2017 年綜合處方藥一覽表 AgeWell New York, LLC LiveWell (HMO) 2017 年處方藥一覽表 ( 承保藥物清單 ) 請閱讀 : 本文件包含有關本計劃承保藥物的資訊 HPMS 核准之處方藥一覽表檔案提交 ID 17398, 版本編號 6 本處方藥一覽表於 2016

LiveWell (HMO) 2017 年處方藥一覽表 ( 承保藥物清單 ) 由 AgeWell New York, LLC( 康逸 ) 提供並與 Medicare( 紅藍卡 ) 簽有合約的 Medicare Advantage 健康維護組織 (HMO) 布朗士區 布碌崙 皇后區 納蘇縣 紐約 ( 曼哈頓區 ) 薩福克縣及威徹斯特縣 健康安寧 HPMS 核准之處方藥一覽表檔案提交 ID 17398, 版本編號 6 此處方藥一覽表於 2016 年 9 月 23 日更新,2017 年 1 月 1 日生效 如需最新資訊或有其他問題, 請聯絡我們藥房福利管理公司 EnvisionRx 的康逸健保會員服務部, 電話 :1-844-782-7670, 聽障人士可致電 711, 服務時間為每週七天, 每天 24 小時 或可瀏覽 www.agewellnewyork.com H4922_1085C_NONSNP Accepted 09062016

2017 年綜合處方藥一覽表 AgeWell New York, LLC LiveWell (HMO) 2017 年處方藥一覽表 ( 承保藥物清單 ) 請閱讀 : 本文件包含有關本計劃承保藥物的資訊 HPMS 核准之處方藥一覽表檔案提交 ID 17398, 版本編號 6 本處方藥一覽表於 2016 年 9 月 23 日更新 如需最新資訊或有其他問題, 請聯絡我們的藥房福利管理公司 EnvisionRx 的康逸健保會員服務部, 電話 :1-844-782-7670, 聽障和語障人士可致電 711, 全天候服務 或可瀏覽 www.agewellnewyork.com AgeWell New York LLC( 康逸 ) 是一項與 Medicare( 紅藍卡 ) 簽有合約並且與紐約州衛生署簽有福利協調協議的健康維護組織 (HMO) 計劃 參保 AgeWell New York LLC( 康逸 ) 將視乎合約續訂情況而定 處方藥一覽表可能會隨時變更 必要時您會收到通知 本資訊並非完整之福利敘述 聯絡計劃以瞭解更多資訊 每年的 1 月 1 日, 福利 保費和 / 或共付額 / 共同保險可能會有所調整 可能存在限額 共付額及限制 可能存在限額 共付額及限制 您必須繼續繳納您的 Medicare B 部份保費 本文件可能會提供其他格式版本, 例如 : 盲文 大號字體印刷版或音訊 本資訊可免費提供其他語言版本 請致電 1-866-586-8044 或聽障專線 1-800-662-1220 聯絡會員服務部, 服務時間為每週七天, 早上 8 點至晚上 8 點 ( 美國東部時間 ) Esta información está disponible de forma gratuita en otros idiomas. Por favor llame a nuestro número de servicio al miembro al 1-866-586-8044 o TTY 1-800-662-1220, 7 días a la semana de 8:00 am - 8:00 pm hora del Este. H4922_1085C_NONSNP Accepted 09062016 1

2017 年綜合處方藥一覽表 欲知更多詳情, 請聯絡我們的顧客服務部, 電話 : 1-866-586-8044 ( 聽障人士 TTY 請致電.. 1-800-662-1220) 服務時間每週 7 天, 美東時間上午 8 時至下午 8 時 會員服務部也為不使用英語的顧客提供免費的翻譯服務 ( 電話號碼印於本小冊子的封底 ) 現有會員請注意 : 本處方藥一覽表自去年已變更 請閱讀本文件, 確保本處方藥一覽表仍然包含您服用的藥物 本文件載有我們計劃截至 2017 年 1 月 1 日的藥物清單 ( 處方藥一覽表 ) 如需最新處方藥一覽表, 請聯絡我們 我們的聯絡資訊連同最後更新處方藥一覽表的日期載於封面和封底 一般而言, 您必須使用網絡內藥房才能享用處方藥福利 自 2017 年 1 月 1 日起和在該年內, 福利 處方藥一覽表 藥房網絡和 / 或共付額 / 共同保險可能會不時有所調整 AgeWell New York LiveWell (HMO) 的處方藥一覽表是什麼? 處方藥一覽表是康逸健保透過諮詢醫療提供者團隊所選出的承保藥物清單, 是高品質治療計劃中不可或缺的處方藥治療 只要具有醫療必要性, 且於康逸健保的網絡內藥房配藥, 並遵守其他計劃規則, 康逸健保通常會承保列於處方藥一覽表中的藥物 要瞭解有關如何按您的處方配藥的更多資訊, 請查閱您的 承保範圍說明書 處方藥一覽表 ( 藥物清單 ) 是否會變更? 一般而言, 若您在服用年初享受承保的 2017 年處方藥一覽表上的藥物, 我們不會在 2017 年承保年度中終止或減少此藥物的承保, 除非推出更廉價的新副廠藥, 或者發佈有關藥物安全性或有效性的最新不利資訊 其他類型的處方藥一覽表變更 ( 例如從處方藥一覽表中刪除某種藥物 ) 不會對目前正在服用此藥物的會員產生影響 在承保年度剩餘時間內, 將以相同的分攤費用向服用此藥物的會員提供此藥物 我們認為, 讓您能夠在承保年度的剩餘時間繼續獲得在您選擇我們的計劃時可用的處方藥一覽表上的藥物十分重要, 除非是能夠為您節省更多費用或確保您的安全 我們若從處方藥一覽表中刪除藥物 或新增對某種藥物的事先授權 數量限制和 / 或階段療法限制, 或提高某種藥物的分攤費用等級, 我們必須在變更生效前至少 60 天或在會員要求再次配藥時向受變更影響的會員發出通知, 會員可在再次配藥時配取 60 天的藥量 若美國食品及藥物管理局認為我們處方藥一覽表上的某種藥物不安全, 或藥物製造商從市場中撤除該藥物, 我們會立即從我們的處方藥一覽表上刪除該藥物, 並向服用該藥物的會員發出通知 本文件內附的處方藥一覽表最後更新於 2017 年 1 月 1 日 若要取得有關康逸健保承保藥物的最新資訊, 請聯絡我們 我們的聯絡資訊載於封面和封底 若本計劃在年中對處方藥一覽表有非維護性的更改, 我們會在更改生效之日前至少 60 天透過郵件通知您更新的資訊 如何使用處方藥一覽表? 有兩種方法在處方藥一覽表中查找您所需的藥物 : 2

2017 年綜合處方藥一覽表 病症 處方藥一覽表從第 8 頁開始 本處方藥一覽表中的藥物按照所治療的病症類型分類 例如 : 用來治療心臟病的藥物列在 心血管藥物 類別 若您瞭解藥物的用途, 在從第 9 頁開始的清單中查找類別名稱 然後, 在此類別名稱下查找所需的藥物 按字母順序排列的清單 如果您不確定要尋找什麼類別, 您可以利用自第 158 頁開始的索引來尋找您的藥物 該索引提供一份按字母順序排列的清單, 其中有本文件包含的所有藥物 該索引中列有原廠藥和副廠藥 請在該索引中查找所需的藥物 藥物旁邊註有頁碼, 您可以在該頁查找承保範圍資訊 轉到該索引中所列的頁碼, 在清單的第一欄即可找到所需的藥物名稱 甚麼是學名藥? 康逸健保對原廠藥及副廠藥均予以承保 副廠藥是一種由 FDA 核准, 具有與原廠藥相同活性成分的藥物 通常, 副廠藥的費用較原廠藥低 對於我享受的承保範圍是否有任何限制? 某些承保藥物可能有其他要求或承保範圍限制 這些要求和限制可能包括 : 事先授權 : 對於某些藥物, 康逸健保要求您或您的醫生取得預先授權 這表示您將需要在配藥前取得康逸健保的批准 如果您未獲得批准, 康逸健保可能不會承保該藥物 數量限制 : 對於某些藥物, 康逸健保限制其將會承保的藥量 例如, 康逸健保為每份 Sumatriptan Succinate 100mg 處方提供 9 粒藥片 這可以另外附加在標準的一個月份或三個月份的藥量上 階段療法 : 某些情況下, 康逸健保會要求您先嘗試使用某些藥物治療您的病症後, 才會承保您使用另外一種藥物 例如, 若藥物 A 與藥物 B 均可治療您的病症, 康逸健保可能只會在您先試用藥物 A 之後才會承保藥物 B 如果藥物 A 對您無效, 則康逸健保將會承保藥物 B 您可以透過第 8 頁開始的處方藥一覽表查詢您的藥物是否有額外的要求或限制 您也可以透過瀏覽我們的網站, 取得更多關於特定承保藥物適用之限制的資訊 我們已在線上刊載文件, 解釋我們事先授權和階段療法的限制 您也可以索取相關的書面文件 我們的聯絡資訊連同最後更新處方藥一覽表的日期載於封面和封底 您可以要求康逸健保對此類限制或使用上限作出例外處理, 或索取可能治療您的病症的其他相似藥物清單 請參閱第 4 頁的 如何申請 AgeWell New York LiveWell (HMO) 的處方藥一覽表例外處理? 部份, 瞭解如何申請例外處理的資訊 3

2017 年綜合處方藥一覽表 若我的藥物不在處方藥一覽表上, 該怎麼辦? 若您的藥物不在此處方藥一覽表 ( 承保藥物清單 ) 上, 那麼您首先應該聯絡會員服務部, 詢問您的藥物是否在承保範圍內 要瞭解更多資訊, 請聯絡我們 我們的聯絡資訊連同最後更新處方藥一覽表的日期載於封面和封底 若您得知康逸健保並未承保您的藥物, 則您有兩種選擇 : 您可向會員服務部索取一份由康逸健保承保的相似藥物清單 當您收到該清單後, 請拿給您的醫生看, 並要求醫生開立由康逸健保承保的相似藥物 您可以要求康逸健保作出例外處理, 並承保您的藥物 請查看以下關於如何申請例外處理的資訊 如何申請 AgeWell New York LiveWell (HMO) 的處方藥一覽表例外處理? 您可以要求康逸健保對我們的承保規則作出例外處理 您可以向我們提出數種例外處理申請 您可以要求我們承保一種藥物, 即使它不在我們的處方藥一覽表上 如獲批准, 此藥物將按預定分攤費用等級獲得承保, 且您不得要求我們以更低的分攤費用等級提供此藥物 如果此藥物在處方藥一覽表上且不屬特殊藥物, 您可要求我們按更低的分攤費用等級承保此藥 如獲批准, 這會減少您必須為藥物支付的金額 您可以要求我們撤銷對您的藥物的承保限制 例如 : 對於某些藥物, 康逸健保限制了藥物的承保數量 若您的藥物有數量限制, 您可以要求我們撤銷限制並承保更多數量 通常只有在替代藥物包含在計劃的處方藥一覽表中時, 或是較低的分攤費用藥物或額外的使用限制對於治療您的病症無法達到相同的效果時, 和 / 或可能造成副作用時, 康逸健保才會批准您的例外處理申請 您應當與我們聯絡, 要求我們做出針對處方藥一覽表或使用限制例外處理的初始承保決定 在提出針對處方藥一覽表或使用限制例外處理申請時, 您應提交一份處方醫師或醫師的聲明以支持您的申請 通常, 我們在收到處方醫師的支持聲明後, 必須在 72 小時內做出決定 若您或您的醫師認為等候 72 小時再做出決定會對您的健康造成嚴重傷害, 您可以申請加急 ( 快速 ) 例外處理 如果您的加急申請獲得批准, 我們在收到您的醫師或其他處方醫師的支持聲明後, 必須在 24 小時內為您做出決定 在向醫師提出變更藥物請求或提交例外處理申請之前, 我應該做什麼? 作為我們計劃的新老會員, 您可能正在使用我們處方藥一覽表上沒有的藥物 或者, 您正在使用一種在我們處方藥一覽表上的藥物, 但您獲取該藥物的能力受到限制 例如, 您在配藥前可能要獲得我們的事先授權 您應當先和您的醫師談談, 以決定您是否應該換用我們承保的適當藥物, 或提出處方藥一覽表例外處理申請以使我們承保您使用的藥物 在您與醫師討論以確定何種措施對您合適的時候, 我們會在您成為我們計劃會員的頭 90 天內針對某些情況為您的藥物提供承保 4

2017 年綜合處方藥一覽表 對於所有不在我們處方藥一覽表上的藥物, 或如果您獲取藥物的能力受到限制, 在您去網絡內藥房配藥時, 我們將承保 30 天的臨時供藥 ( 除非您的處方寫明更少天數 ) 在提供頭 30 天藥量之後, 我們將不再為您支付這些藥物的費用, 即使您成為計劃會員還不足 90 天 若您居住在長期護理機構中, 我們將會允許您重新配藥, 直到我們為您提供與配藥增量一致的至少 91 天 ( 最長為 98 天 ) 份量的過渡期藥物 ( 除非您的處方寫明更少天數 ) 在您成為我們計劃會員後的頭 90 天內, 我們將為您承保這些藥物的多次重新配取 若您需要非處方藥一覽表的藥物, 或您獲取藥物的能力受到限制, 但您成為我們計劃會員已超過 90 天, 則在您尋求處方藥一覽表例外處理時, 我們將會對該藥物承保 31 天份量的緊急藥量 ( 除非您處方的天數較少 ) 現有計劃會員的護理等級變更 如果您不處於過渡期, 並且您的護理等級有變, 從某一治療環境轉至另一環境 ( 例如 : 從長期護理機構轉至醫院, 從醫院轉至家中, 從家中轉至醫院 ), 住進或撤出護理場所或長期護理機構後, 我們允許您獲得處方藥一覽表藥物的 30/31 天重新配藥 ( 零售環境為 30 天, 長期護理環境為 31 天 ), 非處方藥一覽表藥物為 30/31 天緊急重新配藥 ( 零售環境為 30 天, 長期護理環境為 31 天 )( 包括處方藥一覽表上的 D 部份藥物, 但需要事先授權或採取階段療法 ) 這一政策不適用於從長期護理機構或醫院短期離開的情況 ( 即度假 ) 如果您超出 90 天過渡期且處於門診環境中, 在處理例外申請的同時, 我們仍將以逐一評估個案的方式, 提供 30 天非處方一覽表藥物的緊急供藥 ( 包括我們的處方藥一覽表上, 需根據使用管理規則獲得事先授權或採取階段療法的 D 部份藥物 ) 如果您超出 90 天過渡期且處於長期護理環境中, 我們仍將在處理例外申請的同時, 提供 31 天 D 部份承保的非處方一覽表藥物的緊急供藥 ( 包括我們的處方藥一覽表上, 需根據使用管理規則獲得事先授權或採取階段療法的 D 部份承保藥物 ) 瞭解更多資訊 要瞭解關於 AgeWell New York LiveWell (HMO) 處方藥承保範圍的更多資訊, 請查看您的 承保範圍說明書 或其他計劃資料 若您對 AgeWell New York LiveWell (HMO) 有任何疑問, 請聯絡我們 我們的聯絡資訊連同最後更新處方藥一覽表的日期載於封面和封底 若您對 Medicare 處方藥承保範圍有任何疑問, 請致電 Medicare, 電話 :1-800-MEDICARE (1-800-633-4227) ( 全天候服務 ) 聽障和語障人士可致電 1-877-486-2048 或瀏覽 http://www.medicare.gov 5

2017 年綜合處方藥一覽表 AgeWell New York LiveWell (HMO) 的處方藥一覽表 以下處方藥一覽表提供由康逸健保承保之藥物的承保範圍資訊 若您在清單中尋找藥物上遇到困難, 請參閱第 158 頁開始的索引 表格的第一欄列出了藥物名稱 原廠藥用大寫字母表示 ( 如 JAKAFI), 副廠藥則用小寫斜體字母表示 ( 如 atorvastatin) 要求 / 限制欄中的資訊表示康逸健保對於承保您的藥物是否有任何特殊的要求 圖例 符號名稱說明 QL 數量限制每份處方或指定時期內承保的藥物數量存在限制 PA 事先授權 您 ( 或您的醫生 ) 必須先獲得事先授權, 您才可以配取該處方 藥 若無事先授權, 我們不會承保該藥物 ST 階段療法 某些情況下, 康逸健保會要求您先嘗試使用某些藥物治療您的病 症後, 才會承保您使用另外一種藥物 LA 取藥限制此處方藥僅在某些藥房提供 HR 高風險藥物 Medicare 與 Medicaid 服務中心 (CMS) 已確定對患者, 尤其對老年 患者 (65 歲或以上需要 PA) 造成更高風險的藥物名單 BD B 部份與 D 部份 本處方藥物可能由 Medicare B 部份或 D 部份承保 ( 視情況 而定 ) 等級 名稱 1 首選副廠藥 ( 這是分攤費用最低的等級 ) 2 副廠藥 3 首選原廠藥 4 非首選原廠藥 5 特殊藥物 ( 這是分攤費用最高的等級 ) 6

2017 年綜合處方藥一覽表 標準零售分攤費用 ( 網絡內 ) ( 最多 30 天份量的供藥 ) 郵購分攤費用 ( 最多 90 天份量的供藥 ) 長期護理 (LTC) 分攤費用 ( 最多 31 天份量的供藥 ) 網絡外分攤費用 ( 承保僅限於某些情況 ; 如需詳細資訊, 請參見第 5 章 ) ( 最多 30 天份量的供藥 ) 分攤費用第 1 級 ( 首選副廠藥 ) 分攤費用第 2 級 ( 副廠藥 ) 分攤費用第 3 級 ( 首選原廠藥 ) 分攤費用第 4 級 ( 非首選原廠藥 ) 分攤費用第 5 級 ( 特殊藥物 ) $5 的共付額 $12.50 的共付額 $5 的共付額 $5 的共付額 $20 的共付額 $50 的共付額 $20 的共付額 $20 的共付額 $47 的共付額 $117.50 的共付額 $47 的共付額 $47 的共付額 50% 的共同保險 50% 的共同保險 50% 的共同保險 50% 的共同保險 25% 的共同保險 25% 的共同保險 25% 的共同保險 25% 的共同保險 7

LEGEND NAME 1 Preferred Generics 2 Generics 3 Preferred Brands 4 Non-Preferred Brands 5 Specialty SYMBOL NAME DESCRIPTION QL PA ST Quantity Limit Prior Authorization Step Therapy There is a limit on the amount of this drug that is covered per prescription, or within a specific time frame. You (or your physician) are required to get prior authorization before you fill your prescription for this drug. Without prior approval, we may not cover this drug. In some cases, you may be required to first try certain drugs to treat your medical condition before we will cover another drug for that condition. LA Limited Access This prescription drug is limited to certain pharmacies. HR High Risk Medication High Risk Medication (PA required for ages 65 or over) MO Mail Order Eligible This prescription may also be available via mail. 1

Agewell 5-Tier (List of Covered Drugs) DRUG NAME DRUG REQUIREMENTS/LIMITS ANALGESICS OPIOID ANALGESICS, LONG-ACTING EMBEDA CAP 100-4MG 5 QL (60) EMBEDA CAP 20-0.8MG 4 QL (60) EMBEDA CAP 30-1.2MG 4 QL (60) EMBEDA CAP 50-2MG 4 QL (60) EMBEDA CAP 60-2.4MG 4 QL (60) EMBEDA CAP 80-3.2MG 4 QL (60) fentanyl dis 100mcg/h 2 ST, QL (10) fentanyl dis 12mcg/hr 2 ST, QL (10) fentanyl dis 25mcg/hr 2 ST, QL (10) fentanyl dis 37.5mcg 2 fentanyl dis 50mcg/hr 2 ST, QL (10) fentanyl dis 62.5mcg 2 fentanyl dis 75mcg/hr 2 ST, QL (10) fentanyl dis 87.5mcg 2 hydromorphon liq 1mg/ml 2 METHADONE INJ 10MG/ML 1 methadone sol 10mg/5ml 1 methadone sol 5mg/5ml 2 methadone tab 10mg 2 methadone tab 5mg 2 2

MORPHINE SUL BEADS CAP 30MG E 1 MORPHINE SUL BEADS CAP 60MG E 1 morphine sul cap 100mg er 5 morphine sul cap 10mg er 2 MORPHINE SUL CAP 120MG ER 1 morphine sul cap 20mg er 2 morphine sul cap 30mg er 2 MORPHINE SUL CAP 45MG ER 1 morphine sul cap 50mg er 2 morphine sul cap 60mg er 2 MORPHINE SUL CAP 75MG ER 1 morphine sul cap 80mg er 4 MORPHINE SUL CAP 90MG ER 1 morphine sul tab 100mg er 2 morphine sul tab 15mg er 2 morphine sul tab 30mg er 2 morphine sul tab 60mg er 2 OPANA ER TAB 10MG 3 OPANA ER TAB 15MG 3 OPANA ER TAB 20MG 3 OPANA ER TAB 30MG 3 OPANA ER TAB 40MG 3 OPANA ER TAB 5MG 3 OPANA ER TAB 7.5MG 3 3

OXYCODONE TAB 15MG ER 3 OXYCODONE TAB 30MG ER 3 OXYCODONE TAB 60MG ER 3 OXYCONTIN TAB 10MG CR 3 OXYCONTIN TAB 15MG CR 3 OXYCONTIN TAB 20MG CR 3 OXYCONTIN TAB 30MG CR 3 OXYCONTIN TAB 40MG CR 3 OXYCONTIN TAB 60MG CR 3 OXYCONTIN TAB 80MG CR 3 oxymorphone tab 10mg er 2 oxymorphone tab 15mg er 2 oxymorphone tab 20mg er 2 oxymorphone tab 30mg er 2 oxymorphone tab 40mg er 2 oxymorphone tab 5mg er 2 oxymorphone tab 7.5mg er 2 OPIOID ANALGESICS, SHORT-ACTING apap/codeine sol 120-12/5 2 QL (5000) apap/codeine tab 300-15mg 2 QL (400) apap/codeine tab 300-30mg 2 QL (400) apap/codeine tab 300-60mg 2 QL (400) ascomp/cod cap 30mg 2 HR but/apap/caf cap cod 50-325-4 2 HR, QL (370) 4

but/asa/caf/ cap cod 30mg 2 HR, QL (180) duramorph inj 0.5mg/ml 1 duramorph inj 1mg/ml 1 FENTORA TAB 200MCG 5 PA FENTORA TAB 400MCG 5 PA FENTORA TAB 600MCG 5 PA FENTORA TAB 800MCG 5 PA hydroco/apap sol 7.5-325 1 QL (5500) hydroco/apap tab 10-325mg 2 QL (370) hydroco/apap tab 2.5-325 1 QL (370) hydroco/apap tab 5-325mg 2 QL (370) hydroco/apap tab 7.5-325 2 QL (370) hydrocod/ibu tab 10-200mg 2 QL (150) hydrocod/ibu tab 5-200mg 2 QL (150) hydrocod/ibu tab 7.5-200 2 hydromorphon inj 10mg/ml 2 hydromorphon inj 2mg/ml 2 hydromorphon inj 50mg/5ml 2 hydromorphon tab 2mg 2 hydromorphon tab 4mg 2 hydromorphon tab 8mg 2 LAZANDA SPR 100MCG 5 PA LAZANDA SPR 300MCG 5 PA LAZANDA SPR 400MCG 5 PA 5

morphine sul sol 100/5ml 2 morphine sul sol 10mg/5ml 2 morphine sul sol 20mg/5ml 1 morphine sul tab 15mg 2 morphine sul tab 30mg 2 nalbuphine inj 10mg/ml 2 nalbuphine inj 20mg/ml 2 OPANA TAB 10MG 3 OPANA TAB 5MG 3 oxycod/apap tab 10-325mg 2 QL (370) oxycod/apap tab 2.5-325 2 QL (370) oxycod/apap tab 5-325mg 2 QL (370) oxycod/apap tab 7.5-325 2 QL (370) oxycod/asa tab 2 oxycod/ibu tab 5-400mg 2 oxycodone cap 5mg 2 oxycodone tab 10mg 2 oxycodone tab 15mg 2 oxycodone tab 20mg 2 oxycodone tab 30mg 2 oxycodone tab 5mg 2 oxycodone/ sol apap 2 QL (1800) oxymorphone tab hcl 10mg 2 oxymorphone tab hcl 5mg 2 6

pentaz/nalox tab 50-0.5mg 2 HR tramadl/apap tab 37.5-325 2 QL (370) tramadol hcl tab 50mg 1 QL (240) ANESTHETICS LOCAL ANESTHETICS lido/prilocn cre 2.5-2.5% 2 lidocaine hcl gel 10ml/2% jel 2 lidocaine inj 0.5% 1 lidocaine inj 2% 2 ANTI-ADDICTION/SUBSTANCE ABUSE TREATMENT AGENTS ALCOHOL DETERRENTS/ANTI-CRAVING acampro cal tab 333mg 2 MO disulfiram tab 250mg 2 MO disulfiram tab 500mg 2 MO naltrexone tab 50mg 2 OPIOID ANTAGONISTS bupren/nalox sub 2-0.5mg 2 bupren/nalox sub 8-2mg 2 buprenorphin inj 0.3mg/ml car 1 buprenorphin sub 2mg 2 buprenorphin sub 8mg 2 naloxone inj 0.4mg/ml 1 NALOXONE INJ 1MG/ML 1 7

SUBOXONE MIS 12-3MG 3 SUBOXONE MIS 2-0.5MG 3 SUBOXONE MIS 4-1MG 3 SUBOXONE MIS 8-2MG 3 SMOKING CESSATION AGENTS bupropion tab 150mg er 2 MO CHANTIX PAK 0.5& 1MG 3 QL (53) CHANTIX PAK 1MG 3 QL (56/28) CHANTIX TAB 0.5MG 3 QL (11) CHANTIX TAB 1MG 3 QL (180/90) NICOTROL INH 4 ANTIBACTERIALS AMINOGLYCOSIDES gentam/nacl inj 100mg 1 gentam/nacl inj 60mg pb 1 gentam/nacl inj 80mg/50ml 1 gentamicin inj 10mg/ml 1 gentamicin inj 40mg/ml 2 neomycin tab 500mg 2 paromomycin cap 250mg 2 streptomycin inj 1gm 2 tobramycin inj 1.2/30ml 2 tobramycin inj 10mg/ml 2 8

tobramycin neb 300/5ml 2 PA ANTIBACTERIALS, OTHER bacitracin inj 50000unt 1 chloramphen inj 1gm 2 clindamycin cap 150mg 2 clindamycin cap 300mg 2 clindamycin cap 75mg 2 clindamycin inj 300mg d5w 1 clindamycin inj 300mg/2ml 1 clindamycin inj 600/4ml 1 clindamycin inj 600mg 1 clindamycin inj 900mg d5w 1 clindamycin inj 900mg/6 ml 1 clindamycin sol 75mg/5ml 2 colistimeth inj 150mg 2 CUBICIN RF SOL 500MG 4 lincomycin inj 300mg/ml 1 PA linezolid inj 2mg/ml 5 linezolid sus 100/5ml 2 linezolid tab 600mg 5 metron/nacl inj 500mg 2 PA metronidazol cap 375mg 1 metronidazol tab 250mg 1 metronidazol tab 500mg 1 9

nitrofur mac cap 100mg 2 HR nitrofur mac cap 25mg 2 HR nitrofur mac cap 50mg 2 HR nitrofurantn cap 100mg 2 HR SYNERCID INJ 500MG 4 trimethoprim tab 100mg 2 TYGACIL INJ 50MG 4 vancomycin cap 125mg 2 vancomycin cap 250mg 2 vancomycin inj 1000mg 2 vancomycin inj 10gm 2 vancomycin inj 500mg 4 XIFAXAN TAB 550MG 4 MO BETA-LACTAM, CEPHALOSPORINS cefaclor cap 250mg 2 cefaclor cap 500mg 2 cefaclor er tab 500mg 1 cefazolin inj 10gm 1 cefazolin inj 1gm 2 cefazolin inj 500mg 1 cefdinir cap 300mg 2 cefdinir sus 125/5ml 1 cefdinir sus 250/5ml 1 cefepime inj 1gm 2 10

cefepime inj 2gm 2 cefixime sus 200/5ml 2 cefoxitin inj 10gm 2 cefoxitin inj 1gm 2 cefoxitin inj 2gm 2 cefpodo prox sus 100/5ml 2 cefpodo prox sus 50mg/5ml 2 cefpodoxime tab 100mg 2 cefpodoxime tab 200mg 2 cefprozil sus 125/5ml 2 cefprozil sus 250/5ml 2 cefprozil tab 250mg 2 cefprozil tab 500mg 2 ceftriaxone inj 10gm 2 ceftriaxone inj 1gm 2 ceftriaxone inj 250mg 2 ceftriaxone inj 2gm 2 ceftriaxone inj 500mg 2 cefuroxime inj 1.5gm 1 cefuroxime inj 7.5gm 1 cefuroxime inj 750mg 1 cefuroxime tab 250mg 2 cephalexin cap 250mg 1 cephalexin cap 500mg 1 11

cephalexin sus 125/5ml 2 cephalexin sus 250/5ml 1 cephalexin tab 250mg 1 cephalexin tab 500mg 1 SUPRAX CAP 400MG 4 tazicef inj 2gm 2 PA TEFLARO INJ 400MG 4 TEFLARO INJ 600MG 4 BETA-LACTAM, OTHER AZACTAM/DEX INJ 2GM 4 aztreonam inj 1gm 2 CAYSTON INH 75MG 5 imipenem/cil inj 250mg 2 imipenem/cil inj 500mg 2 INVANZ INJ 1GM 4 meropenem inj 500mg 2 BETA-LACTAM, PENICILLINS AMOX/K CLAV CHW 200MG 1 AMOX/K CLAV CHW 400MG 1 amox/k clav sus 200/5ml 1 amox/k clav sus 400/5ml 2 amox/k clav sus 600/5ml 2 amox/k clav tab 250-125 2 amox/k clav tab 500-125 2 12

amox/k clav tab 875mg 2 amoxicillin cap 250mg 1 amoxicillin cap 500mg 1 amoxicillin chw 125mg 1 amoxicillin chw 250mg 1 amoxicillin sus 125/5ml 1 amoxicillin sus 200/5ml 1 amoxicillin sus 250mg/5m 1 amoxicillin sus 400/5ml 1 amoxicillin tab 500mg 1 amoxicillin tab 875mg 2 ampicillin cap 250mg 2 ampicillin cap 500mg 2 ampicillin inj 10gm 2 ampicillin inj 125mg 2 ampicillin inj 1gm 2 ampicillin sus 125/5ml 1 ampicillin sus 250/5ml 1 amp-sulbacta inj 1.5gm 2 amp-sulbacta inj 15gm 2 BICILLIN L-A INJ 600000 4 dicloxacill cap 250mg 2 dicloxacill cap 500mg 2 nafcillin inj 10gm 2 13

nafcillin inj 1gm 2 pen g sod inj 5000000 1 penicill gk/ inj dex 2mu 2 penicill gk/ inj dex 3mu 2 penicilln gk inj 5mu 1 penicilln vk sol 125/5ml 1 penicilln vk sol 250/5ml 1 penicilln vk tab 250mg 1 penicilln vk tab 500mg 2 piper/tazoba inj 3-0.375g 2 piper/tazoba inj 4-0.5gm 2 MACROLIDES azithromycin inj 500mg 1 azithromycin pow 1gm pak 2 azithromycin sus 100/5ml 1 azithromycin sus 200/5ml 2 azithromycin tab 250mg 30ct 2 azithromycin tab 250mg 6ct pa 2 azithromycin tab 500mg 2 azithromycin tab 600mg 2 clarithromyc tab 250mg 2 clarithromyc tab 500mg 2 DIFICID TAB 200MG 5 ST erythrocin inj 500mg 2 14

erythrocin tab 250mg 2 erythrom eth tab 400mg 1 erythromycin cap 250mg ec 2 KETEK TAB 300MG 4 KETEK TAB 400MG 4 QUINOLONES ciprofloxacn inj 200mg 1 ciprofloxacn inj 400mg 1 ciprofloxacn sus 250mg/5 2 ciprofloxacn sus 500mg/5 2 ciprofloxacn tab 1000mg 2 ciprofloxacn tab 100mg 1 ciprofloxacn tab 250mg 1 ciprofloxacn tab 500mg 1 ciprofloxacn tab 500mg er 2 ciprofloxacn tab 750mg 2 levoflox/d5w inj 500/100m 2 levoflox/d5w inj 750/150 2 levofloxacin inj 25mg/ml 2 levofloxacin sol 25mg/ml 2 levofloxacin tab 250mg 2 levofloxacin tab 500mg 2 levofloxacin tab 750mg 2 MOXIFLOXACIN INJ 2 15

ofloxacin tab 400mg 2 SULFONAMIDES smz/tmp ds tab 800-160 1 smz-tmp inj 400-80/5 2 smz-tmp sus 200-40/5 1 smz-tmp tab 400-80mg 1 sulfadiazine tab 500mg 2 sulfasalazin tab 500mg 2 MO sulfasalazin tab 500mg dr 2 MO TETRACYCLINES doxycyc mono cap 100mg 2 doxycyc mono cap 50mg 2 doxycyc mono tab 100mg 2 doxycyc mono tab 50mg 1 doxycyc mono tab 75mg 2 doxycycl hyc cap 100mg 1 doxycycl hyc cap 50mg 1 doxycycl hyc inj 100mg 2 doxycycl hyc tab 100mg 1 doxycycl hyc tab 50mg dr 1 doxycycline sus 25mg/5ml 2 doxycycline tab 20mg 2 minocycline cap 100mg 2 minocycline cap 50mg 2 16

minocycline cap 75mg 2 minocycline tab 100mg 2 minocycline tab 50mg 2 minocycline tab 75mg 2 ANTICONVULSANTS ANTICONVULSANTS, OTHER LEVETIRACETA INJ 10MG/ML 4 LEVETIRACETA INJ 15MG/ML 4 LEVETIRACETA INJ 5MG/ML 4 levetiraceta sol 100mg/ml 2 MO levetiraceta tab 1000mg 2 MO levetiraceta tab 250mg 2 MO levetiraceta tab 500mg 2 MO levetiraceta tab 500mg er 2 MO levetiraceta tab 750mg 2 MO levetiraceta tab 750mg er 2 MO levetiracetm inj 500/5ml 2 POTIGA TAB 200MG 3 MO POTIGA TAB 300MG 3 MO POTIGA TAB 400MG 3 MO POTIGA TAB 50MG 3 MO roweepra tab 500mg 2 MO SPRITAM TAB 1000MG 4 QL (90), MO 17

SPRITAM TAB 250MG 4 QL (120), MO SPRITAM TAB 500MG 4 QL (120), MO SPRITAM TAB 750MG 4 QL (120), MO BARBITURATES BUTISOL SOD TAB 30MG 4 HR phenobarb sol 20mg/5ml 1 HR, MO phenobarb tab 100mg 1 HR, MO phenobarb tab 15mg 1 HR, MO phenobarb tab 16.2mg 1 HR, MO phenobarb tab 30mg 1 HR, MO phenobarb tab 32.4mg 1 HR, MO phenobarb tab 60mg 1 HR, MO phenobarb tab 64.8mg 1 HR, MO phenobarb tab 97.2mg 1 HR, MO BENZODIAZEPINES clonazep odt tab 0.125mg 1 MO clonazep odt tab 0.25mg 1 MO clonazep odt tab 0.5mg 1 MO clonazep odt tab 1mg 1 MO clonazep odt tab 2mg 1 MO clonazepam tab 0.5mg 1 MO clonazepam tab 1mg 1 MO clonazepam tab 2mg 1 MO diazepam gel 10mg 2 18

diazepam gel 2.5mg 2 diazepam gel 20mg 2 ONFI SUS 2.5MG/ML 4 MO ONFI TAB 10MG 4 MO ONFI TAB 20MG 5 MO CALCIUM CHANNEL MODIFYING AGENTS CELONTIN CAP 300MG 4 MO ethosuximide cap 250mg 2 MO ethosuximide sol 250/5ml 1 MO LYRICA CAP 200MG 3 MO LYRICA CAP 225MG 3 MO LYRICA CAP 25MG 3 MO LYRICA CAP 300MG 3 MO LYRICA CAP 50MG 3 MO LYRICA CAP 75MG 3 MO LYRICA SOL 20MG/ML 3 MO zonisamide cap 100mg 2 MO zonisamide cap 25mg 2 MO zonisamide cap 50mg 2 MO GAMMA-AMINOBUTYRIC ACID (GABA) AUGMENTING AGENTS divalproex tab 250mg dr 2 MO divalproex tab 250mg er 2 MO divalproex tab 500mg dr 2 MO divalproex tab 500mg er 2 MO 19

FYCOMPA SUS 0.5MG/ML 4 MO FYCOMPA TAB 10MG 2 MO FYCOMPA TAB 12MG 2 MO FYCOMPA TAB 2MG 4 MO FYCOMPA TAB 4MG 4 MO FYCOMPA TAB 6MG 4 MO FYCOMPA TAB 8MG 4 MO gabapentin cap 100mg 2 MO gabapentin cap 300mg 2 MO gabapentin cap 400mg 2 MO gabapentin sol 300/6ml 2 MO gabapentin tab 600mg 2 MO gabapentin tab 800mg 2 MO GABITRIL TAB 12MG 4 MO GABITRIL TAB 16MG 4 MO primidone tab 250mg 2 MO primidone tab 50mg 2 MO SABRIL POW 500MG 5 MO SABRIL TAB 500MG 5 MO tiagabine tab 2mg 2 MO tiagabine tab 4mg 2 MO valproate inj 100mg/ml 1 valproic acd cap 250mg 2 MO valproic acd syp 250/5ml 2 MO 20

GLUTAMATE REDUCING AGENTS felbamate sus 600/5ml 5 MO felbamate tab 400mg 2 MO felbamate tab 600mg 4 MO LAMICTAL KIT START 35 4 LAMICTAL KIT START 49 4 LAMICTAL KIT START 98 4 LAMICTAL XR KIT 25 & 50 4 LAMICTAL XR KIT 25 & 50 & 100 4 LAMICTAL XR KIT 50 & 100 & 20 4 lamotrigine chw 25mg 2 MO lamotrigine chw 5mg 2 MO lamotrigine tab 100mg 2 MO lamotrigine tab 100mg er 2 MO lamotrigine tab 100mg odt 1 MO lamotrigine tab 150mg 2 MO lamotrigine tab 200mg 2 MO lamotrigine tab 200mg er 2 MO lamotrigine tab 200mg odt 1 MO lamotrigine tab 250mg er 2 MO lamotrigine tab 25mg 2 MO lamotrigine tab 25mg er 2 MO lamotrigine tab 25mg odt 1 MO lamotrigine tab 300mg er 2 MO 21

lamotrigine tab 50mg er 2 MO lamotrigine tab 50mg odt 1 MO topiramate cap 15mg 2 MO topiramate cap 25mg 2 MO TOPIRAMATE CAP ER 100MG 2 MO TOPIRAMATE CAP ER 150MG 2 MO TOPIRAMATE CAP ER 200MG 2 MO TOPIRAMATE CAP ER 25MG 2 MO TOPIRAMATE CAP ER 50MG 2 MO topiramate tab 200mg 2 MO topiramate tab 25mg 2 MO topiramate tab 50mg 2 MO TROKENDI XR CAP 100MG 4 MO TROKENDI XR CAP 200MG 4 MO TROKENDI XR CAP 25MG 4 MO TROKENDI XR CAP 50MG 4 MO SODIUM CHANNEL AGENTS APTIOM TAB 200MG 4 MO APTIOM TAB 400MG 5 MO APTIOM TAB 600MG 5 MO APTIOM TAB 800MG 5 MO BANZEL SUS 40MG/ML 5 MO BANZEL TAB 200MG 4 MO BANZEL TAB 400MG 5 MO 22

BRIVIACT INJ 50MG/5ML 4 PA BRIVIACT SOL 10MG/ML 5 PA, MO BRIVIACT TAB 100MG 5 PA, MO BRIVIACT TAB 10MG 4 PA, MO BRIVIACT TAB 25MG 5 PA, MO BRIVIACT TAB 50MG 5 PA, MO BRIVIACT TAB 75MG 5 PA, MO carbamazepin cap 200mg er 2 MO carbamazepin cap 300mg er 2 MO carbamazepin sus 100/5ml 2 MO carbamazepin tab 100mger 2 MO carbamazepin tab 200mg 2 MO carbamazepin tab 200mg er 2 MO carbamazepin tab 400mg er 2 MO CEREBYX INJ 500/10ML 4 DILANTIN CAP 30MG 4 MO EQUETRO CAP 100MG 4 MO EQUETRO CAP 200MG 4 MO EQUETRO CAP 300MG 4 MO fosphenytoin inj 100/2ml 2 oxcarbazepin sus 300mg/5m 2 MO oxcarbazepin tab 150mg 2 MO oxcarbazepin tab 300mg 2 MO oxcarbazepin tab 600mg 2 MO 23

OXTELLAR XR TAB 150MG 4 MO OXTELLAR XR TAB 300MG 4 MO OXTELLAR XR TAB 600MG 4 MO PEGANONE TAB 250MG 4 MO phenytoin chw 50mg 2 MO phenytoin ex cap 100mg 2 MO phenytoin ex cap 200mg 2 MO phenytoin ex cap 300mg 2 MO phenytoin inj 50mg/ml 1 phenytoin sus 125/5ml 2 MO TEGRETOL-XR TAB 100MG 4 MO VIMPAT INJ 200MG/20 4 VIMPAT SOL 10MG/ML 4 MO VIMPAT TAB 100MG 4 MO VIMPAT TAB 150MG 4 MO VIMPAT TAB 200MG 4 MO VIMPAT TAB 50MG 4 MO ANTIDEMENTIA AGENTS ANTIDEMENTIA AGENTS, OTHER ergoloid mes tab 1mg oral 2 HR, MO CHOLINESTERASE INHIBITORS donepezil tab 10mg 2 MO donepezil tab 10mg odt 2 MO 24

donepezil tab 5mg 2 MO donepezil tab 5mg odt 2 MO donepezil tab hcl 23mg 2 MO EXELON DIS 13.3/24 3 MO EXELON DIS 4.6MG/24 3 MO EXELON DIS 9.5MG/24 3 MO galantamine cap 16mg er 2 MO galantamine cap 24mg er 2 MO galantamine cap 8mg er 2 MO GALANTAMINE SOL 4MG/ML 2 MO galantamine tab 12mg 2 MO galantamine tab 4mg 2 MO galantamine tab 8mg 2 MO rivastigmine cap 1.5mg 2 MO rivastigmine cap 3mg 2 MO rivastigmine cap 4.5mg 2 MO rivastigmine cap 6mg 2 MO N-METHYL-D-ASPARTATE (NMDA) RECEPTOR ANTAGONIST memantine hc sol 2mg/ml 2 MO NAMENDA XR CAP 14MG 3 MO NAMENDA XR CAP 21MG 3 MO NAMENDA XR CAP 28MG 3 MO NAMENDA XR CAP 7MG 3 MO NAMENDA XR CAP TITRATIO 3 25

NAMZARIC CAP 14-10MG 3 QL (30), MO NAMZARIC CAP 28-10MG 3 QL (30), MO ANTIDEPRESSANTS ANTIDEPRESSANTS, OTHER APLENZIN TAB 174MG 4 MO APLENZIN TAB 348MG 4 MO APLENZIN TAB 522MG 4 MO buproban tab 150mg 2 bupropion tab 100mg 2 MO bupropion tab 100mg er 2 MO bupropion tab 200mg er 2 MO bupropion tab 75mg 2 MO bupropn hcl tab 150mg xl 2 MO bupropn hcl tab 300mg xl 2 MO FORFIVO XL TAB 450MG 3 MO maprotiline tab 25mg 1 MO maprotiline tab 50mg 2 MO maprotiline tab 75mg 1 MO mirtazapine tab 15mg 2 MO mirtazapine tab 15mg odt 2 MO mirtazapine tab 30mg 2 MO mirtazapine tab 30mg odt 2 MO mirtazapine tab 45mg 2 MO 26

mirtazapine tab 45mg odt 2 MO mirtazapine tab 7.5mg 2 MO nefazodone tab 100mg 2 MO nefazodone tab 150mg 2 MO nefazodone tab 200mg 2 MO nefazodone tab 250mg 2 MO nefazodone tab 50mg 1 MO trazodone tab 100mg 1 MO trazodone tab 150mg 1 MO trazodone tab 300mg 2 MO trazodone tab 50mg 1 MO TRINTELLIX TAB 10MG 4 ST, MO TRINTELLIX TAB 20MG 4 ST, MO TRINTELLIX TAB 5MG 4 ST, MO VIIBRYD KIT STARTER 3 VIIBRYD TAB 10MG 3 MO VIIBRYD TAB 20MG 3 MO VIIBRYD TAB 40MG 3 MO MONOAMINE OXIDASE INHIBITORS EMSAM DIS 12MG/24H 5 MO EMSAM DIS 6MG/24HR 5 MO EMSAM DIS 9MG/24HR 5 MO MARPLAN TAB 10MG 4 MO phenelzine tab 15mg 2 MO 27

tranylcyprom tab 10mg 2 MO SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITORS BRISDELLE CAP 7.5MG 4 MO citalopram sol 10mg/5ml 2 MO citalopram tab 10mg 2 MO citalopram tab 20mg 1 MO citalopram tab 40mg 1 MO DESVENLAFAX TAB 100MG ER 4 MO DESVENLAFAX TAB 50MG ER 4 MO duloxetine cap 20mg 2 MO duloxetine cap 30mg 2 MO DULOXETINE CAP 40MG 2 MO duloxetine cap 60mg 2 MO escitalopram sol 5mg/5ml 2 MO escitalopram tab 10mg 2 MO escitalopram tab 20mg 2 MO escitalopram tab 5mg 2 MO FETZIMA CAP 120MG 3 MO FETZIMA CAP 20MG 3 MO FETZIMA CAP 40MG 3 MO FETZIMA CAP 80MG 3 MO fluoxetine cap 10mg 1 MO fluoxetine cap 20mg 1 MO fluoxetine cap 40mg 1 MO 28

fluoxetine cap 90mg dr 2 MO fluoxetine sol 20mg/5ml 2 MO fluoxetine tab 10mg 1 MO fluoxetine tab 20mg 2 MO FLUOXETINE TAB 60MG 4 MO fluvoxamine cap 100mg er 2 MO fluvoxamine cap 150mg er 2 MO fluvoxamine tab 100mg 2 MO fluvoxamine tab 25mg 2 MO fluvoxamine tab 50mg 2 MO olanza/fluox cap 12-25mg 2 MO olanza/fluox cap 12-50mg 2 MO olanza/fluox cap 3-25mg 2 MO olanza/fluox cap 6-25mg 2 MO olanza/fluox cap 6-50mg 2 MO paroxetin er tab 12.5mg 2 MO paroxetin er tab 37.5mg 2 MO paroxetine tab 10mg 1 MO paroxetine tab 20mg 1 MO paroxetine tab 25mg er 2 MO paroxetine tab 30mg 2 MO paroxetine tab 40mg 2 MO PAXIL SUS 10MG/5ML 4 MO PEXEVA TAB 10MG 4 MO 29

PEXEVA TAB 20MG 4 MO PEXEVA TAB 30MG 4 MO PEXEVA TAB 40MG 4 MO PRISTIQ TAB 100MG 4 MO PRISTIQ TAB 25MG 4 MO PRISTIQ TAB 50MG 4 MO sertraline con 20mg/ml 2 MO sertraline tab 100mg 2 MO sertraline tab 25mg 2 MO sertraline tab 50mg 2 MO venlafaxine cap 150mg er 2 MO venlafaxine cap 37.5 er 2 MO venlafaxine cap 75mg er 2 MO venlafaxine tab 100mg 2 MO venlafaxine tab 150mg er 2 MO venlafaxine tab 225mg er 2 MO venlafaxine tab 25mg 2 MO venlafaxine tab 37.5 er 2 MO venlafaxine tab 37.5mg 2 MO venlafaxine tab 50mg 2 MO venlafaxine tab 75mg 2 MO venlafaxine tab 75mg er 2 MO TRICYCLICS amitriptylin tab 100mg 1 HR, MO 30

amitriptylin tab 10mg 1 HR, MO amitriptylin tab 150mg 2 HR, MO amitriptylin tab 25mg 1 HR, MO amitriptylin tab 50mg 1 HR, MO amitriptylin tab 75mg 1 HR, MO amoxapine tab 100mg 2 MO amoxapine tab 150mg 1 MO amoxapine tab 25mg 1 MO amoxapine tab 50mg 1 MO cdp/amitrip tab 10-25mg 1 HR, MO cdp/amitrip tab 5-12.5mg 1 HR, MO clomipramine cap 25mg 2 HR, MO clomipramine cap 50mg 2 HR, MO clomipramine cap 75mg 2 HR, MO desipramine tab 100mg 2 MO desipramine tab 10mg 2 MO desipramine tab 150mg 2 MO desipramine tab 25mg 2 MO desipramine tab 50mg 2 MO desipramine tab 75mg 1 MO doxepin hcl cap 100mg 1 HR, MO doxepin hcl cap 10mg 1 HR, MO doxepin hcl cap 150mg 2 HR, MO doxepin hcl cap 25mg 1 HR, MO 31

doxepin hcl cap 50mg 1 HR, MO doxepin hcl cap 75mg 1 HR, MO doxepin hcl con 10mg/ml 1 HR, MO imipram hcl tab 10mg 2 HR, MO imipram hcl tab 25mg 2 HR, MO imipram hcl tab 50mg 2 HR, MO imipram pam cap 100mg 2 HR, MO imipram pam cap 125mg 2 HR, MO imipram pam cap 150mg 2 HR, MO imipram pam cap 75mg 2 HR, MO nortriptylin cap 10mg 1 MO nortriptylin cap 25mg 1 MO nortriptylin cap 50mg 2 MO nortriptylin cap 75mg 2 MO NORTRIPTYLIN SOL 10MG/5ML 2 MO protriptylin tab 10mg 2 MO protriptylin tab 5mg 2 MO trimipramine cap 100mg 2 HR, MO trimipramine cap 25mg 2 HR, MO trimipramine cap 50mg 2 HR, MO ANTIEMETICS ANTIEMETICS, OTHER meclizine tab 12.5mg 1 32

meclizine tab 25mg 1 metoclopram tab 5mg 2 TRANSDERM-SC DIS 1MG 4 EMETOGENIC THERAPY ADJUNCTS dronabinol cap 10mg 5 PA, QL (60) dronabinol cap 2.5mg 2 PA, QL (60) dronabinol cap 5mg 2 PA, QL (60) EMEND CAP 40MG 4 PA EMEND PAK 80 & 125 4 PA, QL (12) EMEND SOL 150MG 4 PA granisetron inj 0.1mg/ml 2 PA, QL (60) granisetron inj 1mg/ml 2 PA, QL (60) granisetron tab 1mg 2 PA, QL (60) ondansetron inj 40/20ml 2 PA, QL (160) ondansetron inj 4mg/2ml 2 PA ondansetron sol 4mg/5ml 2 PA ondansetron tab 24mg 2 PA, QL (30) ondansetron tab 4mg 2 PA, QL (60) ondansetron tab 4mg odt 2 PA, QL (60) ondansetron tab 8mg 2 PA, QL (60) ondansetron tab 8mg odt 2 PA, QL (60) SANCUSO DIS 3.1MG 5 QL (28-Apr) ANTIFUNGALS 33

ANTIFUNGALS ABELCET INJ 5MG/ML 4 PA AMBISOME INJ 50MG 4 PA amphotericin inj 50mg 2 PA CANCIDAS INJ 50MG 4 CANCIDAS INJ 70MG 4 clotrimazole tro 10mg 2 ERAXIS INJ 50MG 4 fluconazole sus 10mg/ml 2 fluconazole sus 40mg/ml 2 fluconazole tab 100mg 2 fluconazole tab 150mg 2 fluconazole tab 200mg 2 fluconazole tab 50mg 2 fluconazole/ inj dex 400 2 PA fluconazole/ inj nacl 200 2 PA flucytosine cap 250mg 5 flucytosine cap 500mg 5 griseofulvin sus 125/5ml 1 itraconazole cap 100mg 2 ketoconazole tab 200mg 2 MYCAMINE INJ 100MG 5 MYCAMINE INJ 50MG 4 NOXAFIL SUS 40MG/ML 4 MO 34

NOXAFIL TAB 100MG 4 MO nystatin tab 500000 2 voriconazole inj 200mg 2 voriconazole sus 40mg/ml 5 voriconazole tab 200mg 5 ANTIGOUT AGENTS ANTIGOUT AGENTS allopurinol tab 100mg 1 MO allopurinol tab 300mg 1 MO COLCHICINE CAP 0.6MG 2 COLCHICINE TAB 0.6MG 2 probenecid tab 500mg 2 MO ULORIC TAB 40MG 4 ST, MO ULORIC TAB 80MG 4 ST, MO ANTI-INFLAMMATORY AGENTS NONSTEROIDAL ANTI-INFLAMMATORY DRUGS celecoxib cap 100mg 2 MO celecoxib cap 200mg 2 MO celecoxib cap 400mg 2 MO celecoxib cap 50mg 2 MO diclofen pot tab 50mg 2 MO diclofenac tab 100mg er 2 MO diclofenac tab 25mg dr 2 MO 35

diclofenac tab 50mg dr 2 MO diclofenac tab 75mg dr 1 MO diflunisal tab 500mg 2 MO etodolac cap 200mg 2 MO etodolac cap 300mg 2 MO etodolac er tab 400mg 2 MO etodolac er tab 500mg 2 MO etodolac er tab 600mg 2 MO etodolac tab 400mg 2 MO etodolac tab 500mg 2 MO fenoprofen tab 600mg 1 MO flurbiprofen tab 100mg 2 MO flurbiprofen tab 50mg 1 MO ibuprofen sus 100/5ml 1 ibuprofen tab 400mg 1 MO ibuprofen tab 600mg 1 MO ibuprofen tab 800mg 1 MO indomethacin cap 25mg 1 HR, MO indomethacin cap 50mg 2 HR, MO indomethacin cap 75mg er 2 HR, MO ketoprofen cap 200mg er 2 MO ketoprofen cap 50mg 1 MO ketoprofen cap 75mg 2 MO ketorolac inj 15mg/ml 1 HR 36

ketorolac inj 30mg/ml 1 HR ketorolac inj 60mg/2ml 2 HR ketorolac tab 10mg 2 HR meclofen sod cap 100mg 1 MO meclofen sod cap 50mg 1 MO meloxicam sus 7.5/5ml 2 MO meloxicam tab 15mg 2 MO meloxicam tab 7.5mg 2 MO nabumetone tab 500mg 2 MO nabumetone tab 750mg 2 MO naproxen dr tab 375mg 1 MO naproxen dr tab 500mg 2 MO naproxen sod tab 275mg 2 MO naproxen sod tab 550mg 2 MO naproxen sus 125/5ml 1 MO naproxen tab 250mg 2 MO naproxen tab 375mg 1 MO naproxen tab 500mg 1 MO oxaprozin tab 600mg 2 MO piroxicam cap 10mg 2 MO piroxicam cap 20mg 1 MO sulindac tab 150mg 2 MO sulindac tab 200mg 2 MO tolmetin sod cap 400mg 2 MO 37

tolmetin sod tab 600mg 1 MO ANTIMIGRAINE AGENTS ANTIMIGRAINE AGENTS, PROPHYLACTIC divalproex cap 125mg 2 MO divalproex tab 125mg dr 2 MO topiramate tab 100mg 2 MO ERGOT ALKALOIDS dihydroergot inj 1mg/ml 1 ERGOMAR SUB 2MG 4 SEROTONIN (5-HT) 1B/1D RECEPTOR AGONISTS frovatriptan tab 2.5mg 2 QL (18) RELPAX TAB 20MG 3 QL (9) RELPAX TAB 40MG 3 QL (9) sumatriptan inj 6mg/0.5 2 QL (10) sumatriptan inj auto-inj 6mg/ 2 QL (4.5) sumatriptan tab 100mg 2 QL (9) sumatriptan tab 25mg 2 QL (9) sumatriptan tab 50mg 2 QL (9) ANTIMYASTHENIC AGENTS PARASYMPATHOMIMETICS GUANIDINE TAB 125MG 2 MESTINON SYP 60MG/5ML 4 pyridostigm tab 60mg 2 38

ANTIMYCOBACTERIALS ANTIMYCOBACTERIALS, OTHER dapsone tab 100mg 2 MO dapsone tab 25mg 2 MO pyrazinamide tab 500mg 2 rifabutin cap 150mg 2 ANTITUBERCULARS CAPASTAT SUL INJ 1GM 4 ethambutol tab 100mg 2 ethambutol tab 400mg 2 isoniazid inj 100mg/ml 1 isoniazid syp 50mg/5ml 1 MO isoniazid tab 100mg 1 MO isoniazid tab 300mg 1 MO PASER GRA 4GM 4 PRIFTIN TAB 150MG 4 rifampin cap 150mg 1 rifampin cap 300mg 2 rifampin inj 600 mg 1 RIFATER TAB 3 SIRTURO TAB 100MG 5 TRECATOR TAB 250MG 4 ANTINEOPLASTICS 39

ALKYLATING AGENTS CYCLOPHOSPH CAP 25MG 2 PA CYCLOPHOSPH CAP 50MG 2 PA GLEOSTINE CAP 5MG 4 HEXALEN CAP 50MG 4 LEUKERAN TAB 2MG 3 ANTIANGIOGENIC AGENTS AVASTIN INJ 5 AVASTIN INJ 400/16ML 3 DEPEN TITRA TAB 250MG 5 REVLIMID CAP 10MG 5 LA REVLIMID CAP 15MG 5 LA REVLIMID CAP 2.5MG 5 REVLIMID CAP 20MG 5 REVLIMID CAP 25MG 5 LA REVLIMID CAP 5MG 5 LA SYPRINE CAP 250MG 5 THALOMID CAP 100MG 5 MO THALOMID CAP 150MG 5 MO THALOMID CAP 200MG 5 MO THALOMID CAP 50MG 5 MO ANTIMETABOLITES ALIMTA INJ 500MG 5 azacitidine inj 100mg 5 40

decitabine inj 50mg 2 fludarabine inj 50mg 2 gemcitabine inj 1gm 5 mercaptopur tab 50mg 2 methotrexate inj 1gm 1 PA methotrexate inj 1gm/40ml 2 PA methotrexate tab 2.5mg 2 PA PRIMAQUINE TAB 26.3MG 4 PURIXAN SUS 20MG/ML 4 TABLOID TAB 40MG 4 ANTINEOPLASTICS ABRAXANE INJ 100MG 4 PA ACTIMMUNE INJ 2MU/0.5 5 MO, LA AFINITOR DIS TAB 2MG 5 AFINITOR DIS TAB 3MG 5 AFINITOR DIS TAB 5MG 5 AFINITOR TAB 10MG 5 AFINITOR TAB 2.5MG 5 AFINITOR TAB 5MG 5 AFINITOR TAB 7.5MG 5 ALECENSA CAP 150MG 5 amifostine inj 500mg 5 PA ARRANON INJ 5MG/ML 4 PA AZASAN TAB 100MG 4 PA, MO 41

AZASAN TAB 75 MG 4 PA, MO BELEODAQ INJ 500MG 5 bexarotene cap 75mg 5 PA bicalutamide tab 50mg 2 BICNU INJ 100MG 4 PA bleomycin inj 30unit 2 PA BOSULIF TAB 100MG 5 PA BOSULIF TAB 500MG 5 PA BUSULFEX INJ 6MG/ML 4 PA CABOMETYX TAB 20MG 5 CABOMETYX TAB 40MG 5 CABOMETYX TAB 60MG 5 CAPRELSA TAB 100MG 5 CAPRELSA TAB 300MG 5 carboplatin inj 600/60ml 2 PA cisplatin inj 100mg 2 PA cladribine inj 1mg/ml 2 PA CLOLAR INJ 1MG/ML 4 PA COMETRIQ KIT 100MG 5 COMETRIQ KIT 140MG 5 COMETRIQ KIT 60MG 5 COSMEGEN INJ 0.5MG 4 PA COTELLIC TAB 20MG 5 LA CYRAMZA INJ 100/10ML 5 PA 42

CYRAMZA INJ 500/50ML 5 PA cytarabine inj 100mg/ml 2 PA cytarabine inj 20mg/ml 2 PA dacarbazine inj 200mg 2 PA DARZALEX SOL 100MG/5M 4 LA daunorubicin inj 5mg/ml 2 PA DEPO-PROVERA INJ 400/ML 4 PA dexrazoxane inj 250mg 5 PA DOCEFREZ INJ 20MG 5 PA DOCETAXEL INJ 80MG/4ML 5 DOCETAXEL INJ 80MG/8ML 5 DOXIL INJ 2MG/ML 5 PA doxorubicin inj 200/100 2 PA doxorubicin inj 2mg/ml 5 PA ELIGARD INJ 22.5MG 4 PA ELIGARD INJ 30MG 4 PA ELIGARD INJ 45MG 4 PA ELIGARD INJ 7.5MG 4 PA ELITEK INJ 1.5MG 5 PA ELITEK INJ 7.5MG 4 PA EMCYT CAP 140MG 4 EMPLICITI INJ 300MG 5 EMPLICITI INJ 400MG 4 PA ERBITUX INJ 100MG 5 PA 43

ERIVEDGE CAP 150MG 5 ERWINAZE INJ 10000UNT 4 PA ETOPOPHOS INJ 100MG 4 PA etoposide inj 500/25ml 2 PA FARESTON TAB 60MG 5 MO FARYDAK CAP 10MG 5 PA FARYDAK CAP 15MG 5 PA FARYDAK CAP 20MG 5 PA FASLODEX INJ 250MG 5 PA FIRMAGON INJ 120MG 5 PA FIRMAGON INJ 80MG 4 PA fluorouracil dro 2% 2 fluorouracil dro 5% 2 fluorouracil inj 5gm/100m 2 PA flutamide cap 125mg 2 FOLOTYN INJ 40MG/2ML 4 PA GILOTRIF TAB 20MG 5 PA GILOTRIF TAB 30MG 5 PA GILOTRIF TAB 40MG 5 PA GLEEVEC TAB 100MG 5 GLEEVEC TAB 400MG 5 HALAVEN INJ 1MG/2ML 5 HERCEPTIN INJ 440MG 5 PA hydroxy capr inj 1.25/5ml 5 PA 44

hydroxyurea cap 500mg 2 IBRANCE CAP 100MG 5 PA IBRANCE CAP 125MG 5 PA IBRANCE CAP 75MG 5 PA ICLUSIG TAB 15MG 5 PA ICLUSIG TAB 45MG 5 PA idarubicin inj 10/10ml 2 PA ifosfamide inj 1gm 2 PA IMBRUVICA CAP 140MG 5 PA INLYTA TAB 1MG 5 INLYTA TAB 5MG 5 INTRON A INJ 10MU 5 MO INTRON A INJ 50MU 4 MO INTRON-A INJ 18MU POW 4 MO INTRON-A INJ 18MU SOL 4 MO IRESSA TAB 250MG 5 irinotecan inj 100/5ml 4 PA ISTODAX INJ 10MG 5 JAKAFI TAB 10MG 5 JAKAFI TAB 15MG 5 JAKAFI TAB 20MG 5 JAKAFI TAB 25MG 5 JAKAFI TAB 5MG 5 JEVTANA INJ 60/1.5ML 5 PA 45

KADCYLA INJ 100MG 5 KEPIVANCE INJ 6.25MG 4 PA KEYTRUDA INJ 100MG/4M 5 PA KEYTRUDA SOL 50MG 5 PA LENVIMA CAP 10 MG 5 LENVIMA CAP 14 MG 5 LENVIMA CAP 18 MG 5 LENVIMA CAP 20 MG 5 LENVIMA CAP 24 MG 5 LENVIMA CAP 8 MG 5 leucovor ca inj 100mg 2 PA leucovor ca inj 350mg 2 PA leucovor ca tab 10mg 2 leucovor ca tab 15mg 2 leucovor ca tab 25mg 2 leucovor ca tab 5mg 2 leuprolide inj 1mg/0.2 2 levoleucovor inj 50mg 2 PA LONSURF TAB 15-6.14 5 LONSURF TAB 20-8.19 5 LUPR DEP-PED INJ 30MG 3 LUPRON DEPOT INJ 22.5MG 4 LUPRON DEPOT INJ 3.75MG 3 LUPRON DEPOT INJ 45MG 5 46

LUPRON DEPOT INJ 7.5MG 4 LYNPARZA CAP 50MG 5 PA LYSODREN TAB 500MG 3 MATULANE CAP 50MG 4 MEGACE ES SUS 625/5ML 5 HR, MO megestrol ac sus 40mg/ml 2 HR megestrol ac tab 20mg 2 HR megestrol ac tab 40mg 2 HR megestrol sus 625mg/5m 4 HR, MO MEKINIST TAB 0.5MG 5 LA MEKINIST TAB 2MG 5 LA melphalan inj 50mg 2 PA mesna inj 1gm 2 PA MESNEX TAB 400MG 4 mitomycin inj 20mg 2 PA mitomycin inj 40mg 2 PA MITOMYCIN INJ 5MG 2 PA mitoxantron inj 2mg/ml 1 MUSTARGEN INJ 10MG 4 PA NEXAVAR TAB 200MG 5 LA NILANDRON TAB 150MG 5 NINLARO CAP 2.3MG 4 NINLARO CAP 3MG 5 NINLARO CAP 4MG 5 47

NIPENT INJ 10MG 4 PA ODOMZO CAP 200MG 5 LA OPDIVO INJ 40MG/4ML 5 PA oxaliplatin inj 100mg 2 PA paclitaxel inj 300/50ml 2 PA PERJETA INJ 420/14ML 5 POMALYST CAP 1MG 5 LA POMALYST CAP 2MG 5 LA POMALYST CAP 3MG 5 LA POMALYST CAP 4MG 5 LA PROLEUKIN INJ 22MU 5 PA RHEUMATREX TAB 2.5MG 4X6 4 PA, MO RITUXAN INJ 500MG 3 SPRYCEL TAB 100MG 5 SPRYCEL TAB 140MG 5 SPRYCEL TAB 20MG 5 SPRYCEL TAB 50MG 5 SPRYCEL TAB 70MG 5 SPRYCEL TAB 80MG 5 STIVARGA TAB 40MG 5 PA SUTENT CAP 12.5MG 3 SUTENT CAP 25MG 3 SUTENT CAP 37.5MG 3 SUTENT CAP 50MG 3 48

SYLATRON KIT 200MCG 5 MO SYLATRON KIT 300MCG 5 MO SYLATRON KIT 600MCG 5 MO SYNRIBO INJ 3.5MG 5 TAFINLAR CAP 50MG 5 LA TAFINLAR CAP 75MG 5 LA TAGRISSO TAB 40MG 5 LA TAGRISSO TAB 80MG 5 LA tamoxifen tab 10mg 1 MO tamoxifen tab 20mg 1 MO TARCEVA TAB 100MG 5 TARCEVA TAB 150MG 5 TARCEVA TAB 25MG 5 TASIGNA CAP 150MG 5 TASIGNA CAP 200MG 5 TECENTRIQ INJ 1200/20 4 PA THIOTEPA INJ 15MG 5 PA topotecan inj 4mg 2 PA TORISEL SOL 25MG/ML 3 PA TREANDA INJ 25MG 5 PA TRELSTAR MIX INJ 11.25MG 5 PA TRELSTAR MIX INJ 22.5MG 5 PA TRELSTAR MIX INJ 3.75MG 5 PA tretinoin cap 10mg 1 49

TRISENOX SOL 10MG/10M 4 PA TYKERB TAB 250MG 5 UVADEX INJ 20MCG/ML 4 PA VECTIBIX INJ 100MG 4 PA VELCADE INJ 3.5MG 5 VENCLEXTA TAB 100MG 5 PA, LA VENCLEXTA TAB 10MG 4 PA, LA VENCLEXTA TAB 50MG 4 PA, LA VENCLEXTA TAB START PK 4 PA, LA vinblastine inj 10mg 2 PA vincristine inj 1mg/ml 2 PA vinorelbine inj 10mg/ml 2 PA VOTRIENT TAB 200MG 5 XALKORI CAP 200MG 5 PA XALKORI CAP 250MG 5 PA XTANDI CAP 40MG 5 PA, ST YERVOY INJ 50MG 5 ZALTRAP INJ 100/4ML 5 ZANOSAR INJ 1GM 4 PA ZELBORAF TAB 240MG 5 ZOLINZA CAP 100MG 5 ZYDELIG TAB 100MG 5 ZYDELIG TAB 150MG 5 ZYKADIA CAP 150MG 5 50

ZYTIGA TAB 250MG 5 AROMATASE INHIBITORS, 3RD GENERATION anastrozole tab 1mg 2 MO exemestane tab 25mg 2 MO letrozole tab 2.5mg 2 MO ANTIPARASITICS ANTHELMINTICS ALBENZA TAB 200MG 4 EMVERM CHW 100MG 3 ivermectin tab 3mg 2 ANTIPROTOZOALS ALINIA SUS 100/5ML 4 ALINIA TAB 500MG 4 atovaq/progu tab 250-100 2 atovaquone sus 750/5ml 2 chloroquine tab 250mg 1 MO chloroquine tab 500mg 1 MO COARTEM TAB 20-120MG 4 DARAPRIM TAB 25MG 4 hydroxychlor tab 200mg 2 MO mefloquine tab 250mg 2 MO NEBUPENT INH 300MG 3 PA PENTAM 300 INJ 300MG 4 51

quinine sulf cap 324mg 2 ANTIPARKINSON AGENTS ANTICHOLINERGICS benztropine inj 1mg/ml 2 benztropine tab 0.5mg 2 HR, MO benztropine tab 1mg 2 HR, MO benztropine tab 2mg 1 HR, MO trihexyphen elx 0.4mg/ml 1 HR, MO trihexyphen tab 2mg 1 HR, MO trihexyphen tab 5mg 2 HR, MO ANTIPARKINSON AGENTS, OTHER amantadine cap 100mg 2 MO amantadine syp 50mg/5ml 2 MO amantadine tab 100mg 2 MO entacapone tab 200mg 2 MO DOPAMINE AGONISTS APOKYN INJ 10MG/ML 5 LA bromocriptin cap 5mg 2 MO bromocriptin tab 2.5mg 2 MO NEUPRO DIS 1MG/24HR 4 MO NEUPRO DIS 2MG/24HR 4 MO NEUPRO DIS 3MG/24HR 4 MO NEUPRO DIS 4MG/24HR 4 MO 52

NEUPRO DIS 6MG/24HR 4 MO NEUPRO DIS 8MG/24HR 4 MO pramipexole tab 0.125mg 2 MO pramipexole tab 0.25mg 2 MO pramipexole tab 0.5mg 2 MO pramipexole tab 0.75mg 2 MO pramipexole tab 1.5mg 2 MO pramipexole tab 1mg 2 MO pramipexole tab 2.25mg 2 MO ropinirole tab 0.25mg 2 MO ropinirole tab 0.5mg 2 MO ropinirole tab 1mg 2 MO ropinirole tab 2mg 2 MO ropinirole tab 3mg 2 MO ropinirole tab 4mg 2 MO ropinirole tab 5mg 2 MO DOPAMINE PRECURSORS/ L-AMINO ACID DECARBOXYLASE INHIBITORS carb/levo er tab 25-100mg 2 MO carb/levo er tab 50-200mg 2 MO carb/levo tab 10-100mg 2 MO carb/levo tab 10-100mg odt 2 MO carb/levo tab 25-100mg 2 MO carb/levo tab 25-100mg odt 2 MO carb/levo tab 25-250mg 2 MO 53

carb/levo tab 25-250mg odt 2 MO MONOAMINE OXIDASE B (MAO-B) INHIBITORS AZILECT TAB 0.5MG 4 MO AZILECT TAB 1MG 4 MO selegiline cap 5mg 2 MO selegiline tab 5mg 2 MO ANTIPSYCHOTICS 1ST GENERATION/TYPICAL chlorpromaz inj 50mg/2ml 1 PA chlorpromaz tab 100mg 2 MO chlorpromaz tab 10mg 2 PA, MO chlorpromaz tab 200mg 2 MO chlorpromaz tab 25mg 2 MO chlorpromaz tab 50mg 2 MO fluphenaz de inj 25mg/ml 2 fluphenazine con 5mg/ml 2 MO fluphenazine elx 2.5/5ml 1 MO fluphenazine inj 2.5mg/ml 1 fluphenazine tab 10mg 2 MO fluphenazine tab 1mg 1 MO fluphenazine tab 2.5mg 2 MO fluphenazine tab 5mg 2 MO haloper dec inj 100mg/ml 2 54

haloper dec inj 50mg/ml 2 haloper lac inj 5mg/ml 2 haloperidol con 2mg/ml 2 MO haloperidol tab 0.5mg 1 MO haloperidol tab 10mg 2 MO haloperidol tab 1mg 1 MO haloperidol tab 20mg 2 MO haloperidol tab 2mg 1 MO haloperidol tab 5mg 1 MO loxapine cap 10mg 2 MO loxapine cap 25mg 2 MO loxapine cap 50mg 2 MO loxapine cap 5mg 2 MO MOLINDONE TAB HCL 10MG 4 MO MOLINDONE TAB HCL 25MG 4 MO MOLINDONE TAB HCL 5MG 4 MO perphen/amit tab 2-10mg 2 HR, MO perphen/amit tab 2-25mg 2 HR, MO perphen/amit tab 4-10mg 1 HR, MO perphen/amit tab 4-25mg 1 HR, MO perphen/amit tab 4-50mg 1 HR, MO perphenazine tab 16mg 2 MO perphenazine tab 2mg 2 MO perphenazine tab 4mg 2 MO 55

perphenazine tab 8mg 2 MO pimozide tab 1mg 2 MO pimozide tab 2mg 2 MO prochlorper inj 10mg/2ml 2 prochlorper sup 25mg 2 prochlorper tab 10mg 1 MO prochlorper tab 5mg 2 MO thioridazine tab 100mg 2 HR, MO thioridazine tab 10mg 2 HR, MO thioridazine tab 25mg 1 HR, MO thioridazine tab 50mg 1 HR, MO thiothixene cap 10mg 2 MO thiothixene cap 1mg 2 MO thiothixene cap 2mg 1 MO thiothixene cap 5mg 2 MO trifluoperaz tab 10mg 2 MO trifluoperaz tab 1mg 2 MO trifluoperaz tab 2mg 2 MO trifluoperaz tab 5mg 2 MO 2ND GENERATION/ATYPICAL ABILIFY MAIN DC INJ 300MG 4 MO ABILIFY MAIN INJ 300MG 4 MO aripiprazole tab 10mg 2 MO ARIPIPRAZOLE TAB 10MG ODT 5 MO 56

aripiprazole tab 15mg 2 MO ARIPIPRAZOLE TAB 15MG ODT 5 MO aripiprazole tab 20mg 5 MO aripiprazole tab 2mg 2 MO aripiprazole tab 30mg 5 MO aripiprazole tab 5mg 2 MO ARISTADA INJ 441MG/1.6 4 ST, MO ARISTADA INJ 662MG/2.4 5 ST, MO ARISTADA INJ 882MG/3.2 5 ST, MO FANAPT PAK 4 FANAPT TAB 10MG 5 FANAPT TAB 12MG 5 FANAPT TAB 1MG 4 FANAPT TAB 2MG 4 FANAPT TAB 4MG 4 FANAPT TAB 6MG 5 FANAPT TAB 8MG 5 GEODON INJ 20MG 4 INVEGA SUST INJ 117/0.75 5 INVEGA SUST INJ 156MG/ML 5 INVEGA SUST INJ 234/1.5 5 INVEGA SUST INJ 39/0.25 4 INVEGA SUST INJ 78/0.5ML 5 INVEGA TRINZ INJ 273MG 5 MO 57

INVEGA TRINZ INJ 410MG 5 MO INVEGA TRINZ INJ 546MG 5 MO INVEGA TRINZ INJ 819MG 5 MO LATUDA TAB 120MG 3 MO LATUDA TAB 20MG 3 MO LATUDA TAB 40MG 3 MO LATUDA TAB 60MG 3 MO LATUDA TAB 80MG 3 MO NUPLAZID TAB 17MG 5 PA, MO olanzapine inj 10mg 2 olanzapine tab 10mg 2 MO olanzapine tab 10mg odt 2 MO olanzapine tab 15mg 2 MO olanzapine tab 15mg odt 2 MO olanzapine tab 2.5mg 2 MO olanzapine tab 20mg 2 MO olanzapine tab 20mg odt 2 MO olanzapine tab 5mg 2 MO olanzapine tab 5mg odt 2 MO olanzapine tab 7.5mg 2 MO paliperidone tab er 1.5mg 2 MO paliperidone tab er 3mg 2 MO paliperidone tab er 6mg 2 MO paliperidone tab er 9mg 2 MO 58

quetiapine tab 100mg 2 MO quetiapine tab 200mg 2 MO quetiapine tab 25mg 2 MO quetiapine tab 300mg 2 MO quetiapine tab 400mg 2 MO quetiapine tab 50mg 2 MO REXULTI TAB 0.25MG 5 PA, MO REXULTI TAB 0.5MG 5 PA, MO REXULTI TAB 1MG 5 PA, MO REXULTI TAB 2MG 5 PA, MO REXULTI TAB 3MG 5 PA, MO REXULTI TAB 4MG 5 PA, MO RISPERDAL INJ 12.5MG 4 RISPERDAL INJ 25MG 4 RISPERDAL INJ 37.5MG 5 RISPERDAL INJ 50MG 5 risperidone sol 1mg/ml 2 MO risperidone tab 0.25 odt 2 MO risperidone tab 0.25mg 2 MO risperidone tab 0.5mg 2 MO risperidone tab 0.5mg od 2 MO risperidone tab 1mg 2 MO risperidone tab 1mg odt 2 MO risperidone tab 2mg 2 MO 59

risperidone tab 2mg odt 2 MO risperidone tab 3mg 2 MO risperidone tab 3mg odt 2 MO risperidone tab 4mg 2 MO risperidone tab 4mg odt 2 MO SAPHRIS SUB 10MG 4 MO SAPHRIS SUB 2.5MG 4 MO SAPHRIS SUB 5MG 4 MO SEROQUEL XR TAB 150MG 3 MO SEROQUEL XR TAB 200MG 3 MO SEROQUEL XR TAB 300MG 3 MO SEROQUEL XR TAB 400MG 3 MO SEROQUEL XR TAB 50MG 3 MO VRAYLAR CAP 1.5-3MG 4 ST VRAYLAR CAP 1.5MG 5 ST, QL (120), MO VRAYLAR CAP 3MG 5 ST, QL (60), MO VRAYLAR CAP 4.5MG 5 ST, QL (30), MO VRAYLAR CAP 6MG 5 ST, QL (30), MO ziprasidone cap 20mg 2 MO ziprasidone cap 40mg 2 MO ziprasidone cap 60mg 2 MO ziprasidone cap 80mg 2 MO ZYPREXA RELP INJ 210MG 4 TREATMENT-RESISTANT 60

clozapine tab 100/odt 2 clozapine tab 100mg 2 CLOZAPINE TAB 12.5/ODT 2 clozapine tab 150/odt 2 clozapine tab 200/odt 5 clozapine tab 200mg 2 clozapine tab 25mg 2 clozapine tab 25mg odt 2 clozapine tab 50mg 2 VERSACLOZ SUS 50MG/ML 4 ANTIVIRALS ANTI-CYTOMEGALOVIRUS (CMV) AGENTS ganciclovir inj 500mg 2 PA valganciclov tab 450mg 5 MO ANTIHEPATITIS AGENTS adefov dipiv tab 10mg 5 MO BARACLUDE SOL.05MG/ML 4 MO DAKLINZA TAB 30MG 5 PA DAKLINZA TAB 60MG 5 PA DAKLINZA TAB 90MG 5 PA entecavir tab 0.5mg 5 MO entecavir tab 1mg 5 MO HARVONI TAB 90-400MG 5 PA 61

PEGASYS INJ 5 PEGASYS INJ 180MCG/M 5 PEGASYS INJ PROCLICK 135MCG/0 5 PEGASYS INJ PROCLICK 180MCG/0 5 PEG-INTRON KIT 120 RP 5 PEGINTRON KIT 120MCG 5 PEG-INTRON KIT 150 RP 5 PEGINTRON KIT 150MCG 5 PEGINTRON KIT 50MCG 5 PEG-INTRON KIT 50MCG RP 5 PEGINTRON KIT 80MCG 5 PEG-INTRON KIT 80MCG RP 5 ribapak pak 1000/day 5 ribapak pak 800/day 5 RIBASPHERE TAB 400MG 2 ribavirin cap 200mg 2 ribavirin tab 200mg 2 SOVALDI TAB 400MG 5 PA TYZEKA TAB 600MG 4 MO ZEPA TAB 50-100MG 5 PA ANTIHERPETIC AGENTS acyclovir cap 200mg 1 acyclovir na inj 50mg/ml 1 PA acyclovir sus 200/5ml 2 62

acyclovir tab 400mg 2 acyclovir tab 800mg 2 famciclovir tab 125mg 2 famciclovir tab 250mg 2 famciclovir tab 500mg 2 valacyclovir tab 1gm 2 valacyclovir tab 500mg 2 ANTI-HIV AGENTS, NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS ATRIPLA TAB 5 MO COMPLERA TAB 5 MO EDURANT TAB 25MG 5 MO GENVOYA TAB 5 MO INTELENCE TAB 100MG 5 MO INTELENCE TAB 200MG 5 MO INTELENCE TAB 25MG 4 MO NEVIRAPINE SUS 50MG/5ML 2 MO nevirapine tab 100mg 2 MO nevirapine tab 200mg 2 MO nevirapine tab 400mg er 2 MO ODEFSEY TAB 5 MO RESCRIPTOR TAB 100 MG 3 MO RESCRIPTOR TAB 200MG 3 MO SUSTIVA CAP 200MG 3 MO SUSTIVA CAP 50MG 3 MO 63

SUSTIVA TAB 600MG 5 MO ANTI-HIV AGENTS, NUCLEOSIDE AND NUCLEOTIDE REVERSE TRANSCRIPTASE INHIBITORS abacav/lamiv tab /zidovud 5 MO abacavir tab 300mg 2 MO DESCOVY TAB 200/25 5 MO desloratadin tab 5mg odt 2 didanosine cap 125mg 2 MO didanosine cap 200mg 2 MO didanosine cap 250mg 2 MO didanosine cap 400mg 2 MO EMTRIVA CAP 200MG 4 MO EMTRIVA SOL 10MG/ML 3 MO EPIVIR HBV SOL 5MG/ML 3 MO EPZICOM TAB 600-300 5 MO EVOTAZ TAB 300-150 5 MO lamivud/zido tab 150-300 4 MO lamivudine sol 10mg/ml 2 MO lamivudine tab 100mg 2 MO lamivudine tab 150mg 2 MO lamivudine tab 300mg 2 MO PREZCOBIX TAB 800-150 5 MO RETROVIR INJ 10MG/ML 4 stavudine cap 15mg 2 MO 64

stavudine cap 20mg 2 MO stavudine cap 30mg 2 MO stavudine cap 40mg 2 MO TRIUMEQ TAB 4 MO TRUVADA TAB 100-150 5 MO TRUVADA TAB 133-200 5 MO TRUVADA TAB 167-250 5 MO TRUVADA TAB 200-300 5 MO VIDEX SOL 2GM 3 MO VIREAD POW 40MG/GM 5 MO VIREAD TAB 150MG 5 MO VIREAD TAB 200MG 5 MO VIREAD TAB 250MG 5 MO VIREAD TAB 300MG 5 MO ZIAGEN SOL 20MG/ML 4 MO zidovudine cap 100mg 2 MO zidovudine syp 50mg/5ml 2 MO zidovudine tab 300mg 2 MO ANTI-HIV AGENTS, OTHER FUZEON INJ 90MG 5 MO ISENTRESS CHW 100MG 5 MO ISENTRESS CHW 25MG 3 MO ISENTRESS POW 100MG 4 MO ISENTRESS TAB 400MG 5 MO 65

SELZENTRY TAB 150MG 5 MO SELZENTRY TAB 300MG 5 MO STRIBILD TAB 5 MO TIVICAY TAB 10MG 4 MO TIVICAY TAB 25MG 4 MO TIVICAY TAB 50MG 5 MO TYBOST TAB 150MG 3 MO VITEKTA TAB 150MG 5 MO VITEKTA TAB 85MG 5 MO ANTI-HIV AGENTS, PROTEASE INHIBITORS APTIVUS CAP 250MG 5 MO APTIVUS SOL 5 MO CRIXIVAN CAP 200MG 3 MO CRIXIVAN CAP 400MG 3 MO INVIRASE CAP 200MG 4 MO INVIRASE TAB 500MG 5 MO KALETRA SOL 5 MO KALETRA TAB 100-25MG 4 MO KALETRA TAB 200-50MG 5 MO LEXIVA SUS 50MG/ML 4 MO LEXIVA TAB 700MG 5 MO NORVIR CAP 100MG 4 MO NORVIR SOL 80MG/ML 4 MO NORVIR TAB 100MG 4 MO 66

PREZISTA SUS 100MG/ML 4 MO PREZISTA TAB 150MG 3 MO PREZISTA TAB 600MG 3 MO PREZISTA TAB 75MG 4 MO PREZISTA TAB 800MG 5 MO REYATAZ CAP 150MG 5 MO REYATAZ CAP 200MG 5 MO REYATAZ CAP 300MG 5 MO REYATAZ POW 50MG 5 MO VIRACEPT TAB 250MG 5 MO VIRACEPT TAB 625MG 5 MO ANTI-INFLUENZA AGENTS RELENZA MIS DISKHALE 4 rimantadine tab 100mg 1 TAMIFLU CAP 30MG 4 TAMIFLU CAP 45MG 4 TAMIFLU CAP 75MG 4 TAMIFLU SUS 6MG/ML 4 VIRAZOLE INH 6GM 5 ANXIOLYTICS ANXIOLYTICS, OTHER buspirone tab 10mg 1 buspirone tab 15mg 2 67

buspirone tab 30mg 2 buspirone tab 5mg 1 buspirone tab 7.5mg 2 hydroxyz hcl inj 25mg/ml 1 HR hydroxyz hcl inj 50mg/ml 1 HR hydroxyz hcl syp 10mg/5ml 1 HR hydroxyz hcl tab 10mg 2 HR hydroxyz hcl tab 25mg 2 HR hydroxyz hcl tab 50mg 2 HR hydroxyz pam cap 100mg 2 HR hydroxyz pam cap 25mg 2 HR hydroxyz pam cap 50mg 2 HR meprobamate tab 200mg 2 HR meprobamate tab 400mg 2 HR BENZODIAZEPINES ALPRAZOLAM CON 1 MG/ML 2 alprazolam tab 0.25 odt 1 QL (720) alprazolam tab 0.25mg 1 alprazolam tab 0.5mg 1 alprazolam tab 0.5mg er 1 QL (120) alprazolam tab 0.5mg od 1 QL (180) alprazolam tab 1mg 1 alprazolam tab 1mg odt 1 QL (360) alprazolam tab 1mg xr 1 QL (120) 68

alprazolam tab 2mg 1 alprazolam tab 2mg odt 2 alprazolam tab 2mg xr 2 alprazolam tab 3mg er 1 QL (120) chlordiazep cap 10mg 1 QL (120) chlordiazep cap 25mg 1 QL (120) chlordiazep cap 5mg 1 QL (120) cloraz dipot tab 15mg 1 QL (180) cloraz dipot tab 3.75mg 1 QL (180) cloraz dipot tab 7.5mg 1 QL (180) diazepam con 5mg/ml 2 QL (240) DIAZEPAM SOL 1MG/ML 2 QL (1200) diazepam tab 10mg 1 QL (120) diazepam tab 2mg 1 QL (600) diazepam tab 5mg 1 QL (240) lorazepam con 2mg/ml 1 lorazepam tab 0.5mg 1 QL (150) lorazepam tab 1mg 1 QL (150) lorazepam tab 2mg 1 QL (150) oxazepam cap 10mg 1 QL (120) oxazepam cap 15mg 1 QL (120) oxazepam cap 30mg 1 QL (120) BIPOLAR AGENTS 69

MOOD STABILIZERS carbamazepin cap 100mg er 2 MO carbamazepin chw 100mg 2 MO lithium carb cap 150mg 2 MO lithium carb cap 300mg 1 MO lithium carb cap 600mg 2 MO lithium carb tab 300mg 2 MO lithium carb tab 300mg er 2 MO lithium carb tab 450mg er 2 MO lithium sol 8meq/5ml 1 MO BLOOD GLUCOSE REGULATORS ANTIDIABETIC AGENTS acarbose tab 100mg 2 MO acarbose tab 25mg 2 MO acarbose tab 50mg 2 MO ALCOHOL PREP PAD 70% 1 AVANDIA TAB 2MG 4 MO AVANDIA TAB 4MG 4 MO BYDUREON DC SYR INJ 3 MO BYDUREON INJ 3 MO BYETTA INJ 10MCG 3 MO BYETTA INJ 5MCG 3 MO chlorpropam tab 100mg 2 HR, MO 70

chlorpropam tab 250mg 2 HR, MO CYCLOSET TAB 0.8MG 4 MO GAUZE PADS & DRESSINGS - PADS 1 glimepiride tab 1mg 1 MO glimepiride tab 2mg 1 MO glimepiride tab 4mg 1 MO glip/metform tab 2.5-250m 2 MO glip/metform tab 2.5-500m 2 MO glip/metform tab 5-500mg 2 MO glipizide er tab 10mg 2 MO glipizide er tab 2.5mg 2 MO glipizide er tab 5mg 2 MO glipizide tab 10mg 1 MO glipizide tab 5mg 1 MO glyb/metform tab 1.25-250 2 HR, MO glyb/metform tab 2.5-500 2 HR, MO glyb/metform tab 5-500mg 2 HR, MO glyburid mcr tab 1.5mg 1 HR, MO glyburid mcr tab 3mg 1 HR, MO glyburid mcr tab 6mg 1 HR, MO glyburide tab 1.25mg 2 HR, MO glyburide tab 2.5mg 1 HR, MO glyburide tab 5mg 1 HR, MO INSULIN PEN NEEDLE 2 71

INSULIN SYRINGE (DISP) U-100 2 INSULIN SYRINGE (DISP) U-100 2 INSULIN SYRINGE (DISP) U-100 2 INVOKAMET TAB 150-1000 3 MO INVOKAMET TAB 150-500 3 MO INVOKAMET TAB 50-1000 3 MO INVOKAMET TAB 50-500MG 3 MO INVOKANA TAB 100MG 3 MO INVOKANA TAB 300MG 3 MO JANUMET TAB 50-1000 3 MO JANUMET TAB 50-500MG 3 MO JANUMET XR TAB 100-1000 3 MO JANUMET XR TAB 50-1000 3 MO JANUMET XR TAB 50-500MG 3 MO JANUVIA TAB 100MG 3 MO JANUVIA TAB 25MG 3 MO JANUVIA TAB 50MG 3 MO JARDIANCE TAB 10MG 3 MO JARDIANCE TAB 25MG 3 MO JENTADUETO TAB 2.5-1000 3 MO JENTADUETO TAB 2.5-500 3 MO JENTADUETO TAB 2.5-850 3 MO JENTADUETO TAB XR 2.5-1000 MG 3 MO JENTADUETO TAB XR 5-1000 MG 3 MO 72

metformin er tab 1000mg 2 MO metformin tab 1000mg 1 MO metformin tab 500mg 1 MO metformin tab 500mg er 1 MO metformin tab 750mg er 2 MO metformin tab 850mg 1 MO miglitol tab 100mg 2 MO miglitol tab 25mg 2 MO miglitol tab 50mg 2 MO nateglinide tab 120mg 2 MO nateglinide tab 60mg 2 MO NEEDLES, INSULIN DISP., SAFET 2 pioglit/glim tab 30-4mg 2 MO pioglita/met tab 15-500mg 2 MO pioglita/met tab 15-850mg 2 MO pioglitazone tab 15mg 2 MO pioglitazone tab 30mg 2 MO pioglitazone tab 45mg 2 MO repaglinide tab 0.5mg 2 MO REPAGLINIDE TAB 1-500MG 2 MO repaglinide tab 1mg 2 MO REPAGLINIDE TAB 2-500MG 2 MO repaglinide tab 2mg 2 MO RIOMET SOL 500/5ML 4 MO 73

SYMLINPEN 60 INJ 1000MCG 4 MO SYMLNPEN 120 INJ 1000MCG 5 MO SYNJARDY TAB 3 MO SYNJARDY TAB 12.5-500 3 MO SYNJARDY TAB 5-1000MG 3 MO SYNJARDY TAB 5-500MG 3 MO tolazamide tab 250mg 2 MO tolazamide tab 500mg 2 MO tolbutamide tab 500mg 2 MO TRADJENTA TAB 5MG 3 MO valsart/hctz tab 160-12.5 2 MO VICTOZA INJ 18MG/3ML 3 MO GLYCEMIC AGENTS GLUCAGEN INJ 1MG 3 GLUCAGON INJ 1MG 3 PROGLYCEM SUS 50MG/ML 3 MO INSULINS LANTUS INJ 100/ML 3 MO LANTUS INJ SOLOSTAR 3 MO LEVEMIR INJ 3 MO LEVEMIR INJ FLEXTOUC 3 MO NOVOLIN INJ 70/30 3 MO NOVOLIN N INJ U-100 3 MO NOVOLIN R INJ U-100 3 MO 74

NOVOLOG INJ 100/ML 3 MO NOVOLOG INJ FLEXPEN 3 MO NOVOLOG INJ PENFILL 3 MO NOVOLOG MIX INJ 70/30 3 MO NOVOLOG MIX INJ FLEXPEN 3 MO TOUJEO SOLO INJ 300IU/ML 3 MO BLOOD PRODUCTS/MODIFIERS/ VOLUME EXPANDERS ANTICOAGULANTS ARGATROBAN INJ 250/250 4 PA ELIQUIS TAB 2.5MG 3 MO ELIQUIS TAB 5MG 3 MO enoxaparin inj 100mg/ml 2 enoxaparin inj 120/0.8 2 enoxaparin inj 150mg/ml 2 enoxaparin inj 30/0.3ml 2 enoxaparin inj 300/3ml 2 enoxaparin inj 40/0.4ml 2 enoxaparin inj 60/0.6ml 2 enoxaparin inj 80/0.8ml 2 fondaparinux inj 10/0.8ml 2 fondaparinux inj 2.5/0.5 2 fondaparinux inj 5/0.4ml 2 fondaparinux inj 7.5/0.6 2 75

FRAGMIN INJ 10000/ML 5 FRAGMIN INJ 12500UNT 5 FRAGMIN INJ 15000UNT 5 FRAGMIN INJ 18000UNT 5 FRAGMIN INJ 2500/0.2 4 FRAGMIN INJ 5000/0.2 4 FRAGMIN INJ 7500/0.3 5 FRAGMIN INJ 95000UNT 5 hep sod/d5w inj 20000unt 1 HEP SOD/D5W INJ 25000UNT 100U 1 hep sod/d5w inj 25000unt 50u/ 1 heparin sod inj 1000/ml 1 heparin sod inj 10000/ml 1 heparin sod inj 20000/ml 1 heparin sod inj 5000/ml 2 jantoven tab 10mg 1 MO jantoven tab 1mg 1 MO jantoven tab 2.5mg 1 MO jantoven tab 2mg 1 MO jantoven tab 3mg 1 MO jantoven tab 4mg 1 MO jantoven tab 5mg 1 MO jantoven tab 6mg 1 MO jantoven tab 7.5mg 1 MO 76

PRADAXA CAP 110MG 4 QL (60), MO PRADAXA CAP 150MG 4 QL (60), MO PRADAXA CAP 75MG 4 QL (60), MO warfarin sod tab 10mg 1 MO warfarin tab 1mg 1 MO warfarin tab 2.5mg 1 MO warfarin tab 2mg 1 MO warfarin tab 3mg 1 MO warfarin tab 4mg 1 MO warfarin tab 5mg 1 MO warfarin tab 6mg 1 MO warfarin tab 7.5mg 1 MO XARELTO STAR TAB 15/20MG 3 XARELTO TAB 10MG 3 MO XARELTO TAB 15MG 3 MO XARELTO TAB 20MG 3 MO BLOOD FORMATION MODIFIERS LEUKINE INJ 250MCG 5 MIRCERA INJ 100MCG 4 PA MIRCERA INJ 50MCG 4 PA MIRCERA INJ 75MCG 4 PA MOZOBIL INJ 5 NEUPOGEN INJ 300/0.5 5 NEUPOGEN INJ 300MCG 5 77

NEUPOGEN INJ 480/0.8 5 NEUPOGEN INJ 480MCG 5 PROCRIT INJ 10000/ML 4 PA, QL (28-Dec) PROCRIT INJ 2000/ML 3 PA, QL (23) PROCRIT INJ 20000/ML 5 PA, QL (28-Dec) PROCRIT INJ 3000/ML 3 PA, QL (16) PROCRIT INJ 4000/ML 4 PA, QL (28-Dec) PROCRIT INJ 40000/ML 5 PA, QL (12) PROMACTA TAB 12.5MG 5 MO PROMACTA TAB 25MG 5 MO PROMACTA TAB 50MG 5 MO PROMACTA TAB 75MG 5 MO tranex acid inj 100mg/ml 2 tranex acid tab 650mg 2 ZARXIO INJ 300/0.5 3 ZARXIO INJ 480/0.8 3 PLATELET MODIFYING AGENTS anagrelide cap 0.5mg 2 MO asa/dipyrida cap 25-200mg 2 MO BRILINTA TAB 60MG 3 MO BRILINTA TAB 90MG 3 MO cilostazol tab 100mg 2 MO cilostazol tab 50mg 2 MO clopidogrel tab 300mg 2 78

clopidogrel tab 75mg 2 MO dipyridamole tab 25mg 2 HR, MO dipyridamole tab 50mg 2 HR, MO dipyridamole tab 75mg 2 HR, MO CARDIOVASCULAR AGENTS ALPHA-ADRENERGIC AGONISTS clonidine dis 0.1/24hr 2 MO clonidine dis 0.2/24hr 2 MO clonidine dis 0.3/24hr 2 MO clonidine tab 0.1mg 1 MO clonidine tab 0.2mg 1 MO clonidine tab 0.3mg 2 MO methyldopa tab 250mg 1 HR, MO methyldopa tab 500mg 1 HR, MO methyldopate inj 250/5ml 1 HR midodrine tab 10mg 2 midodrine tab 2.5mg 2 midodrine tab 5mg 2 ALPHA-ADRENERGIC BLOCKING AGENTS doxazosin tab 1mg 1 MO doxazosin tab 2mg 1 MO doxazosin tab 4mg 1 MO doxazosin tab 8mg 1 MO 79

prazosin hcl cap 1mg 1 MO prazosin hcl cap 2mg 1 MO prazosin hcl cap 5mg 1 MO terazosin cap 10mg 1 MO terazosin cap 1mg 1 MO terazosin cap 2mg 1 MO terazosin cap 5mg 1 MO ANGIOTENSIN II RECEPTOR ANTAGONISTS BENICAR TAB 20MG 4 MO BENICAR TAB 40MG 4 MO BENICAR TAB 5MG 4 MO candesartan tab 16mg 2 MO candesartan tab 32mg 2 MO candesartan tab 4mg 2 MO candesartan tab 8mg 2 MO EPROSART MES TAB 600MG 2 MO irbesartan tab 150mg 2 MO irbesartan tab 300mg 2 MO irbesartan tab 75mg 2 MO losartan pot tab 100mg 2 MO losartan pot tab 25mg 2 MO losartan pot tab 50mg 2 MO telmisartan tab 20mg 2 MO telmisartan tab 40mg 2 MO 80

telmisartan tab 80mg 2 MO ANGIOTENSIN-CONVERTING ENZYME (ACE) INHIBITORS benazepril tab 10mg 1 MO benazepril tab 20mg 1 MO benazepril tab 40mg 1 MO benazepril tab 5mg 1 MO captopril tab 100mg 1 MO captopril tab 12.5mg 1 MO captopril tab 25mg 1 MO captopril tab 50mg 1 MO enalapril tab 10mg 1 MO enalapril tab 2.5mg 1 MO enalapril tab 20mg 1 MO enalapril tab 5mg 1 MO fosinopril tab 10mg 2 MO fosinopril tab 20mg 2 MO fosinopril tab 40mg 2 MO lisinopril tab 10mg 1 MO lisinopril tab 2.5mg 1 MO lisinopril tab 20mg 1 MO lisinopril tab 30mg 2 MO lisinopril tab 40mg 2 MO lisinopril tab 5mg 1 MO moexipril tab 15mg 2 MO 81

moexipril tab 7.5mg 2 MO perindopril tab 2mg 2 MO perindopril tab 4mg 2 MO perindopril tab 8mg 2 MO quinapril tab 10mg 2 MO quinapril tab 20mg 2 MO quinapril tab 40mg 2 MO quinapril tab 5mg 2 MO ramipril cap 1.25mg 2 MO ramipril cap 10mg 2 MO ramipril cap 2.5mg 2 MO ramipril cap 5mg 2 MO trandolapril tab 1mg 1 MO trandolapril tab 2mg 2 MO trandolapril tab 4mg 2 MO ANTIARRHYTHMICS amiodarone inj 50mg/ml 1 amiodarone tab 200mg 2 MO amiodarone tab 400mg 2 MO disopyramide cap 100mg 2 HR, MO disopyramide cap 150mg 2 HR, MO dofetilide cap 125mcg 2 MO dofetilide cap 250mcg 2 MO dofetilide cap 500mcg 2 MO 82

flecainide tab 100mg 2 MO flecainide tab 150mg 2 MO flecainide tab 50mg 2 MO mexiletine cap 150mg 2 MO mexiletine cap 200mg 2 MO mexiletine cap 250mg 2 MO MULTAQ TAB 400MG 4 MO pacerone tab 100mg 2 MO pacerone tab 200mg 2 MO procainamide inj 100mg/ml 1 propafenone tab 150mg 2 MO propafenone tab 225mg 2 MO propafenone tab 300mg 2 MO quinidine gl tab 324mg er 2 MO quinidine su tab 200mg 1 MO QUINIDINE SU TAB 300MG 1 MO ANTIHYPERTENSIVE COMBINATIONS amilor/hctz tab 5-50 1 MO amlod/benazp cap 10-20mg 2 MO amlod/benazp cap 10-40mg 2 MO amlod/benazp cap 2.5-10mg 2 MO amlod/benazp cap 5-10mg 2 MO amlod/benazp cap 5-20mg 2 MO amlod/benazp cap 5-40mg 2 MO 83

amlod/valsar tab /hctz 10-160 2 MO amlod/valsar tab /hctz 10-160 2 MO amlod/valsar tab /hctz 10-320 2 MO amlod/valsar tab /hctz 5-160- 2 MO amlod/valsar tab /hctz 5-160- 2 MO amlod/valsar tab 10-160mg 2 MO amlod/valsar tab 10-320mg 2 MO amlod/valsar tab 5-160mg 2 MO amlod/valsar tab 5-320mg 2 MO atenol/chlor tab 100-25mg 1 MO atenol/chlor tab 50-25mg 1 MO AZOR TAB 10-20MG 4 MO AZOR TAB 10-40MG 4 MO AZOR TAB 5-20MG 4 MO AZOR TAB 5-40MG 4 MO benazep/hctz tab 10-12.5 2 MO benazep/hctz tab 20-12.5 2 MO benazep/hctz tab 20-25mg 2 MO benazep/hctz tab 5-6.25 1 MO BENICAR HCT TAB 20-12.5 4 MO BENICAR HCT TAB 40-12.5 4 MO BENICAR HCT TAB 40-25MG 4 MO bisoprl/hctz tab 10/6.25 1 MO bisoprl/hctz tab 2.5/6.25 1 MO 84

bisoprl/hctz tab 5-6.25mg 1 MO candesa/hctz tab 16-12.5 2 MO candesa/hctz tab 32-12.5 2 MO candesa/hctz tab 32-25mg 2 MO captopr/hctz tab 25-15mg 1 MO captopr/hctz tab 25-25mg 1 MO captopr/hctz tab 50-15mg 1 MO captopr/hctz tab 50-25mg 1 MO enalapr/hctz tab 10-25mg 2 MO enalapr/hctz tab 5-12.5mg 1 MO fosinop/hctz tab 10/12.5 1 MO fosinop/hctz tab 20/12.5 2 MO irbesar/hctz tab 150-12.5 2 MO irbesar/hctz tab 300-12.5 2 MO lisinop/hctz tab 10-12.5 1 MO lisinop/hctz tab 20-12.5 1 MO lisinop/hctz tab 20-25mg 1 MO losartan/hct tab 100-12.5 2 MO losartan/hct tab 100-25 2 MO losartan/hct tab 50-12.5 2 MO methyld/hctz tab 250/15 1 HR, MO methyld/hctz tab 250/25 1 HR, MO metoprl/hctz tab 100-25mg 2 MO metoprl/hctz tab 100-50mg 1 MO 85

metoprl/hctz tab 50-25mg 2 MO moexipr/hctz tab 15-12.5 2 MO moexipr/hctz tab 15-25mg 2 MO moexipr/hctz tab 7.5-12.5 1 MO nadolol/bend tab 40-5mg 2 MO nadolol/bend tab 80-5mg 2 MO pioglit/glim tab 30-2mg 2 MO propran/hctz tab 40/25 1 MO propran/hctz tab 80/25 2 MO qnapril/hctz tab 10-12.5 2 MO qnapril/hctz tab 20-12.5 2 MO qnapril/hctz tab 20-25mg 2 MO spirono/hctz tab 25/25 2 MO telmis/amlod tab 40-10mg 2 MO telmis/amlod tab 40-5mg 2 MO telmis/amlod tab 80-10mg 2 MO telmis/amlod tab 80-5mg 2 MO telmisa/hctz tab 40-12.5 2 MO telmisa/hctz tab 80-12.5 2 MO telmisa/hctz tab 80-25mg 2 MO trando/verap tab 1-240 er 2 MO trando/verap tab 2-180 er 2 MO trando/verap tab 2-240 er 2 MO trando/verap tab 4-240 er 2 MO 86

triamt/hctz cap 50-25mg 1 MO triamt/hctz tab 37.5-25 1 MO triamt/hctz tab 75-50mg 1 MO TRIBENZOR20- TAB 5-12.5MG 4 MO TRIBENZOR40- TAB 10-12.5 4 MO TRIBENZOR40- TAB 10-25MG 4 MO TRIBENZOR40- TAB 5-12.5MG 4 MO TRIBENZOR40- TAB 5-25MG 4 MO valsart/hctz tab 160-25mg 2 MO valsart/hctz tab 320-12.5 2 MO valsart/hctz tab 320-25mg 2 MO valsart/hctz tab 80-12.5 2 MO BETA-ADRENERGIC BLOCKING AGENTS acebutolol cap 200mg 2 MO acebutolol cap 400mg 2 MO atenolol tab 100mg 1 MO atenolol tab 25mg 1 MO atenolol tab 50mg 1 MO betaxolol tab 10mg 1 MO betaxolol tab 20mg 1 MO bisoprol fum tab 10mg 2 MO bisoprol fum tab 5mg 2 MO carvedilol tab 12.5mg 1 MO carvedilol tab 25mg 1 MO 87

carvedilol tab 3.125mg 1 MO carvedilol tab 6.25mg 1 MO labetalol inj 5mg/ml 1 labetalol tab 100mg 2 MO labetalol tab 200mg 2 MO labetalol tab 300mg 2 MO metoprol tar tab 100mg 1 MO metoprol tar tab 25mg 1 MO metoprol tar tab 50mg 1 MO metoprolol inj 1mg/ml 1 PA metoprolol inj 5mg/5ml 1 metoprolol tab 100mg er 2 MO metoprolol tab 200mg er 2 MO metoprolol tab 25mg er 2 MO metoprolol tab 50mg er 2 MO nadolol tab 20mg 1 MO nadolol tab 40mg 1 MO nadolol tab 80mg 2 MO pindolol tab 10mg 1 MO pindolol tab 5mg 1 MO propranolol cap 120mg er 2 MO propranolol cap 160mg er 2 MO propranolol cap 60mg er 2 MO propranolol cap 80mg er 2 MO 88

propranolol inj 1mg/ml 1 propranolol sol 20mg/5ml 1 MO propranolol sol 40mg/5ml 1 MO propranolol tab 10mg 1 MO propranolol tab 20mg 1 MO propranolol tab 40mg 1 MO propranolol tab 60mg 2 MO propranolol tab 80mg 1 MO sotalol hcl tab 120mg 2 MO sotalol hcl tab 160mg 2 MO sotalol hcl tab 240mg 2 MO sotalol hcl tab 80mg 1 MO timolol mal tab 10mg 2 MO timolol mal tab 20mg 1 MO timolol mal tab 5mg 1 MO CALCIUM CHANNEL BLOCKING AGENTS afeditab tab 30mg cr 2 MO afeditab tab 60mg cr 2 MO amlodipine tab 10mg 2 MO amlodipine tab 2.5mg 2 MO amlodipine tab 5mg 2 MO cartia xt cap 120/24hr 2 MO cartia xt cap 180/24hr 2 MO cartia xt cap 240/24hr 2 MO 89

cartia xt cap 300/24hr 2 MO dilt-cd cap 240mg 2 MO diltiazem cap 120mg er 100ct 2 MO diltiazem cap 120mg er 90ct 2 MO diltiazem cap 180mg er 2 MO diltiazem cap 240mg er 2 MO diltiazem cap 300mg er 2 MO diltiazem cap 360mg/24 2 MO diltiazem cap 420mg/24 2 MO diltiazem cap 60mg er 2 MO diltiazem cap 90mg er 2 MO diltiazem inj 100mg 1 diltiazem inj 50/10ml 1 diltiazem tab 120mg 1 MO diltiazem tab 30mg 1 MO diltiazem tab 60mg 1 MO diltiazem tab 90mg 1 MO dilt-xr cap 120mg 2 MO dilt-xr cap 180mg 2 MO felodipine tab 10mg er 2 MO felodipine tab 2.5mg er 2 MO felodipine tab 5mg er 2 MO isradipine cap 2.5mg 1 MO isradipine cap 5mg 1 MO 90

nicardipine cap 20mg 2 MO nicardipine cap 30mg 1 MO nifedical xl tab 30mg 2 MO nifedical xl tab 60mg 2 MO nifedipine cap 10mg 2 HR, MO nifedipine cap 20mg 2 HR, MO nifedipine tab 30mg er 2 MO nifedipine tab 60mg er 2 MO nifedipine tab 90mg er 2 MO nimodipine cap 30mg 2 MO nisoldipine tab 20mg 2 MO nisoldipine tab 30mg 2 MO nisoldipine tab 40mg 2 MO taztia xt cap 120mg/24 2 MO taztia xt cap 180mg/24 2 MO taztia xt cap 240mg/24 2 MO taztia xt cap 300mg/24 2 MO taztia xt cap 360mg/24 2 MO verapamil cap 100mg er 2 MO verapamil cap 120mg er 2 MO verapamil cap 180mg er 2 MO verapamil cap 200mg er 2 MO verapamil cap 240mg er 2 MO verapamil cap 300mg er 2 MO 91

verapamil cap 360mg sr 2 MO verapamil inj 2.5mg/ml 1 verapamil tab 120mg 1 MO verapamil tab 120mg er 100ct 1 MO verapamil tab 180mg er 2 MO verapamil tab 240mg er 2 MO verapamil tab 40mg 2 MO verapamil tab 80mg 1 MO CARDIOVASCULAR AGENTS, OTHER amlod/atorva tab 10-10mg 2 MO amlod/atorva tab 10-20mg 2 MO amlod/atorva tab 10-40mg 2 MO amlod/atorva tab 10-80mg 2 MO amlod/atorva tab 2.5-10mg 2 MO amlod/atorva tab 2.5-20mg 2 MO amlod/atorva tab 2.5-40mg 2 MO amlod/atorva tab 5-10mg 2 MO amlod/atorva tab 5-20mg 2 MO amlod/atorva tab 5-40mg 2 MO amlod/atorva tab 5-80mg 2 MO digitek tab 0.125mg 1 HR, MO digitek tab 0.25mg 1 HR, MO digoxin inj 0.25mg/1 1 digoxin sol 50mcg/ml 1 MO 92

digoxin tab 0.125mg 1 QL (30), MO digoxin tab 0.25mg 1 MO NORTHERA CAP 100MG 5 PA NORTHERA CAP 200MG 5 PA NORTHERA CAP 300MG 5 PA pentoxifylli tab 400mg er 2 MO RANEXA TAB 1000MG 3 MO RANEXA TAB 500MG 3 MO reserpine tab 0.1mg 1 HR, MO DIURETICS, CARBONIC ANHYDRASE INHIBITORS acetazolamid tab 125mg 2 MO acetazolamid tab 250mg 2 MO methazolamid tab 25mg 4 MO methazolamid tab 50mg 4 MO DIURETICS, LOOP bumetanide inj 0.25/ml 1 furosemide inj 10mg/ml 2 furosemide tab 20mg 1 MO furosemide tab 40mg 1 MO furosemide tab 80mg 1 MO torsemide tab 100mg 2 MO torsemide tab 20mg 2 MO DIURETICS, POTASSIUM-SPARING amiloride tab 5mg 1 MO 93

DEMSER CAP 250MG 5 eplerenone tab 25mg 2 MO eplerenone tab 50mg 2 MO spironolact tab 100mg 2 MO spironolact tab 25mg 1 MO spironolact tab 50mg 2 MO DIURETICS, THIAZIDE chlorothiaz tab 250mg 2 MO chlorothiaz tab 500mg 2 MO chlorthalid tab 25mg 1 MO CHLORTHALID TAB 50MG 1 MO hydrochlorot cap 12.5mg 1 MO hydrochlorot tab 12.5mg 2 MO hydrochlorot tab 25mg 1 MO hydrochlorot tab 50mg 1 MO indapamide tab 1.25mg 1 MO indapamide tab 2.5mg 1 MO methyclothia tab 5mg 1 MO metolazone tab 10mg 2 MO metolazone tab 2.5mg 2 MO metolazone tab 5mg 2 MO DYSLIPIDEMICS, FIBRIC ACID DERIVATIVES fenofibrate cap 134mg 2 MO fenofibrate cap 150mg 2 MO 94

fenofibrate cap 200mg 2 MO fenofibrate cap 50mg 2 MO fenofibrate cap 67mg 2 MO fenofibrate tab 145mg 2 MO fenofibrate tab 160mg 2 MO FENOFIBRATE TAB 40MG 2 MO fenofibrate tab 48mg 2 MO fenofibrate tab 54mg 2 MO gemfibrozil tab 600mg 2 MO DYSLIPIDEMICS, HMG COA REDUCTASE INHIBITORS atorvastatin tab 10mg 2 MO atorvastatin tab 20mg 2 MO atorvastatin tab 40mg 2 MO atorvastatin tab 80mg 2 MO fluvastatin cap 20mg 2 MO fluvastatin cap 40mg 2 MO fluvastatin tab 80mg er 2 MO LIVALO TAB 1MG 3 MO LIVALO TAB 2MG 3 MO LIVALO TAB 4MG 3 MO lovastatin tab 10mg 2 MO lovastatin tab 20mg 2 MO lovastatin tab 40mg 2 MO pravastatin tab 10mg 1 MO 95

pravastatin tab 20mg 1 MO pravastatin tab 40mg 1 MO pravastatin tab 80mg 2 MO rosuvastatin tab 10mg 1 MO rosuvastatin tab 20mg 1 MO rosuvastatin tab 40mg 1 MO rosuvastatin tab 5mg 1 MO simvastatin tab 10mg 2 MO simvastatin tab 20mg 2 MO simvastatin tab 40mg 2 MO simvastatin tab 5mg 2 MO simvastatin tab 80mg 2 MO DYSLIPIDEMICS, OTHER cholestyram pow 4gm 2 MO colestipol gra 5gm 1 MO colestipol tab 1gm 2 MO FENOFIBRIC TAB 105MG 2 MO FENOFIBRIC TAB 35MG 2 MO JUXTAPID CAP 10MG 5 PA, MO JUXTAPID CAP 20MG 5 PA, MO JUXTAPID CAP 5MG 5 PA, MO KYNAMRO INJ 200MG/ML 5 PA, MO niacin er tab 1000mg 2 MO niacin er tab 500mg 2 MO 96

niacin er tab 750mg 2 MO NIACOR TAB 500MG 1 omega-3-acid cap 1gm 2 MO PRALUENT PFS INJ 150MG/ML 5 PA, MO PRALUENT PFS INJ 75MG/ML 5 PA, MO PRALUENT SOLN PEN-INJ 150MG/M 5 PA, MO PRALUENT SOLN PEN-INJ 75MG/ML 5 PA, MO REPATHA INJ 140MG/ML 5 PA, MO REPATHA SURE INJ 140MG/ML 5 PA, MO ZETIA TAB 10MG 4 MO VASODILATORS, DIRECT-ACTING ARTERIAL hydralazine inj 20mg/ml 1 hydralazine tab 100mg 2 MO hydralazine tab 10mg 1 MO hydralazine tab 25mg 1 MO hydralazine tab 50mg 2 MO minoxidil tab 10mg 2 MO minoxidil tab 2.5mg 2 MO VASODILATORS, DIRECT-ACTING ARTERIAL/VENOUS isosorb din tab 10mg 2 MO isosorb din tab 20mg 2 MO isosorb din tab 30mg 2 MO ISOSORB DIN TAB 40MG ER 2 MO isosorb din tab 5mg 2 MO 97

isosorb mono tab 10mg 2 MO isosorb mono tab 120mg er 2 MO isosorb mono tab 20mg 2 MO isosorb mono tab 30mg er 1 MO isosorb mono tab 60mg er 1 MO minitran dis 0.1mg/hr 2 MO minitran dis 0.2mg/hr 2 MO minitran dis 0.4mg/hr 2 MO minitran dis 0.6mg/hr 2 MO nitroglycer dis 0.1mg/hr 2 MO nitroglycer dis 0.2mg/hr 2 MO nitroglycer dis 0.4mg/hr 2 MO nitroglycer dis 0.6mg/hr 2 MO nitroglycer inj 5mg/ml 1 nitroglycrn spr lingual 2 MO NITROSTAT SUB 0.3MG 4 MO NITROSTAT SUB 0.4MG 4 MO NITROSTAT SUB 0.6MG 4 MO CENTRAL NERVOUS SYSTEM AGENTS ATTENTION DEFICIT HYPERACTIVITY DISORDER AGENTS, AMPHETAMINES amphet/dextr tab 10mg 2 MO amphet/dextr tab 12.5mg 1 MO amphet/dextr tab 15mg 2 MO 98

amphet/dextr tab 20mg 2 MO amphet/dextr tab 30mg 2 MO amphet/dextr tab 5mg 2 MO amphet/dextr tab 7.5mg 2 MO dextroamphet cap 10mg er 2 MO dextroamphet cap 15mg er 2 MO dextroamphet cap 5mg er 2 MO dextroamphet tab 10mg 2 MO dextroamphet tab 5mg 2 MO ATTENTION DEFICIT HYPERACTIVITY DISORDER AGENTS, NON-AMPHETAMINES guanfacine tab 1mg er 2 HR, MO guanfacine tab 2mg er 2 HR, MO guanfacine tab 3mg er 2 HR, MO guanfacine tab 4mg er 2 HR, MO methlphenida chw 2.5mg 1 MO methylphenid cap 10mg 1 MO methylphenid chw 10mg 1 MO methylphenid chw 5mg 1 MO methylphenid sol 10mg/5ml 1 MO methylphenid sol 5mg/5ml 1 MO methylphenid tab 10mg 1 MO methylphenid tab 20mg 2 MO methylphenid tab 20mg er 2 MO METHYLPHENID TAB 27MG ER 2 HR, MO 99

methylphenid tab 5mg 1 MO STRATTERA CAP 100MG 3 MO STRATTERA CAP 10MG 3 MO STRATTERA CAP 18MG 3 MO STRATTERA CAP 25MG 3 MO STRATTERA CAP 40MG 3 MO STRATTERA CAP 60MG 3 MO STRATTERA CAP 80MG 3 MO CENTRAL NERVOUS SYSTEM, OTHER NUEDEXTA CAP 20-10MG 3 MO riluzole tab 50mg 4 MO tetrabenazin tab 12.5mg 5 MO tetrabenazin tab 25mg 5 MO FIBROMYALGIA AGENTS LYRICA CAP 100MG 3 MO LYRICA CAP 150MG 3 MO SAVELLA MIS TITR PAK 3 SAVELLA TAB 100MG 3 MO SAVELLA TAB 12.5MG 3 MO SAVELLA TAB 25MG 3 MO SAVELLA TAB 50MG 3 MO MULTIPLE SCLEROSIS AGENTS AMPYRA TAB 10MG 5 PA, MO AVONEX KIT 30MCG 5 PA, MO 100

AVONEX PEN KIT 30MCG 5 PA, MO AVONEX PREFL KIT 30MCG 5 PA, MO BETASERON INJ 0.3MG 5 PA, MO COPAXONE INJ 20MG/ML 5 PA, MO COPAXONE INJ 40MG/ML 5 PA, MO GILENYA CAP 0.5MG 5 PA, MO PLEGRIDY INJ 5 PA, MO PLEGRIDY INJ PEN 5 PA, MO PLEGRIDY PEN INJ STARTER 5 PA REBIF INJ 22/0.5 5 PA, MO SOLTAMOX SOL 10MG/5ML 4 MO TECFIDERA CAP 120MG 5 PA, MO TECFIDERA CAP 240MG 5 PA, MO TECFIDERA MIS STARTER 5 PA TYSABRI INJ 300/15ML 5 PA DENTAL AND ORAL AGENTS DENTAL AND ORAL AGENTS chlorhex glu sol 0.12% 1 nystatin sus 100000 2 ORAVIG TAB 50MG 4 pilocarpine tab 5mg 2 MO pilocarpine tab 7.5mg 2 MO triamcin/ora pst 0.1% 2 101

DERMATOLOGICAL AGENTS DERMATOLOGICAL AGENTS 8-MOP CAP 10MG 4 acitretin cap 10mg 2 acitretin cap 17.5mg 2 acitretin cap 25mg 2 amcinonide cre 0.1% 2 amcinonide lot 0.1% 2 amcinonide oin 0.1% 1 ammonium lac lot 12% 2 aug betamet lot 0.05% 2 betameth dip cre 0.05% 1 betameth dip oin 0.05% 2 betameth val cre 0.1% 1 betameth val lot 0.1% 2 betameth val oin 0.1% 1 calcipotrien sol 0.005% 2 ciclopirox cre 0.77% 2 ciclopirox gel 0.77% 2 ciclopirox sol 8% 2 ciclopirox sus 0.77% 2 claravis cap 10mg 2 claravis cap 20mg 2 claravis cap 30mg 5 102

claravis cap 40mg 2 clindamy/ben gel 1-5% 2 clindamycin gel 1% 2 clindamycin lot 1% 2 clindamycin pad 1% 2 clindamycin sol 1% 2 clobetasol cre 0.05% 2 clobetasol gel 0.05% 2 clobetasol oin 0.05% 2 clobetasol sol 0.05% 2 clotrim/beta cre diprop 2 clotrim/beta lot diprop 2 clotrimazole cre 1% 1 clotrimazole sol 1% 1 CONDYLOX GEL 0.5% 4 COSENTYX INJ 150MG/ML 5 ST, MO COSENTYX PEN INJ 150MG/ML 5 ST, MO desonide cre 0.05% 2 desonide lot 0.05% 2 desonide oin 0.05% 2 desoximetas cre 0.05% 2 desoximetas cre 0.25% 2 desoximetas gel 0.05% 2 desoximetas oin 0.25% 2 103

diclofenac gel 1% 2 diclofenac gel 3% 5 diflorasone cre 0.05% 2 DIFLORASONE OIN 0.05% 2 econazole cre 1% 2 ELIDEL CRE 1% 4 erythromycin gel /benzoyl 2 erythromycin gel 2% 2 erythromycin sol 2% 2 EURAX CRE 10% 4 fluocin acet cre 0.01% 1 fluocin acet cre 0.025% 2 fluocin acet oil 0.01%bdy 2 fluocin acet oin 0.025% 2 fluocin acet sol 0.01% 1 fluocinonide cre 0.05% 2 fluocinonide gel 0.05% 2 fluocinonide oin 0.05% 2 fluocinonide sol 0.05% 2 fluorouracil cre 5% 2 fluticasone cre 0.05% 2 fluticasone oin 0.005% 2 gentamicin cre 0.1% 1 gentamicin oin 0.1% 1 104

halobetasol cre 0.05% 2 halobetasol oin 0.05% 2 hc valerate cre 0.2% 2 hc valerate oin 0.2% 2 hydrocort cre 1% 1 hydrocort lot 2.5% 2 hydrocort oin 1% 1 hydrocort oin 2.5% 2 hydrocortiso cre 2.5% 1 imiquimod cre 5% 2 ketoconazole cre 2% 2 ketoconazole sha 2% 2 lidocaine gel 2% jelly 2 lidocaine oin 5% 2 lidocaine pad 5% 2 PA, QL (90) lidocaine sol 4% 2 lindane sha 1% 2 methoxsalen cap 10mg 2 metronidazol cre 0.75% 2 metronidazol gel 0.75% 2 metronidazol lot 0.75% 2 mometasone cre 0.1% 2 mometasone oin 0.1% 2 mupirocin oin 2% 2 105

myorisan cap 30mg 2 nystat/triam cre 1 nystat/triam oin 1 nystatin cre 100000 1 nystatin oin 100000 1 nystatin pow 100000 2 PANRETIN GEL 0.1% 4 permethrin cre 5% 2 PICATO GEL 0.015% 5 PICATO GEL 0.05% 5 podofilox sol 0.5% 1 prednicarbat cre 0.1% 2 prednicarbat oin 0.1% 1 procto-med cre hc 2.5% 1 procto-pak cre 1% 2 proctozone cre -hc 2.5% 2 REGRANEX GEL 0.01% 5 PA SANTYL OIN 250/GM 3 selenium sul lot 2.5% 1 silver sulfa cre 1% 1 STELARA INJ 45MG/0.5 5 ST, MO STELARA INJ 90MG/ML 5 ST, MO sulfacetamid lot 10% 2 TARGRETIN GEL 1% 4 106

TAZORAC CRE 0.05% 4 TAZORAC CRE 0.1% 4 TAZORAC GEL 0.05% 4 TAZORAC GEL 0.1% 4 TOLAK CRE 4% 4 tretinoin gel 0.05% 2 triamcinolon cre 0.025% 1 triamcinolon cre 0.1% 1 triamcinolon cre 0.5% 1 triamcinolon lot 0.025% 2 triamcinolon lot 0.1% 2 triamcinolon oin 0.025% 2 triamcinolon oin 0.1% 1 triamcinolon oin 0.5% 2 UCERIS AER 2MG/ACT 4 ST VALCHLOR GEL 0.016% 4 ENZYME REPLACEMENT/ MODIFIERS ENZYME REPLACEMENT/ MODIFIERS ADAGEN INJ 250/ML 5 LA ALDURAZYME INJ 2.9MG/5M 5 PA, LA CEREZYME INJ 400UNIT 5 PA, LA CREON CAP 36000UNT 3 MO CYSTADANE POW 5 MO 107

ELAPRASE INJ 6MG/3ML 5 PA FABRAZYME INJ 35MG 5 PA, LA KUVAN POW 100MG 5 MO KUVAN POW 500MG 5 MO KUVAN TAB 100MG 5 MO, LA levocarnitin sol 1gm/10ml 1 MO levocarnitin tab 330mg 2 MO LUMIZYME INJ 50MG 5 NAGLAZYME INJ 1MG/ML 5 PA ORFADIN CAP 10MG 5 MO ORFADIN CAP 2MG 5 MO ORFADIN CAP 5MG 5 MO ORFADIN SUS 4MG/ML 5 MO, LA RAVICTI LIQ 1.1GM/ML 4 MO VPRIV INJ 400UNIT 4 ZAVESCA CAP 100MG 5 MO ZENPEP CAP 10000UNT 3 MO ZENPEP CAP 15000UNT 3 MO ZENPEP CAP 20000UNT 3 MO ZENPEP CAP 25000UNT 3 MO ZENPEP CAP 3000UNIT 3 MO ZENPEP CAP 5000UNIT 3 MO GASTROINTESTINAL AGENTS 108

ANTISPASMODICS, GASTROINTESTINAL atropine sul inj 0.05mg/1 1 atropine sul inj 0.1mg/ml 1 dicyclomine cap 10mg 2 dicyclomine inj 10mg/ml 2 dicyclomine sol 10mg/5ml 2 dicyclomine tab 20mg 1 methscopolam tab 2.5mg 2 ROBINUL FORT TAB 2MG 3 ROBINUL INJ 0.2MG/ML 3 GASTROINTESTINAL AGENTS, OTHER diphen/atrop liq 2.5/5 1 diphen/atrop tab 2.5mg 2 GATTEX KIT 5MG 5 MO loperamide cap 2mg 2 metoclopram inj 5mg/ml 1 metoclopram sol 5mg/5ml 1 metoclopram tab 10mg 1 MO MOVANTIK TAB 12.5MG 4 MOVANTIK TAB 25MG 4 OFEV CAP 100MG 5 MO RELISTOR INJ 12/0.6ML 4 RELISTOR INJ 8/0.4ML 5 RELISTOR PFS INJ 12/0.6ML 5 109

ursodiol tab 250mg 2 MO ursodiol tab 500mg 2 MO HISTAMINE2 (H2) RECEPTOR ANTAGONISTS famotidine inj 200/20ml 1 FAMOTIDINE INJ 20MG/50M 1 famotidine tab 20mg 1 MO famotidine tab 40mg 2 MO ranitidine cap 150mg 2 MO ranitidine cap 300mg 2 MO ranitidine inj 50mg/2ml 2 ranitidine syp 15mg/ml 2 MO ranitidine tab 150mg 1 MO ranitidine tab 300mg 1 MO IRRITABLE BOWEL SYNDROME AGENTS alosetron tab 0.5mg 5 MO alosetron tab 1mg 5 MO AMITIZA CAP 24MCG 3 MO AMITIZA CAP 8MCG 3 MO CIMZIA KIT 5 ST CIMZIA PREFL KIT 200MG/ML 5 ST, MO LINZESS CAP 145MCG 3 MO LINZESS CAP 290MCG 3 MO LAXATIVES enulose sol 10gm/15 1 MO 110

generlac sol 10gm/15 1 MO lactulose sol 20gm/30 1 MO peg-3350/kcl sol /sodium 2 polyeth glyc pow 3350 nf 2 PREPOPIK PAK 4 PROTECTANTS CARAFATE SUS 1GM/10ML 4 MO misoprostol tab 100mcg 2 MO misoprostol tab 200mcg 2 MO sucralfate tab 1gm 2 MO PROTON PUMP INHIBITORS ESOMEPRAZOLE INJ 20MG 2 lansoprazole cap 15mg dr 2 MO lansoprazole cap 30mg dr 2 MO omeprazole cap 10mg 2 MO omeprazole cap 20mg 2 MO omeprazole cap 40mg 2 MO pantoprazole tab 20mg 2 MO pantoprazole tab 40mg 2 MO GENITOURINARY AGENTS ANTISPASMODICS, URINARY darifenacin tab hbr er 15mg 2 MO darifenacin tab hbr er 7.5mg 2 MO 111

MYRBETRIQ TAB 25MG 3 ST, MO MYRBETRIQ TAB 50MG 3 ST, MO oxybutynin syp 5mg/5ml 2 MO oxybutynin tab 10mg er 2 MO oxybutynin tab 15mg er 2 MO oxybutynin tab 5mg 1 MO oxybutynin tab 5mg er 2 MO tolterodine tab 1mg 2 MO tolterodine tab 2mg 2 MO VESICARE TAB 10MG 4 MO VESICARE TAB 5MG 4 MO BENIGN PROSTATIC HYPERTROPHY AGENTS dutast/tamsu cap 0.5-0.4 2 MO dutasteride cap 0.5mg 2 MO finasteride tab 5mg 2 MO RAPAFLO CAP 4MG 4 MO RAPAFLO CAP 8MG 4 MO tamsulosin cap 0.4mg 2 MO GENITOURINARY AGENTS, OTHER CYSTAGON CAP 150MG 4 MO CYSTAGON CAP 50MG 4 MO ELMIRON CAP 100MG 3 neo/poly gu sol 40/ml ir 1 sodium chlor sol 0.9% irr 2 112

PHOSPHATE BINDERS calc acetate cap 667mg 2 MO RENVELA PAK 0.8GM 3 MO RENVELA PAK 2.4GM 3 MO RENVELA TAB 800MG 3 MO VAGINAL PRODUCTS clindamycin cre 2% vag 2 metronidazol gel 0.75%vag 2 miconazole 3 sup 200mg 1 PREMARIN VAG CRE 0.625MG 3 MO terconazole cre 0.4% 2 terconazole sup 80mg 1 zazole cre 0.8% 2 HORMONAL AGENTS, STIMULANT/ REPLACEMENT/ MODIFYING (ADRENAL) GLUCOCORTICOIDS/MINERALOCORTICOIDS budesonide cap 3mg/24hr 5 dexameth pho inj 10mg/ml 1 dexameth pho inj 20mg/5ml 2 dexamethason sol 0.5/5ml 2 dexamethason tab 0.5mg 1 dexamethason tab 0.75mg 1 dexamethason tab 1.5mg 2 dexamethason tab 1mg 2 113

dexamethason tab 2mg 2 dexamethason tab 4mg 1 dexamethason tab 6mg 1 fludrocort tab 0.1mg 2 MO hydrocort tab 10mg 2 hydrocort tab 5mg 2 methylpr ace inj 40mg/ml 2 methylpr ace inj 80mg/ml 2 methylpr ss inj 1000mg 2 methylpr ss inj 40mg 2 methylpred pak 4mg 1 methylpred tab 16mg 2 methylpred tab 32mg 1 methylpred tab 4mg 1 methylpred tab 8mg 2 pred sod pho sol 5mg/5ml 2 prednisolone sol 15mg/5ml 2 prednisolone sol 25mg/5ml 2 prednisolone tab 10mg odt 2 prednisolone tab 15mg odt 2 prednisolone tab 30mg odt 2 prednisone sol 5mg/5ml 2 prednisone tab 10mg 1 prednisone tab 1mg 2 114

prednisone tab 2.5mg 1 prednisone tab 20mg 1 prednisone tab 50mg 2 prednisone tab 5mg 1 UCERIS TAB 9MG 5 ST HORMONAL AGENTS, STIMULANT/ REPLACEMENT/ MODIFYING (SEX HORMONES/ MODIFIERS) ANABOLIC STEROIDS ANADROL-50 TAB 50MG 4 oxandrolone tab 10mg 5 oxandrolone tab 2.5mg 1 ANDROGENS ANDRODERM DIS 2MG/24HR 3 MO ANDRODERM DIS 4MG/24HR 3 MO danazol cap 100mg 2 danazol cap 200mg 2 danazol cap 50mg 2 methyltestos cap 10mg 5 MO testost cyp inj 100mg/ml 2 testost cyp inj 200mg/ml 2 testost enan inj 200mg/ml 2 CONTRACEPTIVES bekyree tab 2 MO blisovi 24 tab fe 1/20 2 MO 115

blisovi fe tab 1.5/30 2 MO blisovi fe tab 1/20 2 MO drospirenone tab ethy est 2 MO juleber tab 2 MO kaitlib fe chw 2 MO kimidess tab 2 MO levonor/ethi tab 2 MO lyza tab 0.35mg 2 MO medroxypr ac inj 150mg/ml 2 norethindron tab 0.35mg 2 MO norgest/ethi tab estradio 2 MO pirmella tab 1/35 2 MO setlakin tab 2 QL (91/91), MO tri-lo tab estaryll 2 MO tri-lo- tab sprintec 2 MO trinessa tab 2 MO tri-previfem tab 2 MO tri-sprintec tab 2 vienva tab 0.1-20 2 MO vyfemla tab 0.4-35 1 MO ESTROGENS estradiol tab 0.5mg 1 HR, MO estradiol tab 1mg 1 HR, MO estradiol tab 2mg 1 HR, MO 116

fyavolv tab 0.5-2.5 1 HR, MO fyavolv tab 1-5 1 HR, MO MENEST TAB 0.3MG 2 HR, MO MENEST TAB 0.625MG 2 HR, MO MENEST TAB 1.25MG 2 HR, MO MENEST TAB 2.5MG 2 HR, MO PREMARIN INJ 25MG 3 PREMARIN TAB 0.3MG 3 HR, MO PREMARIN TAB 0.45MG 3 HR, MO PREMARIN TAB 0.625MG 3 HR, MO PREMARIN TAB 0.9MG 3 HR, MO PREMARIN TAB 1.25MG 3 HR, MO PREMPHASE TAB 3 HR, MO PREMPRO TAB.625-2.5 3 HR, MO PREMPRO TAB 0.3-1.5 3 HR, MO PREMPRO TAB 0.45-1.5 3 HR, MO PREMPRO TAB 0.625-5 3 HR, MO PROGESTINS MAKENA INJ 250MG/ML 5 medroxypr ac tab 10mg 1 MO medroxypr ac tab 2.5mg 1 MO medroxypr ac tab 5mg 1 MO norethin ace tab 5mg 1 MO SELECTIVE ESTROGEN RECEPTOR MODIFYING AGENTS 117

raloxifene tab 60mg 2 MO HORMONAL AGENTS, STIMULANT/REPLACEMENT/ MODIFYING (PITUITARY) HORMONAL AGENTS, STIMULANT/REPLACEMENT/ MODIFYING (PITUITARY) cabergoline tab 0.5mg 2 chor gonadot inj 10000unt 2 PA desmopressin inj 4mcg/ml 2 desmopressin sol 0.01% 2 MO desmopressin spr 0.01% 2 MO desmopressin tab 0.1mg 2 MO desmopressin tab 0.2mg 2 MO INCRELEX INJ 40MG/4ML 5 MO, LA NORDITROPIN INJ 10/1.5ML 5 PA, MO NORDITROPIN INJ 15/1.5ML 5 PA, MO NORDITROPIN INJ 30/3ML 5 PA, MO NORDITROPIN INJ 5/1.5ML 5 PA, MO NUTROPIN AQ INJ 10MG/2ML NUSP 5 PA, MO NUTROPIN AQ INJ 20MG/2ML NUSP 5 PA, MO HORMONAL AGENTS, STIMULANT/REPLACEMENT/ MODIFYING (THYROID) HORMONAL AGENTS, STIMULANT/REPLACEMENT/ MODIFYING (THYROID) levothyroxin tab 100mcg 1 MO levothyroxin tab 112mcg 1 MO levothyroxin tab 125mcg 1 MO levothyroxin tab 137mcg 1 MO 118

levothyroxin tab 150mcg 1 MO levothyroxin tab 175mcg 1 MO levothyroxin tab 200mcg 1 MO levothyroxin tab 25mcg 1 MO levothyroxin tab 300mcg 1 MO levothyroxin tab 50mcg 1 MO levothyroxin tab 75mcg 1 MO levothyroxin tab 88mcg 1 MO levoxyl tab 100mcg 1 MO levoxyl tab 112mcg 1 MO levoxyl tab 125mcg 1 MO levoxyl tab 137mcg 1 MO levoxyl tab 150mcg 1 MO levoxyl tab 175mcg 1 MO levoxyl tab 200mcg 1 MO levoxyl tab 25mcg 1 MO levoxyl tab 50mcg 1 MO levoxyl tab 75mcg 1 MO levoxyl tab 88mcg 1 MO liothyronine tab 25mcg 2 MO liothyronine tab 50mcg 2 MO liothyronine tab 5mcg 2 MO SYNTHROID TAB 100MCG 4 MO SYNTHROID TAB 112MCG 4 MO 119

SYNTHROID TAB 125MCG 4 MO SYNTHROID TAB 137MCG 4 MO SYNTHROID TAB 150MCG 4 MO SYNTHROID TAB 175MCG 4 MO SYNTHROID TAB 200MCG 4 MO SYNTHROID TAB 25MCG 4 MO SYNTHROID TAB 300MCG 4 MO SYNTHROID TAB 50MCG 4 MO SYNTHROID TAB 75MCG 4 MO SYNTHROID TAB 88MCG 4 MO unithroid tab 100mcg 1 MO unithroid tab 112mcg 1 MO unithroid tab 125mcg 1 MO unithroid tab 150mcg 1 MO unithroid tab 175mcg 1 MO unithroid tab 200mcg 1 MO unithroid tab 25mcg 1 MO unithroid tab 300mcg 1 MO unithroid tab 50mcg 1 MO unithroid tab 75mcg 1 MO unithroid tab 88mcg 1 MO HORMONAL AGENTS, SUPPRESSANT (PARATHYROID) HORMONAL AGENTS, SUPPRESSANT (PARATHYROID) 120

SENSIPAR TAB 30MG 3 MO SENSIPAR TAB 60MG 5 MO SENSIPAR TAB 90MG 5 MO HORMONAL AGENTS, SUPPRESSANT (PITUITARY) HORMONAL AGENTS, SUPPRESSANT (PITUITARY) KORLYM TAB 300MG 5 PA, MO, LA LUPR DEP-PED INJ 11.25MG 3 LUPR DEP-PED INJ 15MG 3 LUPRON DEPOT INJ 11.25MG 4 octreotide inj 1000mcg 5 MO octreotide inj 100mcg 2 MO octreotide inj 200mcg 2 MO octreotide inj 500mcg 5 MO octreotide inj 50mcg/ml 2 MO SANDOSTATIN KIT LAR 10MG 5 SANDOSTATIN KIT LAR 20MG 5 SANDOSTATIN KIT LAR 30MG 5 SIGNIFOR INJ 0.3MG/ML 4 MO SIGNIFOR INJ 0.6MG/ML 4 MO SIGNIFOR INJ 0.9MG/ML 4 MO SOMATULINE INJ 120/.5ML 5 SOMATULINE INJ 60/0.2ML 5 SOMATULINE INJ 90/0.3ML 5 121

SOMAVERT INJ 10MG 5 MO, LA SOMAVERT INJ 15MG 5 MO, LA SOMAVERT INJ 20MG 5 MO, LA SYNAREL SOL 2MG/ML 5 HORMONAL AGENTS, SUPPRESSANT (THYROID) ANTITHYROID AGENTS methimazole tab 10mg 2 MO methimazole tab 5mg 2 MO propylthiour tab 50mg 2 MO IMMUNOLOGICAL AGENTS IMMUNE SUPPRESSANTS ASTAGRAF XL CAP 0.5MG 4 PA, MO ASTAGRAF XL CAP 1MG 4 PA, MO ASTAGRAF XL CAP 5MG 5 PA, MO AZATHIOPRINE INJ 100MG 2 PA azathioprine tab 50mg 2 PA, MO BENLYSTA INJ 120MG 5 PA BENLYSTA INJ 400MG 5 CELLCEPT IV INJ 500MG 3 PA cyclosporine cap 100mg 2 PA, MO cyclosporine cap 100mg md 2 PA, MO cyclosporine cap 25mg 2 PA, MO cyclosporine cap 25mg mod 2 PA, MO 122

CYCLOSPORINE CAP 50MG MOD 2 PA, MO cyclosporine inj 50mg/ml 2 PA cyclosporine sol modified 2 PA, MO ENBREL INJ 25/0.5ML 5 MO ENBREL INJ 25MG 5 MO ENBREL INJ 50MG/ML 5 MO ENBREL SRCLK INJ 50MG/ML 5 MO ENVARSUS XR TAB 0.75MG 4 PA, MO ENVARSUS XR TAB 1MG 4 PA, MO ENVARSUS XR TAB 4MG 4 PA, MO gengraf cap 100mg 2 PA, MO gengraf cap 25mg 2 PA, MO gengraf sol 100mg/ml 2 PA, MO HUMIRA INJ 10MG/0.2 5 MO HUMIRA KIT 20MG/0.4 5 MO HUMIRA KIT 40MG/0.8 5 MO HUMIRA PEDIA INJ CROHNS 3 CT 5 MO HUMIRA PEDIA INJ CROHNS 6 CT 5 MO HUMIRA PEN INJ 40MG/0.8 5 MO HUMIRA PEN INJ CROHNS 5 MO KINERET INJ 5 ST, MO mycophenolat cap 250mg 2 PA, MO mycophenolat sus 200mg/ml 2 PA, MO mycophenolat tab 500mg 2 PA, MO 123

mycophenolic tab 180mg dr 2 PA, MO mycophenolic tab 360mg dr 2 PA, MO NULOJIX INJ 250MG 5 PA PROGRAF INJ 5MG/ML 4 PA RAPAMUNE SOL 1MG/ML 3 PA, MO SANDIMMUNE CAP 100MG 4 PA, MO SANDIMMUNE CAP 25MG 4 PA, MO SANDIMMUNE SOL 100MG/ML 4 PA, MO SIMPONI ARIA SOL 50MG/4ML 5 ST, MO SIMPONI AUTO-INJ 100MG/ML 5 ST, MO SIMPONI AUTO-INJ 50/0.5ML 5 ST, MO SIMPONI PFS INJ 100MG/ML 5 ST, MO SIMPONI PFS INJ 50/0.5ML 5 ST, MO SIMULECT INJ 20MG 4 PA sirolimus tab 0.5mg 2 PA, MO sirolimus tab 1mg 2 PA, MO sirolimus tab 2mg 2 PA, MO tacrolimus cap 0.5mg 2 PA, MO tacrolimus cap 1mg 2 PA, MO tacrolimus cap 5mg 4 PA, MO TREXALL TAB 10MG 4 PA TREXALL TAB 15MG 4 PA TREXALL TAB 5MG 4 PA TREXALL TAB 7.5MG 4 PA 124

ZORTRESS TAB 0.25MG 4 PA, MO ZORTRESS TAB 0.5MG 5 PA, MO ZORTRESS TAB 0.75MG 5 PA, MO IMMUNIZING AGENTS, PASSIVE ATGAM INJ 250MG 5 PA BIVIGAM INJ 10% 5 PA CARIMUNE NF INJ 3GM 5 PA FLEBOGAMMA INJ DIF 10% 5 PA GAMASTAN S/D INJ 4 PA GAMMAGARD INJ 2.5GM/25 5 PA GAMMAKED INJ 20GM/200 5 PA GAMMAPLEX INJ 20GM 5 PA GAMUNEX-C INJ 40/400ML 4 PA HYPERRAB S/D INJ 150/ML 10ML 4 HYPERRAB S/D INJ 150/ML 2ML V 4 PRIVIGEN INJ 40GRAMS 4 PA SYNAGIS INJ 50MG 5 THYMOGLOBULN INJ 25MG 3 PA VARIZIG INJ 125UNIT 4 IMMUNOMODULATORS ACTEMRA INJ 162/0.9 5 ST, MO ACTEMRA INJ 200/10ML 5 ST ACTEMRA INJ 400/20ML 5 ST ACTEMRA INJ 80MG/4ML 5 ST 125

ARCALYST INJ 220MG 5 PA, MO ILARIS INJ 180MG 5 leflunomide tab 10mg 2 MO leflunomide tab 20mg 2 MO ORENCIA INJ 125MG/ML 5 ST, MO ORENCIA INJ 250MG 5 ST, MO XELJANZ TAB 5MG 5 ST, MO VACCINES ACTHIB INJ 4 ADACEL INJ 4 BCG VACCINE INJ 4 BEXSERO INJ 4 BOOSTRIX INJ 3 BOOSTRIX INJ PFS 3 CERVARIX INJ 4 DAPTACEL INJ 4 DIP/TET PED INJ 25-5LFU 4 ENGERIX-B INJ 10/0.5ML 4 PA ENGERIX-B INJ 20MCG/ML 4 PA ENGERIX-B PFSINJ 10/0.5ML 4 PA GARDASIL 9 INJ SYRNG 4 GARDASIL 9 INJ VIAL 4 GARDASIL INJ SYRNG 4 GARDASIL INJ VIAL 4 126

HAVRIX INJ 1440UNIT 4 HAVRIX INJ 720UNIT 4 HIBERIX SOL 10MCG 4 IMOVAX RABIE INJ 2.5/ML 4 PA INFANRIX INJ 4 IPOL INJ INACTIVE 4 IXIARO INJ 4 MENACTRA INJ 4 MENHIBRIX INJ 4 MENOMUNE INJ A/C/Y/W 4 MENVEO INJ 4 M-M-R II INJ 4 PEDVAX HIB INJ 4 PROQUAD INJ 4 QUADRACEL INJ 4 RABAVERT INJ 4 PA RECOMBIVA HB INJ 10MCG/ML PFS 4 PA RECOMBIVA HB INJ 10MCG/ML SOL 4 PA RECOMBIVA HB INJ 5MCG/0.5 4 PA RECOMBIVA-HB INJ 40MCG/ML 4 PA ROTARIX SUS 4 ROTATEQ SOL 3 TENIVAC INJ 5-2LF 4 TET/DIP TOX INJ 2-2 LF 4 PA 127

TRUMENBA INJ 4 TWINRIX INJ 4 TYPHIM VI INJ 25MCG/0.5ML 4 TYPHIM VI SYR INJ 25MCG/0.5ML 4 VAQTA INJ 25/0.5ML 4 VAQTA INJ 50UNT/ML 4 VARIVAX INJ 4 YF-VAX INJ 4 ZOSTAVAX INJ 4 INFLAMMATORY BOWEL DISEASE AGENTS AMINOSALICYLATES APRISO CAP 0.375GM 3 MO balsalazide cap 750mg 2 DIPENTUM CAP 250MG 5 MO LIALDA TAB 1.2GM 3 mesalamine ene 4gm 2 METABOLIC BONE DISEASE AGENTS METABOLIC BONE DISEASE AGENTS alendronate tab 10mg 2 MO alendronate tab 35mg 1 MO alendronate tab 40mg 2 alendronate tab 5mg 2 MO alendronate tab 70mg 1 MO 128

calcitonin spr 200/act 2 PA, MO calcitriol cap 0.25mcg 2 MO calcitriol cap 0.5mcg 2 MO calcitriol inj 1mcg/ml 2 calcitriol sol 1mcg/ml 2 MO FORTEO SOL 600/2.4 5 MO FOSAMAX + D TAB 70-2800 3 QL (28-Apr), MO FOSAMAX + D TAB 70-5600 3 MO ibandronate tab 150mg 2 MO MIACALCIN INJ 200/ML 4 NATPARA INJ 25MCG 5 MO pamidronate inj 30/10ml 2 pamidronate inj 6mg/ml 2 pamidronate inj 90/10ml 2 paricalcitol cap 1 mcg 2 PA, MO paricalcitol cap 2 mcg 2 PA, MO paricalcitol cap 4 mcg 2 PA, MO paricalcitol inj 2mcg/ml 2 paricalcitol inj 5mcg/ml 2 PA PROLIA SOL 60MG/ML 4 risedron sod tab 35mg dr 2 MO risedronate tab 35mg 4ct 2 MO XGEVA INJ 5 zoledronic inj 4mg/5ml 2 PA 129

zoledronic inj 5/100ml 2 PA ZOMETA INJ 4MG/100 4 PA MISCELLANEOUS MISCELLANEOUS CINRYZE SOL 500 UNIT 3 FETZIMA CAP TITRATIO 3 FIRAZYR INJ 30MG/3ML 5 lactated rin sol irrigat 1 physiolyte sol 1 physiosol sol irrigat 1 ringers irr sol 1 OPHTHALMIC AGENTS OPHTHALMIC PROSTAGLANDIN AND PROSTAMIDE ANALOGS BIMATOPROST SOL 0.03% 2 MO latanoprost sol 0.005% 2 MO LUMIGAN SOL 0.01% 3 MO TRAVATAN Z DRO 0.004% 3 MO travoprost dro 0.004% 1 MO OPHTHALMIC AGENTS, OTHER atropine sul sol 1% op 2 MO naphazoline sol 0.1% op 1 RESTASIS EMU 0.05% 3 MO OPHTHALMIC ANTI INFECTIVES 130

AZASITE SOL 1% 3 bacit/polymy oin op 2 bacitracin oin op 2 ciprofloxacn sol 0.3% op 2 erythromycin oin 5mg/gm 1 gentamicin oin 0.3% op 2 gentamicin sol 0.3% op 1 MOXEZA SOL 0.5% 3 neo/bac/poly oin op 1 neo/poly/gra sol op 2 ofloxacin dro 0.3% op 2 polymyxin b/ sol trimethp 2 sulfacet sod sol 10% op 1 tobramycin sol 0.3% op 1 trifluridine sol 1% op 2 VIGAMOX DRO 0.5% 3 ZIRGAN GEL 0.15% 4 OPHTHALMIC ANTI-ALLERGY AGENTS azelastine dro 0.05% 2 cromolyn sod sol 4% op 2 olopatadine dro 0.1% 1 PATADAY SOL 0.2% 3 PAZEO DRO 0.7% 3 OPHTHALMIC ANTIGLAUCOMA AGENTS 131

ALPHAGAN P SOL 0.1% 3 MO ALPHAGAN P SOL 0.15% 3 MO apraclonidin sol 0.5% op 2 AZOPT SUS 1% OP 3 MO betaxolol sol 0.5% op 1 MO brimonidine sol 0.15% 2 MO brimonidine sol 0.2% op 2 MO carteolol sol 1% op 1 MO COMBIGAN SOL 0.2/0.5% 4 MO dorzol/timol sol 22.3-6.8 2 MO dorzolamide sol 2% op 2 MO levobunolol sol 0.5% op 1 MO metipranolol sol 0.3% oph 1 MO PHOSPHOLINE SOL 0.125%OP 3 MO SIMBRINZA SUS 1-0.2% 4 MO timolol gel sol 0.25% op 2 MO timolol gel sol 0.5% op 2 MO timolol mal sol 0.25% op 2 MO timolol mal sol 0.5% op 2 MO OPHTHALMIC ANTI-INFLAMMATORIES BLEPHAMIDE OIN S.O.P. 3 BLEPHAMIDE SUS OP 3 CYSTARAN SOL 0.44% 5 PA, QL (60), MO DEXAMETH PHO SOL 0.1% OP 2 132

diclofenac sol 0.1% op 2 DUREZOL EMU 0.05% 3 flurbiprofen sol 0.03% op 1 ILEVRO DRO 0.3% OP 4 ketorolac sol 0.4% 2 ketorolac sol 0.5% 2 LOTEMAX GEL 0.5% 3 LOTEMAX OIN 0.5% 3 LOTEMAX SUS 0.5% 3 neo/poly/bac oin /hc 1%op 1 neo/poly/dex oin 0.1% op 1 neo/poly/dex sus 0.1% op 2 neo/poly/hc sus op 2 pred sod pho sol 1% op 2 prednisolone sus 1% op 2 sulf/pred na sol op 1 tobra/dexame sus 0.3-0.1% 2 TOBRADEX OIN 0.3-0.1% 3 TOBRADEX ST SUS 0.3-0.05 3 TOBRADEX SUS 0.3-0.1% 3 OTIC AGENTS OTIC AGENTS acetic acid sol 2% otic 2 133

CIPRODEX SUS 0.3-0.1% 3 fluocin acet oil 0.01% 2 neo/poly/hc sol 1% otic 2 neo/poly/hc sus 1% otic 2 ofloxacin dro 0.3%otic 2 RESPIRATORY TRACT AGENTS ANTIHISTAMINES cetirizine syp 1mg/ml 1 cyproheptad tab 4mg 2 HR desloratadin tab 2.5 odt 2 desloratadin tab 5mg 2 diphenhydram inj 50mg/ml 2 promethazine tab 12.5mg 2 stavudine sol 1mg/ml 2 MO ANTI-INFLAMMATORIES, INHALED CORTICOSTEROIDS FLOVENT DISK AER 100MCG 3 MO FLOVENT DISK AER 250MCG 3 MO FLOVENT DISK AER 50MCG 3 MO FLOVENT HFA AER 110MCG 3 MO FLOVENT HFA AER 220MCG 3 MO FLOVENT HFA AER 44MCG 3 MO PULMICORT INH 180MCG 3 MO PULMICORT INH 90MCG 3 MO 134

PULMICORT SUS 0.25MG/2 3 PA, MO PULMICORT SUS 0.5MG/2 3 PA, MO PULMICORT SUS 1MG/2ML 3 PA, MO ANTILEUKOTRIENES montelukast chw 4mg 2 MO montelukast chw 5mg 2 MO montelukast gra 4mg 2 MO montelukast tab 10mg 2 MO zafirlukast tab 10mg 2 MO zafirlukast tab 20mg 3 MO ZYFLO CR TAB 600MG 5 MO ZYFLO TAB 600MG 5 MO BRONCHODILATORS, ANTICHOLINERGIC ATROVENT HFA AER 17MCG 3 MO ipratropium sol 0.02%inh 1 PA, MO SPIRIVA AER RESPIMAT 3 MO SPIRIVA CAP HANDIHLR 3 MO SPIRIVA SPR RESPIMAT 3 MO BRONCHODILATORS, PHOSPHODIESTERASE INHIBITORS (XANTHINES) aminophyllin inj 25mg/ml 1 theophylline tab 100mg er 2 MO theophylline tab 200mg er 2 MO theophylline tab 300mg er 2 MO theophylline tab 450mg er 2 MO 135

theophylline tab 600mg er 2 MO BRONCHODILATORS, SYMPATHOMIMETIC ADVAIR DISKU AER 100/50 3 MO ADVAIR DISKU AER 250/50 3 MO ADVAIR DISKU AER 500/50 3 MO ADVAIR HFA AER 115/21 3 MO ADVAIR HFA AER 230/21 3 MO ADVAIR HFA AER 45/21 3 MO albuterol neb 0.083% 1 PA, MO albuterol neb 0.5% 2 PA, MO albuterol neb 0.63mg/3 2 PA, MO albuterol neb 1.25mg/3 1 PA, MO albuterol syp 2mg/5ml 1 MO albuterol tab 2mg 1 MO albuterol tab 4mg 1 MO albuterol tab 4mg er 1 MO albuterol tab 8mg er 2 MO BREO ELLIPTA INH 100-25 3 MO BREO ELLIPTA INH 200-25 3 MO COMBIVENT AER RESPIMAT 4 MO ipratropium/ sol albuter 2 PA, MO SEREVENT DIS AER 50MCG 3 MO STIOLTO AER RESPIMAT 3 MO terbutaline inj 1mg/ml 1 136

VENTOLIN HFA AER 3 MO MAST CELL STABILIZERS CROMOLYN SOD NEB 20MG/2ML 1 PA, MO NASAL AGENTS azelastine spr 0.1% 2 azelastine spr 0.15% 2 flunisolide spr 0.025% 2 fluticasone spr 50mcg 2 ipratropium spr 0.03% 2 MO ipratropium spr 0.06% 2 MO mometasone spr 50mcg 2 PULMONARY ANTIHYPERTENSIVES ADCIRCA TAB 20MG 4 PA, MO ADEMPAS TAB 0.5MG 5 MO ADEMPAS TAB 1.5MG 5 MO ADEMPAS TAB 1MG 5 MO ADEMPAS TAB 2.5MG 5 MO ADEMPAS TAB 2MG 5 MO LETAIRIS TAB 10MG 5 MO LETAIRIS TAB 5MG 5 MO OPSUMIT TAB 10MG 5 MO sildenafil inj 2 PA sildenafil tab 20mg 2 PA, MO TRACLEER TAB 125MG 5 MO, LA 137

TRACLEER TAB 62.5MG 5 MO, LA VENTAVIS SOL 10MCG/ML 4 PA, MO VENTAVIS SOL 20MCG/ML 4 PA, MO RESPIRATORY TRACT AGENTS, OTHER acetylcyst sol 10% 2 PA DALIRESP TAB 500MCG 3 MO EPIPEN 2-PAK INJ 0.3MG 3 ESBRIET CAP 267MG 5 PA, MO KALYDECO PAK 50MG 5 PA, MO KALYDECO PAK 75MG 5 PA, MO KALYDECO TAB 150MG 5 PA, MO ORKAMBI TAB 200-125 5 PA, MO PROLASTIN-C INJ 1000MG 5 PA PULMOZYME SOL 1MG/ML 5 PA, MO XOLAIR SOL 150MG 3 LA SKELETAL MUSCLE RELAXANTS SKELETAL MUSCLE RELAXANTS baclofen tab 10mg 1 MO baclofen tab 20mg 2 MO cyclobenzapr tab 10mg 1 HR cyclobenzapr tab 5mg 1 HR methocarbam tab 500mg 2 HR methocarbam tab 750mg 2 HR 138

orphenadrine inj 30mg/ml 2 HR orphenadrine tab 100mg er 2 HR tizanidine tab 2mg 2 MO tizanidine tab 4mg 2 MO SLEEP DISORDER AGENTS BENZODIAZEPINES estazolam tab 1mg 1 QL (60) estazolam tab 2mg 1 QL (30) flurazepam cap 15mg 3 QL (60) flurazepam cap 30mg 3 QL (30) RESTORIL CAP 15MG 3 QL (30) RESTORIL CAP 22.5MG 3 QL (30) RESTORIL CAP 7.5MG 3 QL (120) temazepam cap 15mg 3 QL (30) temazepam cap 22.5mg 3 QL (30) temazepam cap 30mg 1 QL (30) temazepam cap 7.5mg 3 QL (120) TRIAZOLAM TAB 0.125MG 1 QL (30) triazolam tab 0.25mg 1 QL (60) GABA RECEPTOR MODULATORS ROZEREM TAB 8MG 4 MO zaleplon cap 10mg 2 HR zaleplon cap 5mg 2 HR 139

zolpidem tab 10mg 2 HR zolpidem tab 5mg 2 HR zolpidem tar sub 1.75mg 2 HR, QL (30) zolpidem tar sub 3.5mg 2 HR, QL (30) SLEEP DISORDERS, OTHER HETLIOZ CAP 20MG 5 MO modafinil tab 100mg 2 PA, MO modafinil tab 200mg 2 PA, MO XYREM SOL 500MG/ML 5 LA THERAPEUTIC NUTRIENTS/ MINERALS/ ELECTROLYTES ELECTROLYTE/MINERAL MODIFIERS EXJADE TAB 125MG 5 MO EXJADE TAB 250MG 5 MO EXJADE TAB 500MG 5 MO FERRIPROX SOL 100MG/ML 5 MO FERRIPROX TAB 500MG 4 MO kionex sus 15gm/60 2 SAMSCA TAB 15MG 5 PA SAMSCA TAB 30MG 5 PA sod poly sul pow 2 ELECTROLYTE/MINERAL REPLACEMENT CARBAGLU TAB 200MG 5 MO D10W/NACL INJ 0.2% 1 140

d2.5w/nacl inj 0.45% 1 d5w/lr inj 2 d5w/nacl inj 0.2% 1 d5w/nacl inj 0.33% 1 d5w/nacl inj 0.45% 2 d5w/nacl inj 0.9% 1 ISOLYTE-P INJ /D5W 4 ISOLYTE-S INJ 4 kcl in nacl inj 1 kcl/d5w inj 0.15% 1 kcl/d5w inj 0.3% 1 kcl/d5w/lr inj 0.15% 2 kcl/d5w/nacl inj.075/.45 1 kcl/d5w/nacl inj.15/.33% 1 kcl/d5w/nacl inj.15/.45% 1 kcl/d5w/nacl inj.224/.45 1 kcl/d5w/nacl inj 0.3/0.45 1 kcl/d5w/nacl inj 20meq/0.5/0. 2 kcl/d5w/nacl inj 20meq/0.5/0. 1 kcl/nacl inj 0.15-0.9 1 klor-con 10 tab 10meq er 1 MO lactated rin inj 1 magnesium su inj 50% 1 magnesium su pfs inj 50% 1 141

NORMOSOL -M INJ /D5W 2 NORMOSOL -R INJ 4 NORMOSOL -R INJ /D5W 2 PLASMA-LYTE INJ -148 3 PLASMA-LYTE INJ 56/D5W 3 pot chloride cap 10meq er 2 MO pot chloride cap 8meq er 2 MO pot chloride inj 10meq 1 pot chloride inj 20meq 1 pot chloride inj 2meq/ml 2 pot chloride inj 40meq 1 pot chloride sol 10% 2 MO pot chloride sol 20% 2 MO pot chloride tab 10meq er 1 MO pot chloride tab 20meq er 2 MO pot chloride tab 8meq er 1 MO pot citrate tab 1080mg 2 pot citrate tab 1620mg 2 pot citrate tab 540mg er 2 ringers inj 1 sod chloride inj 0.45% 2 sod chloride inj 0.9%bact 2 sod chloride inj 2.5/ml 1 sod chloride inj 3% 1 142

sod chloride inj 5% 1 SOD LACTATE INJ 5MEQ/ML 1 tpn electrol inj 1 NUTRIENTS AMINOSYN 7% INJ /LYTES 4 PA AMINOSYN II INJ 10% 4 PA AMINOSYN II INJ 7% 4 PA AMINOSYN II INJ 8.5% 4 PA aminosyn ii inj 8.5/lyte 2 PA aminosyn inj 8.5/lyte 1 PA AMINOSYN-HBC INJ 7% 4 PA AMINOSYN-PF INJ 10% 4 PA AMINOSYN-PF INJ 7% 4 PA AMINOSYN-RF INJ 5.2% 4 PA CLINIMIX E INJ 2.75/D10 4 PA CLINIMIX E INJ 2.75/D5W 4 PA CLINIMIX E INJ 4.25/D10 4 PA CLINIMIX E INJ 4.25/D25 4 PA CLINIMIX E INJ 4.25/D5W 4 PA CLINIMIX E INJ 5%/D15W 4 PA CLINIMIX E INJ 5%/D20W 4 PA CLINIMIX E INJ 5%/D25W 4 PA CLINIMIX INJ 2.75/D5W 4 PA CLINIMIX INJ 4.25/D10 4 PA 143

CLINIMIX INJ 4.25/D20 4 PA CLINIMIX INJ 4.25/D25 4 PA CLINIMIX INJ 4.25/D5W 4 PA CLINIMIX INJ 5%/D15W 4 PA CLINIMIX INJ 5%/D20W 4 PA CLINIMIX INJ 5%/D25W 4 PA dextrose inj 10% 1 PA dextrose inj 5% 2 PA FREAMINE HBC INJ 6.9% 4 PA HEPATAMINE SOL 8% 1 PA NEPHRAMINE INJ 5.4% 4 PA nutrilipid emu 20% 1 PA plenamine inj 15% 2 PA premasol sol 6% 1 PA PROCALAMINE INJ 3% 3 PA PROSOL INJ 20% 3 PA TRAVASOL INJ 10% 3 PA VITAMINS PRENATAL VITAMIN 3 SOD FLUORIDE TAB 1MG F 1 144

Alphabetical Listing 8 8-MOP CAP 10MG... 105 A abacav/lamiv tab /zidovud... 66 abacavir tab 300mg... 66 ABELCET INJ 5MG/ML... 35 ABILIFY MAIN DC INJ 300MG... 58 ABILIFY MAIN INJ 300MG... 58 ABRAXANE INJ 100MG... 42 acampro cal tab 333mg... 7 acarbose tab 100mg... 72 acarbose tab 25mg... 72 acarbose tab 50mg... 72 acebutolol cap 200mg... 90 acebutolol cap 400mg... 90 acetazolamid tab 125mg... 96 acetazolamid tab 250mg... 96 acetic acid sol 2% otic... 138 acetylcyst sol 10%... 142 acitretin cap 10mg... 105 acitretin cap 17.5mg... 105 acitretin cap 25mg... 105 ACTEMRA INJ 162/0.9... 130 ACTEMRA INJ 200/10ML... 130 ACTEMRA INJ 400/20ML... 130 ACTEMRA INJ 80MG/4ML... 130 ACTHIB INJ... 130 ACTIMMUNE INJ 2MU/0.5... 42 acyclovir cap 200mg... 64 acyclovir na inj 50mg/ml... 64 acyclovir sus 200/5ml... 65 acyclovir tab 400mg... 65 acyclovir tab 800mg... 65 ADACEL INJ... 130 ADAGEN INJ 250/ML... 111 ADCIRCA TAB 20MG... 142 adefov dipiv tab 10mg... 63 ADEMPAS TAB 0.5MG... 142 ADEMPAS TAB 1.5MG... 142 ADEMPAS TAB 1MG... 142 ADEMPAS TAB 2.5MG... 142 ADEMPAS TAB 2MG... 142 ADVAIR DISKU AER 100/50... 140 ADVAIR DISKU AER 250/50... 140 145 ADVAIR DISKU AER 500/50... 140 ADVAIR HFA AER 115/21... 140 ADVAIR HFA AER 230/21... 140 ADVAIR HFA AER 45/21... 140 afeditab tab 30mg cr... 92 afeditab tab 60mg cr... 92 AFINITOR DIS TAB 2MG... 42 AFINITOR DIS TAB 3MG... 42 AFINITOR DIS TAB 5MG... 42 AFINITOR TAB 10MG... 42 AFINITOR TAB 2.5MG... 43 AFINITOR TAB 5MG... 43 AFINITOR TAB 7.5MG... 43 ALBENZA TAB 200MG... 53 albuterol neb 0.083%... 140 albuterol neb 0.5%... 141 albuterol neb 0.63mg/3... 141 albuterol neb 1.25mg/3... 141 albuterol syp 2mg/5ml... 141 albuterol tab 2mg... 141 albuterol tab 4mg... 141 albuterol tab 4mg er... 141 albuterol tab 8mg er... 141 ALCOHOL PREP PAD 70%... 72 ALDURAZYME INJ 2.9MG/5M... 111 ALECENSA CAP 150MG... 43 alendronate tab 10mg... 133 alendronate tab 35mg... 133 alendronate tab 40mg... 133 alendronate tab 5mg... 133 alendronate tab 70mg... 133 ALIMTA INJ 500MG... 42 ALINIA SUS 100/5ML... 53 ALINIA TAB 500MG... 53 allopurinol tab 100mg... 36 allopurinol tab 300mg... 36 alosetron tab 0.5mg... 114 alosetron tab 1mg... 114 ALPHAGAN P SOL 0.1%... 136 ALPHAGAN P SOL 0.15%... 136 ALPRAZOLAM CON 1 MG/ML... 70 alprazolam tab 0.25 odt... 70 alprazolam tab 0.25mg... 70 alprazolam tab 0.5mg... 70 alprazolam tab 0.5mg er... 71

alprazolam tab 0.5mg od... 71 alprazolam tab 1mg... 71 alprazolam tab 1mg odt... 71 alprazolam tab 1mg xr... 71 alprazolam tab 2mg... 71 alprazolam tab 2mg odt... 71 alprazolam tab 2mg xr... 71 alprazolam tab 3mg er... 71 amantadine cap 100mg... 54 amantadine syp 50mg/5ml... 54 amantadine tab 100mg... 54 AMBISOME INJ 50MG... 35 amcinonide cre 0.1%... 105 amcinonide lot 0.1%... 105 amcinonide oin 0.1%... 105 amifostine inj 500mg... 43 amilor/hctz tab 5-50... 86 amiloride tab 5mg... 97 aminophyllin inj 25mg/ml... 140 AMINOSYN 7% INJ /LYTES... 148 AMINOSYN II INJ 10%... 148 AMINOSYN II INJ 7%... 148 AMINOSYN II INJ 8.5%... 148 aminosyn ii inj 8.5/lyte... 148 aminosyn inj 8.5/lyte... 148 AMINOSYN-HBC INJ 7%... 148 AMINOSYN-PF INJ 10%... 148 AMINOSYN-PF INJ 7%... 148 AMINOSYN-RF INJ 5.2%... 148 amiodarone inj 50mg/ml... 85 amiodarone tab 200mg... 85 amiodarone tab 400mg... 85 AMITIZA CAP 24MCG... 114 AMITIZA CAP 8MCG... 114 amitriptylin tab 100mg... 31 amitriptylin tab 10mg... 32 amitriptylin tab 150mg... 32 amitriptylin tab 25mg... 32 amitriptylin tab 50mg... 32 amitriptylin tab 75mg... 32 amlod/atorva tab 10-10mg... 95 amlod/atorva tab 10-20mg... 95 amlod/atorva tab 10-40mg... 95 amlod/atorva tab 10-80mg... 95 amlod/atorva tab 2.5-10mg... 95 amlod/atorva tab 2.5-20mg... 95 amlod/atorva tab 2.5-40mg... 95 amlod/atorva tab 5-10mg... 95 amlod/atorva tab 5-20mg... 95 146 amlod/atorva tab 5-40mg... 95 amlod/atorva tab 5-80mg... 95 amlod/benazp cap 10-20mg... 86 amlod/benazp cap 10-40mg... 86 amlod/benazp cap 2.5-10mg... 86 amlod/benazp cap 5-10mg... 86 amlod/benazp cap 5-20mg... 86 amlod/benazp cap 5-40mg... 86 amlod/valsar tab /hctz 10-160... 86 amlod/valsar tab /hctz 10-320... 86 amlod/valsar tab /hctz 5-160-... 86 amlod/valsar tab 10-160mg... 86 amlod/valsar tab 10-320mg... 87 amlod/valsar tab 5-160mg... 87 amlod/valsar tab 5-320mg... 87 amlodipine tab 10mg... 92 amlodipine tab 2.5mg... 92 amlodipine tab 5mg... 92 ammonium lac lot 12%... 105 AMOX/K CLAV CHW 200MG... 13 AMOX/K CLAV CHW 400MG... 13 amox/k clav sus 200/5ml... 13 amox/k clav sus 400/5ml... 13 amox/k clav sus 600/5ml... 13 amox/k clav tab 250-125... 13 amox/k clav tab 500-125... 13 amox/k clav tab 875mg... 13 amoxapine tab 100mg... 32 amoxapine tab 150mg... 32 amoxapine tab 25mg... 32 amoxapine tab 50mg... 32 amoxicillin cap 250mg... 13 amoxicillin cap 500mg... 13 amoxicillin chw 125mg... 13 amoxicillin chw 250mg... 13 amoxicillin sus 125/5ml... 13 amoxicillin sus 200/5ml... 13 amoxicillin sus 250mg/5m... 13 amoxicillin sus 400/5ml... 13 amoxicillin tab 500mg... 13 amoxicillin tab 875mg... 13 amphet/dextr tab 10mg... 102 amphet/dextr tab 12.5mg... 102 amphet/dextr tab 15mg... 102 amphet/dextr tab 20mg... 102 amphet/dextr tab 30mg... 102 amphet/dextr tab 5mg... 102 amphet/dextr tab 7.5mg... 102 amphotericin inj 50mg... 35

ampicillin cap 250mg... 13 ampicillin cap 500mg... 13 ampicillin inj 10gm... 13 ampicillin inj 125mg... 13 ampicillin inj 1gm... 14 ampicillin sus 125/5ml... 14 ampicillin sus 250/5ml... 14 amp-sulbacta inj 1.5gm... 14 amp-sulbacta inj 15gm... 14 AMPYRA TAB 10MG... 104 ANADROL-50 TAB 50MG... 119 anagrelide cap 0.5mg... 81 anastrozole tab 1mg... 52 ANDRODERM DIS 2MG/24HR... 119 ANDRODERM DIS 4MG/24HR... 119 apap/codeine sol 120-12/5... 4 apap/codeine tab 300-15mg... 4 apap/codeine tab 300-30mg... 4 apap/codeine tab 300-60mg... 4 APLENZIN TAB 174MG... 27 APLENZIN TAB 348MG... 27 APLENZIN TAB 522MG... 27 APOKYN INJ 10MG/ML... 54 apraclonidin sol 0.5% op... 136 APRISO CAP 0.375GM... 132 APTIOM TAB 200MG... 23 APTIOM TAB 400MG... 23 APTIOM TAB 600MG... 23 APTIOM TAB 800MG... 23 APTIVUS CAP 250MG... 68 APTIVUS SOL... 68 ARCALYST INJ 220MG... 130 ARGATROBAN INJ 250/250... 77 aripiprazole tab 10mg... 58 ARIPIPRAZOLE TAB 10MG ODT... 58 aripiprazole tab 15mg... 58 ARIPIPRAZOLE TAB 15MG ODT... 58 aripiprazole tab 20mg... 58 aripiprazole tab 2mg... 58 aripiprazole tab 30mg... 59 aripiprazole tab 5mg... 59 ARISTADA INJ 441MG/1.6... 59 ARISTADA INJ 662MG/2.4... 59 ARISTADA INJ 882MG/3.2... 59 ARRANON INJ 5MG/ML... 43 asa/dipyrida cap 25-200mg... 81 ascomp/cod cap 30mg... 5 ASTAGRAF XL CAP 0.5MG... 126 ASTAGRAF XL CAP 1MG... 126 147 ASTAGRAF XL CAP 5MG... 126 atenol/chlor tab 100-25mg... 87 atenol/chlor tab 50-25mg... 87 atenolol tab 100mg... 90 atenolol tab 25mg... 90 atenolol tab 50mg... 90 ATGAM INJ 250MG... 129 atorvastatin tab 10mg... 98 atorvastatin tab 20mg... 98 atorvastatin tab 40mg... 98 atorvastatin tab 80mg... 98 atovaq/progu tab 250-100... 53 atovaquone sus 750/5ml... 53 ATRIPLA TAB... 65 atropine sul inj 0.05mg/1... 112 atropine sul inj 0.1mg/ml... 112 atropine sul sol 1% op... 135 ATROVENT HFA AER 17MCG... 140 aug betamet lot 0.05%... 105 AVANDIA TAB 2MG... 72 AVANDIA TAB 4MG... 73 AVASTIN INJ... 41 AVASTIN INJ 400/16ML... 41 AVONEX KIT 30MCG... 104 AVONEX PEN KIT 30MCG... 104 AVONEX PREFL KIT 30MCG... 104 azacitidine inj 100mg... 42 AZACTAM/DEX INJ 2GM... 12 AZASAN TAB 100MG... 43 AZASAN TAB 75 MG... 43 AZASITE SOL 1%... 135 AZATHIOPRINE INJ 100MG... 126 azathioprine tab 50mg... 126 azelastine dro 0.05%... 136 azelastine spr 0.1%... 141 azelastine spr 0.15%... 141 AZILECT TAB 0.5MG... 55 AZILECT TAB 1MG... 55 azithromycin inj 500mg... 14 azithromycin pow 1gm pak... 14 azithromycin sus 100/5ml... 15 azithromycin sus 200/5ml... 15 azithromycin tab 250mg 30ct... 15 azithromycin tab 250mg 6ct pa... 15 azithromycin tab 500mg... 15 azithromycin tab 600mg... 15 AZOPT SUS 1% OP... 136 AZOR TAB 10-20MG... 87 AZOR TAB 10-40MG... 87

AZOR TAB 5-20MG... 87 AZOR TAB 5-40MG... 87 aztreonam inj 1gm... 12 B bacit/polymy oin op... 135 bacitracin inj 50000unt... 9 bacitracin oin op... 135 baclofen tab 10mg... 143 baclofen tab 20mg... 143 balsalazide cap 750mg... 132 BANZEL SUS 40MG/ML... 23 BANZEL TAB 200MG... 23 BANZEL TAB 400MG... 23 BARACLUDE SOL.05MG/ML... 63 BCG VACCINE INJ... 130 bekyree tab... 119 BELEODAQ INJ 500MG... 43 benazep/hctz tab 10-12.5... 87 benazep/hctz tab 20-12.5... 87 benazep/hctz tab 20-25mg... 87 benazep/hctz tab 5-6.25... 87 benazepril tab 10mg... 83 benazepril tab 20mg... 83 benazepril tab 40mg... 83 benazepril tab 5mg... 83 BENICAR HCT TAB 20-12.5... 87 BENICAR HCT TAB 40-12.5... 87 BENICAR HCT TAB 40-25MG... 87 BENICAR TAB 20MG... 82 BENICAR TAB 40MG... 82 BENICAR TAB 5MG... 83 BENLYSTA INJ 120MG... 126 BENLYSTA INJ 400MG... 126 benztropine inj 1mg/ml... 53 benztropine tab 0.5mg... 53 benztropine tab 1mg... 53 benztropine tab 2mg... 53 betameth dip cre 0.05%... 105 betameth dip oin 0.05%... 106 betameth val cre 0.1%... 106 betameth val lot 0.1%... 106 betameth val oin 0.1%... 106 BETASERON INJ 0.3MG... 104 betaxolol sol 0.5% op... 136 betaxolol tab 10mg... 90 betaxolol tab 20mg... 90 bexarotene cap 75mg... 43 BEXSERO INJ... 130 148 bicalutamide tab 50mg... 43 BICILLIN L-A INJ 600000... 14 BICNU INJ 100MG... 43 BIMATOPROST SOL 0.03%... 135 bisoprl/hctz tab 10/6.25... 87 bisoprl/hctz tab 2.5/6.25... 87 bisoprl/hctz tab 5-6.25mg... 87 bisoprol fum tab 10mg... 90 bisoprol fum tab 5mg... 90 BIVIGAM INJ 10%... 129 bleomycin inj 30unit... 43 BLEPHAMIDE OIN S.O.P.... 137 BLEPHAMIDE SUS OP... 137 blisovi 24 tab fe 1/20... 119 blisovi fe tab 1.5/30... 119 blisovi fe tab 1/20... 119 BOOSTRIX INJ... 130 BOOSTRIX INJ PFS... 130 BOSULIF TAB 100MG... 43 BOSULIF TAB 500MG... 43 BREO ELLIPTA INH 100-25... 141 BREO ELLIPTA INH 200-25... 141 BRILINTA TAB 60MG... 81 BRILINTA TAB 90MG... 81 brimonidine sol 0.15%... 136 brimonidine sol 0.2% op... 136 BRISDELLE CAP 7.5MG... 28 BRIVIACT INJ 50MG/5ML... 23 BRIVIACT SOL 10MG/ML... 23 BRIVIACT TAB 100MG... 23 BRIVIACT TAB 10MG... 23 BRIVIACT TAB 25MG... 23 BRIVIACT TAB 50MG... 23 BRIVIACT TAB 75MG... 24 bromocriptin cap 5mg... 54 bromocriptin tab 2.5mg... 54 budesonide cap 3mg/24hr... 117 bumetanide inj 0.25/ml... 96 bupren/nalox sub 2-0.5mg... 7 bupren/nalox sub 8-2mg... 7 buprenorphin inj 0.3mg/ml car... 7 buprenorphin sub 2mg... 8 buprenorphin sub 8mg... 8 buproban tab 150mg... 27 bupropion tab 100mg... 27 bupropion tab 100mg er... 27 bupropion tab 150mg er... 8 bupropion tab 200mg er... 27 bupropion tab 75mg... 27

bupropn hcl tab 150mg xl... 27 bupropn hcl tab 300mg xl... 27 buspirone tab 10mg... 70 buspirone tab 15mg... 70 buspirone tab 30mg... 70 buspirone tab 5mg... 70 buspirone tab 7.5mg... 70 BUSULFEX INJ 6MG/ML... 43 but/apap/caf cap cod 50-325-4... 5 but/asa/caf/ cap cod 30mg... 5 BUTISOL SOD TAB 30MG... 18 BYDUREON DC SYR INJ... 73 BYDUREON INJ... 73 BYETTA INJ 10MCG... 73 BYETTA INJ 5MCG... 73 C cabergoline tab 0.5mg... 122 CABOMETYX TAB 20MG... 43 CABOMETYX TAB 40MG... 43 CABOMETYX TAB 60MG... 43 calc acetate cap 667mg... 116 calcipotrien sol 0.005%... 106 calcitonin spr 200/act... 133 calcitriol cap 0.25mcg... 133 calcitriol cap 0.5mcg... 133 calcitriol inj 1mcg/ml... 133 calcitriol sol 1mcg/ml... 133 CANCIDAS INJ 50MG... 35 CANCIDAS INJ 70MG... 35 candesa/hctz tab 16-12.5... 87 candesa/hctz tab 32-12.5... 87 candesa/hctz tab 32-25mg... 87 candesartan tab 16mg... 83 candesartan tab 32mg... 83 candesartan tab 4mg... 83 candesartan tab 8mg... 83 CAPASTAT SUL INJ 1GM... 40 CAPRELSA TAB 100MG... 43 CAPRELSA TAB 300MG... 43 captopr/hctz tab 25-15mg... 87 captopr/hctz tab 25-25mg... 88 captopr/hctz tab 50-15mg... 88 captopr/hctz tab 50-25mg... 88 captopril tab 100mg... 83 captopril tab 12.5mg... 83 captopril tab 25mg... 83 captopril tab 50mg... 84 CARAFATE SUS 1GM/10ML... 115 149 carb/levo er tab 25-100mg... 55 carb/levo er tab 50-200mg... 55 carb/levo tab 10-100mg... 55 carb/levo tab 10-100mg odt... 55 carb/levo tab 25-100mg... 55 carb/levo tab 25-100mg odt... 55 carb/levo tab 25-250mg... 55 carb/levo tab 25-250mg odt... 55 CARBAGLU TAB 200MG... 145 carbamazepin cap 100mg er... 72 carbamazepin cap 200mg er... 24 carbamazepin cap 300mg er... 24 carbamazepin chw 100mg... 72 carbamazepin sus 100/5ml... 24 carbamazepin tab 100mger... 24 carbamazepin tab 200mg... 24 carbamazepin tab 200mg er... 24 carbamazepin tab 400mg er... 24 carboplatin inj 600/60ml... 43 CARIMUNE NF INJ 3GM... 129 carteolol sol 1% op... 136 cartia xt cap 120/24hr... 92 cartia xt cap 180/24hr... 92 cartia xt cap 240/24hr... 92 cartia xt cap 300/24hr... 93 carvedilol tab 12.5mg... 90 carvedilol tab 25mg... 90 carvedilol tab 3.125mg... 90 carvedilol tab 6.25mg... 90 CAYSTON INH 75MG... 12 cdp/amitrip tab 10-25mg... 32 cdp/amitrip tab 5-12.5mg... 32 cefaclor cap 250mg... 10 cefaclor cap 500mg... 10 cefaclor er tab 500mg... 10 cefazolin inj 10gm... 10 cefazolin inj 1gm... 11 cefazolin inj 500mg... 11 cefdinir cap 300mg... 11 cefdinir sus 125/5ml... 11 cefdinir sus 250/5ml... 11 cefepime inj 1gm... 11 cefepime inj 2gm... 11 cefixime sus 200/5ml... 11 cefoxitin inj 10gm... 11 cefoxitin inj 1gm... 11 cefoxitin inj 2gm... 11 cefpodo prox sus 100/5ml... 11 cefpodo prox sus 50mg/5ml... 11

cefpodoxime tab 100mg... 11 cefpodoxime tab 200mg... 11 cefprozil sus 125/5ml... 11 cefprozil sus 250/5ml... 11 cefprozil tab 250mg... 11 cefprozil tab 500mg... 11 ceftriaxone inj 10gm... 11 ceftriaxone inj 1gm... 11 ceftriaxone inj 250mg... 11 ceftriaxone inj 2gm... 11 ceftriaxone inj 500mg... 12 cefuroxime inj 1.5gm... 12 cefuroxime inj 7.5gm... 12 cefuroxime inj 750mg... 12 cefuroxime tab 250mg... 12 celecoxib cap 100mg... 36 celecoxib cap 200mg... 36 celecoxib cap 400mg... 36 celecoxib cap 50mg... 36 CELLCEPT IV INJ 500MG... 126 CELONTIN CAP 300MG... 19 cephalexin cap 250mg... 12 cephalexin cap 500mg... 12 cephalexin sus 125/5ml... 12 cephalexin sus 250/5ml... 12 cephalexin tab 250mg... 12 cephalexin tab 500mg... 12 CEREBYX INJ 500/10ML... 24 CEREZYME INJ 400UNIT... 111 CERVARIX INJ... 130 cetirizine syp 1mg/ml... 138 CHANTIX PAK 0.5& 1MG... 8 CHANTIX PAK 1MG... 8 CHANTIX TAB 0.5MG... 8 CHANTIX TAB 1MG... 8 chloramphen inj 1gm... 9 chlordiazep cap 10mg... 71 chlordiazep cap 25mg... 71 chlordiazep cap 5mg... 71 chlorhex glu sol 0.12%... 105 chloroquine tab 250mg... 53 chloroquine tab 500mg... 53 chlorothiaz tab 250mg... 97 chlorothiaz tab 500mg... 97 chlorpromaz inj 50mg/2ml... 56 chlorpromaz tab 100mg... 56 chlorpromaz tab 10mg... 56 chlorpromaz tab 200mg... 56 chlorpromaz tab 25mg... 56 150 chlorpromaz tab 50mg... 56 chlorpropam tab 100mg... 73 chlorpropam tab 250mg... 73 chlorthalid tab 25mg... 97 CHLORTHALID TAB 50MG... 97 cholestyram pow 4gm... 99 chor gonadot inj 10000unt... 122 ciclopirox cre 0.77%... 106 ciclopirox gel 0.77%... 106 ciclopirox sol 8%... 106 ciclopirox sus 0.77%... 106 cilostazol tab 100mg... 81 cilostazol tab 50mg... 81 CIMZIA KIT... 114 CIMZIA PREFL KIT 200MG/ML... 114 CINRYZE SOL 500 UNIT... 134 CIPRODEX SUS 0.3-0.1%... 138 ciprofloxacn inj 200mg... 15 ciprofloxacn inj 400mg... 15 ciprofloxacn sol 0.3% op... 135 ciprofloxacn sus 250mg/5... 15 ciprofloxacn sus 500mg/5... 15 ciprofloxacn tab 1000mg... 15 ciprofloxacn tab 100mg... 15 ciprofloxacn tab 250mg... 15 ciprofloxacn tab 500mg... 16 ciprofloxacn tab 500mg er... 16 ciprofloxacn tab 750mg... 16 cisplatin inj 100mg... 43 citalopram sol 10mg/5ml... 29 citalopram tab 10mg... 29 citalopram tab 20mg... 29 citalopram tab 40mg... 29 cladribine inj 1mg/ml... 44 claravis cap 10mg... 106 claravis cap 20mg... 106 claravis cap 30mg... 106 claravis cap 40mg... 106 clarithromyc tab 250mg... 15 clarithromyc tab 500mg... 15 clindamy/ben gel 1-5%... 106 clindamycin cap 150mg... 9 clindamycin cap 300mg... 9 clindamycin cap 75mg... 9 clindamycin cre 2% vag... 117 clindamycin gel 1%... 106 clindamycin inj 300mg d5w... 9 clindamycin inj 300mg/2ml... 9 clindamycin inj 600/4ml... 9

clindamycin inj 600mg... 9 clindamycin inj 900mg d5w... 9 clindamycin inj 900mg/6 ml... 9 clindamycin lot 1%... 106 clindamycin pad 1%... 106 clindamycin sol 1%... 106 clindamycin sol 75mg/5ml... 9 CLINIMIX E INJ 2.75/D10... 148 CLINIMIX E INJ 2.75/D5W... 148 CLINIMIX E INJ 4.25/D10... 148 CLINIMIX E INJ 4.25/D25... 148 CLINIMIX E INJ 4.25/D5W... 148 CLINIMIX E INJ 5%/D15W... 148 CLINIMIX E INJ 5%/D20W... 148 CLINIMIX E INJ 5%/D25W... 148 CLINIMIX INJ 2.75/D5W... 148 CLINIMIX INJ 4.25/D10... 148 CLINIMIX INJ 4.25/D20... 148 CLINIMIX INJ 4.25/D25... 148 CLINIMIX INJ 4.25/D5W... 148 CLINIMIX INJ 5%/D15W... 149 CLINIMIX INJ 5%/D20W... 149 CLINIMIX INJ 5%/D25W... 149 clobetasol cre 0.05%... 106 clobetasol gel 0.05%... 106 clobetasol oin 0.05%... 106 clobetasol sol 0.05%... 106 CLOLAR INJ 1MG/ML... 44 clomipramine cap 25mg... 32 clomipramine cap 50mg... 32 clomipramine cap 75mg... 32 clonazep odt tab 0.125mg... 19 clonazep odt tab 0.25mg... 19 clonazep odt tab 0.5mg... 19 clonazep odt tab 1mg... 19 clonazep odt tab 2mg... 19 clonazepam tab 0.5mg... 19 clonazepam tab 1mg... 19 clonazepam tab 2mg... 19 clonidine dis 0.1/24hr... 81 clonidine dis 0.2/24hr... 81 clonidine dis 0.3/24hr... 81 clonidine tab 0.1mg... 81 clonidine tab 0.2mg... 82 clonidine tab 0.3mg... 82 clopidogrel tab 300mg... 81 clopidogrel tab 75mg... 81 cloraz dipot tab 15mg... 71 cloraz dipot tab 3.75mg... 71 151 cloraz dipot tab 7.5mg... 71 clotrim/beta cre diprop... 106 clotrim/beta lot diprop... 107 clotrimazole cre 1%... 107 clotrimazole sol 1%... 107 clotrimazole tro 10mg... 35 clozapine tab 100/odt... 63 clozapine tab 100mg... 63 CLOZAPINE TAB 12.5/ODT... 63 clozapine tab 150/odt... 63 clozapine tab 200/odt... 63 clozapine tab 200mg... 63 clozapine tab 25mg... 63 clozapine tab 25mg odt... 63 clozapine tab 50mg... 63 COARTEM TAB 20-120MG... 53 COLCHICINE CAP 0.6MG... 36 COLCHICINE TAB 0.6MG... 36 colestipol gra 5gm... 99 colestipol tab 1gm... 99 colistimeth inj 150mg... 9 COMBIGAN SOL 0.2/0.5%... 136 COMBIVENT AER RESPIMAT... 141 COMETRIQ KIT 100MG... 44 COMETRIQ KIT 140MG... 44 COMETRIQ KIT 60MG... 44 COMPLERA TAB... 65 CONDYLOX GEL 0.5%... 107 COPAXONE INJ 20MG/ML... 104 COPAXONE INJ 40MG/ML... 104 COSENTYX INJ 150MG/ML... 107 COSENTYX PEN INJ 150MG/ML... 107 COSMEGEN INJ 0.5MG... 44 COTELLIC TAB 20MG... 44 CREON CAP 36000UNT... 111 CRIXIVAN CAP 200MG... 68 CRIXIVAN CAP 400MG... 68 CROMOLYN SOD NEB 20MG/2ML... 141 cromolyn sod sol 4% op... 136 CUBICIN RF SOL 500MG... 9 cyclobenzapr tab 10mg... 143 cyclobenzapr tab 5mg... 143 CYCLOPHOSPH CAP 25MG... 41 CYCLOPHOSPH CAP 50MG... 41 CYCLOSET TAB 0.8MG... 73 cyclosporine cap 100mg... 126 cyclosporine cap 100mg md... 127 cyclosporine cap 25mg... 127 cyclosporine cap 25mg mod... 127

CYCLOSPORINE CAP 50MG MOD... 127 cyclosporine inj 50mg/ml... 127 cyclosporine sol modified... 127 cyproheptad tab 4mg... 138 CYRAMZA INJ 100/10ML... 44 CYRAMZA INJ 500/50ML... 44 CYSTADANE POW... 111 CYSTAGON CAP 150MG... 116 CYSTAGON CAP 50MG... 116 CYSTARAN SOL 0.44%... 137 cytarabine inj 100mg/ml... 44 cytarabine inj 20mg/ml... 44 D D10W/NACL INJ 0.2%... 145 d2.5w/nacl inj 0.45%... 145 d5w/lr inj... 145 d5w/nacl inj 0.2%... 145 d5w/nacl inj 0.33%... 145 d5w/nacl inj 0.45%... 145 d5w/nacl inj 0.9%... 145 dacarbazine inj 200mg... 44 DAKLINZA TAB 30MG... 63 DAKLINZA TAB 60MG... 63 DAKLINZA TAB 90MG... 63 DALIRESP TAB 500MCG... 142 danazol cap 100mg... 119 danazol cap 200mg... 119 danazol cap 50mg... 119 dapsone tab 100mg... 40 dapsone tab 25mg... 40 DAPTACEL INJ... 130 DARAPRIM TAB 25MG... 53 darifenacin tab hbr er 15mg... 115 darifenacin tab hbr er 7.5mg... 115 DARZALEX SOL 100MG/5M... 44 daunorubicin inj 5mg/ml... 44 decitabine inj 50mg... 42 DEMSER CAP 250MG... 97 DEPEN TITRA TAB 250MG... 41 DEPO-PROVERA INJ 400/ML... 44 DESCOVY TAB 200/25... 66 desipramine tab 100mg... 32 desipramine tab 10mg... 32 desipramine tab 150mg... 32 desipramine tab 25mg... 32 desipramine tab 50mg... 32 desipramine tab 75mg... 32 desloratadin tab 2.5 odt... 138 152 desloratadin tab 5mg... 139 desloratadin tab 5mg odt... 66 desmopressin inj 4mcg/ml... 122 desmopressin sol 0.01%... 122 desmopressin spr 0.01%... 122 desmopressin tab 0.1mg... 122 desmopressin tab 0.2mg... 122 desonide cre 0.05%... 107 desonide lot 0.05%... 107 desonide oin 0.05%... 107 desoximetas cre 0.05%... 107 desoximetas cre 0.25%... 107 desoximetas gel 0.05%... 107 desoximetas oin 0.25%... 107 DESVENLAFAX TAB 100MG ER... 29 DESVENLAFAX TAB 50MG ER... 29 dexameth pho inj 10mg/ml... 117 dexameth pho inj 20mg/5ml... 117 DEXAMETH PHO SOL 0.1% OP... 137 dexamethason sol 0.5/5ml... 117 dexamethason tab 0.5mg... 117 dexamethason tab 0.75mg... 117 dexamethason tab 1.5mg... 117 dexamethason tab 1mg... 117 dexamethason tab 2mg... 117 dexamethason tab 4mg... 117 dexamethason tab 6mg... 117 dexrazoxane inj 250mg... 44 dextroamphet cap 10mg er... 102 dextroamphet cap 15mg er... 102 dextroamphet cap 5mg er... 102 dextroamphet tab 10mg... 102 dextroamphet tab 5mg... 102 dextrose inj 10%... 149 dextrose inj 5%... 149 diazepam con 5mg/ml... 71 diazepam gel 10mg... 19 diazepam gel 2.5mg... 19 diazepam gel 20mg... 19 DIAZEPAM SOL 1MG/ML... 71 diazepam tab 10mg... 71 diazepam tab 2mg... 71 diazepam tab 5mg... 71 diclofen pot tab 50mg... 37 diclofenac gel 1%... 107 diclofenac gel 3%... 107 diclofenac sol 0.1% op... 137 diclofenac tab 100mg er... 37 diclofenac tab 25mg dr... 37

diclofenac tab 50mg dr... 37 diclofenac tab 75mg dr... 37 dicloxacill cap 250mg... 14 dicloxacill cap 500mg... 14 dicyclomine cap 10mg... 112 dicyclomine inj 10mg/ml... 112 dicyclomine sol 10mg/5ml... 112 dicyclomine tab 20mg... 112 didanosine cap 125mg... 66 didanosine cap 200mg... 66 didanosine cap 250mg... 66 didanosine cap 400mg... 66 DIFICID TAB 200MG... 15 diflorasone cre 0.05%... 107 DIFLORASONE OIN 0.05%... 107 diflunisal tab 500mg... 37 digitek tab 0.125mg... 95 digitek tab 0.25mg... 96 digoxin inj 0.25mg/1... 96 digoxin sol 50mcg/ml... 96 digoxin tab 0.125mg... 96 digoxin tab 0.25mg... 96 dihydroergot inj 1mg/ml... 39 DILANTIN CAP 30MG... 24 dilt-cd cap 240mg... 93 diltiazem cap 120mg er 100ct... 93 diltiazem cap 120mg er 90ct... 93 diltiazem cap 180mg er... 93 diltiazem cap 240mg er... 93 diltiazem cap 300mg er... 93 diltiazem cap 360mg/24... 93 diltiazem cap 420mg/24... 93 diltiazem cap 60mg er... 93 diltiazem cap 90mg er... 93 diltiazem inj 100mg... 93 diltiazem inj 50/10ml... 93 diltiazem tab 120mg... 93 diltiazem tab 30mg... 93 diltiazem tab 60mg... 93 diltiazem tab 90mg... 93 dilt-xr cap 120mg... 93 dilt-xr cap 180mg... 93 DIP/TET PED INJ 25-5LFU... 130 DIPENTUM CAP 250MG... 132 diphen/atrop liq 2.5/5... 113 diphen/atrop tab 2.5mg... 113 diphenhydram inj 50mg/ml... 139 dipyridamole tab 25mg... 81 dipyridamole tab 50mg... 81 153 dipyridamole tab 75mg... 81 disopyramide cap 100mg... 85 disopyramide cap 150mg... 85 disulfiram tab 250mg... 7 disulfiram tab 500mg... 7 divalproex cap 125mg... 39 divalproex tab 125mg dr... 39 divalproex tab 250mg dr... 20 divalproex tab 250mg er... 20 divalproex tab 500mg dr... 20 divalproex tab 500mg er... 20 DOCEFREZ INJ 20MG... 44 DOCETAXEL INJ 80MG/4ML... 44 DOCETAXEL INJ 80MG/8ML... 44 dofetilide cap 125mcg... 85 dofetilide cap 250mcg... 85 dofetilide cap 500mcg... 85 donepezil tab 10mg... 25 donepezil tab 10mg odt... 25 donepezil tab 5mg... 25 donepezil tab 5mg odt... 25 donepezil tab hcl 23mg... 25 dorzol/timol sol 22.3-6.8... 136 dorzolamide sol 2% op... 136 doxazosin tab 1mg... 82 doxazosin tab 2mg... 82 doxazosin tab 4mg... 82 doxazosin tab 8mg... 82 doxepin hcl cap 100mg... 32 doxepin hcl cap 10mg... 32 doxepin hcl cap 150mg... 32 doxepin hcl cap 25mg... 33 doxepin hcl cap 50mg... 33 doxepin hcl cap 75mg... 33 doxepin hcl con 10mg/ml... 33 DOXIL INJ 2MG/ML... 44 doxorubicin inj 200/100... 44 doxorubicin inj 2mg/ml... 44 doxycyc mono cap 100mg... 16 doxycyc mono cap 50mg... 16 doxycyc mono tab 100mg... 17 doxycyc mono tab 50mg... 17 doxycyc mono tab 75mg... 17 doxycycl hyc cap 100mg... 17 doxycycl hyc cap 50mg... 17 doxycycl hyc inj 100mg... 17 doxycycl hyc tab 100mg... 17 doxycycl hyc tab 50mg dr... 17 doxycycline sus 25mg/5ml... 17

doxycycline tab 20mg... 17 dronabinol cap 10mg... 34 dronabinol cap 2.5mg... 34 dronabinol cap 5mg... 34 drospirenone tab ethy est... 120 duloxetine cap 20mg... 29 duloxetine cap 30mg... 29 DULOXETINE CAP 40MG... 29 duloxetine cap 60mg... 29 duramorph inj 0.5mg/ml... 5 duramorph inj 1mg/ml... 5 DUREZOL EMU 0.05%... 137 dutast/tamsu cap 0.5-0.4... 116 dutasteride cap 0.5mg... 116 E econazole cre 1%... 107 EDURANT TAB 25MG... 65 ELAPRASE INJ 6MG/3ML... 111 ELIDEL CRE 1%... 107 ELIGARD INJ 22.5MG... 44 ELIGARD INJ 30MG... 45 ELIGARD INJ 45MG... 45 ELIGARD INJ 7.5MG... 45 ELIQUIS TAB 2.5MG... 77 ELIQUIS TAB 5MG... 77 ELITEK INJ 1.5MG... 45 ELITEK INJ 7.5MG... 45 ELMIRON CAP 100MG... 116 EMBEDA CAP 100-4MG... 2 EMBEDA CAP 20-0.8MG... 2 EMBEDA CAP 30-1.2MG... 2 EMBEDA CAP 50-2MG... 2 EMBEDA CAP 60-2.4MG... 2 EMBEDA CAP 80-3.2MG... 2 EMCYT CAP 140MG... 45 EMEND CAP 40MG... 34 EMEND PAK 80 & 125... 34 EMEND SOL 150MG... 34 EMPLICITI INJ 300MG... 45 EMPLICITI INJ 400MG... 45 EMSAM DIS 12MG/24H... 28 EMSAM DIS 6MG/24HR... 28 EMSAM DIS 9MG/24HR... 28 EMTRIVA CAP 200MG... 66 EMTRIVA SOL 10MG/ML... 66 EMVERM CHW 100MG... 53 enalapr/hctz tab 10-25mg... 88 enalapr/hctz tab 5-12.5mg... 88 154 enalapril tab 10mg... 84 enalapril tab 2.5mg... 84 enalapril tab 20mg... 84 enalapril tab 5mg... 84 ENBREL INJ 25/0.5ML... 127 ENBREL INJ 25MG... 127 ENBREL INJ 50MG/ML... 127 ENBREL SRCLK INJ 50MG/ML... 127 ENGERIX-B INJ 10/0.5ML... 131 ENGERIX-B INJ 20MCG/ML... 131 ENGERIX-B PFSINJ 10/0.5ML... 131 enoxaparin inj 100mg/ml... 77 enoxaparin inj 120/0.8... 77 enoxaparin inj 150mg/ml... 78 enoxaparin inj 30/0.3ml... 78 enoxaparin inj 300/3ml... 78 enoxaparin inj 40/0.4ml... 78 enoxaparin inj 60/0.6ml... 78 enoxaparin inj 80/0.8ml... 78 entacapone tab 200mg... 54 entecavir tab 0.5mg... 63 entecavir tab 1mg... 63 enulose sol 10gm/15... 114 ENVARSUS XR TAB 0.75MG... 127 ENVARSUS XR TAB 1MG... 127 ENVARSUS XR TAB 4MG... 127 EPIPEN 2-PAK INJ 0.3MG... 142 EPIVIR HBV SOL 5MG/ML... 66 eplerenone tab 25mg... 97 eplerenone tab 50mg... 97 EPROSART MES TAB 600MG... 83 EPZICOM TAB 600-300... 66 EQUETRO CAP 100MG... 24 EQUETRO CAP 200MG... 24 EQUETRO CAP 300MG... 24 ERAXIS INJ 50MG... 35 ERBITUX INJ 100MG... 45 ergoloid mes tab 1mg oral... 25 ERGOMAR SUB 2MG... 39 ERIVEDGE CAP 150MG... 45 ERWINAZE INJ 10000UNT... 45 erythrocin inj 500mg... 15 erythrocin tab 250mg... 15 erythrom eth tab 400mg... 15 erythromycin cap 250mg ec... 15 erythromycin gel /benzoyl... 107 erythromycin gel 2%... 107 erythromycin oin 5mg/gm... 135 erythromycin sol 2%... 107

ESBRIET CAP 267MG... 143 escitalopram sol 5mg/5ml... 29 escitalopram tab 10mg... 29 escitalopram tab 20mg... 29 escitalopram tab 5mg... 29 ESOMEPRAZOLE INJ 20MG... 115 estazolam tab 1mg... 144 estazolam tab 2mg... 144 estradiol tab 0.5mg... 120 estradiol tab 1mg... 120 estradiol tab 2mg... 120 ethambutol tab 100mg... 40 ethambutol tab 400mg... 40 ethosuximide cap 250mg... 19 ethosuximide sol 250/5ml... 19 etodolac cap 200mg... 37 etodolac cap 300mg... 37 etodolac er tab 400mg... 37 etodolac er tab 500mg... 37 etodolac er tab 600mg... 37 etodolac tab 400mg... 37 etodolac tab 500mg... 37 ETOPOPHOS INJ 100MG... 45 etoposide inj 500/25ml... 45 EURAX CRE 10%... 107 EVOTAZ TAB 300-150... 66 EXELON DIS 13.3/24... 25 EXELON DIS 4.6MG/24... 25 EXELON DIS 9.5MG/24... 26 exemestane tab 25mg... 52 EXJADE TAB 125MG... 145 EXJADE TAB 250MG... 145 EXJADE TAB 500MG... 145 F FABRAZYME INJ 35MG... 111 famciclovir tab 125mg... 65 famciclovir tab 250mg... 65 famciclovir tab 500mg... 65 famotidine inj 200/20ml... 113 FAMOTIDINE INJ 20MG/50M... 113 famotidine tab 20mg... 113 famotidine tab 40mg... 114 FANAPT PAK... 59 FANAPT TAB 10MG... 59 FANAPT TAB 12MG... 59 FANAPT TAB 1MG... 59 FANAPT TAB 2MG... 59 FANAPT TAB 4MG... 59 155 FANAPT TAB 6MG... 59 FANAPT TAB 8MG... 59 FARESTON TAB 60MG... 45 FARYDAK CAP 10MG... 45 FARYDAK CAP 15MG... 45 FARYDAK CAP 20MG... 45 FASLODEX INJ 250MG... 45 felbamate sus 600/5ml... 21 felbamate tab 400mg... 21 felbamate tab 600mg... 21 felodipine tab 10mg er... 93 felodipine tab 2.5mg er... 93 felodipine tab 5mg er... 93 fenofibrate cap 134mg... 98 fenofibrate cap 150mg... 98 fenofibrate cap 200mg... 98 fenofibrate cap 50mg... 98 fenofibrate cap 67mg... 98 fenofibrate tab 145mg... 98 fenofibrate tab 160mg... 98 FENOFIBRATE TAB 40MG... 98 fenofibrate tab 48mg... 98 fenofibrate tab 54mg... 98 FENOFIBRIC TAB 105MG... 99 FENOFIBRIC TAB 35MG... 100 fenoprofen tab 600mg... 37 fentanyl dis 100mcg/h... 2 fentanyl dis 12mcg/hr... 2 fentanyl dis 25mcg/hr... 2 fentanyl dis 37.5mcg... 2 fentanyl dis 50mcg/hr... 2 fentanyl dis 62.5mcg... 2 fentanyl dis 75mcg/hr... 2 fentanyl dis 87.5mcg... 2 FENTORA TAB 200MCG... 5 FENTORA TAB 400MCG... 5 FENTORA TAB 600MCG... 5 FENTORA TAB 800MCG... 5 FERRIPROX SOL 100MG/ML... 145 FERRIPROX TAB 500MG... 145 FETZIMA CAP 120MG... 29 FETZIMA CAP 20MG... 29 FETZIMA CAP 40MG... 29 FETZIMA CAP 80MG... 29 FETZIMA CAP TITRATIO... 134 finasteride tab 5mg... 116 FIRAZYR INJ 30MG/3ML... 134 FIRMAGON INJ 120MG... 45 FIRMAGON INJ 80MG... 45

FLEBOGAMMA INJ DIF 10%... 129 flecainide tab 100mg... 85 flecainide tab 150mg... 85 flecainide tab 50mg... 85 FLOVENT DISK AER 100MCG... 139 FLOVENT DISK AER 250MCG... 139 FLOVENT DISK AER 50MCG... 139 FLOVENT HFA AER 110MCG... 139 FLOVENT HFA AER 220MCG... 139 FLOVENT HFA AER 44MCG... 139 fluconazole sus 10mg/ml... 35 fluconazole sus 40mg/ml... 35 fluconazole tab 100mg... 35 fluconazole tab 150mg... 35 fluconazole tab 200mg... 35 fluconazole tab 50mg... 35 fluconazole/ inj dex 400... 35 fluconazole/ inj nacl 200... 35 flucytosine cap 250mg... 35 flucytosine cap 500mg... 35 fludarabine inj 50mg... 42 fludrocort tab 0.1mg... 117 flunisolide spr 0.025%... 141 fluocin acet cre 0.01%... 108 fluocin acet cre 0.025%... 108 fluocin acet oil 0.01%... 138 fluocin acet oil 0.01%bdy... 108 fluocin acet oin 0.025%... 108 fluocin acet sol 0.01%... 108 fluocinonide cre 0.05%... 108 fluocinonide gel 0.05%... 108 fluocinonide oin 0.05%... 108 fluocinonide sol 0.05%... 108 fluorouracil cre 5%... 108 fluorouracil dro 2%... 45 fluorouracil dro 5%... 45 fluorouracil inj 5gm/100m... 45 fluoxetine cap 10mg... 29 fluoxetine cap 20mg... 29 fluoxetine cap 40mg... 29 fluoxetine cap 90mg dr... 29 fluoxetine sol 20mg/5ml... 29 fluoxetine tab 10mg... 30 fluoxetine tab 20mg... 30 FLUOXETINE TAB 60MG... 30 fluphenaz de inj 25mg/ml... 56 fluphenazine con 5mg/ml... 56 fluphenazine elx 2.5/5ml... 56 fluphenazine inj 2.5mg/ml... 56 156 fluphenazine tab 10mg... 56 fluphenazine tab 1mg... 56 fluphenazine tab 2.5mg... 56 fluphenazine tab 5mg... 56 flurazepam cap 15mg... 144 flurazepam cap 30mg... 144 flurbiprofen sol 0.03% op... 137 flurbiprofen tab 100mg... 37 flurbiprofen tab 50mg... 37 flutamide cap 125mg... 46 fluticasone cre 0.05%... 108 fluticasone oin 0.005%... 108 fluticasone spr 50mcg... 141 fluvastatin cap 20mg... 98 fluvastatin cap 40mg... 98 fluvastatin tab 80mg er... 98 fluvoxamine cap 100mg er... 30 fluvoxamine cap 150mg er... 30 fluvoxamine tab 100mg... 30 fluvoxamine tab 25mg... 30 fluvoxamine tab 50mg... 30 FOLOTYN INJ 40MG/2ML... 46 fondaparinux inj 10/0.8ml... 78 fondaparinux inj 2.5/0.5... 78 fondaparinux inj 5/0.4ml... 78 fondaparinux inj 7.5/0.6... 78 FORFIVO XL TAB 450MG... 27 FORTEO SOL 600/2.4... 133 FOSAMAX + D TAB 70-2800... 133 FOSAMAX + D TAB 70-5600... 133 fosinop/hctz tab 10/12.5... 88 fosinop/hctz tab 20/12.5... 88 fosinopril tab 10mg... 84 fosinopril tab 20mg... 84 fosinopril tab 40mg... 84 fosphenytoin inj 100/2ml... 24 FRAGMIN INJ 10000/ML... 78 FRAGMIN INJ 12500UNT... 78 FRAGMIN INJ 15000UNT... 78 FRAGMIN INJ 18000UNT... 78 FRAGMIN INJ 2500/0.2... 78 FRAGMIN INJ 5000/0.2... 78 FRAGMIN INJ 7500/0.3... 78 FRAGMIN INJ 95000UNT... 78 FREAMINE HBC INJ 6.9%... 149 frovatriptan tab 2.5mg... 39 furosemide inj 10mg/ml... 96 furosemide tab 20mg... 96 furosemide tab 40mg... 96

furosemide tab 80mg... 96 FUZEON INJ 90MG... 67 fyavolv tab 0.5-2.5... 120 fyavolv tab 1-5... 121 FYCOMPA SUS 0.5MG/ML... 20 FYCOMPA TAB 10MG... 20 FYCOMPA TAB 12MG... 20 FYCOMPA TAB 2MG... 20 FYCOMPA TAB 4MG... 20 FYCOMPA TAB 6MG... 20 FYCOMPA TAB 8MG... 20 G gabapentin cap 100mg... 20 gabapentin cap 300mg... 20 gabapentin cap 400mg... 21 gabapentin sol 300/6ml... 21 gabapentin tab 600mg... 21 gabapentin tab 800mg... 21 GABITRIL TAB 12MG... 21 GABITRIL TAB 16MG... 21 galantamine cap 16mg er... 26 galantamine cap 24mg er... 26 galantamine cap 8mg er... 26 GALANTAMINE SOL 4MG/ML... 26 galantamine tab 12mg... 26 galantamine tab 4mg... 26 galantamine tab 8mg... 26 GAMASTAN S/D INJ... 129 GAMMAGARD INJ 2.5GM/25... 129 GAMMAKED INJ 20GM/200... 129 GAMMAPLEX INJ 20GM... 129 GAMUNEX-C INJ 40/400ML... 129 ganciclovir inj 500mg... 63 GARDASIL 9 INJ SYRNG... 131 GARDASIL 9 INJ VIAL... 131 GARDASIL INJ SYRNG... 131 GARDASIL INJ VIAL... 131 GATTEX KIT 5MG... 113 GAUZE PADS & DRESSINGS - PADS... 73 gemcitabine inj 1gm... 42 gemfibrozil tab 600mg... 98 generlac sol 10gm/15... 114 gengraf cap 100mg... 127 gengraf cap 25mg... 127 gengraf sol 100mg/ml... 127 gentam/nacl inj 100mg... 8 gentam/nacl inj 60mg pb... 8 gentam/nacl inj 80mg/50ml... 8 157 gentamicin cre 0.1%... 108 gentamicin inj 10mg/ml... 8 gentamicin inj 40mg/ml... 8 gentamicin oin 0.1%... 108 gentamicin oin 0.3% op... 135 gentamicin sol 0.3% op... 135 GENVOYA TAB... 65 GEODON INJ 20MG... 59 GILENYA CAP 0.5MG... 104 GILOTRIF TAB 20MG... 46 GILOTRIF TAB 30MG... 46 GILOTRIF TAB 40MG... 46 GLEEVEC TAB 100MG... 46 GLEEVEC TAB 400MG... 46 GLEOSTINE CAP 5MG... 41 glimepiride tab 1mg... 73 glimepiride tab 2mg... 73 glimepiride tab 4mg... 73 glip/metform tab 2.5-250m... 73 glip/metform tab 2.5-500m... 73 glip/metform tab 5-500mg... 73 glipizide er tab 10mg... 73 glipizide er tab 2.5mg... 73 glipizide er tab 5mg... 73 glipizide tab 10mg... 73 glipizide tab 5mg... 73 GLUCAGEN INJ 1MG... 76 GLUCAGON INJ 1MG... 77 glyb/metform tab 1.25-250... 73 glyb/metform tab 2.5-500... 73 glyb/metform tab 5-500mg... 73 glyburid mcr tab 1.5mg... 74 glyburid mcr tab 3mg... 74 glyburid mcr tab 6mg... 74 glyburide tab 1.25mg... 74 glyburide tab 2.5mg... 74 glyburide tab 5mg... 74 granisetron inj 0.1mg/ml... 34 granisetron inj 1mg/ml... 34 granisetron tab 1mg... 34 griseofulvin sus 125/5ml... 35 guanfacine tab 1mg er... 102 guanfacine tab 2mg er... 102 guanfacine tab 3mg er... 102 guanfacine tab 4mg er... 102 GUANIDINE TAB 125MG... 40 H HALAVEN INJ 1MG/2ML... 46

halobetasol cre 0.05%... 108 halobetasol oin 0.05%... 108 haloper dec inj 100mg/ml... 56 haloper dec inj 50mg/ml... 56 haloper lac inj 5mg/ml... 56 haloperidol con 2mg/ml... 56 haloperidol tab 0.5mg... 56 haloperidol tab 10mg... 56 haloperidol tab 1mg... 56 haloperidol tab 20mg... 57 haloperidol tab 2mg... 57 haloperidol tab 5mg... 57 HARVONI TAB 90-400MG... 63 HAVRIX INJ 1440UNIT... 131 HAVRIX INJ 720UNIT... 131 hc valerate cre 0.2%... 108 hc valerate oin 0.2%... 108 hep sod/d5w inj 20000unt... 78 HEP SOD/D5W INJ 25000UNT 100U... 78 hep sod/d5w inj 25000unt 50u/... 78 heparin sod inj 1000/ml... 78 heparin sod inj 10000/ml... 78 heparin sod inj 20000/ml... 79 heparin sod inj 5000/ml... 79 HEPATAMINE SOL 8%... 149 HERCEPTIN INJ 440MG... 46 HETLIOZ CAP 20MG... 144 HEXALEN CAP 50MG... 41 HIBERIX SOL 10MCG... 131 HUMIRA INJ 10MG/0.2... 127 HUMIRA KIT 20MG/0.4... 127 HUMIRA KIT 40MG/0.8... 127 HUMIRA PEDIA INJ CROHNS 3 CT... 127 HUMIRA PEDIA INJ CROHNS 6 CT... 127 HUMIRA PEN INJ 40MG/0.8... 127 HUMIRA PEN INJ CROHNS... 127 hydralazine inj 20mg/ml... 100 hydralazine tab 100mg... 100 hydralazine tab 10mg... 100 hydralazine tab 25mg... 100 hydralazine tab 50mg... 100 hydrochlorot cap 12.5mg... 97 hydrochlorot tab 12.5mg... 97 hydrochlorot tab 25mg... 97 hydrochlorot tab 50mg... 97 hydroco/apap sol 7.5-325... 5 hydroco/apap tab 10-325mg... 5 hydroco/apap tab 2.5-325... 5 hydroco/apap tab 5-325mg... 5 158 hydroco/apap tab 7.5-325... 5 hydrocod/ibu tab 10-200mg... 5 hydrocod/ibu tab 5-200mg... 5 hydrocod/ibu tab 7.5-200... 5 hydrocort cre 1%... 108 hydrocort lot 2.5%... 108 hydrocort oin 1%... 108 hydrocort oin 2.5%... 108 hydrocort tab 10mg... 118 hydrocort tab 5mg... 118 hydrocortiso cre 2.5%... 108 hydromorphon inj 10mg/ml... 5 hydromorphon inj 2mg/ml... 5 hydromorphon inj 50mg/5ml... 5 hydromorphon liq 1mg/ml... 2 hydromorphon tab 2mg... 5 hydromorphon tab 4mg... 5 hydromorphon tab 8mg... 5 hydroxy capr inj 1.25/5ml... 46 hydroxychlor tab 200mg... 53 hydroxyurea cap 500mg... 46 hydroxyz hcl inj 25mg/ml... 70 hydroxyz hcl inj 50mg/ml... 70 hydroxyz hcl syp 10mg/5ml... 70 hydroxyz hcl tab 10mg... 70 hydroxyz hcl tab 25mg... 70 hydroxyz hcl tab 50mg... 70 hydroxyz pam cap 100mg... 70 hydroxyz pam cap 25mg... 70 hydroxyz pam cap 50mg... 70 HYPERRAB S/D INJ 150/ML 10ML... 129 HYPERRAB S/D INJ 150/ML 2ML V... 129 I ibandronate tab 150mg... 133 IBRANCE CAP 100MG... 46 IBRANCE CAP 125MG... 46 IBRANCE CAP 75MG... 46 ibuprofen sus 100/5ml... 37 ibuprofen tab 400mg... 37 ibuprofen tab 600mg... 37 ibuprofen tab 800mg... 37 ICLUSIG TAB 15MG... 46 ICLUSIG TAB 45MG... 46 idarubicin inj 10/10ml... 46 ifosfamide inj 1gm... 46 ILARIS INJ 180MG... 130 ILEVRO DRO 0.3% OP... 137 IMBRUVICA CAP 140MG... 46

imipenem/cil inj 250mg... 12 imipenem/cil inj 500mg... 12 imipram hcl tab 10mg... 33 imipram hcl tab 25mg... 33 imipram hcl tab 50mg... 33 imipram pam cap 100mg... 33 imipram pam cap 125mg... 33 imipram pam cap 150mg... 33 imipram pam cap 75mg... 33 imiquimod cre 5%... 109 IMOVAX RABIE INJ 2.5/ML... 131 INCRELEX INJ 40MG/4ML... 122 indapamide tab 1.25mg... 97 indapamide tab 2.5mg... 97 indomethacin cap 25mg... 37 indomethacin cap 50mg... 37 indomethacin cap 75mg er... 37 INFANRIX INJ... 131 INLYTA TAB 1MG... 46 INLYTA TAB 5MG... 46 INSULIN PEN NEEDLE... 74 INSULIN SYRINGE (DISP) U-100... 74 INTELENCE TAB 100MG... 65 INTELENCE TAB 200MG... 65 INTELENCE TAB 25MG... 65 INTRON A INJ 10MU... 46 INTRON A INJ 50MU... 46 INTRON-A INJ 18MU POW... 47 INTRON-A INJ 18MU SOL... 47 INVANZ INJ 1GM... 12 INVEGA SUST INJ 117/0.75... 59 INVEGA SUST INJ 156MG/ML... 59 INVEGA SUST INJ 234/1.5... 59 INVEGA SUST INJ 39/0.25... 59 INVEGA SUST INJ 78/0.5ML... 59 INVEGA TRINZ INJ 273MG... 59 INVEGA TRINZ INJ 410MG... 59 INVEGA TRINZ INJ 546MG... 59 INVEGA TRINZ INJ 819MG... 59 INVIRASE CAP 200MG... 68 INVIRASE TAB 500MG... 68 INVOKAMET TAB 150-1000... 74 INVOKAMET TAB 150-500... 74 INVOKAMET TAB 50-1000... 74 INVOKAMET TAB 50-500MG... 74 INVOKANA TAB 100MG... 74 INVOKANA TAB 300MG... 74 IPOL INJ INACTIVE... 131 ipratropium sol 0.02%inh... 140 159 ipratropium spr 0.03%... 142 ipratropium spr 0.06%... 142 ipratropium/ sol albuter... 141 irbesar/hctz tab 150-12.5... 88 irbesar/hctz tab 300-12.5... 88 irbesartan tab 150mg... 83 irbesartan tab 300mg... 83 irbesartan tab 75mg... 83 IRESSA TAB 250MG... 47 irinotecan inj 100/5ml... 47 ISENTRESS CHW 100MG... 67 ISENTRESS CHW 25MG... 68 ISENTRESS POW 100MG... 68 ISENTRESS TAB 400MG... 68 ISOLYTE-P INJ /D5W... 146 ISOLYTE-S INJ... 146 isoniazid inj 100mg/ml... 40 isoniazid syp 50mg/5ml... 40 isoniazid tab 100mg... 40 isoniazid tab 300mg... 40 isosorb din tab 10mg... 101 isosorb din tab 20mg... 101 isosorb din tab 30mg... 101 ISOSORB DIN TAB 40MG ER... 101 isosorb din tab 5mg... 101 isosorb mono tab 10mg... 101 isosorb mono tab 120mg er... 101 isosorb mono tab 20mg... 101 isosorb mono tab 30mg er... 101 isosorb mono tab 60mg er... 101 isradipine cap 2.5mg... 93 isradipine cap 5mg... 94 ISTODAX INJ 10MG... 47 itraconazole cap 100mg... 35 ivermectin tab 3mg... 53 IXIARO INJ... 131 J JAKAFI TAB 10MG... 47 JAKAFI TAB 15MG... 47 JAKAFI TAB 20MG... 47 JAKAFI TAB 25MG... 47 JAKAFI TAB 5MG... 47 jantoven tab 10mg... 79 jantoven tab 1mg... 79 jantoven tab 2.5mg... 79 jantoven tab 2mg... 79 jantoven tab 3mg... 79 jantoven tab 4mg... 79

jantoven tab 5mg... 79 jantoven tab 6mg... 79 jantoven tab 7.5mg... 79 JANUMET TAB 50-1000... 74 JANUMET TAB 50-500MG... 74 JANUMET XR TAB 100-1000... 74 JANUMET XR TAB 50-1000... 74 JANUMET XR TAB 50-500MG... 74 JANUVIA TAB 100MG... 74 JANUVIA TAB 25MG... 74 JANUVIA TAB 50MG... 75 JARDIANCE TAB 10MG... 75 JARDIANCE TAB 25MG... 75 JENTADUETO TAB 2.5-1000... 75 JENTADUETO TAB 2.5-500... 75 JENTADUETO TAB 2.5-850... 75 JENTADUETO TAB XR 2.5-1000 MG... 75 JENTADUETO TAB XR 5-1000 MG... 75 JEVTANA INJ 60/1.5ML... 47 juleber tab... 120 JUXTAPID CAP 10MG... 100 JUXTAPID CAP 20MG... 100 JUXTAPID CAP 5MG... 100 K KADCYLA INJ 100MG... 47 kaitlib fe chw... 120 KALETRA SOL... 68 KALETRA TAB 100-25MG... 68 KALETRA TAB 200-50MG... 68 KALYDECO PAK 50MG... 143 KALYDECO PAK 75MG... 143 KALYDECO TAB 150MG... 143 kcl in nacl inj... 146 kcl/d5w inj 0.15%... 146 kcl/d5w inj 0.3%... 146 kcl/d5w/lr inj 0.15%... 146 kcl/d5w/nacl inj.075/.45... 146 kcl/d5w/nacl inj.15/.33%... 146 kcl/d5w/nacl inj.15/.45%... 146 kcl/d5w/nacl inj.224/.45... 146 kcl/d5w/nacl inj 0.3/0.45... 146 kcl/d5w/nacl inj 20meq/0.5/0.... 146 kcl/nacl inj 0.15-0.9... 146 KEPIVANCE INJ 6.25MG... 47 KETEK TAB 300MG... 15 KETEK TAB 400MG... 15 ketoconazole cre 2%... 109 ketoconazole sha 2%... 109 160 ketoconazole tab 200mg... 35 ketoprofen cap 200mg er... 38 ketoprofen cap 50mg... 38 ketoprofen cap 75mg... 38 ketorolac inj 15mg/ml... 38 ketorolac inj 30mg/ml... 38 ketorolac inj 60mg/2ml... 38 ketorolac sol 0.4%... 137 ketorolac sol 0.5%... 137 ketorolac tab 10mg... 38 KEYTRUDA INJ 100MG/4M... 47 KEYTRUDA SOL 50MG... 47 kimidess tab... 120 KINERET INJ... 128 kionex sus 15gm/60... 145 klor-con 10 tab 10meq er... 146 KORLYM TAB 300MG... 125 KUVAN POW 100MG... 111 KUVAN POW 500MG... 111 KUVAN TAB 100MG... 111 KYNAMRO INJ 200MG/ML... 100 L labetalol inj 5mg/ml... 91 labetalol tab 100mg... 91 labetalol tab 200mg... 91 labetalol tab 300mg... 91 lactated rin inj... 146 lactated rin sol irrigat... 134 lactulose sol 20gm/30... 114 LAMICTAL KIT START 35... 21 LAMICTAL KIT START 49... 21 LAMICTAL KIT START 98... 21 LAMICTAL XR KIT 25 & 50... 21 LAMICTAL XR KIT 25 & 50 & 100... 22 LAMICTAL XR KIT 50 & 100 & 20... 22 lamivud/zido tab 150-300... 66 lamivudine sol 10mg/ml... 66 lamivudine tab 100mg... 66 lamivudine tab 150mg... 66 lamivudine tab 300mg... 66 lamotrigine chw 25mg... 22 lamotrigine chw 5mg... 22 lamotrigine tab 100mg... 22 lamotrigine tab 100mg er... 22 lamotrigine tab 100mg odt... 22 lamotrigine tab 150mg... 22 lamotrigine tab 200mg... 22 lamotrigine tab 200mg er... 22

lamotrigine tab 200mg odt... 22 lamotrigine tab 250mg er... 22 lamotrigine tab 25mg... 22 lamotrigine tab 25mg er... 22 lamotrigine tab 25mg odt... 22 lamotrigine tab 300mg er... 22 lamotrigine tab 50mg er... 22 lamotrigine tab 50mg odt... 22 lansoprazole cap 15mg dr... 115 lansoprazole cap 30mg dr... 115 LANTUS INJ 100/ML... 77 LANTUS INJ SOLOSTAR... 77 latanoprost sol 0.005%... 135 LATUDA TAB 120MG... 60 LATUDA TAB 20MG... 60 LATUDA TAB 40MG... 60 LATUDA TAB 60MG... 60 LATUDA TAB 80MG... 60 LAZANDA SPR 100MCG... 6 LAZANDA SPR 300MCG... 6 LAZANDA SPR 400MCG... 6 leflunomide tab 10mg... 130 leflunomide tab 20mg... 130 LENVIMA CAP 10 MG... 47 LENVIMA CAP 14 MG... 47 LENVIMA CAP 18 MG... 47 LENVIMA CAP 20 MG... 47 LENVIMA CAP 24 MG... 47 LENVIMA CAP 8 MG... 47 LETAIRIS TAB 10MG... 142 LETAIRIS TAB 5MG... 142 letrozole tab 2.5mg... 52 leucovor ca inj 100mg... 47 leucovor ca inj 350mg... 47 leucovor ca tab 10mg... 48 leucovor ca tab 15mg... 48 leucovor ca tab 25mg... 48 leucovor ca tab 5mg... 48 LEUKERAN TAB 2MG... 41 LEUKINE INJ 250MCG... 80 leuprolide inj 1mg/0.2... 48 LEVEMIR INJ... 77 LEVEMIR INJ FLEXTOUC... 77 LEVETIRACETA INJ 10MG/ML... 17 LEVETIRACETA INJ 15MG/ML... 17 LEVETIRACETA INJ 5MG/ML... 17 levetiraceta sol 100mg/ml... 17 levetiraceta tab 1000mg... 17 levetiraceta tab 250mg... 18 161 levetiraceta tab 500mg... 18 levetiraceta tab 500mg er... 18 levetiraceta tab 750mg... 18 levetiraceta tab 750mg er... 18 levetiracetm inj 500/5ml... 18 levobunolol sol 0.5% op... 136 levocarnitin sol 1gm/10ml... 111 levocarnitin tab 330mg... 111 levoflox/d5w inj 500/100m... 16 levoflox/d5w inj 750/150... 16 levofloxacin inj 25mg/ml... 16 levofloxacin sol 25mg/ml... 16 levofloxacin tab 250mg... 16 levofloxacin tab 500mg... 16 levofloxacin tab 750mg... 16 levoleucovor inj 50mg... 48 levonor/ethi tab... 120 levothyroxin tab 100mcg... 122 levothyroxin tab 112mcg... 122 levothyroxin tab 125mcg... 122 levothyroxin tab 137mcg... 123 levothyroxin tab 150mcg... 123 levothyroxin tab 175mcg... 123 levothyroxin tab 200mcg... 123 levothyroxin tab 25mcg... 123 levothyroxin tab 300mcg... 123 levothyroxin tab 50mcg... 123 levothyroxin tab 75mcg... 123 levothyroxin tab 88mcg... 123 levoxyl tab 100mcg... 123 levoxyl tab 112mcg... 123 levoxyl tab 125mcg... 123 levoxyl tab 137mcg... 123 levoxyl tab 150mcg... 123 levoxyl tab 175mcg... 123 levoxyl tab 200mcg... 123 levoxyl tab 25mcg... 123 levoxyl tab 50mcg... 123 levoxyl tab 75mcg... 123 levoxyl tab 88mcg... 123 LEXIVA SUS 50MG/ML... 68 LEXIVA TAB 700MG... 69 LIALDA TAB 1.2GM... 132 lido/prilocn cre 2.5-2.5%... 7 lidocaine gel 2% jelly... 109 lidocaine hcl gel 10ml/2% jel... 7 lidocaine inj 0.5%... 7 lidocaine inj 2%... 7 lidocaine oin 5%... 109

lidocaine pad 5%... 109 lidocaine sol 4%... 109 lincomycin inj 300mg/ml... 9 lindane sha 1%... 109 linezolid inj 2mg/ml... 9 linezolid sus 100/5ml... 9 linezolid tab 600mg... 10 LINZESS CAP 145MCG... 114 LINZESS CAP 290MCG... 114 liothyronine tab 25mcg... 123 liothyronine tab 50mcg... 123 liothyronine tab 5mcg... 123 lisinop/hctz tab 10-12.5... 88 lisinop/hctz tab 20-12.5... 88 lisinop/hctz tab 20-25mg... 88 lisinopril tab 10mg... 84 lisinopril tab 2.5mg... 84 lisinopril tab 20mg... 84 lisinopril tab 30mg... 84 lisinopril tab 40mg... 84 lisinopril tab 5mg... 84 lithium carb cap 150mg... 72 lithium carb cap 300mg... 72 lithium carb cap 600mg... 72 lithium carb tab 300mg... 72 lithium carb tab 300mg er... 72 lithium carb tab 450mg er... 72 lithium sol 8meq/5ml... 72 LIVALO TAB 1MG... 98 LIVALO TAB 2MG... 99 LIVALO TAB 4MG... 99 LONSURF TAB 15-6.14... 48 LONSURF TAB 20-8.19... 48 loperamide cap 2mg... 113 lorazepam con 2mg/ml... 71 lorazepam tab 0.5mg... 71 lorazepam tab 1mg... 71 lorazepam tab 2mg... 72 losartan pot tab 100mg... 83 losartan pot tab 25mg... 83 losartan pot tab 50mg... 83 losartan/hct tab 100-12.5... 88 losartan/hct tab 100-25... 88 losartan/hct tab 50-12.5... 88 LOTEMAX GEL 0.5%... 137 LOTEMAX OIN 0.5%... 137 LOTEMAX SUS 0.5%... 137 lovastatin tab 10mg... 99 lovastatin tab 20mg... 99 162 lovastatin tab 40mg... 99 loxapine cap 10mg... 57 loxapine cap 25mg... 57 loxapine cap 50mg... 57 loxapine cap 5mg... 57 LUMIGAN SOL 0.01%... 135 LUMIZYME INJ 50MG... 112 LUPR DEP-PED INJ 11.25MG... 125 LUPR DEP-PED INJ 15MG... 125 LUPR DEP-PED INJ 30MG... 48 LUPRON DEPOT INJ 11.25MG... 125 LUPRON DEPOT INJ 22.5MG... 48 LUPRON DEPOT INJ 3.75MG... 48 LUPRON DEPOT INJ 45MG... 48 LUPRON DEPOT INJ 7.5MG... 48 LYNPARZA CAP 50MG... 48 LYRICA CAP 100MG... 104 LYRICA CAP 150MG... 104 LYRICA CAP 200MG... 19 LYRICA CAP 225MG... 20 LYRICA CAP 25MG... 20 LYRICA CAP 300MG... 20 LYRICA CAP 50MG... 20 LYRICA CAP 75MG... 20 LYRICA SOL 20MG/ML... 20 LYSODREN TAB 500MG... 48 lyza tab 0.35mg... 120 M magnesium su inj 50%... 146 magnesium su pfs inj 50%... 146 MAKENA INJ 250MG/ML... 121 maprotiline tab 25mg... 27 maprotiline tab 50mg... 27 maprotiline tab 75mg... 27 MARPLAN TAB 10MG... 28 MATULANE CAP 50MG... 48 meclizine tab 12.5mg... 34 meclizine tab 25mg... 34 meclofen sod cap 100mg... 38 meclofen sod cap 50mg... 38 medroxypr ac inj 150mg/ml... 120 medroxypr ac tab 10mg... 121 medroxypr ac tab 2.5mg... 121 medroxypr ac tab 5mg... 121 mefloquine tab 250mg... 53 MEGACE ES SUS 625/5ML... 48 megestrol ac sus 40mg/ml... 48 megestrol ac tab 20mg... 48

megestrol ac tab 40mg... 48 megestrol sus 625mg/5m... 48 MEKINIST TAB 0.5MG... 48 MEKINIST TAB 2MG... 48 meloxicam sus 7.5/5ml... 38 meloxicam tab 15mg... 38 meloxicam tab 7.5mg... 38 melphalan inj 50mg... 49 memantine hc sol 2mg/ml... 26 MENACTRA INJ... 131 MENEST TAB 0.3MG... 121 MENEST TAB 0.625MG... 121 MENEST TAB 1.25MG... 121 MENEST TAB 2.5MG... 121 MENHIBRIX INJ... 131 MENOMUNE INJ A/C/Y/W... 131 MENVEO INJ... 131 meprobamate tab 200mg... 70 meprobamate tab 400mg... 70 mercaptopur tab 50mg... 42 meropenem inj 500mg... 12 mesalamine ene 4gm... 133 mesna inj 1gm... 49 MESNEX TAB 400MG... 49 MESTINON SYP 60MG/5ML... 40 metformin er tab 1000mg... 75 metformin tab 1000mg... 75 metformin tab 500mg... 75 metformin tab 500mg er... 75 metformin tab 750mg er... 75 metformin tab 850mg... 75 METHADONE INJ 10MG/ML... 2 methadone sol 10mg/5ml... 2 methadone sol 5mg/5ml... 2 methadone tab 10mg... 2 methadone tab 5mg... 2 methazolamid tab 25mg... 96 methazolamid tab 50mg... 96 methimazole tab 10mg... 126 methimazole tab 5mg... 126 methlphenida chw 2.5mg... 102 methocarbam tab 500mg... 143 methocarbam tab 750mg... 143 methotrexate inj 1gm... 42 methotrexate inj 1gm/40ml... 42 methotrexate tab 2.5mg... 42 methoxsalen cap 10mg... 109 methscopolam tab 2.5mg... 113 methyclothia tab 5mg... 97 163 methyld/hctz tab 250/15... 88 methyld/hctz tab 250/25... 88 methyldopa tab 250mg... 82 methyldopa tab 500mg... 82 methyldopate inj 250/5ml... 82 methylphenid cap 10mg... 103 methylphenid chw 10mg... 103 methylphenid chw 5mg... 103 methylphenid sol 10mg/5ml... 103 methylphenid sol 5mg/5ml... 103 methylphenid tab 10mg... 103 methylphenid tab 20mg... 103 methylphenid tab 20mg er... 103 METHYLPHENID TAB 27MG ER... 103 methylphenid tab 5mg... 103 methylpr ace inj 40mg/ml... 118 methylpr ace inj 80mg/ml... 118 methylpr ss inj 1000mg... 118 methylpr ss inj 40mg... 118 methylpred pak 4mg... 118 methylpred tab 16mg... 118 methylpred tab 32mg... 118 methylpred tab 4mg... 118 methylpred tab 8mg... 118 methyltestos cap 10mg... 119 metipranolol sol 0.3% oph... 137 metoclopram inj 5mg/ml... 113 metoclopram sol 5mg/5ml... 113 metoclopram tab 10mg... 113 metoclopram tab 5mg... 34 metolazone tab 10mg... 97 metolazone tab 2.5mg... 98 metolazone tab 5mg... 98 metoprl/hctz tab 100-25mg... 88 metoprl/hctz tab 100-50mg... 88 metoprl/hctz tab 50-25mg... 88 metoprol tar tab 100mg... 91 metoprol tar tab 25mg... 91 metoprol tar tab 50mg... 91 metoprolol inj 1mg/ml... 91 metoprolol inj 5mg/5ml... 91 metoprolol tab 100mg er... 91 metoprolol tab 200mg er... 91 metoprolol tab 25mg er... 91 metoprolol tab 50mg er... 91 metron/nacl inj 500mg... 10 metronidazol cap 375mg... 10 metronidazol cre 0.75%... 109 metronidazol gel 0.75%... 109

metronidazol gel 0.75%vag... 117 metronidazol lot 0.75%... 109 metronidazol tab 250mg... 10 metronidazol tab 500mg... 10 mexiletine cap 150mg... 85 mexiletine cap 200mg... 85 mexiletine cap 250mg... 85 MIACALCIN INJ 200/ML... 133 miconazole 3 sup 200mg... 117 midodrine tab 10mg... 82 midodrine tab 2.5mg... 82 midodrine tab 5mg... 82 miglitol tab 100mg... 75 miglitol tab 25mg... 75 miglitol tab 50mg... 75 minitran dis 0.1mg/hr... 101 minitran dis 0.2mg/hr... 101 minitran dis 0.4mg/hr... 101 minitran dis 0.6mg/hr... 101 minocycline cap 100mg... 17 minocycline cap 50mg... 17 minocycline cap 75mg... 17 minocycline tab 100mg... 17 minocycline tab 50mg... 17 minocycline tab 75mg... 17 minoxidil tab 10mg... 101 minoxidil tab 2.5mg... 101 MIRCERA INJ 100MCG... 80 MIRCERA INJ 50MCG... 80 MIRCERA INJ 75MCG... 80 mirtazapine tab 15mg... 27 mirtazapine tab 15mg odt... 27 mirtazapine tab 30mg... 27 mirtazapine tab 30mg odt... 27 mirtazapine tab 45mg... 27 mirtazapine tab 45mg odt... 27 mirtazapine tab 7.5mg... 27 misoprostol tab 100mcg... 115 misoprostol tab 200mcg... 115 mitomycin inj 20mg... 49 mitomycin inj 40mg... 49 MITOMYCIN INJ 5MG... 49 mitoxantron inj 2mg/ml... 49 M-M-R II INJ... 131 modafinil tab 100mg... 145 modafinil tab 200mg... 145 moexipr/hctz tab 15-12.5... 88 moexipr/hctz tab 15-25mg... 88 moexipr/hctz tab 7.5-12.5... 88 164 moexipril tab 15mg... 84 moexipril tab 7.5mg... 84 MOLINDONE TAB HCL 10MG... 57 MOLINDONE TAB HCL 25MG... 57 MOLINDONE TAB HCL 5MG... 57 mometasone cre 0.1%... 109 mometasone oin 0.1%... 109 mometasone spr 50mcg... 142 montelukast chw 4mg... 139 montelukast chw 5mg... 139 montelukast gra 4mg... 139 montelukast tab 10mg... 139 MORPHINE SUL BEADS CAP 30MG E... 3 MORPHINE SUL BEADS CAP 60MG E... 3 morphine sul cap 100mg er... 3 morphine sul cap 10mg er... 3 MORPHINE SUL CAP 120MG ER... 3 morphine sul cap 20mg er... 3 morphine sul cap 30mg er... 3 MORPHINE SUL CAP 45MG ER... 3 morphine sul cap 50mg er... 3 morphine sul cap 60mg er... 3 MORPHINE SUL CAP 75MG ER... 3 morphine sul cap 80mg er... 3 MORPHINE SUL CAP 90MG ER... 3 morphine sul sol 100/5ml... 6 morphine sul sol 10mg/5ml... 6 morphine sul sol 20mg/5ml... 6 morphine sul tab 100mg er... 3 morphine sul tab 15mg... 6 morphine sul tab 15mg er... 3 morphine sul tab 30mg... 6 morphine sul tab 30mg er... 3 morphine sul tab 60mg er... 3 MOVANTIK TAB 12.5MG... 113 MOVANTIK TAB 25MG... 113 MOXEZA SOL 0.5%... 135 MOXIFLOXACIN INJ... 16 MOZOBIL INJ... 80 MULTAQ TAB 400MG... 85 mupirocin oin 2%... 109 MUSTARGEN INJ 10MG... 49 MYCAMINE INJ 100MG... 35 MYCAMINE INJ 50MG... 36 mycophenolat cap 250mg... 128 mycophenolat sus 200mg/ml... 128 mycophenolat tab 500mg... 128 mycophenolic tab 180mg dr... 128 mycophenolic tab 360mg dr... 128

myorisan cap 30mg... 109 MYRBETRIQ TAB 25MG... 115 MYRBETRIQ TAB 50MG... 115 N nabumetone tab 500mg... 38 nabumetone tab 750mg... 38 nadolol tab 20mg... 91 nadolol tab 40mg... 91 nadolol tab 80mg... 91 nadolol/bend tab 40-5mg... 89 nadolol/bend tab 80-5mg... 89 nafcillin inj 10gm... 14 nafcillin inj 1gm... 14 NAGLAZYME INJ 1MG/ML... 112 nalbuphine inj 10mg/ml... 6 nalbuphine inj 20mg/ml... 6 naloxone inj 0.4mg/ml... 8 NALOXONE INJ 1MG/ML... 8 naltrexone tab 50mg... 7 NAMENDA XR CAP 14MG... 26 NAMENDA XR CAP 21MG... 26 NAMENDA XR CAP 28MG... 26 NAMENDA XR CAP 7MG... 26 NAMENDA XR CAP TITRATIO... 26 NAMZARIC CAP 14-10MG... 26 NAMZARIC CAP 28-10MG... 26 naphazoline sol 0.1% op... 135 naproxen dr tab 375mg... 38 naproxen dr tab 500mg... 38 naproxen sod tab 275mg... 38 naproxen sod tab 550mg... 38 naproxen sus 125/5ml... 38 naproxen tab 250mg... 38 naproxen tab 375mg... 38 naproxen tab 500mg... 38 nateglinide tab 120mg... 75 nateglinide tab 60mg... 75 NATPARA INJ 25MCG... 133 NEBUPENT INH 300MG... 53 NEEDLES, INSULIN DISP., SAFET... 75 nefazodone tab 100mg... 27 nefazodone tab 150mg... 27 nefazodone tab 200mg... 28 nefazodone tab 250mg... 28 nefazodone tab 50mg... 28 neo/bac/poly oin op... 135 neo/poly gu sol 40/ml ir... 116 neo/poly/bac oin /hc 1%op... 137 165 neo/poly/dex oin 0.1% op... 137 neo/poly/dex sus 0.1% op... 138 neo/poly/gra sol op... 135 neo/poly/hc sol 1% otic... 138 neo/poly/hc sus 1% otic... 138 neo/poly/hc sus op... 138 neomycin tab 500mg... 8 NEPHRAMINE INJ 5.4%... 149 NEUPOGEN INJ 300/0.5... 80 NEUPOGEN INJ 300MCG... 80 NEUPOGEN INJ 480/0.8... 80 NEUPOGEN INJ 480MCG... 80 NEUPRO DIS 1MG/24HR... 54 NEUPRO DIS 2MG/24HR... 54 NEUPRO DIS 3MG/24HR... 54 NEUPRO DIS 4MG/24HR... 54 NEUPRO DIS 6MG/24HR... 54 NEUPRO DIS 8MG/24HR... 54 NEVIRAPINE SUS 50MG/5ML... 65 nevirapine tab 100mg... 65 nevirapine tab 200mg... 65 nevirapine tab 400mg er... 65 NEXAVAR TAB 200MG... 49 niacin er tab 1000mg... 100 niacin er tab 500mg... 100 niacin er tab 750mg... 100 NIACOR TAB 500MG... 100 nicardipine cap 20mg... 94 nicardipine cap 30mg... 94 NICOTROL INH... 8 nifedical xl tab 30mg... 94 nifedical xl tab 60mg... 94 nifedipine cap 10mg... 94 nifedipine cap 20mg... 94 nifedipine tab 30mg er... 94 nifedipine tab 60mg er... 94 nifedipine tab 90mg er... 94 NILANDRON TAB 150MG... 49 nimodipine cap 30mg... 94 NINLARO CAP 2.3MG... 49 NINLARO CAP 3MG... 49 NINLARO CAP 4MG... 49 NIPENT INJ 10MG... 49 nisoldipine tab 20mg... 94 nisoldipine tab 30mg... 94 nisoldipine tab 40mg... 94 nitrofur mac cap 100mg... 10 nitrofur mac cap 25mg... 10 nitrofur mac cap 50mg... 10

nitrofurantn cap 100mg... 10 nitroglycer dis 0.1mg/hr... 101 nitroglycer dis 0.2mg/hr... 101 nitroglycer dis 0.4mg/hr... 101 nitroglycer dis 0.6mg/hr... 101 nitroglycer inj 5mg/ml... 101 nitroglycrn spr lingual... 101 NITROSTAT SUB 0.3MG... 102 NITROSTAT SUB 0.4MG... 102 NITROSTAT SUB 0.6MG... 102 NORDITROPIN INJ 10/1.5ML... 122 NORDITROPIN INJ 15/1.5ML... 122 NORDITROPIN INJ 30/3ML... 122 NORDITROPIN INJ 5/1.5ML... 122 norethin ace tab 5mg... 121 norethindron tab 0.35mg... 120 norgest/ethi tab estradio... 120 NORMOSOL -M INJ /D5W... 146 NORMOSOL -R INJ... 146 NORMOSOL -R INJ /D5W... 146 NORTHERA CAP 100MG... 96 NORTHERA CAP 200MG... 96 NORTHERA CAP 300MG... 96 nortriptylin cap 10mg... 33 nortriptylin cap 25mg... 33 nortriptylin cap 50mg... 33 nortriptylin cap 75mg... 33 NORTRIPTYLIN SOL 10MG/5ML... 33 NORVIR CAP 100MG... 69 NORVIR SOL 80MG/ML... 69 NORVIR TAB 100MG... 69 NOVOLIN INJ 70/30... 77 NOVOLIN N INJ U-100... 77 NOVOLIN R INJ U-100... 77 NOVOLOG INJ 100/ML... 77 NOVOLOG INJ FLEXPEN... 77 NOVOLOG INJ PENFILL... 77 NOVOLOG MIX INJ 70/30... 77 NOVOLOG MIX INJ FLEXPEN... 77 NOXAFIL SUS 40MG/ML... 36 NOXAFIL TAB 100MG... 36 NUEDEXTA CAP 20-10MG... 103 NULOJIX INJ 250MG... 128 NUPLAZID TAB 17MG... 60 nutrilipid emu 20%... 149 NUTROPIN AQ INJ 10MG/2ML NUSP... 122 NUTROPIN AQ INJ 20MG/2ML NUSP... 122 nystat/triam cre... 109 nystat/triam oin... 109 166 nystatin cre 100000... 109 nystatin oin 100000... 109 nystatin pow 100000... 109 nystatin sus 100000... 105 nystatin tab 500000... 36 O octreotide inj 1000mcg... 125 octreotide inj 100mcg... 125 octreotide inj 200mcg... 125 octreotide inj 500mcg... 125 octreotide inj 50mcg/ml... 125 ODEFSEY TAB... 65 ODOMZO CAP 200MG... 49 OFEV CAP 100MG... 113 ofloxacin dro 0.3% op... 135 ofloxacin dro 0.3%otic... 138 ofloxacin tab 400mg... 16 olanza/fluox cap 12-25mg... 30 olanza/fluox cap 12-50mg... 30 olanza/fluox cap 3-25mg... 30 olanza/fluox cap 6-25mg... 30 olanza/fluox cap 6-50mg... 30 olanzapine inj 10mg... 60 olanzapine tab 10mg... 60 olanzapine tab 10mg odt... 60 olanzapine tab 15mg... 60 olanzapine tab 15mg odt... 60 olanzapine tab 2.5mg... 60 olanzapine tab 20mg... 60 olanzapine tab 20mg odt... 60 olanzapine tab 5mg... 60 olanzapine tab 5mg odt... 60 olanzapine tab 7.5mg... 60 olopatadine dro 0.1%... 136 omega-3-acid cap 1gm... 100 omeprazole cap 10mg... 115 omeprazole cap 20mg... 115 omeprazole cap 40mg... 115 ondansetron inj 40/20ml... 34 ondansetron inj 4mg/2ml... 34 ondansetron sol 4mg/5ml... 34 ondansetron tab 24mg... 34 ondansetron tab 4mg... 34 ondansetron tab 4mg odt... 34 ondansetron tab 8mg... 34 ondansetron tab 8mg odt... 34 ONFI SUS 2.5MG/ML... 19 ONFI TAB 10MG... 19

ONFI TAB 20MG... 19 OPANA ER TAB 10MG... 3 OPANA ER TAB 15MG... 3 OPANA ER TAB 20MG... 3 OPANA ER TAB 30MG... 3 OPANA ER TAB 40MG... 3 OPANA ER TAB 5MG... 3 OPANA ER TAB 7.5MG... 4 OPANA TAB 10MG... 6 OPANA TAB 5MG... 6 OPDIVO INJ 40MG/4ML... 49 OPSUMIT TAB 10MG... 142 ORAVIG TAB 50MG... 105 ORENCIA INJ 125MG/ML... 130 ORENCIA INJ 250MG... 130 ORFADIN CAP 10MG... 112 ORFADIN CAP 2MG... 112 ORFADIN CAP 5MG... 112 ORFADIN SUS 4MG/ML... 112 ORKAMBI TAB 200-125... 143 orphenadrine inj 30mg/ml... 143 orphenadrine tab 100mg er... 143 oxaliplatin inj 100mg... 49 oxandrolone tab 10mg... 119 oxandrolone tab 2.5mg... 119 oxaprozin tab 600mg... 38 oxazepam cap 10mg... 72 oxazepam cap 15mg... 72 oxazepam cap 30mg... 72 oxcarbazepin sus 300mg/5m... 24 oxcarbazepin tab 150mg... 24 oxcarbazepin tab 300mg... 24 oxcarbazepin tab 600mg... 24 OXTELLAR XR TAB 150MG... 24 OXTELLAR XR TAB 300MG... 24 OXTELLAR XR TAB 600MG... 24 oxybutynin syp 5mg/5ml... 115 oxybutynin tab 10mg er... 115 oxybutynin tab 15mg er... 115 oxybutynin tab 5mg... 116 oxybutynin tab 5mg er... 116 oxycod/apap tab 10-325mg... 6 oxycod/apap tab 2.5-325... 6 oxycod/apap tab 5-325mg... 6 oxycod/apap tab 7.5-325... 6 oxycod/asa tab... 6 oxycod/ibu tab 5-400mg... 6 oxycodone cap 5mg... 6 oxycodone tab 10mg... 6 167 oxycodone tab 15mg... 6 OXYCODONE TAB 15MG ER... 4 oxycodone tab 20mg... 6 oxycodone tab 30mg... 6 OXYCODONE TAB 30MG ER... 4 oxycodone tab 5mg... 7 OXYCODONE TAB 60MG ER... 4 oxycodone/ sol apap... 7 OXYCONTIN TAB 10MG CR... 4 OXYCONTIN TAB 15MG CR... 4 OXYCONTIN TAB 20MG CR... 4 OXYCONTIN TAB 30MG CR... 4 OXYCONTIN TAB 40MG CR... 4 OXYCONTIN TAB 60MG CR... 4 OXYCONTIN TAB 80MG CR... 4 oxymorphone tab 10mg er... 4 oxymorphone tab 15mg er... 4 oxymorphone tab 20mg er... 4 oxymorphone tab 30mg er... 4 oxymorphone tab 40mg er... 4 oxymorphone tab 5mg er... 4 oxymorphone tab 7.5mg er... 4 oxymorphone tab hcl 10mg... 7 oxymorphone tab hcl 5mg... 7 P pacerone tab 100mg... 86 pacerone tab 200mg... 86 paclitaxel inj 300/50ml... 49 paliperidone tab er 1.5mg... 60 paliperidone tab er 3mg... 60 paliperidone tab er 6mg... 60 paliperidone tab er 9mg... 60 pamidronate inj 30/10ml... 133 pamidronate inj 6mg/ml... 133 pamidronate inj 90/10ml... 133 PANRETIN GEL 0.1%... 109 pantoprazole tab 20mg... 115 pantoprazole tab 40mg... 115 paricalcitol cap 1 mcg... 133 paricalcitol cap 2 mcg... 134 paricalcitol cap 4 mcg... 134 paricalcitol inj 2mcg/ml... 134 paricalcitol inj 5mcg/ml... 134 paromomycin cap 250mg... 9 paroxetin er tab 12.5mg... 30 paroxetin er tab 37.5mg... 30 paroxetine tab 10mg... 30 paroxetine tab 20mg... 30

paroxetine tab 25mg er... 30 paroxetine tab 30mg... 30 paroxetine tab 40mg... 30 PASER GRA 4GM... 40 PATADAY SOL 0.2%... 136 PAXIL SUS 10MG/5ML... 30 PAZEO DRO 0.7%... 136 PEDVAX HIB INJ... 131 peg-3350/kcl sol /sodium... 114 PEGANONE TAB 250MG... 24 PEGASYS INJ... 64 PEGASYS INJ 180MCG/M... 64 PEGASYS INJ PROCLICK 135MCG/0... 64 PEGASYS INJ PROCLICK 180MCG/0... 64 PEG-INTRON KIT 120 RP... 64 PEGINTRON KIT 120MCG... 64 PEG-INTRON KIT 150 RP... 64 PEGINTRON KIT 150MCG... 64 PEGINTRON KIT 50MCG... 64 PEG-INTRON KIT 50MCG RP... 64 PEGINTRON KIT 80MCG... 64 PEG-INTRON KIT 80MCG RP... 64 pen g sod inj 5000000... 14 penicill gk/ inj dex 2mu... 14 penicill gk/ inj dex 3mu... 14 penicilln gk inj 5mu... 14 penicilln vk sol 125/5ml... 14 penicilln vk sol 250/5ml... 14 penicilln vk tab 250mg... 14 penicilln vk tab 500mg... 14 PENTAM 300 INJ 300MG... 53 pentaz/nalox tab 50-0.5mg... 7 pentoxifylli tab 400mg er... 96 perindopril tab 2mg... 84 perindopril tab 4mg... 84 perindopril tab 8mg... 84 PERJETA INJ 420/14ML... 49 permethrin cre 5%... 109 perphen/amit tab 2-10mg... 57 perphen/amit tab 2-25mg... 57 perphen/amit tab 4-10mg... 57 perphen/amit tab 4-25mg... 57 perphen/amit tab 4-50mg... 57 perphenazine tab 16mg... 57 perphenazine tab 2mg... 57 perphenazine tab 4mg... 57 perphenazine tab 8mg... 57 PEXEVA TAB 10MG... 30 PEXEVA TAB 20MG... 30 168 PEXEVA TAB 30MG... 31 PEXEVA TAB 40MG... 31 phenelzine tab 15mg... 28 phenobarb sol 20mg/5ml... 18 phenobarb tab 100mg... 18 phenobarb tab 15mg... 18 phenobarb tab 16.2mg... 18 phenobarb tab 30mg... 18 phenobarb tab 32.4mg... 18 phenobarb tab 60mg... 19 phenobarb tab 64.8mg... 19 phenobarb tab 97.2mg... 19 phenytoin chw 50mg... 24 phenytoin ex cap 100mg... 25 phenytoin ex cap 200mg... 25 phenytoin ex cap 300mg... 25 phenytoin inj 50mg/ml... 25 phenytoin sus 125/5ml... 25 PHOSPHOLINE SOL 0.125%OP... 137 physiolyte sol... 134 physiosol sol irrigat... 134 PICATO GEL 0.015%... 110 PICATO GEL 0.05%... 110 pilocarpine tab 5mg... 105 pilocarpine tab 7.5mg... 105 pimozide tab 1mg... 57 pimozide tab 2mg... 57 pindolol tab 10mg... 91 pindolol tab 5mg... 91 pioglit/glim tab 30-2mg... 89 pioglit/glim tab 30-4mg... 75 pioglita/met tab 15-500mg... 75 pioglita/met tab 15-850mg... 75 pioglitazone tab 15mg... 76 pioglitazone tab 30mg... 76 pioglitazone tab 45mg... 76 piper/tazoba inj 3-0.375g... 14 piper/tazoba inj 4-0.5gm... 14 pirmella tab 1/35... 120 piroxicam cap 10mg... 39 piroxicam cap 20mg... 39 PLASMA-LYTE INJ -148... 146 PLASMA-LYTE INJ 56/D5W... 146 PLEGRIDY INJ... 104 PLEGRIDY INJ PEN... 104 PLEGRIDY PEN INJ STARTER... 104 plenamine inj 15%... 149 podofilox sol 0.5%... 110 polyeth glyc pow 3350 nf... 114

polymyxin b/ sol trimethp... 135 POMALYST CAP 1MG... 49 POMALYST CAP 2MG... 49 POMALYST CAP 3MG... 49 POMALYST CAP 4MG... 49 pot chloride cap 10meq er... 147 pot chloride cap 8meq er... 147 pot chloride inj 10meq... 147 pot chloride inj 20meq... 147 pot chloride inj 2meq/ml... 147 pot chloride inj 40meq... 147 pot chloride sol 10%... 147 pot chloride sol 20%... 147 pot chloride tab 10meq er... 147 pot chloride tab 20meq er... 147 pot chloride tab 8meq er... 147 pot citrate tab 1080mg... 147 pot citrate tab 1620mg... 147 pot citrate tab 540mg er... 147 POTIGA TAB 200MG... 18 POTIGA TAB 300MG... 18 POTIGA TAB 400MG... 18 POTIGA TAB 50MG... 18 PRADAXA CAP 110MG... 79 PRADAXA CAP 150MG... 79 PRADAXA CAP 75MG... 79 PRALUENT PFS INJ 150MG/ML... 100 PRALUENT PFS INJ 75MG/ML... 100 PRALUENT SOLN PEN-INJ 150MG/M... 100 PRALUENT SOLN PEN-INJ 75MG/ML... 100 pramipexole tab 0.125mg... 54 pramipexole tab 0.25mg... 54 pramipexole tab 0.5mg... 54 pramipexole tab 0.75mg... 54 pramipexole tab 1.5mg... 54 pramipexole tab 1mg... 55 pramipexole tab 2.25mg... 55 pravastatin tab 10mg... 99 pravastatin tab 20mg... 99 pravastatin tab 40mg... 99 pravastatin tab 80mg... 99 prazosin hcl cap 1mg... 82 prazosin hcl cap 2mg... 82 prazosin hcl cap 5mg... 82 pred sod pho sol 1% op... 138 pred sod pho sol 5mg/5ml... 118 prednicarbat cre 0.1%... 110 prednicarbat oin 0.1%... 110 prednisolone sol 15mg/5ml... 118 169 prednisolone sol 25mg/5ml... 118 prednisolone sus 1% op... 138 prednisolone tab 10mg odt... 118 prednisolone tab 15mg odt... 118 prednisolone tab 30mg odt... 118 prednisone sol 5mg/5ml... 118 prednisone tab 10mg... 118 prednisone tab 1mg... 118 prednisone tab 2.5mg... 118 prednisone tab 20mg... 118 prednisone tab 50mg... 118 prednisone tab 5mg... 119 PREMARIN INJ 25MG... 121 PREMARIN TAB 0.3MG... 121 PREMARIN TAB 0.45MG... 121 PREMARIN TAB 0.625MG... 121 PREMARIN TAB 0.9MG... 121 PREMARIN TAB 1.25MG... 121 PREMARIN VAG CRE 0.625MG... 117 premasol sol 6%... 149 PREMPHASE TAB... 121 PREMPRO TAB.625-2.5... 121 PREMPRO TAB 0.3-1.5... 121 PREMPRO TAB 0.45-1.5... 121 PREMPRO TAB 0.625-5... 121 PRENATAL VITAMIN... 149 PREPOPIK PAK... 114 PREZCOBIX TAB 800-150... 66 PREZISTA SUS 100MG/ML... 69 PREZISTA TAB 150MG... 69 PREZISTA TAB 600MG... 69 PREZISTA TAB 75MG... 69 PREZISTA TAB 800MG... 69 PRIFTIN TAB 150MG... 40 PRIMAQUINE TAB 26.3MG... 42 primidone tab 250mg... 21 primidone tab 50mg... 21 PRISTIQ TAB 100MG... 31 PRISTIQ TAB 25MG... 31 PRISTIQ TAB 50MG... 31 PRIVIGEN INJ 40GRAMS... 129 probenecid tab 500mg... 36 procainamide inj 100mg/ml... 86 PROCALAMINE INJ 3%... 149 prochlorper inj 10mg/2ml... 57 prochlorper sup 25mg... 57 prochlorper tab 10mg... 58 prochlorper tab 5mg... 58 PROCRIT INJ 10000/ML... 80

PROCRIT INJ 2000/ML... 80 PROCRIT INJ 20000/ML... 80 PROCRIT INJ 3000/ML... 80 PROCRIT INJ 4000/ML... 80 PROCRIT INJ 40000/ML... 80 procto-med cre hc 2.5%... 110 procto-pak cre 1%... 110 proctozone cre -hc 2.5%... 110 PROGLYCEM SUS 50MG/ML... 77 PROGRAF INJ 5MG/ML... 128 PROLASTIN-C INJ 1000MG... 143 PROLEUKIN INJ 22MU... 50 PROLIA SOL 60MG/ML... 134 PROMACTA TAB 12.5MG... 80 PROMACTA TAB 25MG... 80 PROMACTA TAB 50MG... 80 PROMACTA TAB 75MG... 81 promethazine tab 12.5mg... 139 propafenone tab 150mg... 86 propafenone tab 225mg... 86 propafenone tab 300mg... 86 propran/hctz tab 40/25... 89 propran/hctz tab 80/25... 89 propranolol cap 120mg er... 91 propranolol cap 160mg er... 91 propranolol cap 60mg er... 91 propranolol cap 80mg er... 91 propranolol inj 1mg/ml... 91 propranolol sol 20mg/5ml... 92 propranolol sol 40mg/5ml... 92 propranolol tab 10mg... 92 propranolol tab 20mg... 92 propranolol tab 40mg... 92 propranolol tab 60mg... 92 propranolol tab 80mg... 92 propylthiour tab 50mg... 126 PROQUAD INJ... 131 PROSOL INJ 20%... 149 protriptylin tab 10mg... 33 protriptylin tab 5mg... 33 PULMICORT INH 180MCG... 139 PULMICORT INH 90MCG... 139 PULMICORT SUS 0.25MG/2... 139 PULMICORT SUS 0.5MG/2... 139 PULMICORT SUS 1MG/2ML... 139 PULMOZYME SOL 1MG/ML... 143 PURIXAN SUS 20MG/ML... 42 pyrazinamide tab 500mg... 40 pyridostigm tab 60mg... 40 170 Q qnapril/hctz tab 10-12.5... 89 qnapril/hctz tab 20-12.5... 89 qnapril/hctz tab 20-25mg... 89 QUADRACEL INJ... 131 quetiapine tab 100mg... 60 quetiapine tab 200mg... 60 quetiapine tab 25mg... 61 quetiapine tab 300mg... 61 quetiapine tab 400mg... 61 quetiapine tab 50mg... 61 quinapril tab 10mg... 84 quinapril tab 20mg... 84 quinapril tab 40mg... 84 quinapril tab 5mg... 84 quinidine gl tab 324mg er... 86 quinidine su tab 200mg... 86 QUINIDINE SU TAB 300MG... 86 quinine sulf cap 324mg... 53 R RABAVERT INJ... 131 raloxifene tab 60mg... 122 ramipril cap 1.25mg... 85 ramipril cap 10mg... 85 ramipril cap 2.5mg... 85 ramipril cap 5mg... 85 RANEXA TAB 1000MG... 96 RANEXA TAB 500MG... 96 ranitidine cap 150mg... 114 ranitidine cap 300mg... 114 ranitidine inj 50mg/2ml... 114 ranitidine syp 15mg/ml... 114 ranitidine tab 150mg... 114 ranitidine tab 300mg... 114 RAPAFLO CAP 4MG... 116 RAPAFLO CAP 8MG... 116 RAPAMUNE SOL 1MG/ML... 128 RAVICTI LIQ 1.1GM/ML... 112 REBIF INJ 22/0.5... 104 RECOMBIVA HB INJ 10MCG/ML PFS... 132 RECOMBIVA HB INJ 10MCG/ML SOL... 132 RECOMBIVA HB INJ 5MCG/0.5... 132 RECOMBIVA-HB INJ 40MCG/ML... 132 REGRANEX GEL 0.01%... 110 RELENZA MIS DISKHALE... 69 RELISTOR INJ 12/0.6ML... 113 RELISTOR INJ 8/0.4ML... 113

RELISTOR PFS INJ 12/0.6ML... 113 RELPAX TAB 20MG... 39 RELPAX TAB 40MG... 39 RENVELA PAK 0.8GM... 116 RENVELA PAK 2.4GM... 116 RENVELA TAB 800MG... 117 repaglinide tab 0.5mg... 76 REPAGLINIDE TAB 1-500MG... 76 repaglinide tab 1mg... 76 REPAGLINIDE TAB 2-500MG... 76 repaglinide tab 2mg... 76 REPATHA INJ 140MG/ML... 100 REPATHA SURE INJ 140MG/ML... 100 RESCRIPTOR TAB 100 MG... 65 RESCRIPTOR TAB 200MG... 65 reserpine tab 0.1mg... 96 RESTASIS EMU 0.05%... 135 RESTORIL CAP 15MG... 144 RESTORIL CAP 22.5MG... 144 RESTORIL CAP 7.5MG... 144 RETROVIR INJ 10MG/ML... 67 REVLIMID CAP 10MG... 41 REVLIMID CAP 15MG... 41 REVLIMID CAP 2.5MG... 41 REVLIMID CAP 20MG... 41 REVLIMID CAP 25MG... 41 REVLIMID CAP 5MG... 41 REXULTI TAB 0.25MG... 61 REXULTI TAB 0.5MG... 61 REXULTI TAB 1MG... 61 REXULTI TAB 2MG... 61 REXULTI TAB 3MG... 61 REXULTI TAB 4MG... 61 REYATAZ CAP 150MG... 69 REYATAZ CAP 200MG... 69 REYATAZ CAP 300MG... 69 REYATAZ POW 50MG... 69 RHEUMATREX TAB 2.5MG 4X6... 50 ribapak pak 1000/day... 64 ribapak pak 800/day... 64 RIBASPHERE TAB 400MG... 64 ribavirin cap 200mg... 64 ribavirin tab 200mg... 64 rifabutin cap 150mg... 40 rifampin cap 150mg... 40 rifampin cap 300mg... 40 rifampin inj 600 mg... 41 RIFATER TAB... 41 riluzole tab 50mg... 103 171 rimantadine tab 100mg... 69 ringers inj... 147 ringers irr sol... 134 RIOMET SOL 500/5ML... 76 risedron sod tab 35mg dr... 134 risedronate tab 35mg 4ct... 134 RISPERDAL INJ 12.5MG... 61 RISPERDAL INJ 25MG... 61 RISPERDAL INJ 37.5MG... 61 RISPERDAL INJ 50MG... 61 risperidone sol 1mg/ml... 61 risperidone tab 0.25 odt... 61 risperidone tab 0.25mg... 61 risperidone tab 0.5mg... 61 risperidone tab 0.5mg od... 61 risperidone tab 1mg... 61 risperidone tab 1mg odt... 61 risperidone tab 2mg... 61 risperidone tab 2mg odt... 61 risperidone tab 3mg... 62 risperidone tab 3mg odt... 62 risperidone tab 4mg... 62 risperidone tab 4mg odt... 62 RITUXAN INJ 500MG... 50 rivastigmine cap 1.5mg... 26 rivastigmine cap 3mg... 26 rivastigmine cap 4.5mg... 26 rivastigmine cap 6mg... 26 ROBINUL FORT TAB 2MG... 113 ROBINUL INJ 0.2MG/ML... 113 ropinirole tab 0.25mg... 55 ropinirole tab 0.5mg... 55 ropinirole tab 1mg... 55 ropinirole tab 2mg... 55 ropinirole tab 3mg... 55 ropinirole tab 4mg... 55 ropinirole tab 5mg... 55 rosuvastatin tab 10mg... 99 rosuvastatin tab 20mg... 99 rosuvastatin tab 40mg... 99 rosuvastatin tab 5mg... 99 ROTARIX SUS... 132 ROTATEQ SOL... 132 roweepra tab 500mg... 18 ROZEREM TAB 8MG... 144 S SABRIL POW 500MG... 21 SABRIL TAB 500MG... 21

SAMSCA TAB 15MG... 145 SAMSCA TAB 30MG... 145 SANCUSO DIS 3.1MG... 34 SANDIMMUNE CAP 100MG... 128 SANDIMMUNE CAP 25MG... 128 SANDIMMUNE SOL 100MG/ML... 128 SANDOSTATIN KIT LAR 10MG... 125 SANDOSTATIN KIT LAR 20MG... 125 SANDOSTATIN KIT LAR 30MG... 125 SANTYL OIN 250/GM... 110 SAPHRIS SUB 10MG... 62 SAPHRIS SUB 2.5MG... 62 SAPHRIS SUB 5MG... 62 SAVELLA MIS TITR PAK... 104 SAVELLA TAB 100MG... 104 SAVELLA TAB 12.5MG... 104 SAVELLA TAB 25MG... 104 SAVELLA TAB 50MG... 104 selegiline cap 5mg... 55 selegiline tab 5mg... 55 selenium sul lot 2.5%... 110 SELZENTRY TAB 150MG... 68 SELZENTRY TAB 300MG... 68 SENSIPAR TAB 30MG... 125 SENSIPAR TAB 60MG... 125 SENSIPAR TAB 90MG... 125 SEREVENT DIS AER 50MCG... 141 SEROQUEL XR TAB 150MG... 62 SEROQUEL XR TAB 200MG... 62 SEROQUEL XR TAB 300MG... 62 SEROQUEL XR TAB 400MG... 62 SEROQUEL XR TAB 50MG... 62 sertraline con 20mg/ml... 31 sertraline tab 100mg... 31 sertraline tab 25mg... 31 sertraline tab 50mg... 31 setlakin tab... 120 SIGNIFOR INJ 0.3MG/ML... 125 SIGNIFOR INJ 0.6MG/ML... 125 SIGNIFOR INJ 0.9MG/ML... 125 sildenafil inj... 142 sildenafil tab 20mg... 142 silver sulfa cre 1%... 110 SIMBRINZA SUS 1-0.2%... 137 SIMPONI ARIA SOL 50MG/4ML... 128 SIMPONI AUTO-INJ 100MG/ML... 128 SIMPONI AUTO-INJ 50/0.5ML... 128 SIMPONI PFS INJ 100MG/ML... 128 SIMPONI PFS INJ 50/0.5ML... 128 172 SIMULECT INJ 20MG... 128 simvastatin tab 10mg... 99 simvastatin tab 20mg... 99 simvastatin tab 40mg... 99 simvastatin tab 5mg... 99 simvastatin tab 80mg... 99 sirolimus tab 0.5mg... 128 sirolimus tab 1mg... 128 sirolimus tab 2mg... 128 SIRTURO TAB 100MG... 41 smz/tmp ds tab 800-160... 16 smz-tmp inj 400-80/5... 16 smz-tmp sus 200-40/5... 16 smz-tmp tab 400-80mg... 16 sod chloride inj 0.45%... 147 sod chloride inj 0.9%bact... 147 sod chloride inj 2.5/ml... 147 sod chloride inj 3%... 147 sod chloride inj 5%... 147 SOD FLUORIDE TAB 1MG F... 149 SOD LACTATE INJ 5MEQ/ML... 147 sod poly sul pow... 145 sodium chlor sol 0.9% irr... 116 SOLTAMOX SOL 10MG/5ML... 104 SOMATULINE INJ 120/.5ML... 125 SOMATULINE INJ 60/0.2ML... 126 SOMATULINE INJ 90/0.3ML... 126 SOMAVERT INJ 10MG... 126 SOMAVERT INJ 15MG... 126 SOMAVERT INJ 20MG... 126 sotalol hcl tab 120mg... 92 sotalol hcl tab 160mg... 92 sotalol hcl tab 240mg... 92 sotalol hcl tab 80mg... 92 SOVALDI TAB 400MG... 64 SPIRIVA AER RESPIMAT... 140 SPIRIVA CAP HANDIHLR... 140 SPIRIVA SPR RESPIMAT... 140 spirono/hctz tab 25/25... 89 spironolact tab 100mg... 97 spironolact tab 25mg... 97 spironolact tab 50mg... 97 SPRITAM TAB 1000MG... 18 SPRITAM TAB 250MG... 18 SPRITAM TAB 500MG... 18 SPRITAM TAB 750MG... 18 SPRYCEL TAB 100MG... 50 SPRYCEL TAB 140MG... 50 SPRYCEL TAB 20MG... 50

SPRYCEL TAB 50MG... 50 SPRYCEL TAB 70MG... 50 SPRYCEL TAB 80MG... 50 stavudine cap 15mg... 67 stavudine cap 20mg... 67 stavudine cap 30mg... 67 stavudine cap 40mg... 67 stavudine sol 1mg/ml... 139 STELARA INJ 45MG/0.5... 110 STELARA INJ 90MG/ML... 110 STIOLTO AER RESPIMAT... 141 STIVARGA TAB 40MG... 50 STRATTERA CAP 100MG... 103 STRATTERA CAP 10MG... 103 STRATTERA CAP 18MG... 103 STRATTERA CAP 25MG... 103 STRATTERA CAP 40MG... 103 STRATTERA CAP 60MG... 103 STRATTERA CAP 80MG... 103 streptomycin inj 1gm... 9 STRIBILD TAB... 68 SUBOXONE MIS 12-3MG... 8 SUBOXONE MIS 2-0.5MG... 8 SUBOXONE MIS 4-1MG... 8 SUBOXONE MIS 8-2MG... 8 sucralfate tab 1gm... 115 sulf/pred na sol op... 138 sulfacet sod sol 10% op... 135 sulfacetamid lot 10%... 110 sulfadiazine tab 500mg... 16 sulfasalazin tab 500mg... 16 sulfasalazin tab 500mg dr... 16 sulindac tab 150mg... 39 sulindac tab 200mg... 39 sumatriptan inj 6mg/0.5... 39 sumatriptan inj auto-inj 6mg/... 39 sumatriptan tab 100mg... 39 sumatriptan tab 25mg... 39 sumatriptan tab 50mg... 39 SUPRAX CAP 400MG... 12 SUSTIVA CAP 200MG... 66 SUSTIVA CAP 50MG... 66 SUSTIVA TAB 600MG... 66 SUTENT CAP 12.5MG... 50 SUTENT CAP 25MG... 50 SUTENT CAP 37.5MG... 50 SUTENT CAP 50MG... 50 SYLATRON KIT 200MCG... 50 SYLATRON KIT 300MCG... 50 173 SYLATRON KIT 600MCG... 50 SYMLINPEN 60 INJ 1000MCG... 76 SYMLNPEN 120 INJ 1000MCG... 76 SYNAGIS INJ 50MG... 129 SYNAREL SOL 2MG/ML... 126 SYNERCID INJ 500MG... 10 SYNJARDY TAB... 76 SYNJARDY TAB 12.5-500... 76 SYNJARDY TAB 5-1000MG... 76 SYNJARDY TAB 5-500MG... 76 SYNRIBO INJ 3.5MG... 50 SYNTHROID TAB 100MCG... 124 SYNTHROID TAB 112MCG... 124 SYNTHROID TAB 125MCG... 124 SYNTHROID TAB 137MCG... 124 SYNTHROID TAB 150MCG... 124 SYNTHROID TAB 175MCG... 124 SYNTHROID TAB 200MCG... 124 SYNTHROID TAB 25MCG... 124 SYNTHROID TAB 300MCG... 124 SYNTHROID TAB 50MCG... 124 SYNTHROID TAB 75MCG... 124 SYNTHROID TAB 88MCG... 124 SYPRINE CAP 250MG... 41 T TABLOID TAB 40MG... 42 tacrolimus cap 0.5mg... 128 tacrolimus cap 1mg... 128 tacrolimus cap 5mg... 129 TAFINLAR CAP 50MG... 50 TAFINLAR CAP 75MG... 50 TAGRISSO TAB 40MG... 50 TAGRISSO TAB 80MG... 50 TAMIFLU CAP 30MG... 69 TAMIFLU CAP 45MG... 69 TAMIFLU CAP 75MG... 69 TAMIFLU SUS 6MG/ML... 69 tamoxifen tab 10mg... 50 tamoxifen tab 20mg... 51 tamsulosin cap 0.4mg... 116 TARCEVA TAB 100MG... 51 TARCEVA TAB 150MG... 51 TARCEVA TAB 25MG... 51 TARGRETIN GEL 1%... 110 TASIGNA CAP 150MG... 51 TASIGNA CAP 200MG... 51 tazicef inj 2gm... 12 TAZORAC CRE 0.05%... 110

TAZORAC CRE 0.1%... 110 TAZORAC GEL 0.05%... 110 TAZORAC GEL 0.1%... 110 taztia xt cap 120mg/24... 94 taztia xt cap 180mg/24... 94 taztia xt cap 240mg/24... 94 taztia xt cap 300mg/24... 94 taztia xt cap 360mg/24... 94 TECENTRIQ INJ 1200/20... 51 TECFIDERA CAP 120MG... 104 TECFIDERA CAP 240MG... 104 TECFIDERA MIS STARTER... 105 TEFLARO INJ 400MG... 12 TEFLARO INJ 600MG... 12 TEGRETOL-XR TAB 100MG... 25 telmis/amlod tab 40-10mg... 89 telmis/amlod tab 40-5mg... 89 telmis/amlod tab 80-10mg... 89 telmis/amlod tab 80-5mg... 89 telmisa/hctz tab 40-12.5... 89 telmisa/hctz tab 80-12.5... 89 telmisa/hctz tab 80-25mg... 89 telmisartan tab 20mg... 83 telmisartan tab 40mg... 83 telmisartan tab 80mg... 83 temazepam cap 15mg... 144 temazepam cap 22.5mg... 144 temazepam cap 30mg... 144 temazepam cap 7.5mg... 144 TENIVAC INJ 5-2LF... 132 terazosin cap 10mg... 82 terazosin cap 1mg... 82 terazosin cap 2mg... 82 terazosin cap 5mg... 82 terbutaline inj 1mg/ml... 141 terconazole cre 0.4%... 117 terconazole sup 80mg... 117 testost cyp inj 100mg/ml... 119 testost cyp inj 200mg/ml... 119 testost enan inj 200mg/ml... 119 TET/DIP TOX INJ 2-2 LF... 132 tetrabenazin tab 12.5mg... 103 tetrabenazin tab 25mg... 103 THALOMID CAP 100MG... 41 THALOMID CAP 150MG... 42 THALOMID CAP 200MG... 42 THALOMID CAP 50MG... 42 theophylline tab 100mg er... 140 theophylline tab 200mg er... 140 174 theophylline tab 300mg er... 140 theophylline tab 450mg er... 140 theophylline tab 600mg er... 140 thioridazine tab 100mg... 58 thioridazine tab 10mg... 58 thioridazine tab 25mg... 58 thioridazine tab 50mg... 58 THIOTEPA INJ 15MG... 51 thiothixene cap 10mg... 58 thiothixene cap 1mg... 58 thiothixene cap 2mg... 58 thiothixene cap 5mg... 58 THYMOGLOBULN INJ 25MG... 129 tiagabine tab 2mg... 21 tiagabine tab 4mg... 21 timolol gel sol 0.25% op... 137 timolol gel sol 0.5% op... 137 timolol mal sol 0.25% op... 137 timolol mal sol 0.5% op... 137 timolol mal tab 10mg... 92 timolol mal tab 20mg... 92 timolol mal tab 5mg... 92 TIVICAY TAB 10MG... 68 TIVICAY TAB 25MG... 68 TIVICAY TAB 50MG... 68 tizanidine tab 2mg... 143 tizanidine tab 4mg... 143 tobra/dexame sus 0.3-0.1%... 138 TOBRADEX OIN 0.3-0.1%... 138 TOBRADEX ST SUS 0.3-0.05... 138 TOBRADEX SUS 0.3-0.1%... 138 tobramycin inj 1.2/30ml... 9 tobramycin inj 10mg/ml... 9 tobramycin neb 300/5ml... 9 tobramycin sol 0.3% op... 136 TOLAK CRE 4%... 110 tolazamide tab 250mg... 76 tolazamide tab 500mg... 76 tolbutamide tab 500mg... 76 tolmetin sod cap 400mg... 39 tolmetin sod tab 600mg... 39 tolterodine tab 1mg... 116 tolterodine tab 2mg... 116 topiramate cap 15mg... 22 topiramate cap 25mg... 22 TOPIRAMATE CAP ER 100MG... 22 TOPIRAMATE CAP ER 150MG... 22 TOPIRAMATE CAP ER 200MG... 22 TOPIRAMATE CAP ER 25MG... 23

TOPIRAMATE CAP ER 50MG... 23 topiramate tab 100mg... 39 topiramate tab 200mg... 23 topiramate tab 25mg... 23 topiramate tab 50mg... 23 topotecan inj 4mg... 51 TORISEL SOL 25MG/ML... 51 torsemide tab 100mg... 97 torsemide tab 20mg... 97 TOUJEO SOLO INJ 300IU/ML... 77 tpn electrol inj... 147 TRACLEER TAB 125MG... 142 TRACLEER TAB 62.5MG... 142 TRADJENTA TAB 5MG... 76 tramadl/apap tab 37.5-325... 7 tramadol hcl tab 50mg... 7 trando/verap tab 1-240 er... 89 trando/verap tab 2-180 er... 89 trando/verap tab 2-240 er... 89 trando/verap tab 4-240 er... 89 trandolapril tab 1mg... 85 trandolapril tab 2mg... 85 trandolapril tab 4mg... 85 tranex acid inj 100mg/ml... 81 tranex acid tab 650mg... 81 TRANSDERM-SC DIS 1MG... 34 tranylcyprom tab 10mg... 28 TRAVASOL INJ 10%... 149 TRAVATAN Z DRO 0.004%... 135 travoprost dro 0.004%... 135 trazodone tab 100mg... 28 trazodone tab 150mg... 28 trazodone tab 300mg... 28 trazodone tab 50mg... 28 TREANDA INJ 25MG... 51 TRECATOR TAB 250MG... 41 TRELSTAR MIX INJ 11.25MG... 51 TRELSTAR MIX INJ 22.5MG... 51 TRELSTAR MIX INJ 3.75MG... 51 tretinoin cap 10mg... 51 tretinoin gel 0.05%... 110 TREXALL TAB 10MG... 129 TREXALL TAB 15MG... 129 TREXALL TAB 5MG... 129 TREXALL TAB 7.5MG... 129 triamcin/ora pst 0.1%... 105 triamcinolon cre 0.025%... 110 triamcinolon cre 0.1%... 111 triamcinolon cre 0.5%... 111 175 triamcinolon lot 0.025%... 111 triamcinolon lot 0.1%... 111 triamcinolon oin 0.025%... 111 triamcinolon oin 0.1%... 111 triamcinolon oin 0.5%... 111 triamt/hctz cap 50-25mg... 89 triamt/hctz tab 37.5-25... 89 triamt/hctz tab 75-50mg... 89 TRIAZOLAM TAB 0.125MG... 144 triazolam tab 0.25mg... 144 TRIBENZOR20- TAB 5-12.5MG... 90 TRIBENZOR40- TAB 10-12.5... 90 TRIBENZOR40- TAB 10-25MG... 90 TRIBENZOR40- TAB 5-12.5MG... 90 TRIBENZOR40- TAB 5-25MG... 90 trifluoperaz tab 10mg... 58 trifluoperaz tab 1mg... 58 trifluoperaz tab 2mg... 58 trifluoperaz tab 5mg... 58 trifluridine sol 1% op... 136 trihexyphen elx 0.4mg/ml... 54 trihexyphen tab 2mg... 54 trihexyphen tab 5mg... 54 tri-lo tab estaryll... 120 tri-lo- tab sprintec... 120 trimethoprim tab 100mg... 10 trimipramine cap 100mg... 33 trimipramine cap 25mg... 33 trimipramine cap 50mg... 33 trinessa tab... 120 TRINTELLIX TAB 10MG... 28 TRINTELLIX TAB 20MG... 28 TRINTELLIX TAB 5MG... 28 tri-previfem tab... 120 TRISENOX SOL 10MG/10M... 51 tri-sprintec tab... 120 TRIUMEQ TAB... 67 TROKENDI XR CAP 100MG... 23 TROKENDI XR CAP 200MG... 23 TROKENDI XR CAP 25MG... 23 TROKENDI XR CAP 50MG... 23 TRUMENBA INJ... 132 TRUVADA TAB 100-150... 67 TRUVADA TAB 133-200... 67 TRUVADA TAB 167-250... 67 TRUVADA TAB 200-300... 67 TWINRIX INJ... 132 TYBOST TAB 150MG... 68 TYGACIL INJ 50MG... 10

TYKERB TAB 250MG... 51 TYPHIM VI INJ 25MCG/0.5ML... 132 TYPHIM VI SYR INJ 25MCG/0.5ML... 132 TYSABRI INJ 300/15ML... 105 TYZEKA TAB 600MG... 64 U UCERIS AER 2MG/ACT... 111 UCERIS TAB 9MG... 119 ULORIC TAB 40MG... 36 ULORIC TAB 80MG... 36 unithroid tab 100mcg... 124 unithroid tab 112mcg... 124 unithroid tab 125mcg... 124 unithroid tab 150mcg... 124 unithroid tab 175mcg... 124 unithroid tab 200mcg... 124 unithroid tab 25mcg... 124 unithroid tab 300mcg... 124 unithroid tab 50mcg... 124 unithroid tab 75mcg... 124 unithroid tab 88mcg... 124 ursodiol tab 250mg... 113 ursodiol tab 500mg... 113 UVADEX INJ 20MCG/ML... 51 V valacyclovir tab 1gm... 65 valacyclovir tab 500mg... 65 VALCHLOR GEL 0.016%... 111 valganciclov tab 450mg... 63 valproate inj 100mg/ml... 21 valproic acd cap 250mg... 21 valproic acd syp 250/5ml... 21 valsart/hctz tab 160-12.5... 76 valsart/hctz tab 160-25mg... 90 valsart/hctz tab 320-12.5... 90 valsart/hctz tab 320-25mg... 90 valsart/hctz tab 80-12.5... 90 vancomycin cap 125mg... 10 vancomycin cap 250mg... 10 vancomycin inj 1000mg... 10 vancomycin inj 10gm... 10 vancomycin inj 500mg... 10 VAQTA INJ 25/0.5ML... 132 VAQTA INJ 50UNT/ML... 132 VARIVAX INJ... 132 VARIZIG INJ 125UNIT... 130 VECTIBIX INJ 100MG... 51 176 VELCADE INJ 3.5MG... 51 VENCLEXTA TAB 100MG... 51 VENCLEXTA TAB 10MG... 51 VENCLEXTA TAB 50MG... 51 VENCLEXTA TAB START PK... 52 venlafaxine cap 150mg er... 31 venlafaxine cap 37.5 er... 31 venlafaxine cap 75mg er... 31 venlafaxine tab 100mg... 31 venlafaxine tab 150mg er... 31 venlafaxine tab 225mg er... 31 venlafaxine tab 25mg... 31 venlafaxine tab 37.5 er... 31 venlafaxine tab 37.5mg... 31 venlafaxine tab 50mg... 31 venlafaxine tab 75mg... 31 venlafaxine tab 75mg er... 31 VENTAVIS SOL 10MCG/ML... 142 VENTAVIS SOL 20MCG/ML... 142 VENTOLIN HFA AER... 141 verapamil cap 100mg er... 94 verapamil cap 120mg er... 94 verapamil cap 180mg er... 94 verapamil cap 200mg er... 94 verapamil cap 240mg er... 95 verapamil cap 300mg er... 95 verapamil cap 360mg sr... 95 verapamil inj 2.5mg/ml... 95 verapamil tab 120mg... 95 verapamil tab 120mg er 100ct... 95 verapamil tab 180mg er... 95 verapamil tab 240mg er... 95 verapamil tab 40mg... 95 verapamil tab 80mg... 95 VERSACLOZ SUS 50MG/ML... 63 VESICARE TAB 10MG... 116 VESICARE TAB 5MG... 116 VICTOZA INJ 18MG/3ML... 76 VIDEX SOL 2GM... 67 vienva tab 0.1-20... 120 VIGAMOX DRO 0.5%... 136 VIIBRYD KIT STARTER... 28 VIIBRYD TAB 10MG... 28 VIIBRYD TAB 20MG... 28 VIIBRYD TAB 40MG... 28 VIMPAT INJ 200MG/20... 25 VIMPAT SOL 10MG/ML... 25 VIMPAT TAB 100MG... 25 VIMPAT TAB 150MG... 25

VIMPAT TAB 200MG... 25 VIMPAT TAB 50MG... 25 vinblastine inj 10mg... 52 vincristine inj 1mg/ml... 52 vinorelbine inj 10mg/ml... 52 VIRACEPT TAB 250MG... 69 VIRACEPT TAB 625MG... 69 VIRAZOLE INH 6GM... 69 VIREAD POW 40MG/GM... 67 VIREAD TAB 150MG... 67 VIREAD TAB 200MG... 67 VIREAD TAB 250MG... 67 VIREAD TAB 300MG... 67 VITEKTA TAB 150MG... 68 VITEKTA TAB 85MG... 68 voriconazole inj 200mg... 36 voriconazole sus 40mg/ml... 36 voriconazole tab 200mg... 36 VOTRIENT TAB 200MG... 52 VPRIV INJ 400UNIT... 112 VRAYLAR CAP 1.5-3MG... 62 VRAYLAR CAP 1.5MG... 62 VRAYLAR CAP 3MG... 62 VRAYLAR CAP 4.5MG... 62 VRAYLAR CAP 6MG... 62 vyfemla tab 0.4-35... 120 W warfarin sod tab 10mg... 79 warfarin tab 1mg... 79 warfarin tab 2.5mg... 79 warfarin tab 2mg... 79 warfarin tab 3mg... 79 warfarin tab 4mg... 79 warfarin tab 5mg... 79 warfarin tab 6mg... 79 warfarin tab 7.5mg... 79 X XALKORI CAP 200MG... 52 XALKORI CAP 250MG... 52 XARELTO STAR TAB 15/20MG... 80 XARELTO TAB 10MG... 80 XARELTO TAB 15MG... 80 XARELTO TAB 20MG... 80 XELJANZ TAB 5MG... 130 XGEVA INJ... 134 XIFAXAN TAB 550MG... 10 XOLAIR SOL 150MG... 143 XTANDI CAP 40MG... 52 XYREM SOL 500MG/ML... 145 Y YERVOY INJ 50MG... 52 YF-VAX INJ... 132 Z zafirlukast tab 10mg... 139 zafirlukast tab 20mg... 139 zaleplon cap 10mg... 144 zaleplon cap 5mg... 144 ZALTRAP INJ 100/4ML... 52 ZANOSAR INJ 1GM... 52 ZARXIO INJ 300/0.5... 81 ZARXIO INJ 480/0.8... 81 ZAVESCA CAP 100MG... 112 zazole cre 0.8%... 117 ZELBORAF TAB 240MG... 52 ZENPEP CAP 10000UNT... 112 ZENPEP CAP 15000UNT... 112 ZENPEP CAP 20000UNT... 112 ZENPEP CAP 25000UNT... 112 ZENPEP CAP 3000UNIT... 112 ZENPEP CAP 5000UNIT... 112 ZEPA TAB 50-100MG... 64 ZETIA TAB 10MG... 100 ZIAGEN SOL 20MG/ML... 67 zidovudine cap 100mg... 67 zidovudine syp 50mg/5ml... 67 zidovudine tab 300mg... 67 ziprasidone cap 20mg... 62 ziprasidone cap 40mg... 62 ziprasidone cap 60mg... 62 ziprasidone cap 80mg... 62 ZIRGAN GEL 0.15%... 136 zoledronic inj 4mg/5ml... 134 zoledronic inj 5/100ml... 134 ZOLINZA CAP 100MG... 52 zolpidem tab 10mg... 144 zolpidem tab 5mg... 144 zolpidem tar sub 1.75mg... 144 zolpidem tar sub 3.5mg... 144 ZOMETA INJ 4MG/100... 134 zonisamide cap 100mg... 20 zonisamide cap 25mg... 20 zonisamide cap 50mg... 20 ZORTRESS TAB 0.25MG... 129 ZORTRESS TAB 0.5MG... 129 177

ZORTRESS TAB 0.75MG... 129 ZOSTAVAX INJ... 132 ZYDELIG TAB 100MG... 52 ZYDELIG TAB 150MG... 52 ZYFLO CR TAB 600MG... 140 ZYFLO TAB 600MG... 140 ZYKADIA CAP 150MG... 52 ZYPREXA RELP INJ 210MG... 62 ZYTIGA TAB 250MG... 52 178

歡迎來電, 我們隨時為您服務 免費電話 1.866.586.8044 聽障 / 語障專線 1.800.662.1220 info@agewellnewyork.com agewellnewyork.com HPMS 核准之處方藥一覽表檔案提交 ID 17398, 版本編號 6 此處方藥一覽表於 2016 年 9 月 23 日更新,2017 年 1 月 1 日生效 如需最新資訊或有其他問題, 請聯絡我們藥房福利管理公司 EnvisionRx 的康逸健保會員服務部, 電話 :1-844-782-7670, 聽障人士可致電 711, 服務時間為每週七天, 每天 24 小時 或可瀏覽 www.agewellnewyork.com