express scripts canada – units of measure (package size ......on lutera 28 tablet tablet 02401207...
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Express Scripts Canada – Units of Measure Updates (Package Size)
Reference Guide
Certain DINs/PINs require the use of updated units of measure to determine the appropriate package size on a
claim submission. Units of measure vary depending on the adjudication system and province.
Consider the following scenarios for DIN 02236974 in the Express Scripts Canada (ESC) adjudication system:
Prior to implementation, ESC endeavors to distribute communications informing pharmacy providers and software
vendors of upcoming unit of measure updates in the ESC adjudication system. Where applicable, software vendors
can ensure that the pharmacist’s information system is updated to facilitate appropriate package size
determinations.
Appendix A (below) serves as a list of past unit of measure updates in the ESC adjudication system. Each time, ESC
distributes communications informing pharmacy providers of unit of measure updates, this list will be updated
accordingly.
Note: This is not applicable to the Non-Insured Health Benefits (NIHB) program. This list may be updated at any
time.
Scenario 1 – Previous (prior to the update)
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON ALESSE 21 TABLET PACK 02236974
The unit of measure for this medication is pack
If 1 pack of this medication is dispensed, the quantity field is populated with the following value: 1
Scenario 2 – Current (following the update)
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON ALESSE 21 TABLET TABLET 02236974
The unit of measure for this medication is tablet
If 1 pack of this medication is dispensed, the quantity field is populated with the following value: 21
Document Publication Date: July 2019
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Table of Contents Express Scripts Canada – Units of Measure Updates (Package Size) ................................................................................................ 1
Appendix A .......................................................................................................................................................................................... 3
ALBERTA ......................................................................................................................................................................................... 3
BRITISH COLUMBIA ........................................................................................................................................................................ 3
MANITOBA ...................................................................................................................................................................................... 3
NEW BRUNSWICK .......................................................................................................................................................................... 3
NEWFOUNDLAND AND LABRADOR ............................................................................................................................................... 4
NORTHWEST TERRITORIES ........................................................................................................................................................... 4
NOVA SCOTIA .................................................................................................................................................................................. 4
NUNAVUT ........................................................................................................................................................................................ 4
ONTARIO ......................................................................................................................................................................................... 4
PRINCE EDWARD ISLAND ............................................................................................................................................................ 20
QUÉBEC ........................................................................................................................................................................................ 20
SASKATCHEWAN .......................................................................................................................................................................... 20
YUKON .......................................................................................................................................................................................... 23
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A P P E N D I X A
ALBERTA
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
AB SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
AB SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
AB BOTOX 100 UNIT/VIAL INJ UNIT 01981501
AB BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
BRITISH COLUMBIA
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
BC SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
BC SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
BC SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
BC TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
BC BOTOX 100 UNIT/VIAL INJ UNIT 01981501
BC BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
MANITOBA
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
MB SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
MB TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
MB BOTOX 100 UNIT/VIAL INJ UNIT 01981501
MB BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
NEW BRUNSWICK
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
NB SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
NB SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
NB SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
NB TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
NB BOTOX 100 UNIT/VIAL INJ UNIT 01981501
NB BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
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NEWFOUNDLAND AND LABRADOR
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
NL SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
NL SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
NL TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
NL BOTOX 100 UNIT/VIAL INJ UNIT 01981501
NL BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
NORTHWEST TERRITORIES
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
NT SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
NT SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
NT TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
NT BOTOX 100 UNIT/VIAL INJ UNIT 01981501
NT BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
NOVA SCOTIA
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
NS SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
NS SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
NS SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
NS TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
NS BOTOX 100 UNIT/VIAL INJ UNIT 01981501
NS BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
NS BOTOX INJ 50 UNIT/VIAL (NS) UNIT 00999443
NS BOTOX 200 UNIT/VIAL INJ (NS) UNIT 00999505
NUNAVUT
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
NU BOTOX 100 UNIT/VIAL INJ UNIT 01981501
NU BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
ONTARIO
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON INSPIOLTO RESPIMAT INHALER DOSE 02441888
ON BREO ELLIPTA 200/25MCG INHALER DOSE 02444186
ON AIROMIR 100MCG/ACT INHALER DOSE 02232570
ON TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON NITROLINGUAL 0.4MG PUMPSPRAY DOSE 02231441
ON APO-NITROGLYCERIN 0.4MG PUMPSPRAY DOSE 02393433
ON RHO-NITRO 0.4MG SL PUMPSRAY DOSE 02238998
ON OMNARIS 50MCG NASAL SPRAY DOSE 02303671
ON APO-CICLESONIDE 50MCG NASAL SPRAY DOSE 02417316
ON VENTOLIN HFA 100MCG INHALER DOSE 02241497
ON APO-SALVENT CFC FREE 100MCG INHALER DOSE 02245669
ON TEVA-SALBUTAMOL HFA 100MCG INHALER DOSE 02326450
ON QVAR 100MCG INHALER DOSE 02242030
ON FLOVENT HFA 50MCG INHALER DOSE 02244291
ON FLOVENT HFA 125MCG INHALER DOSE 02244292
ON FLOVENT HFA 250MCG INHALER DOSE 02244293
ON ALVESCO 200MCG INHALER DOSE 02285614
ON PULMICORT TURBUHALER 200MCG DOSE 00851752
ON PULMICORT TURBUHALER 400MCG DOSE 00851760
ON FLOVENT DISKUS 250MCG INHALER DOSE 02237246
ON FLOVENT DISKUS 500MCG INHALER DOSE 02237247
ON ASMANEX TWISTHALER 200MCG INHALER DOSE 02243595
ON ASMANEX TWISTHALER 400MCG INHALER DOSE 02243596
ON ASMANEX TWISTHALER 400MCG INHALER DOSE 09857431
ON CORTIFOAM 10% RECTAL FOAM GRAM 00579335
ON KAYEXALATE 1MEQ/G POWDER GRAM 02026961
ON FLAMAZINE 1% CREAM GRAM 09854037
ON ZITHROMAX 200MG/5ML ORAL LIQUID MILLILITRE 02223724
ON GD-AZITHROMYCIN 200MG/5ML ORAL LIQUID MILLILITRE 02274574
ON NOVO-AZITHROMYCIN 200MG/5ML ORAL LIQUID MILLILITRE 02315165
ON PMS-AZITHROMYCIN 200MG/5ML ORAL LIQUID MILLILITRE 02418460
ON SANDOZ-AZITHROMYCIN 200MG/5ML ORAL LIQUID MILLILITRE 02332396
ON VITAMIN B12 100MCG/ML INJECTION MILLILITRE 00521515
ON CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 01987003
ON CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 02413795
ON JAMP-CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 02420147
ON METHOTREXATE 25MG/ML INJECTION MILLILITRE 02182777
ON SANDOZ-METHOTREXATE 25MG/ML INJECTION MILLILITRE 02398427
ON DEPO-MEDROL 20MG/ML INJECTION MILLILITRE 01934325
ON KENALOG-40 INJECTION MILLILITRE 01999869
ON SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
ON HUMALOG 100U/ML INJECTION MILLILITRE 02229704
ON HUMALOG MIX 25 INJ CARTRIDGE MILLILITRE 02240294
ON LANTUS 100UNIT/ML VIAL MILLILITRE 02245689
ON HUMALOG KWIKPEN 100U/ML INJECTION MILLILITRE 02403412
ON HUMALOG MIX 25 KWIKPEN INJECTION MILLILITRE 02403420
ON HUMALOG KWIKPEN 200U/ML INJECTION MILLILITRE 02439611
ON BASAGLAR 100U/ML INJ CARTRIDGE MILLILITRE 02444844
ON BASAGLAR 100U/ML KWIKPEN INJECTION MILLILITRE 02444852
ON HUMALOG 100U/ML INJ CARTRIDGE MILLILITRE 09853715
ON NOVOLIN GE 30/70 PENFILL INJECTION MILLILITRE 09853812
ON CORTENEMA 100MG/60ML ENEMA MILLILITRE 02112736
ON PENTASA 4G/100ML ENEMA MILLILITRE 02153556
ON SANDOZ TRAVOPROST .004% OP SOL MILLILITRE 02413167
ON APO-TRAVOPROST Z 0.004% OP SOL MILLILITRE 02415739
ON TEVA-TRAVOPROST Z 0.004% OP SOL MILLILITRE 02412063
ON TRAVATAN Z 0.004% OP SOL MILLILITRE 09857332
ON COMBIGAN 0.2%/0.5% OP SOL MILLILITRE 09857298
ON LUMIGAN RC 0.01% 5ML OP SOL MILLILITRE 09857368
ON TRAVATAN Z 0.004% OP SOL MILLILITRE 02318008
ON TEVA-TRAVOPROST Z 0.004% OP SOL MILLILITRE 09857504
ON SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
ON FRAGMIN 12500UNIT/0.5ML INJECTION SYRINGE 02352664
ON MICRONOR 28 TABLET TABLET 00037605
ON JENCYCLA 0.35MG 28 TABLET TABLET 02441306
ON MOVISSE 0.35MG 28 TABLET TABLET 02410303
ON MIN-OVRAL 21 TABLET TABLET 02042320
ON OVIMA 21 TABLET TABLET 02387085
ON PORTIA 21 TABLET TABLET 02295946
ON MIN-OVRAL 28 TABLET TABLET 02042339
ON OVIMA 28 TABLET TABLET 02387093
ON PORTIA 28 TABLET TABLET 02295954
ON MARVELON 28 TABLET TABLET 02042479
ON APRI 28 TABLET TABLET 02317206
ON FREYA 28 TABLET TABLET 02396610
ON MIRVALA 28 TABLET TABLET 02410257
ON RECLIPSEN 28 TABLET TABLET 02417464
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON MARVELON 21 TABLET TABLET 02042487
ON APRI 21 TABLET TABLET 02317192
ON FREYA 21 TABLET TABLET 02396491
ON MIRVALA 21 TABLET TABLET 02410249
ON RECLIPSEN 21 TABLET TABLET 02420813
ON ALESSE 21 TABLET TABLET 02236974
ON ALYSENA 21 TABLET TABLET 02387875
ON AVIANE 21 TABLET TABLET 02298538
ON ESME 21 TABLET TABLET 02388138
ON LUTERA 21 TABLET TABLET 02401185
ON ALESSE 28 TABLET TABLET 02236975
ON ALYSENA 28 TABLET TABLET 02387883
ON AVIANE 28 TABLET TABLET 02298546
ON ESME 28 TABLET TABLET 02388146
ON LUTERA 28 TABLET TABLET 02401207
ON TRI-CYCLEN LO 21 TABLET TABLET 02258560
ON TRICIRA LO 21 TABLET TABLET 02401967
ON TRI-CYCLEN LO 28 TABLET TABLET 02258587
ON TRICIRA LO 28 TABLET TABLET 02401975
ON MYA 28 TABLET TABLET 02415380
ON YAZ 28 TABLET TABLET 02321157
ON LOESTRIN 1.5/30 21 TABLET TABLET 00297143
ON LOESTRIN 1.5/30 28 TABLET TABLET 00353027
ON DEMULEN-30 21 TABLET TABLET 00469327
ON DEMULEN-30 28 TABLET TABLET 00471526
ON ORTHO 7/7/7 21 TABLET TABLET 00602957
ON CYCLEN 21 TABLET TABLET 01968440
ON CYCLEN 28 TABLET TABLET 01992872
ON TRI-CYCLEN 21 TABLET TABLET 02028700
ON TRI-CYCLEN 28 TABLET TABLET 02029421
ON YASMIN 21 TABLET TABLET 02261723
ON YASMIN 28 TABLET TABLET 02261731
ON ZAMINE 28 TABLET TABLET 02410796
ON JINARC 30MG/60MG TABLET TABLET 02437511
ON JINARC 30MG/90MG TABLET TABLET 02437538
ON SYMBICORT 100 TURBUHALER DOSE 02245385
ON SYMBICORT 200 TURBUHALER DOSE 02245386
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON ADVAIR 100 DISKUS DOSE 02240835
ON ADVAIR 250 DISKUS DOSE 02240836
ON ADVAIR 500 DISKUS DOSE 02240837
ON ADVAIR 125 DOSE 02245126
ON ADVAIR 250 DOSE 02245127
ON BREO ELLIPTA DOSE 02408872
ON FORADIL DRY POWDER CAPSULES FOR INHALATION DOSE 02230898
ON OXEZE TURBUHALER 12MCG INH DOSE 02237224
ON OXEZE TURBUHALER 6MCG INH DOSE 02237225
ON ZENHALE 5/100MCG INH DOSE 02361752
ON ZENHALE 5/200MCG INH DOSE 02361760
ON SEREVENT DISKHALER 50MCG DOSE 02214261
ON SEREVENT DISKUS 50MCG DOSE 02231129
ON ANORO ELLIPTA DOSE 02418401
ON EMEND TRI PACK 125/80MG TABLET 02298813
ON JINARC TAB TABLET 02437503
ON CILOXAN 0.3% OP OINT GRAM 02200864
ON LOTEMAX 5MG/G OP OINT GRAM 02421941
ON DUOLUBE OP OINT GRAM 02125706
ON ERYTHROMYCIN 0.5% OP OINT GRAM 02326663
ON MAXITROL OP OINT GRAM 00358177
ON CILOXAN 0.3% OP SOL MILLILITRE 01945270
ON APO-CIPROFLOX 0.3% OP SOL MILLILITRE 02263130
ON SANDOZ CIPROFLOXACIN 0.3% OP MILLILITRE 02387131
ON SIMBRINZA OP SOL MILLILITRE 02435411
ON AZARGA OP SOL MILLILITRE 02331624
ON ACT-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02254786
ON APO-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02296527
ON PMS-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02317125
ON SANDOZ-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02367335
ON GD-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02373041
ON MED-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02426935
ON XALATAN 50MCG/ML OP SOL MILLILITRE 02231493
ON XALACOM STERILE OP SOL MILLILITRE 02246619
ON GD-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02373068
ON SDZ-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02394685
ON APO-LATANOPROST/TIMOP OP SOL MILLILITRE 02414155
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON ACT-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02436256
ON COLYTE MILLILITRE 00677442
ON ENTOCORT ENEMA MILLILITRE 02052431
ON APO-BUTORPHANOL 10MG/ML NASAL SPRAY MILLILITRE 02242504
ON CEFZIL 125MG/5ML SUSP MILLILITRE 02163675
ON CEFZIL 250MG/5ML SUSP MILLILITRE 02163683
ON RAN-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293579
ON APO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02293943
ON APO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293951
ON RAN-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02329204
ON AURO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02347261
ON AURO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02347288
ON DALACIN C 150MG/ML INJ MILLILITRE 00260436
ON CLINDAMYCIN 150MG/ML INJ MILLILITRE 02230540
ON GLYCOPYRROLATE 0.2MG/ML INJ MILLILITRE 02039508
ON NOVORAPID 100U/ML INJ MILLILITRE 02245397
ON RATIO-IPRATROPIUM UDV MILLILITRE 02097168
ON TEVA-IPRATROPIUM STERINEBS MILLILITRE 02216221
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231245
ON APO-IPRAVENT 250MCG/ML INH SOL MILLILITRE 02126222
ON NOVO-IPRAMIDE 250MCG/ML INH SOL MILLILITRE 02210479
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231136
ON MYLAN-IPRATROPIUM 0.25MG/ML INH SOL MILLILITRE 02239131
ON COMBIVENT UDV MILLILITRE 02231675
ON TEVA-COMBO STERINEBS MILLILITRE 02272695
ON TEVA-SALBUTAMOL STERINEBS P.F. MILLILITRE 01926934
ON PMS-SALBUTAMOL INH SOL MILLILITRE 02208229
ON VENTOLIN NEBULES P.F. - 2.5MG/2.5ML MILLILITRE 02213419
ON RATIO-SALBUTAMOL 1MG/ML INH SOL MILLILITRE 01986864
ON PMS-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02069571
ON SANDOZ-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02154412
ON DDAVP SPRAY MILLILITRE 00836362
ON DESMOPRESSIN SPRAY MILLILITRE 02242465
ON MOZOBIL 20MG/ML INJ MILLILITRE 02377225
ON FORTEO 250MCG/ML INJ MILLILITRE 02254689
ON DEPO-TESTOSTERONE 100MG/ML INJ MILLILITRE 00030783
ON DELATESTRYL 200MG/ML INJ MILLILITRE 00029246
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON KENALOG-10 INJ MILLILITRE 01999761
ON ACLASTA 5MG/100ML INJ MILLILITRE 02269198
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02408082
ON TARO-ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02415100
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02422433
ON ZOMETA CONC 4MG/5ML INJ MILLILITRE 02248296
ON ZOLEDRONIC ACID-Z 4MG/5ML INJ MILLILITRE 02401606
ON PMS-ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02403056
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02407639
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02413701
ON TARO-ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02415186
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02421550
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02422425
ON FRAGMIN 2,500U/ML INJ MILLILITRE 02377454
ON ADRENALIN CHLORIDE 1:1000 INJ MILLILITRE 00155357
ON LIORESAL INTRATHECAL 2MG/ML INJ MILLILITRE 02131064
ON VAL-BACLOFEN INTRATHECAL INJ MILLILITRE 02413647
ON HUMIRA PEN 40MG/0.8ML INJ PEN 09857294
ON HUMIRA PFS 40MG/0.8ML INJ SYRINGE 02258595
ON FIRAZYR 10MG/ML INJ SYRINGE 02425696
ON METOJECT 10MG/ML INJ SYRINGE 02304767
ON METOJECT 15MG/1.5ML INJ SYRINGE 02320045
ON IMITREX 6MG/0.5ML INJ SYRINGE 02212188
ON TARO-SUMATRIPTAN 6MG/0.5ML INJ SYRINGE 02361698
ON FRAGMIN 2,500U/0.2ML INJ SYRINGE 02132621
ON FRAGMIN 5,000U/0.2ML INJ SYRINGE 02132648
ON FRAGMIN 25,000U/ML INJ SYRINGE 02231171
ON FRAGMIN 7,500U/0.3ML INJ SYRINGE 02352648
ON FRAGMIN 15,000U/0.6ML INJ SYRINGE 02352672
ON FRAGMIN 3,500U/0.28ML INJ SYRINGE 02430789
ON FRAGMIN 10,000U/0.4ML INJ SYRINGE 02352656
ON FRAGMIN 12,500U/0.5ML INJ SYRINGE 02352664
ON FRAGMIN 18,000U/0.72ML INJ SYRINGE 02352680
ON EPREX 10,00U/0.5ML INJ SYRINGE 02231583
ON EPREX 20,00U/0.5ML INJ SYRINGE 02231584
ON EPREX 3,000U/0.3ML INJ SYRINGE 02231585
ON EPREX 4,000U/0.4ML INJ SYRINGE 02231586
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PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON EPREX 5,000U/0.5ML INJ SYRINGE 02243400
ON EPREX 6,000U/0.6ML INJ SYRINGE 02243401
ON EPREX 8,000U/0.8ML INJ SYRINGE 02243403
ON EPREX 30,000U/0.75ML INJ SYRINGE 02288680
ON BYETTA PREFILL PEN SYRINGE 02361809
ON BYETTA PREFILL PEN SYRINGE 02361817
ON ACTEMRA 162MG/0.9ML INJ SYRINGE 02424770
ON LUCENTIS PFS 10MG/ML INJ SYRINGE 02425629
ON LUCENTIS 10MG/ML INJ VIAL 02296810
ON VITAMIN K1 1MG/0.5ML USP INJ AMPOULE 00781878
ON PUREGON INJ CARTRIDGE 02243948
ON SYMBICORT 100 TURBUHALER DOSE 02245385
ON SYMBICORT 200 TURBUHALER DOSE 02245386
ON ADVAIR 100 DISKUS DOSE 02240835
ON ADVAIR 250 DISKUS DOSE 02240836
ON ADVAIR 500 DISKUS DOSE 02240837
ON ADVAIR 125 DOSE 02245126
ON ADVAIR 250 DOSE 02245127
ON BREO ELLIPTA DOSE 02408872
ON FORADIL DRY POWDER CAPSULES FOR INHALATION DOSE 02230898
ON OXEZE TURBUHALER 12MCG INH DOSE 02237224
ON OXEZE TURBUHALER 6MCG INH DOSE 02237225
ON ZENHALE 5/100MCG INH DOSE 02361752
ON ZENHALE 5/200MCG INH DOSE 02361760
ON SEREVENT DISKHALER 50MCG DOSE 02214261
ON SEREVENT DISKUS 50MCG DOSE 02231129
ON ANORO ELLIPTA DOSE 02418401
ON EMEND TRI PACK 125/80MG TABLET 02298813
ON JINARC TAB TABLET 02437503
ON CILOXAN 0.3% OP OINT GRAM 02200864
ON LOTEMAX 5MG/G OP OINT GRAM 02421941
ON DUOLUBE OP OINT GRAM 02125706
ON ERYTHROMYCIN 0.5% OP OINT GRAM 02326663
ON MAXITROL OP OINT GRAM 00358177
ON CILOXAN 0.3% OP SOL MILLILITRE 01945270
ON APO-CIPROFLOX 0.3% OP SOL MILLILITRE 02263130
ON SANDOZ CIPROFLOXACIN 0.3% OP MILLILITRE 02387131
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12 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON SIMBRINZA OP SOL MILLILITRE 02435411
ON AZARGA OP SOL MILLILITRE 02331624
ON ACT-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02254786
ON APO-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02296527
ON PMS-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02317125
ON SANDOZ-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02367335
ON GD-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02373041
ON MED-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02426935
ON XALATAN 50MCG/ML OP SOL MILLILITRE 02231493
ON XALACOM STERILE OP SOL MILLILITRE 02246619
ON GD-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02373068
ON SDZ-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02394685
ON APO-LATANOPROST/TIMOP OP SOL MILLILITRE 02414155
ON ACT-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02436256
ON COLYTE MILLILITRE 00677442
ON ENTOCORT ENEMA MILLILITRE 02052431
ON APO-BUTORPHANOL 10MG/ML NASAL SPRAY MILLILITRE 02242504
ON CEFZIL 125MG/5ML SUSP MILLILITRE 02163675
ON CEFZIL 250MG/5ML SUSP MILLILITRE 02163683
ON RAN-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293579
ON APO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02293943
ON APO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293951
ON RAN-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02329204
ON AURO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02347261
ON AURO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02347288
ON DALACIN C 150MG/ML INJ MILLILITRE 00260436
ON CLINDAMYCIN 150MG/ML INJ MILLILITRE 02230540
ON GLYCOPYRROLATE 0.2MG/ML INJ MILLILITRE 02039508
ON NOVORAPID 100U/ML INJ MILLILITRE 02245397
ON RATIO-IPRATROPIUM UDV MILLILITRE 02097168
ON TEVA-IPRATROPIUM STERINEBS MILLILITRE 02216221
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231245
ON APO-IPRAVENT 250MCG/ML INH SOL MILLILITRE 02126222
ON NOVO-IPRAMIDE 250MCG/ML INH SOL MILLILITRE 02210479
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231136
ON MYLAN-IPRATROPIUM 0.25MG/ML INH SOL MILLILITRE 02239131
ON COMBIVENT UDV MILLILITRE 02231675
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
13 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON TEVA-COMBO STERINEBS MILLILITRE 02272695
ON TEVA-SALBUTAMOL STERINEBS P.F. MILLILITRE 01926934
ON PMS-SALBUTAMOL INH SOL MILLILITRE 02208229
ON VENTOLIN NEBULES P.F. - 2.5MG/2.5ML MILLILITRE 02213419
ON RATIO-SALBUTAMOL 1MG/ML INH SOL MILLILITRE 01986864
ON PMS-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02069571
ON SANDOZ-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02154412
ON DDAVP SPRAY MILLILITRE 00836362
ON DESMOPRESSIN SPRAY MILLILITRE 02242465
ON MOZOBIL 20MG/ML INJ MILLILITRE 02377225
ON FORTEO 250MCG/ML INJ MILLILITRE 02254689
ON DEPO-TESTOSTERONE 100MG/ML INJ MILLILITRE 00030783
ON DELATESTRYL 200MG/ML INJ MILLILITRE 00029246
ON KENALOG-10 INJ MILLILITRE 01999761
ON ACLASTA 5MG/100ML INJ MILLILITRE 02269198
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02408082
ON TARO-ZOLEDRONIC ACID 5MG/100ML MILLILITRE 02415100
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02422433
ON ZOMETA CONC 4MG/5ML INJ MILLILITRE 02248296
ON ZOLEDRONIC ACID-Z 4MG/5ML INJ MILLILITRE 02401606
ON PMS-ZOLEDRONIC ACID 4MG/5ML MILLILITRE 02403056
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02407639
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02413701
ON TARO-ZOLEDRONIC ACID 4MG/5ML MILLILITRE 02415186
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02421550
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02422425
ON FRAGMIN 2,500U/ML INJ MILLILITRE 02377454
ON ADRENALIN CHLORIDE 1:1000 INJ MILLILITRE 00155357
ON LIORESAL INTRATHECAL 2MG/ML MILLILITRE 02131064
ON VPI-BACLOFEN INTRATHECAL MILLILITRE 02413647
ON HUMIRA PEN 40MG/0.8ML INJ PEN 09857294
ON HUMIRA PFS 40MG/0.8ML INJ SYRINGE 02258595
ON FIRAZYR 10MG/ML INJ SYRINGE 02425696
ON METOJECT 10MG/ML INJ SYRINGE 02304767
ON METOJECT 15MG/1.5ML INJ SYRINGE 02320045
ON IMITREX 6MG/0.5ML INJ SYRINGE 02212188
ON TARO-SUMATRIPTAN 6MG/0.5ML INJ SYRINGE 02361698
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
14 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON FRAGMIN 2,500U/0.2ML INJ SYRINGE 02132621
ON FRAGMIN 5,000U/0.2ML INJ SYRINGE 02132648
ON FRAGMIN 25,000U/ML INJ SYRINGE 02231171
ON FRAGMIN 7,500U/0.3ML INJ SYRINGE 02352648
ON FRAGMIN 15,000U/0.6ML INJ SYRINGE 02352672
ON FRAGMIN 3,500U/0.28ML INJ SYRINGE 02430789
ON FRAGMIN 10,000U/0.4ML INJ SYRINGE 02352656
ON FRAGMIN 12,500U/0.5ML INJ SYRINGE 02352664
ON FRAGMIN 18,000U/0.72ML INJ SYRINGE 02352680
ON EPREX 10,00U/0.5ML INJ SYRINGE 02231583
ON EPREX 20,00U/0.5ML INJ SYRINGE 02231584
ON EPREX 3,000U/0.3ML INJ SYRINGE 02231585
ON EPREX 4,000U/0.4ML INJ SYRINGE 02231586
ON EPREX 5,000U/0.5ML INJ SYRINGE 02243400
ON EPREX 6,000U/0.6ML INJ SYRINGE 02243401
ON EPREX 8,000U/0.8ML INJ SYRINGE 02243403
ON EPREX 30,000U/0.75ML INJ SYRINGE 02288680
ON BYETTA PREFILL PEN SYRINGE 02361809
ON BYETTA PREFILL PEN SYRINGE 02361817
ON ACTEMRA 162MG/0.9ML INJ SYRINGE 02424770
ON LUCENTIS PFS 10MG/ML INJ SYRINGE 02425629
ON LUCENTIS 10MG/ML INJ VIAL 02296810
ON VITAMIN K1 1MG/0.5ML USP INJ AMPOULE 00781878
ON PUREGON CARTRIDGE 02243948
ON SYMBICORT 100 TURBUHALER DOSE 02245385
ON SYMBICORT 200 TURBUHALER DOSE 02245386
ON ADVAIR 100 DISKUS DOSE 02240835
ON ADVAIR 250 DISKUS DOSE 02240836
ON ADVAIR 500 DISKUS DOSE 02240837
ON ADVAIR 125 DOSE 02245126
ON ADVAIR 250 DOSE 02245127
ON BREO ELLIPTA DOSE 02408872
ON FORADIL DRY POWDER CAPSULES FOR INHALATION DOSE 02230898
ON OXEZE TURBUHALER 12MCG INH DOSE 02237224
ON OXEZE TURBUHALER 6MCG INH DOSE 02237225
ON ZENHALE 5/100MCG INH DOSE 02361752
ON ZENHALE 5/200MCG INH DOSE 02361760
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
15 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON SEREVENT DISKHALER 50MCG DOSE 02214261
ON SEREVENT DISKUS 50MCG DOSE 02231129
ON ANORO ELLIPTA DOSE 02418401
ON EMEND TRI PACK 125/80MG TABLET 02298813
ON JINARC TAB TABLET 02437503
ON CILOXAN 0.3% OP OINT GRAM 02200864
ON LOTEMAX 5MG/G OP OINT GRAM 02421941
ON DUOLUBE OP OINT GRAM 02125706
ON ERYTHROMYCIN 0.5% OP OINT GRAM 02326663
ON MAXITROL OP OINT GRAM 00358177
ON CILOXAN 0.3% OP SOL MILLILITRE 01945270
ON APO-CIPROFLOX 0.3% OP SOL MILLILITRE 02263130
ON SANDOZ CIPROFLOXACIN 0.3% OP MILLILITRE 02387131
ON SIMBRINZA OP SOL MILLILITRE 02435411
ON AZARGA OP SOL MILLILITRE 02331624
ON ACT-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02254786
ON APO-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02296527
ON PMS-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02317125
ON SANDOZ-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02367335
ON GD-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02373041
ON MED-LATANOPROST 50MCG/ML OP SOL MILLILITRE 02426935
ON XALATAN 50MCG/ML OP SOL MILLILITRE 02231493
ON XALACOM STERILE OP SOL MILLILITRE 02246619
ON GD-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02373068
ON SDZ-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02394685
ON APO-LATANOPROST/TIMOP OP SOL MILLILITRE 02414155
ON ACT-LATANOPROST/TIMOLOL OP SOL MILLILITRE 02436256
ON COLYTE MILLILITRE 00677442
ON ENTOCORT ENEMA MILLILITRE 02052431
ON APO-BUTORPHANOL 10MG/ML NASAL SPRAY MILLILITRE 02242504
ON CEFZIL 125MG/5ML SUSP MILLILITRE 02163675
ON CEFZIL 250MG/5ML SUSP MILLILITRE 02163683
ON RAN-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293579
ON APO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02293943
ON APO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02293951
ON RAN-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02329204
ON AURO-CEFPROZIL 125MG/5ML SUSP MILLILITRE 02347261
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
16 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON AURO-CEFPROZIL 250MG/5ML SUSP MILLILITRE 02347288
ON DALACIN C 150MG/ML INJ MILLILITRE 00260436
ON CLINDAMYCIN 150MG/ML INJ MILLILITRE 02230540
ON GLYCOPYRROLATE 0.2MG/ML INJ MILLILITRE 02039508
ON NOVORAPID 100U/ML INJ MILLILITRE 02245397
ON RATIO-IPRATROPIUM UDV MILLILITRE 02097168
ON TEVA-IPRATROPIUM STERINEBS MILLILITRE 02216221
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231245
ON APO-IPRAVENT 250MCG/ML INH SOL MILLILITRE 02126222
ON NOVO-IPRAMIDE 250MCG/ML INH SOL MILLILITRE 02210479
ON PMS-IPRATROPIUM 250MCG/ML INH SOL MILLILITRE 02231136
ON MYLAN-IPRATROPIUM 0.25MG/ML INH SOL MILLILITRE 02239131
ON COMBIVENT UDV MILLILITRE 02231675
ON TEVA-COMBO STERINEBS MILLILITRE 02272695
ON TEVA-SALBUTAMOL STERINEBS P.F. MILLILITRE 01926934
ON PMS-SALBUTAMOL INH SOL MILLILITRE 02208229
ON VENTOLIN NEBULES P.F. - 2.5MG/2.5ML MILLILITRE 02213419
ON RATIO-SALBUTAMOL 1MG/ML INH SOL MILLILITRE 01986864
ON PMS-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02069571
ON SANDOZ-SALBUTAMOL 5MG/ML INH SOL MILLILITRE 02154412
ON DDAVP SPRAY MILLILITRE 00836362
ON DESMOPRESSIN SPRAY MILLILITRE 02242465
ON MOZOBIL 20MG/ML INJ MILLILITRE 02377225
ON FORTEO 250MCG/ML INJ MILLILITRE 02254689
ON DEPO-TESTOSTERONE 100MG/ML INJ MILLILITRE 00030783
ON DELATESTRYL 200MG/ML INJ MILLILITRE 00029246
ON KENALOG-10 INJ MILLILITRE 01999761
ON ACLASTA 5MG/100ML INJ MILLILITRE 02269198
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02408082
ON TARO-ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02415100
ON ZOLEDRONIC ACID 5MG/100ML INJ MILLILITRE 02422433
ON ZOMETA CONC 4MG/5ML INJ MILLILITRE 02248296
ON ZOLEDRONIC ACID-Z 4MG/5ML INJ MILLILITRE 02401606
ON PMS-ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02403056
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02407639
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02413701
ON TARO-ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02415186
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
17 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02421550
ON ZOLEDRONIC ACID 4MG/5ML INJ MILLILITRE 02422425
ON FRAGMIN 2,500U/ML INJ MILLILITRE 02377454
ON ADRENALIN CHLORIDE 1:1000 INJ MILLILITRE 00155357
ON LIORESAL INTRATHECAL 2MG/ML INJ MILLILITRE 02131064
ON VAL-BACLOFEN INTRATHECAL INJ MILLILITRE 02413647
ON HUMIRA PEN 40MG/0.8ML INJ PEN 09857294
ON HUMIRA PFS 40MG/0.8ML INJ SYRINGE 02258595
ON FIRAZYR 10MG/ML INJ SYRINGE 02425696
ON METOJECT 10MG/ML INJ SYRINGE 02304767
ON METOJECT 15MG/1.5ML INJ SYRINGE 02320045
ON IMITREX 6MG/0.5ML INJ SYRINGE 02212188
ON TARO-SUMATRIPTAN 6MG/0.5ML INJ SYRINGE 02361698
ON FRAGMIN 2,500U/0.2ML INJ SYRINGE 02132621
ON FRAGMIN 5,000U/0.2ML INJ SYRINGE 02132648
ON FRAGMIN 25,000U/ML INJ SYRINGE 02231171
ON FRAGMIN 7,500U/0.3ML INJ SYRINGE 02352648
ON FRAGMIN 15,000U/0.6ML INJ SYRINGE 02352672
ON FRAGMIN 3,500U/0.28ML INJ SYRINGE 02430789
ON FRAGMIN 10,000U/0.4ML INJ SYRINGE 02352656
ON FRAGMIN 12,500U/0.5ML INJ SYRINGE 02352664
ON FRAGMIN 18,000U/0.72ML INJ SYRINGE 02352680
ON EPREX 10,00U/0.5ML INJ SYRINGE 02231583
ON EPREX 20,00U/0.5ML INJ SYRINGE 02231584
ON EPREX 3,000U/0.3ML INJ SYRINGE 02231585
ON EPREX 4,000U/0.4ML INJ SYRINGE 02231586
ON EPREX 5,000U/0.5ML INJ SYRINGE 02243400
ON EPREX 6,000U/0.6ML INJ SYRINGE 02243401
ON EPREX 8,000U/0.8ML INJ SYRINGE 02243403
ON EPREX 30,000U/0.75ML INJ SYRINGE 02288680
ON BYETTA PREFILL PEN SYRINGE 02361809
ON BYETTA PREFILL PEN SYRINGE 02361817
ON ACTEMRA 162MG/0.9ML INJ SYRINGE 02424770
ON LUCENTIS PFS 10MG/ML INJ SYRINGE 02425629
ON LUCENTIS 10MG/ML INJ VIAL 02296810
ON VITAMIN K1 1MG/0.5ML USP INJ AMPOULE 00781878
ON PUREGON INJ CARTRIDGE 02243948
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
18 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON LOLO 28'S TAB TABLET 02417456
ON NOVO-CYPROTERONE/ETHINYL ESTRADIOL TABLET 02309556
ON DIANE-35 TABLET 02233542
ON CYESTRA-35 TABLET 02290308
ON RAN-CYPROTERONE/ETHINYL ESTRADIOL TABLET 02425017
ON CHAMPIX STARTER PACK TABLET 02298309
ON VIGAMOX 0.5% OP SOL MILLILITRE 02252260
ON SANDOZ MOXIFLOXACIN 0.5% OP SO MILLILITRE 02411520
ON APO-MOXIFLOXACIN 0.5% OP SOL MILLILITRE 02406373
ON ACT MOXIFLOXACIN 0.5% OP SOL MILLILITRE 02404656
ON ACT-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02404095
ON PATADAY 0.2% OP SOL MILLILITRE 02362171
ON SDZ-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02420171
ON APO-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02402823
ON POLYTRIM OP SOL MILLILITRE 02011956
ON DUOTRAV PQ 0.004%/0.5% OP SOL MILLILITRE 02278251
ON DUKORAL MILLILITRE 02247208
ON PMS-ERYTHROMYCIN 0.5% OP OINT GRAM 01912755
ON APO-FLUTICASONE NAS SPR DOSE 02294745
ON FLONASE 50MCG NAS SPR DOSE 02213672
ON RATIO-FLUTICASONE 50MCG NAS SPR DOSE 02296071
ON APO-MOMETASONE 50MCG NAS SPR DOSE 02403587
ON NASONEX NAS SPR DOSE 02238465
ON NASACORT AQ 55MCG NAS SPR DOSE 02213834
ON AVAMYS NAS SPR DOSE 02298589
ON VENTOLIN DISKUS 200MCG DOSE 02243115
ON FLOVENT DISKUS 100MCG DOSE 02237245
ON PREVNAR 13 SYRINGE 02335204
ON BEXSERO VACCINE SYRINGE 02417030
ON SIMPONI 50MG/0.5ML SYRINGE 02324784
ON SIMPONI PRE-FILL 50MG/0.5ML SYRINGE 02324776
ON NEULASTA 10MG/ML SYRINGE 02249790
ON GARDASIL 9 SYRINGE 02437058
ON GARDASIL SYRINGE 02283190
ON ZOSTAVAX II VIAL 02375516
ON XGEVA 120MG/1.7ML VIAL 02368153
ON LOLO 28'S TAB TABLET 02417456
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
19 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON NOVO-CYPROTERONE/ETHINYL ESTRADIOL TABLET 02309556
ON DIANE-35 TABLET 02233542
ON CYESTRA-35 TABLET 02290308
ON RAN-CYPROTERONE/ETHINYL ESTRADIOL TABLET 02425017
ON CHAMPIX STARTER PACK TABLET 02298309
ON VIGAMOX 0.5% OP SOL MILLILITRE 02252260
ON SANDOZ MOXIFLOXACIN 0.5% OP SO MILLILITRE 02411520
ON APO-MOXIFLOXACIN 0.5% OP SOL MILLILITRE 02406373
ON ACT MOXIFLOXACIN 0.5% OP SOL MILLILITRE 02404656
ON ACT-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02404095
ON PATADAY 0.2% OP SOL MILLILITRE 02362171
ON SDZ-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02420171
ON APO-OLOPATADIN/PINE 0.2% OP SOL MILLILITRE 02402823
ON POLYTRIM OP SOL MILLILITRE 02011956
ON DUOTRAV PQ 0.004%/0.5% OP SOL MILLILITRE 02278251
ON DUKORAL MILLILITRE 02247208
ON PMS-ERYTHROMYCIN 0.5% OP OINT GRAM 01912755
ON APO-FLUTICASONE NAS SPR DOSE 02294745
ON FLONASE 50MCG NAS SPR DOSE 02213672
ON RATIO-FLUTICASONE 50MCG NAS SPR DOSE 02296071
ON APO-MOMETASONE 50MCG NAS SPR DOSE 02403587
ON NASONEX NAS SPR DOSE 02238465
ON NASACORT AQ 55MCG NAS SPR DOSE 02213834
ON AVAMYS NAS SPR DOSE 02298589
ON VENTOLIN DISKUS 200MCG DOSE 02243115
ON FLOVENT DISKUS 100MCG DOSE 02237245
ON PREVNAR 13 SYRINGE 02335204
ON BEXSERO VACCINE SYRINGE 02417030
ON SIMPONI 50MG/0.5ML SYRINGE 02324784
ON SIMPONI PRE-FILL 50MG/0.5ML SYRINGE 02324776
ON NEULASTA 10MG/ML SYRINGE 02249790
ON GARDASIL 9 SYRINGE 02437058
ON GARDASIL SYRINGE 02283190
ON ZOSTAVAX II VIAL 02375516
ON XGEVA 120MG/1.7ML VIAL 02368153
ON BOTOX 100 UNIT/VIAL INJ UNIT 01981501
ON BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
20 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
ON BOTOX 200 UNIT/VIAL INJ (ON) UNIT 09857387
ON BOTOX 50 UNIT/VIAL INJ (ON) UNIT 09857386
PRINCE EDWARD ISLAND
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
PE SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
PE SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
PE SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
PE TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
PE BOTOX 100 UNIT/VIAL INJ UNIT 01981501
PE BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
QUÉBEC
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
QC BOTOX 100 UNIT/VIAL INJ UNIT 01981501
QC BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
QC BOTOX INJ 200 UNIT/VIAL (QC) UNIT 99100646
QC BOTOX 50 UNIT/VIAL INJ (QC) UNIT 99100741
SASKATCHEWAN
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
SK NITROLINGUAL 0.4MG PUMPSPRAY DOSE 02231441
SK APO-NITROGLYCERIN 0.4MG PUMPSPRAY DOSE 02393433
SK RHO-NITRO 0.4MG SL PUMPSRAY DOSE 02238998
SK MYLAN-NITRO 0.4MG PUMPSPRAY DOSE 02243588
SK OMNARIS 50MCG NASAL SPRAY DOSE 02303671
SK APO-CICLESONIDE 50MCG NASAL SPRAY DOSE 02417316
SK VENTOLIN HFA 100MCG INHALER DOSE 02241497
SK APO-SALVENT CFC FREE 100MCG INHALER DOSE 02245669
SK TEVA-SALBUTAMOL HFA 100MCG INHALER DOSE 02326450
SK AIROMIR 100MCG/ACT INHALER DOSE 02232570
SK SALBUTAMOL HFA 100MCG INHALER DOSE 02419858
SK QVAR 100MCG INHALER DOSE 02242030
SK FLOVENT HFA 50MCG INHALER DOSE 02244291
SK FLOVENT HFA 125MCG INHALER DOSE 02244292
SK FLOVENT HFA 250MCG INHALER DOSE 02244293
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
21 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
SK ALVESCO 200MCG INHALER DOSE 02285614
SK PULMICORT TURBUHALER 200MCG DOSE 00851752
SK PULMICORT TURBUHALER 400MCG DOSE 00851760
SK FLOVENT DISKUS 250MCG INHALER DOSE 02237246
SK FLOVENT DISKUS 500MCG INHALER DOSE 02237247
SK ASMANEX TWISTHALER 200MCG INHALER DOSE 02243595
SK ASMANEX TWISTHALER 400MCG INHALER DOSE 02243596
SK BREO ELLIPTA 100/25MCG INHALER DOSE 02408872
SK CORTIFOAM 10% RECTAL FOAM GRAM 00579335
SK VITAMIN B12 100MCG/ML INJECTION MILLILITRE 00521515
SK CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 01987003
SK CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 02413795
SK JAMP-CYANOCOBALAMIN 1MG/ML INJECTION MILLILITRE 02420147
SK VITAMIN B12 INJECTION MILLILITRE 00626112
SK HUMALOG 100U/ML INJECTION MILLILITRE 02229704
SK LANTUS 100UNIT/ML VIAL MILLILITRE 02245689
SK HUMALOG KWIKPEN 100U/ML INJECTION MILLILITRE 02403412
SK HUMALOG KWIKPEN 200U/ML INJECTION MILLILITRE 02439611
SK SANDOZ TRAVOPROST .004% OP SOL MILLILITRE 02413167
SK APO-TRAVOPROST Z 0.004% OP SOL MILLILITRE 02415739
SK TEVA-TRAVOPROST Z 0.004% OP SOL MILLILITRE 02412063
SK TRAVATAN Z 0.004% OP SOL MILLILITRE 02318008
SK TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
SK SATIVEX BUCCAL ORAL SPRAY MILLILITRE 02266121
SK MICRONOR 28 TABLET TABLET 00037605
SK JENCYCLA 0.35MG 28 TABLET TABLET 02441306
SK MOVISSE 0.35MG 28 TABLET TABLET 02410303
SK MIN-OVRAL 21 TABLET TABLET 02042320
SK OVIMA 21 TABLET TABLET 02387085
SK PORTIA 21 TABLET TABLET 02295946
SK MIN-OVRAL 28 TABLET TABLET 02042339
SK OVIMA 28 TABLET TABLET 02387093
SK PORTIA 28 TABLET TABLET 02295954
SK MARVELON 28 TABLET TABLET 02042479
SK APRI 28 TABLET TABLET 02317206
SK FREYA 28 TABLET TABLET 02396610
SK MIRVALA 28 TABLET TABLET 02410257
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
22 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
SK RECLIPSEN 28 TABLET TABLET 02417464
SK MARVELON 21 TABLET TABLET 02042487
SK APRI 21 TABLET TABLET 02317192
SK FREYA 21 TABLET TABLET 02396491
SK MIRVALA 21 TABLET TABLET 02410249
SK RECLIPSEN 21 TABLET TABLET 02420813
SK ALESSE 21 TABLET TABLET 02236974
SK ALYSENA 21 TABLET TABLET 02387875
SK AVIANE 21 TABLET TABLET 02298538
SK ESME 21 TABLET TABLET 02388138
SK LUTERA 21 TABLET TABLET 02401185
SK ALESSE 28 TABLET TABLET 02236975
SK ALYSENA 28 TABLET TABLET 02387883
SK AVIANE 28 TABLET TABLET 02298546
SK ESME 28 TABLET TABLET 02388146
SK LUTERA 28 TABLET TABLET 02401207
SK TRI-CYCLEN LO 21 TABLET TABLET 02258560
SK TRICIRA LO 21 TABLET TABLET 02401967
SK TRI-CYCLEN LO 28 TABLET TABLET 02258587
SK TRICIRA LO 28 TABLET TABLET 02401975
SK YAZ 28 TABLET TABLET 02321157
SK LOESTRIN 1.5/30 21 TABLET TABLET 00297143
SK LOESTRIN 1.5/30 28 TABLET TABLET 00353027
SK DEMULEN-30 21 TABLET TABLET 00469327
SK DEMULEN-30 28 TABLET TABLET 00471526
SK ORTHO 7/7/7 21 TABLET TABLET 00602957
SK CYCLEN 21 TABLET TABLET 01968440
SK CYCLEN 28 TABLET TABLET 01992872
SK TRI-CYCLEN 21 TABLET TABLET 02028700
SK TRI-CYCLEN 28 TABLET TABLET 02029421
SK YASMIN 21 TABLET TABLET 02261723
SK YASMIN 28 TABLET TABLET 02261731
SK BOTOX 100 UNIT/VIAL INJ UNIT 01981501
SK BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721
Document Publication Date: July 2019
2019 Express Scripts Canada. All Rights Reserved.
23 @ExpressRxCanada Express Scripts Canada Express Scripts Canada
YUKON
PROVINCE MEDICATION NAME UNIT OF MEASURE DIN/PIN
YT SANDOSTATIN LAR 20MG/VIAL INJECTION MILLILITRE 02239324
YT SANDOSTATIN LAR 30MG/VIAL INJECTION MILLILITRE 02239325
YT TOUJEO SOLOSTAR 300U/ML INJECTION MILLILITRE 02441829
YT BOTOX 100 UNIT/VIAL INJ UNIT 01981501
YT BOTOX COSMETIC 100 UNIT/VIAL INJ UNIT 02243721