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Workers Comp Formulary - Emdeon

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					                                                                                                                                             Coalition for Advanced Pharmacy Services

                                                                                                                                                            2012 National Formulary



                                                                                                                                                                  Table of Contents




Antihistamine Drugs................................................................................................................................................................................................................................................................................................................................7
Antineoplastic Agents.............................................................................................................................................................................................................................................................................................................................7
Autonomic Drugs......................................................................................................................................................................................................................................................................................................................................8
Blood Formation,Coagulation & Thrombosis..........................................................................................................................................................................................................................................................................10
Cardiovascular Drugs............................................................................................................................................................................................................................................................................................................................11
Central Nervous System Agents......................................................................................................................................................................................................................................................................................................19
Dental Agents............................................................................................................................................................................................................................................................................................................................................27
Devices.........................................................................................................................................................................................................................................................................................................................................................27
Diagnostic Agents...................................................................................................................................................................................................................................................................................................................................27
Electrolytic, Caloric, And Water Balance..................................................................................................................................................................................................................................................................................27
Enzymes.......................................................................................................................................................................................................................................................................................................................................................30
Eye, Ear, Nose And Throat (Eent) Preps....................................................................................................................................................................................................................................................................................30
Gastrointestinal Drugs..........................................................................................................................................................................................................................................................................................................................33
Gold Compounds....................................................................................................................................................................................................................................................................................................................................35
Heavy Metal Antagonists....................................................................................................................................................................................................................................................................................................................35
Hormones And Synthetic Substitutes...........................................................................................................................................................................................................................................................................................35
Miscellaneous Therapeutic Agents................................................................................................................................................................................................................................................................................................38
Oxytocics.....................................................................................................................................................................................................................................................................................................................................................40
Pharmaceutical Aids..............................................................................................................................................................................................................................................................................................................................41
Respiratory Tract Agents....................................................................................................................................................................................................................................................................................................................41
Serums, Toxoids, And Vaccines.....................................................................................................................................................................................................................................................................................................46
Skin And Mucous Membrane Agents..........................................................................................................................................................................................................................................................................................46
Smooth Muscle Relaxants..................................................................................................................................................................................................................................................................................................................52
Vitamins.......................................................................................................................................................................................................................................................................................................................................................52




                                                                                                                                                                                                                                                                                                                                                               1
2
                                                                     Coalition for Advanced Pharmacy Services

                                                                             2012 National Formulary



                                                                               CURRENT AS OF 1/1/2012




Drug                                           Brand   Generic   Notes                      Drug                                Brand   Generic   Notes

Anti-Infective Agents                                                                       AUGMENTIN TAB (amoxicillin-pot
                                                                                                                                 3        1
                                                                                            clavulanate)
Adamantanes
                                                                                            AUGMENTIN XR (amoxicillin-pot
amantadine oral                                          1                                                                       3        1
                                                                                            clavulanate)
FLUMADINE (rimantadine)                         3        1                                  PREVPAC                              3
Allylamines                                                                                 Anthelmintics
LAMISIL ORAL GRANULES IN                                                                    ALBENZA                              2
                                                2
PACKET 125 MG, 187.5 MG
                                                                                            BILTRICIDE                           2
LAMISIL TAB (terbinafine)                       3        1
                                                                                            STROMECTOL                           2
Amebicides
                                                                                            Antifungals, Miscellaneous
FLAGYL TAB (metronidazole) 250 MG,
                                                3        1
500 MG                                                                                      GRIFULVIN V                          3
FLAGYL ER                                       3                                           GRIS-PEG TAB 125 MG, 250 MG          3
HELIDAC                                         3                                           griseofulvin microsize oral                   1
paromomycin                                              1                                  Antimalarials
PYLERA                                          2                                           ARALEN (chloroquine phosphate)       3        1
Aminoglycosides                                                                             chloroquine tab 250 mg                        1
KANAMYCIN                                                3                                  COARTEM                              2
NEO-FRADIN                                      3                                           DARAPRIM                             2
neomycin                                                 1                                  HELIDAC                              3
TOBI                                            2                                           MALARONE (atovaquone-proguanil)      3        1
Aminopenicillins                                                                            mefloquine                                    1
amoxicillin cap 250 mg, 500 mg                           1                                  PLAQUENIL (hydroxychloroquine)       3        1
amoxicillin chewable tab                                 1                                  PRIMAQUINE                                    2
amoxicillin oral susp 125 mg/5 ml, 200                                                      PYLERA                               2
                                                         1
mg/5 ml, 250 mg/5 ml, 400 mg/5 ml
                                                                                            QUALAQUIN                            2
amoxicillin tab 500 mg, 875 mg                           1
                                                                                            quinidine gluconate                           1
amoxicillin-potassium clavulanate chewable
                                                         1                                  quinidine sulfate er tab                      1
tab
amoxicillin-potassium clavulanate oral susp                                                 quinidine tab 200 mg, 300 mg                  1
200-28.5 mg/5 ml, 400-57 mg/5 ml,                        1
                                                                                            Antimycobacterials, Miscellaneous
600-42.9 mg/5 ml
                                                                                            DAPSONE TAB 100 MG, 25 MG                     2
amoxicillin-potassium clavulanate tab
                                                         1
250-125 mg                                                                                  Antiprotozoals, Miscellaneous
ampicillin                                               1                                  ALINIA                               2
AMPICILLIN SOLUTION FOR                                                                     DAPSONE                                       2
                                                         3
INJECTION 250 MG
                                                                                            FLAGYL (metronidazole)               3        1
AUGMENTIN ORAL SUSP                                                                         FLAGYL ER                            3
(amoxicillin-pot clavulanate) 250-62.5          3        1
MG/5 ML                                                                                     HELIDAC                              3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                              3
Drug                                           Brand   Generic   Notes   Drug                                         Brand   Generic   Notes

MEPRON                                          2                        First Generation Cephalosporins
NEBUPENT                                        2                        cefadroxil cap                                         1
PYLERA                                          2                        cefadroxil oral susp 250 mg/5 ml, 500 mg/5
                                                                                                                                1
                                                                         ml
TINDAMAX TAB 250 MG, 500 MG                     2
                                                                         cefadroxil tab                                         1
Antituberculosis Agents
                                                                         cephalexin oral susp 125 mg/5 ml, 250 mg/5
AMIKACIN INJ                                             3                                                                      1
                                                                         ml
AMIKACIN (PF)                                            3               cephalexin tab                                         1
AVELOX                                          3                        KEFLEX CAP 750 MG                             3
AVELOX ABC PACK                                 3                        KEFLEX CAP (cephalexin) 250 MG, 500
                                                                                                                       3        1
BIAXIN (clarithromycin)                         3        1               MG

BIAXIN XL (clarithromycin)                      3        1               Glycopeptides

BIAXIN XL PAK (clarithromycin)                  3        1               VANCOCIN CAP 125 MG, 250 MG                   2

CAPASTAT                                        3                        Hcv Protease Inhibitors

CIPRO ORAL SUSP                                 2                        INCIVEK                                       2

CIPRO TAB (ciprofloxacin)                       3        1               VICTRELIS                                     2                T3 AF

CIPRO XR (ciprofloxacin (mixture))              3        1               Hiv Entry And Fusion Inhibitors

IsonaRif                                        1                        FUZEON                                        2

ISONIAZID SYRUP                                          2               SELZENTRY                                     2

isoniazid tab                                            1               Hiv Protease Inhibitors

LEVAQUIN (levofloxacin)                         3        1               APTIVUS                                       2

MYAMBUTOL TAB (ethambutol) 100                                           CRIXIVAN                                      2
                                                3        1
MG, 400 MG                                                               INVIRASE                                      2
MYCOBUTIN                                       2                        KALETRA                                       2
PASER                                           3                        LEXIVA                                        2
PRIFTIN                                         3                        NORVIR                                        2
pyrazinamide                                             1               PREZISTA                                      2
RIFADIN ORAL (rifampin)                         3        1               REYATAZ                                       2
RIFAMATE                                        3                        VIRACEPT                                      2
RIFATER                                         3                        Integrase Inhibitors
SEROMYCIN                                       2                        ISENTRESS                                     2
STREPTOMYCIN IM                                          3               Interferons
TRECATOR                                        3                        ALFERON N                                     3
Azoles                                                                   INFERGEN                                      3
DIFLUCAN ORAL SUSP (fluconazole)                3        1               INTRON A INJ                                  2
DIFLUCAN TAB (fluconazole) 100 MG,                                       INTRON A SUBQ                                 3
                                                3        1
150 MG, 200 MG, 50 MG
                                                                         PEGASYS                                       2
ketoconazole                                             1
                                                                         PEGASYS CONVENIENCE PACK                      2
NOXAFIL                                         2
                                                                         PEGASYS PROCLICK                              2
SPORANOX ORAL SOLN                              2
                                                                         PEGINTRON                                     2
SPORANOX CAP (itraconazole)                     3        1
                                                                         PEGINTRON REDIPEN                             2
SPORANOX PULSEPAK (itraconazole)                3        1
                                                                         SYLATRON                                      2
VFEND (voriconazole)                            3        1
                                                                         SYLATRON 4-PACK                               2
Erythromycins
                                                                         Ketolides
erythromycin-sulfisoxazole                               1
                                                                         KETEK TAB 300 MG, 400 MG                      3
4      T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Lincomycins                                                              Nucleoside,Nucleotide Rev.Trnscrip.Inhib
CLEOCIN CAP 75 MG                               3                        ATRIPLA                                     2
CLEOCIN CAP (clindamycin HCl) 150                                        COMBIVIR (lamivudine-zidovudine)            3        1
                                                3        1
MG, 300 MG
                                                                         COMPLERA                                    2
CLEOCIN ORAL SOLUTION
                                                3        1               EMTRIVA                                     2
(clindamycin palmitate HCl)
CLINDAMYCIN PHOSPHATE INJ                                3               EPIVIR ORAL SOLN                            2

Macrolides                                                               EPIVIR TAB (lamivudine)                     3        1

DIFICID                                         3                        EPIVIR HBV                                  2

E.E.S. 400 (erythromycin ethylsuccinate)        1        1               EPZICOM                                     2

E.E.S. GRANULES                                 3                        RETROVIR ORAL (zidovudine)                  3        1

Ery-Tab Tab 250 mg, 333 mg                      1                        TRIZIVIR                                    2

ERY-TAB TAB 500 MG                              3                        TRUVADA                                     2

ERYPED 200                                      3                        VIDEX 2 GRAM PEDIATRIC                      2

ERYPED 400                                      3                        VIDEX 4 GRAM PEDIATRIC                      2

Erythrocin Stearate                             1                        VIDEX EC (didanosine)                       3        1

erythromycin                                             1               VIREAD                                      2

PCE TAB 333 MG, 500 MG                          3                        ZERIT (stavudine)                           3        1

Monobactams                                                              ZIAGEN                                      2

AZACTAM SOLUTION FOR INJECTION                                           Nucleosides And Nucleotides
                                                3        3
(AZTREONAM) 2 GRAM                                                       BARACLUDE                                   2
CAYSTON                                         2                        COPEGUS (ribavirin)                         3        1
Monoclonal Antibodies                                                    FAMVIR (famciclovir)                        3        1
SYNAGIS IM SOLN 100 MG/ML, 50                                            HEPSERA                                     2
                                                2
MG/0.5 ML
                                                                         REBETOL (ribavirin)                         3        1
Natural Penicillins
                                                                         RibaPak Dose Pack Tabs 400-400 mg
BICILLIN C-R                                    3                        (28)-mg (28), 600-400 mg (28)-mg (28),      1
BICILLIN L-A                                    3                        600-600 mg (28)-mg (28)

PENICILLIN G PROCAINE                                    3               Ribasphere Tab 400 mg, 600 mg               1

PENICILLIN G SODIUM                                      3               Ribasphere Cap (ribavirin)                  1        1

penicillin v potassium oral susp 125 mg/5                                Ribasphere Tab (ribavirin) 200 mg           1        1
                                                         1
ml, 250 mg/5 ml                                                          RIBATAB DOSE PACK                           3
penicillin v potassium tab 250 mg, 500 mg                1               TYZEKA                                      3
PFIZERPEN-G (PENICILLIN G                                                VALCYTE ORAL SOLUTION                       3
                                                3        3
POTASSIUM)
                                                                         VALCYTE TAB                                 2
Neuraminidase Inhibitors
                                                                         VALTREX (valacyclovir)                      3        1
RELENZA DISKHALER                               2
                                                                         VIRAZOLE                                    3
TAMIFLU                                         2
                                                                         ZOVIRAX (acyclovir)                         3        1
Nonnucleoside Rev.Transcriptase Inhib.
                                                                         Other Macrolides
ATRIPLA                                         2
                                                                         BIAXIN ORAL SUSP (clarithromycin)           3        1
EDURANT                                         2
                                                                         BIAXIN TAB (clarithromycin) 250 MG,
INTELENCE                                       2                                                                    3        1
                                                                         500 MG
RESCRIPTOR                                      2                        BIAXIN XL (clarithromycin)                  3        1
SUSTIVA                                         2                        BIAXIN XL PAK (clarithromycin)              3        1
VIRAMUNE                                        2                        clarithromycin oral susp 125 mg/5 ml                 1
VIRAMUNE XR                                     3                        PREVPAC                                     3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  5
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

ZITHROMAX ORAL PACKET                                                    XIFAXAN TAB 550 MG                           2
                                                3        1
(azithromycin)
                                                                         Second Generation Cephalosporins
ZITHROMAX ORAL SUSP (azithromycin)
                                                3        1               cefaclor cap 250 mg, 500 mg                           1
100 MG/5 ML, 200 MG/5 ML
ZITHROMAX TAB (azithromycin)                    3        1               cefaclor er 12 hr tab                                 1

ZITHROMAX TRI-PAK (azithromycin)                3        1               cefprozil oral susp 125 mg/5 ml, 250 mg/5
                                                                                                                               1
                                                                         ml
ZITHROMAX Z-PAK (azithromycin)                  3        1
                                                                         cefprozil tab 250 mg, 500 mg                          1
Other Misc. Antibacterial Agents
                                                                         CEFTIN ORAL SUSP                             2
HELIDAC                                         3
                                                                         CEFTIN TAB (cefuroxime axetil) 250 MG,
                                                                                                                      3        1
PYLERA                                          2                        500 MG
Oxazolidinones                                                           Sulfonamides (Systemic)
ZYVOX ORAL                                      2                        AZULFIDINE (sulfasalazine)                   3        1
Penicillinase-Resistant Penicillins                                      AZULFIDINE EN-TABS (sulfasalazine)           3        1
dicloxacillin cap 250 mg, 500 mg                         1               BACTRIM DS
                                                                                                                      3        1
                                                                         (sulfamethoxazole-trimethoprim)
Polyenes
                                                                         SEPTRA DS
nystatin oral powder 150 million unit                    1                                                            3        1
                                                                         (sulfamethoxazole-trimethoprim)
NYSTATIN ORAL POWDER 50                                                  sulfadiazine oral                                     1
                                                         2
MILLION UNIT, 500 MILLION UNIT
                                                                         SULFAMETHOXAZOLE (BULK)                               3
nystatin oral susp                                       1
                                                                         sulfamethoxazole-trimethoprim oral susp               1
nystatin tab                                             1
                                                                         sulfamethoxazole-trimethoprim tab 400-80
Polymyxins                                                                                                                     1
                                                                         mg
COLISTIN (COLISTIMETHATE NA)                             3               Sulfazine (sulfasalazine)                    1        1
Pyrimidines                                                              Sulfazine EC (sulfasalazine)                 1        1
ANCOBON (flucytosine)                           3        1               Tetracyclines
Quinolones                                                               ADOXA CAP (doxycycline monohydrate)          3        1
AVELOX                                          3                        ADOXA TAB (doxycycline monohydrate)          2        1
AVELOX ABC PACK                                 3                        ADOXA PAK (doxycycline monohydrate)          2        1
CIPRO ORAL SUSP 250 MG/5 ML, 500                                         ALODOX                                       3
                                                2
MG/5 ML
                                                                         demeclocycline oral                                   1
CIPRO TAB (ciprofloxacin) 250 MG, 500
                                                3        1
MG, 750 MG                                                               DORYX                                        3
CIPRO XR (ciprofloxacin (mixture))              3        1               doxycycline hyclate tab                               1
ciprofloxacin (mixture)                                  1               doxycycline hyclate tab, delayed release              1
FACTIVE                                         3                        DYNACIN TAB (minocycline) 100 MG             3        1
LEVAQUIN (levofloxacin)                         3        1               HELIDAC                                      3
NOROXIN                                         2                        MINOCIN MISC                                 3
ofloxacin tab 200 mg, 300 mg, 400 mg                     1               MINOCIN ORAL (minocycline)                   3        1
Rifamycins                                                               minocycline cap 75 mg                                 1
IsonaRif                                        1                        minocycline tab                                       1
MYCOBUTIN                                       2                        MONODOX CAP (doxycycline
                                                                                                                      3        1
                                                                         monohydrate) 100 MG, 50 MG, 75 MG
PRIFTIN                                         3
                                                                         ORACEA                                       2
RIFADIN CAP (rifampin) 150 MG, 300
                                                3        1
MG                                                                       PYLERA                                       2
RIFAMATE                                        3                        SOLODYN 24 HR TAB 105 MG, 115 MG,
                                                                                                                      3
                                                                         55 MG, 65 MG, 80 MG
RIFATER                                         3
                                                                         SOLODYN 24 HR TAB (minocycline) 135
XIFAXAN TAB 200 MG                              3                                                                     3        1
                                                                         MG, 45 MG, 90 MG
6      T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                Brand   Generic   Notes

tetracycline cap 250 mg, 500 mg                          1               CLARINEX-D 24 HOUR                   2
VIBRAMYCIN (doxycycline hyclate)                3        1               SEMPREX-D                            3
Third Generation Cephalosporins                                          XYZAL (levocetirizine)               3        1
CEDAX CAP                                       3                        ZYRTEC CHEWABLE TAB                  3
CEDAX ORAL SUSP 180 MG/5 ML, 90                                          ZYRTEC TAB                           3
                                                3
MG/5 ML
                                                                         ZYRTEC-D                             3
cefdinir cap                                             1
                                                                         Antineoplastic Agents
cefdinir oral susp 125 mg/5 ml, 250 mg/5 ml              1
                                                                         Antineoplastic Agents
cefpodoxime oral susp 100 mg/5 ml, 50
                                                         1               AFINITOR TAB 10 MG, 2.5 MG, 5 MG     2
mg/5 ml
cefpodoxime tab 100 mg, 200 mg                           1               ALKERAN ORAL                         2

SPECTRACEF TAB (CEFDITOREN                                               ARIMIDEX (anastrozole)               3        1
                                                3        3
PIVOXIL) 200 MG, 400 MG                                                  AROMASIN (exemestane)                3        1
SUPRAX ORAL SUSP 100 MG/5 ML, 200                                        CAPRELSA                             2
                                                3
MG/5 ML
                                                                         CASODEX (bicalutamide)               3        1
SUPRAX TAB                                      3
                                                                         CEENU CAP 10 MG, 100 MG, 40 MG       2
Urinary Anti-Infectives
                                                                         cyclophosphamide oral                         1
FURADANTIN                                      2
                                                                         DROXIA CAP 200 MG, 300 MG, 400
HIPREX (methenamine hippurate)                  3        1                                                    2
                                                                         MG
Hyophen                                         1                        ELIGARD SUB-Q SYRINGE 22.5 MG, 30
                                                                                                              3
MACROBID (nitrofurantoin                                                 MG, 45 MG, 7.5 MG
                                                3        1
monohyd/m-cryst)                                                         EMCYT                                2
MACRODANTIN CAP 25 MG                           3                        etoposide oral                                1
MACRODANTIN CAP (nitrofurantoin                                          FEMARA (letrozole)                   3        1
                                                3        1
macrocrystal) 100 MG, 50 MG
                                                                         FIRMAGON SUB-Q SOLN 120 MG, 80
methenamine mandelate tab 0.5 g, 1 gram                  1                                                    2
                                                                         MG
MONUROL                                         3                        FLOXURIDINE                                   3
trimethoprim                                             1               flutamide                                     1
Antihistamine Drugs                                                      GLEEVEC                              2
First Gen. Antihist. Derivatives, Misc.                                  GLIADEL WAFER                        3
cyproheptadine                                           1               HEXALEN                              2
Phenothiazine Derivatives                                                HYCAMTIN ORAL                        2
promethazine                                             1               HYDREA (hydroxyurea)                 3        1
Promethazine VC                                 1                        IRESSA                               3
Promethazine VC-Codeine                                                  LEUKERAN                             2
                                                1        1
(phenyleph-promethazine-cod)
                                                                         leuprolide                                    1
Piperazine Derivatives
                                                                         LUPRON DEPOT IM SYRINGE KIT
hydroxyzine hcl                                          1                                                    2
                                                                         3.75 MG, 7.5 MG
Propylamine Derivatives                                                  LUPRON DEPOT (3 MONTH) IM
                                                                                                              2
dexchlorpheniramine maleate                              1               SYRINGE KIT 11.25 MG, 22.5 MG

Second Generation Antihistamines                                         LUPRON DEPOT (4 MONTH)               2

cetirizine oral soln 1 mg/ml                             1               LUPRON DEPOT (6 MONTH)               2

CLARINEX SYRUP                                  2                        LUPRON DEPOT-PED IM KIT 11.25
                                                                                                              2
                                                                         MG, 15 MG, 7.5 MG (PED)
CLARINEX TAB                                    2
                                                                         LUPRON DEPOT-PED (3 MONTH)           2
CLARINEX TAB, RAPID DISSOLVE                    2
                                                                         LYSODREN                             2

CLARINEX-D 12 HOUR                              2                        MATULANE                             2

       T3 AF = Tier 3 on Advantage Formulary                                                                                           7
Drug                                           Brand   Generic   Notes   Drug                                 Brand   Generic   Notes

MEGACE ES                                       3                        ATROPINE INJ                                   3
MEGACE ORAL (megestrol)                         3        1               ATROVENT HFA                          2
megestrol tab 20 mg, 40 mg                               1               BENTYL IM                             3
METHOTREXATE SODIUM INJ                                  3               BENTYL CAP (dicyclomine)              3        1
methotrexate sodium oral                                 1               BENTYL SYRUP (dicyclomine)            3        1
METHOTREXATE SODIUM (PF)                                 3               BENTYL TAB (dicyclomine)              3        1
MUSTARGEN                                       3                        CANTIL                                3
MYLERAN                                         2                        COMBIVENT                             2
NEXAVAR                                         2                        CUVPOSA                               3
NILANDRON                                       3                        DIGEX NF                              3
ONCASPAR                                        3                        diphenoxylate-atropine oral liquid             1
PURINETHOL (mercaptopurine)                     3        1               DONNATAL ELIXIR                       3
RHEUMATREX                                      3                        DONNATAL TAB
                                                                                                               3        1
                                                                         (phenobarb-hyoscy-atropine-scop)
SPRYCEL TAB 100 MG, 140 MG, 20
                                                2
MG, 50 MG, 70 MG, 80 MG                                                  DONNATAL EXTENTABS                    3
SUPPRELIN LA                                    2                        DUODOTE                               3
SUTENT CAP 12.5 MG, 25 MG, 50 MG                2                        DUONEB (ipratropium-albuterol)        3        1
TABLOID                                         2                        Gastrinex NF                          1
tamoxifen                                                1               hyoscyamine elixir                             1
TARCEVA TAB 100 MG, 150 MG, 25                                           hyoscyamine oral drops                         1
                                                2
MG
                                                                         ipratropium bromide                            1
TARGRETIN                                       3
                                                                         LEVBID (hyoscyamine sulfate)          2        1
TASIGNA CAP 150 MG, 200 MG                      2
                                                                         LEVSIN ORAL (hyoscyamine sulfate)     3        1
TEMODAR CAP 100 MG, 140 MG, 180
                                                2                        LEVSIN/SL (hyoscyamine sulfate)       3        1
MG, 20 MG, 250 MG, 5 MG
TRELSTAR IM SYRINGE 3.75 MG/2 ML                3                        LIBRAX (WITH CLIDINIUM)
                                                                                                               3        1
                                                                         (chlordiazepoxide-clidinium)
tretinoin (chemotherapy)                                 1
                                                                         LOMOTIL (diphenoxylate-atropine)      3        1
TREXALL TAB 10 MG, 15 MG, 5 MG,
                                                2                        NULEV (hyoscyamine sulfate)           3        1
7.5 MG
TYKERB                                          2                        PAMINE (methscopolamine)              3        1

VANTAS                                          2                        PAMINE FORTE (methscopolamine)        3        1

VIDAZA                                          2                        propantheline                                  1

VOTRIENT                                        2                        Quadrapax                             1

XELODA TAB 150 MG, 500 MG                       2                        RESCON                                3

ZELBORAF                                        2                        ROBINUL (glycopyrrolate)              3        1

ZOLADEX SUBQ IMPLANT 10.8 MG,                                            ROBINUL FORTE (glycopyrrolate)        3        1
                                                2
3.6 MG                                                                   SAL-TROPINE                           3
Autonomic Drugs
                                                                         SCOPOLAMINE HBR                                3
Alpha-Adrenergic Blocking Agent(Sympath)
                                                                         SE-Donna PB Hyos                      1
yohimbine oral                                           1
                                                                         SPIRIVA WITH HANDIHALER               2
Antimuscarinics/Antispasmodics
                                                                         STAHIST (REFORMULATED)                3
ALLERX 10                                       3
                                                                         Antiparkinsonian Agents
ALLERX 30                                       3
                                                                         benztropine tab 0.5 mg, 1 mg, 2 mg             1
ALLERX PE                                       3
                                                                         COGENTIN (BENZTROPINE)                3        3
ALLERX-D                                        3
                                                                         trihexyphenidyl elixir                         1
Anaspaz (hyoscyamine sulfate)                   1        1
8      T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

trihexyphenidyl tab 2 mg, 5 mg                           1               pindolol tab 10 mg, 5 mg                              1
Autonomic Drugs, Miscellaneous                                           propranolol oral soln                                 1
CHANTIX TAB 0.5 MG, 1 MG                        2                        propranolol tab 10 mg, 20 mg, 40 mg, 60
                                                                                                                               1
                                                                         mg, 80 mg
CHANTIX CONTINUING MONTH
                                                2
BOX                                                                      propranolol-hydrochlorothiazide tab 40-25
                                                                                                                               1
                                                                         mg, 80-25 mg
CHANTIX STARTING MONTH BOX                      2
                                                                         Sorine (sotalol)                             1        1
nicotine                                                 1
                                                                         Sotalol AF (sotalol)                         1        1
nicotine (polacrilex)                                    1
                                                                         timolol tab 10 mg, 20 mg, 5 mg                        1
NICOTROL                                        2
                                                                         TRANDATE (labetalol)                         3        1
NICOTROL NS                                     2
                                                                         Non-Sel.Alpha-1-Adrenergic Blocking Agts
Thrive Nicotine (nicotine (polacrilex))         1        1
                                                                         CARDURA TAB (doxazosin) 1 MG, 2 MG,
Centrally Acting Skeletal Muscle Relaxnt                                                                              3        1
                                                                         4 MG, 8 MG
AMRIX 24 HR CAP                                                          CARDURA XL 24 HR TAB 4 MG, 8 MG              3
                                                3        3
(CYCLOBENZAPRINE) 15 MG, 30 MG
                                                                         MINIPRESS CAP (prazosin) 1 MG, 2 MG,
carisoprodol-asa-codeine                                 1                                                            3        1
                                                                         5 MG
carisoprodol-aspirin                                     1               terazosin cap 1 mg, 10 mg, 2 mg, 5 mg                 1
cyclobenzaprine tab 7.5 mg                               1               Non-Sel.Alpha-Adrenergic Blocking Agents
FLEXERIL TAB (cyclobenzaprine) 10 MG,                                    CAFERGOT (ergotamine-caffeine)               3        1
                                                3        1
5 MG
                                                                         D.H.E.45 (dihydroergotamine)                 3        1
PARAFON FORTE DSC (chlorzoxazone)               3        1
                                                                         DIBENZYLINE                                  2
ROBAXIN (methocarbamol)                         3        1
                                                                         ergoloid                                              1
ROBAXIN-750 (methocarbamol)                     3        1
                                                                         ERGOMAR                                      2
SKELAXIN (metaxalone)                           2        1
                                                                         Migergot                                     1
SOMA (carisoprodol)                             3        1
                                                                         MIGRANAL                                     3
tizanidine                                               1
                                                                         phentolamine inj                                      1
ZANAFLEX TAB (tizanidine)                       3        1
                                                                         Parasympathomimetic (Cholinergic Agents)
Direct-Acting Skeletal Muscle Relaxants
                                                                         ARICEPT TAB 23 MG                            2
DANTRIUM CAP (dantrolene) 100 MG,
                                                3        1
25 MG, 50 MG                                                             ARICEPT TAB (donepezil) 10 MG, 5 MG          3        1
Gaba-Derivative Skeletal Muscle Relaxant                                 ARICEPT ODT TAB, RAPID DISSOLVE
                                                                                                                      3        1
                                                                         (donepezil) 10 MG, 5 MG
baclofen tab 10 mg, 20 mg                                1
                                                                         EVOXAC                                       2
LIORESAL                                        3
                                                                         EXELON ORAL SOLN                             2
Non-Sel. Beta-Adrenergic Blocking Agents
                                                                         EXELON TRANSDERM 24 HR PATCH
BETAPACE (sotalol)                              3        1                                                            2
                                                                         4.6 MG/24 HOUR, 9.5 MG/24 HOUR
BETAPACE AF TAB (sotalol) 120 MG,                                        EXELON CAP (rivastigmine) 1.5 MG, 3
                                                3        1                                                            3        1
160 MG, 80 MG                                                            MG, 4.5 MG, 6 MG
BYSTOLIC TAB 10 MG, 2.5 MG, 20                                           guanidine                                             1
                                                2
MG, 5 MG
                                                                         MESTINON SYRUP                               2
COREG (carvedilol)                              3        1
                                                                         MESTINON TAB (pyridostigmine
COREG CR 24 HR CAP 10 MG, 20 MG,                                                                                      3        1
                                                2                        bromide)
40 MG, 80 MG
                                                                         MESTINON TIMESPAN                            2
CORGARD (nadolol)                               3        1
                                                                         MYTELASE                                     3
CORZIDE (nadolol-bendroflumethiazide)           3        1
                                                                         NEOSTIGMINE METHYLSULFATE                             3
INDERAL LA 24 HR CAP (propranolol)
                                                3        1
120 MG, 160 MG, 60 MG, 80 MG                                             PROSTIGMIN                                   2

INNOPRAN XL 24 HR CAP 120 MG, 80
                                                3                        RAZADYNE ORAL SOLN (galantamine)             3        1
MG

       T3 AF = Tier 3 on Advantage Formulary                                                                                                   9
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

RAZADYNE TAB (galantamine) 12 MG, 4                                      Selective Beta-Adrenergic Blocking Agent
                                                3        1
MG, 8 MG
                                                                         KERLONE (betaxolol)                          3        1
RAZADYNE ER 24 HR CAP
                                                3        1               LOPRESSOR ORAL (metoprolol tartrate)         3        1
(galantamine) 16 MG, 24 MG, 8 MG
SALAGEN (pilocarpine HCl)                       3        1               LOPRESSOR HCT
                                                                                                                      3        1
                                                                         (metoprolol-hydrochlorothiazide)
URECHOLINE TAB (bethanechol
                                                3        1               metoprolol tartrate tab 25 mg                         1
chloride) 10 MG, 25 MG, 5 MG, 50 MG
Selective Alpha-1-Adrenergic Block.Agent                                 metoprolol-hydrochlorothiazide tab 100-50
                                                                                                                               1
                                                                         mg
COREG (carvedilol)                              3        1
                                                                         SECTRAL (acebutolol)                         3        1
COREG CR 24 HR CAP 10 MG, 20 MG,
                                                2                        TENORETIC 100 (atenolol-chlorthalidone)      3        1
40 MG, 80 MG
FLOMAX (tamsulosin)                             3        1               TENORETIC 50 (atenolol-chlorthalidone)       3        1

JALYN                                           2                        TENORMIN (atenolol)                          3        1

RAPAFLO CAP 4 MG, 8 MG                          3                        TOPROL XL 24 HR TAB (metoprolol
                                                                         succinate) 100 MG, 200 MG, 25 MG, 50         3        1
TRANDATE (labetalol)                            3        1               MG
UROXATRAL (ALFUZOSIN)                           3        3               ZEBETA (bisoprolol fumarate)                 3        1
Selective Beta-2-Adrenergic Agonists                                     ZIAC (bisoprolol-hydrochlorothiazide)        3        1
ACCUNEB NEB SOLUTION (albuterol                                          Skeletal Muscle Relaxants, Miscellaneous
                                                3        1
sulfate) 0.63 MG/3 ML, 1.25 MG/3 ML
                                                                         BOTOX                                        3
ADVAIR DISKUS                                   2
                                                                         BOTOX COSMETIC                               3
ADVAIR HFA                                      2
                                                                         DYSPORT                                      3
albuterol sulfate neb solution 2.5 mg /3 ml
                                                         1               MYOBLOC                                      3
(0.083 %), 2.5 mg/0.5 ml, 5 mg/ml
albuterol sulfate syrup                                  1               NORFLEX (ORPHENADRINE CITRATE)               3        3

albuterol sulfate tab 2 mg, 4 mg                         1               orphenadrine citrate oral                             1

BROVANA                                         3                        Orphenadrine Compound                        1

COMBIVENT                                       2                        Orphenadrine Compound-DS                     1

DULERA                                          2                        XEOMIN                                       3

DUONEB (ipratropium-albuterol)                  3        1               Blood Formation,Coagulation & Thrombosis

FORADIL AEROLIZER                               2                        Coumarin Derivatives

MAXAIR AUTOHALER                                2                        COUMADIN TAB (warfarin) 1 MG, 10
                                                                         MG, 2 MG, 2.5 MG, 3 MG, 4 MG, 5 MG,          2        1
metaproterenol syrup                                     1               6 MG, 7.5 MG

metaproterenol tab 10 mg, 20 mg                          1               Jantoven (warfarin)                          1        1

PERFOROMIST                                     2                        Direct Factor Xa Inhibitors

PROAIR HFA                                      2                        XARELTO                                      3

PROVENTIL HFA                                   3                        Direct Thrombin Inhibitors

SEREVENT DISKUS                                 2                        IPRIVASK                                     2

SYMBICORT                                       2                        PRADAXA                                      2

terbutaline tab 2.5 mg, 5 mg                             1               Hematopoietic Agents

VENTOLIN HFA                                    3                        ARANESP (POLYSORBATE)
                                                                                                                      2
                                                                         INJECTION
VOSPIRE ER (albuterol sulfate)                  3        1
XOPENEX NEB SOLUTION 0.31 MG/3
                                                2
ML, 0.63 MG/3 ML, 1.25 MG/3 ML                                           ARANESP (POLYSORBATE)
                                                                         SYRINGE 100 MCG/0.5 ML, 150
XOPENEX CONCENTRATE                                                      MCG/0.3 ML, 200 MCG/0.4 ML, 25
                                                2        1                                                            2
(levalbuterol HCl)                                                       MCG/0.42 ML, 300 MCG/0.6 ML, 40
                                                                         MCG/0.4 ML, 500 MCG/ML, 60
                                                                         MCG/0.3 ML
XOPENEX HFA                                     2                T3 AF

10     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

EPOGEN INJECTION 10,000 UNIT/ML,                                         Aspirin Low-Strength (aspirin)            1        1
2,000 UNIT/ML, 20,000 UNIT/2 ML,
                                                3                        Bayer Aspirin (aspirin)                   1        1
20,000 UNIT/ML, 3,000 UNIT/ML, 4,000
UNIT/ML                                                                  Bayer Childrens Aspirin (aspirin)         1        1
LEUKINE INJECTION                               2                        BRILINTA                                  3
LEUKINE SOLUTION FOR                                                     Butalbital Compound
                                                2                                                                  1        1
INJECTION                                                                (butalbital-aspirin-caffeine)
MOZOBIL                                         2                        Child Aspirin (aspirin)                   1        1
NEULASTA                                        2                        Children's Aspirin (aspirin)              1        1
NEUMEGA                                         2                        EFFIENT TAB 10 MG, 5 MG                   2
NEUPOGEN INJECTION                              2                        Enteric Coated Aspirin (aspirin)          1        1
NEUPOGEN SYRINGE 300 MCG/0.5                                             FIORINAL (butalbital-aspirin-caffeine)    3        1
                                                2
ML, 480 MCG/0.8 ML
                                                                         LEVACET                                   1
NPLATE                                          2
                                                                         Lite Coat Aspirin (aspirin)               1        1
PROCRIT INJECTION 10,000
UNIT/ML, 2,000 UNIT/ML, 20,000                                           PERSANTINE (dipyridamole)                 3        1
UNIT/2 ML, 20,000 UNIT/ML, 3,000                2
UNIT/ML, 4,000 UNIT/ML, 40,000                                           PLAVIX TAB 300 MG, 75 MG                  2
UNIT/ML
                                                                         PLETAL TAB (cilostazol) 100 MG, 50 MG     3        1
PROMACTA TAB 25 MG, 50 MG, 75
                                                2                        ticlopidine                                        1
MG
                                                                         Platelet-Reducing Agents
Hemorrheologic Agents
                                                                         AGRYLIN (anagrelide)                      3        1
TRENTAL (pentoxifylline)                        3        1
                                                                         anagrelide cap 1 mg                                1
Hemostatics
                                                                         Thrombolytic Agents
AMICAR (aminocaproic acid)                      3        1
                                                                         Adult Low Dose Aspirin (aspirin)          1        1
STIMATE                                         2
                                                                         aspirin tab, delayed release 975 mg                1
Heparins
                                                                         Aspirin Childrens (aspirin)               1        1
FRAGMIN SUB-Q                                   2
                                                                         Aspirin Low Dose (aspirin)                1        1
FRAGMIN SUB-Q SYRINGE 10,000
UNIT/ML, 12,500 UNIT/0.5 ML, 15,000                                      Aspirin Low-Strength (aspirin)            1        1
UNIT/0.6 ML, 18,000 UNIT/0.72 ML,               2
2,500 UNIT/0.2 ML, 5,000 UNIT/0.2 ML,                                    Bayer Aspirin (aspirin)                   1        1
7,500 UNIT/0.3 ML
                                                                         Bayer Childrens Aspirin (aspirin)         1        1
heparin (porcine) injection                              1
                                                                         Butalbital Compound
                                                                                                                   1        1
HEPARIN (PORCINE) INJECTION,                                             (butalbital-aspirin-caffeine)
                                                         3
CARTRIDGE
                                                                         Child Aspirin (aspirin)                   1        1
heparin, porcine (pf) injection 1,000
                                                         1               Children's Aspirin (aspirin)              1        1
unit/ml, 5,000 unit/0.5 ml
HEPARIN, PORCINE (PF) SYRINGE                            3               Enteric Coated Aspirin (aspirin)          1        1

LOVENOX SUB-Q SYRINGE                                                    FIORINAL (butalbital-aspirin-caffeine)    3        1
(enoxaparin) 100 MG/ML, 120 MG/0.8                                       LEVACET                                   1
ML, 150 MG/ML, 30 MG/0.3 ML, 40                 3        1
MG/0.4 ML, 60 MG/0.6 ML, 80 MG/0.8                                       Lite Coat Aspirin (aspirin)               1        1
ML
                                                                         Cardiovascular Drugs
Iron Preparations
                                                                         Alpha-Adrenergic Blocking Agents
NATAFORT (NEW FORMULA 2011)                     2
                                                                         CARDURA TAB (doxazosin) 1 MG, 2 MG,
                                                                                                                   3        1
Platelet-Aggregation Inhibitors                                          4 MG, 8 MG
Adult Low Dose Aspirin (aspirin)                1        1               CARDURA XL 24 HR TAB 4 MG, 8 MG           3
AGGRENOX                                        2                        COREG TAB (carvedilol) 12.5 MG, 25
                                                                                                                   3        1
                                                                         MG, 3.125 MG, 6.25 MG
aspirin tab, delayed release 975 mg                      1
                                                                         COREG CR 24 HR CAP 10 MG, 20 MG,
Aspirin Childrens (aspirin)                     1        1                                                         2
                                                                         40 MG, 80 MG
Aspirin Low Dose (aspirin)                      1        1               MINIPRESS (prazosin)                      3        1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                11
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

terazosin                                                1               DIOVAN HCT                                   2
TRANDATE (labetalol)                            3        1               EDARBI                                       2                T3 AF
Alpha-Adrenergic Blocking Agt.(Hypoten)                                  EXFORGE                                      2
CARDURA (doxazosin)                             3        1               EXFORGE HCT                                  2
CARDURA XL                                      3                        HYZAAR (losartan-hydrochlorothiazide)        3        1
MINIPRESS (prazosin)                            3        1               MICARDIS                                     2
terazosin                                                1               MICARDIS HCT                                 2
TRANDATE (labetalol)                            3        1               TEVETEN                                      3
Angiotensin Ii Receptor Antagon.(Hypotn)                                 TEVETEN HCT                                  3
ATACAND                                         3                        TRIBENZOR                                    2
ATACAND HCT                                     3                        TWYNSTA                                      2
AVALIDE                                         3                        VALTURNA                                     2
AVAPRO TAB 150 MG, 300 MG, 75 MG                3                        Angiotensin-Convert.Enzyme Inhib(Hypotn)
AZOR                                            2                        ACCUPRIL TAB (quinapril) 10 MG, 20
                                                                                                                      3        1
                                                                         MG, 40 MG, 5 MG
BENICAR                                         2                T3 AF
                                                                         ACCURETIC TAB
BENICAR HCT                                     2                T3 AF   (quinapril-hydrochlorothiazide) 10-12.5      3        1
COZAAR TAB (losartan) 100 MG, 25 MG,                                     MG, 20-12.5 MG, 20-25 MG
                                                3        1
50 MG                                                                    ACEON TAB (perindopril erbumine) 4
                                                                                                                      3        1
DIOVAN                                          2                        MG, 8 MG

DIOVAN HCT                                      2                        ALTACE CAP (ramipril) 1.25 MG, 10 MG,
                                                                                                                      3        1
                                                                         2.5 MG, 5 MG
EDARBI                                          2                T3 AF
                                                                         captopril                                             1
EXFORGE                                         2
                                                                         captopril-hydrochlorothiazide                         1
EXFORGE HCT                                     2
                                                                         fosinopril                                            1
HYZAAR TAB
(losartan-hydrochlorothiazide) 100-12.5         3        1               fosinopril-hydrochlorothiazide                        1
MG, 100-25 MG, 50-12.5 MG                                                LOTENSIN (benazepril)                        3        1
MICARDIS                                        2                        LOTENSIN HCT
                                                                                                                      3        1
MICARDIS HCT                                    2                        (benazepril-hydrochlorothiazide)

TEVETEN TAB 400 MG                              3                        LOTREL CAP (amlodipine-benazepril)
                                                                         10-20 MG, 10-40 MG, 2.5-10 MG, 5-10          3        1
TEVETEN TAB (EPROSARTAN) 600 MG                 3        3               MG, 5-20 MG, 5-40 MG

TEVETEN HCT TAB 600-12.5 MG,                                             MAVIK (trandolapril)                         3        1
                                                3
600-25 MG
                                                                         PRINIVIL (lisinopril)                        3        1
TRIBENZOR                                       2
                                                                         PRINZIDE (lisinopril-hydrochlorothiazide)    3        1
TWYNSTA                                         2
                                                                         TARKA                                        3
VALTURNA                                        2
                                                                         UNIRETIC (moexipril-hydrochlorothiazide)     3        1
Angiotensin Ii Receptor Antagonists
                                                                         UNIVASC (moexipril)                          3        1
ATACAND                                         3
                                                                         VASERETIC
                                                                                                                      3        1
ATACAND HCT                                     3                        (enalapril-hydrochlorothiazide)

AVALIDE                                         3                        VASOTEC (enalapril maleate)                  3        1

AVAPRO                                          3                        ZESTORETIC
                                                                                                                      3        1
                                                                         (lisinopril-hydrochlorothiazide)
AZOR                                            2
                                                                         ZESTRIL (lisinopril)                         3        1
BENICAR                                         2                T3 AF
                                                                         Angiotensin-Converting Enzyme Inhibitors
BENICAR HCT                                     2                T3 AF
                                                                         ACCUPRIL (quinapril)                         3        1
COZAAR (losartan)                               3        1
                                                                         ACCURETIC
DIOVAN                                          2                                                                     3        1
                                                                         (quinapril-hydrochlorothiazide)

12     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

ACEON TAB (perindopril erbumine) 4                                       LOPRESSOR ORAL (metoprolol tartrate)       3        1
                                                3        1
MG, 8 MG
                                                                         LOPRESSOR HCT
                                                                                                                    3        1
ALTACE (ramipril)                               3        1               (metoprolol-hydrochlorothiazide)
captopril                                                1               metoprolol tartrate oral                            1
captopril-hydrochlorothiazide                            1               metoprolol-hydrochlorothiazide                      1
fosinopril                                               1               pindolol                                            1
fosinopril-hydrochlorothiazide                           1               propranolol oral                                    1
LOTENSIN (benazepril)                           3        1               propranolol-hydrochlorothiazid                      1
LOTENSIN HCT                                                             SECTRAL (acebutolol)                       3        1
                                                3        1
(benazepril-hydrochlorothiazide)
                                                                         Sorine (sotalol)                           1        1
LOTREL CAP (amlodipine-benazepril)
10-20 MG, 10-40 MG, 2.5-10 MG, 5-10             3        1               Sotalol AF (sotalol)                       1        1
MG, 5-20 MG, 5-40 MG                                                     TENORETIC 100 (atenolol-chlorthalidone)    3        1
MAVIK (trandolapril)                            3        1               TENORETIC 50 (atenolol-chlorthalidone)     3        1
PRINIVIL (lisinopril)                           3        1               TENORMIN (atenolol)                        3        1
PRINZIDE (lisinopril-hydrochlorothiazide)       3        1               timolol maleate                                     1
TARKA                                           3                        TOPROL XL (metoprolol succinate)           3        1
UNIRETIC (moexipril-hydrochlorothiazide)        3        1               TRANDATE (labetalol)                       3        1
UNIVASC (moexipril)                             3        1               ZEBETA (bisoprolol fumarate)               3        1
VASERETIC                                                                ZIAC (bisoprolol-hydrochlorothiazide)      3        1
                                                3        1
(enalapril-hydrochlorothiazide)
                                                                         Beta-Adrenergic Blocking Agt.(Hypoten)
VASOTEC (enalapril maleate)                     3        1
                                                                         BETAPACE (sotalol)                         3        1
ZESTORETIC
                                                3        1
(lisinopril-hydrochlorothiazide)                                         BETAPACE AF (sotalol)                      3        1
ZESTRIL (lisinopril)                            3        1               CORGARD (nadolol)                          3        1
Antiarrhythmics, Miscellaneous                                           CORZIDE (nadolol-bendroflumethiazide)      3        1
digoxin oral soln                                        1               INDERAL LA (propranolol)                   3        1
LANOXIN TAB (digoxin) 125 MCG, 250                                       INNOPRAN XL                                3
                                                3        1
MCG
                                                                         KERLONE (betaxolol)                        3        1
Antilipemic Agents, Miscellaneous
                                                                         LOPRESSOR ORAL (metoprolol tartrate)       3        1
LOVAZA                                          2
                                                                         LOPRESSOR HCT
NIACOR                                          3                                                                   3        1
                                                                         (metoprolol-hydrochlorothiazide)
NIASPAN EXTENDED-RELEASE 24                                              metoprolol tartrate oral                            1
                                                2
HR TAB 1,000 MG, 500 MG, 750 MG
                                                                         metoprolol-hydrochlorothiazide                      1
Beta-Adrenergic Blocking Agents
                                                                         pindolol                                            1
BETAPACE (sotalol)                              3        1
                                                                         propranolol oral                                    1
BETAPACE AF (sotalol)                           3        1
                                                                         propranolol-hydrochlorothiazid                      1
BYSTOLIC TAB 10 MG, 2.5 MG, 20
                                                2                        SECTRAL (acebutolol)                       3        1
MG, 5 MG
COREG (carvedilol)                              3        1               Sorine (sotalol)                           1        1

COREG CR                                        2                        Sotalol AF (sotalol)                       1        1

CORGARD (nadolol)                               3        1               TENORETIC 100 (atenolol-chlorthalidone)    3        1

CORZIDE (nadolol-bendroflumethiazide)           3        1               TENORETIC 50 (atenolol-chlorthalidone)     3        1

INDERAL LA (propranolol)                        3        1               TENORMIN (atenolol)                        3        1

INNOPRAN XL                                     3                        timolol maleate                                     1

KERLONE (betaxolol)                             3        1               TOPROL XL (metoprolol succinate)           3        1

LEVATOL                                         3                        TRANDATE (labetalol)                       3        1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                 13
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

ZEBETA (bisoprolol fumarate)                    3        1               CARDIZEM LA 24 HR TAB 120 MG, 180
                                                                                                                      3
                                                                         MG, 240 MG, 300 MG, 360 MG, 420 MG
ZIAC (bisoprolol-hydrochlorothiazide)           3        1
                                                                         Cartia XT 24 hr Cap (diltiazem HCl) 120
Bile Acid Sequestrants                                                                                                1        1
                                                                         mg, 180 mg, 240 mg, 300 mg
Cholestyramine Light Oral Powder                1                        COVERA-HS 24 HR TAB 180 MG, 240
                                                                                                                      3
Cholestyramine Light Packet                     1                        MG

COLESTID ORAL GRANULES                                                   DILACOR XR (diltiazem HCl)                   3        1
                                                3        1
(colestipol)                                                             DILT-CD (diltiazem HCl)                      1        1
COLESTID ORAL PACKET (colestipol)               3        1               DILT-XR (diltiazem HCl)                      1        1
COLESTID TAB (colestipol)                       3        1               Diltia XT (diltiazem HCl)                    1        1
COLESTID FLAVORED (colestipol)                  3        1               diltiazem er 12 hr cap                                1
Prevalite                                       1                        Diltzac ER (diltiazem HCl)                   1        1
QUESTRAN (cholestyramine (with sugar))          3        1               TARKA 24 HR TAB 1-240 MG, 2-180
                                                                                                                      3
QUESTRAN LIGHT                                  3                        MG, 2-240 MG, 4-240 MG

WELCHOL ORAL POWDER PACK                        2                        Taztia XT (diltiazem HCl)                    1        1

WELCHOL TAB                                     2                        TIAZAC CAP (diltiazem HCl) 120 MG,
                                                                         180 MG, 240 MG, 300 MG, 360 MG, 420          3        1
Calcium-Channel Block.Agt,Misc(Hypoten)                                  MG

CALAN (verapamil)                               3        1               verapamil tab 40 mg                                   1

CALAN SR (verapamil)                            3        1               VERELAN 24 HR CAP (verapamil) 120
                                                                                                                      3        1
                                                                         MG, 180 MG, 240 MG, 360 MG
CARDIZEM (diltiazem HCl)                        3        1
                                                                         VERELAN PM CAP (verapamil) 100 MG,
CARDIZEM CD (diltiazem HCl)                     3        1                                                            3        1
                                                                         200 MG, 300 MG
CARDIZEM LA 24 HR TAB 120 MG, 180                                        Carbonic Anhydrase Inhibitors(Hypoten)
                                                3
MG, 240 MG, 300 MG, 360 MG, 420 MG
                                                                         acetazolamide tab 125 mg, 250 mg                      1
Cartia XT (diltiazem HCl)                       1        1
                                                                         DIAMOX SEQUELS (acetazolamide)               3        1
COVERA-HS                                       3
                                                                         Cardiac Drugs, Miscellaneous
DILACOR XR (diltiazem HCl)                      3        1
                                                                         RANEXA                                       2
DILT-CD (diltiazem HCl)                         1        1
                                                                         Cardiotonic Agents
DILT-XR (diltiazem HCl)                         1        1
                                                                         digoxin oral                                          1
Diltia XT (diltiazem HCl)                       1        1
                                                                         LANOXIN                                      3
diltiazem hcl oral                                       1
                                                                         LANOXIN PEDIATRIC                            3
Diltzac ER (diltiazem HCl)                      1        1
                                                                         Central Alpha-Agonists
TARKA                                           3
                                                                         CATAPRES TAB (clonidine) 0.1 MG, 0.2
Taztia XT (diltiazem HCl)                       1        1                                                            3        1
                                                                         MG, 0.3 MG
TIAZAC (diltiazem HCl)                          3        1               CATAPRES-TTS-1 (clonidine)                   3        1
verapamil oral                                           1               CATAPRES-TTS-2 (clonidine)                   3        1
VERELAN (verapamil)                             3        1               CATAPRES-TTS-3 (clonidine)                   3        1
VERELAN PM (verapamil)                          3        1               CLORPRES                                     3
Calcium-Channel Blocking Agents, Misc.                                   KAPVAY                                       3
CALAN TAB (verapamil) 120 MG, 80 MG             3        1               methyldopa tab 250 mg, 500 mg                         1
CALAN SR TAB (verapamil) 120 MG, 180                                     methyldopa-hydrochlorothiazide tab 250-15
                                                3        1                                                                     1
MG, 240 MG                                                               mg, 250-25 mg
CARDIZEM TAB (diltiazem HCl) 120 MG,                                     NEXICLON XR                                  3
                                                3        1
30 MG, 60 MG, 90 MG
                                                                         TENEX TAB (guanfacine) 1 MG, 2 MG            3        1
CARDIZEM CD 24 HR CAP 360 MG                    3
                                                                         Cholesterol Absorption Inhibitors

CARDIZEM CD 24 HR CAP (diltiazem                                         VYTORIN 10-10                                2
                                                3        1
HCl) 120 MG, 180 MG, 240 MG, 300 MG
                                                                         VYTORIN 10-20                                2
14     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

VYTORIN 10-40                                   2                        propranolol oral soln 20 mg/5 ml, 40 mg/5
                                                                                                                               1
                                                                         ml
VYTORIN 10-80                                   2
                                                                         propranolol tab 10 mg, 20 mg, 40 mg, 60
ZETIA                                           2                                                                              1
                                                                         mg, 80 mg
Class Ia Antiarrhythmics                                                 propranolol-hydrochlorothiazid                        1
NORPACE CAP (disopyramide) 100 MG,                                       SECTRAL (acebutolol)                         3        1
                                                3        1
150 MG
                                                                         Sotalol AF Tab (sotalol) 120 mg, 160 mg,
NORPACE CR CAP 100 MG, 150 MG                   3                                                                     1        1
                                                                         80 mg
QUINIDINE GLUCONATE INJ                                  3               TENORETIC 100 (atenolol-chlorthalidone)      3        1
quinidine gluconate oral                                 1               TENORETIC 50 (atenolol-chlorthalidone)       3        1
quinidine sulfate er tab                                 1               TENORMIN (atenolol)                          3        1
quinidine tab 200 mg, 300 mg                             1               timolol tab 10 mg, 20 mg, 5 mg                        1
Class Ib Antiarrhythmics                                                 TOPROL XL 24 HR TAB (metoprolol
DILANTIN                                        2                        succinate) 100 MG, 200 MG, 25 MG, 50         3        1
                                                                         MG
DILANTIN EXTENDED (phenytoin
                                                2        1               TRANDATE (labetalol)                         3        1
sodium extended)
DILANTIN INFATABS                               2                        ZEBETA (bisoprolol fumarate)                 3        1

DILANTIN-125 (phenytoin)                        2        1               ZIAC (bisoprolol-hydrochlorothiazide)        3        1

mexiletine cap 150 mg, 200 mg, 250 mg                    1               Class Iii Antiarrhythmics

PHENYTEK CAP (phenytoin sodium                                           BETAPACE TAB (sotalol) 120 MG, 160
                                                3        1                                                            3        1
extended) 200 MG, 300 MG                                                 MG, 240 MG, 80 MG

phenytoin oral susp 100 mg/4 ml                          1               BETAPACE AF TAB (sotalol) 120 MG,
                                                                                                                      3        1
                                                                         160 MG, 80 MG
Class Ic Antiarrhythmics
                                                                         CORDARONE (amiodarone)                       3        1
propafenone tab 300 mg                                   1
                                                                         MULTAQ                                       2
RYTHMOL TAB (propafenone) 150 MG,
                                                3        1               PACERONE TAB 100 MG                          2
225 MG
RYTHMOL SR (propafenone)                        3        1               Pacerone Tab (amiodarone) 200 mg             1        1

TAMBOCOR TAB (flecainide) 100 MG,                                        PACERONE TAB (amiodarone) 400 MG             3        1
                                                3        1
150 MG, 50 MG                                                            Sorine (sotalol)                             1        1
Class Ii Antiarrhythmics                                                 Sotalol AF (sotalol)                         1        1
BETAPACE (sotalol)                              3        1               TIKOSYN CAP 125 MCG, 250 MCG,
                                                                                                                      2
BETAPACE AF (sotalol)                           3        1               500 MCG

COREG (carvedilol)                              3        1               Class Iv Antiarrhythmics

COREG CR                                        2                        CALAN (verapamil)                            3        1

CORGARD (nadolol)                               3        1               CALAN SR (verapamil)                         3        1

CORZIDE (nadolol-bendroflumethiazide)           3        1               CARDIZEM (diltiazem HCl)                     3        1

INDERAL LA (propranolol)                        3        1               CARDIZEM CD (diltiazem HCl)                  3        1

INNOPRAN XL                                     3                        CARDIZEM LA 24 HR TAB 120 MG, 180
                                                                                                                      3
                                                                         MG, 240 MG, 300 MG, 360 MG, 420 MG
KERLONE TAB (betaxolol) 10 MG, 20
                                                3        1               Cartia XT (diltiazem HCl)                    1        1
MG
LOPRESSOR TAB (metoprolol tartrate)                                      COVERA-HS                                    3
                                                3        1
100 MG, 50 MG                                                            DILACOR XR (diltiazem HCl)                   3        1
LOPRESSOR HCT TAB                                                        DILT-CD (diltiazem HCl)                      1        1
(metoprolol-hydrochlorothiazide) 100-25         3        1
MG, 50-25 MG                                                             DILT-XR (diltiazem HCl)                      1        1
metoprolol tartrate tab 25 mg                            1               Diltia XT (diltiazem HCl)                    1        1
metoprolol-hydrochlorothiazide tab 100-50                                diltiazem hcl oral                                    1
                                                         1
mg
                                                                         Diltzac ER (diltiazem HCl)                   1        1
pindolol tab 10 mg, 5 mg                                 1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                   15
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Taztia XT (diltiazem HCl)                       1        1               isradipine                                           1
TIAZAC (diltiazem HCl)                          3        1               LOTREL CAP (amlodipine-benazepril)
                                                                         10-20 MG, 10-40 MG, 2.5-10 MG, 5-10         3        1
verapamil oral                                           1               MG, 5-20 MG, 5-40 MG
VERELAN (verapamil)                             3        1               NICARDIPINE ORAL                                     3
VERELAN PM (verapamil)                          3        1               NIMOTOP (nimodipine)                        3        1
Dihydropyridines                                                         nisoldipine                                          1
ADALAT CC TAB (nifedipine) 30 MG, 60                                     NORVASC (amlodipine)                        3        1
                                                3        1
MG, 90 MG
                                                                         PROCARDIA (nifedipine)                      3        1
Afeditab CR (nifedipine)                        1        1
                                                                         PROCARDIA XL (nifedipine)                   3        1
AMTURNIDE                                       2
                                                                         SULAR (nisoldipine)                         3        1
AZOR                                            2
                                                                         TEKAMLO                                     2
CADUET TAB (amlodipine-atorvastatin)
10-10 MG, 10-20 MG, 10-40 MG, 10-80                                      Direct Vasodilators
                                                3        1
MG, 2.5-10 MG, 2.5-20 MG, 2.5-40 MG,
5-10 MG, 5-20 MG, 5-40 MG, 5-80 MG                                       BIDIL                                       2

DYNACIRC CR 24 HR TAB 10 MG, 5                                           hydralazine tab 10 mg, 100 mg, 25 mg, 50
                                                3                                                                             1
MG                                                                       mg

EXFORGE                                         2                        minoxidil tab 10 mg, 2.5 mg                          1

EXFORGE HCT                                     2                        Diuretics, Miscellaneous (Hypotensive)

felodipine er 24 hr tab 10 mg, 2.5 mg, 5 mg              1               ELIXOPHYLLIN                                2

isradipine cap 2.5 mg, 5 mg                              1               THEO-24 24 HR CAP 100 MG, 200 MG,
                                                                                                                     3
                                                                         300 MG, 400 MG
LOTREL CAP (amlodipine-benazepril)
10-20 MG, 10-40 MG, 2.5-10 MG, 5-10             3        1               Theochron (theophylline)                    1        1
MG, 5-20 MG, 5-40 MG                                                     theophylline er 12 hr tab 450 mg                     1
NICARDIPINE CAP 20 MG, 30 MG                             3               theophylline er tab                                  1
Nifediac CC (nifedipine)                        1        1               theophylline oral soln                               1
Nifedical XL (nifedipine)                       1        1               Fibric Acid Derivatives
nifedipine cap 20 mg                                     1               ANTARA                                      3
NIMOTOP (nimodipine)                            3        1               fenofibrate                                          1
nisoldipine er 24 hr tab 20 mg, 25.5 mg, 30                              FENOGLIDE TAB 120 MG, 40 MG                 3
                                                         1
mg, 40 mg
                                                                         FIBRICOR TAB (fenofibric acid) 105 MG,
NORVASC TAB (amlodipine) 10 MG, 2.5                                                                                  3        1
                                                3        1               35 MG
MG, 5 MG
                                                                         Lipofen                                     1
PROCARDIA (nifedipine)                          3        1
                                                                         LOFIBRA CAP (fenofibrate micronized)        3        1
PROCARDIA XL 24 HR TAB (nifedipine)
                                                3        1
30 MG, 60 MG, 90 MG                                                      LOPID (gemfibrozil)                         3        1
SULAR (nisoldipine)                             3        1               TRICOR                                      3
TEKAMLO                                         2                        TRIGLIDE                                    3
TRIBENZOR                                       2                        TRILIPIX                                    3
TWYNSTA                                         2                        Hmg-Coa Reductase Inhibitors
Dihydropyridines (Hypotensive Agents)                                    ADVICOR 24 HR TAB 1,000-20 MG,
                                                                                                                     3
                                                                         1,000-40 MG, 500-20 MG, 750-20 MG
ADALAT CC (nifedipine)                          3        1
                                                                         ALTOPREV                                    2
AZOR                                            2
                                                                         CADUET TAB (amlodipine-atorvastatin)
CADUET (amlodipine-atorvastatin)                3        1               10-10 MG, 10-20 MG, 10-40 MG, 10-80
                                                                                                                     3        1
DYNACIRC CR                                     3                        MG, 2.5-10 MG, 2.5-20 MG, 2.5-40 MG,
                                                                         5-10 MG, 5-20 MG, 5-40 MG, 5-80 MG
EXFORGE                                         2
                                                                         CRESTOR                                     2
EXFORGE HCT                                     2
                                                                         JUVISYNC                                    2
felodipine                                               1
16     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

LESCOL CAP 20 MG, 40 MG                         3                        INSPRA (eplerenone)                         3        1
LESCOL XL                                       3                        Mineralocorticoid(Aldoster.)Antag(Hypot)
LIPITOR (atorvastatin)                          3        1               ALDACTAZIDE                                 3
LIVALO TAB 1 MG, 2 MG, 4 MG                     3                        ALDACTONE (spironolactone)                  3        1
lovastatin tab 10 mg                                     1               INSPRA (eplerenone)                         3        1
MEVACOR TAB (lovastatin) 20 MG, 40                                       Nitrates And Nitrites
                                                3        1
MG
                                                                         BIDIL                                       2
PRAVACHOL TAB (pravastatin) 10 MG,
                                                3        1               DILATRATE-SR                                2
20 MG, 40 MG, 80 MG
SIMCOR 24 HR TAB 1,000-20 MG,                                            IMDUR (isosorbide mononitrate)              3        1
1,000-40 MG, 500-20 MG, 500-40 MG,              2                        ISOCHRON (isosorbide dinitrate)             3        1
750-20 MG
                                                                         ISODITRATE (isosorbide dinitrate)           3        1
VYTORIN 10-10                                   2
                                                                         ISORDIL                                     3
VYTORIN 10-20                                   2
                                                                         ISORDIL TITRADOSE (isosorbide
VYTORIN 10-40                                   2                                                                    3        1
                                                                         dinitrate)
VYTORIN 10-80                                   2                        isosorbide dinitrate                                 1
ZOCOR TAB (simvastatin) 10 MG, 20 MG,                                    MINITRAN (nitroglycerin)                    2        1
                                                3        1
40 MG, 5 MG, 80 MG
                                                                         MONOKET (isosorbide mononitrate)            3        1
Hypotensive Agents, Miscellaneous
                                                                         Nitro-Bid                                   1
BETAPACE (sotalol)                              3        1
                                                                         NITRO-DUR (nitroglycerin)                   3        1
BETAPACE AF (sotalol)                           3        1
                                                                         nitroglycerin oral                                   1
CARDURA (doxazosin)                             3        1
                                                                         NITROLINGUAL                                2
CARDURA XL                                      3
                                                                         NITROMIST                                   3
COREG (carvedilol)                              3        1
                                                                         NITROSTAT SUBLINGUAL TAB 0.3
COREG CR                                        2                                                                    2
                                                                         MG, 0.4 MG, 0.6 MG
DIBENZYLINE                                     2                        Peripheral Adrenergic Inhibitors
INDERAL LA (propranolol)                        3        1               reserpine tab 0.1 mg, 0.25 mg                        1
INNOPRAN XL                                     3                        Phosphodiesterase Type 5 Inhibitors
KERLONE (betaxolol)                             3        1               ADCIRCA                                     3
pindolol                                                 1               CIALIS                                      2
propranolol oral                                         1               LEVITRA                                     3
SECTRAL (acebutolol)                            3        1               PLETAL (cilostazol)                         3        1
Sorine (sotalol)                                1        1               REVATIO ORAL                                2
Sotalol AF (sotalol)                            1        1               VIAGRA                                      2
terazosin                                                1               Potassium-Sparing Diuretics (Hypoten)
timolol maleate                                          1               ALDACTAZIDE TAB 50-50 MG                    3
Loop Diuretics (Hypotensive Agents)                                      ALDACTAZIDE TAB
bumetanide tab 0.5 mg, 1 mg, 2 mg                        1               (spironolacton-hydrochlorothiaz) 25-25      3        1
                                                                         MG
DEMADEX TAB (torsemide) 10 MG, 100
                                                3        1               ALDACTONE TAB (spironolactone) 100
MG, 20 MG, 5 MG                                                                                                      3        1
                                                                         MG, 25 MG, 50 MG
EDECRIN                                         3
                                                                         amiloride-hydrochlorothiazide                        1
furosemide oral soln                                     1
                                                                         DYAZIDE
                                                                                                                     3        1
LASIX (furosemide)                              3        1               (triamterene-hydrochlorothiazid)
Mineralocorticoid (Aldosterone) Antagnts                                 DYRENIUM                                    3
ALDACTAZIDE                                     3
                                                                         INSPRA TAB (eplerenone) 25 MG, 50 MG        3        1
ALDACTONE (spironolactone)                      3        1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  17
Drug                                           Brand   Generic   Notes   Drug                                        Brand   Generic   Notes

MAXZIDE                                                                  methyclothiazide                                      1
                                                3        1
(triamterene-hydrochlorothiazid)
                                                                         methyldopa-hydrochlorothiazide                        1
MAXZIDE-25MG
                                                3        1               metoprolol-hydrochlorothiazide                        1
(triamterene-hydrochlorothiazid)
MIDAMOR (amiloride)                             3        1               MICARDIS HCT                                 2

triamterene-hydrochlorothiazide cap                      1               MICROZIDE (hydrochlorothiazide)              3        1

Renin Inhibitors                                                         PRINZIDE (lisinopril-hydrochlorothiazide)    3        1

AMTURNIDE                                       2                        propranolol-hydrochlorothiazide tab 40-25
                                                                                                                               1
                                                                         mg, 80-25 mg
TEKAMLO                                         2
                                                                         TEKTURNA HCT TAB 150-12.5 MG,
                                                                                                                      2
TEKTURNA                                        2                        150-25 MG, 300-12.5 MG, 300-25 MG
TEKTURNA HCT                                    2                        TEVETEN HCT TAB 600-12.5 MG,
                                                                                                                      3
                                                                         600-25 MG
VALTURNA                                        2
                                                                         triamterene-hydrochlorothiazid                        1
Thiazide Diuretics(Hypotensive Agents)
                                                                         TRIBENZOR                                    2
ACCURETIC
                                                3        1
(quinapril-hydrochlorothiazide)                                          UNIRETIC (moexipril-hydrochlorothiazide)     3        1
ALDACTAZIDE                                     3                        VASERETIC
                                                                                                                      3        1
                                                                         (enalapril-hydrochlorothiazide)
amiloride-hydrochlorothiazide                            1
                                                                         ZESTORETIC
AMTURNIDE                                       2                                                                     3        1
                                                                         (lisinopril-hydrochlorothiazide)
ATACAND HCT                                     3                        ZIAC (bisoprolol-hydrochlorothiazide)        3        1
AVALIDE TAB 150-12.5 MG, 300-12.5                                        Thiazide-Like Diuretics(Hypotensive Agt)
                                                3
MG
                                                                         chlorthalidone tab 25 mg, 50 mg                       1
benazepril-hydrochlorothiazide tab 5-6.25
                                                         1
mg                                                                       CLORPRES TAB 0.1-15 MG, 0.2-15 MG,
                                                                                                                      3
                                                                         0.3-15 MG
BENICAR HCT                                     2                T3 AF
                                                                         indapamide tab 1.25 mg, 2.5 mg                        1
captopril-hydrochlorothiazide                            1
                                                                         metolazone tab 10 mg                                  1
chlorothiazide                                           1
                                                                         TENORETIC 100 (atenolol-chlorthalidone)      3        1
CORZIDE (nadolol-bendroflumethiazide)           3        1
                                                                         TENORETIC 50 (atenolol-chlorthalidone)       3        1
DIOVAN HCT TAB 160-12.5 MG,
160-25 MG, 320-12.5 MG, 320-25 MG,              2                        THALITONE                                    3
80-12.5 MG
                                                                         ZAROXOLYN (metolazone)                       3        1
DIURIL                                          3
                                                                         Vasodilating Agents, Miscellaneous
DYAZIDE
                                                3        1               ADALAT CC (nifedipine)                       3        1
(triamterene-hydrochlorothiazid)
enalapril-hydrochlorothiazide tab 5-12.5                                 Afeditab CR (nifedipine)                     1        1
                                                         1
mg                                                                       AGGRENOX                                     2
fosinopril-hydrochlorothiazide tab 10-12.5                               AMTURNIDE                                    2
                                                         1
mg, 20-12.5 mg
                                                                         AZOR                                         2
hydrochlorothiazide tab 12.5 mg, 25 mg, 50
                                                         1
mg                                                                       CADUET (amlodipine-atorvastatin)             3        1
HYZAAR TAB                                                               CALAN (verapamil)                            3        1
(losartan-hydrochlorothiazide) 100-12.5         3        1
MG, 100-25 MG, 50-12.5 MG                                                CALAN SR (verapamil)                         3        1

LOPRESSOR HCT TAB                                                        CARDIZEM (diltiazem HCl)                     3        1
(metoprolol-hydrochlorothiazide) 100-25         3        1
                                                                         CARDIZEM CD (diltiazem HCl)                  3        1
MG, 50-25 MG
                                                                         CARDIZEM LA 24 HR TAB 120 MG, 180
LOTENSIN HCT                                                                                                          3
                                                3        1               MG, 240 MG, 300 MG, 360 MG, 420 MG
(benazepril-hydrochlorothiazide)
                                                                         Cartia XT (diltiazem HCl)                    1        1
MAXZIDE
                                                3        1
(triamterene-hydrochlorothiazid)                                         CAVERJECT                                    2

MAXZIDE-25MG
                                                3        1               CAVERJECT IMPULSE                            2
(triamterene-hydrochlorothiazid)

18     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

COVERA-HS                                       3                        Amphetamines
DILACOR XR (diltiazem HCl)                      3        1               ADDERALL                                    3
DILT-CD (diltiazem HCl)                         1        1               ADDERALL XR
                                                                                                                     3        1
                                                                         (amphetamine-dextroamphetamine)
DILT-XR (diltiazem HCl)                         1        1
                                                                         Amphetamine Salt Combo                      1
Diltia XT (diltiazem HCl)                       1        1
                                                                         DESOXYN (methamphetamine)                   3        1
diltiazem hcl oral                                       1
                                                                         DEXEDRINE SPANSULE
Diltzac ER (diltiazem HCl)                      1        1                                                           3        1
                                                                         (dextroamphetamine)
EDEX                                            3                        DIDREX (benzphetamine)                      3        1
EXFORGE                                         2                        ProCentra                                   1
isoxsuprine                                              1               VYVANSE                                     2
LETAIRIS                                        2                        Analgesics And Antipyretics, Misc.
LOTREL CAP (amlodipine-benazepril)                                       acetaminophen-codeine                                1
10-20 MG, 10-40 MG, 2.5-10 MG, 5-10             3        1
MG, 5-20 MG, 5-40 MG                                                     ANABAR                                      3
MUSE                                            2                        CAPITAL WITH CODEINE                        3
NICARDIPINE ORAL                                         3               CLONIDINE (PF)                                       3
Nifediac CC (nifedipine)                        1        1               CO-GESIC (hydrocodone-acetaminophen)        3        1
Nifedical XL (nifedipine)                       1        1               COCET                                       3
NIMOTOP (nimodipine)                            3        1               COCET PLUS                                  3
NORVASC (amlodipine)                            3        1               COTABFLU                                    3
PAPAVERINE                                               3               DURAXIN                                     3
PERSANTINE (dipyridamole)                       3        1               Endocet Tab (oxycodone-acetaminophen)
                                                                         10-325 mg, 5-325 mg, 7.5-325 mg, 7.5-500    1        1
PROCARDIA (nifedipine)                          3        1               mg
PROCARDIA XL (nifedipine)                       3        1               ENDOCET TAB
                                                                                                                     3        1
PROSTIN VR PEDIATRIC (alprostadil)              3        1               (oxycodone-acetaminophen) 10-650 MG

REMODULIN                                       2                        Epidrin (acetaminophn-isometh-dichloral)    1        1

TARKA                                           3                        ESGIC (butalbital-acetaminophen-caff)       3        1

Taztia XT (diltiazem HCl)                       1        1               ESGIC-PLUS                                  3

TEKAMLO                                         2                        FIORICET (butalbital-acetaminophen-caff)    3        1

TIAZAC (diltiazem HCl)                          3        1               FIORICET-CODEINE
                                                                                                                     3        1
                                                                         (cod-butalbital-acetaminop-caf)
TRACLEER                                        2
                                                                         FLEXTRA PLUS                                3
TRIBENZOR                                       2
                                                                         HYCET                                       3
TWYNSTA                                         2
                                                                         hydrocodone-acetaminophen oral soln
TYVASO                                          2                        10-325 mg/15 ml(15 ml), 2.5-167 mg/5 ml,
                                                                                                                              1
                                                                         5-163 mg/7.5ml(7.5ml), 5-334 mg/10 ml,
TYVASO REFILL KIT                               2                        7.5-500 mg/15 ml(15 ml)
TYVASO STARTER KIT                              2                        hydrocodone-acetaminophen tab 2.5-500
                                                                                                                              1
                                                                         mg
VENTAVIS                                        2
                                                                         LEVACET                                     1
verapamil oral                                           1
                                                                         LORCET 10/650
VERELAN (verapamil)                             3        1                                                           3        1
                                                                         (hydrocodone-acetaminophen)
VERELAN PM (verapamil)                          3        1
                                                                         LORCET PLUS
                                                                                                                     3        1
Central Nervous System Agents                                            (hydrocodone-acetaminophen)

Adamantanes (Cns)                                                        LORTAB (hydrocodone-acetaminophen)          3        1
                                                                         LORTAB ELIXIR
                                                                                                                     3        1
                                                                         (hydrocodone-acetaminophen)
amantadine oral                                          1
                                                                         MAGNACET                                    3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  19
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Margesic (butalbital-acetaminophen-caff)        1        1               ZGESIC                                      3
Marten-Tab (butalbital-acetaminophen)           1        1               ZOLVIT                                      3
MAXIDONE                                                                 ZYDONE                                      3
                                                3        1
(hydrocodone-acetaminophen)
                                                                         Anorex.,Respir.,Cerebral Stimulants,Misc
MAXIFLU CD                                      3
                                                                         ADIPEX-P (phentermine)                      3        1
MAXIFLU CDX                                     3
                                                                         Alagesic (butalbital-acetaminophen-caff)    1        1
NEURONTIN CAP (gabapentin)                      3        1
                                                                         Alagesic LQ                                 1
NEURONTIN ORAL SOLN (gabapentin)                3        1
                                                                         AMMONIA AROMATIC INHALATION                          3
NEURONTIN TAB (gabapentin)                      3        1
                                                                         BONTRIL PDM (phendimetrazine tartrate)      3        1
NORCO (hydrocodone-acetaminophen)               3        1
                                                                         Bontril Slow-Release (phendimetrazine
                                                                                                                     1        1
ORBIVAN                                         3                        tartrate)
pentazocine-acetaminophen                                1               Butalbital Compound
                                                                                                                     1        1
                                                                         (butalbital-aspirin-caffeine)
PERCOCET (oxycodone-acetaminophen)              3        1
                                                                         Butalbital Compound W/Codeine               1
PHENFLU CD                                      3
                                                                         CAFCIT ORAL (CAFFEINE CITRATED)             3        3
PHENFLU CDX                                     3
                                                                         CONCERTA                                    2
PHRENILIN FORTE                                 3
                                                                         DAYTRANA                                    2
Polygesic (hydrocodone-acetaminophen)           1        1
                                                                         diethylpropion                                       1
PRIMLEV TAB 10-300 MG                           3
                                                                         DOLGIC PLUS                                 3
Primlev Tab 5-300 mg, 7.5-300 mg                1
                                                                         ESGIC (butalbital-acetaminophen-caff)       3        1
PROTID                                          3
                                                                         ESGIC-PLUS                                  3
RHINOFLEX                                       3
                                                                         FIORICET (butalbital-acetaminophen-caff)    3        1
RHINOFLEX-650                                   3
                                                                         FIORICET-CODEINE
ROXICET ORAL SOLN                               3                                                                    3        1
                                                                         (cod-butalbital-acetaminop-caf)
ROXICET TAB 5-500 MG                            3                        FIORINAL (butalbital-aspirin-caffeine)      3        1
Roxicet Tab (oxycodone-acetaminophen)                                    FIORINAL-CODEINE #3                         3
                                                1        1
5-325 mg
                                                                         FOCALIN (dexmethylphenidate)                3        1
Stagesic (hydrocodone-acetaminophen)            1        1
                                                                         FOCALIN XR CAP 10 MG, 15 MG, 20
TYLENOL-CODEINE #3                                                                                                   3
                                                3        1               MG, 30 MG, 40 MG, 5 MG
(acetaminophen-codeine)
                                                                         IC800                                       3
TYLENOL-CODEINE #4
                                                3        1
(acetaminophen-codeine)                                                  IONAMIN-30                                  3
TYLOX (oxycodone-acetaminophen)                 3        1               Margesic (butalbital-acetaminophen-caff)    1        1
ULTRACET (tramadol-acetaminophen)               3        1               METADATE CD                                 2
VICODIN (hydrocodone-acetaminophen)             3        1               METADATE ER (methylphenidate)               1        1
VICODIN ES                                                               METHYLIN                                    3
                                                3        1
(hydrocodone-acetaminophen)
                                                                         NUVIGIL                                     3
VICODIN HP
                                                3        1               ORBIVAN                                     3
(hydrocodone-acetaminophen)
XODOL 10/300                                                             phentermine                                          1
                                                3        1
(hydrocodone-acetaminophen)                                              PROVIGIL                                    2
XODOL 5/300                                                              Repan (butalbital-acetaminophen-caff)       1        1
                                                3        1
(hydrocodone-acetaminophen)
                                                                         RITALIN (methylphenidate)                   3        1
XODOL 7.5/300
                                                3        1
(hydrocodone-acetaminophen)                                              RITALIN LA                                  3
Xolox                                           1                        RITALIN SR (methylphenidate)                3        1
ZAMICET                                         3
                                                                         Zebutal                                     1
Zebutal                                         1

20     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Anticholinergic Agents (Cns)                                             Antidepressants, Miscellaneous
benztropine oral                                         1               Budeprion SR (bupropion HCl)                1        1
COGENTIN (BENZTROPINE)                          3        3               Budeprion XL (bupropion HCl)                1        1
trihexyphenidyl                                          1               Buproban (bupropion HCl)                    1        1
Anticonvulsants, Miscellaneous                                           REMERON (mirtazapine)                       3        1
BANZEL ORAL SUSP                                3                        REMERON SOLTAB (mirtazapine)                3        1
BANZEL TAB                                      2                        WELLBUTRIN (bupropion HCl)                  3        1
CARBATROL (carbamazepine)                       3        1               WELLBUTRIN SR (bupropion HCl)               3        1
DEPAKENE (valproic acid)                        3        1               WELLBUTRIN XL (bupropion HCl)               3        1
DEPAKOTE (divalproex)                           2        1               ZYBAN (bupropion HCl)                       2        1
DEPAKOTE ER (divalproex)                        2        1               Antimanic Agents
DEPAKOTE SPRINKLES (divalproex)                 2        1               DEPAKENE (valproic acid)                    3        1
Epitol (carbamazepine)                          1        1               DEPAKOTE (divalproex)                       2        1
EQUETRO (carbamazepine)                         3        1               DEPAKOTE ER (divalproex)                    2        1
FANATREX                                        3                        DEPAKOTE SPRINKLES (divalproex)             2        1
FELBATOL ORAL SUSP                                                       lithium carbonate                                    1
                                                2        3
(FELBAMATE)
                                                                         lithium citrate                                      1
FELBATOL TAB (felbamate)                        3        1
                                                                         LITHOBID (lithium carbonate)                3        1
GABITRIL                                        2
                                                                         STAVZOR                                     3
KEPPRA ORAL (levetiracetam)                     3        1
                                                                         Antimigraine Agents, Miscellaneous
KEPPRA XR (levetiracetam)                       3        1
                                                                         aspirin tab, delayed release 975 mg                  1
LAMICTAL (lamotrigine)                          3        1
                                                                         Butalbital Compound
                                                                                                                     1        1
LAMICTAL ODT                                    2                        (butalbital-aspirin-caffeine)
LAMICTAL XR 24 HR TAB 100 MG,                                            CAFERGOT (ergotamine-caffeine)              3        1
200 MG, 25 MG, 250 MG, 300 MG, 50               2
MG                                                                       D.H.E.45 (dihydroergotamine)                3        1

levetiracetam oral soln                                  1               ERGOMAR                                     2

LYRICA                                          2                        FIORINAL (butalbital-aspirin-caffeine)      3        1

MAGNESIUM SULFATE INJ                                    3               INDERAL LA (propranolol)                    3        1

NEURONTIN CAP (gabapentin)                      3        1               INNOPRAN XL                                 3

NEURONTIN ORAL SOLN (gabapentin)                3        1               LEVACET                                     1

NEURONTIN TAB (gabapentin)                      3        1               Migergot                                    1

SABRIL                                          3                        MIGRANAL                                    3

STAVZOR                                         3                        propranolol oral                                     1

TEGRETOL (carbamazepine)                        3        1               PROTID                                      3

TEGRETOL XR 12 HR TAB 100 MG                    2                        timolol maleate                                      1

TEGRETOL XR 12 HR TAB                                                    ULTRACET (tramadol-acetaminophen)           3        1
                                                3        1
(carbamazepine) 200 MG, 400 MG                                           Antipsychotics, Miscellaneous
TOPAMAX (topiramate)                            3        1               LOXITANE (loxapine succinate)               3        1
Topiragen (topiramate)                          1        1               MOBAN                                       2
TRILEPTAL (oxcarbazepine)                       3        1               ORAP                                        2
VIMPAT ORAL SOLN                                3                        Anxiolytics, Sedatives & Hypnotics,Misc.
VIMPAT TAB                                      2                        ALDEX AN                                    3
                                                                         AMBIEN (zolpidem)                           3        1
ZONEGRAN (zonisamide)                           3        1
                                                                         AMBIEN CR (zolpidem)                        3        1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  21
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

buspirone                                                1               LUMINAL                                     3
chloral hydrate oral                                     1               MYSOLINE (primidone)                        3        1
Doxytex                                         1                        phenobarbital                                        1
HYDROXYZINE HCL IM                                       3               Barbiturates (Anxiolytic, Sedative/Hyp)
hydroxyzine hcl oral                                     1               Alagesic (butalbital-acetaminophen-caff)    1        1
LUNESTA                                         3                        Alagesic LQ                                 1
meprobamate                                              1               Ascomp w/Codeine                            1
PHENERGAN (PROMETHAZINE)                        3        3               BUPAP                                       3
PROMETHAZINE INJ                                         3               Butalbital Compound
                                                                                                                     1        1
                                                                         (butalbital-aspirin-caffeine)
promethazine oral                                        1
                                                                         Butalbital Compound W/Codeine               1
promethazine rect                                        1
                                                                         BUTISOL                                     3
ROZEREM                                         3
                                                                         CEPHADYN                                    3
SOMNOTE                                         3
                                                                         DOLGIC PLUS                                 3
SONATA (zaleplon)                               3        1
                                                                         DONNATAL                                    3
VISTARIL (hydroxyzine pamoate)                  3        1
                                                                         DONNATAL EXTENTABS                          3
ZOLPIMIST                                       3
                                                                         ESGIC (butalbital-acetaminophen-caff)       3        1
Atypical Antipsychotics
                                                                         ESGIC-PLUS                                  3
ABILIFY                                         3
                                                                         FIORICET (butalbital-acetaminophen-caff)    3        1
ABILIFY DISCMELT                                3
                                                                         FIORICET-CODEINE
clozapine tab 200 mg, 50 mg                              1                                                           3        1
                                                                         (cod-butalbital-acetaminop-caf)
CLOZARIL (clozapine)                            2        1               FIORINAL (butalbital-aspirin-caffeine)      3        1
FANAPT                                          3                        FIORINAL-CODEINE #3                         3
FAZACLO                                         3                        LUMINAL                                     3
GEODON IM                                       3                        Margesic (butalbital-acetaminophen-caff)    1        1
GEODON ORAL                                     2                        Marten-Tab (butalbital-acetaminophen)       1        1
INVEGA                                          3                        ORBIVAN                                     3
INVEGA SUSTENNA                                 3                        phenobarbital                                        1
LATUDA                                          3                        PHRENILIN FORTE                             3
RISPERDAL (risperidone)                         3        1               PROMACET                                    3
RISPERDAL CONSTA                                3                        Quadrapax                                   1
RISPERDAL M-TAB (risperidone)                   3        1               Repan (butalbital-acetaminophen-caff)       1        1
risperidone tab, rapid dissolve 0.25 mg                  1               SE-Donna PB Hyos                            1
Risperidone M-Tab (risperidone)                 1        1               SECONAL SODIUM                              3
SAPHRIS                                         3                        SEDAPAP                                     3
SEROQUEL                                        2                        TENCON                                      3
SEROQUEL XR                                     2                        Zebutal                                     1
SYMBYAX                                         3                        Benzodiazepines (Anticonvulsants)
ZYPREXA IM                                      2                        DIASTAT (diazepam)                          3        1
ZYPREXA ORAL (olanzapine)                       3        1               DIASTAT ACUDIAL RECTAL KIT
ZYPREXA RELPREVV                                3                        (diazepam) 12.5-15-17.5-20 MG, 5-7.5-10     3        1
                                                                         MG
ZYPREXA ZYDIS (olanzapine)                      3        1
                                                                         DIAZEPAM INJ                                         3
Barbiturates (Anticonvulsants)
                                                                         diazepam oral soln                                   1
DONNATAL                                        3
                                                                         DIAZEPAM INTENSOL                           3
DONNATAL EXTENTABS                              3
22     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

KLONOPIN (clonazepam)                           3        1               STALEVO 75                                 3
TRANXENE T-TAB (clorazepate                                              TASMAR                                     3
                                                3        1
dipotassium)
                                                                         Central Nervous System Agents, Misc.
VALIUM (diazepam)                               3        1
                                                                         CAMPRAL                                    3
Benzodiazepines (Anxiolytic,Sedativ/Hyp)
                                                                         INTUNIV ER                                 2
ALPRAZOLAM INTENSOL                             3
                                                                         LODOSYN                                    2
amitriptyline-chlordiazepoxide                           1
                                                                         NAMENDA                                    2
ATIVAN ORAL (lorazepam)                         3        1
                                                                         NAMENDA TITRATION PAK                      2
chlordiazepoxide hcl                                     1
                                                                         NUEDEXTA                                   2
DIASTAT (diazepam)                              3        1
                                                                         RILUTEK                                    2
DIASTAT ACUDIAL RECTAL KIT
(diazepam) 12.5-15-17.5-20 MG, 5-7.5-10         3        1               STRATTERA                                  2
MG                                                                       XENAZINE                                   2
diazepam oral soln                                       1               XYREM                                      2
DIAZEPAM INTENSOL                               3                        Cyclooxygenase-2 (Cox-2) Inhibitors
DORAL                                           3                        CELEBREX                                   2
estazolam                                                1               Dopamine Precursors
flurazepam                                               1               PARCOPA (carbidopa-levodopa)               3        1
HALCION (triazolam)                             3        1               SINEMET (carbidopa-levodopa)               3        1
KLONOPIN (clonazepam)                           3        1               SINEMET CR (carbidopa-levodopa)            3        1
LIBRAX (WITH CLIDINIUM)                                                  STALEVO 100                                3
                                                3        1
(chlordiazepoxide-clidinium)
                                                                         STALEVO 125                                3
LORAZEPAM INTENSOL (lorazepam)                  3        1
                                                                         STALEVO 150                                3
midazolam oral                                           1
                                                                         STALEVO 200                                3
NIRAVAM (alprazolam)                            3        1
                                                                         STALEVO 50                                 3
ONFI                                            3
                                                                         STALEVO 75                                 3
oxazepam                                                 1
                                                                         Ergot-Deriv. Dopamine Receptor Agonists
RESTORIL (temazepam)                            3        1
                                                                         cabergoline                                         1
TRANXENE T-TAB (clorazepate
                                                3        1
dipotassium)                                                             CYCLOSET                                   3
VALIUM (diazepam)                               3        1               PARLODEL (bromocriptine)                   3        1
XANAX (alprazolam)                              3        1               Fibromyalgia Agents
XANAX XR (alprazolam)                           3        1               SAVELLA                                    3
Butyrophenones                                                           Hydantoins
HALDOL (HALOPERIDOL LACTATE)                    3        3               DILANTIN                                   2
HALDOL DECANOATE                                                         DILANTIN EXTENDED (phenytoin
                                                3        3                                                          2        1
(HALOPERIDOL DECANOATE)                                                  sodium extended)
haloperidol                                              1               DILANTIN INFATABS                          2
haloperidol lactate oral                                 1               DILANTIN-125 (phenytoin)                   2        1
Catechol-O-Methyltransferase(Comt)Inhib.                                 PEGANONE                                   2
COMTAN                                          2                        PHENYTEK (phenytoin sodium extended)       3        1
STALEVO 100                                     3                        Inhalation Anesthetics
STALEVO 125                                     3                        CHLOROFORM                                          3
STALEVO 150                                     3                        COMPOUND 347                               3
STALEVO 200                                     3
                                                                         ETHRANE                                    3
STALEVO 50                                      3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                 23
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Monoamine Oxidase B Inhibitors                                           DEMEROL ORAL (meperidine)                   3        1
AZILECT                                         2                        DESPEC-PDC                                  3
EMSAM                                           3                        DiHydro-PE                                  1
selegiline hcl                                           1               dihydrocode-acetaminophen-caff                       1
ZELAPAR                                         3                        DILAUDID (hydromorphone)                    3        1
Monoamine Oxidase Inhibitors                                             DILAUDID-5                                  2
EMSAM                                           3                        Diskets (methadone)                         1        1
MARPLAN                                         3                        DOLOPHINE (methadone)                       3        1
NARDIL (phenelzine)                             3        1               DURAGESIC (fentanyl)                        3        1
PARNATE (tranylcypromine)                       3        1               ENDACOF-C                                   3
selegiline hcl                                           1               Endocet Tab (oxycodone-acetaminophen)
                                                                         10-325 mg, 5-325 mg, 7.5-325 mg, 7.5-500    1        1
ZELAPAR                                         3                        mg
Nonergot-Deriv.Dopamine Receptor Agonist                                 ENDOCET TAB
                                                                                                                     3        1
APOKYN                                          2                        (oxycodone-acetaminophen) 10-650 MG

MIRAPEX (pramipexole)                           3        1               Endodan                                     1

MIRAPEX ER 24 HR TAB 0.375 MG,                                           EXALGO ER                                   3
                                                2
0.75 MG, 1.5 MG, 3 MG, 4.5 MG                                            FENTORA                                     3
REQUIP (ropinirole)                             3        1               FIORICET-CODEINE
                                                                                                                     3        1
REQUIP XL                                       2                        (cod-butalbital-acetaminop-caf)

Opiate Agonists                                                          FIORINAL-CODEINE #3                         3

ABSTRAL                                         3                        HYCET                                       3

acetaminophen-codeine                                    1               hydrocodone-acetaminophen oral soln
                                                                         10-325 mg/15 ml(15 ml), 2.5-167 mg/5 ml,
                                                                                                                              1
ACTIQ (fentanyl citrate)                        3        1               5-163 mg/7.5ml(7.5ml), 5-334 mg/10 ml,
                                                                         7.5-500 mg/15 ml(15 ml)
ALA-HIST AC                                     3
                                                                         hydrocodone-acetaminophen tab 2.5-500
ALA-HIST DHC                                    3                                                                             1
                                                                         mg
Ascomp w/Codeine                                1                        HYDROMORPHONE INJ                                    3
AVINZA                                          2                        hydromorphone rect                                   1
BELLADONNA ALKALOIDS-OPIUM                               3               HYDROMORPHONE (PF)                                   3
BELLADONNA-OPIUM                                3                        IBUDONE                                     3
BROVEX CB                                       3                        ibuprofen-oxycodone                                  1
BROVEX CBX                                      3                        J-COF DHC                                   3
BROVEX PB C                                     3                        KADIAN                                      3
BROVEX PB CX                                    3                        levorphanol tartrate                                 1
Butalbital Compound W/Codeine                   1                        LEXUSS 210                                  3
CAPCOF                                          3                        LORCET 10/650
                                                                                                                     3        1
                                                                         (hydrocodone-acetaminophen)
CAPITAL WITH CODEINE                            3
                                                                         LORCET PLUS
carisoprodol-asa-codeine                                 1                                                           3        1
                                                                         (hydrocodone-acetaminophen)
CO-GESIC (hydrocodone-acetaminophen)            3        1
                                                                         LORTAB (hydrocodone-acetaminophen)          3        1
COCET                                           3
                                                                         LORTAB ELIXIR
                                                                                                                     3        1
COCET PLUS                                      3                        (hydrocodone-acetaminophen)

codeine sulfate                                          1               M-END PE                                    3

COTAB A                                         3                        M-End WC                                    1

COTAB AX                                        3                        MAGNACET                                    3

COTABFLU                                        3                        MAR-COF BP                                  3

24     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                  Brand   Generic   Notes

MAXIDONE                                                                 REPREXAIN TAB 2.5-200 MG, 5-200 MG     3
                                                3        1
(hydrocodone-acetaminophen)
                                                                         ROXICODONE TAB (oxycodone) 15 MG,
                                                                                                                3        1
MAXIFLU CD                                      3                        30 MG
MAXIFLU CDX                                     3                        RYBIX ODT                              3
meperidine oral                                          1               Rydex                                  1
Meperitab (meperidine)                          1        1               RYZOLT                                 3
Mesehist WC                                     1                        SYNALGOS-DC                            3
methadone oral                                           1               SYNAPRYN                               3
Methadone Intensol (methadone)                  1        1               TL-Hist CD                             1
METHADOSE ORAL CONCENTRATE                                               TL-HIST CM                             3
                                                3        1
(methadone)
                                                                         TREZIX                                 3
Methadose Soluble Tab (methadone)               1        1
                                                                         TYLENOL-CODEINE #3
                                                                                                                3        1
Methadose Tab (methadone)                       1        1               (acetaminophen-codeine)
MORPHINE IM                                              3               TYLENOL-CODEINE #4
                                                                                                                3        1
                                                                         (acetaminophen-codeine)
MORPHINE INJECTION 5 MG/ML, 50
                                                         3
MG/ML, 8 MG/ML                                                           TYLOX (oxycodone-acetaminophen)        3        1
morphine oral soln                                       1               ULTRACET (tramadol-acetaminophen)      3        1
morphine rect                                            1               ULTRAM (tramadol)                      3        1
MORPHINE SYRINGE 4 MG/ML, 8                                              ULTRAM ER                              3
                                                         3
MG/ML
                                                                         VANACOF CD                             3
morphine tab                                             1
                                                                         VICODIN (hydrocodone-acetaminophen)    3        1
morphine concentrate                                     1
                                                                         VICODIN ES
                                                                                                                3        1
MS CONTIN (morphine)                            3        1               (hydrocodone-acetaminophen)
NASOTUSS                                        3                        VICODIN HP
                                                                                                                3        1
                                                                         (hydrocodone-acetaminophen)
NEO AC                                          3
                                                                         VICOPROFEN (hydrocodone-ibuprofen)     3        1
NORCO (hydrocodone-acetaminophen)               3        1
                                                                         XODOL 10/300
NUCYNTA                                         3                                                               3        1
                                                                         (hydrocodone-acetaminophen)
NUCYNTA ER                                      3                        XODOL 5/300
                                                                                                                3        1
ONSOLIS                                         3                        (hydrocodone-acetaminophen)

OPANA                                           3                        XODOL 7.5/300
                                                                                                                3        1
                                                                         (hydrocodone-acetaminophen)
OPANA ER                                        3
                                                                         ZAMICET                                3
oxycodone                                                1
                                                                         ZOLVIT                                 3
OXYCONTIN                                       2
                                                                         ZOTEX-C                                3
PERCOCET (oxycodone-acetaminophen)              3        1
                                                                         ZYDONE                                 3
PERCODAN                                        3
                                                                         Opiate Antagonists
PHENFLU CD                                      3
                                                                         NALOXONE                                        3
PHENFLU CDX                                     3
                                                                         REVIA (naltrexone)                     3        1
POLY HIST DHC                                   3
                                                                         VIVITROL                               3
POLY HIST NC                                    3
                                                                         Opiate Partial Agonists
POLY-TUSSIN AC                                  3
                                                                         butorphanol tartrate nasl                       1
POLY-TUSSIN DHC                                 3
                                                                         BUTRANS                                3
PRO-CLEAR AC                                    3
                                                                         pentazocine-acetaminophen                       1
PRO-RED AC                                      3
                                                                         pentazocine-naloxone                            1
Promethazine VC-Codeine
                                                1        1               SUBOXONE                               2
(phenyleph-promethazine-cod)

Reprexain Tab 10-200 mg                         1                        SUBUTEX (buprenorphine)                3        1

       T3 AF = Tier 3 on Advantage Formulary                                                                                             25
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

Other Nonsteroidal Anti-Inflam. Agents                                   ZIPSOR                                      3
ANAPROX (naproxen sodium)                       3        1               Phenothiazines
ANAPROX DS (naproxen sodium)                    3        1               chlorpromazine oral                                  1
ANSAID (flurbiprofen)                           3        1               fluphenazine hcl oral                                1
ARTHROTEC 50                                    3                        perphenazine                                         1
ARTHROTEC 75                                    3                        perphenazine-amitriptyline                           1
CATAFLAM (diclofenac potassium)                 3        1               thioridazine                                         1
CLINORIL (sulindac)                             3        1               trifluoperazine                                      1
DAYPRO (oxaprozin)                              3        1               Salicylates
diflunisal                                               1               Adult Low Dose Aspirin (aspirin)            1        1
EC-NAPROSYN (naproxen)                          3        1               AGGRENOX                                    2
etodolac                                                 1               Ascomp w/Codeine                            1
FELDENE (piroxicam)                             3        1               aspirin tab, delayed release 975 mg                  1
fenoprofen                                               1               Bayer Childrens Aspirin (aspirin)           1        1
FLECTOR                                         3                        Butalbital Compound
                                                                                                                     1        1
                                                                         (butalbital-aspirin-caffeine)
flurbiprofen                                             1
                                                                         Butalbital Compound W/Codeine               1
IBUDONE                                         3
                                                                         carisoprodol-asa-codeine                             1
ibuprofen tab 400 mg, 600 mg, 800 mg                     1
                                                                         carisoprodol-aspirin                                 1
ibuprofen-oxycodone                                      1
                                                                         choline & magnesium salicylate                       1
IC400                                           3
                                                                         Endodan                                     1
IC800                                           3
                                                                         FIORINAL (butalbital-aspirin-caffeine)      3        1
INDOCIN ORAL                                    3
                                                                         FIORINAL-CODEINE #3                         3
INDOCIN RECT                                    3
                                                                         LEVACET                                     1
indomethacin                                             1
                                                                         Orphenadrine Compound                       1
ketoprofen                                               1
                                                                         Orphenadrine Compound-DS                    1
ketorolac oral                                           1
                                                                         PERCODAN                                    3
meclofenamate oral                                       1
                                                                         salsalate                                            1
MOBIC (meloxicam)                               3        1
                                                                         Sel. Serotonin & Norepi Reuptake Inhibtr
MOTRIN ORAL SUSP (ibuprofen)                    3        1
                                                                         CYMBALTA                                    2
nabumetone                                               1
                                                                         EFFEXOR XR (venlafaxine)                    3        1
NALFON                                          3
                                                                         PRISTIQ                                     2
NAPRELAN CR                                     3
                                                                         venlafaxine                                          1
NAPROSYN (naproxen)                             3        1
                                                                         Selective Serotonin Agonists
PENNSAID                                        3
                                                                         ALSUMA (sumatriptan succinate)              3        1
PONSTEL (mefenamic acid)                        3        1
                                                                         AMERGE (naratriptan)                        3        1
Reprexain Tab 10-200 mg                         1
                                                                         AXERT                                       3
REPREXAIN TAB 2.5-200 MG, 5-200 MG              3
                                                                         FROVA                                       2
sulindac oral                                            1
                                                                         IMITREX (sumatriptan succinate)             3        1
tolmetin                                                 1
                                                                         IMITREX STATDOSE KIT REFILL
TREXIMET                                        3                                                                    3        1
                                                                         (sumatriptan succinate)
VICOPROFEN (hydrocodone-ibuprofen)              3        1               IMITREX STATDOSE PEN (sumatriptan
                                                                                                                     3        1
VIMOVO                                          3                        succinate)

VOLTAREN                                        3                        MAXALT                                      2

VOLTAREN-XR (diclofenac sodium)                 3        1               MAXALT-MLT                                  2
26     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                               Brand   Generic   Notes

RELPAX                                          2                        TOFRANIL-PM (imipramine pamoate)    3        1
SUMAVEL DOSEPRO                                 3                        VIVACTIL (protriptyline)            3        1
TREXIMET                                        3                        Dental Agents
ZOMIG NASL                                      2                T3 AF   Dental Agents

ZOMIG TAB 2.5 MG, 5 MG                          2                T3 AF   BUCALCIDE                           3

ZOMIG ZMT                                       2                T3 AF   Q-CARE RX Q2                        3

Selective-Serotonin Reuptake Inhibitors                                  Q-CARE RX Q4                        3

CELEXA (citalopram)                             3        1               Devices

fluvoxamine                                              1               Devices

LEXAPRO                                         3                        ACCU-CHEK ADVANTAGE
                                                                                                             2
                                                                         DIABETES
LUVOX CR                                        3
                                                                         ACCU-CHEK AVIVA MONITORING          2
PAXIL ORAL SUSP                                 2
                                                                         ACCU-CHEK COMPACT PLUS CARE         2
PAXIL TAB (paroxetine HCl)                      3        1
                                                                         ACCU-CHEK MULTICLIX LANCET          2
PAXIL CR (paroxetine HCl)                       3        1
                                                                         ACCU-CHEK SOFTCLIX LANCETS          2
PEXEVA                                          3
                                                                         BD INSULIN PEN NEEDLE UF MINI       2
PROZAC (fluoxetine)                             3        1
                                                                         BD INSULIN PEN NEEDLE UF ORIG       2
PROZAC WEEKLY (fluoxetine)                      3        1
                                                                         BD INSULIN PEN NEEDLE UF SHORT      2
SARAFEM (fluoxetine)                            3        1
                                                                         BD INSULIN SYRINGE 1 ML 25 X 1"     2
SYMBYAX                                         3
                                                                         BD INSULIN SYRINGE HALF UNIT        2
ZOLOFT (sertraline)                             3        1
                                                                         BD INSULIN SYRINGE MICRO-FINE       2
Serotonin Modulators
                                                                         ONE TOUCH BASIC SYSTEM              2
NEFAZODONE                                               3
                                                                         ONE TOUCH DELICA LANCETS            2
OLEPTRO ER                                      3
                                                                         ONE TOUCH ULTRA 2                   2
trazodone                                                1
                                                                         ONE TOUCH ULTRA SMART               2
VIIBRYD                                         3
                                                                         ONE TOUCH ULTRA SYSTEM KIT          2
Succinimides
                                                                         ONE TOUCH ULTRAMINI                 2
CELONTIN                                        2
                                                                         ONE TOUCH ULTRASOFT LANCETS         2
ZARONTIN (ethosuximide)                         3        1
                                                                         SURESTEP COMPLETE SYSTEM            2
Thioxanthenes
                                                                         SURESTEP PRO LINEARITY              2
NAVANE (thiothixene)                            3        1
                                                                         SYNVISC                             2
thiothixene                                              1
                                                                         SYNVISC-ONE                         2
Trycyclics & Other Norepineph.-Ru Inhib
                                                                         Diagnostic Agents
amitriptyline                                            1
                                                                         Diabetes Mellitus
amitriptyline-chlordiazepoxide                           1
                                                                         ACCU-CHEK ACTIVE TEST               2
amoxapine                                                1
                                                                         ACCU-CHEK AVIVA                     2
ANAFRANIL (clomipramine)                        3        1
                                                                         ACCU-CHEK COMFORT CURVE
doxepin oral                                             1                                                   2
                                                                         TEST
maprotiline                                              1               ACCU-CHEK COMPACT TEST              2
NORPRAMIN (desipramine)                         3        1               FASTTAKE TEST                       2
PAMELOR (nortriptyline)                         3        1               ONE TOUCH TEST                      2
perphenazine-amitriptyline                               1               ONE TOUCH ULTRA TEST                2
SILENOR                                         3                        SURESTEP PRO TEST                   2
SURMONTIL (trimipramine)                        3        1
                                                                         SURESTEP TEST                       2
TOFRANIL (imipramine HCl)                       3        1
       T3 AF = Tier 3 on Advantage Formulary                                                                                          27
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

Electrolytic, Caloric, And Water Balance                                 MAGNEBIND 400                              3
Acidifying Agents                                                        PHOSLO (calcium acetate)                   2        1
K-PHOS MF                                       3                        RENAGEL                                    2
K-PHOS NO 2                                     3                        RENVELA ORAL PWPK                          3
K-PHOS ORIGINAL                                 3                        RENVELA TAB                                2
K-Phos-Neutral                                  1                        Potassium-Removing Agents
Phospha 250 Neutral                             1                        KAYEXALATE (sodium polystyrene
                                                                                                                    3        1
                                                                         sulfonate)
Alkalinizing Agents
                                                                         Potassium-Sparing Diuretics
CYTRA K CRYSTALS                                3
                                                                         ALDACTAZIDE                                3
CYTRA-2 (sodium citrate-citric acid)            3        1
                                                                         ALDACTONE (spironolactone)                 3        1
CYTRA-K (potassium citrate-citric acid)         3        1
                                                                         amiloride-hydrochlorothiazide                       1
UROCIT-K 10 (potassium citrate)                 3        1
                                                                         DYAZIDE
UROCIT-K 15                                     2                                                                   3        1
                                                                         (triamterene-hydrochlorothiazid)
UROCIT-K 5 (potassium citrate)                  3        1               DYRENIUM                                   3
Ammonia Detoxicants                                                      MAXZIDE
                                                                                                                    3        1
BUPHENYL                                        2                        (triamterene-hydrochlorothiazid)

CARBAGLU                                        2                        MAXZIDE-25MG
                                                                                                                    3        1
                                                                         (triamterene-hydrochlorothiazid)
Enulose (lactulose)                             1        1
                                                                         MIDAMOR (amiloride)                        3        1
Generlac (lactulose)                            1        1
                                                                         triamterene-hydrochlorothiazid                      1
KRISTALOSE                                      2
                                                                         Replacement Preparations
LITHOSTAT                                       3
                                                                         ATABEX EC                                  2
Carbonic Anhydrase Inhibitors
                                                                         CARDIOPLEGIC SOLN                                   3
acetazolamide oral                                       1
                                                                         Cavan-Alpha Kit                            1
DIAMOX SEQUELS (acetazolamide)                  3        1
                                                                         CITRANATAL 90 DHA (NEW
                                                                                                                    2
Diuretics, Miscellaneous                                                 FORMULA

ELIXOPHYLLIN                                    2                        CITRANATAL ASSURE                          2

THEO-24                                         3                        CITRANATAL B-CALM                          2

Theochron (theophylline)                        1        1               CITRANATAL DHA (NEW
                                                                                                                    2
                                                                         FORMULA)
theophylline er 12 hr tab                                1
                                                                         CITRANATAL RX (NEW FORMULA)                2
theophylline er tab                                      1
                                                                         Co-Natal FA                                1
theophylline oral soln                                   1
                                                                         DUET DHA BALANCED
Loop Diuretics                                                                                                      2
                                                                         PACK,TAB&CAP,DR 27-1-430 MG
BUMETANIDE INJ                                           3               DUET DHA COMPLETE                          2
bumetanide oral                                          1               EFFER-K EFFERVESCENT TAB 10
                                                                                                                    2
                                                                         MEQ, 20 MEQ
DEMADEX (torsemide)                             3        1
                                                                         Effer-K Effervescent Tab (potassium
EDECRIN                                         3                                                                   1        1
                                                                         bicarb-citric acid) 25 mEq
FUROSEMIDE INJ                                           3
                                                                         Folcal DHA                                 1
furosemide oral soln 10 mg/ml, 40 mg/5 ml                1
                                                                         Folcaps Omega-3                            1
LASIX (furosemide)                              3        1
                                                                         HYPER-SAL                                  3
Osmotic Diuretics
                                                                         iNatal Advance                             1
SORBITOL-MANNITOL                                        3
                                                                         iNatal Ultra                               1
Phosphate-Removing Agents
                                                                         K-Effervescent (potassium bicarb-citric
                                                                                                                    1        1
Eliphos                                         1                        acid)

FOSRENOL                                        2                        K-TAB (potassium chloride)                 3        1
28     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                 Brand   Generic   Notes

KAOCHLOR                                        3                        Prenatal Plus (calcium carb)          1
Klor-Con Oral Packet 20 mEq                     1                        Prenatal Plus with Iron (Ca)          1
KLOR-CON ORAL PACKET 25 MEQ                     3                        PRENATE ESSENTIAL                     2
Klor-Con Tab (potassium chloride)               1        1               PreNate Plus                          1
Klor-Con 8 (potassium chloride)                 1        1               PRENEXA                               2
Klor-Con M10 (potassium chloride)               1        1               PROTECT NATAL                         2
KLOR-CON M15                                    3                        Se-Natal 19 Chewable Tab              1
Klor-Con M20 (potassium chloride)               1        1               Se-Natal One                          1
Klor-Con/EF (potassium bicarb-citric acid)      1        1               SetonET                               1
Lactocal-F                                      1                        Setonet-EC                            1
MARNATAL-F                                      2                        sodium chloride neb solution 0.9 %             1
Mynatal Cap                                     1                        SODIUM CHLORIDE NEB SOLUTION
                                                                                                                        3
                                                                         10 %, 3 %
Mynatal Advance                                 1
                                                                         sodium chloride 0.9 % syringe                  1
Mynatal Plus                                    1
                                                                         Taron-Bc                              1
Mynatal-Z                                       1
                                                                         Taron-Duo EC                          1
NATALVIT                                        2
                                                                         TL G-FOL OS                           3
NATELLE ONE                                     2
                                                                         Tri Rx                                1
NEEVO DHA                                       2
                                                                         TriAdvance                            1
NESTABS                                         2
                                                                         TRICARE                               2
O-CAL FA                                        2
                                                                         Trinatal Rx 1                         1
O-CAL PRENATAL                                  2
                                                                         Trinate                               1
OB COMPLETE                                     2
                                                                         Triveen-Duo DHA                       1
OB COMPLETE ONE                                 2
                                                                         Triveen-One                           1
OB COMPLETE PREMIER                             2
                                                                         Triveen-PRx RNF                       1
OB-Natal One                                    1
                                                                         UltimateCare One                      1
PNV-DHA + Docusate                              1
                                                                         ULTIMATECARE ONE NF                   2
PNV-DHA PLUS                                    2
                                                                         VemaVite-PRx-2                        1
PNV-IRON                                        2
                                                                         VENATAL-FA                            2
PNV-Omega                                       1
                                                                         Vinacal                               1
Poly Iron PN                                    1
                                                                         Vinate AZ                             1
Poly Iron PN Forte                              1
                                                                         Vinate II                             1
potassium bicarb & chloride                              1
                                                                         Vinate One                            1
potassium chloride oral                                  1
                                                                         Vinate Ultra                          1
PR Natal 400                                    1
                                                                         VITAFOL-OB                            2
PR Natal 400 EC                                 1
                                                                         VITAFOL-OB+DHA                        2
PR Natal 430                                    1
                                                                         VITAFOL-PN (UD)                       2
PR Natal 430 EC                                 1
                                                                         VOL-NATE                              2
PrenaFirst                                      1
                                                                         VOL-TAB RX                            2
PrenaPlus                                       1
                                                                         Vynatal FA                            1
Prenatabs FA                                    1
                                                                         Zatean-CH                             1
Prenatabs Rx                                    1
                                                                         Zatean-Pn Plus                        1
Prenatal 19 Chewable Tab                        1
Prenatal AD                                     1
                                                                         Zincate (zinc sulfate)                1        1
Prenatal Low Iron                               1
       T3 AF = Tier 3 on Advantage Formulary                                                                                            29
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

Thiazide Diuretics                                                       CLORPRES                                   3
ACCURETIC                                                                indapamide                                          1
                                                3        1
(quinapril-hydrochlorothiazide)
                                                                         metolazone                                          1
ALDACTAZIDE                                     3
                                                                         TENORETIC 100 (atenolol-chlorthalidone)    3        1
amiloride-hydrochlorothiazide                            1
                                                                         TENORETIC 50 (atenolol-chlorthalidone)     3        1
AMTURNIDE                                       2
                                                                         THALITONE                                  3
ATACAND HCT                                     3
                                                                         ZAROXOLYN (metolazone)                     3        1
AVALIDE                                         3
                                                                         Uricosuric Agents
BENICAR HCT                                     2                T3 AF
                                                                         colchicine-probenecid                               1
captopril-hydrochlorothiazide                            1
                                                                         probenecid                                          1
chlorothiazide                                           1
                                                                         Vasopressin Antagonists
CORZIDE (nadolol-bendroflumethiazide)           3        1
                                                                         SAMSCA                                     2
DIOVAN HCT                                      2
                                                                         Enzymes
DIURIL                                          3
                                                                         Enzymes
DYAZIDE
                                                3        1               ADAGEN                                     2
(triamterene-hydrochlorothiazid)
EXFORGE HCT                                     2                        PULMOZYME                                  2

fosinopril-hydrochlorothiazide                           1               SUCRAID                                    3

hydrochlorothiazide                                      1               VITRASE                                    3

HYZAAR (losartan-hydrochlorothiazide)           3        1               XIAFLEX                                    2

LOPRESSOR HCT                                                            Eye, Ear, Nose And Throat (Eent) Preps.
                                                3        1
(metoprolol-hydrochlorothiazide)                                         Alpha-Adrenergic Agonists (Eent)
LOTENSIN HCT                                                             ALPHAGAN P EYE DROPS 0.1 %                 2
                                                3        1
(benazepril-hydrochlorothiazide)
                                                                         ALPHAGAN P EYE DROPS (brimonidine)
MAXZIDE                                                                                                             3        1
                                                3        1               0.15 %
(triamterene-hydrochlorothiazid)
                                                                         brimonidine                                         1
MAXZIDE-25MG
                                                3        1
(triamterene-hydrochlorothiazid)                                         COMBIGAN                                   3
methyclothiazide                                         1               Antiallergic Agents
methyldopa-hydrochlorothiazide                           1               ALOCRIL                                    3
metoprolol-hydrochlorothiazide                           1               ALOMIDE                                    3
MICARDIS HCT                                    2                        ASTELIN (azelastine)                       2        1
MICROZIDE (hydrochlorothiazide)                 3        1               ASTEPRO                                    2
PRINZIDE (lisinopril-hydrochlorothiazide)       3        1               BEPREVE                                    3
propranolol-hydrochlorothiazid                           1               cromolyn opht                                       1
TEKTURNA HCT                                    2                        ELESTAT (epinastine)                       3        1
TEVETEN HCT                                     3                        EMADINE                                    3
triamterene-hydrochlorothiazid                           1               KETOTIFEN FUMARATE                                  3
TRIBENZOR                                       2                        LASTACAFT                                  3
UNIRETIC (moexipril-hydrochlorothiazide)        3        1               OPTIVAR (azelastine)                       3        1
VASERETIC                                                                PATADAY                                    2
                                                3        1
(enalapril-hydrochlorothiazide)
                                                                         PATANASE                                   3
ZESTORETIC
                                                3        1               PATANOL                                    2
(lisinopril-hydrochlorothiazide)
ZIAC (bisoprolol-hydrochlorothiazide)           3        1               Antibacterials (Eent)

Thiazide-Like Diuretics                                                  AK-Poly-Bac (bacitracin-polymyxin B)       1        1

chlorthalidone                                           1               AK-Tob (tobramycin sulfate)                1        1

30     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

ARESTIN                                         3                        ZYLET                                     2
AZASITE                                         3                        ZYMAXID                                   2
bacitracin opht                                          1               Antifungals (Eent)
BACTROBAN NASAL                                 3                        NATACYN                                   2
BESIVANCE                                       2                        Antivirals (Eent)
BLEPH-10 (sulfacetamide sodium)                 3        1               VIROPTIC (trifluridine)                   3        1
BLEPHAMIDE                                      3                        VITRASERT                                 3
BLEPHAMIDE S.O.P.                               2                        ZIRGAN                                    3
CETRAXAL                                        3                        Beta-Adrenergic Blocking Agents (Eent)
CILOXAN EYE OINTMENT                            2                        BETAGAN (levobunolol)                     3        1
CILOXAN EYE DROPS (ciprofloxacin)               3        1               betaxolol                                          1
CIPRO HC                                        3                        BETIMOL                                   3
CIPRODEX                                        2                        BETOPTIC S                                2
COLY-MYCIN S                                    3                        COMBIGAN                                  3
CORTISPORIN (neomycin-polymyxin-HC)             3        1               COSOPT (dorzolamide-timolol)              3        1
CORTISPORIN-TC                                  3                        ISTALOL                                   3
doxycycline hyclate oral                                 1               levobunolol                                        1
GARAMYCIN EYE OINTMENT                          3                        OPTIPRANOLOL (metipranolol)               3        1
Gentak Eye Ointment                             1                        TIMOPTIC (timolol maleate)                3        1
gentamicin eye drops                                     1               TIMOPTIC OCUDOSE                          3
ILOTYCIN (erythromycin)                         3        1               TIMOPTIC-XE (timolol maleate)             3        1
levofloxacin opht                                        1               Carbonic Anhydrase Inhibitors (Eent)
MAXITROL                                                                 acetazolamide oral                                 1
                                                3        1
(neomycin-polymyxin-dexameth)
                                                                         AZOPT                                     2
neomycin-bacitracin-poly-hc                              1
                                                                         COSOPT (dorzolamide-timolol)              3        1
neomycin-bacitracin-polymyxin                            1
                                                                         DIAMOX SEQUELS (acetazolamide)            3        1
neomycin-polymyxin-hc                                    1
                                                                         NEPTAZANE (methazolamide)                 3        1
NEOSPORIN OPHT
                                                3        1               TRUSOPT (dorzolamide)                     3        1
(neomycin-polymyxin-gramicidin)
OCUFLOX (ofloxacin)                             3        1               Corticosteroids (Eent)

POLYTRIM (trimethoprim-polymyxin B)             3        1               ALREX                                     2

PRED-G                                          3                        BECONASE AQ                               3

PRED-G S.O.P.                                   3                        CORTANE-B                                 3

sulfacetamide-prednisolone                               1               DERMOTIC OIL                              3

Sulfamide (sulfacetamide sodium)                1        1               dexamethasone sodium phosphate                     1

TERRAMYCIN WITH POLYMYXIN B                     3                        DUREZOL                                   3

TOBRADEX EYE OINTMENT                           2                        EXXOTIC-HC                                3

TOBRADEX EYE DROPS                                                       FLAREX                                    3
                                                3        1
(tobramycin-dexamethasone)                                               FLONASE (fluticasone)                     3        1
TOBRADEX ST                                     2                        flunisolide                                        1
TOBREX EYE OINTMENT                             2                        FML FORTE                                 3
TOBREX EYE DROPS (tobramycin                                             FML LIQUIFILM (fluorometholone)           3        1
                                                3        1
sulfate)
                                                                         FML S.O.P.                                2
TRIOXIN                                         3
                                                                         LOTEMAX EYE DROPS                         2
VIGAMOX                                         2
                                                                         LOTEMAX EYE OINTMENT                      2
       T3 AF = Tier 3 on Advantage Formulary                                                                                                31
Drug                                           Brand   Generic   Notes   Drug                                    Brand   Generic   Notes

MAXIDEX                                         3                        BSS                                      1
MAXITROL                                                                 BSS PLUS                                 3
                                                3        1
(neomycin-polymyxin-dexameth)
                                                                         carteolol                                         1
NASACORT AQ (triamcinolone acetonide)           3        1
                                                                         CELLUGEL                                 3
NASONEX                                         2
                                                                         FRESHKOTE                                3
neomycin-bacitracin-poly-hc                              1
                                                                         GELFILM OPHT                             3
neomycin-polymyxin-hc                                    1
                                                                         IOPIDINE                                 3
OMNARIS                                         3
                                                                         LACRISERT                                2
OMNIPRED (prednisolone acetate)                 3        1
                                                                         LUCENTIS                                 2
OZURDEX                                         2
                                                                         MACUGEN                                  3
PRED FORTE (prednisolone acetate)               3        1
                                                                         Ocucoat                                  1
PRED MILD                                       2
                                                                         Eent Nonsteroidal Anti-Inflam. Agents
PRED-G                                          3
                                                                         ACULAR (ketorolac)                       3        1
PRED-G S.O.P.                                   3
                                                                         ACULAR LS (ketorolac)                    3        1
prednisolone sodium phosphate                            1
                                                                         ACUVAIL                                  3
RETISERT                                        2
                                                                         BROMDAY                                  3
RHINOCORT AQUA                                  2                T3 AF
                                                                         BROMDAY TWINPACK                         3
TOBRADEX EYE OINTMENT                           2
                                                                         NEVANAC                                  3
TOBRADEX EYE DROPS
                                                3        1               OCUFEN (flurbiprofen sodium)             3        1
(tobramycin-dexamethasone)
TOBRADEX ST                                     2                        VOLTAREN (diclofenac sodium)             3        1

TRIOXIN                                         3                        Local Anesthetics (Eent)

VERAMYST                                        2                T3 AF   AKTEN (PF)                               3

VEXOL                                           3                        ALCAINE (PROPARACAINE)                   3        3

ZYLET                                           2                        ALTAFLUOR                                3

Eent Anti-Infectives, Miscellaneous                                      Aurodex (antipyrine-benzocaine)          1        1

Acetasol HC (hydrocortisone-acetic acid)        1        1               Auroguard (antipyrine-benzocaine)        1        1

acetic acid otic                                         1               BUCALSEP                                 3

acetic acid-aluminum acetate                             1               COCAINE                                           3

BETADINE OPHTHALMIC PREP                        3                        FIRST-BXN                                3

CRESYLATE                                       3                        FLUORESCEIN-PROPARACAINE                          3

OTICIN                                          3                        FLURESS                                  3

PERIDEX (chlorhexidine gluconate)               3        1               FLUROX                                   3

Periogard (chlorhexidine gluconate)             1        1               lidocaine hcl mm                                  1

VOSOL-HC (hydrocortisone-acetic acid)           3        1               Lidocaine Viscous (lidocaine HCl)        1        1

ZINOTIC (WITH GLYCERIN)                         3                        NEOTIC (WITH GLYCERIN)                   3

ZINOTIC ES (WITH GLYCERIN)                      3                        ORASEP                                   3

Eent Anti-Inflammatory Agents, Misc.                                     OTICIN                                   3

RESTASIS                                        2                        PARCAINE (PROPARACAINE)                  3        3

Eent Drugs, Miscellaneous                                                TETCAINE (tetracaine HCl)                3        1

Akorn Balanced Salt                             1                        tetracaine hcl (pf)                               1

ALODOX                                          3                        TETRAVISC                                3

ATROVENT (ipratropium bromide)                  3        1               TETRAVISC FORTE                          3
                                                                         TREAGAN OTIC                             3
BALANCED SALT                                   3
                                                                         TRIOXIN                                  3
32     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

XYLOCAINE MM (lidocaine HCl)                    3        1               ZOFRAN ORAL (ondansetron HCl)              3        1
XYLOCAINE JELLY (lidocaine HCl)                 3        1               ZOFRAN ODT (ondansetron)                   3        1
ZINOTIC (WITH GLYCERIN)                         3                        ZUPLENZ                                    3
ZINOTIC ES (WITH GLYCERIN)                      3                        Anti-Inflammatory Agents (Gi Drugs)
Miotics                                                                  APRISO                                     2
ISOPTO CARBACHOL                                2                        ASACOL                                     2
ISOPTO CARPINE (pilocarpine HCl)                3        1               ASACOL HD                                  2
MIOCHOL-E                                       3                        balsalazide                                         1
MIOSTAT                                         3                        CANASA                                     2
PHOSPHOLINE IODIDE                              2                        DIPENTUM                                   3
PILOPINE HS                                     2                        LIALDA                                     3
Mydriatics                                                               PENTASA                                    2
AK-Pentolate (cyclopentolate)                   1        1               ROWASA (mesalamine-cleansing wipes)        3        1
atropine opht                                            1               SFROWASA (mesalamine)                      3        1
Atropine-Care (atropine)                        1        1               Antidiarrhea Agents
CYCLOGYL                                        3                        LOMOTIL (diphenoxylate-atropine)           3        1
CYCLOMYDRIL                                     3                        loperamide cap                                      1
Homatropaire                                    1                        MOTOFEN                                    2
ISOPTO ATROPINE (atropine)                      3        1               OPIUM TINCTURE                                      3
ISOPTO HOMATROPINE                              3                        paregoric                                           1
ISOPTO HYOSCINE                                 3                        REZYST IM                                  3
MYDRIACYL (tropicamide)                         3        1               VSL#3 DS                                   3
PAREMYD                                         3                        Antiemetics, Miscellaneous
Tropicacyl (tropicamide)                        1        1               CESAMET                                    3
Prostaglandin Analogs                                                    EMEND ORAL                                 2
LATISSE                                         3                        MARINOL (DRONABINOL)                       3        3
LUMIGAN                                         2                T3 AF   TRANSDERM-SCOP                             2
TRAVATAN Z                                      2                        Antiflatulents
XALATAN (latanoprost)                           3        1               SIMETHICONE MISC                                    3
Vasoconstrictors                                                         Antihistamines (Gi Drugs)
ADRENALIN                                       3                        ANTIVERT (meclizine)                       3        1
AK-Con                                          1                        DIMENHYDRINATE INJ                                  3
AK-Dilate                                       1                        prochlorperazine                                    1
Altafrin Eye Drops 10 %                         1                        PROCHLORPERAZINE EDISYLATE
                                                                                                                             3
                                                                         INJECTION 5 MG/ML
MYDFRIN (phenylephrine HCl)                     3        1
                                                                         prochlorperazine maleate oral                       1
Neofrin                                         1
                                                                         TIGAN                                      3
TYZINE                                          3
                                                                         TRIMETHOBENZAMIDE IM                                3
Gastrointestinal Drugs
                                                                         Antiulcer Agents & Acid Suppress., Misc
5-Ht3 Receptor Antagonists
                                                                         HELIDAC                                    3
ANZEMET ORAL                                    2
                                                                         PYLERA                                     2
granisetron oral                                         1
                                                                         Cathartics And Laxatives
GRANISOL                                        3
                                                                         AMITIZA                                    2
ondansetron hcl oral                                     1
SANCUSO                                         2                        ATABEX EC                                  2

       T3 AF = Tier 3 on Advantage Formulary                                                                                                 33
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

CITRANATAL 90 DHA (NEW                                                   Digestants
                                                2
FORMULA
                                                                         CREON CAP 12,000-38,000 -60,000
CITRANATAL DHA (NEW                                                      UNIT, 24,000-76,000 -120,000 UNIT,         2
                                                2
FORMULA)                                                                 6,000-19,000 -30,000 UNIT
CITRANATAL RX (NEW FORMULA)                     2                        HYDROCHLORIC ACID (BULK)                            3
COLYTE WITH FLAVOR PACKS                                                 PANCREAZE                                  3
ORAL SOLUTION 227.1-21.5-6.36                   2
GRAM                                                                     PANCRECARB MS-16                           3

COLYTE WITH FLAVOR PACKS ORAL                                            PANCRECARB MS-4                            3
SOLUTION (peg 3350-electrolytes)                3        1               PANCRECARB MS-8                            3
240-22.72-6.72 GRAM
                                                                         Pancrelipase 5000                          1
COMPLETE-RF PRENATAL                            2
                                                                         ULTRASE EC                                 2
Folcal DHA                                      1
                                                                         ULTRASE MT 12                              2
Folivane-PRx DHA NF                             1
                                                                         ULTRASE MT 18                              2
GLYCOLAX (polyethylene glycol 3350)             3        1
                                                                         ULTRASE MT 20                              2
GOLYTELY (peg 3350-electrolytes)                2        1
                                                                         VIOKASE 16                                 2
HALFLYTELY-BISACODYL W-FLAV
                                                2
PK                                                                       VIOKASE 8                                  2
iNatal Ultra                                    1                        ZENPEP CAP 10,000-34,000 -55,000
                                                                         UNIT, 15,000-51,000 -82,000 UNIT,
MIRALAX ORAL POWDER (polyethylene                                        20,000-68,000 -109,000 UNIT,
                                                3        1                                                          2
glycol 3350)                                                             25,000-85,000- 136,000 UNIT,
MOVIPREP                                        3                        3,000-10,000- 16,000 UNIT, 5,000-17,000
                                                                         -27,000 UNIT
NEXA SELECT                                     3
                                                                         Gi Drugs, Miscellaneous
NULYTELY WITH FLAVOR PACKS
                                                2        1               CIMZIA                                     3
(peg-electrolyte soln)
OBSTETRIX EC                                    2                        ENTEREG                                    3

OBTREX                                          2                        NUTRESTORE                                 3

OSMOPREP                                        3                        RELISTOR                                   2

PEG-3350 with flavor packs                                               XENICAL                                    2
                                                1        1
(peg-electrolyte soln)                                                   Histamine H2-Antagonists
PNV-DHA + Docusate                              1                        AXID CAP (nizatidine)                      3        1
polyethylene glycol 3350 oral                            1               AXID ORAL SOLN (nizatidine)                2        1
PRENEXA                                         2                        cimetidine oral                                     1
SORBITOL SOLN                                            3               DEPRIZINE                                  3
SUPREP                                          3                        PEPCID (famotidine)                        3        1
Taron-Prex Prenatal-DHA                         1                        ranitidine hcl oral                                 1
Tri Rx                                          1                        ZANTAC (ranitidine HCl)                    3        1
TRICARE PRENATAL DHA ONE                        2                        ZANTAC 25 EFFERDOSE                        3
Triveen-PRx RNF                                 1                        Lipotropic Agents
VemaVite-PRx-2                                  1                        lecithin oral granules                              1
Vinacal                                         1                        Prokinetic Agents
Vinate Ultra                                    1                        metoclopramide oral                                 1
Cholelitholytic Agents                                                   METOZOLV ODT                               3
ACTIGALL (ursodiol)                             3        1               REGLAN (metoclopramide)                    3        1
CHENODAL                                        3                        Prostaglandins
URSO 250 (ursodiol)                             3        1               ARTHROTEC 50                               3

URSO FORTE (ursodiol)                           3        1               ARTHROTEC 75                               3

34     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

CYTOTEC (misoprostol)                           3        1               CORTEF (hydrocortisone)                     3        1
Protectants                                                              cortisone oral                                       1
CARAFATE ORAL SUSP                                                       dexamethasone oral soln                              1
                                                2        2
(SUCRALFATE)
                                                                         dexamethasone tab 0.5 mg, 0.75 mg, 1 mg,
                                                                                                                              1
CARAFATE TAB (sucralfate)                       3        1               1.5 mg, 2 mg, 4 mg, 6 mg
Proton-Pump Inhibitors                                                   DEXAMETHASONE INTENSOL                      3
ACIPHEX                                         3                        DEXAMETHASONE SODIUM
                                                                                                                              3
                                                                         PHOSPHATE
DEXILANT                                        3
                                                                         DEXPAK                                      3
NEXIUM                                          2
                                                                         DEXPAK JR.                                  3
NEXIUM PACKET                                   2
                                                                         DULERA                                      2
PREVACID (lansoprazole)                         3        1
                                                                         ENTOCORT EC (budesonide)                    3        1
PREVACID SOLUTAB (lansoprazole)                 3        1
                                                                         FLOVENT DISKUS                              2
PREVPAC                                         3
                                                                         FLOVENT HFA                                 2
PRILOSEC (omeprazole)                           3        1
                                                                         fludrocortisone                                      1
PROTONIX ORAL                                   3
                                                                         KENALOG (TRIAMCINOLONE
PROTONIX ORAL (pantoprazole)                    3        1                                                           3        3
                                                                         ACETONIDE)
VIMOVO                                          3                        MEDROL (methylprednisolone)                 3        1
ZEGERID (omeprazole-sodium                                               MEDROL (PAK) (methylprednisolone)           3        1
                                                3        1
bicarbonate)
                                                                         METHYLPREDNISOLONE ACETATE                           3
Gold Compounds
                                                                         MILLIPRED ORAL SOLN                         3
Gold Compounds
                                                                         Millipred Tab                               1
RIDAURA                                         2
                                                                         Millipred DP                                1
Heavy Metal Antagonists
                                                                         ORAPRED (prednisolone sodium
Heavy Metal Antagonists                                                                                              3        1
                                                                         phosphate)
BAL IN OIL                                      3                        ORAPRED ODT                                 3
CALCIUM DISODIUM VERSENATE                      3                        PEDIAPRED (prednisolone sodium
                                                                                                                     3        1
CHEMET                                          2                        phosphate)

CUPRIMINE                                       2                        prednisone oral                                      1

DEPEN TITRATABS                                 3                        PREDNISONE INTENSOL                         3

DESFERAL (DEFEROXAMINE)                         3        3               PRELONE (prednisolone)                      3        1

EXJADE                                          2                        PULMICORT NEB SUSPENSION 1
                                                                                                                     2
                                                                         MG/2 ML
GALZIN                                          3
                                                                         PULMICORT NEB SUSPENSION
                                                                                                                     3        1
SYPRINE                                         3                        (budesonide) 0.25 MG/2 ML, 0.5 MG/2 ML
Hormones And Synthetic Substitutes                                       PULMICORT FLEXHALER                         2
Adrenals                                                                 QVAR                                        2
ADVAIR DISKUS                                   2                        SYMBICORT                                   2
ADVAIR HFA                                      2                        Alpha-Glucosidase Inhibitors
ALVESCO                                         3                        GLYSET                                      3
ASMALPRED                                       3                        PRECOSE (acarbose)                          3        1
ASMALPRED PLUS                                  3                        Amylinomimetics
ASMANEX TWISTHALER BREATH                                                SYMLIN                                      2
ACTIVATED 110 MCG (30 DOSES),
                                                2                        SYMLINPEN 120                               2
220 MCG (120 DOSES), 220 MCG (30
DOSES), 220 MCG (60 DOSES)
Baycadron (dexamethasone)                       1        1               SYMLINPEN 60                                2
BETAMETHASONE ACET & SOD PHOS                            3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  35
Drug                                           Brand   Generic   Notes   Drug                                  Brand   Generic   Notes

Androgens                                                                RIOMET                                 3
ANDRODERM                                       2                T3 AF   Contraceptives
ANDROGEL TRANSDERMAL GEL                                                 Amethia                                1
PUMP 1.25 G/ACTUATION, 20.25                    2
MG/1.25 GRAM (1.62 %)                                                    Amethia Lo (L norgest&E estradiol-E
                                                                                                                1        1
                                                                         estrad)
ANDROGEL TRANSDERMAL
                                                2                        Apri                                   1
PACKET
ANDROID                                         3                        Aviane                                 1

Androxy                                         1                        BEYAZ                                  2

AXIRON                                          3                        Camila                                 1

Covaryx (estrogens-methyltestosterone)          1        1               Camrese                                1

Covaryx H.S.                                                             Camrese Lo (L norgest&E estradiol-E
                                                1        1                                                      1        1
(estrogens-methyltestosterone)                                           estrad)

danazol oral                                             1               ELLA                                   3

DEPO-TESTOSTERONE (testosterone                                          Gianvi                                 1
                                                3        1
cypionate)                                                               Kariva                                 1
EEMT (estrogens-methyltestosterone)             1        1               Lessina                                1
EEMT HS (estrogens-methyltestosterone)          1        1               LO LOESTRIN FE                         2
FORTESTA                                        3                        LOESTRIN 1.5/30 (21)                   2
METHITEST                                       2                        LOESTRIN 1/20 (21)                     2
OXANDRIN (oxandrolone)                          3        1               LOESTRIN 24 FE                         2
STRIANT                                         3                        LOESTRIN FE 1.5/30 (28)                2
TESTIM                                          2                        LOESTRIN FE 1/20 (28)                  2
TESTOSTERONE ENANTHATE                                   3               LOSEASONIQUE (L norgest&E
                                                                                                                3        1
Antidiabetic Agents, Miscellaneous                                       estradiol-E estrad)

WELCHOL                                         2                        LYBREL                                 3

Antihypoglycemic Agents, Miscellaneous                                   Microgestin 1/20 (21)                  1

PROGLYCEM                                       3                        Microgestin FE 1/20 (28)               1

Antithyroid Agents                                                       Mononessa (28)                         1

Lugols                                          1                        NATAZIA                                2

propylthiouracil                                         1               Necon 0.5/35 (28)                      1

SSKI                                            3                        Necon 1/35 (28)                        1

Strong Iodine Oral                              1                        Necon 1/50 (28)                        1

TAPAZOLE (methimazole)                          3        1               Necon 10/11 (28)                       1

Biguanides                                                               Necon 7/7/7 (28)                       1

ACTOPLUS MET                                    2                        NOR-QD                                 3

ACTOPLUS MET XR                                 3                        NUVARING                               2

FORTAMET (metformin)                            3        1               ORTHO EVRA                             3

glipizide-metformin                                      1               Portia                                 1

GLUCOPHAGE (metformin)                          3        1               SEASONIQUE                             3

GLUCOPHAGE XR (metformin)                       3        1               Sprintec (28)                          1

GLUCOVANCE (glyburide-metformin)                3        1               Syeda                                  1

GLUMETZA                                        3                        YAZ 28                                 2

JANUMET                                         2                        Zovia 1/35E (28)                       1

KOMBIGLYZE XR                                   2
                                                                         Zovia 1/50E (28)                       1
PRANDIMET                                       3
36     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                        Brand   Generic   Notes

Dipeptidyl Peptidase-4(Dpp-4) Inhibitors                                 VAGIFEM                      2
JANUMET                                         2                        VIVELLE-DOT                  2
JANUVIA                                         2                        Glycogenolytic Agents
JUVISYNC                                        2                        GLUCAGEN                     3
KOMBIGLYZE XR                                   2                        GLUCAGEN DIAGNOSTIC KIT      3
ONGLYZA                                         2                        GLUCAGEN HYPOKIT             3
TRADJENTA                                       3                        GLUCAGON EMERGENCY           2
Estrogen Agonist-Antagonists                                             Gonadotropins
CLOMID (clomiphene citrate)                     3        1               BRAVELLE                     2
EVISTA                                          2                        FOLLISTIM AQ                 2
Estrogens                                                                GONAL-F                      3
ACTIVELLA (estradiol-norethindrone                                       GONAL-F RFF                  3
                                                3        1
acet)
                                                                         GONAL-F RFF PEN              3
ALORA                                           3
                                                                         LUVERIS                      3
ANGELIQ                                         3
                                                                         MENOPUR                      3
CENESTIN                                        2
                                                                         NOVAREL (CHORIONIC
                                                                                                      3        2
CLIMARA (estradiol)                             2        1               GONADOTROPIN, HUMAN)
CLIMARA PRO                                     3                        OVIDREL                      2
COMBIPATCH                                      2                        PREGNYL (CHORIONIC
                                                                                                      3        2
                                                                         GONADOTROPIN, HUMAN)
DIVIGEL                                         2
                                                                         REPRONEX                     2
ELESTRIN                                        3
                                                                         SUPPRELIN LA                 2
ENJUVIA                                         2
                                                                         SYNAREL                      2
ESTRACE VAGL                                    2
                                                                         VANTAS                       2
ESTRACE ORAL (estradiol)                        3        1
                                                                         Incretin Mimetics
ESTRADIOL VALERATE                                       3
                                                                         BYETTA                       2
ESTRASORB                                       3
                                                                         VICTOZA                      3
ESTRING                                         2
                                                                         Insulins
ESTROGEL                                        3
                                                                         APIDRA                       2
EVAMIST                                         2
                                                                         APIDRA SOLOSTAR              2
FEMHRT 1/5                                      3
                                                                         HUMALOG                      2                T3 AF
FEMHRT LOW DOSE                                 3
                                                                         HUMALOG KWIKPEN              2                T3 AF
FEMRING                                         3
                                                                         HUMALOG MIX 50-50            2                T3 AF
FEMTRACE                                        3
                                                                         HUMALOG MIX 50-50 KWIKPEN    2                T3 AF
Jevantique                                      1
                                                                         HUMALOG MIX 75-25            2                T3 AF
Jinteli                                         1
                                                                         HUMALOG MIX 75-25 KWIKPEN    2                T3 AF
MENEST                                          3
                                                                         HUMULIN 70/30                2                T3 AF
MENOSTAR                                        3
                                                                         HUMULIN 70/30 PEN            2                T3 AF
OGEN 2.5 (estropipate)                          3        1
                                                                         HUMULIN N                    2                T3 AF
PREFEST                                         3
                                                                         HUMULIN N PEN                2                T3 AF
PREMARIN INJ                                    3
                                                                         HUMULIN R                    2                T3 AF
PREMARIN ORAL                                   2
                                                                         HUMULIN R U-500
PREMARIN VAGL                                   3                                                     2
                                                                         "CONCENTRATED"
PREMPHASE                                       2                        LANTUS                       2

PREMPRO                                         2                        LANTUS SOLOSTAR              2

       T3 AF = Tier 3 on Advantage Formulary                                                                                   37
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

LEVEMIR                                         2                T3 AF   Progesterone in Oil (progesterone)        1        1
LEVEMIR FLEXPEN                                 2                T3 AF   PROMETRIUM                                2
NOVOLIN 70/30                                   2                        PROVERA (medroxyprogesterone)             3        1
NOVOLIN N                                       2                        Somatotropin Agonists
NOVOLIN R                                       2                        EGRIFTA                                   3
NOVOLOG                                         2                        INCRELEX                                  3
NOVOLOG FLEXPEN                                 2                        Somatotropin Antagonists
NOVOLOG MIX 70-30                               2                        SOMAVERT                                  2
NOVOLOG MIX 70-30 FLEXPEN                       2                        Sulfonylureas
NOVOLOG PENFILL                                 2                        AMARYL (glimepiride)                      3        1
Meglitinides                                                             AVANDARYL                                 3
PRANDIMET                                       3                        chlorpropamide                                     1
PRANDIN                                         2                        DIABETA (glyburide)                       3        1
STARLIX (nateglinide)                           3        1               DUETACT                                   2
Parathyroid                                                              glipizide-metformin                                1
FORTEO                                          2                        GLUCOTROL (glipizide)                     3        1
FORTICAL (calcitonin (salmon))                  1        1               GLUCOTROL XL (glipizide)                  3        1
MIACALCIN                                       3                        GLUCOVANCE (glyburide-metformin)          3        1
Pituitary                                                                GLYNASE (glyburide micronized)            3        1
DDAVP (DESMOPRESSIN)                            3        3               tolazamide                                         1
desmopressin nasal spray                                 1               tolbutamide                                        1
GENOTROPIN                                      2                        Thiazolidinediones
GENOTROPIN MINIQUICK                            2                        ACTOPLUS MET                              2
HUMATROPE                                       2                        ACTOPLUS MET XR                           3
NORDITROPIN FLEXPRO                             2                        ACTOS                                     2
NORDITROPIN NORDIFLEX                           2                        AVANDAMET                                 3
NUTROPIN                                        3                        AVANDARYL                                 3
NUTROPIN AQ                                     3                        AVANDIA                                   3
NUTROPIN AQ NUSPIN                              3                        DUETACT                                   2
OMNITROPE                                       3                        Thyroid Agents
PITRESSIN (VASOPRESSIN)                         3        3               ARMOUR THYROID                            3
SAIZEN                                          3                        CYTOMEL (liothyronine)                    3        1
SAIZEN CLICK.EASY                               3                        LEVOTHROID (levothyroxine)                3        1
SEROSTIM                                        3                        LEVOTHYROXINE IV SOLUTION 200
                                                                                                                            3
                                                                         MCG, 500 MCG
STIMATE                                         2
                                                                         Levoxyl (levothyroxine)                   1        1
TEV-TROPIN                                      3
                                                                         NP Thyroid                                1
ZORBTIVE                                        3
                                                                         SYNTHROID (levothyroxine)                 2        1
Progestins
                                                                         Unithroid (levothyroxine)                 1        1
ANGELIQ                                         3
                                                                         Westhroid Tab 130 mg, 195 mg, 32.5 mg,
AYGESTIN (norethindrone acetate)                3        1                                                         1
                                                                         65 mg
CRINONE                                         2
FEMHRT 1/5                                      3
                                                                         WESTHROID TAB 16.25 MG, 260 MG,
                                                                                                                   3
FEMHRT LOW DOSE                                 3                        325 MG, 48.75 MG, 97.5 MG

MAKENA                                          2
38     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                          Brand   Generic   Notes

Miscellaneous Therapeutic Agents                                         Cariostatic Agents
5-Alpha-Reductase Inhibitors                                             Denta 5000 Plus                                1
AVODART                                         2                        DentaGel                                       1
JALYN                                           2                        Epiflur (sodium fluoride)                      1        1
PROSCAR (finasteride)                           3        1               FLUOR-A-DAY                                    3
Alcohol Deterrents                                                       FLUOR-A-DAY (WITH XYLITOL)
                                                                         CHEWABLE TAB 0.25 MG FLUORID
ANTABUSE (disulfiram)                           3        1                                                              2
                                                                         (0.55)-236.79MG, 0.5 MG FLUORIDE
Antidotes                                                                (1.1)-236.79 MG

DUODOTE                                         3                        FLUOR-A-DAY (WITH XYLITOL)
                                                                         CHEWABLE TAB 1 MG FLUORIDE                     3
leucovorin calcium tab 10 mg, 15 mg, 25                                  (2.2)-236.79 MG
                                                         1
mg, 5 mg
                                                                         FLUORABON                                      2
PRALIDOXIME                                              3
                                                                         Fluoritab Chewable (sodium fluoride)           1        1
PROTOPAM CHLORIDE                               3
                                                                         FLURA-DROPS                                    2
Antigout Agents
                                                                         Lozi-Flur                                      1
colchicine-probenecid                                    1
                                                                         Ludent Fluoride (sodium fluoride)              1        1
COLCRYS                                         2
                                                                         Multi Vit-Fluoride-Iron                        1
ULORIC                                          2
                                                                         Multi-Vitamin With Fluoride                    1
ZYLOPRIM (allopurinol)                          3        1
                                                                         Multivitamins-Fluoride-Folic A                 1
Biologic Response Modifiers
                                                                         MVC-FLUORIDE                                   3
ACTIMMUNE                                       2
                                                                         MYKIDZ IRON FLUORIDE                           3
AVONEX                                          2
                                                                         Nafrinse                                       1
AVONEX ADMINISTRATION PACK                      2
                                                                         pediatric multivitamin-fl                               1
BETASERON                                       2                T3 AF
                                                                         PHOS-FLUR DENTAL GEL                           3
COPAXONE                                        2
                                                                         Poly-Vitamin With Fluoride (pediatric
                                                                                                                        1        1
EXTAVIA                                         2                        multivitamin-Fl)

GILENYA                                         2                        Poly-Vitamin/Fluoride/Iron                     1

REBIF                                           2                T3 AF   PREVIDENT                                      3

REBIF TITRATION PACK                            2                T3 AF   PREVIDENT 5000 BOOSTER                         3

REVLIMID                                        2                        PREVIDENT 5000 DRY MOUTH                       3

THALOMID                                        2                        PREVIDENT 5000 PLUS                            3

Bone Resorption Inhibitors                                               PREVIDENT 5000 SENSITIVE                       3

ACTONEL TAB 150 MG, 35 MG, 5 MG                 3                        SF                                             1

ACTONEL TAB 30 MG                               2                        SF 5000 Plus                                   1

alendronate                                              1               sodium fluoride                                         1

ATELVIA                                         3                        stannous fluoride                                       1

BONIVA ORAL                                     2                        Tri-Vit with Fluoride & Iron                   1

DIDRONEL (etidronate disodium)                  3        1               Tri-Vitamin W/Fluoride & Iron                  1

etidronate disodium                                      1               Tri-Vitamin/Fluoride                           1

FOSAMAX (alendronate)                           3        1               Triple Vitamin with Fluoride Oral Drops 0.5
                                                                                                                        1
                                                                         mg/mL
FOSAMAX PLUS D                                  2
                                                                         Trivit/Fluoride                                1
PROLIA                                          3
                                                                         Complement Inhibitors
SKELID                                          3


XGEVA                                           3                        FIRAZYR                                        3


       T3 AF = Tier 3 on Advantage Formulary                                                                                                     39
Drug                                           Brand   Generic   Notes   Drug                                 Brand   Generic   Notes

Disease-Modifying Antirheumatic Agents                                   CARNITOR ORAL (levocarnitine (with
                                                                                                               3        1
                                                                         sugar))
ARAVA (leflunomide)                             3        1
                                                                         CARNITOR SUGAR-FREE                   3
CIMZIA                                          3
                                                                         CRYOSERV                              3
CIMZIA POWDER FOR RECONST                       3
                                                                         CYSTADANE                             2
CIMZIA STARTER KIT                              3
                                                                         CYSTAGON                              2
ENBREL                                          2
                                                                         DEMSER                                2
ENBREL SURECLICK                                2
                                                                         DIVISTA                               3
HUMIRA                                          2
                                                                         DYSPORT                               3
HUMIRA CROHN'S DIS START PCK                    2
                                                                         ELMIRON                               2
HUMIRA PEN                                      2
                                                                         ETHANOL (ETHYL ALCOHOL)                        3
HUMIRA PSORIASIS STARTER PACK                   2
                                                                         FOSTEUM                               3
KINERET                                         3
                                                                         FOVEX                                 3
ORENCIA IV                                      3
                                                                         GASTROMARK                            3
ORENCIA SUBQ                                    3
                                                                         GLUTATHIONE-L                         3
REMICADE                                        2
                                                                         INFLUDO                               3
SIMPONI                                         3
                                                                         KUVAN                                 2
Gonadotropin-Releasing Hormone Antagnts
                                                                         LIPOCHOL PLUS                         3
CETROTIDE                                       2
                                                                         MACUTEK                               3
GANIRELIX                                                3
                                                                         MYOBLOC                               3
Immunosuppressive Agents
                                                                         NEXAVIR                               3
AZASAN                                          2
                                                                         NICAZEL                               3
AZATHIOPRINE SODIUM                                      3
                                                                         NPLATE                                2
CELLCEPT ORAL SUSP                              2
                                                                         octreotide acetate syringe                     1
CELLCEPT CAP (mycophenolate mofetil)            3        1
                                                                         ORFADIN                               2
CELLCEPT TAB (mycophenolate mofetil)            3        1
                                                                         POTABA                                3
cyclosporine modified cap 50 mg                          1
                                                                         PRYFLEX                               3
Gengraf (cyclosporine modified)                 1        1
                                                                         QUINZYME                              3
IMURAN (azathioprine)                           3        1
                                                                         Relamine                              1
MYFORTIC                                        3
                                                                         SANDOSTATIN (octreotide acetate)      3        1
NEORAL (cyclosporine modified)                  2        1
                                                                         SANDOSTATIN LAR DEPOT                 2
PROGRAF ORAL (tacrolimus)                       3        1
                                                                         SENSIPAR                              2
RAPAMUNE                                        2
                                                                         SODIUM BISULFITE                               3
SANDIMMUNE ORAL                                 2
                                                                         SOMATULINE DEPOT                      2
SANDIMMUNE ORAL (cyclosporine)                  2        1
                                                                         THIOLA                                3
ZORTRESS                                        3
                                                                         Protective Agents
Other Miscellaneous Therapeutic Agents
                                                                         MESNEX ORAL                           2
acetylcysteine soln                                      1
                                                                         Oxytocics
AMPYRA                                          3
                                                                         Oxytocics
ARCALYST                                        2
                                                                         CERVIDIL                              3
AVAILNEX                                        3
                                                                         HEMABATE                              3
BOTOX                                           3
                                                                         METHERGINE ORAL (methylergonovine)    3        1
BOTOX COSMETIC                                  3
                                                                         METHYLERGONOVINE INJ                           3
CARDIOVID PLUS                                  3
CARNITOR ORAL (levocarnitine)                   3        1               MIFEPREX                              3
40     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                    Brand   Generic   Notes

OXYTOCIN                                                 3               MAXIFED CDX                              3
PREPIDIL                                        3                        MAXIFED-G CD                             3
PROSTIN E2                                      3                        MAXIFED-G CDX                            3
Pharmaceutical Aids                                                      MAXIFLU CD                               3
Pharmaceutical Aids                                                      MAXIFLU CDX                              3
ALUMINUM MONOSTEARATE                                    3               NEO DM                                   3
BACTERIOSTATIC                                                           NEOTUSS-D                                3
                                                3
WATER(PARABENS)
                                                                         Neutrahist                               1
SODIUM SUCCINATE                                         3
                                                                         Neutrahist PDX                           1
SPECTRAGEL                                      3
                                                                         PEDIATEX TD                              3
STEARIC ACID                                             3
                                                                         Phenylhistine DH                         1
Respiratory Tract Agents
                                                                         POLY HIST NC                             3
Alpha And Beta Adrenergic Agonist(Respr)
                                                                         PSEUDOEPHEDRINE TAB 60 MG                         3
ADRENACLICK                                     3
                                                                         RESPA-AR                                 3
Adrenalin (epinephrine)                         1        1
                                                                         RESPAIRE-30                              3
ALLERX 10                                       3
                                                                         Ru-Tuss DM                               1
ALLERX 30                                       3
                                                                         SEMPREX-D                                3
ALLERX-D                                        3
                                                                         STAHIST (REFORMULATED)                   3
AMBIFED                                         3
                                                                         SudaHist                                 1
AMBIFED CD                                      3
                                                                         SudaTex-DM                               1
AMBIFED CDX                                     3
                                                                         Suttar-2                                 1
AMBIFED DM                                      3
                                                                         Suttar-SF                                1
AMBIFED-G CD                                    3
                                                                         TEKRAL                                   3
AMBIFED-G CDX                                   3
                                                                         Trip-PSE                                 1
BROMFED DM                                      3
                                                                         Tusnel C                                 1
BROVEX PD                                       3
                                                                         TUSNEL NEW FORMULA                       3
BROVEX PSB                                      3
                                                                         TUSNEL PED-C                             3
BROVEX SR                                       3
                                                                         Tusnel Pediatric Oral Drops              1
CLARINEX-D 12 HOUR                              2
                                                                         TUSNEL PEDIATRIC ORAL LIQUID             3
CLARINEX-D 24 HOUR                              2
                                                                         TUSNEL-DM PEDIATRIC                      3
Despec-EXP                                      1
                                                                         TWINJECT AUTOINJECTOR                    3
ENDACOF-DC                                      3
                                                                         ZYRTEC-D                                 3
EPHEDRINE SULFATE INJ                                    3
                                                                         Anticholinergic Agents (Respir.Tract)
epinephrine (pf)                                         1
                                                                         ATROPEN                                  3
epinephrine hcl                                          1
                                                                         ATROPINE INJ                                      3
EPIPEN                                          2
                                                                         ATROVENT HFA                             2
EPIPEN JR                                       2
                                                                         COMBIVENT                                2
ExeFen-IR                                       1
                                                                         DUONEB (ipratropium-albuterol)           3        1
Hist-PSE                                        1
                                                                         ipratropium bromide                               1
J-TAN D PD                                      3
                                                                         LOMOTIL (diphenoxylate-atropine)         3        1
LoHist - D                                      1
                                                                         SPIRIVA WITH HANDIHALER                  2
LoHist 12D                                      1
                                                                         STAHIST (REFORMULATED)                   3
LORTUSS EX                                      3
                                                                         Antitussives
MAXIFED CD                                      3                        ALA-HIST AC                              3
       T3 AF = Tier 3 on Advantage Formulary                                                                                               41
Drug                                           Brand   Generic   Notes   Drug                                Brand   Generic   Notes

ALA-HIST DHC                                    3                        HYDROCODONE-HOMATROPINE
                                                                                                                       3
                                                                         SYRUP
ALA-HIST DM                                     3
                                                                         Iophen C-NR (codeine-guaifenesin)    1        1
Allfen DM                                       1
                                                                         Iophen DM-NR                         1
AMBIFED CD                                      3
                                                                         J-COF DHC                            3
AMBIFED CDX                                     3
                                                                         J-MAX DHC                            3
AMBIFED DM                                      3
                                                                         LEXUSS 210                           3
AMBIFED-G CD                                    3
                                                                         LOHIST-DM                            3
AMBIFED-G CDX                                   3
                                                                         LORTUSS EX                           3
BIOTUSS                                         3
                                                                         M-CLEAR                              1
Biotuss Pediatric                               1
                                                                         M-Clear WC                           1
BROMFED DM                                      3
                                                                         M-END PE                             3
BRONKIDS                                        3
                                                                         M-End WC                             1
BRONTUSS SF                                     3
                                                                         MAR-COF BP                           3
BROVEX CB                                       3
                                                                         MAR-COF CG                           3
BROVEX CBX                                      3
                                                                         MAXIFED CD                           3
BROVEX PB C                                     3
                                                                         MAXIFED CDX                          3
BROVEX PB CX                                    3
                                                                         MAXIFED-G CD                         3
BROVEX PEB DM                                   3
                                                                         MAXIFED-G CDX                        3
BROVEX PSB                                      3
                                                                         MAXIFLU CD                           3
CAPCOF                                          3
                                                                         MAXIFLU CDX                          3
CARBA-XP                                        3
                                                                         MAXIPHEN CD                          3
Carbatuss                                       1
                                                                         MAXIPHEN CDX                         3
CARBATUSS-12                                    3
                                                                         MAXIPHEN DM                          3
CARBATUSS-CL                                    3
                                                                         Mesehist WC                          1
Centergy DM                                     1
                                                                         MyHist-DM                            1
codeine sulfate                                          1
                                                                         NASOHIST DM                          3
Corfen-DM                                       1
                                                                         NASOTUSS                             3
COTAB A                                         3
                                                                         NEO AC                               3
COTAB AX                                        3
                                                                         NEO DM                               3
COTABFLU                                        3
                                                                         NEOTUSS-D                            3
De-Chlor DM                                     1
                                                                         Neutrahist PDX                       1
DESPEC-PDC                                      3
                                                                         NOHIST DMX                           3
Dex-Tuss                                        1
                                                                         NUEDEXTA                             2
DEXTROMETHORPHAN-GUAIFENESI
                                                         3
N                                                                        PE-Hist DM                           1
DiHydro-PE                                      1                        PHENFLU CD                           3
DONATUSS DC                                     3                        PHENFLU CDX                          3
DONATUSSIN DM                                   3                        Phenylhistine DH                     1
ED DM                                           1                        POLY HIST DHC                        3
ENDACOF-C                                       3                        POLY HIST NC                         3
ENDACOF-DC                                      3                        POLY-TUSSIN AC                       3
GENTEX 30                                       3                        POLY-TUSSIN DHC                      3
GILTUSS PED-C                                   3                        POLY-TUSSIN EX                       3

Giltuss TR Cap                                  1                        PRO-CLEAR AC                         3
42     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                Brand   Generic   Notes

PRO-CLEAR CAPS                                  3                        BIOTUSS                              3
PRO-RED AC                                      3                        Biotuss Pediatric                    1
Promethazine VC-Codeine                                                  BRONCOMAR-1                          3
                                                1        1
(phenyleph-promethazine-cod)
                                                                         BRONTUSS SF                          3
promethazine-codeine                                     1
                                                                         CARBA-XP                             3
promethazine-dm                                          1
                                                                         Carbatuss                            1
Pyril DM                                        1
                                                                         CARBATUSS-CL                         3
RelCof C                                        1
                                                                         COPD                                 3
Robafen AC (codeine-guaifenesin)                1        1
                                                                         Despec-EXP                           1
Ru-Tuss DM                                      1
                                                                         Dex-Tuss                             1
Rydex                                           1
                                                                         DEXTROMETHORPHAN-GUAIFENESI
                                                                                                                       3
SERADEX                                         3                        N
SudaTex-DM                                      1                        DIFIL-G 400                          3
Suttar-2                                        1                        DILEX-G 200                          3
Suttar-SF                                       1                        DILEX-G 400                          3
TESSALON (benzonatate)                          3        1               DONATUSS DC                          3
TESSALON PERLES (benzonatate)                   3        1               DONATUSSIN PEDI
                                                                                                              3
                                                                         (REFORMULATED)
TL-Hist CD                                      1
                                                                         dyphylline-guaifenesin                        1
TL-HIST CM                                      3
                                                                         ExeFen-IR                            1
Trexbrom                                        1
                                                                         GENTEX 30                            3
TUSNEL                                          3
                                                                         GILTUSS PED-C                        3
Tusnel C                                        1
                                                                         Giltuss TR Cap                       1
Tusnel Diabetic                                 1
                                                                         Iophen C-NR (codeine-guaifenesin)    1        1
TUSNEL NEW FORMULA                              3
                                                                         Iophen DM-NR                         1
TUSNEL PED-C                                    3
                                                                         Iophen-NR                            1
TUSNEL PEDIATRIC                                3
                                                                         J-MAX DHC                            3
TUSNEL-DM PEDIATRIC                             3
                                                                         JAY-PHYL                             3
TUSSICAPS                                       2
                                                                         LORTUSS EX                           3
TUSSIGON                                        3
                                                                         Lugols                               1
TUSSIONEX PENNKINETIC ER
                                                2        1
(chlorpheniramine-hydrocodone)                                           Lusair                               1
VANACOF CD                                      3                        M-CLEAR                              1
ZONATUSS                                        3                        M-Clear WC                           1
ZOTEX-C                                         3                        MAR-COF CG                           3
Expectorants                                                             MAXIFED CD                           3
ALLFEN CD                                       3                        MAXIFED CDX                          3
ALLFEN CDX                                      3                        MAXIFED-G CD                         3
Allfen DM                                       1                        MAXIFED-G CDX                        3
AMBIFED                                         3                        MAXIFLU CD                           3
AMBIFED CD                                      3                        MAXIFLU CDX                          3
AMBIFED CDX                                     3                        Maxiphen                             1
AMBIFED DM                                      3                        MAXIPHEN CD                          3
AMBIFED-G CD                                    3                        MAXIPHEN CDX                         3

AMBIFED-G CDX                                   3                        MAXIPHEN DM                          3

       T3 AF = Tier 3 on Advantage Formulary                                                                                           43
Drug                                           Brand   Generic   Notes   Drug                        Brand   Generic   Notes

NEOTUSS-D                                       3                        BROVEX PSB                   3
Organ-I NR (guaifenesin)                        1        1               BROVEX SR                    3
PHENFLU CD                                      3                        CAPCOF                       3
PHENFLU CDX                                     3                        CENTERGY                     3
POLY-TUSSIN EX                                  3                        Centergy DM                  1
PRO-CLEAR CAPS                                  3                        clemastine syrup                      1
RelCof C                                        1                        CLEMASTINE TAB                        3
RESPAIRE-30                                     3                        Corfen-DM                    1
Robafen AC (codeine-guaifenesin)                1        1               COTAB A                      3
Ru-Tuss DM                                      1                        COTAB AX                     3
SSKI                                            3                        COTABFLU                     3
Strong Iodine Oral                              1                        cyproheptadine                        1
SudaTex-DM                                      1                        DALLERGY                     3
Suttar-2                                        1                        De-Chlor DM                  1
Suttar-SF                                       1                        DESPEC-PDC                   3
TUSNEL                                          3                        DICOPANOL                    3
Tusnel C                                        1                        DIGEX NF                     3
Tusnel Diabetic                                 1                        DiHydro-PE                   1
TUSNEL NEW FORMULA                              3                        DIPHENHYDRAMINE CAP 25 MG             3
TUSNEL PED-C                                    3                        diphenhydramine cap 50 mg             1
Tusnel Pediatric Oral Drops                     1                        diphenhydramine elixir                1
TUSNEL PEDIATRIC ORAL LIQUID                    3                        DIPHENHYDRAMINE HCL INJ               3
TUSNEL-DM PEDIATRIC                             3                        DONATUSSIN DM                3
First Generation Antihist.(Respir Tract)                                 Doxytex                      1
ALA-HIST DM                                     3                        DURAXIN                      3
ALA-HIST LQ                                     3                        ED A-HIST                    3
ALDEX AN                                        3                        ED DM                        1
ALLERX 10                                       3                        ENDACOF-C                    3
ALLERX 30                                       3                        Gastrinex NF                 1
ALLERX DF                                       3                        Hist-PSE                     1
ALLERX DF 30                                    3                        J-COF DHC                    3
ALLERX PE                                       3                        J-TAN D PD                   3
ANABAR                                          3                        J-TAN PD                     3
BROMFED DM                                      3                        LEXUSS 210                   3
BRONKIDS                                        3                        LoHist - D                   1
BROVEX                                          3                        LOHIST 12                    3
BROVEX ADT                                      3                        LoHist 12D                   1
BROVEX CB                                       3                        LOHIST-DM                    3
BROVEX CBX                                      3                        M-END PE                     3
BROVEX PB C                                     3                        M-End WC                     1
BROVEX PB CX                                    3                        MAR-COF BP                   3
BROVEX PD                                       3                        Mesehist WC                  1
BROVEX PEB                                      3                        MyHist-DM                    1
BROVEX PEB DM                                   3                        MYHIST-PD                    3
44     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                       Brand   Generic   Notes

NASOHIST                                        3                        TEKRAL                                      3
NASOHIST DM                                     3                        TL-Hist CD                                  1
NASOTUSS                                        3                        TL-HIST CM                                  3
NEO AC                                          3                        Trip-PSE                                    1
NEO DM                                          3                        TUSNEL                                      3
NEOTUSS-D                                       3                        TUSSICAPS                                   2
Neutrahist                                      1                        TUSSIONEX PENNKINETIC ER
                                                                                                                     2        1
                                                                         (chlorpheniramine-hydrocodone)
Neutrahist PDX                                  1
                                                                         V-HIST                                      3
NOHIST ER TAB                                   3
                                                                         VANACOF CD                                  3
NOHIST DMX                                      3
                                                                         ZOTEX-C                                     3
NOTUSS-NX                                       3
                                                                         Leukotriene Modifiers
NOTUSS-NXD                                      3
                                                                         ACCOLATE (zafirlukast)                      3        1
PALGIC Oral Liquid                              1
                                                                         SINGULAIR                                   2
PALGIC TAB                                      3
                                                                         ZYFLO                                       3
PE-Hist DM                                      1
                                                                         ZYFLO CR                                    3
PEDIATEX TD                                     3
                                                                         Mast-Cell Stabilizers
PHENA-PLUS                                      3
                                                                         ALOCRIL                                     3
PHENA-S                                         3
                                                                         cromolyn inhl                                        1
PHENA-S 12                                      3
                                                                         cromolyn opht                                        1
Phenylhistine DH                                1
                                                                         GASTROCROM (cromolyn)                       3        1
POLY HIST DHC                                   3
                                                                         Mucolytic Agents
POLY HIST NC                                    3
                                                                         acetylcysteine soln                                  1
POLY-TUSSIN AC                                  3
                                                                         Nasal Preparations (Steroids)
POLY-TUSSIN DHC                                 3
                                                                         BECONASE AQ                                 3
PRO-CLEAR AC                                    3
                                                                         FLONASE (fluticasone)                       3        1
PRO-RED AC                                      3
                                                                         flunisolide                                          1
PROMETHAZINE INJ                                         3
                                                                         NASACORT AQ (triamcinolone acetonide)       3        1
promethazine oral                                        1
                                                                         NASONEX                                     2
Promethazine VC                                 1
                                                                         OMNARIS                                     3
Promethazine VC-Codeine
                                                1        1
(phenyleph-promethazine-cod)                                             RHINOCORT AQUA                              2                T3 AF
promethazine-codeine                                     1               VERAMYST                                    2                T3 AF
promethazine-dm                                          1               Non-Select.Beta-Adrenergic Agont(Respir)
PROTID                                          3                        ISUPREL                                     3
PYRIL D                                         3                        Orally Inhaled Preparations (Steroids)
Pyril DM                                        1                        ADVAIR DISKUS                               2
RESCON                                          3                        ADVAIR HFA                                  2
RESCON JR                                       3                        ALVESCO                                     3
RESCON-MX                                       3                        ASMANEX TWISTHALER BREATH
                                                                         ACTIVATED 110 MCG (30 DOSES),
RESPA-AR                                        3                                                                    2
                                                                         220 MCG (120 DOSES), 220 MCG (30
RU-HIST FORTE                                   3                        DOSES), 220 MCG (60 DOSES)

Rydex                                           1                        DULERA                                      2

STAHIST (REFORMULATED)                          3                        FLOVENT DISKUS                              2

SudaHist                                        1                        FLOVENT HFA                                 2

       T3 AF = Tier 3 on Advantage Formulary                                                                                                  45
Drug                                           Brand   Generic   Notes   Drug                                      Brand   Generic   Notes

PULMICORT NEB SUSPENSION 1                                               VENTOLIN HFA                               3
                                                2
MG/2 ML
                                                                         VOSPIRE ER (albuterol sulfate)             3        1
PULMICORT NEB SUSPENSION
                                                3        1               XOPENEX                                    2
(budesonide) 0.25 MG/2 ML, 0.5 MG/2 ML
PULMICORT FLEXHALER                             2                        XOPENEX HFA                                2                T3 AF

QVAR                                            2                        Vasodilating Agents (Respiratory Tract)

SYMBICORT                                       2                        ADCIRCA                                    3

Phosphodiesterase Type 4 Inhibitors                                      REMODULIN                                  2

DALIRESP                                        2                        REVATIO ORAL                               2

Pulmonary Surfactants                                                    TRACLEER                                   2

CUROSURF                                        3                        TYVASO                                     2

INFASURF                                        3                        TYVASO REFILL KIT                          2

SURVANTA                                        3                        TYVASO STARTER KIT                         2

Respiratory Tract Agents, Miscellaneous                                  Xanthine Derivatives

XOLAIR                                          3                        aminophylline oral                                  1

Second Generation Antihist(Respir Tract)                                 BRONCOMAR-1                                3

cetirizine oral soln 1 mg/ml                             1               COPD                                       3

CLARINEX                                        2                        DIFIL-G 400                                3

CLARINEX-D 12 HOUR                              2                        DILEX-G 200                                3

CLARINEX-D 24 HOUR                              2                        DILEX-G 400                                3

SEMPREX-D                                       3                        DYLIX                                      3

XYZAL (levocetirizine)                          3        1               dyphylline-guaifenesin                              1

ZYRTEC CHEWABLE TAB                             3                        ELIXOPHYLLIN                               2

ZYRTEC TAB                                      3                        JAY-PHYL                                   3

ZYRTEC-D                                        3                        LUFYLLIN                                   3

Select.Beta-2-Adrenergic Agonist(Respir)                                 THEO-24                                    3

ACCUNEB (albuterol sulfate)                     3        1               Theochron (theophylline)                   1        1

ADVAIR DISKUS                                   2                        theophylline er 12 hr tab                           1

ADVAIR HFA                                      2                        theophylline er tab                                 1

albuterol sulfate                                        1               theophylline oral soln                              1

BROVANA                                         3                        Serums, Toxoids, And Vaccines

COMBIVENT                                       2                        Serums

DULERA                                          2                        HIZENTRA                                   2

DUONEB (ipratropium-albuterol)                  3        1               Skin And Mucous Membrane Agents

FORADIL AEROLIZER                               2                        Allylamines (Skin & Mucous Membrane)

MAXAIR AUTOHALER                                2                        LAMISIL                                    3

metaproterenol oral                                      1               NAFTIN                                     3

PERFOROMIST                                     2                        Anti-Inflammatory Agents (Skin & Mucous)

PROAIR HFA                                      2                        ACLOVATE (alclometasone)                   3        1

PROVENTIL HFA                                   3                        Ala-Cort (hydrocortisone)                  1        1

SEREVENT DISKUS                                 2                        ALA-SCALP                                  3

SYMBICORT                                       2                        alclometasone                                       1

terbutaline oral                                         1               ALCORTIN A                                 3


TERBUTALINE SUBQ                                         3               amcinonide                                          1

46     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                           Brand   Generic   Notes

ANALPRAM E                                                               Fluocinonide-E (fluocinonide-emollient)         1        1
                                                2        1
(hydrocortisone-pramox-E-pram#1)
                                                                         Halac                                           1
ANALPRAM-HC
                                                2        1               HALOG                                           3
(hydrocortisone-pramoxine)
ANALPRAM-HC SINGLES                                                      Halonate                                        1
                                                2        1
(hydrocortisone-pramoxine)                                               Halonate Pac                                    1
Anucort-HC (hydrocortisone acetate)             1        1               Hemril-30 (hydrocortisone acetate)              1        1
ANUSOL-HC (hydrocortisone acetate)              2        1               HYDROCORTISONE LOTION 1 %                                3
APEXICON (diflorasone)                          3        1               hydrocortisone lotion 2.5 %                              1
ApexiCon E                                      1                        hydrocortisone ointment 1 %, 2.5 %                       1
betamethasone dipropionate                               1               HYDROCORTISONE TOPICAL CREAM
                                                                                                                                  3
betamethasone valerate                                   1               0.5 %

CAPEX                                           2                        hydrocortisone topical cream 2.5 %                       1

CARMOL HC                                       2                        hydrocortisone acet-aloe vera                            1

CLOBEX                                          2                        hydrocortisone valerate                                  1

CLODERM                                         3                        KENALOG                                         3

COLOCORT (hydrocortisone)                       3        1               LIDAMANTLE HC                                   3

CORDRAN LOTION                                  3                        lidocaine-hydrocortisone rectal kit 3-1 % (7
                                                                                                                                  1
                                                                         g)
CORDRAN TAPE                                    2
                                                                         LIDOCORT
                                                                                                                         3        1
CORDRAN SP                                      3                        (lidocaine-hydrocortisone-aloe)
Cormax Ointment (clobetasol)                    1        1               LOCOID LOTION                                   2
CORMAX TOPICAL SOLN (clobetasol)                3        1               LOCOID OINTMENT (hydrocortisone
                                                                                                                         3        1
                                                                         butyrate)
CORTENEMA (hydrocortisone)                      3        1
                                                                         LOCOID TOPICAL CREAM
CORTIFOAM                                       2                                                                        3        1
                                                                         (hydrocortisone butyrate)
CUTIVATE (fluticasone)                          3        1               LOCOID TOPICAL SOLN (hydrocortisone
                                                                                                                         3        1
DERMA-SMOOTH/FS BODY OIL                        3                        butyrate)

DERMA-SMOOTHE/FS SCALP OIL                      3                        LOCOID LIPOCREAM                                2

DERMATOP (PREDNICARBATE)                        3        3               LOKARA (desonide)                               3        1

DESONATE                                        3                        LUXIQ                                           3

desonide                                                 1               MOMEXIN                                         3

DESOWEN (desonide)                              3        1               NOVACORT                                        3

DESOWEN OINTMENT & LOTION                       3                        NUCORT                                          3

diflorasone                                              1               OLUX (clobetasol)                               3        1

DIPROLENE (betamethasone, augmented)            3        1               OLUX-E                                          3

DIPROLENE AF (betamethasone,                                             ORALONE (triamcinolone acetonide)               3        1
                                                3        1
augmented)                                                               PANDEL                                          3
ELOCON (mometasone)                             3        1               PEDIADERM HC                                    3
EPIFOAM                                         3                        PEDIADERM TA                                    3
FIRST-DUKE'S                                    3                        PRAMOSONE LOTION                                2
FIRST-HYDROCORTISONE                            3                        PRAMOSONE OINTMENT                              2
FIRST-MARY'S MOUTHWASH                          3                        PRAMOSONE TOPICAL CREAM 1-1 %                   3
fluocinolone ointment                                    1               PRAMOSONE TOPICAL CREAM
                                                                                                                         2        1
fluocinolone topical cream                               1               (hydrocortisone-pramoxine) 2.5-1 %

fluocinolone topical soln                                1               PRAMOSONE E                                     2


fluocinonide                                             1               Procto-Pak                                      1

       T3 AF = Tier 3 on Advantage Formulary                                                                                                      47
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

PROCTOCORT (hydrocortisone acetate)             3        1               BENZAMYCIN (erythromycin-benzoyl
                                                                                                                    3       1
                                                                         peroxide)
PROCTOCREAM-HC                                  2
                                                                         BENZAMYCINPAK
PROCTOFOAM HC                                   2                                                                   3       1
                                                                         (erythromycin-benzoyl peroxide)
Proctosol HC                                    1                        CENTANY (mupirocin)                        3       1
Proctozone-HC                                   1                        CENTANY AT                                 3
RIMSO-50                                        3                        CLEOCIN VAGL                               3
TACLONEX                                        3                        CLEOCIN VAGL (clindamycin phosphate)       3       1
TACLONEX SCALP                                  3                        CLEOCIN T (clindamycin phosphate)          3       1
TEMOVATE (clobetasol)                           3        1               Clinda-Derm (clindamycin phosphate)        1       1
TEMOVATE E (clobetasol-emollient)               3        1               CLINDAGEL (clindamycin phosphate)          3       1
TEXACORT                                        3                        CLINDAMAX (clindamycin phosphate)          3       1
TOPICORT OINTMENT 0.05 %                        3                        CLINDAREACH                                3
TOPICORT OINTMENT (desoximetasone)                                       CLINDESSE                                  2
                                                3        1
0.25 %
                                                                         CORTISPORIN                                3
TOPICORT TOPICAL CREAM
                                                3        1
(desoximetasone)                                                         Emgel (erythromycin with ethanol)          1       1
TOPICORT TOPICAL GEL                                                     Ery Pads (erythromycin with ethanol)       1       1
                                                3        1
(desoximetasone)
                                                                         EVOCLIN (clindamycin phosphate)            3       1
TOPICORT LP (desoximetasone)                    3        1
                                                                         FIRST-MARY'S MOUTHWASH                     3
triamcinolone acetonide lotion                           1
                                                                         gentamicin top                                     1
triamcinolone acetonide ointment 0.025 %,
                                                         1               METROCREAM (metronidazole)                 3       1
0.1 %, 0.5 %
TRIAMCINOLONE ACETONIDE                                                  METROGEL                                   2
                                                         3
OINTMENT 0.05 %                                                          METROGEL VAGINAL (metronidazole)           3       1
triamcinolone acetonide topical cream                    1               METROLOTION (metronidazole)                3       1
Triderm (triamcinolone acetonide)               1        1               metronidazole                                      1
U-CORT                                          3                        NEOSPORIN GU IRRIGANT
                                                                                                                    3       3
ULTRAVATE (halobetasol propionate)              3        1               (NEOMYCIN-POLYMYXIN B GU)

ULTRAVATE PAC                                   3                        NORITATE                                   3

VANOS                                           3                        TRIPLE ANTIBIOTIC TOPICAL
                                                                                                                    3
                                                                         PACKET
VANOXIDE-HC                                     3
                                                                         Vandazole (metronidazole)                  1       1
VERDESO                                         3
                                                                         VELTIN                                     3
WESTCORT (hydrocortisone valerate)              3        1
                                                                         Vitazol (metronidazole)                    1       1
XERESE                                          3
                                                                         ZIANA                                      3
ZYPRAM                                          3
                                                                         Antifulgals(Skin & Mucous Membrane),Misc
Antibacterials (Skin & Mucous Membrane)
                                                                         EXODERM                                    3
ACANYA                                          2
                                                                         TRIPLE DYE TOPICAL SWAB                    3
AKNE-MYCIN                                      3
                                                                         VERSICLEAR                                 3
ALTABAX                                         3
                                                                         Antifungals (Skin & Mucous Membrane)
BACITRACIN (BULK) POWDER 5
                                                         2               ALA-QUIN                                   3
MILLION UNIT
BACTROBAN (mupirocin)                           3        1               BENSAL HP                                  3

BENZACLIN (clindamycin-benzoyl                                           LOTRISONE (clotrimazole-betamethasone)     3       1
                                                2        1
peroxide)                                                                MENTAX                                     2
                                                                         Antipruritics And Local Anesthetics
BENZACLIN PUMP
                                                2        1
(clindamycin-benzoyl peroxide)
                                                                         AMERICAINE ANESTHETIC                      3

48     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

ANACAINE                                        3                        DRYSOL DAB-O-MATIC                        3
ANALPRAM E                                                               Hypercare                                 1
                                                2        1
(hydrocortisone-pramox-E-pram#1)
                                                                         XERAC AC                                  3
ANALPRAM-HC
                                                2        1               Azoles (Skin & Mucous Membrane)
(hydrocortisone-pramoxine)
ANALPRAM-HC SINGLES                                                      clotrimazole mm                                    1
                                                2        1
(hydrocortisone-pramoxine)                                               clotrimazole top                                   1
CETACAINE                                       3                        econazole top                                      1
CETACAINE ANESTHETIC                            3                        ERTACZO                                   3
CETACAINE MEDICAL KIT E                         3                        EXELDERM                                  3
EMLA (lidocaine-prilocaine)                     3        1               EXTINA (ketoconazole)                     3        1
EPIFOAM                                         3                        ketoconazole topical cream                         1
ETHYL CHLORIDE                                           3               Miconazole-3 Vaginal Suppository          1
EXACTACAIN                                      3                        NIZORAL (ketoconazole)                    3        1
FIRST-BXN                                       3                        OXISTAT                                   3
FIRST-DUKE'S                                    3                        TERAZOL 3 (terconazole)                   3        1
FIRST-MARY'S MOUTHWASH                          3                        TERAZOL 7 (terconazole)                   3        1
lidocaine ointment                                       1               VUSION                                    3
lidocaine-hydrocortisone rectal kit 3-1 % (7                             XOLEGEL                                   3
                                                         1
g)
                                                                         ZAZOLE Vaginal Cream (terconazole) 0.4
LIDOCORT                                                                                                           1        1
                                                3        1               %
(lidocaine-hydrocortisone-aloe)
                                                                         ZAZOLE VAGINAL CREAM
LIDODERM                                        2                                                                  3        1
                                                                         (terconazole) 0.8 %
LTA PRE-ATTACHED                                3                        ZAZOLE Vaginal Suppository
                                                                                                                   1        1
NOVACORT                                        3                        (terconazole)

PAIN EASE                                       3                        Basic Lotions And Liniments

phenazopyridine                                          1               ATOPICLAIR                                3

PHENAZOPYRIDINE PLUS                            3                        LAC-HYDRIN (ammonium lactate)             3        1

PONTOCAINE TOPICAL SOLN                         3                        LAClotion (ammonium lactate)              1        1

PRAMOSONE LOTION                                2                        lactic acid                                        1

PRAMOSONE OINTMENT                              2                        PruClair                                  1

PRAMOSONE TOPICAL CREAM 1-1 %                   3                        Basic Oils And Other Solvents

PRAMOSONE TOPICAL CREAM                                                  BIAFINE EMULSION                          3
                                                2        1
(hydrocortisone-pramoxine) 2.5-1 %                                       MURI-LUBE                                 3
PRAMOSONE E                                     2                        OLIVE OIL                                          3
PRUDOXIN                                        3                        PruTect                                   1
SPRAY AND STRETCH                               3                        Basic Ointments And Protectants
SYNERA                                          3                        ELETONE                                   3
ZONALON                                         3                        LAC-HYDRIN (ammonium lactate)             3        1
ZYPRAM                                          3                        Lactic Acid E                             1
Antivirals (Skin & Mucous Membrane)                                      LANOLIN (BULK) TOP                                 3
DENAVIR                                         3                        XCLAIR                                    3
XERESE                                          3                        Basic Powders And Demulcents
ZOVIRAX                                         2                        ZINC STEARATE                                      3
Astringents                                                              Cell Stimulants And Proliferants
aluminum acetate top                                     1               ATRALIN                                   3

       T3 AF = Tier 3 on Advantage Formulary                                                                                                49
Drug                                           Brand   Generic   Notes   Drug                                     Brand   Generic   Notes

Avita Topical Cream (tretinoin)                 1        1               Drithocreme HP                            1
AVITA TOPICAL GEL (tretinoin)                   3        1               ZITHRANOL-RR                              3
REFISSA (TRETINOIN (EMOLLIENT))                 3        3               Local Anti-Infectives, Miscellaneous
RENOVA                                          3                        ACID JELLY                                3
RETIN-A (tretinoin)                             3        1               ALCOHOL PREP PADS (alcohol swabs)         3        1
RETIN-A MICRO                                   3                        ALCORTIN A                                3
RETIN-A MICRO PUMP                              3                        ALOQUIN                                   3
TRETIN-X                                        3                        AVC VAGINAL                               2
TRETIN-X (GEL)                                  3                        BD ALCOHOL SWAB (alcohol swabs)           2        1
VELTIN                                          3                        BP 10-1                                   1
ZIANA                                           3                        Cerisa                                    1
Depigmenting Agents                                                      CLARIFOAM EF (sulfacetamide
                                                                                                                   3        1
                                                                         sodium-sulfur)
ACLARO                                          3
                                                                         Claris Clarifying Wash                    1
ACLARO PD                                       3
                                                                         Cleansing Wash                            1
Alphaquin HP                                    1
                                                                         CLENIA TOPICAL CREAM                      3
ELDOPAQUE FORTE                                 3
                                                                         Clenia Topical Cleanser (sulfacetamide
ELDOQUIN FORTE (hydroquinone)                   3        1                                                         1        1
                                                                         sodium-sulfur)
EPIQUIN MICRO                                   3                        CURITY ALCOHOL SWABS (alcohol
                                                                                                                   3        1
hydroquinone microspheres                                1               swabs)

LUSTRA (hydroquinone)                           3        1               DERMAZENE (IODOQUINOL-HC)                 3        3

LUSTRA-AF                                       3                        FEM PH                                    3

Lustra-Ultra                                    1                        GLUCOPRO ALCOHOL (alcohol swabs)          3        1

Melpaque HP                                     1                        IODOFLEX                                  3

TRI-LUMA                                        3                        IODOSORB                                  3

Detergents                                                               KLARON (sulfacetamide sodium (acne))      3        1

CHOLESTEROL                                              3               LUGOLS                                    3

POLYOXYL 40 STEARATE                                     3               PHENOL LIQUID                                      3

POLYSORBATE 40                                           3               PHISOHEX                                  3

POLYSORBATE 60                                           3               PLEXION (sulfacetamide sodium-sulfur)     3        1

POLYSORBATE 80                                           3               PLEXION CLEANSING CLOTHS
                                                                                                                   3        1
                                                                         (sulfacetamide sodium-sulfur)
SODIUM LAURYL SULFATE                                    3
                                                                         PLEXION SCT                               3
Hydroxypyridones(Skin & Mucous Membrane)
                                                                         PRASCION (sulfacetamide sodium-sulfur)    1        1
CNL 8 NAIL (ciclopirox-vitE-nail lacq
                                                3        1               PRASCION FC (sulfacetamide
remo)                                                                                                              1        1
                                                                         sodium-sulfur)
LOPROX (ciclopirox)                             3        1
                                                                         PRASCION RA                               3
PENLAC (ciclopirox)                             3        1
                                                                         Q-CARE RX Q2                              3
Keratolytic Agents
                                                                         Q-CARE RX Q4                              3
BENZACLIN (clindamycin-benzoyl
                                                2        1               RELAGARD                                  3
peroxide)
benzoyl peroxide topical cleanser 10 %                   1               ROSANIL                                   3

benzoyl peroxide topical gel 5 %                         1               SE 10-5 SS                                1

Keratoplastic Agents                                                     selenium sulfide topical susp 2.5 %                1

COAL TAR                                                 3               SILVADENE (silver sulfadiazine)           3        1


DRITHO-SCALP                                    2                        SILVER NITRATE TOP                                 3

50     T3 AF = Tier 3 on Advantage Formulary
Drug                                           Brand   Generic   Notes   Drug                         Brand   Generic   Notes

SILVER NITRATE TOPICAL SOLN 0.5                                          AMEVIVE                       3
                                                         3
%, 25 %, 50 %
                                                                         Amnesteem                     1
SSD (silver sulfadiazine)                       1        1
                                                                         ARTISS                        3
sulfacetamide sodium top                                 1
                                                                         AVAGE                         2
sulfacetamide sodium-sulfur lotion 10-5 %
                                                         1               AZELEX                        2
(w/w)
sulfacetamide sodium-sulfur topical susp                                 BENZOIN                                3
                                                         1
10-5 %                                                                   Calcitrene (calcipotriene)    1        1
SULFAMYLON                                      3                        CARAC                         2
SUMAXIN (sulfacetamide sodium-sulfur)           3        1               Claravis                      1
SUMAXIN TS                                      3                        CONDYLOX (podofilox)          2        1
SURE COMFORT ALCOHOL PREP                                                DEBACTEROL                    3
                                                3        1
PADS (alcohol swabs)
                                                                         DIFFERIN (adapalene)          2        1
SURE-PREP ALCOLOL PREP PADS
                                                3        1
(alcohol swabs)                                                          DOVONEX TOPICAL CREAM         2
TERSI FOAM                                      3                        DOVONEX TOPICAL SOLN
                                                                                                       3        1
                                                                         (calcipotriene)
Thermazene (silver sulfadiazine)                1        1
                                                                         EFUDEX (fluorouracil)         3        1
ULESFIA                                         2
                                                                         ELIDEL                        2
ULTILET ALCOHOL SWAB (alcohol
                                                3        1
swabs)                                                                   EPIDUO                        2
Zencia (sulfacetamide sodium-sulfur)            1        1               FINACEA                       2
Pigmenting Agents                                                        FINACEA PLUS                  3
8-MOP                                           3                        FLUOROPLEX                    3
OXSORALEN                                       2                        fluorouracil top                       1
OXSORALEN ULTRA                                 2                        FORMADON TOPICAL SOLN         3
UVADEX                                          3                        GRANULEX                      3
Polyenes (Skin & Mucous Membrane)                                        LEVULAN                       3
FIRST-BXN                                       3                        METVIXIA                      3
FIRST-DUKE'S                                    3                        MUCOTROL                      3
FIRST-MARY'S MOUTHWASH                          3                        OPTASE                        3
Nyamyc (nystatin)                               1        1               OXALIS                        3
nystatin                                                 1               PANRETIN                      2
nystatin-triamcinolone                                   1               PODOCON                       3
Nystop (nystatin)                               1        1               PROPECIA                      3
Pedi-Dri (nystatin)                             1        1               PROTOPIC                      2
PEDIADERM AF                                    3                        PYROGALLIC ACID               3
Scabicides And Pediculicides                                             QUTENZA                       3
EURAX                                           2                        REGRANEX                      3
LINDANE                                                  3               SANTYL                        3
NATROBA                                         3                        SOLARAZE                      2
OVIDE (malathion)                               3        1               SORIATANE                     2
permethrin topical cream                                 1               Sotret                        1
ULESFIA                                         2                        TACLONEX                      3
Skin And Mucous Membrane Agents, Misc.                                   TACLONEX SCALP                3
ACZONE                                          3                        TARGRETIN                     3

ALDARA (imiquimod)                              3        1               TAZORAC                       2

       T3 AF = Tier 3 on Advantage Formulary                                                                                    51
Drug                                           Brand   Generic   Notes   Drug                          Brand   Generic   Notes

TRI-CHLOR                                       3                        Vitamins
TRICHLOROACETIC ACID TOPICAL                                             Multivitamin Preparations
                                                         3
SOLN
                                                                         Complete Natal DHA             1
VANIQA                                          3
                                                                         COMPLETE-RF PRENATAL           2
Vasolex                                         1
                                                                         CompleteNate                   1
VECTICAL                                        2
                                                                         CONCEPT DHA                    2
VENELEX                                         3
                                                                         CONCEPT OB                     2
XENADERM                                        3
                                                                         DUET DHA BALANCED
                                                                                                        2
ZYCLARA                                         3                        PACK,TAB&CAP,DR 27-1-430 MG

Sunscreen Agents                                                         DUET DHA COMPLETE              2

ACLARO                                          3                        Elite-OB Cap                   1

ACLARO PD                                       3                        ELITE-OB TAB                   2

Nuquin HP (hydroquinone with sunscreen)         1        1               Elite-OB 400                   1
Smooth Muscle Relaxants                                                  MARNATAL-F                     2
Genitourinary Smooth Muscle Relaxants                                    Maternity                      1
DETROL                                          2                        Multinatal Plus                1
DETROL LA                                       2                        NEEVO DHA                      2
DITROPAN XL (oxybutynin chloride)               3        1               OB COMPLETE                    2
ENABLEX                                         2                        OB COMPLETE ONE                2
flavoxate                                                1               OB COMPLETE PREMIER            2
GELNIQUE                                        2                        Prenatabs Rx                   1
oxybutynin chloride oral                                 1               Prenatal 19 Chewable Tab       1
OXYTROL                                         2                        PRENATE ESSENTIAL              2
SANCTURA (trospium)                             3        1               Vitamin B Complex
SANCTURA XR                                     2                        folic acid tab                          1
TOVIAZ                                          3                        FOLTX                          2
VESICARE                                        2                        NESTABS                        2
Respiratory Smooth Muscle Relaxants                                      NESTABS DHA                    2
aminophylline oral                                       1
BRONCOMAR-1                                     3
COPD                                            3
DIFIL-G 400                                     3
DILEX-G 200                                     3
DILEX-G 400                                     3
DYLIX                                           3
dyphylline-guaifenesin                                   1
ELIXOPHYLLIN                                    2
JAY-PHYL                                        3
LUFYLLIN                                        3
THEO-24                                         3
Theochron (theophylline)                        1        1
theophylline er 12 hr tab                                1
theophylline er tab                                      1

theophylline oral soln                                   1
52     T3 AF = Tier 3 on Advantage Formulary
Index




8-MOP ....................................................................................51              acetylcysteine ......................................................................40          ADVAIR DISKUS .........................................................35

ABILIFY ...............................................................................22                 acetylcysteine ......................................................................45          ADVAIR DISKUS .........................................................45

ABILIFY DISCMELT ...................................................22                                    ACID JELLY .....................................................................50               ADVAIR DISKUS .........................................................46

ABSTRAL ...........................................................................24                     ACIPHEX ............................................................................35           ADVAIR HFA ..................................................................10

ACANYA ............................................................................48                     ACLARO ..............................................................................50          ADVAIR HFA ..................................................................35

acarbose.................................................................................35               ACLARO ..............................................................................52          ADVAIR HFA ..................................................................45

ACCOLATE .......................................................................45                        ACLARO PD .....................................................................50                ADVAIR HFA ..................................................................46
                                                                                                                                                                                                           ADVICOR 1,000-20 MG, 1,000-40 MG, 500-20
ACCU-CHEK ACTIVE TEST ..............................27                                                    ACLARO PD .....................................................................52
                                                                                                                                                                                                           MG, 750-20 MG.................................................................16
ACCU-CHEK ADVANTAGE DIABETES
                                                                                                          ACLOVATE .......................................................................46
.....................................................................................................27                                                                                                    Afeditab CR ........................................................................16
                                                                                                          ACTIGALL .........................................................................34
ACCU-CHEK AVIVA ................................................27                                                                                                                                         Afeditab CR ........................................................................18
                                                                                                          ACTIMMUNE .................................................................39
ACCU-CHEK AVIVA MONITORING ..........27                                                                                                                                                                    AFINITOR 10 MG, 2.5 MG, 5 MG........................7
ACCU-CHEK COMFORT CURVE TEST                                                                              ACTIQ ...................................................................................24
                                                                                                                                                                                                           AGGRENOX ....................................................................11
.....................................................................................................27
                                                                                                          ACTIVELLA ......................................................................37
                                                                                                                                                                                                           AGGRENOX ....................................................................18
ACCU-CHEK COMPACT PLUS CARE ......27
                                                                                                          ACTONEL 150 MG, 35 MG, 5 MG........................39
                                                                                                                                                                                                           AGGRENOX ....................................................................26
ACCU-CHEK COMPACT TEST .......................27
                                                                                                          ACTONEL 30 MG.........................................................39
                                                                                                                                                                                                           AGRYLIN ............................................................................11
ACCU-CHEK MULTICLIX LANCET ..........27
                                                                                                          ACTOPLUS MET .........................................................36
                                                                                                                                                                                                           AK-Con .................................................................................33
ACCU-CHEK SOFTCLIX LANCETS ............27
                                                                                                          ACTOPLUS MET .........................................................38
                                                                                                                                                                                                           AK-Dilate .............................................................................33
ACCUNEB ..........................................................................46
                                                                                                          ACTOPLUS MET XR ...................................................36
                                                                                                                                                                                                           AKNE-MYCIN .................................................................48
ACCUNEB 0.63 MG/3 ML, 1.25 MG/3 ML......10
                                                                                                          ACTOPLUS MET XR ...................................................38
                                                                                                                                                                                                           Akorn Balanced Salt .......................................................32
ACCUPRIL .........................................................................12
                                                                                                          ACTOS .................................................................................38
                                                                                                                                                                                                           AK-Pentolate ......................................................................33
ACCUPRIL 10 MG, 20 MG, 40 MG, 5 MG.......12
                                                                                                          ACULAR ..............................................................................32
                                                                                                                                                                                                           AK-Poly-Bac ......................................................................30
ACCURETIC .....................................................................12
                                                                                                          ACULAR LS ......................................................................32
                                                                                                                                                                                                           AKTEN (PF) .......................................................................32
ACCURETIC .....................................................................18
                                                                                                          ACUVAIL ............................................................................32
                                                                                                                                                                                                           AK-Tob .................................................................................30
ACCURETIC .....................................................................29
ACCURETIC 10-12.5 MG, 20-12.5 MG, 20-25                                                                   acyclovir....................................................................................5
                                                                                                                                                                                                           Ala-Cort .................................................................................46
MG............................................................................................12          ACZONE ..............................................................................51
                                                                                                                                                                                                           Alagesic .................................................................................20
acebutolol..............................................................................10                ADAGEN ............................................................................30
                                                                                                                                                                                                           Alagesic .................................................................................22
acebutolol..............................................................................13                ADALAT CC .....................................................................16
                                                                                                                                                                                                           Alagesic LQ ........................................................................20
acebutolol..............................................................................15                ADALAT CC .....................................................................18
                                                                                                                                                                                                           Alagesic LQ ........................................................................22
acebutolol..............................................................................17                ADALAT CC 30 MG, 60 MG, 90 MG..................16
                                                                                                                                                                                                           ALA-HIST AC ..................................................................24
ACEON 4 MG, 8 MG.....................................................12                                   adapalene...............................................................................51
                                                                                                                                                                                                           ALA-HIST AC ..................................................................41
acetaminophen-codeine..................................................20                                 ADCIRCA ............................................................................17
                                                                                                                                                                                                           ALA-HIST DHC ..............................................................24
acetaminophen-codeine..................................................25                                 ADCIRCA ............................................................................46
                                                                                                                                                                                                           ALA-HIST DHC ..............................................................41
acetaminophen-codeine .................................................19                                 ADDERALL .......................................................................19
                                                                                                                                                                                                           ALA-HIST DM .................................................................42
acetaminophen-codeine .................................................24                                 ADDERALL XR ..............................................................19
                                                                                                                                                                                                           ALA-HIST DM .................................................................44
acetaminophn-isometh-dichloral...............................19                                           ADIPEX-P ...........................................................................20
                                                                                                                                                                                                           ALA-HIST LQ ...................................................................44
Acetasol HC ........................................................................32                    ADOXA ...................................................................................6
                                                                                                                                                                                                           ALA-QUIN .........................................................................48
acetazolamide......................................................................14                     ADOXA PAK ......................................................................6
                                                                                                                                                                                                           ALA-SCALP ......................................................................46
acetazolamide......................................................................28                     ADRENACLICK .............................................................41
                                                                                                                                                                                                           ALBENZA ............................................................................3
acetazolamide......................................................................31                     ADRENALIN ....................................................................33
                                                                                                                                                                                                           albuterol sulfate..................................................................10
acetazolamide .....................................................................28                     Adrenalin ..............................................................................41
                                                                                                                                                                                                           albuterol sulfate..................................................................46
acetazolamide .....................................................................31                     Adult Low Dose Aspirin ...............................................11
                                                                                                                                                                                                           albuterol sulfate ................................................................10
acetazolamide 125 mg, 250 mg..................................14                                          Adult Low Dose Aspirin ...............................................26
                                                                                                                                                                                                           albuterol sulfate ................................................................46
acetic acid ............................................................................32                ADVAIR DISKUS .........................................................10
                                                                                                                                                                                                           albuterol sulfate 2 mg, 4 mg.........................................10
acetic acid-aluminum acetate ....................................32
                                                                                                                                                                                                                                                                                                  53
albuterol sulfate 2.5 mg /3 ml (0.083 %), 2.5
                                                                                              ALOCRIL ............................................................................45       amcinonide ...........................................................................46
mg/0.5 ml, 5 mg/ml............................................................10
                                                                                              ALODOX ................................................................................6     AMERGE .............................................................................26
ALCAINE ............................................................................32
                                                                                              ALODOX .............................................................................32       AMERICAINE ANESTHETIC ................................48
alclometasone......................................................................46
                                                                                              ALOMIDE ...........................................................................30        Amethia .................................................................................36
alclometasone .....................................................................46
                                                                                              ALOQUIN ...........................................................................50        Amethia Lo ..........................................................................36
ALCOHOL PREP PADS .............................................50
                                                                                              ALORA .................................................................................37    AMEVIVE ...........................................................................51
alcohol swabs.......................................................................50
                                                                                              ALPHAGAN P 0.1 %...................................................30                        AMICAR ..............................................................................11
alcohol swabs.......................................................................51
                                                                                              ALPHAGAN P 0.15 %...................................................30                       AMIKACIN ...........................................................................4
ALCORTIN A ...................................................................46
                                                                                              Alphaquin HP .....................................................................50         AMIKACIN (PF) ................................................................4
ALCORTIN A ...................................................................50
                                                                                              alprazolam.............................................................................23    amiloride................................................................................18
ALDACTAZIDE ..............................................................17
                                                                                              ALPRAZOLAM INTENSOL ....................................23                                   amiloride................................................................................28
ALDACTAZIDE ..............................................................18
                                                                                              alprostadil.............................................................................19   amiloride-hydrochlorothiazide ..................................17
ALDACTAZIDE ..............................................................28
                                                                                              ALREX .................................................................................31    amiloride-hydrochlorothiazide ..................................18
ALDACTAZIDE ..............................................................30
                                                                                              ALSUMA .............................................................................26       amiloride-hydrochlorothiazide ..................................28
ALDACTAZIDE 25-25 MG........................................17
                                                                                              ALTABAX ..........................................................................48         amiloride-hydrochlorothiazide ..................................30
ALDACTAZIDE 50-50 MG........................................17
                                                                                              ALTACE ...............................................................................13     aminocaproic acid.............................................................11
ALDACTONE ...................................................................17
                                                                                              ALTACE 1.25 MG, 10 MG, 2.5 MG, 5 MG.......12                                                 aminophylline .....................................................................46
ALDACTONE ...................................................................28
                                                                                              ALTAFLUOR ....................................................................32             aminophylline .....................................................................52
ALDACTONE 100 MG, 25 MG, 50 MG.............17
                                                                                              Altafrin 10 %........................................................................33      amiodarone...........................................................................15
ALDARA .............................................................................51
                                                                                              ALTOPREV ......................................................................16            AMITIZA ............................................................................33
ALDEX AN ........................................................................21
                                                                                              aluminum acetate .............................................................49             amitriptyline ........................................................................27
ALDEX AN ........................................................................44
                                                                                              ALUMINUM MONOSTEARATE .........................41                                            amitriptyline-chlordiazepoxide .................................23
alendronate...........................................................................39
                                                                                              ALVESCO ...........................................................................35        amitriptyline-chlordiazepoxide .................................27
alendronate ..........................................................................39
                                                                                              ALVESCO ...........................................................................45        amlodipine.............................................................................16
ALFERON N ........................................................................4
                                                                                              amantadine ..........................................................................19      amlodipine.............................................................................19
ALFUZOSIN.......................................................................10
                                                                                              AMARYL ............................................................................38        amlodipine-atorvastatin.................................................16
ALINIA ...................................................................................3
                                                                                              AMBIEN ...............................................................................21     amlodipine-atorvastatin.................................................18
ALKERAN ............................................................................7
                                                                                              AMBIEN CR ......................................................................21           amlodipine-benazepril.....................................................12
ALLERX 10 ...........................................................................8
                                                                                              AMBIFED ............................................................................41       amlodipine-benazepril.....................................................13
ALLERX 10 ........................................................................41
                                                                                              AMBIFED ............................................................................43       amlodipine-benazepril.....................................................16
ALLERX 10 ........................................................................44
                                                                                              AMBIFED CD ...................................................................41             amlodipine-benazepril.....................................................19
ALLERX 30 ...........................................................................8
                                                                                              AMBIFED CD ...................................................................42             AMMONIA AROMATIC ...........................................20
ALLERX 30 ........................................................................41
                                                                                              AMBIFED CD ...................................................................43             ammonium lactate.............................................................49
ALLERX 30 ........................................................................44
                                                                                              AMBIFED CDX ...............................................................41                Amnesteem ..........................................................................51
ALLERX DF ......................................................................44
                                                                                              AMBIFED CDX ...............................................................42                amoxapine ............................................................................27
ALLERX DF 30 ................................................................44
                                                                                              AMBIFED CDX ...............................................................43                amoxicillin ..............................................................................3
ALLERX PE ..........................................................................8
                                                                                                                                                                                           amoxicillin 125 mg/5 ml, 200 mg/5 ml, 250 mg/5
                                                                                              AMBIFED DM ..................................................................41
ALLERX PE .......................................................................44                                                                                                        ml, 400 mg/5 ml.....................................................................3
                                                                                              AMBIFED DM ..................................................................42
ALLERX-D ............................................................................8                                                                                                     amoxicillin 250 mg, 500 mg............................................3
                                                                                              AMBIFED DM ..................................................................43
ALLERX-D .........................................................................41                                                                                                       amoxicillin 500 mg, 875 mg............................................3
                                                                                              AMBIFED-G CD .............................................................41
ALLFEN CD ......................................................................43                                                                                                         amoxicillin-pot clavulanate.............................................3
                                                                                              AMBIFED-G CD .............................................................42
ALLFEN CDX ...................................................................43                                                                                                           amoxicillin-pot clavulanate ...........................................3
                                                                                              AMBIFED-G CD .............................................................43                 amoxicillin-pot clavulanate 200-28.5 mg/5 ml,
Allfen DM ............................................................................42
                                                                                                                                                                                           400-57 mg/5 ml, 600-42.9 mg/5 ml.............................3
                                                                                              AMBIFED-G CDX .........................................................41
Allfen DM ............................................................................43
                                                                                                                                                                                           amoxicillin-pot clavulanate 250-125 mg..................3
                                                                                              AMBIFED-G CDX .........................................................42
allopurinol.............................................................................39
                                                                                                                                                                                           Amphetamine Salt Combo ...........................................19
                                                                                              AMBIFED-G CDX .........................................................43
ALOCRIL ............................................................................30
                                                                                                                                                                                           amphetamine-dextroamphetamine............................19
54
ampicillin .................................................................................3       APRISO ...............................................................................33           ATACAND HCT .............................................................18

AMPICILLIN SODIUM 250 MG...............................3                                            APTIVUS ...............................................................................4           ATACAND HCT .............................................................30

AMPYRA .............................................................................40              ARALEN .................................................................................3          ATELVIA ............................................................................39

AMRIX 15 MG, 30 MG...................................................9                              ARANESP (POLYSORBATE) .............................10                                              atenolol...................................................................................10
                                                                                                    ARANESP (POLYSORBATE) 100 MCG/0.5
AMTURNIDE ..................................................................16                                                                                                                         atenolol...................................................................................13
                                                                                                    ML, 150 MCG/0.3 ML, 200 MCG/0.4 ML, 25
AMTURNIDE ..................................................................18                      MCG/0.42 ML, 300 MCG/0.6 ML, 40                                                                    atenolol...................................................................................15
                                                                                                    MCG/0.4 ML, 500 MCG/ML, 60 MCG/0.3
AMTURNIDE ..................................................................30                      ML............................................................................................10   atenolol-chlorthalidone..................................................10

ANABAR .............................................................................19              ARAVA .................................................................................39          atenolol-chlorthalidone..................................................13

ANABAR .............................................................................44              ARCALYST ......................................................................40                  atenolol-chlorthalidone..................................................15

ANACAINE ........................................................................48                 ARESTIN .............................................................................30            atenolol-chlorthalidone..................................................18

ANAFRANIL .....................................................................27                   ARICEPT 10 MG, 5 MG.................................................9                              atenolol-chlorthalidone..................................................30

anagrelide..............................................................................11          ARICEPT 23 MG..............................................................9                       ATIVAN ...............................................................................23

anagrelide 1 mg..................................................................11                 ARICEPT ODT 10 MG, 5 MG.....................................9                                      ATOPICLAIR ....................................................................49

ANALPRAM E ................................................................46                       ARIMIDEX ............................................................................7             atorvastatin...........................................................................17

ANALPRAM E ................................................................49                       ARMOUR THYROID ...................................................38                               atovaquone-proguanil........................................................3

ANALPRAM-HC ...........................................................47                           AROMASIN ..........................................................................7               ATRALIN ............................................................................49

ANALPRAM-HC ...........................................................49                           ARTHROTEC 50 .............................................................26                       ATRIPLA ..............................................................................5

ANALPRAM-HC SINGLES ..................................47                                            ARTHROTEC 50 .............................................................34                       ATROPEN ...........................................................................41

ANALPRAM-HC SINGLES ..................................49                                            ARTHROTEC 75 .............................................................26                       atropine...................................................................................33

ANAPROX ..........................................................................25                ARTHROTEC 75 .............................................................34                       ATROPINE ............................................................................8

ANAPROX DS ..................................................................26                     ARTISS .................................................................................51         atropine .................................................................................33

Anaspaz ....................................................................................8       ASACOL .............................................................................33             ATROPINE .........................................................................41

anastrozole...............................................................................7         ASACOL HD ....................................................................33                   Atropine-Care .....................................................................33

ANCOBON ............................................................................6               Ascomp w/Codeine .........................................................22                       ATROVENT .......................................................................32

ANDRODERM ................................................................35                        Ascomp w/Codeine .........................................................24                       ATROVENT HFA ...........................................................8

ANDROGEL .....................................................................36                    Ascomp w/Codeine .........................................................26                       ATROVENT HFA .........................................................41
ANDROGEL 1.25 G/ACTUATION, 20.25
                                                                                                    ASMALPRED ...................................................................35                    AUGMENTIN ......................................................................3
MG/1.25 GRAM (1.62 %)..........................................36
                                                                                                    ASMALPRED PLUS .....................................................35                             AUGMENTIN 250-62.5 MG/5 ML...........................3
ANDROID ...........................................................................36
                                                                                                    ASMANEX TWISTHALER 110 MCG (30
                                                                                                    DOSES), 220 MCG (120 DOSES), 220 MCG                                                               AUGMENTIN XR .............................................................3
Androxy .................................................................................36
                                                                                                    (30 DOSES), 220 MCG (60 DOSES)...................35                                                Aurodex .................................................................................32
ANGELIQ ............................................................................37              ASMANEX TWISTHALER 110 MCG (30
                                                                                                    DOSES), 220 MCG (120 DOSES), 220 MCG                                                               Auroguard ............................................................................32
ANGELIQ ............................................................................38
                                                                                                    (30 DOSES), 220 MCG (60 DOSES)...................45
                                                                                                                                                                                                       AVAGE ................................................................................51
ANSAID ...............................................................................26
                                                                                                    aspirin......................................................................................11
                                                                                                                                                                                                       AVAILNEX ........................................................................40
ANTABUSE .......................................................................39
                                                                                                    aspirin......................................................................................26
                                                                                                                                                                                                       AVALIDE ............................................................................12
ANTARA .............................................................................16
                                                                                                    aspirin 975 mg.....................................................................11
                                                                                                                                                                                                       AVALIDE ............................................................................30
antipyrine-benzocaine.....................................................32
                                                                                                    aspirin 975 mg.....................................................................21
                                                                                                                                                                                                       AVALIDE 150-12.5 MG, 300-12.5 MG...............18
ANTIVERT .........................................................................33
                                                                                                    aspirin 975 mg.....................................................................26
                                                                                                                                                                                                       AVANDAMET .................................................................38
Anucort-HC .........................................................................47
                                                                                                    Aspirin Childrens .............................................................11
                                                                                                                                                                                                       AVANDARYL ..................................................................38
ANUSOL-HC ....................................................................47
                                                                                                    Aspirin Low Dose ............................................................11
                                                                                                                                                                                                       AVANDIA ...........................................................................38
ANZEMET .........................................................................33
                                                                                                    Aspirin Low-Strength .....................................................11
                                                                                                                                                                                                       AVAPRO ..............................................................................12
APEXICON .........................................................................47
                                                                                                    ASTELIN ............................................................................30
                                                                                                                                                                                                       AVAPRO 150 MG, 300 MG, 75 MG.....................12
ApexiCon E .........................................................................47
                                                                                                    ASTEPRO ..........................................................................30
                                                                                                                                                                                                       AVC VAGINAL .............................................................50
APIDRA ...............................................................................37
                                                                                                    ATABEX EC .....................................................................28
                                                                                                                                                                                                       AVELOX ................................................................................4
APIDRA SOLOSTAR ................................................37
                                                                                                    ATABEX EC .....................................................................33
                                                                                                                                                                                                       AVELOX ................................................................................6
APOKYN ............................................................................24
                                                                                                    ATACAND .........................................................................12
                                                                                                                                                                                                       AVELOX ABC PACK ....................................................4
Apri ..........................................................................................36
                                                                                                    ATACAND HCT .............................................................12
                                                                                                                                                                                                                                                                                               55
AVELOX ABC PACK ....................................................6                                     Bayer Childrens Aspirin ...............................................26                    betamethasone valerate .................................................47

Aviane ....................................................................................36             BD ALCOHOL SWAB ...............................................50                            betamethasone, augmented...........................................47

AVINZA ...............................................................................24                  BD INSULIN PEN NEEDLE UF MINI ...........27                                                  BETAPACE ...........................................................................9

Avita ........................................................................................49          BD INSULIN PEN NEEDLE UF ORIG .........27                                                    BETAPACE ........................................................................13

AVITA ...................................................................................50               BD INSULIN PEN NEEDLE UF SHORT .....27                                                       BETAPACE ........................................................................15

AVODART .........................................................................38                       BD INSULIN SYRINGE 1 ML 25 X 1"............27                                                BETAPACE ........................................................................17
                                                                                                                                                                                                       BETAPACE 120 MG, 160 MG, 240 MG, 80
AVONEX ............................................................................39                     BD INSULIN SYRINGE HALF UNIT ............27
                                                                                                                                                                                                       MG............................................................................................15
AVONEX ADMINISTRATION PACK ..........39                                                                   BD INSULIN SYRINGE MICRO-FINE ........27
                                                                                                                                                                                                       BETAPACE AF ................................................................13
AXERT ..................................................................................26                BECONASE AQ ..............................................................31
                                                                                                                                                                                                       BETAPACE AF ................................................................15
AXID ......................................................................................34             BECONASE AQ ..............................................................45
                                                                                                                                                                                                       BETAPACE AF ................................................................17
AXIRON ...............................................................................36                  BELLADONNA ALKALOIDS-OPIUM ............24
                                                                                                                                                                                                       BETAPACE AF 120 MG, 160 MG, 80 MG..........9
AYGESTIN .........................................................................38                      BELLADONNA-OPIUM ............................................24
                                                                                                                                                                                                       BETAPACE AF 120 MG, 160 MG, 80 MG.......15
AZACTAM 2 GRAM........................................................5                                   benazepril..............................................................................12
                                                                                                                                                                                                       BETASERON ...................................................................39
AZASAN ..............................................................................40                   benazepril..............................................................................13
                                                                                                                                                                                                       betaxolol.................................................................................10
AZASITE .............................................................................31                   benazepril-hydrochlorothiazide.................................12
                                                                                                                                                                                                       betaxolol.................................................................................13
azathioprine..........................................................................40                  benazepril-hydrochlorothiazide.................................13
                                                                                                                                                                                                       betaxolol.................................................................................15
AZATHIOPRINE SODIUM ......................................40                                              benazepril-hydrochlorothiazide.................................18
                                                                                                                                                                                                       betaxolol.................................................................................17
azelastine................................................................................30              benazepril-hydrochlorothiazide.................................30
                                                                                                                                                                                                       betaxolol ................................................................................31
AZELEX ..............................................................................51                   benazepril-hydrochlorothiazide 5-6.25 mg..........18
                                                                                                                                                                                                       bethanechol chloride........................................................10
AZILECT ............................................................................23                    BENICAR ...........................................................................12
                                                                                                                                                                                                       BETIMOL ............................................................................31
azithromycin............................................................................5                 BENICAR HCT ..............................................................12
                                                                                                                                                                                                       BETOPTIC S ....................................................................31
azithromycin............................................................................6                 BENICAR HCT ..............................................................18
                                                                                                                                                                                                       BEYAZ .................................................................................36
AZOPT .................................................................................31                 BENICAR HCT ..............................................................30
                                                                                                                                                                                                       BIAFINE EMULSION ..................................................49
AZOR ....................................................................................12               BENSAL HP .......................................................................48
                                                                                                                                                                                                       BIAXIN ....................................................................................4
AZOR ....................................................................................16               BENTYL .................................................................................8
                                                                                                                                                                                                       BIAXIN ....................................................................................5
AZOR ....................................................................................18               BENZACLIN ....................................................................48
                                                                                                                                                                                                       BIAXIN 250 MG, 500 MG.............................................5
AZTREONAM......................................................................5                          BENZACLIN ....................................................................50
                                                                                                                                                                                                       BIAXIN XL ...........................................................................4
AZULFIDINE .......................................................................6                       BENZACLIN PUMP ...................................................48
                                                                                                                                                                                                       BIAXIN XL ...........................................................................5
AZULFIDINE EN-TABS ...............................................6                                       BENZAMYCIN ................................................................48
                                                                                                                                                                                                       BIAXIN XL PAK ...............................................................4
bacitracin ..............................................................................31               BENZAMYCINPAK .....................................................48
                                                                                                                                                                                                       BIAXIN XL PAK ...............................................................5
BACITRACIN (BULK) 5 MILLION UNIT.......48                                                                 BENZOIN ............................................................................51
                                                                                                                                                                                                       bicalutamide............................................................................7
bacitracin-polymyxin b...................................................30                               benzonatate...........................................................................43
                                                                                                                                                                                                       BICILLIN C-R .....................................................................5
baclofen 10 mg, 20 mg.......................................................9                             benzoyl peroxide 10 %....................................................50
                                                                                                                                                                                                       BICILLIN L-A .....................................................................5
BACTERIOSTATIC WATER(PARABENS)
                                                                                                          benzoyl peroxide 5 %.......................................................50
.....................................................................................................41                                                                                                BIDIL ....................................................................................16
                                                                                                          benzphetamine.....................................................................19
BACTRIM DS ......................................................................6                                                                                                                     BIDIL ....................................................................................17
                                                                                                          BENZTROPINE...................................................................8
BACTROBAN ...................................................................48                                                                                                                        BILTRICIDE ......................................................................3
                                                                                                          BENZTROPINE................................................................21
BACTROBAN NASAL ................................................31                                                                                                                                     BIOTUSS .............................................................................42
                                                                                                          benztropine ..........................................................................20
BAL IN OIL ........................................................................35                                                                                                                  BIOTUSS .............................................................................43
                                                                                                          benztropine 0.5 mg, 1 mg, 2 mg....................................8
BALANCED SALT ........................................................32                                                                                                                               Biotuss Pediatric ...............................................................42
                                                                                                          BEPREVE ............................................................................30
balsalazide ...........................................................................33                                                                                                              Biotuss Pediatric ...............................................................43
                                                                                                          BESIVANCE ....................................................................31
BANZEL ...............................................................................21                                                                                                               bisoprolol fumarate..........................................................10
                                                                                                          BETADINE OPHTHALMIC PREP .......................32
BARACLUDE ....................................................................5                                                                                                                        bisoprolol fumarate..........................................................13
                                                                                                          BETAGAN ..........................................................................31
Baycadron ............................................................................35                                                                                                               bisoprolol fumarate..........................................................15
                                                                                                          BETAMETHASONE ACET & SOD PHOS .....35
Bayer Aspirin .....................................................................11                                                                                                                  bisoprolol-hydrochlorothiazide..................................10
                                                                                                          betamethasone dipropionate .......................................47
Bayer Childrens Aspirin ...............................................11                                                                                                                              bisoprolol-hydrochlorothiazide..................................13

56
bisoprolol-hydrochlorothiazide..................................14                             BROVEX PB CX .............................................................24                       butalbital-aspirin-caffeine.............................................21

bisoprolol-hydrochlorothiazide..................................15                             BROVEX PB CX .............................................................42                       butalbital-aspirin-caffeine.............................................22

bisoprolol-hydrochlorothiazide..................................18                             BROVEX PB CX .............................................................44                       butalbital-aspirin-caffeine.............................................26

bisoprolol-hydrochlorothiazide..................................30                             BROVEX PD .....................................................................41                  BUTISOL .............................................................................22

BLEPH-10 ............................................................................31        BROVEX PD .....................................................................44                  butorphanol tartrate ........................................................25

BLEPHAMIDE .................................................................31                 BROVEX PEB ...................................................................44                   BUTRANS ...........................................................................25

BLEPHAMIDE S.O.P. ...............................................31                            BROVEX PEB DM .........................................................42                          BYETTA ..............................................................................37

BONIVA ..............................................................................39        BROVEX PEB DM .........................................................44                          BYSTOLIC 10 MG, 2.5 MG, 20 MG, 5 MG.....9
                                                                                                                                                                                                  BYSTOLIC 10 MG, 2.5 MG, 20 MG, 5
BONTRIL PDM ................................................................20                 BROVEX PSB ...................................................................41
                                                                                                                                                                                                  MG............................................................................................13
Bontril Slow-Release ......................................................20                  BROVEX PSB ...................................................................42
                                                                                                                                                                                                  cabergoline ..........................................................................23
BOTOX .................................................................................10      BROVEX PSB ...................................................................44
                                                                                                                                                                                                  CADUET ..............................................................................16
BOTOX .................................................................................40      BROVEX SR ......................................................................41
                                                                                                                                                                                                  CADUET ..............................................................................18
BOTOX COSMETIC .....................................................10                         BROVEX SR ......................................................................44                 CADUET 10-10 MG, 10-20 MG, 10-40 MG,
                                                                                                                                                                                                  10-80 MG, 2.5-10 MG, 2.5-20 MG, 2.5-40 MG,
BOTOX COSMETIC .....................................................40                         BSS ..........................................................................................32   5-10 MG, 5-20 MG, 5-40 MG, 5-80 MG..............16
BP 10-1 ..................................................................................50   BSS PLUS ............................................................................32            CAFCIT .................................................................................20
BRAVELLE ......................................................................37              BUCALCIDE .....................................................................27                  CAFERGOT ..........................................................................9
BRILINTA ...........................................................................11         BUCALSEP ........................................................................32                CAFERGOT .......................................................................21
brimonidine...........................................................................30       Budeprion SR .....................................................................21               CAFFEINE CITRATED................................................20
brimonidine .........................................................................30        Budeprion XL .....................................................................21               CALAN .................................................................................14
BROMDAY ........................................................................32             budesonide.............................................................................35          CALAN .................................................................................15
BROMDAY TWINPACK ...........................................32                                 budesonide.............................................................................46          CALAN .................................................................................18
BROMFED DM ................................................................41                  BUMETANIDE ................................................................28                      CALAN 120 MG, 80 MG.............................................14
BROMFED DM ................................................................42                  bumetanide 0.5 mg, 1 mg, 2 mg..................................17                                  CALAN SR .........................................................................14
BROMFED DM ................................................................44                  BUPAP ..................................................................................22         CALAN SR .........................................................................15
bromocriptine......................................................................23          BUPHENYL ......................................................................28                  CALAN SR .........................................................................18
BRONCOMAR-1 .............................................................43                    buprenorphine.....................................................................25               CALAN SR 120 MG, 180 MG, 240 MG..............14
BRONCOMAR-1 .............................................................46                    Buproban ...............................................................................21         calcipotriene.........................................................................51
BRONCOMAR-1 .............................................................52                    bupropion hcl.......................................................................21             calcitonin (salmon)...........................................................38
BRONKIDS ........................................................................42            buspirone ..............................................................................21         Calcitrene ..............................................................................51
BRONKIDS ........................................................................44            Butalbital Compound .....................................................11                        calcium acetate...................................................................28
BRONTUSS SF ................................................................42                 Butalbital Compound .....................................................20                        CALCIUM DISODIUM VERSENATE ...............35
BRONTUSS SF ................................................................43                 Butalbital Compound .....................................................21                        Camila ....................................................................................36
BROVANA .........................................................................10            Butalbital Compound .....................................................22                        CAMPRAL ..........................................................................23
BROVANA .........................................................................46            Butalbital Compound .....................................................26                        Camrese .................................................................................36
BROVEX ..............................................................................44        Butalbital Compound W/Codeine ............................20                                       Camrese Lo ..........................................................................36
BROVEX ADT .................................................................44                 Butalbital Compound W/Codeine ............................22                                       CANASA .............................................................................33
BROVEX CB .....................................................................24              Butalbital Compound W/Codeine ............................24                                       CANTIL ...................................................................................8
BROVEX CB .....................................................................42              Butalbital Compound W/Codeine ............................26                                       CAPASTAT ...........................................................................4
BROVEX CB .....................................................................44              butalbital-acetaminophen..............................................20                           CAPCOF ...............................................................................24
BROVEX CBX .................................................................24                 butalbital-acetaminophen..............................................22                           CAPCOF ...............................................................................42
BROVEX CBX .................................................................42                 butalbital-acetaminophen-caff....................................19                                CAPCOF ...............................................................................44
BROVEX CBX .................................................................44                 butalbital-acetaminophen-caff....................................20                                CAPEX .................................................................................47
BROVEX PB C .................................................................24                butalbital-acetaminophen-caff....................................22                                CAPITAL WITH CODEINE .....................................19
BROVEX PB C .................................................................42                butalbital-aspirin-caffeine.............................................11                         CAPITAL WITH CODEINE .....................................24
BROVEX PB C .................................................................44                butalbital-aspirin-caffeine.............................................20                         CAPRELSA .........................................................................7

                                                                                                                                                                                                                                                                                            57
captopril ................................................................................12       carisoprodol-asa-codeine ............................................26                            CELEXA ...............................................................................27

captopril ................................................................................13       carisoprodol-aspirin ..........................................................9                   CELLCEPT .......................................................................40

captopril-hydrochlorothiazide ...................................12                                carisoprodol-aspirin .......................................................26                     CELLUGEL ........................................................................32

captopril-hydrochlorothiazide ...................................13                                CARMOL HC ..................................................................47                     CELONTIN .......................................................................27

captopril-hydrochlorothiazide ...................................18                                CARNITOR ........................................................................40                CENESTIN ........................................................................37

captopril-hydrochlorothiazide ...................................30                                CARNITOR SUGAR-FREE ......................................40                                       CENTANY ..........................................................................48

CARAC ................................................................................51           carteolol ................................................................................32       CENTANY AT ..................................................................48

CARAFATE ......................................................................35                  Cartia XT ..............................................................................14         CENTERGY .......................................................................44

CARBAGLU .....................................................................28                   Cartia XT ..............................................................................15         Centergy DM ......................................................................42

carbamazepine....................................................................21                Cartia XT ..............................................................................18         Centergy DM ......................................................................44

CARBATROL ...................................................................21                    Cartia XT 120 mg, 180 mg, 240 mg, 300 mg.....14                                                    CEPHADYN .......................................................................22

Carbatuss ...............................................................................42        carvedilol..................................................................................9      cephalexin................................................................................4

Carbatuss ...............................................................................43        carvedilol...............................................................................10        cephalexin ...............................................................................4

CARBATUSS-12 .............................................................42                       carvedilol...............................................................................11        cephalexin 125 mg/5 ml, 250 mg/5 ml.......................4

CARBATUSS-CL ............................................................42                        carvedilol...............................................................................13        Cerisa ......................................................................................50

CARBATUSS-CL ............................................................43                        carvedilol...............................................................................15        CERVIDIL ...........................................................................40

CARBA-XP .........................................................................42               carvedilol...............................................................................17        CESAMET ...........................................................................33

CARBA-XP .........................................................................43               CASODEX .............................................................................7             CETACAINE .....................................................................49

carbidopa-levodopa..........................................................23                     CATAFLAM ......................................................................26                  CETACAINE ANESTHETIC ...................................49

CARDIOPLEGIC SOLN .............................................28                                  CATAPRES 0.1 MG, 0.2 MG, 0.3 MG.................14                                                 CETACAINE MEDICAL KIT E .............................49

CARDIOVID PLUS .......................................................40                           CATAPRES-TTS-1 .........................................................14                         cetirizine 1 mg/ml.................................................................7

CARDIZEM ........................................................................14                CATAPRES-TTS-2 .........................................................14                         cetirizine 1 mg/ml..............................................................46

CARDIZEM ........................................................................15                CATAPRES-TTS-3 .........................................................14                         CETRAXAL .......................................................................31

CARDIZEM ........................................................................18                Cavan-Alpha Kit ...............................................................28                  CETROTIDE ....................................................................40
CARDIZEM 120 MG, 30 MG, 60 MG, 90
                                                                                                   CAVERJECT ...................................................................18                    CHANTIX 0.5 MG, 1 MG............................................9
MG............................................................................................14
                                                                                                   CAVERJECT IMPULSE .........................................18                                      CHANTIX CONTINUING MONTH BOX .....9
CARDIZEM CD ...............................................................14
                                                                                                   CAYSTON ............................................................................5              CHANTIX STARTING MONTH BOX .............9
CARDIZEM CD ...............................................................15
                                                                                                   CEDAX ....................................................................................7        CHEMET ............................................................................35
CARDIZEM CD ...............................................................18
CARDIZEM CD 120 MG, 180 MG, 240 MG,                                                                CEDAX 180 MG/5 ML, 90 MG/5 ML.....................7                                                CHENODAL ......................................................................34
300 MG...................................................................................14
                                                                                                   CEENU 10 MG, 100 MG, 40 MG............................7                                            Child Aspirin ......................................................................11
CARDIZEM CD 360 MG.............................................14
CARDIZEM LA 120 MG, 180 MG, 240 MG,                                                                cefaclor .....................................................................................6    Children's Aspirin .............................................................11
300 MG, 360 MG, 420 MG..........................................14                                 cefaclor 250 mg, 500 mg..................................................6                         chloral hydrate ...................................................................22
CARDIZEM LA 120 MG, 180 MG, 240 MG,
300 MG, 360 MG, 420 MG..........................................15                                 cefadroxil .................................................................................4      chlordiazepoxide hcl .......................................................23
CARDIZEM LA 120 MG, 180 MG, 240 MG,
                                                                                                   cefadroxil 250 mg/5 ml, 500 mg/5 ml.........................4                                      chlordiazepoxide-clidinium.............................................8
300 MG, 360 MG, 420 MG..........................................18
                                                                                                   cefdinir ......................................................................................7   chlordiazepoxide-clidinium..........................................23
CARDURA .........................................................................12
                                                                                                   cefdinir 125 mg/5 ml, 250 mg/5 ml..............................7                                   chlorhexidine gluconate.................................................32
CARDURA .........................................................................17
                                                                                                   CEFDITOREN PIVOXIL................................................7                                CHLOROFORM ...............................................................23
CARDURA 1 MG, 2 MG, 4 MG, 8 MG..................9
                                                                                                   cefpodoxime 100 mg, 200 mg.........................................7                               chloroquine phosphate.......................................................3
CARDURA 1 MG, 2 MG, 4 MG, 8 MG...............11
                                                                                                   cefpodoxime 100 mg/5 ml, 50 mg/5 ml......................7                                         chloroquine phosphate 250 mg.....................................3
CARDURA XL .................................................................12
                                                                                                   cefprozil 125 mg/5 ml, 250 mg/5 ml............................6                                    chlorothiazide .....................................................................18
CARDURA XL .................................................................17
                                                                                                   cefprozil 250 mg, 500 mg.................................................6                         chlorothiazide .....................................................................30
CARDURA XL 4 MG, 8 MG........................................9
                                                                                                   CEFTIN ..................................................................................6         chlorpheniramine-hydrocodone.................................43
CARDURA XL 4 MG, 8 MG.....................................11
                                                                                                   CEFTIN 250 MG, 500 MG.............................................6                                chlorpheniramine-hydrocodone.................................45
carisoprodol............................................................................9
                                                                                                   cefuroxime axetil...................................................................6              chlorpromazine ..................................................................26
carisoprodol-asa-codeine ...............................................9
                                                                                                   CELEBREX ......................................................................23                  chlorpropamide .................................................................38
carisoprodol-asa-codeine ............................................24

58
chlorthalidone ....................................................................30                     CLARINEX .......................................................................46             clorazepate dipotassium.................................................23

chlorthalidone 25 mg, 50 mg.......................................18                                      CLARINEX-D 12 HOUR ............................................7                               CLORPRES .........................................................................14

chlorzoxazone.........................................................................9                   CLARINEX-D 12 HOUR .........................................41                                 CLORPRES .........................................................................30
                                                                                                                                                                                                         CLORPRES 0.1-15 MG, 0.2-15 MG, 0.3-15
CHOLESTEROL ..............................................................50                              CLARINEX-D 12 HOUR .........................................46
                                                                                                                                                                                                         MG............................................................................................18
cholestyramine (with sugar).........................................14                                    CLARINEX-D 24 HOUR ............................................7
                                                                                                                                                                                                         clotrimazole .........................................................................49
Cholestyramine Light .....................................................14                              CLARINEX-D 24 HOUR .........................................41
                                                                                                                                                                                                         clotrimazole-betamethasone........................................48
choline & magnesium salicylate ...............................26                                          CLARINEX-D 24 HOUR .........................................46
                                                                                                                                                                                                         clozapine................................................................................22
CHORIONIC GONADOTROPIN, HUMAN.....37                                                                      Claris Clarifying Wash ..................................................50
                                                                                                                                                                                                         clozapine 200 mg, 50 mg...............................................22
CIALIS .................................................................................17                clarithromycin........................................................................4
                                                                                                                                                                                                         CLOZARIL .......................................................................22
ciclopirox...............................................................................50               clarithromycin........................................................................5
                                                                                                                                                                                                         CNL 8 NAIL .......................................................................50
ciclopirox-vite-nail lacq remo.....................................50                                     clarithromycin 125 mg/5 ml............................................5
                                                                                                                                                                                                         COAL TAR .........................................................................50
cilostazol................................................................................11              Cleansing Wash .................................................................50
                                                                                                                                                                                                         COARTEM ..........................................................................3
cilostazol................................................................................17              clemastine .............................................................................44
                                                                                                                                                                                                         COCAINE ............................................................................32
CILOXAN ..........................................................................31                      CLENIA ................................................................................50
                                                                                                                                                                                                         COCET ..................................................................................19
cimetidine .............................................................................34                CLEOCIN ...............................................................................5
                                                                                                                                                                                                         COCET ..................................................................................24
CIMZIA .................................................................................34                CLEOCIN ............................................................................48
                                                                                                                                                                                                         COCET PLUS ....................................................................19
CIMZIA .................................................................................40                CLEOCIN 150 MG, 300 MG.........................................5
                                                                                                                                                                                                         COCET PLUS ....................................................................24
CIMZIA POWDER FOR RECONST ...................40                                                           CLEOCIN 75 MG................................................................4
                                                                                                                                                                                                         cod-butalbital-acetaminop-caf....................................19
CIMZIA STARTER KIT .............................................40                                        CLEOCIN T ........................................................................48
                                                                                                                                                                                                         cod-butalbital-acetaminop-caf....................................20
CIPRO .....................................................................................4              CLIMARA .........................................................................37
                                                                                                                                                                                                         cod-butalbital-acetaminop-caf....................................22
CIPRO 250 MG, 500 MG, 750 MG...........................6                                                  CLIMARA PRO ...............................................................37
                                                                                                                                                                                                         cod-butalbital-acetaminop-caf....................................24
CIPRO 250 MG/5 ML, 500 MG/5 ML.................6                                                          Clinda-Derm .......................................................................48
                                                                                                                                                                                                         codeine sulfate ...................................................................24
CIPRO HC ...........................................................................31                    CLINDAGEL .....................................................................48
                                                                                                                                                                                                         codeine sulfate ...................................................................42
CIPRO XR ..............................................................................4                  CLINDAMAX ...................................................................48
                                                                                                                                                                                                         codeine-guaifenesin..........................................................42
CIPRO XR ..............................................................................6                  clindamycin hcl......................................................................5
                                                                                                                                                                                                         codeine-guaifenesin..........................................................43
CIPRODEX .......................................................................31                        clindamycin palmitate hcl................................................5
                                                                                                                                                                                                         codeine-guaifenesin..........................................................44
ciprofloxacin...........................................................................4                 clindamycin phosphate....................................................48
                                                                                                                                                                                                         COGENTIN ...........................................................................8
ciprofloxacin...........................................................................6                 CLINDAMYCIN PHOSPHATE ................................5
                                                                                                                                                                                                         COGENTIN ........................................................................21
ciprofloxacin........................................................................31                   clindamycin-benzoyl peroxide.....................................48
                                                                                                                                                                                                         CO-GESIC ...........................................................................19
ciprofloxacin (mixture)......................................................4                            clindamycin-benzoyl peroxide.....................................50
                                                                                                                                                                                                         CO-GESIC ...........................................................................24
ciprofloxacin (mixture)......................................................6                            CLINDAREACH .............................................................48
                                                                                                                                                                                                         colchicine-probenecid ....................................................30
ciprofloxacin (mixture) .....................................................6                            CLINDESSE .....................................................................48
                                                                                                                                                                                                         colchicine-probenecid ....................................................39
citalopram.............................................................................27                 CLINORIL ...........................................................................26
                                                                                                                                                                                                         COLCRYS .........................................................................39
CITRANATAL 90 DHA (NEW FORMULA
                                                                                                          clobetasol...............................................................................47
.....................................................................................................28                                                                                                  COLESTID ..........................................................................14
CITRANATAL 90 DHA (NEW FORMULA                                                                            clobetasol...............................................................................48
                                                                                                                                                                                                         COLESTID FLAVORED ............................................14
.....................................................................................................33
                                                                                                          clobetasol-emollient.........................................................48
                                                                                                                                                                                                         colestipol................................................................................14
CITRANATAL ASSURE .........................................28
                                                                                                          CLOBEX .............................................................................47
                                                                                                                                                                                                         COLISTIN (COLISTIMETHATE NA) ..................6
CITRANATAL B-CALM .........................................28
CITRANATAL DHA (NEW FORMULA)                                                                              CLODERM .........................................................................47
                                                                                                                                                                                                         COLOCORT .......................................................................47
.....................................................................................................28
                                                                                                          CLOMID ...............................................................................37
CITRANATAL DHA (NEW FORMULA)                                                                                                                                                                             COLY-MYCIN S .............................................................31
.....................................................................................................34   clomiphene citrate.............................................................37              COLYTE WITH FLAVOR PACKS
                                                                                                                                                                                                         227.1-21.5-6.36 GRAM................................................34
CITRANATAL RX (NEW FORMULA) ........28                                                                    clomipramine.......................................................................27          COLYTE WITH FLAVOR PACKS
                                                                                                          clonazepam...........................................................................22        240-22.72-6.72 GRAM...................................................34
CITRANATAL RX (NEW FORMULA) ........34
                                                                                                          clonazepam...........................................................................23        COMBIGAN .......................................................................30
Claravis ..................................................................................51
                                                                                                          clonidine.................................................................................14   COMBIGAN .......................................................................31
CLARIFOAM EF .............................................................50
                                                                                                          CLONIDINE (PF) ............................................................19                  COMBIPATCH ..............................................................37
CLARINEX ..........................................................................7

                                                                                                                                                                                                                                                                                                   59
COMBIVENT .....................................................................8                       CORTEF ...............................................................................35       CUTIVATE .........................................................................47

COMBIVENT ..................................................................10                         CORTENEMA ..................................................................47                 CUVPOSA .............................................................................8

COMBIVENT ..................................................................41                         CORTIFOAM ..................................................................47                 CYCLOBENZAPRINE....................................................9

COMBIVENT ..................................................................46                         cortisone ................................................................................35   cyclobenzaprine 7.5 mg.....................................................9

COMBIVIR ............................................................................5                 CORTISPORIN .................................................................31                CYCLOGYL .......................................................................33

COMPLERA .......................................................................5                      CORTISPORIN .................................................................48                CYCLOMYDRIL ............................................................33

Complete Natal DHA .....................................................52                             CORTISPORIN-TC ........................................................31                      cyclopentolate......................................................................33

CompleteNate .....................................................................52                   CORZIDE ...............................................................................9       cyclophosphamide ...............................................................7

COMPLETE-RF PRENATAL .............................34                                                   CORZIDE ............................................................................13         CYCLOSET ........................................................................23

COMPLETE-RF PRENATAL .............................52                                                   CORZIDE ............................................................................15         cyclosporine..........................................................................40

COMPOUND 347 ............................................................23                            CORZIDE ............................................................................18         cyclosporine modified......................................................40

COMTAN ...........................................................................23                   CORZIDE ............................................................................30         cyclosporine modified 50 mg.......................................40

Co-Natal FA ........................................................................28                 COSOPT ...............................................................................31       CYMBALTA ....................................................................26

CONCEPT DHA ............................................................52                             COTAB A ............................................................................24         cyproheptadine .....................................................................7

CONCEPT OB ................................................................52                          COTAB A ............................................................................42         cyproheptadine ..................................................................44

CONCERTA .....................................................................20                       COTAB A ............................................................................44         CYSTADANE ..................................................................40

CONDYLOX ....................................................................51                        COTAB AX ........................................................................24            CYSTAGON .....................................................................40

COPAXONE .....................................................................39                       COTAB AX ........................................................................42            CYTOMEL ..........................................................................38

COPD .....................................................................................43           COTAB AX ........................................................................44            CYTOTEC ...........................................................................34

COPD .....................................................................................46           COTABFLU .......................................................................19             CYTRA K CRYSTALS ................................................28

COPD .....................................................................................52           COTABFLU .......................................................................24             CYTRA-2 .............................................................................28

COPEGUS ..............................................................................5                COTABFLU .......................................................................42             CYTRA-K ............................................................................28

CORDARONE ..................................................................15                         COTABFLU .......................................................................44             D.H.E.45 ..................................................................................9
                                                                                                       COUMADIN 1 MG, 10 MG, 2 MG, 2.5 MG, 3
CORDRAN .........................................................................47                                                                                                                   D.H.E.45 ...............................................................................21
                                                                                                       MG, 4 MG, 5 MG, 6 MG, 7.5 MG........................10
CORDRAN SP ..................................................................47                                                                                                                       DALIRESP .........................................................................46
                                                                                                       Covaryx .................................................................................36
COREG ....................................................................................9                                                                                                           DALLERGY .......................................................................44
                                                                                                       Covaryx H.S. ......................................................................36
COREG .................................................................................10                                                                                                             danazol ...................................................................................36
                                                                                                       COVERA-HS .....................................................................14
COREG .................................................................................13                                                                                                             DANTRIUM 100 MG, 25 MG, 50 MG....................9
                                                                                                       COVERA-HS .....................................................................15
COREG .................................................................................15                                                                                                             dantrolene................................................................................9
                                                                                                       COVERA-HS .....................................................................18
COREG .................................................................................17                                                                                                             DAPSONE ..............................................................................3
                                                                                                       COVERA-HS 180 MG, 240 MG...............................14
COREG 12.5 MG, 25 MG, 3.125 MG, 6.25
                                                                                                                                                                                                      DAPSONE 100 MG, 25 MG..........................................3
MG............................................................................................11       COZAAR ..............................................................................12
                                                                                                                                                                                                      DARAPRIM .........................................................................3
COREG CR .......................................................................13                     COZAAR 100 MG, 25 MG, 50 MG........................12
                                                                                                       CREON 12,000-38,000 -60,000 UNIT,                                                              DAYPRO ..............................................................................26
COREG CR .......................................................................15
                                                                                                       24,000-76,000 -120,000 UNIT, 6,000-19,000
                                                                                                       -30,000 UNIT......................................................................34           DAYTRANA .....................................................................20
COREG CR .......................................................................17
COREG CR 10 MG, 20 MG, 40 MG, 80                                                                       CRESTOR ..........................................................................16           DDAVP .................................................................................38
MG.................................................................................................9
COREG CR 10 MG, 20 MG, 40 MG, 80                                                                       CRESYLATE .....................................................................32              DEBACTEROL ................................................................51
MG............................................................................................10                                                                                                      De-Chlor DM .....................................................................42
                                                                                                       CRINONE ..........................................................................38
COREG CR 10 MG, 20 MG, 40 MG, 80
MG............................................................................................11       CRIXIVAN ...........................................................................4          De-Chlor DM .....................................................................44

Corfen-DM ..........................................................................42                 cromolyn.................................................................................45    DEFEROXAMINE...........................................................35

Corfen-DM ..........................................................................44                 cromolyn ...............................................................................30     DEMADEX .........................................................................28
                                                                                                                                                                                                      DEMADEX 10 MG, 100 MG, 20 MG, 5
CORGARD ............................................................................9                  cromolyn ...............................................................................45     MG............................................................................................17
CORGARD .........................................................................13                    CRYOSERV .......................................................................40             demeclocycline .....................................................................6
CORGARD .........................................................................15                    CUPRIMINE ....................................................................35               DEMEROL ..........................................................................24
Cormax ..................................................................................47            CURITY ALCOHOL SWABS .................................50                                       DEMSER .............................................................................40
CORTANE-B .....................................................................31                      CUROSURF .......................................................................46             DENAVIR ............................................................................49

60
                                                                                                          DEXTROMETHORPHAN-GUAIFENESIN
Denta 5000 Plus ................................................................39                                                                                                                                  digoxin ....................................................................................14
                                                                                                          .....................................................................................................42
DentaGel ...............................................................................39                DEXTROMETHORPHAN-GUAIFENESIN                                                                              dihydrocode-acetaminophen-caff .............................24
                                                                                                          .....................................................................................................43
DEPAKENE .......................................................................21                                                                                                                                  dihydroergotamine...............................................................9
                                                                                                          Dex-Tuss ...............................................................................42
DEPAKOTE ......................................................................21                                                                                                                                   dihydroergotamine............................................................21
                                                                                                          Dex-Tuss ...............................................................................43
DEPAKOTE ER .............................................................21                                                                                                                                         DiHydro-PE .........................................................................24
                                                                                                          DIABETA ............................................................................38
DEPAKOTE SPRINKLES ......................................21                                                                                                                                                         DiHydro-PE .........................................................................42
                                                                                                          DIAMOX SEQUELS .....................................................14
DEPEN TITRATABS ....................................................35                                                                                                                                              DiHydro-PE .........................................................................44
                                                                                                          DIAMOX SEQUELS .....................................................28
DEPO-TESTOSTERONE ...........................................36                                                                                                                                                     DILACOR XR ...................................................................14
                                                                                                          DIAMOX SEQUELS .....................................................31
DEPRIZINE ........................................................................34                                                                                                                                DILACOR XR ...................................................................15
                                                                                                          DIASTAT .............................................................................22
DERMA-SMOOTH/FS BODY OIL ......................47                                                                                                                                                                   DILACOR XR ...................................................................19
                                                                                                          DIASTAT .............................................................................23
DERMA-SMOOTHE/FS SCALP OIL .................47                                                            DIASTAT ACUDIAL 12.5-15-17.5-20 MG,                                                                       DILANTIN .........................................................................15

DERMATOP ......................................................................47                         5-7.5-10 MG.........................................................................22                    DILANTIN .........................................................................23
                                                                                                          DIASTAT ACUDIAL 12.5-15-17.5-20 MG,
DERMAZENE ...................................................................50                           5-7.5-10 MG.........................................................................23                    DILANTIN EXTENDED ..........................................15

DERMOTIC OIL .............................................................31                              diazepam................................................................................22                DILANTIN EXTENDED ..........................................23

DESFERAL .........................................................................35                      diazepam................................................................................23                DILANTIN INFATABS .............................................15

desipramine...........................................................................27                  DIAZEPAM ........................................................................22                       DILANTIN INFATABS .............................................23

DESMOPRESSIN.............................................................38                               diazepam ...............................................................................23                DILANTIN-125 ...............................................................15

desmopressin .......................................................................38                    DIAZEPAM INTENSOL .............................................22                                         DILANTIN-125 ...............................................................23

DESONATE .......................................................................47                        DIAZEPAM INTENSOL .............................................23                                         DILATRATE-SR ...........................................................17

desonide..................................................................................47              DIBENZYLINE .................................................................9                            DILAUDID .........................................................................24

desonide .................................................................................47              DIBENZYLINE ..............................................................17                              DILAUDID-5 ....................................................................24

DESOWEN .........................................................................47                       diclofenac potassium........................................................26                            DILEX-G 200 .....................................................................43

DESOWEN OINTMENT & LOTION ..................47                                                            diclofenac sodium..............................................................26                         DILEX-G 200 .....................................................................46

desoximetasone...................................................................48                       diclofenac sodium..............................................................32                         DILEX-G 200 .....................................................................52

DESOXYN ..........................................................................19                      dicloxacillin 250 mg, 500 mg.........................................6                                    DILEX-G 400 .....................................................................43

Despec-EXP ........................................................................41                     DICOPANOL .....................................................................44                         DILEX-G 400 .....................................................................46

Despec-EXP ........................................................................43                     dicyclomine..............................................................................8                DILEX-G 400 .....................................................................52

DESPEC-PDC ....................................................................24                         didanosine................................................................................5               DILT-CD ..............................................................................14

DESPEC-PDC ....................................................................42                         DIDREX ...............................................................................19                  DILT-CD ..............................................................................15

DESPEC-PDC ....................................................................44                         DIDRONEL ........................................................................39                       DILT-CD ..............................................................................19

DETROL .............................................................................52                    diethylpropion ....................................................................20                     Diltia XT ...............................................................................14

DETROL LA ....................................................................52                          DIFFERIN ..........................................................................51                     Diltia XT ...............................................................................15

dexamethasone....................................................................35                       DIFICID ...................................................................................5              Diltia XT ...............................................................................19

dexamethasone ...................................................................35                       DIFIL-G 400 .......................................................................43                     diltiazem hcl.........................................................................14
dexamethasone 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2
                                                                                                          DIFIL-G 400 .......................................................................46                     diltiazem hcl.........................................................................15
mg, 4 mg, 6 mg....................................................................35
                                                                                                          DIFIL-G 400 .......................................................................52                     diltiazem hcl.........................................................................16
DEXAMETHASONE INTENSOL ........................35
                                                                                                          diflorasone.............................................................................47                diltiazem hcl.........................................................................18
dexamethasone sodium phosphate ...........................31
DEXAMETHASONE SODIUM PHOSPHATE                                                                            diflorasone ...........................................................................47                 diltiazem hcl.........................................................................19
.....................................................................................................35
                                                                                                          DIFLUCAN ...........................................................................4                     diltiazem hcl ........................................................................14
dexchlorpheniramine maleate ......................................7                                       DIFLUCAN 100 MG, 150 MG, 200 MG, 50
                                                                                                                                                                                                                    diltiazem hcl ........................................................................15
DEXEDRINE SPANSULE .........................................19                                            MG..................................................................................................4
                                                                                                                                                                                                                    diltiazem hcl ........................................................................19
DEXILANT .........................................................................35                      diflunisal ...............................................................................26
                                                                                                                                                                                                                    DILT-XR ..............................................................................14
dexmethylphenidate..........................................................20                            DIGEX NF .............................................................................8
                                                                                                                                                                                                                    DILT-XR ..............................................................................15
DEXPAK ..............................................................................35                   DIGEX NF ...........................................................................44
                                                                                                                                                                                                                    DILT-XR ..............................................................................19
DEXPAK JR. ......................................................................35                       digoxin.....................................................................................13
                                                                                                                                                                                                                    Diltzac ER ............................................................................14
dextroamphetamine...........................................................19                            digoxin ....................................................................................13

                                                                                                                                                                                                                                                                                                            61
Diltzac ER ............................................................................15                 DOVONEX ........................................................................51              dyphylline-guaifenesin ...................................................43

Diltzac ER ............................................................................19                 doxazosin..................................................................................9    dyphylline-guaifenesin ...................................................46

DIMENHYDRINATE ...................................................33                                      doxazosin................................................................................11     dyphylline-guaifenesin ...................................................52

DIOVAN ..............................................................................12                   doxazosin................................................................................12     DYRENIUM .......................................................................17

DIOVAN HCT .................................................................12                            doxazosin................................................................................17     DYRENIUM .......................................................................28

DIOVAN HCT .................................................................30                            doxepin ...................................................................................27   DYSPORT ...........................................................................10
DIOVAN HCT 160-12.5 MG, 160-25 MG,
                                                                                                          doxycycline hyclate..............................................................7              DYSPORT ...........................................................................40
320-12.5 MG, 320-25 MG, 80-12.5 MG.............18
                                                                                                          doxycycline hyclate ............................................................6               E.E.S. 400 ...............................................................................5
DIPENTUM ........................................................................33
                                                                                                          doxycycline hyclate ..........................................................31                E.E.S. GRANULES ...........................................................5
diphenhydramine hcl ......................................................44
                                                                                                          doxycycline monohydrate.................................................6                       EC-NAPROSYN ..............................................................26
DIPHENHYDRAMINE HCL 25 MG....................44
                                                                                                          Doxytex .................................................................................22     econazole ..............................................................................49
diphenhydramine hcl 50 mg.........................................44
                                                                                                          Doxytex .................................................................................44     ED A-HIST ..........................................................................44
diphenoxylate-atropine......................................................8
                                                                                                          Drithocreme HP ................................................................50               ED DM ...................................................................................42
diphenoxylate-atropine...................................................33
                                                                                                          DRITHO-SCALP ...........................................................50                      ED DM ...................................................................................44
diphenoxylate-atropine...................................................41
                                                                                                          DRONABINOL..................................................................33                  EDARBI ...............................................................................12
diphenoxylate-atropine ....................................................8
                                                                                                          DROXIA 200 MG, 300 MG, 400 MG....................7                                              EDECRIN ............................................................................17
DIPROLENE ......................................................................47
                                                                                                          DRYSOL DAB-O-MATIC .........................................49                                  EDECRIN ............................................................................28
DIPROLENE AF ..............................................................47
                                                                                                          DUET DHA BALANCED 27-1-430 MG..........28                                                       EDEX .....................................................................................19
dipyridamole........................................................................11
                                                                                                          DUET DHA BALANCED 27-1-430 MG..........52                                                       EDURANT ............................................................................5
dipyridamole........................................................................19
                                                                                                          DUET DHA COMPLETE ........................................28                                    EEMT .....................................................................................36
Diskets ....................................................................................24
                                                                                                          DUET DHA COMPLETE ........................................52                                    EEMT HS .............................................................................36
disopyramide........................................................................15
                                                                                                          DUETACT .........................................................................38             EFFER-K 10 MEQ, 20 MEQ...................................28
disulfiram...............................................................................39
                                                                                                          DULERA .............................................................................10          Effer-K 25 mEq..................................................................28
DITROPAN XL ................................................................52
                                                                                                          DULERA .............................................................................35          EFFEXOR XR ...................................................................26
DIURIL .................................................................................18
                                                                                                          DULERA .............................................................................45          EFFIENT 10 MG, 5 MG.............................................11
DIURIL .................................................................................30
                                                                                                          DULERA .............................................................................46          EFUDEX ...............................................................................51
divalproex..............................................................................21
                                                                                                          DUODOTE ............................................................................8           EGRIFTA .............................................................................38
DIVIGEL ............................................................................37
                                                                                                          DUODOTE ..........................................................................39            ELDOPAQUE FORTE .................................................50
DIVISTA ..............................................................................40
                                                                                                          DUONEB ................................................................................8        ELDOQUIN FORTE ......................................................50
DOLGIC PLUS .................................................................20
                                                                                                          DUONEB .............................................................................10          ELESTAT ............................................................................30
DOLGIC PLUS .................................................................22
                                                                                                          DUONEB .............................................................................41          ELESTRIN ..........................................................................37
DOLOPHINE .....................................................................24
                                                                                                          DUONEB .............................................................................46          ELETONE ............................................................................49
DONATUSS DC ..............................................................42
                                                                                                          DURAGESIC .....................................................................24               ELIDEL ...............................................................................51
DONATUSS DC ..............................................................43
                                                                                                                                                                                                          ELIGARD 22.5 MG, 30 MG, 45 MG, 7.5
                                                                                                          DURAXIN ...........................................................................19
DONATUSSIN DM ........................................................42                                                                                                                                  MG..................................................................................................7
                                                                                                          DURAXIN ...........................................................................44
DONATUSSIN DM ........................................................44                                                                                                                                  Eliphos ...................................................................................28
DONATUSSIN PEDI (REFORMULATED)                                                                            DUREZOL ...........................................................................31
                                                                                                                                                                                                          Elite-OB ................................................................................52
.....................................................................................................43
                                                                                                          DYAZIDE ............................................................................17
                                                                                                                                                                                                          Elite-OB 400 .......................................................................52
donepezil...................................................................................9
                                                                                                          DYAZIDE ............................................................................18
                                                                                                                                                                                                          ELIXOPHYLLIN ..........................................................16
DONNATAL .........................................................................8
                                                                                                          DYAZIDE ............................................................................28
                                                                                                                                                                                                          ELIXOPHYLLIN ..........................................................28
DONNATAL ......................................................................22
                                                                                                          DYAZIDE ............................................................................30
                                                                                                                                                                                                          ELIXOPHYLLIN ..........................................................46
DONNATAL EXTENTABS ........................................8
                                                                                                          DYLIX ...................................................................................46
                                                                                                                                                                                                          ELIXOPHYLLIN ..........................................................52
DONNATAL EXTENTABS .....................................22
                                                                                                          DYLIX ...................................................................................52
                                                                                                                                                                                                          ELLA ......................................................................................36
DORAL .................................................................................23
                                                                                                          DYNACIN 100 MG............................................................6
                                                                                                                                                                                                          ELMIRON .........................................................................40
DORYX ...................................................................................6
                                                                                                          DYNACIRC CR ...............................................................16
                                                                                                                                                                                                          ELOCON ..............................................................................47
dorzolamide..........................................................................31
                                                                                                          DYNACIRC CR 10 MG, 5 MG.................................16
                                                                                                                                                                                                          EMADINE ...........................................................................30
dorzolamide-timolol.........................................................31
62
EMCYT ..................................................................................7        EPIQUIN MICRO ...........................................................50                        ETHANOL (ETHYL ALCOHOL) .........................40

EMEND ................................................................................33         Epitol .......................................................................................21   ethosuximide.........................................................................27

Emgel ......................................................................................48   EPIVIR ....................................................................................5       ETHRANE ...........................................................................23

EMLA ....................................................................................49      EPIVIR HBV .......................................................................5                ETHYL CHLORIDE ......................................................49

EMSAM ................................................................................24         eplerenone.............................................................................17          etidronate disodium..........................................................39
                                                                                                 EPOGEN 10,000 UNIT/ML, 2,000 UNIT/ML,
EMTRIVA ............................................................................5                                                                                                               etidronate disodium .........................................................39
                                                                                                 20,000 UNIT/2 ML, 20,000 UNIT/ML, 3,000
ENABLEX ..........................................................................52             UNIT/ML, 4,000 UNIT/ML........................................10                                   etodolac .................................................................................26

enalapril maleate...............................................................12               EPROSARTAN..................................................................12                     etoposide ..................................................................................7

enalapril maleate...............................................................13               EPZICOM .............................................................................5             EURAX .................................................................................51

enalapril-hydrochlorothiazide....................................12                              EQUETRO ...........................................................................21              EVAMIST ...........................................................................37

enalapril-hydrochlorothiazide....................................13                              ergoloid ....................................................................................9     EVISTA ................................................................................37

enalapril-hydrochlorothiazide....................................18                              ERGOMAR ..........................................................................9                EVOCLIN ............................................................................48

enalapril-hydrochlorothiazide....................................30                              ERGOMAR .......................................................................21                  EVOXAC ...............................................................................9

enalapril-hydrochlorothiazide 5-12.5 mg.............18                                           ergotamine-caffeine.............................................................9                  EXACTACAIN .................................................................49

ENBREL ..............................................................................40          ergotamine-caffeine..........................................................21                    EXALGO ER .....................................................................24

ENBREL SURECLICK .............................................40                                 ERTACZO ...........................................................................49              ExeFen-IR ............................................................................41

ENDACOF-C .....................................................................24                Ery Pads ................................................................................48        ExeFen-IR ............................................................................43

ENDACOF-C .....................................................................42                ERYPED 200 ........................................................................5               EXELDERM .......................................................................49

ENDACOF-C .....................................................................44                ERYPED 400 ........................................................................5               EXELON ................................................................................9

ENDACOF-DC .................................................................41                   Ery-Tab 250 mg, 333 mg.................................................5                           EXELON 1.5 MG, 3 MG, 4.5 MG, 6 MG...............9
                                                                                                 ERY-TAB 500 MG.............................................................5                       EXELON 4.6 MG/24 HOUR, 9.5 MG/24
ENDACOF-DC .................................................................42
                                                                                                                                                                                                    HOUR..........................................................................................9
Endocet 10-325 mg, 5-325 mg, 7.5-325 mg,                                                         Erythrocin Stearate .............................................................5
7.5-500 mg............................................................................19                                                                                                            exemestane...............................................................................7
Endocet 10-325 mg, 5-325 mg, 7.5-325 mg,                                                         erythromycin........................................................................31
                                                                                                                                                                                                    EXFORGE .........................................................................12
7.5-500 mg............................................................................24
                                                                                                 erythromycin ..........................................................................5
                                                                                                                                                                                                    EXFORGE .........................................................................16
ENDOCET 10-650 MG..................................................19
                                                                                                 erythromycin ethylsuccinate...........................................5
                                                                                                                                                                                                    EXFORGE .........................................................................19
ENDOCET 10-650 MG..................................................24
                                                                                                 erythromycin with ethanol.............................................48
                                                                                                                                                                                                    EXFORGE HCT ............................................................12
Endodan .................................................................................24
                                                                                                 erythromycin-benzoyl peroxide..................................48
                                                                                                                                                                                                    EXFORGE HCT ............................................................16
Endodan .................................................................................26
                                                                                                 erythromycin-sulfisoxazole ............................................4
                                                                                                                                                                                                    EXFORGE HCT ............................................................30
ENJUVIA ............................................................................37
                                                                                                 ESGIC ....................................................................................19
                                                                                                                                                                                                    EXJADE ..............................................................................35
enoxaparin.............................................................................11
                                                                                                 ESGIC ....................................................................................20
                                                                                                                                                                                                    EXODERM .........................................................................48
ENTEREG ...........................................................................34
                                                                                                 ESGIC ....................................................................................22
                                                                                                                                                                                                    EXTAVIA ...........................................................................39
Enteric Coated Aspirin ..................................................11
                                                                                                 ESGIC-PLUS .....................................................................19
                                                                                                                                                                                                    EXTINA ................................................................................49
ENTOCORT EC ...............................................................35
                                                                                                 ESGIC-PLUS .....................................................................20
                                                                                                                                                                                                    EXXOTIC-HC ...................................................................31
Enulose ..................................................................................28
                                                                                                 ESGIC-PLUS .....................................................................22
                                                                                                                                                                                                    FACTIVE ................................................................................6
EPHEDRINE SULFATE .............................................41
                                                                                                 estazolam ..............................................................................23
                                                                                                                                                                                                    famciclovir...............................................................................5
Epidrin ....................................................................................19
                                                                                                 ESTRACE ..........................................................................37
                                                                                                                                                                                                    famotidine..............................................................................34
EPIDUO ...............................................................................51
                                                                                                 estradiol..................................................................................37
                                                                                                                                                                                                    FAMVIR .................................................................................5
Epiflur ....................................................................................39
                                                                                                 ESTRADIOL VALERATE ........................................37
                                                                                                                                                                                                    FANAPT ...............................................................................22
EPIFOAM ............................................................................47
                                                                                                 estradiol-norethindrone acet.......................................37
                                                                                                                                                                                                    FANATREX .......................................................................21
EPIFOAM ............................................................................49
                                                                                                 ESTRASORB .....................................................................37
                                                                                                                                                                                                    FASTTAKE TEST ........................................................27
epinastine...............................................................................30
                                                                                                 ESTRING ............................................................................37
                                                                                                                                                                                                    FAZACLO ...........................................................................22
epinephrine...........................................................................41
                                                                                                 ESTROGEL ........................................................................37
                                                                                                                                                                                                    FELBAMATE.....................................................................21
epinephrine (pf) .................................................................41
                                                                                                 estrogens-methyltestosterone.......................................36
                                                                                                                                                                                                    FELBATOL .......................................................................21
epinephrine hcl ..................................................................41
                                                                                                 estropipate.............................................................................37
                                                                                                                                                                                                    FELDENE ............................................................................26
EPIPEN ................................................................................41
                                                                                                 ethambutol................................................................................4
                                                                                                                                                                                                    felodipine ..............................................................................16
EPIPEN JR ........................................................................41
                                                                                                                                                                                                                                                                                            63
felodipine 10 mg, 2.5 mg, 5 mg...................................16                              FIRST-HYDROCORTISONE ..................................47                                      FLURA-DROPS .............................................................39

FEM PH ................................................................................50        FIRST-MARY'S MOUTHWASH ...........................47                                           flurazepam ............................................................................23

FEMARA ................................................................................7         FIRST-MARY'S MOUTHWASH ...........................48                                           flurbiprofen...........................................................................26

FEMHRT 1/5 ......................................................................37              FIRST-MARY'S MOUTHWASH ...........................49                                           flurbiprofen ..........................................................................26

FEMHRT 1/5 ......................................................................38              FIRST-MARY'S MOUTHWASH ...........................51                                           flurbiprofen sodium..........................................................32

FEMHRT LOW DOSE .................................................37                              FLAGYL .................................................................................3      FLURESS .............................................................................32

FEMHRT LOW DOSE .................................................38                              FLAGYL 250 MG, 500 MG...........................................3                              FLUROX ..............................................................................32

FEMRING ............................................................................37           FLAGYL ER .........................................................................3           flutamide ..................................................................................7

FEMTRACE .......................................................................37               FLAREX ...............................................................................31       fluticasone.............................................................................31

fenofibrate ............................................................................16       flavoxate ................................................................................52   fluticasone.............................................................................45

fenofibrate micronized....................................................16                     flecainide................................................................................15   fluticasone.............................................................................47

fenofibric acid......................................................................16          FLECTOR ............................................................................26         fluvoxamine .........................................................................27

FENOGLIDE 120 MG, 40 MG..................................16                                      FLEXERIL 10 MG, 5 MG...............................................9                           FML FORTE ......................................................................31

fenoprofen ............................................................................26        FLEXTRA PLUS .............................................................19                   FML LIQUIFILM ............................................................31

fentanyl....................................................................................24   FLOMAX .............................................................................10         FML S.O.P. ........................................................................31

fentanyl citrate....................................................................24           FLONASE ............................................................................31         FOCALIN ............................................................................20
                                                                                                                                                                                                FOCALIN XR 10 MG, 15 MG, 20 MG, 30 MG,
FENTORA ...........................................................................24            FLONASE ............................................................................45
                                                                                                                                                                                                40 MG, 5 MG......................................................................20
FIBRICOR 105 MG, 35 MG.......................................16                                  FLOVENT DISKUS .....................................................35
                                                                                                                                                                                                Folcal DHA .........................................................................28
FINACEA ...........................................................................51            FLOVENT DISKUS .....................................................45
                                                                                                                                                                                                Folcal DHA .........................................................................34
FINACEA PLUS ..............................................................51                    FLOVENT HFA .............................................................35
                                                                                                                                                                                                Folcaps Omega-3 ..............................................................28
finasteride..............................................................................39      FLOVENT HFA .............................................................45
                                                                                                                                                                                                folic acid ................................................................................52
FIORICET ............................................................................19          FLOXURIDINE ..................................................................7
                                                                                                                                                                                                Folivane-PRx DHA NF .................................................34
FIORICET ............................................................................20          fluconazole...............................................................................4
                                                                                                                                                                                                FOLLISTIM AQ ............................................................37
FIORICET ............................................................................22          flucytosine................................................................................6
                                                                                                                                                                                                FOLTX .................................................................................52
FIORICET-CODEINE ..................................................19                            fludrocortisone ...................................................................35
                                                                                                                                                                                                FORADIL AEROLIZER ..........................................10
FIORICET-CODEINE ..................................................20                            FLUMADINE .......................................................................3
                                                                                                                                                                                                FORADIL AEROLIZER ..........................................46
FIORICET-CODEINE ..................................................22                            flunisolide .............................................................................31
                                                                                                                                                                                                FORMADON .....................................................................51
FIORICET-CODEINE ..................................................24                            flunisolide .............................................................................45
                                                                                                                                                                                                FORTAMET .......................................................................36
FIORINAL ...........................................................................11           fluocinolone .........................................................................47
                                                                                                                                                                                                FORTEO .............................................................................38
FIORINAL ...........................................................................20           fluocinonide .........................................................................47
                                                                                                                                                                                                FORTESTA .........................................................................36
FIORINAL ...........................................................................21           Fluocinonide-E ..................................................................47
                                                                                                                                                                                                FORTICAL .........................................................................38
FIORINAL ...........................................................................22           fluocinonide-emollient.....................................................47
                                                                                                                                                                                                FOSAMAX .........................................................................39
FIORINAL ...........................................................................26           FLUORABON .................................................................39
                                                                                                                                                                                                FOSAMAX PLUS D ....................................................39
FIORINAL-CODEINE #3 ...........................................20                                FLUOR-A-DAY ...............................................................39
                                                                                                                                                                                                fosinopril ...............................................................................12
                                                                                                 FLUOR-A-DAY (WITH XYLITOL) 0.25 MG
FIORINAL-CODEINE #3 ...........................................22
                                                                                                 FLUORID (0.55)-236.79MG, 0.5 MG                                                                fosinopril ...............................................................................13
FIORINAL-CODEINE #3 ...........................................24                                FLUORIDE (1.1)-236.79 MG..................................39
                                                                                                                                                                                                fosinopril-hydrochlorothiazide ..................................12
                                                                                                 FLUOR-A-DAY (WITH XYLITOL) 1 MG
FIORINAL-CODEINE #3 ...........................................26                                FLUORIDE (2.2)-236.79 MG.....................................39                                fosinopril-hydrochlorothiazide ..................................13
FIRAZYR .............................................................................39          FLUORESCEIN-PROPARACAINE .....................32                                               fosinopril-hydrochlorothiazide ..................................30
FIRMAGON 120 MG, 80 MG...................................7                                       Fluoritab ................................................................................39   fosinopril-hydrochlorothiazide 10-12.5 mg,
                                                                                                                                                                                                20-12.5 mg.............................................................................18
FIRST-BXN ........................................................................32             fluorometholone..................................................................31
                                                                                                                                                                                                FOSRENOL ......................................................................28
FIRST-BXN ........................................................................49             FLUOROPLEX .................................................................51
                                                                                                                                                                                                FOSTEUM ...........................................................................40
FIRST-BXN ........................................................................51             fluorouracil...........................................................................51
                                                                                                                                                                                                FOVEX ..................................................................................40
FIRST-DUKE'S .................................................................47                 fluorouracil ..........................................................................51
                                                                                                                                                                                                FRAGMIN .........................................................................11
FIRST-DUKE'S .................................................................49                 fluoxetine................................................................................27
FIRST-DUKE'S .................................................................51                 fluphenazine hcl ................................................................26

64
FRAGMIN 10,000 UNIT/ML, 12,500
                                                                                                 glipizide...................................................................................38            Halonate Pac .......................................................................47
UNIT/0.5 ML, 15,000 UNIT/0.6 ML, 18,000
UNIT/0.72 ML, 2,500 UNIT/0.2 ML, 5,000                                                           glipizide-metformin .........................................................36                           haloperidol ...........................................................................23
UNIT/0.2 ML, 7,500 UNIT/0.3 ML......................11
                                                                                                 glipizide-metformin .........................................................38                           HALOPERIDOL DECANOATE..............................23
FRESHKOTE .....................................................................32
                                                                                                 GLUCAGEN ......................................................................37                         HALOPERIDOL LACTATE......................................23
FROVA .................................................................................26
                                                                                                 GLUCAGEN DIAGNOSTIC KIT ..........................37                                                      haloperidol lactate ...........................................................23
FURADANTIN ..................................................................7
                                                                                                 GLUCAGEN HYPOKIT .............................................37                                          HELIDAC ...............................................................................3
furosemide.............................................................................17
                                                                                                 GLUCAGON EMERGENCY ................................37                                                     HELIDAC ...............................................................................6
furosemide.............................................................................28
                                                                                                 GLUCOPHAGE ...............................................................36                              HELIDAC ............................................................................33
furosemide ............................................................................17
                                                                                                 GLUCOPHAGE XR .......................................................36                                   HEMABATE ......................................................................40
FUROSEMIDE .................................................................28
                                                                                                 GLUCOPRO ALCOHOL ............................................50                                           Hemril-30 .............................................................................47
furosemide 10 mg/ml, 40 mg/5 ml.............................28
                                                                                                 GLUCOTROL ...................................................................38                           heparin (porcine) ..............................................................11
FUZEON ................................................................................4
                                                                                                 GLUCOTROL XL ...........................................................38                                HEPARIN, PORCINE (PF) ........................................11
gabapentin.............................................................................20
                                                                                                                                                                                                           heparin, porcine (pf) 1,000 unit/ml, 5,000
                                                                                                 GLUCOVANCE ...............................................................36
gabapentin.............................................................................21                                                                                                                  unit/0.5 ml..............................................................................11
                                                                                                 GLUCOVANCE ...............................................................38
GABITRIL .........................................................................21                                                                                                                       HEPSERA .............................................................................5
                                                                                                 GLUMETZA ......................................................................36
galantamine.............................................................................9                                                                                                                  HEXALEN ............................................................................7
                                                                                                 GLUTATHIONE-L .........................................................40
galantamine..........................................................................10                                                                                                                    HIPREX ...................................................................................7
                                                                                                 glyburide................................................................................38
GALZIN ................................................................................35                                                                                                                  Hist-PSE ................................................................................41
                                                                                                 glyburide micronized.......................................................38
GANIRELIX .......................................................................40                                                                                                                        Hist-PSE ................................................................................44
                                                                                                 glyburide-metformin.........................................................36
GARAMYCIN ...................................................................31                                                                                                                            HIZENTRA .......................................................................46
                                                                                                 glyburide-metformin.........................................................38
Gastrinex NF .........................................................................8                                                                                                                    Homatropaire ......................................................................33
                                                                                                 GLYCOLAX ......................................................................34
Gastrinex NF .......................................................................44                                                                                                                     HUMALOG .......................................................................37
                                                                                                 glycopyrrolate........................................................................8
GASTROCROM ...............................................................45                                                                                                                               HUMALOG KWIKPEN ...........................................37
                                                                                                 GLYNASE ...........................................................................38
GASTROMARK ..............................................................40                                                                                                                                HUMALOG MIX 50-50 .............................................37
                                                                                                 GLYSET ...............................................................................35
GELFILM ............................................................................32                                                                                                                     HUMALOG MIX 50-50 KWIKPEN .................37
                                                                                                 GOLYTELY .....................................................................34
GELNIQUE .......................................................................52                                                                                                                         HUMALOG MIX 75-25 .............................................37
                                                                                                 GONAL-F ............................................................................37
gemfibrozil.............................................................................16                                                                                                                 HUMALOG MIX 75-25 KWIKPEN .................37
                                                                                                 GONAL-F RFF .................................................................37
Generlac ................................................................................28                                                                                                                HUMATROPE ................................................................38
                                                                                                 GONAL-F RFF PEN ......................................................37
Gengraf ..................................................................................40                                                                                                               HUMIRA .............................................................................40
                                                                                                 granisetron ...........................................................................33
GENOTROPIN ...............................................................38                                                                                                                               HUMIRA CROHN'S DIS START PCK .........40
                                                                                                 GRANISOL .........................................................................33
GENOTROPIN MINIQUICK ...............................38                                                                                                                                                     HUMIRA PEN .................................................................40
                                                                                                 GRANULEX ......................................................................51                         HUMIRA PSORIASIS STARTER PACK
Gentak ....................................................................................31                                                                                                              .....................................................................................................40
                                                                                                 GRIFULVIN V ....................................................................3
gentamicin ............................................................................31                                                                                                                  HUMULIN 70/30 ............................................................37
                                                                                                 griseofulvin microsize .......................................................3
gentamicin ............................................................................48                                                                                                                  HUMULIN 70/30 PEN ................................................37
                                                                                                 GRIS-PEG 125 MG, 250 MG........................................3
GENTEX 30 ........................................................................42                                                                                                                       HUMULIN N ....................................................................37
                                                                                                 guaifenesin............................................................................44
GENTEX 30 ........................................................................43                                                                                                                       HUMULIN N PEN ........................................................37
                                                                                                 guanfacine.............................................................................14
GEODON .............................................................................22                                                                                                                     HUMULIN R ....................................................................37
                                                                                                 guanidine .................................................................................9              HUMULIN R U-500 "CONCENTRATED"
Gianvi .....................................................................................36
                                                                                                                                                                                                           .....................................................................................................37
                                                                                                 Halac .......................................................................................47
GILENYA ...........................................................................39
                                                                                                 HALCION ............................................................................23                    HYCAMTIN ........................................................................7
GILTUSS PED-C .............................................................42
                                                                                                 HALDOL ..............................................................................23                   HYCET ..................................................................................19
GILTUSS PED-C .............................................................43
                                                                                                 HALDOL DECANOATE ............................................23                                           HYCET ..................................................................................24
Giltuss TR ............................................................................42
                                                                                                 HALFLYTELY-BISACODYL W-FLAV PK                                                                            hydralazine 10 mg, 100 mg, 25 mg, 50 mg...........16
Giltuss TR ............................................................................43        .....................................................................................................34
                                                                                                                                                                                                           HYDREA ................................................................................7
GLEEVEC ............................................................................7            halobetasol propionate...................................................48
                                                                                                                                                                                                           HYDROCHLORIC ACID (BULK) .......................34
GLIADEL WAFER ...........................................................7                       HALOG .................................................................................47
                                                                                                                                                                                                           hydrochlorothiazide..........................................................18
glimepiride............................................................................38        Halonate ................................................................................47

                                                                                                                                                                                                                                                                                                            65
hydrochlorothiazide..........................................................30               Hyophen ...................................................................................7            INNOPRAN XL ................................................................13

hydrochlorothiazide ........................................................30                hyoscyamine sulfate............................................................8                        INNOPRAN XL ................................................................15

hydrochlorothiazide 12.5 mg, 25 mg, 50 mg.......18                                            hyoscyamine sulfate ...........................................................8                        INNOPRAN XL ................................................................17

hydrocodone-acetaminophen.......................................19                            Hypercare .............................................................................49               INNOPRAN XL ................................................................21

hydrocodone-acetaminophen.......................................20                            HYPER-SAL ......................................................................28                      INNOPRAN XL 120 MG, 80 MG..............................9

hydrocodone-acetaminophen.......................................24                            HYZAAR .............................................................................12                  INSPRA .................................................................................17

hydrocodone-acetaminophen.......................................25                            HYZAAR .............................................................................30                  INSPRA 25 MG, 50 MG...............................................17
hydrocodone-acetaminophen 10-325 mg/15                                                        HYZAAR 100-12.5 MG, 100-25 MG, 50-12.5
                                                                                                                                                                                                      INTELENCE .......................................................................5
ml(15 ml), 2.5-167 mg/5 ml, 5-163                                                             MG............................................................................................12
mg/7.5ml(7.5ml), 5-334 mg/10 ml, 7.5-500 mg/15                                                HYZAAR 100-12.5 MG, 100-25 MG, 50-12.5                                                                  INTRON A ............................................................................4
ml(15 ml)................................................................................19   MG............................................................................................18
hydrocodone-acetaminophen 10-325 mg/15                                                                                                                                                                INTUNIV ER ....................................................................23
ml(15 ml), 2.5-167 mg/5 ml, 5-163                                                             IBUDONE ............................................................................24
mg/7.5ml(7.5ml), 5-334 mg/10 ml, 7.5-500 mg/15                                                                                                                                                        INVEGA ...............................................................................22
                                                                                              IBUDONE ............................................................................26
ml(15 ml)................................................................................24                                                                                                           INVEGA SUSTENNA ..................................................22
                                                                                              ibuprofen................................................................................26
hydrocodone-acetaminophen 2.5-500 mg.............19                                                                                                                                                   INVIRASE ............................................................................4
                                                                                              ibuprofen 400 mg, 600 mg, 800 mg..........................26
hydrocodone-acetaminophen 2.5-500 mg.............24                                                                                                                                                   IODOFLEX .........................................................................50
                                                                                              ibuprofen-oxycodone ......................................................24
HYDROCODONE-HOMATROPINE ..................42                                                                                                                                                          IODOQUINOL-HC..........................................................50
                                                                                              ibuprofen-oxycodone ......................................................26
hydrocodone-ibuprofen...................................................25                                                                                                                            IODOSORB ........................................................................50
                                                                                              IC400 ......................................................................................26
hydrocodone-ibuprofen...................................................26                                                                                                                            IONAMIN-30 .....................................................................20
                                                                                              IC800 ......................................................................................20
hydrocortisone.....................................................................35                                                                                                                 Iophen C-NR .......................................................................42
                                                                                              IC800 ......................................................................................26
hydrocortisone.....................................................................46                                                                                                                 Iophen C-NR .......................................................................43
                                                                                              ILOTYCIN ..........................................................................31
hydrocortisone.....................................................................47                                                                                                                 Iophen DM-NR ..................................................................42
                                                                                              IMDUR ..................................................................................17
HYDROCORTISONE 0.5 %......................................47                                                                                                                                          Iophen DM-NR ..................................................................43
                                                                                              imipramine hcl....................................................................27
HYDROCORTISONE 1 %..........................................47                                                                                                                                        Iophen-NR ............................................................................43
                                                                                              imipramine pamoate.........................................................27
hydrocortisone 1 %, 2.5 %............................................47                                                                                                                               IOPIDINE ............................................................................32
                                                                                              imiquimod..............................................................................51
hydrocortisone 2.5 %.......................................................47                                                                                                                         ipratropium bromide........................................................32
                                                                                              IMITREX .............................................................................26
hydrocortisone acet-aloe vera ...................................47                                                                                                                                   ipratropium bromide .........................................................8
                                                                                              IMITREX STATDOSE KIT REFILL ...................26
hydrocortisone acetate....................................................47                                                                                                                          ipratropium bromide .......................................................41
                                                                                              IMITREX STATDOSE PEN .....................................26
hydrocortisone butyrate.................................................47                                                                                                                            ipratropium-albuterol........................................................8
                                                                                              IMURAN ..............................................................................40
hydrocortisone valerate..................................................48                                                                                                                           ipratropium-albuterol......................................................10
                                                                                              iNatal Advance ..................................................................28
hydrocortisone valerate ................................................47                                                                                                                            ipratropium-albuterol......................................................41
                                                                                              iNatal Ultra ..........................................................................28
hydrocortisone-acetic acid............................................32                                                                                                                              ipratropium-albuterol......................................................46
                                                                                              iNatal Ultra ..........................................................................34
hydrocortisone-pramox-e-pram#1............................46                                                                                                                                          IPRIVASK .........................................................................10
                                                                                              INCIVEK ...............................................................................4
hydrocortisone-pramox-e-pram#1............................49                                                                                                                                          IRESSA ....................................................................................7
                                                                                              INCRELEX .........................................................................38
hydrocortisone-pramoxine............................................47                                                                                                                                ISENTRESS .........................................................................4
                                                                                              indapamide ..........................................................................30
hydrocortisone-pramoxine............................................49                                                                                                                                ISOCHRON ........................................................................17
                                                                                              indapamide 1.25 mg, 2.5 mg........................................18
hydromorphone...................................................................24                                                                                                                    ISODITRATE ....................................................................17
                                                                                              INDERAL LA ....................................................................13
HYDROMORPHONE ...................................................24                                                                                                                                   IsonaRif ....................................................................................4
                                                                                              INDERAL LA ....................................................................15
HYDROMORPHONE (PF) ........................................24                                                                                                                                         IsonaRif ....................................................................................6
                                                                                              INDERAL LA ....................................................................17
hydroquinone.......................................................................50                                                                                                                 ISONIAZID ...........................................................................4
                                                                                              INDERAL LA ....................................................................21
hydroquinone microspheres ........................................50                                                                                                                                  ISOPTO ATROPINE .....................................................33
                                                                                              INDERAL LA 120 MG, 160 MG, 60 MG, 80
hydroquinone with sunscreen......................................52                           MG..................................................................................................9   ISOPTO CARBACHOL ...........................................33
hydroxychloroquine.............................................................3              INDOCIN .............................................................................26                 ISOPTO CARPINE .........................................................33
hydroxyurea.............................................................................7     indomethacin .......................................................................26                  ISOPTO HOMATROPINE .........................................33
hydroxyzine hcl .....................................................................7        INFASURF ..........................................................................46                   ISOPTO HYOSCINE .....................................................33
HYDROXYZINE HCL .................................................22                           INFERGEN ............................................................................4                  ISORDIL ...............................................................................17
hydroxyzine pamoate.......................................................22                  INFLUDO ............................................................................40                  ISORDIL TITRADOSE ................................................17

66
isosorbide dinitrate...........................................................17                   KERLONE ...........................................................................17             LAMICTAL ODT .........................................................21
                                                                                                                                                                                                      LAMICTAL XR 100 MG, 200 MG, 25 MG,
isosorbide dinitrate ..........................................................17                   KERLONE 10 MG, 20 MG.........................................15
                                                                                                                                                                                                      250 MG, 300 MG, 50 MG...........................................21
isosorbide mononitrate...................................................17                         KETEK 300 MG, 400 MG..............................................4
                                                                                                                                                                                                      LAMISIL .................................................................................3
isoxsuprine ...........................................................................19           ketoconazole.........................................................................49
                                                                                                                                                                                                      LAMISIL ..............................................................................46
isradipine ..............................................................................16         ketoconazole ..........................................................................4
                                                                                                                                                                                                      LAMISIL 125 MG, 187.5 MG...................................3
isradipine 2.5 mg, 5 mg..................................................16                         ketoconazole ........................................................................49
                                                                                                                                                                                                      lamivudine................................................................................5
ISTALOL .............................................................................31             ketoprofen .............................................................................26
                                                                                                                                                                                                      lamivudine-zidovudine.......................................................5
ISUPREL ..............................................................................45            ketorolac.................................................................................32
                                                                                                                                                                                                      lamotrigine............................................................................21
itraconazole.............................................................................4          ketorolac ...............................................................................26
                                                                                                                                                                                                      LANOLIN (BULK) ........................................................49
JALYN ..................................................................................10          KETOTIFEN FUMARATE ........................................30
                                                                                                                                                                                                      LANOXIN ...........................................................................14
JALYN ..................................................................................39          KINERET .............................................................................40
                                                                                                                                                                                                      LANOXIN 125 MCG, 250 MCG..............................13
Jantoven .................................................................................10        KLARON .............................................................................50
                                                                                                                                                                                                      LANOXIN PEDIATRIC ..............................................14
JANUMET .........................................................................36                 KLONOPIN ........................................................................22
                                                                                                                                                                                                      lansoprazole.........................................................................35
JANUVIA ............................................................................37              KLONOPIN ........................................................................23
                                                                                                                                                                                                      LANTUS ..............................................................................37
JAY-PHYL ..........................................................................43               Klor-Con ...............................................................................29
                                                                                                                                                                                                      LANTUS SOLOSTAR ................................................37
JAY-PHYL ..........................................................................46               Klor-Con 20 mEq..............................................................29
                                                                                                                                                                                                      LASIX ....................................................................................17
JAY-PHYL ..........................................................................52               KLOR-CON 25 MEQ.....................................................29
                                                                                                                                                                                                      LASIX ....................................................................................28
J-COF DHC .........................................................................24               Klor-Con 8 ...........................................................................29
                                                                                                                                                                                                      LASTACAFT .....................................................................30
J-COF DHC .........................................................................42               Klor-Con M10 ....................................................................29
                                                                                                                                                                                                      latanoprost............................................................................33
J-COF DHC .........................................................................44               KLOR-CON M15 .............................................................29
                                                                                                                                                                                                      LATISSE ..............................................................................33
Jevantique .............................................................................37          Klor-Con M20 ....................................................................29
                                                                                                                                                                                                      LATUDA ..............................................................................22
Jinteli .......................................................................................37   Klor-Con/EF .......................................................................29
                                                                                                                                                                                                      lecithin ....................................................................................34
J-MAX DHC .......................................................................42                 KOMBIGLYZE XR .....................................................36
                                                                                                                                                                                                      leflunomide............................................................................39
J-MAX DHC .......................................................................43                 KOMBIGLYZE XR .....................................................37
                                                                                                                                                                                                      LESCOL 20 MG, 40 MG..............................................16
J-TAN D PD .......................................................................41                K-PHOS MF .......................................................................27
                                                                                                                                                                                                      LESCOL XL .......................................................................17
J-TAN D PD .......................................................................44                K-PHOS NO 2 ...................................................................28
                                                                                                                                                                                                      Lessina ...................................................................................36
J-TAN PD .............................................................................44            K-PHOS ORIGINAL .....................................................28
                                                                                                                                                                                                      LETAIRIS ..........................................................................19
JUVISYNC .........................................................................16                K-Phos-Neutral ..................................................................28
                                                                                                                                                                                                      letrozole.....................................................................................7
JUVISYNC .........................................................................37                KRISTALOSE .................................................................28                    leucovorin calcium 10 mg, 15 mg, 25 mg, 5
                                                                                                                                                                                                      mg..............................................................................................39
KADIAN ...............................................................................24            K-TAB ...................................................................................28
                                                                                                                                                                                                      LEUKERAN ........................................................................7
KALETRA ............................................................................4               KUVAN ................................................................................40
                                                                                                                                                                                                      LEUKINE ...........................................................................11
KANAMYCIN .....................................................................3                    l norgest&e estradiol-e estrad....................................36
                                                                                                                                                                                                      leuprolide ................................................................................7
KAOCHLOR ......................................................................28                   labetalol.....................................................................................9
                                                                                                                                                                                                      LEVACET ...........................................................................11
KAPVAY .............................................................................14              labetalol..................................................................................10
                                                                                                                                                                                                      LEVACET ...........................................................................19
Kariva .....................................................................................36      labetalol..................................................................................12
                                                                                                                                                                                                      LEVACET ...........................................................................21
KAYEXALATE ...............................................................28                        labetalol..................................................................................13
                                                                                                                                                                                                      LEVACET ...........................................................................26
K-Effervescent ...................................................................28                labetalol..................................................................................15
                                                                                                                                                                                                      levalbuterol hcl...................................................................10
KEFLEX 250 MG, 500 MG...........................................4                                   LAC-HYDRIN ..................................................................49
                                                                                                                                                                                                      LEVAQUIN ...........................................................................4
KEFLEX 750 MG................................................................4                      LAClotion ............................................................................49
                                                                                                                                                                                                      LEVAQUIN ...........................................................................6
KENALOG ..........................................................................35                LACRISERT ....................................................................32
                                                                                                                                                                                                      LEVATOL ...........................................................................13
KENALOG ..........................................................................47                lactic acid .............................................................................49
                                                                                                                                                                                                      LEVBID ..................................................................................8
KEPPRA ...............................................................................21            Lactic Acid E ......................................................................49
                                                                                                                                                                                                      LEVEMIR ..........................................................................37
KEPPRA XR ......................................................................21                  Lactocal-F ............................................................................29
                                                                                                                                                                                                      LEVEMIR FLEXPEN ................................................38
KERLONE ...........................................................................10               lactulose..................................................................................28
                                                                                                                                                                                                      levetiracetam........................................................................21
KERLONE ...........................................................................13               LAMICTAL ........................................................................21
                                                                                                                                                                                                      levetiracetam .......................................................................21
                                                                                                                                                                                                                                                                                                  67
LEVITRA .............................................................................17        Lipofen ...................................................................................16   LOPROX ..............................................................................50

levobunolol............................................................................31      lisinopril.................................................................................12   lorazepam..............................................................................23

levobunolol ..........................................................................31       lisinopril.................................................................................13   LORAZEPAM INTENSOL ........................................23

levocarnitine.........................................................................40       lisinopril-hydrochlorothiazide....................................12                            LORCET 10/650 ...............................................................19

levocarnitine (with sugar).............................................40                      lisinopril-hydrochlorothiazide....................................13                            LORCET 10/650 ...............................................................24

levocetirizine...........................................................................7     lisinopril-hydrochlorothiazide....................................18                            LORCET PLUS ................................................................19

levocetirizine........................................................................46       lisinopril-hydrochlorothiazide....................................30                            LORCET PLUS ................................................................24

levofloxacin.............................................................................4     Lite Coat Aspirin ..............................................................11              LORTAB ..............................................................................19

levofloxacin.............................................................................6     lithium carbonate...............................................................21              LORTAB ..............................................................................24

levofloxacin .........................................................................31       lithium carbonate .............................................................21               LORTAB ELIXIR ...........................................................19

levorphanol tartrate ........................................................24                lithium citrate .....................................................................21         LORTAB ELIXIR ...........................................................24

LEVOTHROID .................................................................38                 LITHOBID ..........................................................................21           LORTUSS EX ...................................................................41

levothyroxine........................................................................38        LITHOSTAT ......................................................................28              LORTUSS EX ...................................................................42

LEVOTHYROXINE 200 MCG, 500 MCG.........38                                                      LIVALO 1 MG, 2 MG, 4 MG.....................................17                                  LORTUSS EX ...................................................................43

Levoxyl ..................................................................................38   LO LOESTRIN FE .......................................................36                        losartan...................................................................................12

LEVSIN ...................................................................................8    LOCOID ..............................................................................47         losartan-hydrochlorothiazide......................................12

LEVSIN/SL ............................................................................8        LOCOID LIPOCREAM ...........................................47                                  losartan-hydrochlorothiazide......................................18

LEVULAN ..........................................................................51           LODOSYN .........................................................................23             losartan-hydrochlorothiazide......................................30

LEXAPRO ...........................................................................27          LOESTRIN 1.5/30 (21) ...............................................36                          LOSEASONIQUE ...........................................................36

LEXIVA .................................................................................4      LOESTRIN 1/20 (21) ...................................................36                        LOTEMAX ........................................................................31

LEXUSS 210 ......................................................................24            LOESTRIN 24 FE .........................................................36                      LOTENSIN .........................................................................12

LEXUSS 210 ......................................................................42            LOESTRIN FE 1.5/30 (28) .......................................36                               LOTENSIN .........................................................................13

LEXUSS 210 ......................................................................44            LOESTRIN FE 1/20 (28) ...........................................36                             LOTENSIN HCT .............................................................12

LIALDA ................................................................................33      LOFIBRA .............................................................................16         LOTENSIN HCT .............................................................13

LIBRAX (WITH CLIDINIUM) ..................................8                                    LoHist - D ............................................................................41       LOTENSIN HCT .............................................................18

LIBRAX (WITH CLIDINIUM) ...............................23                                      LoHist - D ............................................................................44       LOTENSIN HCT .............................................................30
                                                                                                                                                                                               LOTREL 10-20 MG, 10-40 MG, 2.5-10 MG,
LIDAMANTLE HC ........................................................47                       LOHIST 12 ..........................................................................44
                                                                                                                                                                                               5-10 MG, 5-20 MG, 5-40 MG....................................12
lidocaine hcl.........................................................................32       LoHist 12D ..........................................................................41         LOTREL 10-20 MG, 10-40 MG, 2.5-10 MG,
                                                                                                                                                                                               5-10 MG, 5-20 MG, 5-40 MG....................................13
lidocaine hcl.........................................................................33       LoHist 12D ..........................................................................44         LOTREL 10-20 MG, 10-40 MG, 2.5-10 MG,
lidocaine hcl ........................................................................32       LOHIST-DM ......................................................................42              5-10 MG, 5-20 MG, 5-40 MG....................................16
                                                                                                                                                                                               LOTREL 10-20 MG, 10-40 MG, 2.5-10 MG,
lidocaine hcl ........................................................................49       LOHIST-DM ......................................................................44              5-10 MG, 5-20 MG, 5-40 MG....................................19
Lidocaine Viscous ............................................................32               LOKARA .............................................................................47          LOTRISONE ......................................................................48
lidocaine-hydrocortisone ac 3-1 % (7 g)...............47                                       LOMOTIL ..............................................................................8         lovastatin................................................................................17
lidocaine-hydrocortisone ac 3-1 % (7 g)...............49                                       LOMOTIL ............................................................................33          lovastatin 10 mg.................................................................17
lidocaine-hydrocortisone-aloe....................................47                            LOMOTIL ............................................................................41          LOVAZA .............................................................................13
                                                                                                                                                                                               LOVENOX 100 MG/ML, 120 MG/0.8 ML, 150
lidocaine-hydrocortisone-aloe....................................49                            loperamide ...........................................................................33
                                                                                                                                                                                               MG/ML, 30 MG/0.3 ML, 40 MG/0.4 ML, 60
lidocaine-prilocaine.........................................................49                LOPID ....................................................................................16    MG/0.6 ML, 80 MG/0.8 ML.......................................11

LIDOCORT .........................................................................47           LOPRESSOR .....................................................................10               loxapine succinate.............................................................21

LIDOCORT .........................................................................49           LOPRESSOR .....................................................................13               LOXITANE .........................................................................21

LIDODERM ......................................................................49              LOPRESSOR 100 MG, 50 MG.................................15                                      Lozi-Flur ...............................................................................39

LINDANE ............................................................................51         LOPRESSOR HCT .........................................................10                       LTA PRE-ATTACHED ................................................49

LIORESAL ............................................................................9         LOPRESSOR HCT .........................................................13                       LUCENTIS ........................................................................32

liothyronine...........................................................................38      LOPRESSOR HCT .........................................................30                       Ludent Fluoride .................................................................39

LIPITOR ...............................................................................17      LOPRESSOR HCT 100-25 MG, 50-25 MG.......15                                                      LUFYLLIN .........................................................................46

LIPOCHOL PLUS ...........................................................40                    LOPRESSOR HCT 100-25 MG, 50-25 MG.......18                                                      LUFYLLIN .........................................................................52

68
Lugols .....................................................................................36    MARNATAL-F ...............................................................52                  MAXITROL .......................................................................32

Lugols .....................................................................................43    MARPLAN .........................................................................24           MAXZIDE ...........................................................................17

LUGOLS ...............................................................................50          Marten-Tab ..........................................................................20       MAXZIDE ...........................................................................18

LUMIGAN .........................................................................33               Marten-Tab ..........................................................................22       MAXZIDE ...........................................................................28

LUMINAL ...........................................................................22             Maternity ...............................................................................52   MAXZIDE ...........................................................................30

LUNESTA ...........................................................................22             MATULANE .......................................................................7             MAXZIDE-25MG ...........................................................18
LUPRON DEPOT (3 MONTH) 11.25 MG,
                                                                                                  MAVIK .................................................................................12     MAXZIDE-25MG ...........................................................28
22.5 MG....................................................................................7
                                                                                                  MAVIK .................................................................................13     MAXZIDE-25MG ...........................................................30
LUPRON DEPOT (4 MONTH) ..............................7
                                                                                                  MAXAIR AUTOHALER .........................................10                                  M-CLEAR ............................................................................42
LUPRON DEPOT (6 MONTH) ..............................7
                                                                                                  MAXAIR AUTOHALER .........................................46                                  M-CLEAR ............................................................................43
LUPRON DEPOT 3.75 MG, 7.5 MG....................7
                                                                                                  MAXALT ............................................................................26         M-Clear WC ........................................................................42
LUPRON DEPOT-PED (3 MONTH) ..................7
LUPRON DEPOT-PED 11.25 MG, 15 MG, 7.5                                                             MAXALT-MLT ..............................................................26                   M-Clear WC ........................................................................43
MG (PED)...............................................................................7
                                                                                                  MAXIDEX ..........................................................................31          meclizine.................................................................................33
Lusair ......................................................................................43
                                                                                                  MAXIDONE .......................................................................20            meclofenamate ...................................................................26
LUSTRA ...............................................................................50
                                                                                                  MAXIDONE .......................................................................24            MEDROL .............................................................................35
LUSTRA-AF ......................................................................50
                                                                                                  MAXIFED CD ...................................................................41              MEDROL (PAK) .............................................................35
Lustra-Ultra .........................................................................50
                                                                                                  MAXIFED CD ...................................................................42              medroxyprogesterone......................................................38
LUVERIS .............................................................................37
                                                                                                  MAXIFED CD ...................................................................43              mefenamic acid...................................................................26
LUVOX CR ........................................................................27
                                                                                                  MAXIFED CDX ...............................................................41                 mefloquine ...............................................................................3
LUXIQ ...................................................................................47
                                                                                                  MAXIFED CDX ...............................................................42                 MEGACE ES ........................................................................7
LYBREL ...............................................................................36
                                                                                                  MAXIFED CDX ...............................................................43                 MEGACE ORAL ................................................................8
LYRICA ...............................................................................21
                                                                                                  MAXIFED-G CD .............................................................41                  megestrol...................................................................................8
LYSODREN .........................................................................7
                                                                                                  MAXIFED-G CD .............................................................42                  megestrol 20 mg, 40 mg....................................................8
MACROBID .........................................................................7
                                                                                                  MAXIFED-G CD .............................................................43                  meloxicam..............................................................................26
MACRODANTIN 100 MG, 50 MG..........................7
                                                                                                  MAXIFED-G CDX .........................................................41                     Melpaque HP ......................................................................50
MACRODANTIN 25 MG...............................................7
                                                                                                  MAXIFED-G CDX .........................................................42                     M-END PE ...........................................................................24
MACUGEN .........................................................................32
                                                                                                  MAXIFED-G CDX .........................................................43                     M-END PE ...........................................................................42
MACUTEK .........................................................................40
                                                                                                  MAXIFLU CD ...................................................................20              M-END PE ...........................................................................44
MAGNACET .....................................................................19
                                                                                                  MAXIFLU CD ...................................................................25              M-End WC ...........................................................................24
MAGNACET .....................................................................24
                                                                                                  MAXIFLU CD ...................................................................41              M-End WC ...........................................................................42
MAGNEBIND 400 ..........................................................28
                                                                                                  MAXIFLU CD ...................................................................42              M-End WC ...........................................................................44
MAGNESIUM SULFATE ..........................................21
                                                                                                  MAXIFLU CD ...................................................................43              MENEST ..............................................................................37
MAKENA ...........................................................................38
                                                                                                  MAXIFLU CDX ...............................................................20                 MENOPUR .........................................................................37
MALARONE ........................................................................3
                                                                                                  MAXIFLU CDX ...............................................................25                 MENOSTAR ......................................................................37
malathion...............................................................................51
                                                                                                  MAXIFLU CDX ...............................................................41                 MENTAX ............................................................................48
maprotiline ...........................................................................27
                                                                                                  MAXIFLU CDX ...............................................................42                 meperidine.............................................................................24
MAR-COF BP ...................................................................24
                                                                                                  MAXIFLU CDX ...............................................................43                 meperidine.............................................................................25
MAR-COF BP ...................................................................42
                                                                                                  Maxiphen ..............................................................................43     meperidine ............................................................................25
MAR-COF BP ...................................................................44
                                                                                                  MAXIPHEN CD ...............................................................42                 Meperitab ..............................................................................25
MAR-COF CG ...................................................................42
                                                                                                  MAXIPHEN CD ...............................................................43                 meprobamate ......................................................................22
MAR-COF CG ...................................................................43
                                                                                                  MAXIPHEN CDX ...........................................................42                    MEPRON ...............................................................................3
Margesic ................................................................................19
                                                                                                  MAXIPHEN CDX ...........................................................43                    mercaptopurine.....................................................................8
Margesic ................................................................................20
                                                                                                  MAXIPHEN DM .............................................................42                   mesalamine...........................................................................33
Margesic ................................................................................22
                                                                                                  MAXIPHEN DM .............................................................43                   mesalamine-cleansing wipes........................................33
MARINOL ...........................................................................33
                                                                                                  MAXITROL .......................................................................31            Mesehist WC ......................................................................25
MARNATAL-F ...............................................................29
                                                                                                                                                                                                                                                                                       69
Mesehist WC ......................................................................42         metolazone ...........................................................................30   MIFEPREX .........................................................................40

Mesehist WC ......................................................................44         metolazone 10 mg..............................................................18           Migergot ..................................................................................9

MESNEX .............................................................................40       metoprolol succinate........................................................10             Migergot ................................................................................21

MESTINON .........................................................................9          metoprolol succinate........................................................13             MIGRANAL .........................................................................9

MESTINON TIMESPAN ............................................9                              metoprolol succinate........................................................15             MIGRANAL .......................................................................21

METADATE CD ............................................................20                   metoprolol tartrate............................................................10          MILLIPRED .......................................................................35

METADATE ER ..............................................................20                 metoprolol tartrate............................................................13          Millipred DP .......................................................................35

metaproterenol ...................................................................10         metoprolol tartrate............................................................15          MINIPRESS ........................................................................11

metaproterenol ...................................................................46         metoprolol tartrate ...........................................................13          MINIPRESS ........................................................................12

metaproterenol 10 mg, 20 mg......................................10                          metoprolol tartrate 25 mg.............................................10                   MINIPRESS 1 MG, 2 MG, 5 MG...............................9

metaxalone...............................................................................9   metoprolol tartrate 25 mg.............................................15                   MINITRAN .......................................................................17

metformin...............................................................................36   metoprolol-hydrochlorothiazide................................10                           MINOCIN ...............................................................................6

methadone.............................................................................24     metoprolol-hydrochlorothiazide................................13                           minocycline..............................................................................6

methadone.............................................................................25     metoprolol-hydrochlorothiazide................................15                           minocycline ............................................................................6

methadone ............................................................................25     metoprolol-hydrochlorothiazide................................18                           minocycline 75 mg...............................................................6

Methadone Intensol .........................................................25               metoprolol-hydrochlorothiazide................................30                           minoxidil 10 mg, 2.5 mg.................................................16

METHADOSE ...................................................................25              metoprolol-hydrochlorothiazide ...............................13                           MIOCHOL-E ......................................................................33

methamphetamine..............................................................19              metoprolol-hydrochlorothiazide ...............................18                           MIOSTAT ............................................................................33

methazolamide.....................................................................31         metoprolol-hydrochlorothiazide ...............................30                           MIRALAX ...........................................................................34

methenamine hippurate.....................................................7                  metoprolol-hydrochlorothiazide 100-50 mg........10                                         MIRAPEX ............................................................................24
                                                                                                                                                                                        MIRAPEX ER 0.375 MG, 0.75 MG, 1.5 MG, 3
methenamine mandelate 0.5 g, 1 gram......................7                                   metoprolol-hydrochlorothiazide 100-50 mg........15
                                                                                                                                                                                        MG, 4.5 MG........................................................................24
METHERGINE .................................................................40               METOZOLV ODT ..........................................................34
                                                                                                                                                                                        mirtazapine...........................................................................21
methimazole..........................................................................36      METROCREAM ..............................................................48
                                                                                                                                                                                        misoprostol............................................................................34
METHITEST ....................................................................36             METROGEL ....................................................................48
                                                                                                                                                                                        MOBAN ...............................................................................21
methocarbamol......................................................................9         METROGEL VAGINAL .............................................48
                                                                                                                                                                                        MOBIC ..................................................................................26
METHOTREXATE SODIUM .....................................8                                   METROLOTION .............................................................48
                                                                                                                                                                                        moexipril................................................................................12
METHOTREXATE SODIUM (PF) ..........................8                                         metronidazole.........................................................................3
                                                                                                                                                                                        moexipril................................................................................13
methscopolamine..................................................................8           metronidazole......................................................................48
                                                                                                                                                                                        moexipril-hydrochlorothiazide...................................12
methyclothiazide ...............................................................18           metronidazole .....................................................................48
                                                                                                                                                                                        moexipril-hydrochlorothiazide...................................13
methyclothiazide ...............................................................30           METVIXIA .........................................................................51
                                                                                                                                                                                        moexipril-hydrochlorothiazide...................................18
methyldopa 250 mg, 500 mg........................................14                          MEVACOR 20 MG, 40 MG........................................17
                                                                                                                                                                                        moexipril-hydrochlorothiazide...................................30
methyldopa-hydrochlorothiazide ..............................18                              mexiletine 150 mg, 200 mg, 250 mg.........................15
                                                                                                                                                                                        mometasone..........................................................................47
methyldopa-hydrochlorothiazide ..............................30                              MIACALCIN .....................................................................38
                                                                                                                                                                                        MOMEXIN .........................................................................47
methyldopa-hydrochlorothiazide 250-15 mg,
                                                                                             MICARDIS ........................................................................12
250-25 mg..............................................................................14                                                                                               MONODOX 100 MG, 50 MG, 75 MG.....................6
                                                                                             MICARDIS HCT ...........................................................12
methylergonovine...............................................................40                                                                                                       MONOKET .........................................................................17
                                                                                             MICARDIS HCT ...........................................................18
METHYLERGONOVINE ..........................................40                                                                                                                           Mononessa (28) .................................................................36
                                                                                             MICARDIS HCT ...........................................................30
METHYLIN ........................................................................20                                                                                                     MONUROL ...........................................................................7
                                                                                             Miconazole-3 ......................................................................49
methylphenidate..................................................................20                                                                                                     morphine................................................................................25
                                                                                             Microgestin 1/20 (21) .....................................................36
methylprednisolone...........................................................35                                                                                                         MORPHINE ........................................................................25
                                                                                             Microgestin FE 1/20 (28) .............................................36
METHYLPREDNISOLONE ACETATE ...........35                                                                                                                                                MORPHINE 4 MG/ML, 8 MG/ML.........................25
                                                                                             MICROZIDE ......................................................................18         MORPHINE 5 MG/ML, 50 MG/ML, 8
metipranolol.........................................................................31
                                                                                                                                                                                        MG/ML...................................................................................25
                                                                                             MICROZIDE ......................................................................30
metoclopramide..................................................................34
                                                                                                                                                                                        morphine concentrate .....................................................25
                                                                                             MIDAMOR .........................................................................18
metoclopramide .................................................................34
                                                                                                                                                                                        MOTOFEN ........................................................................33
                                                                                             MIDAMOR .........................................................................28
metolazone.............................................................................18
                                                                                                                                                                                        MOTRIN ...............................................................................26
                                                                                             midazolam ............................................................................23
metolazone.............................................................................30
                                                                                                                                                                                        MOVIPREP .........................................................................34
70
MOZOBIL .........................................................................11               NALOXONE ......................................................................25             Neofrin ...................................................................................33

MS CONTIN ......................................................................25                naltrexone..............................................................................25    neomycin ..................................................................................3

MUCOTROL ......................................................................51                 NAMENDA ........................................................................23            neomycin-bacitracin-poly-hc ......................................31

MULTAQ ............................................................................15             NAMENDA TITRATION PAK ...........................23                                           neomycin-bacitracin-poly-hc ......................................32

Multi Vit-Fluoride-Iron .................................................39                       NAPRELAN CR ...............................................................26                 neomycin-bacitracin-polymyxin ................................31

Multinatal Plus ...................................................................52             NAPROSYN .......................................................................26            NEOMYCIN-POLYMYXIN B GU........................48

Multi-Vitamin With Fluoride .....................................39                               naproxen.................................................................................26   neomycin-polymyxin-dexameth...................................31

Multivitamins-Fluoride-Folic A ................................39                                 naproxen sodium................................................................25             neomycin-polymyxin-dexameth...................................32

mupirocin...............................................................................48        naproxen sodium................................................................26             neomycin-polymyxin-gramicidin................................31

MURI-LUBE ......................................................................49                naratriptan............................................................................26     neomycin-polymyxin-hc..................................................31

MUSE ....................................................................................19       NARDIL ...............................................................................24      neomycin-polymyxin-hc .................................................31

MUSTARGEN .....................................................................8                  NASACORT AQ ..............................................................32                  neomycin-polymyxin-hc .................................................32

MVC-FLUORIDE ...........................................................39                        NASACORT AQ ..............................................................45                  NEORAL .............................................................................40

MYAMBUTOL 100 MG, 400 MG.............................4                                            NASOHIST .........................................................................44          NEOSPORIN ......................................................................31

MYCOBUTIN ....................................................................4                   NASOHIST DM ...............................................................42                 NEOSPORIN GU IRRIGANT ..................................48

MYCOBUTIN ....................................................................6                   NASOHIST DM ...............................................................45                 NEOSTIGMINE METHYLSULFATE ...................9

mycophenolate mofetil....................................................40                       NASONEX .........................................................................32           NEOTIC (WITH GLYCERIN) .................................32

MYDFRIN ...........................................................................33             NASONEX .........................................................................45           NEOTUSS-D ......................................................................41

MYDRIACYL ...................................................................33                   NASOTUSS ........................................................................25           NEOTUSS-D ......................................................................42

MYFORTIC ........................................................................40               NASOTUSS ........................................................................42           NEOTUSS-D ......................................................................43

MyHist-DM .........................................................................42             NASOTUSS ........................................................................45           NEOTUSS-D ......................................................................45

MyHist-DM .........................................................................44             NATACYN .........................................................................31           NEPTAZANE ....................................................................31

MYHIST-PD .......................................................................44               NATAFORT (NEW FORMULA 2011) ...........11                                                     NESTABS ...........................................................................29

MYKIDZ IRON FLUORIDE ....................................39                                       NATALVIT .......................................................................29            NESTABS ...........................................................................52

MYLERAN ...........................................................................8              NATAZIA ...........................................................................36         NESTABS DHA ..............................................................52

Mynatal ..................................................................................29      nateglinide.............................................................................38    NEULASTA .......................................................................11

Mynatal Advance .............................................................29                   NATELLE ONE .............................................................29                   NEUMEGA ........................................................................11

Mynatal Plus .......................................................................29            NATROBA ..........................................................................51          NEUPOGEN .....................................................................11
                                                                                                                                                                                                NEUPOGEN 300 MCG/0.5 ML, 480 MCG/0.8
Mynatal-Z .............................................................................29         NAVANE .............................................................................27
                                                                                                                                                                                                ML............................................................................................11
MYOBLOC .........................................................................10               NEBUPENT .........................................................................4
                                                                                                                                                                                                NEURONTIN ....................................................................20
MYOBLOC .........................................................................40               Necon 0.5/35 (28) .............................................................36
                                                                                                                                                                                                NEURONTIN ....................................................................21
MYSOLINE ........................................................................22               Necon 1/35 (28) .................................................................36
                                                                                                                                                                                                Neutrahist .............................................................................41
MYTELASE ..........................................................................9              Necon 1/50 (28) .................................................................36
                                                                                                                                                                                                Neutrahist .............................................................................45
nabumetone .........................................................................26            Necon 10/11 (28) ..............................................................36
                                                                                                                                                                                                Neutrahist PDX .................................................................41
nadolol.......................................................................................9   Necon 7/7/7 (28) ...............................................................36
                                                                                                                                                                                                Neutrahist PDX .................................................................42
nadolol.....................................................................................13    NEEVO DHA ...................................................................29
                                                                                                                                                                                                Neutrahist PDX .................................................................45
nadolol.....................................................................................15    NEEVO DHA ...................................................................52
                                                                                                                                                                                                NEVANAC .........................................................................32
nadolol-bendroflumethiazide..........................................9                            NEFAZODONE ................................................................27
                                                                                                                                                                                                NEXA SELECT ................................................................34
nadolol-bendroflumethiazide.......................................13                              NEO AC ................................................................................25
                                                                                                                                                                                                NEXAVAR ............................................................................8
nadolol-bendroflumethiazide.......................................15                              NEO AC ................................................................................42
                                                                                                                                                                                                NEXAVIR ............................................................................40
nadolol-bendroflumethiazide.......................................18                              NEO AC ................................................................................45
                                                                                                                                                                                                NEXICLON XR ................................................................14
nadolol-bendroflumethiazide.......................................30                              NEO DM ...............................................................................41
                                                                                                                                                                                                NEXIUM .............................................................................35
Nafrinse .................................................................................39      NEO DM ...............................................................................42
                                                                                                                                                                                                NEXIUM PACKET ......................................................35
NAFTIN ................................................................................46         NEO DM ...............................................................................45
                                                                                                                                                                                                NIACOR ...............................................................................13
NALFON ..............................................................................26           NEO-FRADIN ......................................................................3            NIASPAN EXTENDED-RELEASE 1,000 MG,
                                                                                                                                                                                                500 MG, 750 MG.............................................................13
                                                                                                                                                                                                                                                                                           71
NICARDIPINE .................................................................16                   NORFLEX ...........................................................................10            nystatin .....................................................................................6

NICARDIPINE .................................................................19                   NORITATE .........................................................................48             nystatin ...................................................................................51

NICARDIPINE 20 MG, 30 MG................................16                                        NOROXIN ............................................................................6            nystatin 150 million unit...................................................6
                                                                                                                                                                                                   NYSTATIN 50 MILLION UNIT, 500 MILLION
NICAZEL .............................................................................40           NORPACE 100 MG, 150 MG....................................15
                                                                                                                                                                                                   UNIT.............................................................................................6
nicotine .....................................................................................9   NORPACE CR 100 MG, 150 MG............................15
                                                                                                                                                                                                   nystatin-triamcinolone ...................................................51
nicotine (polacrilex)............................................................9                NORPRAMIN ....................................................................27
                                                                                                                                                                                                   Nystop ....................................................................................51
nicotine (polacrilex) ...........................................................9                NOR-QD ...............................................................................36
                                                                                                                                                                                                   OB COMPLETE ............................................................29
NICOTROL .........................................................................9               nortriptyline..........................................................................27
                                                                                                                                                                                                   OB COMPLETE ............................................................52
NICOTROL NS .................................................................9                    NORVASC ..........................................................................16
                                                                                                                                                                                                   OB COMPLETE ONE ...............................................29
Nifediac CC .........................................................................16           NORVASC ..........................................................................19
                                                                                                                                                                                                   OB COMPLETE ONE ...............................................52
Nifediac CC .........................................................................19           NORVASC 10 MG, 2.5 MG, 5 MG........................16
                                                                                                                                                                                                   OB COMPLETE PREMIER .................................29
Nifedical XL .......................................................................16            NORVIR .................................................................................4
                                                                                                                                                                                                   OB COMPLETE PREMIER .................................52
Nifedical XL .......................................................................19            NOTUSS-NX .....................................................................45
                                                                                                                                                                                                   OB-Natal One .....................................................................29
nifedipine................................................................................16      NOTUSS-NXD .................................................................45
                                                                                                                                                                                                   OBSTETRIX EC ............................................................34
nifedipine................................................................................18      NOVACORT ......................................................................47
                                                                                                                                                                                                   OBTREX .............................................................................34
nifedipine................................................................................19      NOVACORT ......................................................................49
                                                                                                                                                                                                   O-CAL FA ..........................................................................29
nifedipine 20 mg.................................................................16               NOVAREL ..........................................................................37
                                                                                                                                                                                                   O-CAL PRENATAL ....................................................29
NILANDRON .......................................................................8                NOVOLIN 70/30 .............................................................38
                                                                                                                                                                                                   octreotide acetate...............................................................40
nimodipine.............................................................................16         NOVOLIN N .....................................................................38
                                                                                                                                                                                                   octreotide acetate .............................................................40
nimodipine.............................................................................19         NOVOLIN R .....................................................................38
                                                                                                                                                                                                   Ocucoat ..................................................................................32
NIMOTOP ...........................................................................16             NOVOLOG ........................................................................38
                                                                                                                                                                                                   OCUFEN ..............................................................................32
NIMOTOP ...........................................................................19             NOVOLOG FLEXPEN .............................................38
                                                                                                                                                                                                   OCUFLOX ..........................................................................31
NIRAVAM ..........................................................................23              NOVOLOG MIX 70-30 ..............................................38
                                                                                                                                                                                                   ofloxacin.................................................................................31
nisoldipine.............................................................................16        NOVOLOG MIX 70-30 FLEXPEN ...................38
                                                                                                                                                                                                   ofloxacin 200 mg, 300 mg, 400 mg.............................6
nisoldipine ............................................................................16        NOVOLOG PENFILL ...............................................38
                                                                                                                                                                                                   OGEN 2.5 .............................................................................37
nisoldipine 20 mg, 25.5 mg, 30 mg, 40 mg...........16                                             NOXAFIL ..............................................................................4
                                                                                                                                                                                                   olanzapine.............................................................................22
Nitro-Bid ...............................................................................17       NP Thyroid ..........................................................................38
                                                                                                                                                                                                   OLEPTRO ER ...................................................................27
NITRO-DUR ......................................................................17                NPLATE ..............................................................................11
                                                                                                                                                                                                   OLIVE OIL .........................................................................49
nitrofurantoin macrocrystal............................................7                          NPLATE ..............................................................................40
                                                                                                                                                                                                   OLUX .....................................................................................47
nitrofurantoin monohyd/m-cryst...................................7                                NUCORT ..............................................................................47
                                                                                                                                                                                                   OLUX-E ................................................................................47
nitroglycerin.........................................................................17          NUCYNTA .........................................................................25
                                                                                                                                                                                                   omeprazole............................................................................35
nitroglycerin ........................................................................17          NUCYNTA ER .................................................................25
                                                                                                                                                                                                   omeprazole-sodium bicarbonate................................35
NITROLINGUAL .........................................................17                          NUEDEXTA ......................................................................23
                                                                                                                                                                                                   OMNARIS ...........................................................................32
NITROMIST .......................................................................17               NUEDEXTA ......................................................................42
                                                                                                                                                                                                   OMNARIS ...........................................................................45
NITROSTAT 0.3 MG, 0.4 MG, 0.6 MG...........17                                                     NULEV ....................................................................................8
                                                                                                                                                                                                   OMNIPRED ........................................................................32
nizatidine................................................................................34      NULYTELY WITH FLAVOR PACKS ..........34
                                                                                                                                                                                                   OMNITROPE ....................................................................38
NIZORAL ............................................................................49            Nuquin HP ...........................................................................52
                                                                                                                                                                                                   ONCASPAR ..........................................................................8
NOHIST ................................................................................45         NUTRESTORE .................................................................34
                                                                                                                                                                                                   ondansetron..........................................................................33
NOHIST DMX ..................................................................42                   NUTROPIN .........................................................................38
                                                                                                                                                                                                   ondansetron hcl..................................................................33
NOHIST DMX ..................................................................45                   NUTROPIN AQ ................................................................38
                                                                                                                                                                                                   ondansetron hcl .................................................................33
NORCO .................................................................................20         NUTROPIN AQ NUSPIN ...........................................38
                                                                                                                                                                                                   ONE TOUCH BASIC SYSTEM ..........................27
NORCO .................................................................................25         NUVARING ......................................................................36
                                                                                                                                                                                                   ONE TOUCH DELICA LANCETS ...................27
NORDITROPIN FLEXPRO ..................................38                                          NUVIGIL .............................................................................20
                                                                                                                                                                                                   ONE TOUCH TEST ....................................................27
NORDITROPIN NORDIFLEX ............................38                                              Nyamyc .................................................................................51
                                                                                                                                                                                                   ONE TOUCH ULTRA 2 ...........................................27
norethindrone acetate......................................................38                     nystatin....................................................................................51
                                                                                                                                                                                                   ONE TOUCH ULTRA SMART ...........................27

72
ONE TOUCH ULTRA SYSTEM KIT .............27                                                       oxybutynin chloride .........................................................52                 PEDIADERM HC ............................................................47

ONE TOUCH ULTRA TEST ................................27                                          oxycodone..............................................................................25       PEDIADERM TA ............................................................47

ONE TOUCH ULTRAMINI ..................................27                                         oxycodone .............................................................................25       PEDIAPRED ......................................................................35

ONE TOUCH ULTRASOFT LANCETS .......27                                                            oxycodone-acetaminophen............................................19                           PEDIATEX TD .................................................................41

ONFI .......................................................................................23   oxycodone-acetaminophen............................................20                           PEDIATEX TD .................................................................45

ONGLYZA .........................................................................37              oxycodone-acetaminophen............................................24                           pediatric multivitamin-fl.................................................39

ONSOLIS .............................................................................25          oxycodone-acetaminophen............................................25                           pediatric multivitamin-fl ...............................................39

OPANA .................................................................................25        OXYCONTIN ..................................................................25                  Pedi-Dri .................................................................................51

OPANA ER .........................................................................25             OXYTOCIN ........................................................................40             peg 3350-electrolytes.......................................................34

OPIUM TINCTURE .......................................................33                         OXYTROL .........................................................................52             PEG-3350 with flavor packs .......................................34

OPTASE ...............................................................................51         OZURDEX .........................................................................32             PEGANONE .....................................................................23

OPTIPRANOLOL ...........................................................31                       PACERONE 100 MG...................................................15                            PEGASYS ..............................................................................4

OPTIVAR ............................................................................30           Pacerone 200 mg................................................................15               PEGASYS CONVENIENCE PACK ....................4

ORACEA ...............................................................................6          PACERONE 400 MG.....................................................15                          PEGASYS PROCLICK ................................................4

ORALONE ..........................................................................47             PAIN EASE ........................................................................49            peg-electrolyte soln...........................................................34

ORAP ....................................................................................21      PALGIC ................................................................................45       PEGINTRON ......................................................................4

ORAPRED ...........................................................................35            PAMELOR ..........................................................................27            PEGINTRON REDIPEN .............................................4

ORAPRED ODT ..............................................................35                     PAMINE ..................................................................................8      PE-Hist DM .........................................................................42

ORASEP ...............................................................................32         PAMINE FORTE ................................................................8                  PE-Hist DM .........................................................................45

ORBIVAN ...........................................................................20            PANCREAZE ....................................................................34                PENICILLIN G POTASSIUM.....................................5

ORBIVAN ...........................................................................22            PANCRECARB MS-16 ................................................34                             PENICILLIN G PROCAINE ........................................5

ORENCIA ............................................................................40           PANCRECARB MS-4 ...................................................34                           PENICILLIN G SODIUM .............................................5
                                                                                                                                                                                                 penicillin v potassium 125 mg/5 ml, 250 mg/5
ORFADIN ...........................................................................40            PANCRECARB MS-8 ...................................................34
                                                                                                                                                                                                 ml.....................................................................................................5
Organ-I NR ..........................................................................44          Pancrelipase 5000 .............................................................34
                                                                                                                                                                                                 penicillin v potassium 250 mg, 500 mg.....................5
ORPHENADRINE CITRATE....................................10                                       PANDEL ...............................................................................47
                                                                                                                                                                                                 PENLAC ...............................................................................50
orphenadrine citrate .......................................................10                   PANRETIN ........................................................................51
                                                                                                                                                                                                 PENNSAID .........................................................................26
Orphenadrine Compound .............................................10                            pantoprazole.........................................................................35
                                                                                                                                                                                                 PENTASA ...........................................................................33
Orphenadrine Compound .............................................26                            PAPAVERINE ..................................................................19
                                                                                                                                                                                                 pentazocine-acetaminophen ........................................20
Orphenadrine Compound-DS .....................................10                                 PARAFON FORTE DSC ...............................................9
                                                                                                                                                                                                 pentazocine-acetaminophen ........................................25
Orphenadrine Compound-DS .....................................26                                 PARCAINE .........................................................................32
                                                                                                                                                                                                 pentazocine-naloxone .....................................................25
ORTHO EVRA .................................................................36                   PARCOPA ...........................................................................23
                                                                                                                                                                                                 pentoxifylline........................................................................11
OSMOPREP .......................................................................34               paregoric ...............................................................................33
                                                                                                                                                                                                 PEPCID .................................................................................34
OTICIN .................................................................................32       PAREMYD .........................................................................33
                                                                                                                                                                                                 PERCOCET ........................................................................20
OVIDE ...................................................................................51      PARLODEL ........................................................................23
                                                                                                                                                                                                 PERCOCET ........................................................................25
OVIDREL ...........................................................................37            PARNATE ...........................................................................24
                                                                                                                                                                                                 PERCODAN .......................................................................25
OXALIS ................................................................................51        paromomycin .........................................................................3
                                                                                                                                                                                                 PERCODAN .......................................................................26
OXANDRIN .......................................................................36               paroxetine hcl......................................................................27
                                                                                                                                                                                                 PERFOROMIST ............................................................10
oxandrolone..........................................................................36          PASER ......................................................................................4
                                                                                                                                                                                                 PERFOROMIST ............................................................46
oxaprozin................................................................................26      PATADAY .........................................................................30
                                                                                                                                                                                                 PERIDEX .............................................................................32
oxazepam ..............................................................................23        PATANASE ........................................................................30
                                                                                                                                                                                                 perindopril erbumine.......................................................12
oxcarbazepine......................................................................21            PATANOL .........................................................................30
                                                                                                                                                                                                 Periogard ...............................................................................32
OXISTAT .............................................................................49          PAXIL ...................................................................................27
                                                                                                                                                                                                 permethrin ............................................................................51
OXSORALEN ..................................................................51                   PAXIL CR ...........................................................................27
                                                                                                                                                                                                 perphenazine .......................................................................26
OXSORALEN ULTRA ..............................................51                                 PCE 333 MG, 500 MG......................................................5
                                                                                                                                                                                                 perphenazine-amitriptyline .........................................26
oxybutynin chloride..........................................................52                  PEDIADERM AF ............................................................51
                                                                                                                                                                                                 perphenazine-amitriptyline .........................................27

                                                                                                                                                                                                                                                                                                 73
PERSANTINE ...................................................................11                      PHOSPHOLINE IODIDE ........................................33                                   POLY-TUSSIN AC ........................................................45

PERSANTINE ...................................................................19                      PHRENILIN FORTE .....................................................20                         POLY-TUSSIN DHC .....................................................25

PEXEVA ...............................................................................27              PHRENILIN FORTE .....................................................22                         POLY-TUSSIN DHC .....................................................42

PFIZERPEN-G .....................................................................5                    pilocarpine hcl....................................................................10           POLY-TUSSIN DHC .....................................................45

PHENA-PLUS ...................................................................45                      pilocarpine hcl....................................................................33           POLY-TUSSIN EX .........................................................42

PHENA-S .............................................................................45               PILOPINE HS .................................................................33                 POLY-TUSSIN EX .........................................................44

PHENA-S 12 ......................................................................45                   pindolol ..................................................................................13   Poly-Vitamin With Fluoride .......................................39

phenazopyridine ................................................................49                    pindolol ..................................................................................17   Poly-Vitamin/Fluoride/Iron .........................................39

PHENAZOPYRIDINE PLUS ...................................49                                            pindolol 10 mg, 5 mg..........................................................9                 PONSTEL ............................................................................26

phendimetrazine tartrate................................................20                            pindolol 10 mg, 5 mg.......................................................15                   PONTOCAINE .................................................................49

phenelzine..............................................................................24            piroxicam...............................................................................26      Portia .......................................................................................36

PHENERGAN ...................................................................22                       PITRESSIN .........................................................................38           POTABA ..............................................................................40

PHENFLU CD ...................................................................20                      PLAQUENIL ........................................................................3             potassium bicarb & chloride ......................................29

PHENFLU CD ...................................................................25                      PLAVIX 300 MG, 75 MG..........................................11                                potassium bicarb-citric acid........................................28

PHENFLU CD ...................................................................42                      PLETAL ................................................................................17       potassium bicarb-citric acid........................................29

PHENFLU CD ...................................................................44                      PLETAL 100 MG, 50 MG............................................11                              potassium chloride............................................................28

PHENFLU CDX ...............................................................20                         PLEXION .............................................................................50         potassium chloride............................................................29

PHENFLU CDX ...............................................................25                         PLEXION CLEANSING CLOTHS .......................50                                              potassium chloride ...........................................................29

PHENFLU CDX ...............................................................42                         PLEXION SCT ..................................................................50                potassium citrate................................................................28

PHENFLU CDX ...............................................................44                         PNV-DHA + Docusate ..................................................29                         potassium citrate-citric acid........................................28

phenobarb-hyoscy-atropine-scop.................................8                                      PNV-DHA + Docusate ..................................................34                         PR Natal 400 .......................................................................29

phenobarbital .....................................................................22                 PNV-DHA PLUS ............................................................29                     PR Natal 400 EC ...............................................................29

PHENOL              .............................................................................50   PNV-IRON .........................................................................29            PR Natal 430 .......................................................................29

phentermine..........................................................................20               PNV-Omega ........................................................................29            PR Natal 430 EC ...............................................................29

phentermine .........................................................................20               PODOCON ..........................................................................51            PRADAXA .........................................................................10

phentolamine .........................................................................9               podofilox.................................................................................51    PRALIDOXIME ...............................................................39

phenyleph-promethazine-cod.........................................7                                  POLY HIST DHC ............................................................25                    pramipexole..........................................................................24

phenyleph-promethazine-cod.......................................25                                   POLY HIST DHC ............................................................42                    PRAMOSONE .................................................................47

phenyleph-promethazine-cod.......................................43                                   POLY HIST DHC ............................................................45                    PRAMOSONE .................................................................49

phenyleph-promethazine-cod.......................................45                                   POLY HIST NC ................................................................25                 PRAMOSONE 1-1 %......................................................47

phenylephrine hcl...............................................................33                    POLY HIST NC ................................................................41                 PRAMOSONE 1-1 %......................................................49

Phenylhistine DH .............................................................41                      POLY HIST NC ................................................................42                 PRAMOSONE 2.5-1 %...............................................47

Phenylhistine DH .............................................................42                      POLY HIST NC ................................................................45                 PRAMOSONE 2.5-1 %...............................................49

Phenylhistine DH .............................................................45                      Poly Iron PN .......................................................................29          PRAMOSONE E ............................................................47

PHENYTEK .......................................................................23                    Poly Iron PN Forte ...........................................................29                PRAMOSONE E ............................................................49

PHENYTEK 200 MG, 300 MG.................................15                                            polyethylene glycol 3350................................................34                      PRANDIMET ....................................................................36

phenytoin................................................................................15           polyethylene glycol 3350 ..............................................34                       PRANDIMET ....................................................................38

phenytoin................................................................................23           Polygesic ...............................................................................20     PRANDIN ...........................................................................38

phenytoin 100 mg/4 ml....................................................15                           POLYOXYL 40 STEARATE ....................................50                                     PRASCION .........................................................................50
phenytoin sodium extended...........................................15                                POLYSORBATE 40 .......................................................50                        PRASCION FC .................................................................50

phenytoin sodium extended...........................................23                                POLYSORBATE 60 .......................................................50                        PRASCION RA ................................................................50
                                                                                                                                                                                                      PRAVACHOL 10 MG, 20 MG, 40 MG, 80
PHISOHEX .........................................................................50                  POLYSORBATE 80 .......................................................50
                                                                                                                                                                                                      MG............................................................................................17
PHOS-FLUR .......................................................................39                   POLYTRIM ........................................................................31
                                                                                                                                                                                                      pravastatin.............................................................................17
PHOSLO .............................................................................28                POLY-TUSSIN AC ........................................................25
                                                                                                                                                                                                      prazosin.....................................................................................9
Phospha 250 Neutral .......................................................28                         POLY-TUSSIN AC ........................................................42
                                                                                                                                                                                                      prazosin...................................................................................11

74
prazosin...................................................................................12   PREVIDENT 5000 SENSITIVE ..............................39                                     Progesterone in Oil ..........................................................38

PRECOSE ............................................................................35          PREVPAC ..............................................................................3       PROGLYCEM ...................................................................36

PRED FORTE ....................................................................32               PREVPAC ..............................................................................5       PROGRAF ...........................................................................40

PRED MILD .....................................................................32               PREVPAC ............................................................................35        PROLIA ................................................................................39

PRED-G ................................................................................31       PREZISTA ............................................................................4        PROMACET .......................................................................22

PRED-G ................................................................................32       PRIFTIN ..................................................................................4   PROMACTA 25 MG, 50 MG, 75 MG...............11

PRED-G S.O.P. .................................................................31               PRIFTIN ..................................................................................6   PROMETHAZINE...........................................................22

PRED-G S.O.P. .................................................................32               PRILOSEC ..........................................................................35         promethazine .........................................................................7

PREDNICARBATE.........................................................47                        PRIMAQUINE .....................................................................3             PROMETHAZINE ..........................................................22

prednisolone.........................................................................35         primidone...............................................................................22    PROMETHAZINE ..........................................................45

prednisolone acetate........................................................32                  PRIMLEV 10-300 MG...................................................20                        Promethazine VC ................................................................7

prednisolone sodium phosphate.................................35                                Primlev 5-300 mg, 7.5-300 mg...................................20                             Promethazine VC .............................................................45

prednisolone sodium phosphate ................................32                                PRINIVIL .............................................................................12      Promethazine VC-Codeine .............................................7

prednisone ............................................................................35       PRINIVIL .............................................................................13      Promethazine VC-Codeine ..........................................25

PREDNISONE INTENSOL .......................................35                                   PRINZIDE ...........................................................................12        Promethazine VC-Codeine ..........................................43

PREFEST .............................................................................37         PRINZIDE ...........................................................................13        Promethazine VC-Codeine ..........................................45

PREGNYL ...........................................................................37           PRINZIDE ...........................................................................18        promethazine-codeine ....................................................43

PRELONE ............................................................................35          PRINZIDE ...........................................................................30        promethazine-codeine ....................................................45

PREMARIN ........................................................................37             PRISTIQ ..............................................................................26      promethazine-dm ..............................................................43

PREMPHASE ..................................................................37                  PROAIR HFA ..................................................................10               promethazine-dm ..............................................................45

PREMPRO .........................................................................37             PROAIR HFA ..................................................................46               PROMETRIUM .............................................................38

PrenaFirst ..............................................................................29     probenecid ............................................................................30     propafenone..........................................................................15

PrenaPlus ..............................................................................29      PROCARDIA .....................................................................16             propafenone 300 mg.........................................................15

Prenatabs FA .......................................................................29          PROCARDIA .....................................................................19             propantheline ........................................................................8

Prenatabs Rx .......................................................................29          PROCARDIA XL ............................................................16                   PROPARACAINE............................................................32

Prenatabs Rx .......................................................................52          PROCARDIA XL ............................................................19                   PROPECIA ..........................................................................51

Prenatal 19 ...........................................................................29       PROCARDIA XL 30 MG, 60 MG, 90 MG.........16                                                   propranolol..............................................................................9

Prenatal 19 ...........................................................................52       ProCentra ..............................................................................19    propranolol...........................................................................13

Prenatal AD .........................................................................29         prochlorperazine ...............................................................33            propranolol...........................................................................15
                                                                                                PROCHLORPERAZINE EDISYLATE 5
Prenatal Low Iron .............................................................29                                                                                                             propranolol...........................................................................17
                                                                                                MG/ML...................................................................................33
Prenatal Plus (calcium carb) .......................................29                                                                                                                        propranolol...........................................................................21
                                                                                                prochlorperazine maleate ............................................33
Prenatal Plus with Iron (Ca) ........................................29                                                                                                                       propranolol ............................................................................9
                                                                                                PRO-CLEAR AC .............................................................25
PRENATE ESSENTIAL ...........................................29                                                                                                                               propranolol ..........................................................................13
                                                                                                PRO-CLEAR AC .............................................................42
PRENATE ESSENTIAL ...........................................52                                                                                                                               propranolol ..........................................................................17
                                                                                                PRO-CLEAR AC .............................................................45
PreNate Plus ........................................................................29                                                                                                       propranolol ..........................................................................21
                                                                                                PRO-CLEAR CAPS .......................................................42
                                                                                                                                                                                              propranolol 10 mg, 20 mg, 40 mg, 60 mg, 80
PRENEXA ..........................................................................29
                                                                                                PRO-CLEAR CAPS .......................................................44                      mg....................................................................................................9
PRENEXA ..........................................................................34            PROCRIT 10,000 UNIT/ML, 2,000 UNIT/ML,                                                        propranolol 10 mg, 20 mg, 40 mg, 60 mg, 80
                                                                                                20,000 UNIT/2 ML, 20,000 UNIT/ML, 3,000                                                       mg..............................................................................................15
PREPIDIL ............................................................................41         UNIT/ML, 4,000 UNIT/ML, 40,000
                                                                                                UNIT/ML.............................................................................11        propranolol 20 mg/5 ml, 40 mg/5 ml.......................15
PREVACID .........................................................................35
                                                                                                PROCTOCORT ................................................................47                 propranolol-hydrochlorothiazid ...............................13
PREVACID SOLUTAB ...............................................35
                                                                                                PROCTOCREAM-HC ...............................................48                              propranolol-hydrochlorothiazid ...............................15
Prevalite .................................................................................14
                                                                                                PROCTOFOAM HC ...................................................48                           propranolol-hydrochlorothiazid ...............................30
PREVIDENT ......................................................................39                                                                                                            propranolol-hydrochlorothiazid 40-25 mg, 80-25
                                                                                                Procto-Pak ............................................................................47     mg....................................................................................................9
PREVIDENT 5000 BOOSTER ................................39
                                                                                                Proctosol HC .......................................................................48        propranolol-hydrochlorothiazid 40-25 mg, 80-25
PREVIDENT 5000 DRY MOUTH ........................39                                                                                                                                           mg..............................................................................................18
                                                                                                Proctozone-HC ..................................................................48
PREVIDENT 5000 PLUS ............................................39                                                                                                                            propylthiouracil .................................................................36
                                                                                                progesterone.........................................................................38
                                                                                                                                                                                                                                                                                             75
PRO-RED AC ....................................................................25                   Q-CARE RX Q2 ...............................................................50                  REMERON .........................................................................21

PRO-RED AC ....................................................................43                   Q-CARE RX Q4 ...............................................................27                  REMERON SOLTAB ...................................................21

PRO-RED AC ....................................................................45                   Q-CARE RX Q4 ...............................................................50                  REMICADE ......................................................................40

PROSCAR ...........................................................................39               Quadrapax ...............................................................................8      REMODULIN ..................................................................19

PROSTIGMIN ...................................................................9                     Quadrapax ............................................................................22        REMODULIN ..................................................................46

PROSTIN E2 ......................................................................41                 QUALAQUIN .....................................................................3                RENAGEL .........................................................................28

PROSTIN VR PEDIATRIC .......................................19                                      QUESTRAN .......................................................................14              RENOVA .............................................................................50

PROTECT NATAL ......................................................29                              QUESTRAN LIGHT ......................................................14                         RENVELA ...........................................................................28

PROTID ................................................................................20           quinapril.................................................................................12    Repan ......................................................................................20

PROTID ................................................................................21           quinapril-hydrochlorothiazide....................................12                             Repan ......................................................................................22

PROTID ................................................................................45           quinapril-hydrochlorothiazide....................................18                             Reprexain 10-200 mg......................................................25

PROTONIX .........................................................................35                quinapril-hydrochlorothiazide....................................29                             Reprexain 10-200 mg......................................................26

PROTOPAM CHLORIDE ..........................................39                                      quinidine gluconate ............................................................3               REPREXAIN 2.5-200 MG, 5-200 MG..................25

PROTOPIC .......................................................................51                  QUINIDINE GLUCONATE ......................................15                                    REPREXAIN 2.5-200 MG, 5-200 MG..................26

protriptyline..........................................................................27           quinidine sulfate ...................................................................3          REPRONEX ......................................................................37

PROVENTIL HFA ..........................................................10                          quinidine sulfate ................................................................15            REQUIP ................................................................................24

PROVENTIL HFA ..........................................................46                          quinidine sulfate 200 mg, 300 mg................................3                               REQUIP XL ......................................................................24

PROVERA ...........................................................................38               quinidine sulfate 200 mg, 300 mg.............................15                                 RESCON .................................................................................8

PROVIGIL .........................................................................20                QUINZYME .......................................................................40              RESCON ...............................................................................45

PROZAC ...............................................................................27            QUTENZA ..........................................................................51            RESCON JR ........................................................................45

PROZAC WEEKLY .......................................................27                             QVAR ....................................................................................35     RESCON-MX ....................................................................45

PruClair .................................................................................49        QVAR ....................................................................................46     RESCRIPTOR ...................................................................5

PRUDOXIN ........................................................................49                 ramipril...................................................................................12   reserpine 0.1 mg, 0.25 mg.............................................17

PruTect ...................................................................................49       ramipril...................................................................................13   RESPA-AR ..........................................................................41

PRYFLEX ............................................................................40              RANEXA .............................................................................14          RESPA-AR ..........................................................................45

PSEUDOEPHEDRINE HCL 60 MG......................41                                                   ranitidine hcl........................................................................34        RESPAIRE-30 ...................................................................41
PULMICORT 0.25 MG/2 ML, 0.5 MG/2
                                                                                                    ranitidine hcl .......................................................................34        RESPAIRE-30 ...................................................................44
ML.............................................................................................35
PULMICORT 0.25 MG/2 ML, 0.5 MG/2                                                                    RAPAFLO 4 MG, 8 MG...............................................10                             RESTASIS ..........................................................................32
ML.............................................................................................46
                                                                                                    RAPAMUNE ....................................................................40                 RESTORIL ..........................................................................23
PULMICORT 1 MG/2 ML.......................................35
                                                                                                    RAZADYNE .........................................................................9             RETIN-A ..............................................................................50
PULMICORT 1 MG/2 ML.......................................45
                                                                                                    RAZADYNE 12 MG, 4 MG, 8 MG...........................9                                          RETIN-A MICRO ...........................................................50
PULMICORT FLEXHALER ................................35
                                                                                                    RAZADYNE ER 16 MG, 24 MG, 8 MG..............10                                                  RETIN-A MICRO PUMP ............................................50
PULMICORT FLEXHALER ................................46
                                                                                                    REBETOL ..............................................................................5         RETISERT .........................................................................32
PULMOZYME ................................................................30
                                                                                                    REBIF ...................................................................................39     RETROVIR ............................................................................5
PURINETHOL .....................................................................8
                                                                                                    REBIF TITRATION PACK ...................................39                                      REVATIO ...........................................................................17
PYLERA ................................................................................3
                                                                                                    REFISSA ..............................................................................50        REVATIO ...........................................................................46
PYLERA ................................................................................4
                                                                                                    REGLAN ..............................................................................34         REVIA ...................................................................................25
PYLERA ................................................................................6
                                                                                                    REGRANEX .......................................................................51              REVLIMID ........................................................................39
PYLERA ..............................................................................33
                                                                                                    RELAGARD .......................................................................50              REYATAZ ............................................................................4
pyrazinamide .........................................................................4
                                                                                                    Relamine ...............................................................................40      REZYST IM ........................................................................33
pyridostigmine bromide....................................................9
                                                                                                    RelCof C ...............................................................................43      RHEUMATREX .................................................................8
PYRIL D ...............................................................................45
                                                                                                    RelCof C ...............................................................................44      RHINOCORT AQUA .................................................32
Pyril DM ...............................................................................43
                                                                                                    RELENZA DISKHALER ...........................................5                                  RHINOCORT AQUA .................................................45
Pyril DM ...............................................................................45
                                                                                                    RELISTOR ........................................................................34             RHINOFLEX .....................................................................20
PYROGALLIC ACID ...................................................51
                                                                                                    RELPAX ..............................................................................26         RHINOFLEX-650 ............................................................20
Q-CARE RX Q2 ...............................................................27
76
RibaPak Dose Pack 400-400 mg (28)-mg (28),
                                                                                                         Ru-Tuss DM ........................................................................41            Se-Natal One .......................................................................29
600-400 mg (28)-mg (28), 600-600 mg (28)-mg
(28).................................................................................................5   Ru-Tuss DM ........................................................................43            SENSIPAR .........................................................................40
Ribasphere ..............................................................................5               Ru-Tuss DM ........................................................................44            SEPTRA DS ..........................................................................6
Ribasphere 200 mg..............................................................5                         RYBIX ODT .......................................................................25              SERADEX ...........................................................................43
Ribasphere 400 mg, 600 mg...........................................5                                    Rydex ......................................................................................25   SEREVENT DISKUS ..................................................10
RIBATAB DOSE PACK ................................................5                                      Rydex ......................................................................................43   SEREVENT DISKUS ..................................................46
ribavirin.....................................................................................5          Rydex ......................................................................................45   SEROMYCIN .....................................................................4
RIDAURA ..........................................................................35                     RYTHMOL 150 MG, 225 MG...................................15                                      SEROQUEL ......................................................................22
RIFADIN .................................................................................4               RYTHMOL SR .................................................................15                   SEROQUEL XR .............................................................22
RIFADIN 150 MG, 300 MG..........................................6                                        RYZOLT ...............................................................................25         SEROSTIM .........................................................................38
RIFAMATE ...........................................................................4                    SABRIL .................................................................................21       sertraline................................................................................27
RIFAMATE ...........................................................................6                    SAIZEN .................................................................................38       SetonET .................................................................................29
rifampin.....................................................................................4           SAIZEN CLICK.EASY ................................................38                             Setonet-EC ...........................................................................29
rifampin.....................................................................................6           SALAGEN ...........................................................................10            SF ..............................................................................................39
RIFATER ................................................................................4                salsalate .................................................................................26    SF 5000 Plus .......................................................................39
RIFATER ................................................................................6                SAL-TROPINE ....................................................................8                SFROWASA .......................................................................33
RILUTEK ...........................................................................23                    SAMSCA .............................................................................30           SILENOR .............................................................................27
rimantadine.............................................................................3                SANCTURA .......................................................................52               SILVADENE ......................................................................50
RIMSO-50 ............................................................................48                  SANCTURA XR .............................................................52                      SILVER NITRATE .........................................................50
RIOMET ...............................................................................36                 SANCUSO ..........................................................................33             SILVER NITRATE 0.5 %, 25 %, 50 %.................50
RISPERDAL .......................................................................22                      SANDIMMUNE ..............................................................40                      silver sulfadiazine..............................................................50
RISPERDAL CONSTA ................................................22                                      SANDOSTATIN ..............................................................40                     silver sulfadiazine..............................................................51
RISPERDAL M-TAB ....................................................22                                                                                                                                    SIMCOR 1,000-20 MG, 1,000-40 MG, 500-20
                                                                                                         SANDOSTATIN LAR DEPOT .............................40
                                                                                                                                                                                                          MG, 500-40 MG, 750-20 MG...................................17
risperidone............................................................................22                SANTYL ...............................................................................51
                                                                                                                                                                                                          SIMETHICONE ...............................................................33
risperidone 0.25 mg..........................................................22                          SAPHRIS ..............................................................................22
                                                                                                                                                                                                          SIMPONI ..............................................................................40
Risperidone M-Tab ..........................................................22                           SARAFEM ..........................................................................27
                                                                                                                                                                                                          simvastatin.............................................................................17
RITALIN ..............................................................................20                 SAVELLA ...........................................................................23
                                                                                                                                                                                                          SINEMET ............................................................................23
RITALIN LA ......................................................................20                      SCOPOLAMINE HBR ....................................................8
                                                                                                                                                                                                          SINEMET CR ....................................................................23
RITALIN SR ......................................................................20                      SE 10-5 SS ...........................................................................50
                                                                                                                                                                                                          SINGULAIR .....................................................................45
rivastigmine.............................................................................9               SEASONIQUE ..................................................................36
                                                                                                                                                                                                          SKELAXIN ..........................................................................9
Robafen AC .........................................................................43                   SECONAL SODIUM .....................................................22
                                                                                                                                                                                                          SKELID .................................................................................39
Robafen AC .........................................................................44                   SECTRAL ............................................................................10
                                                                                                                                                                                                          SODIUM BISULFITE ...................................................40
ROBAXIN ..............................................................................9                  SECTRAL ............................................................................13
                                                                                                                                                                                                          sodium chloride 0.9 %.....................................................29
ROBAXIN-750 ....................................................................9                        SECTRAL ............................................................................15
                                                                                                                                                                                                          sodium chloride 0.9 % ...................................................29
ROBINUL ...............................................................................8                 SECTRAL ............................................................................17
                                                                                                                                                                                                          SODIUM CHLORIDE 10 %, 3 %............................29
ROBINUL FORTE ............................................................8                              SEDAPAP ............................................................................22
                                                                                                                                                                                                          sodium citrate-citric acid...............................................28
ropinirole...............................................................................24              SE-Donna PB Hyos ............................................................8
                                                                                                                                                                                                          sodium fluoride...................................................................39
ROSANIL ............................................................................50                   SE-Donna PB Hyos .........................................................22
                                                                                                                                                                                                          sodium fluoride ..................................................................39
ROWASA ............................................................................33                    selegiline hcl .......................................................................24
                                                                                                                                                                                                          SODIUM LAURYL SULFATE ...............................50
ROXICET ............................................................................20                   selenium sulfide 2.5 %.....................................................50
                                                                                                                                                                                                          sodium polystyrene sulfonate.......................................28
Roxicet 5-325 mg..............................................................20                         SELZENTRY ......................................................................4
                                                                                                                                                                                                          SODIUM SUCCINATE ...............................................41
ROXICET 5-500 MG......................................................20                                 SEMPREX-D ........................................................................7
                                                                                                                                                                                                          SOLARAZE ......................................................................51
ROXICODONE 15 MG, 30 MG...............................25                                                 SEMPREX-D .....................................................................41                SOLODYN 105 MG, 115 MG, 55 MG, 65 MG,
                                                                                                                                                                                                          80 MG........................................................................................6
ROZEREM ..........................................................................22                     SEMPREX-D .....................................................................46
                                                                                                                                                                                                          SOLODYN 135 MG, 45 MG, 90 MG.......................6
RU-HIST FORTE ............................................................45                             Se-Natal 19 ..........................................................................29
                                                                                                                                                                                                          SOMA .......................................................................................9
                                                                                                                                                                                                                                                                                                       77
SOMATULINE DEPOT ...........................................40                                      STALEVO 75 .....................................................................23              SUMAVEL DOSEPRO ................................................27

SOMAVERT .....................................................................38                    stannous fluoride ..............................................................39              SUMAXIN ...........................................................................51

SOMNOTE ..........................................................................22                STARLIX .............................................................................38         SUMAXIN TS ...................................................................51

SONATA ..............................................................................22             stavudine...................................................................................5   SUPPRELIN LA ...............................................................8

SORBITOL .........................................................................34                STAVZOR ...........................................................................21           SUPPRELIN LA .............................................................37

SORBITOL-MANNITOL ...........................................28                                     STEARIC ACID ...............................................................41                  SUPRAX .................................................................................7

SORIATANE ....................................................................51                    STIMATE ...........................................................................11           SUPRAX 100 MG/5 ML, 200 MG/5 ML................7

Sorine ........................................................................................9    STIMATE ...........................................................................38           SUPREP ................................................................................34
                                                                                                                                                                                                    SURE COMFORT ALCOHOL PREP PADS
Sorine ......................................................................................13     STRATTERA ...................................................................23
                                                                                                                                                                                                    .....................................................................................................51
Sorine ......................................................................................15     STREPTOMYCIN .............................................................4
                                                                                                                                                                                                    SURE-PREP ALCOLOL PREP PADS ................51
Sorine ......................................................................................17     STRIANT .............................................................................36
                                                                                                                                                                                                    SURESTEP COMPLETE SYSTEM .................27
sotalol.........................................................................................9   STROMECTOL ................................................................3
                                                                                                                                                                                                    SURESTEP PRO LINEARITY ............................27
sotalol......................................................................................13     Strong Iodine ......................................................................36
                                                                                                                                                                                                    SURESTEP PRO TEST ............................................27
sotalol......................................................................................15     Strong Iodine ......................................................................44
                                                                                                                                                                                                    SURESTEP TEST .........................................................27
sotalol......................................................................................17     SUBOXONE ......................................................................25
                                                                                                                                                                                                    SURMONTIL ....................................................................27
Sotalol AF ...............................................................................9         SUBUTEX ...........................................................................25
                                                                                                                                                                                                    SURVANTA .......................................................................46
Sotalol AF ............................................................................13           SUCRAID ............................................................................30
                                                                                                                                                                                                    SUSTIVA ...............................................................................5
Sotalol AF ............................................................................15           SUCRALFATE...................................................................35
                                                                                                                                                                                                    SUTENT 12.5 MG, 25 MG, 50 MG........................8
Sotalol AF ............................................................................17           SudaHist ................................................................................41
                                                                                                                                                                                                    Suttar-2 ..................................................................................41
Sotalol AF 120 mg, 160 mg, 80 mg.........................15                                         SudaHist ................................................................................45
                                                                                                                                                                                                    Suttar-2 ..................................................................................43
Sotret .......................................................................................51    SudaTex-DM ......................................................................41
                                                                                                                                                                                                    Suttar-2 ..................................................................................44
SPECTRACEF 200 MG, 400 MG...............................7                                           SudaTex-DM ......................................................................43
                                                                                                                                                                                                    Suttar-SF ...............................................................................41
SPECTRAGEL ..................................................................41                     SudaTex-DM ......................................................................44
                                                                                                                                                                                                    Suttar-SF ...............................................................................43
SPIRIVA WITH HANDIHALER ..........................8                                                 SULAR ..................................................................................16
                                                                                                                                                                                                    Suttar-SF ...............................................................................44
SPIRIVA WITH HANDIHALER .......................41                                                   sulfacetamide sodium.......................................................31
                                                                                                                                                                                                    Syeda .......................................................................................36
spironolactone.....................................................................17               sulfacetamide sodium .....................................................51
                                                                                                                                                                                                    SYLATRON .........................................................................4
spironolactone.....................................................................28               sulfacetamide sodium (acne)........................................50
                                                                                                                                                                                                    SYLATRON 4-PACK ....................................................4
spironolacton-hydrochlorothiaz.................................17                                   sulfacetamide sodium-sulfur........................................50
                                                                                                                                                                                                    SYMBICORT ...................................................................10
SPORANOX ........................................................................4                  sulfacetamide sodium-sulfur........................................51
                                                                                                                                                                                                    SYMBICORT ...................................................................35
SPORANOX PULSEPAK .............................................4                                    sulfacetamide sodium-sulfur 10-5 %.......................51
                                                                                                                                                                                                    SYMBICORT ...................................................................46
SPRAY AND STRETCH ............................................49                                    sulfacetamide sodium-sulfur 10-5 % (w/w)..........51
                                                                                                                                                                                                    SYMBYAX .........................................................................22
Sprintec (28) ........................................................................36            sulfacetamide-prednisolone ........................................31
                                                                                                                                                                                                    SYMBYAX .........................................................................27
SPRYCEL 100 MG, 140 MG, 20 MG, 50 MG,
                                                                                                    sulfadiazine ............................................................................6
70 MG, 80 MG.....................................................................8                                                                                                                  SYMLIN ..............................................................................35
                                                                                                    SULFAMETHOXAZOLE (BULK) ..........................6
SSD ..........................................................................................51                                                                                                    SYMLINPEN 120 ..........................................................35
                                                                                                    sulfamethoxazole-trimethoprim.....................................6
SSKI ........................................................................................36                                                                                                     SYMLINPEN 60 .............................................................35
                                                                                                    sulfamethoxazole-trimethoprim ...................................6
SSKI ........................................................................................44                                                                                                     SYNAGIS 100 MG/ML, 50 MG/0.5 ML.............5
                                                                                                    sulfamethoxazole-trimethoprim 400-80 mg............6
Stagesic ..................................................................................20                                                                                                       SYNALGOS-DC ..............................................................25
                                                                                                    Sulfamide ..............................................................................31
STAHIST (REFORMULATED) ................................8                                                                                                                                            SYNAPRYN .......................................................................25
                                                                                                    SULFAMYLON ...............................................................51
STAHIST (REFORMULATED) .............................41                                                                                                                                              SYNAREL ..........................................................................37
                                                                                                    sulfasalazine............................................................................6
STAHIST (REFORMULATED) .............................45                                                                                                                                              SYNERA ..............................................................................49
                                                                                                    Sulfazine ..................................................................................6
STALEVO 100 ..................................................................23                                                                                                                    SYNTHROID ...................................................................38
                                                                                                    Sulfazine EC ..........................................................................6
STALEVO 125 ..................................................................23                                                                                                                    SYNVISC ............................................................................27
                                                                                                    sulindac...................................................................................26
STALEVO 150 ..................................................................23                                                                                                                    SYNVISC-ONE ...............................................................27
                                                                                                    sulindac .................................................................................26
STALEVO 200 ..................................................................23                                                                                                                    SYPRINE .............................................................................35
                                                                                                    sumatriptan succinate......................................................26
STALEVO 50 .....................................................................23                                                                                                                  TABLOID ..............................................................................8

78
TACLONEX .......................................................................48             TENEX 1 MG, 2 MG......................................................14                       TEXACORT .......................................................................48

TACLONEX .......................................................................51             TENORETIC 100 .............................................................10                  THALITONE .....................................................................18

TACLONEX SCALP .....................................................48                         TENORETIC 100 .............................................................13                  THALITONE .....................................................................30

TACLONEX SCALP .....................................................51                         TENORETIC 100 .............................................................15                  THALOMID .....................................................................39

tacrolimus..............................................................................40     TENORETIC 100 .............................................................18                  THEO-24 ..............................................................................28

TAMBOCOR 100 MG, 150 MG, 50 MG.............15                                                  TENORETIC 100 .............................................................30                  THEO-24 ..............................................................................46

TAMIFLU .............................................................................5         TENORETIC 50 ...............................................................10                 THEO-24 ..............................................................................52
                                                                                                                                                                                              THEO-24 100 MG, 200 MG, 300 MG, 400
tamoxifen .................................................................................8   TENORETIC 50 ...............................................................13
                                                                                                                                                                                              MG............................................................................................16
tamsulosin..............................................................................10     TENORETIC 50 ...............................................................15
                                                                                                                                                                                              Theochron ............................................................................16
TAPAZOLE ........................................................................36            TENORETIC 50 ...............................................................18
                                                                                                                                                                                              Theochron ............................................................................28
TARCEVA 100 MG, 150 MG, 25 MG..................8                                               TENORETIC 50 ...............................................................30
                                                                                                                                                                                              Theochron ............................................................................46
TARGRETIN ........................................................................8            TENORMIN .......................................................................10
                                                                                                                                                                                              Theochron ............................................................................52
TARGRETIN .....................................................................51              TENORMIN .......................................................................13
                                                                                                                                                                                              theophylline...........................................................................16
TARKA .................................................................................12      TENORMIN .......................................................................15
                                                                                                                                                                                              theophylline...........................................................................28
TARKA .................................................................................13      TERAZOL 3 .......................................................................49
                                                                                                                                                                                              theophylline...........................................................................46
TARKA .................................................................................14      TERAZOL 7 .......................................................................49
                                                                                                                                                                                              theophylline...........................................................................52
TARKA .................................................................................19      terazosin ................................................................................11
                                                                                                                                                                                              theophylline .........................................................................16
TARKA 1-240 MG, 2-180 MG, 2-240 MG,
                                                                                               terazosin ................................................................................12
4-240 MG...............................................................................14                                                                                                     theophylline .........................................................................28
                                                                                               terazosin ................................................................................17
Taron-Bc ...............................................................................29                                                                                                    theophylline .........................................................................46
                                                                                               terazosin 1 mg, 10 mg, 2 mg, 5 mg..............................9
Taron-Duo EC ....................................................................29                                                                                                           theophylline .........................................................................52
                                                                                               terbinafine................................................................................3
Taron-Prex Prenatal-DHA ...........................................34                                                                                                                         theophylline 450 mg.........................................................16
                                                                                               terbutaline ............................................................................46
TASIGNA 150 MG, 200 MG......................................8                                                                                                                                 Thermazene .........................................................................51
                                                                                               terbutaline 2.5 mg, 5 mg................................................10
TASMAR .............................................................................23                                                                                                        THIOLA ................................................................................40
                                                                                               terconazole............................................................................49
TAZORAC .........................................................................51                                                                                                           thioridazine ..........................................................................26
                                                                                               TERRAMYCIN WITH POLYMYXIN B ...........31
Taztia XT ..............................................................................14                                                                                                    thiothixene.............................................................................27
                                                                                               TERSI FOAM ....................................................................51
Taztia XT ..............................................................................15                                                                                                    thiothixene ............................................................................27
                                                                                               TESSALON ........................................................................43
Taztia XT ..............................................................................19                                                                                                    Thrive Nicotine ....................................................................9
                                                                                               TESSALON PERLES ....................................................43
TEGRETOL ........................................................................21                                                                                                           TIAZAC ................................................................................14
                                                                                               TESTIM ...............................................................................36
TEGRETOL XR 100 MG..........................................21                                                                                                                                TIAZAC ................................................................................16
                                                                                               testosterone cypionate.....................................................36
TEGRETOL XR 200 MG, 400 MG.........................21                                                                                                                                         TIAZAC ................................................................................19
                                                                                               TESTOSTERONE ENANTHATE .........................36                                             TIAZAC 120 MG, 180 MG, 240 MG, 300 MG,
TEKAMLO ........................................................................16
                                                                                                                                                                                              360 MG, 420 MG..............................................................14
                                                                                               TETCAINE .........................................................................32
TEKAMLO ........................................................................18
                                                                                                                                                                                              ticlopidine .............................................................................11
                                                                                               tetracaine hcl.......................................................................32
TEKAMLO ........................................................................19
                                                                                                                                                                                              TIGAN ...................................................................................33
                                                                                               tetracaine hcl (pf) .............................................................32            TIKOSYN 125 MCG, 250 MCG, 500
TEKRAL ...............................................................................41
                                                                                               tetracycline 250 mg, 500 mg...........................................6                        MCG........................................................................................15
TEKRAL ...............................................................................45
                                                                                               TETRAVISC ......................................................................32             timolol maleate....................................................................31
TEKTURNA .....................................................................18
                                                                                               TETRAVISC FORTE ....................................................32                         timolol maleate ..................................................................13
TEKTURNA HCT ........................................................18
                                                                                               TEVETEN ............................................................................12         timolol maleate ..................................................................17
TEKTURNA HCT ........................................................30
TEKTURNA HCT 150-12.5 MG, 150-25 MG,                                                           TEVETEN 400 MG..........................................................12                     timolol maleate ..................................................................21
300-12.5 MG, 300-25 MG...........................................18
                                                                                               TEVETEN 600 MG..........................................................12                     timolol maleate 10 mg, 20 mg, 5 mg...........................9
temazepam.............................................................................23
                                                                                               TEVETEN HCT ................................................................12                 timolol maleate 10 mg, 20 mg, 5 mg........................15
TEMODAR 100 MG, 140 MG, 180 MG, 20
MG, 250 MG, 5 MG.........................................................8                     TEVETEN HCT ................................................................30                 TIMOPTIC ..........................................................................31

TEMOVATE ......................................................................48              TEVETEN HCT 600-12.5 MG, 600-25 MG.......12                                                    TIMOPTIC OCUDOSE ................................................31

TEMOVATE E ..................................................................48                TEVETEN HCT 600-12.5 MG, 600-25 MG.......18                                                    TIMOPTIC-XE .................................................................31

TENCON ..............................................................................22        TEV-TROPIN ....................................................................38              TINDAMAX 250 MG, 500 MG.................................4


                                                                                                                                                                                                                                                                                         79
tizanidine...................................................................................9     TRANDATE .......................................................................10                    TRIBENZOR ....................................................................12

tizanidine .................................................................................9      TRANDATE .......................................................................12                    TRIBENZOR ....................................................................16

TL G-FOL OS ....................................................................29                 TRANDATE .......................................................................13                    TRIBENZOR ....................................................................18

TL-Hist CD ..........................................................................25            TRANDATE .......................................................................15                    TRIBENZOR ....................................................................19

TL-Hist CD ..........................................................................43            trandolapril...........................................................................12             TRIBENZOR ....................................................................30

TL-Hist CD ..........................................................................45            trandolapril...........................................................................13             TRICARE ...........................................................................29

TL-HIST CM ......................................................................25                TRANSDERM-SCOP .................................................33                                    TRICARE PRENATAL DHA ONE ..................34

TL-HIST CM ......................................................................43                TRANXENE T-TAB ......................................................23                               TRI-CHLOR .......................................................................51

TL-HIST CM ......................................................................45                tranylcypromine..................................................................24                   TRICHLOROACETIC ACID ...................................52

TOBI .........................................................................................3    TRAVATAN Z ................................................................33                         TRICOR ................................................................................16

TOBRADEX .....................................................................31                   trazodone ..............................................................................27            Triderm ..................................................................................48

TOBRADEX .....................................................................32                   TREAGAN OTIC ............................................................32                           trifluoperazine ....................................................................26

TOBRADEX ST .............................................................31                        TRECATOR ..........................................................................4                  trifluridine.............................................................................31

TOBRADEX ST .............................................................32                        TRELSTAR 3.75 MG/2 ML...........................................8                                     TRIGLIDE ...........................................................................16

tobramycin sulfate.............................................................30                  TRENTAL ...........................................................................11                 trihexyphenidyl .....................................................................8

tobramycin sulfate.............................................................31                  tretinoin...................................................................................49        trihexyphenidyl ..................................................................21

tobramycin-dexamethasone..........................................31                               tretinoin...................................................................................50        trihexyphenidyl 2 mg, 5 mg.............................................8

tobramycin-dexamethasone..........................................32                               tretinoin (chemotherapy) .................................................8                           TRILEPTAL .......................................................................21

TOBREX .............................................................................31             TRETINOIN (EMOLLIENT).....................................50                                          TRILIPIX .............................................................................16

TOFRANIL .........................................................................27               TRETIN-X ...........................................................................50                TRI-LUMA .........................................................................50

TOFRANIL-PM ................................................................27                     TRETIN-X (GEL) ............................................................50                         TRIMETHOBENZAMIDE .........................................33

tolazamide ............................................................................38          TREXALL 10 MG, 15 MG, 5 MG, 7.5 MG......8                                                             trimethoprim ..........................................................................7

tolbutamide ..........................................................................38           Trexbrom ..............................................................................43             trimethoprim-polymyxin b.............................................31

tolmetin ..................................................................................26      TREXIMET .........................................................................26                  trimipramine.........................................................................27

TOPAMAX .........................................................................21                TREXIMET .........................................................................27                  Trinatal Rx 1 .......................................................................29

TOPICORT .........................................................................48               TREZIX .................................................................................25            Trinate ....................................................................................29

TOPICORT 0.05 %..........................................................48                        Tri Rx .....................................................................................29        TRIOXIN ..............................................................................31

TOPICORT 0.25 %..........................................................48                        Tri Rx .....................................................................................34        TRIOXIN ..............................................................................32

TOPICORT LP ..................................................................48                   TriAdvance ..........................................................................29               TRIPLE ANTIBIOTIC ..................................................48

Topiragen ..............................................................................21         triamcinolone acetonide.................................................32                            TRIPLE DYE .....................................................................48

topiramate.............................................................................21          TRIAMCINOLONE ACETONIDE.........................35                                                    Triple Vitamin with Fluoride 0.5 mg/mL..............39

TOPROL XL ......................................................................13                 triamcinolone acetonide.................................................45                            Trip-PSE ...............................................................................41
TOPROL XL 100 MG, 200 MG, 25 MG, 50
                                                                                                   triamcinolone acetonide.................................................47                            Trip-PSE ...............................................................................45
MG............................................................................................10
TOPROL XL 100 MG, 200 MG, 25 MG, 50                                                                triamcinolone acetonide.................................................48                            Triveen-Duo DHA ...........................................................29
MG............................................................................................15
                                                                                                   triamcinolone acetonide ................................................48                            Triveen-One ........................................................................29
torsemide................................................................................17        triamcinolone acetonide 0.025 %, 0.1 %, 0.5
                                                                                                                                                                                                         Triveen-PRx RNF ............................................................29
                                                                                                   %................................................................................................48
torsemide................................................................................28
                                                                                                                                                                                                         Triveen-PRx RNF ............................................................34
                                                                                                   TRIAMCINOLONE ACETONIDE 0.05 %........48
TOVIAZ ................................................................................52
                                                                                                                                                                                                         Tri-Vit with Fluoride & Iron .......................................39
                                                                                                   triamterene-hydrochlorothiazid.................................17
TRACLEER ......................................................................19
                                                                                                                                                                                                         Trivit/Fluoride ....................................................................39
                                                                                                   triamterene-hydrochlorothiazid.................................18
TRACLEER ......................................................................46
                                                                                                                                                                                                         Tri-Vitamin W/Fluoride & Iron ................................39
                                                                                                   triamterene-hydrochlorothiazid.................................28
TRADJENTA .....................................................................37
                                                                                                                                                                                                         Tri-Vitamin/Fluoride ......................................................39
                                                                                                   triamterene-hydrochlorothiazid.................................30
tramadol.................................................................................25
                                                                                                                                                                                                         TRIZIVIR .............................................................................5
                                                                                                   triamterene-hydrochlorothiazid ................................18
tramadol-acetaminophen...............................................20
                                                                                                                                                                                                         Tropicacyl ............................................................................33
                                                                                                   triamterene-hydrochlorothiazid ................................28
tramadol-acetaminophen...............................................21
                                                                                                                                                                                                         tropicamide...........................................................................33
                                                                                                   triamterene-hydrochlorothiazid ................................30
tramadol-acetaminophen...............................................25
                                                                                                                                                                                                         trospium..................................................................................52
                                                                                                   triazolam................................................................................23
TRANDATE .........................................................................9
80
TRUSOPT ............................................................................31        TYZINE ................................................................................33          VANCOCIN 125 MG, 250 MG.................................4

TRUVADA ............................................................................5         U-CORT ................................................................................48          Vandazole .............................................................................48

TUSNEL ...............................................................................43      ULESFIA ............................................................................51             VANIQA ...............................................................................52

TUSNEL ...............................................................................44      ULORIC ..............................................................................39            VANOS .................................................................................48

TUSNEL ...............................................................................45      ULTILET ALCOHOL SWAB ..................................51                                          VANOXIDE-HC ..............................................................48

Tusnel C ................................................................................41   UltimateCare One .............................................................29                   VANTAS ................................................................................8

Tusnel C ................................................................................43   ULTIMATECARE ONE NF ..................................29                                           VANTAS ..............................................................................37

Tusnel C ................................................................................44   ULTRACET ........................................................................20                VASERETIC ......................................................................12

Tusnel Diabetic ..................................................................43          ULTRACET ........................................................................21                VASERETIC ......................................................................13

Tusnel Diabetic ..................................................................44          ULTRACET ........................................................................25                VASERETIC ......................................................................18

TUSNEL NEW FORMULA ......................................41                                   ULTRAM .............................................................................25             VASERETIC ......................................................................30

TUSNEL NEW FORMULA ......................................43                                   ULTRAM ER .....................................................................25                  Vasolex ..................................................................................52

TUSNEL NEW FORMULA ......................................44                                   ULTRASE EC ..................................................................34                    VASOPRESSIN.................................................................38

TUSNEL PED-C ..............................................................41                 ULTRASE MT 12 ..........................................................34                         VASOTEC ...........................................................................12

TUSNEL PED-C ..............................................................43                 ULTRASE MT 18 ..........................................................34                         VASOTEC ...........................................................................13

TUSNEL PED-C ..............................................................44                 ULTRASE MT 20 ..........................................................34                         VECTICAL .......................................................................52

Tusnel Pediatric .................................................................41          ULTRAVATE ....................................................................48                   VELTIN ................................................................................48

TUSNEL PEDIATRIC ..................................................43                         ULTRAVATE PAC ........................................................48                           VELTIN ................................................................................50

Tusnel Pediatric .................................................................44          UNIRETIC ...........................................................................12             VemaVite-PRx-2 ..............................................................29

TUSNEL-DM PEDIATRIC ........................................41                                UNIRETIC ...........................................................................13             VemaVite-PRx-2 ..............................................................34

TUSNEL-DM PEDIATRIC ........................................43                                UNIRETIC ...........................................................................18             VENATAL-FA .................................................................29

TUSNEL-DM PEDIATRIC ........................................44                                UNIRETIC ...........................................................................30             VENELEX ...........................................................................52

TUSSICAPS ......................................................................43            Unithroid ...............................................................................38        venlafaxine............................................................................26

TUSSICAPS ......................................................................45            UNIVASC ............................................................................12             venlafaxine ...........................................................................26

TUSSIGON .........................................................................43          UNIVASC ............................................................................13             VENTAVIS ........................................................................19
                                                                                              URECHOLINE 10 MG, 25 MG, 5 MG, 50
TUSSIONEX PENNKINETIC ER .....................43                                                                                                                                                 VENTOLIN HFA .............................................................10
                                                                                              MG............................................................................................10
TUSSIONEX PENNKINETIC ER .....................45                                                                                                                                                 VENTOLIN HFA .............................................................46
                                                                                              UROCIT-K 10 ...................................................................28
TWINJECT AUTOINJECTOR ................................41                                                                                                                                         VERAMYST .....................................................................32
                                                                                              UROCIT-K 15 ..................................................................28
TWYNSTA .........................................................................12                                                                                                              VERAMYST .....................................................................45
                                                                                              UROCIT-K 5 ......................................................................28
TWYNSTA .........................................................................16                                                                                                              verapamil...............................................................................14
                                                                                              UROXATRAL ...................................................................10
TWYNSTA .........................................................................19                                                                                                              verapamil...............................................................................15
                                                                                              URSO 250 ............................................................................34
TYKERB ................................................................................8                                                                                                         verapamil...............................................................................16
                                                                                              URSO FORTE ...................................................................34
TYLENOL-CODEINE #3 ...........................................20                                                                                                                                 verapamil...............................................................................18
                                                                                              ursodiol...................................................................................34
TYLENOL-CODEINE #3 ...........................................25                                                                                                                                 verapamil...............................................................................19
                                                                                              UVADEX .............................................................................51
TYLENOL-CODEINE #4 ...........................................20                                                                                                                                 verapamil ..............................................................................14
                                                                                              VAGIFEM ..........................................................................37
TYLENOL-CODEINE #4 ...........................................25                                                                                                                                 verapamil ..............................................................................16
                                                                                              valacyclovir.............................................................................5
TYLOX .................................................................................20                                                                                                        verapamil ..............................................................................19
                                                                                              VALCYTE .............................................................................5
TYLOX .................................................................................25                                                                                                        verapamil 40 mg.................................................................14
                                                                                              VALIUM ..............................................................................23
TYVASO .............................................................................19                                                                                                           VERDESO ...........................................................................48
                                                                                              valproic acid.........................................................................21
TYVASO .............................................................................46                                                                                                           VERELAN ...........................................................................14
                                                                                              VALTREX .............................................................................5
TYVASO REFILL KIT .............................................19                                                                                                                                VERELAN ...........................................................................16
                                                                                              VALTURNA .....................................................................12
TYVASO REFILL KIT .............................................46                                                                                                                                VERELAN ...........................................................................19
                                                                                              VALTURNA .....................................................................18
                                                                                                                                                                                                 VERELAN 120 MG, 180 MG, 240 MG, 360
TYVASO STARTER KIT ........................................19
                                                                                              VANACOF CD .................................................................25                     MG............................................................................................14
TYVASO STARTER KIT ........................................46
                                                                                              VANACOF CD .................................................................43                     VERELAN PM ..................................................................14
TYZEKA .................................................................................5
                                                                                              VANACOF CD .................................................................45                     VERELAN PM ..................................................................16

                                                                                                                                                                                                                                                                                           81
VERELAN PM ..................................................................19                 VITAFOL-OB+DHA ...................................................29                             XENADERM .....................................................................52

VERELAN PM 100 MG, 200 MG, 300 MG.......14                                                      VITAFOL-PN (UD) ......................................................29                         XENAZINE .......................................................................23

VERSICLEAR ...................................................................48                Vitazol ....................................................................................48   XENICAL ...........................................................................34

VESICARE ........................................................................52             VITRASE .............................................................................30          XEOMIN ..............................................................................10

VEXOL .................................................................................32       VITRASERT ......................................................................31               XERAC AC .........................................................................49

VFEND ....................................................................................4     VIVACTIL ..........................................................................27            XERESE ...............................................................................48

V-HIST ..................................................................................45     VIVELLE-DOT ..............................................................37                     XERESE ...............................................................................49

VIAGRA ..............................................................................17         VIVITROL ..........................................................................25            XGEVA .................................................................................39

VIBRAMYCIN ....................................................................7                VOL-NATE .......................................................................29               XIAFLEX ............................................................................30

VICODIN .............................................................................20         VOL-TAB RX ..................................................................29                  XIFAXAN 200 MG............................................................6

VICODIN .............................................................................25         VOLTAREN .......................................................................26               XIFAXAN 550 MG...........................................................6

VICODIN ES .....................................................................20              VOLTAREN .......................................................................32               XODOL 10/300 .................................................................20

VICODIN ES .....................................................................25              VOLTAREN-XR ..............................................................26                     XODOL 10/300 .................................................................25

VICODIN HP .....................................................................20              voriconazole............................................................................4        XODOL 5/300 ...................................................................20

VICODIN HP .....................................................................25              VOSOL-HC .........................................................................32             XODOL 5/300 ...................................................................25

VICOPROFEN ..................................................................25                 VOSPIRE ER .....................................................................10               XODOL 7.5/300 ...............................................................20

VICOPROFEN ..................................................................26                 VOSPIRE ER .....................................................................46               XODOL 7.5/300 ...............................................................25

VICTOZA ............................................................................37          VOTRIENT ..........................................................................8             XOLAIR ...............................................................................46

VICTRELIS .........................................................................4            VSL#3 DS ............................................................................33          XOLEGEL ...........................................................................49

VIDAZA .................................................................................8       VUSION ...............................................................................49         Xolox ......................................................................................20

VIDEX 2 GRAM PEDIATRIC ................................5                                        Vynatal FA ...........................................................................29         XOPENEX .........................................................................46
                                                                                                                                                                                                 XOPENEX 0.31 MG/3 ML, 0.63 MG/3 ML,
VIDEX 4 GRAM PEDIATRIC ................................5                                        VYTORIN 10-10 .............................................................14
                                                                                                                                                                                                 1.25 MG/3 ML...................................................................10
VIDEX EC .............................................................................5         VYTORIN 10-10 .............................................................17
                                                                                                                                                                                                 XOPENEX CONCENTRATE ...............................10
VIGAMOX .........................................................................31             VYTORIN 10-20 .............................................................14
                                                                                                                                                                                                 XOPENEX HFA .............................................................10
VIIBRYD .............................................................................27         VYTORIN 10-20 .............................................................17
                                                                                                                                                                                                 XOPENEX HFA .............................................................46
VIMOVO ..............................................................................26         VYTORIN 10-40 .............................................................14
                                                                                                                                                                                                 XYLOCAINE ....................................................................32
VIMOVO ..............................................................................35         VYTORIN 10-40 .............................................................17
                                                                                                                                                                                                 XYLOCAINE JELLY ...................................................33
VIMPAT ...............................................................................21        VYTORIN 10-80 .............................................................15
                                                                                                                                                                                                 XYREM ...............................................................................23
Vinacal ...................................................................................29   VYTORIN 10-80 .............................................................17
                                                                                                                                                                                                 XYZAL ....................................................................................7
Vinacal ...................................................................................34   VYVANSE ..........................................................................19
                                                                                                                                                                                                 XYZAL .................................................................................46
Vinate AZ .............................................................................29       warfarin..................................................................................10
                                                                                                                                                                                                 YAZ 28 ..................................................................................36
Vinate II ................................................................................29    WELCHOL .......................................................................14
                                                                                                                                                                                                 yohimbine ................................................................................8
Vinate One ...........................................................................29        WELCHOL .......................................................................36
                                                                                                                                                                                                 zafirlukast..............................................................................45
Vinate Ultra .........................................................................29        WELLBUTRIN .................................................................21
                                                                                                                                                                                                 zaleplon...................................................................................22
Vinate Ultra .........................................................................34        WELLBUTRIN SR .........................................................21
                                                                                                                                                                                                 ZAMICET ............................................................................20
VIOKASE 16 ....................................................................34               WELLBUTRIN XL ........................................................21
                                                                                                                                                                                                 ZAMICET ............................................................................25
VIOKASE 8 .......................................................................34             WESTCORT .......................................................................48
                                                                                                                                                                                                 ZANAFLEX ..........................................................................9
VIRACEPT ..........................................................................4            Westhroid 130 mg, 195 mg, 32.5 mg, 65 mg......38
                                                                                                                                                                                                 ZANTAC ..............................................................................34
                                                                                                WESTHROID 16.25 MG, 260 MG, 325 MG,
VIRAMUNE ........................................................................5
                                                                                                48.75 MG, 97.5 MG.........................................................38                     ZANTAC 25 EFFERDOSE ........................................34
VIRAMUNE XR .................................................................5
                                                                                                XALATAN ..........................................................................33             ZARONTIN ........................................................................27
VIRAZOLE ............................................................................5
                                                                                                XANAX ................................................................................23         ZAROXOLYN ..................................................................18
VIREAD .................................................................................5
                                                                                                XANAX XR ........................................................................23              ZAROXOLYN ..................................................................30
VIROPTIC ...........................................................................31
                                                                                                XARELTO ...........................................................................10            Zatean-CH ............................................................................29
VISTARIL ...........................................................................22
                                                                                                XCLAIR ................................................................................49        Zatean-Pn Plus ...................................................................29
VITAFOL-OB ..................................................................29
                                                                                                XELODA 150 MG, 500 MG........................................8                                   ZAZOLE ...............................................................................49

82
ZAZOLE 0.4 %..................................................................49                 ZITHROMAX 100 MG/5 ML, 200 MG/5 ML.....6                                                           ZYRTEC ...............................................................................46

ZAZOLE 0.8 %..................................................................49                 ZITHROMAX TRI-PAK ................................................6                                ZYRTEC-D ............................................................................7

ZEBETA ...............................................................................10         ZITHROMAX Z-PAK .....................................................6                             ZYRTEC-D .........................................................................41
                                                                                                 ZOCOR 10 MG, 20 MG, 40 MG, 5 MG, 80
ZEBETA ...............................................................................13                                                                                                            ZYRTEC-D .........................................................................46
                                                                                                 MG............................................................................................17
ZEBETA ...............................................................................15                                                                                                            ZYVOX ...................................................................................6
                                                                                                 ZOFRAN ..............................................................................33
Zebutal ...................................................................................20
                                                                                                 ZOFRAN ODT ..................................................................33
Zebutal ...................................................................................22
                                                                                                 ZOLADEX 10.8 MG, 3.6 MG....................................8
ZEGERID .............................................................................35
                                                                                                 ZOLOFT ...............................................................................27
ZELAPAR ............................................................................24
                                                                                                 zolpidem..................................................................................21
ZELBORAF .........................................................................8
                                                                                                 ZOLPIMIST ........................................................................22
Zencia .....................................................................................51
                                                                                                 ZOLVIT ................................................................................20
ZENPEP 10,000-34,000 -55,000 UNIT,
15,000-51,000 -82,000 UNIT, 20,000-68,000                                                        ZOLVIT ................................................................................25
-109,000 UNIT, 25,000-85,000- 136,000 UNIT,
3,000-10,000- 16,000 UNIT, 5,000-17,000                                                          ZOMIG .................................................................................27
-27,000 UNIT......................................................................34
                                                                                                 ZOMIG 2.5 MG, 5 MG................................................27
ZERIT .......................................................................................5
                                                                                                 ZOMIG ZMT ...................................................................27
ZESTORETIC ....................................................................12
                                                                                                 ZONALON ..........................................................................49
ZESTORETIC ....................................................................13
                                                                                                 ZONATUSS ........................................................................43
ZESTORETIC ....................................................................18
                                                                                                 ZONEGRAN ......................................................................21
ZESTORETIC ....................................................................30
                                                                                                 zonisamide.............................................................................21
ZESTRIL ..............................................................................12
                                                                                                 ZORBTIVE .........................................................................38
ZESTRIL ..............................................................................13
                                                                                                 ZORTRESS .........................................................................40
ZETIA ...................................................................................15
                                                                                                 ZOTEX-C .............................................................................25
ZGESIC .................................................................................20
                                                                                                 ZOTEX-C .............................................................................43
ZIAC .......................................................................................10
                                                                                                 ZOTEX-C .............................................................................45
ZIAC .......................................................................................13
                                                                                                 Zovia 1/35E (28) ...............................................................36
ZIAC .......................................................................................14
                                                                                                 Zovia 1/50E (28) ...............................................................36
ZIAC .......................................................................................15
                                                                                                 ZOVIRAX ..............................................................................5
ZIAC .......................................................................................18
                                                                                                 ZOVIRAX ..........................................................................49
ZIAC .......................................................................................30
                                                                                                 ZUPLENZ ............................................................................33
ZIAGEN .................................................................................5
                                                                                                 ZYBAN .................................................................................21
ZIANA ...................................................................................48
                                                                                                 ZYCLARA ..........................................................................52
ZIANA ...................................................................................50
                                                                                                 ZYDONE ..............................................................................20
zidovudine................................................................................5
                                                                                                 ZYDONE ..............................................................................25
ZINC STEARATE ...........................................................49
                                                                                                 ZYFLO ..................................................................................45
zinc sulfate.............................................................................29
                                                                                                 ZYFLO CR ..........................................................................45
Zincate ....................................................................................29
                                                                                                 ZYLET .................................................................................31
ZINOTIC (WITH GLYCERIN) ...............................32
                                                                                                 ZYLET .................................................................................32
ZINOTIC (WITH GLYCERIN) ...............................33
                                                                                                 ZYLOPRIM ........................................................................39
ZINOTIC ES (WITH GLYCERIN) ........................32
                                                                                                 ZYMAXID .........................................................................31
ZINOTIC ES (WITH GLYCERIN) ........................33
                                                                                                 ZYPRAM .............................................................................48
ZIPSOR .................................................................................26
                                                                                                 ZYPRAM .............................................................................49
ZIRGAN ...............................................................................31
                                                                                                 ZYPREXA ..........................................................................22
ZITHRANOL-RR ............................................................50
                                                                                                 ZYPREXA RELPREVV ..............................................22
ZITHROMAX ......................................................................5
                                                                                                 ZYPREXA ZYDIS ..........................................................22
ZITHROMAX ......................................................................6
                                                                                                 ZYRTEC .................................................................................7

                                                                                                                                                                                                                                                                                         83

				
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