Revised: 10/13/2017
OPTIMA HEALTH PRESCRIPTION DRUG FORMULARY
SMALL GROUP STANDARD FORMULARY (50 or Less Employees)
Effective: October 1, 2017
Erythrocin Stearate
PCE
TETRACYCLINES
October 2017
TIER 01 PREFERRED GENERIC
avidoxy
ANTI-INFECTIVES
demeclocycline HCL
doxycycline
PENICILLINS
doxycycline hyclate
TIER 01 PREFERRED GENERIC
doxycycline hyclate DRST
amoxicillin
minocycline HCL
amoxicillin/clavulanate potassium
minocycline HCL ER
amoxicillin/clavulanate potassium ER
mondoxyne nl
ampicillin
morgidox 1X100MG
dicloxacillin sodium
morgidox 1X50MG
penicillin v potassium
morgidox 2X100MG
Amoxicillin
tetracycline hydrochloride
Amoxicillin/Clavulanate Potassium
tetracycline HCL
Ampicillin
Minocycline HCL ERST
TIER 02 NON-PREFERRED GENERIC
Tetracycline HCL
Amoxicillin ER
TIER 02 NON-PREFERRED GENERIC
doxycycline monohydrate
CEPHALOSPORIN
TIER 03 NON-PREFERRED BRAND
FIRST GENERATION
Avidoxy DK
TIER 01 PREFERRED GENERIC
Minocin Kit
cefadroxil
Morgidox 1X100MG
cephalexin
Morgidox 2X100MG
TIER 02 NON-PREFERRED GENERIC
Nutridox
Cephalexin
SECOND GENERATION
QUINOLONES
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
cefaclor
ciprofloxacin ER
cefprozil
ciprofloxacin HCL
cefuroxime axetil
levofloxacin
Cefaclor
ofloxacin
Cefaclor ER
Ciprofloxacin HCL
TIER 03 NON-PREFERRED BRAND
Ofloxacin
Ceftin
TIER 02 NON-PREFERRED GENERIC
THIRD GENERATION
ciprofloxacin
TIER 01 PREFERRED GENERIC
moxifloxacin HCL
cefdinir
Levofloxacin
cefpodoxime proxetil
TIER 03 NON-PREFERRED BRAND
TIER 02 NON-PREFERRED GENERIC
Factive
cefixime
Cefditoren Pivoxil
AMINOGLYCOSIDES
Ceftibuten
TIER 01 PREFERRED GENERIC
Ceftriaxone Sodium
neomycin sulfate
TIER 03 NON-PREFERRED BRAND
paromomycin sulfate
Cedax
TIER 04 SPECIALTY
Suprax
tobramycin
tobramycin inhalation solution PAK
MACROLIDES
Bethkis
TIER 01 PREFERRED GENERIC
Tobi PodhalerPA
azithromycin
clarithromycin
SULFONAMIDES
clarithromycin ER
TIER 02 NON-PREFERRED GENERIC
erythromycin
Sulfadiazine
Azithromycin
Clarithromycin
ANTIMYCOBACTERIAL AGENTS
E.e.s. 400
Erythromycin Base
TIER 01 PREFERRED GENERIC
Erythromycin Ethylsuccinate
ethambutol HCL
TIER 02 NON-PREFERRED GENERIC
isoniazid
erythromycin ethylsuccinate
pyrazinamide
TIER 03 NON-PREFERRED BRAND
rifampin
DificidPA
Isoniazid
Ery-TAB
TIER 02 NON-PREFERRED GENERIC
Eryped 400
rifabutin
Cycloserine
TIER 03
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 1
NON-PREFERRED BRAND
EpclusaPA
Paser
Epivir HBV
Priftin
Evotaz
Rifamate
Fuzeon
Rifater
Genvoya
SirturoPA
HarvoniPA
Trecator
Hepsera
Intelence
ANTIFUNGALS
Invirase
Isentress
TIER 01 PREFERRED GENERIC
Isentress HD
bio-statin
Kaletra
fluconazole
Lexiva
griseofulvin microsize
Moderiba
griseofulvin ultramicrosize
Nevirapine
itraconazole
Norvir
ketoconazole
Odefsey
nystatin
OlysioPA
terbinafine HCL
Peg-intron
voriconazole
Peg-intron Redipen
Peg-intron Redipen PAK 4
TIER 02 NON-PREFERRED GENERIC
Pegasys
flucytosine
Pegasys Proclick
TIER 03 NON-PREFERRED BRAND
Pegintron
Bio-statin
Prezcobix
Cresemba
Prezista
Noxafil
Rebetol
Onmel
Rescriptor
Sporanox
Retrovir IV Infusion
Reyataz
ANTIVIRALS
Ribasphere
TIER 01 PREFERRED GENERIC
Ribasphere Ribapak
acyclovir
Ribatab
famciclovir
Selzentry
rimantadine HCL
SovaldiPA
valacyclovir HCL
Stribild
TIER 02 NON-PREFERRED GENERIC
Sustiva
oseltamivir phosphateQL
TechniviePA
TIER 03 NON-PREFERRED BRAND
Tivicay
Relenza DiskhalerQL
Triumeq
TamifluQL
Truvada
TIER 04 SPECIALTY
Tybost
abacavir
Tyzeka
abacavir sulfate/lamivudine/zidovudine
Vemlidy
abacavir/lamivudine
Victrelis
adefovir dipivoxil
Videx Pediatric
didanosine
Viekira PAKPA
entecavir
Viekira XRPA
fosamprenavir calcium
Viracept
lamivudine
Virazole
lamivudine/zidovudine
Viread
lopinavir/ritonavir
Vitekta
moderiba
ZepatierPA
nevirapine
Ziagen
nevirapine ER
ribasphere
ANTIMALARIALS
ribavirin
TIER 01 PREFERRED GENERIC
stavudine
chloroquine phosphate
valganciclovir
hydroxychloroquine sulfate
valganciclovir hydrochlorde
mefloquine HCL
zidovudine
Chloroquine Phosphate
Aptivus
Primaquine Phosphate
Atripla
TIER 02 NON-PREFERRED GENERIC
Baraclude
atovaquone/proguanil HCL
Complera
quinine sulfate
Crixivan
TIER 03 NON-PREFERRED BRAND
DaklinzaPA
Coartem
Descovy
DaraprimPA
Edurant
Emtriva
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 2
ANTHELMINTICS
PREFERRED BRAND
Trexall
TIER 01 PREFERRED GENERIC
TIER 04 SPECIALTY
ivermectin
capecitabine
TIER 02 PREFERRED BRAND
Purixan
pin-x
Tabloid
pinworm medicine
reeses pinworm medicine
HORMONAL AGENTS
AlbenzaST
EmvermST
FORMULARY FORMULARY
Pin-x
tamoxifen citrate
Reeses Pinworm Medicine
TIER 01 PREFERRED GENERIC
TIER 03 NON-PREFERRED BRAND
anastrozole
Biltricide
bicalutamide
StromectolST
exemestane
flutamide
MISC. ANTI-INFECTIVES
letrozole
megestrol acetate
TIER 01 PREFERRED GENERIC
nilutamide
clindamycin palmitate HCL
TIER 02 PREFERRED BRAND
clindamycin HCL
Emcyt
dapsone
Fareston
linezolid
TIER 03 NON-PREFERRED BRAND
metronidazole
Depo-provera
sulfamethoxazole/trimethoprim
Soltamox
sulfamethoxazole/trimethoprim DS
TIER 04 SPECIALTY
sulfatrim pediatric
Firmagon
tinidazole
Lysodren
trimethoprim
Xtandi
vancomycin HCL
Zytiga
TIER 02 NON-PREFERRED GENERIC
atovaquone
IMMUNOMODULATORS
vancomycin
PREFERRED BRAND
TIER 01 PREFERRED GENERIC
Alinia
azathioprine
Nebupent
cyclosporine
TIER 03 NON-PREFERRED BRAND
cyclosporine modified
Impavido
gengraf
Ketek
mycophenolate mofetil
Primsol
mycophenolic acid DR
XifaxanQL,PA
tacrolimus
ZyvoxST
Cyclosporine Modified
TIER 04 SPECIALTY
TIER 02 NON-PREFERRED GENERIC
Cayston
sirolimus
First-vancomycin 25
PREFERRED BRAND
First-vancomycin 50
Sandimmune
Sivextro
TIER 03 NON-PREFERRED BRAND
Vancomycin HCL + Syrspendsf PH4
Rapamune
TIER 04 SPECIALTY
ANTINEOPLASTICS, ETC.
Envarsus XR
PomalystPA
ALKYLATING AGENTS
RevlimidPA
TIER 01 PREFERRED GENERIC
Thalomid
melphalan
Zortress
TIER 04 SPECIALTY
temozolomide
MITOTIC INHIBITORS
Cyclophosphamide
TIER 04 SPECIALTY
Gleostine
Etoposide
Hexalen
Leukeran
ENZYME INHIBITORS
Lomustine
TIER 04 SPECIALTY
Myleran
imatinib mesylate
Valchlor
Afinitor
Yondelis
Afinitor Disperz
Alecensa
ANTIMETABOLITES
Bosulif
TIER 01 PREFERRED GENERIC
CabometyxQL
mercaptopurine
Caprelsa
methotrexate
CometriqQL
methotrexate sodium
Cotellic
Methotrexate Sodium
Farydak
TIER 02
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 3
Gilotrif
Digoxin
Gleevec
TIER 03 NON-PREFERRED BRAND
IbrancePA
Lanoxin
IclusigPA
Imbruvica
ANTIANGINAL AGENTS
Inlyta
TIER 01 PREFERRED GENERIC
IressaPA
isosorbide dinitrate
Jakafi
isosorbide mononitrate
KisqaliPA
isosorbide mononitrate ER
Lenvima 10 MG Daily Dose
minitran
Lenvima 14 MG Daily Dose
nitro-time
Lenvima 18 MG Daily Dose
nitroglycerin
Lenvima 20 MG Daily Dose
nitroglycerin transdermal
Lenvima 24 MG Daily Dose
nitroglycerin ER
Lenvima 8 MG Daily Dose
Isosorbide Dinitrate ER
Lynparza
TIER 02 NON-PREFERRED GENERIC
Mekinist
nitroglycerin lingual
NexavarPA
Nitroglycerin Lingual
Ninlaro
PREFERRED BRAND
Sprycel
Nitro-bid
StivargaPA
Nitro-dur
SutentPA
Nitrostat
Tafinlar
TIER 03 NON-PREFERRED BRAND
TagrissoPA
Dilatrate SR
Tarceva
Ranexa
Tasigna
TykerbPA
BETA BLOCKERS
Votrient
TIER 01 PREFERRED GENERIC
XalkoriPA
acebutolol HCL
ZelborafPA
atenolol
Zolinza
betaxolol HCL
Zydelig
bisoprolol fumarate
ZykadiaPA
carvedilol
labetalol HCL
TOPOISOMERASE I INHIBITOR
metoprolol succinate ER
TIER 04 SPECIALTY
metoprolol tartrate
Hycamtin
nadolol
Onivyde
propranolol hydrochloride
propranolol HCL
ANTINEOPLASTICS MISC.
propranolol HCL ER
TIER 01 PREFERRED GENERIC
sorine
hydroxyurea
sotalol HCL
tretinoin
sotalol HCL (AF)
TIER 04 SPECIALTY
Metoprolol Tartrate
bexarotene
Propranolol HCL
ActimmunePA
Timolol Maleate
Alferon N
TIER 02 NON-PREFERRED GENERIC
Intron A
pindolol
Intron A W/Diluent
TIER 03 NON-PREFERRED BRAND
Matulane
BystolicST
Sylatron
Hemangeol
CHEMOTHERAPY RESCUE
CALCIUM CHANNEL BLOCKERS
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
leucovorin calcium
afeditab CR
Leucovorin Calcium
amlodipine besylate
TIER 04 SPECIALTY
cartia XT
Mesnex
dilt-XR
diltiazem CD
ANTINEOPLASTIC COMBO
diltiazem HCL
diltiazem HCL CD
TIER 04 SPECIALTY
diltiazem HCL ER
Lonsurf
felodipine ER
isradipine
CARDIOVASCULAR DRUGS
matzim LA
CARDIAC GLYCOSIDES
nicardipine HCL
TIER 01 PREFERRED GENERIC
nifedical XL
digitek
nifedipine
digox
nifedipine ER
digoxin
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 4
nimodipine
NON-PREFERRED GENERIC
nisoldipine ER
Reserpine
taztia XT
TIER 03 NON-PREFERRED BRAND
verapamil HCL
Demser
verapamil HCL ER
Vecamyl
verapamil HCL SR
Nisoldipine ER
ANTIHYPERTENSIVE COMBO
TIER 01 PREFERRED GENERIC
ANTIARRHYTHMICS
amlodipine besylate/benazepril hydrochloride
TIER 01 PREFERRED GENERIC
amlodipine besylate/benazepril HCL
amiodarone HCL
atenolol/chlorthalidone
disopyramide phosphate
benazepril HCL/hydrochlorothiazide
flecainide acetate
bisoprolol fumarate/hydrochlorothiazide
mexiletine HCL
candesartan cilexetil/hydrochlorothiazide
propafenone HCL
enalapril maleate/hydrochlorothiazide
quinidine gluconate CR
fosinopril sodium/hydrochlorothiazide
quinidine gluconate ER
irbesartan/hydrochlorothiazide
quinidine sulfate
lisinopril/hydrochlorothiazide
Quinidine Sulfate
losartan potassium/hydrochlorothiazide
Quinidine Sulfate ER
metoprolol/hydrochlorothiazide
TIER 02 NON-PREFERRED GENERIC
moexipril/hydrochlorothiazide
dofetilide
nadolol/bendroflumethiazide
pacerone
quinapril/hydrochlorothiazide
propafenone HCL ER
valsartan/hydrochlorothiazide
PREFERRED BRAND
Captopril/Hydrochlorothiazide
Multaq
Methyldopa/Hydrochlorothiazide
Metoprolol/Hydrochlorothiazide
ACE INHIBITORS
Propranolol/Hydrochlorothiazide
TIER 02 NON-PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
amlodipine besylate/valsartan
benazepril HCL
amlodipine/olmesartan medoxomil
captopril
amlodipine/valsartan/hctz
enalapril maleate
olmesartan medoxomil/hydrochlorothiazide
fosinopril sodium
telmisartan/amlodipine
lisinopril
telmisartan/hydrochlorothiazide
moexipril HCL
trandolapril/verapamil HCL ER
perindopril erbumine
PREFERRED BRAND
quinapril HCL
Clorpres
ramipril
EdarbyclorST
trandolapril
TIER 03 NON-PREFERRED BRAND
TIER 02 PREFERRED BRAND
Prestalia
Epaned
DIURETICS
ANGIOTENSIN RCPTR BLOCKER
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
acetazolamide
irbesartan
acetazolamide ER
losartan potassium
amiloride HCL
TIER 02 NON-PREFERRED GENERIC
amiloride/hydrochlorothiazide
candesartan cilexetil
bumetanide
olmesartan medoxomil
chlorothiazide
telmisartan
chlorthalidone
valsartan
furosemide
Eprosartan Mesylate
hydrochlorothiazide
PREFERRED BRAND
indapamide
EdarbiST
methazolamide
metolazone
ANTIHYPERTENSIVES MISC.
spironolactone
TIER 01 PREFERRED GENERIC
spironolactone/hydrochlorothiazide
clonidine HCL
torsemide
doxazosin
triamterene/hydrochlorothiazide
doxazosin mesylate
Chlorothiazide
eplerenone
Furosemide
guanfacine HCL
Triamterene/Hydrochlorothiazide
hydralazine HCL
TIER 02 NON-PREFERRED GENERIC
methyldopa
ethacrynic acidPA
minoxidil
Methyclothiazide
phenoxybenzamine hydrochloride
PREFERRED BRAND
prazosin HCL
Diuril
terazosin HCL
Dyrenium
TIER 02
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 5
TIER 03 NON-PREFERRED BRAND
AdcircaPA
Keveyis
AdempasST
Letairis
VASOPRESSORS
Opsumit
Orenitram
TIER 01 PREFERRED GENERIC
RevatioPA
epinephrine HCL
Tracleer
midodrine HCL
Tyvaso
EpinephrineQL
Tyvaso Refill
TIER 02 PREFERRED BRAND
Tyvaso Starter
Epipen 2-PAKQL
UptraviPA
Epipen-JR 2-PAKQL
Ventavis
TIER 04 SPECIALTY
NortheraPA
DERMATOLOGICALS
ANTIHYPERLIPIDEMICS
ACNE PRODUCTS
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
atorvastatin calcium
acne foaming wash
cholestyramine
acne medication 10
cholestyramine light
acne medication 5
colestipol HCL
acne pimple medication maximum strength/vanishing
ezetimibe/simvastatinST
acne treatment gel
fenofibrate
acne-clear
fenofibrate micronized
adapaleneAL
fenofibric acid DR
adapalene P.M.AL
fluvastatin
amnesteem
gemfibrozil
avar cleanser
lovastatin
avitaAL
pravastatin sodium
benzoyl peroxide
prevalite
benzoyl peroxide wash
simvastatin
bp foaming wash
Niacor
bp gel
bp wash
TIER 02 NON-PREFERRED GENERIC
bpo-10 wash
ezetimibe
claravis
fluvastatin sodium ERST
clean & clear persa-gel maximum strength
niacin ER
clearplex v
omega-3-acid ethyl estersPA
clearplex x
rosuvastatin calcium
clindacin etz pledgets
trikloPA
clindacin-p
Fenofibrate
clindamycin phosphate
Fenofibric Acid
ery
PREFERRED BRAND
erythromycin
Welchol
erythromycin/benzoyl peroxide
TIER 03 NON-PREFERRED BRAND
kp benzoyl peroxide
Altoprev
kp benzoyl peroxide wash
LivaloST
myorisan
Omega-3/D-3 Wellness Pack
neuac
Sure Result O3d3 System
panoxyl wash
TIER 04 SPECIALTY
ra renewal medicated acne treatment maximum strength
JuxtapidPA
rosanil cleanser
KynamroPA
sodium sulfacetamide
PraluentQL,PA
sodium sulfacetamide/sulfur
RepathaQL,PA
sulfacetamide sodium
Repatha Pushtronex SystemQL,PA
sulfacetamide sodium/sulfur cleanser
Repatha SureclickQL,PA
tretinoinAL
zenatane
CARDIOVASCULAR - MISC.
CVS acne foaming face wash
TIER 01 PREFERRED GENERIC
CVS acne treatment
amlodipine besylate/atorvastatin calcium
CVS acne treatment/maximum strength
TIER 02 NON-PREFERRED GENERIC
CVS creamy acne face wash
isoxsuprine HCL
CVS foaming acne face wash
Isoxsuprine HCL
DifferinAL
TIER 03 NON-PREFERRED BRAND
Sodium Sulfacetamide/Sulfur
CialisPA
Sodium Sulfacetamide/Sulfur Cleanser IN Urea
CorlanorPA
EntrestoPA
TIER 02 NON-PREFERRED GENERIC
TIER 04 SPECIALTY
adapalene and benzoyl peroxidePA,ST
sildenafilPA
avar-e emollient
sildenafil citratePA
avar-e green
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 6
benzepro creamy wash
PREFERRED GENERIC
benzepro foaming cloths
ciclodan
benzepro SHORT contact
ciclopirox
benzoyl peroxide SHORT contact
ciclopirox nail lacquer
bp foam
ciclopirox olamine
bp 10-1
ciclopirox treatment
bpo 6% foaming cloths
clotrimazole/betamethasone dipropionate
cerisa wash
dermazene
clindamycin phosphate/tretinoin
econazole nitrate
clindamycin/benzoyl peroxide
hydrocortisone/iodoquinol
pr benzoyl peroxide wash
ketoconazole
sodium sulfacetamide/sulfur cleanser
nyamyc
sodium sulfacetamide/sulfur green
nyata
sodium sulfacetamide/sulfur w/sunscreen
nystatin
sodium sulfacetamide/sulfur wash
nystatin/triamcinolone
sss 10%-5%
nystop
sulfacetamide sodium/sulfur
TIER 02 NON-PREFERRED GENERIC
sulfacleanse 8/4
hydrocortisone acetate & iodoquinol
tretinoin microsphereST
ketodan
tretinoin microsphere P.M.ST
naftifine hydrochloride
zencia
naftifine HCL
AdapaleneAL
oxiconazole nitrate
Bp Cleansing Wash
Exoderm
Sodium Sulfacetamide/Sulfur IN Urea
TIER 03 NON-PREFERRED BRAND
Sss 10-5
Ala-quin
Zaclir Cleansing
Ciclodan Cream Kit
PREFERRED BRAND
Ciclodan Solution Kit
Desquam-x Wash
Dermasorb AF
Panoxyl-4 Creamy Wash
ErtaczoST
TIER 03 NON-PREFERRED BRAND
ExeldermST
Aktipak
JubliaPA
Avar
KerydinPA
Avar LS
Ketodan Kit
Avar LS Cleanser
Loprox
Benzamycin
LuzuST
Clindacin Etz
Mentax
Clindacin PAC
NaftinST
Epiduo ForteST
OxistatST
Inova
Pediaderm AF Complete Kit
Neuac KitST
Penlac Nail Lacquer
Rosula
Xolegel Corepak
Zacare 4% Kit
ANTIVIRALS - TOPICAL
ROSACEA AGENTS
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
acyclovir
metronidazole
TIER 03 NON-PREFERRED BRAND
rosadan
DenavirST
TIER 02 NON-PREFERRED GENERIC
DoxycyclineST
ANTI-INFLAMMATORY AGENTS
TIER 03 NON-PREFERRED BRAND
TIER 02 NON-PREFERRED GENERIC
Metronidazole
diclofenac sodium
MirvasoPA
klofensaid II
Rosadan Kit
TIER 03 NON-PREFERRED BRAND
Lexixryl
ANTIBIOTICS - TOPICAL
Xrylix
TIER 01 PREFERRED GENERIC
gentamicin sulfate
ANTIPRURITICS
Gentamicin Sulfate
TIER 02 NON-PREFERRED GENERIC
TIER 02 NON-PREFERRED GENERIC
Doxepin Hydrochloride
mupirocin
TIER 03 NON-PREFERRED BRAND
mupirocin calcium
Zonalon
TIER 03 NON-PREFERRED BRAND
Altabax
ANTIPSORIATICS
Centany AT
TIER 01 PREFERRED GENERIC
Neo-synalar
calcipotriene
Neo-synalar Kit
TIER 02 NON-PREFERRED GENERIC
acitretin
ANTIFUNGALS - TOPICAL
calcitrene
TIER 01
methoxsalen
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 7
tazaroteneST
Apexicon EST
Calcitriol
Clocortolone Pivalate
Dritho-creme HP
Clocortolone Pivalate P.M.
PREFERRED BRAND
Halac
8-mop
TIER 03 NON-PREFERRED BRAND
TIER 03 NON-PREFERRED BRAND
CapexST
SoriataneST
Clodan Kit
TazoracST
Cortane-b
Zithranol
Dermasorb HCST
Zithranol-rr
Dermasorb TaST
TIER 04 SPECIALTY
Dermazone
CosentyxPA
DesowenST
Cosentyx Sensoready PenPA
EnstilarST
StelaraPA
Epifoam
TaltzPA
HalogST
Nucort
ANTISEBORRHEIC AGENTS
PandelST
Pediaderm HCST
TIER 01 PREFERRED GENERIC
Pediaderm TaST
seb-prev wash
Silazone Pharmapak
selenium sulfide
Silazone-II
sodium sulfacetamide wash
Synalar Cream Kit
TIER 02 NON-PREFERRED GENERIC
Synalar Ointment Kit
sodium sulfacetamide
TexacortST
TIER 03 NON-PREFERRED BRAND
TrianexST
Sodium Sulfacetamide Wash
TridesilonST
CORTICOSTEROIDS - TOPICAL
IMMUNOMODULATING AGENTS
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
ala-cort
imiquimod
alclometasone dipropionate
TIER 02 NON-PREFERRED GENERIC
alphatrex
tacrolimus
augmented betamethasone dipropionate
PREFERRED BRAND
betamethasone dipropionate
Elidel
betamethasone dipropionate/augmented
betamethasone valerate
DERMATOLOGICALS - MISC.
clobetasol propionate
clobetasol propionate e
TIER 01 PREFERRED GENERIC
clobetasol propionate emollient
agoneaze
cormax scalp application
anodyne lpt
desonide
dermacinrx empricaine
desoximetasone
dermacinrx prizopak
fluocinolone acetonide
lactic acid
fluocinonide
lactic acid e
fluocinonide emulsified base
lactic acid w/vitamin e
fluticasone propionate
latrix
halobetasol propionate
leva set
hydrocortisone
leva set/occlusive dressing
hydrocortisone butyrate
lido bdk
hydrocortisone butyrate (lipid)ST
lido-prilo caine pack
hydrocortisone butyrate (lipophilic)ST
lidocaine
hydrocortisone valerate
lidocaine HCL
lokara
lidocaine PAK
mometasone furoate
lidocaine-prilocaine-cream base
prednicarbate
lidocaine/prilocaine
triamcinolone acetonide
lidopril
triderm
lidopril XR
Amcinonide
liprozonepak
Diflorasone Diacetate
livixil PAK
Synalar
medolor PAK
permethrin
TIER 02 NON-PREFERRED GENERIC
podofilox
calcipotriene/betamethasone dipropionateST
premium lidocaine
clodan
prilolid
fluocinolone acetonide body
priloxx LP
fluocinolone acetonide scalp
rea LO 40
flurandrenolideST
relador PAK
hydrocortisone acetate/pramoxine
relador PAK plus
nolixST
remeven
scalacort
salacyn
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 8
salicylic acid lotion
HPR
salitech forte
HPR Plus
ure-k
Kamdoy
urea
Ldo Plus
Lidocaine HCL
Lido-k
LindaneST
Lido-RX 4.1
LP lite PAK
Lidocin
Lidopin
TIER 02 NON-PREFERRED GENERIC
Lidorx
cerovel
Lidothol
cidaleaze
Lidotral
ethyl chloride
Lidovex
lidopin
Lidozol
lindaneST
Neosalus
malathion
Neosalus CP
rea LO 39
Nivatopic Plus
salicylic acid
Oxsoralen
salicylic acid cream
Phlag Spray
salicylic acid wart remover
Presera
salicylic acid ER
Pruclair
salisol forte
Prumyx
sodium hyaluronate
Qutenza
umecta mousse
Ra Saline Wound Wash
ure-39
Renuu Patch
urea hydrating
Safe Wash
urea nail
Saline Wound Wash
urea nail gel
Saljet
urea 40% nail film
Saljet Rinse
urea-c40
Salvax
Cem-urea
Salvax Duo Plus
Coal TAR
Silvera Pain Relief
Ethyl Chloride
SkliceST
Ethyl Chloride/Fine Pinpoint
Synera
Ethyl Chloride/Fine Stream
Synerderm
Ethyl Chloride/Medium Jet Stream
Synvexia Tc
Ethyl Chloride/Medium Stream
Tranzarel
Ethyl Chloride/Mist
UlesfiaPA
Latrix XM
Ultrasal-ER
Lidocaine And Tetracaine Cream
Umecta
Podocon 25 IN Benzoin Tincture
Umecta Nail FilmST
Pyrogallic Acid
Umecta PD
Relyyks
Urevaz
Scar Patch
Utopic
Spinosad
Velma Pain Relief
Tetrix
Veltrix
Tretinoin EmollientPA
Wound Wash Saline
Uramaxin
Xeralux
Urea IN Zinc Undecylenate/Lactic Acid Vehicle
Urea Nail Kit
ENDOCRINE AND METABOLIC
Urea Topical
CORTICOSTEROIDS
PREFERRED BRAND
TIER 01 PREFERRED GENERIC
regenecare HA
budesonide
TIER 03 NON-PREFERRED BRAND
dexamethasone
Accucaine
fludrocortisone acetate
Adazin
hydrocortisone
Anacaine
methylprednisolone
Astero
methylprednisolone dose pack
Atopiclair
prednisolone
Avaderm
prednisolone sodium phosphate
Ceracade
prednisone
CVS Saline Wound Wash
Cortisone Acetate
Dexeryl
Dexamethasone
Eletone
Prednisone
Eletone Twinpack
TIER 02 NON-PREFERRED GENERIC
Emulsion SB
deltasone
Entty Spray Emulsion
prednisolone sodium phosphate odt
Epiceram
Prednisolone Sodium Phosphate
EuraxST
PREFERRED BRAND
Gnp Saline Wound Wash
Dexamethasone Intensol
Hylatopic Plus
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 9
Prednisone Intensol
altavera
TIER 03 NON-PREFERRED BRAND
alyacen 1/35
Dexpak 10 DayST
alyacen 7/7/7
Dexpak 13 DayST
amethia
Dexpak 6 DayST
amethia LO
Medrol Dosepak
amethyst
Millipred DP
apri
RayosST
aranelle
Zodex 6-dayST
ashlyna
aubra
ANDROGENS-ANABOLIC
aviane
azurette
TIER 01 PREFERRED GENERIC
balziva
methyltestosterone
bekyree
oxandrolone
blisovi FE 1.5/30
testosteronePA
blisovi FE 1/20
testosterone P.M.PA
blisovi 24 FE
Testosterone P.M.PA
briellyn
TIER 02 NON-PREFERRED GENERIC
camila
danazol
camrese
testosterone topical solutionPA
camrese LO
TestosteronePA
caziant
PREFERRED BRAND
chateal
AndrogelPA
cryselle-28
Androgel P.M.PA
cyclafem 1/35
Androxy
cyclafem 7/7/7
TIER 03 NON-PREFERRED BRAND
cyred
Anadrol-50
dasetta 1/35
Methitest
dasetta 7/7/7
daysee
ESTROGENS
deblitane
TIER 01 PREFERRED GENERIC
delyla
amabelz
desogestrel/ethinyl estradiol
eemt
drospirenone/ethinyl estradiol
eemt HS
drospirenone/ethinyl estradiol/levomefolate calcium
esterified estrogens/methltestosterone
econtra EZ
esterified estrogens/methyltestosterone
elinest
esterified estrogens/methyltestosterone DS
emoquette
esterified estrogens/methyltestosterone HS
enpresse-28
estradiol
enskyce
estradiol/norethindrone acetate
errin
lopreeza
estarylla
mimvey
ethynodiol diacetate/ethinyl estradiol
mimvey LO
fallback solo
Estropipate
falmina
fayosim
TIER 02 NON-PREFERRED GENERIC
femynor
covaryx
gianvi
covaryx HS
gildagia
fyavolv
gildess FE 1.5/30
jevantique LO
gildess FE 1/20
jinteli
gildess 1.5/30
norethindrone acetate/ethinyl estradiol
gildess 1/20
PREFERRED BRAND
gildess 24 FE
Prefest
heather
Premarin
introvale
Premphase
isibloom
Prempro
jencycla
TIER 03 NON-PREFERRED BRAND
jolessa
Alora
jolivette
Combipatch
juleber
Duavee
junel FE 1.5/30
Enjuvia
junel FE 1/20
Menest
junel FE 24
Minivelle
junel 1.5/30
Vivelle-dot
junel 1/20
kaitlib FE
CONTRACEPTIVES
kariva
FORMULARY FORMULARY
kelnor 1/35
aftera
kimidess
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 10
kurvelo
sronyx
larin FE 1.5/30
syeda
larin FE 1/20
take action
larin 1.5/30
tarina FE 1/20
larin 1/20
tilia FE
larin 24 FE
tri femynor
larissia
tri-estarylla
layolis FE
tri-legest FE
leena
tri-linyah
lessina
tri-previfem
levonest
tri-sprintec
levonorgestrel
tri-LO-estarylla
levonorgestrel and ethinyl estradiol
tri-LO-marzia
levonorgestrel/ethinyl estradiol
tri-LO-sprintec
levora 0.15/30-28
trinessa
lillow
trinessa LO
lomedia 24 FE
trivora-28
loryna
velivet
low-ogestrel
vestura
lutera
vienva
lyza
viorele
marlissa
vyfemla
medroxyprogesterone acetate
wera
melodetta 24 FE
wymzya FE
mibelas 24 FE
zarah
microgestin FE
zenchent
microgestin FE 1.5/30
zenchent FE
microgestin 1.5/30
zovia 1/35e
microgestin 1/20
zovia 1/50e
microgestin 24 FE
Ella
mono-linyah
Levonorgestrel And Ethinyl Estradiol
mononessa
Necon 1/50-28
my way
Nuvaring
myzilra
Ogestrel
necon 0.5/35-28
Xulane
necon 1/35
TIER 03 NON-PREFERRED BRAND
necon 10/11-28
Falessa
necon 7/7/7
LO Loestrin FE
next choice one dose
Natazia
nikki
Nor-QD
nora-be
Ortho Micronor
norethindrone
Safyral
norethindrone & ethinyl estradiol ferrous fumarate
norethindrone acetate/ethinyl estradiol
PROGESTINS
norethindrone acetate/ethinyl estradiol/ferrous fumarate
TIER 01 PREFERRED GENERIC
norethindrone/ethinyl estradiol/ferrous fumarate
medroxyprogesterone acetate
norgestimate/ethinyl estradiol
norethindrone acetate
norlyda
progesterone
norlyroc
TIER 02 NON-PREFERRED GENERIC
nortrel 0.5/35 (28)
megestrol acetate
nortrel 1/35
nortrel 7/7/7
ANTIDIABETIC AGENTS
ocella
INSULIN
opcicon one-step
TIER 02 PREFERRED BRAND
option 2
Humalog
orsythia
Humalog Junior Kwikpen
philith
Humalog Kwikpen
pimtrea
Humalog Mix 50/50
pirmella 1/35
Humalog Mix 50/50 Kwikpen
pirmella 7/7/7
Humalog Mix 75/25
portia-28
Humalog Mix 75/25 Kwikpen
previfem
Humulin N
quasense
Humulin N Kwikpen
rajani
Humulin R
react
Humulin R U-500 (concentrated)
reclipsen
Humulin R U-500 Kwikpen
rivelsa
Humulin 70/30
setlakin
Humulin 70/30 Kwikpen
sharobel
Lantus
sprintec 28
Lantus Solostar
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 11
Toujeo Solostar
Tradjenta
TIER 03 NON-PREFERRED BRAND
TIER 03 NON-PREFERRED BRAND
ApidraST
AlogliptinST
Apidra SolostarST
NesinaST
LevemirST
OnglyzaST
Levemir FlextouchST
INSULIN SENSITIZING AGENT
Novolog Mix 70/30ST
TIER 01 PREFERRED GENERIC
Novolog Mix 70/30 Prefilled FlexpenST
pioglitazone HCL
Tresiba FlextouchST
TIER 03 NON-PREFERRED BRAND
AMYLIN ANALOGS
Avandia
TIER 03 NON-PREFERRED BRAND
ANTIDIABETIC COMBINATIONS
Symlinpen 120
TIER 01 PREFERRED GENERIC
Symlinpen 60
glipizide/metformin HCL
INCRETIN MIMETIC AGENTS
glyburide/metformin HCL
TIER 02 PREFERRED BRAND
pioglitazone HCL/metformin HCL
Bydureon
TIER 02 NON-PREFERRED GENERIC
Bydureon Pen
pioglitazone HCL-glimepiride
Byetta
Repaglinide/Metformin Hydrochloride
Trulicity
PREFERRED BRAND
VictozaQL
Invokamet
TIER 03 NON-PREFERRED BRAND
Invokamet XR
AdlyxinST
Janumet
Adlyxin Starter PackST
Janumet XR
TanzeumST
Jentadueto
SULFONYLUREAS
Jentadueto XR
TIER 01 PREFERRED GENERIC
Soliqua 100/33QL,ST
glimepiride
Synjardy
glipizide
Synjardy XR
glipizide ER
TIER 03 NON-PREFERRED BRAND
glipizide XL
GlyxambiST
glyburide
Xigduo XRST
glyburide micronized
Chlorpropamide
BISPHOSPHONATES
TIER 02 NON-PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
Tolazamide
alendronate sodium
Tolbutamide
ibandronate sodium
BIGUANIDES
Alendronate Sodium
TIER 01 PREFERRED GENERIC
Etidronate Disodium
metformin hydrochloride
TIER 02 NON-PREFERRED GENERIC
metformin HCL
risedronate sodium
metformin HCL ER
risedronate sodium DR
TIER 03 NON-PREFERRED BRAND
PREFERRED BRAND
Riomet
Fosamax Plus D
MEGLITINIDE ANALOGUES
TIER 03 NON-PREFERRED BRAND
TIER 01 PREFERRED GENERIC
Binosto
nateglinide
TIER 02 NON-PREFERRED GENERIC
CALCITONINS
repaglinide
TIER 01 PREFERRED GENERIC
TIER 03 NON-PREFERRED BRAND
calcitonin salmon
PrandinST
calcitonin-salmon
DIABETIC OTHER
TIER 02 PREFERRED BRAND
PARATHYROID HORMONE
Glucagen Hypokit
TIER 04 SPECIALTY
Glucagon Emergency Kit
Forteo
Invokana
NatparaPA
Jardiance
TIER 03 NON-PREFERRED BRAND
HORMONE RECEPTOR MDLTR
Cycloset
FORMULARY FORMULARY
FarxigaST
raloxifene hydrochloride
Proglycem
TIER 03 NON-PREFERRED BRAND
TIER 04 SPECIALTY
Evista
KorlymPA
OsphenaST
ALPHA-GLUCOSIDASE INHIBIT
TIER 01 PREFERRED GENERIC
FERTILITY REGULATORS
acarbose
TIER 04 SPECIALTY
TIER 02 NON-PREFERRED GENERIC
Chorionic Gonadotropin
miglitol
Novarel
DPP-4 INHIBITORS
Pregnyl W/Diluent Benzyl Alcohol/NACL
TIER 02 PREFERRED BRAND
Januvia
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 12
GROWTH HORMONES
NON-PREFERRED BRAND
ZemplarST
TIER 04 SPECIALTY
TIER 04 SPECIALTY
GenotropinPA
sodium phenylbutyrate
Genotropin MiniquickPA
Buphenyl
HumatropePA
Carbaglu
Humatrope Combo PackPA
Cystadane
Norditropin CartridgePA
KuvanPA
Norditropin FlexproPA
MyaleptPA
Nutropin AQ Nuspin 10PA
Orfadin
Nutropin AQ Nuspin 20PA
Ravicti
Nutropin AQ Nuspin 5PA
Strensiq
Nutropin AQ PenPA
Xuriden
OmnitropePA
SaizenPA
Saizen Click.easyPA
THYROID AGENTS
Saizenprep ReconstitutionkitPA
SerostimPA
TIER 01 PREFERRED GENERIC
ZomactonPA
levo-t
ZorbtivePA
levothyroxine sodium
levothyroxine sodium TAB 0.075MG
GHRH
levoxyl
liothyronine sodium
TIER 04 SPECIALTY
methimazole
EgriftaPA
propylthiouracil
unithroid
SOMATOMEDINS
unithroid direct
TIER 04 SPECIALTY
Nature-throid
IncrelexPA
NP thyroid
TIER 02 NON-PREFERRED GENERIC
SOMATOSTATIC AGENTS
NP thyroid 30
TIER 04 SPECIALTY
NP thyroid 60
SigniforPA
NP thyroid 90
Westhroid
GH RECEPTOR ANTAGONISTS
PREFERRED BRAND
TIER 04 SPECIALTY
Armour Thyroid
Somavert
Nature-throid Nt-2.5
Wp Thyroid
POSTERIOR PITUITARY
TIER 03 NON-PREFERRED BRAND
TIER 01 PREFERRED GENERIC
Synthroid
desmopressin acetate
Thyrolar-1
TIER 04 SPECIALTY
Thyrolar-1/2
Stimate
Thyrolar-1/4
Thyrolar-2
CORTICOTROPIN
Thyrolar-3
TIER 04 SPECIALTY
H.p. ActharPA
GASTROINTESTINAL
LAXATIVES
PROLACTIN INHIBITORS
FORMULARY FORMULARY
TIER 01 PREFERRED GENERIC
clearlax
cabergoline
dulcolax balance
eq clearlax
VASOPRESSIN ANTAGONISTS
eql clearlax
TIER 04 SPECIALTY
gavilax
SamscaPA
gavilyte-c
gavilyte-n/flavor pack
PROGESTERONE ANTAGONISTS
gavilyte-G
TIER 03 NON-PREFERRED BRAND
gentlelax
Mifeprex
glycolax
gnp clearlax
METABOLIC MODIFIERS
kls laxaclear
TIER 01 PREFERRED GENERIC
laxative polyethlyene glycol 3350
calcitriol
peg 3350
TIER 02 NON-PREFERRED GENERIC
peg 3350/electrolytes
doxercalciferol
peg-3350/electrolytes
levocarnitine
peg-3350/NACL/NA bicarbonate/KCL
paricalcitol
pegylax
PREFERRED BRAND
peg3350
Sensipar
polyethylene glycol 3350
TIER 03
polyethylene glycol 3350-grx
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 13
qc natura-LAX
lansoprazole/amoxicillin/clarithromycin
ra laxative
omeppiST
sm clearlax
omeprazole/sodium bicarbonateST
smooth LAX
rabeprazole sodium
sw clearlax
Belladonna & Opium
tgt powderlax
Belladonna Alkaloids & Opium
trilyte
Nizatidine
CVS purelax
Propantheline Bromide
HM clearlax
TIER 03 NON-PREFERRED BRAND
SB polyethylene glycol 3 350
Aciphex Sprinkle
TIER 01 PREFERRED GENERIC
Cantil
constulose
Carafate
lactulose
Cuvposa
TIER 02 NON-PREFERRED GENERIC
DexilantST
gavilyte-h
Donnatal
peg-prep
Omeclamox-PAK
TIER 03 NON-PREFERRED BRAND
Protonix
Moviprep
Robinul
Osmoprep
Robinul Forte
Prepopik
TIER 04 SPECIALTY
Suprep Bowel Prep Kit
First-lansoprazole
First-omeprazole
ANTIDIARRHEALS
Omeprazole + Syrspend SF Alka
TIER 01 PREFERRED GENERIC
ANTIEMETICS
diphenoxylate/atropine
Paregoric
TIER 01 PREFERRED GENERIC
TIER 02 NON-PREFERRED GENERIC
dronabinol
opium
granisetron HCLQL
opium tincture
meclizine HCL
Diphenoxylate/Atropine
ondansetron odt
TIER 03 NON-PREFERRED BRAND
ondansetron HCL
Motofen
scopolamine
Restora RX
trimethobenzamide HCL
TIER 04 SPECIALTY
TIER 02 NON-PREFERRED GENERIC
FulyzaqPA
aprepitantQL
TIER 03 NON-PREFERRED BRAND
ULCER DRUGS
AkynzeoQL
AnzemetQL
TIER 01 PREFERRED GENERIC
Cesamet
b-donna
VarubiQL
belladonna alkaloids/phenobarbital
cimetidine
DIGESTIVE AIDS
cimetidine HCL
dicyclomine HCL
TIER 01 PREFERRED GENERIC
ed-spaz
Pancrelipase
famotidine
TIER 02 PREFERRED BRAND
glycopyrrolate
Creon
hyoscyamine sulfate
Pancreaze
hyoscyamine sulfate odt
Pertzye
hyoscyamine sulfate ER
Ultresa
hyoscyamine sulfate SR
Viokace
hyosyne
Zenpep
lansoprazole
TIER 04 SPECIALTY
methscopolamine bromide
SucraidQL,PA
misoprostol
nizatidine
GASTROINTESTINAL - MISC.
nulev
TIER 01 PREFERRED GENERIC
omeprazole
ana-lex
oscimin
anucort-HC
oscimin SR
anusol-HC
pantoprazole sodium
balsalazide disodium
phenohytro
calcium acetateQL
ranitidine HCL
colocort
sucralfate
cromolyn sodium
symax-SL
enulose
symax-SR
generlac
hemmorex-HC
TIER 02 NON-PREFERRED GENERIC
hydrocortisone
chlordiazepoxide HCL/clidinium bromide
hydrocortisone acetate
esomeprazole magnesiumST
hydrocortisone acetate/pramoxine
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 14
lactulose
ur n-c
lidocaine HCL/hydrocortisone acetate
uramit mb
mesalamine
urelle
metoclopramide HCL
uretron d/s
procto-MED HC
uribel
procto-PAK
urin d/s
proctosol HC
uro-blue
proctozone-HC
uro-l
sulfasalazine
uro-mp
ursodiol
uro-458
Mesalamine DR
uroav-b
TIER 02 NON-PREFERRED GENERIC
uroav-81
alosetron hydrochloride
urophen mb
hydrocortisone acetate/pramoxine HCL
ustell
mesalamine DR
uta
pramcort
uticap
sevelamer carbonateQL
utira-c
Lidocaine HCL-hydrocortisone Acetate With Aloe
utrona-c
Metoclopramide OdtST
Methenamine Mandelate
PREFERRED BRAND
Urimar-t
AuryxiaQL,ST
TIER 03 NON-PREFERRED BRAND
Canasa
Monurol
Delzicol
Dipentum
URINARY ANTISPASMODICS
Pentasa
TIER 01 PREFERRED GENERIC
Proctofoam HC
bethanechol chloride
Sfrowasa
flavoxate HCL
TIER 03 NON-PREFERRED BRAND
oxybutynin chloride
Apriso
oxybutynin chloride ER
Entereg
tolterodine tartrate
FosrenolQL,ST
trospium chloride ER
Giazo
TIER 02 NON-PREFERRED GENERIC
Linzess
darifenacin hydrobromide ERST
LotronexST
tolterodine tartrate ER
PhoslyraQL
trospium chloride
Rectiv
PREFERRED BRAND
RelistorPA
Oxytrol For Women
RenagelQL
TIER 03 NON-PREFERRED BRAND
RenvelaQL
EnablexST
Rowasa
GelniqueST
Uceris
Gelnique P.M.ST
VelphoroQL,ST
MyrbetriqST
Viberzi
Oxytrol
TIER 04 SPECIALTY
ToviazST
Chenodal
UrecholineST
Cholbam
VesicareST
CimziaPA
Cimzia Starter KitPA
VAGINAL PRODUCTS
GattexPA
FORMULARY FORMULARY
Ocaliva
vcf vaginal contraceptive foam
vcf vaginal contraceptivegel
GENITOURINARY
Encare
URINARY ANTI-INFECTIVES
Options Gynol II Vaginal Contraceptive
Shur-seal
TIER 01 PREFERRED GENERIC
Today Sponge
me/naphos/mb/hyo 1
Vcf Vaginal Contraceptive Film
nitrofurantoin macrocrystals
Vcf Vaginal Contraceptive Foam
nitrofurantoin monohydrate
TIER 01 PREFERRED GENERIC
nitrofurantoin monohydrate/macrocrystals
clindamycin phosphate
urolet mb
metronidazole vaginal
uryl
terconazole
TIER 02 NON-PREFERRED GENERIC
vandazole
azuphen mb
zazole
hyolev mb
Miconazole 3
hyophen
TIER 02 NON-PREFERRED GENERIC
indiomin mb
estradiol
methenamine hippurate
yuvafem
methenamine mandelate
PREFERRED BRAND
nitrofurantoin
Cleocin
phosphasal
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 15
Premarin
tricon
TIER 03 NON-PREFERRED BRAND
trigels-f forte
Avc
virt-gard
Fem PH
virt-vite
Gynazole-1
AV-vite fb
Intrarosa
Bp Vit 3
Relagard
TL gard RX
TIER 04 SPECIALTY
TL icon
CrinonePA
TIER 02 NON-PREFERRED GENERIC
corvita 150
GENITOURINARY - MISC.
k-tan plus
purevit dualfe plus
TIER 01 PREFERRED GENERIC
se-tan plus
alfuzosin HCL ER
B-12 Kit
argyle sterile saline 100ML
Ferraplus 90
curity sterile saline
Hematogen Fa
cytra k crystals
Multigen
finasteride
Multigen Folic
phenazo
Multigen Plus
phenazopyridine HCL
Tandem F
potassium citrate ER
PREFERRED BRAND
potassium citrate-citric acid crystals
ferate
potassium citrate/citric acid
fergon
sodium chloride
ferrotabs
sodium chloride 0.9%
ferrous gluconate
sodium citrate/citric acid
iron
tamsulosin HCL
iron 27
taron-crystals
CVS iron
virtrate-k
TIER 03 NON-PREFERRED BRAND
virtrate-2
Abaneu-SL
Active FE
TIER 02 NON-PREFERRED GENERIC
Animi-3
dutasteride
Animi-3/Vitamin D
dutasteride/tamsulosin hydrochloride
B-12 Compliance Injectionkit
dutasteride/tamsulosin HCL
Bp Vit 3 Plus
potassium citrate/sodium citrate/citric acid
Cenfol
tricitrates
Centratex
virtrate-3
Ciferex
PREFERRED BRAND
Cifrazol
Rimso-50
Dermacinrx Purefolix
TIER 03 NON-PREFERRED BRAND
Divista
Elmiron
Droxia
Lithostat
Durachol
Oracit
Feriva
PyridiumST
Ferro-plex Hematinic
RapafloST
Ferrotrin
TIER 04 SPECIALTY
Folivane-plus
Cystagon
Folixapure
Procysbi
Hemocyte Plus
Thiola
Integra Plus
Maxfe
HEMATOLOGICAL AGENTS
Nephron Fa
HEMATOPOIETIC AGENTS
Neurin-SL
TIER 01 PREFERRED GENERIC
Noxifol-d
airavite
Ortho D
cyanocobalamin
Physicians EZ Use B-12 Compliance Kit
fabb
Pre-folic
ferocon
Proferrin-forte
ferotrinsic
Protectiron
ferrocite plus
Purefe Plus
folbee
Revesta
folic acid/vitamin b-6/vitamin b-12
Roxifol-d
folplex 2.2
Vitamin Deficiency Injectable System-b12
foltrin
Zavara
hematinic plus vitamins/minerals
Zolate
hematinic/folic acid
TIER 04 SPECIALTY
hematogen forte
Aranesp Albumin FreePA
hemocyte-f
Cerdelga
hemocyte-plus
EpogenPA
nufol
GranixPA
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 16
LeukinePA
cevimeline HCL
Mircera
chlorhexidine gluconate
NeulastaPA
chlorhexidine gluconate oral rinse
Neulasta Onpro KitPA
clotrimazole
NeupogenPA
controlrx
ProcritPA
denta 5000 plus
PromactaPA
dentagel
ZarxioPA
fluoridex daily defense
Zavesca
fluoridex daily defense enhanced whitening
karigel
ANTICOAGULANTS
karigel-n
lidocaine viscousAL
TIER 01 PREFERRED GENERIC
lidocaine HCL viscousAL
heparin lock flush
neutragard advanced
heparin lock flush for flushing vascular access devices
oralone dental paste
heparin lock flush/NACL for flushing vascular access devices
paroex
heparin sodium
periogard
heparin sodium dcu
phos-flur
heparin sodium lock flush
pilocarpine hydrochloride
heparin sodium/sodium chloride 0.9% premix
pilocarpine HCL
heparin sodium/D5W
triamcinolone acetonide dental paste
heparin sodium/NACL 0.9%
SF
jantoven
SF 5000 plus
monoject pharma grade flush syringe/heparin lock
TIER 02 NON-PREFERRED GENERIC
monoject prefill advanced heparin lock flush
clinpro 5000
sash kit for flushing vascular access devices
fluoridex
warfarin sodium
fluoridex daily defense sensitivity relief
Heparin Lock Flush
fluoridex enhanced whitening
Heparin Sodium/D5W
fluoridex sensitivity relief
Heparin Sodium/NACL 0.45%
fluoridex sensitivity relief/sls free
Heparin Sodium/Sodium Chloride 0.9%
nystatin
Sash Kit For Flushing Vascular Access Devices
Lidocaine HCL
PREFERRED BRAND
TIER 02 PREFERRED BRAND
cold sore treatment
EliquisPA
cough drops
XareltoPA
eql cold sore treatment
Xarelto Starter PackPA
flanax cough relief
TIER 03 NON-PREFERRED BRAND
gnp cold sore treatment
SavaysaPA
ra cold sore treatment
TIER 04 SPECIALTY
sm cough drops
enoxaparin sodium
Moi-stir
fondaparinux sodium
Mouthkote
Fragmin
Oramagic Plus
Prevident 5000 Plus
HEMOSTATICS
TIER 03 NON-PREFERRED BRAND
TIER 02 NON-PREFERRED GENERIC
Debacterol
tranexamic acid
Episil
Fluoridex Daily Defense Sensitivity Relief
HEMATOLOGICAL - MISC.
Gelclair
Gelx
TIER 01 PREFERRED GENERIC
Mucotrol
anagrelide hydrochloride
MugardQL,ST
cilostazol
Nafrinse Daily/Acidulated
clopidogrel
Nafrinse Daily/Neutral
dipyridamole
Nafrinse Weekly
pentoxifylline ER
Orafate
prasugrel
Oramagicrx
OravigST
TIER 02 NON-PREFERRED GENERIC
Prevident Fluoride
aspirin/dipyridamole
Prevident 5000 Booster
TIER 03 NON-PREFERRED BRAND
Prevident 5000 Booster Plus
Aggrenox
Prevident 5000 Dry Mouth
Brilinta
Prothelial
Durlaza
Salicept
ZontivityPA
Thera-flur-n
MOUTH/THROAT/DENTAL AGENT
NEUROLOGY, CNS, PSYCH
TIER 01 PREFERRED GENERIC
cavarest
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 17
ANTIANXIETY AGENTS
BrintellixQL,ST
Emsam
TIER 01 PREFERRED GENERIC
FetzimaQL,ST
alprazolam
Fetzima Titration PackQL,ST
alprazolam odt
Marplan
alprazolam ER
NardilST
alprazolam XR
Pexeva
buspirone HCL
TrintellixQL,ST
chlordiazepoxide HCL
ViibrydQL,ST
clorazepate dipotassium
Viibryd Starter PackQL,ST
diazepam
diazepam intensol
ANTIPSYCHOTICS
hydroxyzine pamoate
hydroxyzine HCL
TIER 01 PREFERRED GENERIC
meprobamate
aripiprazoleQL
oxazepam
aripiprazole odtQL
Hydroxyzine Pamoate
chlorpromazine HCLQL
TIER 02 NON-PREFERRED GENERIC
clozapineQL
lorazepam
compro
lorazepam intensol
fluphenazine decanoate
Diazepam
fluphenazine HCLQL
PREFERRED BRAND
haloperidolQL
Alprazolam Intensol
haloperidol lactate
lithium carbonate
ANTIDEPRESSANTS
lithium carbonate ER
loxapineQL
TIER 01 PREFERRED GENERIC
loxapine succinateQL
amitriptyline HCL
olanzapineQL
bupropion HCLQL
olanzapine odtQL
bupropion HCL ERQL
perphenazineQL
bupropion HCL SRQL
prochlorperazine
bupropion HCL XLQL
prochlorperazine maleate
citalopram hydrobromideQL
quetiapine fumarateQL
clomipramine HCL
risperidoneQL
desipramine HCL
risperidone odtQL
doxepin HCL
risperidone M-TABQL
escitalopram oxalateQL
thioridazine HCLQL
fluoxetine HCLQL
thiothixeneQL
fluvoxamine maleateQL
trifluoperazine HCLQL
imipramine pamoate
ziprasidone HCLQL
imipramine HCL
Fluphenazine HCLQL
mirtazapineQL
Lithium
mirtazapine odtQL
Lithium Carbonate
nefazodone HCL
TIER 02 NON-PREFERRED GENERIC
nortriptyline HCL
clozapine odtQL
paroxetine HCLQL
haloperidol decanoate
paroxetine HCL ERQL
paliperidone ERQL,ST
phenelzine sulfate
quetiapine fumarate ERQL,ST
protriptyline HCL
Clozapine OdtQL
sertraline HCLQL
Molindone Hydrochloride
tranylcypromine sulfate
TIER 03 NON-PREFERRED BRAND
trazodone HCLQL
FanaptQL,ST
venlafaxine HCLQL
Fanapt Titration PackQL,ST
venlafaxine HCL ERQL
LatudaQL,ST
Amoxapine
NuplazidQL,PA
Doxepin HCL
RexultiQL,ST
Fluoxetine DRQL
SaphrisQL,ST
Fluoxetine HCLQL
Versacloz
Maprotiline HCL
VraylarQL,ST
Nefazodone HCL
TIER 04 SPECIALTY
Nortriptyline HCL
Aristada
Venlafaxine HCL ERQL
QL
HYPNOTICS
TIER 02 NON-PREFERRED GENERIC
desvenlafaxine ERQL,PA,ST
TIER 01 PREFERRED GENERIC
duloxetine HCLQL
estazolam
fluvoxamine maleate ERQL
eszopicloneQL
trimipramine maleate
midazolam HCL
Desvenlafaxine ERQL
phenobarbital
TIER 03 NON-PREFERRED BRAND
temazepamQL
Aplenzin
triazolamQL
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 18
zaleplonQL
levetiracetam ER
zolpidem tartrateQL
oxcarbazepine
zolpidem tartrate ERQL
phenytoin
Flurazepam HCLQL
phenytoin infatabs
Phenobarbital
phenytoin sodium extended
TriazolamQL
primidone
TIER 02 NON-PREFERRED GENERIC
roweepra
Quazepam
tiagabine hydrochloride
TIER 03 NON-PREFERRED BRAND
topiramate
RozeremQL,ST
valproic acid
Seconal
zonisamide
Seconal Sodium
Diazepam
ZolpimistQL,ST
Diazepam Rectal Gel
TIER 04 SPECIALTY
Hetlioz
TIER 02 NON-PREFERRED GENERIC
felbamate
ADHD, NARCOLEPSY, ETC.
lamotrigine odt
lamotrigine titration
TIER 01 PREFERRED GENERIC
Topiramate ER
caffeine citrate
TIER 03 NON-PREFERRED BRAND
dexedrineQL
Banzel
dextroamphetamine sulfateQL
CarbatrolST
dextroamphetamine sulfate ERQL
Celontin
methamphetamine HCLQL
DepakeneST
methylphenidate HCLQL
DepakoteST
zenzediQL
Depakote ERST
TIER 02 NON-PREFERRED GENERIC
Depakote SprinklesST
amphetamine/dextroamphetamineQL
Diastat Acudial
armodafinilQL,PA
Diastat Pediatric
atomoxetineQL,AL,ST
DilantinST
clonidine HCL ER
Dilantin InfatabsST
dexmethylphenidate HCLQL
Dilantin-125ST
dexmethylphenidate HCL ERQL
FelbatolST
guanfacine ER
GabitrilST
metadate ERQL
KeppraST
methylphenidate hydrochlorideQL
Keppra XRST
methylphenidate HCL CDQL
KlonopinST
methylphenidate HCL ERQL
LamictalST
modafinilQL,PA
Lamictal Chewable DispersibleST
phendimetrazine tartratePA
Lamictal OdtST
phentermine HCLPA
Lamictal XRST
Methylphenidate HCLQL
LyricaST
Methylphenidate HCL ERQL
MysolineST
Methylphenidate HCL ER (LA)QL,AL
NeurontinST
Phendimetrazine Tartrate ERPA
Onfi
TIER 03 NON-PREFERRED BRAND
Oxtellar XR
Aptensio XRQL,PA
Peganone
BelviqPA
PhenytekST
Belviq XRPA
TegretolST
ContravePA
Tegretol-XRST
QsymiaPA
TopamaxST
VyvanseQL,AL
Topamax Sprinkle
TrileptalST
ANTICONVULSANTS
VimpatST
TIER 01 PREFERRED GENERIC
ZarontinST
carbamazepine
ZonegranST
carbamazepine ER
TIER 04 SPECIALTY
clonazepam
vigabatrin
clonazepam odt
Sabril
divalproex sodium
divalproex sodium DR
ANTIPARKINSON AGENTS
divalproex sodium ER
TIER 01 PREFERRED GENERIC
epitol
amantadine HCL
ethosuximide
benztropine mesylate
gabapentin
bromocriptine mesylate
lamotrigine
carbidopa/levodopa
lamotrigine starter kit/blue
carbidopa/levodopa odt
lamotrigine starter kit/green
carbidopa/levodopa ER
lamotrigine ER
entacapone
levetiracetam
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 19
pramipexole dihydrochloride
tgt nicotine step twoQL
ropinirole ER
thriveQL
ropinirole HCL
CVS nicotineQL
selegiline HCL
CVS nicotine lozengeQL
trihexyphenidyl HCL
CVS nicotine polacrilexQL
Carbidopa/Levodopa/Entacapone
CVS nicotine polacrilex starterQL
TIER 02 NON-PREFERRED GENERIC
CVS nicotine transdermal systemQL
carbidopa
CVS nts step 1QL
pramipexole dihydrochloride ER
HM nicotine polacrilexQL
rasagiline mesylate
HM nicotine transdermal systemQL
tolcapone
HM nicotine transdermal system step 3QL
TIER 03 NON-PREFERRED BRAND
Nicotine Transdermal SystemQL
EldeprylST
SR nicotine gumQL
LodosynST
TIER 01 PREFERRED GENERIC
TasmarST
disulfiram
Zelapar
fluoxetine HCLQL
TIER 04 SPECIALTY
galantamine hydrobromide
Apokyn
galantamine hydrobromide ER
memantine hydrochloride
NEUROLOGY, PSYCH - MISC.
memantine HCL
memantine HCL titration PAK
FORMULARY FORMULARY
olanzapine/fluoxetine
buprobanQL
pimozideQL
bupropion HCL SRQL
rivastigmine tartrate
eq nicotineQL
rivastigmine transdermal system
eq nicotine gum refillQL
Chlordiazepoxide/Amitriptyline
eq nicotine gum starterQL
FluoxetineQL
eq nicotine polacrilexQL
Galantamine Hydrobromide
eq nicotine step 3QL
Perphenazine/Amitriptyline
eql nicotineQL
TIER 02 NON-PREFERRED GENERIC
eql nicotine polacrilexQL
acamprosate calcium DR
eql nicotine polacrilex refillQL
donepezil HCL
eql nicotine polacrilex starterQL
Ergoloid Mesylates
gnp nicotine gumQL
TIER 03 NON-PREFERRED BRAND
gnp nicotine mini lozengeQL
AddyiPA
gnp nicotine polacrilexQL
ChantixQL
gnp nicotine polacrilex miniQL
Chantix Continuing Month PAKQL
gnp nicotine transdermal systemQL
Chantix Starting Month PAKQL
goodsense nicotine gumQL
Namenda XRST
kls quit2QL
Namenda XR Titration PackST
kls quit4QL
Namzaric
nicoreliefQL
Nicotrol InhalerQL
nicotineQL
Nicotrol NsQL
nicotine mini lozengeQL
NuedextaQL,PA
nicotine polacrilexQL
OrapQL,ST
nicotine polacrilex refillQL
TIER 04 SPECIALTY
nicotine polacrilex starter kitQL
glatopaST
nicotine step 1QL
tetrabenazine
nicotine step 2QL
AmpyraQL
nicotine step 3QL
AubagioST
nicotine transdermal systemQL
Avonex
nicotine transdermal system step 1QL
Avonex Pen
nicotine transdermal system step 2QL
Betaseron
nicotine transdermal system step 3QL
Copaxone
px stop smoking aidQL
ExtaviaST
qc nicotine polacrilexQL
GilenyaST
ra mini nicotineQL
IngrezzaPA
ra nicotineQL
PlegridyST
ra nicotine gumQL
Plegridy Starter PackST
ra nicotine polacrilexQL
RebifST
ra nicotine transdermal systemQL
Rebif RebidoseST
ra nicotine transdermal system step 3QL
Rebif Rebidose Titration PackST
sm nicotineQL
Rebif Titration PackST
sm nicotine polacrilexQL
SavellaST
sm nicotine transdermal systemQL
Savella Titration PackST
sw nicotine polacrilexQL
Tecfidera
tgt nicotine gumQL
Tecfidera Starter Pack
tgt nicotine polacrilexQL
XenazineST
tgt nicotine step oneQL
XyremPA
tgt nicotine step threeQL
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 20
NEUROMUSCULAR AGENTS
Betadine Ophthalmic Prep
Mitosol
TIER 02 NON-PREFERRED GENERIC
Natacyn
riluzole
Zirgan
TIER 03 NON-PREFERRED BRAND
Zymaxid
RilutekST
ARTIFICIAL TEAR/LUBRICANT
MUSCULOSKELETAL AGENTS
TIER 02 PREFERRED BRAND
TIER 01 PREFERRED GENERIC
Lacrisert
baclofen
carisoprodol
BETA-BLOCKERS
carisoprodol/aspirin
carisoprodol/aspirin/codeine
TIER 01 PREFERRED GENERIC
chlorzoxazone
betaxolol HCL
cyclobenzaprine HCL
carteolol HCL
dantrolene sodium
dorzolamide HCL/timolol maleate
methocarbamol
levobunolol HCL
orphenadrine citrate ER
timolol maleate
tizanidine HCL
timolol maleate ophthalmic gel forming
Metipranolol
TIER 02 NON-PREFERRED GENERIC
TIER 02 PREFERRED BRAND
metaxall
Betimol
metaxalone
Betoptic-s
Metaxalone
Istalol
TIER 03 NON-PREFERRED BRAND
TIER 03 NON-PREFERRED BRAND
Tizanidine Comfort PAC
Combigan
ANTIMYASTHENIC AGENTS
OPHTHALMIC STEROIDS
TIER 01 PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
pyridostigmine bromide
fluorometholone
pyridostigmine bromide ER
neo-polycin HC
TIER 02 NON-PREFERRED GENERIC
neomycin/polymyxin/bacitracin/hydrocortisone
Guanidine HCL
prednisolone acetate
sulfacetamide sodium/prednisolone sodium phosphate
OPHTHALMOLOGY AND OTIC
tobramycin/dexamethasone
Dexamethasone Sodium Phosphate
ANTI-INFECTIVES
TIER 02 NON-PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
neomycin/polymyxin/dexamethasone
ak-poly-bac
Neomycin/Polymyxin/Hydrocortisone
bacitracin/polymyxin b
Prednisolone Sodium Phosphate
ciprofloxacin HCL
PREFERRED BRAND
erythromycin
Blephamide
gentak
Blephamide S.o.p.
gentamicin sulfate
Flarex
ilotycin
FML Forte
moxifloxacin HCL
Pred Mild
neo-polycin
Tobradex ST
neomycin/bacitracin/polymyxin
TIER 03 NON-PREFERRED BRAND
neomycin/polymyxin/bacitracin zinc
Durezol
neomycin/polymyxin/gramicidin
FML
ofloxacin
Lotemax
polycin
Pred-G
polymyxin b sulfate/trimethoprim sulfate
Pred-G S.o.p.
tobramycin
Tobradex
tobramycin sulfate
Triesence
trifluridine
Vexol
trimethoprim sulfate/polymyxin b sulfate
Gentak
PROSTAGLANDINS
TIER 02 NON-PREFERRED GENERIC
TIER 01 PREFERRED GENERIC
gatifloxacin
latanoprost
levofloxacin
TIER 02 NON-PREFERRED GENERIC
sodium sulfacetamide
Bimatoprost
sulfacetamide sodium
Travoprost
Bacitracin
PREFERRED BRAND
Sulfacetamide Sodium
Travatan Z
PREFERRED BRAND
TIER 03 NON-PREFERRED BRAND
Ciloxan
LumiganST
Moxeza
ResculaST
TIER 03 NON-PREFERRED BRAND
ZioptanST
Azasite
Besivance
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 21
CYCLOPLEGIC MYDRIATICS
ra antihistamine eye drops
ra eye itch relief
TIER 01 PREFERRED GENERIC
sm eye itch relief
tropicamide
tgt eye itch relief
TIER 02 NON-PREFERRED GENERIC
theratears allergy eye itch relief
cyclopentolate hydrochloride
wal-zyr
cyclopentolate HCL
CVS allergy eye drops
homatropaire
CVS eye itch relief
homatropine HBR
HM eye itch relief
Atropine Sulfate
TIER 02 NON-PREFERRED GENERIC
bromfenac
DECONGESTANTS
epinastine HCL
TIER 01 PREFERRED GENERIC
flurbiprofen sodium
Naphazoline HCL
olopatadine HCLST
TIER 02 NON-PREFERRED GENERIC
Bromfenac
altafrin
Flurbiprofen Sodium
phenylephrine HCL
PREFERRED BRAND
Alomide
MIOTICS
Azopt
TIER 01 PREFERRED GENERIC
TIER 03 NON-PREFERRED BRAND
pilocarpine HCL
AlocrilST
TIER 02 PREFERRED BRAND
BepreveST
Phospholine Iodide
EmadineST
TIER 03 NON-PREFERRED BRAND
LastacaftST
Miochol-e
Nevanac
PatanolST
ADRENERGIC AGENTS
TIER 04 SPECIALTY
TIER 01 PREFERRED GENERIC
Cystaran
apraclonidine
brimonidine tartrate
OTIC AGENTS
TIER 02 PREFERRED BRAND
TIER 01 PREFERRED GENERIC
Iopidine
acetasol HC
TIER 03 NON-PREFERRED BRAND
acetic acid
SimbrinzaST
cortic-nd
cyotic
IMMUNOMODULATORS
exotic-HC
TIER 03 NON-PREFERRED BRAND
hydrocortisone/acetic acid
Restasis
neomycin/polymyxin/hydrocortisone
Restasis Multidose
neomycin/polymyxin/HC
ofloxacin
LOCAL ANESTHETICS
otomax-HC
TIER 01 PREFERRED GENERIC
Acetic Acid/Aluminum Acetate
altacaine
TIER 02 NON-PREFERRED GENERIC
proparacaine HCL
fluocinolone acetonide
tetcaine
fluocinolone acetonide ear drops
tetracaine HCL
Ciprofloxacin
tetravisc
PREFERRED BRAND
tetravisc forte
Cipro HC
TIER 03 NON-PREFERRED BRAND
Ciprodex
Akten
TIER 03 NON-PREFERRED BRAND
Coly-mycin S
OPHTHALMICS - MISC.
Cortane-b Aqueous
TIER 01 PREFERRED GENERIC
Cortane-b-otic
alaway
Cortisporin-tc
alaway childrens allergy eye itch relief
Oticin HC NR
allergy eye drops
Otiprio
azelastine HCL
Pramotic
claritin eye
cromolyn sodium
OXYTOCICS
diclofenac sodium
dorzolamide HCL
TIER 02 NON-PREFERRED GENERIC
eq eye itch relief
methylergonovine maleate
eq itchy eye drops
Methergine
eye itch relief
gnp eye itch relief
PAIN MANAGEMENT
gnp itchy eye
ANALGESICS - NONNARCOTIC
goodsense itchy eye
FORMULARY FORMULARY
ketorolac tromethamine
aspirin
ketotifen fumarate
bayer advanced aspirin regular strength
kp ketotifen fumarate
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 22
bayer aspirin
oxymorphone hydrochlorideQL,PA
eq aspirin
oxymorphone hydrochloride ERQL,PA
eql aspirin
tramadol hydrochloride/acetaminophenQL
gnp aspirin
tramadol HCLQL
goodsense aspirin
tramadol HCL ERQL
norwich aspirin
vicodinQL
px aspirin
vicodin ESQL
qc aspirin
vicodin HPQL
ra aspirin
Codeine SulfateQL
sm aspirin
FentanylQL
tgt aspirin
Hydromorphone HCLQL
Aspirin Low Dose
Meperidine HCLQL
CVS aspirin
Methadone HCLQL
HM aspirin
MethadoseQL
MM aspirin
Methadose Sugar-freeQL
SB aspirin
Morphine SulfateQL
TIER 01 PREFERRED GENERIC
Morphine Sulfate ERQL
butalbital/acetaminophenQL
Oxycodone/IbuprofenQL
butalbital/acetaminophen/caffeineQL
Oxymorphone Hydrochloride ERQL,PA
butalbital/aspirin/caffeine
TIER 02 NON-PREFERRED GENERIC
capacetQL
hydrocodone bitartrate/acetaminophenQL
choline magnesium trisalicylate
hydromorphone hydrochlorideQL,PA
diflunisal
hydromorphone hydrochloride ERQL,PA
esgicQL
hydromorphone HCL ERQL,PA
margesicQL
morphine sulfateQL
marten-TABQL
pentazocine/naloxone HCLQL
phrenilin forteQL
reprexainQL
salsalate
verdrocetQL
zebutalQL
xylonQL
Butalbital/Aspirin/Caffeine
Acetaminophen/Caffeine/DihydrocodeineQL,PA
Duraxin
Aspirin-caffeine-dihydrocodeineQL
TenconQL
Levorphanol TartrateQL
TIER 02 NON-PREFERRED GENERIC
Meperidine HCL/Promethazine HCLQL
Vanatol LQQL
Oxycodone HCL ERQL,PA
Vanatol SQL
Oxycodone/AcetaminophenQL
TIER 03 NON-PREFERRED BRAND
Tramadol HCL ERQL,ST
AllzitalQL,ST
PREFERRED BRAND
Levacet
SuboxoneQL
TIER 03 NON-PREFERRED BRAND
ANALGESICS - OPIOID
AbstralQL,PA
BelbucaQL,PA
TIER 01 PREFERRED GENERIC
Capital/CodeineQL
acetaminophen/codeineQL
EmbedaQL
acetaminophen/codeine phosphateQL
FentoraQL,PA
ascomp/codeineQL
Hysingla ERQL,PA
buprenorphine HCLQL
KadianQL
buprenorphine HCL/naloxone HCLQL
LazandaQL,PA
butalbital/acetaminophen/caffeine/codeineQL
NucyntaQL,PA
butalbital/aspirin/caffeine/codeineQL
Nucynta ERQL,PA
butorphanol tartrateQL,PA
Opana ER (crush Resistant)QL,PA
codeine sulfateQL
OxaydoQL,PA
endocetQL
OxycontinQL,PA
fentanylQL
PrimlevQL
fentanyl citrate oral transmucosalQL,PA
SubsysQL,PA
hydrocodone/acetaminophenQL
TrezixQL,PA
hydrocodone/ibuprofenQL
ZamicetQL
hydromorphone HCLQL
QL
ibudoneQL
lorcetQL
ANTI-INFLAMMATORY
lorcet plusQL
lorcet HDQL
TIER 01 PREFERRED GENERIC
lortabQL
diclofenac potassium
meperidine HCLQL
diclofenac sodium DR
methadone HCLQL
diclofenac sodium ER
methadone HCL intensolQL
diclofenac sodium/misoprostol
methadose
etodolac
morphine sulfate ERQL
etodolac ER
oxycodone HCLQL
flurbiprofen
oxycodone/acetaminophenQL
ibuprofen
oxycodone/aspirinQL
indomethacin
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 23
indomethacin ER
sumatriptanQL
ketoprofen
sumatriptan succinateQL
ketorolac tromethamineQL
sumatriptan succinate refillQL
leflunomide
zolmitriptanQL
meloxicam
zolmitriptan odtQL
nabumetone
Sumatriptan SuccinateQL
naproxenQL
TIER 02 NON-PREFERRED GENERIC
naproxen kitQL
almotriptanQL,ST
naproxen sodium
almotriptan malateQL,ST
naproxen DRQL
eletriptan hydrobromideQL,PA,ST
oxaprozinQL
ergotamine tartrate/caffeine
piroxicam
frovatriptan succinateQL,ST
sulindac
isometheptene mucate/caffeine/acetaminophen
tolmetin sodium
Dihydroergotamine MesylateQL
Meclofenamate Sodium
PREFERRED BRAND
Meloxicam
CambiaQL,ST
NaproxenQL
Ergomar
Tolmetin Sodium
TIER 03 NON-PREFERRED BRAND
TIER 02 NON-PREFERRED GENERIC
AxertQL
celecoxibQL
FrovaQL
fenoprofen calcium
Imitrex Statdose SystemQL
inflammacin
Migergot
mefenamic acid
ZomigQL,ST
naproxen sodium CR
naproxen sodium ER
GOUT AGENTS
nudiclo tabpak
TIER 01 PREFERRED GENERIC
previdolrx plus analgesicpak
allopurinol
xenaflamm
probenecid
Fenoprofen Calcium
probenecid/colchicine
Ketoprofen ER
TIER 02 NON-PREFERRED GENERIC
PREFERRED BRAND
Colchicine
Indocin
PREFERRED BRAND
Rheumatrex
UloricST
Ridaura
TIER 03 NON-PREFERRED BRAND
RESPIRATORY, ALLERGY, ETC
CelebrexQL
ANTIHISTAMINES
Flanax Pain Relief Kit
TIER 01 PREFERRED GENERIC
Ibuprofen Comfort PAC
arbinoxa
Meloxicam Comfort PAC
carbinoxamine maleate
NaprosynQL
clemastine fumarate
Naproxen Comfort PAC
cyproheptadine HCL
OtrexupST
desloratadine
RasuvoST
levocetirizine dihydrochloride
Vivlodex
phenadoz
TIER 04 SPECIALTY
phenergan
ActemraPA
promethazine HCL
Arcalyst
promethazine HCL plain
EnbrelPA
promethegan
Enbrel SureclickPA
Brompheniramine Tannate
HumiraPA
Clemastine Fumarate
Humira Pediatric Crohns Disease Starter PackPA
TIER 02 NON-PREFERRED GENERIC
Humira PenPA
bpm
Humira Pen-crohns DiseasestarterPA
Desloratadine Odt
Humira Pen-psoriasis StarterPA
Respa-BR
KineretPA
TIER 03 NON-PREFERRED BRAND
OrenciaPA
Karbinal ER
Orencia ClickjectPA
Phenergan Fortis
OtezlaPA
SimponiPA
NASAL AGENTS
XeljanzPA
TIER 01 PREFERRED GENERIC
Xeljanz XRPA
azelastine HCL
budesonide nasal spray
MIGRAINE PRODUCTS
fluticasone propionate
TIER 01 PREFERRED GENERIC
ipratropium bromide
isometheptene/dichloralphenazone/acetaminophen
mometasone furoateST
naratriptan HCLQL
ra budesonide nasal spray
nodolor
rhinocort allergy
rizatriptan benzoateQL
Flunisolide
rizatriptan benzoate odtQL
TIER 02
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 24
NON-PREFERRED GENERIC
Metaproterenol Sulfate
olopatadine HCL
PREFERRED BRAND
PREFERRED BRAND
Advair Diskus
Bactroban Nasal
Advair HFA
TIER 03 NON-PREFERRED BRAND
Anoro Ellipta
Adrenalin
Asmanex HFA
Tyzine Pediatric Nasal Drops
Asmanex Twisthaler 120 Metered Doses
Asmanex Twisthaler 14 Metered Doses
COUGH/COLD/ALLERGY
Asmanex Twisthaler 30 Metered Doses
Asmanex Twisthaler 60 Metered Doses
TIER 01 PREFERRED GENERIC
Asmanex Twisthaler 7 Metered Doses
acetylcysteine
Breo Ellipta
benzonatate
Combivent Respimat
hydrocodone bitartrate/homatropine methylbromide
Dulera
hydrocodone polistirex/chlorpheniramine polistirexQL
Flovent Diskus
hydrocodone/homatropine
Flovent HFA
hydromet
Fluticasone Propionate/Salmeterol
promethazine VC plain
Foradil Aerolizer
promethazine VC/codeine
Qvar
promethazine-DM
Serevent Diskus
promethazine/codeine
Spiriva Handihaler
promethazine/dextromethorphan
Spiriva Respimat
promethazine/phenylephrine
Ventolin HFA
promethazine/phenylephrine/codeine
TIER 03 NON-PREFERRED BRAND
pulmosal
Aerospan
sodium chloride
AlvescoST
tussigon
Arcapta NeohalerST
TIER 02 NON-PREFERRED GENERIC
Atrovent HFA
hydrocodone bitartrate/chlorpheniramine maleate/PSE
BrovanaST
Nortuss-EX
Daliresp
Tgq 30PSE/150GFN/15DM
Elixophyllin
Tgq 30PSE/3BRM/15DM
Incruse Ellipta
TIER 03 NON-PREFERRED BRAND
Striverdi RespimatST
Carbaphen 12
Theo-24
Carbaphen 12 PED
Utibron NeohalerST
Codar AR
ZyfloPA
Decon-a
Zyflo CRPA
Decon-G
Flowtuss
RESPIRATORY AGENTS - MISC
Hycofenix
Hypersal
TIER 04 SPECIALTY
Nebusal
Esbriet
Neotuss Plus
KalydecoPA
Obredon
Ofev
Panatuss Dxp
OrkambiPA
Relhist
Pulmozyme
Rezira
Tusnel
VACCINES
Tuzistra XR
VituzQL
FORMULARY FORMULARY
Afluria PF 2015-2016
ANTIASTHMATIC/COPD AGENTS
Afluria PF 2016-2017
TIER 01 PREFERRED GENERIC
Afluria PF 2017-2018
albuterol sulfate
Afluria Quadrivalent 2016-2017
albuterol sulfate ER
Afluria Quadrivalent 2017-2018
budesonide
Afluria 2015-2016
ipratropium bromide
Afluria 2016-2017
ipratropium bromide/albuterol sulfate
Afluria 2017-2018
levalbuterol
Fluad 2016-2017
levalbuterol HCL
Fluad 2017-2018
montelukast sodium
Fluarix Quadrivalent 2015-2016
terbutaline sulfate
Fluarix Quadrivalent 2016-2017
theochron
Fluarix Quadrivalent 2017-2018
theophylline CR
Flublok Quadrivalent 2017-2018
theophylline ER
Flublok 2015-2016
zafirlukast
Flublok 2016-2017
Cromolyn Sodium
Flublok 2017-2018
TIER 02 NON-PREFERRED GENERIC
Flucelvax Quadrivalent 2016-2017
difil-G forte
Flucelvax Quadrivalent 2017-2018
theophylline
Flucelvax 2015-2016
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 25
Flulaval Quadrivalent 2014-2015
vitacel
Flulaval Quadrivalent 2015-2016
vitamax pediatric
Flulaval Quadrivalent 2016-2017
vitamins a/c/d/fluoride
Flulaval Quadrivalent 2017-2018
Bp Folinatal Plus B
Flumist Quadrivalent
Bp Multinatal Plus
Fluvirin 2015-2016
Complete Natal DHA
Fluvirin 2016-2017
Completenate
Fluvirin 2017-2018
CO-natal Fa
Fluzone Intradermal Quadrivalent 2015-2016
Elite-OB
Fluzone Intradermal Quadrivalent 2016-2017
Floriva Plus
Fluzone Intradermal Quadrivalent 2017-2018
Folbee Plus Cz
Fluzone Quadrivalent 2015-2016
Inatal Advance
Fluzone Quadrivalent 2016-2017
Inatal GT
Fluzone Quadrivalent 2017-2018
Inatal Ultra
Fluzone Split 2015-2016
Macnatal CN DHA
Influenza Vaccine For Safeway Dependants
Mynatal Advance
Medical Provider EZ Flu Shot PF 2014-2015
Mynatal Plus
Medical Provider EZ Flu Shot 2015-2016
Mynatal Ultracaplet
Medical Provider Single Use EZ Flu Shot
Mynatal-z
Medical Provider Single Use EZ Flu Shot 2016-2017
Mynate 90 Plus
Zostavax
MVC-fluoride
Nutricap
VITAMINS
Pr Natal 400
Pr Natal 400 EC
VITAMINS
Pr Natal 430
TIER 01 PREFERRED GENERIC
Pr Natal 430 EC
decara
Prenaissance Plus
d3
Prenatabs RX
d3-50
Prenatal-u
optimal-d
PNV-select
optimal-d pack
PNV-DHA
vitamin d
Quflora Pediatric
vitamin d3
Se-natal 19
TIER 02 PREFERRED BRAND
Se-tan DHA
Mephyton
Siderol
TIER 03 NON-PREFERRED BRAND
Taron-prex
Potaba
Triadvance
Trinatal RX 1
MULTIVITAMINS
Trinate
TIER 01 PREFERRED GENERIC
Ultimatecare One
b-plex plus
Ultimatecare One NF
biocel
Vinate II
corvita
Vinate M
corvite free
Vinate One
lysiplex plus
Vitafol-OB
mult-vitamin/fluoride
TIER 02 NON-PREFERRED GENERIC
multi vitamin/fluoride
Floriva
multi-vit/fluoride
Tri-vit/Fluoride/Iron
multi-vit/iron/fluoride
PREFERRED BRAND
multi-vitamin/fluoride
AP-zel
multi-vitamin/fluoride drops
Bacmin
multi-vitamin/fluoride/iron
C-nate DHA
multivitamin with fluoride
Calcium PNV
multivitamin/fluoride
Citranatal Assure
multivitamins/fluoride
Citranatal B-calm
mynephrocaps
Citranatal DHA
mynephron
Citranatal Harmony
niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper
Citranatal RX
nutrifac ZX
Citranatal 90 DHA
renal CAPS
Concept DHA
reno CAPS
Concept OB
tri-vit/fluoride
Dialyvite Supreme D
tri-vitamin/fluoride
Dothelle DHA
triphrocaps
Duet DHA Balanced
triple-vitamin/fluoride
Duet DHA 400
v-c forte
Extra-virt Plus DHA
vic-forte
Focalgin CA
virt-CAPS
Focalgin 90 DHA
vita s forte
Folcal DHA
vita-min
Folcaps Omega 3
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 26
Folivane-OB
Virt-vite GT
Fortavit
Virtprex
Hemenatal OB + DHA
Vitafol
Multivitamin With Fluoride
Vitafol Fe+
Natachew
Vitafol Gummies
Natelle One
Vitafol Ultra
Nestabs
Vitafol-nano
Newgen
Vitafol-ob+dha
Nexa Plus
Vitafol-one
Nicadan
Vitamedmd One RX/Quatrefolic
Nicadan ZX
Vitamedmd Redichew RX
Nicazel
Vitapearl
Nicazel Forte
Viva DHA
Ocuvel
Vol-nate
OB Complete
Vp-heme One
OB Complete Gold
Vp-heme OB + DHA
OB Complete One
Vp-zel
OB Complete Petite
Vp-CH-PNV
OB Complete Premier
Vp-PNV-DHA
OB Complete/DHA
Zatean-pn DHA
Preferaob +dha
Zatean-pn Plus
Preferaob One
Zatean-CH
Prenaissance
TIER 03 NON-PREFERRED BRAND
Prenaissance Balance
Active OB
Prenata
Atabex EC
Prenatabs Fa
Bal-care DHA
Prenatal 19
Enbrace HR
Prenate
Escavite
Prenate AM
Folet DHA
Prenate DHA
Folet One
Prenate Enhance
Hemenatal OB
Prenate Mini
Infanate Balance
Prenate Pixie
Levomefolate DHA
Prenate Restore
Marnatal-f
Prenate Star
Mykidz Iron Fl
Prena1 Chew
Mynatal
Prena1 Pearl
Natalvit
Preque 10
Neevo DHA
Pretab
Nestabs Abc
Protect Plus
Nestabs DHA
Provida OB
O-CAL Prenatal
PNV Ferrous Fumarate/Docusate/Folic Acid
Obstetrix One
PNV Ob+dha
Poly-VI-flor
PNV-dha+docusate
Poly-VI-flor/Iron
PNV-omega
Prefera OB
PNV-vp-u
Prenaissance Harmony DHA
Relnate DHA
Prenaissance Next
Req 49+
Prenaissance Next-b
Rulavite DHA
Prenatal Plus Iron
Select-ob+dha
Prenate Elite
Select-OB
Prenate Essential
Strovite Forte
Provida DHA
Strovite One
Purefe OB Plus
Synagex
PNV TABS 29-1
Synatek
PNV-total
Taron-c DHA
R-natal OB
Thrivite 19
Taron-bc
Trinatal GT
Thrivite RX
Triveen-prx RNF
Tri-TABS DHA
TL-select
Tri-VI-flor
Udamin SP
Tri-VI-floro
Vemavite-prx 2
Tricare Prenatal
Virt Nate
Tricare Prenatal Compleat
Virt-advance
Tricare Prenatal DHA One
Virt-c DHA
Tristart DHA
Virt-nate DHA
Triveen-duo DHA
Virt-pn
TL Folate
Virt-pn DHA
TL-care DHA
Virt-pn Plus
TL-fluorivite
Virt-select
Vena-bal DHA
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 27
Vinate DHA RF
BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2"
Vita-pren
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 15/64"
Vitamedmd Plus RX/Quatre Folic
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16"
Vitaroca Plus
BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2"
Vol-TAB RX
BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16"
Vp-ggr-b6 Prenatal
BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2"
Vp-heme OB
BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16"
Vp-CH Plus
BD Insulin Syringe Ultrafine/1ML/30G X 1/2"
BD Insulin Syringe Ultrafine/1ML/31G X 5/16"
MEDICAL DEVICES
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1"
DIABETIC SUPPLIES
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8"
TIER 01 PREFERRED GENERIC
Advocate Insulin Pen Needles 29GX12.7MM
BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2"
Advocate Insulin Pen Needles 31GX5MM
Advocate Insulin Pen Needles 31GX8MM
BD Insulin Syringe/U-100/0.5ML/30G X 1/2"
Advocate Insulin Syringe/U-100/0.3ML/29GX1/2"
BD Insulin Syringe/U-100/1ML/27G X 1/2"
Advocate Insulin Syringe/U-100/0.3ML/30GX5/16"
BD Insulin Syringe/U-100/1ML/28G X 1/2"
Advocate Insulin Syringe/U-100/0.3ML/31GX5/16"
BD Insulin Syringe/U-100/2ML/27.5G X 5/8"
Advocate Insulin Syringe/U-100/0.5ML/29GX1/2"
BD Integra Insulin Syringe/U-100/1ML/29G X 1/2"
Advocate Insulin Syringe/U-100/0.5ML/30GX5/16"
BD Integra Syringe/Retracting Needle/1ML/25G X 1"
Advocate Insulin Syringe/U-100/0.5ML/31GX5/16"
BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2"
Advocate Insulin Syringe/U-100/1ML/29GX1/2"
BD Pen Needle/Mini/Ultrafine/31G X 3/16"
Advocate Insulin Syringe/U-100/1ML/30GX5/16"
BD Pen Needle/Nano/Ultra Fine/32G X 4MM
Advocate Insulin Syringe/U-100/1ML/31GX5/16"
BD Pen Needle/SHORT/Ultrafine/31G X 5/16"
Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2"
BD Pen Needle/Ultrafine/29G X 12.7MM
Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2"
BD Pen Needle/Ultrafine/29GX1/2" 12.7MM
Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2"
BD Pen Needles SHORT/Ultrafine/31G X 5/16"
Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2"
BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2"
Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2"
BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2"
Aurora Pen Needles 29GX12MM
Aurora Pen Needles 31G X 6MM
BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16"
Aurora Pen Needles 31G X 8MM
BD Ultra-fine Micro Pen Needles 6MM X 32G
Aurora Unifine Pentips/Mini/31GX3/16"
Carefine Pen Needle 32GX4MM
Aurora Unifine Pentips/32GX5/32"
Carefine Pen Needles 29GX1/2"
B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16"
Carefine Pen Needles 30GX5/16"
B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16"
Carefine Pen Needles 31GX6MM
B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16"
Carefine Pen Needles 31GX8MM
B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2"
Carefine Pen Needles 32GX5MM
B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2"
Carefine Pen Needles 32GX6MM
B-d Insulin Syringe Ultrafine/1ML/30G X 1/2"
Careone Insulin Syringes/0.3ML/30G X 1/2"
BD Autoshield 29G X 3/16"
Careone Insulin Syringes/0.3ML/31G X 5/16"
BD Autoshield 29G X 5/16"
Careone Insulin Syringes/0.5ML/30G X 1/2"
BD Insulin Syringe LUER-LOK/U-100/1ML
Careone Insulin Syringes/0.5ML/31G X 5/16"
BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2"
Careone Insulin Syringes/1ML/30G X 1/2"
BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2"
Careone Insulin Syringes/1ML/31GX5/16"
BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8"
Careone Unifine Pentips Pen Needles 32GX4MM
BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2"
Careone Unifine Pentips Plus Pen Needles 29GX12MM
BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2"
Careone Unifine Pentips Plus Pen Needles 31GX5MM
BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2"
Careone Unifine Pentips Plus Pen Needles 31GX6MM
BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8"
Careone Unifine Pentips Plus Pen Needles 31GX8MM
BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2"
Careone Unifine Pentips Plus Pen Needles 32GX4MM
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 15/64"
Careone Unifine Pentips 29GX12MM
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16"
Careone Unifine Pentips 31GX5MM
BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2"
Careone Unifine Pentips 31GX6MM
BD Insulin Syringe Safetyglide/1ML/29G X 1/2"
Careone Unifine Pentips 31GX8MM
BD Insulin Syringe Slip Tip/U-100/1ML
Caretouch Pen Needles 31 G X 6 MM
BD Insulin Syringe U-40/1ML/25G X 5/8"
Caretouch Pen Needles 31GX 5MM
BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16"
Caretouch Pen Needles 31GX 8MM
BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16"
Caretouch Pen Needles 32GX 4MM
BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16"
Caretouch Pen Needles 32GX 5MM
BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2"
Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM
BD Insulin Syringe Ultrafine/U-100/0.3ML/30G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16"
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 15/64"
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 5/16"
Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2"
BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2"
BD Insulin Syringe Ultrafine/U-100/0.5ML/30G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 1/2"
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 15/64"
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 5/16"
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16"
BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 28
Clever Choice Comfort EZ Insulin Syringe/0.3ML/31G X 5/16"
Easy Touch Fliplock Safety Insulin Syringe 1ML/29GX1/2"
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX1/2"
Clever Choice Comfort EZ Insulin Syringe/0.5ML/28G X 1/2"
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX5/16"
Clever Choice Comfort EZ Insulin Syringe/0.5ML/29G X 1/2"
Easy Touch Fliplock Safety Insulin Syringe 1ML/31GX5/16"
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 1/2"
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16"
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16"
Clever Choice Comfort EZ Insulin Syringe/0.5ML/31G X 5/16"
Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2"
Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/1.0ML/30G X 1/2"
Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2"
Easy Touch Insulin Syringe/U-100/0.5ML/27G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2"
Easy Touch Insulin Syringe/U-100/0.5ML/28G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/1ML/29G X 1/2"
Easy Touch Insulin Syringe/U-100/0.5ML/30G X 1/2"
Clever Choice Comfort EZ Insulin Syringe/1ML/30G X 5/16"
Easy Touch Insulin Syringe/U-100/0.5ML/31G X 5/16"
Easy Touch Insulin Syringe/U-100/1ML/27G X 1/2"
Clever Choice Comfort EZ Pen Needles 29GX12MM
Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2"
Clever Choice Comfort EZ Pen Needles 31GX5MM
Easy Touch Insulin Syringe/U-100/1ML/29G X 1/2"
Clever Choice Comfort EZ Pen Needles 31GX6MM
Easy Touch Insulin Syringe/U-100/1ML/30G X 1/2"
Clever Choice Comfort EZ Pen Needles 31GX8MM
Easy Touch Insulin Syringe/U-100/1ML/31G X 5/16"
Clever Choice Comfort EZ Pen Needles 32GX4MM
Easy Touch Insulin Syringe/0.3ML/30G X 5/16"
Clever Choice Comfort EZ Pen Needles 32GX5MM
Easy Touch Insulin Syringe/0.3ML/31G X 5/16"
Clever Choice Comfort EZ Pen Needles 32GX6MM
Easy Touch Insulin Syringe/0.5ML/29G X 1/2"
Clever Choice Comfort EZ Pen Needles 32GX8MM
Easy Touch Insulin Syringe/0.5ML/30G X 5/16"
Clever Choice Comfort EZ Pen Needles 33GX5MM
Easy Touch Insulin Syringe/1ML/30G X 5/16"
Clever Choice Comfort EZ Pen Needles 33GX6MM
Easy Touch Pen Needle 30 G X 5/16"
Clever Choice Comfort EZ Pen Needles 33GX8MM
Easy Touch Pen Needles 29GX1/2"
Clickfine Pen Needle Universal/31GX1/4"
Easy Touch Pen Needles 31GX1/4"
Clickfine Pen Needle Universal/31GX5/16"
Easy Touch Pen Needles 31GX5/16"
Clickfine Pen Needle 32GX5/32"
Easy Touch Pen Needles 32GX1/4"
Clickfine Pen Needles/31GX1/4"
Easy Touch Pen Needles 32GX3/16"
Clickfine Pen Needles/31GX5/16"
Easy Touch Pen Needles 32GX5/32"
Clickfine Universal Pen Needles 31GX5/16"
Easy Touch Pen Needles/31G X 3/16"
Comfort Assist Insulin Syringe 0.3ML/29G X 1/2"
Easy Touch Sheathlock Safety Insulin Syringe 1ML/29GX1/2"
Comfort Assist Insulin Syringe/0.3ML/30G X 5/16"
Comfort Assist Insulin Syringe/0.3ML/31G X 5/16"
Easy Touch Sheathlock Safety Insulin Syringe 1ML/30GX5/16"
Comfort Assist Insulin Syringe/0.5ML/29G X 1/2"
Comfort Assist Insulin Syringe/0.5ML/30G X 5/16"
Easy Touch Sheathlock Safety Insulin Syringe 1ML/31GX5/16"
Comfort Assist Insulin Syringe/0.5ML/31G X 5/16"
Comfort Assist Insulin Syringe/1ML/29G X 1/2"
Easy Touch Sheathlock Safety Syringe 1ML/30GX1/2"
Comfort Assist Insulin Syringe/1ML/30G X 5/16"
Easy Touch 32GX5MM
Comfort Assist Insulin Syringe/1ML/31G X 5/16"
Easy Touch 32GX6MM
Droplet Pen Needles 29GX12MM
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 1/2"
Droplet Pen Needles 31GX5MM
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 5/16"
Droplet Pen Needles 31GX6MM
Elite-thin Insulin Syringe/U-100/0.5ML/29G X 5/16"
Droplet Pen Needles 31GX8MM
Elite-thin Insulin Syringe/U-100/0.5ML/31G X 5/16"
Droplet Pen Needles 32GX4MM
Elite-thin Insulin Syringe/U-100/1ML/28G X 1/2"
Droplet Pen Needles 32GX5MM
Elite-thin Insulin Syringe/U-100/1ML/28G X 5/16"
Droplet Pen Needles 32GX6MM
Elite-thin Insulin Syringe/U-100/1ML/29G X 1/2"
Droplet Pen Needles 32GX8MM
Elite-thin Insulin Syringe/U-100/1ML/31G X 5/16"
Drug Mart Unifine Pentips 31GX5MM
Elite-thin Insulin Syringe/0.3ML/31G X 5/16"
Drug Mart Unifine Pentipsplus 32GX4MM
Elite-thin Insulin Syringe/0.5ML/29G X 1/2"
Drug Mart Unifine Pentips29G X 12MM
Elite-thin Insulin Syringe/0.5ML/30G X 5/16"
Drug Mart Unifine Pentips31GX6MM
Elite-thin Insulin Syringe/1ML/29G X 5/16"
Drug Mart Unifine Pentips31GX8MM
Elite-thin Insulin Syringe/1ML/30G X 5/16"
Drug Mart Unifine Pentips32GX4MM
Eql Insulin Syringe/U-100/0.3ML/29G X 1/2"
Duane Reade Unifine Pentips 29G X 12MM
Eql Insulin Syringe/U-100/0.5ML/29G X 1/2"
Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT
Eql Insulin Syringe/U-100/1ML/29G X 1/2"
Duane Reade Unifine Pentips 31G X 8MM SHORT
Eql Insulin Syringe/0.3ML/29G X 1/2"
Easy Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2"
Eql Insulin Syringe/0.3ML/30G X 5/16"
Easy Comfort Insulin Syringe/U-100/1ML/30G X 1/2"
Eql Insulin Syringe/0.3ML/31G X 5/16"
Easy Comfort Insulin Syringe/0.3ML/30G X 5/16"
Eql Insulin Syringe/0.5ML/29G X 1/2"
Easy Comfort Insulin Syringe/0.5ML/30G X 5/16"
Eql Insulin Syringe/0.5ML/30G X 5/16"
Easy Comfort Insulin Syringe/0.5ML/31G X 5/16"
Eql Insulin Syringe/0.5ML/31G X 5/16"
Easy Comfort Insulin Syringe/1ML/30G X 5/16"
Eql Insulin Syringe/1ML/29G X 1/2"
Easy Comfort Insulin Syringe/1ML/31G X 5/16"
Eql Insulin Syringe/1ML/30G X 5/16"
Easy Comfort Pen Needles 31GX1/4"
Eql Insulin Syringe/1ML/31G X 5/16"
Easy Comfort Pen Needles 31GX3/16"
Eql SHORT Pen Needles 31G X 8MM
Easy Comfort Pen Needles 31GX5/16"
Eql Ultra Comfort Insulinsyringe/0.3ML/31G X 5/16"
Easy Comfort Pen Needles 32GX5/32"
Eql Ultra Comfort Insulinsyringe/1ML/30G X 5/16"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 29
Eql Ultra SHORT Pen Needles 31G X 6MM
Glucopro Insulin Syringe/U-100/1ML/31G X 5/16"
Exel Comfort Point Insulin Pen Needles 29G X 12MM
Gnp Clickfine Pen Needle Universal/31GX5/16"
Exel Comfort Point Insulin Pen Needles 31G X 6MM
Gnp Clickfine Universal Pen Needles 31GX1/4"
Exel Comfort Point Insulin Pen Needles 31G X 8MM
Gnp Clickfine Universal Pen Needles 31GX5/16"
Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2"
Gnp Insulin Syringe/0.3ML/29G X 1/2"
Exel Comfort Point Insulin Syringe/0.3ML/30G X 5/16"
Gnp Insulin Syringe/0.3ML/30G X 5/16"
Exel Comfort Point Insulin Syringe/0.5ML/28G X 1/2"
Gnp Insulin Syringe/0.3ML/31G X 5/16"
Exel Comfort Point Insulin Syringe/0.5ML/29G X 1/2"
Gnp Insulin Syringe/0.5ML/28G X 1/2"
Exel Comfort Point Insulin Syringe/0.5ML/30G X 5/16"
Gnp Insulin Syringe/0.5ML/29G X 1/2"
Exel Comfort Point Insulin Syringe/1ML/28G X 1/2"
Gnp Insulin Syringe/0.5ML/30G X 5/16"
Exel Comfort Point Insulin Syringe/1ML/29G X 1/2"
Gnp Insulin Syringe/0.5ML/31G X 5/16"
Exel Comfort Point Insulin Syringe/1ML/30G X 5/16"
Gnp Insulin Syringe/1ML/28G X 1/2"
Fifty50 Pen Needles 31G X3/16" (5MM)
Gnp Insulin Syringe/1ML/29G X 1/2"
Fifty50 Pen Needles 31G X5/16" (8MM)
Gnp Insulin Syringe/1ML/30G X 5/16"
Fifty50 Pen Needles 31GX5MM
Gnp Insulin Syringe/1ML/31G X 5/16"
Fifty50 Pen Needles/31GX8MM
Gnp Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"
Fifty50 Pen Needles/32GX4MM
Gnp Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16" SHORT
Fifty50 Pen Needles/32GX6MM
Gnp Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16" SHORT
Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16"
Gnp Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2"
Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16"
Gnp Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2"
Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16"
Gnp Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16" SHORT
Freds Pharmacy Unifine Pentips Pen Needles 32GX4MM
Gnp Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16" SHORT
Freds Pharmacy Unifine Pentips Plus 31GX5MM
Freds Pharmacy Unifine Pentips Plus 31GX8MM
Gnp Ultra Comfort Insulin Syringe/1ML/28G X 1/2"
Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16"
Gnp Ultra Comfort Insulin Syringe/1ML/29G X 1/2"
Gnp Ultra Comfort Insulin Syringe/1ML/30G X 5/16" SHORT
Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16"
Gnp Ultra Comfort Insulin Syringe/1ML/31G X 5/16" SHORT
Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16"
H-e-b Incontrol Pen Needles 29GX12MM
Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16"
H-e-b IN Control Pen Needles 31GX5MM
Global Ease Inject Pen Needles 29GX12MM
H-e-b IN Control Pen Needles 31GX6MM
Global Ease Inject Pen Needles 31GX8MM
H-e-b IN Control Pen Needles 31GX8MM
Global Ease Inject Pen Needles 32GX4MM
H-e-b IN Control Pen Needles/Nano/32GX4MM
Global Ease Inject Pen Neeedles 31GX5MM
H-e-b IN Control Unifine Pentips Plus 31GX5MM
Global Easy Glide Insulinsyringe/U-100/0.3ML/31G X 5/16"
H-e-b IN Control Unifine Pentips Plus 32GX4MM
Healthwise Mini Pen Needles 31GX6MM
Global Easy Glide Pen Needles 32GX4MM
Healthwise Pen Needles 29GX12MM
Global Inject Ease Insulin Syringe/U-100/0.3ML/29G X 1/2"
Healthwise SHORT Pen Needles 31GX8MM
Healthwise Unifine Pentips Pen Needles 32GX4MM
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 1/2"
Healthy Accents Unifine Pentips Pen Needles 29GX12MM
Healthy Accents Unifine Pentips Pen Needles 31GX5MM
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 5/16"
Healthy Accents Unifine Pentips Pen Needles 31GX6MM
Healthy Accents Unifine Pentips Pen Needles 31GX8MM
Global Inject Ease Insulin Syringe/U-100/0.3ML/31G X 5/16"
Healthy Accents Unifine Pentips Pen Needles 32GX4MM
Global Inject Ease Insulin Syringe/U-100/0.5ML/28G X 1/2"
Insulin Syringe/U-100/0.3ML/29G X 1/2"
Insulin Syringe/U-100/0.5ML/28G X 1/2"
Global Inject Ease Insulin Syringe/U-100/0.5ML/29G X 1/2"
Insulin Syringe/U-100/0.5ML/29G X 1/2"
Insulin Syringe/U-100/1ML/28G X 1/2"
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 1/2"
Insulin Syringe/U-100/1ML/29G X 1/2"
Insulin Syringe/U-100/1ML/30G X 5/16"
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 5/16"
Insulin Syringe/U-100/1ML/31G X 5/16"
Insulin Syringe/0.3ML/29G X 1/2"
Global Inject Ease Insulin Syringe/U-100/0.5ML/31G X 5/16"
Insulin Syringe/0.3ML/29G X 1"
Global Inject Ease Insulin Syringe/U-100/1ML/28G X 1/2"
Insulin Syringe/0.3ML/30G X 5/16"
Global Inject Ease Insulin Syringe/U-100/1ML/29G X 1/2"
Insulin Syringe/0.3ML/31G X 5/16"
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 1/2"
Insulin Syringe/0.5ML/27G X 1/2"
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 5/16"
Insulin Syringe/0.5ML/28G X 1/2"
Global Inject Ease Insulin Syringe/U-100/1ML/31G X 5/16"
Insulin Syringe/0.5ML/29G X 1/2"
Global Insulin Syringe/U-100/0.3ML/30G X 1/2"
Insulin Syringe/0.5ML/30G X 1/2"
Global Insulin Syringes/U-100/0.3ML/30GX5/16"
Insulin Syringe/0.5ML/30G X 5/16"
Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2"
Insulin Syringe/0.5ML/31G X 5/16"
Glucopro Insulin Syringe/U-100/0.3ML/30G X 5/16"
Insulin Syringe/1ML/28G X 1/2"
Glucopro Insulin Syringe/U-100/0.3ML/31G X 5/16"
Insulin Syringe/1ML/29G X 1/2"
Glucopro Insulin Syringe/U-100/0.5ML/30G X 1/2"
Insulin Syringe/1ML/30G X 5/16"
Glucopro Insulin Syringe/U-100/0.5ML/30G X 5/16"
Insulin Syringe/1ML/31G X 5/16"
Glucopro Insulin Syringe/U-100/0.5ML/31G X 5/16"
Insulin Syringes/0.5ML/27GX1/2"
Glucopro Insulin Syringe/U-100/1ML/30G X 1/2"
Insulin Syringes/0.5ML/28GX1/2"
Glucopro Insulin Syringe/U-100/1ML/30G X 5/16"
Insulin Syringes/0.5ML/29GX1/2"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 30
Insulin Syringes/0.5ML/30GX5/16"
Litetouch Pen Needles 31G X 6MM
Insulin Syringes/0.5ML/31GX 5/16"
Litetouch Pen Needles 31GX8MM SHORT
Insulin Syringes/0.5ML/31GX5/16"
Live Better Pen Needles 29G X 12MM
Insulin Syringes/1ML/27GX/1/2"
Live Better Pen Needles 31G X 12MM
Insulin Syringes/1ML/27GX1/2"
Live Better Pen Needles 31G X 6MM
Insulin Syringes/1ML/28GX1/2"
Longs Insulin Syringe/0.5ML/31G X 5/16"
Insulin Syringes/1ML/29GX1/2"
Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2"
Insulin Syringes/1ML/30GX1/2"
Magellan Insulin Safety Syringe/U-100/0.3ML/30G X 5/16"
Insulin Syringes/1ML/31GX5/16"
Magellan Insulin Safety Syringe/U-100/0.5ML/29G X 1/2"
Insupen Pen Needles 32G X4MM
Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16"
Insupen Sensitive 32GX6MM
Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2"
Insupen Sensitive 32GX8MM
Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16"
Insupen Ultrafin 29GX12MM
Marathon Medical Pentips 29GX12MM
Insupen Ultrafin 30GX8MM
Marathon Medical Pentips 31GX5MM
Insupen Ultrafin 31GX6MM
Marathon Medical Pentips 31GX8MM
Insupen Ultrafin 31GX8MM
Marathon Medical Pentips 32GX4MM
Insupen 29G X 12MM
Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2"
Insupen 31G X 5MM
Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2"
Insupen 31G X 8MM
Medic Insulin Syringe/0.3ML/30G X 5/16"
Insupen 32G X 4MM
Medic Insulin Syringe/0.5ML/30G X 5/16"
Kinray Insulin Syringe Preferred Plus/0.3ML/31G X 5/16"
Medicine Shoppe Pen Needles 29G X 12MM
Kinray Insulin Syringe Preferred Plus/0.5ML/31G X 5/16"
Medicine Shoppe Pen Needles 31G X 6MM
Kinray Insulin Syringe Preferred Plus/1ML/31G X 5/16"
Medicine Shoppe Pen Needles 31G X 8MM
Kinray Insulin Syringe/0.5ML/29G X 1/2"
Meijer Pen Needles 29G X 12MM
Kmart Valu Plus Insulin Syringe/0.3ML/30G
Meijer Pen Needles 31G X 6MM
Kmart Valu Plus Insulin Syringe/0.5ML/29G
Meijer Pen Needles 31G X 8MM
Kmart Valu Plus Insulin Syringe/0.5ML/30G
Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML
Kmart Valu Plus Insulin Syringe/1ML/29G
Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8"
Kmart Valu Plus Insulin Syringe/1ML/30G
Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2"
Kroger Insulin Syringe/0.3ML/29G X 1/2"
Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2"
Kroger Insulin Syringe/0.3ML/30G X 5/16"
Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2"
Kroger Insulin Syringe/0.3ML/31G X 5/16"
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2"
Kroger Insulin Syringe/0.5ML/29G X 1/2"
Kroger Insulin Syringe/0.5ML/30G X 5/16"
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2"
Kroger Insulin Syringe/0.5ML/31G X 5/16"
Kroger Insulin Syringe/1ML/29G X 1/2"
Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2"
Kroger Insulin Syringe/1ML/30G X 5/16"
Kroger Insulin Syringe/1ML/31G X 5/16"
Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2"
Kroger Pen Needles 29G X 12MM
Kroger Pen Needles 31G X 8MM
Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2"
Kroger Pen Needles 31GX1/4"
Monoject Insulin Syringe/Softpack/1ML/27G X 1/2"
Leader Insulin Syringe/0.3ML/29G X 1/2"
Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16"
Leader Insulin Syringe/0.3ML/30G X 5/16"
Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"
Leader Insulin Syringe/0.3ML/31G X 5/16"
Monoject Insulin Syringe/U-100/0.5ML/30G X 5/16"
Leader Insulin Syringe/0.5ML/28G X 1/2"
Monoject Insulin Syringe/U-100/1ML/28G X 1/2"
Leader Insulin Syringe/0.5ML/29G X 1/2"
Monoject Insulin Syringe/U-100/1ML/30G X 5/16"
Leader Insulin Syringe/0.5ML/30G X 5/16"
Monoject Insulin Syringe/1ML
Leader Insulin Syringe/0.5ML/31G X 5/16"
Monoject Insulin Syringe/1ML/31G X 5/16"
Leader Insulin Syringe/1ML/28G X 1/2"
Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2"
Leader Insulin Syringe/1ML/29G X 1/2"
Monoject Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16"
Leader Insulin Syringe/1ML/30G X 5/16"
Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16"
Leader Insulin Syringe/1ML/31G X 5/16"
Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2"
Leader Unifine Pentips Plus/Mini/31GX3/16"
Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2"
Leader Unifine Pentips Plus/SHORT/31GX5/16"
Monoject Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16"
Leader Unifine Pentips/Mini/31GX3/16"
Monoject Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16"
Leader Unifine Pentips/Nano/32GX5/32"
Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2"
Leader Unifine Pentips/Plus/32GX5/32"
Monoject Ultra Comfort Insulin Syringe/1ML/29G X 1/2"
Lite Touch Pen Needles/31G X 3/16"
Monoject Ultra Comfort Insulin Syringe/1ML/30G X 5/16"
Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2"
Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"
Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2"
Litetouch Insulin Syringe/U-100/1ML/28G X 1/2"
Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"
Litetouch Insulin Syringe/U-100/1ML/29G X 1/2"
Litetouch Insulin Syringe/U-100/1ML/31G X 5/16"
Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2"
Litetouch Insulin Syringe/0.3ML/29G X 1/2"
Litetouch Insulin Syringe/0.3ML/30G X 5/16"
Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2"
Litetouch Insulin Syringe/0.3ML/31G X 5/16"
Litetouch Insulin Syringe/0.5ML/30G X 5/16"
MS Insulin Syringe/0.3ML/29G X 1/2"
Litetouch Insulin Syringe/0.5ML/31G X 5/16"
MS Insulin Syringe/0.3ML/30G X 5/16"
Litetouch Insulin Syringe/1ML/30G X 5/16"
MS Insulin Syringe/0.3ML/31G X 5/16"
Litetouch Pen Needles 29GX12.7MM
MS Insulin Syringe/0.5ML/29G X 1/2"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 31
MS Insulin Syringe/0.5ML/30G X 5/16"
Px Insulin Syringe/U-100/1ML/31G X 5/16"
MS Insulin Syringe/0.5ML/31G X 5/16"
Px Mini Pen Needles 31GX5MM
MS Insulin Syringe/1ML/29G X 1/2"
Px Pen Needle 29GX12MM
MS Insulin Syringe/1ML/30G X 5/16"
Px Pen Needle 31GX8MM
MS Insulin Syringe/1ML/31G X 5/16"
Px Shortlength Pen Needles/31GX8MM
Novofine Autocover 30GX8MM
PC Unifine Pentips 29G X 1/2"
Novofine Plus 32GX4MM
PC Unifine Pentips 31G X 5MM Mini
Novofine 30GX8MM
PC Unifine Pentips 31G X 6MM Ultra SHORT
Novofine 32GX6MM
PC Unifine Pentips 31G X 8MM SHORT
Novotwist 30GX8MM
Qc Insulin Syringe/0.3ML/29G X 1/2"
Novotwist 32GX5MM
Qc Insulin Syringe/0.5ML/29G X 1/2"
Pen Needles 29G X 12MM
Qc Insulin Syringe/0.5ML/31G X 5/16"
Pen Needles 29GX1/2"
Qc Insulin Syringe/1ML/29G X 1/2"
Pen Needles 30GX5/16"
Qc Insulin Syringe/1ML/31G X 5/16"
Pen Needles 30GX8MM
Qc Pen Needles 29G X 12MM
Pen Needles 31G X 1/4" SHORT
Qc Pen Needles 31G X 6MM
Pen Needles 31G X 3/16"
Qc Pen Needles 31G X 8MM
Pen Needles 31G X 5MM
Qc Unifine Pentips 32GX4MM
Pen Needles 31G X 6MM
Ra Insulin Syringe/U-100/0.5ML/30G X 5/16"
Pen Needles 31G X 8MM
Ra Insulin Syringe/U-100/1 ML/30G X 5/16"
Pen Needles 31GX5/16"
Ra Insulin Syringe/0.5ML/29G X 1/2"
Pen Needles 31GX6MM (1/4")
Ra Insulin Syringe/1ML/29G X 1/2"
Pen Needles 31GX8MM
Ra Pen Needles 31G X 5MM 3/16"
Pen Needles 31GX8MM (5/16")
Ra Pen Needles 31G X 8MM 5/16"
Pen Needles 32G X 4MM
Reality Insulin Syringe/U-100/0.5ML/28G X 1/2"
Pen Needles 32G X 5MM
Reality Insulin Syringe/U-100/0.5ML/29G X 1/2"
Pen Needles 32G X 6MM
Reality Insulin Syringe/U-100/1ML/28G X 1/2"
Pen Needles 32GX4MM
Reality Insulin Syringe/U-100/1ML/29G X 1/2"
Pentips 29G X 12MM
Relion Insulin Syringe 0.5ML/31G X 15/64"
Pentips 29GX12MM
Relion Insulin Syringe 1ML/31GX15/64"
Pentips 31G X 5MM
Relion Insulin Syringe/U -100/0.5ML/29G
Pentips 31G X 8MM
Relion Insulin Syringe/U-00/1ML/29G X 1/2"
Pentips 31GX5MM
Relion Insulin Syringe/U-100/0.3ML/29G
Pentips 31GX6MM
Relion Insulin Syringe/U-100/0.3ML/29G X 1/2"
Pentips 31GX8MM
Relion Insulin Syringe/U-100/0.3ML/30G
Pentips 32G X 4MM
Relion Insulin Syringe/U-100/0.3ML/30G X 5/16"
Pentips 32GX4MM
Relion Insulin Syringe/U-100/0.3ML/31G X 15/64"
Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16"
Relion Insulin Syringe/U-100/0.3ML/31G X 5/16"
Precision Sure-dose Insulin Syringe/0.5ML/28G X 1/2"
Relion Insulin Syringe/U-100/0.5ML/29G X 1/2"
Precision Sure-dose Insulin Syringe/0.5ML/29G X 1/2"
Relion Insulin Syringe/U-100/0.5ML/30G
Precision Sure-dose Insulin Syringe/0.5ML/30G X 3/8"
Relion Insulin Syringe/U-100/0.5ML/30G X 5/16"
Precision Sure-dose Insulin Syringe/1ML/28G X 1/2"
Relion Insulin Syringe/U-100/0.5ML/31G X 5/16"
Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2"
Relion Insulin Syringe/U-100/1ML/30G
Relion Insulin Syringe/U-100/1ML/30G X 5/16"
Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2"
Relion Insulin Syringe/U-100/1ML/31G X 15/64"
Preferred Plus Insulin Syringe/U-100/0.3ML/29G X 1/2"
Relion Insulin Syringe/U-100/1ML/31G X 5/16"
Preferred Plus Insulin Syringe/U-100/0.3ML/30G X 5/16"
Relion Mini Pen Needles 31GX6MM
Preferred Plus Insulin Syringe/U-100/0.5ML/28G X 1/2"
Relion Pen Needles 29GX12MM
Preferred Plus Insulin Syringe/U-100/0.5ML/29G X 1/2"
Relion Pen Needles 31GX6MM
Preferred Plus Insulin Syringe/U-100/0.5ML/30G X 5/16"
Relion Pen Needles 31GX8MM
Preferred Plus Insulin Syringe/U-100/1ML/28G X 1/2"
Relion Pen Needles 32GX4MM
Preferred Plus Insulin Syringe/U-100/1ML/29G X 1/2"
Relion SHORT Pen Needles 31GX8MM
Preferred Plus Insulin Syringe/U-100/1ML/30G X 5/16"
Safesnap Insulin Syringe/0.3ML/30G X 5/16"
Preferred Plus Unifine Pentips 29G X 12MM
Safesnap Insulin Syringe/0.5ML/29G X 1/2"
Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT
Safesnap Insulin Syringe/0.5ML/30G X 5/16"
Preferred Plus Unifine Pentips 31G X 8MM SHORT
Safesnap Insulin Syringe/1ML/28G X 1/2"
Preferred Plus Unifine Pentips 32GX4MM
Safesnap Insulin Syringe/1ML/29G X 1/2"
Preferred Plus Unifine Pentips/Mini/31GX5MM
Safety Insulin Syringes 0.5ML/29GX1/2"
Pro Comfort Pen Needles/ 31G X 8MM
Safety Insulin Syringes 0.5ML/30GX5/16"
Pro Comfort Pen Needles/ 32G X 4MM
Safety Insulin Syringes 1ML/27GX1/2"
Pro Comfort Pen Needles/ 32G X 5MM
Safety Insulin Syringes 1ML/29GX1/2"
Pro Comfort Pen Needles/ 32G X 6MM
Safety Insulin Syringes 1ML/30GX1/2"
Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16"
Safety-glide Insulin Syringe/0.3ML/29G X 1/2"
Prodigy Insulin Syringe/1/2ML/31G X 5/16"
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/29G X 1/2"
Prodigy Insulin Syringe/1ML/28G X 1/2"
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/30G X 5/16"
Px Extra SHORT Pen Needles 31GX6MM
Px Insulin Syringe/U-100/0.3ML/30G X 1/2"
Shopko Unifine Pentips Pen Needles/Micro/32GX4MM
Px Insulin Syringe/U-100/0.3ML/31G X 5/16"
Shopko Unifine Pentips Pen Needles/Mini/31GX5MM
Px Insulin Syringe/U-100/0.5ML/30G X 1/2"
Shopko Unifine Pentips Pen Needles/Original/29GX12MM
Px Insulin Syringe/U-100/0.5ML/31G X 5/16"
Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM
Px Insulin Syringe/U-100/1ML/30G X 1/2"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 32
Shopko Unifine Pentips Plus Pen Needles/Micro/Removr/32GX4MM
Topcare Ultra Comfort Insulin Syringe/1ML/30G X 5/16"
Topcare Ultra Comfort Insulin Syringe/1ML/31G X 5/16"
Shopko Unifine Pentips Plus Pen Needles/Mini/Remover/31GX5MM
Topco Insulin Syringe/U-100/0.3ML/29G X 1/2"
Topco Insulin Syringe/U-100/0.5ML/28G X 1/2"
Shopko Unifine Pentips Plus Pen Needles/Remover/29GX12MM
Topco Insulin Syringe/U-100/0.5ML/29G X 1/2"
Topco Insulin Syringe/U-100/1ML/28G X 1/2"
Shopko Unifine Pentips Plus Pen Needles/SHORT/Removr/31GX8MM
Topco Insulin Syringe/U-100/1ML/29G X 1/2"
Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2"
Sm Insulin Syringe/1ML/31G X 5/16"
Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"
Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 1/2"
Trueplus Insulin Syringe/U-100/0.5ML/28G X 1/2"
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"
Trueplus Insulin Syringe/U-100/0.5ML/29G X 1/2"
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16
Trueplus Insulin Syringe/U-100/0.5ML/30G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16"
Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.5ML/28G X 1/2"
Trueplus Insulin Syringe/U-100/1ML/28G X 1/2"
Sure Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"
Trueplus Insulin Syringe/U-100/1ML/29G X 1/2"
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2"
Trueplus Insulin Syringe/U-100/1ML/30G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 5/16"
Trueplus Insulin Syringe/U-100/1ML/31G X 5/16"
Sure Comfort Insulin Syringe/U-100/0.5ML/31G X 5/16
Trueplus Pen Needles 29GX12MM
Sure Comfort Insulin Syringe/U-100/1ML/28G X 1/2"
Trueplus Pen Needles 31GX5MM
Sure Comfort Insulin Syringe/U-100/1ML/29G X 1/2"
Trueplus Pen Needles 31GX6MM
Sure Comfort Insulin Syringe/U-100/1ML/30G X 1/2"
Trueplus Pen Needles 31GX8MM
Sure Comfort Insulin Syringe/U-100/1ML/30G X 5/16"
Trueplus Pen Needles 32GX4MM
Sure Comfort Insulin Syringe/U-100/1ML/31G X 5/16"
Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2"
Sure Comfort Pen Needles 29GX1/2" 12.7MM
Ulticare Insulin Safety Syringe/1ML/29G X 1/2"
Sure Comfort Pen Needles 30GX5/16" SHORT
Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16"
Sure Comfort Pen Needles 31GX3/16" (5MM)
Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16"
Sure Comfort Pen Needles 31GX5/16" (8MM)
Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16"
Sure Comfort Pen Needles 32GX5/32"
Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16"
Sure Comfort Pen Needles 32GX6MM
Ulticare Insulin Syringe/SHORT/0.3ML/31G X 5/16"
Sure-fine Pen Needles 29GX1/2" 12.7MM
Ulticare Insulin Syringe/SHORT/0.5ML/30G X 5/16"
Sure-fine Pen Needles 31GX3/16" 5MM
Ulticare Insulin Syringe/SHORT/0.5ML/31G X 5/16"
Sure-fine Pen Needles 31GX5/16" 8MM
Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16"
Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2"
Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16"
Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16"
Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2"
Sure-ject Insulin Syringe/U-100/0.3ML/31G X 5/16"
Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2"
Sure-ject Insulin Syringe/U-100/0.5ML/28G X 1/2"
Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16"
Sure-ject Insulin Syringe/U-100/0.5ML/29G X 1/2"
Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16"
Sure-ject Insulin Syringe/U-100/0.5ML/30G X 5/16"
Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2"
Sure-ject Insulin Syringe/U-100/0.5ML/31G X 5/16"
Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2"
Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2"
Ulticare Insulin Syringe/U-100/0.5ML/30G X 5/16"
Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2"
Ulticare Insulin Syringe/U-100/0.5ML/31G X 5/16"
Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16"
Ulticare Insulin Syringe/U-100/1ML/29G X 1/2"
Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16"
Ulticare Insulin Syringe/U-100/1ML/30G X 1/2"
SB Insulin Syringe/U-100/0.5ML/29G X 1/2"
Ulticare Insulin Syringe/U-100/1ML/30G X 5/16"
SB Insulin Syringe/U-100/0.5ML/30G X 5/16"
Ulticare Insulin Syringe/U-100/1ML/31G X 5/16"
SB Insulin Syringe/U-100/1ML/29G X 1/2"
Ulticare Insulin Syringe/0.3ML/29G X 1/2"
SB Insulin Syringe/U-100/1ML/30G X 5/16"
Ulticare Insulin Syringe/0.3ML/30G X 1/2"
SB Insulin Syringe/U-100/1ML/31G X 5/16"
Ulticare Insulin Syringe/0.3ML/30G X 5/16"
Techlite Pen Needles 29G X 12 MM
Ulticare Insulin Syringe/0.5ML/28G X 1/2"
Techlite Pen Needles 31G X 5MM
Ulticare Insulin Syringe/0.5ML/29G X 1/2"
Techlite Pen Needles/31G X 5MM
Ulticare Insulin Syringe/0.5ML/30G X 1/2"
Techlite Pen Needles/31G X 6 MM
Ulticare Insulin Syringe/0.5ML/30G X 5/16"
Techlite Pen Needles/31G X 8MM
Ulticare Insulin Syringe/1ML/28G X 1/2"
Techlite Pen Needles/32G X 4MM
Ulticare Insulin Syringe/1ML/29G X 1/2"
Techlite Pen Needles/32G X 6MM
Ulticare Insulin Syringe/1ML/30G X 1/2"
Techlite Pen Needles/32G X 8MM
Ulticare Insulin Syringe/1ML/30G X 5/16"
Todays Health Mini Pen Needles 31G X 1/4"
Ulticare Micro Pen Needles 31G X 8MM
Todays Health Original Pen Needles 29G X 1/2"
Ulticare Micro Pen Needles 32G X 4MM
Todays Health SHORT Pen Needles 31G X 5/16"
Ulticare Micro Pen Needles/32G X 4MM
Topcare Clickfine Universal Pen Eedles 31GX1/4"
Ulticare Mini Pen Needles Ulti-fine IV
Topcare Clickfine Universal Pen Eedles 31GX5/16"
Ulticare Mini Pen Needles 31GX6MM
Topcare Ultra Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"
Ulticare Mini Pen Needles/31G X 6MM
Topcare Ultra Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"
Ulticare Mini Pen Needles31GX6MM
Ulticare Original Pen Needles Ulti-fine
Topcare Ultra Comfort Insulin Syringe/U-100/1ML/29G X 1/2"
Ulticare Pen Needles 31G X 5MM/Mini
Ulticare Pen Needles/29G X 12.7MM
Topcare Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16"
Ulticare SHORT Pen Needles Ulti-fine IV
Topcare Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16"
Ulticare SHORT Pen Needles 31GX8MM
Topcare Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16"
Ulticare SHORT Pen Needles/31G X 8MM
Topcare Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 33
Ultiguard Insulin Syringe/U-100/0.5ML/30G X 5/16"
Value Health Insulin Syringe/U-100/0.5ML/29G X 1/2"
Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16"
Value Health Insulin Syringe/U-100/1ML/29G X 1/2"
Ultilet Insulin Syringe 31X6MM
Valumark Pen Needles 29GX12MM
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 12.7MM
Valumark Pen Needles 31G X 6MM
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16"
Valumark Pen Needles 31G X 8MM
Ultilet Insulin Syringe/SHORT/0.3ML/31G X 5/16"
Vanishpoint Insulin Syringe/0.5ML/30G X 1/2"
Ultilet Insulin Syringe/SHORT/0.5ML/30G X 5/16"
Vanishpoint Insulin Syringe/0.5ML/30G X 5/16"
Ultilet Insulin Syringe/SHORT/0.5ML/31G X 5/16"
Vanishpoint Insulin Syringe/1ML/29G X 1/2"
Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16"
Vanishpoint Insulin Syringe/1ML/29G X 5/16"
Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16"
Vanishpoint Insulin Syringe/1ML/30G X 5/16"
Ultilet Insulin Syringe/U-100/0.5ML/30G X 1/2"
Vida Mia Unifine Pentips Mini 31GX6MM
Ultilet Insulin Syringe/U-100/0.5ML/31GX6MM
Vida Mia Unifine Pentips Original 29GX12MM
Ultilet Insulin Syringe/U-100/1ML/30G X 1/2"
Vida Mia Unifine Pentips 32GX4MM
Ultilet Insulin Syringe/0.3ML/30G X 8MM
Vida Mia Unipfine Pentipsshort 31GX8MM
Ultilet Insulin Syringe/0.3ML/31G X 8MM
Vp Insulin Syringe/U-100/0.3ML/29G X 1/2"
Ultilet Insulin Syringe/0.5ML/30G X 8MM
Wegmans Unifine Pentips Plus 32GX4MM
Ultilet Insulin Syringe/1ML/30G X 8MM
Wegmans Unifine Pentips Plus/Mini/31GX5MM
Ultilet Insulin Syringe/1ML/31G X 8MM
Wegmans Unifine Pentips Plus/SHORT/31GX8MM
Ultilet Pen Needle 29GX12.7MM
Wegmans Unifine Pentips Plus/Ultra SHORT/31GX6MM
Ultilet Pen Needle 31GX5MM
1ST Tier Unifine Pentips /Mini/31GX5MM
Ultilet Pen Needle 31GX8MM
1ST Tier Unifine Pentips Plus 31GX8MM
Ultilet Pen Needle 32GX4MM
1ST Tier Unifine Pentips Plus 32GX4MM
Ultilet Pen Needle 32GX4MM/SHORT
1ST Tier Unifine Pentips Plus/Mini/31GX5MM
Ultilet SHORT Pen Needles 31GX5/16"
1ST Tier Unifine Pentips Plus/Original/29GX12MM
Ultilet SHORT Pen Needles31GX3/16"
1ST Tier Unifine Pentips Plus/Ultra SHORT/31GX6MM
Ultra Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"
1ST Tier Unifine Pentips 29GX12MM
Ultra-comfort Insulin Syringe/U-100/0.3ML/29G X 1/2"
1ST Tier Unifine Pentips 31GX6MM
Ultra-comfort Insulin Syringe/U-100/0.3ML/30G X 5/16"
1ST Tier Unifine Pentips 31GX8MM
Ultra-comfort Insulin Syringe/U-100/0.3ML/31G X 5/16"
1ST Tier Unifine Pentips 32GX4MM
Ultra-comfort Insulin Syringe/U-100/0.5ML/28G X 1/2"
Ultra-comfort Insulin Syringe/U-100/0.5ML/29G X 1/2"
MEDICAL DEVICES - MISC
Ultra-comfort Insulin Syringe/U-100/0.5ML/30G X 5/16"
FORMULARY FORMULARY
Ultra-comfort Insulin Syringe/U-100/0.5ML/31G X 5/16"
Aerochamber Mini Aerosol Chamber
Ultra-comfort Insulin Syringe/U-100/1ML/28G X 1/2"
Aerochamber MV
Ultra-comfort Insulin Syringe/U-100/1ML/29G X 1/2"
Aerochamber Plus Flow VU
Ultra-comfort Insulin Syringe/U-100/1ML/30G X 5/16"
Aerochamber Plus Flow-VU
Ultra-comfort Insulin Syringe/U-100/1ML/31G X 5/16"
Aerochamber Plus Flow-VU/Large Mask
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16"
Aerochamber Plus Flow-VU/Mask
Aerochamber Plus Flow-VU/Medium Mask
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/31GX5/16"
Aerochamber Plus Flow-VU/Small Mask
Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/30GX5/16"
Aerochamber Z-stat Plus/Flowsignal
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/31GX5/16"
Aerochamber Z-stat Plus/Large Mask
Aerochamber Z-stat Plus/Medium Mask
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16"
Aerochamber Z-stat Plus/Small Mask
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16"
Aerochamber/Flowsignal
Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2"
Aerovent Plus Holding Chamber/Collapsible
Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2"
Arial Chamber
Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2"
Breatherite
Ultra-thin II Mini Pen Neeedles/31GX3/16"
Breatherite Collapsible Adult Spacer W/Mask
Ultra-thin II Pen Needles 29GX1/2"
Breatherite Collapsible Child Spacer W/Mask
Ultra-thin II Pen Needles/SHORT/31GX5/16"
Breatherite Collapsible Infant Spacer W/Mask
Unifine Pentips Plus 29GX12MM
Breatherite Collapsible Small Child Spacer W/Mask
Unifine Pentips Plus 31GX5MM
Breatherite Collapsible Spacer W/ Neonate Mask
Unifine Pentips Plus 31GX6MM
Breatherite Rigid Spacer W/Mask
Unifine Pentips Plus 31GX8MM
Breatherite W/Large Mask
Unifine Pentips Plus 32GX4MM
Breatherite W/Medium Mask
Unifine Pentips 29GX12MM
Breatherite W/Small Mask
Unifine Pentips 31G X 3/16"
Clever Choice Anti-staticvalved Holding Chamber/Adult Large
Unifine Pentips 31G X 6MM
Unifine Pentips 31G X 8MM
Clever Choice Anti-staticvalved Holding Chamber/Medium
Unifine Pentips 31GX5MM
Clever Choice Anti-staticvalved Holding Chamber/Small
Unifine Pentips 31GX6MM
Compact Space Chamber/Anti-static
Unifine Pentips 31GX8MM
Compact Space Chamber/Anti-static/Large Mask
Unifine Pentips 32GX4MM
Compact Space Chamber/Anti-static/Medium Mask
V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2"
Compact Space Chamber/Anti-static/Small Mask
V-r Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2"
E-z Spacer
V-r Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2"
E-z Spacer The Body Guards Pack
V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2"
Easivent
V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2"
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 34
Easivent/Mask-large
Easivent/Mask-medium
Easivent/Mask-small
Flexichamber
Inspirachamber/Anti-static Valved/Mouthpiece
Inspirachamber/Large
Inspirachamber/Soothermask/Inspiramask/Medium
Inspirachamber/Soothermask/Inspiramask/Small
Inspirease Drug Delivery System
Liteaire
Microchamber
Microspacer
Optichamber Advantage
Optichamber Advantage/Large Mask
Optichamber Advantage/Medium Face Mask
Optichamber Advantage/Small Face Mask
Optichamber Diamond
Optichamber Diamond/Largeface Mask
Optichamber Diamond/Medium Face Mask
Optichamber Diamond/Smallface Mask
Optichamber Face Mask/Large
Optichamber Face Mask/Medium
Optichamber Face Mask/Small
Optihaler
Optihaler MDI Drug Delivery System
Pocket Chamber
Pocket Spacer
Riteflo
Valved Holding Chamber
Vortex Valved Holding Chamber
Watchhaler
MISCELLANEOUS AGENTS
TIER 01 PREFERRED GENERIC
naltrexone HCL
TIER 02 NON-PREFERRED GENERIC
naloxone HCL
Naloxone HCL
PREFERRED BRAND
Chemet
Narcan
TIER 03 NON-PREFERRED BRAND
EvzioST
TIER 04 SPECIALTY
Exjade
FerriproxST
Jadenu
Jadenu Sprinkle
Effective October 1, 2017
PA=Prior Auth Required; ST=Step Therapy; QL=Quantity Limits; AL=Age Limit; 35
Index
A
5ML/31GX5/16", 28
Allzital, 23
Advocate Insulin Syringe/U-100/1ML/29GX1/2", 28
almotriptan, 24
abacavir, 2
almotriptan malate, 24
abacavir sulfate/lamivudine/zidovudine, 2
Advocate Insulin Syringe/U-100/1ML/30GX5/16", 28
Alocril, 22
abacavir/lamivudine, 2
Alogliptin, 12
Abaneu-SL, 16
Advocate Insulin Syringe/U-100/1ML/31GX5/16", 28
Alomide, 22
Abstral, 23
Alora, 10
acamprosate calcium DR, 20
Aerochamber Mini Aerosol Chamber, 34
alosetron hydrochloride, 15
acarbose, 12
Aerochamber MV, 34
alphatrex, 8
Accucaine, 9
Aerochamber Plus Flow VU, 34
alprazolam, 18
acebutolol HCL, 4
Aerochamber Plus Flow-VU, 34
alprazolam ER, 18
Acetaminophen/Caffeine/Dihydrocodeine, 23
Aerochamber Plus Flow-VU/Large Mask, 34
Alprazolam Intensol, 18
alprazolam odt, 18
acetaminophen/codeine, 23
Aerochamber Plus Flow-VU/Mask, 34
alprazolam XR, 18
acetaminophen/codeine phosphate, 23
Aerochamber Plus Flow-VU/Medium Mask, 34
Altabax, 7
acetasol HC, 22
altacaine, 22
acetazolamide, 5
Aerochamber Plus Flow-VU/Small Mask, 34
altafrin, 22
acetazolamide ER, 5
altavera, 10
acetic acid, 22
Aerochamber Z-stat Plus Valved Holding Chamber W/Flow VU, 34
Altoprev, 6
Acetic Acid/Aluminum Acetate, 22
Alvesco, 25
acetylcysteine, 25
Aerochamber Z-stat Plus/Flowsignal, 34
alyacen 1/35, 10
Aciphex Sprinkle, 14
Aerochamber Z-stat Plus/Large Mask, 34
alyacen 7/7/7, 10
acitretin, 7
Aerochamber Z-stat Plus/Medium Mask, 34
amabelz, 10
acne foaming wash, 6
amantadine HCL, 19
acne medication 10, 6
Aerochamber Z-stat Plus/Small Mask, 34
Amcinonide, 8
acne medication 5, 6
Aerochamber/Flowsignal, 34
amethia, 10
acne pimple medication maximum strength/vanishing, 6
Aerospan, 25
amethia LO, 10
Aerovent Plus Holding Chamber/Collapsible, 34
amethyst, 10
acne treatment gel, 6
amiloride HCL, 5
acne-clear, 6
afeditab CR, 4
amiloride/hydrochlorothiazide, 5
Actemra, 24
Afinitor, 3
amiodarone HCL, 5
Actimmune, 4
Afinitor Disperz, 3
amitriptyline HCL, 18
Active FE, 16
Afluria 2015-2016, 25
amlodipine besylate, 4
Active OB, 27
Afluria 2016-2017, 25
amlodipine besylate/atorvastatin calcium, 6
acyclovir, 2, 7
Afluria 2017-2018, 25
adapalene, 6
Afluria PF 2015-2016, 25
amlodipine besylate/benazepril HCL, 5
Adapalene, 7
Afluria PF 2016-2017, 25
amlodipine besylate/benazepril hydrochloride, 5
adapalene and benzoyl peroxide, 6
Afluria PF 2017-2018, 25
adapalene P.M., 6
Afluria Quadrivalent 2016-2017, 25
amlodipine besylate/valsartan, 5
Adazin, 9
Afluria Quadrivalent 2017-2018, 25
amlodipine/olmesartan medoxomil, 5
Adcirca, 6
aftera, 10
amlodipine/valsartan/hctz, 5
Addyi, 20
Aggrenox, 17
amnesteem, 6
adefovir dipivoxil, 2
agoneaze, 8
Amoxapine, 18
Adempas, 6
airavite, 16
amoxicillin, 1
Adlyxin, 12
ak-poly-bac, 21
Amoxicillin, 1
Adlyxin Starter Pack, 12
Akten, 22
Amoxicillin ER, 1
Adrenalin, 25
Aktipak, 7
amoxicillin/clavulanate potassium, 1
Advair Diskus, 25
Akynzeo, 14
Amoxicillin/Clavulanate Potassium, 1
Advair HFA, 25
ala-cort, 8
amoxicillin/clavulanate potassium ER, 1
Advocate Insulin Pen Needles 29GX12.7MM, 28
Ala-quin, 7
amphetamine/dextroamphetamine, 19
alaway, 22
ampicillin, 1
Advocate Insulin Pen Needles 31GX5MM, 28
alaway childrens allergy eye itch relief, 22
Ampicillin, 1
Ampyra, 20
Advocate Insulin Pen Needles 31GX8MM, 28
Albenza, 3
ana-lex, 14
albuterol sulfate, 25
Anacaine, 9
Advocate Insulin Syringe/U-100/0.3ML/29GX1/2", 28
albuterol sulfate ER, 25
Anadrol-50, 10
alclometasone dipropionate, 8
anagrelide hydrochloride, 17
Advocate Insulin Syringe/U-100/0.3ML/30GX5/16", 28
Alecensa, 3
anastrozole, 3
alendronate sodium, 12
Androgel, 10
Advocate Insulin Syringe/U-100/0.3ML/31GX5/16", 28
Alendronate Sodium, 12
Androgel P.M., 10
Alferon N, 4
Androxy, 10
Advocate Insulin Syringe/U-100/0.5ML/29GX1/2", 28
alfuzosin HCL ER, 16
Animi-3, 16
Alinia, 3
Animi-3/Vitamin D, 16
Advocate Insulin Syringe/U-100/0.5ML/30GX5/16", 28
allergy eye drops, 22
anodyne lpt, 8
allopurinol, 24
Anoro Ellipta, 25
Advocate Insulin Syringe/U-100/0.
Anti-stick Insulin Syringe/U-100/0.5ML/28G X 1/2", 28
augmented betamethasone dipropionate, 8
BD Insulin Syringe Microfine IV/U-100/0.3ML/28G X 1/2", 28
Anti-stick Insulin Syringe/U-100/0.5ML/29G X 1/2", 28
Aurora Pen Needles 29GX12MM, 28
BD Insulin Syringe Microfine IV/U-100/0.5ML/28G X 1/2", 28
Aurora Pen Needles 31G X 6MM, 28
Anti-stick Insulin Syringe/U-100/1ML/29G X 1/2", 28
Aurora Pen Needles 31G X 8MM, 28
BD Insulin Syringe Microfine IV/U-100/1ML/27G X 5/8", 28
Aurora Unifine Pentips/32GX5/32", 28
anucort-HC, 14
Aurora Unifine Pentips/Mini/31GX3/16", 28
BD Insulin Syringe Microfine IV/U-100/1ML/28G X 1/2", 28
anusol-HC, 14
Anzemet, 14
Auryxia, 15
BD Insulin Syringe Microfine/U-100/0.3ML/28G X 1/2", 28
AP-zel, 26
AV-vite fb, 16
Apexicon E, 8
Avaderm, 9
BD Insulin Syringe Microfine/U-100/0.5ML/28G X 1/2", 28
Apidra, 12
Avandia, 12
Apidra Solostar, 12
Avar, 7
BD Insulin Syringe Microfine/U-100/1ML/27G X 5/8", 28
Aplenzin, 18
avar cleanser, 6
Apokyn, 20
Avar LS, 7
BD Insulin Syringe Microfine/U-100/1ML/28G X 1/2", 28
apraclonidine, 22
Avar LS Cleanser, 7
aprepitant, 14
avar-e emollient, 6
BD Insulin Syringe Safetyglide/0.5ML/29G X 1/2", 28
apri, 10
avar-e green, 6
Apriso, 15
Avc, 16
BD Insulin Syringe Safetyglide/1ML/29G X 1/2", 28
Aptensio XR, 19
aviane, 10
Aptivus, 2
avidoxy, 1
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 15/64", 28
aranelle, 10
Avidoxy DK, 1
Aranesp Albumin Free, 16
avita, 6
BD Insulin Syringe Safetyglide/U-100/0.3ML/31G X 5/16", 28
arbinoxa, 24
Avonex, 20
Arcalyst, 24
Avonex Pen, 20
BD Insulin Syringe Slip Tip/U-100/1ML, 28
Arcapta Neohaler, 25
Axert, 24
argyle sterile saline 100ML, 16
Azasite, 21
BD Insulin Syringe U-40/1ML/25G X 5/8", 28
Arial Chamber, 34
azathioprine, 3
aripiprazole, 18
azelastine HCL, 22, 24
BD Insulin Syringe Ultrafine Half-unit/0.3ML/31G X 5/16", 28
aripiprazole odt, 18
azithromycin, 1
Aristada, 18
Azithromycin, 1
BD Insulin Syringe Ultrafine II/SHORT/0.5ML/31G X 5/16", 28
armodafinil, 19
Azopt, 22
Armour Thyroid, 13
azuphen mb, 15
BD Insulin Syringe Ultrafine II/SHORT/1ML/31G X 5/16", 28
ascomp/codeine, 23
azurette, 10
ashlyna, 10
B
BD Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 28
Asmanex HFA, 25
B-12 Compliance Injectionkit, 16
Asmanex Twisthaler 120 Metered Doses, 25
BD Insulin Syringe Ultrafine/0.3ML/31G X 5/16", 28
B-12 Kit, 16
B-d Insulin Syringe Ultrafine II/0.3ML/31G X 5/16", 28
Asmanex Twisthaler 14 Metered Doses, 25
BD Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 28
B-d Insulin Syringe Ultrafine II/0.5ML/31G X 5/16", 28
Asmanex Twisthaler 30 Metered Doses, 25
BD Insulin Syringe Ultrafine/0.5ML/31G X 5/16", 28
B-d Insulin Syringe Ultrafine II/1ML/31G X 5/16", 28
Asmanex Twisthaler 60 Metered Doses, 25
BD Insulin Syringe Ultrafine/1ML/30G X 1/2", 28
B-d Insulin Syringe Ultrafine/0.3ML/30G X 1/2", 28
Asmanex Twisthaler 7 Metered Doses, 25
BD Insulin Syringe Ultrafine/1ML/31G X 5/16", 28
B-d Insulin Syringe Ultrafine/0.5ML/30G X 1/2", 28
aspirin, 22
BD Insulin Syringe Ultrafine/U-100/0.3ML/29G X 1/2", 28
Aspirin Low Dose, 23
B-d Insulin Syringe Ultrafine/1ML/30G X 1/2", 28
Aspirin-caffeine-dihydrocodeine, 23
BD Insulin Syringe Ultrafine/U-100/0.3ML/30G X 1/2", 28
aspirin/dipyridamole, 17
b-donna, 14
Assure ID Insulin Safety Syringe/U-100/0.5ML/29G X 1/2", 28
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 15/64", 28
b-plex plus, 26
Bacitracin, 21
Assure ID Insulin Safety Syringe/U-100/1ML/29G X 1/2", 28
BD Insulin Syringe Ultrafine/U-100/0.3ML/31G X 5/16", 28
bacitracin/polymyxin b, 21
baclofen, 21
Astero, 9
BD Insulin Syringe Ultrafine/U-100/0.5ML/29G X 1/2", 28
Bacmin, 26
Atabex EC, 27
Bactroban Nasal, 25
atenolol, 4
BD Insulin Syringe Ultrafine/U-100/0.5ML/30G X 1/2", 28
Bal-care DHA, 27
atenolol/chlorthalidone, 5
balsalazide disodium, 14
atomoxetine, 19
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 15/64", 28
balziva, 10
Atopiclair, 9
Banzel, 19
atorvastatin calcium, 6
BD Insulin Syringe Ultrafine/U-100/0.5ML/31G X 5/16", 28
Baraclude, 2
atovaquone, 3
bayer advanced aspirin regular strength, 22
atovaquone/proguanil HCL, 2
BD Insulin Syringe Ultrafine/U-100/1ML/29G X 1/2", 28
Atripla, 2
bayer aspirin, 23
Atropine Sulfate, 22
BD Insulin Syringe Ultrafine/U-100/1ML/30G X 1/2", 28
BD Autoshield 29G X 3/16", 28
Atrovent HFA, 25
BD Autoshield 29G X 5/16", 28
Aubagio, 20
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 15/64", 28
BD Insulin Syringe LUER-LOK/U-100/1ML, 28
aubra, 10
BD Insulin Syringe Ultrafine/U-100/1ML/31G X 5/16", 28
betaxolol HCL, 4, 21
bupropion HCL ER, 18
bethanechol chloride, 15
bupropion HCL SR, 18, 20
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 1", 28
Bethkis, 1
bupropion HCL XL, 18
Betimol, 21
buspirone HCL, 18
BD Insulin Syringe/Detachable Needle/U-100/1ML/25G X 5/8", 28
Betoptic-s, 21
butalbital/acetaminophen, 23
bexarotene, 4
butalbital/acetaminophen/caffeine, 23
BD Insulin Syringe/Detachable Needle/U-100/1ML/26G X 1/2", 28
bicalutamide, 3
butalbital/acetaminophen/caffeine/codeine, 23
Biltricide, 3
BD Insulin Syringe/U-100/0.5ML/30G X 1/2", 28
Bimatoprost, 21
butalbital/aspirin/caffeine, 23
Binosto, 12
Butalbital/Aspirin/Caffeine, 23
BD Insulin Syringe/U-100/1ML/27G X 1/2", 28
bio-statin, 2
butalbital/aspirin/caffeine/codeine, 23
Bio-statin, 2
butorphanol tartrate, 23
BD Insulin Syringe/U-100/1ML/28G X 1/2", 28
biocel, 26
Bydureon, 12
bisoprolol fumarate, 4
Bydureon Pen, 12
BD Insulin Syringe/U-100/2ML/27.5G X 5/8", 28
bisoprolol fumarate/hydrochlorothiazide, 5
Byetta, 12
Bystolic, 4
BD Integra Insulin Syringe/U-100/1ML/29G X 1/2", 28
Blephamide, 21
C
Blephamide S.o.p., 21
C-nate DHA, 26
BD Integra Syringe/Retracting Needle/1ML/25G X 1", 28
blisovi 24 FE, 10
cabergoline, 13
blisovi FE 1.5/30, 10
Cabometyx, 3
BD LO-dose Insulin Syringe Microfine IV/0.5ML/28G X 1/2", 28
blisovi FE 1/20, 10
caffeine citrate, 19
Bosulif, 3
calcipotriene, 7
BD Pen Needle/Mini/Ultrafine/31G X 3/16", 28
bp 10-1, 7
calcipotriene/betamethasone dipropionate, 8
Bp Cleansing Wash, 7
BD Pen Needle/Nano/Ultra Fine/32G X 4MM, 28
bp foam, 7
calcitonin salmon, 12
bp foaming wash, 6
calcitonin-salmon, 12
BD Pen Needle/SHORT/Ultrafine/31G X 5/16", 28
Bp Folinatal Plus B, 26
calcitrene, 7
bp gel, 6
Calcitriol, 8
BD Pen Needle/Ultrafine/29G X 12.7MM, 28
Bp Multinatal Plus, 26
calcitriol, 13
Bp Vit 3, 16
calcium acetate, 14
BD Pen Needle/Ultrafine/29GX1/2" 12.7MM, 28
Bp Vit 3 Plus, 16
Calcium PNV, 26
bp wash, 6
Cambia, 24
BD Pen Needles SHORT/Ultrafine/31G X 5/16", 28
bpm, 24
camila, 10
bpo 6% foaming cloths, 7
camrese, 10
BD Safety-glide Insulin Syringe/0.5ML/29G X 1/2", 28
bpo-10 wash, 6
camrese LO, 10
Breatherite, 34
Canasa, 15
BD Safety-lok Insulin Syringe/Perm Needle/UF/1ML/29G X 1/2", 28
Breatherite Collapsible Adult Spacer W/Mask, 34
candesartan cilexetil, 5
candesartan cilexetil/hydrochlorothiazide, 5
BD Safetyglide Insulin Sysyringe/0.5ML/30G X 5/16", 28
Breatherite Collapsible Child Spacer W/Mask, 34
Cantil, 14
BD Ultra-fine Micro Pen Needles 6MM X 32G, 28
Breatherite Collapsible Infant Spacer W/Mask, 34
capacet, 23
capecitabine, 3
bekyree, 10
Breatherite Collapsible Small Child Spacer W/Mask, 34
Capex, 8
Belbuca, 23
Capital/Codeine, 23
Belladonna & Opium, 14
Breatherite Collapsible Spacer W/ Neonate Mask, 34
Caprelsa, 3
Belladonna Alkaloids & Opium, 14
captopril, 5
belladonna alkaloids/phenobarbital, 14
Breatherite Rigid Spacer W/Mask, 34
Captopril/Hydrochlorothiazide, 5
Belviq, 19
Breatherite W/Large Mask, 34
Carafate, 14
Belviq XR, 19
Breatherite W/Medium Mask, 34
Carbaglu, 13
benazepril HCL, 5
Breatherite W/Small Mask, 34
carbamazepine, 19
benazepril HCL/hydrochlorothiazide, 5
Breo Ellipta, 25
carbamazepine ER, 19
Benzamycin, 7
briellyn, 10
Carbaphen 12, 25
benzepro creamy wash, 7
Brilinta, 17
Carbaphen 12 PED, 25
benzepro foaming cloths, 7
brimonidine tartrate, 22
Carbatrol, 19
benzepro SHORT contact, 7
Brintellix, 18
carbidopa, 20
benzonatate, 25
bromfenac, 22
carbidopa/levodopa, 19
benzoyl peroxide, 6
Bromfenac, 22
carbidopa/levodopa ER, 19
benzoyl peroxide SHORT contact, 7
bromocriptine mesylate, 19
carbidopa/levodopa odt, 19
benzoyl peroxide wash, 6
Brompheniramine Tannate, 24
Carbidopa/Levodopa/Entacapone, 20
benztropine mesylate, 19
Brovana, 25
carbinoxamine maleate, 24
Bepreve, 22
budesonide, 9, 25
Carefine Pen Needle 32GX4MM, 28
Besivance, 21
budesonide nasal spray, 24
Carefine Pen Needles 29GX1/2", 28
Betadine Ophthalmic Prep, 21
bumetanide, 5
Carefine Pen Needles 30GX5/16", 28
betamethasone dipropionate, 8
Buphenyl, 13
Carefine Pen Needles 31GX6MM, 28
betamethasone dipropionate/augmented, 8
buprenorphine HCL, 23
Carefine Pen Needles 31GX8MM, 28
buprenorphine HCL/naloxone HCL, 23
Carefine Pen Needles 32GX5MM, 28
betamethasone valerate, 8
buproban, 20
Carefine Pen Needles 32GX6MM, 28
Betaseron, 20
bupropion HCL, 18
Careone Insulin Syringes/0.3ML/30G X
1/2", 28
cerovel, 9
clearplex x, 6
Careone Insulin Syringes/0.3ML/31G X 5/16", 28
Cesamet, 14
clemastine fumarate, 24
cevimeline HCL, 17
Clemastine Fumarate, 24
Careone Insulin Syringes/0.5ML/30G X 1/2", 28
Chantix, 20
Cleocin, 15
Chantix Continuing Month PAK, 20
Clever Choice Anti-staticvalved Holding Chamber/Adult Large, 34
Careone Insulin Syringes/0.5ML/31G X 5/16", 28
Chantix Starting Month PAK, 20
chateal, 10
Clever Choice Anti-staticvalved Holding Chamber/Medium, 34
Careone Insulin Syringes/1ML/30G X 1/2", 28
Chemet, 35
Chenodal, 15
Clever Choice Anti-staticvalved Holding Chamber/Small, 34
Careone Insulin Syringes/1ML/31GX5/16", 28
chlordiazepoxide HCL, 18
chlordiazepoxide HCL/clidinium bromide, 14
Clever Choice Comfort EZ Insulin Pen Needles 31GX8MM, 28
Careone Unifine Pentips 29GX12MM, 28
Careone Unifine Pentips 31GX5MM, 28
Chlordiazepoxide/Amitriptyline, 20
Clever Choice Comfort EZ Insulin Syringe/0.3ML/29G X 1/2", 28
Careone Unifine Pentips 31GX6MM, 28
chlorhexidine gluconate, 17
Careone Unifine Pentips 31GX8MM, 28
chlorhexidine gluconate oral rinse, 17
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 1/2", 28
Careone Unifine Pentips Pen Needles 32GX4MM, 28
chloroquine phosphate, 2
Chloroquine Phosphate, 2
Clever Choice Comfort EZ Insulin Syringe/0.3ML/30G X 5/16", 28
Careone Unifine Pentips Plus Pen Needles 29GX12MM, 28
chlorothiazide, 5
Chlorothiazide, 5
Clever Choice Comfort EZ Insulin Syringe/0.3ML/31G X 5/16", 28
Careone Unifine Pentips Plus Pen Needles 31GX5MM, 28
chlorpromazine HCL, 18
Chlorpropamide, 12
Clever Choice Comfort EZ Insulin Syringe/0.5ML/28G X 1/2", 29
Careone Unifine Pentips Plus Pen Needles 31GX6MM, 28
chlorthalidone, 5
chlorzoxazone, 21
Clever Choice Comfort EZ Insulin Syringe/0.5ML/29G X 1/2", 29
Careone Unifine Pentips Plus Pen Needles 31GX8MM, 28
Cholbam, 15
cholestyramine, 6
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 1/2", 29
Careone Unifine Pentips Plus Pen Needles 32GX4MM, 28
cholestyramine light, 6
choline magnesium trisalicylate, 23
Clever Choice Comfort EZ Insulin Syringe/0.5ML/30G X 5/16", 29
Caretouch Pen Needles 31 G X 6 MM, 28
Chorionic Gonadotropin, 12
Cialis, 6
Clever Choice Comfort EZ Insulin Syringe/0.5ML/31G X 5/16", 29
Caretouch Pen Needles 31GX 5MM, 28
ciclodan, 7
Caretouch Pen Needles 31GX 8MM, 28
Ciclodan Cream Kit, 7
Clever Choice Comfort EZ Insulin Syringe/1.0ML/30G X 1/2", 29
Caretouch Pen Needles 32GX 4MM, 28
Ciclodan Solution Kit, 7
Caretouch Pen Needles 32GX 5MM, 28
ciclopirox, 7
Clever Choice Comfort EZ Insulin Syringe/1ML/28G X 1/2", 29
carisoprodol, 21
ciclopirox nail lacquer, 7
carisoprodol/aspirin, 21
ciclopirox olamine, 7
Clever Choice Comfort EZ Insulin Syringe/1ML/29G X 1/2", 29
carisoprodol/aspirin/codeine, 21
ciclopirox treatment, 7
carteolol HCL, 21
cidaleaze, 9
Clever Choice Comfort EZ Insulin Syringe/1ML/30G X 5/16", 29
cartia XT, 4
Ciferex, 16
carvedilol, 4
Cifrazol, 16
Clever Choice Comfort EZ Insulin Syringe/U-100/1ML/31GX5/16", 28
cavarest, 17
cilostazol, 17
Cayston, 3
Ciloxan, 21
Clever Choice Comfort EZ Pen Needles 29GX12MM, 29
caziant, 10
cimetidine, 14
Cedax, 1
cimetidine HCL, 14
Clever Choice Comfort EZ Pen Needles 31GX5MM, 29
cefaclor, 1
Cimzia, 15
Cefaclor, 1
Cimzia Starter Kit, 15
Clever Choice Comfort EZ Pen Needles 31GX6MM, 29
Cefaclor ER, 1
Cipro HC, 22
cefadroxil, 1
Ciprodex, 22
Clever Choice Comfort EZ Pen Needles 31GX8MM, 29
cefdinir, 1
ciprofloxacin, 1
Cefditoren Pivoxil, 1
Ciprofloxacin, 22
Clever Choice Comfort EZ Pen Needles 32GX4MM, 29
cefixime, 1
ciprofloxacin ER, 1
cefpodoxime proxetil, 1
ciprofloxacin HCL, 1, 21
Clever Choice Comfort EZ Pen Needles 32GX5MM, 29
cefprozil, 1
Ciprofloxacin HCL, 1
Ceftibuten, 1
citalopram hydrobromide, 18
Clever Choice Comfort EZ Pen Needles 32GX6MM, 29
Ceftin, 1
Citranatal 90 DHA, 26
Ceftriaxone Sodium, 1
Citranatal Assure, 26
Clever Choice Comfort EZ Pen Needles 32GX8MM, 29
cefuroxime axetil, 1
Citranatal B-calm, 26
Celebrex, 24
Citranatal DHA, 26
Clever Choice Comfort EZ Pen Needles 33GX5MM, 29
celecoxib, 24
Citranatal Harmony, 26
Celontin, 19
Citranatal RX, 26
Clever Choice Comfort EZ Pen Needles 33GX6MM, 29
Cem-urea, 9
claravis, 6
Cenfol, 16
clarithromycin, 1
Clever Choice Comfort EZ Pen Needles 33GX8MM, 29
Centany AT, 7
Clarithromycin, 1
Centratex, 16
clarithromycin ER, 1
Clickfine Pen Needle 32GX5/32", 29
cephalexin, 1
claritin eye, 22
Clickfine Pen Needle Universal/31GX1/4", 29
Cephalexin, 1
clean & clear persa-gel maximum strength, 6
Ceracade, 9
Clickfine Pen Needle Universal/31GX5/16", 29
Cerdelga, 16
clearlax, 13
cerisa wash, 7
clearplex v, 6
Clickfine Pen Needles/31GX1/4", 29
Clickfine Pen Needles/31GX5/16", 29
Compact Space Chamber/Anti-static/Large Mask, 34
Cycloset, 12
Clickfine Universal Pen Needles 31GX5/16", 29
cyclosporine, 3
Compact Space Chamber/Anti-static/Medium Mask, 34
cyclosporine modified, 3
Clindacin Etz, 7
Cyclosporine Modified, 3
clindacin etz pledgets, 6
Compact Space Chamber/Anti-static/Small Mask, 34
cyotic, 22
Clindacin PAC, 7
cyproheptadine HCL, 24
clindacin-p, 6
Complera, 2
cyred, 10
clindamycin HCL, 3
Complete Natal DHA, 26
Cystadane, 13
clindamycin palmitate HCL, 3
Completenate, 26
Cystagon, 16
clindamycin phosphate, 6, 15
compro, 18
Cystaran, 22
clindamycin phosphate/tretinoin, 7
Concept DHA, 26
cytra k crystals, 16
clindamycin/benzoyl peroxide, 7
Concept OB, 26
D
clinpro 5000, 17
constulose, 14
d3, 26
clobetasol propionate, 8
Contrave, 19
d3-50, 26
clobetasol propionate e, 8
controlrx, 17
Daklinza, 2
clobetasol propionate emollient, 8
Copaxone, 20
Daliresp, 25
Clocortolone Pivalate, 8
Corlanor, 6
danazol, 10
Clocortolone Pivalate P.M., 8
cormax scalp application, 8
dantrolene sodium, 21
clodan, 8
Cortane-b, 8
dapsone, 3
Clodan Kit, 8
Cortane-b Aqueous, 22
Daraprim, 2
clomipramine HCL, 18
Cortane-b-otic, 22
darifenacin hydrobromide ER, 15
clonazepam, 19
cortic-nd, 22
dasetta 1/35, 10
clonazepam odt, 19
Cortisone Acetate, 9
dasetta 7/7/7, 10
clonidine HCL, 5
Cortisporin-tc, 22
daysee, 10
clonidine HCL ER, 19
corvita, 26
Debacterol, 17
clopidogrel, 17
corvita 150, 16
deblitane, 10
clorazepate dipotassium, 18
corvite free, 26
decara, 26
Clorpres, 5
Cosentyx, 8
Decon-a, 25
clotrimazole, 17
Cosentyx Sensoready Pen, 8
Decon-G, 25
clotrimazole/betamethasone dipropionate, 7
Cotellic, 3
deltasone, 9
cough drops, 17
delyla, 10
clozapine, 18
covaryx, 10
Delzicol, 15
clozapine odt, 18
covaryx HS, 10
demeclocycline HCL, 1
Clozapine Odt, 18
Creon, 14
Demser, 5
CO-natal Fa, 26
Cresemba, 2
Denavir, 7
Coal TAR, 9
Crinone, 16
denta 5000 plus, 17
Coartem, 2
Crixivan, 2
dentagel, 17
Codar AR, 25
cromolyn sodium, 14, 22
Depakene, 19
codeine sulfate, 23
Cromolyn Sodium, 25
Depakote, 19
Codeine Sulfate, 23
cryselle-28, 10
Depakote ER, 19
Colchicine, 24
curity sterile saline, 16
Depakote Sprinkles, 19
cold sore treatment, 17
Cuvposa, 14
Depo-provera, 3
colestipol HCL, 6
CVS acne foaming face wash, 6
dermacinrx empricaine, 8
colocort, 14
CVS acne treatment, 6
dermacinrx prizopak, 8
Coly-mycin S, 22
CVS acne treatment/maximum strength, 6
Dermacinrx Purefolix, 16
Combigan, 21
Dermasorb AF, 7
Combipatch, 10
CVS allergy eye drops, 22
Dermasorb HC, 8
Combivent Respimat, 25
CVS aspirin, 23
Dermasorb Ta, 8
Cometriq, 3
CVS creamy acne face wash, 6
dermazene, 7
Comfort Assist Insulin Syringe 0.3ML/29G X 1/2", 29
CVS eye itch relief, 22
Dermazone, 8
CVS foaming acne face wash, 6
Descovy, 2
Comfort Assist Insulin Syringe/0.3ML/30G X 5/16", 29
CVS iron, 16
desipramine HCL, 18
CVS nicotine, 20
desloratadine, 24
Comfort Assist Insulin Syringe/0.3ML/31G X 5/16", 29
CVS nicotine lozenge, 20
Desloratadine Odt, 24
CVS nicotine polacrilex, 20
desmopressin acetate, 13
Comfort Assist Insulin Syringe/0.5ML/29G X 1/2", 29
CVS nicotine polacrilex starter, 20
desogestrel/ethinyl estradiol, 10
CVS nicotine transdermal system, 20
desonide, 8
Comfort Assist Insulin Syringe/0.5ML/30G X 5/16", 29
CVS nts step 1, 20
Desowen, 8
CVS purelax, 14
desoximetasone, 8
Comfort Assist Insulin Syringe/0.5ML/31G X 5/16", 29
CVS Saline Wound Wash, 9
Desquam-x Wash, 7
cyanocobalamin, 16
desvenlafaxine ER, 18
Comfort Assist Insulin Syringe/1ML/29G X 1/2", 29
cyclafem 1/35, 10
Desvenlafaxine ER, 18
cyclafem 7/7/7, 10
dexamethasone, 9
Comfort Assist Insulin Syringe/1ML/30G X 5/16", 29
cyclobenzaprine HCL, 21
Dexamethasone, 9
cyclopentolate HCL, 22
Dexamethasone Intensol, 9
Comfort Assist Insulin Syringe/1ML/31G X 5/16", 29
cyclopentolate hydrochloride, 22
Dexamethasone Sodium Phosphate, 21
Cyclophosphamide, 3
dexedrine, 19
Compact Space Chamber/Anti-static, 34
Cycloserine, 1
Dexeryl, 9
Dexilant, 14
doxycycline hyclate DR, 1
29
dexmethylphenidate HCL, 19
doxycycline monohydrate, 1
Easy Comfort Pen Needles 31GX5/16", 29
dexmethylphenidate HCL ER, 19
Dritho-creme HP, 8
Dexpak 10 Day, 10
dronabinol, 14
Easy Comfort Pen Needles 32GX5/32", 29
Dexpak 13 Day, 10
Droplet Pen Needles 29GX12MM, 29
Dexpak 6 Day, 10
Droplet Pen Needles 31GX5MM, 29
Easy Touch 32GX5MM, 29
dextroamphetamine sulfate, 19
Droplet Pen Needles 31GX6MM, 29
Easy Touch 32GX6MM, 29
dextroamphetamine sulfate ER, 19
Droplet Pen Needles 31GX8MM, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/29GX1/2", 29
Dialyvite Supreme D, 26
Droplet Pen Needles 32GX4MM, 29
Diastat Acudial, 19
Droplet Pen Needles 32GX5MM, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX1/2", 29
Diastat Pediatric, 19
Droplet Pen Needles 32GX6MM, 29
diazepam, 18
Droplet Pen Needles 32GX8MM, 29
Easy Touch Fliplock Safety Insulin Syringe 1ML/30GX5/16", 29
Diazepam, 18, 19
drospirenone/ethinyl estradiol, 10
diazepam intensol, 18
drospirenone/ethinyl estradiol/levomefolate calcium, 10
Easy Touch Fliplock Safety Insulin Syringe 1ML/31GX5/16", 29
Diazepam Rectal Gel, 19
diclofenac potassium, 23
Droxia, 16
Easy Touch Insulin Syringe/0.3ML/30G X 5/16", 29
diclofenac sodium, 7, 22
Drug Mart Unifine Pentips 31GX5MM, 29
diclofenac sodium DR, 23
Drug Mart Unifine Pentips29G X 12MM, 29
Easy Touch Insulin Syringe/0.3ML/31G X 5/16", 29
diclofenac sodium ER, 23
diclofenac sodium/misoprostol, 23
Drug Mart Unifine Pentips31GX6MM, 29
Easy Touch Insulin Syringe/0.5ML/29G X 1/2", 29
dicloxacillin sodium, 1
Drug Mart Unifine Pentips31GX8MM, 29
dicyclomine HCL, 14
Drug Mart Unifine Pentips32GX4MM, 29
Easy Touch Insulin Syringe/0.5ML/30G X 5/16", 29
didanosine, 2
Drug Mart Unifine Pentipsplus 32GX4MM, 29
Differin, 6
Easy Touch Insulin Syringe/1ML/30G X 5/16", 29
Dificid, 1
Duane Reade Unifine Pentips 29G X 12MM, 29
difil-G forte, 25
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/29G X 1/2", 29
Diflorasone Diacetate, 8
Duane Reade Unifine Pentips 31G X 6MM Ultra SHORT, 29
diflunisal, 23
Easy Touch Insulin Syringe/Safety/U-100/0.5ML/30G X 5/16", 29
digitek, 4
Duane Reade Unifine Pentips 31G X 8MM SHORT, 29
digox, 4
Easy Touch Insulin Syringe/Safety/U-100/1ML/29G X 1/2", 29
digoxin, 4
Duavee, 10
Digoxin, 4
Duet DHA 400, 26
Easy Touch Insulin Syringe/Safety/U-100/1ML/30G X 1/2", 29
Dihydroergotamine Mesylate, 24
Duet DHA Balanced, 26
Dilantin, 19
dulcolax balance, 13
Easy Touch Insulin Syringe/U-100/0.3ML/30G X 1/2", 29
Dilantin Infatabs, 19
Dulera, 25
Dilantin-125, 19
duloxetine HCL, 18
Easy Touch Insulin Syringe/U-100/0.5ML/27G X 1/2", 29
Dilatrate SR, 4
Durachol, 16
dilt-XR, 4
Duraxin, 23
Easy Touch Insulin Syringe/U-100/0.5ML/28G X 1/2", 29
diltiazem CD, 4
Durezol, 21
diltiazem HCL, 4
Durlaza, 17
Easy Touch Insulin Syringe/U-100/0.5ML/30G X 1/2", 29
diltiazem HCL CD, 4
dutasteride, 16
diltiazem HCL ER, 4
dutasteride/tamsulosin HCL, 16
Easy Touch Insulin Syringe/U-100/0.5ML/31G X 5/16", 29
Dipentum, 15
dutasteride/tamsulosin hydrochloride, 16
diphenoxylate/atropine, 14
Dyrenium, 5
Easy Touch Insulin Syringe/U-100/1ML/27G X 1/2", 29
Diphenoxylate/Atropine, 14
E
dipyridamole, 17
Easy Touch Insulin Syringe/U-100/1ML/28G X 1/2", 29
E-z Spacer, 34
disopyramide phosphate, 5
E-z Spacer The Body Guards Pack, 34
disulfiram, 20
Easy Touch Insulin Syringe/U-100/1ML/29G X 1/2", 29
E.e.s. 400, 1
Diuril, 5
Easivent, 34
divalproex sodium, 19
Easy Touch Insulin Syringe/U-100/1ML/30G X 1/2", 29
Easivent/Mask-large, 35
divalproex sodium DR, 19
Easivent/Mask-medium, 35
divalproex sodium ER, 19
Easy Touch Insulin Syringe/U-100/1ML/31G X 5/16", 29
Easivent/Mask-small, 35
Divista, 16
Easy Comfort Insulin Syringe/0.3ML/30G X 5/16", 29
dofetilide, 5
Easy Touch Pen Needle 30 G X 5/16", 29
donepezil HCL, 20
Easy Comfort Insulin Syringe/0.5ML/30G X 5/16", 29
Donnatal, 14
Easy Touch Pen Needles 29GX1/2", 29
dorzolamide HCL, 22
Easy Touch Pen Needles 31GX1/4", 29
Easy Comfort Insulin Syringe/0.5ML/31G X 5/16", 29
dorzolamide HCL/timolol maleate, 21
Easy Touch Pen Needles 31GX5/16", 29
Dothelle DHA, 26
Easy Touch Pen Needles 32GX1/4", 29
Easy Comfort Insulin Syringe/1ML/30G X 5/16", 29
doxazosin, 5
Easy Touch Pen Needles 32GX3/16", 29
doxazosin mesylate, 5
Easy Touch Pen Needles 32GX5/32", 29
Easy Comfort Insulin Syringe/1ML/31G X 5/16", 29
doxepin HCL, 18
Easy Touch Pen Needles/31G X 3/16", 29
Doxepin HCL, 18
Easy Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2", 29
Doxepin Hydrochloride, 7
Easy Touch Sheathlock Safety Insulin Syringe 1ML/29GX1/2", 29
doxercalciferol, 13
Easy Comfort Insulin Syringe/U-100/1ML/30G X 1/2", 29
doxycycline, 1
Easy Touch Sheathlock Safety Insulin Syringe 1ML/30GX5/16", 29
Doxycycline, 7
Easy Comfort Pen Needles 31GX1/4", 29
doxycycline hyclate, 1
Easy Touch Sheathlock Safety Insulin
Easy Comfort Pen Needles 31GX3/16",
Syringe 1ML/31GX5/16", 29
enskyce, 10
Ergoloid Mesylates, 20
Easy Touch Sheathlock Safety Syringe 1ML/30GX1/2", 29
Enstilar, 8
Ergomar, 24
entacapone, 19
ergotamine tartrate/caffeine, 24
econazole nitrate, 7
entecavir, 2
errin, 10
econtra EZ, 10
Entereg, 15
Ertaczo, 7
ed-spaz, 14
Entresto, 6
ery, 6
Edarbi, 5
Entty Spray Emulsion, 9
Ery-TAB, 1
Edarbyclor, 5
enulose, 14
Eryped 400, 1
Edurant, 2
Envarsus XR, 3
Erythrocin Stearate, 1
eemt, 10
Epaned, 5
erythromycin, 1, 6, 21
eemt HS, 10
Epclusa, 2
Erythromycin Base, 1
Egrifta, 13
Epiceram, 9
Erythromycin Ethylsuccinate, 1
Eldepryl, 20
Epiduo Forte, 7
erythromycin ethylsuccinate, 1
Eletone, 9
Epifoam, 8
erythromycin/benzoyl peroxide, 6
Eletone Twinpack, 9
epinastine HCL, 22
Esbriet, 25
eletriptan hydrobromide, 24
Epinephrine, 6
Escavite, 27
Elidel, 8
epinephrine HCL, 6
escitalopram oxalate, 18
elinest, 10
Epipen 2-PAK, 6
esgic, 23
Eliquis, 17
Epipen-JR 2-PAK, 6
esomeprazole magnesium, 14
Elite-OB, 26
Episil, 17
estarylla, 10
Elite-thin Insulin Syringe/0.3ML/31G X 5/16", 29
epitol, 19
estazolam, 18
Epivir HBV, 2
esterified estrogens/methltestosterone, 10
Elite-thin Insulin Syringe/0.5ML/29G X 1/2", 29
eplerenone, 5
Epogen, 16
esterified estrogens/methyltestosterone, 10
Elite-thin Insulin Syringe/0.5ML/30G X 5/16", 29
Eprosartan Mesylate, 5
eq aspirin, 23
esterified estrogens/methyltestosterone DS, 10
Elite-thin Insulin Syringe/1ML/29G X 5/16", 29
eq clearlax, 13
eq eye itch relief, 22
esterified estrogens/methyltestosterone HS, 10
Elite-thin Insulin Syringe/1ML/30G X 5/16", 29
eq itchy eye drops, 22
eq nicotine, 20
estradiol, 10, 15
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 1/2", 29
eq nicotine gum refill, 20
estradiol/norethindrone acetate, 10
eq nicotine gum starter, 20
Estropipate, 10
Elite-thin Insulin Syringe/U-100/0.5ML/28G X 5/16", 29
eq nicotine polacrilex, 20
eszopiclone, 18
eq nicotine step 3, 20
ethacrynic acid, 5
Elite-thin Insulin Syringe/U-100/0.5ML/29G X 5/16", 29
eql aspirin, 23
ethambutol HCL, 1
eql clearlax, 13
ethosuximide, 19
Elite-thin Insulin Syringe/U-100/0.5ML/31G X 5/16", 29
eql cold sore treatment, 17
ethyl chloride, 9
Eql Insulin Syringe/0.3ML/29G X 1/2", 29
Ethyl Chloride, 9
Elite-thin Insulin Syringe/U-100/1ML/28G X 1/2", 29
Eql Insulin Syringe/0.3ML/30G X 5/16", 29
Ethyl Chloride/Fine Pinpoint, 9
Ethyl Chloride/Fine Stream, 9
Elite-thin Insulin Syringe/U-100/1ML/28G X 5/16", 29
Eql Insulin Syringe/0.3ML/31G X 5/16", 29
Ethyl Chloride/Medium Jet Stream, 9
Ethyl Chloride/Medium Stream, 9
Elite-thin Insulin Syringe/U-100/1ML/29G X 1/2", 29
Eql Insulin Syringe/0.5ML/29G X 1/2", 29
Ethyl Chloride/Mist, 9
Eql Insulin Syringe/0.5ML/30G X 5/16", 29
ethynodiol diacetate/ethinyl estradiol, 10
Elite-thin Insulin Syringe/U-100/1ML/31G X 5/16", 29
Etidronate Disodium, 12
Eql Insulin Syringe/0.5ML/31G X 5/16", 29
etodolac, 23
Elixophyllin, 25
etodolac ER, 23
Ella, 11
Eql Insulin Syringe/1ML/29G X 1/2", 29
Etoposide, 3
Elmiron, 16
Eql Insulin Syringe/1ML/30G X 5/16", 29
Eurax, 9
Emadine, 22
Eql Insulin Syringe/1ML/31G X 5/16", 29
Evista, 12
Embeda, 23
Eql Insulin Syringe/U-100/0.3ML/29G X 1/2", 29
Evotaz, 2
Emcyt, 3
Evzio, 35
emoquette, 10
Eql Insulin Syringe/U-100/0.5ML/29G X 1/2", 29
Exel Comfort Point Insulin Pen Needles 29G X 12MM, 30
Emsam, 18
Emtriva, 2
Eql Insulin Syringe/U-100/1ML/29G X 1/2", 29
Exel Comfort Point Insulin Pen Needles 31G X 6MM, 30
Emulsion SB, 9
Emverm, 3
eql nicotine, 20
Exel Comfort Point Insulin Pen Needles 31G X 8MM, 30
Enablex, 15
eql nicotine polacrilex, 20
enalapril maleate, 5
eql nicotine polacrilex refill, 20
Exel Comfort Point Insulin Syringe/0.3ML/29G X 1/2", 30
enalapril maleate/hydrochlorothiazide, 5
eql nicotine polacrilex starter, 20
Enbrace HR, 27
Eql SHORT Pen Needles 31G X 8MM, 29
Exel Comfort Point Insulin Syringe/0.3ML/30G X 5/16", 30
Enbrel, 24
Enbrel Sureclick, 24
Eql Ultra Comfort Insulinsyringe/0.3ML/31G X 5/16", 29
Exel Comfort Point Insulin Syringe/0.5ML/28G X 1/2", 30
Encare, 15
endocet, 23
Eql Ultra Comfort Insulinsyringe/1ML/30G X 5/16", 29
Exel Comfort Point Insulin Syringe/0.5ML/29G X 1/2", 30
Enjuvia, 10
enoxaparin sodium, 17
Eql Ultra SHORT Pen Needles 31G X 6MM, 30
Exel Comfort Point Insulin Syringe/0.5ML/30G X 5/16", 30
enpresse-28, 10
Exel Comfort Point Insulin Syringe/1ML/28G X 1/2", 30
Fifty50 Superior Comfort Insulin Syringe/0.3ML/31G X 5/16", 30
Fluphenazine HCL, 18
flurandrenolide, 8
Exel Comfort Point Insulin Syringe/1ML/29G X 1/2", 30
Fifty50 Superior Comfort Insulin Syringe/0.5ML/31G X 5/16", 30
Flurazepam HCL, 19
flurbiprofen, 23
Exel Comfort Point Insulin Syringe/1ML/30G X 5/16", 30
Fifty50 Superior Comfort Insulin Syringe/1ML/31G X 5/16", 30
flurbiprofen sodium, 22
Flurbiprofen Sodium, 22
Exelderm, 7
finasteride, 16
flutamide, 3
exemestane, 3
Firmagon, 3
fluticasone propionate, 8, 24
Exjade, 35
First-lansoprazole, 14
Fluticasone Propionate/Salmeterol, 25
Exoderm, 7
First-omeprazole, 14
fluvastatin, 6
exotic-HC, 22
First-vancomycin 25, 3
fluvastatin sodium ER, 6
Extavia, 20
First-vancomycin 50, 3
Fluvirin 2015-2016, 26
Extra-virt Plus DHA, 26
flanax cough relief, 17
Fluvirin 2016-2017, 26
eye itch relief, 22
Flanax Pain Relief Kit, 24
Fluvirin 2017-2018, 26
ezetimibe, 6
Flarex, 21
fluvoxamine maleate, 18
ezetimibe/simvastatin, 6
flavoxate HCL, 15
fluvoxamine maleate ER, 18
F
flecainide acetate, 5
Fluzone Intradermal Quadrivalent 2015-2016, 26
Flexichamber, 35
fabb, 16
Floriva, 26
Fluzone Intradermal Quadrivalent 2016-2017, 26
Factive, 1
Floriva Plus, 26
Falessa, 11
Flovent Diskus, 25
Fluzone Intradermal Quadrivalent 2017-2018, 26
fallback solo, 10
Flovent HFA, 25
falmina, 10
Flowtuss, 25
Fluzone Quadrivalent 2015-2016, 26
famciclovir, 2
Fluad 2016-2017, 25
Fluzone Quadrivalent 2016-2017, 26
famotidine, 14
Fluad 2017-2018, 25
Fluzone Quadrivalent 2017-2018, 26
Fanapt, 18
Fluarix Quadrivalent 2015-2016, 25
Fluzone Split 2015-2016, 26
Fanapt Titration Pack, 18
Fluarix Quadrivalent 2016-2017, 25
FML, 21
Fareston, 3
Fluarix Quadrivalent 2017-2018, 25
FML Forte, 21
Farxiga, 12
Flublok 2015-2016, 25
Focalgin 90 DHA, 26
Farydak, 3
Flublok 2016-2017, 25
Focalgin CA, 26
fayosim, 10
Flublok 2017-2018, 25
folbee, 16
felbamate, 19
Flublok Quadrivalent 2017-2018, 25
Folbee Plus Cz, 26
Felbatol, 19
Flucelvax 2015-2016, 25
Folcal DHA, 26
felodipine ER, 4
Flucelvax Quadrivalent 2016-2017, 25
Folcaps Omega 3, 26
Fem PH, 16
Flucelvax Quadrivalent 2017-2018, 25
Folet DHA, 27
femynor, 10
fluconazole, 2
Folet One, 27
fenofibrate, 6
flucytosine, 2
folic acid/vitamin b-6/vitamin b-12, 16
Fenofibrate, 6
fludrocortisone acetate, 9
Folivane-OB, 27
fenofibrate micronized, 6
Flulaval Quadrivalent 2014-2015, 26
Folivane-plus, 16
Fenofibric Acid, 6
Flulaval Quadrivalent 2015-2016, 26
Folixapure, 16
fenofibric acid DR, 6
Flulaval Quadrivalent 2016-2017, 26
folplex 2.2, 16
fenoprofen calcium, 24
Flulaval Quadrivalent 2017-2018, 26
foltrin, 16
Fenoprofen Calcium, 24
Flumist Quadrivalent, 26
fondaparinux sodium, 17
fentanyl, 23
Flunisolide, 24
Foradil Aerolizer, 25
Fentanyl, 23
fluocinolone acetonide, 8, 22
Fortavit, 27
fentanyl citrate oral transmucosal, 23
fluocinolone acetonide body, 8
Forteo, 12
Fentora, 23
fluocinolone acetonide ear drops, 22
Fosamax Plus D, 12
ferate, 16
fluocinolone acetonide scalp, 8
fosamprenavir calcium, 2
fergon, 16
fluocinonide, 8
fosinopril sodium, 5
Feriva, 16
fluocinonide emulsified base, 8
fosinopril sodium/hydrochlorothiazide, 5
ferocon, 16
fluoridex, 17
Fosrenol, 15
ferotrinsic, 16
fluoridex daily defense, 17
Fragmin, 17
Ferraplus 90, 16
fluoridex daily defense enhanced whitening, 17
Freds Pharmacy Unifine Pentips Pen Needles 32GX4MM, 30
Ferriprox, 35
Ferro-plex Hematinic, 16
fluoridex daily defense sensitivity relief, 17
Freds Pharmacy Unifine Pentips Plus 31GX5MM, 30
ferrocite plus, 16
ferrotabs, 16
Fluoridex Daily Defense Sensitivity Relief, 17
Freds Pharmacy Unifine Pentips Plus 31GX8MM, 30
Ferrotrin, 16
ferrous gluconate, 16
fluoridex enhanced whitening, 17
Freestyle Precision Insulin Syringe/U-100/0.5ML/30G X 5/16", 30
Fetzima, 18
fluoridex sensitivity relief, 17
Fetzima Titration Pack, 18
fluoridex sensitivity relief/sls free, 17
Freestyle Precision Insulin Syringe/U-100/0.5ML/31G X 5/16", 30
Fifty50 Pen Needles 31G X3/16" (5MM), 30
fluorometholone, 21
Fluoxetine, 20
Freestyle Precision Insulin Syringe/U-100/1ML/31G X 5/16", 30
Fifty50 Pen Needles 31G X5/16" (8MM), 30
Fluoxetine DR, 18
fluoxetine HCL, 18, 20
Freestyle Precision Insulin Syringes/U-100/1ML/30G X 5/16", 30
Fifty50 Pen Needles 31GX5MM, 30
Fluoxetine HCL, 18
Fifty50 Pen Needles/31GX8MM, 30
fluphenazine decanoate, 18
Frova, 24
Fifty50 Pen Needles/32GX4MM, 30
fluphenazine HCL, 18
frovatriptan succinate, 24
Fifty50 Pen Needles/32GX6MM, 30
Fulyzaq, 14
100/0.3ML/30G X 5/16", 30
30
furosemide, 5
Global Inject Ease Insulin Syringe/U-100/0.3ML/31G X 5/16", 30
Gnp Insulin Syringe/0.5ML/28G X 1/2", 30
Furosemide, 5
Fuzeon, 2
Global Inject Ease Insulin Syringe/U-100/0.5ML/28G X 1/2", 30
Gnp Insulin Syringe/0.5ML/29G X 1/2", 30
fyavolv, 10
G
Global Inject Ease Insulin Syringe/U-100/0.5ML/29G X 1/2", 30
Gnp Insulin Syringe/0.5ML/30G X 5/16", 30
gabapentin, 19
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 1/2", 30
Gnp Insulin Syringe/0.5ML/31G X 5/16", 30
Gabitril, 19
galantamine hydrobromide, 20
Global Inject Ease Insulin Syringe/U-100/0.5ML/30G X 5/16", 30
Gnp Insulin Syringe/1ML/28G X 1/2", 30
Galantamine Hydrobromide, 20
Gnp Insulin Syringe/1ML/29G X 1/2", 30
galantamine hydrobromide ER, 20
Global Inject Ease Insulin Syringe/U-100/0.5ML/31G X 5/16", 30
Gnp Insulin Syringe/1ML/30G X 5/16", 30
gatifloxacin, 21
Gnp Insulin Syringe/1ML/31G X 5/16", 30
Gattex, 15
Global Inject Ease Insulin Syringe/U-100/1ML/28G X 1/2", 30
gnp itchy eye, 22
gavilax, 13
gnp nicotine gum, 20
gavilyte-c, 13
Global Inject Ease Insulin Syringe/U-100/1ML/29G X 1/2", 30
gnp nicotine mini lozenge, 20
gavilyte-G, 13
gnp nicotine polacrilex, 20
gavilyte-h, 14
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 1/2", 30
gnp nicotine polacrilex mini, 20
gavilyte-n/flavor pack, 13
gnp nicotine transdermal system, 20
Gelclair, 17
Global Inject Ease Insulin Syringe/U-100/1ML/30G X 5/16", 30
Gnp Saline Wound Wash, 9
Gelnique, 15
Gnp Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 30
Gelnique P.M., 15
Global Inject Ease Insulin Syringe/U-100/1ML/31G X 5/16", 30
Gelx, 17
Gnp Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16" SHORT, 30
gemfibrozil, 6
Global Insulin Syringe/U-100/0.3ML/30G X 1/2", 30
generlac, 14
Gnp Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16" SHORT, 30
gengraf, 3
Global Insulin Syringes/U-100/0.3ML/30GX5/16", 30
Genotropin, 13
Gnp Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 30
Genotropin Miniquick, 13
Glucagen Hypokit, 12
gentak, 21
Glucagon Emergency Kit, 12
Gnp Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 30
Gentak, 21
Glucopro Insulin Syringe/U-100/0.3ML/30G X 1/2", 30
gentamicin sulfate, 7, 21
Gnp Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16" SHORT, 30
Gentamicin Sulfate, 7
Glucopro Insulin Syringe/U-100/0.3ML/30G X 5/16", 30
gentlelax, 13
Gnp Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16" SHORT, 30
Genvoya, 2
Glucopro Insulin Syringe/U-100/0.3ML/31G X 5/16", 30
gianvi, 10
Gnp Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 30
Giazo, 15
Glucopro Insulin Syringe/U-100/0.5ML/30G X 1/2", 30
gildagia, 10
Gnp Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 30
gildess 1.5/30, 10
Glucopro Insulin Syringe/U-100/0.5ML/30G X 5/16", 30
gildess 1/20, 10
Gnp Ultra Comfort Insulin Syringe/1ML/30G X 5/16" SHORT, 30
gildess 24 FE, 10
Glucopro Insulin Syringe/U-100/0.5ML/31G X 5/16", 30
gildess FE 1.5/30, 10
Gnp Ultra Comfort Insulin Syringe/1ML/31G X 5/16" SHORT, 30
gildess FE 1/20, 10
Glucopro Insulin Syringe/U-100/1ML/30G X 1/2", 30
Gilenya, 20
goodsense aspirin, 23
Gilotrif, 4
Glucopro Insulin Syringe/U-100/1ML/30G X 5/16", 30
goodsense itchy eye, 22
glatopa, 20
goodsense nicotine gum, 20
Gleevec, 4
Glucopro Insulin Syringe/U-100/1ML/31G X 5/16", 30
granisetron HCL, 14
Gleostine, 3
Granix, 16
glimepiride, 12
glyburide, 12
griseofulvin microsize, 2
glipizide, 12
glyburide micronized, 12
griseofulvin ultramicrosize, 2
glipizide ER, 12
glyburide/metformin HCL, 12
guanfacine ER, 19
glipizide XL, 12
glycolax, 13
guanfacine HCL, 5
glipizide/metformin HCL, 12
glycopyrrolate, 14
Guanidine HCL, 21
Global Ease Inject Pen Needles 29GX12MM, 30
Glyxambi, 12
Gynazole-1, 16
gnp aspirin, 23
H
Global Ease Inject Pen Needles 31GX8MM, 30
gnp clearlax, 13
H-e-b IN Control Pen Needles 31GX5MM, 30
Gnp Clickfine Pen Needle Universal/31GX5/16", 30
Global Ease Inject Pen Needles 32GX4MM, 30
H-e-b IN Control Pen Needles 31GX6MM, 30
Gnp Clickfine Universal Pen Needles 31GX1/4", 30
Global Ease Inject Pen Neeedles 31GX5MM, 30
H-e-b IN Control Pen Needles 31GX8MM, 30
Gnp Clickfine Universal Pen Needles 31GX5/16", 30
Global Easy Glide Insulinsyringe/U-100/0.3ML/31G X 5/16", 30
H-e-b IN Control Pen Needles/Nano/32GX4MM, 30
gnp cold sore treatment, 17
Global Easy Glide Pen Needles 32GX4MM, 30
gnp eye itch relief, 22
H-e-b IN Control Unifine Pentips Plus 31GX5MM, 30
Gnp Insulin Syringe/0.3ML/29G X 1/2", 30
Global Inject Ease Insulin Syringe/U-100/0.3ML/29G X 1/2", 30
H-e-b IN Control Unifine Pentips Plus 32GX4MM, 30
Gnp Insulin Syringe/0.3ML/30G X 5/16", 30
Global Inject Ease Insulin Syringe/U-100/0.3ML/30G X 1/2", 30
H-e-b Incontrol Pen Needles 29GX12MM, 30
Gnp Insulin Syringe/0.3ML/31G X 5/16",
Global Inject Ease Insulin Syringe/U-
H.p. Acthar, 13
Humalog, 11
Hypersal, 25
Halac, 8
Humalog Junior Kwikpen, 11
Hysingla ER, 23
halobetasol propionate, 8
Humalog Kwikpen, 11
I
Halog, 8
Humalog Mix 50/50, 11
ibandronate sodium, 12
haloperidol, 18
Humalog Mix 50/50 Kwikpen, 11
Ibrance, 4
haloperidol decanoate, 18
Humalog Mix 75/25, 11
ibudone, 23
haloperidol lactate, 18
Humalog Mix 75/25 Kwikpen, 11
ibuprofen, 23
Harvoni, 2
Humatrope, 13
Ibuprofen Comfort PAC, 24
Healthwise Mini Pen Needles 31GX6MM, 30
Humatrope Combo Pack, 13
Iclusig, 4
Humira, 24
ilotycin, 21
Healthwise Pen Needles 29GX12MM, 30
Humira Pediatric Crohns Disease Starter Pack, 24
imatinib mesylate, 3
Healthwise SHORT Pen Needles 31GX8MM, 30
Imbruvica, 4
Humira Pen, 24
imipramine HCL, 18
Healthwise Unifine Pentips Pen Needles 32GX4MM, 30
Humira Pen-crohns Diseasestarter, 24
imipramine pamoate, 18
Humira Pen-psoriasis Starter, 24
imiquimod, 8
Healthy Accents Unifine Pentips Pen Needles 29GX12MM, 30
Humulin 70/30, 11
Imitrex Statdose System, 24
Humulin 70/30 Kwikpen, 11
Impavido, 3
Healthy Accents Unifine Pentips Pen Needles 31GX5MM, 30
Humulin N, 11
Inatal Advance, 26
Humulin N Kwikpen, 11
Inatal GT, 26
Healthy Accents Unifine Pentips Pen Needles 31GX6MM, 30
Humulin R, 11
Inatal Ultra, 26
Humulin R U-500 (concentrated), 11
Increlex, 13
Healthy Accents Unifine Pentips Pen Needles 31GX8MM, 30
Humulin R U-500 Kwikpen, 11
Incruse Ellipta, 25
Hycamtin, 4
indapamide, 5
Healthy Accents Unifine Pentips Pen Needles 32GX4MM, 30
Hycofenix, 25
indiomin mb, 15
hydralazine HCL, 5
Indocin, 24
heather, 10
hydrochlorothiazide, 5
indomethacin, 23
Hemangeol, 4
hydrocodone bitartrate/acetaminophen, 23
indomethacin ER, 24
hematinic plus vitamins/minerals, 16
Infanate Balance, 27
hematinic/folic acid, 16
hydrocodone bitartrate/chlorpheniramine maleate/PSE, 25
inflammacin, 24
Hematogen Fa, 16
Influenza Vaccine For Safeway Dependants, 26
hematogen forte, 16
hydrocodone bitartrate/homatropine methylbromide, 25
Hemenatal OB, 27
Ingrezza, 20
Hemenatal OB + DHA, 27
hydrocodone polistirex/chlorpheniramine polistirex, 25
Inlyta, 4
hemmorex-HC, 14
Inova, 7
Hemocyte Plus, 16
hydrocodone/acetaminophen, 23
Inspirachamber/Anti-static Valved/Mouthpiece, 35
hemocyte-f, 16
hydrocodone/homatropine, 25
hemocyte-plus, 16
hydrocodone/ibuprofen, 23
Inspirachamber/Large, 35
heparin lock flush, 17
hydrocortisone, 8, 9, 14
Inspirachamber/Soothermask/Inspiramask/Medium, 35
Heparin Lock Flush, 17
hydrocortisone acetate, 14
heparin lock flush for flushing vascular access devices, 17
hydrocortisone acetate & iodoquinol, 7
Inspirachamber/Soothermask/Inspiramask/Small, 35
hydrocortisone acetate/pramoxine, 8, 14
heparin lock flush/NACL for flushing vascular access devices, 17
hydrocortisone acetate/pramoxine HCL, 15
Inspirease Drug Delivery System, 35
Insulin Syringe/0.3ML/29G X 1", 30
heparin sodium, 17
hydrocortisone butyrate, 8
Insulin Syringe/0.3ML/29G X 1/2", 30
heparin sodium dcu, 17
hydrocortisone butyrate (lipid), 8
Insulin Syringe/0.3ML/30G X 5/16", 30
heparin sodium lock flush, 17
hydrocortisone butyrate (lipophilic), 8
Insulin Syringe/0.3ML/31G X 5/16", 30
heparin sodium/D5W, 17
hydrocortisone valerate, 8
Insulin Syringe/0.5ML/27G X 1/2", 30
Heparin Sodium/D5W, 17
hydrocortisone/acetic acid, 22
Insulin Syringe/0.5ML/28G X 1/2", 30
Heparin Sodium/NACL 0.45%, 17
hydrocortisone/iodoquinol, 7
Insulin Syringe/0.5ML/29G X 1/2", 30
heparin sodium/NACL 0.9%, 17
hydromet, 25
Insulin Syringe/0.5ML/30G X 1/2", 30
Heparin Sodium/Sodium Chloride 0.9%, 17
hydromorphone HCL, 23
Insulin Syringe/0.5ML/30G X 5/16", 30
Hydromorphone HCL, 23
Insulin Syringe/0.5ML/31G X 5/16", 30
heparin sodium/sodium chloride 0.9% premix, 17
hydromorphone HCL ER, 23
Insulin Syringe/1ML/28G X 1/2", 30
hydromorphone hydrochloride, 23
Insulin Syringe/1ML/29G X 1/2", 30
Hepsera, 2
hydromorphone hydrochloride ER, 23
Insulin Syringe/1ML/30G X 5/16", 30
Hetlioz, 19
hydroxychloroquine sulfate, 2
Insulin Syringe/1ML/31G X 5/16", 30
Hexalen, 3
hydroxyurea, 4
Insulin Syringe/U-100/0.3ML/29G X 1/2", 30
HM aspirin, 23
hydroxyzine HCL, 18
HM clearlax, 14
hydroxyzine pamoate, 18
Insulin Syringe/U-100/0.5ML/28G X 1/2", 30
HM eye itch relief, 22
Hydroxyzine Pamoate, 18
HM nicotine polacrilex, 20
Hylatopic Plus, 9
Insulin Syringe/U-100/0.5ML/29G X 1/2", 30
HM nicotine transdermal system, 20
hyolev mb, 15
HM nicotine transdermal system step 3, 20
hyophen, 15
Insulin Syringe/U-100/1ML/28G X 1/2", 30
hyoscyamine sulfate, 14
homatropaire, 22
hyoscyamine sulfate ER, 14
Insulin Syringe/U-100/1ML/29G X 1/2", 30
homatropine HBR, 22
hyoscyamine sulfate odt, 14
HPR, 9
hyoscyamine sulfate SR, 14
Insulin Syringe/U-100/1ML/30G X 5/16", 30
HPR Plus, 9
hyosyne, 14
Insulin Syringe/U-100/1ML/31G X 5/16", 30
Janumet XR, 12
Korlym, 12
Januvia, 12
kp benzoyl peroxide, 6
Insulin Syringes/0.5ML/27GX1/2", 30
Jardiance, 12
kp benzoyl peroxide wash, 6
Insulin Syringes/0.5ML/28GX1/2", 30
jencycla, 10
kp ketotifen fumarate, 22
Insulin Syringes/0.5ML/29GX1/2", 30
Jentadueto, 12
Kroger Insulin Syringe/0.3ML/29G X 1/2", 31
Insulin Syringes/0.5ML/30GX5/16", 31
Jentadueto XR, 12
Insulin Syringes/0.5ML/31GX 5/16", 31
jevantique LO, 10
Kroger Insulin Syringe/0.3ML/30G X 5/16", 31
Insulin Syringes/0.5ML/31GX5/16", 31
jinteli, 10
Insulin Syringes/1ML/27GX/1/2", 31
jolessa, 10
Kroger Insulin Syringe/0.3ML/31G X 5/16", 31
Insulin Syringes/1ML/27GX1/2", 31
jolivette, 10
Insulin Syringes/1ML/28GX1/2", 31
Jublia, 7
Kroger Insulin Syringe/0.5ML/29G X 1/2", 31
Insulin Syringes/1ML/29GX1/2", 31
juleber, 10
Insulin Syringes/1ML/30GX1/2", 31
junel 1.5/30, 10
Kroger Insulin Syringe/0.5ML/30G X 5/16", 31
Insulin Syringes/1ML/31GX5/16", 31
junel 1/20, 10
Insupen 29G X 12MM, 31
junel FE 1.5/30, 10
Kroger Insulin Syringe/0.5ML/31G X 5/16", 31
Insupen 31G X 5MM, 31
junel FE 1/20, 10
Insupen 31G X 8MM, 31
junel FE 24, 10
Kroger Insulin Syringe/1ML/29G X 1/2", 31
Insupen 32G X 4MM, 31
Juxtapid, 6
Insupen Pen Needles 32G X4MM, 31
K
Kroger Insulin Syringe/1ML/30G X 5/16", 31
Insupen Sensitive 32GX6MM, 31
k-tan plus, 16
Insupen Sensitive 32GX8MM, 31
Kroger Insulin Syringe/1ML/31G X 5/16", 31
Kadian, 23
Insupen Ultrafin 29GX12MM, 31
kaitlib FE, 10
Insupen Ultrafin 30GX8MM, 31
Kroger Pen Needles 29G X 12MM, 31
Kaletra, 2
Insupen Ultrafin 31GX6MM, 31
Kroger Pen Needles 31G X 8MM, 31
Kalydeco, 25
Insupen Ultrafin 31GX8MM, 31
Kroger Pen Needles 31GX1/4", 31
Kamdoy, 9
Integra Plus, 16
kurvelo, 11
Karbinal ER, 24
Intelence, 2
Kuvan, 13
karigel, 17
Intrarosa, 16
Kynamro, 6
karigel-n, 17
Intron A, 4
L
kariva, 10
Intron A W/Diluent, 4
kelnor 1/35, 10
labetalol HCL, 4
introvale, 10
Keppra, 19
Lacrisert, 21
Invirase, 2
Keppra XR, 19
lactic acid, 8
Invokamet, 12
Kerydin, 7
lactic acid e, 8
Invokamet XR, 12
Ketek, 3
lactic acid w/vitamin e, 8
Invokana, 12
ketoconazole, 2, 7
lactulose, 14, 15
Iopidine, 22
ketodan, 7
Lamictal, 19
ipratropium bromide, 24, 25
Ketodan Kit, 7
Lamictal Chewable Dispersible, 19
ipratropium bromide/albuterol sulfate, 25
ketoprofen, 24
Lamictal Odt, 19
irbesartan, 5
Ketoprofen ER, 24
Lamictal XR, 19
irbesartan/hydrochlorothiazide, 5
ketorolac tromethamine, 22, 24
lamivudine, 2
Iressa, 4
ketotifen fumarate, 22
lamivudine/zidovudine, 2
iron, 16
Keveyis, 6
lamotrigine, 19
iron 27, 16
kimidess, 10
lamotrigine ER, 19
Isentress, 2
Kineret, 24
lamotrigine odt, 19
Isentress HD, 2
Kinray Insulin Syringe Preferred Plus/0.3ML/31G X 5/16", 31
lamotrigine starter kit/blue, 19
isibloom, 10
lamotrigine starter kit/green, 19
isometheptene mucate/caffeine/acetaminophen, 24
Kinray Insulin Syringe Preferred Plus/0.5ML/31G X 5/16", 31
lamotrigine titration, 19
Lanoxin, 4
isometheptene/dichloralphenazone/acetaminophen, 24
Kinray Insulin Syringe Preferred Plus/1ML/31G X 5/16", 31
lansoprazole, 14
lansoprazole/amoxicillin/clarithromycin, 14
isoniazid, 1
Kinray Insulin Syringe/0.5ML/29G X 1/2", 31
Isoniazid, 1
Lantus, 11
isosorbide dinitrate, 4
Kisqali, 4
Lantus Solostar, 11
Isosorbide Dinitrate ER, 4
klofensaid II, 7
larin 1.5/30, 11
isosorbide mononitrate, 4
Klonopin, 19
larin 1/20, 11
isosorbide mononitrate ER, 4
kls laxaclear, 13
larin 24 FE, 11
isoxsuprine HCL, 6
kls quit2, 20
larin FE 1.5/30, 11
Isoxsuprine HCL, 6
kls quit4, 20
larin FE 1/20, 11
isradipine, 4
Kmart Valu Plus Insulin Syringe/0.3ML/30G, 31
larissia, 11
Istalol, 21
Lastacaft, 22
itraconazole, 2
Kmart Valu Plus Insulin Syringe/0.5ML/29G, 31
latanoprost, 21
ivermectin, 3
latrix, 8
J
Kmart Valu Plus Insulin Syringe/0.5ML/30G, 31
Latrix XM, 9
Jadenu, 35
Latuda, 18
Jadenu Sprinkle, 35
Kmart Valu Plus Insulin Syringe/1ML/29G, 31
laxative polyethlyene glycol 3350, 13
Jakafi, 4
layolis FE, 11
jantoven, 17
Kmart Valu Plus Insulin Syringe/1ML/30G, 31
Lazanda, 23
Janumet, 12
Ldo Plus, 9
Leader Insulin Syringe/0.3ML/29G X 1/2", 31
levora 0.15/30-28, 11
Litetouch Pen Needles 31GX8MM SHORT, 31
Levorphanol Tartrate, 23
Leader Insulin Syringe/0.3ML/30G X 5/16", 31
levothyroxine sodium, 13
Lithium, 18
levothyroxine sodium TAB 0.075MG, 13
lithium carbonate, 18
Leader Insulin Syringe/0.3ML/31G X 5/16", 31
levoxyl, 13
Lithium Carbonate, 18
Lexiva, 2
lithium carbonate ER, 18
Leader Insulin Syringe/0.5ML/28G X 1/2", 31
Lexixryl, 7
Lithostat, 16
lido bdk, 8
Livalo, 6
Leader Insulin Syringe/0.5ML/29G X 1/2", 31
Lido-k, 9
Live Better Pen Needles 29G X 12MM, 31
lido-prilo caine pack, 8
Leader Insulin Syringe/0.5ML/30G X 5/16", 31
Lido-RX 4.1, 9
Live Better Pen Needles 31G X 12MM, 31
lidocaine, 8
Leader Insulin Syringe/0.5ML/31G X 5/16", 31
Lidocaine And Tetracaine Cream, 9
Live Better Pen Needles 31G X 6MM, 31
lidocaine HCL, 8
livixil PAK, 8
Leader Insulin Syringe/1ML/28G X 1/2", 31
Lidocaine HCL, 9, 17
LO Loestrin FE, 11
lidocaine HCL viscous, 17
Lodosyn, 20
Leader Insulin Syringe/1ML/29G X 1/2", 31
Lidocaine HCL-hydrocortisone Acetate With Aloe, 15
lokara, 8
lomedia 24 FE, 11
Leader Insulin Syringe/1ML/30G X 5/16", 31
lidocaine HCL/hydrocortisone acetate, 15
Lomustine, 3
lidocaine PAK, 8
Longs Insulin Syringe/0.5ML/31G X 5/16", 31
Leader Insulin Syringe/1ML/31G X 5/16", 31
lidocaine viscous, 17
lidocaine-prilocaine-cream base, 8
Lonsurf, 4
Leader Unifine Pentips Plus/Mini/31GX3/16", 31
lidocaine/prilocaine, 8
lopinavir/ritonavir, 2
Lidocin, 9
lopreeza, 10
Leader Unifine Pentips Plus/SHORT/31GX5/16", 31
lidopin, 9
Loprox, 7
Lidopin, 9
lorazepam, 18
Leader Unifine Pentips/Mini/31GX3/16", 31
lidopril, 8
lorazepam intensol, 18
lidopril XR, 8
lorcet, 23
Leader Unifine Pentips/Nano/32GX5/32", 31
Lidorx, 9
lorcet HD, 23
Lidothol, 9
lorcet plus, 23
Leader Unifine Pentips/Plus/32GX5/32", 31
Lidotral, 9
lortab, 23
Lidovex, 9
loryna, 11
leena, 11
Lidozol, 9
losartan potassium, 5
leflunomide, 24
lillow, 11
losartan potassium/hydrochlorothiazide, 5
Lenvima 10 MG Daily Dose, 4
Lindane, 9
Lenvima 14 MG Daily Dose, 4
lindane, 9
Lotemax, 21
Lenvima 18 MG Daily Dose, 4
linezolid, 3
Lotronex, 15
Lenvima 20 MG Daily Dose, 4
Linzess, 15
lovastatin, 6
Lenvima 24 MG Daily Dose, 4
liothyronine sodium, 13
low-ogestrel, 11
Lenvima 8 MG Daily Dose, 4
liprozonepak, 8
loxapine, 18
lessina, 11
lisinopril, 5
loxapine succinate, 18
Letairis, 6
lisinopril/hydrochlorothiazide, 5
LP lite PAK, 9
letrozole, 3
Lite Touch Pen Needles/31G X 3/16", 31
Lumigan, 21
leucovorin calcium, 4
Liteaire, 35
lutera, 11
Leucovorin Calcium, 4
Litetouch Insulin Syringe/0.3ML/29G X 1/2", 31
Luzu, 7
Leukeran, 3
Lynparza, 4
Leukine, 17
Litetouch Insulin Syringe/0.3ML/30G X 5/16", 31
Lyrica, 19
leva set, 8
lysiplex plus, 26
leva set/occlusive dressing, 8
Litetouch Insulin Syringe/0.3ML/31G X 5/16", 31
Lysodren, 3
Levacet, 23
lyza, 11
levalbuterol, 25
Litetouch Insulin Syringe/0.5ML/30G X 5/16", 31
M
levalbuterol HCL, 25
Macnatal CN DHA, 26
Levemir, 12
Litetouch Insulin Syringe/0.5ML/31G X 5/16", 31
Magellan Insulin Safety Syringe/U-100/0.3ML/29G X 1/2", 31
Levemir Flextouch, 12
levetiracetam, 19
Litetouch Insulin Syringe/1ML/30G X 5/16", 31
Magellan Insulin Safety Syringe/U-100/0.3ML/30G X 5/16", 31
levetiracetam ER, 19
levo-t, 13
Litetouch Insulin Syringe/U-100/0.5ML/28G X 1/2", 31
Magellan Insulin Safety Syringe/U-100/0.5ML/29G X 1/2", 31
levobunolol HCL, 21
levocarnitine, 13
Litetouch Insulin Syringe/U-100/0.5ML/29G X 1/2", 31
Magellan Insulin Safety Syringe/U-100/0.5ML/30G X 5/16", 31
levocetirizine dihydrochloride, 24
levofloxacin, 1, 21
Litetouch Insulin Syringe/U-100/1ML/28G X 1/2", 31
Magellan Insulin Safety Syringe/U-100/1ML/29G X 1/2", 31
Levofloxacin, 1
Levomefolate DHA, 27
Litetouch Insulin Syringe/U-100/1ML/29G X 1/2", 31
Magellan Insulin Safety Syringe/U-100/1ML/30G X 5/16", 31
levonest, 11
levonorgestrel, 11
Litetouch Insulin Syringe/U-100/1ML/31G X 5/16", 31
malathion, 9
levonorgestrel and ethinyl estradiol, 11
Maprotiline HCL, 18
Levonorgestrel And Ethinyl Estradiol, 11
Litetouch Pen Needles 29GX12.7MM, 31
Marathon Medical Pentips 29GX12MM, 31
levonorgestrel/ethinyl estradiol, 11
Litetouch Pen Needles 31G X 6MM, 31
Marathon Medical Pentips 31GX5MM, 31
metaxall, 21
mimvey, 10
Marathon Medical Pentips 31GX8MM, 31
metaxalone, 21
mimvey LO, 10
Marathon Medical Pentips 32GX4MM, 31
Metaxalone, 21
minitran, 4
margesic, 23
metformin HCL, 12
Minivelle, 10
marlissa, 11
metformin HCL ER, 12
Minocin Kit, 1
Marnatal-f, 27
metformin hydrochloride, 12
minocycline HCL, 1
Marplan, 18
methadone HCL, 23
minocycline HCL ER, 1
marten-TAB, 23
Methadone HCL, 23
Minocycline HCL ER, 1
Matulane, 4
methadone HCL intensol, 23
minoxidil, 5
matzim LA, 4
methadose, 23
Miochol-e, 22
Maxfe, 16
Methadose, 23
Mircera, 17
Maxi-comfort Insulin Syringe/U-100/0.5ML/28GX1/2", 31
Methadose Sugar-free, 23
mirtazapine, 18
methamphetamine HCL, 19
mirtazapine odt, 18
Maxi-comfort Insulin Syringe/U-100/1ML/28GX1/2", 31
methazolamide, 5
Mirvaso, 7
methenamine hippurate, 15
misoprostol, 14
me/naphos/mb/hyo 1, 15
methenamine mandelate, 15
Mitosol, 21
meclizine HCL, 14
Methenamine Mandelate, 15
MM aspirin, 23
Meclofenamate Sodium, 24
Methergine, 22
modafinil, 19
Medic Insulin Syringe/0.3ML/30G X 5/16", 31
methimazole, 13
moderiba, 2
Methitest, 10
Moderiba, 2
Medic Insulin Syringe/0.5ML/30G X 5/16", 31
methocarbamol, 21
moexipril HCL, 5
methotrexate, 3
moexipril/hydrochlorothiazide, 5
Medical Provider EZ Flu Shot 2015-2016, 26
methotrexate sodium, 3
Moi-stir, 17
Methotrexate Sodium, 3
Molindone Hydrochloride, 18
Medical Provider EZ Flu Shot PF 2014-2015, 26
methoxsalen, 7
mometasone furoate, 8, 24
methscopolamine bromide, 14
mondoxyne nl, 1
Medical Provider Single Use EZ Flu Shot, 26
Methyclothiazide, 5
mono-linyah, 11
methyldopa, 5
Monoject Insulin Syringe Regular LUER Tip/Softpack/1ML, 31
Medical Provider Single Use EZ Flu Shot 2016-2017, 26
Methyldopa/Hydrochlorothiazide, 5
methylergonovine maleate, 22
Monoject Insulin Syringe/1ML, 31
Medicine Shoppe Pen Needles 29G X 12MM, 31
methylphenidate HCL, 19
Monoject Insulin Syringe/1ML/31G X 5/16", 31
Methylphenidate HCL, 19
Medicine Shoppe Pen Needles 31G X 6MM, 31
methylphenidate HCL CD, 19
Monoject Insulin Syringe/Detach Needle/1ML/25G X 5/8", 31
methylphenidate HCL ER, 19
Medicine Shoppe Pen Needles 31G X 8MM, 31
Methylphenidate HCL ER, 19
Monoject Insulin Syringe/Detach Needle/1ML/27G X 1/2", 31
Methylphenidate HCL ER (LA), 19
medolor PAK, 8
methylphenidate hydrochloride, 19
Monoject Insulin Syringe/Perm Needle/1ML/28G X 1/2", 31
Medrol Dosepak, 10
methylprednisolone, 9
medroxyprogesterone acetate, 11(2)
methylprednisolone dose pack, 9
Monoject Insulin Syringe/Perm Needle/U-100/0.5ML/28G X 1/2", 31
mefenamic acid, 24
methyltestosterone, 10
mefloquine HCL, 2
Metipranolol, 21
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29G X 1/2", 31
megestrol acetate, 3, 11
metoclopramide HCL, 15
Meijer Pen Needles 29G X 12MM, 31
Metoclopramide Odt, 15
Monoject Insulin Syringe/Safety/Perm Needle/0.3ML/29GX1/2", 31
Meijer Pen Needles 31G X 6MM, 31
metolazone, 5
Meijer Pen Needles 31G X 8MM, 31
metoprolol succinate ER, 4
Monoject Insulin Syringe/Safety/Perm Needle/0.5ML/29G X 1/2", 31
Mekinist, 4
metoprolol tartrate, 4
melodetta 24 FE, 11
Metoprolol Tartrate, 4
Monoject Insulin Syringe/Safety/Perm Needle/1ML/29G X 1/2", 31
meloxicam, 24
metoprolol/hydrochlorothiazide, 5
Meloxicam, 24
Metoprolol/Hydrochlorothiazide, 5
Monoject Insulin Syringe/Softpack/1ML/27G X 1/2", 31
Meloxicam Comfort PAC, 24
metronidazole, 3, 7
melphalan, 3
Metronidazole, 7
Monoject Insulin Syringe/Softpack/U-100/0.5ML/28G X 1/2", 31
memantine HCL, 20
metronidazole vaginal, 15
memantine HCL titration PAK, 20
mexiletine HCL, 5
Monoject Insulin Syringe/U-100/0.3ML/30G X 5/16", 31
memantine hydrochloride, 20
mibelas 24 FE, 11
Menest, 10
Miconazole 3, 15
Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 31
Mentax, 7
Microchamber, 35
meperidine HCL, 23
microgestin 1.5/30, 11
Monoject Insulin Syringe/U-100/0.5ML/30G X 5/16", 31
Meperidine HCL, 23
microgestin 1/20, 11
Meperidine HCL/Promethazine HCL, 23
microgestin 24 FE, 11
Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 31
Mephyton, 26
microgestin FE, 11
meprobamate, 18
microgestin FE 1.5/30, 11
Monoject Insulin Syringe/U-100/1ML/30G X 5/16", 31
mercaptopurine, 3
Microspacer, 35
mesalamine, 15
midazolam HCL, 18
monoject pharma grade flush syringe/heparin lock, 17
Mesalamine DR, 15
midodrine HCL, 6
mesalamine DR, 15
Mifeprex, 13
monoject prefill advanced heparin lock flush, 17
Mesnex, 4
Migergot, 24
metadate ER, 19
miglitol, 12
Monoject Ultra Comfort Insulin Syringe/0.3ML/29G X 1/2", 31
Metaproterenol Sulfate, 25
Millipred DP, 10
Monoject Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16", 31
Multigen Plus, 16
Necon 1/50-28, 11
multivitamin with fluoride, 26
necon 10/11-28, 11
Monoject Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 31
Multivitamin With Fluoride, 27
necon 7/7/7, 11
multivitamin/fluoride, 26
Neevo DHA, 27
Monoject Ultra Comfort Insulin Syringe/0.5ML/28G X 1/2", 31
multivitamins/fluoride, 26
nefazodone HCL, 18
mupirocin, 7
Nefazodone HCL, 18
Monoject Ultra Comfort Insulin Syringe/0.5ML/29G X 1/2", 31
mupirocin calcium, 7
neo-polycin, 21
MVC-fluoride, 26
neo-polycin HC, 21
Monoject Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 31
my way, 11
Neo-synalar, 7
Myalept, 13
Neo-synalar Kit, 7
Monoject Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 31
mycophenolate mofetil, 3
neomycin sulfate, 1
mycophenolic acid DR, 3
neomycin/bacitracin/polymyxin, 21
Monoject Ultra Comfort Insulin Syringe/1ML/28G X 1/2", 31
Mykidz Iron Fl, 27
neomycin/polymyxin/bacitracin zinc, 21
Myleran, 3
neomycin/polymyxin/bacitracin/hydrocortisone, 21
Monoject Ultra Comfort Insulin Syringe/1ML/29G X 1/2", 31
Mynatal, 27
Mynatal Advance, 26
neomycin/polymyxin/dexamethasone, 21
Monoject Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 31
Mynatal Plus, 26
neomycin/polymyxin/gramicidin, 21
Mynatal Ultracaplet, 26
neomycin/polymyxin/HC, 22
mononessa, 11
Mynatal-z, 26
Neomycin/Polymyxin/Hydrocortisone, 21
montelukast sodium, 25
Mynate 90 Plus, 26
neomycin/polymyxin/hydrocortisone, 22
Monurol, 15
mynephrocaps, 26
Neosalus, 9
Moore MED Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 31
mynephron, 26
Neosalus CP, 9
myorisan, 6
Neotuss Plus, 25
Moore MED Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2", 31
Myrbetriq, 15
Nephron Fa, 16
Mysoline, 19
Nesina, 12
Moore MED Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 31
myzilra, 11
Nestabs, 27
N
Nestabs Abc, 27
Moore MED Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 31
Nestabs DHA, 27
nabumetone, 24
neuac, 6
nadolol, 4
morgidox 1X100MG, 1
Neuac Kit, 7
nadolol/bendroflumethiazide, 5
Morgidox 1X100MG, 1
Neulasta, 17
Nafrinse Daily/Acidulated, 17
morgidox 1X50MG, 1
Neulasta Onpro Kit, 17
Nafrinse Daily/Neutral, 17
morgidox 2X100MG, 1
Neupogen, 17
Nafrinse Weekly, 17
Morgidox 2X100MG, 1
Neurin-SL, 16
naftifine HCL, 7
Morphine Sulfate, 23
Neurontin, 19
naftifine hydrochloride, 7
morphine sulfate, 23
neutragard advanced, 17
Naftin, 7
morphine sulfate ER, 23
Nevanac, 22
naloxone HCL, 35
Morphine Sulfate ER, 23
nevirapine, 2
Naloxone HCL, 35
Motofen, 14
Nevirapine, 2
naltrexone HCL, 35
Mouthkote, 17
nevirapine ER, 2
Namenda XR, 20
Moviprep, 14
Newgen, 27
Namenda XR Titration Pack, 20
Moxeza, 21
Nexa Plus, 27
Namzaric, 20
moxifloxacin HCL, 1, 21
Nexavar, 4
Naphazoline HCL, 22
MS Insulin Syringe/0.3ML/29G X 1/2", 31
next choice one dose, 11
Naprosyn, 24
MS Insulin Syringe/0.3ML/30G X 5/16", 31
niacin ER, 6
naproxen, 24
niacinamide/azelaic ac/ turmer/fa/b6/zinc ox/copper, 26
Naproxen, 24
MS Insulin Syringe/0.3ML/31G X 5/16", 31
Naproxen Comfort PAC, 24
Niacor, 6
naproxen DR, 24
MS Insulin Syringe/0.5ML/29G X 1/2", 31
Nicadan, 27
naproxen kit, 24
MS Insulin Syringe/0.5ML/30G X 5/16", 32
Nicadan ZX, 27
naproxen sodium, 24
nicardipine HCL, 4
naproxen sodium CR, 24
MS Insulin Syringe/0.5ML/31G X 5/16", 32
Nicazel, 27
naproxen sodium ER, 24
Nicazel Forte, 27
naratriptan HCL, 24
MS Insulin Syringe/1ML/29G X 1/2", 32
nicorelief, 20
Narcan, 35
MS Insulin Syringe/1ML/30G X 5/16", 32
nicotine, 20
Nardil, 18
MS Insulin Syringe/1ML/31G X 5/16", 32
nicotine mini lozenge, 20
Natachew, 27
Mucotrol, 17
nicotine polacrilex, 20
Natacyn, 21
Mugard, 17
nicotine polacrilex refill, 20
Natalvit, 27
mult-vitamin/fluoride, 26
nicotine polacrilex starter kit, 20
Natazia, 11
Multaq, 5
nicotine step 1, 20
nateglinide, 12
multi vitamin/fluoride, 26
nicotine step 2, 20
Natelle One, 27
multi-vit/fluoride, 26
nicotine step 3, 20
Natpara, 12
multi-vit/iron/fluoride, 26
nicotine transdermal system, 20
Nature-throid, 13
multi-vitamin/fluoride, 26
Nicotine Transdermal System, 20
Nature-throid Nt-2.5, 13
multi-vitamin/fluoride drops, 26
nicotine transdermal system step 1, 20
Nebupent, 3
multi-vitamin/fluoride/iron, 26
nicotine transdermal system step 2, 20
Nebusal, 25
Multigen, 16
nicotine transdermal system step 3, 20
necon 0.5/35-28, 11
Multigen Folic, 16
Nicotrol Inhaler, 20
necon 1/35, 11
Nicotrol Ns, 20
NP thyroid 60, 13
Optichamber Advantage, 35
nifedical XL, 4
NP thyroid 90, 13
Optichamber Advantage/Large Mask, 35
nifedipine, 4
Nucort, 8
Optichamber Advantage/Medium Face Mask, 35
nifedipine ER, 4
Nucynta, 23
nikki, 11
Nucynta ER, 23
Optichamber Advantage/Small Face Mask, 35
nilutamide, 3
nudiclo tabpak, 24
nimodipine, 5
Nuedexta, 20
Optichamber Diamond, 35
Ninlaro, 4
nufol, 16
Optichamber Diamond/Largeface Mask, 35
nisoldipine ER, 5
nulev, 14
Nisoldipine ER, 5
Nuplazid, 18
Optichamber Diamond/Medium Face Mask, 35
Nitro-bid, 4
Nutricap, 26
Nitro-dur, 4
Nutridox, 1
Optichamber Diamond/Smallface Mask, 35
nitro-time, 4
nutrifac ZX, 26
nitrofurantoin, 15
Nutropin AQ Nuspin 10, 13
Optichamber Face Mask/Large, 35
nitrofurantoin macrocrystals, 15
Nutropin AQ Nuspin 20, 13
Optichamber Face Mask/Medium, 35
nitrofurantoin monohydrate, 15
Nutropin AQ Nuspin 5, 13
Optichamber Face Mask/Small, 35
nitrofurantoin monohydrate/macrocrystals, 15
Nutropin AQ Pen, 13
Optihaler, 35
Nuvaring, 11
Optihaler MDI Drug Delivery System, 35
nitroglycerin, 4
nyamyc, 7
optimal-d, 26
nitroglycerin ER, 4
nyata, 7
optimal-d pack, 26
nitroglycerin lingual, 4
nystatin, 2, 7, 17
option 2, 11
Nitroglycerin Lingual, 4
nystatin/triamcinolone, 7
Options Gynol II Vaginal Contraceptive, 15
nitroglycerin transdermal, 4
nystop, 7
Nitrostat, 4
O
Oracit, 16
Nivatopic Plus, 9
Orafate, 17
O-CAL Prenatal, 27
nizatidine, 14
oralone dental paste, 17
OB Complete, 27
Nizatidine, 14
Oramagic Plus, 17
OB Complete Gold, 27
nodolor, 24
Oramagicrx, 17
OB Complete One, 27
nolix, 8
Orap, 20
OB Complete Petite, 27
Nor-QD, 11
Oravig, 17
OB Complete Premier, 27
nora-be, 11
Orencia, 24
OB Complete/DHA, 27
Norditropin Cartridge, 13
Orencia Clickject, 24
Obredon, 25
Norditropin Flexpro, 13
Orenitram, 6
Obstetrix One, 27
norethindrone, 11
Orfadin, 13
Ocaliva, 15
norethindrone & ethinyl estradiol ferrous fumarate, 11
Orkambi, 25
ocella, 11
orphenadrine citrate ER, 21
Ocuvel, 27
norethindrone acetate, 11
orsythia, 11
Odefsey, 2
norethindrone acetate/ethinyl estradiol, 10, 11
Ortho D, 16
Ofev, 25
Ortho Micronor, 11
ofloxacin, 1, 21, 22
norethindrone acetate/ethinyl estradiol/ferrous fumarate, 11
oscimin, 14
Ofloxacin, 1
oscimin SR, 14
Ogestrel, 11
norethindrone/ethinyl estradiol/ferrous fumarate, 11
oseltamivir phosphate, 2
olanzapine, 18
Osmoprep, 14
olanzapine odt, 18
norgestimate/ethinyl estradiol, 11
Osphena, 12
olanzapine/fluoxetine, 20
norlyda, 11
Otezla, 24
olmesartan medoxomil, 5
norlyroc, 11
Oticin HC NR, 22
olmesartan medoxomil/hydrochlorothiazide, 5
Northera, 6
Otiprio, 22
nortrel 0.5/35 (28), 11
otomax-HC, 22
olopatadine HCL, 22, 25
nortrel 1/35, 11
Otrexup, 24
Olysio, 2
nortrel 7/7/7, 11
oxandrolone, 10
Omeclamox-PAK, 14
nortriptyline HCL, 18
oxaprozin, 24
omega-3-acid ethyl esters, 6
Nortriptyline HCL, 18
Oxaydo, 23
Omega-3/D-3 Wellness Pack, 6
Nortuss-EX, 25
oxazepam, 18
omeppi, 14
Norvir, 2
oxcarbazepine, 19
omeprazole, 14
norwich aspirin, 23
oxiconazole nitrate, 7
Omeprazole + Syrspend SF Alka, 14
Novarel, 12
Oxistat, 7
omeprazole/sodium bicarbonate, 14
Novofine 30GX8MM, 32
Oxsoralen, 9
Omnitrope, 13
Novofine 32GX6MM, 32
Oxtellar XR, 19
ondansetron HCL, 14
Novofine Autocover 30GX8MM, 32
oxybutynin chloride, 15
ondansetron odt, 14
Novofine Plus 32GX4MM, 32
oxybutynin chloride ER, 15
Onfi, 19
Novolog Mix 70/30, 12
oxycodone HCL, 23
Onglyza, 12
Novolog Mix 70/30 Prefilled Flexpen, 12
Oxycodone HCL ER, 23
Onivyde, 4
Novotwist 30GX8MM, 32
oxycodone/acetaminophen, 23
Onmel, 2
Novotwist 32GX5MM, 32
Oxycodone/Acetaminophen, 23
Opana ER (crush Resistant), 23
Noxafil, 2
oxycodone/aspirin, 23
opcicon one-step, 11
Noxifol-d, 16
Oxycodone/Ibuprofen, 23
opium, 14
NP thyroid, 13
Oxycontin, 23
opium tincture, 14
NP thyroid 30, 13
oxymorphone hydrochloride, 23
Opsumit, 6
oxymorphone hydrochloride ER, 23
Pentips 29GX12MM, 32
PNV-vp-u, 27
Oxymorphone Hydrochloride ER, 23
Pentips 31G X 5MM, 32
Pocket Chamber, 35
Oxytrol, 15
Pentips 31G X 8MM, 32
Pocket Spacer, 35
Oxytrol For Women, 15
Pentips 31GX5MM, 32
Podocon 25 IN Benzoin Tincture, 9
P
Pentips 31GX6MM, 32
podofilox, 8
Pentips 31GX8MM, 32
Poly-VI-flor, 27
pacerone, 5
Pentips 32G X 4MM, 32
Poly-VI-flor/Iron, 27
paliperidone ER, 18
Pentips 32GX4MM, 32
polycin, 21
Panatuss Dxp, 25
pentoxifylline ER, 17
polyethylene glycol 3350, 13
Pancreaze, 14
perindopril erbumine, 5
polyethylene glycol 3350-grx, 13
Pancrelipase, 14
periogard, 17
polymyxin b sulfate/trimethoprim sulfate, 21
Pandel, 8
permethrin, 8
panoxyl wash, 6
perphenazine, 18
Pomalyst, 3
Panoxyl-4 Creamy Wash, 7
Perphenazine/Amitriptyline, 20
portia-28, 11
pantoprazole sodium, 14
Pertzye, 14
Potaba, 26
Paregoric, 14
Pexeva, 18
potassium citrate ER, 16
paricalcitol, 13
phenadoz, 24
potassium citrate-citric acid crystals, 16
paroex, 17
phenazo, 16
potassium citrate/citric acid, 16
paromomycin sulfate, 1
phenazopyridine HCL, 16
potassium citrate/sodium citrate/citric acid, 16
paroxetine HCL, 18
phendimetrazine tartrate, 19
paroxetine HCL ER, 18
Phendimetrazine Tartrate ER, 19
pr benzoyl peroxide wash, 7
Paser, 2
phenelzine sulfate, 18
Pr Natal 400, 26
Patanol, 22
phenergan, 24
Pr Natal 400 EC, 26
PC Unifine Pentips 29G X 1/2", 32
Phenergan Fortis, 24
Pr Natal 430, 26
PC Unifine Pentips 31G X 5MM Mini, 32
phenobarbital, 18
Pr Natal 430 EC, 26
PC Unifine Pentips 31G X 6MM Ultra SHORT, 32
Phenobarbital, 19
Praluent, 6
phenohytro, 14
pramcort, 15
PC Unifine Pentips 31G X 8MM SHORT, 32
phenoxybenzamine hydrochloride, 5
pramipexole dihydrochloride, 20
phentermine HCL, 19
pramipexole dihydrochloride ER, 20
PCE, 1
phenylephrine HCL, 22
Pramotic, 22
Pediaderm AF Complete Kit, 7
Phenytek, 19
Prandin, 12
Pediaderm HC, 8
phenytoin, 19
prasugrel, 17
Pediaderm Ta, 8
phenytoin infatabs, 19
pravastatin sodium, 6
peg 3350, 13
phenytoin sodium extended, 19
prazosin HCL, 5
peg 3350/electrolytes, 13
philith, 11
Pre-folic, 16
peg-3350/electrolytes, 13
Phlag Spray, 9
Precision Sure-dose Insulin Syringe/0.3ML/30G X 5/16", 32
peg-3350/NACL/NA bicarbonate/KCL, 13
phos-flur, 17
Peg-intron, 2
Phoslyra, 15
Precision Sure-dose Insulin Syringe/0.5ML/28G X 1/2", 32
Peg-intron Redipen, 2
phosphasal, 15
Peg-intron Redipen PAK 4, 2
Phospholine Iodide, 22
Precision Sure-dose Insulin Syringe/0.5ML/29G X 1/2", 32
peg-prep, 14
phrenilin forte, 23
peg3350, 13
Physicians EZ Use B-12 Compliance Kit, 16
Precision Sure-dose Insulin Syringe/0.5ML/30G X 3/8", 32
Peganone, 19
Pegasys, 2
pilocarpine HCL, 17, 22
Precision Sure-dose Insulin Syringe/1ML/28G X 1/2", 32
Pegasys Proclick, 2
pilocarpine hydrochloride, 17
Pegintron, 2
pimozide, 20
Precision Sure-dose Plus Insulin Syringe/0.3ML/29G X 1/2", 32
pegylax, 13
pimtrea, 11
Pen Needles 29G X 12MM, 32
pin-x, 3
Precision Sure-dose Plus Insulin Syringe/1ML/29G X 1/2", 32
Pen Needles 29GX1/2", 32
Pin-x, 3
Pen Needles 30GX5/16", 32
pindolol, 4
Pred Mild, 21
Pen Needles 30GX8MM, 32
pinworm medicine, 3
Pred-G, 21
Pen Needles 31G X 1/4" SHORT, 32
pioglitazone HCL, 12
Pred-G S.o.p., 21
Pen Needles 31G X 3/16", 32
pioglitazone HCL-glimepiride, 12
prednicarbate, 8
Pen Needles 31G X 5MM, 32
pioglitazone HCL/metformin HCL, 12
prednisolone, 9
Pen Needles 31G X 6MM, 32
pirmella 1/35, 11
prednisolone acetate, 21
Pen Needles 31G X 8MM, 32
pirmella 7/7/7, 11
prednisolone sodium phosphate, 9
Pen Needles 31GX5/16", 32
piroxicam, 24
Prednisolone Sodium Phosphate, 9, 21
Pen Needles 31GX6MM (1/4"), 32
Plegridy, 20
prednisolone sodium phosphate odt, 9
Pen Needles 31GX8MM, 32
Plegridy Starter Pack, 20
prednisone, 9
Pen Needles 31GX8MM (5/16"), 32
PNV Ferrous Fumarate/Docusate/Folic Acid, 27
Prednisone, 9
Pen Needles 32G X 4MM, 32
Prednisone Intensol, 10
Pen Needles 32G X 5MM, 32
PNV Ob+dha, 27
Prefera OB, 27
Pen Needles 32G X 6MM, 32
PNV TABS 29-1, 27
Preferaob +dha, 27
Pen Needles 32GX4MM, 32
PNV-DHA, 26
Preferaob One, 27
penicillin v potassium, 1
PNV-dha+docusate, 27
Preferred Plus Insulin Syringe/U-100/0.3ML/29G X 1/2", 32
Penlac Nail Lacquer, 7
PNV-omega, 27
Pentasa, 15
PNV-select, 26
Preferred Plus Insulin Syringe/U-100/0.3ML/30G X 5/16", 32
pentazocine/naloxone HCL, 23
PNV-total, 27
Pentips 29G X 12MM, 32
Preferred Plus Insulin Syringe/U-100/0.5ML/28G X 1/2", 32
Priftin, 2
Purefe Plus, 16
prilolid, 8
purevit dualfe plus, 16
Preferred Plus Insulin Syringe/U-100/0.5ML/29G X 1/2", 32
priloxx LP, 8
Purixan, 3
Primaquine Phosphate, 2
px aspirin, 23
Preferred Plus Insulin Syringe/U-100/0.5ML/30G X 5/16", 32
primidone, 19
Px Extra SHORT Pen Needles 31GX6MM, 32
Primlev, 23
Preferred Plus Insulin Syringe/U-100/1ML/28G X 1/2", 32
Primsol, 3
Px Insulin Syringe/U-100/0.3ML/30G X 1/2", 32
Pro Comfort Pen Needles/ 31G X 8MM, 32
Preferred Plus Insulin Syringe/U-100/1ML/29G X 1/2", 32
Px Insulin Syringe/U-100/0.3ML/31G X 5/16", 32
Pro Comfort Pen Needles/ 32G X 4MM, 32
Preferred Plus Insulin Syringe/U-100/1ML/30G X 5/16", 32
Px Insulin Syringe/U-100/0.5ML/30G X 1/2", 32
Pro Comfort Pen Needles/ 32G X 5MM, 32
Preferred Plus Unifine Pentips 29G X 12MM, 32
Px Insulin Syringe/U-100/0.5ML/31G X 5/16", 32
Pro Comfort Pen Needles/ 32G X 6MM, 32
Preferred Plus Unifine Pentips 31G X 6MM Ultra SHORT, 32
Px Insulin Syringe/U-100/1ML/30G X 1/2", 32
probenecid, 24
Preferred Plus Unifine Pentips 31G X 8MM SHORT, 32
probenecid/colchicine, 24
Px Insulin Syringe/U-100/1ML/31G X 5/16", 32
prochlorperazine, 18
Preferred Plus Unifine Pentips 32GX4MM, 32
prochlorperazine maleate, 18
Px Mini Pen Needles 31GX5MM, 32
Procrit, 17
Px Pen Needle 29GX12MM, 32
Preferred Plus Unifine Pentips/Mini/31GX5MM, 32
procto-MED HC, 15
Px Pen Needle 31GX8MM, 32
procto-PAK, 15
Px Shortlength Pen Needles/31GX8MM, 32
Prefest, 10
Proctofoam HC, 15
Pregnyl W/Diluent Benzyl Alcohol/NACL, 12
proctosol HC, 15
px stop smoking aid, 20
proctozone-HC, 15
pyrazinamide, 1
Premarin, 10, 16
Procysbi, 16
Pyridium, 16
premium lidocaine, 8
Prodigy Insulin Syring/U-100/0.3ML/31G X 5/16", 32
pyridostigmine bromide, 21
Premphase, 10
pyridostigmine bromide ER, 21
Prempro, 10
Prodigy Insulin Syringe/1/2ML/31G X 5/16", 32
Pyrogallic Acid, 9
Prena1 Chew, 27
Q
Prena1 Pearl, 27
Prodigy Insulin Syringe/1ML/28G X 1/2", 32
qc aspirin, 23
Prenaissance, 27
Qc Insulin Syringe/0.3ML/29G X 1/2", 32
Prenaissance Balance, 27
Proferrin-forte, 16
Qc Insulin Syringe/0.5ML/29G X 1/2", 32
Prenaissance Harmony DHA, 27
progesterone, 11
Qc Insulin Syringe/0.5ML/31G X 5/16", 32
Prenaissance Next, 27
Proglycem, 12
Prenaissance Next-b, 27
Promacta, 17
Qc Insulin Syringe/1ML/29G X 1/2", 32
Prenaissance Plus, 26
promethazine HCL, 24
Qc Insulin Syringe/1ML/31G X 5/16", 32
Prenata, 27
promethazine HCL plain, 24
qc natura-LAX, 14
Prenatabs Fa, 27
promethazine VC plain, 25
qc nicotine polacrilex, 20
Prenatabs RX, 26
promethazine VC/codeine, 25
Qc Pen Needles 29G X 12MM, 32
Prenatal 19, 27
promethazine-DM, 25
Qc Pen Needles 31G X 6MM, 32
Prenatal Plus Iron, 27
promethazine/codeine, 25
Qc Pen Needles 31G X 8MM, 32
Prenatal-u, 26
promethazine/dextromethorphan, 25
Qc Unifine Pentips 32GX4MM, 32
Prenate, 27
promethazine/phenylephrine, 25
Qsymia, 19
Prenate AM, 27
promethazine/phenylephrine/codeine, 25
quasense, 11
Prenate DHA, 27
promethegan, 24
Quazepam, 19
Prenate Elite, 27
propafenone HCL, 5
quetiapine fumarate, 18
Prenate Enhance, 27
propafenone HCL ER, 5
quetiapine fumarate ER, 18
Prenate Essential, 27
Propantheline Bromide, 14
Quflora Pediatric, 26
Prenate Mini, 27
proparacaine HCL, 22
quinapril HCL, 5
Prenate Pixie, 27
propranolol HCL, 4
quinapril/hydrochlorothiazide, 5
Prenate Restore, 27
Propranolol HCL, 4
quinidine gluconate CR, 5
Prenate Star, 27
propranolol HCL ER, 4
quinidine gluconate ER, 5
Prepopik, 14
propranolol hydrochloride, 4
quinidine sulfate, 5
Preque 10, 27
Propranolol/Hydrochlorothiazide, 5
Quinidine Sulfate, 5
Presera, 9
propylthiouracil, 13
Quinidine Sulfate ER, 5
Prestalia, 5
Protect Plus, 27
quinine sulfate, 2
Pretab, 27
Protectiron, 16
Qutenza, 9
prevalite, 6
Prothelial, 17
Qvar, 25
Prevident 5000 Booster, 17
Protonix, 14
R
Prevident 5000 Booster Plus, 17
protriptyline HCL, 18
Prevident 5000 Dry Mouth, 17
Provida DHA, 27
R-natal OB, 27
Prevident 5000 Plus, 17
Provida OB, 27
ra antihistamine eye drops, 22
Prevident Fluoride, 17
Pruclair, 9
ra aspirin, 23
previdolrx plus analgesicpak, 24
Prumyx, 9
ra budesonide nasal spray, 24
previfem, 11
pulmosal, 25
ra cold sore treatment, 17
Prezcobix, 2
Pulmozyme, 25
ra eye itch relief, 22
Prezista, 2
Purefe OB Plus, 27
Ra Insulin Syringe/0.5ML/29G X 1/2", 32
Ra Insulin Syringe/1ML/29G X 1/2", 32
32
rifabutin, 1
Ra Insulin Syringe/U-100/0.5ML/30G X 5/16", 32
Relion Insulin Syringe/U-100/0.3ML/30G X 5/16", 32
Rifamate, 2
rifampin, 1
Ra Insulin Syringe/U-100/1 ML/30G X 5/16", 32
Relion Insulin Syringe/U-100/0.3ML/31G X 15/64", 32
Rifater, 2
Rilutek, 21
ra laxative, 14
Relion Insulin Syringe/U-100/0.3ML/31G X 5/16", 32
riluzole, 21
ra mini nicotine, 20
rimantadine HCL, 2
ra nicotine, 20
Relion Insulin Syringe/U-100/0.5ML/29G X 1/2", 32
Rimso-50, 16
ra nicotine gum, 20
Riomet, 12
ra nicotine polacrilex, 20
Relion Insulin Syringe/U-100/0.5ML/30G, 32
risedronate sodium, 12
ra nicotine transdermal system, 20
risedronate sodium DR, 12
ra nicotine transdermal system step 3, 20
Relion Insulin Syringe/U-100/0.5ML/30G X 5/16", 32
risperidone, 18
Ra Pen Needles 31G X 5MM 3/16", 32
risperidone M-TAB, 18
Ra Pen Needles 31G X 8MM 5/16", 32
Relion Insulin Syringe/U-100/0.5ML/31G X 5/16", 32
risperidone odt, 18
ra renewal medicated acne treatment maximum strength, 6
Riteflo, 35
Relion Insulin Syringe/U-100/1ML/30G, 32
rivastigmine tartrate, 20
Ra Saline Wound Wash, 9
rivastigmine transdermal system, 20
rabeprazole sodium, 14
Relion Insulin Syringe/U-100/1ML/30G X 5/16", 32
rivelsa, 11
rajani, 11
rizatriptan benzoate, 24
raloxifene hydrochloride, 12
Relion Insulin Syringe/U-100/1ML/31G X 15/64", 32
rizatriptan benzoate odt, 24
ramipril, 5
Robinul, 14
Ranexa, 4
Relion Insulin Syringe/U-100/1ML/31G X 5/16", 32
Robinul Forte, 14
ranitidine HCL, 14
ropinirole ER, 20
Rapaflo, 16
Relion Mini Pen Needles 31GX6MM, 32
ropinirole HCL, 20
Rapamune, 3
Relion Pen Needles 29GX12MM, 32
rosadan, 7
rasagiline mesylate, 20
Relion Pen Needles 31GX6MM, 32
Rosadan Kit, 7
Rasuvo, 24
Relion Pen Needles 31GX8MM, 32
rosanil cleanser, 6
Ravicti, 13
Relion Pen Needles 32GX4MM, 32
Rosula, 7
Rayos, 10
Relion SHORT Pen Needles 31GX8MM, 32
rosuvastatin calcium, 6
rea LO 39, 9
Rowasa, 15
rea LO 40, 8
Relistor, 15
roweepra, 19
react, 11
Relnate DHA, 27
Roxifol-d, 16
Reality Insulin Syringe/U-100/0.5ML/28G X 1/2", 32
Relyyks, 9
Rozerem, 19
remeven, 8
Rulavite DHA, 27
Reality Insulin Syringe/U-100/0.5ML/29G X 1/2", 32
Renagel, 15
S
renal CAPS, 26
Sabril, 19
Reality Insulin Syringe/U-100/1ML/28G X 1/2", 32
reno CAPS, 26
Safe Wash, 9
Renuu Patch, 9
Safesnap Insulin Syringe/0.3ML/30G X 5/16", 32
Reality Insulin Syringe/U-100/1ML/29G X 1/2", 32
Renvela, 15
repaglinide, 12
Safesnap Insulin Syringe/0.5ML/29G X 1/2", 32
Rebetol, 2
Repaglinide/Metformin Hydrochloride, 12
Rebif, 20
Repatha, 6
Safesnap Insulin Syringe/0.5ML/30G X 5/16", 32
Rebif Rebidose, 20
Repatha Pushtronex System, 6
Rebif Rebidose Titration Pack, 20
Repatha Sureclick, 6
Safesnap Insulin Syringe/1ML/28G X 1/2", 32
Rebif Titration Pack, 20
reprexain, 23
reclipsen, 11
Req 49+, 27
Safesnap Insulin Syringe/1ML/29G X 1/2", 32
Rectiv, 15
Rescriptor, 2
reeses pinworm medicine, 3
Rescula, 21
Safety Insulin Syringes 0.5ML/29GX1/2", 32
Reeses Pinworm Medicine, 3
Reserpine, 5
regenecare HA, 9
Respa-BR, 24
Safety Insulin Syringes 0.5ML/30GX5/16", 32
relador PAK, 8
Restasis, 22
relador PAK plus, 8
Restasis Multidose, 22
Safety Insulin Syringes 1ML/27GX1/2", 32
Relagard, 16
Restora RX, 14
Relenza Diskhaler, 2
Retrovir IV Infusion, 2
Safety Insulin Syringes 1ML/29GX1/2", 32
Relhist, 25
Revatio, 6
Relion Insulin Syringe 0.5ML/31G X 15/64", 32
Revesta, 16
Safety Insulin Syringes 1ML/30GX1/2", 32
Revlimid, 3
Relion Insulin Syringe 1ML/31GX15/64", 32
Rexulti, 18
Safety-glide Insulin Syringe/0.3ML/29G X 1/2", 32
Reyataz, 2
Relion Insulin Syringe/U -100/0.5ML/29G, 32
Rezira, 25
Safyral, 11
Rheumatrex, 24
Saizen, 13
Relion Insulin Syringe/U-00/1ML/29G X 1/2", 32
rhinocort allergy, 24
Saizen Click.easy, 13
ribasphere, 2
Saizenprep Reconstitutionkit, 13
Relion Insulin Syringe/U-100/0.3ML/29G, 32
Ribasphere, 2
salacyn, 8
Ribasphere Ribapak, 2
Salicept, 17
Relion Insulin Syringe/U-100/0.3ML/29G X 1/2", 32
Ribatab, 2
salicylic acid, 9
ribavirin, 2
salicylic acid cream, 9
Relion Insulin Syringe/U-100/0.3ML/30G,
Ridaura, 24
salicylic acid ER, 9
salicylic acid lotion, 9
Shopko Unifine Pentips Plus Pen Needles/Micro/Removr/32GX4MM, 32
sss 10%-5%, 7
salicylic acid wart remover, 9
Sss 10-5, 7
Saline Wound Wash, 9
Shopko Unifine Pentips Plus Pen Needles/Mini/Remover/31GX5MM, 33
stavudine, 2
salisol forte, 9
Stelara, 8
salitech forte, 9
Shopko Unifine Pentips Plus Pen Needles/Remover/29GX12MM, 33
Stimate, 13
Saljet, 9
Stivarga, 4
Saljet Rinse, 9
Shopko Unifine Pentips Plus Pen Needles/SHORT/Removr/31GX8MM, 33
Strensiq, 13
salsalate, 23
Stribild, 2
Salvax, 9
Shur-seal, 15
Striverdi Respimat, 25
Salvax Duo Plus, 9
Siderol, 26
Stromectol, 3
Samsca, 13
Signifor, 13
Strovite Forte, 27
Sandimmune, 3
Silazone Pharmapak, 8
Strovite One, 27
Saphris, 18
Silazone-II, 8
Suboxone, 23
sash kit for flushing vascular access devices, 17
sildenafil, 6
Subsys, 23
sildenafil citrate, 6
Sucraid, 14
Sash Kit For Flushing Vascular Access Devices, 17
Silvera Pain Relief, 9
sucralfate, 14
Simbrinza, 22
sulfacetamide sodium, 6, 21
Savaysa, 17
Simponi, 24
Sulfacetamide Sodium, 21
Savella, 20
simvastatin, 6
sulfacetamide sodium/prednisolone sodium phosphate, 21
Savella Titration Pack, 20
sirolimus, 3
SB aspirin, 23
Sirturo, 2
sulfacetamide sodium/sulfur, 7
SB Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
Sivextro, 3
sulfacetamide sodium/sulfur cleanser, 6
Sklice, 9
sulfacleanse 8/4, 7
SB Insulin Syringe/U-100/0.5ML/30G X 5/16", 33
sm aspirin, 23
Sulfadiazine, 1
sm clearlax, 14
sulfamethoxazole/trimethoprim, 3
SB Insulin Syringe/U-100/1ML/29G X 1/2", 33
sm cough drops, 17
sulfamethoxazole/trimethoprim DS, 3
sm eye itch relief, 22
sulfasalazine, 15
SB Insulin Syringe/U-100/1ML/30G X 5/16", 33
Sm Insulin Syringe/1ML/31G X 5/16", 33
sulfatrim pediatric, 3
sm nicotine, 20
sulindac, 24
SB Insulin Syringe/U-100/1ML/31G X 5/16", 33
sm nicotine polacrilex, 20
sumatriptan, 24
sm nicotine transdermal system, 20
sumatriptan succinate, 24
SB polyethylene glycol 3 350, 14
smooth LAX, 14
Sumatriptan Succinate, 24
scalacort, 8
sodium chloride, 16, 25
sumatriptan succinate refill, 24
Scar Patch, 9
sodium chloride 0.9%, 16
Suprax, 1
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/29G X 1/2", 32
sodium citrate/citric acid, 16
Suprep Bowel Prep Kit, 14
sodium hyaluronate, 9
Sure Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
Schnucks Insulin Syringe Ulti-fine/U-100/0.5ML/30G X 5/16", 32
sodium phenylbutyrate, 13
sodium sulfacetamide, 6, 8, 21
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 1/2", 33
scopolamine, 14
sodium sulfacetamide wash, 8
Se-natal 19, 26
Sodium Sulfacetamide Wash, 8
Sure Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 33
Se-tan DHA, 26
sodium sulfacetamide/sulfur, 6
se-tan plus, 16
Sodium Sulfacetamide/Sulfur, 6
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16, 33
seb-prev wash, 8
sodium sulfacetamide/sulfur cleanser, 7
Seconal, 19
Sodium Sulfacetamide/Sulfur Cleanser IN Urea, 6
Sure Comfort Insulin Syringe/U-100/0.3ML/31G X 5/16", 33
Seconal Sodium, 19
Select-OB, 27
sodium sulfacetamide/sulfur green, 7
Sure Comfort Insulin Syringe/U-100/0.5ML/28G X 1/2", 33
Select-ob+dha, 27
Sodium Sulfacetamide/Sulfur IN Urea, 7
selegiline HCL, 20
sodium sulfacetamide/sulfur w/sunscreen, 7
Sure Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
selenium sulfide, 8
Selzentry, 2
sodium sulfacetamide/sulfur wash, 7
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 1/2", 33
Sensipar, 13
Soliqua 100/33, 12
Serevent Diskus, 25
Soltamox, 3
Sure Comfort Insulin Syringe/U-100/0.5ML/30G X 5/16", 33
Serostim, 13
Somavert, 13
sertraline HCL, 18
Soriatane, 8
Sure Comfort Insulin Syringe/U-100/0.5ML/31G X 5/16, 33
setlakin, 11
sorine, 4
sevelamer carbonate, 15
sotalol HCL, 4
Sure Comfort Insulin Syringe/U-100/1ML/28G X 1/2", 33
SF, 17
sotalol HCL (AF), 4
SF 5000 plus, 17
Sovaldi, 2
Sure Comfort Insulin Syringe/U-100/1ML/29G X 1/2", 33
Sfrowasa, 15
Spinosad, 9
sharobel, 11
Spiriva Handihaler, 25
Sure Comfort Insulin Syringe/U-100/1ML/30G X 1/2", 33
Shopko Unifine Pentips Pen Needles/Micro/32GX4MM, 32
Spiriva Respimat, 25
spironolactone, 5
Sure Comfort Insulin Syringe/U-100/1ML/30G X 5/16", 33
Shopko Unifine Pentips Pen Needles/Mini/31GX5MM, 32
spironolactone/hydrochlorothiazide, 5
Sporanox, 2
Sure Comfort Insulin Syringe/U-100/1ML/31G X 5/16", 33
Shopko Unifine Pentips Pen Needles/Original/29GX12MM, 32
sprintec 28, 11
Sprycel, 4
Sure Comfort Pen Needles 29GX1/2" 12.7MM, 33
Shopko Unifine Pentips Pen Needles/SHORT/31GX8MM, 32
SR nicotine gum, 20
sronyx, 11
Sure Comfort Pen Needles 30GX5/16"
SHORT, 33
tamsulosin HCL, 16
Thera-flur-n, 17
Sure Comfort Pen Needles 31GX3/16" (5MM), 33
Tandem F, 16
theratears allergy eye itch relief, 22
Tanzeum, 12
Thiola, 16
Sure Comfort Pen Needles 31GX5/16" (8MM), 33
Tarceva, 4
thioridazine HCL, 18
tarina FE 1/20, 11
thiothixene, 18
Sure Comfort Pen Needles 32GX5/32", 33
Taron-bc, 27
thrive, 20
Taron-c DHA, 27
Thrivite 19, 27
Sure Comfort Pen Needles 32GX6MM, 33
taron-crystals, 16
Thrivite RX, 27
Taron-prex, 26
Thyrolar-1, 13
Sure Result O3d3 System, 6
Tasigna, 4
Thyrolar-1/2, 13
Sure-fine Pen Needles 29GX1/2" 12.7MM, 33
Tasmar, 20
Thyrolar-1/4, 13
tazarotene, 8
Thyrolar-2, 13
Sure-fine Pen Needles 31GX3/16" 5MM, 33
Tazorac, 8
Thyrolar-3, 13
taztia XT, 5
tiagabine hydrochloride, 19
Sure-fine Pen Needles 31GX5/16" 8MM, 33
Tecfidera, 20
tilia FE, 11
Tecfidera Starter Pack, 20
Timolol Maleate, 4
Sure-ject Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
Techlite Pen Needles 29G X 12 MM, 33
timolol maleate, 21
Techlite Pen Needles 31G X 5MM, 33
timolol maleate ophthalmic gel forming, 21
Sure-ject Insulin Syringe/U-100/0.3ML/30G X 5/16", 33
Techlite Pen Needles/31G X 5MM, 33
Techlite Pen Needles/31G X 6 MM, 33
tinidazole, 3
Sure-ject Insulin Syringe/U-100/0.3ML/31G X 5/16", 33
Techlite Pen Needles/31G X 8MM, 33
Tivicay, 2
Techlite Pen Needles/32G X 4MM, 33
Tizanidine Comfort PAC, 21
Sure-ject Insulin Syringe/U-100/0.5ML/28G X 1/2", 33
Techlite Pen Needles/32G X 6MM, 33
tizanidine HCL, 21
Techlite Pen Needles/32G X 8MM, 33
TL Folate, 27
Sure-ject Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
Technivie, 2
TL gard RX, 16
Tegretol, 19
TL icon, 16
Sure-ject Insulin Syringe/U-100/0.5ML/30G X 5/16", 33
Tegretol-XR, 19
TL-care DHA, 27
telmisartan, 5
TL-fluorivite, 27
Sure-ject Insulin Syringe/U-100/0.5ML/31G X 5/16", 33
telmisartan/amlodipine, 5
TL-select, 27
telmisartan/hydrochlorothiazide, 5
Tobi Podhaler, 1
Sure-ject Insulin Syringe/U-100/1ML/28G X 1/2", 33
temazepam, 18
Tobradex, 21
temozolomide, 3
Tobradex ST, 21
Sure-ject Insulin Syringe/U-100/1ML/29G X 1/2", 33
Tencon, 23
tobramycin, 1, 21
terazosin HCL, 5
tobramycin inhalation solution PAK, 1
Sure-ject Insulin Syringe/U-100/1ML/30G X 5/16", 33
terbinafine HCL, 2
tobramycin sulfate, 21
terbutaline sulfate, 25
tobramycin/dexamethasone, 21
Sure-ject Insulin Syringe/U-100/1ML/31G X 5/16", 33
terconazole, 15
Today Sponge, 15
testosterone, 10
Todays Health Mini Pen Needles 31G X 1/4", 33
Sustiva, 2
Testosterone, 10
Sutent, 4
testosterone P.M., 10
Todays Health Original Pen Needles 29G X 1/2", 33
sw clearlax, 14
Testosterone P.M., 10
sw nicotine polacrilex, 20
testosterone topical solution, 10
Todays Health SHORT Pen Needles 31G X 5/16", 33
syeda, 11
tetcaine, 22
Sylatron, 4
tetrabenazine, 20
Tolazamide, 12
symax-SL, 14
tetracaine HCL, 22
Tolbutamide, 12
symax-SR, 14
tetracycline HCL, 1
tolcapone, 20
Symlinpen 120, 12
Tetracycline HCL, 1
tolmetin sodium, 24
Symlinpen 60, 12
tetracycline hydrochloride, 1
Tolmetin Sodium, 24
Synagex, 27
tetravisc, 22
tolterodine tartrate, 15
Synalar, 8
tetravisc forte, 22
tolterodine tartrate ER, 15
Synalar Cream Kit, 8
Tetrix, 9
Topamax, 19
Synalar Ointment Kit, 8
Texacort, 8
Topamax Sprinkle, 19
Synatek, 27
Tgq 30PSE/150GFN/15DM, 25
Topcare Clickfine Universal Pen Eedles 31GX1/4", 33
Synera, 9
Tgq 30PSE/3BRM/15DM, 25
Synerderm, 9
tgt aspirin, 23
Topcare Clickfine Universal Pen Eedles 31GX5/16", 33
Synjardy, 12
tgt eye itch relief, 22
Synjardy XR, 12
tgt nicotine gum, 20
Topcare Ultra Comfort Insulin Syringe/0.3ML/30G X 5/16", 33
Synthroid, 13
tgt nicotine polacrilex, 20
Synvexia Tc, 9
tgt nicotine step one, 20
Topcare Ultra Comfort Insulin Syringe/0.3ML/31G X 5/16", 33
T
tgt nicotine step three, 20
tgt nicotine step two, 20
Topcare Ultra Comfort Insulin Syringe/0.5ML/30G X 5/16", 33
Tabloid, 3
tgt powderlax, 14
tacrolimus, 3, 8
Thalomid, 3
Topcare Ultra Comfort Insulin Syringe/0.5ML/31G X 5/16", 33
Tafinlar, 4
Theo-24, 25
Tagrisso, 4
theochron, 25
Topcare Ultra Comfort Insulin Syringe/1ML/30G X 5/16", 33
take action, 11
theophylline, 25
Taltz, 8
theophylline CR, 25
Topcare Ultra Comfort Insulin Syringe/1ML/31G X 5/16", 33
Tamiflu, 2
theophylline ER, 25
tamoxifen citrate, 3
Topcare Ultra Comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
Tricare Prenatal Compleat, 27
Tykerb, 4
Tricare Prenatal DHA One, 27
Tyvaso, 6
Topcare Ultra Comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
tricitrates, 16
Tyvaso Refill, 6
tricon, 16
Tyvaso Starter, 6
Topcare Ultra Comfort Insulin Syringe/U-100/1ML/29G X 1/2", 33
triderm, 8
Tyzeka, 2
Tridesilon, 8
Tyzine Pediatric Nasal Drops, 25
Topco Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
Triesence, 21
U
trifluoperazine HCL, 18
Uceris, 15
Topco Insulin Syringe/U-100/0.5ML/28G X 1/2", 33
trifluridine, 21
Udamin SP, 27
trigels-f forte, 16
Ulesfia, 9
Topco Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
trihexyphenidyl HCL, 20
Uloric, 24
triklo, 6
Ulticare Insulin Safety Syringe/0.5ML/29G X 1/2", 33
Topco Insulin Syringe/U-100/1ML/28G X 1/2", 33
Trileptal, 19
trilyte, 14
Ulticare Insulin Safety Syringe/1ML/29G X 1/2", 33
Topco Insulin Syringe/U-100/1ML/29G X 1/2", 33
trimethobenzamide HCL, 14
trimethoprim, 3
Ulticare Insulin Syringe Ultrafine U-100/0.3ML/31G X 5/16", 33
topiramate, 19
trimethoprim sulfate/polymyxin b sulfate, 21
Topiramate ER, 19
Ulticare Insulin Syringe Ultrafine U-100/0.5ML/31G X 5/16", 33
torsemide, 5
trimipramine maleate, 18
Toujeo Solostar, 12
Trinatal GT, 27
Ulticare Insulin Syringe Ultrafine U-100/1ML/31G X 5/16", 33
Toviaz, 15
Trinatal RX 1, 26
Tracleer, 6
Trinate, 26
Ulticare Insulin Syringe/0.3ML/29G X 1/2", 33
Tradjenta, 12
trinessa, 11
tramadol HCL, 23
trinessa LO, 11
Ulticare Insulin Syringe/0.3ML/30G X 1/2", 33
tramadol HCL ER, 23
Trintellix, 18
Tramadol HCL ER, 23
triphrocaps, 26
Ulticare Insulin Syringe/0.3ML/30G X 5/16", 33
tramadol hydrochloride/acetaminophen, 23
triple-vitamin/fluoride, 26
Tristart DHA, 27
Ulticare Insulin Syringe/0.5ML/28G X 1/2", 33
trandolapril, 5
Triumeq, 2
trandolapril/verapamil HCL ER, 5
Triveen-duo DHA, 27
Ulticare Insulin Syringe/0.5ML/29G X 1/2", 33
tranexamic acid, 17
Triveen-prx RNF, 27
tranylcypromine sulfate, 18
trivora-28, 11
Ulticare Insulin Syringe/0.5ML/30G X 1/2", 33
Tranzarel, 9
tropicamide, 22
Travatan Z, 21
trospium chloride, 15
Ulticare Insulin Syringe/0.5ML/30G X 5/16", 33
Travoprost, 21
trospium chloride ER, 15
trazodone HCL, 18
Trueplus Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
Ulticare Insulin Syringe/1ML/28G X 1/2", 33
Trecator, 2
Tresiba Flextouch, 12
Trueplus Insulin Syringe/U-100/0.3ML/30G X 5/16", 33
Ulticare Insulin Syringe/1ML/29G X 1/2", 33
tretinoin, 4, 6
Tretinoin Emollient, 9
Trueplus Insulin Syringe/U-100/0.3ML/31G X 5/16", 33
Ulticare Insulin Syringe/1ML/30G X 1/2", 33
tretinoin microsphere, 7
tretinoin microsphere P.M., 7
Trueplus Insulin Syringe/U-100/0.5ML/28G X 1/2", 33
Ulticare Insulin Syringe/1ML/30G X 5/16", 33
Trexall, 3
Trezix, 23
Trueplus Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
Ulticare Insulin Syringe/SHORT/0.3ML/30G X 5/16", 33
tri femynor, 11
tri-estarylla, 11
Trueplus Insulin Syringe/U-100/0.5ML/30G X 5/16", 33
Ulticare Insulin Syringe/SHORT/0.3ML/31G X 5/16", 33
tri-legest FE, 11
tri-linyah, 11
Trueplus Insulin Syringe/U-100/0.5ML/31G X 5/16", 33
Ulticare Insulin Syringe/SHORT/0.5ML/30G X 5/16", 33
tri-LO-estarylla, 11
tri-LO-marzia, 11
Trueplus Insulin Syringe/U-100/1ML/28G X 1/2", 33
Ulticare Insulin Syringe/SHORT/0.5ML/31G X 5/16", 33
tri-LO-sprintec, 11
tri-previfem, 11
Trueplus Insulin Syringe/U-100/1ML/29G X 1/2", 33
Ulticare Insulin Syringe/SHORT/1ML/30G X 5/16", 33
tri-sprintec, 11
Tri-TABS DHA, 27
Trueplus Insulin Syringe/U-100/1ML/30G X 5/16", 33
Ulticare Insulin Syringe/SHORT/1ML/31G X 5/16", 33
Tri-VI-flor, 27
Tri-VI-floro, 27
Trueplus Insulin Syringe/U-100/1ML/31G X 5/16", 33
Ulticare Insulin Syringe/U-100/0.3ML/29G X 1/2", 33
tri-vit/fluoride, 26
Tri-vit/Fluoride/Iron, 26
Trueplus Pen Needles 29GX12MM, 33
Ulticare Insulin Syringe/U-100/0.3ML/30G X 1/2", 33
tri-vitamin/fluoride, 26
Trueplus Pen Needles 31GX5MM, 33
Triadvance, 26
Trueplus Pen Needles 31GX6MM, 33
Ulticare Insulin Syringe/U-100/0.3ML/30G X 5/16", 33
triamcinolone acetonide, 8
Trueplus Pen Needles 31GX8MM, 33
triamcinolone acetonide dental paste, 17
Trueplus Pen Needles 32GX4MM, 33
Ulticare Insulin Syringe/U-100/0.3ML/31G X 5/16", 33
triamterene/hydrochlorothiazide, 5
Trulicity, 12
Triamterene/Hydrochlorothiazide, 5
Truvada, 2
Ulticare Insulin Syringe/U-100/0.5ML/29G X 1/2", 33
Trianex, 8
Tusnel, 25
triazolam, 18
tussigon, 25
Ulticare Insulin Syringe/U-100/0.5ML/30G X 1/2", 33
Triazolam, 19
Tuzistra XR, 25
Tricare Prenatal, 27
Tybost, 2
Ulticare Insulin Syringe/U-100/0.5ML/30G
X 5/16", 33
Ultilet Pen Needle 29GX12.7MM, 34
Unifine Pentips 31G X 8MM, 34
Ulticare Insulin Syringe/U-100/0.5ML/31G X 5/16", 33
Ultilet Pen Needle 31GX5MM, 34
Unifine Pentips 31GX5MM, 34
Ultilet Pen Needle 31GX8MM, 34
Unifine Pentips 31GX6MM, 34
Ulticare Insulin Syringe/U-100/1ML/29G X 1/2", 33
Ultilet Pen Needle 32GX4MM, 34
Unifine Pentips 31GX8MM, 34
Ultilet Pen Needle 32GX4MM/SHORT, 34
Unifine Pentips 32GX4MM, 34
Ulticare Insulin Syringe/U-100/1ML/30G X 1/2", 33
Unifine Pentips Plus 29GX12MM, 34
Ultilet SHORT Pen Needles 31GX5/16", 34
Unifine Pentips Plus 31GX5MM, 34
Ulticare Insulin Syringe/U-100/1ML/30G X 5/16", 33
Unifine Pentips Plus 31GX6MM, 34
Ultilet SHORT Pen Needles31GX3/16", 34
Unifine Pentips Plus 31GX8MM, 34
Ulticare Insulin Syringe/U-100/1ML/31G X 5/16", 33
Unifine Pentips Plus 32GX4MM, 34
Ultimatecare One, 26
unithroid, 13
Ulticare Micro Pen Needles 31G X 8MM, 33
Ultimatecare One NF, 26
unithroid direct, 13
Ultra Comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 34
Uptravi, 6
Ulticare Micro Pen Needles 32G X 4MM, 33
ur n-c, 15
Ultra-comfort Insulin Syringe/U-100/0.3ML/29G X 1/2", 34
Uramaxin, 9
Ulticare Micro Pen Needles/32G X 4MM, 33
uramit mb, 15
Ultra-comfort Insulin Syringe/U-100/0.3ML/30G X 5/16", 34
ure-39, 9
Ulticare Mini Pen Needles 31GX6MM, 33
ure-k, 9
Ulticare Mini Pen Needles Ulti-fine IV, 33
Ultra-comfort Insulin Syringe/U-100/0.3ML/31G X 5/16", 34
urea, 9
Ulticare Mini Pen Needles/31G X 6MM, 33
urea 40% nail film, 9
Ultra-comfort Insulin Syringe/U-100/0.5ML/28G X 1/2", 34
urea hydrating, 9
Ulticare Mini Pen Needles31GX6MM, 33
Urea IN Zinc Undecylenate/Lactic Acid Vehicle, 9
Ulticare Original Pen Needles Ulti-fine, 33
Ultra-comfort Insulin Syringe/U-100/0.5ML/29G X 1/2", 34
urea nail, 9
Ulticare Pen Needles 31G X 5MM/Mini, 33
Ultra-comfort Insulin Syringe/U-100/0.5ML/30G X 5/16", 34
urea nail gel, 9
Urea Nail Kit, 9
Ulticare Pen Needles/29G X 12.7MM, 33
Ultra-comfort Insulin Syringe/U-100/0.5ML/31G X 5/16", 34
Urea Topical, 9
Ulticare SHORT Pen Needles 31GX8MM, 33
urea-c40, 9
Ultra-comfort Insulin Syringe/U-100/1ML/28G X 1/2", 34
Urecholine, 15
Ulticare SHORT Pen Needles Ulti-fine IV, 33
urelle, 15
Ultra-comfort Insulin Syringe/U-100/1ML/29G X 1/2", 34
uretron d/s, 15
Ulticare SHORT Pen Needles/31G X 8MM, 33
Urevaz, 9
Ultra-comfort Insulin Syringe/U-100/1ML/30G X 5/16", 34
uribel, 15
Ultiguard Insulin Syringe/U-100/0.5ML/30G X 5/16", 34
Urimar-t, 15
Ultra-comfort Insulin Syringe/U-100/1ML/31G X 5/16", 34
urin d/s, 15
Ultiguard Insulin Syringe/U-100/1ML/30G X 5/16", 34
uro-458, 15
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/30GX5/16", 34
uro-blue, 15
Ultilet Insulin Syringe 31X6MM, 34
uro-l, 15
Ultilet Insulin Syringe/0.3ML/30G X 8MM, 34
Ultra-thin II Insulin Syringe SHORT/U-100/0.3ML/31GX5/16", 34
uro-mp, 15
uroav-81, 15
Ultilet Insulin Syringe/0.3ML/31G X 8MM, 34
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/30GX5/16", 34
uroav-b, 15
urolet mb, 15
Ultilet Insulin Syringe/0.5ML/30G X 8MM, 34
Ultra-thin II Insulin Syringe SHORT/U-100/0.5ML/31GX5/16", 34
urophen mb, 15
ursodiol, 15
Ultilet Insulin Syringe/1ML/30G X 8MM, 34
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/30GX5/16", 34
uryl, 15
ustell, 15
Ultilet Insulin Syringe/1ML/31G X 8MM, 34
Ultra-thin II Insulin Syringe SHORT/U-100/1ML/31GX5/16", 34
uta, 15
Utibron Neohaler, 25
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 12.7MM, 34
Ultra-thin II Insulin Syringe/U-100/0.3ML/29GX1/2", 34
uticap, 15
utira-c, 15
Ultilet Insulin Syringe/SHORT/0.3ML/30G X 5/16", 34
Ultra-thin II Insulin Syringe/U-100/0.5ML/29GX1/2", 34
Utopic, 9
utrona-c, 15
Ultilet Insulin Syringe/SHORT/0.3ML/31G X 5/16", 34
Ultra-thin II Insulin Syringe/U-100/1ML/29GX1/2", 34
V
v-c forte, 26
Ultilet Insulin Syringe/SHORT/0.5ML/30G X 5/16", 34
Ultra-thin II Mini Pen Neeedles/31GX3/16", 34
V-r Monoject Insulin Syringe/U-100/0.3ML/29G X 1/2", 34
Ultilet Insulin Syringe/SHORT/0.5ML/31G X 5/16", 34
Ultra-thin II Pen Needles 29GX1/2", 34
V-r Monoject Insulin Syringe/U-100/0.5ML/28G X 1/2", 34
Ultra-thin II Pen Needles/SHORT/31GX5/16", 34
Ultilet Insulin Syringe/SHORT/1ML/30G X 5/16", 34
V-r Monoject Insulin Syringe/U-100/0.5ML/29G X 1/2", 34
Ultrasal-ER, 9
Ultilet Insulin Syringe/SHORT/1ML/31G X 5/16", 34
Ultresa, 14
V-r Monoject Insulin Syringe/U-100/1ML/28G X 1/2", 34
Umecta, 9
Ultilet Insulin Syringe/U-100/0.5ML/30G X 1/2", 34
umecta mousse, 9
V-r Monoject Insulin Syringe/U-100/1ML/29G X 1/2", 34
Umecta Nail Film, 9
Ultilet Insulin Syringe/U-100/0.5ML/31GX6MM, 34
Umecta PD, 9
valacyclovir HCL, 2
Unifine Pentips 29GX12MM, 34
Valchlor, 3
Ultilet Insulin Syringe/U-100/1ML/30G X 1/2", 34
Unifine Pentips 31G X 3/16", 34
valganciclovir, 2
Unifine Pentips 31G X 6MM, 34
valganciclovir hydrochlorde, 2
valproic acid, 19
Viekira PAK, 2
Vp-CH-PNV, 27
valsartan, 5
Viekira XR, 2
Vp-ggr-b6 Prenatal, 28
valsartan/hydrochlorothiazide, 5
vienva, 11
Vp-heme OB, 28
Value Health Insulin Syringe/U-100/0.5ML/29G X 1/2", 34
vigabatrin, 19
Vp-heme OB + DHA, 27
Viibryd, 18
Vp-heme One, 27
Value Health Insulin Syringe/U-100/1ML/29G X 1/2", 34
Viibryd Starter Pack, 18
Vp-PNV-DHA, 27
Vimpat, 19
Vp-zel, 27
Valumark Pen Needles 29GX12MM, 34
Vinate DHA RF, 28
Vraylar, 18
Valumark Pen Needles 31G X 6MM, 34
Vinate II, 26
vyfemla, 11
Valumark Pen Needles 31G X 8MM, 34
Vinate M, 26
Vyvanse, 19
Valved Holding Chamber, 35
Vinate One, 26
W
Vanatol LQ, 23
Viokace, 14
wal-zyr, 22
Vanatol S, 23
viorele, 11
warfarin sodium, 17
vancomycin, 3
Viracept, 2
Watchhaler, 35
vancomycin HCL, 3
Virazole, 2
Wegmans Unifine Pentips Plus 32GX4MM, 34
Vancomycin HCL + Syrspendsf PH4, 3
Viread, 2
vandazole, 15
Virt Nate, 27
Wegmans Unifine Pentips Plus/Mini/31GX5MM, 34
Vanishpoint Insulin Syringe/0.5ML/30G X 1/2", 34
Virt-advance, 27
Virt-c DHA, 27
Wegmans Unifine Pentips Plus/SHORT/31GX8MM, 34
Vanishpoint Insulin Syringe/0.5ML/30G X 5/16", 34
virt-CAPS, 26
virt-gard, 16
Wegmans Unifine Pentips Plus/Ultra SHORT/31GX6MM, 34
Vanishpoint Insulin Syringe/1ML/29G X 1/2", 34
Virt-nate DHA, 27
Virt-pn, 27
Welchol, 6
Vanishpoint Insulin Syringe/1ML/29G X 5/16", 34
Virt-pn DHA, 27
wera, 11
Virt-pn Plus, 27
Westhroid, 13
Vanishpoint Insulin Syringe/1ML/30G X 5/16", 34
Virt-select, 27
Wound Wash Saline, 9
virt-vite, 16
Wp Thyroid, 13
Varubi, 14
Virt-vite GT, 27
wymzya FE, 11
Vcf Vaginal Contraceptive Film, 15
Virtprex, 27
X
vcf vaginal contraceptive foam, 15
virtrate-2, 16
Vcf Vaginal Contraceptive Foam, 15
virtrate-3, 16
Xalkori, 4
vcf vaginal contraceptivegel, 15
virtrate-k, 16
Xarelto, 17
Vecamyl, 5
vita s forte, 26
Xarelto Starter Pack, 17
velivet, 11
vita-min, 26
Xeljanz, 24
Velma Pain Relief, 9
Vita-pren, 28
Xeljanz XR, 24
Velphoro, 15
vitacel, 26
xenaflamm, 24
Veltrix, 9
Vitafol, 27
Xenazine, 20
Vemavite-prx 2, 27
Vitafol Fe+, 27
Xeralux, 9
Vemlidy, 2
Vitafol Gummies, 27
Xifaxan, 3
Vena-bal DHA, 27
Vitafol Ultra, 27
Xigduo XR, 12
venlafaxine HCL, 18
Vitafol-nano, 27
Xolegel Corepak, 7
venlafaxine HCL ER, 18
Vitafol-OB, 26
Xrylix, 7
Venlafaxine HCL ER, 18
Vitafol-ob+dha, 27
Xtandi, 3
Ventavis, 6
Vitafol-one, 27
Xulane, 11
Ventolin HFA, 25
vitamax pediatric, 26
Xuriden, 13
verapamil HCL, 5
Vitamedmd One RX/Quatrefolic, 27
xylon, 23
verapamil HCL ER, 5
Vitamedmd Plus RX/Quatre Folic, 28
Xyrem, 20
verapamil HCL SR, 5
Vitamedmd Redichew RX, 27
Y
verdrocet, 23
vitamin d, 26
Yondelis, 3
Versacloz, 18
vitamin d3, 26
yuvafem, 15
Vesicare, 15
Vitamin Deficiency Injectable System-b12, 16
Z
vestura, 11
Vexol, 21
vitamins a/c/d/fluoride, 26
Zacare 4% Kit, 7
Viberzi, 15
Vitapearl, 27
Zaclir Cleansing, 7
vic-forte, 26
Vitaroca Plus, 28
zafirlukast, 25
vicodin, 23
Vitekta, 2
zaleplon, 19
vicodin ES, 23
Vituz, 25
Zamicet, 23
vicodin HP, 23
Viva DHA, 27
zarah, 11
Victoza, 12
Vivelle-dot, 10
Zarontin, 19
Victrelis, 2
Vivlodex, 24
Zarxio, 17
Vida Mia Unifine Pentips 32GX4MM, 34
Vol-nate, 27
Zatean-CH, 27
Vida Mia Unifine Pentips Mini 31GX6MM, 34
Vol-TAB RX, 28
Zatean-pn DHA, 27
voriconazole, 2
Zatean-pn Plus, 27
Vida Mia Unifine Pentips Original 29GX12MM, 34
Vortex Valved Holding Chamber, 35
Zavara, 16
Votrient, 4
Zavesca, 17
Vida Mia Unipfine Pentipsshort 31GX8MM, 34
Vp Insulin Syringe/U-100/0.3ML/29G X 1/2", 34
zazole, 15
zebutal, 23
Videx Pediatric, 2
Vp-CH Plus, 28
Zelapar, 20
Zelboraf, 4
Zemplar, 13
zenatane, 6
zenchent, 11
zenchent FE, 11
zencia, 7
Zenpep, 14
zenzedi, 19
Zepatier, 2
Ziagen, 2
zidovudine, 2
Zioptan, 21
ziprasidone HCL, 18
Zirgan, 21
Zithranol, 8
Zithranol-rr, 8
Zodex 6-day, 10
Zolate, 16
Zolinza, 4
zolmitriptan, 24
zolmitriptan odt, 24
zolpidem tartrate, 19
zolpidem tartrate ER, 19
Zolpimist, 19
Zomacton, 13
Zomig, 24
Zonalon, 7
Zonegran, 19
zonisamide, 19
Zontivity, 17
Zorbtive, 13
Zortress, 3
Zostavax, 26
zovia 1/35e, 11
zovia 1/50e, 11
Zydelig, 4
Zyflo, 25
Zyflo CR, 25
Zykadia, 4
Zymaxid, 21
Zytiga, 3
Zyvox, 3
1
1ST Tier Unifine Pentips /Mini/31GX5MM, 34
1ST Tier Unifine Pentips 29GX12MM, 34
1ST Tier Unifine Pentips 31GX6MM, 34
1ST Tier Unifine Pentips 31GX8MM, 34
1ST Tier Unifine Pentips 32GX4MM, 34
1ST Tier Unifine Pentips Plus 31GX8MM, 34
1ST Tier Unifine Pentips Plus 32GX4MM, 34
1ST Tier Unifine Pentips Plus/Mini/31GX5MM, 34
1ST Tier Unifine Pentips Plus/Original/29GX12MM, 34
1ST Tier Unifine Pentips Plus/Ultra SHORT/31GX6MM, 34
8
8-mop, 8