excluded drugs - blue cross blue shield associationambien tab 10 mg ambien cr tab 6.25 mg ambien cr...

1 A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

NM NP 11-16

Excluded Drugs Moving from the Enhanced Drug List (formerly Generics Plus) to new Performance Drug List

ABILIFY TAB 2 MG

ABILIFY TAB 5 MG

ABILIFY TAB 10 MG

ABILIFY TAB 15 MG

ABILIFY TAB 20 MG

ABILIFY TAB 30 MG

ABSORICA CAP 10 MG

ABSORICA CAP 20 MG

ABSORICA CAP 25 MG

ABSORICA CAP 30 MG

ABSORICA CAP 35 MG

ABSORICA CAP 40 MG

ABSTRAL SUB 100 MCG

ABSTRAL SUB 200 MCG

ABSTRAL SUB 300 MCG

ABSTRAL SUB 400 MCG

ABSTRAL SUB 600 MCG

ABSTRAL SUB 800 MCG

ACANYA GEL 1.2-2.5%

ACCOLATE TAB 10 MG

ACCOLATE TAB 20 MG

ACCUPRIL TAB 5 MG

ACCUPRIL TAB 10 MG

ACCUPRIL TAB 20 MG

ACCUPRIL TAB 40 MG

ACCURETIC TAB 10-12.5

ACCURETIC TAB 20-25 MG

ACEON TAB 4 MG

ACEON TAB 8 MG

ACETADOTE INJ 200 MG/ML

ACIPHEX SPR CAP 5 MG

ACIPHEX SPR CAP 10 MG

ACIPHEX TAB 20 MG

ACLOVATE CRE 0.05%

ACTICLATE TAB 75 MG

ACTICLATE TAB 150 MG

ACTIGALL CAP 300 MG

ACTIQ LOZ 200 MCG

ACTIQ LOZ 400 MCG

ACTIQ LOZ 600 MCG

ACTIQ LOZ 800 MCG

ACTIQ LOZ 1200 MCG

ACTIQ LOZ 1600 MCG

ACTIVE OB CAP

ACTIVELLA TAB 0.5-0.1 MG

ACTIVELLA TAB 1-0.5 MG

ACTONEL TAB 5 MG

ACTONEL TAB 30 MG

ACTONEL TAB 35 MG

ACTONEL TAB 150 MG

ACTOPLUS MET TAB 15-500 MG

ACTOPLUS MET TAB 15-850 MG

ACTOS TAB 15 MG

ACTOS TAB 30 MG

ACTOS TAB 45 MG

ACULAR SOL 0.5% OP

ACULAR LS SOL 0.4%

ACUVAIL SOL 0.45%

ACYCLOVIR OIN 5%

ACZONE GEL 5%

ADALAT CC TAB 30 MG ER



ADAPALENE LOT 0.1%

ADDERALL TAB 5 MG

ADDERALL TAB 7.5MG

ADDERALL TAB 10 MG

ADDERALL TAB 12.5 MG

ADDERALL TAB 15 MG

ADDERALL TAB 20 MG

ADDERALL TAB 30 MG

ADENOCARD INJ 3 MG/ML

ADENOCARD INJ 6 MG/2 ML

ADENOCARD INJ 12 MG/4 ML

ADIPEX-P CAP 37.5 MG

ADIPEX-P TAB 37.5 MG

ADOXA CAP 150 MG

ADOXA TAB 50 MG

ADOXA TAB 75 MG

ADOXA TAB 100 MG

ADOXA PAK 1/ TAB 100 MG



ADRENACLICK INJ 0.15 MG

ADRENACLICK INJ 0.3 MG

AEROSPAN AER 80 MCG

AFREZZA POW 4 & 8 UNIT

AFREZZA POW 4 UNIT

AFREZZA POW 8 &12 UNIT

AGRYLIN CAP 0.5 MG

AKNE-MYCIN OIN 2%

ALA CORT CRE 1%

ALA SCALP LOT 2%

ALCAINE SOL 0.5% OP

ALDACTAZIDE TAB 25/25

ALDACTONE TAB 25 MG

ALDACTONE TAB 50 MG

ALDACTONE TAB 100 MG

ALDARA CRE 5%

ALFENTA INJ 500/ML

ALKERAN INJ 50 MG

ALOCRIL SOL 2%

Excluded Drugs

2

NM NP 11-16

ALOG/PIOGLIP TAB 12.5-15 MG

ALOG/PIOGLIP TAB 12.5-30 MG

ALOG/PIOGLIT TAB 12.5-45 MG

ALOG/PIOGLIT TAB 25-15 MG



ALOGLIPTIN TAB 6.25MG

ALOGLIPTIN TAB 12.5 MG

ALOGLIPTIN TAB 25 MG

ALOGLIPTIN/ TAB METFORM

ALOMIDE SOL 0.1% OP

ALOSETRON TAB 0.5 MG

ALOSETRON TAB 1 MG

ALPHAGAN P SOL 0.1%

ALPHAGAN P SOL 0.15%

ALSUMA INJ 6 MG/0.5

ALTABAX OIN 1%

ALTACE CAP 1.25 MG

ALTACE CAP 2.5 MG

ALTACE CAP 5 MG

ALTACE CAP 10 MG

ALTOPREV TAB 20 MG ER



ALVESCO AER 80 MCG

ALVESCO AER 160 MCG

AMARYL TAB 1 MG

AMARYL TAB 2 MG

AMARYL TAB 4 MG

AMBIEN TAB 5 MG

AMBIEN TAB 10 MG

AMBIEN CR TAB 6.25 MG

AMBIEN CR TAB 12.56 MG

AMCINONIDE CRE 0.1%

AMCINONIDE LOT 0.1%

AMCINONIDE OIN 0.1%

AMERGE TAB 1 MG

AMERGE TAB 2.5 MG

AMIDATE INJ 2 MG/ML

AMINOSYN II INJ 15%

AMLOD/ATORVA TAB 2.5-10 MG



AMLOD/ATORVA TAB 5-10 MG








AMMONIUM LAC CRE 12%

AMMONIUM LAC LOT 12%

AMOXAPINE TAB 25 MG

AMOXAPINE TAB 50 MG

AMOXAPINE TAB 100 MG

AMOXAPINE TAB 150 MG

AMRIX CAP 15 MG

AMRIX CAP 30 MG

AMTURNIDE 150 TAB -5-12.5 MG


AMTURNIDE 300 TAB -10-25 MG


AMTURNIDE 300 TAB -5-25 MG

ANAFRANIL CAP 25 MG

ANAFRANIL CAP 50 MG

ANAFRANIL CAP 75 MG

ANALPRAM HC CRE 1-1%

ANALPRAM-HC CRE 2.5-1%

ANALPRAM-HC CRE SINGLES

ANALPRM SNGL CRE HC 2.5-1

ANAPROX DS TAB 550 MG

ANCOBON CAP 250 MG

ANCOBON CAP 500 MG

ANDRODERM DIS 2 MG/24 HR

ANDRODERM DIS 4 MG/24 HR

ANDROGEL GEL 1%(25 MG)

ANDROGEL GEL 1%(50 MG)

ANDROGEL GEL PUMP 1%

ANDROID CAP 10 MG

ANECTINE INJ 20 MG/ML

ANGIOMAX INJ 250 MG

ANTABUSE TAB 250 MG

ANTABUSE TAB 500 MG

ANTARA CAP 30 MG

ANTARA CAP 90 MG

ANTIZOL INJ 1 GM/ML

ANUSOL-HC CRE 2.5%

APEXICON E CRE 0.05%

APIDRA INJ SOLOSTAR

APIDRA INJ U-100

APLENZIN TAB 174 MG

APLENZIN TAB 348 MG

APLENZIN TAB 522 MG

APRISO CAP 0.375 GM

APTENSIO XR CAP 10 MG







ARALEN TAB 500 MG

ARAVA TAB 10 MG

ARAVA TAB 20 MG

ARESTIN MIS 1 MG

ARICEPT TAB 5 MG

ARICEPT TAB 10 MG

ARICEPT TAB 23 MG

ARICEPT ODT TAB 10 MG

ARIMIDEX TAB 1 MG

ARIXTRA INJ 2.5/0.5 ML

ARIXTRA INJ 5/0.4 ML

ARIXTRA INJ 7.5/0.6 ML

Excluded Drugs

3

NM NP 11-16

ARIXTRA INJ 10/0.8 ML

ARMODAFINIL TAB 50 MG




AROMASIN TAB 25 MG

ARTHROTEC 50 TAB

ARTHROTEC 75 TAB

ASTEPRO SPR 0.15%

ATACAND TAB 4 MG

ATACAND TAB 8 MG

ATACAND TAB 16 MG

ATACAND TAB 32 MG

ATACAND HCT TAB 16-12.5 MG

ATACAND HCT TAB 32-12.5 MG

ATACAND HCT TAB 32-25 MG

ATELVIA TAB

ATIVAN INJ 2 MG/ML

ATIVAN INJ 4 MG/ML

ATIVAN TAB 0.5 MG

ATIVAN TAB 1 MG

ATIVAN TAB 2 MG

ATRALIN GEL 0.05%

ATROVENT NAS SOL 0.03%

ATROVENT NAS SOL 0.06%

AUGMENTIN SUS 250/5 ML

AUGMENTIN SUS ES-600

AUGMENTIN TAB 500 MG

AUGMENTIN TAB 875 MG

AUGMENTIN XR TAB 12 HR

AUVI-Q INJ 0.15 MG

AUVI-Q INJ 0.3 MG

AVALIDE TAB 150-12.5

AVALIDE TAB 300-12.5

AVANDAMET TAB 2-500 MG



AVANDARYL TAB 4-2 MG




AVANDIA TAB 2 MG

AVANDIA TAB 4 MG

AVANDIA TAB 8 MG

AVAPRO TAB 75 MG

AVAPRO TAB 150 MG

AVAPRO TAB 300 MG

AVEED INJ 750/3 ML

AVELOX TAB 400 MG

AVELOX ABC TAB 400 MG

AVINZA CAP 30 MG

AVINZA CAP 45 MG

AVINZA CAP 60 MG

AVINZA CAP 75 MG

AVINZA CAP 90 MG

AVINZA CAP 120 MG

AVODART CAP 0.5 MG

AXERT TAB 6.25 MG

AXERT TAB 12.5 MG

AYGESTIN TAB 5 MG

AZACTAM INJ 1 GM

AZACTAM INJ 2 GM

AZASITE SOL 1%

AZELASTINE SPR 0.15%

AZELEX CRE 20%

AZOPT SUS 1% OP

AZOR TAB 5-20 MG

AZOR TAB 5-40 MG

AZOR TAB 10-20 MG

AZOR TAB 10-40 MG

AZULFIDINE TAB 500 MG

AZULFIDINE TAB 500 MG EN

BACTRIM TAB 400-80 MG

BACTRIM DS TAB 800-160

BACTROBAN CRE 2%

BACTROBAN OIN 2%

BAL-CARE MIS DHA

BARACLUDE TAB 0.5 MG

BARACLUDE TAB 1 MG

BECONASE AQ SUS 0.042%

BELBUCA MIS 75 MCG

BELBUCA MIS 150 MCG

BELBUCA MIS 300 MCG

BELBUCA MIS 450 MCG

BELBUCA MIS 600 MCG

BELBUCA MIS 750 MCG

BELBUCA MIS 900 MCG

BELSOMRA TAB 5 MG

BELSOMRA TAB 10 MG

BELSOMRA TAB 15 MG

BELSOMRA TAB 20 MG

BENICAR TAB 5 MG

BENICAR TAB 20 MG

BENICAR TAB 40 MG

BENICAR HCT TAB 20-12.5 MG

BENICAR HCT TAB 40-12.5 MG

BENICAR HCT TAB 40-25 MG

BENTYL CAP 10 MG

BENTYL INJ 10 MG/ML

BENTYL TAB 20 MG

BENZACLIN GEL 1-5%

BENZACLIN GEL 1-5% PUMP

BENZAMYCIN GEL 5-3%

BENZAMYCIN GEL PAK

BENZPHETAMINE TAB 25 MG

BENZPHETMINE TAB 50 MG

BEPREVE DRO 1.5%

BESIVANCE SUS 0.6%

BETADINE SOL 5% OP

BETAGAN SOL 0.5% OP

BETAPACE TAB 80 MG

BETAPACE TAB 120 MG

BETAPACE TAB 160 MG

BETAPACE AF TAB 80 MG

Excluded Drugs

4

NM NP 11-16



BETIMOL SOL 0.25%

BETIMOL SOL 0.5%

BETOPTIC-S SUS 0.25% OP

BETTERMILK PAK GLYTACTI

BETTERMILK15 POW GLYTACTN

BIAXIN SUS 250/5 ML

BIAXIN TAB 250 MG

BIAXIN TAB 500 MG

BIAXIN XL TAB 500 MG

BIAXIN XL TAB PAC 500 MG

BIMATOPROST SOL 0.03%

BINOSTO TAB 70 MG

BLEPH-10 SOL 10% OP

BLEPHAMIDE OIN S.O.P.

BLEPHAMIDE SUS OP

BLOXIVERZ INJ 5 MG/10 ML

BLOXIVERZ INJ 10 MG/10 ML

BONIVA INJ 3 MG/3 ML

BONIVA TAB 150 MG

BONTRIL PDM TAB 35 MG

BP FOLINATAL TAB PLUS B

BP MULTINATL CHW PLUS

BP MULTINATL TAB PLUS

BRAVELLE INJ 75 UNIT

BREVIBLOC INJ 10 MG/ML

BREVICON TAB 0.5/35

BRISDELLE CAP 7.5 MG

BROM/PSE/DM SYP

BROMFED DM SYP

BSS PLUS SOL OP

BUDESONIDE SUS 32 MCG

BUMEX TAB 0.5 MG

BUMEX TAB 1 MG

BUMEX TAB 2 MG

BUNAVAIL MIS 2.1-0.3 MG

BUNAVAIL MIS 4.2-0.7 MG

BUNAVAIL MIS 6.3-1 MG

BUPAP TAB 50-300 MG

BUPHENYL POW

BUPRENEX INJ 0.3 MG/ML

BUTISOL SOD ELX 30 MG/5 ML

BUTISOL SOD TAB 30 MG

BUTISOL SOD TAB 50 MG

BUTRANS DIS 5 MCG/HR

BUTRANS DIS 7.5 MCG/HR




BYETTA INJ 5 MCG

BYETTA INJ 10 MCG

BYSTOLIC TAB 2.5 MG

BYSTOLIC TAB 5 MG

BYSTOLIC TAB 10 MG

BYSTOLIC TAB 20 MG

CADUET TAB 2.5-10 MG



CADUET TAB 5-10 MG

CADUET TAB 5-20 MG

CADUET TAB 5-40 MG

CADUET TAB 5-80 MG

CADUET TAB 10-10 MG

CADUET TAB 10-20 MG

CADUET TAB 10-40 MG

CADUET TAB 10-80 MG

CAFCIT INJ 60 MG/3 ML

CAFCIT SOL 60 MG/3 ML

CALAN TAB 80 MG

CALAN TAB 120 MG

CALAN SR TAB 120 MG

CALAN SR TAB 180 MG

CALAN SR TAB 240 MG

CALC ACETATE TAB 667 MG

CALCITRIOL OIN 3 MCG/GM

CALCIUM PNV CAP

CAMBIA POW 50 MG

CAMINO PRO LIQ 15PE

CAMPRAL TAB 333 MG

CAMPTOSAR INJ 40 MG/2 ML

CAMPTOSAR INJ 100 MG/5 ML

CANDIN INJ

CAPEX SHA 0.01%

CAPITAL/COD SUS 120-12/5

CAPTOPR/HCTZ TAB 25-15 MG




CARAC CRE 0.5%

CARAFATE TAB 1 GM

CARBOCAINE INJ 1%

CARBOCAINE INJ 2%

CARBOCAINE INJ 1% PF

CARBOCAINE INJ 1.5% PF

CARBOCAINE INJ 2% PF

CARDIZEM TAB 30 MG

CARDIZEM TAB 60 MG

CARDIZEM TAB 120 MG

CARDIZEM CD CAP 120 MG/24





CARDIZEM LA TAB 180 MG/24





CARDURA TAB 1 MG

CARDURA TAB 2 MG

CARDURA TAB 4 MG

CARDURA TAB 8 MG

CARDURA XL TAB 4 MG

Excluded Drugs

5

NM NP 11-16

CARDURA XL TAB 8MG

CARISOPR/ASA TAB 200-325 mg

CARISOPRODOL TAB 250 MG

CARISOPRODOL TAB 350 MG

CARISOPRODOL TAB ASA/COD

CARNITOR INJ 1 GM/5 ML

CARNITOR SOL 1 GM/10 ML

CARNITOR SF SOL 1 GM/10 ML

CARNITOR TAB 330 MG

CASODEX TAB 50 MG

CATAFLAM TAB 50 MG

CATAPRES TAB 0.1 MG

CATAPRES TAB 0.2 MG

CATAPRES TAB 0.3 MG

CATAPRES-TTS DIS 0.1/24 HR



CEFACLOR SUS 125/5 ML



CEFACLOR ER TAB 500 MG

CEFDITOREN TAB 200 MG

CEFDITOREN TAB 400 MG

CEFOTAN INJ 1 GM/10 ML

CEFOTAN INJ 2 GM

CEFTIN TAB 250 MG

CEFTIN TAB 500 MG

CELEBREX CAP 50 MG

CELEBREX CAP 100 MG

CELEBREX CAP 200 MG

CELEBREX CAP 400 MG

CELESTONE INJ SOLUSPAN

CELEXA TAB 10 MG

CELEXA TAB 20 MG

CELEXA TAB 40 MG

CELLCEPT SUS 200 MG/ML

CENTANY OIN 2%

CEPHALEXIN TAB 250 MG

CEPHALEXIN TAB 500 MG

CEREBYX INJ 100/2 ML

CEREBYX INJ 500/10 ML

CETIRIZINE SYP 1 MG/ML

CHLORD/CLIDI CAP 5-2.5 MG

CHOR GONADOT INJ 10000 UNT

CILOXAN OIN 0.3% OP

CILOXAN SOL 0.3% OP

CIMETIDINE SOL 300/5 ML

CIMETIDINE TAB 200 MG




CIMZIA KIT

CIMZIA KIT STARTER

CIMZIA PREFL KIT 200 MG/ML

CIPRO TAB 250 MG

CIPRO TAB 500 MG

CIPRO (5%) SUS 250 MG/5

CIPRO (10%) SUS 500 MG/5

CIPRO I.V. INJ 400 MG

CIPRO XR TAB 500 MG

CIPRO XR TAB 1000 MG

CITRANATAL CAP HARMONY

CITRANATAL MIS 90 DHA

CITRANATAL MIS B-CALM

CITRANATAL PAK ASSURE

CITRANATAL PAK DHA

CITRANATAL TAB RX

CLAFORAN INJ 1 GM

CLAFORAN INJ 2 GM

CLAFORAN INJ 10 GM

CLAFORAN INJ 500 MG

CLARINEX SYP 0.5 MG/ML

CLARINEX TAB 5 MG

CLARINEX-D TAB 2.5-120 MG

CLEOCIN CAP 75 MG

CLEOCIN CAP 150 MG

CLEOCIN CAP 300 MG

CLEOCIN CRE 2% VAG

CLEOCIN PED SOL 75 MG/5 ML

CLEOCIN PHOS INJ 9 GM/60 ML

CLEOCIN PHOS INJ 300 MG



CLEOCIN/D5W INJ 300 MG



CLEOCIN-T GEL 1%

CLEOCIN-T LOT 1%

CLEOCIN-T PAD 1%

CLEOCIN-T SOL 1%

CLIMARA DIS 0.1 MG

CLIMARA DIS 0.025 MG


CLIMARA DIS 0.05 MG

CLIMARA DIS 0.06 MG


CLOBEX LOT 0.05%

CLOBEX SHA 0.05%

CLOBEX SPR 0.05%

CLOCORTOLONE CRE PIV 0.1%

CLODERM CRE 0.1%

CLODERM CRE 0.1% PMP

CLORPRES TAB 0.1-15 MG



CLOTRIMAZOLE CRE 1%

CLOTRIMAZOLE SOL 1%

CLOZARIL TAB 25 MG

CLOZARIL TAB 100 MG

C-NATE DHA CAP 28-1-200

CODEINE SULF SOL 30 MG/5 ML

CODEINE SULF TAB 15 MG



Excluded Drugs

6

NM NP 11-16

COGENTIN INJ 1 MG/ML

COLAZAL CAP 750 MG

COLCHICINE CAP 0.6 MG

COLCHICINE TAB 0.6 MG

COLESTID FLA GRA 5 GM

COLESTID FLA GRA 5/7.5 GM

COLESTID GRA 5 GM

COLESTID POW 5 GM

COLESTID TAB 1 GM

COLY-MYCIN M INJ 150 MG

COLYTE/FLAVR SOL PACKS

COMBIGAN SOL 0.2/0.5%

COMBIVIR TAB 150-300 MG

COMPAZINE PAK 5 MG

COMPAZINE TAB 10 MG

COMPLETE NAT PAK DHA

COMPLETENATE CHW

COMTAN TAB 200 MG

CO-NATAL FA TAB 29-1 MG

CONCEPT DHA CAP

CONCEPT OB CAP

CONDYLOX SOL 0.5%

CONZIP CAP 100 MG

CONZIP CAP 200 MG

CONZIP CAP 300 MG

COPAXONE INJ 20 MG/ML

COPEGUS TAB 200 MG

CORDARONE TAB 200 MG

CORDRAN CRE 0.05%

CORDRAN LOT 0.05%

CORDRAN OIN 0.05%

CORDRAN 24X3 TAP 4 MCG/CM

CORDRAN 80X3 TAP 4 MCG/CM

COREG TAB 3.125 MG

COREG TAB 6.25 MG

COREG TAB 12.5 MG

COREG TAB 25 MG

CORGARD TAB 20 MG

CORGARD TAB 40 MG

CORGARD TAB 80 MG

CORLOPAM INJ 10 MG/ML

CORTEF TAB 5 MG

CORTEF TAB 10 MG

CORTEF TAB 20 MG

CORTENEMA ENE 100 MG

CORTISPORIN CRE 0.5%

CORTISPORIN OIN 1%

CORTROSYN INJ 0.25 MG

CORVERT INJ 1 MG/10 ML

CORZIDE TAB 40-5 MG

CORZIDE TAB 80-5 MG

COSOPT SOL 22.3-6.8 MG/ML

COSOPT PF SOL

COZAAR TAB 25 MG

COZAAR TAB 50 MG

COZAAR TAB 100 MG

CRESTOR TAB 5 MG

CRESTOR TAB 10 MG

CRESTOR TAB 20 MG

CRESTOR TAB 40 MG

CRNATAL PAK

CUPRIMINE CAP 250 MG

CUTIVATE CRE 0.05%

CUTIVATE LOT 0.05%

CYCLESSA PAK

CYCLOGYL SOL 0.5% OP

CYCLOGYL SOL 1% OP

CYCLOGYL SOL 2% OP

CYCLOSET TAB 0.8 MG

CYKLOKAPRON INJ 100 MG/ML

CYMBALTA CAP 20 MG

CYMBALTA CAP 30 MG

CYMBALTA CAP 60 MG

CYTOMEL TAB 5 MCG

CYTOMEL TAB 25 MCG

CYTOMEL TAB 50 MCG

CYTOTEC TAB 100 MCG

CYTOTEC TAB 200 MCG

CYTOVENE INJ 500 MG

D.H.E. 45 INJ 1 MG/ML

DACOGEN INJ 50 MG

DANTRIUM CAP 25 MG

DANTRIUM CAP 50 MG

DANTRIUM IV INJ 20 MG

DARIFENACIN TAB HBR ER

DAYPRO TAB 600 MG

DAYTRANA DIS 10 MG/9 HR




DDAVP INJ 4 MCG/ML

DDAVP SOL 0.01%

DDAVP SPR 0.01%

DDAVP TAB 0.1 MG

DDAVP TAB 0.2 MG

DELESTROGEN INJ 20 MG/ML

DELESTROGEN INJ 40 MG/ML

DEMADEX TAB 5 MG

DEMADEX TAB 10 MG

DEMADEX TAB 20 MG

DEMADEX TAB 100 MG

DEMEROL INJ 25 MG/ML



DEMEROL TAB 50 MG

DEMEROL TAB 100 MG

DEMSER CAP 250 MG

DENAVIR CRE 1%

DEPACON INJ 100 MG/ML

DEPAKOTE TAB 125 MG DR



DEPAKOTE ER TAB 250 MG

DEPAKOTE ER TAB 500 MG

Excluded Drugs

7

NM NP 11-16

DEPAKOTE SPR CAP 125 MG

DEPO-MEDROL INJ 40 MG/ML

DEPO-MEDROL INJ 80 MG/ML

DEPO-PROVERA INJ 150MG/ML

DEPO-TESTOST INJ 100 MG/ML

DEPO-TESTOST INJ 200 MG/ML

DERMA-SMOOTH OIL /FS BODY

DERMA-SMOOTH OIL /FS SCLP

DERMATOP CRE 0.1%

DERMATOP OIN 0.1%

DERMOTIC OIL 0.01%

DESFERAL INJ 2 GM

DESFERAL INJ 500 MG

DESLORATADIN TAB 5 MG

DESLORATADIN TAB 5 MG ODT

DESLORATADIN TAB 2.5 ODT

DESOGEN-28 TAB

DESONATE GEL 0.05%

DESOWEN CRE 0.05%

DESOWEN LOT 0.05%

DESOXIMETAS CRE 0.05%

DESOXIMETAS OIN 0.05%

DESOXYN TAB 5 MG

DESVENLAFAX TAB 50 MG ER

DESVENLAFAX TAB 100 MG ER

DETROL TAB 1 MG

DETROL TAB 2 MG

DETROL LA CAP 2 MG

DETROL LA CAP 4 MG

DEXEDRINE CAP 5 MG CR



DEXILANT CAP 30 MG DR

DEXILANT CAP 60 MG DR

DEXPAK PAK 6 DAY

DEXPAK PAK 10 DAY

DEXPAK PAK 13 DAY

DIAMOX SEQUE CAP 500 MG CR

DIBENZYLINE CAP 10 MG

DIDREX TAB 50 MG

DIETHYLPROP TAB 25 MG

DIETHYLPROP TAB 75 MG ER

DIFFERIN CRE 0.1%

DIFFERIN GEL 0.1%

DIFFERIN GEL 0.3%

DIFFERIN LOT 0.1%

DIFLORASONE CRE 0.05%

DIFLORASONE OIN 0.05%

DIFLUCAN SUS 10 MG/ML

DIFLUCAN SUS 40 MG/ML

DIFLUCAN TAB 50 MG

DIFLUCAN TAB 100 MG

DIFLUCAN TAB 150 MG

DIFLUCAN TAB 200 MG

DIHYDROCOD/ CAP ASA/CAFF

DILAUDID-HP INJ 10 MG/ML

DILAUDID INJ 1 MG/ML

DILAUDID LIQ 1 MG/ML

DILAUDID TAB 2 MG

DILAUDID TAB 4 MG

DILAUDID TAB 8 MG

DIOVAN TAB 40 MG

DIOVAN TAB 80 MG

DIOVAN TAB 160 MG

DIOVAN TAB 320 MG

DIOVAN HCT TAB 80/12.5 MG

DIOVAN HCT TAB 160-12.5 MG

DIOVAN HCT TAB 160-25 MG

DIOVAN HCT TAB 320-12.5 MG

DIOVAN HCT TAB 320-25 MG

DIPENTUM CAP 250 MG

DIPHENHYDRAM ELX 12.5/5 ML

DIPRIVAN INJ

DIPRIVAN INJ 200/20 ML

DIPRIVAN INJ 500/50 ML

DIPROLENE AF CRE 0.05%

DIPROLENE LOT 0.05%

DIPROLENE OIN 0.05%

DITROPAN XL TAB 5 MG



DOLOPHINE TAB 5 MG

DOLOPHINE TAB 10 MG

DONNATAL ELX GRAPE

DONNATAL ELX MINT

DONNATAL TAB 16.2 MG

DOPRAM INJ 20 MG/ML

DORYX TAB 50 MG

DORYX TAB 200 MG

DORYX MPC TAB 120 MG

DOTHELLE DHA CAP

DOVONEX CRE 0.005%

DOXIL INJ 2 MG/ML

DOXYCYCL HYC TAB 50 MG DR





DOXYCYCLINE CAP 40 MG

DRISDOL CAP 50000 UNT

DUAC GEL 1.2-5%

DUET DHA MIS BALANCED

DUET DHA 400 MIS 25-1-400

DUET DHA 430 MIS 25-1-430

DUETACT TAB 30-2 MG

DUETACT TAB 30-4 MG

DUEXIS TAB 800-26.6

DULOXETINE CAP 40 MG

DURACLON INJ

DURAGESIC DIS 12 MCG/H

DURAGESIC DIS 25 MCG/HR




Excluded Drugs

8

NM NP 11-16

DUREZOL EMU 0.05%

DURLAZA CAP 162.5 MG

DUTOPROL TAB 25-12.5 MG



DYANAVEL XR SUS 2.5 MG/ML

DYAZIDE CAP 37.5-25 MG

DYMISTA SPR 137-50

EC-NAPROSYN TAB 375 MG

EC-NAPROSYN TAB 500 MG

ECOZA AER 1%

EDARBI TAB 40 MG

EDARBI TAB 80 MG

EDARBYCLOR TAB 40-12.5 MG

EDARBYCLOR TAB 40-25 MG

EDECRIN TAB 25 MG

EDLUAR SUB 5 MG

EDLUAR SUB 10 MG

EFFEXOR XR CAP 37.5 MG

EFFEXOR XR CAP 75 MG

EFFEXOR XR CAP 150 MG

EFUDEX CRE 5%

ELAVIL TAB 25 MG

ELDEPRYL CAP 5 MG

ELESTAT DRO 0.05%

ELIDEL CRE 1%

ELIMITE CRE 5%

ELIPHOS TAB 667 MG

ELITE-OB TAB

ELLENCE INJ 2 MG/ML

ELOCON CRE 0.1%

ELOCON LOT 0.1%

ELOCON OIN 0.1%

ELOXATIN INJ 50 MG

ELOXATIN INJ 100 MG

EMADINE SOL 0.05% OP

EMBEDA CAP 20-0.8 MG


EMBEDA CAP 50-2 MG



EMBEDA CAP 100-4 MG

EMLA CRE 2.5-2.5%

ENABLEX TAB 7.5 MG

ENABLEX TAB 15 MG

ENBRACE HR CAP

ENDOMETRIN SUP 100 MG

ENSTILAR AER

ENTOCORT EC CAP 3 MG/24 HR

EPIDUO GEL 0.1-2.5%

EPIDUO FORTE GEL 0.3-2.5%

EPIFOAM AER 1%

EPINASTINE DRO 0.05%

EPINEPHRINE INJ 0.15 MG

EPINEPHRINE INJ 0.3 MG

EPIVIR SOL 10 MG/ML

EPIVIR TAB 150 MG

EPIVIR TAB 300 MG

EPIVIR HBV TAB 100 MG

EPROSART MES TAB 600 MG

ERGOLOID MES TAB 1 MG ORAL

ERTACZO CRE 2%

ERYGEL GEL 2%

ESGIC TAB

ESOMEPRA MAG CAP 20 MG DR

ESOMEPRA MAG CAP 40 MG DR

ESOMEPRAZOLE CAP 49.3 MG

ESTRACE TAB 0.5 MG

ESTRACE TAB 1 MG

ESTRACE TAB 2 MG

ESTROSTEP FE TAB

ETHYOL INJ 500 MG

ETIDRON DISD TAB 200 MG

ETIDRON DISD TAB 400 MG

EVEKEO TAB 5 MG

EVEKEO TAB 10 MG

EVISTA TAB 60 MG

EVOCLIN AER 1%

EVOXAC CAP 30 MG

EVZIO INJ

EXALGO TAB 8 MG

EXALGO TAB 12 MG

EXALGO TAB 16 MG

EXALGO TAB 32 MG

EXELDERM CRE 1%

EXELDERM SOL 1%

EXELON CAP 1.5 MG

EXELON CAP 3 MG

EXELON CAP 4.5 MG

EXELON CAP 6 MG

EXELON DIS 4.6 MG /24 HR

EXELON DIS 9.5 MG /24 HR

EXELON DIS 13.3 MG/24 HR

EXFORGE TAB 5-160 MG




EXFORGEH/5- TAB 160-12.5 MG

EXFORGEH/5- TAB 160-25 MG

EXFORGEH/10- TAB 160-12.5 MG



EXTAVIA INJ 0.3 MG

EXTINA AER 2%

EXTRA-VIRT CAP PLUS DHA

FABIOR AER 0.1%

FAMOTIDINE SUS 40 MG/5 ML

FAMOTIDINE TAB 20 MG

FAMVIR TAB 125 MG

FAMVIR TAB 250 MG

FAMVIR TAB 500 MG

FAZACLO TAB 25 MG ODT

FAZACLO TAB 100 ODT

FELBATOL SUS 600/5M L

Excluded Drugs

9

NM NP 11-16

FELBATOL TAB 400 MG

FELBATOL TAB 600 MG

FELDENE CAP 10 MG

FELDENE CAP 20 MG

FEMARA TAB 2.5 MG

FEMCON FE CHW

FEMHRT TAB 0.5 MG-2.5 MCG

FENOFIBRATE CAP 50 MG



FENOFIBRATE TAB 40 MG

FENOFIBRATE TAB 120 MG

FENOFIBRIC TAB 35 MG

FENOFIBRIC TAB 105 MG

FENOGLIDE TAB 40 MG

FENOGLIDE TAB 120 MG

FENOPROFEN CAP 200 MG

FENOPROFEN CAP 400 MG

FENOPROFEN TAB 600 MG

FENORTHO CAP 200 MG

FENORTHO CAP 400 MG

FENTANYL DIS 37.5 MCG



FENTORA TAB 100 MCG

FENTORA TAB 200 MCG

FENTORA TAB 400 MCG

FENTORA TAB 600 MCG

FENTORA TAB 800 MCG

FERRLECIT INJ 12.5 MG/M

FEXMID TAB 7.5 MG

FIBRICOR TAB 35 MG

FIBRICOR TAB 105 MG

FIORICET CAP

FIORICET CAP CODEINE

FIORINAL CAP

FIORINAL/COD CAP 30 MG

FLAGYL CAP 375 MG

FLAGYL TAB 250 MG

FLAGYL TAB 500 MG

FLAVOXATE TAB 100 MG

FLECTOR DIS 1.3%

FLOLAN INJ 0.5 MG

FLOLAN INJ 1.5 MG

FLOMAX CAP 0.4 MG

FLONASE SPR 0.05%

FLOWTUSS SOL 2.5-200

FLUDARA INJ 50 MG

FLUMADINE TAB 100 MG

FLUNISOLIDE SPR 0.025%

FLUORESCITE INJ 10% OP

FLUOROPLEX CRE 1%

FLUOROURACIL CRE 0.5%

FLUOXETINE TAB 60 MG

FLUVOXAMINE CAP 100 MG ER

FLUVOXAMINE CAP 150 MG ER

FML OIN 0.1% OP

FML FORTE SUS 0.25% OP

FML LIQUIFLM SUS 0.1% OP

FOCALGIN 90 MIS DHA

FOCALGIN CA MIS

FOCALGIN-B TAB

FOCALIN TAB 2.5 MG

FOCALIN TAB 5 MG

FOCALIN TAB 10 MG

FOCALIN XR CAP 5 MG

FOCALIN XR CAP 10 MG







FOLCAL DHA CAP

FOLCAPS CAP OMEGA 3

FOLET DHA PAK

FOLET ONE CAP 38-1-225

FOLIVANE-OB CAP

FOLIVANE-PRX CAP DHA NF

FORADIL CAP AEROLIZE

FORANE SOL

FORFIVO XL TAB 450 MG

FORTAMET TAB 500 MG

FORTAMET TAB 1000 MG

FORTAZ INJ 1 GM

FORTAZ INJ 2 GM

FORTAZ INJ 6 GM

FORTESTA GEL 10 MG/ACT

FORTICAL SPR 200/ACT

FOSAMAX TAB 70 MG

FOSAMAX + D TAB 70-2800

FOSAMAX + D TAB 70-5600

FROVA TAB 2.5 MG

FURADANTIN SUS 25 MG/5 ML

FUROSEMIDE SOL 8 MG/ML

GABITRIL TAB 2 MG

GABITRIL TAB 4 MG

GARAMYCIN SOL 0.3% OP

GASTROCROM CON 100/5 ML

GASTROGRAFIN SOL 66-10%

GEL-KAM CON 0.63%

GELNIQUE GEL 3%

GELNIQUE GEL 10%

GEMZAR INJ 1 GM

GEMZAR INJ 200 MG

GENERESS FE CHW

GENOTROPIN INJ 0.2 MG




GENOTROPIN INJ 1 MG




Excluded Drugs

10

NM NP 11-16


GENOTROPIN INJ 2 MG

GENOTROPIN INJ 5MG

GENOTROPIN INJ 12 MG

GENTAMICIN OIN 0.1%

GEODON CAP 20 MG

GEODON CAP 40 MG

GEODON CAP 60 MG

GEODON CAP 80 MG

GESTICARE PAK DHA

GIALAX KIT

GIAZO TAB 1.1 GM

GLEEVEC TAB 100 MG

GLEEVEC TAB 400 MG

GLUCOPHAGE TAB 500 MG



GLUCOPHAGE TAB 500 MG XR

GLUCOPHAGE TAB 750 MG XR

GLUCOTROL TAB 5 MG

GLUCOTROL TAB 10 MG

GLUCOTROL XL TAB 2.5 MG

GLUCOTROL XL TAB 5 MG

GLUCOTROL XL TAB 10 MG

GLUCOVANCE TAB 1.25-250 MG

GLUCOVANCE TAB 2.5-500 MG

GLUCOVANCE TAB 5-500MG MG

GLUMETZA TAB 500 MG

GLUMETZA TAB 1000 MG

GLYDO GEL 2%

GLYNASE TAB 1.5 MG

GLYNASE TAB 3 MG

GLYNASE TAB 6 MG

GLYSET TAB 25 MG

GLYSET TAB 50 MG

GLYSET TAB 100 MG

GLYTACTIN LIQ RTD 10

GLYTACTIN LIQ RTD 15

GLYXAMBI TAB 10-5 MG

GLYXAMBI TAB 25-5 MG

GOLYTELY SOL

GOLYTELY SOL PINEAPPL

GONAL-F INJ 450 UNIT

GONAL-F INJ 1050 UNIT

GONAL-F RFF INJ 75 UNIT

GONAL-F RFF INJ 300/0.5 UNIT



GRALISE STAR MIS 300/600

GRALISE TAB 300 MG

GRALISE TAB 600 MG

GRIFULVIN V TAB 500 MG

GRIS-PEG TAB 125 MG

GRIS-PEG TAB 250 MG

HALCION TAB 0.25 MG

HALDOL DECAN INJ 50 MG/ML

HALDOL DECAN INJ 100 MG/ML

HALDOL INJ 5 MG/ML

HALOG CRE 0.1%

HALOG OIN 0.1%

HECTOROL CAP 0.5 MCG

HECTOROL CAP 1 MCG

HECTOROL CAP 2.5 MCG

HECTOROL INJ 4 MCG/2 ML

HEMANGEOL SOL 4.28/ML

HEMENATAL OB MIS + DHA

HEMENATAL OB TAB 28-6-1 MG

HEP SOD/D5W INJ 50 UNT/ML

HEP SOD/NACL INJ 1000 UNIT

HEP SOD/NACL INJ 2000 UNIT

HEPSERA TAB 10 MG

HESPAN INJ 6%/NACL

HIPREX TAB 1 GM

HOMACTIN AA LIQ PLUS

HORIZANT TAB 300 MG

HORIZANT TAB 600 MG

HUMALOG INJ 100/ML

HUMALOG KWIK INJ 100/ML

HUMALOG KWIK INJ 200/ML

HUMALOG MIX INJ 50/50

HUMALOG MIX INJ 50/50KWP

HUMALOG MIX INJ 75/25KWP

HUMALOG MIX SUS 75/25

HUMATROPE INJ 5 MG

HUMATROPE INJ 6 MG

HUMATROPE INJ 12 MG

HUMATROPE INJ 24 MG

HYCAMTIN INJ 4 MG

HYCET SOL 7.5-325

HYCOFENIX SOL

HYDREA CAP 500 MG

HYDROCO/APAP SOL 7.5-500

HYDROCORT CRE 1%

HYDROCORT OIN 1%

HYDROCORT/AB OIN 1%

HYDROMORPHON TAB 32 MG ER

HYSINGLA ER TAB 20 MG







HYZAAR TAB 50-12.5

HYZAAR TAB 100-12.5

HYZAAR TAB 100-25

IBUDONE TAB 10-200 MG

IBUPROFEN SUS 100/5 ML

IC GREEN INJ 25 MG

IDAMYCIN PFS INJ 5 MG/5 ML

IDAMYCIN PFS INJ 10/10 ML

IDAMYCIN PFS INJ 20/20 ML

IFEX INJ 1 GM

ILEVRO DRO 0.3% OP

Excluded Drugs

11

NM NP 11-16

IMDUR TAB 30 MG ER

IMDUR TAB 60 MG ER

IMDUR TAB 120 MG ER

IMITREX INJ 4 MG/0.5

IMITREX INJ 6 MG/0.5

IMITREX SPR 5 MG/ACT

IMITREX SPR 20 MG/ACT

IMITREX TAB 25 MG

IMITREX TAB 50 MG

IMITREX TAB 100 MG

INATAL ADV TAB

INATAL GT TAB

INATAL ULTRA TAB

INCIVEK TAB 375 MG

INDERAL LA CAP 60 MG




INDERAL XL CAP 80 MG

INDERAL XL CAP 120 MG

INDOCIN SUP 25 MG/5 ML

INDOCIN SUS 50 MG

INFANATE CAP BALANCE

INFANATE CAP PLUS

INNOPRAN XL CAP 80 MG

INNOPRAN XL CAP 120 MG

INSPRA TAB 25 MG

INSPRA TAB 50 MG

INTEGRILIN INJ

INTEGRILIN INJ 0.75 MG/1 ML

INTEGRILIN INJ 2 MG/ML

INTEGRILIN INJ 20 MG/10 ML

INTERMEZZO SUB 1.75 MG

INTERMEZZO SUB 3.5 MG

INTUNIV TAB 1 MG

INTUNIV TAB 2 MG

INTUNIV TAB 3 MG

INTUNIV TAB 4 MG

INVEGA TAB 1.5 MG

INVEGA TAB 3 MG

INVEGA TAB 6 MG

INVEGA TAB 9 MG

IOPIDINE SOL 0.5% OP

IOPIDINE SOL 1% OP

IRENKA CAP 40 MG

ISOPTO CARP SOL 1% OP



ISORDIL TAB 5 MG

ISOVACTIN AA LIQ PLUS

ISTALOL SOL 0.5% OP

JALYN CAP

JUBLIA SOL 10%

KADIAN CAP 10 MG ER

KADIAN CAP 20 MG ER

KADIAN CAP 30 MG ER

KADIAN CAP 40 MG ER

KADIAN CAP 50 MG ER

KADIAN CAP 60 MG ER

KADIAN CAP 80 MG ER

KADIAN CAP 100 MG ER

KADIAN CAP 200 MG ER

KAPVAY TAB 0.1 MG

KAYEXALATE POW

KAZANO 12.5- TAB 500 MG

KAZANO 12.5- TAB 1000 MG

KEFLEX CAP 250 MG

KEFLEX CAP 500 MG

KEFLEX CAP 750 MG

KENALOG AER SPRAY

KEPPRA INJ 500/5 ML

KEPPRA SOL 100 MG/ML

KEPPRA TAB 250 MG

KEPPRA TAB 500 MG

KEPPRA TAB 750 MG

KEPPRA TAB 1000 MG

KEPPRA XR TAB 500 MG

KEPPRA XR TAB 750 MG

KERLONE TAB 10 MG

KERLONE TAB 20 MG

KERYDIN SOL 5%

KETALAR INJ 10 MG/ML



KETEK TAB 300 MG

KETEK TAB 400 MG

KETOCONAZOLE TAB 200 MG

KETOPROFEN CAP 200 MG ER

KETOVIE LIQ CHOCOLAT

KETOVIE LIQ PEPTIDE

KETOVIE LIQ VANILLA

KEVEYIS TAB 50 MG

KHEDEZLA TAB 50 MG ER

KHEDEZLA TAB 100 MG ER

KINERET INJ

KLARON LOT 10%

KLONOPIN TAB 0.5 MG

KLONOPIN TAB 1 MG

KLONOPIN TAB 2 MG

KRISTALOSE PAK 10 GM

KRISTALOSE PAK 20 GM

K-TAB TAB 10 MEQ CR

LAC-HYDRIN CRE 12%

LAC-HYDRIN LOT 12%

LACRISERT MIS 5 MG OP

LAMICTAL CHW 5 MG

LAMICTAL CHW 25 MG

LAMICTAL TAB 25 MG

LAMICTAL TAB 100 MG

LAMICTAL TAB 150 MG

LAMICTAL TAB 200 MG

LAMICTAL ODT KIT

LAMICTAL ODT TAB 25 MG


Excluded Drugs

12

NM NP 11-16



LAMICTAL XR TAB 25 MG






LAMISIL SPR 1%

LAMISIL TAB 250 MG

LANOXIN INJ 0.25 MG/1 ML

LANSOPR/AMOX MIS /CLARITH

LANSOPRAZOLE CAP 15 MG DR

LANSOPRAZOLE CAP 30 MG DR

LASIX TAB 20 MG

LASIX TAB 40 MG

LASIX TAB 80 MG

LASTACAFT SOL 0.25%

LAZANDA SPR 100 MCG

LAZANDA SPR 300 MCG

LAZANDA SPR 400 MCG

LESCOL CAP 20 MG

LESCOL CAP 40 MG

LESCOL XL TAB 80 MG

LEVAQUIN SOL 25 MG/ML

LEVAQUIN TAB 250 MG

LEVAQUIN TAB 500 MG

LEVAQUIN TAB 750 MG

LEVAQUIN/D5W INJ 250 MG/50 ML



LEVATOL TAB 20 MG

LEVOCETIRIZINE SOL 2.5 MG/5 ML

LEVOCETIRIZINE TAB 5 MG

LEVOMEFOLATE CAP DHA

LEVOPHED INJ 1 MG/ML

LEVORPHANOL TAB 2 MG

LEVULAN KERA SOL 20%

LEXAPRO SOL 5 MG/5 ML

LEXAPRO TAB 5 MG

LEXAPRO TAB 10 MG

LEXAPRO TAB 20 MG

LIBRAX CAP 5-2.5 MG

LIDOCAINE GEL 2%

LIDOCAINE GEL 2% JELLY

LIDODERM DIS 5%

LINCOCIN INJ 300 MG/ML

LIPITOR TAB 10 MG

LIPITOR TAB 20 MG

LIPITOR TAB 40 MG

LIPITOR TAB 80 MG

LIPOFEN CAP 50 MG

LIPOFEN CAP 150 MG

LIVALO TAB 1 MG

LIVALO TAB 2 MG

LIVALO TAB 4 MG

LOCOID CRE 0.1%

LOCOID LIPO CRE 0.1%

LOCOID LOT 0.1%

LOCOID OIN 0.1%

LOCOID SOL 0.1%

LODOSYN TAB 25 MG

LOESTRIN TAB 1/20-21

LOESTRIN 21 TAB 1.5/30

LOESTRIN FE TAB 1/20

LOESTRIN FE TAB 1.5/30

LOFIBRA CAP 67 MG

LOFIBRA CAP 134 MG

LOFIBRA CAP 200 MG

LOFIBRA TAB 54 MG

LOFIBRA TAB 160 MG

LOMOTIL TAB 2.5 MG

LOPERAMIDE CAP 2 MG

LOPID TAB 600 MG

LOPRESS HCT TAB 50-25MG

LOPRESS HCT TAB 100-25 MG

LOPRESSOR INJ 5 MG/5 ML

LOPRESSOR TAB 50 MG

LOPRESSOR TAB 100 MG

LOPROX SHA 1%

LORTAB ELX 10-300 MG

LORZONE TAB 375 MG

LORZONE TAB 750 MG

LOSEASONIQUE TAB

LOTENSIN TAB 10 MG

LOTENSIN TAB 20 MG

LOTENSIN TAB 40 MG

LOTENSIN HCT TAB 10-12.5 MG

LOTENSIN HCT TAB 20-12.5 MG

LOTENSIN HCT TAB 20-25 MG

LOTREL CAP 2.5-10 MG

LOTREL CAP 5-10 MG

LOTREL CAP 5-20 MG

LOTREL CAP 5-40 MG

LOTREL CAP 10-20 MG

LOTREL CAP 10-40 MG

LOTRISONE CRE

LOTRONEX TAB 0.5 MG

LOTRONEX TAB 1 MG

LOVAZA CAP 1 GM

LOVENOX INJ 30 MG/0.3 ML




LOVENOX INJ 100 MG/ML


LOVENOX INJ 150 MG/ ML

LOVENOX INJ 300 MG/3 ML

LUMIGAN SOL 0.01%

LUNESTA TAB 1 MG

LUNESTA TAB 2 MG

LUNESTA TAB 3 MG

LUVOX CR CAP 100 MG

LUVOX CR CAP 150 MG

Excluded Drugs

13

NM NP 11-16

LUXIQ AER 0.12%

LUZU CRE 1%

LYSTEDA TAB 650 MG

MACNATAL CN CAP DHA

MACROBID CAP 100 MG

MACRODANTIN CAP 25 MG



MALARONE TAB 62.5-25 MG

MALARONE TAB 250-100 MG

MAPROTILINE TAB 25 MG



MARCAINE INJ 0.25%

MARCAINE INJ 0.5%

MARCAINE INJ 0.75%

MARCAINE INJ SPINAL

MARCAINE/EPI INJ 0.25%

MARCAINE/EPI INJ 0.5%

MARINOL CAP 2.5 MG

MARINOL CAP 5 MG

MARINOL CAP 10 MG

MARNATAL-F CAP

MAVIK TAB 1 MG

MAVIK TAB 2 MG

MAVIK TAB 4 MG

MAXALT TAB 10 MG

MAXALT TAB 5 MG

MAXALT-MLT TAB 5 MG

MAXALT-MLT TAB 10 MG

MAXIPIME INJ 1 GM

MAXIPIME INJ 2 GM

MAXITROL OIN 0.1% OP

MAXITROL SUS 0.1% OP

MAXZIDE TAB 75-50 MG

MAXZIDE-25 TAB MG

MECLIZINE TAB 12.5 MG

MECLIZINE TAB 25 MG

MECLOFEN SOD CAP 50 MG

MECLOFEN SOD CAP 100 MG

MEDROL TAB 4 MG

MEDROL TAB 8 MG

MEDROL TAB 16 MG

MEDROL TAB 32 MG

MEGACE ES SUS 625 MG/5 ML

MEGACE ORAL SUS 40 MG/ML

MELOXICAM SUS 7.5 MG/5 ML

MENTAX CRE 1%

MEPERIDINE SOL 50 MG/5 ML

MEPERIDINE TAB 50 MG

MEPERIDINE TAB 100 MG

MEPROBAMATE TAB 200 MG

MEPROBAMATE TAB 400 MG

MEPRON SUS

MERREM INJ 500 MG

MERREM INJ 1 GM

MESNEX INJ 1 GM

MESTINON TAB 60 MG

MESTINON TAB TIMESPAN

METADATE CD CAP 10 MG






METAPROTEREN SYP 10 MG/5 ML

METAPROTEREN TAB 10 MG

METAPROTEREN TAB 20 MG

METFORMIN TAB 1000 MG

METFORMIN TAB 500 MG ER

METHADONE SOL 5 MG/5 ML

METHADONE SOL 10 MG/5 ML

METHADOSE CON 10 MG/ML

METHADOSE SF CON 10 MG/ML

METHYLD/HCTZ TAB 250/15 MG

METHYLD/HCTZ TAB 250/25 MG

METHYLIN CHW 2.5 MG

METHYLIN CHW 5 MG

METHYLIN CHW 10 MG

METHYLIN SOL 5 MG/5 ML

METHYLIN SOL 10 MG/5 ML

METHYLPHENID TAB 18 MG ER




METOZOLV ODT TAB 5 MG

METROCREAM CRE 0.75%

METROGEL GEL 1%

METROGEL-VAG GEL 0.75%

METROLOTION LOT 0.75%

MEVACOR TAB 40 MG

MIACALCIN SPR 200/ACT

MICARDIS TAB 20 MG

MICARDIS TAB 40 MG

MICARDIS TAB 80 MG

MICARDIS HCT TAB 40/12.5 MG

MICARDIS HCT TAB 80/12.5 MG

MICARDIS HCT TAB 80/25 MG

MICRO-K CAP 8 MEQ CR

MICRO-K CAP 10 MEQ CR

MICROZIDE CAP 12.5 MG

MINIPRESS CAP 1 MG

MINIPRESS CAP 2 MG

MINIPRESS CAP 5 MG

MINOCIN CAP 50 MG

MINOCIN CAP 75 MG

MINOCIN CAP 100 MG

MIRAPEX TAB 0.125 MG

MIRAPEX TAB 0.25 MG

MIRAPEX TAB 0.5 MG

MIRAPEX TAB 0.75 MG

MIRAPEX TAB 1 MG

MIRAPEX TAB 1.5 MG

MIRAPEX ER TAB 0.375 MG

Excluded Drugs

14

NM NP 11-16




MIRAPEX ER TAB 3 MG



MIRCETTE TAB 28 DAY

MITIGARE CAP 0.6 MG

MITOSOL KIT 0.2 MG

MOBIC SUS 7.5 MG /5 ML

MOBIC TAB 7.5 MG

MOBIC TAB 15 MG

MODICON TAB 0.5/35 MG

MOMETASONE SPR 50 MCG

MONODOX CAP 75 MG

MONODOX CAP 100 MG

MONTELUKAST GRA 4 MG

MORPHINE SUL CAP 30 MG ER






MORPHINE SUL INJ 4 MG/ML



MOVIPREP SOL

MOXEZA SOL 0.5%

MS CONTIN TAB 15 MG CR





M-VIT TAB 27-1 MG

MYAMBUTOL TAB 100 MG

MYAMBUTOL TAB 400 MG

MYCOBUTIN CAP 150 MG

MYDRIACYL SOL 1% OP

MYNATAL CAP

MYNATE 90 TAB PLUS

NAFTIFINE CRE HCL 1%

NAFTIFINE CRE HCL 2%

NAFTIN CRE 1%

NAFTIN CRE 2%

NAFTIN GEL 1%

NAFTIN GEL 2%

NALFON CAP 400 MG

NAMENDA SOL 10 MG/5 ML

NAMENDA TAB 5 MG

NAMENDA TAB 5-10 MG

NAMENDA TAB 10 MG

NAMENDA XR CAP 7 MG

NAMENDA XR CAP 14 MG



NAMENDA XR CAP TITRATIO

NAMZARIC CAP 14-10 MG

NAMZARIC CAP 28-10 MG

NAPRELAN TAB 375 MG CR



NAPROSYN SUS 125 MG/5 ML

NAPROSYN TAB 250 MG

NAPROSYN TAB 375 MG

NAPROSYN TAB 500 MG

NARDIL TAB 15 MG

NAROPIN INJ 2 MG/ML

NAROPIN INJ 5 MG/ML

NAROPIN INJ 7.5 MG/ML

NAROPIN INJ 10 MG/ML

NASONEX SPR 50 MCG/AC

NATACHEW CHW

NATALVIRT CA PAK

NATALVIRT MIS 90 DHA

NATALVIT TAB 75-1 MG

NATELLE ONE CAP

NATESTO GEL 5.5 MG

NAVELBINE INJ 10 MG/ML

NAVELBINE INJ 50 MG/5 ML

NEEVO DHA CAP 27-1.13 MG

NEFAZODONE TAB 50 MG





NEO/POLY/HC SUS OP

NEOSPORIN SOL OP

NEOSPORIN GU SOL 40/ML IR

NEO-SYNALAR CRE

NEPTAZANE TAB 25 MG

NEPTAZANE TAB 50 MG

NESACAINE INJ 2%

NESACAINE INJ -MPF 2%

NESACAINE INJ -MPF 3%

NESINA TAB 6.25 MG

NESINA TAB 12.5 MG

NESINA TAB 25 MG

NESTABS TAB

NESTABS ABC MIS

NESTABS DHA PAK

NEURONTIN CAP 100 MG



NEURONTIN SOL 250 MG/ 5 ML

NEURONTIN TAB 600 MG

NEURONTIN TAB 800 MG

NEVANAC SUS 0.1%

NEWGEN TAB 32-1 MG

NEXA PLUS CAP

NEXIUM CAP 20 MG

NEXIUM CAP 40 MG

NEXIUM I.V. INJ 40 MG

NIACOR TAB 500 MG

NIASPAN TAB 500 MG ER

Excluded Drugs

15

NM NP 11-16



NICAZELDOXY KIT 30

NICAZELDOXY KIT 60

NIMBEX INJ 2 MG/ML

NIMBEX INJ 10 MG/ML

NIRAVAM TAB 0.25 MG

NISOLDIPINE TAB 8.5 MG ER

NISOLDIPINE TAB 17 MG ER

NISOLDIPINE TAB 34 MG ER

NITRO-DUR DIS 0.1 MG/HR




NITROGLY/D5W INJ 25 MG



NITROLINGUAL SPR PUMPSPRA

NIVA-PLUS TAB

NIZATIDINE CAP 150 MG

NIZATIDINE CAP 300 MG

NIZATIDINE SOL 15 MG/ML

NIZORAL SHA 2%

NORCO TAB 5-325 MG

NORCO TAB 7.5-325 MG

NORCO TAB 10-325 MG

NORDITROPIN INJ 5 MG/1.5 ML



NORDITROPIN INJ 30 MG/3 ML

NORFLEX INJ 30 MG/ML

NORINYL TAB 1/35

NORITATE CRE 1%

NORPRAMIN TAB 10 MG

NORPRAMIN TAB 25 MG

NORPRAMIN TAB 50 MG

NORPRAMIN TAB 75 MG

NORPRAMIN TAB 100 MG

NORPRAMIN TAB 150 MG

NOR-QD TAB 0.35 MG

NORTHERA CAP 100 MG

NORTHERA CAP 200 MG

NORTHERA CAP 300 MG

NORVASC TAB 2.5 MG

NORVASC TAB 5 MG

NORVASC TAB 10 MG

NOVAREL INJ 10000 UNT

NUCYNTA TAB 50 MG

NUCYNTA TAB 75 MG

NUCYNTA TAB 100 MG

NUCYNTA ER TAB 50 MG





NULYTELY SOL FLAV PKS

NUTRITIONAL DRINK

NUTROPIN AQ INJ 10 MG/2 ML

NUTROPIN AQ INJ 20 MG/2 ML

NUTROPIN AQ INJ NUSPIN 5

NUVIGIL TAB 50 MG

NUVIGIL TAB 150 MG

NUVIGIL TAB 200 MG

NUVIGIL TAB 250 MG

NYSTAT/TRIAM CRE

NYSTAT/TRIAM OIN

OB COMPLETE CAP GOLD

OB COMPLETE CAP ONE

OB COMPLETE CAP PETITE

OB COMPLETE TAB

OB COMPLETE TAB PREMIER

OB COMPLETE/ CAP DHA

OBREDON SOL 2.5-200

OBSTETRIX PAK DHA

OBSTETRIX EC TAB

O-CAL TAB PRENATAL

O-CAL FA TAB

OCUFEN SOL 0.03% OP

OCUFLOX DRO 0.3% OP

OLANZA/FLUOX CAP 3-25 MG




OLANZA/FLUOX CAP12-50 MG

OLEPTRO TAB 24 HR 150 MG

OLEPTRO TAB 24 HR 300 MG

OLOPATADINE DRO 0.1%

OLOPATADINE SPR 0.6%

OLUX AER 0.05%

OLUX-E AER 0.05%

OMECLAMOX- MIS PAK

OMEGA-3-ACID CAP 1 GM

OMEPRA/BICAR CAP 20-1100 MG

OMEPRA/BICAR CAP 40-1100 MG

OMNARIS SPR

OMNIPRED SUS 1% OP

OMONTYS INJ 10 MG/ML

OMONTYS INJ 20 MG/2 ML

ONEXTON GEL 1.2-3.75%

ONMEL TAB 200 MG

OPANA TAB 5 MG

OPANA TAB 10 MG

OPANA ER TAB 5 MG

OPANA ER TAB 7.5 MG

OPANA ER TAB 10 MG

OPANA ER TAB 15 MG

OPANA ER TAB 20 MG

OPANA ER TAB 30 MG

OPANA ER TAB 40 MG

OPTIVAR DRO 0.05%

ORACEA CAP 40 MG

ORAP TAB 1 MG

ORAP TAB 2 MG

ORAPRED ODT TAB 10 MG

Excluded Drugs

16

NM NP 11-16



ORTHO-CEPT TAB 28

ORTHO-CYCLEN TAB 0.25/35

ORTHO EVRA DIS WEEK

ORTHO MICRON TAB 0.35 MG

ORTHO-NOVUM TAB 1/35

ORTHO-NOVUM TAB 7/7/7

ORTHO TRI- TAB CYCLEN

ORTHO TRI- TAB CYCLN LO

OSENI TAB 12.5-15 MG



OSENI TAB 25-15 MG

OSENI TAB 25-30 MG

OSENI TAB 25-45 MG

OSMOPREP TAB 1.5 GM

OSPHENA TAB 60 MG

OVCON-35 TAB

OVIDE LOT 0.5%

OXANDRIN TAB 2.5 MG

OXANDRIN TAB 10 MG

OXAYDO TAB 5 MG

OXAYDO TAB 7.5 MG

OXISTAT CRE 1%

OXISTAT LOT 1%

OXSORALEN-UL CAP 10 MG

OXTELLAR XR TAB 150 MG



OXYCODONE TAB 10 MG ER







OXYTROL DIS 3.9 MG/24 HR

PAIRE OB MIS

PAMELOR CAP 10 MG

PAMELOR CAP 25 MG

PAMELOR CAP 50 MG

PAMELOR CAP 75 MG

PAMINE TAB 2.5 MG

PAMINE FORTE TAB 5 MG

PANCREAZE CAP 4200 UNT



PANCREAZE CAP 21000 UNIT

PANCRELIPASE CAP 5000 UNIT

PANDEL CRE 0.1%

PANRETIN GEL 0.1%

PARAFON FORT TAB 500 MG

PARLODEL CAP 5 MG

PARNATE TAB 10 MG

PAROXETIN ER TAB 12.5 MG

PAROXETIN ER TAB 37.5 MG

PATADAY SOL 0.2%

PATANASE SPR 0.6%

PATANOL SOL 0.1% OP

PAXIL SUS 10 MG/5 ML

PAXIL TAB 10 MG

PAXIL TAB 20 MG

PAXIL TAB 30 MG

PAXIL TAB 40 MG

PAXIL CR TAB 12.5 MG

PAXIL CR TAB 25 MG

PAXIL CR TAB 37.5 MG

PAZEO DRO 0.7%

PCP 100 KIT

PEDIAPRED SOL 6.7/5 ML

PEGYLAX POW

PENLAC SOL 8%

PENNSAID SOL 1.5%

PENNSAID SOL 2%

PENTAZ/NALOX TAB 50-0.5 MG

PEPCID SUS 40 MG/5 ML

PEPCID TAB 20 MG

PEPCID TAB 40 MG

PERCOCET TAB 2.5-325 MG

PERCOCET TAB 5-325 MG

PERCOCET TAB 7.5-325 MG

PERCOCET TAB 10-325 MG

PERCODAN TAB

PERIDEX SOL 0.12%

PERSANTINE TAB 25 MG



PERTZYE CAP

PEXEVA TAB 10 MG

PEXEVA TAB 20 MG

PEXEVA TAB 30 MG

PEXEVA TAB 40 MG

PFIZERPEN-G INJ 5 MU

PFIZERPEN-G INJ 20 MU

PHENACTIN AA LIQ PLUS

PHENDIMETRAZ CAP 105 MG ER

PHENDIMETRAZ TAB 35 MG

PHENERGAN INJ 25 MG/ML

PHENERGAN INJ 50 MG/ML

PHOSLO CAP 667 MG

PHOSPHOLINE SOL 0.125% OP

PICATO GEL 0.015%

PICATO GEL 0.05%

PIOGLIT/GLIM TAB 30-2 MG

PIOGLIT/GLIM TAB 30-4 MG

PITOCIN INJ 10 UNT/ML

PLAQUENIL TAB 200 MG

PLAVIX TAB 75 MG

PLAVIX TAB 300 MG

PLEGISOL SOL

PLETAL TAB 50 MG

PLETAL TAB 100 MG

PLIAGLIS CRE 7-7%

Excluded Drugs

17

NM NP 11-16

PNV-DHA CAP

PNV-DHA CAP DOCUSATE

PNV FE FUM TAB DOC/FA

PNV FOLIC AC TAB + IRON

PNV OB+DHA PAK

PNV-OMEGA CAP

PNV PRENATAL TAB PLUS

PNV-SELECT TAB

PNV TABS TAB 29-1 MG

PNV-TOTAL CAP

PNV-VP-U CAP 106.5-1 MG

POLYETH GLYC POW 3350 NF

POLYTRIM SOL OP

PONSTEL CAP 250 MG

PR NATAL 400 PAK

PR NATAL 400 PAK EC

PR NATAL 430 PAK

PR NATAL 430 PAK EC

PRAMOSONE CRE 1%

PRAMOSONE CRE 1-1%

PRAMOSONE CRE 1-2.5%

PRAMOSONE LOT 1%

PRAMOSONE LOT 2.5%

PRANDIMET TAB 1-500 MG

PRANDIMET TAB 2-500 MG

PRANDIN TAB 0.5 MG

PRANDIN TAB 1 MG

PRANDIN TAB 2 MG

PRAVACHOL TAB 20 MG

PRAVACHOL TAB 40 MG

PRAVACHOL TAB 80 MG

PRECEDEX INJ 100 MCG

PRECOSE TAB 25 MG

PRECOSE TAB 50 MG

PRECOSE TAB 100 MG

PRED FORTE SUS 1% OP

PRED MILD SUS 0.12% OP

PREFERA OB MIS + DHA

PREFERA OB TAB

PREFERAOB CAP ONE

PREFERAOB MIS +DHA

PREFOL-DHA CAP

PREGNYL INJ 10000 UNT

PRENA1 CAP QUATREFO

PRENA1 CHW

PRENA1 PEARL CAP

PRENA1 PLUS MIS QUATREFO

PRENAISSANCE CAP

PRENAISSANCE CAP BALANCE

PRENAISSANCE CAP PLUS

PRENAISSANCE MIS HARMONY

PRENAISSANCE PAK 90 DHA

PRENAISSANCE PAK DHA

PRENAISSANCE PAK PROMISE

PRENAISSANCE TAB NEXT

PRENAISSANCE TAB NEXT-B

PRENATA CHW 29-1 MG

PRENATAL MIS COMPLEAT

PRENATAL TAB 27-1 MG

PRENATE AM TAB 1 MG

PRENATE CAP ENHANCE

PRENATE CAP ESSENT

PRENATE CAP ESSENTIA

PRENATE CAP PIXIE

PRENATE CAP RESTORE

PRENATE CHW 0.6-0.4

PRENATE DHA CAP

PRENATE MINI CAP

PRENATE STAR TAB 20-1 MG

PRENATE TAB ELITE

PREPLUS TAB 27-1 MG

PREPOPIK PAK

PREQUE 10 TAB

PRESTALIA TAB 3.5-2.5 MG

PRESTALIA TAB 7-5 MG

PRESTALIA TAB 14-10 MG

PRETAB TAB 29-1 MG

PREVACID CAP 15 MG DR

PREVACID CAP 30 MG DR

PREVACID TAB 15 MG STB

PREVACID TAB 30 MG STB

PREVIDENT 5000 PST 1.1%

PREVIDENT CRE 5000 PLS

PREVIDENT GEL 1.1%

PREVIDENT GEL 1.1% BER

PREVIDENT GEL 1.1% CHR

PREVIDENT GEL 1.1% MIN

PREVIDENT PST 5000 BST

PREVIDENT PST 5000 SEN

PREVIDENT SOL RINSE

PREVPAC MIS

PRILOSEC CAP 10 MG

PRILOSEC CAP 20 MG

PRILOSEC CAP 40 MG

PRILOSEC POW 2.5 MG

PRILOSEC POW 10 MG

PRIMAXIN IV INJ 250 MG

PRIMAXIN IV INJ 500 MG

PRIMLEV TAB 5-300 MG

PRIMLEV TAB 7.5-300 MG

PRIMLEV TAB 10-300 MG

PRINIVIL TAB 5 MG

PRINIVIL TAB 10 MG

PRINIVIL TAB 20 MG

PROCARDIA CAP 10 MG

PROCARDIA XL TAB 30 MG CR



PROCENTRA SOL 5 MG/5 ML

PROCTOCORT CRE 1%

PROLENSA SOL 0.07%

PROMETRIUM CAP 100 MG

PROMETRIUM CAP 200 MG

PROSCAR TAB 5 MG

Excluded Drugs

18

NM NP 11-16

PROSTIN VR INJ 500 MCG

PROTONIX PAK

PROTONIX TAB 20 MG

PROTONIX TAB 40 MG

PROTOPIC OIN 0.03%

PROTOPIC OIN 0.1%

PROVENTIL AER HFA

PROVERA TAB 2.5 MG

PROVERA TAB 5 MG

PROVERA TAB 10 MG

PROVIDA DHA CAP

PROVIDA OB CAP

PROVIGIL TAB 100 MG

PROVIGIL TAB 200 MG

PROZAC CAP 10 MG

PROZAC CAP 20 MG

PROZAC CAP 40 MG

PROZAC WEEKLY CAP 90 MG

PRVDNT 5000 PST ENAML PR

PSORCON CRE 0.05%

PULMICORT INH 90 MCG

PULMICORT INH 180 MCG

PULMICORT SUS 0.25 MG/2 ML

PULMICORT SUS 0.5 MG/2 ML

PULMICORT SUS 1 MG/2 ML

PUREFE OB CAP PLUS

PURINETHOL TAB 50 MG

PYLERA CAP

QNASL AER 80 MCG

QNASL CHILD SPR 40 MCG

QUALAQUIN CAP 324 MG

QUELICIN INJ 20 MG/ML

QUESTRAN POW 4 GM

QUESTRAN POW 4 GM LITE

QUILLICHEW CHW 20 MG ER



QUILLIVANT SUS 25 MG/5 ML

RABEPRAZOLE TAB 20 MG

RANITIDINE CAP 150 MG

RANITIDINE CAP 300 MG

RANITIDINE SYP 15 MG/ML

RANITIDINE SYP 75 MG/5 ML

RANITIDINE SYP 150 MG/10 ML

RANITIDINE TAB 150 MG

RAPAFLO CAP 4 MG

RAPAFLO CAP 8 MG

RAPAMUNE TAB 0.5 MG

RAPAMUNE TAB 1 MG

RAPAMUNE TAB 2 MG

RAYOS TAB 1 MG

RAYOS TAB 2 MG

RAYOS TAB 5 MG

RAZADYNE ER CAP 8 MG



RAZADYNE SOL 4 MG/ML

RAZADYNE TAB 4 MG

RAZADYNE TAB 8 MG

RAZADYNE TAB 12 MG

REBETOL CAP 200 MG

RECLAST INJ 5 MG/100 ML

REDICHEW RX CHW

REGIMEX TAB 25 MG

REGLAN TAB 5 MG

REGLAN TAB 10 MG

RELISTOR INJ 8 MG/0.4 ML

RELISTOR INJ 12 MG/0.6 ML

RELISTOR KIT 12 MG/0.6 ML

RELNATE DHA CAP

REMERON TAB 15 MG

REMERON TAB 30 MG

REMERON TAB 45 MG

REMERON SLTB TAB 15 MG



REPREXAIN TAB 2.5-200 MG

REPREXAIN TAB 5-200 MG

REQUIP TAB 0.25 MG

REQUIP TAB 0.5 MG

REQUIP TAB 1 MG

REQUIP TAB 2 MG

REQUIP TAB 3 MG

REQUIP TAB 4 MG

REQUIP TAB 5 MG

REQUIP XL TAB 2 MG

REQUIP XL TAB 4 MG

REQUIP XL TAB 6 MG

REQUIP XL TAB 8 MG

REQUIP XL TAB 12 MG

RESCULA SOL 0.15%

RESERPINE TAB 0.1 MG

RESERPINE TAB 0.25 MG

RESTASIS EMU 0.05%

RESTORIL CAP 7.5 MG

RESTORIL CAP 15 MG

RESTORIL CAP 22.5 MG

RESTORIL CAP 30 MG

RETIN-A CRE 0.025%

RETIN-A CRE 0.05%

RETIN-A CRE 0.1%

RETIN-A GEL 0.01%

RETIN-A GEL 0.025%

RETIN-A MICR GEL 0.04%

RETIN-A MICR GEL 0.04% PMP



RETIN-A MICR GEL 0.1% PUMP

RETROVIR CAP 100 MG

RETROVIR SYP 50 MG/5 ML

REVATIO INJ

REVATIO TAB 20 MG

REVIA TAB 50 MG

REZIRA SOL 60-5/5ML

Excluded Drugs

19

NM NP 11-16

RHINOCORT SUS AQUA

RIFADIN CAP 150 MG

RIFADIN CAP 300 MG

RIFADIN INJ 600 MG

RILUTEK TAB 50 MG

RIOMET SOL

RIOMET SOL 500/5 ML

RISPERDAL SOL 1 MG/ML

RISPERDAL TAB 0.25 MG

RISPERDAL TAB 0.5 MG

RISPERDAL TAB 1 MG

RISPERDAL TAB 2 MG

RISPERDAL TAB 3 MG

RISPERDAL TAB 4 MG

RISPERDAL M TAB 0.5 MG

RISPERDAL M TAB 1 MG




RITALIN LA CAP 10 MG





RITALIN TAB 5 MG

RITALIN TAB 10 MG

RITALIN TAB 20 MG

RITALIN TAB 20 MG SR

R-NATAL OB CAP 20-1-320

ROBAXIN INJ 100 MG/ML

ROBAXIN TAB 500 MG

ROBAXIN-750 TAB 750 MG

ROBINUL INJ 0.2 MG/ML

ROBINUL INJ 0.4 MG/2 ML

ROBINUL TAB 1 MG

ROBINUL FORT TAB 2 MG

ROCALTROL CAP 0.25 MCG

ROCALTROL CAP 0.5 MCG

ROCALTROL SOL 1 MCG/ML

ROCEPHIN INJ 1 GM

ROWASA KIT 4 GM

ROXICET SOL 5-325/5

ROXICODONE TAB 5 MG

ROXICODONE TAB 15 MG

ROXICODONE TAB 30 MG

RULAVITE DHA CAP

RYTHMOL SR CAP 225 MG



RYTHMOL TAB 150 MG

RYTHMOL TAB 225 MG

SAIZEN INJ 5 MG

SAIZEN INJ 8.8 MG

SALAGEN TAB 5 MG

SALAGEN TAB 7.5 MG

SANCTURA TAB 20 MG

SANCUSO DIS 3.1 MG

SANDIMMUNE INJ 50 MG/ML

SANDOSTATIN INJ 50 MCG

SANDOSTATIN INJ 100 MCG/ML




SARAFEM TAB 10 MG

SARAFEM TAB 20 MG

SEASONIQUE TAB

SECONAL CAP 100 MG

SECONAL SOD CAP 100 MG

SECTRAL CAP 200 MG

SECTRAL CAP 400 MG

SELECT-OB CHW

SELECT-OB+ PAK DHA

SEMPREX-D CAP 8-60 MG

SEROQUEL TAB 25 MG

SEROQUEL TAB 50 MG

SEROQUEL TAB 100 MG

SEROQUEL TAB 200 MG

SEROQUEL TAB 300 MG

SEROQUEL TAB 400 MG

SEROSTIM INJ 4 MG

SEROSTIM INJ 5 MG

SEROSTIM INJ 6 MG

SE-TAN DHA CAP

SILENOR TAB 3 MG

SILENOR TAB 6 MG

SILVADENE CRE 1%

SINEMET TAB 10-100 MG



SINEMET CR TAB 25-100 MG

SINEMET CR TAB 50-200 MG

SINGULAIR CHW 4 MG

SINGULAIR CHW 5 MG

SINGULAIR GRA 4 MG

SINGULAIR TAB 10 MG

SKELAXIN TAB 800 MG

SOD DIURIL INJ 500 MG

SOLARAZE GEL 3% W/W

SOLODYN TAB 55 MG

SOLODYN TAB 65 MG

SOLODYN TAB 80 MG

SOLODYN TAB 105 MG

SOLODYN TAB 115 MG

SOLU-MEDROL INJ 1 MG

SOLU-MEDROL INJ 40 GM



SOMA TAB 250 MG

SOMA TAB 350 MG

SONATA CAP 5 MG

SONATA CAP 10 MG

SOOLANTRA CRE 1%

SORIATANE CAP 10 MG

SORIATANE CAP 17.5 MG

Excluded Drugs

20

NM NP 11-16

SORIATANE CAP 25 MG

SORILUX AER 0.005%

SOTYLIZE SOL 5 MG/ML

SPECTRACEF TAB 200 MG

SPECTRACEF TAB 400 MG

SPORANOX CAP 100 MG

SPORANOX CAP PULSEPAK

SPRIX SPR 15.75 MG

STARLIX TAB 60 MG

STARLIX TAB 120 MG

STIOLTO AER 2.5-2.5

STRIANT MIS 30 MG

STROMECTOL TAB 3 MG

SUBLIMAZE INJ 100 MCG



SUBSYS SPR 100 MCG

SUBSYS SPR 200 MCG

SUBSYS SPR 400 MCG

SUBSYS SPR 600 MCG

SUBSYS SPR 800 MCG

SUBSYS SPR 1200 MCG

SUBSYS SPR 1600 MCG

SUCLEAR KIT

SUFENTA INJ 50 MCG/ML

SULAR TAB 8.5 MG

SULAR TAB 17 MG

SULAR TAB 34 MG

SULFAMYLON PAK 5%

SUMAVEL DOSE INJ 4 MG/0.5 ML

SUMAVEL DOSE INJ 6 MG/0.5 ML

SUPRAX CHW 100 MG

SUPRAX CHW 200 MG

SUPRAX SUS 100 MG/5 ML



SURMONTIL CAP 25 MG

SURMONTIL CAP 50 MG

SURMONTIL CAP 100 MG

SYMBYAX CAP 3-25 MG

SYMBYAX CAP 6-25 MG

SYMBYAX CAP 6-50 MG

SYMBYAX CAP 12-25 MG

SYMBYAX CAP 12-50 MG

SYNALAR CRE 0.025%

SYNALAR OIN 0.025%

SYNALAR SOL 0.01%

SYNALGOS-DC CAP

SYNERA DIS 70-70 MG

TACLONEX OIN

TAPAZOLE TAB 5 MG

TAPAZOLE TAB 10 MG

TARGADOX TAB 50 MG

TARGRETIN CAP 75 MG

TARGRETIN GEL 1%

TARKA TAB 1-240 CR

TARKA TAB 2-180 CR

TARKA TAB 2-240 CR

TARKA TAB 4-240 CR

TARON-BC MIS

TARON-C DHA CAP

TARON-PREX CAP

TASMAR TAB 100 MG

TAXOTERE INJ 20 MG/ML

TAXOTERE INJ 80 MG/4 ML

TECHNIVIE TAB

TEKAMLO TAB 150-5 MG




TEKTURNA TAB 150 MG

TEKTURNA TAB 300 MG

TEKTURNA HCT TAB 150-12.5 MG

TEKTURNA HCT TAB 150-25 MG

TEKTURNA HCT TAB 300-12.5 MG

TEKTURNA HCT TAB 300-25 MG

TEMODAR CAP 5 MG

TEMODAR CAP 20 MG

TEMODAR CAP 100 MG

TEMODAR CAP 140 MG

TEMODAR CAP 180 MG

TEMODAR CAP 250 MG

TEMOVATE CRE 0.05%

TEMOVATE GEL 0.05%

TEMOVATE OIN 0.05%

TEMOVATE SOL 0.05%

TEMOVATE E CRE 0.05%EML

TENEX TAB 1 MG

TENEX TAB 2 MG

TENORETIC TAB 100

TENORETIC TAB 50

TENORMIN TAB 25 MG

TENORMIN TAB 50 MG

TENORMIN TAB 100 MG

TERAZOL 3 CRE 0.8%

TERAZOL 7 CRE 0.4%

TESSALON PER CAP 100 MG

TESTIM GEL 1%(50 MG)

TESTOSTERONE GEL 1%(25 MG)

TESTOSTERONE GEL 1%(50 MG)

TESTOSTERONE GEL 10 MG/ACT

TESTOSTERONE GEL PUMP 1%

TESTRED CAP 10 MG

TETRACYCLINE CAP 250 MG

TETRACYCLINE CAP 500 MG

TEVETEN TAB 600 MG

TEVETEN HCT TAB 600-12.5 MG

TEVETEN HCT TAB 600-25 MG

TEV-TROPIN INJ 5 MG

TEXACORT SOL 2.5%

THERA-FLUR-N DRO 1.1%

THIORIDAZINE TAB 10 MG



Excluded Drugs

21

NM NP 11-16


THRIVITE 19 TAB

THRIVITE RX TAB 29-1 MG

TIAZAC CAP 120 MG/24






TICLOPIDINE TAB 250 MG

TIGAN CAP 300 MG

TIKOSYN CAP 125 MCG

TIKOSYN CAP 250 MCG

TIKOSYN CAP 500 MCG

TIMOLOL MAL TAB 5 MG



TIMOPTIC SOL 0.25% OP

TIMOPTIC SOL 0.5% OP

TIMOPTIC OCU SOL 0.25% OP

TIMOPTIC OCU SOL 0.5% OP

TIMOPTIC-XE SOL 0.25% OP

TIMOPTIC-XE SOL 0.5% OP

TINDAMAX TAB 250 MG

TINDAMAX TAB 500 MG

TIVORBEX CAP 20 MG

TIVORBEX CAP 40 MG

TL-CARE DHA CAP 27-1-500

TL FOLATE TAB

TL-SELECT CAP

TOBI NEB 300 MG/5 ML

TOBRADEX SUS 0.3-0.1%

TOBRADEX ST SUS 0.3-0.05%

TOBREX SOL 0.3% OP

TOFRANIL TAB 10 MG

TOFRANIL TAB 25 MG

TOFRANIL TAB 50 MG

TOFRANIL-PM CAP 75 MG




TOLAK CRE 4%

TOLMETIN SOD TAB 200 MG

TOLMETIN SOD TAB 600 MG

TOPAMAX TAB 25 MG

TOPAMAX TAB 50 MG

TOPAMAX TAB 100 MG

TOPAMAX TAB 200 MG

TOPAMAX SPR CAP 15 MG

TOPAMAX SPR CAP 25 MG

TOPICORT CRE 0.05%

TOPICORT CRE 0.25%

TOPICORT GEL 0.05%

TOPICORT OIN 0.05%

TOPICORT OIN 0.25%

TOPICORT SPR 0.25%

TOPROL XL TAB 25 MG

TOPROL XL TAB 50 MG

TOPROL XL TAB 100 MG

TOPROL XL TAB 200 MG

TOVIAZ TAB 4 MG

TOVIAZ TAB 8 MG

TRAMADOL HCL CAP ER 100 MG




TRANDATE TAB 100 MG

TRANDATE TAB 200 MG

TRANDATE TAB 300 MG

TRANXENE T TAB 3.75 MG

TRANXENE T TAB 7.5 MG

TRANXENE T TAB 15 MG

TRAVATAN Z DRO 0.004%

TRAVOPROST DRO 0.004%

TRETIN-X CRE 0.0375%

TRETIN-X CRE 0.075%

TREXIMET TAB 85-500 MG

TREZIX CAP

TRIADVANCE TAB

TRIAMCINOLON AER 55 MCG/AC

TRIAMCINOLON OIN 0.5%

TRIANEX OIN 0.05%

TRIAZOLAM TAB 0.125 MG

TRIAZOLAM TAB 0.25 MG

TRIBENZOR 20- TAB 5-12.5 MG


TRIBENZOR 40- TAB 5-25 MG


TRIBENZOR 40- TAB 10-25 MG

TRICARE PAK PRENATAL

TRICARE TAB PRENATAL

TRICARE PRE CAP 27-1-500

TRICOR TAB 48 MG

TRICOR TAB 145 MG

TRIGLIDE TAB 160 MG

TRILEPTAL SUS 300 MG/5 ML

TRILEPTAL TAB 150 MG



TRILIPIX CAP 45 MG

TRILIPIX CAP 135 MG

TRINATAL GT TAB

TRINATAL RX TAB 1

TRI-NORINYL TAB 28

TRIOSTAT INJ 10 MCG/ML

TRISTART DHA CAP

TRI-TABS DHA MIS

TRIVEEN-DUO PAK DHA

TRIVEEN-PRX CAP RNF

TRIZIVIR TAB

TROPHAMINE INJ 6%

TRUSOPT SOL 2% OP

TUDORZA PRES AER 400 MCG/ACT

TUSSICAPS CAP 5-4 MG

Excluded Drugs

22

NM NP 11-16

TUSSICAPS CAP 10-8 MG

TUSSIONEX SUS 10-8/5 ML

TUZISTRA XR SUS

TWYNSTA TAB 40-5 MG

TWYNSTA TAB 40-10 MG

TWYNSTA TAB 80-5 MG

TWYNSTA TAB 80-10 MG

TYLACTIN LIQ REST 10

TYLACTIN LIQ RTD 15

TYLENOL/COD TAB #3

TYLENOL/COD TAB #4

TYZINE SOL 0.1%

TYZINE PED DRO 0.05%

UCERIS TAB 9 MG

ULTANE SOL

ULTIMATECARE CAP ONE

ULTIMATECARE CAP ONE NF

ULTRA TABS TAB

ULTRACET TAB 37.5-325 MG

ULTRAM TAB 50 MG

ULTRAM ER TAB 100 MG



ULTRAVATE CRE 0.05%

ULTRAVATE OIN 0.05%

ULTRESA CAP 13800 UNIT



UNASYN INJ 1.5 GM

UNASYN INJ 3 GM

UNASYN INJ 15 GM

UNIRETIC TAB 15-12.5 MG

UNIVASC TAB 7.5 MG

UNIVASC TAB 15 MG

URECHOLINE TAB 5 MG

URECHOLINE TAB 10 MG



UROCIT-K 5 TAB

UROCIT-K 10 TAB

UROCIT-K 15 TAB

UROXATRAL TAB 10 MG

URSO 250 TAB 250 MG

URSO FORTE TAB 500 MG

UTIBRON CAP NEOHALER

VALCYTE TAB 450 MG

VALIUM TAB 2 MG

VALIUM TAB 5 MG

VALIUM TAB 10 MG

VALTREX TAB 1 GM

VALTREX TAB 500 MG

VANATOL LQ SOL

VANCOCIN HCL CAP 125 MG

VANCOCIN HCL CAP 250 MG

VANOS CRE 0.1%

VASCEPA CAP 1 GM

VASERETIC TAB 10-25 MG

VASOTEC TAB 2.5 MG

VASOTEC TAB 5 MG

VASOTEC TAB 10 MG

VASOTEC TAB 20 MG

VECTICAL OIN 3 MCG/GM

VELTIN GEL

VEMAVITE- CAP PRX 2

VENA-BAL MIS DHA

VENATAL-FA TAB

VENLAFAXINE TAB 37.5 MG ER

VENLAFAXINE TAB 75 MG ER



VERAMYST SPR 27.5 MCG

VERDESO AER 0.05%

VERELAN CAP 120 MG SR




VERELAN PM CAP 100 MG ER



VFEND SUS 40 MG/ML

VFEND TAB 50 MG

VFEND TAB 200 MG

VFEND IV INJ 200 MG

VIBERZI TAB 75 MG

VIBERZI TAB 100 MG

VIBRAMYCIN CAP 100 MG

VIBRAMYCIN SUS 25 MG/5 ML

VIBRAMYCIN SYP 50 MG/5 ML

VICOPROFEN TAB 7.5-200 MG

VICTRELIS CAP 200 MG

VIDAZA INJ 100 MG

VIDEX EC CAP 125 MG

VIDEX EC CAP 200 MG

VIDEX EC CAP 250 MG

VIDEX EC CAP 400 MG

VIEKIRA PAK TAB

VIGAMOX DRO 0.5%

VILACTIN AA LIQ PLUS

VIMOVO TAB 375-20 MG

VIMOVO TAB 500-20 MG

VINACAL B MIS

VINATE AZ EX TAB

VINATE C TAB

VINATE CARE CHW

VINATE DHA CAP 27-1.13 MG

VIOKACE TAB

VIOKACE TAB 20880

VIRAMUNE TAB 200 MG

VIRAMUNE XR TAB 100 MG

VIRAMUNE XR TAB 400 MG

VIROPTIC SOL 1% OP

VIRT-ADVANCE TAB 90-1 MG

VIRT-C DHA CAP

VIRT-CARE CAP ONE

Excluded Drugs

23

NM NP 11-16

VIRT-NATE CAP DHA

VIRT NATE TAB

VIRT NATE TAB 28-1 MG

VIRT-PN DHA CAP

VIRT-PN PLUS CAP

VIRT-PN TAB

VIRTPREX CAP

VIRT-SELECT CAP

VIRT-VITE GT TAB 90-1 MG

VISTARIL CAP 25 MG

VISTARIL CAP 50 MG

VISTIDE INJ 75 MG/ML

VITAFOL CAP ULTRA

VITAFOL CHW GUMMIES

VITAFOL FE+ CAP

VITAFOL-NANO TAB

VITAFOL-OB PAK +DHA

VITAFOL-OB TAB 65-1 MG

VITAFOL-ONE CAP

VITAMEDMD CAP ONE RX

VITAMEDMD MIS PLUS RX

VITAPEARL CAP

VITA-PREN TAB

VITATRUE MIS

VITUZ SOL 5-4 MG

VIVA DHA CAP

VIVACTIL TAB 5 MG

VIVACTIL TAB 10 MG

VIVELLE-DOT DIS 0.025 MG





VIVLODEX CAP 5 MG

VIVLODEX CAP 10 MG

VOGELXO GEL 1%(50 MG)

VOGELXO GEL PUMP 1%

VOL-NATE TAB

VOL-PLUS TAB

VOL-TAB RX TAB

VOLTAREN GEL 1%

VOLTAREN-XR TAB 100 MG

VOSOL HC SOL OTIC

VOSPIRE ER TAB 4 MG

VOSPIRE ER TAB 8 MG

VP-CH PLUS CAP

VP-CH-PNV CAP

VP CH ULTRA CAP

VP-GGR-B6 TAB PRENATAL

VP-HEME OB MIS + DHA

VP-HEME OB TAB

VP-HEME-OB TAB 28-6-1 MG

VP-HEME ONE CAP

VP-PNV-DHA CAP

VUSION OIN

VYTORIN TAB 10-10 MG




WELLBUTRIN TAB 75 MG

WELLBUTRIN TAB 100 MG

WELLBUTRIN TAB 100 MG SR



WELLBUTRIN TAB XL 150 MG

WELLBUTRIN TAB XL 300 MG

WESTCORT OIN 0.2%

XALATAN SOL 0.005%

XANAX TAB 0.25 MG

XANAX TAB 0.5 MG

XANAX TAB 1 MG

XANAX TAB 2 MG

XANAX XR TAB 0.5 MG

XANAX XR TAB 1 MG

XANAX XR TAB 2 MG

XANAX XR TAB 3 MG

XARTEMIS XR TAB 7.5-325 MG

XELODA TAB 150 MG

XELODA TAB 500 MG

XENAZINE TAB 12.5 MG

XENAZINE TAB 25 MG

XERESE CRE 5-1%

XIGDUO XR TAB 5-500 MG




XODOL TAB 5-300 MG

XODOL TAB 7.5-300 MG

XODOL TAB 10-300 MG

XOLEGEL GEL 2%

XOPENEX NEB 0.31 MG

XOPENEX NEB 0.63 MG

XOPENEX NEB 1.25 MG/3 ML XOPENEX CONC NEB 1.25 MG/0.5 ML

XOPENEX HFA AER

XURIDEN POW 2 GM

XYLO/EPI INJ 0.5%

XYLO/EPI INJ 2%

XYLO/EPI 1%- INJ 1:100000

XYLOCAINE INJ 0.5%

XYLOCAINE INJ 1%

XYLOCAINE INJ 2%

XYLOCAINE INJ MPF 0.5%

XYLOCAINE INJ -MPF 1%

XYLOCAINE INJ MPF 1.5%



XYLOCAINE SOL 4%

XYLO-MPF/EPI INJ 1.5%

XYLO-MPF/EPI INJ 2%

XYZAL SOL

XYZAL SOL 2.5 MG/5 ML

XYZAL TAB 5 MG

YASMIN 28 TAB 3-0.03 MG

Excluded Drugs

24

NM NP 11-16

YAZ TAB 3-0.02 MG

ZAMICET SOL 10-325 MG

ZANAFLEX CAP 2 MG

ZANAFLEX CAP 4 MG

ZANAFLEX CAP 6MG

ZANAFLEX TAB 4 MG

ZANTAC INJ 25 MG/ML

ZANTAC INJ 50 MG/2 ML

ZANTAC TAB 150 MG

ZANTAC TAB 300 MG

ZAROXOLYN TAB 2.5 MG

ZAROXOLYN TAB 5 MG

ZATEAN-CH CAP

ZATEAN-PN CAP DHA

ZATEAN-PN CAP PLUS

ZATEAN-PN TAB

ZEBETA TAB 5 MG

ZEBETA TAB 10 MG

ZECUITY PAD 6.5 MG/4H

ZEGERID CAP 20-1100 MG

ZEGERID CAP 40-1100 MG

ZEGERID POW 20-1680

ZEGERID POW 40-1680

ZEMPLAR CAP 1 MCG

ZEMPLAR CAP 2 MCG

ZEMPLAR INJ 2 MCG/ML

ZEMPLAR INJ 5 MCG/ML

ZEMURON INJ 10 MG/ML

ZENZEDI TAB 2.5 MG

ZENZEDI TAB 7.5 MG

ZENZEDI TAB 15 MG

ZENZEDI TAB 20 MG

ZENZEDI TAB 30 MG

ZEPATIER TAB 50-100 MG

ZERIT CAP 15 MG

ZERIT CAP 20 MG

ZERIT CAP 30 MG

ZERIT CAP 40 MG

ZERIT SOL 1 MG/ML

ZESTORETIC TAB 10-12.5 MG

ZESTORETIC TAB 20-12.5 MG

ZESTORETIC TAB 20-25 MG

ZESTRIL TAB 2.5 MG

ZESTRIL TAB 5 MG

ZESTRIL TAB 10 MG

ZESTRIL TAB 20 MG

ZESTRIL TAB 30 MG

ZESTRIL TAB 40 MG

ZETONNA AER 37 MCG

ZIAC TAB 2.5/6.25 MG

ZIAC TAB 5/6.25 MG

ZIAC TAB 10/6.25 MG

ZIAGEN TAB 300 MG

ZIANA GEL

ZINACEF INJ 1.5 GM

ZINACEF INJ 7.5 GM

ZINACEF INJ 750 MG

ZINECARD INJ 250 MG

ZINECARD INJ 500 MG

ZIOPTAN DRO 0.0015%

ZIPSOR CAP 25 MG

ZIRGAN GEL 0.15%

ZITHROMAX INJ 500 MG

ZITHROMAX SUS 100 MG/5 ML

ZITHROMAX SUS 200 MG/5 ML

ZITHROMAX TAB 250 MG



ZITHROMAX TAB TRI-PAK

ZITHROMAX TAB Z-PAK

ZOCOR TAB 5 MG

ZOCOR TAB 10 MG

ZOCOR TAB 20 MG

ZOCOR TAB 40 MG

ZOCOR TAB 80 MG

ZOFRAN INJ 40 MG/20 ML

ZOFRAN SOL 4 MG/5 ML

ZOFRAN TAB 4 MG

ZOFRAN TAB 4 MG ODT

ZOFRAN TAB 8 MG

ZOFRAN TAB 8 MG ODT

ZOHYDRO ER CAP 10 MG






ZOLOFT CON 20 MG/ML

ZOLOFT TAB 25 MG

ZOLOFT TAB 50 MG

ZOLOFT TAB 100 MG

ZOLPIMIST SPR 5 MG

ZOMACTON INJ 5 MG

ZOMACTON INJ 10 MG

ZOMETA INJ 4 MG/5 ML

ZOMIG SPR 2.5 MG

ZOMIG TAB 2.5 MG

ZOMIG TAB 5 MG

ZOMIG NASAL SPR 5 MG

ZOMIG ZMT TAB 2.5 MG

ZOMIG ZMT TAB 5 MG

ZONATUSS CAP 150 MG

ZONEGRAN CAP 25 MG

ZONEGRAN CAP 100 MG

ZORBTIVE INJ 8.8 MG

ZORVOLEX CAP 18 MG

ZORVOLEX CAP 35 MG

ZOSYN INJ 2-0.25 GM

ZOSYN INJ 3-0.375G GM

ZOSYN INJ 4-0.5 GM

ZOSYN INJ 36-4.5 GM

ZOVIRAX CAP 200 MG

ZOVIRAX CRE 5%

ZOVIRAX OIN 5%

Excluded Drugs

25

NM NP 11-16

ZOVIRAX SUS 200 MG/5 ML

ZOVIRAX TAB 400 MG

ZOVIRAX TAB 800 MG

ZUBSOLV SUB 1.4-0.36 MG





ZUPLENZ MIS 4 MG

ZUPLENZ MIS 8 MG

ZUTRIPRO LIQ 60-4-5 MG

ZYBAN TAB 150 MG SR

ZYCLARA CRE 3.75%

ZYCLARA PUMP CRE 2.5%

ZYCLARA PUMP CRE 3.75%

ZYFLO TAB 600 MG

ZYFLO CR TAB 600 MG

ZYLET SUS 0.5-0.3%

ZYLOPRIM TAB 100 MG

ZYLOPRIM TAB 300 MG

ZYMAXID SOL 0.5%

ZYPREXA INJ 10 MG

ZYPREXA TAB 2.5 MG

ZYPREXA TAB 5 MG

ZYPREXA TAB 7.5 MG

ZYPREXA TAB 10 MG

ZYPREXA TAB 15 MG

ZYPREXA TAB 20 MG

ZYPREXA ZYDI TAB 5 MG




ZYVOX SOL 2 MG/ML

ZYVOX SUS 100 MG/5 ML

ZYVOX TAB 600 MG

Third-party brand names are the property of their respective owners.

excluded drugs - blue cross blue shield associationambien tab 10 mg ambien cr tab 6.25 mg ambien cr...

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