 5 TERUMO INSULIN syrex sodium chloride 0.9%.63 TEGADERM SYRINGE...... 102 SYRINGE WITH NEEDLE HYDROCOLLOID ...... 101 TERUMO SYRINGE...... 102 ...... 101 TEGADERM TESTOPEL...... 107 T HYDROCOLLOID THIN testosterone ...... 108 tab a vite ...... 174 ...... 101 TESTOSTERONE (BULK) tab tussin...... 144 TEGAGEN HG ...... 101 ...... 107 tab tussin dm...... 144 TEGAGEN HI...... 101 TESTOSTERONE CYP, tab-a-vite...... 174 TEGRETOL ...... 18 MICRO (BULK) ...... 107 tab-a-vite/iron...... 174 TEGRETOL XR...... 18 TESTOSTERONE tab-a-vite-minerals ...... 174 TELCARE LANCETS...... 101 CYPIONATE (BULK)...107 TABLOID ...... 16 TELFA AMD ...... 101 TESTOSTERONE tacrolimus...... 16, 47 TELFA CLEAR WOUND ENANTHATE (BULK) .107 TACROLIMUS (BULK) .....47 DRESSING ...... 101 TESTOSTERONE MICRONIZED (BULK) 107

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 223 TESTOSTERONE therems-m...... 175 TITANIUM DIOXIDE PROPIONATE (BULK) 108 THERMACARE (BULK)...... 48 tetcaine ...... 131 KNEE/ELBOW...... 102 TIVICAY...... 5 tetrabenazine...... 20 thermazene...... 42 tizanidine ...... 21 TETRACAINE (BULK) ...... 52 THERMOMETER COVERS TIZANIDINE (BULK)...... 21 tetracaine hcl ...... 131 ...... 102 tl gard rx ...... 175 TETRACAINE HCL (BULK) THERMOMETER PROBE tl g-fol os...... 175 ...... 52 COVERS ...... 102 tl icon...... 175 tetracaine hcl (pf) ...... 52, 131 THERMOPHORE tl-care dha ...... 175 tetracycline ...... 11 MAXHEAT...... 102 tl-dmx ...... 144 TETRACYCLINE (BULK) .11 THERMOPHORE PACK tl-fluorivite...... 175 TETRACYCLINE HCL STANDARD ...... 102 tl-hem 150...... 175 (BULK) ...... 11 THERMOSCAN tl-hist dm...... 144 TETRAHYDROBIOPTERIN THERMOMETER...... 102 tl-select ...... 175 DI-HCL ...... 108 THIABENDAZOLE ...... 9 tobramycin...... 129 TETRAHYDROZOLINE ..133 THIAMINE HCL (BULK).175 TOBRAMYCIN (BULK)...... 9 TEV-TROPIN ...... 121 thiamine hcl (vitamin b1) ...175 tobramycin in 0.225 % nacl....9 tg 10peh-380gfn-15dm...... 144 thinpro insulin syringe...... 102 tobramycin in 0.9 % nacl...... 9 THALOMID...... 16 THINPRO INSULIN tobramycin sulfate ...... 9 the magic bullet ...... 117 SYRINGE...... 102 TOBRAMYCIN SULFATE THEOBROMINE (BULK) ..64 THIOGUANINE (BULK)....16 (BULK)...... 9 theochron...... 148 thioridazine...... 34 tobramycin-dexamethasone 132 theophylline...... 148 THIORIDAZINE (BULK)...34 TODAY CONTRACEPTIVE THEOPHYLLINE (BULK)148 thiotepa ...... 16 SPONGE...... 125 theophylline in dextrose 5 % THIOTEPA (BULK)...... 16 tolazamide...... 102 ...... 148 thiothixene...... 34 TOLAZOLINE (BULK) ...... 38 thera m plus (ferrous fumarat) THREONINE (BULK)...... 163 tolbutamide ...... 102 ...... 175 thritex...... 47 tolcapone...... 19 thera vitamin...... 175 thrivite-19 ...... 175 TOLEREX...... 163 thera-d...... 175 THYROGEN...... 64 tolmetin...... 30 theralogix companion...... 175 THYROID (BULK) ...... 108 tolnaftate ...... 54 thera-m ...... 175 THYROID, PORK (BULK) tolterodine...... 148 therapeutic blue ...... 47 ...... 108 TOOMEY SYRINGE...... 102 therapeutic formula/hematinics THYROLAR-1...... 108 TOOTHETTE...... 102 ...... 175 THYROLAR-1/2...... 108 TOPCARE ULTRA therapeutic liquid...... 175 THYROLAR-1/4...... 108 COMFORT...... 102 therapeutic m + beta-carotene THYROLAR-2...... 108 TOPCARE UNIVERSAL1 ...... 175 THYROLAR-3...... 108 LANCET ...... 102 therapeutic moisturizing...... 47 tiagabine ...... 18 topiragen ...... 18 therapeutic-m...... 175 tiger balm...... 47, 48 topiramate ...... 18 therapeutic-m vitamin/minerals tilia fe...... 128 TOPIRAMATE (BULK)...... 18 ...... 175 timolol maleate...... 38, 129 toposar ...... 16 thera-tabs ...... 175 TIMOLOL MALEATE topotecan...... 16 thera-tabs m...... 175 (BULK) ...... 38 TORISEL...... 16 theratrum complete 50 plus 175 tinactin...... 54 torsemide ...... 38 theratrum complete 50 plus/lut tinidazole ...... 9 total allergy medicine ...... 145 ...... 175 TINIDAZOLE (BULK) ...... 9 total b/c ...... 175 therems ...... 175 tis-u-sol pentalyte ...... 57

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 224 TOTAL HOME INSECT TRIAMTERENE...... 38 triple paste af ...... 54 REPELLENT ...... 48 triamterene-hydrochlorothiazid triple vitamin with fluoride.175 TOUCH-TROL ...... 102 ...... 38 tri-previfem (28) ...... 128 TRACLEER ...... 148 trianex...... 56 TRIPROLIDINE HCL TRAINING PANTS 2T-3T 102 triazolam...... 34 (BULK)...... 145 tramadol...... 30 tri-buffered aspirin...... 30 TRISENOX ...... 16 TRAMADOL tri-chlor...... 48 tri-sprintec (28)...... 128 HYDROCHLORIDE TRICHLORMETHIAZIDE tri-tabs dha ...... 175 (BULK) ...... 30 (BULK) ...... 38 TRIUMEQ...... 5 tramadol-acetaminophen ...... 30 TRICHLOROACETIC ACID triveen-duo dha...... 175 trandolapril ...... 38 ...... 48 triveen-one...... 175 trandolapril-verapamil...... 38 TRICITRASOL...... 64 triveen-prx rnf...... 175 tranexamic acid ...... 40, 125 tricitrates...... 149 tri-vit with fluoride and iron TRANEXAMIC ACID TRICLOSAN (BULK)...... 52 ...... 175 (BULK) ...... 40 tricon...... 175 tri-vita ...... 175 TRANQUILITY PREMIUM triderm ...... 56 tri-vitamin...... 175 UNDERWEAR ...... 102 tri-estarylla...... 128 tri-vitamin with fluoride .....175 TRANQUILITY TOPLINER trifluoperazine ...... 34 trivora (28)...... 128 PADS...... 102 trifluridine...... 129 trixaicin...... 48 TRANSFER PIN...... 102 TRIFLURIDINE (BULK)..129 TRIZIVIR ...... 5 TRANSPORE SURGICAL102 trigels-f forte...... 175 TROLAMINE (BULK) ...... 48 tranylcypromine ...... 34 trihexyphenidyl...... 19 trolamine salicylate...... 48 travasol 10 %...... 163 tri-legest fe...... 128 tropicamide ...... 130 travel sickness ...... 117 tri-linyah ...... 128 TROPICAMIDE...... 130 travel sickness (meclizine) .118 tri-lo-estarylla ...... 128 trospium...... 148 travoprost (benzalkonium) .132 tri-lo-marzia...... 128 TRUEDRAW LANCING trazodone ...... 34 tri-lo-sprintec...... 128 DEVICE ...... 102 TRAZODONE (BULK)...... 34 trilyte with flavor packets...118 TRUEPLUS INSULIN...... 102 treagan otic ...... 67 TRIMEPRAZINE TRUEPLUS KETONE...... 102 TREANDA...... 16 TARTRATE (BULK)...... 64 TRUEPLUS LANCETS.....102 tretinoin ...... 50 trimethobenzamide ...... 118 TRUEPLUS PEN NEEDLE TRETINOIN...... 50 TRIMETHOBENZAMIDE ...... 102 tretinoin (chemotherapy) ...... 16 (BULK) ...... 118 tru-micin ...... 48 tretinoin microspheres ...... 50 trimethoprim...... 11 trust natal dha ...... 175 TREXALL...... 16 TRIMETHOPRIM (BULK).11 TRUSTEX LUBRICATED trezix...... 24 TRIMETHOPRIM, MICRO CONDOMS ...... 102 TRIACETIN...... 54 (BULK) ...... 11 TRUSTEX-RIA triadvance ...... 175 trimipramine ...... 34 LUB/SPERMICIDE ...... 102 TRIAMCIN DIACET, MICRO trinatal gt...... 175 TRUVADA...... 5 (BULK) ...... 68 trinatal rx 1 ...... 175 TRUZONE PEAK FLOW TRIAMCINOLONE (BULK) trinatal ultra ...... 175 METER...... 102 ...... 68 trinate...... 175 trymine cg...... 145 triamcinolone acetonide 56, 66, trinessa (28) ...... 128 TRYPSIN ...... 64 68, 148 trinessa lo...... 128 TUBERCULIN SYRINGE 103 TRIAMCINOLONE TRIOXSALEN (BULK) ...... 64 TUBERCULIN-ALLERGY ACETONIDE (BULK) ....56 TRIPELENNAMINE (BULK) SYRINGES...... 103 TRIAMCINOLONE ...... 145 TUDORZA PRESSAIR .....148 DIACETATE (BULK).....69 triphrocaps...... 175 TUGABOOS DIAPERS.....103

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 225 TUGABOOS OVERNIGHTS TYVASO STARTER KIT .148 UNDECYLENIC ACID ...... 103 TYZEKA...... 5 (BULK)...... 54 TUGABOOS TRAINING U UNDERGARMENT EXTRA PANTS ...... 103 UBIQUINOL (BULK) ...... 163 ABSORBENT ...... 103 tums ultra...... 118, 154 UCD 2...... 163 UNDERJAMS SMALL- tusnel c...... 145 UCD ANAMIX JUNIOR...163 MEDIUM ...... 103 tusnel diabetic...... 145 UCERIS...... 118 UNDERPADS ...... 103 tusnel pediatric ...... 145 ULORIC ...... 123 UNDERPADS REGULAR 104 tussi pres-b...... 145 ULTICARE ...... 103 UNDERWEAR...... 104 tussigon...... 145 ULTICARE INSULIN UNDERWEAR FOR MEN 104 tussin...... 145 SYRINGE...... 103 unicomplex-m...... 176 tussin cf ...... 145 ULTI-LANCE ...... 103 UNIFINE PENTIPS ...... 104 tussin cf (pe-dm-guaif)...... 145 ULTILET ALCOHOL SWAB UNIFINE PENTIPS PLUS.104 tussin cf max...... 145 ...... 103 UNIGARD INCONTINENT tussin chest congestion ...... 145 ULTILET BASIC LANCETS PAD ...... 104 tussin cold-congestion...... 145 ...... 103 UNILET COMFORTOUCH tussin cough (dm only)...... 145 ULTILET CLASSIC LANCET ...... 104 tussin cough dm...... 145 LANCETS...... 103 UNILET EXCELITE II tussin cough-chest congestion ULTILET INSULIN LANCET ...... 104 ...... 145 SYRINGE...... 103 UNILET EXCELITE tussin dm ...... 145 ULTILET LANCETS...... 103 LANCET ...... 104 tussin dm clear...... 145 ULTILET PEN NEEDLE ..103 UNILET GP LANCET...... 104 tussin dm cough...... 145 ULTILET SAFETY UNILET LANCET...... 104 tussin dm cough and chest..145 LANCETS...... 103 unisom sleepgels...... 145 tussin dm max...... 145 ultimate ob dha ...... 175 UNISTIK 2 DEVICE ...... 104 tussin honey...... 145 ultimatecare one ...... 175 UNISTIK 3 ...... 104 tussin long-acting ...... 145 ultimatecare one nf ...... 176 UNISTIK 3 EXTRA LANCET tussin maximum strength ...145 ultra b-100 complex...... 176 ...... 104 tussin maximum strength ultra comfort insulin syringe UNISTIK CZT LANCET...104 cough ...... 145 ...... 103 UNISTIK SAFETY ...... 104 tussin pe...... 145 ULTRA COMFORT INSULIN UNISTIK TOUCH LANCETS tussinmax...... 145 SYRINGE...... 103 ...... 104 tussi-pres...... 145 ultra sleep (doxylamine succ) unithroid ...... 108 TWOCAL HN...... 163 ...... 34 UNITUXIN...... 16 TYGACIL ...... 9 ULTRA THIN LANCETS .103 UNIVERSAL 1 LANCETS104 TYKERB...... 16 ULTRA THIN PLUS UNNA-FLEX ELASTIC tylophen...... 30 LANCETS...... 103 UNNA BOOT...... 104 tyr cooler ...... 163 ULTRA TLC LANCETS ...103 UP AND UP BABY DIAPER TYR EXPRESS20...... 163 ultracin t...... 48 ...... 104 TYR GEL POWDER ...... 163 ULTRA-FLEX ...... 103 UPTRAVI...... 38 TYREX-1 ...... 163 ULTRALANCE LANCETS ur n-c...... 149 TYREX-2 ...... 163 ...... 103 uramit mb...... 149 TYROS 1...... 163 ULTRA-LIGHT ROLLATOR urea ...... 48 TYROS 2...... 163 ...... 103 UREA (BULK)...... 48 TYROSINE (BULK)...... 163 ULTRA-SOFT GLOVES...103 urea (with lactic,salicy acid).48 TYSABRI...... 20 ULTRA-THIN II INSULIN urea 50%...... 48 TYVASO...... 148 SYRINGE...... 103 urea nail stick...... 48 TYVASO REFILL KIT .....148 umecta ...... 48 urea-hyaluronate sodium ...... 48

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 226 ure-k ...... 48 valproic acid ...... 19 venlafaxine ...... 34 URETHRAL CATHETER.104 valproic acid (as sodium salt) VENOFER...... 176 uretron d-s ...... 149 ...... 19 VENTAVIS ...... 148 urimar-t...... 149 VALPROIC ACID (BULK).19 VENTED URINARY LEG urin ds...... 149 valsartan...... 38 BAG...... 105 URINARY LEG MEDIUM valsartan-hydrochlorothiazide VENTOLIN HFA...... 148 BAG ...... 104 ...... 38 verapamil ...... 38 URISTIX 4 ...... 104 VALSTAR...... 16 VERAPAMIL (BULK) ...... 38 URISTIX REAGENT ...... 104 valu-tapp...... 145 verdrocet ...... 24 URO MINICAP...... 104 vancomycin ...... 12 veripred 20...... 69 uro-458 ...... 149 VANCOMYCIN (BULK)....11 VERSALON...... 105 uro-blue ...... 149 VANCOMYCIN IN 0.9% VERSIVA XC ...... 105 UROCARE URINARY SODIUM CL ...... 12 vestura (28)...... 128 DRAIN BOTTLE...... 104 VANCOMYCIN IN VGO 20 ...... 105 urogesic-blue ...... 149 DEXTROSE 5 %...... 12 VGO 30 ...... 105 uro-l ...... 149 vandazole...... 126 VGO 40 ...... 105 urolet mb ...... 149 VANISHPOINT VIBERZI ...... 118 uro-mp ...... 149 TUBERCULIN SYRINGE vic-forte ...... 176 urophen mb...... 149 ...... 105 vicks dayquil cold-flu relief145 UROSTOMY DRAIN TUBE VANTAS...... 16 vicks dayquil cough...... 145 ADAPTER ...... 104 VAPORIZER INHALANT 105 VICKS DIGITAL UROSTOMY MICRO- VAPORIZERS ...... 105 THERMOMETER...... 105 POUCH ...... 104 VASCEPA...... 41 VICKS HUMIDIFIER...... 105 UROSTOMY MULTI- VASELINE PETROLATUM vicks nature fusion...... 145 CHAMBER POUCH .....104 GAUZE ...... 105 vicks nature fusion cough...145 UROSTOMY NIGHT BAG VASELINE WHITE vicks qlearquil allergy ...... 145 ...... 104 PETROLEUM...... 48 vicks qlearquil nighttime rlf145 UROSTOMY POUCH...... 104 vasolex...... 56 vicks qlearquil(oxymetazoline) ursodiol...... 118 vasopressin ...... 108 ...... 66 URSODIOL (BULK) ...... 118 vazobid-pd...... 145 vicks sinex 12-hour...... 66 uryl ...... 149 v-c forte ...... 176 vicks sinex ultra fine mist 1266 ustell ...... 149 VCF CONTRACEPTIVE GEL VICKS WARM MIST utira-c ...... 149 ...... 126 HUMIDIFIER...... 105 UVADEX...... 48 VECTIBIX ...... 16 vicodin ...... 24 V vecuronium bromide...... 21 vicodin es...... 24 VAGINAL vegetable laxative ...... 118 vicodin hp ...... 24 CONTRACEPTIVE FILM VELCADE ...... 16 VIDARABINE (BULK).....129 ...... 125 veletri...... 38 VIDARABINE vaginal contraceptive foam 126 velivet triphasic regimen (28) MONOHYDRATE (BULK) vagistat-3 ...... 126 ...... 128 ...... 129 valacyclovir ...... 5 VELTASSA...... 64 VIDEX 2 GRAM PEDIATRIC VALACYCLOVIR (BULK)..5 vemavite-prx-2 ...... 176 ...... 5 VALCHLOR ...... 48 VEMLIDY...... 5 vienva ...... 128 valganciclovir ...... 5 vena-bal dha ...... 176 VIGILON PRIMARY VALINE...... 163 venatal-fa...... 176 WOUND DRESSING ....105 valproate sodium ...... 18 VENCLEXTA...... 16 VIMPAT...... 19 VALPROATE SODIUM VENCLEXTA STARTING vinacal...... 176 (BULK) ...... 19 PACK ...... 16 vinate care...... 176

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 227 vinate dha ...... 176 VISI-FLOW STOMA CONE VIVITROL ...... 30 vinate gt ...... 176 ...... 105 VIVONEX PEDIATRIC ....163 vinate ii...... 176 vision formula (with lutein)176 VIVONEX PLUS ...... 163 vinate m...... 176 VISTEC X-RAY DETECT 105 vivonex rtf ...... 163 vinate one ...... 176 VISTOGARD...... 12 VIVONEX T.E.N...... 163 vinate pn care ...... 176 vit 3...... 176 vol-care rx...... 177 vinate ultra...... 176 vit b complex-folic acid...... 176 vol-nate ...... 177 vinblastine ...... 17 VIT E ACID SUCCINATE vol-plus...... 177 vincasar pfs...... 17 (BULK) ...... 176 vol-tab rx ...... 177 vincristine...... 17 vitabee/c...... 176 voriconazole ...... 3 vinorelbine...... 17 vita-c...... 176 VORICONAZOLE (BULK) ..3 VINYL CATHETER...... 105 VITAFOL-OB...... 176 VORTEX HOLDING VINYL GLOVES...... 105 vitafol-pn (ud)...... 176 CHAMBER ...... 105 VIOKACE...... 118 VITAL 1.0 CAL...... 163 VORTEX VHC FROG viorele (28) ...... 128 VITAL 1.5 CAL...... 163 MASK-CHILD ...... 105 VIRACEPT ...... 5 VITAL AF 1.2 CAL...... 163 VORTEX VHC LADYBUG virdec...... 145 VITAL HIGH PROTEIN ...163 MASK-TODDLR ...... 105 VIREAD...... 5 vitalee ...... 176 VOTRIENT ...... 17 virt-advance...... 176 vitalets ...... 176 vp-ch plus ...... 177 virt-bal dha ...... 176 VITAMAX ...... 176 vp-ch-pnv...... 177 virt-bal dha plus...... 176 vitamin a...... 176 vp-era ob plus ...... 177 virt-c dha ...... 176 VITAMIN A ACETATE vp-ggr-b6 ...... 177 virt-care one...... 176 (BULK) ...... 176 vp-heme ob ...... 177 virt-gard...... 176 VITAMIN A PALMITATE vp-heme ob + dha ...... 177 virti-sulf...... 50 ...... 176 vp-heme one ...... 177 virt-nate ...... 176 VITAMIN A PALMITATE VPRIV ...... 108 virt-nate dha...... 176 (BULK) ...... 176 vp-vite rx ...... 177 virt-phos 250 neutral ...... 154 vitamin b complex...... 176 vyfemla (28) ...... 128 virt-pn...... 176 vitamin b complex with c ...176 VYVANSE...... 34 virt-pn dha ...... 176 vitamin b-1 ...... 176 W virt-pn plus ...... 176 vitamin b-1 (mononitrate) ..176 wal-act d cold and allergy...145 virtrate-2...... 149 vitamin b-6 ...... 177 wal-dram...... 118 virtrate-3...... 149 vitamin c...... 177 wal-dryl (diphenhydramine).48 virtrate-k...... 149 vitamin c cough drops ...... 177 wal-dryl (diphenhydramine-zn) virt-select...... 176 vitamin c with rose hips...... 177 ...... 48 virtussin ac...... 145 vitamin d3...... 177 wal-dryl allergy ...... 145 virtussin dac...... 145 VITAMIN E (DL, ACETATE) wal-dryl-d allergy and sinus virt-vite...... 176 (BULK) ...... 177 ...... 145 virt-vite gt...... 176 VITAMIN E ACETATE wal-fex allergy...... 146 VISI-FLOW IRRIGATION (BULK) ...... 177 wal-fex d 12 hour...... 146 SLEEVE...... 105 vitamin k...... 40 wal-fex d 24 hour...... 146 VISI-FLOW IRRIGATION vitamin k1...... 40 wal-finate...... 146 STARTER ...... 105 VITAMIN K1...... 40 wal-finate-d...... 146 VISI-FLOW IRRIGATOR- vitamins a,c,d and fluoride .177 wal-four ...... 66 STOMA CONE...... 105 vitamins and minerals...... 177 wal-itin...... 146 VISI-FLOW SLEEVE TAIL vitamins b complex ...... 177 wal-itin d...... 146 CLOSURES ...... 105 vitamins for hair ...... 177 wal-itin d 12 hour ...... 146 vitrum senior...... 177 wal-mucil fiber ...... 118

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 228 wal-mucil fiber (aspartame)118 WINGS CHOICE PLUS XLYS, XTRP MAXAMAID wal-mucil fiber (sugar)...... 118 ADULT BRIEFS...... 106 ...... 164 wal-mucil natural fiber lax .118 WINGS CHOICE PLUS XLYS, XTRP MAXAMUM wal-phed...... 146 YOUTH BRIEFS ...... 106 ...... 164 wal-phed 12 hour...... 146 WINGS CLASSIC ADULT XMET ANALOG...... 164 wal-phed pe ...... 146 BRIEFS ...... 106 XMET MAXAMUM...... 164 wal-phed pe sinus and allergy WINGS CLASSIC ADULT XMTVI ANALOG ...... 164 ...... 146 BRIEFS X-L...... 106 xmtvi maxamaid ...... 164 wal-profen ...... 30 WINGS FLUFF AND xmtvi maxamum...... 164 wal-som (diphenhydramine) POLYMER...... 106 XOFIGO...... 17 ...... 146 WINGS MAXIMA XOLAIR ...... 148 wal-som (doxylamine)...... 34 UNDERPADS...... 106 xolox...... 24 wal-tap dm...... 146 WINGS UNDERPAD ...... 106 XPHE MAXAMAID...... 164 wal-tussin cough...... 146 WINGS XXL ADULT BRIEF xphe maxamum ...... 164 wal-tussin cough and cold cf ...... 106 XPHE MAXAMUM ...... 164 ...... 146 WND 2 ...... 163 XPHE, XTRP MAXAMAID wal-tussin dm ...... 146 woman's laxative ...... 118 ...... 164 wal-tussin max strength cough WOMEN'S ADVANCED BP XPHE, XTYR ANALOG...164 ...... 146 MONITOR ...... 106 XPTM ANALOG ...... 164 wal-zan 150 ...... 120 women's daily formula ...... 177 XTRACAL PLUS ...... 164 wal-zan 75 ...... 120 women's gentle laxative(bisac) xulane ...... 126 wal-zyr (cetirizine) ...... 146 ...... 118 XURIDEN ...... 64 wal-zyr d...... 146 women's laxative (bisacodyl) x-viate...... 48 warfarin ...... 40 ...... 118 xylocaine dental-epinephrine52 WARFARIN (BULK)...... 40 women's one daily ...... 177 WARM STEAM women's stool softener ...... 118 (BULK)...... 67 VAPORIZER ...... 105 WOMEN'S UNDERWEAR xylon 10 ...... 24 WATCHHALER...... 105 ...... 106 XYREM...... 34 WATER BOTTLE- WONDERPANTS...... 106 Y FOUNTAIN SYRINGE .105 WOUND DRAINAGE yelets...... 177 water for injection, sterile.....64 COLLECTOR ...... 106 YERVOY ...... 17 water for irrigation, sterile....64 WOUN'DRES HYDROGEL YOHIMBINE ...... 64 WATER SHIELD WOUND DRESS ...... 106 YONDELIS ...... 17 BANDAGES ...... 105 wymzya fe ...... 128 Y-PORT CONNECTOR ....106 WATERPROOF STRONG X yuvafem ...... 125 STRIPS...... 106 XANTHAN GUM...... 64 Z WEBCOL...... 106 XARELTO ...... 40 zafirlukast ...... 148 wee care...... 177 XEROFLO GAUZE zaleplon...... 34 WELL BEGINNINGS DRESSING ...... 106 zamicet...... 24 DIAPERS ...... 106 XEROFORM...... 106 ZANOSAR ...... 17 WELL BEGINNINGS SLEEP XEROFORM PETROLATUM zantac maximum strength...120 PANTS ...... 106 OVERWRAP...... 106 zarah ...... 128 WELL BEGINNINGS XGEVA...... 12 ZARONTIN...... 19 TRAINING PANTS...... 106 XIAFLEX...... 64 ZARXIO ...... 121 wera (28) ...... 128 XIFAXAN...... 9 zatean-ch...... 177 westhroid ...... 108 XLEU ANALOG ...... 163 zatean-pn...... 177 WINGS CHOICE ADULT XLEU MAXAMAID ...... 164 zatean-pn dha...... 177 BRIEF...... 106 XLYS- XTRP ANALOG ...164 zatean-pn plus...... 178

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 229 zavara ...... 178 zidovudine ...... 5 zoledronic acid...... 108 ZAVESCA ...... 108 ZINC ACETATE zoledronic acid-mannitol-water zeasorb (miconazole)...... 54 DIHYDRATE (BULK) ..154 ...... 64 ZEAXANTHIN (BULK) ...178 zinc chloride ...... 154 ZOLINZA...... 17 zebutal ...... 24 ZINC CHLORIDE (BULK) zolmitriptan...... 20 ZEGERID OTC...... 120 ...... 154 zolpidem ...... 34 ZELBORAF ...... 17 zinc oxide ...... 48 ZOMETA ...... 108 ZEMAIRA...... 64 ZINC OXIDE (BULK)...... 48 ZOMIG...... 20 zenatane...... 50 ZINC PICOLINATE (BULK) zonisamide...... 19 zenchent (28)...... 128 ...... 164 zoo chews ...... 178 zenchent fe...... 128 zinc sulfate...... 154 ZORTRESS ...... 17 zencia...... 50 ZINC SULFATE (BULK) .154 ZOSTAVAX (PF) ...... 123 zenzedi...... 34 ZINC SULFATE zostrix ...... 48 zeosa...... 128 HEPTAHYDRAT(BULK) zostrix-hp...... 48 ZEPATIER...... 5 ...... 64 zovia 1/35e (28)...... 128 ZERBAXA...... 6 ZINC UNDECYLENATE ...54 zovia 1/50e (28)...... 128 zeruvia ...... 52 zingiber...... 178 ZOVIRAX ...... 54 ZETIA ...... 41 ziprasidone hcl...... 34 ZYDELIG...... 17 ZEVALIN (Y-90)...... 17 ZODRYL AC 40 ...... 146 ZYKADIA...... 17 zflex...... 30 ZODRYL DEC 30...... 146 zyncof ...... 146 zgesic...... 30 ZOLADEX ...... 17 ZYTIGA ...... 17 ZIAGEN...... 5 zolate ...... 178 ZYVOX ...... 9

You can find information on what the symbols and abbreviations on this table mean by going to the beginning of this table. 230