GuildNet Gold Plus FIDA Plan 2015 年 承保藥物清單 ( 處方集 ) 這一份名單是投保人能從 GuildNet Gold Plus FIDA Plan 獲得的藥物清單 GuildNet Gold Plus FIDA Plan 是與聯邦醫療保險和紐約州衛生署 ( 醫療補

Transcription

1 GuildNet Gold Plus FIDA Plan MMP-POS 承保藥物清單 處方集 2015 年 本處方集上次於 2014 年 8 月 8 日更新 請撥打 聽障 語障人士請撥 聯絡計劃以取得最新資訊或查詢其他問題 我們的服務時間為週一至週日每天上午 8 Este vademécum se actualizó el 8/8/2014. Para obtener información más reciente o si tiene otras preguntas, comuníquese 時到晚上 8 時 或請造訪 con el Plan al o, para usuarios de teléfonos de texto (TTY), al Se atiende de lunes a domingo, de 8 a.m. a 8 p.m., o visite Accepted H0811_MEM15_GN56ch_Formulary_ H0811_MEM15_GN56s_Formulary_ v v5

2 GuildNet Gold Plus FIDA Plan 2015 年 承保藥物清單 ( 處方集 ) 這一份名單是投保人能從 GuildNet Gold Plus FIDA Plan 獲得的藥物清單 GuildNet Gold Plus FIDA Plan 是與聯邦醫療保險和紐約州衛生署 ( 醫療補助 ) 皆簽訂合約的管理式醫療保險計劃, 透過 Fully Integrated Duals Advantage (FIDA) 示範, 為上述兩個計劃的投保人提供保險福利 保險福利 承保藥物清單和藥房與提供者網路可能在一年之中及每年的 1 月 1 日變更 您可以隨時上網 查看或者撥打 致電 GuildNet Gold Plus FIDA Plan 投保人服務部以查詢 GuildNet Gold Plus FIDA Plan 最新的承保藥物清單 聽障 / 語障人士請撥 可能適用限制和要求條件 請致電 GuildNet Gold Plus FIDA Plan 投保人服務部或參閱 GuildNet Gold Plus FIDA Plan 投保人手冊以瞭解詳情 所有承保的藥物都不需要共付額 您可以索取其他格式的相關資訊, 如盲文或大字體版本 請撥 這是一支免費電話 您可以免費獲得其他語言的此類資訊 請於週一至週日每天上午 8 時到晚上 8 時致電 ( 聽障 / 語障專線 ) 這是一支免費電話 Usted puede obtener esta información en otros idiomas gratis. Llame al o TTY/TDD al , de lunes a domingo de 8am a 8pm. La llamada es gratis. Queste informazioni sono disponibili gratuitamente in altre lingue. Chiamare il numero verde o mediante un telefono testuale per non udenti (TTY/TDD), da lunedì a domenica, dalle 8 alle 20. La chiamata è gratuita. You can get this information for free in other languages. Call and (TTY/TDD) during Monday through Sunday, 8am to 8pm. The call is free. Вы можете бесплатно получить эту информацию на других языках. Позвоните по телефону и TTY/TDD Служба работает с понедельника по воскресенье с 08:00 до 20:00 ч. Звонок бесплатный. Ou kapab jwenn enfòmasyon sa yo gratis nan lòt lang. Rele nimewo oswa TTY/TDD , lendi jiska dimanch, depi 8am jiska 8pm. Koutfil la gratis.

3 다른언어로작성된이정보를무료로얻으실수있습니다. 월요일 - 일요일오전 8 시부터오후 8 시사이에 번이나 TTY/TDD 번으로 전화주세요. 통화는무료입니다. 紐約州已成立一項名為獨立消費者權益網路 (ICAN) 的投保人監察員計劃, 針對 GuildNet Gold Plus FIDA Plan 所提供的任何服務, 為投保人提供免費且保密的協助 請撥免費電話 ( 聽障專線 :711) 或是上網 與 ICAN 聯絡 常見問答 (FAQ) 如果您對承保藥物清單有任何疑問, 可以在這裡找到答案 您可以閱讀整篇 常見問答 以瞭解更多資訊, 或者尋找某個問題的答案 1. 有哪些處方藥在承保藥物清單上? ( 我們將承保藥物清單簡稱為 藥物清單 ) 從第 2 頁開始的承保藥物清單上所列的藥物是 GuildNet Gold Plus FIDA Plan 所承保的藥物 您可以從我們的網路內藥房獲得這些藥物 如果某家藥房與我們簽訂協議共同為您提供服務, 那麼這家藥房就在我們的網路中 我們將這些藥房稱為 網路內藥房 在以下情況下,GuildNet Gold Plus FIDA Plan 會承保藥物清單上的所有藥物 : 您的醫生或其他網路內處方者表示您需要這些藥物來恢復或保持健康, 這種藥物對於您目前的病況有醫療上的必要, 並且 您是在 GuildNet Gold Plus FIDA Plan 網路內藥房購買處方藥 GuildNet Gold Plus FIDA Plan 對於取得某些藥物可能有其他規定 ( 詳見下方問題 5) 在某些情況下, 您可能需要完成某些步驟才能取得一種藥物, 例如先嘗試使用其他藥物 您也可以造訪我們的網站 或撥打 致電投保人服務部以查詢最新的承保藥物清單 聽障 / 語障人士請撥 藥物清單是否會有所改變? 是 GuildNet Gold Plus FIDA Plan 可能會在一年之中增加或移除藥物清單上的藥物 一般來說, 藥物清單只會在出現以下情況時改變 : 有一種新藥與藥物清單上現有的某種藥物療效相同, 或者 我們瞭解到某種藥物不安全 我們也可能改變我們對藥物的規定 : 例如, 我們可能會 :

4 GUILDNET GOLD PLUS FIDA PLAN 2015 決定某種藥物是否需要事先批准 ( 事先批准是指您在購買處方藥之前先獲得 GuildNet Gold Plus FIDA Plan 或者您的跨學科團隊 (IDT) 的准許 ) 增加或改變您可以獲得的藥量 ( 稱為 藥量限制 ) 增加或改變對某種藥物的階梯療法限制 ( 階梯療法是指在我們承保某一種藥物之前, 您必須先嘗試使用另一種藥物 ) ( 如欲瞭解關於這些藥物規定詳情, 請參閱第 iv 頁 ) 如果您正在使用的藥物被從藥物清單中刪除, 我們會通知您 如果我們改變某種藥物的承保規定, 我們也會通知您 下方的問題 3 4 和 7 對藥物清單改變時會發生的情況有更詳細的說明 您可以隨時上網 查看 GuildNet Gold Plus FIDA Plan 的最新藥物清單 您也可以撥打 致電給投保人服務部以查詢最新的藥物清單 聽障 / 語障人士請撥 如果有一種更便宜的新藥與藥物清單上現有的藥物療效相同, 會怎麼樣? 如果有一種更便宜的新藥與藥物清單上現有的藥物療效相同 : 您的藥房可能會在您下次購買處方藥時給您這種較便宜的藥物 如果您和您的提供者認為較便宜的新藥不適合您, 您的提供者可以讓藥劑師繼續為您提供您現在使用的藥物 GuildNet Gold Plus FIDA Plan 可能決定將較貴的藥物從藥物清單中刪除 如果我們要將您正在使用的藥物從藥物清單中刪除, 因為它與一種更便宜的新藥療效相同, 我們會在將現有藥物從清單中刪除之前至少 60 天或者您要求再次補充藥物時通知您 這樣您依然可以在藥物清單改變之前的 60 天以內獲得該種藥物 您會在改變生效之前至少 60 天收到一封通知函 4. 如果我們發現某種藥物不安全, 會怎麼樣? 如果食品和藥物管理局 (FDA) 認為您正在使用的某種藥物不安全, 我們會立即將它從藥物清單中刪除 我們會發出通知函或者打電話告訴您不安全的藥物已被從藥物清單中刪除 如果您收到通知函, 您應該致電您的醫療保險經理或處方醫生以安排替代處方藥 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA Plan 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 iii

5 5. 藥物承保範圍是否有任何限制或限量? 或者, 是否需要採取必要行動才能獲得某些藥物? 是, 某些藥物有承保範圍規定或者對於您可獲得的藥量有所限制 在某些情況下, 您需要完成某些步驟才能取得一種藥物 例如 : 事先批准 ( 或事先授權 ): 對於某些藥物, 您 您的醫生或其他處方者必須在您購買處方藥之前取得 GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 的批准 如果您沒有獲得批准,GuildNet Gold Plus FIDA Plan 可能無法承保您的藥物 藥量限制 : 有時候 GuildNet Gold Plus FIDA Plan 會限制您可以獲得的藥量 階梯療法 : 有時候 GuildNet Gold Plus FIDA Plan 會規定您接受階梯療法 這意味著根據您的醫療病症, 您必須按照一定的順序嘗試使用各種藥物 在我們承保某一種藥物之前, 您可能必須先嘗試使用另一種藥物 如果您的醫生認為第一種藥對您沒有療效, 我們將承保第二種藥物 您可以參閱第 2 頁開始的表格, 查看您的藥物是否有其他規定或限制 您也可以造訪我們的網站 以瞭解詳情 我們在網站上刊登說明事先授權和階梯療法限制的文件 您也可以向我們索取副本 您可以要求對這些限制做出 破例 請參閱問題 11 以瞭解關於破例的詳情 如果您身處療養院或其他長期照護機構, 需要某種不在藥物清單上的藥物, 或者您無法輕易獲得所需藥物, 我們可以幫助您 無論您是否是 GuildNet Gold Plus FIDA Plan 的新投保人, 對於您所需藥物, 我們會承保 31 天的緊急藥物供應 ( 除非如果您的處方箋所開的天數更短 ) 這樣您就能有足夠的時間與您的醫生或其他處方者洽談 他或她可以幫助您決定藥物清單上是否有您可使用的類似藥物, 或者是否要求破例 請參閱問題 11 以瞭解關於破例的詳情 6. 您如何瞭解您所需藥物是否有限制, 或者是否需要採取必要行動才能獲得此藥物? 第 2 頁的承保藥物清單上有一個標為 必要行動 使用限制或限量 的欄目 7. 如果我們改變某些藥物的承保規定, 會怎麼樣? 例如, 如果我們對某種藥物增加事先授權 ( 批准 ) 藥量限制和 / 或階梯治療限制 如果我們對某種藥物增加事先授權 ( 批准 ) 藥量限制和 / 或階梯療法限制, 我們會通知您 我們會在增加限制之前至少 60 天或您下次要求再次補充藥物時通知您 這樣您依然可以在藥物清單改變之前的 60 天以內獲得該種藥物 這樣您就能有足夠的時間與您的醫生或其他處方者洽談下一步的計劃 8. 您如何在藥物清單上找到一種藥物?

6 GUILDNET GOLD PLUS FIDA PLAN 2015 有兩種方法可以尋找一種藥物 : 您可以按照字母順序尋找 ( 如果您知道如何拼寫藥物名稱 ), 或者 根據您的醫療病症尋找 若要按照字母順序尋找, 請參閱第 190 頁 字母順序排列清單 段落 然後在清單中尋找您的藥物名稱 若要根據醫療病症尋找, 請參閱第 2 頁標有 根據醫療病症排列藥物清單 段落 然後尋找您的醫療病症 例如, 如果您患有心臟病, 您應該在心臟病類別下尋找 您可以在這個類別下找到治療心臟病的藥物 9. 如果您需要使用的藥物不在藥物清單上該怎麼辦? 如果您在藥物清單上找不到您的藥物, 請撥打 ( 聽障 / 語障專線 ) 致電投保人服務部以查詢有關資訊 如果您瞭解到 GuildNet Gold Plus FIDA Plan 不承保這種藥, 您可以採取以下其中一種行動 : 請投保人服務部為您提供與您所需藥物類似的藥物清單 然後請您的醫生或其他處方者查看這份清單 他或她會為您選擇藥物清單上與您所需藥物類似的處方藥 或者 您可以要求計劃或您的跨學科團隊 (IDT) 為您破例以承保您的藥物 請參閱問題 11 以瞭解關於破例的詳情 10. 如果您是 GuildNet Gold Plus FIDA Plan 的新投保人, 且在藥物清單上找不到所需藥物, 或者無法獲得所需藥物時該怎麼辦? 我們可以提供協助 在您成為 GuildNet Gold Plus FIDA Plan 投保人的前 90 天內, 在需要時, 我們必須為您提供最多 90 天的臨時藥物供應 這樣您就能有足夠的時間與您的醫生或其他處方者洽談 他或她可以幫助您決定藥物清單上是否有您可使用的類似藥物, 或者是否要求破例 在以下情況下, 我們會為您的藥物提供最多 90 天的臨時藥物供應 : 您正在使用的藥物不在我們的藥物清單上, 或者 健康計劃規定不允許您獲得處方者指定的藥量, 或者 這種藥物需要獲得 GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 的事先批准, 或者 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA Plan 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 v

7 您正在使用的藥物是階梯療法限制的一部分 如果您居住在療養院或其他長期照護機構, 您可以有長達 98 天的時間再次補充藥物 您可以在這 98 天以內多次補充藥物 這樣您的處方者就能有足夠的時間將您的藥物更換為藥物清單上的藥物, 或者要求破例 如果您是我們計劃的現任投保人, 並且您的照護等級有所改變, 例如入住長期照護機構或 者從此機構出院, 那麼在需要時您將能夠 較早的 再次補充您的藥物, 以幫助您過渡到 您的新的照護等級 11. 您能否要求破例以承保您的藥物? 是 您可以要求 GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 做出破例以承保不藥物清單上的藥物 您也可以要求 GuildNet Gold Plus FIDA Plan 或您的跨學科團隊改變您的藥物規定 例如,GuildNet Gold Plus FIDA Plan 可能會限制我們承保某種藥物的藥量 如果您的藥物有藥量限制, 您可以要求我們或您的跨學科團隊改變這種限制並承保更多藥量 其他例子 : 您可以要求我們或者您的跨學科團隊取消階梯療法限制或事先批准規定 12. 獲得破例需要多長時間? 首先,GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 必須要收到您的處方者提供的說明, 表示支持您要求破例 在我們收到說明之後, 您將在 72 小時以內得知破例要求的結果 如果您或您的處方者認為, 等待 72 小時才能得知決定會對您的健康造成傷害, 您可以要求加急破例 這是比較快速的決定 如果您的處方者支持您的要求, 您將會在我們收到處方者支持說明之後的 24 小時以內得知我們的決定 13. 您如何要求破例? 若要要求破例, 請致電您的醫療保險經理 您的醫療保險經理會與您和您的提供者共同合作以幫助您要求破例 14. 什麼是非品牌藥物? 非品牌藥物所含的成分與品牌藥物相同 這種藥物通常比品牌藥物更便宜, 而且通常沒有眾所周知的品牌名 非品牌藥物都經過食品與藥物管理局 (FDA) 的批准 GuildNet Gold Plus FIDA Plan 承保品牌藥物和非品牌藥物

8 GUILDNET GOLD PLUS FIDA PLAN 什麼是非處方 (OTC) 藥? OTC 意思是指 櫃檯購買 (over-the-counter) GuildNet Gold Plus FIDA Plan 承保某些由您的提供者開具處方的非處方藥物 您可以參閱 GuildNet Gold Plus FIDA Plan 藥物清單以瞭解我們承保哪些非處方藥物 承保的非處方藥物例子如下 : 阿斯匹靈 醋氨酚 Advil 抗酸劑 過敏和感冒藥 抗生素軟膏 瀉藥 尼古丁貼片和口香糖 維他命等 16. GuildNet Gold Plus FIDA Plan 是否承保非處方非藥物產品? GuildNet Gold Plus FIDA Plan 承保某些由您的提供者開具處方的非處方非藥物產品 您可以參閱 GuildNet Gold Plus FIDA Plan 藥物清單瞭解我們承保哪些非處方非藥物產品 承保的非處方非藥物產品例子如下 : 繃帶 急救用品 醫療支援 高低壓軟管 牙刷和牙膏 失禁用品和假牙產品 17. 您的共付額是多少? 當您購買藥物清單上的藥物時, 不需要支付共付額 18. 藥物等級是哪些? 承保藥物清單上的每種藥物都分別屬於四個等級之一 第 1 級 聯邦醫療保險 D 部分非品牌藥第 2 級 聯邦醫療保險 D 部分品牌藥第 3 級 醫療補助承保的 ( 非 D 部分 ) 處方藥第 4 級 非處方 (OTC) 項目 我們藥物清單上的所有藥物和項目的共付額為 $0 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA Plan 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 vii

9 承保藥物清單 下一頁開始的承保藥物清單為您提供 GuildNet Gold Plus FIDA Plan 承保藥物的資訊 如果您在清單上找不到您的藥物, 請翻到第 189 頁開始的索引 表格的第一欄是藥物名稱 品牌藥物為大寫 ( 例如 SYNTHROID), 非品牌藥物為斜體小寫 ( 如 atenolol) 必要行動 使用限制或限量一欄的資訊告訴您 GuildNet Gold Plus FIDA Plan 對於您的藥物是否有任何承保規定

10 GUILDNET GOLD PLUS FIDA PLAN 2015 備註 : 藥物旁邊的 * 表示這種藥物不是 D 部分藥物 這些藥物的上訴規則各有不同 上訴是當您認為承保決定有錯誤, 您要求計劃對某項承保決定進行審查並作出改變的正式途徑 例如,GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 決定您需要的某種藥物不是或者將不再是聯邦醫療保險或醫療補助計劃的承保藥物 如果您 您的醫生或其他處方者不同意此項決定, 您可以提出上訴 若要獲得如何提出上訴的指示說明, 請撥打 ( 聽障 / 語障人士請撥 ) 致電投保人服務部, 或者撥打 ( 聽障 / 語障專線 :711) 以尋求獨立消費者權益網路 (ICAN) 的免費服務 您也可以參閱 投保人手冊 以瞭解如何對一項決定提出上訴 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA Plan 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 ix

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12 以下清單中的縮寫可能會出現在以下幾頁的必要行動 使用限制或限量一欄, 此欄資訊讓 您瞭解您的藥物是否有任何特定的承保規定 縮寫清單 *: 藥物旁邊的 * 表示這種藥物不是 D 部分藥物 這些藥物的上訴規則各有不同 上訴是當您認為承保決定有錯誤, 您要求計劃對某項承保決定進行審查並作出改變的正式途徑 例如,GuildNet Gold Plus FIDA Plan 或您的跨學科團隊 (IDT) 決定您需要的某種藥物不是或者將不再是聯邦醫療保險或醫療補助計劃的承保藥物 如果您 您的醫生或其他處方者不同意此項決定, 您可以提出上訴 若要獲得如何提出上訴的指示說明, 請撥打 致電 GuildNet Gold Plan FIDA Plan; 聽障 / 語障人士請撥 您也可以參閱 投保人手冊 以瞭解如何對一項決定提出上訴 B/D PA: 視情況而定, 這種處方藥會由聯邦醫療保險 B 部分或 D 部分承保 可能需要提 出關於藥物使用和背景的資訊以做出決定 LA: 限制供應 這種處方藥只能在特定藥房獲得 請致電客戶服務部洽詢詳情 MO: 郵購藥物 這種處方藥可以透過郵購服務獲得, 也可以從我們的零售網路內藥房獲得 請考慮使用郵購服務獲得長期 ( 維持 ) 藥物 ( 例如高血壓治療藥物 ) 零售網路內藥房可 能比較適合獲得短期處方藥 ( 例如抗生素 ) PA: 事先授權 對於某些藥物, 計劃規定您或您的醫生需要獲得事先授權 這意味著您需 要在購買處方藥之前先獲得批准 如果您沒有獲得批准, 我們可能無法為您的藥物承保 QL: 數量限制 對於某些藥物, 計劃限制我們承保的藥量 ST: 階梯療法 在某些情況下, 計劃規定在我們承保某一種藥物之前, 您必須先嘗試使用另一種藥物來治療您的醫療病症 例如, 如果藥物 A 和藥物 B 都能治療您的醫療病症, 除非您先嘗試使用藥物 A, 否則我們可能不會承保藥物 B 如果藥物 A 對您沒有療效, 我們將會承保藥物 B 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 1

13 抗感染藥物 抗真菌藥物 ABELCET 2 $0 B/D PA; MO SUSPENSION AMBISOME 2 $0 B/D PA; MO SUSPENSION FOR RECONSTITUTION amphotericin b injection recon soln 1 $0 B/D PA; MO CANCIDAS RECON 2 $0 B/D PA; MO SOLN clotrimazole mucous membrane troche 1 $0 MO clotrimazole mucous membrane troche 1 $0 MO fluconazole oral suspension for 1 $0 MO reconstitution fluconazole oral tablet 100 mg, 200 mg, 1 $0 MO; QL( 每 7 天 2 單位 ) 50 mg fluconazole in dextrose(iso-o) intravenous 1 $0 B/D PA piggyback flucytosine oral capsule 1 $0 MO griseofulvin microsize oral suspension 1 $0 MO griseofulvin microsize oral tablet 1 $0 MO griseofulvin ultramicrosize oral tablet 1 $0 MO itraconazole oral capsule 1 $0 MO; QL( 每 30 天 120 單位 ) ketoconazole oral tablet 1 $0 MO NOXAFIL ORAL SUSPENSION 2 $0 MO nystatin oral suspension 1 $0 MO nystatin oral tablet 1 $0 MO terbinafine oral tablet 1 $0 MO; QL( 每 365 天 90 單位 ) voriconazole intravenous solution 1 $0 B/D PA; MO VORICONAZOLE ORAL SUSPENSION 2 $0 MO FOR RECONSTITUTION VORICONAZOLE ORAL TABLET $0 MO MG voriconazole oral tablet 50 mg 1 $0 MO 抗病毒藥物 abacavir oral tablet 1 $0 MO abacavir-lamivudine-zidovudine oral tablet 1 $0 MO 2

14 acyclovir oral capsule 1 $0 MO acyclovir oral suspension 1 $0 MO acyclovir oral tablet 1 $0 MO acyclovir sodium intravenous recon soln 1 $0 B/D 1,000 mg acyclovir sodium intravenous solution 1 $0 B/D ADEFOVIR ORAL TABLET 2 $0 MO amantadine hcl oral capsule 1 $0 MO amantadine hcl oral syrup 1 $0 MO amantadine hcl oral tablet 1 $0 MO APTIVUS ORAL CAPSULE 2 $0 MO APTIVUS ORAL SOLUTION 2 $0 ATRIPLA ORAL TABLET 2 $0 MO BARACLUDE ORAL SOLUTION 2 $0 MO BARACLUDE ORAL TABLET 2 $0 MO CIDOFOVIR 2 $0 B/D PA; MO SOLUTION COMBIVIR ORAL TABLET 2 $0 MO COMPLERA ORAL TABLET 2 $0 MO CRIXIVAN ORAL CAPSULE 2 $0 MO didanosine oral capsule,delayed 1 $0 MO release(dr/ec) EDURANT ORAL TABLET 2 $0 MO EMTRIVA ORAL CAPSULE 2 $0 MO EMTRIVA ORAL SOLUTION 2 $0 MO EPIVIR ORAL SOLUTION 2 $0 MO EPIVIR HBV ORAL SOLUTION 2 $0 MO EPZICOM ORAL TABLET 2 $0 MO famciclovir oral tablet 125 mg 1 $0 MO; QL( 每 10 天 21 單位 ) famciclovir oral tablet 250 mg 1 $0 MO; QL( 每 30 天 60 單位 ) famciclovir oral tablet 500 mg 1 $0 MO; QL( 每 7 天 21 單位 ) foscarnet intravenous solution 1 $0 MO FUZEON SUBCUTANEOUS RECON 2 $0 MO SOLN ganciclovir sodium intravenous recon soln 1 $0 B/D PA; MO 3

15 INTELENCE ORAL TABLET 100 MG, 2 $0 MO 200 MG INTELENCE ORAL TABLET 25 MG 2 $0 INVIRASE ORAL CAPSULE 2 $0 MO INVIRASE ORAL TABLET 2 $0 MO ISENTRESS ORAL POWDER IN 2 $0 PACKET ISENTRESS ORAL TABLET 2 $0 MO ISENTRESS ORAL 2 $0 MO TABLET,CHEWABLE KALETRA ORAL SOLUTION 2 $0 MO KALETRA ORAL TABLET 2 $0 MO lamivudine oral tablet 1 $0 MO LAMIVUDINE-ZIDOVUDINE ORAL 2 $0 MO TABLET LEXIVA ORAL SUSPENSION 2 $0 MO LEXIVA ORAL TABLET 2 $0 MO nevirapine oral suspension 1 $0 MO nevirapine oral tablet 1 $0 MO nevirapine oral tablet extended release 24 1 $0 MO hr NORVIR ORAL CAPSULE 2 $0 MO NORVIR ORAL SOLUTION 2 $0 MO NORVIR ORAL TABLET 2 $0 MO OLYSIO ORAL CAPSULE 2 $0 PA; MO; QL( 每 30 天 30 單位 ) PREZISTA ORAL SUSPENSION 2 $0 MO PREZISTA ORAL TABLET 150 MG, $0 MO MG, 75 MG, 800 MG RELENZA DISKHALER INHALATION BLISTER WITH DEVICE 2 $0 MO; QL( 每 180 天 60 單位 ) RESCRIPTOR ORAL TABLET 2 $0 MO RESCRIPTOR ORAL TABLET, 2 $0 MO DISPERSIBLE RETROVIR SOLUTION 2 $0 REYATAZ ORAL CAPSULE 2 $0 MO ribavirin oral capsule 1 $0 PA; MO 4

16 ribavirin oral tablet 1 $0 PA; MO rimantadine oral tablet 1 $0 MO SELZENTRY ORAL TABLET 2 $0 MO SOVALDI ORAL TABLET 2 $0 PA; MO; QL( 每 30 天 30 單位 ) stavudine oral capsule 1 $0 MO stavudine oral recon soln 1 $0 MO STRIBILD ORAL TABLET 2 $0 MO SUSTIVA ORAL CAPSULE 2 $0 MO SUSTIVA ORAL TABLET 2 $0 MO SYNAGIS INTRAMUSCULAR 2 $0 PA; MO; LA SOLUTION 50 MG/0.5 ML TAMIFLU ORAL CAPSULE 30 MG 2 $0 MO; QL( 每 180 天 84 單位 ) TAMIFLU ORAL CAPSULE 45 MG, 75 MG TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION 2 $0 MO; QL( 每 180 天 42 單位 ) 2 $0 MO; QL( 每 180 天 600 單 位 ) TIVICAY ORAL TABLET 2 $0 MO TRUVADA ORAL TABLET 2 $0 MO TYZEKA ORAL TABLET 2 $0 MO valacyclovir oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) VALCYTE ORAL RECON SOLN 2 $0 MO VALCYTE ORAL TABLET 2 $0 MO VIDEX 2 GRAM PEDIATRIC ORAL 2 $0 MO RECON SOLN VIDEX 4 GRAM PEDIATRIC ORAL 2 $0 MO RECON SOLN VIRACEPT ORAL TABLET 2 $0 MO VIRAMUNE ORAL SUSPENSION 2 $0 MO VIRAMUNE XR ORAL TABLET 2 $0 MO EXTENDED RELEASE 24 HR 100 MG VIRAZOLE INHALATION RECON 2 $0 B/D PA; MO SOLN VIREAD ORAL POWDER 2 $0 MO VIREAD ORAL TABLET 2 $0 MO 5

17 ZIAGEN ORAL SOLUTION 2 $0 MO zidovudine oral capsule 1 $0 MO zidovudine oral syrup 1 $0 MO zidovudine oral tablet 1 $0 MO 頭孢菌素 cefaclor oral capsule 1 $0 MO cefaclor oral tablet extended release 12 hr 1 $0 MO cefadroxil oral capsule 1 $0 MO cefadroxil oral suspension for reconstitution 1 $0 MO cefadroxil oral tablet 1 $0 MO cefazolin injection recon soln 1 gram 1 $0 B/D PA; MO cefazolin injection recon soln 10 gram, 20 1 $0 B/D PA gram, 500 mg cefazolin intravenous recon soln 1 $0 B/D PA cefazolin in dextrose (iso-os) intravenous 1 $0 B/D PA; MO piggyback 1 gram/50 ml cefazolin in dextrose (iso-os) intravenous 1 $0 B/D PA piggyback 2 gram/50 ml cefdinir oral capsule 1 $0 MO cefdinir oral suspension for reconstitution 1 $0 MO cefditoren pivoxil oral tablet 1 $0 cefepime injection recon soln 1 $0 B/D PA; MO cefotaxime injection recon soln 1 gram, 2 1 $0 B/D PA gram, 500 mg cefotaxime injection recon soln 10 gram 1 $0 B/D PA; MO cefotetan injection recon soln 1 $0 cefotetan intravenous recon soln 1 $0 cefoxitin intravenous recon soln 1 gram 1 $0 B/D PA; MO cefoxitin intravenous recon soln 10 gram, 2 1 $0 B/D PA gram cefoxitin in dextrose, iso-osm intravenous 1 $0 B/D PA piggyback cefpodoxime oral suspension for 1 $0 MO reconstitution cefpodoxime oral tablet 1 $0 MO cefprozil oral suspension for reconstitution 1 $0 MO cefprozil oral tablet 1 $0 MO 6

18 ceftazidime injection recon soln 1 gram 1 $0 B/D PA ceftazidime injection recon soln 2 gram 1 $0 B/D PA; MO ceftazidime injection recon soln 6 gram 1 $0 ceftriaxone injection recon soln 1 gram, 2 1 $0 B/D PA; MO gram, 250 mg, 500 mg ceftriaxone injection recon soln 10 gram 1 $0 B/D PA ceftriaxone intravenous recon soln 1 $0 B/D PA; MO ceftriaxone in dextrose,iso-os intravenous 1 $0 B/D PA; MO piggyback 1 gram/50 ml cefuroxime axetil oral tablet 1 $0 MO cefuroxime sodium injection recon soln 1 $0 B/D PA; MO cefuroxime sodium intravenous recon soln 1 $0 B/D PA cephalexin oral capsule 1 $0 MO cephalexin oral suspension for 1 $0 MO reconstitution cephalexin oral tablet 1 $0 MO SUPRAX ORAL SUSPENSION FOR 2 $0 MO RECONSTITUTION 100 MG/5 ML, 200 MG/5 ML SUPRAX ORAL SUSPENSION FOR 2 $0 RECONSTITUTION 500 MG/5 ML SUPRAX ORAL TABLET 2 $0 MO SUPRAX ORAL TABLET,CHEWABLE 2 $0 MO TEFLARO RECON 2 $0 B/D PA; MO SOLN 紅黴素 / 其他大環內酯類藥物 azithromycin intravenous recon soln 1 $0 B/D PA; MO azithromycin oral packet 1 $0 MO azithromycin oral suspension for 1 $0 MO reconstitution azithromycin oral tablet 1 $0 MO clarithromycin oral suspension for 1 $0 MO reconstitution clarithromycin oral tablet 1 $0 MO clarithromycin oral tablet extended release 24 hr 1 $0 MO 7

19 ERYPED 200 ORAL SUSPENSION FOR 2 $0 MO RECONSTITUTION ERYTHROCIN RECON 2 $0 B/D PA SOLN 500 MG ERYTHROCIN (AS STEARATE) ORAL 2 $0 MO TABLET erythromycin oral capsule,delayed 1 $0 MO release(dr/ec) erythromycin oral tablet 1 $0 MO erythromycin ethylsuccinate oral tablet 1 $0 MO 其他抗感染藥物 ALBENZA ORAL TABLET 2 $0 MO ALINIA ORAL SUSPENSION FOR 2 $0 MO; QL( 每 30 天 180 單 RECONSTITUTION 位 ) ALINIA ORAL TABLET 2 $0 MO; QL( 每 30 天 12 單位 ) amikacin injection solution 1 $0 B/D PA; MO ATOVAQUONE ORAL SUSPENSION 2 $0 MO atovaquone-proguanil oral tablet 1 $0 MO aztreonam injection recon soln 1 $0 MO baciim intramuscular recon soln 1 $0 B/D PA bacitracin intramuscular recon soln 1 $0 B/D PA; MO CAPASTAT INJECTION RECON SOLN 2 $0 B/D PA CAYSTON INHALATION SOLUTION 2 $0 MO; QL( 每 28 天 84 單位 ) FOR NEBULIZATION chloramphenicol sod succinate intravenous 1 $0 B/D PA recon soln chloroquine phosphate oral tablet 1 $0 MO clindamycin hcl oral capsule 1 $0 MO clindamycin palmitate hcl oral recon soln 1 $0 MO clindamycin pediatric oral recon soln 1 $0 clindamycin phosphate injection solution 1 $0 B/D PA; MO clindamycin phosphate intravenous solution 1 $0 B/D PA 300 mg/2 ml, 900 mg/6 ml clindamycin phosphate intravenous solution 1 $0 B/D PA; MO 600 mg/4 ml COARTEM ORAL TABLET 2 $0 MO COLISTIN (COLISTIMETHATE NA) 2 $0 B/D PA; MO 8

20 INJECTION RECON SOLN CUBICIN RECON 2 $0 B/D PA; MO SOLN cycloserine oral capsule 1 $0 MO DAPSONE ORAL TABLET 2 $0 MO DARAPRIM ORAL TABLET 2 $0 MO ethambutol oral tablet 1 $0 MO gentamicin injection solution 1 $0 B/D PA; MO gentamicin in nacl (iso-osm) intravenous 1 $0 B/D PA piggyback 100 mg/100 ml, 120 mg/100 ml gentamicin in nacl (iso-osm) intravenous 1 $0 piggyback 60 mg/50 ml, 70 mg/50 ml, 80 mg/50 ml, 90 mg/100 ml GENTAMICIN IN NACL (ISO-OSM) 2 $0 B/D PA PIGGYBACK 80 MG/100 ML gentamicin sulfate (ped) (pf) injection 1 $0 B/D PA; MO solution gentamicin sulfate (pf) intravenous solution 1 $0 B/D PA; MO 100 mg/10 ml GENTAMICIN SULFATE (PF) 2 $0 B/D PA SOLUTION 60 MG/6 ML gentamicin sulfate (pf) intravenous solution 1 $0 B/D PA 80 mg/8 ml hydroxychloroquine oral tablet 1 $0 MO imipenem-cilastatin intravenous recon soln 1 $0 B/D PA; MO INVANZ INJECTION RECON SOLN 2 $0 B/D PA; MO INVANZ RECON SOLN 2 $0 B/D PA isoniazid injection solution 1 $0 isoniazid oral solution 1 $0 MO isoniazid oral tablet 1 $0 MO MALARONE PEDIATRIC ORAL 2 $0 MO TABLET mefloquine oral tablet 1 $0 MO meropenem intravenous recon soln 500 mg 1 $0 B/D PA; MO metronidazole oral capsule 1 $0 9

21 metronidazole oral tablet 1 $0 MO metronidazole in nacl (iso-os) intravenous 1 $0 MO piggyback NEBUPENT INHALATION RECON 2 $0 B/D PA; MO SOLN neomycin oral tablet 1 $0 MO paromomycin oral capsule 1 $0 MO PASER ORAL GRANULES DR FOR 2 $0 MO SUSP IN PACKET PENTAM INJECTION RECON SOLN 2 $0 B/D PA; MO polymyxin b sulfate injection recon soln 1 $0 MO PRIFTIN ORAL TABLET 2 $0 MO PRIMAQUINE ORAL TABLET 2 $0 MO pyrazinamide oral tablet 1 $0 MO quinine sulfate oral capsule 1 $0 PA; MO rifabutin oral capsule 1 $0 MO rifampin intravenous recon soln 1 $0 B/D PA; MO rifampin oral capsule 1 $0 MO STREPTOMYCIN INTRAMUSCULAR 2 $0 B/D PA; MO RECON SOLN STROMECTOL ORAL TABLET 2 $0 MO SYNERCID RECON 2 $0 B/D PA SOLN tinidazole oral tablet 1 $0 MO TOBRAMYCIN IN % NACL 2 $0 B/D PA; MO INHALATION SOLUTION FOR NEBULIZATION tobramycin in 0.9 % nacl intravenous 1 $0 MO piggyback 80 mg/100 ml tobramycin sulfate injection solution 1 $0 B/D PA; MO TRECATOR ORAL TABLET 2 $0 MO TYGACIL RECON 2 $0 MO SOLN XIFAXAN ORAL TABLET 550 MG 2 $0 MO ZYVOX PARENTERAL 2 $0 PA SOLUTION 200 MG/100 ML ZYVOX PARENTERAL 2 $0 PA; MO 10

22 SOLUTION 600 MG/300 ML ZYVOX ORAL SUSPENSION FOR 2 $0 PA; MO RECONSTITUTION ZYVOX ORAL TABLET 2 $0 PA; MO 青黴素 ( 盤尼西林 ) amoxicillin oral capsule 1 $0 MO amoxicillin oral suspension for 1 $0 MO reconstitution amoxicillin oral tablet 1 $0 MO amoxicillin oral tablet,chewable 1 $0 MO amoxicillin-pot clavulanate oral suspension 1 $0 MO for reconstitution amoxicillin-pot clavulanate oral tablet 1 $0 MO amoxicillin-pot clavulanate oral tablet 1 $0 MO extended release 12 hr amoxicillin-pot clavulanate oral 1 $0 MO tablet,chewable ampicillin oral capsule 1 $0 MO ampicillin oral suspension for reconstitution 1 $0 MO ampicillin sodium injection recon soln 1 1 $0 B/D PA; MO gram, 10 gram, 125 mg, 2 gram, 250 mg ampicillin sodium injection recon soln $0 B/D PA mg ampicillin sodium intravenous recon soln 1 $0 B/D PA ampicillin-sulbactam injection recon soln 15 1 $0 B/D PA gram ampicillin-sulbactam injection recon soln 3 1 $0 B/D PA; MO gram ampicillin-sulbactam intravenous recon soln 1 $0 B/D PA 3 gram BICILLIN C-R INTRAMUSCULAR 2 $0 B/D PA; MO SYRINGE BICILLIN L-A INTRAMUSCULAR 2 $0 MO SYRINGE dicloxacillin oral capsule 1 $0 MO nafcillin injection recon soln 1 gram 1 $0 B/D PA; MO NAFCILLIN INJECTION RECON SOLN 2 $0 B/D PA; MO 11

23 10 GRAM, 2 GRAM nafcillin intravenous recon soln 1 gram 1 $0 B/D PA NAFCILLIN RECON 2 $0 B/D PA; MO SOLN 2 GRAM NAFCILLIN IN DEXTROSE ISO-OSM 2 $0 B/D PA PIGGYBACK 1 GRAM/50 ML NAFCILLIN IN DEXTROSE ISO-OSM 2 $0 B/D PA; MO PIGGYBACK 2 GRAM/100 ML oxacillin injection recon soln 1 gram, 2 1 $0 B/D PA; MO gram OXACILLIN INJECTION RECON SOLN 2 $0 B/D PA; MO 10 GRAM oxacillin intravenous recon soln 1 $0 B/D PA oxacillin in dextrose(iso-osm) intravenous 1 $0 B/D PA piggyback 1 gram/50 ml OXACILLIN IN DEXTROSE(ISO-OSM) 2 $0 B/D PA PIGGYBACK 2 GRAM/50 ML penicillin g potassium injection recon soln 1 $0 B/D PA; MO 5 million unit penicillin g procaine intramuscular syringe 1 $0 B/D PA; MO 1.2 million unit/2 ml penicillin g procaine intramuscular syringe 1 $0 B/D PA 600,000 unit/ml penicillin g sodium injection recon soln 1 $0 B/D PA; MO penicillin v potassium oral recon soln 1 $0 MO penicillin v potassium oral tablet 1 $0 MO piperacillin-tazobactam intravenous recon 1 $0 B/D PA; MO soln 喹諾酮類藥物 AVELOX IN NACL (ISO-OSMOTIC) PIGGYBACK CIPRO ORAL SUSPENSION,MICROCAPSULE RECON ciprofloxacin intravenous solution 400 mg/40 ml 2 $0 B/D PA; MO 2 $0 MO 1 $0 B/D PA 12

24 ciprofloxacin oral suspension,microcapsule 1 $0 recon ciprofloxacin oral tablet 1 $0 MO ciprofloxacin (mixture) oral tablet, er 1 $0 MO multiphase 24 hr ciprofloxacin in 5 % dextrose intravenous 1 $0 B/D PA; MO piggyback 400 mg/200 ml levofloxacin intravenous solution 1 $0 B/D PA; MO levofloxacin oral solution 1 $0 MO levofloxacin oral tablet 1 $0 MO levofloxacin in d5w intravenous piggyback 1 $0 500 mg/100 ml moxifloxacin oral tablet 1 $0 MO ofloxacin oral tablet 1 $0 MO 磺胺 / 相關製劑 sulfadiazine oral tablet 1 $0 MO sulfamethoxazole-trimethoprim intravenous 1 $0 B/D PA; MO solution sulfamethoxazole-trimethoprim oral 1 $0 MO suspension sulfamethoxazole-trimethoprim oral tablet 1 $0 MO 四環素 demeclocycline oral tablet 1 $0 MO doxy-100 intravenous recon soln 1 $0 B/D PA; MO doxycycline hyclate intravenous recon soln 1 $0 B/D PA doxycycline hyclate oral capsule 1 $0 MO doxycycline hyclate oral tablet 1 $0 MO doxycycline hyclate oral tablet,delayed 1 $0 MO release (dr/ec) doxycycline monohydrate oral capsule 1 $0 MO doxycycline monohydrate oral tablet 1 $0 MO minocycline oral capsule 1 $0 MO minocycline oral tablet 1 $0 MO minocycline oral tablet extended release 24 1 $0 MO hr morgidox oral capsule 1 $0 MO 13

25 ORACEA ORAL CAPSULE, ER 2 $0 MO MULTIPHASE 24 HR tetracycline oral capsule 1 $0 MO 尿道藥 methenamine hippurate oral tablet 1 $0 MO nitrofurantoin macrocrystal oral capsule 50 1 $0 PA; MO mg nitrofurantoin monohyd/m-cryst oral 1 $0 PA; MO capsule trimethoprim oral tablet 1 $0 MO 泛可黴素 VANCOCIN ORAL CAPSULE 2 $0 MO vancomycin intravenous recon soln 1 $0 B/D PA; MO VANCOMYCIN ORAL CAPSULE 2 $0 MO 抗腫瘤藥物 / 免疫抑制藥物 輔劑 AMIFOSTINE CRYSTALLINE 2 $0 B/D PA; MO RECON SOLN dexrazoxane intravenous recon soln 250 mg 1 $0 B/D PA dexrazoxane intravenous recon soln 500 mg 1 $0 B/D PA; MO ELITEK RECON SOLN 2 $0 B/D PA 1.5 MG leucovorin calcium injection recon soln $0 B/D PA; MO mg, 200 mg, 350 mg, 50 mg leucovorin calcium injection recon soln $0 B/D PA mg leucovorin calcium oral tablet 1 $0 MO mesna intravenous solution 1 $0 B/D PA; MO MESNEX ORAL TABLET 2 $0 MO XGEVA SUBCUTANEOUS SOLUTION 2 $0 B/D PA; MO 抗腫瘤藥物 / 免疫抑制藥物 adriamycin intravenous solution 10 mg/5 ml 1 $0 B/D PA adriamycin intravenous solution 20 mg/10 1 $0 B/D PA; MO ml, 50 mg/25 ml adrucil intravenous solution 2.5 gram/50 ml 1 $0 B/D PA adrucil intravenous solution 5 gram/100 ml, 500 mg/10 ml 1 $0 B/D PA; MO 14

26 AFINITOR ORAL TABLET 2 $0 PA; MO AFINITOR DISPERZ ORAL TABLET 2 $0 PA; MO FOR SUSPENSION ALIMTA RECON SOLN 2 $0 B/D PA; MO 500 MG anastrozole oral tablet 1 $0 MO ARZERRA SOLUTION 2 $0 B/D PA; MO 1,000 MG/50 ML ASTAGRAF XL ORAL 2 $0 B/D PA; MO CAPSULE,EXTENDED RELEASE 24HR AVASTIN SOLUTION 2 $0 B/D PA; MO AZACITIDINE INJECTION RECON 2 $0 MO SOLN AZASAN ORAL TABLET 2 $0 B/D PA; MO azathioprine oral tablet 1 $0 B/D PA; MO bicalutamide oral tablet 1 $0 MO BICNU RECON SOLN 2 $0 B/D PA; MO bleomycin injection recon soln 30 unit 1 $0 B/D PA; MO BOSULIF ORAL TABLET 2 $0 PA; MO BUSULFEX SOLUTION 2 $0 B/D PA CAPRELSA ORAL TABLET 2 $0 MO carboplatin intravenous solution 1 $0 B/D PA; MO CELLCEPT ORAL SUSPENSION FOR 2 $0 B/D PA; MO RECONSTITUTION CELLCEPT 2 $0 B/D PA RECON SOLN cisplatin intravenous solution 1 $0 B/D PA; MO cladribine intravenous solution 1 $0 B/D PA; MO COMETRIQ ORAL CAPSULE 2 $0 PA; MO COSMEGEN RECON 2 $0 B/D PA; MO SOLN CYCLOPHOSPHAMIDE ORAL 2 $0 B/D PA CAPSULE cyclophosphamide oral tablet 1 $0 B/D PA; MO cyclosporine intravenous solution 1 $0 B/D PA cyclosporine oral capsule 1 $0 B/D PA; MO 15

27 cyclosporine modified oral capsule 1 $0 B/D PA; MO cyclosporine modified oral solution 1 $0 B/D PA; MO cytarabine injection solution 1 $0 B/D PA; MO dacarbazine intravenous recon soln 200 mg 1 $0 B/D PA; MO daunorubicin intravenous solution 1 $0 B/D PA DECITABINE RECON 2 $0 B/D PA; MO SOLN DOXIL SOLUTION 2 $0 B/D PA; MO doxorubicin intravenous solution 1 $0 B/D PA; MO DROXIA ORAL CAPSULE 2 $0 MO ELIGARD SUBCUTANEOUS SYRINGE 2 $0 PA; MO EMCYT ORAL CAPSULE 2 $0 MO EPIRUBICIN 2 $0 B/D PA; MO SOLUTION 50 MG/25 ML ERIVEDGE ORAL CAPSULE 2 $0 PA; MO ERWINAZE INTRAMUSCULAR RECON 2 $0 PA SOLN etoposide intravenous solution 1 $0 B/D PA; MO exemestane oral tablet 1 $0 MO FARESTON ORAL TABLET 2 $0 MO FASLODEX INTRAMUSCULAR 2 $0 B/D PA; MO SYRINGE FLUDARABINE 2 $0 B/D PA; MO RECON SOLN fluorouracil intravenous solution 1 $0 B/D PA; MO flutamide oral capsule 1 $0 MO GAZYVA SOLUTION 2 $0 B/D PA; MO GEMCITABINE 2 $0 B/D PA; MO RECON SOLN 1 GRAM GEMCITABINE 2 $0 B/D PA SOLUTION 1 GRAM/26.3 ML (38 MG/ML) GEMZAR RECON 2 $0 B/D PA; MO SOLN 1 GRAM gengraf oral capsule 1 $0 B/D PA; MO gengraf oral solution 1 $0 B/D PA; MO GILOTRIF ORAL TABLET 2 $0 PA; MO 16

28 GLEEVEC ORAL TABLET 100 MG 2 $0 PA; MO GLEEVEC ORAL TABLET 400 MG 2 $0 PA; MO; QL (60 para 30 días) hecoria oral capsule 0.5 mg, 1 mg 1 $0 B/D PA; MO HERCEPTIN RECON 2 $0 B/D PA; MO SOLN HEXALEN ORAL CAPSULE 2 $0 MO hydroxyurea oral capsule 1 $0 MO ICLUSIG ORAL TABLET 2 $0 MO idarubicin intravenous solution 1 $0 B/D PA IFEX RECON SOLN 2 $0 B/D PA; MO IFOSFAMIDE RECON 2 $0 B/D PA; MO SOLN 1 GRAM IMBRUVICA ORAL CAPSULE 2 $0 PA; MO INLYTA ORAL TABLET 2 $0 PA; MO IRINOTECAN 2 $0 B/D PA; MO SOLUTION 100 MG/5 ML, 40 MG/2 ML IRINOTECAN 2 $0 B/D PA SOLUTION 500 MG/25 ML ISTODAX RECON 2 $0 B/D PA; MO SOLN JAKAFI ORAL TABLET 10 MG, 15 MG, 2 $0 PA; MO 20 MG, 5 MG JAKAFI ORAL TABLET 25 MG 2 $0 PA; MO; QL (60 para 30 días) KADCYLA RECON 2 $0 B/D PA; MO SOLN letrozole oral tablet 1 $0 MO LEUKERAN ORAL TABLET 2 $0 MO leuprolide subcutaneous kit 1 $0 MO LOMUSTINE ORAL CAPSULE 2 $0 MO LUPRON DEPOT INTRAMUSCULAR 2 $0 PA; MO SYRINGE KIT LUPRON DEPOT (3 MONTH) 2 $0 PA; MO INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT (4 MONTH) 2 $0 PA; MO INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT (6 MONTH) INTRAMUSCULAR SYRINGE KIT 2 $0 PA; MO 17

29 LUPRON DEPOT-PED 2 $0 PA; MO INTRAMUSCULAR KIT MG, 15 MG LYSODREN ORAL TABLET 2 $0 MO MATULANE ORAL CAPSULE 2 $0 MO megestrol oral tablet 1 $0 MO MEKINIST ORAL TABLET 2 $0 PA; MO melphalan intravenous recon soln 1 $0 B/D PA mercaptopurine oral tablet 1 $0 MO methotrexate sodium injection solution 1 $0 B/D PA; MO methotrexate sodium oral tablet 1 $0 B/D PA; MO methotrexate sodium (pf) injection recon 1 $0 B/D PA soln methotrexate sodium (pf) injection solution 1 $0 B/D PA; MO mitomycin intravenous recon soln 20 mg 1 $0 B/D PA; MO mitoxantrone intravenous concentrate 1 $0 B/D PA; MO MUSTARGEN INJECTION RECON 2 $0 B/D PA; MO SOLN mycophenolate mofetil oral capsule 1 $0 B/D PA; MO mycophenolate mofetil oral tablet 1 $0 B/D PA; MO mycophenolate sodium oral tablet,delayed 1 $0 B/D PA; MO release (dr/ec) NEORAL ORAL CAPSULE 2 $0 B/D PA; MO NEORAL ORAL SOLUTION 2 $0 B/D PA; MO NEXAVAR ORAL TABLET 2 $0 PA; MO NILANDRON ORAL TABLET 2 $0 MO NULOJIX RECON 2 $0 B/D PA; MO SOLN OCTREOTIDE ACETATE INJECTION 2 $0 PA; MO SOLUTION 1,000 MCG/ML, 500 MCG/ML octreotide acetate injection solution $0 PA; MO mcg/ml, 200 mcg/ml, 50 mcg/ml octreotide acetate injection syringe $0 PA; MO mcg/ml (1 ml), 50 mcg/ml (1 ml) OCTREOTIDE ACETATE INJECTION SYRINGE 500 MCG/ML (1 ML) 2 $0 PA; MO 18

30 ONCASPAR INJECTION SOLUTION 2 $0 PA; MO OXALIPLATIN 2 $0 B/D PA; MO SOLUTION 100 MG/20 ML PACLITAXEL 2 $0 B/D PA; MO CONCENTRATE PERJETA SOLUTION 2 $0 B/D PA; MO POMALYST ORAL CAPSULE 2 $0 PA; MO RAPAMUNE ORAL SOLUTION 2 $0 B/D PA; MO RAPAMUNE ORAL TABLET 2 $0 B/D PA; MO REVLIMID ORAL CAPSULE 2 $0 PA; MO; LA RHEUMATREX ORAL TABLETS,DOSE 2 $0 B/D PA; MO PACK RITUXAN 2 $0 PA; MO CONCENTRATE SANDIMMUNE ORAL CAPSULE 2 $0 B/D PA; MO SANDIMMUNE ORAL SOLUTION 2 $0 B/D PA; MO SANDOSTATIN LAR DEPOT 2 $0 PA; MO INTRAMUSCULAR KIT SIGNIFOR SUBCUTANEOUS 2 $0 PA; MO SOLUTION SIMULECT RECON 2 $0 B/D PA; MO SOLN 20 MG sirolimus oral tablet 1 $0 B/D PA; MO SOLTAMOX ORAL SOLUTION 2 $0 MO SOMATULINE DEPOT 2 $0 B/D PA; MO SUBCUTANEOUS SYRINGE SPRYCEL ORAL TABLET 100 MG, $0 PA; MO; QL (30 para 30 días) MG, 80 MG SPRYCEL ORAL TABLET 20 MG, 50 2 $0 PA; MO MG SPRYCEL ORAL TABLET 70 MG 2 $0 PA; MO; QL (60 para 30 días) STIVARGA ORAL TABLET 2 $0 PA; MO SUTENT ORAL CAPSULE 12.5 MG, 25 2 $0 PA; MO MG, 50 MG SYNRIBO SUBCUTANEOUS RECON 2 $0 B/D PA; MO SOLN TABLOID ORAL TABLET 2 $0 MO 19

31 tacrolimus oral capsule 0.5 mg, 1 mg 1 $0 B/D PA; MO TACROLIMUS ORAL CAPSULE 5 MG 2 $0 B/D PA; MO TAFINLAR ORAL CAPSULE 2 $0 PA; MO tamoxifen oral tablet 1 $0 MO TARCEVA ORAL TABLET 100 MG, 25 2 $0 PA; MO MG TARCEVA ORAL TABLET 150 MG 2 $0 PA; MO; QL (30 para 30 días) TARGRETIN ORAL CAPSULE 2 $0 PA; MO TARGRETIN TOPICAL GEL 2 $0 MO TASIGNA ORAL CAPSULE 2 $0 PA; MO THALOMID ORAL CAPSULE 2 $0 PA; MO toposar intravenous solution 1 $0 B/D PA; MO TOPOTECAN RECON 2 $0 B/D PA; MO SOLN TREANDA RECON 2 $0 B/D PA; MO SOLN 100 MG TRELSTAR INTRAMUSCULAR 2 $0 B/D PA; MO SUSPENSION FOR RECONSTITUTION TRELSTAR INTRAMUSCULAR 2 $0 B/D PA; MO SYRINGE MG/2 ML, 3.75 MG/2 ML TRELSTAR DEPOT INTRAMUSCULAR 2 $0 B/D PA SUSPENSION FOR RECONSTITUTION TRELSTAR LA INTRAMUSCULAR 2 $0 B/D PA SUSPENSION FOR RECONSTITUTION TRETINOIN (CHEMOTHERAPY) ORAL 2 $0 MO CAPSULE TRISENOX SOLUTION 2 $0 B/D PA; MO TYKERB ORAL TABLET 2 $0 PA; MO VELCADE INJECTION RECON SOLN 2 $0 B/D PA; MO VIDAZA INJECTION RECON SOLN 2 $0 MO VINBLASTINE RECON 2 $0 B/D PA; MO SOLN VINBLASTINE 2 $0 B/D PA; MO SOLUTION vincristine intravenous solution 1 mg/ml 1 $0 B/D PA; MO vinorelbine intravenous solution 50 mg/5 ml 1 $0 B/D PA; MO VOTRIENT ORAL TABLET 2 $0 PA; MO 20

32 XALKORI ORAL CAPSULE 2 $0 PA; MO XTANDI ORAL CAPSULE 2 $0 PA; MO; QL (120 para 30 días) ZALTRAP SOLUTION 2 $0 B/D PA; MO ZELBORAF ORAL TABLET 2 $0 PA; MO ZOLINZA ORAL CAPSULE 2 $0 MO ZORTRESS ORAL TABLET 2 $0 B/D PA; MO ZYKADIA ORAL CAPSULE 2 $0 PA; MO; QL (150 para 30 días) ZYTIGA ORAL TABLET 2 $0 MO 自主神經系統 /CNS 藥物, 神經內科 / 精神科藥物 抗驚厥藥物 APTIOM ORAL TABLET 2 $0 MO BANZEL ORAL SUSPENSION 2 $0 MO BANZEL ORAL TABLET 2 $0 MO carbamazepine oral capsule, er multiphase 1 $0 MO 12 hr carbamazepine oral suspension 1 $0 MO carbamazepine oral tablet 1 $0 MO carbamazepine oral tablet extended release 1 $0 MO 12 hr carbamazepine oral tablet,chewable 1 $0 MO CELONTIN ORAL CAPSULE 2 $0 MO clonazepam oral tablet 1 $0 PA; MO clonazepam oral tablet,disintegrating 1 $0 PA; MO DIASTAT RECTAL KIT 2 $0 PA; MO DIASTAT ACUDIAL RECTAL KIT 2 $0 PA; MO diazepam rectal kit 1 $0 PA; MO DILANTIN ORAL CAPSULE 2 $0 MO DILANTIN EXTENDED ORAL 2 $0 MO CAPSULE DILANTIN INFATABS ORAL 2 $0 MO TABLET,CHEWABLE DILANTIN-125 ORAL SUSPENSION 2 $0 MO divalproex oral capsule, sprinkle 1 $0 MO divalproex oral tablet extended release 24 1 $0 MO 21

33 hr divalproex oral tablet,delayed release 1 $0 MO (dr/ec) epitol oral tablet 1 $0 MO ethosuximide oral capsule 1 $0 MO ethosuximide oral solution 1 $0 MO felbamate oral suspension 1 $0 MO felbamate oral tablet 1 $0 MO fosphenytoin injection solution 1 $0 B/D PA; MO FYCOMPA ORAL TABLET 2 $0 MO gabapentin oral capsule 1 $0 MO gabapentin oral solution 250 mg/5 ml 1 $0 MO gabapentin oral solution 250 mg/5 ml (5 1 $0 ml), 300 mg/6 ml (6 ml) gabapentin oral tablet 1 $0 MO GABITRIL ORAL TABLET 12 MG, 16 2 $0 MO MG lamotrigine oral tablet 1 $0 MO lamotrigine oral tablet extended release 1 $0 MO 24hr lamotrigine oral tablet, chewable 1 $0 MO dispersible lamotrigine oral tablets,dose pack 1 $0 levetiracetam intravenous solution 1 $0 B/D PA; MO levetiracetam oral solution 100 mg/ml 1 $0 MO levetiracetam oral solution 500 mg/5 ml (5 1 $0 ml) levetiracetam oral tablet 1 $0 MO levetiracetam oral tablet extended release 1 $0 MO 24 hr LYRICA ORAL CAPSULE 2 $0 MO LYRICA ORAL SOLUTION 2 $0 MO ONFI ORAL SUSPENSION 2 $0 PA; MO ONFI ORAL TABLET 2 $0 PA; MO oxcarbazepine oral suspension 1 $0 MO oxcarbazepine oral tablet 1 $0 MO OXTELLAR XR ORAL TABLET 2 $0 MO 22

34 EXTENDED RELEASE 24 HR PEGANONE ORAL TABLET 2 $0 MO phenobarbital oral elixir 1 $0 MO phenobarbital oral tablet 1 $0 MO PHENYTEK ORAL CAPSULE 2 $0 MO phenytoin oral suspension 100 mg/4 ml 1 $0 phenytoin oral suspension 125 mg/5 ml 1 $0 MO phenytoin oral tablet,chewable 1 $0 MO phenytoin sodium intravenous solution 1 $0 B/D PA; MO phenytoin sodium intravenous syringe 1 $0 B/D PA phenytoin sodium extended oral capsule 1 $0 MO POTIGA ORAL TABLET 2 $0 MO primidone oral tablet 1 $0 MO QUDEXY XR ORAL 2 $0 PA CAPSULE,SPRINKLE, ER 24HR SABRIL ORAL POWDER IN PACKET 2 $0 PA; MO SABRIL ORAL TABLET 2 $0 PA; MO TEGRETOL XR ORAL TABLET 2 $0 MO EXTENDED RELEASE 12 HR 100 MG tiagabine oral tablet 1 $0 MO topiramate oral capsule, sprinkle 1 $0 PA; MO topiramate oral tablet 1 $0 PA; MO TROKENDI XR ORAL CAPSULE, 2 $0 MO EXTENDED RELEASE 24HR valproate sodium intravenous solution 1 $0 B/D PA; MO valproic acid oral capsule 1 $0 MO valproic acid (as sodium salt) oral solution 1 $0 MO 250 mg/5 ml valproic acid (as sodium salt) oral solution 1 $0 250 mg/5 ml (5 ml), 500 mg/10 ml (10 ml) VIMPAT SOLUTION 2 $0 PA VIMPAT ORAL SOLUTION 2 $0 PA; MO VIMPAT ORAL TABLET 2 $0 PA; MO zonisamide oral capsule 1 $0 PA; MO 抗帕金森氏症藥物 23

35 APOKYN SUBCUTANEOUS 2 $0 MO CARTRIDGE AZILECT ORAL TABLET 2 $0 MO benztropine injection solution 1 $0 B/D PA; MO benztropine oral tablet 1 $0 PA; MO bromocriptine oral capsule 1 $0 MO bromocriptine oral tablet 1 $0 MO carbidopa oral tablet 1 $0 MO carbidopa-levodopa oral tablet 1 $0 MO carbidopa-levodopa oral tablet extended 1 $0 MO release carbidopa-levodopa oral 1 $0 MO tablet,disintegrating carbidopa-levodopa-entacapone oral tablet 1 $0 MO entacapone oral tablet 1 $0 MO NEUPRO TRANSDERMAL PATCH 24 2 $0 PA; MO HOUR pramipexole oral tablet 1 $0 MO ropinirole oral tablet 1 $0 MO ropinirole oral tablet extended release 24 hr 1 $0 MO selegiline hcl oral capsule 1 $0 MO selegiline hcl oral tablet 1 $0 MO trihexyphenidyl oral elixir 1 $0 MO trihexyphenidyl oral tablet 1 $0 MO 偏頭痛 / 叢發性頭痛治療 dihydroergotamine injection solution 1 $0 MO migergot rectal suppository 1 $0 MO naratriptan oral tablet 1 $0 MO; QL( 每 28 天 18 單位 ) rizatriptan oral tablet 1 $0 MO; QL( 每 30 天 36 單位 ) rizatriptan oral tablet,disintegrating 1 $0 MO; QL( 每 30 天 36 單位 ) sumatriptan nasal spray,non-aerosol 1 $0 MO sumatriptan succinate oral tablet 1 $0 MO; QL( 每 30 天 9 單位 ) sumatriptan succinate subcutaneous cartridge sumatriptan succinate subcutaneous pen injector 1 $0 MO; QL( 每 30 天 10 單位 ) 1 $0 MO; QL( 每 30 天 10 單位 ) 24

36 sumatriptan succinate subcutaneous solution 1 $0 MO; QL( 每 30 天 10 單位 ) zolmitriptan oral tablet 1 $0 MO; QL( 每 30 天 12 單位 ) zolmitriptan oral tablet,disintegrating 1 $0 MO; QL( 每 30 天 12 單位 ) 其他神經性治療 AMPYRA ORAL TABLET EXTENDED RELEASE 12 HR COPAXONE SUBCUTANEOUS SYRINGE COPAXONE SUBCUTANEOUS SYRINGE KIT 2 $0 PA; MO 2 $0 PA; MO; QL( 每 28 天 12 單 位 ) 2 $0 PA; MO; QL( 每 30 天 30 單 位 ) donepezil oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) donepezil oral tablet,disintegrating 1 $0 MO; QL( 每 30 天 30 單位 ) EXELON TRANSDERMAL PATCH 24 2 $0 MO; QL( 每 30 天 30 單位 ) HOUR galantamine oral capsule,ext rel. pellets 24 1 $0 MO; QL( 每 30 天 30 單位 ) hr galantamine oral solution 1 $0 MO galantamine oral tablet 1 $0 MO GILENYA ORAL CAPSULE 2 $0 MO HORIZANT ORAL TABLET EXTENDED 2 $0 MO RELEASE NAMENDA ORAL SOLUTION 2 $0 PA; MO NAMENDA XR ORAL 2 $0 PA; MO CAP,SPRINKLE,ER 24HR DOSE PACK NAMENDA XR ORAL 2 $0 PA; MO CAPSULE,SPRINKLE,ER 24HR NUEDEXTA ORAL CAPSULE 2 $0 MO rivastigmine tartrate oral capsule 1.5 mg 1 $0 MO; QL( 每 30 天 240 單位 ) rivastigmine tartrate oral capsule 3 mg 1 $0 MO; QL( 每 30 天 120 單 位 ) rivastigmine tartrate oral capsule 4.5 mg, 6 mg TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) 1 $0 MO; QL( 每 30 天 60 單位 ) 2 $0 MO 25

37 TYSABRI SOLUTION 2 $0 PA; MO XENAZINE ORAL TABLET 2 $0 PA; MO 肌肉鬆弛劑 / 抗痙攣治療 baclofen oral tablet 1 $0 MO carisoprodol oral tablet 250 mg 1 $0 MO cyclobenzaprine oral tablet 1 $0 PA; MO dantrolene oral capsule 1 $0 MO meprobamate oral tablet 1 $0 PA; MO MESTINON ORAL SYRUP 2 $0 MO MESTINON TIMESPAN ORAL TABLET 2 $0 MO EXTENDED RELEASE metaxalone oral tablet 1 $0 PA; MO pyridostigmine bromide oral tablet 1 $0 MO regonol injection solution 1 $0 B/D PA tizanidine oral capsule 1 $0 MO tizanidine oral tablet 1 $0 MO 麻醉性鎮痛藥 acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 300 mg-30 mg /12.5 ml acetaminophen-codeine oral solution mg/5 ml acetaminophen-codeine oral tablet mg, mg acetaminophen-codeine oral tablet mg 1 $0 QL( 每 30 天 4500 單位 ) 1 $0 MO; QL( 每 30 天 4500 單 位 ) 1 $0 MO; QL( 每 30 天 360 單 位 ) 1 $0 MO; QL( 每 30 天 180 單 位 ) buprenorphine injection syringe 1 $0 B/D PA; QL( 每 30 天 267 單位 ) buprenorphine sublingual tablet 2 mg 1 $0 MO; QL( 每 30 天 300 單 位 ) buprenorphine sublingual tablet 8 mg 1 $0 MO; QL( 每 30 天 75 單位 ) butalbital-acetaminop-caf-cod oral capsule 1 $0 PA; MO; QL( 每 30 天 360 單位 ) codeine sulfate oral tablet 1 $0 MO; QL( 每 30 天 180 單 位 ) 26

38 DILAUDID ORAL LIQUID 2 $0 MO; QL( 每 30 天 1500 單 位 ) DURAMORPH (PF) INJECTION SOLUTION 0.5 MG/ML DURAMORPH (PF) INJECTION SOLUTION 1 MG/ML endocet oral tablet mg, mg, mg FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 1,200 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 1,600 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 200 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 400 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 600 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 800 MCG fentanyl patches transdermal patch 72 hour 100 mcg/hr fentanyl patches transdermal patch 72 hour 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr hydrocodone-acetaminophen oral solution mg/5 ml hydrocodone-acetaminophen oral solution mg/15 ml 2 $0 B/D PA; MO; QL( 每 30 天 4000 單位 ) 2 $0 B/D PA; QL( 每 30 天 2000 單位 ) 1 $0 MO; QL( 每 30 天 360 單 位 ) 2 $0 PA; MO; QL( 每 30 天 39 單 位 ) 2 $0 PA; MO; QL( 每 30 天 29 單 位 ) 2 $0 PA; MO; QL( 每 30 天 120 單位 ) 2 $0 PA; MO; QL( 每 30 天 116 單位 ) 2 $0 PA; MO; QL( 每 30 天 77 單 位 ) 2 $0 PA; MO; QL( 每 30 天 58 單 位 ) 1 $0 MO; QL( 每 30 天 9 單位 ) 1 $0 MO; QL( 每 30 天 10 單位 ) 1 $0 QL( 每 30 天 5550 單位 ) 1 $0 MO; QL( 每 30 天 5550 單 位 ) hydrocodone-acetaminophen oral tablet 1 $0 MO; QL( 每 30 天 360 單 位 ) hydrocodone-ibuprofen oral tablet 1 $0 MO; QL( 每 30 天 50 單位 ) hydromorphone oral liquid 1 $0 MO; QL( 每 30 天 1500 單 位 ) hydromorphone oral tablet 1 $0 MO; QL( 每 30 天 180 單 27

39 hydromorphone (pf) injection solution 10 mg/ml 位 ) 1 $0 B/D PA; MO; QL( 每 30 天 120 單位 ) ibuprofen-oxycodone oral tablet 1 $0 MO; QL( 每 30 天 28 單位 ) KADIAN ORAL 2 $0 MO; QL( 每 30 天 60 單位 ) CAPSULE,EXTEND.RELEASE PELLETS 10 MG, 100 MG, 20 MG, 30 MG, 50 MG, 80 MG KADIAN ORAL 2 $0 MO; QL( 每 30 天 30 單位 ) CAPSULE,EXTEND.RELEASE PELLETS 200 MG KADIAN ORAL 2 $0 MO; QL( 每 30 天 90 單位 ) CAPSULE,EXTEND.RELEASE PELLETS 60 MG levorphanol tartrate oral tablet 1 $0 MO; QL( 每 30 天 120 單位 ) methadone injection solution 1 $0 B/D PA; QL( 每 30 天 160 單位 ) methadone oral concentrate 1 $0 QL( 每 30 天 120 單位 ) methadone oral solution 10 mg/5 ml 1 $0 MO; QL( 每 30 天 600 單 位 ) methadone oral solution 5 mg/5 ml 1 $0 MO; QL( 每 30 天 1200 單 位 ) methadone oral tablet 10 mg 1 $0 MO; QL( 每 30 天 120 單 位 ) methadone oral tablet 5 mg 1 $0 MO; QL( 每 30 天 240 單 位 ) methadone oral tablet,soluble 1 $0 QL( 每 30 天 30 單位 ) methadone intensol oral concentrate 1 $0 MO; QL( 每 30 天 120 單 位 ) methadose oral concentrate 1 $0 QL( 每 30 天 120 單位 ) methadose oral tablet,soluble 1 $0 MO; QL( 每 30 天 30 單位 ) morphine oral capsule, er multiphase 24 hr 120 mg morphine oral capsule, er multiphase 24 hr 30 mg, 45 mg, 60 mg, 75 mg, 90 mg 1 $0 MO; QL( 每 30 天 50 單位 ) 1 $0 MO; QL( 每 30 天 60 單位 ) 28

40 morphine oral capsule,extend.release pellets 1 $0 MO; QL( 每 30 天 60 單位 ) morphine oral solution 1 $0 MO; QL( 每 30 天 900 單 位 ) morphine oral tablet 1 $0 MO; QL( 每 30 天 180 單 位 ) morphine oral tablet extended release $0 MO; QL( 每 30 天 60 單位 ) mg morphine oral tablet extended release 15 1 $0 MO; QL( 每 30 天 90 單位 ) mg, 30 mg, 60 mg morphine oral tablet extended release $0 MO; QL( 每 30 天 30 單位 ) mg morphine concentrate oral solution 1 $0 MO; QL( 每 30 天 300 單位 ) oxycodone oral capsule 1 $0 MO; QL( 每 30 天 360 單 位 ) oxycodone oral concentrate 1 $0 MO; QL( 每 30 天 180 單 位 ) oxycodone oral solution 1 $0 MO; QL( 每 30 天 1200 單 位 ) oxycodone oral tablet 10 mg, 15 mg, 20 mg 1 $0 MO; QL( 每 30 天 180 單 位 ) oxycodone oral tablet 30 mg 1 $0 MO; QL( 每 30 天 134 單 位 ) oxycodone oral tablet 5 mg 1 $0 MO; QL( 每 30 天 360 單 位 ) oxycodone-acetaminophen oral tablet 1 $0 MO; QL( 每 30 天 360 單 位 ) oxycodone-aspirin oral tablet 1 $0 MO; QL( 每 30 天 360 單 位 ) oxymorphone oral tablet 10 mg 1 $0 MO; QL( 每 30 天 200 單 位 ) oxymorphone oral tablet 5 mg 1 $0 MO; QL( 每 30 天 180 單 位 ) oxymorphone oral tablet extended release 12 hr 1 $0 MO; QL( 每 30 天 90 單位 ) 29

41 reprexain oral tablet 1 $0 MO; QL( 每 30 天 50 單位 ) zamicet oral solution 1 $0 MO; QL( 每 30 天 5550 單 位 ) 非麻醉性鎮痛藥 8 HOUR PAIN RELIEVER ORAL 4 $0 MO; * TABLET EXTENDED RELEASE ACEPHEN RECTAL SUPPOSITORY $0 MO; * MG, 650 MG ACEPHEN RECTAL SUPPOSITORY $0 * MG acetaminophen oral drops 4 $0 * acetaminophen oral elixir 4 $0 * acetaminophen oral liquid 4 $0 * acetaminophen oral solution 160 mg/5 ml (5 4 $0 * ml) acetaminophen oral suspension 4 $0 * acetaminophen oral tablet 4 $0 MO; * acetaminophen oral tablet, disintegrating 4 $0 * ADDED STRENGTH PAIN RELIEVER 4 $0 * ORAL TABLET ADVIL ORAL TABLET 100 MG 4 $0 * ADVIL ORAL TABLET,CHEWABLE 4 $0 * ASCRIPTIN ORAL TABLET 4 $0 MO; * aspirin oral tablet 4 $0 MO; * aspirin oral tablet, chewable 4 $0 MO; * aspirin oral tablet, delayed release (dr/ec) 4 $0 MO; * 325 mg, 81 mg BUFFERIN ORAL TABLET 4 $0 * buprenorphine-naloxone sublingual tablet 1 $0 MO; QL( 每 30 天 90 單位 ) butorphanol tartrate injection solution 1 mg/ml butorphanol tartrate injection solution 2 mg/ml 1 $0 MO; QL( 每 30 天 720 單 位 ) 1 $0 MO; QL( 每 30 天 360 單 位 ) butorphanol tartrate nasal spray,nonaerosol 1 $0 MO; QL( 每 30 天 40 單位 ) CELEBREX ORAL CAPSULE 2 $0 MO 30

42 CHILDREN'S MAPAP ORAL 4 $0 * TABLET,DISINTEGRATING CHILDREN'S PAIN & FEVER RELIEF 4 $0 * ORAL TABLET,CHEWABLE diclofenac potassium oral tablet 1 $0 MO diclofenac sodium oral tablet extended 1 $0 MO release 24 hr diclofenac sodium oral tablet,delayed 1 $0 MO release (dr/ec) 25 mg, 50 mg, 75 mg diclofenac sodium topical drops 1 $0 MO diclofenac-misoprostol oral tablet,ir & 1 $0 MO delay rel,biphasic diflunisal oral tablet 1 $0 MO diphenhydramine-acetaminophen oral tablet 4 $0 * EFFERVESCENT PAIN RELIEF ORAL 4 $0 * TABLET, EFFERVESCENT etodolac oral capsule 1 $0 MO etodolac oral tablet 1 $0 MO etodolac oral tablet extended release 24 hr 1 $0 MO EXCEDRIN TENSION HEADACHE 4 $0 * ORAL TABLET fenoprofen oral tablet 1 $0 MO FEVERALL RECTAL SUPPOSITORY 80 4 $0 * MG flurbiprofen oral tablet 1 $0 MO ibuprofen oral capsule 4 $0 * ibuprofen oral suspension 1 $0 MO ibuprofen oral tablet 200 mg 4 $0 MO; * ibuprofen oral tablet 400 mg, 600 mg, $0 MO mg INFANT'S IBUPROFEN ORAL 4 $0 * DROPS,SUSPENSION INFANT'S PAIN RELIEF ORAL 4 $0 * DROPS,SUSPENSION INFANTS' TRIAMINIC FEVER ORAL 4 $0 * LIQUID ketoprofen oral capsule 1 $0 MO 31

43 ketoprofen oral capsule,ext rel. pellets 24 hr 1 $0 MO MAPAP (ACETAMINOPHEN) ORAL 4 $0 * CAPSULE meclofenamate oral capsule 1 $0 MO mefenamic acid oral capsule 1 $0 MO meloxicam oral suspension 1 $0 MO meloxicam oral tablet 1 $0 MO nabumetone oral tablet 1 $0 MO nalbuphine injection solution 10 mg/ml 1 $0 B/D PA; MO; QL( 每 30 天 200 單位 ) nalbuphine injection solution 20 mg/ml 1 $0 B/D PA; MO; QL( 每 30 天 100 單位 ) naloxone injection syringe 1 mg/ml 1 $0 MO naltrexone oral tablet 1 $0 MO NAPRELAN CR ORAL TABLET, ER 2 $0 MO MULTIPHASE 24 HR naproxen oral suspension 1 $0 MO naproxen oral tablet 1 $0 MO naproxen oral tablet,delayed release (dr/ec) 1 $0 MO naproxen sodium oral capsule 4 $0 * naproxen sodium oral tablet 220 mg 4 $0 MO; * naproxen sodium oral tablet 275 mg, $0 MO mg NUCYNTA ORAL TABLET 2 $0 MO NUCYNTA ER ORAL TABLET 2 $0 MO EXTENDED RELEASE 12 HR oxaprozin oral tablet 1 $0 MO piroxicam oral capsule 1 $0 MO PRE-MENSTRUAL RELIEF ORAL 4 $0 * TABLET SUBOXONE SUBLINGUAL FILM $0 MO; QL( 每 30 天 60 單位 ) MG SUBOXONE SUBLINGUAL FILM $0 MO; QL( 每 30 天 90 單位 ) MG, 4-1 MG, 8-2 MG sulindac oral tablet 1 $0 MO TENSION HEADACHE ORAL TABLET 4 $0 * tolmetin oral capsule 1 $0 MO 32

44 tolmetin oral tablet 1 $0 MO tramadol oral tablet 1 $0 MO; QL( 每 30 天 240 單 位 ) tramadol oral tablet extended release 24 hr 1 $0 MO; QL( 每 30 天 30 單位 ) tramadol oral tablet, er multiphase 24 hr 1 $0 MO; QL( 每 30 天 30 單位 ) tramadol-acetaminophen oral tablet 1 $0 MO; QL( 每 30 天 240 單 位 ) TRI-BUFFERED ASPIRIN ORAL 4 $0 MO; * TABLET VIMOVO ORAL TABLET,IR & DELAY 2 $0 MO REL,BIPHASIC VOLTAREN GEL TOPICAL GEL 2 $0 MO 精神治療藥物 ABILIFY INTRAMUSCULAR 2 $0 B/D PA; MO SOLUTION ABILIFY ORAL SOLUTION 2 $0 MO ABILIFY ORAL TABLET 10 MG 2 $0 MO; QL( 每 30 天 90 單位 ) ABILIFY ORAL TABLET 15 MG, 20 MG 2 $0 MO; QL( 每 30 天 60 單位 ) ABILIFY ORAL TABLET 2 MG 2 $0 MO; QL( 每 30 天 450 單 位 ) ABILIFY ORAL TABLET 30 MG 2 $0 MO; QL( 每 30 天 30 單位 ) ABILIFY ORAL TABLET 5 MG 2 $0 MO; QL( 每 30 天 180 單 位 ) ABILIFY DISCMELT ORAL 2 $0 MO; QL( 每 30 天 90 單位 ) TABLET,DISINTEGRATING 10 MG ABILIFY DISCMELT ORAL 2 $0 MO; QL( 每 30 天 60 單位 ) TABLET,DISINTEGRATING 15 MG ABILIFY MAINTENA 2 $0 B/D PA; MO INTRAMUSCULAR SUSPENSION,EXTENDED REL RECON alprazolam oral tablet 1 $0 PA; MO alprazolam oral tablet extended release 24 1 $0 PA; MO hr alprazolam oral tablet,disintegrating 1 $0 PA; MO amitriptyline oral tablet 1 $0 MO 33

45 amoxapine oral tablet 1 $0 MO amphetamine salt combo oral tablet 1 $0 MO BRINTELLIX ORAL TABLET 2 $0 MO BRISDELLE ORAL CAPSULE 2 $0 MO bupropion hcl oral tablet 1 $0 MO bupropion hcl oral tablet extended release 1 $0 MO bupropion hcl oral tablet extended release 1 $0 MO 24 hr buspirone oral tablet 1 $0 MO chlorpromazine injection solution 1 $0 MO chlorpromazine oral tablet 1 $0 MO citalopram oral solution 1 $0 MO citalopram oral tablet 1 $0 MO clomipramine oral capsule 1 $0 MO clonidine hcl oral tablet extended release 12 1 $0 MO hr clorazepate dipotassium oral tablet 1 $0 PA; MO clozapine oral tablet 1 $0 clozapine oral tablet,disintegrating 1 $0 desipramine oral tablet 1 $0 MO dexmethylphenidate oral tablet 1 $0 MO dextroamphetamine oral capsule, extended 1 $0 MO release dextroamphetamine oral tablet 1 $0 MO dextroamphetamine-amphetamine oral 1 $0 MO capsule,extended release 24hr diazepam oral solution 5 mg/5 ml 1 $0 PA; MO diazepam oral solution 5 mg/5 ml (5 ml) 1 $0 PA diazepam oral tablet 1 $0 PA; MO diazepam intensol oral concentrate 1 $0 PA; MO doxepin oral capsule 1 $0 MO doxepin oral concentrate 1 $0 MO duloxetine oral capsule,delayed 1 $0 MO release(dr/ec) EMSAM TRANSDERMAL PATCH 24 2 $0 MO HOUR ergoloid oral tablet 1 $0 MO 34

46 escitalopram oxalate oral solution 1 $0 MO escitalopram oxalate oral tablet 1 $0 MO eszopiclone oral tablet 1 $0 PA; MO FANAPT ORAL TABLET 2 $0 MO FANAPT ORAL TABLETS,DOSE PACK 2 $0 FAZACLO ORAL 2 $0 TABLET,DISINTEGRATING FETZIMA ORAL CAPSULE,EXT REL 2 $0 MO 24HR DOSE PACK FETZIMA ORAL CAPSULE,EXTENDED 2 $0 MO RELEASE 24 HR fluoxetine oral capsule 1 $0 MO fluoxetine oral capsule,delayed 1 $0 MO release(dr/ec) fluoxetine oral solution 1 $0 MO fluoxetine oral tablet 10 mg, 20 mg 1 $0 MO FLUOXETINE ORAL TABLET 60 MG 2 $0 MO fluphenazine decanoate injection solution 1 $0 B/D PA; MO fluphenazine hcl injection solution 1 $0 B/D PA; MO fluphenazine hcl oral concentrate 1 $0 MO fluphenazine hcl oral elixir 1 $0 MO fluphenazine hcl oral tablet 1 $0 MO fluvoxamine oral capsule,extended release 1 $0 MO 24hr fluvoxamine oral tablet 1 $0 MO FORFIVO XL ORAL TABLET 2 $0 MO EXTENDED RELEASE 24 HR GEODON INTRAMUSCULAR RECON 2 $0 B/D PA; MO SOLN guanidine oral tablet 1 $0 MO haloperidol oral tablet 1 $0 MO haloperidol decanoate intramuscular 1 $0 B/D PA; MO solution haloperidol lactate injection solution 1 $0 B/D PA; MO haloperidol lactate oral concentrate 1 $0 MO imipramine hcl oral tablet 1 $0 MO 35

47 imipramine pamoate oral capsule 1 $0 MO INVEGA ORAL TABLET EXTENDED 2 $0 MO RELEASE 24HR INVEGA SUSTENNA 2 $0 B/D PA; MO INTRAMUSCULAR SYRINGE KHEDEZLA ORAL TABLET 2 $0 MO EXTENDED RELEASE 24HR LATUDA ORAL TABLET 2 $0 MO lithium carbonate oral capsule 1 $0 MO lithium carbonate oral tablet 1 $0 MO lithium carbonate oral tablet extended 1 $0 MO release lithium citrate oral solution 1 $0 MO lorazepam oral tablet 1 $0 PA; MO lorazepam intensol oral concentrate 1 $0 PA; MO loxapine succinate oral capsule 1 $0 MO maprotiline oral tablet 1 $0 MO MARPLAN ORAL TABLET 2 $0 MO metadate er oral tablet extended release 1 $0 MO methamphetamine oral tablet 1 $0 MO methylphenidate oral capsule, er biphasic 1 $0 MO mg, 50 mg, 60 mg methylphenidate oral capsule,er biphasic 1 $0 MO methylphenidate oral solution 1 $0 MO methylphenidate oral tablet 1 $0 MO methylphenidate oral tablet extended release 1 $0 MO methylphenidate oral tablet extended release 1 $0 MO 24hr 18 mg mirtazapine oral tablet 1 $0 MO mirtazapine oral tablet,disintegrating 1 $0 MO modafinil oral tablet 1 $0 PA; MO nefazodone oral tablet 1 $0 MO nortriptyline oral capsule 1 $0 MO nortriptyline oral solution 1 $0 MO NUVIGIL ORAL TABLET 150 MG, 250 MG, 50 MG 2 $0 PA; MO 36

48 olanzapine intramuscular recon soln 1 $0 MO olanzapine oral tablet 1 $0 MO olanzapine oral tablet,disintegrating 1 $0 MO olanzapine-fluoxetine oral capsule 1 $0 MO ORAP ORAL TABLET 2 $0 MO oxazepam oral capsule 1 $0 PA; MO paroxetine hcl oral tablet 1 $0 MO paroxetine hcl oral tablet extended release 1 $0 MO 24 hr PAXIL ORAL SUSPENSION 2 $0 MO perphenazine oral tablet 1 $0 MO perphenazine-amitriptyline oral tablet 1 $0 MO phenelzine oral tablet 1 $0 MO PRISTIQ ORAL TABLET EXTENDED 2 $0 MO RELEASE 24 HR protriptyline oral tablet 1 $0 MO quetiapine oral tablet 1 $0 MO RISPERDAL CONSTA 2 $0 B/D PA; MO INTRAMUSCULAR SYRINGE risperidone oral solution 1 $0 MO risperidone oral tablet 1 $0 MO risperidone oral tablet,disintegrating 1 $0 MO ROZEREM ORAL TABLET 2 $0 MO; QL( 每 30 天 30 單位 ) SAPHRIS SUBLINGUAL TABLET 2 $0 MO SAPHRIS (BLACK CHERRY) 2 $0 MO SUBLINGUAL TABLET SEROQUEL XR ORAL TABLET 2 $0 MO EXTENDED RELEASE 24 HR sertraline oral concentrate 1 $0 MO sertraline oral tablet 1 $0 MO STRATTERA ORAL CAPSULE 2 $0 MO SURMONTIL ORAL CAPSULE 2 $0 PA; MO temazepam oral capsule 1 $0 PA; MO thioridazine oral tablet 1 $0 PA; MO thiothixene oral capsule 1 $0 MO 37

49 tranylcypromine oral tablet 1 $0 MO trazodone oral tablet 1 $0 MO trifluoperazine oral tablet 1 $0 MO venlafaxine oral capsule,extended release 1 $0 MO 24hr venlafaxine oral tablet 1 $0 MO venlafaxine oral tablet extended release 1 $0 MO 24hr 150 mg, 37.5 mg, 75 mg VENLAFAXINE ORAL TABLET 2 $0 MO EXTENDED RELEASE 24HR 225 MG VERSACLOZ ORAL SUSPENSION 2 $0 VIIBRYD ORAL TABLET 2 $0 MO VIIBRYD ORAL TABLETS,DOSE PACK 2 $0 MO; QL( 每 30 天 30 單位 ) XYREM ORAL SOLUTION 2 $0 MO; LA ziprasidone hcl oral capsule 1 $0 MO zolpidem oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) zolpidem oral tablet,ext release multiphase 1 $0 MO; QL( 每 30 天 30 單位 ) ZYPREXA INTRAMUSCULAR RECON SOLN 心血管, 高血壓 / 血脂藥物 抗心律失常藥物 2 $0 MO amiodarone intravenous solution 1 $0 B/D PA; MO amiodarone intravenous syringe 1 $0 B/D PA amiodarone oral tablet 1 $0 MO flecainide oral tablet 1 $0 MO mexiletine oral capsule 1 $0 MO MULTAQ ORAL TABLET 2 $0 MO pacerone oral tablet 1 $0 MO procainamide injection solution 100 mg/ml 1 $0 MO procainamide injection solution 500 mg/ml 1 $0 propafenone oral capsule,extended release 1 $0 MO 12 hr propafenone oral tablet 1 $0 MO quinidine gluconate injection solution 1 $0 MO quinidine gluconate oral tablet extended 1 $0 MO 38

50 release quinidine sulfate oral tablet 1 $0 MO quinidine sulfate oral tablet extended 1 $0 MO release sorine oral tablet 120 mg, 160 mg, 80 mg 1 $0 MO sorine oral tablet 240 mg 1 $0 sotalol oral tablet 1 $0 MO sotalol af oral tablet 1 $0 MO TIKOSYN ORAL CAPSULE 2 $0 MO 降壓治療 acebutolol oral capsule 1 $0 MO afeditab cr oral tablet extended release 1 $0 MO amiloride oral tablet 1 $0 MO amiloride-hydrochlorothiazide oral tablet 1 $0 MO amlodipine oral tablet 1 $0 MO amlodipine-benazepril oral capsule 1 $0 MO AMTURNIDE ORAL TABLET 2 $0 MO atenolol oral tablet 1 $0 MO atenolol-chlorthalidone oral tablet 1 $0 MO AZOR ORAL TABLET 2 $0 MO benazepril oral tablet 1 $0 MO benazepril-hydrochlorothiazide oral tablet 1 $0 MO BENICAR ORAL TABLET 2 $0 MO; QL( 每 30 天 30 單位 ) BENICAR HCT ORAL TABLET 2 $0 MO betaxolol oral tablet 1 $0 MO bisoprolol fumarate oral tablet 1 $0 MO bisoprolol-hydrochlorothiazide oral tablet 1 $0 MO bumetanide injection solution 1 $0 MO bumetanide oral tablet 1 $0 MO BYSTOLIC ORAL TABLET 2 $0 MO candesartan oral tablet 1 $0 MO candesartan-hydrochlorothiazid oral tablet 1 $0 MO captopril oral tablet 1 $0 MO captopril-hydrochlorothiazide oral tablet 1 $0 MO cartia xt oral capsule,extended release 24hr 1 $0 MO 39

51 carvedilol oral tablet 1 $0 MO chlorothiazide oral tablet 1 $0 MO chlorothiazide sodium intravenous recon 1 $0 MO soln chlorthalidone oral tablet 1 $0 MO clonidine transdermal patch weekly 1 $0 MO clonidine hcl oral tablet 1 $0 MO COREG CR ORAL CAPSULE, ER 2 $0 ST; MO MULTIPHASE 24 HR DEMSER ORAL CAPSULE 2 $0 PA; MO dilt-xr oral capsule,ext release degradablev 1 $0 MO diltiazem hcl intravenous recon soln 1 $0 B/D PA diltiazem hcl intravenous solution 1 $0 B/D PA diltiazem hcl oral capsule, extended release 1 $0 MO diltiazem hcl oral capsule,ext release 1 $0 MO degradable diltiazem hcl oral capsule,extended release 1 $0 MO 12 hr diltiazem hcl oral capsule,extended release 1 $0 MO 24hr diltiazem hcl oral tablet 1 $0 MO diltiazem hcl oral tablet extended release 24 1 $0 hr DIOVAN ORAL TABLET 2 $0 MO; QL( 每 30 天 30 單位 ) doxazosin oral tablet 1 $0 MO enalapril maleate oral tablet 1 $0 MO enalapril-hydrochlorothiazide oral tablet 1 $0 MO EPANED ORAL RECON SOLN 2 $0 MO eplerenone oral tablet 1 $0 MO eprosartan oral tablet 1 $0 MO EXFORGE HCT ORAL TABLET 2 $0 MO felodipine oral tablet extended release 24 hr 1 $0 MO fosinopril oral tablet 1 $0 MO fosinopril-hydrochlorothiazide oral tablet 1 $0 MO furosemide injection solution 1 $0 B/D PA; MO furosemide injection syringe 1 $0 B/D PA; MO 40

52 furosemide oral solution 1 $0 MO furosemide oral tablet 1 $0 MO hydralazine injection solution 1 $0 B/D PA; MO hydralazine oral tablet 1 $0 MO hydrochlorothiazide oral capsule 1 $0 MO hydrochlorothiazide oral tablet 1 $0 MO indapamide oral tablet 1 $0 MO irbesartan oral tablet 1 $0 MO irbesartan-hydrochlorothiazide oral tablet 1 $0 MO isradipine oral capsule 1 $0 MO labetalol intravenous solution 1 $0 B/D PA; MO labetalol intravenous syringe 1 $0 B/D PA labetalol oral tablet 1 $0 MO lisinopril oral tablet 1 $0 MO lisinopril-hydrochlorothiazide oral tablet 1 $0 MO losartan oral tablet 1 $0 MO losartan-hydrochlorothiazide oral tablet 1 $0 MO matzim la oral tablet extended release 24 hr 1 $0 MO methyclothiazide oral tablet 1 $0 MO methyldopa-hydrochlorothiazide oral tablet 1 $0 PA; MO metolazone oral tablet 1 $0 MO metoprolol succinate oral tablet extended 1 $0 MO release 24 hr metoprolol ta-hydrochlorothiaz oral tablet 1 $0 MO metoprolol tartrate intravenous solution 1 $0 B/D PA; MO metoprolol tartrate intravenous syringe 1 $0 B/D PA metoprolol tartrate oral tablet 1 $0 MO minoxidil oral tablet 1 $0 MO moexipril oral tablet 1 $0 MO moexipril-hydrochlorothiazide oral tablet 1 $0 MO nadolol oral tablet 1 $0 MO nadolol-bendroflumethiazide oral tablet 1 $0 MO nicardipine intravenous solution 1 $0 MO nicardipine oral capsule 1 $0 MO nifedical xl oral tablet extended release 1 $0 MO 41

53 24hr nifedipine oral tablet extended release 1 $0 MO nifedipine oral tablet extended release 24hr 1 $0 MO nimodipine oral capsule 1 $0 MO nisoldipine oral tablet extended release 24 1 $0 MO hr perindopril erbumine oral tablet 1 $0 MO pindolol oral tablet 1 $0 MO prazosin oral capsule 1 $0 MO propranolol intravenous solution 1 $0 B/D PA propranolol oral capsule,extended release 1 $0 MO 24 hr propranolol oral solution 1 $0 MO propranolol oral tablet 1 $0 MO propranolol-hydrochlorothiazid oral tablet 1 $0 MO quinapril oral tablet 1 $0 MO quinapril-hydrochlorothiazide oral tablet 1 $0 MO ramipril oral capsule 1 $0 MO REMODULIN INJECTION SOLUTION 2 $0 B/D PA; MO reserpine oral tablet 1 $0 PA; MO spironolacton-hydrochlorothiaz oral tablet 1 $0 MO spironolactone oral tablet 1 $0 MO taztia xt oral capsule, extended release 1 $0 MO TEKAMLO ORAL TABLET 2 $0 MO TEKTURNA ORAL TABLET 2 $0 MO TEKTURNA HCT ORAL TABLET 2 $0 MO telmisartan oral tablet 1 $0 MO telmisartan-hydrochlorothiazid oral tablet 1 $0 MO terazosin oral capsule 1 $0 MO timolol maleate oral tablet 1 $0 MO torsemide intravenous solution 20 mg/2 ml 1 $0 (10 mg/ml) TORSEMIDE 2 $0 SOLUTION 50 MG/5 ML (10 MG/ML) torsemide oral tablet 1 $0 MO trandolapril oral tablet 1 $0 MO 42

54 triamterene-hydrochlorothiazid oral capsule 1 $0 MO triamterene-hydrochlorothiazid oral tablet 1 $0 MO TRIBENZOR ORAL TABLET 2 $0 MO valsartan-hydrochlorothiazide oral tablet 1 $0 MO verapamil intravenous solution 1 $0 B/D PA; MO verapamil intravenous syringe 1 $0 B/D PA verapamil oral capsule, 24 hr er pellet ct 1 $0 MO verapamil oral capsule,ext rel. pellets 24 hr 1 $0 MO verapamil oral tablet 1 $0 MO verapamil oral tablet extended release 1 $0 MO 強心苷類藥物 digox oral tablet 1 $0 MO digoxin injection solution 1 $0 MO digoxin oral solution 1 $0 MO digoxin oral tablet 1 $0 MO LANOXIN ORAL TABLET 125 MCG, 2 $0 PA; MO 250 MCG, 62.5 MCG LANOXIN ORAL TABLET MCG 2 $0 PA 凝血治療 AGGRENOX ORAL CAPSULE, ER 2 $0 MO MULTIPHASE 12 HR BRILINTA ORAL TABLET 2 $0 MO cilostazol oral tablet 1 $0 MO clopidogrel oral tablet 300 mg 1 $0 MO; QL( 每 30 天 1 單位 ) clopidogrel oral tablet 75 mg 1 $0 MO COUMADIN ORAL TABLET 2 $0 MO EFFIENT ORAL TABLET 2 $0 MO ELIQUIS ORAL TABLET 2 $0 MO enoxaparin subcutaneous solution 1 $0 MO; QL( 每 30 天 180 單位 ) enoxaparin subcutaneous syringe $0 MO; QL( 每 30 天 60 單位 ) mg/ml, 150 mg/ml enoxaparin subcutaneous syringe $0 MO; QL( 每 30 天 48 單位 ) mg/0.8 ml, 80 mg/0.8 ml enoxaparin subcutaneous syringe 30 mg/0.3 1 $0 MO; QL( 每 30 天 18 單位 ) 43

55 ml enoxaparin subcutaneous syringe 40 mg/0.4 ml enoxaparin subcutaneous syringe 60 mg/0.6 ml FONDAPARINUX SUBCUTANEOUS SYRINGE 10 MG/0.8 ML fondaparinux subcutaneous syringe 2.5 mg/0.5 ml fondaparinux subcutaneous syringe 5 mg/0.4 ml FONDAPARINUX SUBCUTANEOUS SYRINGE 7.5 MG/0.6 ML FRAGMIN SUBCUTANEOUS SOLUTION FRAGMIN SUBCUTANEOUS SYRINGE 10,000 UNIT/ML FRAGMIN SUBCUTANEOUS SYRINGE 12,500 UNIT/0.5 ML FRAGMIN SUBCUTANEOUS SYRINGE 15,000 UNIT/0.6 ML FRAGMIN SUBCUTANEOUS SYRINGE 18,000 UNIT/0.72 ML 1 $0 MO; QL( 每 30 天 24 單位 ) 1 $0 MO; QL( 每 30 天 36 單位 ) 2 $0 MO; QL( 每 30 天 24 單位 ) 1 $0 MO; QL( 每 30 天 15 單位 ) 1 $0 MO; QL( 每 30 天 12 單位 ) 2 $0 MO; QL( 每 30 天 18 單位 ) 2 $0 MO; QL( 每 30 天 30 單位 ) 2 $0 MO; QL( 每 30 天 30 單位 ) 2 $0 MO; QL( 每 30 天 15 單位 ) 2 $0 MO; QL( 每 30 天 18 單位 ) 2 $0 MO; QL( 每 30 天 21.6 單 位 ) FRAGMIN SUBCUTANEOUS SYRINGE 2 $0 MO; QL( 每 30 天 6 單位 ) 2,500 UNIT/0.2 ML, 5,000 UNIT/0.2 ML FRAGMIN SUBCUTANEOUS SYRINGE 2 $0 MO; QL( 每 30 天 9 單位 ) 7,500 UNIT/0.3 ML heparin (porcine) injection cartridge 1 $0 B/D PA; MO heparin (porcine) injection solution 1 $0 B/D PA; MO HEPARIN (PORCINE) IN 5 % DEX 2 $0 B/D PA PARENTERAL SOLUTION 12,500 UNIT/250 ML heparin (porcine) in 5 % dex intravenous 1 $0 B/D PA parenteral solution 20,000 unit/500 ml (40 unit/ml), 25,000 unit/250 ml(100 unit/ml) heparin (porcine) in 5 % dex intravenous 1 $0 B/D PA; MO parenteral solution 25,000 unit/500 ml (50 unit/ml) heparin (porcine) in nacl (pf) intravenous 1 $0 B/D PA 44

56 parenteral solution 1,000 unit/500 ml HEPARIN (PORCINE) IN NACL (PF) 2 $0 B/D PA PARENTERAL SOLUTION 2,000 UNIT/1,000 ML HEPARIN(PORCINE) IN 0.45% NACL 2 $0 B/D PA PARENTERAL SOLUTION 12,500 UNIT/250 ML, 25,000 UNIT/250 ML, 25,000 UNIT/500 ML heparin, porcine (pf) injection solution 1 $0 B/D PA 1,000 unit/ml heparin, porcine (pf) injection solution 1 $0 B/D PA; MO 5,000 unit/0.5 ml heparin, porcine (pf) injection syringe 1 $0 B/D PA; MO jantoven oral tablet 1 $0 MO MEPHYTON ORAL TABLET 3 $0 MO; * pentoxifylline oral tablet extended release 1 $0 MO PROMACTA ORAL TABLET 2 $0 PA; MO tranexamic acid intravenous solution 1 $0 B/D PA; MO VITAMIN K INJECTION SOLUTION 3 $0 MO; * VITAMIN K1 INJECTION SOLUTION 3 $0 MO; * warfarin oral tablet 1 $0 MO XARELTO ORAL TABLET 2 $0 MO 血脂 / 降膽固醇藥 amlodipine-atorvastatin oral tablet 1 $0 MO ANTARA ORAL CAPSULE 30 MG 2 $0 ANTARA ORAL CAPSULE 90 MG 2 $0 MO atorvastatin oral tablet 1 $0 MO cholestyramine (with sugar) oral powder 1 $0 MO cholestyramine (with sugar) oral powder in 1 $0 MO packet cholestyramine light oral powder 1 $0 MO cholestyramine light oral powder in packet 1 $0 MO colestipol oral granules 1 $0 MO colestipol oral packet 1 $0 MO colestipol oral tablet 1 $0 MO CRESTOR ORAL TABLET 2 $0 MO 45

57 fenofibrate oral tablet 1 $0 MO fenofibrate micronized oral capsule 1 $0 MO fenofibrate nanocrystallized oral tablet 1 $0 MO fenofibric acid (choline) oral 1 $0 MO capsule,delayed release(dr/ec) fluvastatin oral capsule 1 $0 MO gemfibrozil oral tablet 1 $0 MO lovastatin oral tablet 1 $0 MO LOVAZA ORAL CAPSULE 2 $0 MO niacin oral tablet 4 $0 MO; * niacin oral tablet extended release 1,000 4 $0 MO; * mg, 750 mg niacin oral tablet extended release 24 hr 1 $0 MO omega-3 acid ethyl esters oral capsule 1 $0 MO pravastatin oral tablet 1 $0 MO prevalite oral powder 1 $0 MO prevalite oral powder in packet 1 $0 MO SIMCOR ORAL TABLET, ER 2 $0 MO MULTIPHASE 24 HR 1, MG, MG, MG, MG simvastatin oral tablet 1 $0 MO VYTORIN ORAL TABLET 2 $0 MO VYTORIN ORAL TABLET 2 $0 MO VYTORIN ORAL TABLET 2 $0 MO VYTORIN ORAL TABLET 2 $0 MO WELCHOL ORAL POWDER IN PACKET 2 $0 MO WELCHOL ORAL TABLET 2 $0 MO ZETIA ORAL TABLET 2 $0 MO 其他心血管藥物 RANEXA ORAL TABLET EXTENDED 2 $0 MO RELEASE 12 HR VECAMYL ORAL TABLET 2 $0 硝酸鹽 ISORDIL ORAL TABLET 2 $0 MO isosorbide dinitrate oral tablet 1 $0 MO isosorbide dinitrate oral tablet extended 1 $0 MO 46

58 release isosorbide mononitrate oral tablet 1 $0 MO isosorbide mononitrate oral tablet extended 1 $0 MO release 24 hr nitro-bid transdermal ointment 1 $0 MO nitroglycerin intravenous solution 1 $0 B/D PA nitroglycerin transdermal patch 24 hour 1 $0 MO nitroglycerin translingual aerosol,spray 1 $0 MO nitroglycerin translingual spray,non-aerosol 1 $0 MO NITROLINGUAL TRANSLINGUAL 2 $0 MO SPRAY,NON-AEROSOL NITROSTAT SUBLINGUAL TABLET 2 $0 MO 皮膚科 / 局部治療 牛皮癬 / 抗皮脂溢藥 acitretin oral capsule 10 mg 1 $0 MO ACITRETIN ORAL CAPSULE 17.5 MG, 2 $0 MO 25 MG calcipotriene topical cream 1 $0 MO calcipotriene topical ointment 1 $0 MO calcipotriene topical solution 1 $0 MO CALCITRENE TOPICAL OINTMENT 2 $0 MO calcitriol topical ointment 1 $0 MO selenium sulfide topical suspension 1 $0 MO 燒燙傷治療 silver sulfadiazine topical cream 1 $0 MO ssd topical cream 1 $0 MO 去角質藥物 HYDRISALIC TOPICAL GEL 4 $0 * MEDIPLAST CORN-CALLUS-WART 4 $0 MO; * TOPICAL ADHESIVE PATCH,MEDICATED SEBEX TOPICAL SHAMPOO 4 $0 * 其他皮膚科藥物 A + D (LAN, PET) TOPICAL OINTMENT 4 $0 MO; * ammonium lactate topical cream 1 $0 MO 47

59 ammonium lactate topical lotion 1 $0 MO ANTI-ITCH (DIPHENHYDRAMINE) 4 $0 * TOPICAL AEROSOL,SPRAY ASTRINGENT TOPICAL POWDER IN 4 $0 * PACKET BANOPHEN ANTI-ITCH TOPICAL 4 $0 * CREAM BETASEPT SURGICAL SCRUB 4 $0 MO; * TOPICAL LIQUID capsaicin topical cream % 4 $0 MO; * capsaicin topical cream 0.1 % 4 $0 * CARAC TOPICAL CREAM 2 $0 MO diclofenac sodium topical gel 1 $0 PA; MO DR. SMITH'S DIAPER TOPICAL 4 $0 MO; * OINTMENT ELIDEL TOPICAL CREAM 2 $0 MO fluorouracil topical cream 1 $0 MO fluorouracil topical solution 1 $0 MO imiquimod topical cream in packet 1 $0 MO methoxsalen rapid oral capsule 1 $0 OXSORALEN ULTRA ORAL CAPSULE 2 $0 MO PANRETIN TOPICAL GEL 2 $0 MO PETROLEUM JELLY TOPICAL GEL 4 $0 MO; * podofilox topical solution 1 $0 MO PROTOPIC TOPICAL OINTMENT 2 $0 MO REGRANEX TOPICAL GEL 2 $0 MO; QL( 每 30 天 30 單位 ) RESINOL TOPICAL OINTMENT 4 $0 MO; * SECURA EXTRA PROTECTIVE 4 $0 * TOPICAL CREAM TRIXAICIN TOPICAL CREAM 4 $0 MO; * vits a & d-white pet-lanolin topical ointment 4 $0 * in packet zinc oxide topical ointment 4 $0 MO; * ZOSTRIX DIABETIC TOPICAL CREAM 4 $0 * ZYCLARA TOPICAL CREAM IN 2 $0 MO METERED- DOSE PUMP ZYCLARA TOPICAL CREAM IN 2 $0 MO 48

60 PACKET 痤瘡 ( 抗痘 ) 治療 adapalene topical cream 1 $0 PA; MO adapalene topical gel 0.1 % 1 $0 PA; MO amnesteem oral capsule 1 $0 MO benzoyl peroxide topical cleanser 10 %, 5 4 $0 MO; * %, 6 % benzoyl peroxide topical gel 4 $0 MO; * benzoyl peroxide topical lotion 4 $0 MO; * BP TOPICAL LOTION 4 $0 * BP TOPICAL SUSPENSION 4 $0 MO; * claravis oral capsule 1 $0 MO clindacin etz topical swab 1 $0 MO clindacin p topical swab 1 $0 MO clindamycin phosphate topical foam 1 $0 MO clindamycin phosphate topical gel 1 $0 MO clindamycin phosphate topical lotion 1 $0 MO clindamycin phosphate topical solution 1 $0 MO clindamycin phosphate topical swab 1 $0 MO clindamycin-benzoyl peroxide topical gel 1 $0 MO clindamycin-benzoyl peroxide topical 1 $0 MO gel,extended release ery pads topical swab 1 $0 MO erythromycin with ethanol topical gel 1 $0 MO erythromycin with ethanol topical solution 1 $0 MO erythromycin with ethanol topical swab 1 $0 MO erythromycin-benzoyl peroxide topical gel 1 $0 MO INVISIBLE ACNE TOPICAL CREAM 4 $0 * metronidazole topical cream 1 $0 MO metronidazole topical gel 1 $0 MO metronidazole topical gel with pump 1 $0 MO metronidazole topical lotion 1 $0 MO PANOXYL TOPICAL BAR 4 $0 MO; * PANOXYL-4 TOPICAL CLEANSER 4 $0 MO; * rosadan topical cream 1 $0 MO 49

61 rosadan topical gel 1 $0 MO TAZORAC TOPICAL CREAM 2 $0 MO TAZORAC TOPICAL GEL 2 $0 MO tretinoin topical cream 1 $0 PA; MO tretinoin topical gel 1 $0 PA; MO tretinoin microsphere topical gel 1 $0 PA; MO 外用麻醉劑 ANECREAM TOPICAL CREAM 4 $0 MO; * CALDYPHEN TOPICAL LOTION 4 $0 * lidocaine topical adhesive patch,medicated 1 $0 PA; MO lidocaine topical ointment 1 $0 MO lidocaine (pf) injection solution 10 mg/ml (1 1 $0 B/D PA; MO %), 20 mg/ml (2 %), 40 mg/ml (4 %), 5 mg/ml (0.5 %) lidocaine (pf) injection solution 15 mg/ml 1 $0 B/D PA (1.5 %) lidocaine hcl injection solution 1 $0 B/D PA; MO lidocaine hcl laryngotracheal solution 1 $0 MO lidocaine hcl mucous membrane gel 1 $0 MO lidocaine hcl mucous membrane jelly in 1 $0 MO applicator lidocaine hcl mucous membrane solution 2 1 $0 % lidocaine hcl mucous membrane solution 4 1 $0 MO % lidocaine viscous mucous membrane 1 $0 MO solution lidocaine-prilocaine topical cream 1 $0 MO lidocaine-prilocaine topical kit 1 $0 lta pre-attached laryngotracheal solution 1 $0 外用抗菌藥物 bacitracin topical ointment 4 $0 MO; * bacitracin zinc topical packet 4 $0 * bacitracin-polymyxin b topical packet 4 $0 * BETADINE SPRAY TOPICAL AEROSOL 4 $0 * FIRST AID ANTISEPTIC TOPICAL SOLUTION 4 $0 * 50

62 gentamicin topical cream 1 $0 MO gentamicin topical ointment 1 $0 MO GRX DYNE TOPICAL SOLUTION 7.5 % 4 $0 * mupirocin topical ointment 1 $0 MO mupirocin calcium topical cream 1 $0 MO povidone-iodine topical ointment 4 $0 MO; * povidone-iodine topical swab 10 % 4 $0 * sulfacetamide sodium (acne) topical 1 $0 MO suspension TRIPLE ANTIBIOTIC TOPICAL 4 $0 * PACKET TRIPLE ANTIBIOTIC PLUS TOPICAL 4 $0 * OINTMENT 外用抗真菌藥物 ALOE VESTA TOPICAL OINTMENT 2 4 $0 * % ANTIFUNGAL (TOLNAFTATE) 4 $0 * TOPICAL AEROSOL,SPRAY ANTIFUNGAL (TOLNAFTATE) 4 $0 MO; * TOPICAL POWDER ANTIFUNGAL CREAM TOPICAL 4 $0 * CREAM ANTIFUNGAL SPRAY TOPICAL 4 $0 * AEROSOL POWDER ATHLETE'S FOOT (TERBINAFINE) 4 $0 * TOPICAL CREAM ATHLETE'S FOOT (TOLNAFTATE) 4 $0 * TOPICAL AEROSOL POWDER ATHLETE'S FOOT (TOLNAFTATE) 4 $0 * TOPICAL CREAM AZOLEN TINCTURE TOPICAL 4 $0 * TINCTURE ciclodan topical cream 1 $0 MO ciclodan topical solution 1 $0 MO ciclopirox topical cream 1 $0 MO ciclopirox topical gel 1 $0 MO ciclopirox topical shampoo 1 $0 MO 51

63 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請 造訪 ciclopirox topical solution 1 $0 MO ciclopirox topical suspension 1 $0 MO clotrimazole topical cream 1 $0 MO clotrimazole topical solution 1 $0 MO clotrimazole-betamethasone topical cream 1 $0 MO clotrimazole-betamethasone topical lotion 1 $0 MO DESENEX TOPICAL POWDER 4 $0 MO; * econazole topical cream 1 $0 MO ketoconazole topical cream 1 $0 MO ketoconazole topical shampoo 1 $0 MO ketodan topical foam 1 $0 MO ketodan kit topical combo pack 1 $0 MO LAMISIL (AEROSOL) TOPICAL 4 $0 MO; * AEROSOL,SPRAY LAMISIL AT TOPICAL GEL 4 $0 MO; * nyamyc topical powder 1 $0 MO nystatin topical cream 1 $0 MO nystatin topical ointment 1 $0 MO nystatin topical powder 1 $0 MO nystatin-triamcinolone topical cream 1 $0 MO nystatin-triamcinolone topical ointment 1 $0 MO nystop topical powder 1 $0 MO pedi-dri topical powder 1 $0 MO tolnaftate topical solution 4 $0 MO; * 外用抗病毒藥物 ABREVA TOPICAL CREAM 4 $0 MO; * acyclovir topical ointment 1 $0 MO DENAVIR TOPICAL CREAM 2 $0 MO ZOVIRAX TOPICAL CREAM 2 $0 MO 外用皮質類固醇 alclometasone topical cream 1 $0 MO alclometasone topical ointment 1 $0 MO amcinonide topical cream 1 $0 MO amcinonide topical lotion 1 $0 MO amcinonide topical ointment 1 $0 MO ANTI-ITCH (HC) TOPICAL CREAM 4 $0 * 52

64 ANTI-ITCH (HC) WITH OATMEAL 4 $0 * TOPICAL CREAM betamethasone dipropionate topical cream 1 $0 MO betamethasone dipropionate topical lotion 1 $0 MO betamethasone dipropionate topical 1 $0 MO ointment betamethasone valerate topical cream 1 $0 MO betamethasone valerate topical foam 1 $0 MO betamethasone valerate topical lotion 1 $0 MO betamethasone valerate topical ointment 1 $0 MO betamethasone, augmented topical cream 1 $0 MO betamethasone, augmented topical gel 1 $0 MO betamethasone, augmented topical lotion 1 $0 MO betamethasone, augmented topical ointment 1 $0 MO clobetasol topical cream 1 $0 MO clobetasol topical foam 1 $0 MO clobetasol topical gel 1 $0 MO clobetasol topical lotion 1 $0 MO clobetasol topical ointment 1 $0 MO clobetasol topical shampoo 1 $0 MO clobetasol topical solution 1 $0 MO clobetasol-emollient topical cream 1 $0 MO clobetasol-emollient topical foam 1 $0 MO cormax topical solution 1 $0 MO desonide topical cream 1 $0 MO desonide topical lotion 1 $0 MO desonide topical ointment 1 $0 MO desoximetasone topical cream 1 $0 MO desoximetasone topical gel 1 $0 MO desoximetasone topical ointment 1 $0 MO diflorasone topical cream 1 $0 MO diflorasone topical ointment 1 $0 MO fluocinolone topical cream 1 $0 MO fluocinolone topical oil 1 $0 MO fluocinolone topical ointment 1 $0 MO 53

65 fluocinolone topical solution 1 $0 MO fluocinolone-shower cap topical oil 1 $0 MO fluocinonide topical cream 1 $0 MO fluocinonide topical gel 1 $0 MO fluocinonide topical ointment 1 $0 MO fluocinonide topical solution 1 $0 MO fluocinonide-e topical cream 1 $0 MO fluticasone topical cream 1 $0 MO fluticasone topical lotion 1 $0 MO fluticasone topical ointment 1 $0 MO halobetasol propionate topical cream 1 $0 MO halobetasol propionate topical ointment 1 $0 MO HYDRO SKIN TOPICAL LOTION 4 $0 MO; * hydrocortisone topical cream 0.5 %, 1 % 4 $0 MO; * hydrocortisone topical cream 1 %, 2.5 % 1 $0 MO hydrocortisone topical lotion 2.5 % 1 $0 MO hydrocortisone topical ointment 0.5 %, 1 % 4 $0 MO; * hydrocortisone topical ointment 1 %, 2.5 % 1 $0 MO hydrocortisone butyr-emollient topical 1 $0 MO cream hydrocortisone butyrate topical cream 1 $0 MO hydrocortisone butyrate topical ointment 1 $0 MO hydrocortisone butyrate topical solution 1 $0 MO hydrocortisone valerate topical cream 1 $0 MO hydrocortisone valerate topical ointment 1 $0 MO hydrocortisone-min oil-wht pet topical 1 $0 MO ointment MEDI-CORTISONE TOPICAL CREAM 4 $0 * mometasone topical cream 1 $0 MO mometasone topical ointment 1 $0 MO mometasone topical solution 1 $0 MO prednicarbate topical cream 1 $0 MO prednicarbate topical ointment 1 $0 MO SCALPICIN TOPICAL SOLUTION 4 $0 * triamcinolone acetonide topical cream 1 $0 MO triamcinolone acetonide topical lotion 1 $0 MO 54

66 triamcinolone acetonide topical ointment 1 $0 MO trianex topical ointment 1 $0 MO triderm topical cream 1 $0 MO 局部酶 SANTYL TOPICAL OINTMENT 2 $0 MO 外用殺疥蟲藥 / 滅蝨藥 LICE COMPLETE KIT TOPICAL 4 $0 * KIT LICE KILLING TOPICAL SHAMPOO 4 $0 * LICE TREATMENT TOPICAL LIQUID 4 $0 * lindane topical lotion 1 $0 MO lindane topical shampoo 1 $0 MO malathion topical lotion 1 $0 MO permethrin topical cream 1 $0 MO permethrin topical liquid 4 $0 MO; * PYRETHRIN LICE TREATMENT M 4 $0 * TOPICAL LIQUID 診斷 / 其他製劑 灌洗液 lactated ringers irrigation solution 1 $0 MO neomycin-polymyxin b gu irrigation solution 1 $0 MO 其他製劑 acamprosate oral tablet,delayed release 1 $0 MO (dr/ec) ADAGEN INTRAMUSCULAR 2 $0 B/D PA; MO SOLUTION alendronate oral tablet 40 mg 1 $0 MO; QL( 每 30 天 30 單位 ) anagrelide oral capsule 1 $0 MO ARALAST NP RECON 2 $0 B/D PA; MO SOLN cevimeline oral capsule 1 $0 MO CHEMET ORAL CAPSULE 2 $0 MO CLINIMIX 4.25%/D5W SULFIT FREE PARENTERAL SOLUTION 2 $0 B/D PA 55

67 CLINIMIX E 2.75%/D10W SUL FREE 2 $0 B/D PA PARENTERAL SOLUTION CLINIMIX E 2.75%/D5W SULF FREE 2 $0 B/D PA PARENTERAL SOLUTION d10 % & 0.45 % sodium chloride 1 $0 intravenous parenteral solution d2.5 %-0.45 % sodium chloride intravenous 1 $0 B/D PA parenteral solution d5 % and 0.9 % sodium chloride 1 $0 B/D PA; MO intravenous parenteral solution d5 %-0.45 % sodium chloride intravenous 1 $0 B/D PA; MO parenteral solution dextrose 10 % & 0.2 % nacl intravenous 1 $0 B/D PA parenteral solution dextrose 10 % in water (d10w) intravenous 1 $0 B/D PA; MO parenteral solution dextrose 20 % in water (d20w) intravenous 1 $0 B/D PA parenteral solution dextrose 25 % in water (d25w) intravenous 1 $0 B/D PA syringe dextrose 30 % in water (d30w) intravenous 1 $0 B/D PA parenteral solution dextrose 40 % in water (d40w) intravenous 1 $0 B/D PA parenteral solution dextrose 5 % in water (d5w) intravenous 1 $0 B/D PA; MO parenteral solution dextrose 5 % in water (d5w) intravenous 1 $0 B/D PA; MO piggyback dextrose 5 %-lactated ringers intravenous 1 $0 B/D PA; MO parenteral solution dextrose 5%-0.2 % sod chloride intravenous 1 $0 B/D PA parenteral solution dextrose 5%-0.3 % sod.chloride intravenous 1 $0 B/D PA parenteral solution dextrose 50 % in water (d50w) intravenous 1 $0 B/D PA; MO parenteral solution dextrose 50 % in water (d50w) intravenous 1 $0 B/D PA 56

68 syringe dextrose 70 % in water (d70w) intravenous 1 $0 B/D PA parenteral solution disulfiram oral tablet 1 $0 MO etidronate disodium oral tablet 1 $0 MO EXJADE ORAL TABLET, DISPERSIBLE 2 $0 MO FOSRENOL ORAL 2 $0 MO TABLET,CHEWABLE INCRELEX SUBCUTANEOUS 2 $0 B/D PA; MO SOLUTION KIONEX ORAL POWDER 2 $0 MO kionex oral suspension 1 $0 MO levocarnitine intravenous solution 1 $0 B/D PA; MO levocarnitine oral tablet 1 $0 B/D PA; MO levocarnitine (with sugar) oral solution 1 $0 B/D PA; MO midodrine oral tablet 1 $0 MO pilocarpine hcl oral tablet 1 $0 MO RENVELA ORAL POWDER IN PACKET 2 $0 MO RENVELA ORAL TABLET 2 $0 MO riluzole oral tablet 1 $0 MO sevelamer carbonate oral tablet 1 $0 MO sodium chloride irrigation solution 1 $0 MO sodium chloride 0.9 % intravenous 1 $0 MO parenteral solution sodium chloride 0.9 % intravenous 1 $0 MO piggyback sodium polystyrene (sorb free) oral 1 $0 suspension sodium polystyrene sulfonate oral powder 1 $0 MO sodium polystyrene sulfonate oral 1 $0 suspension sps oral suspension 1 $0 MO SYPRINE ORAL CAPSULE 2 $0 MO zoledronic acid-mannitol-water intravenous solution 1 $0 B/D PA; MO 營養藥品 57

69 CENTRAL VITE ORAL TABLET 4 $0 * 戒煙輔助劑 buproban oral tablet extended release 1 $0 MO CHANTIX ORAL TABLET 2 $0 MO CHANTIX CONTINUING MONTH BOX 2 $0 MO ORAL TABLET CHANTIX STARTING MONTH BOX 2 $0 MO ORAL TABLETS,DOSE PACK NICODERM CQ TRANSDERMAL 4 $0 MO; * PATCH 24 HOUR nicotine transdermal patch 24 hour 4 $0 MO; * nicotine transdermal patch, td daily, 4 $0 MO; * sequential nicotine (polacrilex) buccal gum 4 $0 MO; * nicotine (polacrilex) buccal lozenge 2 mg 4 $0 * nicotine (polacrilex) buccal lozenge 4 mg 4 $0 MO; * NICOTROL INHALATION CARTRIDGE 2 $0 MO NICOTROL NS NASAL SPRAY,NON- 2 $0 MO AEROSOL 耳鼻喉科藥物 其他製劑 4 WAY NASAL SPRAY, NON- 4 $0 * AEROSOL azelastine nasal aerosol,spray 1 $0 MO; QL( 每 30 天 60 單位 ) azelastine nasal spray,non-aerosol 1 $0 MO; QL( 每 30 天 60 單位 ) chlorhexidine gluconate mucous membrane 1 $0 MO mouthwash DRISTAN LONG LASTING NASAL 4 $0 * MIST ipratropium bromide nasal spray,nonaerosol 1 $0 MO; QL( 每 30 天 60 單位 ) 0.03 % ipratropium bromide nasal spray,nonaerosol 1 $0 MO; QL( 每 30 天 30 單位 ) 0.06 % oralone dental paste 1 $0 MO periogard mucous membrane mouthwash 1 $0 MO SALINE MIST NASAL AEROSOL, SPRAY 4 $0 MO; * 58

70 sf 5000 plus dental cream 1 $0 MO sodium fluoride dental solution 1 $0 MO triamcinolone acetonide dental paste 1 $0 MO 其他耳製劑 acetasol hc otic drops 1 $0 MO acetic acid otic solution 1 $0 MO EAR WAX REMOVAL DROPS OTIC 4 $0 * DROPS fluocinolone acetonide oil otic drops 1 $0 MO hydrocortisone-acetic acid otic drops 1 $0 MO ofloxacin otic drops 1 $0 MO 耳類固醇 / 抗生素 CORTISPORIN-TC OTIC DROPS, 2 $0 MO SUSPENSION neomycin-polymyxin-hc otic 1 $0 MO drops,suspension neomycin-polymyxin-hc otic solution 1 $0 MO 內分泌 / 糖尿病 腎上腺皮質激素 A-HYDROCORT INJECTION RECON 2 $0 B/D PA; MO SOLN a-methapred injection recon soln 1 $0 B/D PA ACTHAR H.P. INJECTION GEL 2 $0 PA; MO cortisone oral tablet 1 $0 MO dexamethasone oral elixir 1 $0 MO dexamethasone oral solution 1 $0 MO dexamethasone oral tablet 1 $0 MO dexamethasone intensol oral drops 1 $0 MO dexamethasone sodium phos (pf) injection 1 $0 B/D PA; MO solution dexamethasone sodium phosphate injection 1 $0 B/D PA; MO solution fludrocortisone oral tablet 1 $0 MO hydrocortisone oral tablet 1 $0 MO KENALOG INJECTION SUSPENSION 2 $0 MO 59

71 methylprednisolone oral tablet 1 $0 MO methylprednisolone oral tablets,dose pack 1 $0 MO methylprednisolone acetate injection 1 $0 B/D PA; MO suspension methylprednisolone sodium succ injection 1 $0 B/D PA; MO recon soln 125 mg methylprednisolone sodium succ injection 1 $0 B/D PA recon soln 40 mg methylprednisolone sodium succ intravenous 1 $0 B/D PA; MO recon soln millipred oral tablet 1 $0 MO prednisolone oral solution 1 $0 MO prednisolone sodium phosphate oral 1 $0 MO solution 15 mg/5 ml, 5 mg base/5 ml (6.7 mg/5 ml) prednisolone sodium phosphate oral 1 $0 solution 25 mg/5 ml (5 mg/ml) prednisone oral solution 1 $0 MO prednisone oral tablet 1 $0 MO prednisone oral tablets,dose pack 1 $0 MO prednisone intensol oral concentrate 1 $0 MO RAYOS ORAL TABLET,DELAYED 2 $0 MO RELEASE (DR/EC) SOLU-CORTEF (PF) INJECTION RECON 2 $0 B/D PA; MO SOLN 100 MG/2 ML, 250 MG/2 ML triamcinolone acetonide injection 1 $0 MO suspension 10 mg/ml triamcinolone acetonide injection 1 $0 suspension 40 mg/ml veripred 20 oral solution 1 $0 MO 抗甲狀腺藥物 methimazole oral tablet 1 $0 MO propylthiouracil oral tablet 1 $0 MO 糖尿病治療 acarbose oral tablet 1 $0 MO ACTOPLUS MET XR ORAL TABLET, 2 $0 MO; QL( 每 30 天 60 單位 ) ER MULTIPHASE 24 HR 15-1,000 MG 60

72 ACTOPLUS MET XR ORAL TABLET, 2 $0 MO; QL( 每 30 天 30 單位 ) ER MULTIPHASE 24 HR 30-1,000 MG ALCOHOL PADS TOPICAL PADS, 2 $0 MEDICATED BYETTA SUBCUTANEOUS PEN 2 $0 MO INJECTOR CYCLOSET ORAL TABLET 2 $0 MO gauze pads 2 x 2 2 $0 glimepiride oral tablet 1 $0 MO glipizide oral tablet 1 $0 MO glipizide oral tablet extended release 24hr 1 $0 MO glipizide-metformin oral tablet mg 1 $0 MO; QL( 每 30 天 240 單位 ) glipizide-metformin oral tablet mg, mg GLUCAGEN INJECTION RECON SOLN 2 $0 GLUCAGEN HYPOKIT INJECTION 2 $0 MO RECON SOLN GLUCAGON EMERGENCY INJECTION 2 $0 MO KIT HUMALOG SUBCUTANEOUS 2 $0 MO CARTRIDGE HUMALOG SUBCUTANEOUS 2 $0 MO SOLUTION HUMALOG KWIKPEN 2 $0 MO SUBCUTANEOUS INSULIN PEN HUMALOG MIX $0 MO SUBCUTANEOUS SUSPENSION HUMALOG MIX KWIKPEN 2 $0 MO SUBCUTANEOUS INSULIN PEN HUMALOG MIX $0 MO SUBCUTANEOUS SUSPENSION HUMALOG MIX KWIKPEN 2 $0 MO SUBCUTANEOUS INSULIN PEN HUMULIN 70/30 SUBCUTANEOUS 2 $0 MO SUSPENSION HUMULIN 70/30 KWIKPEN 2 $0 MO 1 $0 MO; QL( 每 30 天 120 單 位 ) 61

73 SUBCUTANEOUS INSULIN PEN HUMULIN 70/30 PEN SUBCUTANEOUS 2 $0 MO INSULIN PEN HUMULIN N SUBCUTANEOUS 2 $0 MO SUSPENSION HUMULIN N KWIKPEN 2 $0 MO SUBCUTANEOUS INSULIN PEN HUMULIN N PEN SUBCUTANEOUS 2 $0 MO INSULIN PEN HUMULIN R INJECTION SOLUTION 2 $0 MO HUMULIN R U-500 "CONCENTRATED" 2 $0 MO SUBCUTANEOUS SOLUTION insulin pen needle 2 $0 MO insulin syringe (disp) u ml 2 $0 MO insulin syringe (disp) u ml 2 $0 insulin syringe (disp) u-100 1/2 ml 2 $0 MO INVOKANA ORAL TABLET 2 $0 MO JANUMET ORAL TABLET 2 $0 MO; QL( 每 30 天 60 單位 ) JANUMET XR ORAL TABLET, ER 2 $0 MO; QL( 每 30 天 60 單位 ) MULTIPHASE 24 HR JANUVIA ORAL TABLET 2 $0 MO; QL( 每 30 天 30 單位 ) KOMBIGLYZE XR ORAL TABLET, ER 2 $0 MO; QL( 每 30 天 60 單位 ) MULTIPHASE 24 HR 2.5-1,000 MG KOMBIGLYZE XR ORAL TABLET, ER 2 $0 MO; QL( 每 30 天 30 單位 ) MULTIPHASE 24 HR 5-1,000 MG, MG LEVEMIR SUBCUTANEOUS 2 $0 MO SOLUTION LEVEMIR FLEXPEN SUBCUTANEOUS 2 $0 MO INSULIN PEN LEVEMIR FLEXTOUCH 2 $0 MO SUBCUTANEOUS INSULIN PEN metformin oral tablet 1 $0 MO metformin oral tablet extended release 24 hr 1 $0 MO metformin oral tablet extended release 24hr 1 $0 MO nateglinide oral tablet 1 $0 MO needles, insulin disp.,safety 2 $0 62

74 NOVOFINE NEEDLE 2 $0 MO NOVOLIN 70/30 SUBCUTANEOUS 2 $0 MO SUSPENSION NOVOLIN N SUBCUTANEOUS 2 $0 MO SUSPENSION NOVOLIN R INJECTION SOLUTION 2 $0 MO NOVOLOG SUBCUTANEOUS 2 $0 MO SOLUTION NOVOLOG FLEXPEN SUBCUTANEOUS 2 $0 MO INSULIN PEN NOVOLOG MIX $0 MO SUBCUTANEOUS SOLUTION NOVOLOG MIX FLEXPEN 2 $0 MO SUBCUTANEOUS INSULIN PEN NOVOLOG PENFILL SUBCUTANEOUS 2 $0 MO CARTRIDGE NOVOTWIST NEEDLE 2 $0 MO ONGLYZA ORAL TABLET 2 $0 MO; QL( 每 30 天 30 單位 ) pioglitazone oral tablet 1 $0 MO pioglitazone-glimepiride oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) pioglitazone-metformin oral tablet 1 $0 MO; QL( 每 30 天 90 單位 ) PROGLYCEM ORAL SUSPENSION 2 $0 MO repaglinide oral tablet 0.5 mg 1 $0 MO; QL( 每 30 天 930 單 位 ) repaglinide oral tablet 1 mg 1 $0 MO; QL( 每 30 天 480 單 位 ) repaglinide oral tablet 2 mg 1 $0 MO; QL( 每 30 天 240 單 位 ) SYMLINPEN 120 SUBCUTANEOUS PEN 2 $0 MO INJECTOR SYMLINPEN 60 SUBCUTANEOUS PEN 2 $0 MO INJECTOR tolazamide oral tablet 1 $0 MO tolbutamide oral tablet 1 $0 MO VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR 2 $0 MO 63

75 VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR 其他激素 2 $0 MO ALDURAZYME 2 $0 B/D PA; MO SOLUTION ANDROGEL TRANSDERMAL GEL 2 $0 MO ANDROID ORAL CAPSULE 2 $0 MO ANDROXY ORAL TABLET 2 $0 MO cabergoline oral tablet 1 $0 MO; QL( 每 30 天 20 單位 ) calcitonin (salmon) nasal spray,non-aerosol 1 $0 MO calcitriol intravenous solution 1 $0 B/D PA; MO calcitriol oral capsule 1 $0 B/D PA; MO calcitriol oral solution 1 $0 B/D PA; MO CEREZYME RECON 2 $0 B/D PA; MO SOLN chorionic gonadotropin, human 1 $0 PA; MO intramuscular recon soln danazol oral capsule 1 $0 MO desmopressin injection solution 1 $0 MO desmopressin nasal aerosol,spray 1 $0 MO desmopressin nasal solution 1 $0 MO desmopressin nasal spray,non-aerosol 1 $0 MO desmopressin oral tablet 1 $0 MO ELAPRASE SOLUTION 2 $0 B/D PA; MO ELELYSO RECON 2 $0 B/D PA; MO SOLN FABRAZYME RECON 2 $0 B/D PA; MO SOLN 35 MG fortical nasal spray,non-aerosol 1 $0 MO KUVAN ORAL TABLET,SOLUBLE 2 $0 PA; MO MIACALCIN INJECTION SOLUTION 2 $0 B/D PA; MO MYOZYME RECON 2 $0 B/D PA; MO SOLN NAGLAZYME 2 $0 B/D PA; MO SOLUTION novarel intramuscular recon soln 1 $0 PA; MO OXANDROLONE ORAL TABLET 10 MG 2 $0 MO 64

76 oxandrolone oral tablet 2.5 mg 1 $0 MO pamidronate intravenous recon soln 1 $0 B/D PA; MO pamidronate intravenous solution 1 $0 B/D PA; MO paricalcitol oral capsule 1 $0 B/D PA; MO PREGNYL INTRAMUSCULAR RECON 2 $0 PA; MO SOLN SENSIPAR ORAL TABLET 2 $0 MO SOMAVERT SUBCUTANEOUS RECON 2 $0 B/D PA; MO SOLN SYNAREL NASAL SPRAY,NON- 2 $0 MO AEROSOL TESTIM TRANSDERMAL GEL 2 $0 MO testosterone cypionate intramuscular oil 1 $0 B/D PA; MO testosterone enanthate intramuscular oil 1 $0 B/D PA; MO VPRIV RECON SOLN 2 $0 B/D PA; MO ZAVESCA ORAL CAPSULE 2 $0 MO ZEMPLAR SOLUTION 2 $0 B/D PA; MO zoledronic acid intravenous recon soln 1 $0 B/D PA zoledronic acid intravenous solution 1 $0 B/D PA; MO ZOMETA SOLUTION 4 2 $0 B/D PA; MO MG/100 ML 甲狀腺激素 LEVOTHYROXINE 2 $0 B/D PA; MO RECON SOLN 100 MCG levothyroxine oral tablet 1 $0 MO levoxyl oral tablet 1 $0 MO liothyronine intravenous solution 1 $0 liothyronine oral tablet 1 $0 MO SYNTHROID ORAL TABLET 2 $0 MO unithroid oral tablet 100 mcg, 112 mcg, $0 MO mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcg 腸胃科藥物 止瀉藥 / 解痙藥 ANTI-DIARRHEAL (LOPERAMIDE) ORAL LIQUID 4 $0 * 65

77 ANTI-DIARRHEAL (LOPERAMIDE) 4 $0 * ORAL TABLET atropine injection syringe 1 $0 BISMATROL ORAL SUSPENSION $0 MO; * MG/15 ML BISMATROL ORAL SUSPENSION $0 * MG/15 ML BISMATROL ORAL 4 $0 * TABLET,CHEWABLE dicyclomine oral capsule 1 $0 MO dicyclomine oral solution 1 $0 MO dicyclomine oral tablet 1 $0 MO glycopyrrolate injection solution 1 $0 MO glycopyrrolate oral tablet 1 $0 MO loperamide oral capsule 1 $0 MO loperamide oral liquid 1 mg/7.5 ml 4 $0 * loperamide oral tablet 4 $0 * methscopolamine oral tablet 1 $0 MO PEPTO-BISMOL ORAL TABLET 4 $0 MO; * 其他腸胃科藥物 ACID GONE ANTACID ORAL 4 $0 * SUSPENSION ADVANCED ANTACID-ANTIGAS 4 $0 * ORAL SUSPENSION ALAMAG-PLUS ORAL 4 $0 * TABLET,CHEWABLE ALMACONE ORAL SUSPENSION 4 $0 * ALMACONE-2 ORAL SUSPENSION 4 $0 * aluminum hydroxide gel oral suspension 4 $0 MO; * 320 mg/5 ml AMITIZA ORAL CAPSULE 2 $0 MO; QL( 每 30 天 60 單位 ) ANTACID EXTRA STRENGTH ORAL TABLET,CHEWABLE APRISO ORAL CAPSULE,EXTENDED RELEASE 24HR ASACOL HD ORAL TABLET,DELAYED RELEASE (DR/EC) 4 $0 * 2 $0 MO 2 $0 MO 66

78 balsalazide oral capsule 1 $0 MO bisacodyl oral tablet,delayed release (dr/ec) 4 $0 MO; * BUDESONIDE ORAL CAPSULE, 2 $0 MO DELAYED & EXT.RELEASE CANASA RECTAL SUPPOSITORY 2 $0 MO CHILDREN'S PEPTO ORAL 4 $0 * TABLET,CHEWABLE CIMZIA SUBCUTANEOUS SYRINGE 2 $0 ST; MO KIT CIMZIA POWDER FOR RECONST 2 $0 B/D PA; ST; MO SUBCUTANEOUS KIT CITRATE OF MAGNESIA ORAL 4 $0 * SOLUTION CITRUCEL ORAL TABLET 4 $0 MO; * CITRUCEL SUGAR FREE ORAL 4 $0 MO; * POWDER CLEARLAX ORAL POWDER 4 $0 MO; * CLEARLAX ORAL POWDER IN 4 $0 * PACKET COLACE ORAL CAPSULE 50 MG 4 $0 MO; * compro rectal suppository 1 $0 MO constulose oral solution 1 $0 MO cromolyn oral solution 1 $0 MO CYSTADANE ORAL POWDER 2 $0 MO DELZICOL ORAL CAPSULE,DELAYED 2 $0 MO RELEASE(DR/EC) dimenhydrinate oral tablet 4 $0 MO; * DIOCTO ORAL LIQUID 4 $0 * DIPENTUM ORAL CAPSULE 2 $0 MO DOC-Q-LACE ORAL CAPSULE 4 $0 MO; * DOCUPRENE ORAL TABLET 4 $0 * docusate calcium oral capsule 4 $0 MO; * docusate sodium oral capsule 250 mg 4 $0 MO; * DOK PLUS ORAL TABLET 4 $0 * DRONABINOL ORAL CAPSULE 10 MG 2 $0 B/D PA; MO; QL( 每 30 天 60 單位 ) 67

79 dronabinol oral capsule 2.5 mg, 5 mg 1 $0 B/D PA; MO; QL( 每 30 天 60 單位 ) EMEND ORAL CAPSULE 125 MG 2 $0 B/D PA; MO; QL( 每 30 天 2 單位 ) EMEND ORAL CAPSULE 40 MG 2 $0 B/D PA; MO; QL 每 1 天 1 單 位 ) EMEND ORAL CAPSULE 80 MG 2 $0 B/D PA; MO; QL( 每 30 天 4 單位 ) EMEND ORAL CAPSULE,DOSE PACK 2 $0 B/D PA; MO; QL( 每 3 天 3 單位 ) enulose oral solution 1 $0 MO EPSOM SALT ORAL GRANULES 4 $0 * EX-LAX (SENNOSIDES) ORAL TABLET 4 $0 MO; * EX-LAX MAXIMUM STRENGTH ORAL 4 $0 * TABLET FIBER (PSYLLIUM HUSK/SUGAR) 4 $0 * ORAL POWDER FIBER (WITH ASPARTAME) ORAL 4 $0 * POWDER FIBER LAXATIVE ORAL TABLET 4 $0 * FIBER LAXATIVE (PSYLLIUM HUSK) 4 $0 * ORAL CAPSULE FIBER THERAPY ORAL POWDER 4 $0 * FLEET GLYCERIN (ADULT) RECTAL 4 $0 * SUPPOSITORY GAS RELIEF ORAL CAPSULE 4 $0 * GAS RELIEF ORAL 4 $0 MO; * TABLET,CHEWABLE GAS RELIEF EXTRA STRENGTH ORAL 4 $0 * CAPSULE gavilyte-c oral recon soln 1 $0 MO gavilyte-g oral recon soln 1 $0 MO gavilyte-n oral recon soln 1 $0 MO GAVISCON ORAL 4 $0 MO; * TABLET,CHEWABLE GAVISCON EXTRA STRENGTH ORAL SUSPENSION 4 $0 MO; * 68

80 generlac oral solution 1 $0 MO GERI-MUCIL ORAL POWDER 4 $0 * granisetron intravenous solution 1 $0 B/D PA; MO granisetron oral tablet 1 $0 B/D PA; MO; QL( 每 1 天 2 單位 ) granisetron (pf) intravenous solution 1 1 $0 B/D PA; MO mg/ml (1 ml) granisetron (pf) intravenous solution $0 B/D PA mcg/ml granisol oral solution 1 $0 B/D PA; MO; QL( 每 30 天 3 單位 ) hydrocortisone rectal enema 1 $0 MO INFANTS GAS RELIEF ORAL 4 $0 * DROPS,SUSPENSION KONSYL ORAL POWDER IN PACKET 4 $0 MO; * KONSYL (SUGAR) ORAL POWDER $0 * GRAM/11 GRAM KONSYL (SUGAR) ORAL POWDER IN 4 $0 * PACKET KONSYL (WITH ASPARTAME) ORAL 4 $0 * POWDER KONSYL EASY MIX ORAL POWDER 4 $0 * KONSYL FORMULA-D ORAL POWDER 4 $0 * lactulose oral solution 10 gram/15 ml, 20 1 $0 MO gram/30 ml lactulose oral solution 10 gram/15 ml (15 1 $0 ml) LAXATIVE MAXIMUM STRENGTH 4 $0 * ORAL TABLET LIALDA ORAL TABLET,DELAYED 2 $0 MO RELEASE (DR/EC) LOTRONEX ORAL TABLET 2 $0 MO meclizine oral tablet 1 $0 MO meclizine oral tablet,chewable 4 $0 MO; * mesalamine rectal enema 1 $0 MO mesalamine with cleansing wipe rectal 1 $0 MO 69

81 enema kit METAMUCIL FIBER SINGLES ORAL 4 $0 MO; * POWDER IN PACKET metoclopramide hcl injection solution 1 $0 B/D PA; MO metoclopramide hcl injection syringe 1 $0 B/D PA metoclopramide hcl oral solution 1 $0 MO metoclopramide hcl oral tablet 1 $0 MO MI-ACID ORAL TABLET,CHEWABLE 4 $0 * MILK OF MAGNESIA ORAL 4 $0 MO; * SUSPENSION MILK OF MAGNESIA 4 $0 MO; * CONCENTRATED ORAL SUSPENSION mineral oil oral oil 4 $0 MO; * MOTION RELIEF (MECLIZINE) ORAL 4 $0 * TABLET MOTION SICKNESS ORAL TABLET 4 $0 * MOVIPREP ORAL POWDER IN 2 $0 MO PACKET ondansetron oral tablet,disintegrating 1 $0 B/D PA; MO; QL( 每 5 天 12 單位 ) ondansetron hcl intravenous solution 1 $0 B/D PA; MO ondansetron hcl oral solution 1 $0 B/D PA; MO; QL( 每 5 天 150 單位 ) ondansetron hcl oral tablet 24 mg 1 $0 B/D PA; QL( 每 1 天 1 單 位 ) ondansetron hcl oral tablet 4 mg, 8 mg 1 $0 B/D PA; MO; QL( 每 5 天 12 單位 ) ondansetron hcl (pf) injection solution 1 $0 B/D PA; MO ondansetron hcl (pf) injection syringe 1 $0 B/D PA PEDIA-LAX STOOL SOFTENER ORAL 4 $0 * SYRUP peg 3350-electrolytes oral recon soln $0 MO gram peg-3350 with flavor packs oral recon soln 1 $0 MO peg-electrolyte soln oral recon soln 1 $0 PENTASA ORAL CAPSULE, EXTENDED RELEASE 2 $0 MO 70

82 polyethylene glycol 3350 oral powder 1 $0 MO polyethylene glycol 3350 oral powder in 1 $0 MO packet prochlorperazine rectal suppository 1 $0 MO prochlorperazine edisylate injection solution 1 $0 MO prochlorperazine maleate oral tablet 1 $0 MO procto-pak rectal cream 1 $0 MO proctozone-hc rectal cream 1 $0 MO REGULOID ORAL POWDER 4 $0 MO; * RELISTOR SUBCUTANEOUS KIT 2 $0 MO RELISTOR SUBCUTANEOUS 2 $0 MO SOLUTION RELISTOR SUBCUTANEOUS SYRINGE 2 $0 MO REMICADE RECON 2 $0 PA; MO SOLN SANCUSO TRANSDERMAL PATCH WEEKLY 2 $0 B/D PA; MO; QL( 每 15 天 2 單位 ) SANI-SUPP (ADULT) RECTAL 4 $0 MO; * SUPPOSITORY SENEXON ORAL SYRUP 4 $0 * SENNA ORAL TABLET 4 $0 * SENOKOTXTRA ORAL TABLET 4 $0 MO; * sodium bicarbonate oral tablet 4 $0 MO; * sulfasalazine oral tablet 1 $0 MO sulfasalazine oral tablet,delayed release 1 $0 MO (dr/ec) sulfazine oral tablet 1 $0 MO sulfazine ec oral tablet,delayed release 1 $0 MO (dr/ec) TRANSDERM-SCOP TRANSDERMAL 2 $0 MO; QL( 每 30 天 10 單位 ) PATCH 72 HOUR trilyte with flavor packets oral recon soln 1 $0 MO ursodiol oral capsule 1 $0 MO ursodiol oral tablet 1 $0 MO ZENPEP ORAL CAPSULE,DELAYED RELEASE(DR/EC) 2 $0 MO 71

83 胃潰瘍治療 ACID CONTROL (RANITIDINE) ORAL 4 $0 * TABLET ACID CONTROLLER ORAL TABLET 4 $0 * amoxicil-clarithromy-lansopraz oral combo 1 $0 MO pack AXID AR 4 $0 * CARAFATE ORAL SUSPENSION 2 $0 MO cimetidine oral tablet 1 $0 MO cimetidine hcl oral solution 1 $0 MO COMPLETE ORAL 4 $0 * TABLET,CHEWABLE DEXILANT ORAL CAPSULE,BIPHASE 2 $0 MO DELAYED RELEAS esomeprazole sodium intravenous recon 1 $0 B/D PA soln famotidine intravenous solution 1 $0 B/D PA; MO famotidine oral suspension 1 $0 MO famotidine oral tablet 20 mg, 40 mg 1 $0 MO famotidine (pf) intravenous solution 1 $0 B/D PA; MO famotidine (pf)-nacl (iso-os) intravenous 1 $0 B/D PA piggyback lansoprazole oral capsule,delayed 1 $0 MO release(dr/ec) 15 mg, 30 mg lansoprazole oral capsule,delayed 4 $0 MO; * release(dr/ec) 15 mg misoprostol oral tablet 1 $0 MO NEXIUM IV RECON 2 $0 B/D PA SOLN 20 MG NEXIUM IV RECON 2 $0 B/D PA; MO SOLN 40 MG nizatidine oral capsule 1 $0 MO nizatidine oral solution 1 $0 MO omeprazole oral capsule,delayed 1 $0 MO release(dr/ec) omeprazole oral tablet,delayed release (dr/ec) 4 $0 MO; * 72

84 omeprazole-sodium bicarbonate oral 1 $0 MO capsule pantoprazole oral tablet,delayed release 1 $0 MO (dr/ec) PEPCID AC ORAL TABLET 20 MG 4 $0 MO; * PEPCID AC ORAL 4 $0 * TABLET,CHEWABLE PRILOSEC OTC ORAL 4 $0 MO; * TABLET,DELAYED RELEASE (DR/EC) rabeprazole oral tablet,delayed release 1 $0 MO (dr/ec) ranitidine hcl injection solution 1 $0 B/D PA; MO ranitidine hcl oral capsule 1 $0 MO ranitidine hcl oral syrup 1 $0 MO ranitidine hcl oral tablet 150 mg, 300 mg 1 $0 MO sucralfate oral suspension 1 $0 MO sucralfate oral tablet 1 $0 MO TAGAMET HB ORAL TABLET 4 $0 MO; * ZANTAC 75 ORAL TABLET 4 $0 MO; * 免疫科, 疫苗 / 生物技術藥物 生物技術藥物 ACTIMMUNE SUBCUTANEOUS 2 $0 PA; MO SOLUTION ARCALYST SUBCUTANEOUS RECON 2 $0 PA; MO SOLN AVONEX INTRAMUSCULAR KIT 2 $0 PA; MO; QL( 每 28 天 4 單位 ) AVONEX INTRAMUSCULAR PEN INJECTOR KIT 2 $0 PA; MO; QL( 每 28 天 2 單 位 ) AVONEX INTRAMUSCULAR SYRINGE 2 $0 PA; MO; QL( 每 28 天 2 單 位 ) AVONEX ADMINISTRATION PACK INTRAMUSCULAR KIT 2 $0 PA; MO; QL( 每 28 天 2 單 位 ) EGRIFTA SUBCUTANEOUS RECON 2 $0 PA; MO SOLN EXTAVIA SUBCUTANEOUS KIT 2 $0 PA; MO; QL( 每 30 天 15 單 73

85 位 ) ILARIS (PF) SUBCUTANEOUS RECON 2 $0 PA; MO; LA SOLN INTRON A INJECTION RECON SOLN 2 $0 B/D PA; MO 10 MILLION UNIT (1 ML) INTRON A INJECTION SOLUTION 6 2 $0 B/D PA; MO MILLION UNIT/ML LEUKINE INJECTION RECON SOLN 2 $0 PA; MO MOZOBIL SUBCUTANEOUS 2 $0 B/D PA; MO SOLUTION NEUMEGA SUBCUTANEOUS RECON SOLN 2 $0 B/D PA; MO; QL( 每 21 天 21 單位 ) NEUPOGEN INJECTION SOLUTION $0 PA; MO MCG/1.6 ML NEUPOGEN INJECTION SYRINGE 2 $0 PA; MO NORDITROPIN FLEXPRO 2 $0 PA; MO SUBCUTANEOUS PEN INJECTOR NORDITROPIN NORDIFLEX 2 $0 PA; MO SUBCUTANEOUS PEN INJECTOR PEGINTRON SUBCUTANEOUS KIT 2 $0 PA; MO; QL( 每 30 天 5 單位 ) PEGINTRON REDIPEN SUBCUTANEOUS PEN INJECTOR KIT PROCRIT INJECTION SOLUTION 10,000 UNIT/ML, 2,000 UNIT/ML, 20,000 UNIT/2 ML, 20,000 UNIT/ML, 3,000 UNIT/ML, 4,000 UNIT/ML PROCRIT INJECTION SOLUTION 40,000 UNIT/ML PROLEUKIN RECON SOLN REBIF (WITH ALBUMIN) SUBCUTANEOUS SYRINGE REBIF TITRATION PACK SUBCUTANEOUS SYRINGE 2 $0 PA; MO; QL( 每 30 天 5 單 位 ) 2 $0 PA; MO; QL( 每 30 天 24 單 位 ) 2 $0 PA; MO; QL( 每 30 天 6 單 位 ) 2 $0 B/D PA; MO 2 $0 PA; MO; QL( 每 28 天 6 單 位 ) 2 $0 PA; MO; QL( 每 28 天 6 單 位 ) SYLATRON SUBCUTANEOUS KIT 2 $0 PA; MO SYLATRON 4-PACK SUBCUTANEOUS 2 $0 PA; MO 74

86 KIT 疫苗 / 其他免疫製劑 ACTHIB (PF) INTRAMUSCULAR 2 $0 MO RECON SOLN ADACEL(TDAP ADOLESN/ADULT)(PF) 2 $0 MO INTRAMUSCULAR SUSPENSION ADACEL(TDAP ADOLESN/ADULT)(PF) 2 $0 MO INTRAMUSCULAR SYRINGE BCG VACCINE, LIVE (PF) 2 $0 B/D PA PERCUTANEOUS SUSPENSION FOR RECONSTITUTION BOOSTRIX TDAP INTRAMUSCULAR 2 $0 MO SUSPENSION BOOSTRIX TDAP INTRAMUSCULAR 2 $0 MO SYRINGE CERVARIX VACCINE (PF) 2 $0 MO INTRAMUSCULAR SYRINGE COMVAX (PF) INTRAMUSCULAR 2 $0 MO SUSPENSION DAPTACEL (DTAP PEDIATRIC) (PF) 2 $0 MO INTRAMUSCULAR SUSPENSION ENGERIX-B (PF) INTRAMUSCULAR 2 $0 B/D PA; MO SUSPENSION ENGERIX-B (PF) INTRAMUSCULAR 2 $0 B/D PA; MO SYRINGE ENGERIX-B PEDIATRIC (PF) 2 $0 B/D PA; MO INTRAMUSCULAR SUSPENSION ENGERIX-B PEDIATRIC (PF) 2 $0 B/D PA INTRAMUSCULAR SYRINGE fomepizole intravenous solution 1 $0 B/D PA; MO GAMMAGARD LIQUID 2 $0 PA; MO SOLUTION GAMUNEX-C INJECTION SOLUTION 1 2 $0 PA; MO GRAM/10 ML (10 %) GARDASIL (PF) INTRAMUSCULAR 2 $0 MO SUSPENSION GARDASIL (PF) INTRAMUSCULAR SYRINGE 2 $0 MO 75

87 HAVRIX (PF) INTRAMUSCULAR 2 $0 B/D PA; MO SUSPENSION HAVRIX (PF) INTRAMUSCULAR 2 $0 B/D PA; MO SYRINGE 1,440 ELISA UNIT/ML HAVRIX (PF) INTRAMUSCULAR 2 $0 B/D PA SYRINGE 720 ELISA UNIT/0.5 ML IMOVAX RABIES VACCINE (PF) 2 $0 MO INTRAMUSCULAR RECON SOLN INFANRIX (DTAP) (PF) 2 $0 INTRAMUSCULAR SUSPENSION INFANRIX (DTAP) (PF) 2 $0 MO INTRAMUSCULAR SYRINGE IPOL INJECTION SUSPENSION 2 $0 MO IPOL INJECTION SYRINGE 2 $0 MO IXIARO (PF) INTRAMUSCULAR 2 $0 MO SYRINGE M-M-R II (PF) SUBCUTANEOUS 2 $0 MO RECON SOLN MENACTRA (PF) INTRAMUSCULAR 2 $0 MO SOLUTION MENOMUNE - A/C/Y/W $0 SUBCUTANEOUS RECON SOLN MENOMUNE - A/C/Y/W-135 (PF) 2 $0 MO SUBCUTANEOUS RECON SOLN MENVEO A-C-Y-W-135-DIP (PF) 2 $0 MO INTRAMUSCULAR KIT PEDVAX HIB (PF) INTRAMUSCULAR 2 $0 MO SOLUTION PROQUAD (PF) SUBCUTANEOUS 2 $0 SUSPENSION FOR RECONSTITUTION RABAVERT (PF) INTRAMUSCULAR 2 $0 MO KIT RECOMBIVAX HB (PF) 2 $0 B/D PA; MO INTRAMUSCULAR SUSPENSION 10 MCG/ML, 40 MCG/ML RECOMBIVAX HB (PF) 2 $0 B/D PA; MO INTRAMUSCULAR SYRINGE 10 MCG/ML ROTARIX ORAL SUSPENSION FOR 2 $0 76

88 RECONSTITUTION ROTATEQ VACCINE ORAL SUSPENSION tetanus toxoid,adsorbed (pf) intramuscular suspension TETANUS,DIPHTHERIA TOX PED(PF) INTRAMUSCULAR SUSPENSION TETANUS-DIPHTHERIA TOXOIDS-TD INTRAMUSCULAR SUSPENSION TWINRIX (PF) INTRAMUSCULAR SUSPENSION TWINRIX (PF) INTRAMUSCULAR SYRINGE TYPHIM VI INTRAMUSCULAR SOLUTION TYPHIM VI INTRAMUSCULAR SYRINGE VAQTA (PF) INTRAMUSCULAR SUSPENSION 25 UNIT/0.5 ML VAQTA (PF) INTRAMUSCULAR SYRINGE 25 UNIT/0.5 ML VARIVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION YF-VAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION ZOSTAVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION 肌肉骨骼 / 風濕病藥物 痛風治療 2 $0 1 $0 B/D PA; MO 2 $0 MO 2 $0 B/D PA; MO 2 $0 B/D PA; MO 2 $0 B/D PA; MO 2 $0 2 $0 MO 2 $0 B/D PA; MO 2 $0 B/D PA 2 $0 MO 2 $0 MO 2 $0 MO; QL (1 para 365 días) allopurinol oral tablet 1 $0 MO colchicine-probenecid oral tablet 1 $0 MO COLCRYS ORAL TABLET 2 $0 MO probenecid oral tablet 1 $0 MO ULORIC ORAL TABLET 2 $0 MO 骨質疏鬆症治療 alendronate oral solution 1 $0 MO; QL( 每 30 天 375 單 位 ) 77

89 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障 / 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請 造訪 alendronate oral tablet 10 mg, 5 mg 1 $0 MO; QL( 每 30 天 30 單位 ) alendronate oral tablet 35 mg, 70 mg 1 $0 MO; QL( 每 30 天 5 單位 ) FORTEO SUBCUTANEOUS PEN INJECTOR 78 2 $0 MO; QL( 每 28 天 2.4 單 位 ) ibandronate oral tablet 1 $0 MO; QL( 每 30 天 1 單位 ) PROLIA SUBCUTANEOUS SYRINGE 2 $0 B/D PA; MO raloxifene oral tablet 1 $0 MO risedronate oral tablet 1 $0 MO 其他風濕病藥物 ACTEMRA SOLUTION 2 $0 B/D PA; ST; MO 200 MG/10 ML (20 MG/ML) BENLYSTA RECON 2 $0 B/D PA; MO SOLN 120 MG CUPRIMINE ORAL CAPSULE 2 $0 MO DEPEN TITRATABS ORAL TABLET 2 $0 PA; MO ENBREL SUBCUTANEOUS KIT 2 $0 MO; QL( 每 28 天 8 單位 ) ENBREL SUBCUTANEOUS SYRINGE 25 MG/0.5ML (0.51) ENBREL SUBCUTANEOUS SYRINGE 50 MG/ML (0.98 ML) ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR HUMIRA SUBCUTANEOUS KIT 20 MG/0.4 ML HUMIRA SUBCUTANEOUS KIT 40 MG/0.8 ML HUMIRA CROHN'S DIS START PCK SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PSORIASIS STARTER PACK SUBCUTANEOUS PEN INJECTOR KIT 2 $0 MO; QL( 每 28 天 4 單位 ) 2 $0 MO; QL( 每 28 天 8 單位 ) 2 $0 MO; QL( 每 28 天 8 單位 ) 2 $0 MO; QL( 每 28 天 1.6 單 位 ) 2 $0 MO; QL( 每 28 天 4.8 單 位 ) 2 $0 MO; QL( 每 180 天 4.8 單 位 ) 2 $0 MO; QL( 每 28 天 1.6 單 位 ) 2 $0 MO; QL( 每 21 天 3.2 單 位 ) leflunomide oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) SAVELLA ORAL TABLET 2 $0 MO; QL( 每 30 天 60 單位 ) SAVELLA ORAL TABLETS,DOSE PACK 2 $0 MO; QL( 每 30 天 60 單位 )

90 婦產科藥物 雌激素 / 孕激素 camila oral tablet 1 $0 MO COMBIPATCH TRANSDERMAL 2 $0 MO PATCH SEMIWEEKLY DEPO-PROVERA INTRAMUSCULAR 2 $0 B/D PA; MO SOLUTION DEPO-SUBQ PROVERA $0 MO SUBCUTANEOUS SYRINGE errin oral tablet 1 $0 MO ESTRACE VAGINAL CREAM 2 $0 MO estradiol oral tablet 1 $0 PA; MO estradiol transdermal patch weekly 1 $0 MO estradiol valerate intramuscular oil 1 $0 B/D PA; MO heather oral tablet 1 $0 MO jencycla oral tablet 1 $0 MO jolivette oral tablet 1 $0 MO lyza oral tablet 1 $0 medroxyprogesterone intramuscular 1 $0 MO; QL( 每 90 天 1 單位 ) suspension medroxyprogesterone intramuscular syringe 1 $0 MO; QL( 每 90 天 1 單位 ) medroxyprogesterone oral tablet 1 $0 MO norethindrone (contraceptive) oral tablet 1 $0 MO norethindrone acetate oral tablet 1 $0 MO PREMARIN INJECTION RECON SOLN 2 $0 B/D PA; MO PREMARIN VAGINAL CREAM 2 $0 MO progesterone micronized oral capsule 1 $0 MO VAGIFEM VAGINAL TABLET 2 $0 MO VIVELLE-DOT TRANSDERMAL PATCH 2 $0 MO SEMIWEEKLY 其他婦產科藥物 3 DAY VAGINAL VAGINAL CREAM 4 $0 * 3-DAY VAGINAL VAGINAL CREAM 4 $0 * CLEOCIN VAGINAL SUPPOSITORY 2 $0 MO clindamycin phosphate vaginal cream 1 $0 MO 79

91 clotrimazole vaginal cream 4 $0 MO; * metronidazole vaginal gel 1 $0 MO miconazole nitrate vaginal comb 4 $0 *; QL( 每 30 天 24 單位 ) pack,prefill appl & cream miconazole nitrate vaginal cream 4 $0 MO; *; QL( 每 30 天 45 單位 ) miconazole nitrate vaginal kit 4 $0 *; QL( 每 30 天 1 單位 ) miconazole nitrate vaginal suppository 4 $0 *; QL( 每 30 天 7 單位 ) MICONAZOLE-3 VAGINAL KIT 4 $0 *; QL( 每 30 天 24 單位 ) miconazole-3 vaginal suppository 1 $0 MO; QL( 每 3 天 3 單位 ) NUVARING VAGINAL RING 2 $0 MO ORTHO EVRA TRANSDERMAL PATCH 2 $0 MO WEEKLY terconazole vaginal cream 0.4 % 1 $0 MO; QL ( 每 7 天 45 單位 ) terconazole vaginal cream 0.8 % 1 $0 MO terconazole vaginal suppository 1 $0 MO; QL( 每 3 天 3 單位 ) tioconazole vaginal ointment 4 $0 * tranexamic acid oral tablet 1 $0 MO vandazole vaginal gel 1 $0 MO 口服避孕藥 / 相關製劑 altavera (28) oral tablet 1 $0 MO alyacen 1/35 (28) oral tablet 1 $0 MO alyacen 7/7/7 (28) oral tablet 1 $0 MO amethia oral tablets,dose pack,3 month 1 $0 MO amethia lo oral tablets,dose pack,3 month 1 $0 MO amethyst oral tablet 1 $0 MO apri oral tablet 1 $0 MO aranelle (28) oral tablet 1 $0 MO aubra oral tablet 1 $0 MO aviane oral tablet 1 $0 MO azurette (28) oral tablet 1 $0 MO balziva (28) oral tablet 1 $0 MO briellyn oral tablet 1 $0 MO camrese oral tablets,dose pack,3 month 1 $0 MO camrese lo oral tablets,dose pack,3 month 1 $0 MO 80

92 CAZIANT (28) ORAL TABLET 2 $0 MO chateal oral tablet 1 $0 MO cryselle (28) oral tablet 1 $0 MO cyclafem 1/35 (28) oral tablet 1 $0 MO cyclafem 7/7/7 (28) oral tablet 1 $0 MO dasetta 1/35 (28) oral tablet 1 $0 MO dasetta 7/7/7 (28) oral tablet 1 $0 MO daysee oral tablets,dose pack,3 month 1 $0 MO elinest oral tablet 1 $0 MO ELLA ORAL TABLET 2 $0 MO emoquette oral tablet 1 $0 MO enpresse oral tablet 1 $0 MO enskyce oral tablet 1 $0 MO estarylla oral tablet 1 $0 MO falmina (28) oral tablet 1 $0 MO gildess oral tablet 1 $0 MO gildess fe oral tablet 1 $0 MO introvale oral tablets,dose pack,3 month 1 $0 MO jolessa oral tablets,dose pack,3 month 1 $0 MO junel 1.5/30 (21) oral tablet 1 $0 MO junel 1/20 (21) oral tablet 1 $0 MO junel fe 1.5/30 (28) oral tablet 1 $0 MO junel fe 1/20 (28) oral tablet 1 $0 MO kariva (28) oral tablet 1 $0 MO kelnor 1/35 (28) oral tablet 1 $0 MO kurvelo oral tablet 1 $0 MO l norgest&e estradiol-e estrad oral 1 $0 MO tablets,dose pack,3 month lessina oral tablet 1 $0 MO levonorgestrel oral tablet 0.75 mg 3 $0 * levonorgestrel oral tablet 1.5 mg 1 $0 levonorgestrel-ethinyl estrad oral tablet $0 20 mg-mcg levonorgestrel-ethinyl estrad oral tablet mg-mcg 1 $0 MO 81

93 levonorgestrel-ethinyl estrad oral 1 $0 MO tablets,dose pack,3 month levora-28 oral tablet 1 $0 MO low-ogestrel (28) oral tablet 1 $0 MO lutera (28) oral tablet 1 $0 MO marlissa oral tablet 1 $0 MO microgestin 1.5/30 (21) oral tablet 1 $0 MO microgestin 1/20 (21) oral tablet 1 $0 MO microgestin fe 1.5/30 (28) oral tablet 1 $0 MO microgestin fe 1/20 (28) oral tablet 1 $0 MO mono-linyah oral tablet 1 $0 MO mononessa (28) oral tablet 1 $0 MO myzilra oral tablet 1 $0 MO necon 0.5/35 (28) oral tablet 1 $0 MO necon 1/35 (28) oral tablet 1 $0 MO necon 10/11 (28) oral tablet 1 $0 MO necon 7/7/7 (28) oral tablet 1 $0 MO NEXT CHOICE ONE DOSE ORAL 3 $0 * TABLET norgestimate-ethinyl estradiol oral tablet 1 $0 MO nortrel 0.5/35 (28) oral tablet 1 $0 MO nortrel 1/35 (21) oral tablet 1 $0 MO nortrel 1/35 (28) oral tablet 1 $0 MO nortrel 7/7/7 (28) oral tablet 1 $0 MO ogestrel (28) oral tablet 1 $0 MO orsythia oral tablet 1 $0 MO ORTHO TRI-CYCLEN LO (28) ORAL 2 $0 MO TABLET philith oral tablet 1 $0 MO pirmella oral tablet 1 $0 MO portia oral tablet 1 $0 MO previfem oral tablet 1 $0 MO quasense oral tablets,dose pack,3 month 1 $0 MO reclipsen (28) oral tablet 1 $0 MO sprintec (28) oral tablet 1 $0 MO sronyx oral tablet 1 $0 MO 82

94 syeda oral tablet 1 $0 MO tilia fe oral tablet 1 $0 MO tri-estarylla oral tablet 1 $0 MO tri-legest fe oral tablet 1 $0 MO tri-linyah oral tablet 1 $0 MO tri-previfem (28) oral tablet 1 $0 MO tri-sprintec (28) oral tablet 1 $0 MO trinessa (28) oral tablet 1 $0 MO trivora (28) oral tablet 1 $0 MO velivet triphasic regimen (28) oral tablet 1 $0 MO vestura (28) oral tablet 1 $0 MO viorele (28) oral tablet 1 $0 MO wera (28) oral tablet 1 $0 MO wymzya fe oral tablet,chewable 1 $0 MO zarah oral tablet 1 $0 MO zenchent (28) oral tablet 1 $0 MO zenchent fe oral tablet,chewable 1 $0 MO zeosa oral tablet,chewable 1 $0 MO zovia 1/35e (28) oral tablet 1 $0 MO zovia 1/50e (28) oral tablet 1 $0 MO 催產藥 METHYLERGONOVINE INJECTION 2 $0 B/D PA; MO SOLUTION methylergonovine oral tablet 1 $0 MO 眼科藥物 抗生素 ak-poly-bac ophthalmic ointment 1 $0 MO AZASITE OPHTHALMIC DROPS 2 $0 MO bacitracin ophthalmic ointment 1 $0 MO bacitracin-polymyxin b ophthalmic ointment 1 $0 MO CILOXAN OPHTHALMIC OINTMENT 2 $0 MO ciprofloxacin ophthalmic drops 1 $0 MO erythromycin ophthalmic ointment 1 $0 MO garamycin ophthalmic drops 1 $0 gatifloxacin ophthalmic drops 1 $0 MO 83

95 gentak ophthalmic drops 1 $0 MO gentak ophthalmic ointment 1 $0 MO gentamicin ophthalmic drops 1 $0 MO gentamicin ophthalmic ointment 1 $0 levofloxacin ophthalmic drops 1 $0 MO NATACYN OPHTHALMIC 2 $0 MO DROPS,SUSPENSION neo-polycin ophthalmic ointment 1 $0 neomycin-bacitracin-polymyxin ophthalmic 1 $0 MO ointment neomycin-polymyxin-gramicidin ophthalmic 1 $0 MO drops ofloxacin ophthalmic drops 1 $0 MO polycin ophthalmic ointment 1 $0 polymyxin b sulf-trimethoprim ophthalmic 1 $0 MO drops tobramycin ophthalmic drops 1 $0 MO TOBREX OPHTHALMIC OINTMENT 2 $0 MO VIGAMOX OPHTHALMIC DROPS 2 $0 MO 抗病毒藥物 trifluridine ophthalmic drops 1 $0 MO ZIRGAN OPHTHALMIC GEL 2 $0 MO 貝他受體阻斷劑 betaxolol ophthalmic drops 1 $0 MO BETIMOL OPHTHALMIC DROPS 0.25 % 2 $0 MO BETOPTIC S OPHTHALMIC 2 $0 MO DROPS,SUSPENSION carteolol ophthalmic drops 1 $0 MO levobunolol ophthalmic drops 1 $0 MO metipranolol ophthalmic drops 1 $0 MO timolol maleate ophthalmic drops 1 $0 MO timolol maleate ophthalmic gel forming 1 $0 MO solution 膽鹼酯酶抑製劑 / 縮瞳劑 PHOSPHOLINE IODIDE OPHTHALMIC DROPS 2 $0 MO 84

96 睫狀肌散瞳劑 cyclopentolate ophthalmic drops 1 % 1 $0 MO cyclopentolate ophthalmic drops 2 % 1 $0 tropicamide ophthalmic drops 1 $0 MO 直接作用縮瞳劑 pilocarpine hcl ophthalmic drops 1 $0 MO 其他眼科藥物 AKWA TEARS OPHTHALMIC 4 $0 MO; * OINTMENT AKWA TEARS (POLYVINYL 4 $0 MO; * ALCOHOL) OPHTHALMIC DROPS ALAWAY OPHTHALMIC DROPS 4 $0 MO; * ARTIFICIAL TEARS OPHTHALMIC 4 $0 * DROPS ARTIFICIAL TEARS (PETRO/MIN) 4 $0 * OPHTHALMIC OINTMENT azelastine ophthalmic drops 1 $0 MO cromolyn ophthalmic drops 1 $0 MO epinastine ophthalmic drops 1 $0 MO LASTACAFT OPHTHALMIC DROPS 2 $0 MO MURO 128 OPHTHALMIC DROPS 4 $0 MO; * MURO 128 OPHTHALMIC OINTMENT 4 $0 MO; * NATURAL BALANCE OPHTHALMIC 4 $0 MO; * DROPS PATADAY OPHTHALMIC DROPS 2 $0 ST; MO PATANOL OPHTHALMIC DROPS 2 $0 ST; MO proparacaine ophthalmic drops 1 $0 MO REFRESH CLASSIC (PF) OPHTHALMIC 4 $0 MO; * DROPPERETTE REFRESH OPTIVE SENSITIVE (PF) 4 $0 MO; * OPHTHALMIC DROPPERETTE RESTASIS OPHTHALMIC 2 $0 MO; QL( 每 30 天 60 單位 ) DROPPERETTE SYSTANE GEL OPHTHALMIC 4 $0 MO; * DROPS,GEL TEARS PURE OPHTHALMIC DROPS 4 $0 * 85

97 非類固醇消炎劑 bromfenac ophthalmic drops 1 $0 MO diclofenac sodium ophthalmic drops 1 $0 MO flurbiprofen sodium ophthalmic drops 1 $0 MO ketorolac ophthalmic drops 1 $0 MO 治療青光眼口服藥物 acetazolamide oral capsule, extended 1 $0 MO release acetazolamide oral tablet 1 $0 MO acetazolamide sodium injection recon soln 1 $0 methazolamide oral tablet 1 $0 MO 其他青光眼藥物 AZOPT OPHTHALMIC 2 $0 MO DROPS,SUSPENSION COMBIGAN OPHTHALMIC DROPS 2 $0 MO dorzolamide ophthalmic drops 1 $0 MO dorzolamide-timolol ophthalmic drops 1 $0 MO latanoprost ophthalmic drops 1 $0 MO LUMIGAN OPHTHALMIC DROPS 2 $0 MO; QL( 每 30 天 2.5 單位 ) travoprost (benzalkonium) ophthalmic drops 1 $0 MO 類固醇抗生素合劑 neo-polycin hc ophthalmic ointment 1 $0 neomycin-bacitracin-poly-hc ophthalmic 1 $0 MO ointment neomycin-polymyxin-dexameth ophthalmic 1 $0 MO drops,suspension neomycin-polymyxin-dexameth ophthalmic 1 $0 MO ointment neomycin-polymyxin-hc ophthalmic 1 $0 MO drops,suspension tobramycin-dexamethasone ophthalmic drops,suspension 1 $0 MO 類固醇 ALREX OPHTHALMIC DROPS,SUSPENSION 2 $0 MO 86

98 dexamethasone sodium phosphate 1 $0 MO ophthalmic drops fluorometholone ophthalmic 1 $0 MO drops,suspension FML S.O.P. OPHTHALMIC OINTMENT 2 $0 MO prednisolone acetate ophthalmic 1 $0 MO drops,suspension prednisolone sodium phosphate ophthalmic 1 $0 MO drops 類固醇磺酰胺合劑 BLEPHAMIDE S.O.P. OPHTHALMIC OINTMENT sulfacetamide-prednisolone ophthalmic drops 磺胺類藥物 2 $0 MO 1 $0 MO sulfacetamide sodium ophthalmic drops 1 $0 MO sulfacetamide sodium ophthalmic ointment 1 $0 MO 擬交感神經藥物 ALPHAGAN P OPHTHALMIC DROPS 2 $0 MO 0.1 % apraclonidine ophthalmic drops 1 $0 MO brimonidine ophthalmic drops 1 $0 MO 血管收縮劑 / 解充血藥 naphazoline ophthalmic drops 1 $0 MO 呼吸和過敏 抗組織胺劑 / 抗過敏藥物 12 HOUR DECONGESTANT ORAL TABLET EXTENDED RELEASE ADT ROBITUSSIN PEAK CLD DM MAX ORAL LIQUID ADULT ROBITUSSIN LINGERING CLD ORAL SYRUP ADULT ROBITUSSIN M-S COLD ORAL LIQUID ADULT ROBITUSSIN NASAL RELIEF ORAL TABLET 4 $0 * 4 $0 * 4 $0 * 4 $0 * 4 $0 MO; * 87

99 ADULT ROBITUSSIN NIGHT M-S CLD 4 $0 * ORAL LIQUID ADULT ROBITUSSIN PEAK COLD M-S 4 $0 * ORAL LIQUID ADVIL COLD & SINUS ORAL 4 $0 MO; * CAPSULE ADVIL COLD & SINUS ORAL TABLET 4 $0 * ALA-HIST IR ORAL TABLET 4 $0 MO; * ALA-HIST PE ORAL TABLET 4 $0 MO; * ALAVERT ORAL TABLET,DISINTEGRATING 4 $0 MO; *; QL( 每 30 天 34 單位 ) ALAVERT D-12 ALLERGY-SINUS ORAL TABLET EXTENDED RELEASE 12 HR 4 $0 MO; *; QL( 每 30 天 68 單 位 ) ALDEX GS ORAL TABLET 4 $0 * ALL DAY ALLERGY (CETIRIZINE) 4 $0 * ORAL SOLUTION ALL DAY ALLERGY (CETIRIZINE) ORAL TABLET 4 $0 MO; *; QL( 每 30 天 34 單位 ) ALL DAY ALLERGY-D ORAL TABLET EXTENDED RELEASE 12 HR 4 $0 MO; *; QL( 每 30 天 68 單 位 ) ALLER-CHLOR ORAL SYRUP 4 $0 MO; * ALLER-CHLOR ORAL TABLET 4 $0 * ALLER-EASE ORAL TABLET 180 MG 4 $0 *; QL( 每 30 天 34 單位 ) ALLER-EASE ORAL TABLET 60 MG 4 $0 *; QL( 每 30 天 68 單位 ) ALLERCLEAR ORAL TABLET 4 $0 *; QL( 每 30 天 34 單位 ) ALLERCLEAR D-24HR ORAL TABLET EXTENDED RELEASE 24 HR ALLERGY (DIPHENHYDRAMINE) 4 $0 * ORAL CAPSULE ALLERGY (DIPHENHYDRAMINE) 4 $0 * ORAL TABLET ALLERGY MULTI-SYMPTOM ORAL 4 $0 * TABLET ALLERGY RELIEF (LORATADINE) 4 $0 * ORAL SOLUTION ALLERHIST-1 ORAL TABLET 4 $0 * 4 $0 MO; *; QL( 每 30 天 34 單 位 ) 88

100 ALLFEN DM ORAL TABLET 4 $0 MO; * APRODINE ORAL TABLET 4 $0 MO; * benzonatate oral capsule 3 $0 MO; * BICLORA ORAL LIQUID 4 $0 * BICLORA ORAL TABLET 4 $0 * BP 8 COUGH ORAL SUSPENSION 4 $0 * BROHIST D ORAL TABLET 4 $0 * brompheniramin-phenylephrin-dm oral 4 $0 * liquid mg/5 ml brompheniramine-pseudoeph-dm oral 4 $0 * liquid mg/5 ml brompheniramine-pseudoeph-dm oral syrup 4 $0 * BROTAPP ORAL LIQUID 4 $0 MO; * BROTAPP DM ORAL ELIXIR 4 $0 * CAPMIST DM ORAL TABLET $0 MO; * MG CARDEC ORAL DROPS 4 $0 * cetirizine oral solution 1 mg/ml 1 $0 MO cetirizine oral tablet 5 mg 4 $0 MO; *; QL( 每 30 天 34 單位 ) cetirizine oral tablet,chewable 10 mg 4 $0 MO; *; QL( 每 30 天 34 單 位 ) cetirizine oral tablet,chewable 5 mg 4 $0 *; QL( 每 30 天 34 單位 ) CHEST CONGESTION RELIEF ORAL 4 $0 * TABLET CHEST CONGESTION RELIEF PE ORAL 4 $0 * TABLET CHILD ALLERGY RELIEF (DIPHEN) 4 $0 * ORAL TABLET,DISINTEGRATING CHILD DELSYM NIGHTTIME C-C 4 $0 * ORAL LIQUID CHILD MUCUS RELIEF COUGH ORAL 4 $0 * LIQUID CHILD MUCUS RELIEF 4 $0 * EXPECTORANT ORAL LIQUID CHILD WAL-TAP COLD-ALLERGY 4 $0 * 89

101 ORAL SOLUTION CHILD'S BENADRYL-D ALLERGY-SIN ORAL SOLUTION CHILDREN'S ALLEGRA ALLERGY ORAL SUSPENSION CHILDREN'S ALLERGY (DIPHENHYD) ORAL TABLET,DISINTEGRATING CHILDREN'S CLARITIN ORAL TABLET,CHEWABLE 4 $0 * 4 $0 MO; * 4 $0 * 4 $0 MO; *; QL( 每 30 天 34 單 位 ) CHILDREN'S COLD & COUGH DM 4 $0 * ORAL SOLUTION CHILDREN'S DIMETAPP COLD &FLU 4 $0 * ORAL LIQUID CHILDREN'S MUCINEX COLD-FEVER 4 $0 * ORAL LIQUID CHILDREN'S MUCINEX MULTI-SYMP 4 $0 * ORAL LIQUID CHILDREN'S SILFEDRINE ORAL 4 $0 * LIQUID CHILDREN'S WAL-DRYL ALLERGY 4 $0 * ORAL TABLET,DISINTEGRATING CHILDRENS PLUS COLD ORAL 4 $0 * SUSPENSION CHLO TUSS EX ORAL LIQUID 4 $0 * chlorpheniramine maleate oral tablet 4 $0 MO; * extended release CLARINEX ORAL SYRUP 2 $0 MO CLARITIN LIQUI-GEL ORAL CAPSULE 4 $0 MO; *; QL( 每 30 天 34 單位 ) CLARITIN REDITABS ORAL 4 $0 MO; * TABLET,DISINTEGRATING 5 MG clemastine oral syrup 1 $0 PA; MO clemastine oral tablet 2.68 mg 1 $0 PA; MO CLOFERA ORAL LIQUID 4 $0 * CODITUSS DM ORAL LIQUID 4 $0 MO; * COLD & ALLERGY PE ORAL TABLET 4 $0 * COLD HEAD CONGESTION DAY/NITE ORAL TABLETS, SEQUENTIAL 4 $0 * 90

102 COLD HEAD CONGESTION DAYTIME 4 $0 * ORAL TABLET COLD HEAD CONGESTION 4 $0 * NIGHTTIME ORAL TABLET COLD HEAD CONGESTION SEVER 4 $0 * DAY ORAL TABLET CONEX ORAL SOLUTION 4 $0 * CONEX ORAL TABLET 4 $0 * CONGESTAC ORAL TABLET 4 $0 * CORFEN-DM ORAL LIQUID 4 $0 MO; * COUGH DM ER ORAL 4 $0 * SUSPENSION,EXTENDED REL 12 HR COUGH SUPPRESSANT- 4 $0 * EXPECTORANT ORAL SYRUP COUGHTAB ORAL TABLET 4 $0 * cyproheptadine oral syrup 1 $0 PA; MO cyproheptadine oral tablet 1 $0 PA; MO DALLERGY (CHLORCYCLIZINE-PE) 4 $0 MO; * ORAL LIQUID DAYTIME COLD & FLU RELIEF ORAL 4 $0 * CAPSULE DAYTIME COLD-FLU ORAL LIQUID 4 $0 * DE-CHLOR DM ORAL SYRUP 4 $0 MO; * DELSYM COUGH & COLD ORAL 4 $0 * LIQUID DELSYM MULTI-SYMPTOM ORAL 4 $0 * LIQUID DELSYM NIGHTTIME MULTI- 4 $0 * SYMPTOM ORAL LIQUID desloratadine oral tablet 1 $0 MO desloratadine oral tablet,disintegrating 1 $0 MO DICEL CD ORAL LIQUID 4 $0 * DIMETANE-DX ORAL SYRUP 4 $0 * DIMETAPP LONG-ACTING (CPM-DM) 4 $0 * ORAL LIQUID DIPHENHIST ORAL TABLET 50 MG 4 $0 * diphenhydramine hcl injection solution 1 $0 B/D PA; MO 91

103 diphenhydramine hcl oral capsule 50 mg 4 $0 MO; * ED A-HIST ORAL LIQUID 4 $0 MO; * ED BRON GP ORAL LIQUID 4 $0 * ED CHLORPED D ORAL DROPS 4 $0 * ED-CHLORPED ORAL DROPS 4 $0 * ENDACOF - DM ORAL SOLUTION 4 $0 * ENTRE-COUGH ORAL LIQUID 4 $0 * epinephrine injection auto-injector 0.3 mg/0.3 ml (1:1,000) 1 $0 B/D PA; MO; QL( 每 2 天 4 單位 ) epinephrine injection solution 1 mg/ml 1 $0 B/D PA; MO (1:1,000) epinephrine injection syringe 1 $0 B/D PA; MO epinephrine (pf) injection solution 1 $0 B/D PA; MO EPIPEN 2-PAK INJECTION AUTO- 2 $0 MO; QL( 每 2 天 4 單位 ) INJECTOR EPIPEN JR 2-PAK INJECTION AUTO- 2 $0 MO; QL( 每 2 天 4 單位 ) INJECTOR EXEFEN DMX ORAL TABLET 4 $0 * EXEFEN-IR ORAL TABLET 4 $0 * FLU & SORE THROAT ORAL PACKET 4 $0 * guaifenesin oral tablet extended release 4 $0 MO; * HIST-PSE ORAL LIQUID 4 $0 * hydroxyzine hcl intramuscular solution 1 $0 B/D PA; MO IBUPROFEN COLD ORAL SUSPENSION 4 $0 * KIDKARE COUGH/COLD ORAL 4 $0 * LIQUID levocetirizine oral solution 1 $0 MO levocetirizine oral tablet 1 $0 MO; QL( 每 30 天 30 單位 ) LOHIST - D ORAL LIQUID 4 $0 MO; * LOHIST-PEB ORAL LIQUID 4 $0 * LORTUSS DM ORAL LIQUID 4 $0 MO; * LORTUSS LQ ORAL LIQUID 4 $0 * M-END DMX ORAL LIQUID 4 $0 * MUCINEX ORAL TABLET,ER 4 $0 MO; * BIPHASIC 12 HR 1,200 MG MUCINEX COLD & SINUS ORAL 4 $0 * 92

104 LIQUID MUCINEX COUGH MINI-MELTS ORAL 4 $0 MO; * GRANULES IN PACKET MUCINEX D ORAL TABLET 4 $0 MO; * EXTENDED RELEASE 12 HR MUCINEX D MAXIMUM STRENGTH 4 $0 MO; * ORAL TABLET EXTENDED RELEASE 12 HR MUCINEX DM ORAL TABLET 4 $0 MO; * EXTENDED RELEASE 12 HR MUCINEX DM ORAL TABLET, ER 4 $0 MO; * MULTIPHASE 12 HR MUCINEX MINI-MELTS ORAL 4 $0 * GRANULES IN PACKET 100 MG MUCINEX MINI-MELTS ORAL 4 $0 MO; * GRANULES IN PACKET 50 MG NASAL DECONGESTANT ORAL 4 $0 * LIQUID NASAL DECONGESTANT ORAL 4 $0 * TABLET NASAL DECONGESTANT (PE) ORAL 4 $0 * TABLET NIGHT-TIME ORAL LIQUID 4 $0 * NIGHTTIME COUGH ORAL SOLUTION 4 $0 * NIGHTTIME SINUS ORAL CAPSULE 4 $0 * NOREL AD ORAL TABLET 4 $0 MO; * NOREL CS ORAL LIQUID 4 $0 * PEDIATEX TDM ORAL LIQUID 4 $0 * PRIMATENE ASTHMA ORAL TABLET 4 $0 MO; * PRO-CHLO ORAL LIQUID 4 $0 * pseudoephedrine hcl oral liquid 4 $0 MO; * pseudoephedrine hcl oral tablet 60 mg 4 $0 * PYRIL DM ORAL SUSPENSION 4 $0 * pyrilamine-phenylephrine oral suspension 4 $0 * RESCON ORAL TABLET 4 $0 * RESCON-DM ORAL LIQUID 4 $0 MO; * ROBAFEN COUGH ORAL CAPSULE 4 $0 MO; * 93

105 ROBITUSSIN COUGH & COLD CF 4 $0 * ORAL LIQUID ROBITUSSIN LONG-ACTING ORAL 4 $0 * LIQUID ROBITUSSIN PEDIATRIC ORAL SYRUP 4 $0 MO; * RU-HIST-D (WITH PYRILAMINE) 4 $0 MO; * ORAL TABLET RYMED ORAL TABLET 4 $0 MO; * SCOT-TUSSIN DM ORAL LIQUID 4 $0 * SCOT-TUSSIN SENIOR ORAL LIQUID 4 $0 * SILPHEN DM COUGH LIQUID 10 MG/5 4 $0 * ML SILTUSSIN SA ORAL LIQUID 4 $0 MO; * SINUS CONG & PAIN DAY-NIGHT 4 $0 * ORAL TABLETS, SEQUENTIAL STAHIST AD ORAL TABLET 4 $0 MO; * SUDOGEST COLD & ALLERGY ORAL 4 $0 * TABLET THERAFLU NIGHTTIME COLD- 4 $0 * COUGH ORAL POWDER IN PACKET TRIACTING COUGH & COLD ORAL 4 $0 * LIQUID TRIAMINIC CHEST-NASAL CONGESTI 4 $0 * ORAL LIQUID TRIAMINIC COLD & COUGH (PE) 4 $0 * ORAL LIQUID TRIAMINIC COLD- ALLERGY PE 4 $0 * ORAL LIQUID TUSNEL NEW FORMULA ORAL 4 $0 * TABLET TUSNEL PEDIATRIC ORAL DROPS 4 $0 * TUSSIN CF ORAL LIQUID 4 $0 MO; * TUSSIN COUGH (DM ONLY) ORAL 4 $0 * LIQUID TUSSIN DM ORAL SYRUP 4 $0 * VICKS VAPOSTEAM LIQUID 4 $0 * VIRDEC DM ORAL DROPS 4 $0 * WAL-DRYL SEVERE ALLERGY-SINUS 4 $0 * 94

106 ORAL TABLET WAL-DRYL-D ALLERGY & SINUS 4 $0 * ORAL TABLET Z-COF I ORAL SUSPENSION 4 $0 * 肺製劑 acetylcysteine solution 1 $0 B/D PA; MO ADCIRCA ORAL TABLET 2 $0 PA; MO; QL( 每 30 天 60 單 位 ) ADVAIR DISKUS INHALATION BLISTER WITH DEVICE ADVAIR HFA INHALATION HFA AEROSOL INHALER albuterol sulfate inhalation solution for nebulization 0.63 mg/3 ml, 1.25 mg/3 ml, 2.5 mg /3 ml (0.083 %), 2.5 mg/0.5 ml albuterol sulfate inhalation solution for nebulization 5 mg/ml 2 $0 MO; QL( 每 30 天 120 單 位 ) 2 $0 MO; QL( 每 30 天 24 單位 ) 1 $0 B/D PA; MO; QL( 每 30 天 360 單位 ) 1 $0 B/D PA; MO; QL( 每 30 天 60 單位 ) albuterol sulfate oral syrup 1 $0 MO albuterol sulfate oral tablet 1 $0 MO albuterol sulfate oral tablet extended 1 $0 MO release 12 hr aminophylline intravenous solution $0 B/D PA; MO mg/10 ml aminophylline intravenous solution $0 B/D PA mg/20 ml ASMANEX TWISTHALER 2 $0 MO; QL( 每 30 天 2 單位 ) INHALATION AEROSOL POWDR BREATH ACTIVATED 110 MCG (30 DOSES), 220 MCG (120 DOSES), 220 MCG (30 DOSES), 220 MCG (60 DOSES) ASMANEX TWISTHALER 2 $0 QL( 每 30 天 2 單位 ) INHALATION AEROSOL POWDR BREATH ACTIVATED 110 MCG (7 DOSES), 220 MCG (14 DOSES) ATROVENT HFA INHALATION HFA AEROSOL INHALER 2 $0 MO; QL ( 每 30 天 26 單位 ) budesonide inhalation suspension for 1 $0 B/D PA; MO; QL( 每 30 天 95

107 nebulization 120 單位 ) budesonide nasal spray,non-aerosol 1 $0 MO CINRYZE RECON 2 $0 PA; MO SOLN COMBIVENT RESPIMAT INHALATION 2 $0 MO; QL( 每 30 天 8 單位 ) AEROSOL cromolyn inhalation solution for nebulization 1 $0 B/D PA; MO; QL( 每 30 天 240 單位 ) cromolyn nasal spray,non-aerosol 4 $0 MO; * DALIRESP ORAL TABLET 2 $0 MO DULERA INHALATION HFA AEROSOL 2 $0 MO; QL( 每 30 天 13 單位 ) INHALER ELIXOPHYLLIN ORAL ELIXIR 2 $0 MO ephedrine sulfate oral capsule 4 $0 MO; * FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 100 MCG/ACTUATION, 50 MCG/ACTUATION 2 $0 MO; QL( 每 30 天 120 單位 ) FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 250 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 110 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 220 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 44 MCG/ACTUATION 2 $0 MO; QL( 每 30 天 300 單 位 ) 2 $0 MO; QL( 每 30 天 12 單位 ) 2 $0 MO; QL( 每 30 天 36 單位 ) 2 $0 MO; QL( 每 30 天 21 單位 ) flunisolide nasal spray,non-aerosol 1 $0 MO; QL( 每 30 天 50 單位 ) fluticasone nasal spray,suspension 1 $0 MO; QL( 每 30 天 16 單位 ) FORADIL AEROLIZER INHALATION 2 $0 MO; QL( 每 30 天 60 單位 ) CAPSULE, W/INHALATION DEVICE ipratropium bromide inhalation solution 1 $0 B/D PA; MO; QL( 每 30 天 315 單位 ) ipratropium-albuterol inhalation solution for nebulization 1 $0 B/D PA; MO; QL( 每 30 天 540 單位 ) LETAIRIS ORAL TABLET 2 $0 PA; MO levalbuterol hcl inhalation solution for 1 $0 B/D PA; MO 96

108 nebulization 0.31 mg/3 ml, 0.63 mg/3 ml levalbuterol hcl inhalation solution for nebulization 1.25 mg/0.5 ml, 1.25 mg/3 ml 1 $0 B/D PA; MO; QL( 每 30 天 90 單位 ) metaproterenol oral syrup 1 $0 MO metaproterenol oral tablet 1 $0 MO montelukast oral granules in packet 1 $0 MO montelukast oral tablet 1 $0 MO montelukast oral tablet,chewable 1 $0 MO NASACORT AQ NASAL 2 $0 MO; QL( 每 30 天 17 單位 ) AEROSOL,SPRAY NASONEX NASAL SPRAY,NON- AEROSOL 2 $0 MO; QL( 每 30 天 51 單位 ) PERFOROMIST INHALATION SOLUTION FOR NEBULIZATION 2 $0 B/D PA; MO; QL( 每 30 天 120 單位 ) PROAIR HFA INHALATION HFA 2 $0 MO; QL( 每 30 天 18 單位 ) AEROSOL INHALER PROVENTIL HFA INHALATION HFA 2 $0 MO; QL( 每 30 天 20 單位 ) AEROSOL INHALER PULMOZYME INHALATION 2 $0 B/D PA; MO SOLUTION QVAR INHALATION AEROSOL 2 $0 MO; QL( 每 30 天 24 單位 ) SEREVENT DISKUS INHALATION BLISTER WITH DEVICE 2 $0 MO; QL( 每 30 天 120 單 位 ) sildenafil oral tablet 1 $0 PA; MO; QL( 每 30 天 90 單 位 ) SYMBICORT INHALATION HFA 2 $0 MO; QL( 每 30 天 20 單位 ) AEROSOL INHALER terbutaline oral tablet 1 $0 MO terbutaline subcutaneous solution 1 $0 B/D PA; MO theophylline oral solution 1 $0 theophylline oral tablet extended release 1 $0 MO theophylline oral tablet extended release 12 1 $0 MO hr TRACLEER ORAL TABLET 2 $0 PA; MO; LA triamcinolone acetonide nasal aerosol,spray 1 $0 MO; QL( 每 30 天 17 單位 ) 97

109 TUDORZA PRESSAIR INHALATION AEROSOL POWDR BREATH ACTIVATED VENTOLIN HFA INHALATION HFA AEROSOL INHALER VERAMYST NASAL SPRAY,SUSPENSION XOLAIR SUBCUTANEOUS RECON SOLN 2 $0 MO zafirlukast oral tablet 1 $0 MO 泌尿科藥物 抗膽鹼藥 / 解痙藥 2 $0 MO; QL( 每 30 天 54 單位 ) 2 $0 MO; QL( 每 30 天 20 單位 ) 2 $0 PA; MO; QL( 每 28 天 8.4 單 位 ) flavoxate oral tablet 1 $0 MO GELNIQUE TRANSDERMAL GEL IN 2 $0 ST; MO PACKET MYRBETRIQ ORAL TABLET 2 $0 MO EXTENDED RELEASE 24 HR oxybutynin chloride oral syrup 1 $0 MO oxybutynin chloride oral tablet 1 $0 MO oxybutynin chloride oral tablet extended 1 $0 MO release24hr tolterodine oral capsule,extended release 1 $0 MO 24hr tolterodine oral tablet 1 $0 MO TOVIAZ ORAL TABLET EXTENDED 2 $0 MO RELEASE 24 HR trospium oral capsule,extended release 24hr 1 $0 MO trospium oral tablet 1 $0 MO VESICARE ORAL TABLET 2 $0 MO 良性攝護腺增生 (BPH) 治療 alfuzosin oral tablet extended release 24 hr 1 $0 MO AVODART ORAL CAPSULE 2 $0 MO finasteride oral tablet 5 mg 1 $0 MO tamsulosin oral capsule,extended release 1 $0 MO 24hr 膽鹼能興奮劑 bethanechol chloride oral tablet 1 $0 MO 98

110 其他泌尿科藥物 CIALIS ORAL TABLET 2.5 MG, 5 MG 2 $0 PA; MO; QL( 每 30 天 30 單 位 ) CYSTAGON ORAL CAPSULE 2 $0 MO ELMIRON ORAL CAPSULE 2 $0 MO potassium citrate oral tablet extended 1 $0 MO release 10 meq, 5 meq 維他命, 補血劑 / 電解質 電解質 ALCALAK ORAL TABLET,CHEWABLE 4 $0 * ANTACID EXTRA-STRENGTH ORAL 4 $0 * TABLET,CHEWABLE ANTACID ULTRA STRENGTH ORAL 4 $0 * TABLET,CHEWABLE calcium acetate oral capsule 1 $0 MO calcium acetate oral tablet 1 $0 MO CALCIUM ANTACID ORAL 4 $0 * TABLET,CHEWABLE 300 MG (750 MG) calcium gluconate oral tablet 45 mg (500 4 $0 MO; * mg) eliphos oral tablet 1 $0 MO ENFALYTE ORAL SOLUTION 4 $0 * klor-con oral packet 1 $0 MO klor-con 10 oral tablet extended release 1 $0 MO klor-con 8 oral tablet extended release 1 $0 MO klor-con m10 oral tablet,er 1 $0 MO particles/crystals klor-con m15 oral tablet,er 1 $0 MO particles/crystals klor-con m20 oral tablet,er 1 $0 MO particles/crystals lactated ringers intravenous parenteral 1 $0 MO solution magnesium oxide oral tablet 420 mg 4 $0 MO; * magnesium sulfate injection solution 1 $0 B/D PA; MO magnesium sulfate injection syringe 1 $0 B/D PA 99

111 NORMOSOL-R IN 5 % DEXTROSE 2 $0 B/D PA PARENTERAL SOLUTION PEDIALYTE ORAL SOLUTION 4 $0 MO; * PEDIATRIC ELECTROLYTE ORAL 4 $0 * SOLUTION potassium bicarb & chloride oral tablet, 1 $0 MO effervescent potassium chlorid-d5-0.45%nacl 1 $0 B/D PA intravenous parenteral solution 10 meq/l, 30 meq/l, 40 meq/l potassium chlorid-d5-0.45%nacl 1 $0 B/D PA; MO intravenous parenteral solution 20 meq/l potassium chloride intravenous parenteral 1 $0 MO solution potassium chloride intravenous piggyback 1 $0 potassium chloride oral capsule, extended 1 $0 MO release potassium chloride oral liquid 1 $0 MO potassium chloride oral tablet extended 1 $0 MO release 10 meq, 8 meq potassium chloride oral tablet extended 1 $0 release 20 meq potassium chloride oral tablet,er 1 $0 MO particles/crystals potassium chloride in 0.9%nacl intravenous 1 $0 B/D PA parenteral solution potassium chloride in 5 % dex intravenous 1 $0 B/D PA parenteral solution potassium chloride in lr-d5 intravenous 1 $0 B/D PA; MO parenteral solution 20 meq/l potassium chloride in lr-d5 intravenous 1 $0 B/D PA parenteral solution 40 meq/l potassium chloride-0.45 % nacl intravenous 1 $0 parenteral solution potassium chloride-d5-0.2%nacl 1 $0 B/D PA; MO intravenous parenteral solution 20 meq/l potassium chloride-d5-0.2%nacl intravenous parenteral solution 30 meq/l, 40 1 $0 B/D PA 100

112 meq/l potassium chloride-d5-0.3%nacl 1 $0 B/D PA intravenous parenteral solution potassium chloride-d5-0.9%nacl 1 $0 B/D PA intravenous parenteral solution ringers intravenous parenteral solution 1 $0 B/D PA sodium chloride intravenous parenteral 1 $0 MO solution sodium chloride 0.45 % intravenous 1 $0 MO parenteral solution sodium chloride 0.45 % intravenous 1 $0 piggyback sodium chloride 3 % intravenous parenteral 1 $0 MO solution sodium chloride 5 % intravenous parenteral 1 $0 solution sodium lactate intravenous solution 1 $0 TITRALAC ORAL TABLET,CHEWABLE 4 $0 MO; * TPN ELECTROLYTES 2 $0 B/D PA SOLUTION TUMS ULTRA ORAL 4 $0 MO; * TABLET,CHEWABLE 其他營養製品 amino acids 15 % intravenous parenteral 1 $0 B/D solution AMINOSYN 10 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN 8.5 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN 8.5 %-ELECTROLYTES 2 $0 B/D PARENTERAL SOLUTION AMINOSYN II 10 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN II 15 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN II 7 % 2 $0 B/D 101

113 PARENTERAL SOLUTION AMINOSYN II 8.5 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN II 8.5 %-ELECTROLYTES 2 $0 B/D PARENTERAL SOLUTION AMINOSYN M 3.5 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN-HBC 7% 2 $0 B/D PARENTERAL SOLUTION AMINOSYN-PF 10 % 2 $0 B/D PARENTERAL SOLUTION AMINOSYN-PF 7 % (SULFITE-FREE) 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 5%/D15W SULFITE FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 5%/D25W SULFITE-FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 2.75%/D5W SULFIT FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 4.25%-D20W SULF-FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 4.25%-D25W SULF-FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 4.25%/D10W SULF FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX 5%-D20W(SULFITE-FREE) 2 $0 B/D PARENTERAL SOLUTION CLINIMIX E 4.25%/D25W SUL FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX E 4.25%/D5W SULF FREE 2 $0 B/D 102

114 PARENTERAL SOLUTION CLINIMIX E 5%/D15W SULFIT FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX E 5%/D20W SULFIT FREE 2 $0 B/D PARENTERAL SOLUTION CLINIMIX E 5%/D25W SULFIT FREE 2 $0 B/D PARENTERAL SOLUTION CLINISOL SF 15 % 2 $0 B/D PA; MO PARENTERAL SOLUTION electrolyte-48 in d5w intravenous 1 $0 B/D parenteral solution HEPATAMINE 8% 2 $0 B/D PARENTERAL SOLUTION HEPATASOL 8 % 2 $0 B/D PARENTERAL SOLUTION INTRALIPID 2 $0 B/D PA; MO EMULSION 20 % INTRALIPID 2 $0 B/D EMULSION 30 % IONOSOL-B IN D5W 2 $0 B/D PA PARENTERAL SOLUTION IONOSOL-MB IN D5W 2 $0 B/D PA PARENTERAL SOLUTION ISOLYTE-P IN 5 % DEXTROSE 2 $0 PARENTERAL SOLUTION ISOLYTE-S 2 $0 PARENTERAL SOLUTION LIPOSYN II 2 $0 B/D PA EMULSION liposyn iii intravenous emulsion 1 $0 B/D PA NEPHRAMINE 5.4 % 2 $0 B/D PA PARENTERAL SOLUTION NORMOSOL-M IN 5 % DEXTROSE 2 $0 B/D PA 103

115 PARENTERAL SOLUTION NORMOSOL-R PH 7.4 PARENTERAL SOLUTION PLASMA-LYTE 148 PARENTERAL SOLUTION PLASMA-LYTE A PARENTERAL SOLUTION PLASMA-LYTE-56 IN 5 % DEXTROSE PARENTERAL SOLUTION PREMASOL 10 % PARENTERAL SOLUTION PREMASOL 6 % PARENTERAL SOLUTION PROCALAMINE 3% PARENTERAL SOLUTION PROSOL 20 % PARENTERAL SOLUTION TRAVASOL 10 % PARENTERAL SOLUTION TROPHAMINE 10 % PARENTERAL SOLUTION TROPHAMINE 6% PARENTERAL SOLUTION 維他命 / 補血劑 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA; MO 2 $0 B/D PA 2 $0 B/D PA 2 $0 B/D PA ANIMAL CHEWS ORAL 4 $0 * TABLET,CHEWABLE ANIMAL SHAPES COMPLETE CHEW 4 $0 * TABLET ANIMAL SHAPES PLUS C ORAL 4 $0 * TABLET,CHEWABLE ANIMAL SHAPES PLUS IRON ORAL 4 $0 * TABLET,CHEWABLE ANTIOXIDANT FORMULA ORAL 4 $0 MO; * CAPSULE APATATE ORAL LIQUID 4 $0 MO; * AQUADEKS PEDIATRIC ORAL DROPS 4 $0 MO; * 104

116 ascorbic acid oral tablet 4 $0 * B COMPLETE ORAL TABLET 4 $0 * b complex vitamins oral capsule 4 $0 * b complex-vitamin c-folic acid oral tablet 4 $0 MO; * B-50 COMPLEX ORAL TABLET 4 $0 * EXTENDED RELEASE b-complex with vitamin c oral tablet 4 $0 * b-complex with vitamin c oral tablet 4 $0 * extended release B100 BALANCED ORAL TABLET 4 $0 * EXTENDED RELEASE BALANCED B-100 ORAL TABLET 4 $0 * beta carotene oral capsule 4 $0 MO; * BIO-D-MULSION ORAL DROPS 4 $0 * biotin oral capsule 5 mg 4 $0 * biotin oral tablet 300 mcg 4 $0 * C COMPLEX ORAL TABLET 4 $0 * EXTENDED RELEASE 1,000 MG CALCIDOL ORAL DROPS 4 $0 * CEMILL-1000 ORAL TABLET 4 $0 * CENTRUM KIDS ORAL 4 $0 MO; * TABLET,CHEWABLE CENTRUM SILVER ORAL 4 $0 MO; * TABLET,CHEWABLE CHEWABLE MULTI VITAMIN ORAL 4 $0 * TABLET,CHEWABLE cholecalciferol (vitamin d3) oral capsule 4 $0 * 10,000 unit, 400 unit cholecalciferol (vitamin d3) oral capsule 4 $0 MO; * 5,000 unit, 50,000 unit cholecalciferol (vitamin d3) oral drops 4 $0 MO; * cholecalciferol (vitamin d3) oral tablet 4 $0 MO; * 2,000 unit cholecalciferol (vitamin d3) oral 4 $0 * tablet,chewable COMPLEX B-100 ORAL TABLET EXTENDED RELEASE 4 $0 MO; * 105

117 CORVITA 150 ORAL TABLET 3 $0 MO; * cyanocobalamin (vitamin b-12) injection 3 $0 MO; * solution D3 DOTS ORAL TABLET 4 $0 * DAILY MULTIPLE ORAL TABLET 4 $0 * DAILY VITAMIN WITH IRON ORAL 4 $0 * TABLET DECARA ORAL CAPSULE 25,000 UNIT 4 $0 MO; * DELTA D3 ORAL TABLET 4 $0 MO; * DEXFERRUM 3 $0 MO; * SOLUTION 100 MG/2 ML (50 MG/ML) DIALYVITE 800 WITH ZINC 50 ORAL 4 $0 MO; * TABLET DINO-LIFE WITH IRON-ZINC ORAL 4 $0 * TABLET,CHEWABLE ECEE PLUS ORAL TABLET 4 $0 MO; * ELDERTONIC ORAL ELIXIR 4 $0 MO; * ergocalciferol (vitamin d2) oral drops 4 $0 MO; * FER-IN-SOL ORAL DROPS 4 $0 MO; * FER-IRON ORAL DROPS 4 $0 * ferrous sulfate oral liquid 4 $0 MO; * ferrous sulfate oral solution 4 $0 MO; * ferrous sulfate oral tablet 4 $0 MO; * ferrous sulfate oral tablet,delayed release 4 $0 MO; * (dr/ec) FLINTSTONES PLUS CALCIUM ORAL 4 $0 * TABLET,CHEWABLE FOLGARD ORAL TABLET 4 $0 MO; * folic acid injection solution 3 $0 MO; * folic acid oral tablet 1 mg 3 $0 MO; * folic acid oral tablet 400 mcg, 800 mcg 4 $0 MO; * FOLTABS 800 ORAL TABLET 4 $0 MO; * FORMULA E 400 ORAL CAPSULE 4 $0 * GERIATON ORAL LIQUID 4 $0 * HALLS DEFENSE ORAL LOZENGE 4 $0 * HIGH POTENCY IRON ORAL TABLET 4 $0 * HONEY BEARS ORAL 4 $0 * 106

118 TABLET,CHEWABLE hydroxocobalamin intramuscular solution 3 $0 MO; * ICAPS ORAL TABLET EXTENDED 4 $0 MO; * RELEASE IROMIN-G MG 4 $0 * IRON (FERROUS SULFATE) ORAL 4 $0 * TABLET K-PAX IMMUNE SUPPORT ORAL 4 $0 * TABLET MULTI-DELYN ORAL LIQUID 4 $0 MO; * MULTI-DELYN WITH IRON ORAL 4 $0 * LIQUID MYKIDZ IRON ORAL SUSPENSION 10-4 $0 * 1, MG -UNIT-UNIT/2 ML NAIL-EX 2.5 MG TABLET 4 $0 * NATURAL B-100 COMPLEX ORAL 4 $0 * TABLET NEPHRONEX ORAL LIQUID 4 $0 * OCUVITE EXTRA TABLET 4 $0 * ONE DAILY WOMEN'S HEALTH ORAL 4 $0 * TABLET ONE-A-DAY MEN'S MULTIVITAMIN 4 $0 MO; * ORAL TABLET ONE-A-DAY WOMENS FORMULA 4 $0 MO; * ORAL TABLET 18 MG IRON-400 MCG- 500 MG CA pantothenic acid oral tablet 4 $0 MO; * POLY-VI-SOL ORAL DROPS 4 $0 MO; * POLY-VI-SOL WITH IRON ORAL 4 $0 MO; * DROPS POLY-VITAMIN ORAL DROPS 4 $0 * prenatal vitamins oral tablet 1 $0 PRESERVISION AREDS 2 (OMEGA-3) 4 $0 MO; * ORAL CAPSULE pyridoxine injection solution 3 $0 MO; * pyridoxine oral tablet 100 mg, 25 mg, 50 mg 4 $0 * SLOW RELEASE IRON ORAL TABLET 4 $0 * 107

119 EXTENDED RELEASE 140 MG (45 MG IRON), 142 MG (45 MG IRON), 143 MG (45 MG IRON), 47.5 MG IRON SLOW RELEASE IRON ORAL TABLET 4 $0 MO; * EXTENDED RELEASE 160 MG (50 MG IRON) sodium fluoride oral tablet 1 $0 SPECTRAVITE ORAL LIQUID 4 $0 * SPECTRAVITE ORAL 4 $0 * TABLET,CHEWABLE STRESS FORMULA ORAL TABLET 4 $0 * STRESS FORMULA WITH ZINC ORAL 4 $0 MO; * TABLET SUPER B/C ORAL CAPSULE 4 $0 * THERA-PLUS ORAL LIQUID 4 $0 MO; * thiamine hcl injection solution 3 $0 MO; * TL G-FOL OS ORAL TABLET 3 $0 MO; * TRI-VI-SOL ORAL DROPS 4 $0 MO; * TRI-VI-SOL WITH IRON ORAL DROPS 4 $0 MO; * TRI-VITA ORAL DROPS 4 $0 * TRI-VITAMIN ORAL DROPS 4 $0 MO; * VISION FORMULA ORAL TABLET 4 $0 * VITALETS ORAL TABLET,CHEWABLE 4 $0 * vitamin a oral capsule 10,000 unit 4 $0 MO; * vitamin a oral capsule 25,000 unit, 8,000 4 $0 * unit VITAMIN C ORAL CAPSULE, 4 $0 MO; * EXTENDED RELEASE VITAMIN C ORAL 4 $0 MO; * TABLET,CHEWABLE 500 MG VITAMIN D2 ORAL CAPSULE 3 $0 MO; * VITAMIN D3 ORAL CAPSULE 2,000 4 $0 MO; * UNIT VITAMIN D3 ORAL TABLET 1,000 4 $0 MO; * UNIT VITAMIN D3 ORAL TABLET 5,000 4 $0 * UNIT VITAMIN D3 ORAL 4 $0 MO; * 108

120 TABLET,CHEWABLE 1,000 UNIT ZOO CHEWS ORAL TABLET,CHEWABLE 4 $0 * 109

121 索引 1 12 HOUR DECONGESTANT ORAL TABLET EXTENDED RELEASE DAY VAGINAL VAGINAL CREAM DAY VAGINAL VAGINAL CREAM WAY NASAL SPRAY, NON-AEROSOL HOUR PAIN RELIEVER ORAL TABLET EXTENDED RELEASE A A + D (LAN, PET) TOPICAL OINTMENT abacavir oral tablet... 2 abacavir-lamivudinezidovudine oral tablet... 2 ABELCET SUSPENSION... 2 ABILIFY DISCMELT ORAL TABLET,DISINTEGRA TING 10 MG ABILIFY DISCMELT ORAL TABLET,DISINTEGRA TING 15 MG ABILIFY INTRAMUSCULAR SOLUTION ABILIFY MAINTENA INTRAMUSCULAR SUSPENSION,EXTEND ED REL RECON ABILIFY ORAL SOLUTION ABILIFY ORAL TABLET 10 MG ABILIFY ORAL TABLET 15 MG, 20 MG ABILIFY ORAL TABLET 2 MG ABILIFY ORAL TABLET 30 MG ABILIFY ORAL TABLET 5 MG ABREVA TOPICAL CREAM acamprosate oral tablet,delayed release (dr/ec) acarbose oral tablet acebutolol oral capsule.. 39 ACEPHEN RECTAL SUPPOSITORY 120 MG, 650 MG ACEPHEN RECTAL SUPPOSITORY 325 MG acetaminophen oral drops acetaminophen oral elixir acetaminophen oral liquid acetaminophen oral solution 160 mg/5 ml (5 ml) acetaminophen oral suspension acetaminophen oral tablet acetaminophen oral tablet, disintegrating acetaminophen-codeine oral solution 120 mg-12 mg /5 ml (5 ml), 300 mg- 30 mg /12.5 ml acetaminophen-codeine oral solution mg/5 ml acetaminophen-codeine oral tablet mg, mg acetaminophen-codeine oral tablet mg. 26 acetasol hc otic drops acetazolamide oral capsule, extended release acetazolamide oral tablet 86 acetazolamide sodium injection recon soln acetic acid otic solution. 59 acetylcysteine solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 110

122 ACID CONTROL (RANITIDINE) ORAL TABLET ACID CONTROLLER ORAL TABLET ACID GONE ANTACID ORAL SUSPENSION 66 acitretin oral capsule 10 mg ACITRETIN ORAL CAPSULE 17.5 MG, 25 MG ACTEMRA SOLUTION 200 MG/10 ML (20 MG/ML) ACTHAR H.P. INJECTION GEL ACTHIB (PF) INTRAMUSCULAR RECON SOLN ACTIMMUNE SUBCUTANEOUS SOLUTION ACTOPLUS MET XR ORAL TABLET, ER MULTIPHASE 24 HR 15-1,000 MG ACTOPLUS MET XR ORAL TABLET, ER MULTIPHASE 24 HR 30-1,000 MG acyclovir oral capsule... 3 acyclovir oral suspension 3 acyclovir oral tablet... 3 acyclovir sodium intravenous recon soln 1,000 mg... 3 acyclovir sodium intravenous solution... 3 acyclovir topical ointment ADACEL(TDAP ADOLESN/ADULT)(PF ) INTRAMUSCULAR SUSPENSION ADACEL(TDAP ADOLESN/ADULT)(PF ) INTRAMUSCULAR SYRINGE ADAGEN INTRAMUSCULAR SOLUTION adapalene topical cream 49 adapalene topical gel 0.1 % ADCIRCA ORAL TABLET ADDED STRENGTH PAIN RELIEVER ORAL TABLET ADEFOVIR ORAL TABLET... 3 adriamycin intravenous solution 10 mg/5 ml adriamycin intravenous solution 20 mg/10 ml, 50 mg/25 ml adrucil intravenous solution 2.5 gram/50 ml adrucil intravenous solution 5 gram/100 ml, 500 mg/10 ml ADT ROBITUSSIN PEAK CLD DM MAX ORAL LIQUID ADULT ROBITUSSIN LINGERING CLD ORAL SYRUP ADULT ROBITUSSIN M- S COLD ORAL LIQUID ADULT ROBITUSSIN NASAL RELIEF ORAL TABLET ADULT ROBITUSSIN NIGHT M-S CLD ORAL LIQUID ADULT ROBITUSSIN PEAK COLD M-S ORAL LIQUID ADVAIR DISKUS INHALATION BLISTER WITH DEVICE ADVAIR HFA INHALATION HFA AEROSOL INHALER 95 ADVANCED ANTACID- ANTIGAS ORAL SUSPENSION ADVIL COLD & SINUS ORAL CAPSULE ADVIL COLD & SINUS ORAL TABLET ADVIL ORAL TABLET 100 MG ADVIL ORAL TABLET,CHEWABLE afeditab cr oral tablet extended release 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 111

123 AFINITOR DISPERZ ORAL TABLET FOR SUSPENSION AFINITOR ORAL TABLET AGGRENOX ORAL CAPSULE, ER MULTIPHASE 12 HR 43 A-HYDROCORT INJECTION RECON SOLN ak-poly-bac ophthalmic ointment AKWA TEARS (POLYVINYL ALCOHOL) OPHTHALMIC DROPS AKWA TEARS OPHTHALMIC OINTMENT ALA-HIST IR ORAL TABLET ALA-HIST PE ORAL TABLET ALAMAG-PLUS ORAL TABLET,CHEWABLE ALAVERT D-12 ALLERGY-SINUS ORAL TABLET EXTENDED RELEASE 12 HR ALAVERT ORAL TABLET,DISINTEGRA TING ALAWAY OPHTHALMIC DROPS ALBENZA ORAL TABLET... 8 albuterol sulfate inhalation solution for nebulization 0.63 mg/3 ml, 1.25 mg/3 ml, 2.5 mg /3 ml (0.083 %), 2.5 mg/0.5 ml albuterol sulfate inhalation solution for nebulization 5 mg/ml albuterol sulfate oral syrup albuterol sulfate oral tablet albuterol sulfate oral tablet extended release 12 hr 95 ALCALAK ORAL TABLET,CHEWABLE alclometasone topical cream alclometasone topical ointment ALCOHOL PADS TOPICAL PADS, MEDICATED ALDEX GS ORAL TABLET ALDURAZYME SOLUTION alendronate oral solution 77 alendronate oral tablet 10 mg, 5 mg alendronate oral tablet 35 mg, 70 mg alendronate oral tablet 40 mg alfuzosin oral tablet extended release 24 hr 98 ALIMTA RECON SOLN 500 MG ALINIA ORAL SUSPENSION FOR RECONSTITUTION... 8 ALINIA ORAL TABLET 8 ALL DAY ALLERGY (CETIRIZINE) ORAL SOLUTION ALL DAY ALLERGY (CETIRIZINE) ORAL TABLET ALL DAY ALLERGY-D ORAL TABLET EXTENDED RELEASE 12 HR ALLER-CHLOR ORAL SYRUP ALLER-CHLOR ORAL TABLET ALLERCLEAR D-24HR ORAL TABLET EXTENDED RELEASE 24 HR ALLERCLEAR ORAL TABLET ALLER-EASE ORAL TABLET 180 MG ALLER-EASE ORAL TABLET 60 MG ALLERGY (DIPHENHYDRAMINE ) ORAL CAPSULE 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 112

124 ALLERGY (DIPHENHYDRAMINE ) ORAL TABLET ALLERGY MULTI- SYMPTOM ORAL TABLET ALLERGY RELIEF (LORATADINE) ORAL SOLUTION ALLERHIST-1 ORAL TABLET ALLFEN DM ORAL TABLET allopurinol oral tablet ALMACONE ORAL SUSPENSION ALMACONE-2 ORAL SUSPENSION ALOE VESTA TOPICAL OINTMENT 2 % ALPHAGAN P OPHTHALMIC DROPS 0.1 % alprazolam oral tablet alprazolam oral tablet extended release 24 hr 33 alprazolam oral tablet,disintegrating ALREX OPHTHALMIC DROPS,SUSPENSION altavera (28) oral tablet. 80 aluminum hydroxide gel oral suspension 320 mg/5 ml alyacen 1/35 (28) oral tablet alyacen 7/7/7 (28) oral tablet amantadine hcl oral capsule... 3 amantadine hcl oral syrup 3 amantadine hcl oral tablet 3 AMBISOME SUSPENSION FOR RECONSTITUTION... 2 amcinonide topical cream amcinonide topical lotion 52 amcinonide topical ointment a-methapred injection recon soln amethia lo oral tablets,dose pack,3 month amethia oral tablets,dose pack,3 month amethyst oral tablet AMIFOSTINE CRYSTALLINE RECON SOLN amikacin injection solution... 8 amiloride oral tablet amiloridehydrochlorothiazide oral tablet amino acids 15 % intravenous parenteral solution aminophylline intravenous solution 250 mg/10 ml. 95 aminophylline intravenous solution 500 mg/20 ml. 95 AMINOSYN 10 % PARENTERAL SOLUTION AMINOSYN 8.5 % PARENTERAL SOLUTION AMINOSYN 8.5 %- ELECTROLYTES PARENTERAL SOLUTION AMINOSYN II 10 % PARENTERAL SOLUTION AMINOSYN II 15 % PARENTERAL SOLUTION AMINOSYN II 7 % PARENTERAL SOLUTION AMINOSYN II 8.5 % PARENTERAL SOLUTION AMINOSYN II 8.5 %- ELECTROLYTES PARENTERAL SOLUTION AMINOSYN M 3.5 % 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 113

125 PARENTERAL SOLUTION AMINOSYN-HBC 7% PARENTERAL SOLUTION AMINOSYN-PF 10 % PARENTERAL SOLUTION AMINOSYN-PF 7 % (SULFITE-FREE) PARENTERAL SOLUTION amiodarone intravenous solution amiodarone intravenous syringe amiodarone oral tablet AMITIZA ORAL CAPSULE amitriptyline oral tablet. 33 amlodipine oral tablet amlodipine-atorvastatin oral tablet amlodipine-benazepril oral capsule ammonium lactate topical cream ammonium lactate topical lotion amnesteem oral capsule. 49 amoxapine oral tablet amoxicil-clarithromylansopraz oral combo pack amoxicillin oral capsule. 11 amoxicillin oral suspension for reconstitution amoxicillin oral tablet amoxicillin oral tablet,chewable amoxicillin-pot clavulanate oral suspension for reconstitution amoxicillin-pot clavulanate oral tablet amoxicillin-pot clavulanate oral tablet extended release 12 hr amoxicillin-pot clavulanate oral tablet,chewable amphetamine salt combo oral tablet amphotericin b injection recon soln... 2 ampicillin oral capsule ampicillin oral suspension for reconstitution ampicillin sodium injection recon soln 1 gram, 10 gram, 125 mg, 2 gram, 250 mg ampicillin sodium injection recon soln 500 mg ampicillin sodium intravenous recon soln 11 ampicillin-sulbactam injection recon soln 15 gram ampicillin-sulbactam injection recon soln 3 gram ampicillin-sulbactam intravenous recon soln 3 gram AMPYRA ORAL TABLET EXTENDED RELEASE 12 HR AMTURNIDE ORAL TABLET anagrelide oral capsule.. 55 anastrozole oral tablet ANDROGEL TRANSDERMAL GEL ANDROID ORAL CAPSULE ANDROXY ORAL TABLET ANECREAM TOPICAL CREAM ANIMAL CHEWS ORAL TABLET,CHEWABLE ANIMAL SHAPES COMPLETE CHEW TABLET ANIMAL SHAPES PLUS C ORAL TABLET,CHEWABLE ANIMAL SHAPES PLUS IRON ORAL TABLET,CHEWABLE ANTACID EXTRA STRENGTH ORAL TABLET,CHEWABLE 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 114

126 ANTACID EXTRA- STRENGTH ORAL TABLET,CHEWABLE ANTACID ULTRA STRENGTH ORAL TABLET,CHEWABLE ANTARA ORAL CAPSULE 30 MG ANTARA ORAL CAPSULE 90 MG ANTI-DIARRHEAL (LOPERAMIDE) ORAL LIQUID ANTI-DIARRHEAL (LOPERAMIDE) ORAL TABLET ANTIFUNGAL (TOLNAFTATE) TOPICAL AEROSOL,SPRAY ANTIFUNGAL (TOLNAFTATE) TOPICAL POWDER. 51 ANTIFUNGAL CREAM TOPICAL CREAM ANTIFUNGAL SPRAY TOPICAL AEROSOL POWDER ANTI-ITCH (DIPHENHYDRAMINE ) TOPICAL AEROSOL,SPRAY ANTI-ITCH (HC) TOPICAL CREAM ANTI-ITCH (HC) WITH OATMEAL TOPICAL CREAM ANTIOXIDANT FORMULA ORAL CAPSULE APATATE ORAL LIQUID APOKYN SUBCUTANEOUS CARTRIDGE apraclonidine ophthalmic drops apri oral tablet APRISO ORAL CAPSULE,EXTENDED RELEASE 24HR APRODINE ORAL TABLET APTIOM ORAL TABLET APTIVUS ORAL CAPSULE... 3 APTIVUS ORAL SOLUTION... 3 AQUADEKS PEDIATRIC ORAL DROPS ARALAST NP RECON SOLN aranelle (28) oral tablet. 80 ARCALYST SUBCUTANEOUS RECON SOLN ARTIFICIAL TEARS (PETRO/MIN) OPHTHALMIC OINTMENT ARTIFICIAL TEARS OPHTHALMIC DROPS ARZERRA SOLUTION 1,000 MG/50 ML ASACOL HD ORAL TABLET,DELAYED RELEASE (DR/EC) ascorbic acid oral tablet ASCRIPTIN ORAL TABLET ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 110 MCG (30 DOSES), 220 MCG (120 DOSES), 220 MCG (30 DOSES), 220 MCG (60 DOSES) ASMANEX TWISTHALER INHALATION AEROSOL POWDR BREATH ACTIVATED 110 MCG (7 DOSES), 220 MCG (14 DOSES) aspirin oral tablet aspirin oral tablet, chewable aspirin oral tablet, delayed release (dr/ec) 325 mg, 81 mg 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 115

127 ASTAGRAF XL ORAL CAPSULE,EXTENDED RELEASE 24HR ASTRINGENT TOPICAL POWDER IN PACKET atenolol oral tablet atenolol-chlorthalidone oral tablet ATHLETE'S FOOT (TERBINAFINE) TOPICAL CREAM ATHLETE'S FOOT (TOLNAFTATE) TOPICAL AEROSOL POWDER ATHLETE'S FOOT (TOLNAFTATE) TOPICAL CREAM atorvastatin oral tablet ATOVAQUONE ORAL SUSPENSION... 8 atovaquone-proguanil oral tablet... 8 ATRIPLA ORAL TABLET... 3 atropine injection syringe66 ATROVENT HFA INHALATION HFA AEROSOL INHALER 95 aubra oral tablet AVASTIN SOLUTION AVELOX IN NACL (ISO- OSMOTIC) PIGGYBACK aviane oral tablet AVODART ORAL CAPSULE AVONEX ADMINISTRATION PACK INTRAMUSCULAR KIT AVONEX INTRAMUSCULAR KIT AVONEX INTRAMUSCULAR PEN INJECTOR KIT. 73 AVONEX INTRAMUSCULAR SYRINGE AXID AR AZACITIDINE INJECTION RECON SOLN AZASAN ORAL TABLET AZASITE OPHTHALMIC DROPS azathioprine oral tablet.. 15 azelastine nasal aerosol,spray azelastine nasal spray,nonaerosol azelastine ophthalmic drops AZILECT ORAL TABLET azithromycin intravenous recon soln... 7 azithromycin oral packet.. 7 azithromycin oral suspension for reconstitution... 7 azithromycin oral tablet... 7 AZOLEN TINCTURE TOPICAL TINCTURE AZOPT OPHTHALMIC DROPS,SUSPENSION AZOR ORAL TABLET. 39 aztreonam injection recon soln... 8 azurette (28) oral tablet.. 80 B B COMPLETE ORAL TABLET b complex vitamins oral capsule b complex-vitamin c-folic acid oral tablet B100 BALANCED ORAL TABLET EXTENDED RELEASE B-50 COMPLEX ORAL TABLET EXTENDED RELEASE baciim intramuscular recon soln... 8 bacitracin intramuscular recon soln... 8 bacitracin ophthalmic ointment bacitracin topical ointment bacitracin zinc topical packet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 116

128 bacitracin-polymyxin b ophthalmic ointment bacitracin-polymyxin b topical packet baclofen oral tablet BALANCED B-100 ORAL TABLET balsalazide oral capsule. 67 balziva (28) oral tablet BANOPHEN ANTI-ITCH TOPICAL CREAM BANZEL ORAL SUSPENSION BANZEL ORAL TABLET BARACLUDE ORAL SOLUTION... 3 BARACLUDE ORAL TABLET... 3 BCG VACCINE, LIVE (PF) PERCUTANEOUS SUSPENSION FOR RECONSTITUTION. 75 b-complex with vitamin c oral tablet b-complex with vitamin c oral tablet extended release benazepril oral tablet benazeprilhydrochlorothiazide oral tablet BENICAR HCT ORAL TABLET BENICAR ORAL TABLET BENLYSTA RECON SOLN 120 MG benzonatate oral capsule 89 benzoyl peroxide topical cleanser 10 %, 5 %, 6 % benzoyl peroxide topical gel benzoyl peroxide topical lotion benztropine injection solution benztropine oral tablet beta carotene oral capsule BETADINE SPRAY TOPICAL AEROSOL 50 betamethasone dipropionate topical cream betamethasone dipropionate topical lotion betamethasone dipropionate topical ointment betamethasone valerate topical cream betamethasone valerate topical foam betamethasone valerate topical lotion betamethasone valerate topical ointment betamethasone, augmented topical cream betamethasone, augmented topical gel betamethasone, augmented topical lotion betamethasone, augmented topical ointment BETASEPT SURGICAL SCRUB TOPICAL LIQUID betaxolol ophthalmic drops betaxolol oral tablet bethanechol chloride oral tablet BETIMOL OPHTHALMIC DROPS 0.25 % BETOPTIC S OPHTHALMIC DROPS,SUSPENSION bicalutamide oral tablet. 15 BICILLIN C-R INTRAMUSCULAR SYRINGE BICILLIN L-A INTRAMUSCULAR SYRINGE BICLORA ORAL LIQUID BICLORA ORAL TABLET BIO-D-MULSION ORAL DROPS biotin oral capsule 5 mg 105 biotin oral tablet 300 mcg bisacodyl oral tablet,delayed release (dr/ec) 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 117

129 BISMATROL ORAL SUSPENSION 262 MG/15 ML BISMATROL ORAL SUSPENSION 525 MG/15 ML BISMATROL ORAL TABLET,CHEWABLE bisoprolol fumarate oral tablet bisoprololhydrochlorothiazide oral tablet bleomycin injection recon soln 30 unit BLEPHAMIDE S.O.P. OPHTHALMIC OINTMENT BOOSTRIX TDAP INTRAMUSCULAR SUSPENSION BOOSTRIX TDAP INTRAMUSCULAR SYRINGE BOSULIF ORAL TABLET BP 8 COUGH ORAL SUSPENSION BP TOPICAL LOTION. 49 BP TOPICAL SUSPENSION briellyn oral tablet BRILINTA ORAL TABLET brimonidine ophthalmic drops BRINTELLIX ORAL TABLET BRISDELLE ORAL CAPSULE BROHIST D ORAL TABLET bromfenac ophthalmic drops bromocriptine oral capsule bromocriptine oral tablet 24 brompheniraminepseudoeph-dm oral liquid mg/5 ml brompheniraminepseudoeph-dm oral syrup brompheniraminphenylephrin-dm oral liquid mg/5 ml BROTAPP DM ORAL ELIXIR BROTAPP ORAL LIQUID budesonide inhalation suspension for nebulization budesonide nasal spray,non-aerosol BUDESONIDE ORAL CAPSULE, DELAYED & EXT.RELEASE BUFFERIN ORAL TABLET bumetanide injection solution bumetanide oral tablet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 buprenorphine injection syringe buprenorphine sublingual tablet 2 mg buprenorphine sublingual tablet 8 mg buprenorphine-naloxone sublingual tablet buproban oral tablet extended release bupropion hcl oral tablet 34 bupropion hcl oral tablet extended release bupropion hcl oral tablet extended release 24 hr 34 buspirone oral tablet BUSULFEX SOLUTION butalbital-acetaminop-cafcod oral capsule butorphanol tartrate injection solution 1 mg/ml butorphanol tartrate injection solution 2 mg/ml butorphanol tartrate nasal spray,non-aerosol BYETTA SUBCUTANEOUS PEN INJECTOR BYSTOLIC ORAL TABLET C C COMPLEX ORAL TABLET EXTENDED RELEASE 1,000 MG 105 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 118

130 cabergoline oral tablet CALCIDOL ORAL DROPS calcipotriene topical cream calcipotriene topical ointment calcipotriene topical solution calcitonin (salmon) nasal spray,non-aerosol CALCITRENE TOPICAL OINTMENT calcitriol intravenous solution calcitriol oral capsule calcitriol oral solution calcitriol topical ointment calcium acetate oral capsule calcium acetate oral tablet CALCIUM ANTACID ORAL TABLET,CHEWABLE 300 MG (750 MG) calcium gluconate oral tablet 45 mg (500 mg). 99 CALDYPHEN TOPICAL LOTION camila oral tablet camrese lo oral tablets,dose pack,3 month camrese oral tablets,dose pack,3 month CANASA RECTAL SUPPOSITORY CANCIDAS RECON SOLN... 2 candesartan oral tablet.. 39 candesartanhydrochlorothiazid oral tablet CAPASTAT INJECTION RECON SOLN... 8 CAPMIST DM ORAL TABLET MG CAPRELSA ORAL TABLET capsaicin topical cream % capsaicin topical cream 0.1 % captopril oral tablet captoprilhydrochlorothiazide oral tablet CARAC TOPICAL CREAM CARAFATE ORAL SUSPENSION carbamazepine oral capsule, er multiphase 12 hr carbamazepine oral suspension carbamazepine oral tablet carbamazepine oral tablet extended release 12 hr 21 carbamazepine oral tablet,chewable carbidopa oral tablet carbidopa-levodopa oral tablet carbidopa-levodopa oral tablet extended release 24 carbidopa-levodopa oral tablet,disintegrating carbidopa-levodopaentacapone oral tablet 24 carboplatin intravenous solution CARDEC ORAL DROPS carisoprodol oral tablet 250 mg carteolol ophthalmic drops cartia xt oral capsule,extended release 24hr carvedilol oral tablet CAYSTON INHALATION SOLUTION FOR NEBULIZATION... 8 CAZIANT (28) ORAL TABLET cefaclor oral capsule... 6 cefaclor oral tablet extended release 12 hr.. 6 cefadroxil oral capsule... 6 cefadroxil oral suspension for reconstitution... 6 cefadroxil oral tablet... 6 cefazolin in dextrose (isoos) intravenous piggyback 1 gram/50 ml 6 cefazolin in dextrose (isoos) intravenous piggyback 2 gram/50 ml 6 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 119

131 cefazolin injection recon soln 1 gram... 6 cefazolin injection recon soln 10 gram, 20 gram, 500 mg... 6 cefazolin intravenous recon soln... 6 cefdinir oral capsule... 6 cefdinir oral suspension for reconstitution... 6 cefditoren pivoxil oral tablet... 6 cefepime injection recon soln... 6 cefotaxime injection recon soln 1 gram, 2 gram, 500 mg... 6 cefotaxime injection recon soln 10 gram... 6 cefotetan injection recon soln... 6 cefotetan intravenous recon soln... 6 cefoxitin in dextrose, isoosm intravenous piggyback... 6 cefoxitin intravenous recon soln 1 gram... 6 cefoxitin intravenous recon soln 10 gram, 2 gram... 6 cefpodoxime oral suspension for reconstitution... 6 cefpodoxime oral tablet... 6 cefprozil oral suspension for reconstitution... 6 cefprozil oral tablet... 6 ceftazidime injection recon soln 1 gram... 7 ceftazidime injection recon soln 2 gram... 7 ceftazidime injection recon soln 6 gram... 7 ceftriaxone in dextrose,isoos intravenous piggyback 1 gram/50 ml... 7 ceftriaxone injection recon soln 1 gram, 2 gram, 250 mg, 500 mg... 7 ceftriaxone injection recon soln 10 gram... 7 ceftriaxone intravenous recon soln... 7 cefuroxime axetil oral tablet... 7 cefuroxime sodium injection recon soln... 7 cefuroxime sodium intravenous recon soln.. 7 CELEBREX ORAL CAPSULE CELLCEPT RECON SOLN CELLCEPT ORAL SUSPENSION FOR RECONSTITUTION. 15 CELONTIN ORAL CAPSULE CEMILL-1000 ORAL TABLET CENTRAL VITE ORAL TABLET CENTRUM KIDS ORAL TABLET,CHEWABLE CENTRUM SILVER ORAL TABLET,CHEWABLE cephalexin oral capsule... 7 cephalexin oral suspension for reconstitution... 7 cephalexin oral tablet... 7 CEREZYME RECON SOLN CERVARIX VACCINE (PF) INTRAMUSCULAR SYRINGE cetirizine oral solution 1 mg/ml cetirizine oral tablet 5 mg cetirizine oral tablet,chewable 10 mg 89 cetirizine oral tablet,chewable 5 mg.. 89 cevimeline oral capsule.. 55 CHANTIX CONTINUING MONTH BOX ORAL TABLET CHANTIX ORAL TABLET CHANTIX STARTING MONTH BOX ORAL TABLETS,DOSE PACK chateal oral tablet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 120

132 CHEMET ORAL CAPSULE CHEST CONGESTION RELIEF ORAL TABLET CHEST CONGESTION RELIEF PE ORAL TABLET CHEWABLE MULTI VITAMIN ORAL TABLET,CHEWABLE CHILD ALLERGY RELIEF (DIPHEN) ORAL TABLET,DISINTEGRA TING CHILD DELSYM NIGHTTIME C-C ORAL LIQUID CHILD MUCUS RELIEF COUGH ORAL LIQUID CHILD MUCUS RELIEF EXPECTORANT ORAL LIQUID CHILD WAL-TAP COLD- ALLERGY ORAL SOLUTION CHILDREN'S ALLEGRA ALLERGY ORAL SUSPENSION CHILDREN'S ALLERGY (DIPHENHYD) ORAL TABLET,DISINTEGRA TING CHILDREN'S CLARITIN ORAL TABLET,CHEWABLE CHILDREN'S COLD & COUGH DM ORAL SOLUTION CHILDREN'S DIMETAPP COLD &FLU ORAL LIQUID CHILDREN'S MAPAP ORAL TABLET,DISINTEGRA TING CHILDREN'S MUCINEX COLD-FEVER ORAL LIQUID CHILDREN'S MUCINEX MULTI-SYMP ORAL LIQUID CHILDREN'S PAIN & FEVER RELIEF ORAL TABLET,CHEWABLE CHILDREN'S PEPTO ORAL TABLET,CHEWABLE CHILDRENS PLUS COLD ORAL SUSPENSION CHILDREN'S SILFEDRINE ORAL LIQUID CHILDREN'S WAL- DRYL ALLERGY ORAL TABLET,DISINTEGRA TING CHILD'S BENADRYL-D ALLERGY-SIN ORAL SOLUTION CHLO TUSS EX ORAL LIQUID chloramphenicol sod succinate intravenous recon soln... 8 chlorhexidine gluconate mucous membrane mouthwash chloroquine phosphate oral tablet... 8 chlorothiazide oral tablet 40 chlorothiazide sodium intravenous recon soln 40 chlorpheniramine maleate oral tablet extended release chlorpromazine injection solution chlorpromazine oral tablet chlorthalidone oral tablet40 cholecalciferol (vitamin d3) oral capsule 10,000 unit, 400 unit cholecalciferol (vitamin d3) oral capsule 5,000 unit, 50,000 unit cholecalciferol (vitamin d3) oral drops cholecalciferol (vitamin d3) oral tablet 2,000 unit 105 cholecalciferol (vitamin d3) oral tablet,chewable. 105 cholestyramine (with sugar) oral powder 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 121

133 cholestyramine (with sugar) oral powder in packet. 45 cholestyramine light oral powder cholestyramine light oral powder in packet chorionic gonadotropin, human intramuscular recon soln CIALIS ORAL TABLET 2.5 MG, 5 MG ciclodan topical cream ciclodan topical solution 51 ciclopirox topical cream. 51 ciclopirox topical gel ciclopirox topical shampoo ciclopirox topical solution ciclopirox topical suspension CIDOFOVIR SOLUTION... 3 cilostazol oral tablet CILOXAN OPHTHALMIC OINTMENT cimetidine hcl oral solution cimetidine oral tablet CIMZIA POWDER FOR RECONST SUBCUTANEOUS KIT CIMZIA SUBCUTANEOUS SYRINGE KIT CINRYZE RECON SOLN CIPRO ORAL SUSPENSION,MICROC APSULE RECON ciprofloxacin (mixture) oral tablet, er multiphase 24 hr ciprofloxacin in 5 % dextrose intravenous piggyback 400 mg/200 ml ciprofloxacin intravenous solution 400 mg/40 ml. 12 ciprofloxacin ophthalmic drops ciprofloxacin oral suspension,microcapsule recon ciprofloxacin oral tablet. 13 cisplatin intravenous solution citalopram oral solution. 34 citalopram oral tablet CITRATE OF MAGNESIA ORAL SOLUTION CITRUCEL ORAL TABLET CITRUCEL SUGAR FREE ORAL POWDER cladribine intravenous solution claravis oral capsule CLARINEX ORAL SYRUP clarithromycin oral suspension for reconstitution... 7 clarithromycin oral tablet 7 clarithromycin oral tablet extended release 24 hr.. 7 CLARITIN LIQUI-GEL ORAL CAPSULE CLARITIN REDITABS ORAL TABLET,DISINTEGRA TING 5 MG CLEARLAX ORAL POWDER CLEARLAX ORAL POWDER IN PACKET clemastine oral syrup clemastine oral tablet 2.68 mg CLEOCIN VAGINAL SUPPOSITORY clindacin etz topical swab clindacin p topical swab. 49 clindamycin hcl oral capsule... 8 clindamycin palmitate hcl oral recon soln... 8 clindamycin pediatric oral recon soln... 8 clindamycin phosphate injection solution... 8 clindamycin phosphate intravenous solution 300 mg/2 ml, 900 mg/6 ml... 8 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 122

134 clindamycin phosphate intravenous solution 600 mg/4 ml... 8 clindamycin phosphate topical foam clindamycin phosphate topical gel clindamycin phosphate topical lotion clindamycin phosphate topical solution clindamycin phosphate topical swab clindamycin phosphate vaginal cream clindamycin-benzoyl peroxide topical gel clindamycin-benzoyl peroxide topical gel,extended release CLINIMIX 5%/D15W SULFITE FREE PARENTERAL SOLUTION CLINIMIX 5%/D25W SULFITE-FREE PARENTERAL SOLUTION CLINIMIX 2.75%/D5W SULFIT FREE PARENTERAL SOLUTION CLINIMIX 4.25%/D10W SULF FREE PARENTERAL SOLUTION CLINIMIX 4.25%/D5W SULFIT FREE PARENTERAL SOLUTION CLINIMIX 4.25%-D20W SULF-FREE PARENTERAL SOLUTION CLINIMIX 4.25%-D25W SULF-FREE PARENTERAL SOLUTION CLINIMIX 5%- D20W(SULFITE-FREE) PARENTERAL SOLUTION CLINIMIX E 2.75%/D10W SUL FREE PARENTERAL SOLUTION CLINIMIX E 2.75%/D5W SULF FREE PARENTERAL SOLUTION CLINIMIX E 4.25%/D25W SUL FREE PARENTERAL SOLUTION CLINIMIX E 4.25%/D5W SULF FREE PARENTERAL SOLUTION CLINIMIX E 5%/D15W SULFIT FREE PARENTERAL SOLUTION CLINIMIX E 5%/D20W SULFIT FREE PARENTERAL SOLUTION CLINIMIX E 5%/D25W SULFIT FREE PARENTERAL SOLUTION CLINISOL SF 15 % PARENTERAL SOLUTION clobetasol topical cream 53 clobetasol topical foam.. 53 clobetasol topical gel clobetasol topical lotion. 53 clobetasol topical ointment clobetasol topical shampoo clobetasol topical solution clobetasol-emollient topical cream clobetasol-emollient topical foam 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 123

135 CLOFERA ORAL LIQUID clomipramine oral capsule clonazepam oral tablet clonazepam oral tablet,disintegrating clonidine hcl oral tablet. 40 clonidine hcl oral tablet extended release 12 hr 34 clonidine transdermal patch weekly clopidogrel oral tablet 300 mg clopidogrel oral tablet 75 mg clorazepate dipotassium oral tablet clotrimazole mucous membrane troche... 2 clotrimazole topical cream clotrimazole topical solution clotrimazole vaginal cream clotrimazolebetamethasone topical cream clotrimazolebetamethasone topical lotion clozapine oral tablet clozapine oral tablet,disintegrating COARTEM ORAL TABLET... 8 codeine sulfate oral tablet CODITUSS DM ORAL LIQUID COLACE ORAL CAPSULE 50 MG colchicine-probenecid oral tablet COLCRYS ORAL TABLET COLD HEAD CONGESTION DAY/NITE ORAL TABLETS, SEQUENTIAL COLD HEAD CONGESTION DAYTIME ORAL TABLET COLD HEAD CONGESTION NIGHTTIME ORAL TABLET COLD HEAD CONGESTION SEVER DAY ORAL TABLET 91 colestipol oral granules.. 45 colestipol oral packet colestipol oral tablet COLISTIN (COLISTIMETHATE NA) INJECTION RECON SOLN... 8 COMBIGAN OPHTHALMIC DROPS COMBIPATCH TRANSDERMAL PATCH SEMIWEEKLY COMBIVENT RESPIMAT INHALATION AEROSOL COMBIVIR ORAL TABLET... 3 COMETRIQ ORAL CAPSULE COMPLERA ORAL TABLET... 3 COMPLETE ORAL TABLET,CHEWABLE COMPLEX B-100 ORAL TABLET EXTENDED RELEASE compro rectal suppository COMVAX (PF) INTRAMUSCULAR SUSPENSION CONEX ORAL SOLUTION CONEX ORAL TABLET CONGESTAC ORAL TABLET constulose oral solution.. 67 COPAXONE SUBCUTANEOUS SYRINGE COPAXONE SUBCUTANEOUS SYRINGE KIT COREG CR ORAL CAPSULE, ER MULTIPHASE 24 HR 40 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 124

136 CORFEN-DM ORAL LIQUID cormax topical solution.. 53 cortisone oral tablet CORTISPORIN-TC OTIC DROPS, SUSPENSION CORVITA 150 ORAL TABLET COSMEGEN RECON SOLN COUGH DM ER ORAL SUSPENSION,EXTEND ED REL 12 HR COUGH SUPPRESSANT- EXPECTORANT ORAL SYRUP COUGHTAB ORAL TABLET COUMADIN ORAL TABLET CRESTOR ORAL TABLET CRIXIVAN ORAL CAPSULE... 3 cromolyn inhalation solution for nebulization cromolyn nasal spray,nonaerosol cromolyn ophthalmic drops cromolyn oral solution cryselle (28) oral tablet.. 81 CUBICIN RECON SOLN... 9 CUPRIMINE ORAL CAPSULE cyanocobalamin (vitamin b- 12) injection solution 106 cyclafem 1/35 (28) oral tablet cyclafem 7/7/7 (28) oral tablet cyclobenzaprine oral tablet cyclopentolate ophthalmic drops 1 % cyclopentolate ophthalmic drops 2 % CYCLOPHOSPHAMIDE ORAL CAPSULE cyclophosphamide oral tablet cycloserine oral capsule... 9 CYCLOSET ORAL TABLET cyclosporine intravenous solution cyclosporine modified oral capsule cyclosporine modified oral solution cyclosporine oral capsule15 cyproheptadine oral syrup cyproheptadine oral tablet CYSTADANE ORAL POWDER CYSTAGON ORAL CAPSULE cytarabine injection solution D d10 % & 0.45 % sodium chloride intravenous parenteral solution d2.5 %-0.45 % sodium chloride intravenous parenteral solution D3 DOTS ORAL TABLET d5 % and 0.9 % sodium chloride intravenous parenteral solution d5 %-0.45 % sodium chloride intravenous parenteral solution dacarbazine intravenous recon soln 200 mg DAILY MULTIPLE ORAL TABLET DAILY VITAMIN WITH IRON ORAL TABLET DALIRESP ORAL TABLET DALLERGY (CHLORCYCLIZINE- PE) ORAL LIQUID danazol oral capsule dantrolene oral capsule.. 26 DAPSONE ORAL TABLET... 9 DAPTACEL (DTAP PEDIATRIC) (PF) INTRAMUSCULAR SUSPENSION DARAPRIM ORAL TABLET... 9 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 125

137 dasetta 1/35 (28) oral tablet dasetta 7/7/7 (28) oral tablet daunorubicin intravenous solution daysee oral tablets,dose pack,3 month DAYTIME COLD & FLU RELIEF ORAL CAPSULE DAYTIME COLD-FLU ORAL LIQUID DECARA ORAL CAPSULE 25,000 UNIT DE-CHLOR DM ORAL SYRUP DECITABINE RECON SOLN DELSYM COUGH & COLD ORAL LIQUID DELSYM MULTI- SYMPTOM ORAL LIQUID DELSYM NIGHTTIME MULTI-SYMPTOM ORAL LIQUID DELTA D3 ORAL TABLET DELZICOL ORAL CAPSULE,DELAYED RELEASE(DR/EC) demeclocycline oral tablet DEMSER ORAL CAPSULE DENAVIR TOPICAL CREAM DEPEN TITRATABS ORAL TABLET DEPO-PROVERA INTRAMUSCULAR SOLUTION DEPO-SUBQ PROVERA 104 SUBCUTANEOUS SYRINGE DESENEX TOPICAL POWDER desipramine oral tablet.. 34 desloratadine oral tablet 91 desloratadine oral tablet,disintegrating desmopressin injection solution desmopressin nasal aerosol,spray desmopressin nasal solution desmopressin nasal spray,non-aerosol desmopressin oral tablet 64 desonide topical cream desonide topical lotion desonide topical ointment53 desoximetasone topical cream desoximetasone topical gel desoximetasone topical ointment dexamethasone intensol oral drops dexamethasone oral elixir dexamethasone oral solution dexamethasone oral tablet dexamethasone sodium phos (pf) injection solution dexamethasone sodium phosphate injection solution dexamethasone sodium phosphate ophthalmic drops DEXFERRUM SOLUTION 100 MG/2 ML (50 MG/ML) DEXILANT ORAL CAPSULE,BIPHASE DELAYED RELEAS. 72 dexmethylphenidate oral tablet dexrazoxane intravenous recon soln 250 mg dexrazoxane intravenous recon soln 500 mg dextroamphetamine oral capsule, extended release dextroamphetamine oral tablet dextroamphetamineamphetamine oral capsule,extended release 24hr 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 126

138 dextrose 10 % & 0.2 % nacl intravenous parenteral solution dextrose 10 % in water (d10w) intravenous parenteral solution dextrose 20 % in water (d20w) intravenous parenteral solution dextrose 25 % in water (d25w) intravenous syringe dextrose 30 % in water (d30w) intravenous parenteral solution dextrose 40 % in water (d40w) intravenous parenteral solution dextrose 5 % in water (d5w) intravenous parenteral solution dextrose 5 % in water (d5w) intravenous piggyback dextrose 5 %-lactated ringers intravenous parenteral solution dextrose 5%-0.2 % sod chloride intravenous parenteral solution dextrose 5%-0.3 % sod.chloride intravenous parenteral solution dextrose 50 % in water (d50w) intravenous parenteral solution dextrose 50 % in water (d50w) intravenous syringe dextrose 70 % in water (d70w) intravenous parenteral solution DIALYVITE 800 WITH ZINC 50 ORAL TABLET DIASTAT ACUDIAL RECTAL KIT DIASTAT RECTAL KIT diazepam intensol oral concentrate diazepam oral solution 5 mg/5 ml diazepam oral solution 5 mg/5 ml (5 ml) diazepam oral tablet diazepam rectal kit DICEL CD ORAL LIQUID diclofenac potassium oral tablet diclofenac sodium ophthalmic drops diclofenac sodium oral tablet extended release 24 hr diclofenac sodium oral tablet,delayed release (dr/ec) 25 mg, 50 mg, 75 mg diclofenac sodium topical drops diclofenac sodium topical gel diclofenac-misoprostol oral tablet,ir & delay rel,biphasic dicloxacillin oral capsule 11 dicyclomine oral capsule 66 dicyclomine oral solution 66 dicyclomine oral tablet didanosine oral capsule,delayed release(dr/ec)... 3 diflorasone topical cream diflorasone topical ointment diflunisal oral tablet digox oral tablet digoxin injection solution 43 digoxin oral solution digoxin oral tablet dihydroergotamine injection solution DILANTIN EXTENDED ORAL CAPSULE DILANTIN INFATABS ORAL TABLET,CHEWABLE DILANTIN ORAL CAPSULE DILANTIN-125 ORAL SUSPENSION DILAUDID ORAL LIQUID diltiazem hcl intravenous recon soln diltiazem hcl intravenous solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 127

139 diltiazem hcl oral capsule, extended release diltiazem hcl oral capsule,ext release degradable diltiazem hcl oral capsule,extended release 12 hr diltiazem hcl oral capsule,extended release 24hr diltiazem hcl oral tablet.. 40 diltiazem hcl oral tablet extended release 24 hr 40 dilt-xr oral capsule,ext release degradablev dimenhydrinate oral tablet DIMETANE-DX ORAL SYRUP DIMETAPP LONG- ACTING (CPM-DM) ORAL LIQUID DINO-LIFE WITH IRON- ZINC ORAL TABLET,CHEWABLE DIOCTO ORAL LIQUID DIOVAN ORAL TABLET DIPENTUM ORAL CAPSULE DIPHENHIST ORAL TABLET 50 MG diphenhydramine hcl injection solution diphenhydramine hcl oral capsule 50 mg diphenhydramineacetaminophen oral tablet disulfiram oral tablet divalproex oral capsule, sprinkle divalproex oral tablet extended release 24 hr 21 divalproex oral tablet,delayed release (dr/ec) DOC-Q-LACE ORAL CAPSULE DOCUPRENE ORAL TABLET docusate calcium oral capsule docusate sodium oral capsule 250 mg DOK PLUS ORAL TABLET donepezil oral tablet donepezil oral tablet,disintegrating dorzolamide ophthalmic drops dorzolamide-timolol ophthalmic drops doxazosin oral tablet doxepin oral capsule doxepin oral concentrate 34 DOXIL SOLUTION doxorubicin intravenous solution doxy-100 intravenous recon soln doxycycline hyclate intravenous recon soln 13 doxycycline hyclate oral capsule doxycycline hyclate oral tablet doxycycline hyclate oral tablet,delayed release (dr/ec) doxycycline monohydrate oral capsule doxycycline monohydrate oral tablet DR. SMITH'S DIAPER TOPICAL OINTMENT DRISTAN LONG LASTING NASAL MIST DRONABINOL ORAL CAPSULE 10 MG dronabinol oral capsule 2.5 mg, 5 mg DROXIA ORAL CAPSULE DULERA INHALATION HFA AEROSOL INHALER duloxetine oral capsule,delayed release(dr/ec) DURAMORPH (PF) INJECTION SOLUTION 0.5 MG/ML 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 128

140 DURAMORPH (PF) INJECTION SOLUTION 1 MG/ML E EAR WAX REMOVAL DROPS OTIC DROPS59 ECEE PLUS ORAL TABLET econazole topical cream. 52 ED A-HIST ORAL LIQUID ED BRON GP ORAL LIQUID ED CHLORPED D ORAL DROPS ED-CHLORPED ORAL DROPS EDURANT ORAL TABLET... 3 EFFERVESCENT PAIN RELIEF ORAL TABLET, EFFERVESCENT EFFIENT ORAL TABLET EGRIFTA SUBCUTANEOUS RECON SOLN ELAPRASE SOLUTION ELDERTONIC ORAL ELIXIR electrolyte-48 in d5w intravenous parenteral solution ELELYSO RECON SOLN ELIDEL TOPICAL CREAM ELIGARD SUBCUTANEOUS SYRINGE elinest oral tablet eliphos oral tablet ELIQUIS ORAL TABLET ELITEK RECON SOLN 1.5 MG ELIXOPHYLLIN ORAL ELIXIR ELLA ORAL TABLET. 81 ELMIRON ORAL CAPSULE EMCYT ORAL CAPSULE EMEND ORAL CAPSULE 125 MG EMEND ORAL CAPSULE 40 MG EMEND ORAL CAPSULE 80 MG EMEND ORAL CAPSULE,DOSE PACK emoquette oral tablet EMSAM TRANSDERMAL PATCH 24 HOUR EMTRIVA ORAL CAPSULE... 3 EMTRIVA ORAL SOLUTION... 3 enalapril maleate oral tablet enalaprilhydrochlorothiazide oral tablet ENBREL SUBCUTANEOUS KIT ENBREL SUBCUTANEOUS SYRINGE 25 MG/0.5ML (0.51) ENBREL SUBCUTANEOUS SYRINGE 50 MG/ML (0.98 ML) ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR ENDACOF - DM ORAL SOLUTION endocet oral tablet mg, mg, mg ENFALYTE ORAL SOLUTION ENGERIX-B (PF) INTRAMUSCULAR SUSPENSION ENGERIX-B (PF) INTRAMUSCULAR SYRINGE ENGERIX-B PEDIATRIC (PF) INTRAMUSCULAR SUSPENSION 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 129

141 ENGERIX-B PEDIATRIC (PF) INTRAMUSCULAR SYRINGE enoxaparin subcutaneous solution enoxaparin subcutaneous syringe 100 mg/ml, 150 mg/ml enoxaparin subcutaneous syringe 120 mg/0.8 ml, 80 mg/0.8 ml enoxaparin subcutaneous syringe 30 mg/0.3 ml enoxaparin subcutaneous syringe 40 mg/0.4 ml enpresse oral tablet enskyce oral tablet entacapone oral tablet ENTRE-COUGH ORAL LIQUID enulose oral solution EPANED ORAL RECON SOLN ephedrine sulfate oral capsule epinastine ophthalmic drops epinephrine (pf) injection solution epinephrine injection autoinjector 0.3 mg/0.3 ml (1 1,000) epinephrine injection solution 1 mg/ml (1 1,000) epinephrine injection syringe EPIPEN 2-PAK INJECTION AUTO- INJECTOR EPIPEN JR 2-PAK INJECTION AUTO- INJECTOR EPIRUBICIN SOLUTION 50 MG/25 ML epitol oral tablet EPIVIR HBV ORAL SOLUTION... 3 EPIVIR ORAL SOLUTION... 3 eplerenone oral tablet eprosartan oral tablet EPSOM SALT ORAL GRANULES EPZICOM ORAL TABLET... 3 ergocalciferol (vitamin d2) oral drops ergoloid oral tablet ERIVEDGE ORAL CAPSULE errin oral tablet ERWINAZE INTRAMUSCULAR RECON SOLN ery pads topical swab ERYPED 200 ORAL SUSPENSION FOR RECONSTITUTION... 8 ERYTHROCIN (AS STEARATE) ORAL TABLET... 8 ERYTHROCIN RECON SOLN 500 MG... 8 erythromycin ethylsuccinate oral tablet... 8 erythromycin ophthalmic ointment erythromycin oral capsule,delayed release(dr/ec)... 8 erythromycin oral tablet... 8 erythromycin with ethanol topical gel erythromycin with ethanol topical solution erythromycin with ethanol topical swab erythromycin-benzoyl peroxide topical gel escitalopram oxalate oral solution escitalopram oxalate oral tablet esomeprazole sodium intravenous recon soln 72 estarylla oral tablet ESTRACE VAGINAL CREAM estradiol oral tablet estradiol transdermal patch weekly estradiol valerate intramuscular oil eszopiclone oral tablet ethambutol oral tablet... 9 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 130

142 ethosuximide oral capsule ethosuximide oral solution etidronate disodium oral tablet etodolac oral capsule etodolac oral tablet etodolac oral tablet extended release 24 hr 31 etoposide intravenous solution EXCEDRIN TENSION HEADACHE ORAL TABLET EXEFEN DMX ORAL TABLET EXEFEN-IR ORAL TABLET EXELON TRANSDERMAL PATCH 24 HOUR exemestane oral tablet EXFORGE HCT ORAL TABLET EXJADE ORAL TABLET, DISPERSIBLE EX-LAX (SENNOSIDES) ORAL TABLET EX-LAX MAXIMUM STRENGTH ORAL TABLET EXTAVIA SUBCUTANEOUS KIT 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 F FABRAZYME RECON SOLN 35 MG falmina (28) oral tablet.. 81 famciclovir oral tablet 125 mg... 3 famciclovir oral tablet 250 mg... 3 famciclovir oral tablet 500 mg... 3 famotidine (pf) intravenous solution famotidine (pf)-nacl (isoos) intravenous piggyback famotidine intravenous solution famotidine oral suspension famotidine oral tablet 20 mg, 40 mg FANAPT ORAL TABLET FANAPT ORAL TABLETS,DOSE PACK FARESTON ORAL TABLET FASLODEX INTRAMUSCULAR SYRINGE FAZACLO ORAL TABLET,DISINTEGRA TING felbamate oral suspension felbamate oral tablet felodipine oral tablet extended release 24 hr 40 fenofibrate micronized oral capsule fenofibrate nanocrystallized oral tablet fenofibrate oral tablet fenofibric acid (choline) oral capsule,delayed release(dr/ec) fenoprofen oral tablet FENTANYL CITRATE BUCCAL LOZENGE 27 FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 1,200 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 1,600 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 200 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 400 MCG FENTANYL CITRATE BUCCAL LOZENGE ON A HANDLE 600 MCG fentanyl patches transdermal patch 72 hour 100 mcg/hr 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 131

143 fentanyl patches transdermal patch 72 hour 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr FER-IN-SOL ORAL DROPS FER-IRON ORAL DROPS ferrous sulfate oral liquid ferrous sulfate oral solution ferrous sulfate oral tablet ferrous sulfate oral tablet,delayed release (dr/ec) FETZIMA ORAL CAPSULE,EXT REL 24HR DOSE PACK FETZIMA ORAL CAPSULE,EXTENDED RELEASE 24 HR FEVERALL RECTAL SUPPOSITORY 80 MG FIBER (PSYLLIUM HUSK/SUGAR) ORAL POWDER FIBER (WITH ASPARTAME) ORAL POWDER FIBER LAXATIVE (PSYLLIUM HUSK) ORAL CAPSULE FIBER LAXATIVE ORAL TABLET FIBER THERAPY ORAL POWDER finasteride oral tablet 5 mg FIRST AID ANTISEPTIC TOPICAL SOLUTION flavoxate oral tablet flecainide oral tablet FLEET GLYCERIN (ADULT) RECTAL SUPPOSITORY FLINTSTONES PLUS CALCIUM ORAL TABLET,CHEWABLE FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 100 MCG/ACTUATION, 50 MCG/ACTUATION FLOVENT DISKUS INHALATION BLISTER WITH DEVICE 250 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 110 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 220 MCG/ACTUATION FLOVENT HFA INHALATION AEROSOL 44 MCG/ACTUATION FLU & SORE THROAT ORAL PACKET fluconazole in dextrose(isoo) intravenous piggyback... 2 fluconazole oral suspension for reconstitution... 2 fluconazole oral tablet 100 mg, 200 mg, 50 mg... 2 flucytosine oral capsule... 2 FLUDARABINE RECON SOLN fludrocortisone oral tablet flunisolide nasal spray,nonaerosol fluocinolone acetonide oil otic drops fluocinolone topical cream fluocinolone topical oil fluocinolone topical ointment fluocinolone topical solution fluocinolone-shower cap topical oil fluocinonide topical cream fluocinonide topical gel.. 54 fluocinonide topical ointment fluocinonide topical solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 132

144 fluocinonide-e topical cream fluorometholone ophthalmic drops,suspension fluorouracil intravenous solution fluorouracil topical cream fluorouracil topical solution fluoxetine oral capsule fluoxetine oral capsule,delayed release(dr/ec) fluoxetine oral solution fluoxetine oral tablet 10 mg, 20 mg FLUOXETINE ORAL TABLET 60 MG fluphenazine decanoate injection solution fluphenazine hcl injection solution fluphenazine hcl oral concentrate fluphenazine hcl oral elixir fluphenazine hcl oral tablet flurbiprofen oral tablet flurbiprofen sodium ophthalmic drops flutamide oral capsule fluticasone nasal spray,suspension fluticasone topical cream 54 fluticasone topical lotion 54 fluticasone topical ointment fluvastatin oral capsule.. 46 fluvoxamine oral capsule,extended release 24hr fluvoxamine oral tablet FML S.O.P. OPHTHALMIC OINTMENT FOLGARD ORAL TABLET folic acid injection solution folic acid oral tablet 1 mg folic acid oral tablet 400 mcg, 800 mcg FOLTABS 800 ORAL TABLET fomepizole intravenous solution FONDAPARINUX SUBCUTANEOUS SYRINGE 10 MG/0.8 ML fondaparinux subcutaneous syringe 2.5 mg/0.5 ml.. 44 fondaparinux subcutaneous syringe 5 mg/0.4 ml FONDAPARINUX SUBCUTANEOUS SYRINGE 7.5 MG/0.6 ML FORADIL AEROLIZER INHALATION CAPSULE, W/INHALATION DEVICE FORFIVO XL ORAL TABLET EXTENDED RELEASE 24 HR FORMULA E 400 ORAL CAPSULE FORTEO SUBCUTANEOUS PEN INJECTOR fortical nasal spray,nonaerosol foscarnet intravenous solution... 3 fosinopril oral tablet fosinoprilhydrochlorothiazide oral tablet fosphenytoin injection solution FOSRENOL ORAL TABLET,CHEWABLE FRAGMIN SUBCUTANEOUS SOLUTION FRAGMIN SUBCUTANEOUS SYRINGE 10,000 UNIT/ML FRAGMIN SUBCUTANEOUS SYRINGE 12,500 UNIT/0.5 ML FRAGMIN SUBCUTANEOUS SYRINGE 15,000 UNIT/0.6 ML 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 133

145 FRAGMIN SUBCUTANEOUS SYRINGE 18,000 UNIT/0.72 ML FRAGMIN SUBCUTANEOUS SYRINGE 2,500 UNIT/0.2 ML, 5,000 UNIT/0.2 ML FRAGMIN SUBCUTANEOUS SYRINGE 7,500 UNIT/0.3 ML furosemide injection solution furosemide injection syringe furosemide oral solution. 41 furosemide oral tablet FUZEON SUBCUTANEOUS RECON SOLN... 3 FYCOMPA ORAL TABLET G gabapentin oral capsule. 22 gabapentin oral solution 250 mg/5 ml gabapentin oral solution 250 mg/5 ml (5 ml), 300 mg/6 ml (6 ml) gabapentin oral tablet GABITRIL ORAL TABLET 12 MG, 16 MG galantamine oral capsule,ext rel. pellets 24 hr galantamine oral solution galantamine oral tablet.. 25 GAMMAGARD LIQUID SOLUTION GAMUNEX-C INJECTION SOLUTION 1 GRAM/10 ML (10 %) ganciclovir sodium intravenous recon soln.. 3 garamycin ophthalmic drops GARDASIL (PF) INTRAMUSCULAR SUSPENSION GARDASIL (PF) INTRAMUSCULAR SYRINGE GAS RELIEF EXTRA STRENGTH ORAL CAPSULE GAS RELIEF ORAL CAPSULE GAS RELIEF ORAL TABLET,CHEWABLE gatifloxacin ophthalmic drops gauze pads 2 x gavilyte-c oral recon soln 68 gavilyte-g oral recon soln68 gavilyte-n oral recon soln68 GAVISCON EXTRA STRENGTH ORAL SUSPENSION 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 GAVISCON ORAL TABLET,CHEWABLE GAZYVA SOLUTION GELNIQUE TRANSDERMAL GEL IN PACKET GEMCITABINE RECON SOLN 1 GRAM GEMCITABINE SOLUTION 1 GRAM/26.3 ML (38 MG/ML) gemfibrozil oral tablet GEMZAR RECON SOLN 1 GRAM generlac oral solution gengraf oral capsule gengraf oral solution gentak ophthalmic drops 84 gentak ophthalmic ointment gentamicin in nacl (isoosm) intravenous piggyback 100 mg/100 ml, 120 mg/100 ml... 9 gentamicin in nacl (isoosm) intravenous piggyback 60 mg/50 ml, 70 mg/50 ml, 80 mg/50 ml, 90 mg/100 ml... 9 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 134

146 GENTAMICIN IN NACL (ISO-OSM) PIGGYBACK 80 MG/100 ML... 9 gentamicin injection solution... 9 gentamicin ophthalmic drops gentamicin ophthalmic ointment gentamicin sulfate (ped) (pf) injection solution... 9 gentamicin sulfate (pf) intravenous solution 100 mg/10 ml... 9 GENTAMICIN SULFATE (PF) SOLUTION 60 MG/6 ML... 9 gentamicin sulfate (pf) intravenous solution 80 mg/8 ml... 9 gentamicin topical cream 51 gentamicin topical ointment GEODON INTRAMUSCULAR RECON SOLN GERIATON ORAL LIQUID GERI-MUCIL ORAL POWDER gildess fe oral tablet gildess oral tablet GILENYA ORAL CAPSULE GILOTRIF ORAL TABLET GLEEVEC ORAL TABLET 100 MG GLEEVEC ORAL TABLET 400 MG glimepiride oral tablet glipizide oral tablet glipizide oral tablet extended release 24hr. 61 glipizide-metformin oral tablet mg glipizide-metformin oral tablet mg, mg GLUCAGEN HYPOKIT INJECTION RECON SOLN GLUCAGEN INJECTION RECON SOLN GLUCAGON EMERGENCY INJECTION KIT glycopyrrolate injection solution glycopyrrolate oral tablet66 granisetron (pf) intravenous solution 1 mg/ml (1 ml) granisetron (pf) intravenous solution 100 mcg/ml granisetron intravenous solution granisetron oral tablet granisol oral solution griseofulvin microsize oral suspension... 2 griseofulvin microsize oral tablet... 2 griseofulvin ultramicrosize oral tablet... 2 GRX DYNE TOPICAL SOLUTION 7.5 % guaifenesin oral tablet extended release guanidine oral tablet H HALLS DEFENSE ORAL LOZENGE halobetasol propionate topical cream halobetasol propionate topical ointment haloperidol decanoate intramuscular solution 35 haloperidol lactate injection solution haloperidol lactate oral concentrate haloperidol oral tablet HAVRIX (PF) INTRAMUSCULAR SUSPENSION HAVRIX (PF) INTRAMUSCULAR SYRINGE 1,440 ELISA UNIT/ML HAVRIX (PF) INTRAMUSCULAR SYRINGE 720 ELISA UNIT/0.5 ML heather oral tablet hecoria oral capsule 0.5 mg, 1 mg 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 135

147 HEPARIN (PORCINE) IN 5 % DEX PARENTERAL SOLUTION 12,500 UNIT/250 ML heparin (porcine) in 5 % dex intravenous parenteral solution 20,000 unit/500 ml (40 unit/ml), 25,000 unit/250 ml(100 unit/ml) heparin (porcine) in 5 % dex intravenous parenteral solution 25,000 unit/500 ml (50 unit/ml) heparin (porcine) in nacl (pf) intravenous parenteral solution 1,000 unit/500 ml HEPARIN (PORCINE) IN NACL (PF) PARENTERAL SOLUTION 2,000 UNIT/1,000 ML heparin (porcine) injection cartridge heparin (porcine) injection solution HEPARIN(PORCINE) IN 0.45% NACL PARENTERAL SOLUTION 12,500 UNIT/250 ML, 25,000 UNIT/250 ML, 25,000 UNIT/500 ML heparin, porcine (pf) injection solution 1,000 unit/ml heparin, porcine (pf) injection solution 5,000 unit/0.5 ml heparin, porcine (pf) injection syringe HEPATAMINE 8% PARENTERAL SOLUTION HEPATASOL 8 % PARENTERAL SOLUTION HERCEPTIN RECON SOLN HEXALEN ORAL CAPSULE HIGH POTENCY IRON ORAL TABLET HIST-PSE ORAL LIQUID HONEY BEARS ORAL TABLET,CHEWABLE HUMALOG KWIKPEN SUBCUTANEOUS INSULIN PEN HUMALOG MIX KWIKPEN SUBCUTANEOUS INSULIN PEN HUMALOG MIX SUBCUTANEOUS SUSPENSION HUMALOG MIX KWIKPEN SUBCUTANEOUS INSULIN PEN HUMALOG MIX SUBCUTANEOUS SUSPENSION HUMALOG SUBCUTANEOUS CARTRIDGE HUMALOG SUBCUTANEOUS SOLUTION HUMIRA CROHN'S DIS START PCK SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT HUMIRA PSORIASIS STARTER PACK SUBCUTANEOUS PEN INJECTOR KIT HUMIRA SUBCUTANEOUS KIT 20 MG/0.4 ML HUMIRA SUBCUTANEOUS KIT 40 MG/0.8 ML HUMULIN 70/30 KWIKPEN SUBCUTANEOUS INSULIN PEN 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 136

148 HUMULIN 70/30 PEN SUBCUTANEOUS INSULIN PEN HUMULIN 70/30 SUBCUTANEOUS SUSPENSION HUMULIN N KWIKPEN SUBCUTANEOUS INSULIN PEN HUMULIN N PEN SUBCUTANEOUS INSULIN PEN HUMULIN N SUBCUTANEOUS SUSPENSION HUMULIN R INJECTION SOLUTION HUMULIN R U hydralazine injection solution hydralazine oral tablet HYDRISALIC TOPICAL GEL HYDRO SKIN TOPICAL LOTION hydrochlorothiazide oral capsule hydrochlorothiazide oral tablet hydrocodoneacetaminophen oral solution mg/5 ml hydrocodoneacetaminophen oral solution mg/15 ml hydrocodoneacetaminophen oral tablet hydrocodone-ibuprofen oral tablet hydrocortisone butyrate topical cream hydrocortisone butyrate topical ointment hydrocortisone butyrate topical solution hydrocortisone butyremollient topical cream hydrocortisone oral tablet hydrocortisone rectal enema hydrocortisone topical cream 0.5 %, 1 % hydrocortisone topical cream 1 %, 2.5 % hydrocortisone topical lotion 2.5 % hydrocortisone topical ointment 0.5 %, 1 % hydrocortisone topical ointment 1 %, 2.5 % hydrocortisone valerate topical cream hydrocortisone valerate topical ointment hydrocortisone-acetic acid otic drops hydrocortisone-min oil-wht pet topical ointment hydromorphone (pf) injection solution 10 mg/ml hydromorphone oral liquid hydromorphone oral tablet hydroxocobalamin intramuscular solution hydroxychloroquine oral tablet... 9 hydroxyurea oral capsule 17 hydroxyzine hcl intramuscular solution 92 I ibandronate oral tablet IBUPROFEN COLD ORAL SUSPENSION 92 ibuprofen oral capsule ibuprofen oral suspension ibuprofen oral tablet 200 mg ibuprofen oral tablet 400 mg, 600 mg, 800 mg ibuprofen-oxycodone oral tablet ICAPS ORAL TABLET EXTENDED RELEASE ICLUSIG ORAL TABLET idarubicin intravenous solution IFEX RECON SOLN 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 137

149 IFOSFAMIDE RECON SOLN 1 GRAM ILARIS (PF) SUBCUTANEOUS RECON SOLN IMBRUVICA ORAL CAPSULE imipenem-cilastatin intravenous recon soln.. 9 imipramine hcl oral tablet imipramine pamoate oral capsule imiquimod topical cream in packet IMOVAX RABIES VACCINE (PF) INTRAMUSCULAR RECON SOLN INCRELEX SUBCUTANEOUS SOLUTION indapamide oral tablet INFANRIX (DTAP) (PF) INTRAMUSCULAR SUSPENSION INFANRIX (DTAP) (PF) INTRAMUSCULAR SYRINGE INFANTS GAS RELIEF ORAL DROPS,SUSPENSION INFANT'S IBUPROFEN ORAL DROPS,SUSPENSION INFANT'S PAIN RELIEF ORAL DROPS,SUSPENSION INFANTS' TRIAMINIC FEVER ORAL LIQUID INLYTA ORAL TABLET insulin pen needle insulin syringe (disp) u ml insulin syringe (disp) u ml insulin syringe (disp) u-100 1/2 ml INTELENCE ORAL TABLET 100 MG, 200 MG... 4 INTELENCE ORAL TABLET 25 MG... 4 INTRALIPID EMULSION 20 % INTRALIPID EMULSION 30 % INTRON A INJECTION RECON SOLN 10 MILLION UNIT (1 ML) INTRON A INJECTION SOLUTION 6 MILLION UNIT/ML introvale oral tablets,dose pack,3 month INVANZ INJECTION RECON SOLN... 9 INVANZ RECON SOLN... 9 INVEGA ORAL TABLET EXTENDED RELEASE 24HR INVEGA SUSTENNA INTRAMUSCULAR SYRINGE INVIRASE ORAL CAPSULE... 4 INVIRASE ORAL TABLET... 4 INVISIBLE ACNE TOPICAL CREAM INVOKANA ORAL TABLET IONOSOL-B IN D5W PARENTERAL SOLUTION IONOSOL-MB IN D5W PARENTERAL SOLUTION IPOL INJECTION SUSPENSION IPOL INJECTION SYRINGE ipratropium bromide inhalation solution ipratropium bromide nasal spray,non-aerosol 0.03 % ipratropium bromide nasal spray,non-aerosol 0.06 % 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 138

150 ipratropium-albuterol inhalation solution for nebulization irbesartan oral tablet irbesartanhydrochlorothiazide oral tablet IRINOTECAN SOLUTION 100 MG/5 ML, 40 MG/2 ML IRINOTECAN SOLUTION 500 MG/25 ML IROMIN-G MG. 107 IRON (FERROUS SULFATE) ORAL TABLET ISENTRESS ORAL POWDER IN PACKET 4 ISENTRESS ORAL TABLET... 4 ISENTRESS ORAL TABLET,CHEWABLE 4 ISOLYTE-P IN 5 % DEXTROSE PARENTERAL SOLUTION ISOLYTE-S PARENTERAL SOLUTION isoniazid injection solution 9 isoniazid oral solution... 9 isoniazid oral tablet... 9 ISORDIL ORAL TABLET isosorbide dinitrate oral tablet isosorbide dinitrate oral tablet extended release 46 isosorbide mononitrate oral tablet isosorbide mononitrate oral tablet extended release 24 hr isradipine oral capsule ISTODAX RECON SOLN itraconazole oral capsule. 2 IXIARO (PF) INTRAMUSCULAR SYRINGE J JAKAFI ORAL TABLET 10 MG, 15 MG, 20 MG, 5 MG JAKAFI ORAL TABLET 25 MG jantoven oral tablet JANUMET ORAL TABLET JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 62 JANUVIA ORAL TABLET jencycla oral tablet jolessa oral tablets,dose pack,3 month jolivette oral tablet junel 1.5/30 (21) oral tablet junel 1/20 (21) oral tablet junel fe 1.5/30 (28) oral tablet junel fe 1/20 (28) oral tablet K KADCYLA RECON SOLN KADIAN ORAL CAPSULE,EXTEND.RE LEASE KADIAN ORAL CAPSULE,EXTEND.RE LEASE PELLETS 200 MG KADIAN ORAL CAPSULE,EXTEND.RE LEASE PELLETS 60 MG KALETRA ORAL SOLUTION... 4 KALETRA ORAL TABLET... 4 kariva (28) oral tablet kelnor 1/35 (28) oral tablet KENALOG INJECTION SUSPENSION ketoconazole oral tablet... 2 ketoconazole topical cream ketoconazole topical shampoo 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 139

151 ketodan kit topical combo pack ketodan topical foam ketoprofen oral capsule.. 31 ketoprofen oral capsule,ext rel. pellets 24 hr ketorolac ophthalmic drops KHEDEZLA ORAL TABLET EXTENDED RELEASE 24HR KIDKARE COUGH/COLD ORAL LIQUID KIONEX ORAL POWDER kionex oral suspension klor-con 10 oral tablet extended release klor-con 8 oral tablet extended release klor-con m10 oral tablet,er particles/crystals klor-con m15 oral tablet,er particles/crystals klor-con m20 oral tablet,er particles/crystals klor-con oral packet KOMBIGLYZE XR ORAL TABLET, ER MULTIPHASE 24 HR 2.5-1,000 MG KOMBIGLYZE XR ORAL TABLET, ER MULTIPHASE 24 HR 5-1,000 MG, MG. 62 KONSYL (SUGAR) ORAL POWDER 3.4 GRAM/11 GRAM KONSYL (SUGAR) ORAL POWDER IN PACKET KONSYL (WITH ASPARTAME) ORAL POWDER KONSYL EASY MIX ORAL POWDER KONSYL FORMULA-D ORAL POWDER KONSYL ORAL POWDER IN PACKET K-PAX IMMUNE SUPPORT ORAL TABLET kurvelo oral tablet KUVAN ORAL TABLET,SOLUBLE.. 64 L l norgest&e estradiol-e estrad oral tablets,dose pack,3 month labetalol intravenous solution labetalol intravenous syringe labetalol oral tablet lactated ringers intravenous parenteral solution lactated ringers irrigation solution lactulose oral solution 10 gram/15 ml (15 ml) lactulose oral solution 10 gram/15 ml, 20 gram/30 ml LAMISIL (AEROSOL) TOPICAL AEROSOL,SPRAY LAMISIL AT TOPICAL GEL lamivudine oral tablet... 4 LAMIVUDINE- ZIDOVUDINE ORAL TABLET... 4 lamotrigine oral tablet lamotrigine oral tablet extended release 24hr. 22 lamotrigine oral tablet, chewable dispersible.. 22 lamotrigine oral tablets,dose pack LANOXIN ORAL TABLET 125 MCG, 250 MCG, 62.5 MCG LANOXIN ORAL TABLET MCG. 43 lansoprazole oral capsule,delayed release(dr/ec) 15 mg lansoprazole oral capsule,delayed release(dr/ec) 15 mg, 30 mg LASTACAFT OPHTHALMIC DROPS latanoprost ophthalmic drops LATUDA ORAL TABLET 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 140

152 LAXATIVE MAXIMUM STRENGTH ORAL TABLET leflunomide oral tablet lessina oral tablet LETAIRIS ORAL TABLET letrozole oral tablet leucovorin calcium injection recon soln 100 mg, 200 mg, 350 mg, 50 mg leucovorin calcium injection recon soln 500 mg leucovorin calcium oral tablet LEUKERAN ORAL TABLET LEUKINE INJECTION RECON SOLN leuprolide subcutaneous kit levalbuterol hcl inhalation solution for nebulization 0.31 mg/3 ml, 0.63 mg/3 ml levalbuterol hcl inhalation solution for nebulization 1.25 mg/0.5 ml, 1.25 mg/3 ml LEVEMIR FLEXPEN SUBCUTANEOUS INSULIN PEN LEVEMIR FLEXTOUCH SUBCUTANEOUS INSULIN PEN LEVEMIR SUBCUTANEOUS SOLUTION levetiracetam intravenous solution levetiracetam oral solution 100 mg/ml levetiracetam oral solution 500 mg/5 ml (5 ml) levetiracetam oral tablet 22 levetiracetam oral tablet extended release 24 hr 22 levobunolol ophthalmic drops levocarnitine (with sugar) oral solution levocarnitine intravenous solution levocarnitine oral tablet. 57 levocetirizine oral solution levocetirizine oral tablet. 92 levofloxacin in d5w intravenous piggyback 500 mg/100 ml levofloxacin intravenous solution levofloxacin ophthalmic drops levofloxacin oral solution 13 levofloxacin oral tablet levonorgestrel oral tablet 0.75 mg levonorgestrel oral tablet 1.5 mg levonorgestrel-ethinyl estrad oral tablet mg-mcg levonorgestrel-ethinyl estrad oral tablet mg-mcg levonorgestrel-ethinyl estrad oral tablets,dose pack,3 month levora-28 oral tablet levorphanol tartrate oral tablet LEVOTHYROXINE RECON SOLN 100 MCG levothyroxine oral tablet 65 levoxyl oral tablet LEXIVA ORAL SUSPENSION... 4 LEXIVA ORAL TABLET4 LIALDA ORAL TABLET,DELAYED RELEASE (DR/EC) LICE COMPLETE KIT TOPICAL KIT LICE KILLING TOPICAL SHAMPOO LICE TREATMENT TOPICAL LIQUID lidocaine (pf) injection solution 10 mg/ml (1 %), 20 mg/ml (2 %), 40 mg/ml (4 %), 5 mg/ml (0.5 %) lidocaine (pf) injection solution 15 mg/ml (1.5 %) lidocaine hcl injection solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 141

153 lidocaine hcl laryngotracheal solution lidocaine hcl mucous membrane gel lidocaine hcl mucous membrane jelly in applicator lidocaine hcl mucous membrane solution 2 % lidocaine hcl mucous membrane solution 4 % lidocaine topical adhesive patch,medicated lidocaine topical ointment lidocaine viscous mucous membrane solution lidocaine-prilocaine topical cream lidocaine-prilocaine topical kit lindane topical lotion lindane topical shampoo 55 liothyronine intravenous solution liothyronine oral tablet LIPOSYN II EMULSION liposyn iii intravenous emulsion lisinopril oral tablet lisinoprilhydrochlorothiazide oral tablet lithium carbonate oral capsule lithium carbonate oral tablet lithium carbonate oral tablet extended release 36 lithium citrate oral solution LOHIST - D ORAL LIQUID LOHIST-PEB ORAL LIQUID LOMUSTINE ORAL CAPSULE loperamide oral capsule. 66 loperamide oral liquid 1 mg/7.5 ml loperamide oral tablet lorazepam intensol oral concentrate lorazepam oral tablet LORTUSS DM ORAL LIQUID LORTUSS LQ ORAL LIQUID losartan oral tablet losartanhydrochlorothiazide oral tablet LOTRONEX ORAL TABLET lovastatin oral tablet LOVAZA ORAL CAPSULE low-ogestrel (28) oral tablet loxapine succinate oral capsule 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 lta pre-attached laryngotracheal solution LUMIGAN OPHTHALMIC DROPS LUPRON DEPOT (3 MONTH) INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT (4 MONTH) INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT (6 MONTH) INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT INTRAMUSCULAR SYRINGE KIT LUPRON DEPOT-PED INTRAMUSCULAR KIT MG, 15 MG lutera (28) oral tablet LYRICA ORAL CAPSULE LYRICA ORAL SOLUTION LYSODREN ORAL TABLET lyza oral tablet M magnesium oxide oral tablet 420 mg magnesium sulfate injection solution 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 142

154 magnesium sulfate injection syringe MALARONE PEDIATRIC ORAL TABLET... 9 malathion topical lotion. 55 MAPAP (ACETAMINOPHEN) ORAL CAPSULE maprotiline oral tablet marlissa oral tablet MARPLAN ORAL TABLET MATULANE ORAL CAPSULE matzim la oral tablet extended release 24 hr 41 meclizine oral tablet meclizine oral tablet,chewable meclofenamate oral capsule MEDI-CORTISONE TOPICAL CREAM MEDIPLAST CORN- CALLUS-WART TOPICAL ADHESIVE PATCH,MEDICATED medroxyprogesterone intramuscular suspension medroxyprogesterone intramuscular syringe. 79 medroxyprogesterone oral tablet mefenamic acid oral capsule mefloquine oral tablet... 9 megestrol oral tablet MEKINIST ORAL TABLET meloxicam oral suspension meloxicam oral tablet melphalan intravenous recon soln MENACTRA (PF) INTRAMUSCULAR SOLUTION M-END DMX ORAL LIQUID MENOMUNE - A/C/Y/W- 135 (PF) SUBCUTANEOUS RECON SOLN MENOMUNE - A/C/Y/W- 135 SUBCUTANEOUS RECON SOLN MENVEO A-C-Y-W-135- DIP (PF) INTRAMUSCULAR KIT MEPHYTON ORAL TABLET meprobamate oral tablet 26 mercaptopurine oral tablet meropenem intravenous recon soln 500 mg... 9 mesalamine rectal enema 69 mesalamine with cleansing wipe rectal enema kit.. 69 mesna intravenous solution MESNEX ORAL TABLET MESTINON ORAL SYRUP MESTINON TIMESPAN ORAL TABLET EXTENDED RELEASE metadate er oral tablet extended release METAMUCIL FIBER SINGLES ORAL POWDER IN PACKET metaproterenol oral syrup metaproterenol oral tablet metaxalone oral tablet metformin oral tablet metformin oral tablet extended release 24 hr 62 metformin oral tablet extended release 24hr. 62 methadone injection solution methadone intensol oral concentrate methadone oral concentrate methadone oral solution 10 mg/5 ml methadone oral solution 5 mg/5 ml methadone oral tablet 10 mg methadone oral tablet 5 mg methadone oral tablet,soluble 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 143

155 methadose oral concentrate methadose oral tablet,soluble methamphetamine oral tablet methazolamide oral tablet methenamine hippurate oral tablet methimazole oral tablet.. 60 methotrexate sodium (pf) injection recon soln methotrexate sodium (pf) injection solution methotrexate sodium injection solution methotrexate sodium oral tablet methoxsalen rapid oral capsule methscopolamine oral tablet methyclothiazide oral tablet methyldopahydrochlorothiazide oral tablet METHYLERGONOVINE INJECTION SOLUTION methylergonovine oral tablet methylphenidate oral capsule, er biphasic mg, 50 mg, 60 mg methylphenidate oral capsule,er biphasic methylphenidate oral solution methylphenidate oral tablet methylphenidate oral tablet extended release methylphenidate oral tablet extended release 24hr 18 mg methylprednisolone acetate injection suspension methylprednisolone oral tablet methylprednisolone oral tablets,dose pack methylprednisolone sodium succ injection recon soln 125 mg methylprednisolone sodium succ injection recon soln 40 mg methylprednisolone sodium succ intravenous recon soln metipranolol ophthalmic drops metoclopramide hcl injection solution metoclopramide hcl injection syringe metoclopramide hcl oral solution metoclopramide hcl oral tablet metolazone oral tablet metoprolol succinate oral tablet extended release 24 hr metoprolol tahydrochlorothiaz oral tablet metoprolol tartrate intravenous solution metoprolol tartrate intravenous syringe metoprolol tartrate oral tablet metronidazole in nacl (isoos) intravenous piggyback metronidazole oral capsule... 9 metronidazole oral tablet 10 metronidazole topical cream metronidazole topical gel 49 metronidazole topical gel with pump metronidazole topical lotion metronidazole vaginal gel mexiletine oral capsule MIACALCIN INJECTION SOLUTION MI-ACID ORAL TABLET,CHEWABLE miconazole nitrate vaginal comb pack,prefill appl & cream miconazole nitrate vaginal cream 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 144

156 miconazole nitrate vaginal kit miconazole nitrate vaginal suppository MICONAZOLE-3 VAGINAL KIT miconazole-3 vaginal suppository microgestin 1.5/30 (21) oral tablet microgestin 1/20 (21) oral tablet microgestin fe 1.5/30 (28) oral tablet microgestin fe 1/20 (28) oral tablet midodrine oral tablet migergot rectal suppository MILK OF MAGNESIA CONCENTRATED ORAL SUSPENSION 70 MILK OF MAGNESIA ORAL SUSPENSION 70 millipred oral tablet mineral oil oral oil minocycline oral capsule 13 minocycline oral tablet.. 13 minocycline oral tablet extended release 24 hr 13 minoxidil oral tablet mirtazapine oral tablet mirtazapine oral tablet,disintegrating misoprostol oral tablet mitomycin intravenous recon soln 20 mg mitoxantrone intravenous concentrate M-M-R II (PF) SUBCUTANEOUS RECON SOLN modafinil oral tablet moexipril oral tablet moexiprilhydrochlorothiazide oral tablet mometasone topical cream mometasone topical ointment mometasone topical solution mono-linyah oral tablet.. 82 mononessa (28) oral tablet montelukast oral granules in packet montelukast oral tablet montelukast oral tablet,chewable morgidox oral capsule morphine concentrate oral solution morphine oral capsule, er multiphase 24 hr 120 mg morphine oral capsule, er multiphase 24 hr 30 mg, 45 mg, 60 mg, 75 mg, 90 mg morphine oral capsule,extend.release pellets morphine oral solution morphine oral tablet morphine oral tablet extended release 100 mg morphine oral tablet extended release 15 mg, 30 mg, 60 mg morphine oral tablet extended release 200 mg MOTION RELIEF (MECLIZINE) ORAL TABLET MOTION SICKNESS ORAL TABLET MOVIPREP ORAL POWDER IN PACKET moxifloxacin oral tablet.. 13 MOZOBIL SUBCUTANEOUS SOLUTION MUCINEX COLD & SINUS ORAL LIQUID MUCINEX COUGH MINI-MELTS ORAL GRANULES IN PACKET MUCINEX D MAXIMUM STRENGTH ORAL TABLET EXTENDED RELEASE 12 HR MUCINEX D ORAL TABLET EXTENDED RELEASE 12 HR 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 145

157 MUCINEX DM ORAL TABLET EXTENDED RELEASE 12 HR MUCINEX DM ORAL TABLET, ER MULTIPHASE 12 HR 93 MUCINEX MINI-MELTS ORAL GRANULES IN PACKET 100 MG MUCINEX MINI-MELTS ORAL GRANULES IN PACKET 50 MG MUCINEX ORAL TABLET,ER BIPHASIC 12 HR 1,200 MG MULTAQ ORAL TABLET MULTI-DELYN ORAL LIQUID MULTI-DELYN WITH IRON ORAL LIQUID mupirocin calcium topical cream mupirocin topical ointment MURO 128 OPHTHALMIC DROPS MURO 128 OPHTHALMIC OINTMENT MUSTARGEN INJECTION RECON SOLN mycophenolate mofetil oral capsule mycophenolate mofetil oral tablet mycophenolate sodium oral tablet,delayed release (dr/ec) MYKIDZ IRON ORAL SUSPENSION 10-1, MG -UNIT-UNIT/2 ML MYOZYME RECON SOLN MYRBETRIQ ORAL TABLET EXTENDED RELEASE 24 HR myzilra oral tablet N nabumetone oral tablet nadolol oral tablet nadololbendroflumethiazide oral tablet NAFCILLIN IN DEXTROSE ISO-OSM PIGGYBACK 1 GRAM/50 ML NAFCILLIN IN DEXTROSE ISO-OSM PIGGYBACK 2 GRAM/100 ML nafcillin injection recon soln 1 gram NAFCILLIN INJECTION RECON SOLN 10 GRAM, 2 GRAM nafcillin intravenous recon soln 1 gram NAFCILLIN RECON SOLN 2 GRAM NAGLAZYME SOLUTION NAIL-EX 2.5 MG TABLET nalbuphine injection solution 10 mg/ml nalbuphine injection solution 20 mg/ml naloxone injection syringe 1 mg/ml naltrexone oral tablet NAMENDA ORAL SOLUTION NAMENDA XR ORAL CAP,SPRINKLE,ER 24HR DOSE PACK NAMENDA XR ORAL CAPSULE,SPRINKLE, ER 24HR naphazoline ophthalmic drops NAPRELAN CR ORAL TABLET, ER MULTIPHASE 24 HR 32 naproxen oral suspension32 naproxen oral tablet naproxen oral tablet,delayed release (dr/ec) naproxen sodium oral capsule 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 146

158 naproxen sodium oral tablet 220 mg naproxen sodium oral tablet 275 mg, 550 mg 32 naratriptan oral tablet NASACORT AQ NASAL AEROSOL,SPRAY NASAL DECONGESTANT (PE) ORAL TABLET NASAL DECONGESTANT ORAL LIQUID NASAL DECONGESTANT ORAL TABLET NASONEX NASAL SPRAY,NON- AEROSOL NATACYN OPHTHALMIC DROPS,SUSPENSION nateglinide oral tablet NATURAL B-100 COMPLEX ORAL TABLET NATURAL BALANCE OPHTHALMIC DROPS NEBUPENT INHALATION RECON SOLN necon 0.5/35 (28) oral tablet necon 1/35 (28) oral tablet necon 10/11 (28) oral tablet necon 7/7/7 (28) oral tablet needles, insulin disp.,safety nefazodone oral tablet neomycin oral tablet neomycin-bacitracin-polyhc ophthalmic ointment 86 neomycin-bacitracinpolymyxin ophthalmic ointment neomycin-polymyxin b gu irrigation solution neomycin-polymyxindexameth ophthalmic drops,suspension neomycin-polymyxindexameth ophthalmic ointment neomycin-polymyxingramicidin ophthalmic drops neomycin-polymyxin-hc ophthalmic drops,suspension neomycin-polymyxin-hc otic drops,suspension. 59 neomycin-polymyxin-hc otic solution neo-polycin hc ophthalmic ointment neo-polycin ophthalmic ointment NEORAL ORAL CAPSULE NEORAL ORAL SOLUTION NEPHRAMINE 5.4 % PARENTERAL SOLUTION NEPHRONEX ORAL LIQUID NEUMEGA SUBCUTANEOUS RECON SOLN NEUPOGEN INJECTION SOLUTION 480 MCG/1.6 ML NEUPOGEN INJECTION SYRINGE NEUPRO TRANSDERMAL PATCH 24 HOUR nevirapine oral suspension4 nevirapine oral tablet... 4 nevirapine oral tablet extended release 24 hr.. 4 NEXAVAR ORAL TABLET NEXIUM IV RECON SOLN 20 MG NEXIUM IV RECON SOLN 40 MG NEXT CHOICE ONE DOSE ORAL TABLET niacin oral tablet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 147

159 niacin oral tablet extended release 1,000 mg, 750 mg niacin oral tablet extended release 24 hr nicardipine intravenous solution nicardipine oral capsule. 41 NICODERM CQ TRANSDERMAL PATCH 24 HOUR nicotine (polacrilex) buccal gum nicotine (polacrilex) buccal lozenge 2 mg nicotine (polacrilex) buccal lozenge 4 mg nicotine transdermal patch 24 hour nicotine transdermal patch, td daily, sequential NICOTROL INHALATION CARTRIDGE NICOTROL NS NASAL SPRAY,NON- AEROSOL nifedical xl oral tablet extended release 24hr. 41 nifedipine oral tablet extended release nifedipine oral tablet extended release 24hr. 42 NIGHTTIME COUGH ORAL SOLUTION NIGHT-TIME ORAL LIQUID NIGHTTIME SINUS ORAL CAPSULE NILANDRON ORAL TABLET nimodipine oral capsule. 42 nisoldipine oral tablet extended release 24 hr 42 nitro-bid transdermal ointment nitrofurantoin macrocrystal oral capsule 50 mg nitrofurantoin monohyd/mcryst oral capsule nitroglycerin intravenous solution nitroglycerin transdermal patch 24 hour nitroglycerin translingual aerosol,spray nitroglycerin translingual spray,non-aerosol NITROLINGUAL TRANSLINGUAL SPRAY,NON- AEROSOL NITROSTAT SUBLINGUAL TABLET nizatidine oral capsule nizatidine oral solution NORDITROPIN FLEXPRO SUBCUTANEOUS PEN INJECTOR NORDITROPIN NORDIFLEX SUBCUTANEOUS PEN INJECTOR NOREL AD ORAL TABLET NOREL CS ORAL LIQUID norethindrone (contraceptive) oral tablet norethindrone acetate oral tablet norgestimate-ethinyl estradiol oral tablet NORMOSOL-M IN 5 % DEXTROSE PARENTERAL SOLUTION NORMOSOL-R IN 5 % DEXTROSE PARENTERAL SOLUTION NORMOSOL-R PH 7.4 PARENTERAL SOLUTION nortrel 0.5/35 (28) oral tablet nortrel 1/35 (21) oral tablet nortrel 1/35 (28) oral tablet nortrel 7/7/7 (28) oral tablet nortriptyline oral capsule 36 nortriptyline oral solution NORVIR ORAL CAPSULE... 4 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 148

160 NORVIR ORAL SOLUTION... 4 NORVIR ORAL TABLET... 4 novarel intramuscular recon soln NOVOFINE NEEDLE NOVOLIN 70/30 SUBCUTANEOUS SUSPENSION NOVOLIN N SUBCUTANEOUS SUSPENSION NOVOLIN R INJECTION SOLUTION NOVOLOG FLEXPEN SUBCUTANEOUS INSULIN PEN NOVOLOG MIX FLEXPEN SUBCUTANEOUS INSULIN PEN NOVOLOG MIX SUBCUTANEOUS SOLUTION NOVOLOG PENFILL SUBCUTANEOUS CARTRIDGE NOVOLOG SUBCUTANEOUS SOLUTION NOVOTWIST NEEDLE 63 NOXAFIL ORAL SUSPENSION... 2 NUCYNTA ER ORAL TABLET EXTENDED RELEASE 12 HR NUCYNTA ORAL TABLET NUEDEXTA ORAL CAPSULE NULOJIX RECON SOLN NUVARING VAGINAL RING NUVIGIL ORAL TABLET 150 MG, 250 MG, 50 MG nyamyc topical powder.. 52 nystatin oral suspension... 2 nystatin oral tablet... 2 nystatin topical cream nystatin topical ointment 52 nystatin topical powder.. 52 nystatin-triamcinolone topical cream nystatin-triamcinolone topical ointment nystop topical powder O OCTREOTIDE ACETATE INJECTION SOLUTION 1,000 MCG/ML, 500 MCG/ML octreotide acetate injection solution 100 mcg/ml, 200 mcg/ml, 50 mcg/ml octreotide acetate injection syringe 100 mcg/ml (1 ml), 50 mcg/ml (1 ml) OCTREOTIDE ACETATE INJECTION SYRINGE 500 MCG/ML (1 ML) 18 OCUVITE EXTRA TABLET ofloxacin ophthalmic drops ofloxacin oral tablet ofloxacin otic drops ogestrel (28) oral tablet.. 82 olanzapine intramuscular recon soln olanzapine oral tablet olanzapine oral tablet,disintegrating olanzapine-fluoxetine oral capsule OLYSIO ORAL CAPSULE... 4 omega-3 acid ethyl esters oral capsule omeprazole oral capsule,delayed release(dr/ec) omeprazole oral tablet,delayed release (dr/ec) omeprazole-sodium bicarbonate oral capsule ONCASPAR INJECTION SOLUTION ondansetron hcl (pf) injection solution ondansetron hcl (pf) injection syringe ondansetron hcl intravenous solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 149

161 ondansetron hcl oral solution ondansetron hcl oral tablet 24 mg ondansetron hcl oral tablet 4 mg, 8 mg ondansetron oral tablet,disintegrating ONE DAILY WOMEN'S HEALTH ORAL TABLET ONE-A-DAY MEN'S MULTIVITAMIN ORAL TABLET ONE-A-DAY WOMENS FORMULA ORAL TABLET 18 MG IRON- 400 MCG-500 MG CA ONFI ORAL SUSPENSION ONFI ORAL TABLET.. 22 ONGLYZA ORAL TABLET ORACEA ORAL CAPSULE, ER MULTIPHASE 24 HR 14 oralone dental paste ORAP ORAL TABLET. 37 orsythia oral tablet ORTHO EVRA TRANSDERMAL PATCH WEEKLY ORTHO TRI-CYCLEN LO (28) ORAL TABLET. 82 otassium chloride oral liquid oxacillin in dextrose(isoosm) intravenous piggyback 1 gram/50 ml OXACILLIN IN DEXTROSE(ISO-OSM) PIGGYBACK 2 GRAM/50 ML oxacillin injection recon soln 1 gram, 2 gram OXACILLIN INJECTION RECON SOLN 10 GRAM oxacillin intravenous recon soln OXALIPLATIN SOLUTION 100 MG/20 ML OXANDROLONE ORAL TABLET 10 MG oxandrolone oral tablet 2.5 mg oxaprozin oral tablet oxazepam oral capsule oxcarbazepine oral suspension oxcarbazepine oral tablet 22 OXSORALEN ULTRA ORAL CAPSULE OXTELLAR XR ORAL TABLET EXTENDED RELEASE 24 HR oxybutynin chloride oral syrup oxybutynin chloride oral tablet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 oxybutynin chloride oral tablet extended release24hr oxycodone oral capsule.. 29 oxycodone oral concentrate oxycodone oral solution. 29 oxycodone oral tablet 10 mg, 15 mg, 20 mg oxycodone oral tablet 30 mg oxycodone oral tablet 5 mg oxycodone-acetaminophen oral tablet oxycodone-aspirin oral tablet oxymorphone oral tablet 10 mg oxymorphone oral tablet 5 mg oxymorphone oral tablet extended release 12 hr 29 P pacerone oral tablet PACLITAXEL CONCENTRATE pamidronate intravenous recon soln pamidronate intravenous solution PANOXYL TOPICAL BAR PANOXYL-4 TOPICAL CLEANSER PANRETIN TOPICAL GEL 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 150

162 pantoprazole oral tablet,delayed release (dr/ec) pantothenic acid oral tablet paricalcitol oral capsule 65 paromomycin oral capsule paroxetine hcl oral tablet 37 paroxetine hcl oral tablet extended release 24 hr 37 PASER ORAL GRANULES DR FOR SUSP IN PACKET PATADAY OPHTHALMIC DROPS PATANOL OPHTHALMIC DROPS PAXIL ORAL SUSPENSION PEDIA-LAX STOOL SOFTENER ORAL SYRUP PEDIALYTE ORAL SOLUTION PEDIATEX TDM ORAL LIQUID PEDIATRIC ELECTROLYTE ORAL SOLUTION pedi-dri topical powder.. 52 PEDVAX HIB (PF) INTRAMUSCULAR SOLUTION peg 3350-electrolytes oral recon soln gram peg-3350 with flavor packs oral recon soln PEGANONE ORAL TABLET peg-electrolyte soln oral recon soln PEGINTRON REDIPEN SUBCUTANEOUS PEN INJECTOR KIT PEGINTRON SUBCUTANEOUS KIT penicillin g potassium injection recon soln 5 million unit penicillin g procaine intramuscular syringe 1.2 million unit/2 ml penicillin g procaine intramuscular syringe 600,000 unit/ml penicillin g sodium injection recon soln penicillin v potassium oral recon soln penicillin v potassium oral tablet PENTAM INJECTION RECON SOLN PENTASA ORAL CAPSULE, EXTENDED RELEASE pentoxifylline oral tablet extended release PEPCID AC ORAL TABLET 20 MG PEPCID AC ORAL TABLET,CHEWABLE PEPTO-BISMOL ORAL TABLET PERFOROMIST INHALATION SOLUTION FOR NEBULIZATION perindopril erbumine oral tablet periogard mucous membrane mouthwash 58 PERJETA SOLUTION permethrin topical cream 55 permethrin topical liquid 55 perphenazine oral tablet. 37 perphenazine-amitriptyline oral tablet PETROLEUM JELLY TOPICAL GEL phenelzine oral tablet phenobarbital oral elixir 23 phenobarbital oral tablet 23 PHENYTEK ORAL CAPSULE phenytoin oral suspension 100 mg/4 ml phenytoin oral suspension 125 mg/5 ml phenytoin oral tablet,chewable phenytoin sodium extended oral capsule 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 151

163 phenytoin sodium intravenous solution phenytoin sodium intravenous syringe philith oral tablet PHOSPHOLINE IODIDE OPHTHALMIC DROPS pilocarpine hcl ophthalmic drops pilocarpine hcl oral tablet pindolol oral tablet pioglitazone oral tablet.. 63 pioglitazone-glimepiride oral tablet pioglitazone-metformin oral tablet piperacillin-tazobactam intravenous recon soln 12 pirmella oral tablet piroxicam oral capsule PLASMA-LYTE 148 PARENTERAL SOLUTION PLASMA-LYTE A PARENTERAL SOLUTION PLASMA-LYTE-56 IN 5 % DEXTROSE PARENTERAL SOLUTION podofilox topical solution 48 polycin ophthalmic ointment polyethylene glycol 3350 oral powder polyethylene glycol 3350 oral powder in packet. 71 polymyxin b sulfate injection recon soln polymyxin b sulftrimethoprim ophthalmic drops POLY-VI-SOL ORAL DROPS POLY-VI-SOL WITH IRON ORAL DROPS POLY-VITAMIN ORAL DROPS POMALYST ORAL CAPSULE portia oral tablet potassium bicarb & chloride oral tablet, effervescent potassium chlorid-d5-0.45%nacl intravenous parenteral solution 10 meq/l, 30 meq/l, 40 meq/l potassium chlorid-d5-0.45%nacl intravenous parenteral solution 20 meq/l potassium chloride in 0.9%nacl intravenous parenteral solution potassium chloride in 5 % dex intravenous parenteral solution potassium chloride in lr-d5 intravenous parenteral solution 20 meq/l potassium chloride in lr-d5 intravenous parenteral solution 40 meq/l potassium chloride intravenous parenteral solution potassium chloride intravenous piggyback potassium chloride oral capsule, extended release potassium chloride oral tablet extended release 10 meq, 8 meq potassium chloride oral tablet extended release 20 meq potassium chloride oral tablet,er particles/crystals potassium chloride-0.45 % nacl intravenous parenteral solution potassium chloride-d5-0.2%nacl intravenous parenteral solution 20 meq/l potassium chloride-d5-0.2%nacl intravenous parenteral solution 30 meq/l, 40 meq/l potassium chloride-d5-0.3%nacl intravenous parenteral solution 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 152

164 potassium chloride-d5-0.9%nacl intravenous parenteral solution potassium citrate oral tablet extended release 10 meq, 5 meq POTIGA ORAL TABLET povidone-iodine topical ointment povidone-iodine topical swab 10 % pramipexole oral tablet.. 24 pravastatin oral tablet prazosin oral capsule prednicarbate topical cream prednicarbate topical ointment prednisolone acetate ophthalmic drops,suspension prednisolone oral solution prednisolone sodium phosphate ophthalmic drops prednisolone sodium phosphate oral solution 15 mg/5 ml, 5 mg base/5 ml (6.7 mg/5 ml) prednisolone sodium phosphate oral solution 25 mg/5 ml (5 mg/ml). 60 prednisone intensol oral concentrate prednisone oral solution. 60 prednisone oral tablet prednisone oral tablets,dose pack PREGNYL INTRAMUSCULAR RECON SOLN PREMARIN INJECTION RECON SOLN PREMARIN VAGINAL CREAM PREMASOL 10 % PARENTERAL SOLUTION PREMASOL 6 % PARENTERAL SOLUTION PRE-MENSTRUAL RELIEF ORAL TABLET prenatal vitamins oral tablet PRESERVISION AREDS 2 (OMEGA-3) ORAL CAPSULE prevalite oral powder prevalite oral powder in packet previfem oral tablet PREZISTA ORAL SUSPENSION... 4 PREZISTA ORAL TABLET 150 MG, 600 MG, 75 MG, 800 MG... 4 PRIFTIN ORAL TABLET PRILOSEC OTC ORAL TABLET,DELAYED RELEASE (DR/EC) PRIMAQUINE ORAL TABLET PRIMATENE ASTHMA ORAL TABLET primidone oral tablet PRISTIQ ORAL TABLET EXTENDED RELEASE 24 HR PROAIR HFA INHALATION HFA AEROSOL INHALER97 probenecid oral tablet procainamide injection solution 100 mg/ml procainamide injection solution 500 mg/ml PROCALAMINE 3% PARENTERAL SOLUTION PRO-CHLO ORAL LIQUID prochlorperazine edisylate injection solution prochlorperazine maleate oral tablet prochlorperazine rectal suppository PROCRIT INJECTION SOLUTION 10,000 UNIT/ML, 2,000 UNIT/ML, 20,000 UNIT/2 ML, 20,000 UNIT/ML, 3,000 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 153

165 UNIT/ML, 4,000 UNIT/ML PROCRIT INJECTION SOLUTION 40,000 UNIT/ML procto-pak rectal cream. 71 proctozone-hc rectal cream progesterone micronized oral capsule PROGLYCEM ORAL SUSPENSION PROLEUKIN RECON SOLN PROLIA SUBCUTANEOUS SYRINGE PROMACTA ORAL TABLET propafenone oral capsule,extended release 12 hr propafenone oral tablet.. 38 proparacaine ophthalmic drops propranolol intravenous solution propranolol oral capsule,extended release 24 hr propranolol oral solution 42 propranolol oral tablet propranololhydrochlorothiazid oral tablet propylthiouracil oral tablet PROQUAD (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION. 76 PROSOL 20 % PARENTERAL SOLUTION PROTOPIC TOPICAL OINTMENT protriptyline oral tablet.. 37 PROVENTIL HFA INHALATION HFA AEROSOL INHALER 97 pseudoephedrine hcl oral liquid pseudoephedrine hcl oral tablet 60 mg PULMOZYME INHALATION SOLUTION pyrazinamide oral tablet 10 PYRETHRIN LICE TREATMENT M TOPICAL LIQUID pyridostigmine bromide oral tablet pyridoxine injection solution pyridoxine oral tablet 100 mg, 25 mg, 50 mg PYRIL DM ORAL SUSPENSION pyrilamine-phenylephrine oral suspension 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 Q quasense oral tablets,dose pack,3 month QUDEXY XR ORAL CAPSULE,SPRINKLE, ER 24HR quetiapine oral tablet quinapril oral tablet quinaprilhydrochlorothiazide oral tablet quinidine gluconate injection solution quinidine gluconate oral tablet extended release 38 quinidine sulfate oral tablet quinidine sulfate oral tablet extended release quinine sulfate oral capsule QVAR INHALATION AEROSOL R RABAVERT (PF) INTRAMUSCULAR KIT rabeprazole oral tablet,delayed release (dr/ec) raloxifene oral tablet ramipril oral capsule RANEXA ORAL TABLET EXTENDED RELEASE 12 HR ranitidine hcl injection solution ranitidine hcl oral capsule ranitidine hcl oral syrup. 73 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 154

166 ranitidine hcl oral tablet 150 mg, 300 mg RAPAMUNE ORAL SOLUTION RAPAMUNE ORAL TABLET RAYOS ORAL TABLET,DELAYED RELEASE (DR/EC) REBIF (WITH ALBUMIN) SUBCUTANEOUS SYRINGE REBIF TITRATION PACK SUBCUTANEOUS SYRINGE reclipsen (28) oral tablet 82 RECOMBIVAX HB (PF) INTRAMUSCULAR SUSPENSION 10 MCG/ML, 40 MCG/ML RECOMBIVAX HB (PF) INTRAMUSCULAR SYRINGE 10 MCG/ML REFRESH CLASSIC (PF) OPHTHALMIC DROPPERETTE REFRESH OPTIVE SENSITIVE (PF) OPHTHALMIC DROPPERETTE regonol injection solution 26 REGRANEX TOPICAL GEL REGULOID ORAL POWDER RELEASE RELENZA DISKHALER INHALATION BLISTER WITH DEVICE... 4 RELISTOR SUBCUTANEOUS KIT RELISTOR SUBCUTANEOUS SOLUTION RELISTOR SUBCUTANEOUS SYRINGE REMICADE RECON SOLN REMODULIN INJECTION SOLUTION RENVELA ORAL POWDER IN PACKET RENVELA ORAL TABLET repaglinide oral tablet 0.5 mg repaglinide oral tablet 1 mg repaglinide oral tablet 2 mg reprexain oral tablet RESCON ORAL TABLET RESCON-DM ORAL LIQUID RESCRIPTOR ORAL TABLET... 4 RESCRIPTOR ORAL TABLET, DISPERSIBLE... 4 reserpine oral tablet RESINOL TOPICAL OINTMENT RESTASIS OPHTHALMIC DROPPERETTE RETROVIR SOLUTION... 4 REVLIMID ORAL CAPSULE REYATAZ ORAL CAPSULE... 4 RHEUMATREX ORAL TABLETS,DOSE PACK ribavirin oral capsule... 4 ribavirin oral tablet... 5 rifabutin oral capsule rifampin intravenous recon soln rifampin oral capsule riluzole oral tablet rimantadine oral tablet... 5 ringers intravenous parenteral solution risedronate oral tablet RISPERDAL CONSTA INTRAMUSCULAR SYRINGE risperidone oral solution 37 risperidone oral tablet risperidone oral tablet,disintegrating 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 155

167 RITUXAN CONCENTRATE rivastigmine tartrate oral capsule 1.5 mg rivastigmine tartrate oral capsule 3 mg rivastigmine tartrate oral capsule 4.5 mg, 6 mg.. 25 rizatriptan oral tablet rizatriptan oral tablet,disintegrating ROBAFEN COUGH ORAL CAPSULE ROBITUSSIN COUGH & COLD CF ORAL LIQUID ROBITUSSIN LONG- ACTING ORAL LIQUID ROBITUSSIN PEDIATRIC ORAL SYRUP ropinirole oral tablet ropinirole oral tablet extended release 24 hr 24 rosadan topical cream rosadan topical gel ROTARIX ORAL SUSPENSION FOR RECONSTITUTION. 76 ROTATEQ VACCINE ORAL SUSPENSION 77 ROZEREM ORAL TABLET RU-HIST-D (WITH PYRILAMINE) ORAL TABLET RYMED ORAL TABLET 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 S SABRIL ORAL POWDER IN PACKET SABRIL ORAL TABLET SALINE MIST NASAL AEROSOL, SPRAY SANCUSO TRANSDERMAL PATCH WEEKLY SANDIMMUNE ORAL CAPSULE SANDIMMUNE ORAL SOLUTION SANDOSTATIN LAR DEPOT INTRAMUSCULAR KIT SANI-SUPP (ADULT) RECTAL SUPPOSITORY SANTYL TOPICAL OINTMENT SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET SAPHRIS SUBLINGUAL TABLET SAVELLA ORAL TABLET SAVELLA ORAL TABLETS,DOSE PACK SCALPICIN TOPICAL SOLUTION SCOT-TUSSIN DM ORAL LIQUID SCOT-TUSSIN SENIOR ORAL LIQUID SEBEX TOPICAL SHAMPOO SECURA EXTRA PROTECTIVE TOPICAL CREAM selegiline hcl oral capsule selegiline hcl oral tablet. 24 selenium sulfide topical suspension SELZENTRY ORAL TABLET... 5 SENEXON ORAL SYRUP SENNA ORAL TABLET SENOKOTXTRA ORAL TABLET SENSIPAR ORAL TABLET SEREVENT DISKUS INHALATION BLISTER WITH DEVICE SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 HR sertraline oral concentrate sertraline oral tablet sevelamer carbonate oral tablet sf 5000 plus dental cream 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 156

168 SIGNIFOR SUBCUTANEOUS SOLUTION sildenafil oral tablet SILPHEN DM COUGH LIQUID 10 MG/5 ML 94 SILTUSSIN SA ORAL LIQUID silver sulfadiazine topical cream SIMCOR ORAL TABLET, ER MULTIPHASE 24 HR 1, MG, MG, MG, MG SIMULECT RECON SOLN 20 MG simvastatin oral tablet SINUS CONG & PAIN DAY-NIGHT ORAL TABLETS, SEQUENTIAL sirolimus oral tablet SLOW RELEASE IRON ORAL TABLET EXTENDED RELEASE 140 MG (45 MG IRON), 142 MG (45 MG IRON), 143 MG (45 MG IRON), 47.5 MG IRON SLOW RELEASE IRON ORAL TABLET EXTENDED RELEASE 160 MG (50 MG IRON) sodium bicarbonate oral tablet sodium chloride 0.45 % intravenous parenteral solution sodium chloride 0.45 % intravenous piggyback sodium chloride 0.9 % intravenous parenteral solution sodium chloride 0.9 % intravenous piggyback 57 sodium chloride 3 % intravenous parenteral solution sodium chloride 5 % intravenous parenteral solution sodium chloride intravenous parenteral solution sodium chloride irrigation solution sodium fluoride dental solution sodium fluoride oral tablet sodium lactate intravenous solution sodium polystyrene (sorb free) oral suspension.. 57 sodium polystyrene sulfonate oral powder. 57 sodium polystyrene sulfonate oral suspension SOLTAMOX ORAL SOLUTION SOLU-CORTEF (PF) INJECTION RECON SOLN 100 MG/2 ML, 250 MG/2 ML SOMATULINE DEPOT SUBCUTANEOUS SYRINGE SOMAVERT SUBCUTANEOUS RECON SOLN sorine oral tablet 120 mg, 160 mg, 80 mg sorine oral tablet 240 mg 39 sotalol af oral tablet sotalol oral tablet SOVALDI ORAL TABLET... 5 SPECTRAVITE ORAL LIQUID SPECTRAVITE ORAL TABLET,CHEWABLE spironolactone oral tablet spironolactonhydrochlorothiaz oral tablet sprintec (28) oral tablet.. 82 SPRYCEL ORAL TABLET 100 MG, 140 MG, 80 MG SPRYCEL ORAL TABLET 20 MG, 50 MG SPRYCEL ORAL TABLET 70 MG 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 157

169 sps oral suspension sronyx oral tablet ssd topical cream STAHIST AD ORAL TABLET stavudine oral capsule... 5 stavudine oral recon soln. 5 STIVARGA ORAL TABLET STRATTERA ORAL CAPSULE STREPTOMYCIN INTRAMUSCULAR RECON SOLN STRESS FORMULA ORAL TABLET STRESS FORMULA WITH ZINC ORAL TABLET STRIBILD ORAL TABLET... 5 STROMECTOL ORAL TABLET SUBOXONE SUBLINGUAL FILM 12-3 MG SUBOXONE SUBLINGUAL FILM MG, 4-1 MG, 8-2 MG sucralfate oral suspension sucralfate oral tablet SUDOGEST COLD & ALLERGY ORAL TABLET sulfacetamide sodium (acne) topical suspension sulfacetamide sodium ophthalmic drops sulfacetamide sodium ophthalmic ointment sulfacetamide-prednisolone ophthalmic drops sulfadiazine oral tablet.. 13 sulfamethoxazoletrimethoprim intravenous solution sulfamethoxazoletrimethoprim oral suspension sulfamethoxazoletrimethoprim oral tablet sulfasalazine oral tablet. 71 sulfasalazine oral tablet,delayed release (dr/ec) sulfazine ec oral tablet,delayed release (dr/ec) sulfazine oral tablet sulindac oral tablet sumatriptan nasal spray,non-aerosol sumatriptan succinate oral tablet sumatriptan succinate subcutaneous cartridge24 sumatriptan succinate subcutaneous pen injector sumatriptan succinate subcutaneous solution. 25 SUPER B/C ORAL CAPSULE SUPRAX ORAL SUSPENSION FOR RECONSTITUTION 100 MG/5 ML, 200 MG/5 ML... 7 SUPRAX ORAL SUSPENSION FOR RECONSTITUTION 500 MG/5 ML... 7 SUPRAX ORAL TABLET... 7 SUPRAX ORAL TABLET,CHEWABLE 7 SURMONTIL ORAL CAPSULE SUSTIVA ORAL CAPSULE... 5 SUSTIVA ORAL TABLET... 5 SUTENT ORAL CAPSULE 12.5 MG, 25 MG, 50 MG syeda oral tablet SYLATRON 4-PACK SUBCUTANEOUS KIT SYLATRON SUBCUTANEOUS KIT SYMBICORT INHALATION HFA AEROSOL INHALER 97 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 158

170 SYMLINPEN 120 SUBCUTANEOUS PEN INJECTOR SYMLINPEN 60 SUBCUTANEOUS PEN INJECTOR SYNAGIS INTRAMUSCULAR SOLUTION 50 MG/0.5 ML... 5 SYNAREL NASAL SPRAY,NON- AEROSOL SYNERCID RECON SOLN SYNRIBO SUBCUTANEOUS RECON SOLN SYNTHROID ORAL TABLET SYPRINE ORAL CAPSULE SYSTANE GEL OPHTHALMIC DROPS,GEL T TABLOID ORAL TABLET tacrolimus oral capsule 0.5 mg, 1 mg TACROLIMUS ORAL CAPSULE 5 MG TAFINLAR ORAL CAPSULE TAGAMET HB ORAL TABLET TAMIFLU ORAL CAPSULE 30 MG... 5 TAMIFLU ORAL CAPSULE 45 MG, 75 MG... 5 TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION... 5 tamoxifen oral tablet tamsulosin oral capsule,extended release 24hr TARCEVA ORAL TABLET 100 MG, 25 MG TARCEVA ORAL TABLET 150 MG TARGRETIN ORAL CAPSULE TARGRETIN TOPICAL GEL TASIGNA ORAL CAPSULE TAZORAC TOPICAL CREAM TAZORAC TOPICAL GEL taztia xt oral capsule, extended release TEARS PURE OPHTHALMIC DROPS TECFIDERA ORAL CAPSULE,DELAYED RELEASE(DR/EC) TEFLARO RECON SOLN... 7 TEGRETOL XR ORAL TABLET EXTENDED RELEASE 12 HR 100 MG TEKAMLO ORAL TABLET TEKTURNA HCT ORAL TABLET TEKTURNA ORAL TABLET telmisartan oral tablet telmisartanhydrochlorothiazid oral tablet temazepam oral capsule. 37 TENSION HEADACHE ORAL TABLET terazosin oral capsule terbinafine oral tablet... 2 terbutaline oral tablet terbutaline subcutaneous solution terconazole vaginal cream 0.4 % terconazole vaginal cream 0.8 % terconazole vaginal suppository TESTIM TRANSDERMAL GEL testosterone cypionate intramuscular oil testosterone enanthate intramuscular oil tetanus toxoid,adsorbed (pf) intramuscular suspension 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 159

171 TETANUS,DIPHTHERIA TOX PED(PF) INTRAMUSCULAR SUSPENSION TETANUS-DIPHTHERIA TOXOIDS-TD INTRAMUSCULAR SUSPENSION tetracycline oral capsule 14 THALOMID ORAL CAPSULE theophylline oral solution97 theophylline oral tablet extended release theophylline oral tablet extended release 12 hr 97 THERAFLU NIGHTTIME COLD-COUGH ORAL POWDER IN PACKET THERA-PLUS ORAL LIQUID thiamine hcl injection solution thioridazine oral tablet thiothixene oral capsule. 37 tiagabine oral tablet TIKOSYN ORAL CAPSULE tilia fe oral tablet timolol maleate ophthalmic drops timolol maleate ophthalmic gel forming solution timolol maleate oral tablet tinidazole oral tablet tioconazole vaginal ointment TITRALAC ORAL TABLET,CHEWABLE TIVICAY ORAL TABLET... 5 tizanidine oral capsule tizanidine oral tablet TL G-FOL OS ORAL TABLET TOBRAMYCIN IN % NACL INHALATION SOLUTION FOR NEBULIZATION tobramycin in 0.9 % nacl intravenous piggyback 80 mg/100 ml tobramycin ophthalmic drops tobramycin sulfate injection solution tobramycin-dexamethasone ophthalmic drops,suspension TOBREX OPHTHALMIC OINTMENT tolazamide oral tablet tolbutamide oral tablet tolmetin oral capsule tolmetin oral tablet tolnaftate topical solution 52 tolterodine oral capsule,extended release 24hr tolterodine oral tablet topiramate oral capsule, sprinkle topiramate oral tablet toposar intravenous solution TOPOTECAN RECON SOLN torsemide intravenous solution 20 mg/2 ml (10 mg/ml) TORSEMIDE SOLUTION 50 MG/5 ML (10 MG/ML) torsemide oral tablet TOVIAZ ORAL TABLET EXTENDED RELEASE 24 HR TPN ELECTROLYTES SOLUTION TRACLEER ORAL TABLET tramadol oral tablet tramadol oral tablet extended release 24 hr 33 tramadol oral tablet, er multiphase 24 hr tramadol-acetaminophen oral tablet trandolapril oral tablet tranexamic acid intravenous solution tranexamic acid oral tablet 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 160

172 TRANSDERM-SCOP TRANSDERMAL PATCH 72 HOUR tranylcypromine oral tablet TRAVASOL 10 % PARENTERAL SOLUTION travoprost (benzalkonium) ophthalmic drops trazodone oral tablet TREANDA RECON SOLN 100 MG TRECATOR ORAL TABLET TRELSTAR DEPOT INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION. 20 TRELSTAR INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION. 20 TRELSTAR INTRAMUSCULAR SYRINGE MG/2 ML, 3.75 MG/2 ML TRELSTAR LA INTRAMUSCULAR SUSPENSION FOR RECONSTITUTION. 20 TRETINOIN (CHEMOTHERAPY) ORAL CAPSULE tretinoin microsphere topical gel tretinoin topical cream tretinoin topical gel TRIACTING COUGH & COLD ORAL LIQUID triamcinolone acetonide dental paste triamcinolone acetonide injection suspension 10 mg/ml triamcinolone acetonide injection suspension 40 mg/ml triamcinolone acetonide nasal aerosol,spray triamcinolone acetonide topical cream triamcinolone acetonide topical lotion triamcinolone acetonide topical ointment TRIAMINIC CHEST- NASAL CONGESTI ORAL LIQUID TRIAMINIC COLD & COUGH (PE) ORAL LIQUID TRIAMINIC COLD- ALLERGY PE ORAL LIQUID triamterenehydrochlorothiazid oral capsule triamterenehydrochlorothiazid oral tablet trianex topical ointment.. 55 TRIBENZOR ORAL TABLET TRI-BUFFERED ASPIRIN ORAL TABLET triderm topical cream tri-estarylla oral tablet trifluoperazine oral tablet trifluridine ophthalmic drops trihexyphenidyl oral elixir trihexyphenidyl oral tablet tri-legest fe oral tablet tri-linyah oral tablet trilyte with flavor packets oral recon soln trimethoprim oral tablet. 14 trinessa (28) oral tablet.. 83 TRIPLE ANTIBIOTIC PLUS TOPICAL OINTMENT TRIPLE ANTIBIOTIC TOPICAL PACKET tri-previfem (28) oral tablet TRISENOX SOLUTION tri-sprintec (28) oral tablet TRI-VI-SOL ORAL DROPS TRI-VI-SOL WITH IRON ORAL DROPS 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 161

173 TRI-VITA ORAL DROPS TRI-VITAMIN ORAL DROPS trivora (28) oral tablet TRIXAICIN TOPICAL CREAM TROKENDI XR ORAL CAPSULE, EXTENDED RELEASE 24HR TROPHAMINE 10 % PARENTERAL SOLUTION TROPHAMINE 6% PARENTERAL SOLUTION tropicamide ophthalmic drops trospium oral capsule,extended release 24hr trospium oral tablet TRUVADA ORAL TABLET... 5 TUDORZA PRESSAIR INHALATION AEROSOL POWDR BREATH ACTIVATED TUMS ULTRA ORAL TABLET,CHEWABLE TUSNEL NEW FORMULA ORAL TABLET TUSNEL PEDIATRIC ORAL DROPS TUSSIN CF ORAL LIQUID TUSSIN COUGH (DM ONLY) ORAL LIQUID TUSSIN DM ORAL SYRUP TWINRIX (PF) INTRAMUSCULAR SUSPENSION TWINRIX (PF) INTRAMUSCULAR SYRINGE TYGACIL RECON SOLN TYKERB ORAL TABLET TYPHIM VI INTRAMUSCULAR SOLUTION TYPHIM VI INTRAMUSCULAR SYRINGE TYSABRI SOLUTION TYZEKA ORAL TABLET... 5 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 U ULORIC ORAL TABLET unithroid oral tablet 100 mcg, 112 mcg, 125 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 mcg ursodiol oral capsule ursodiol oral tablet V VAGIFEM VAGINAL TABLET valacyclovir oral tablet... 5 VALCYTE ORAL RECON SOLN... 5 VALCYTE ORAL TABLET... 5 valproate sodium intravenous solution valproic acid (as sodium salt) oral solution 250 mg/5 ml valproic acid (as sodium salt) oral solution 250 mg/5 ml (5 ml), 500 mg/10 ml (10 ml) valproic acid oral capsule valsartanhydrochlorothiazide oral tablet VANCOCIN ORAL CAPSULE vancomycin intravenous recon soln VANCOMYCIN ORAL CAPSULE vandazole vaginal gel VAQTA (PF) INTRAMUSCULAR SUSPENSION 25 UNIT/0.5 ML 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 162

174 VAQTA (PF) INTRAMUSCULAR SYRINGE 25 UNIT/0.5 ML VARIVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION. 77 VECAMYL ORAL TABLET VELCADE INJECTION RECON SOLN velivet triphasic regimen (28) oral tablet venlafaxine oral capsule,extended release 24hr venlafaxine oral tablet venlafaxine oral tablet extended release 24hr 150 mg, 37.5 mg, 75 mg VENLAFAXINE ORAL TABLET EXTENDED RELEASE 24HR 225 MG VENTOLIN HFA INHALATION HFA AEROSOL INHALER 98 VERAMYST NASAL SPRAY,SUSPENSION verapamil intravenous solution verapamil intravenous syringe verapamil oral capsule, 24 hr er pellet ct verapamil oral capsule,ext rel. pellets 24 hr verapamil oral tablet verapamil oral tablet extended release veripred 20 oral solution 60 VERSACLOZ ORAL SUSPENSION VESICARE ORAL TABLET vestura (28) oral tablet VICKS VAPOSTEAM LIQUID VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR VIDAZA INJECTION RECON SOLN VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN... 5 VIDEX 4 GRAM PEDIATRIC ORAL RECON SOLN... 5 VIGAMOX OPHTHALMIC DROPS VIIBRYD ORAL TABLET VIIBRYD ORAL TABLETS,DOSE PACK VIMOVO ORAL TABLET,IR & DELAY REL,BIPHASIC VIMPAT SOLUTION VIMPAT ORAL SOLUTION VIMPAT ORAL TABLET VINBLASTINE RECON SOLN VINBLASTINE SOLUTION vincristine intravenous solution 1 mg/ml vinorelbine intravenous solution 50 mg/5 ml viorele (28) oral tablet VIRACEPT ORAL TABLET... 5 VIRAMUNE ORAL SUSPENSION... 5 VIRAMUNE XR ORAL TABLET EXTENDED RELEASE 24 HR 100 MG... 5 VIRAZOLE INHALATION RECON SOLN... 5 VIRDEC DM ORAL DROPS VIREAD ORAL POWDER... 5 VIREAD ORAL TABLET... 5 VISION FORMULA ORAL TABLET 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 163

175 VITALETS ORAL TABLET,CHEWABLE vitamin a oral capsule 10,000 unit vitamin a oral capsule 25,000 unit, 8,000 unit VITAMIN C ORAL CAPSULE, EXTENDED RELEASE VITAMIN C ORAL TABLET,CHEWABLE 500 MG VITAMIN D2 ORAL CAPSULE VITAMIN D3 ORAL CAPSULE 2,000 UNIT VITAMIN D3 ORAL TABLET 1,000 UNIT VITAMIN D3 ORAL TABLET 5,000 UNIT VITAMIN D3 ORAL TABLET,CHEWABLE 1,000 UNIT VITAMIN K INJECTION SOLUTION VITAMIN K1 INJECTION SOLUTION vits a & d-white pet-lanolin topical ointment in packet VIVELLE-DOT TRANSDERMAL PATCH SEMIWEEKLY VOLTAREN GEL TOPICAL GEL voriconazole intravenous solution... 2 VORICONAZOLE ORAL SUSPENSION FOR RECONSTITUTION... 2 VORICONAZOLE ORAL TABLET 200 MG... 2 voriconazole oral tablet 50 mg... 2 VOTRIENT ORAL TABLET VPRIV RECON SOLN VYTORIN ORAL TABLET VYTORIN ORAL TABLET VYTORIN ORAL TABLET VYTORIN ORAL TABLET 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 W WAL-DRYL SEVERE ALLERGY-SINUS ORAL TABLET WAL-DRYL-D ALLERGY & SINUS ORAL TABLET warfarin oral tablet WELCHOL ORAL POWDER IN PACKET WELCHOL ORAL TABLET wera (28) oral tablet wymzya fe oral tablet,chewable X XALKORI ORAL CAPSULE XARELTO ORAL TABLET XENAZINE ORAL TABLET XGEVA SUBCUTANEOUS SOLUTION XIFAXAN ORAL TABLET 550 MG XOLAIR SUBCUTANEOUS RECON SOLN XTANDI ORAL CAPSULE XYREM ORAL SOLUTION Y YF-VAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION. 77 Z zafirlukast oral tablet ZALTRAP SOLUTION zamicet oral solution ZANTAC 75 ORAL TABLET zarah oral tablet 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 164

176 ZAVESCA ORAL CAPSULE Z-COF I ORAL SUSPENSION ZELBORAF ORAL TABLET ZEMPLAR SOLUTION zenchent (28) oral tablet. 83 zenchent fe oral tablet,chewable ZENPEP ORAL CAPSULE,DELAYED RELEASE(DR/EC) zeosa oral tablet,chewable ZETIA ORAL TABLET 46 ZIAGEN ORAL SOLUTION... 6 zidovudine oral capsule... 6 zidovudine oral syrup... 6 zidovudine oral tablet... 6 zinc oxide topical ointment ziprasidone hcl oral capsule ZIRGAN OPHTHALMIC GEL zoledronic acid intravenous recon soln zoledronic acid intravenous solution zoledronic acid-mannitolwater intravenous solution ZOLINZA ORAL CAPSULE zolmitriptan oral tablet zolmitriptan oral tablet,disintegrating zolpidem oral tablet zolpidem oral tablet,ext release multiphase ZOMETA SOLUTION 4 MG/100 ML zonisamide oral capsule. 23 ZOO CHEWS ORAL TABLET,CHEWABLE ZORTRESS ORAL TABLET ZOSTAVAX (PF) SUBCUTANEOUS SUSPENSION FOR RECONSTITUTION. 77 ZOSTRIX DIABETIC TOPICAL CREAM zovia 1/35e (28) oral tablet zovia 1/50e (28) oral tablet ZOVIRAX TOPICAL CREAM ZYCLARA TOPICAL CREAM IN METERED- DOSE PUMP ZYCLARA TOPICAL CREAM IN PACKET 48 ZYKADIA ORAL CAPSULE ZYPREXA INTRAMUSCULAR RECON SOLN ZYTIGA ORAL TABLET ZYVOX PARENTERAL SOLUTION 200 MG/100 ML ZYVOX PARENTERAL SOLUTION 600 MG/300 ML ZYVOX ORAL SUSPENSION FOR RECONSTITUTION. 11 ZYVOX ORAL TABLET 請參閱第 1 頁以瞭解表格中的符號及縮寫的意思 如果您有任何疑問, 請於週一至週日每天上午 8 時到晚上 8 時撥打 致電給 GuildNet Gold Plus FIDA 聽障/ 語障人士請撥 這是一支免費電話 如欲瞭解更多資訊, 請造訪 165

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