Formulary Information - Basic Core Formulary (BCF)

The Basic Core Formulary (BCF) is a list of medications required to be on formulary at all full-service Military Treatment Facilities (MTFs). BCF medications are intended to meet the majority of the primary care needs of DoD beneficiaries.

Medications are selected for the BCF or ECF because they offer significant clinical or cost-effectiveness advantages to MTFs compared to other medications in a therapeutic class. MTFs should utilize BCF or ECF medications to the greatest extent consistent with the clinical needs of their patients.

The P&T Committee stated its position that BCF designated drugs will be stocked in the Pharmacy or readily available on the next duty day for MTFs located in the continental United States (CONUS), and be readily available on the next available order for MTFs located outside the continental United States (OCONUS).

MTFs MUST have on formulary MTFs MAY have on formulary MTFs MUST NOT have on formulary

All BCF medications

All ECF medications if the therapeutic class is on the MTF formulary

Medications that are on the Uniform Formulary, but not on the BCF or ECF

Medications in classes not yet reviewed by the DoD P&T Committee for the Uniform Formulary, unless not allowed by a national pharmaceutical contract

Medications designated as non-formulary under the Uniform Formulary

Medications that are not allowed on MTF formularies due to a national pharmaceutical contract.

The DoD P&T Committee is reviewing therapeutic classes for the UF on a class by class basis. For information on classes to be reviewed at upcoming meetings, please visit the DoD P&T Committee schedule page. The DoD P&T Committee makes recommendations regarding the formulary status of medications on the BCF, ECF, and UF to the Director, TRICARE Management Activity (TMA). The Director, TMA, makes final decisions after considering comments of the Beneficiary Advisory Panel (BAP).

References: HA policy 04-032, TRICARE Pharmacy Benefit Program Formulary Management, provides additional information about the BCF, ECF, and Uniform Formulary.



Special Notes

P&T Committee also include:

Medications designated as non-formulary under the Uniform Formulary. MTFs are not allowed to have these medications on their formularies.

Medications on the Uniform Formulary (UF), but not on the BCF or ECF. MTFs are not required to have any of these medications on formulary, but may choose to add one or more depending on local needs.

Brand names are provided for reference purposes and do not imply the recommendation of a specific product except when noted. For multi-source items, it is expected that the most favorably priced product will be used.

Classifications for drugs classes not yet reviewed by the DoD P&T Committee are general groupings provided for convenience only and are subject to change.

Newer antihistamines - Effective 17 Oct 07, all MTFs must have at least one single ingredient agent (loratadine, cetirizine, or fexofenadine), including at least one dosage form suitable for pediatric use.

Low molecular weight heparins/heparinoids - All MTFs must have at least one of the following products on the MTF formulary: dalteparin (Fragmin); enoxaparin (Lovenox); or tinzaparin (Innohep).



AHFS Therapeutic Class   Generic Name   Strength Form Quantity Limits
(per day supply)
5-alpha-Reductase InhibitorsFINASTERIDE5MGTablet-
AdamantanesAMANTADINE HYDROCHLORIDE100MGCapsule-
AdamantanesAMANTADINE HYDROCHLORIDE50MG/5MLSyrup-
AdrenalsFLUTICASONE PROPIONATE100MCG/BLISTAerosol Powder Breath Activated60.00 per 30 days
AdrenalsFLUTICASONE PROPIONATE110MCG/ACTAerosol2.00 per 30 days
AdrenalsFLUTICASONE PROPIONATE220MCG/ACTAerosol2.00 per 30 days
AdrenalsFLUTICASONE PROPIONATE250MCG/BLISTAerosol Powder Breath Activated60.00 per 30 days
AdrenalsFLUTICASONE PROPIONATE44MCG/ACTAerosol2.00 per 30 days
AdrenalsFLUTICASONE PROPIONATE50MCG/BLISTAerosol Powder Breath Activated60.00 per 30 days
AdrenalsMOMETASONE FUROATE110MCG/INHAerosol Powder Breath Activated120.00 per 30 days
AdrenalsMOMETASONE FUROATE220MCG/INHAerosol Powder Breath Activated120.00 per 30 days
AdrenalsPREDNISOLONE SODIUM PHOSPHATE15MG/5MLSolution-
AdrenalsPREDNISONE10MGTablet-
AdrenalsPREDNISONE1MGTablet-
AdrenalsPREDNISONE20MGTablet-
AdrenalsPREDNISONE5MGTablet-
alpha-Adrenergic AgonistsBRIMONIDINE TARTRATE0.15%Solution-
alpha-Adrenergic AgonistsBRIMONIDINE TARTRATE0.2%Solution-
alpha-Adrenergic Blocking AgentsTERAZOSIN HCL10MGCapsule-
alpha-Adrenergic Blocking AgentsTERAZOSIN HCL1MGCapsule-
alpha-Adrenergic Blocking AgentsTERAZOSIN HCL2MGCapsule-
alpha-Adrenergic Blocking AgentsTERAZOSIN HCL5MGCapsule-
AminopenicillinsAMOXICILLIN250MGCapsule-
AminopenicillinsAMOXICILLIN250MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN400MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN500MGCapsule-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID125MG/5ML; 31.25MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID200MG/5ML; 28.5MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID250MG/5ML; 62.5MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID250MG; 125MGTablet-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID400MG/5ML; 57MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID500MG; 125MGTablet-
AminopenicillinsAMOXICILLIN; CLAVULANIC ACID875MG; 125MGTablet-
AminopenicillinsAMOXICILLIN; POTASSIUM CLAVULANATE400MG/5ML; 57MG/5MLSuspension Reconstituted-
AminopenicillinsAMOXICILLIN; POTASSIUM CLAVULANATE600MG/5ML; 42.9MG/5MLSuspension Reconstituted-
Ammonia DetoxicantsLACTULOSE10GM/15MLSolution-
Ammonia DetoxicantsLACTULOSE10GM/15MLSolution-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE1.25MG; 1.25MG; 1.25MG; 1.25MGCapsule Extended Release 24 Hour-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE2.5MG; 2.5MG; 2.5MG; 2.5MGCapsule Extended Release 24 Hour-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE3.75MG; 3.75MG; 3.75MG; 3.75MGCapsule Extended Release 24 Hour-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE5MG; 5MG; 5MG; 5MGCapsule Extended Release 24 Hour-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE6.25MG; 6.25MG; 6.25MG; 6.25MGCapsule Extended Release 24 Hour-
AmphetaminesAMPHETAMINE ASPARTATE; AMPHETAMINE SULFATE; DEXTROAMPHETAMINE SACCHARATE; DEXTROAMPHETAMINE SULFATE7.5MG; 7.5MG; 7.5MG; 7.5MGCapsule Extended Release 24 Hour-
Analgesics and Antipyretics, MiscACETAMINOPHEN; BUTALBITAL; CAFFEINE325MG; 50MG; 40MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; LOSARTAN POTASSIUM12.5MG; 100MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; LOSARTAN POTASSIUM12.5MG; 50MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; LOSARTAN POTASSIUM25MG; 100MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; TELMISARTAN12.5MG; 40MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; TELMISARTAN12.5MG; 80MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; TELMISARTAN25MG; 80MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; VALSARTAN12.5MG; 160MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; VALSARTAN12.5MG; 320MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; VALSARTAN12.5MG; 80MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; VALSARTAN25MG; 160MGTablet-
Angiotensin II Receptor AntagonistsHYDROCHLOROTHIAZIDE; VALSARTAN25MG; 320MGTablet-
Angiotensin II Receptor AntagonistsLOSARTAN POTASSIUM100MGTablet-
Angiotensin II Receptor AntagonistsLOSARTAN POTASSIUM25MGTablet-
Angiotensin II Receptor AntagonistsLOSARTAN POTASSIUM50MGTablet-
Angiotensin II Receptor AntagonistsTELMISARTAN20MGTablet-
Angiotensin II Receptor AntagonistsTELMISARTAN40MGTablet-
Angiotensin II Receptor AntagonistsTELMISARTAN80MGTablet-
Angiotensin II Receptor AntagonistsVALSARTAN160MGTablet-
Angiotensin II Receptor AntagonistsVALSARTAN320MGTablet-
Angiotensin II Receptor AntagonistsVALSARTAN40MGTablet-
Angiotensin II Receptor AntagonistsVALSARTAN80MGTablet-
Angiotensin-Converting Enzyme InhibitorsCAPTOPRIL100MGTablet-
Angiotensin-Converting Enzyme InhibitorsCAPTOPRIL12.5MGTablet-
Angiotensin-Converting Enzyme InhibitorsCAPTOPRIL25MGTablet-
Angiotensin-Converting Enzyme InhibitorsCAPTOPRIL50MGTablet-
Angiotensin-Converting Enzyme InhibitorsHYDROCHLOROTHIAZIDE; LISINOPRIL12.5MG; 10MGTablet-
Angiotensin-Converting Enzyme InhibitorsHYDROCHLOROTHIAZIDE; LISINOPRIL12.5MG; 20MGTablet-
Angiotensin-Converting Enzyme InhibitorsHYDROCHLOROTHIAZIDE; LISINOPRIL25MG; 20MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL10MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL2.5MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL20MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL30MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL40MGTablet-
Angiotensin-Converting Enzyme InhibitorsLISINOPRIL5MGTablet-
Angiotensin-Converting Enzyme InhibitorsRAMIPRIL1.25MGCapsule-
Angiotensin-Converting Enzyme InhibitorsRAMIPRIL10MGCapsule-
Angiotensin-Converting Enzyme InhibitorsRAMIPRIL2.5MGCapsule-
Angiotensin-Converting Enzyme InhibitorsRAMIPRIL5MGCapsule-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE10MGCapsule Extended Release 24 Hour-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE10MGTablet-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE18MGTablet Extended Release-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE20MGCapsule Extended Release 24 Hour-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE20MGTablet-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE27MGTablet Extended Release-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE30MGCapsule Extended Release 24 Hour-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE36MGTablet Extended Release-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE40MGCapsule Extended Release 24 Hour-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE54MGTablet Extended Release-
Anorexigenics & Resp & Cereb Stim, MiscMETHYLPHENIDATE HYDROCHLORIDE5MGTablet-
Antiallergic AgentsOLOPATADINE HYDROCHLORIDE0.1%Solution-
AntibacterialsBACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE400UNIT/GM; 3.5MG/GM; 10000UNIT/GMOintment-
AntibacterialsBACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE400UNIT/GM; 5MG/GM; 10000UNIT/GMOintment-
AntibacterialsCLINDAMYCIN PHOSPHATE1%Solution-
AntibacterialsCLINDAMYCIN PHOSPHATE2%Cream-
AntibacterialsERYTHROMYCIN2%Gel-
AntibacterialsERYTHROMYCIN2%Solution-
AntibacterialsERYTHROMYCIN5MG/GMOintment-
AntibacterialsGENTAMICIN SULFATE0.3%Ointment-
AntibacterialsGENTAMICIN SULFATE0.3%Solution-
AntibacterialsGRAMICIDIN; NEOMYCIN SULFATE; POLYMYXIN B SULFATE0.025MG/ML; 1.75MG/ML; 10000UNIT/MLSolution-
AntibacterialsMETRONIDAZOLE0.75%Gel-
AntibacterialsMUPIROCIN2%Ointment-
AntibacterialsPOLYMYXIN B SULFATE; TRIMETHOPRIM SULFATE10000UNIT/ML; 0.1%Solution-
AntibacterialsSULFACETAMIDE SODIUM10%Solution-
Anticholinergic AgentsBENZTROPINE MESYLATE0.5MGTablet-
Anticholinergic AgentsBENZTROPINE MESYLATE1MGTablet-
Anticholinergic AgentsBENZTROPINE MESYLATE2MGTablet-
Anticholinergic AgentsTRIHEXYPHENIDYL HYDROCHLORIDE0.4MG/MLElixir-
Anticholinergic AgentsTRIHEXYPHENIDYL HYDROCHLORIDE2MGTablet-
Anticonvulsants, MiscellaneousCARBAMAZEPINE100MGTablet Chewable-
Anticonvulsants, MiscellaneousCARBAMAZEPINE100MG/5MLSuspension-
Anticonvulsants, MiscellaneousCARBAMAZEPINE200MGTablet-
Anticonvulsants, MiscellaneousCARBAMAZEPINE400MGTablet Extended Release 12 Hour-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM125MGCapsule Sprinkle-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM125MGTablet Delayed Release-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM250MGTablet Delayed Release-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM250MGTablet Extended Release 24 Hour-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM500MGTablet Delayed Release-
Anticonvulsants, MiscellaneousDIVALPROEX SODIUM500MGTablet Extended Release 24 Hour-
Anticonvulsants, MiscellaneousGABAPENTIN100MGCapsule-
Anticonvulsants, MiscellaneousGABAPENTIN300MGCapsule-
Anticonvulsants, MiscellaneousGABAPENTIN400MGCapsule-
Anticonvulsants, MiscellaneousGABAPENTIN600MGTablet-
Anticonvulsants, MiscellaneousGABAPENTIN800MGTablet-
Antidiarrhea AgentsLOPERAMIDE HYDROCHLORIDE2MGCapsule-
Antifungals, MiscellaneousGRISEOFULVIN125MG/5MLSuspension-
Antifungals, MiscellaneousGRISEOFULVIN ULTRAMICROSIZE125MGTablet-
Antifungals, MiscellaneousGRISEOFULVIN ULTRAMICROSIZE250MGTablet-
Antigout AgentsALLOPURINOL100MGTablet-
Antigout AgentsALLOPURINOL300MGTablet-
Anti-inflammatory AgentsFLUOCINONIDE0.05%Cream-
Anti-inflammatory AgentsHYDROCORTISONE2.5%Cream-
Anti-inflammatory AgentsHYDROCORTISONE ACETATE25MGSuppository-
Anti-inflammatory AgentsMESALAMINE (5-ASA)400MGTablet Delayed Release-
Anti-inflammatory AgentsTRIAMCINOLONE ACETONIDE0.1%Cream-
Antilipemic Agents, MiscellaneousNIACIN1000MGTablet Extended Release-
Antilipemic Agents, MiscellaneousNIACIN500MGTablet Extended Release-
Antilipemic Agents, MiscellaneousNIACIN750MGTablet Extended Release-
Antimanic AgentsLITHIUM CARBONATE150MGCapsule-
Antimanic AgentsLITHIUM CARBONATE300MGCapsule-
Antimanic AgentsLITHIUM CITRATE8MEQ/5MLSolution-
Antimuscarinics/AntispasmodicsDICYCLOMINE HYDROCHLORIDE10MGCapsule-
Antimuscarinics/AntispasmodicsDICYCLOMINE HYDROCHLORIDE10MG/5MLSolution-
Antimuscarinics/AntispasmodicsDICYCLOMINE HYDROCHLORIDE10MG/5MLSyrup-
Antimuscarinics/AntispasmodicsDICYCLOMINE HYDROCHLORIDE20MGTablet-
Antimuscarinics/AntispasmodicsIPRATROPIUM BROMIDE0.02%Solution450.00 per 30 days
Antimuscarinics/AntispasmodicsIPRATROPIUM BROMIDE17MCG/ACTAerosol Solution2.00 per 30 days
Antineoplastic AgentsGOSERELIN ACETATE10.8MGImplant-
Antineoplastic AgentsGOSERELIN ACETATE3.6MGImplant-
Antineoplastic AgentsMETHOTREXATE2.5MGTablet-
Antineoplastic AgentsTAMOXIFEN CITRATE10MGTablet-
Antineoplastic AgentsTAMOXIFEN CITRATE20MGTablet-
Antiprotozoals, MiscellaneousMETRONIDAZOLE250MGTablet-
Antiprotozoals, MiscellaneousMETRONIDAZOLE500MGTablet-
Antipruritics and Local AnestheticsPHENAZOPYRIDINE HYDROCHLORIDE100MGTablet-
Antipruritics and Local AnestheticsPHENAZOPYRIDINE HYDROCHLORIDE200MGTablet-
Antithyroid AgentsPROPYLTHIOURACIL50MGTablet-
Antituberculosis AgentsETHAMBUTOL HYDROCHLORIDE100MGTablet-
Antituberculosis AgentsETHAMBUTOL HYDROCHLORIDE400MGTablet-
Antituberculosis AgentsISONIAZID100MGTablet-
Antituberculosis AgentsISONIAZID300MGTablet-
Antituberculosis AgentsPYRAZINAMIDE500MGTablet-
Antituberculosis AgentsRIFAMPIN300MGCapsule-
Anxiolytics, Sedatives, & Hypnotics MiscBUSPIRONE HYDROCHLORIDE10MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscBUSPIRONE HYDROCHLORIDE15MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscBUSPIRONE HYDROCHLORIDE5MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscHYDROXYZINE HYDROCHLORIDE10MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscHYDROXYZINE HYDROCHLORIDE10MG/5MLSolution-
Anxiolytics, Sedatives, & Hypnotics MiscHYDROXYZINE HYDROCHLORIDE10MG/5MLSyrup-
Anxiolytics, Sedatives, & Hypnotics MiscHYDROXYZINE HYDROCHLORIDE25MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscHYDROXYZINE HYDROCHLORIDE50MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscZOLPIDEM TARTRATE10MGTablet-
Anxiolytics, Sedatives, & Hypnotics MiscZOLPIDEM TARTRATE5MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE100MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE150MGTablet Extended Release 24 Hour-
Atypical AntipsychoticsQUETIAPINE FUMARATE200MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE200MGTablet Extended Release 24 Hour-
Atypical AntipsychoticsQUETIAPINE FUMARATE25MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE300MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE300MGTablet Extended Release 24 Hour-
Atypical AntipsychoticsQUETIAPINE FUMARATE400MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE400MGTablet Extended Release 24 Hour-
Atypical AntipsychoticsQUETIAPINE FUMARATE50MGTablet-
Atypical AntipsychoticsQUETIAPINE FUMARATE50MGTablet Extended Release 24 Hour-
Atypical AntipsychoticsRISPERIDONE0.25MGTablet-
Atypical AntipsychoticsRISPERIDONE0.5MGTablet-
Atypical AntipsychoticsRISPERIDONE1MGTablet-
Atypical AntipsychoticsRISPERIDONE1MG/MLSolution-
Atypical AntipsychoticsRISPERIDONE2MGTablet-
Atypical AntipsychoticsRISPERIDONE3MGTablet-
Atypical AntipsychoticsRISPERIDONE4MGTablet-
AzolesCLOTRIMAZOLE1%Solution-
AzolesFLUCONAZOLE150MGTablet-
BarbituratesPHENOBARBITAL100MGTablet-
BarbituratesPHENOBARBITAL15MGTablet-
BarbituratesPHENOBARBITAL20MG/5MLElixir-
BarbituratesPHENOBARBITAL20MG/5MLSolution-
BarbituratesPHENOBARBITAL30MGTablet-
BarbituratesPHENOBARBITAL60MGTablet-
BenzodiazepinesCLONAZEPAM0.5MGTablet-
BenzodiazepinesDIAZEPAM5MGTablet-
BenzodiazepinesTEMAZEPAM15MGCapsule-
BenzodiazepinesTEMAZEPAM30MGCapsule-
beta-Adrenergic Blocking AgentsATENOLOL100MGTablet-
beta-Adrenergic Blocking AgentsATENOLOL25MGTablet-
beta-Adrenergic Blocking AgentsATENOLOL50MGTablet-
beta-Adrenergic Blocking AgentsCARVEDILOL12.5MGTablet-
beta-Adrenergic Blocking AgentsCARVEDILOL25MGTablet-
beta-Adrenergic Blocking AgentsCARVEDILOL3.125MGTablet-
beta-Adrenergic Blocking AgentsCARVEDILOL6.25MGTablet-
beta-Adrenergic Blocking AgentsMETOPROLOL SUCCINATE100MGTablet Extended Release 24 Hour-
beta-Adrenergic Blocking AgentsMETOPROLOL SUCCINATE200MGTablet Extended Release 24 Hour-
beta-Adrenergic Blocking AgentsMETOPROLOL SUCCINATE25MGTablet Extended Release 24 Hour-
beta-Adrenergic Blocking AgentsMETOPROLOL SUCCINATE50MGTablet Extended Release 24 Hour-
beta-Adrenergic Blocking AgentsMETOPROLOL TARTRATE100MGTablet-
beta-Adrenergic Blocking AgentsMETOPROLOL TARTRATE25MGTablet-
beta-Adrenergic Blocking AgentsMETOPROLOL TARTRATE50MGTablet-
beta-Adrenergic Blocking AgentsTIMOLOL MALEATE0.25%Gel Forming Solution-
beta-Adrenergic Blocking AgentsTIMOLOL MALEATE0.25%Solution-
beta-Adrenergic Blocking AgentsTIMOLOL MALEATE0.5%Gel Forming Solution-
beta-Adrenergic Blocking AgentsTIMOLOL MALEATE0.5%Solution-
BiguanidesMETFORMIN HYDROCHLORIDE1000MGTablet-
BiguanidesMETFORMIN HYDROCHLORIDE500MGTablet-
BiguanidesMETFORMIN HYDROCHLORIDE500MGTablet Extended Release 24 Hour-
BiguanidesMETFORMIN HYDROCHLORIDE750MGTablet Extended Release 24 Hour-
BiguanidesMETFORMIN HYDROCHLORIDE850MGTablet-
Bone Resorption InhibitorsALENDRONATE SODIUM10MGTablet-
Bone Resorption InhibitorsALENDRONATE SODIUM35MGTablet-
Bone Resorption InhibitorsALENDRONATE SODIUM5MGTablet-
Bone Resorption InhibitorsALENDRONATE SODIUM70MGTablet-
Bone Resorption InhibitorsALENDRONATE SODIUM; CHOLECALCIFEROL70MG; 5600UNITTablet-
Bone Resorption InhibitorsIBANDRONATE SODIUM150MGTablet-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE120MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE180MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE240MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE300MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE360MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscDILTIAZEM HYDROCHLORIDE420MGCapsule Extended Release 24 Hour-
Calcium-Channel Blocking Agents, MiscVERAPAMIL HYDROCHLORIDE120MGTablet Extended Release-
Calcium-Channel Blocking Agents, MiscVERAPAMIL HYDROCHLORIDE180MGTablet Extended Release-
Calcium-Channel Blocking Agents, MiscVERAPAMIL HYDROCHLORIDE240MGTablet Extended Release-
Cardiotonic AgentsDIGOXIN0.125MGTablet-
Cardiotonic AgentsDIGOXIN0.25MGTablet-
Cell Stimulants and ProliferantsTRETINOIN0.025%Cream-
Cell Stimulants and ProliferantsTRETINOIN0.05%Cream-
Central Alpha-AgonistsCLONIDINE HYDROCHLORIDE0.1MGTablet-
Central Alpha-AgonistsCLONIDINE HYDROCHLORIDE0.2MGTablet-
Central Alpha-AgonistsCLONIDINE HYDROCHLORIDE0.3MGTablet-
Centrally Acting Skeletal Muscle RelaxantsCYCLOBENZAPRINE HYDROCHLORIDE10MGTablet-
Centrally Acting Skeletal Muscle RelaxantsMETHOCARBAMOL500MGTablet-
Class III AntiarrhythmicsAMIODARONE HCL200MGTablet-
ContraceptivesDROSPIRENONE; ETHINYL ESTRADIOL3MG; 0.02MGTablet-
ContraceptivesDROSPIRENONE; ETHINYL ESTRADIOL3MG; 0.03MGTablet-
ContraceptivesETHINYL ESTRADIOL; LEVONORGESTREL0.03MG; 0.15MGTablet-
ContraceptivesETHINYL ESTRADIOL; LEVONORGESTREL0.03MG; 0.15MGTablet-
ContraceptivesETHINYL ESTRADIOL; LEVONORGESTREL20MCG; 0.1MGTablet-
ContraceptivesETHINYL ESTRADIOL; LEVONORGESTREL30MCG; 0.15MGTablet-
ContraceptivesETHINYL ESTRADIOL; NORETHINDRONE35MCG; 1MGTablet-
ContraceptivesETHINYL ESTRADIOL; NORGESTIMATE0; 0Tablet-
ContraceptivesETHINYL ESTRADIOL; NORGESTIMATE0; 0Tablet-
ContraceptivesETHINYL ESTRADIOL; NORGESTIMATE35MCG; 0.25MGTablet-
ContraceptivesLEVONORGESTREL0.75MGTablet2.00 per days
ContraceptivesNORETHINDRONE0.35MGTablet-
CorticosteroidsFLUTICASONE PROPIONATE50MCG/ACTSuspension16.00 per 30 days
CorticosteroidsHYDROCORTISONE; NEOMYCIN SULFATE; POLYMYXIN B SULFATE1%; 3.5MG/ML; 10000UNIT/MLSuspension-
CorticosteroidsPREDNISOLONE ACETATE0.12%Suspension-
CorticosteroidsPREDNISOLONE ACETATE1%Suspension-
Coumarin DerivativesWARFARIN SODIUM10MGTablet-
Coumarin DerivativesWARFARIN SODIUM1MGTablet-
Coumarin DerivativesWARFARIN SODIUM2.5MGTablet-
Coumarin DerivativesWARFARIN SODIUM2MGTablet-
Coumarin DerivativesWARFARIN SODIUM3MGTablet-
Coumarin DerivativesWARFARIN SODIUM4MGTablet-
Coumarin DerivativesWARFARIN SODIUM5MGTablet-
Coumarin DerivativesWARFARIN SODIUM6MGTablet-
Coumarin DerivativesWARFARIN SODIUM7.5MGTablet-
Derivatives, MiscellaneousCYPROHEPTADINE HYDROCHLORIDE2MG/5MLSyrup-
Derivatives, MiscellaneousCYPROHEPTADINE HYDROCHLORIDE4MGTablet-
DevicesINHALER SPACER (MTF CHOICE)Miscellaneous-
DevicesINSULIN SYRINGEU-100/1ML/31G X 5/16"Miscellaneous-
Diabetes MellitusGLUCOSE TEST STRIPS0Strip204.00 per 30 days
DihydropyridinesAMLODIPINE BESYLATE10MGTablet-
DihydropyridinesAMLODIPINE BESYLATE2.5MGTablet-
DihydropyridinesAMLODIPINE BESYLATE5MGTablet-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL10MG; 20MGCapsule-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL10MG; 40MGCapsule-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL2.5MG; 10MGCapsule-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL5MG; 10MGCapsule-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL5MG; 20MGCapsule-
DihydropyridinesAMLODIPINE BESYLATE; BENAZEPRIL HCL5MG; 40MGCapsule-
DihydropyridinesNIFEDIPINE30MGTablet Extended Release 24 Hour-
DihydropyridinesNIFEDIPINE60MGTablet Extended Release 24 Hour-
DihydropyridinesNIFEDIPINE90MGTablet Extended Release 24 Hour-
Dipeptidyl Peptidase-4 (DPP-4) InhibitorsMETFORMIN HYDROCHLORIDE; SITAGLIPTIN PHOSPHATE1000MG; 50MGTablet-
Dipeptidyl Peptidase-4 (DPP-4) InhibitorsMETFORMIN HYDROCHLORIDE; SITAGLIPTIN PHOSPHATE500MG; 50MGTablet-
Dipeptidyl Peptidase-4 (DPP-4) InhibitorsSITAGLIPTIN PHOSPHATE100MGTablet-
Dipeptidyl Peptidase-4 (DPP-4) InhibitorsSITAGLIPTIN PHOSPHATE25MGTablet-
Dipeptidyl Peptidase-4 (DPP-4) InhibitorsSITAGLIPTIN PHOSPHATE50MGTablet-
Direct VasodilatorsHYDRALAZINE HYDROCHLORIDE10MGTablet-
Direct VasodilatorsHYDRALAZINE HYDROCHLORIDE25MGTablet-
Direct VasodilatorsHYDRALAZINE HYDROCHLORIDE50MGTablet-
Dopamine PrecursorsCARBIDOPA ANHYDROUS; LEVODOPA10MG; 100MGTablet-
Dopamine PrecursorsCARBIDOPA ANHYDROUS; LEVODOPA25MG; 100MGTablet-
Dopamine PrecursorsCARBIDOPA ANHYDROUS; LEVODOPA25MG; 250MGTablet-
EENT Anti-infectives, MiscellaneousCHLORHEXIDINE GLUCONATE0.12%Solution-
ErythromycinsERYTHROMYCIN250MGTablet Delayed Release-
ErythromycinsERYTHROMYCIN ETHYLSUCCINATE200MG/5MLSuspension Reconstituted-
ErythromycinsERYTHROMYCIN STEARATE250MGTablet-
Estrogen Agonist-AntagonistsRALOXIFENE HYDROCHLORIDE60MGTablet-
EstrogensESTRADIOL0.025MG/24HRPatch Weekly-
EstrogensESTRADIOL0.05MG/24HRPatch Weekly-
EstrogensESTRADIOL0.06MG/24HRPatch Weekly-
EstrogensESTRADIOL0.075MG/24HRPatch Weekly-
EstrogensESTRADIOL0.1MG/24HRPatch Weekly-
EstrogensESTRADIOL37.5MCG/24HRPatch Weekly-
EstrogensESTROGENS, CONJUGATED0.3MGTablet-
EstrogensESTROGENS, CONJUGATED0.45MGTablet-
EstrogensESTROGENS, CONJUGATED0.625MGTablet-
EstrogensESTROGENS, CONJUGATED0.625MG/GMCream-
EstrogensESTROGENS, CONJUGATED1.25MGTablet-
EstrogensESTROGENS, CONJUGATED; MEDROXYPROGESTERONE ACETATE0.3MG; 1.5MGTablet-
EstrogensESTROGENS, CONJUGATED; MEDROXYPROGESTERONE ACETATE0.45MG; 1.5MGTablet-
EstrogensESTROGENS, CONJUGATED; MEDROXYPROGESTERONE ACETATE0.625MG; 2.5MGTablet-
EstrogensESTROGENS, CONJUGATED; MEDROXYPROGESTERONE ACETATE0.625MG; 5MGTablet-
Fibric Acid DerivativesFENOFIBRATE145MGTablet-
Fibric Acid DerivativesFENOFIBRATE48MGTablet-
Fibric Acid DerivativesGEMFIBROZIL600MGTablet-
First Generation CephalosporinsCEPHALEXIN250MGCapsule-
First Generation CephalosporinsCEPHALEXIN250MG/5MLSuspension Reconstituted-
First Generation CephalosporinsCEPHALEXIN500MGCapsule-
First Generation CephalosporinsCEPHALEXIN MONOHYDRATE250MGCapsule-
First Generation CephalosporinsCEPHALEXIN MONOHYDRATE250MG/5MLSuspension Reconstituted-
First Generation CephalosporinsCEPHALEXIN MONOHYDRATE500MGCapsule-
Genitourinary Smooth Muscle RelaxantsOXYBUTYNIN CHLORIDE10MGTablet Extended Release 24 Hour-
Genitourinary Smooth Muscle RelaxantsOXYBUTYNIN CHLORIDE15MGTablet Extended Release 24 Hour-
Genitourinary Smooth Muscle RelaxantsOXYBUTYNIN CHLORIDE5MGTablet Extended Release 24 Hour-
Genitourinary Smooth Muscle RelaxantsTOLTERODINE TARTRATE2MGCapsule Extended Release 24 Hour-
Genitourinary Smooth Muscle RelaxantsTOLTERODINE TARTRATE4MGCapsule Extended Release 24 Hour-
Histamine H2-AntagonistsRANITIDINE HYDROCHLORIDE150MGTablet-
Histamine H2-AntagonistsRANITIDINE HYDROCHLORIDE150MG/10MLSyrup-
Histamine H2-AntagonistsRANITIDINE HYDROCHLORIDE15MG/MLSyrup-
Histamine H2-AntagonistsRANITIDINE HYDROCHLORIDE75MG/5MLSyrup-
HMG-CoA Reductase InhibitorsATORVASTATIN CALCIUM10MGTablet-
HMG-CoA Reductase InhibitorsATORVASTATIN CALCIUM20MGTablet-
HMG-CoA Reductase InhibitorsATORVASTATIN CALCIUM40MGTablet-
HMG-CoA Reductase InhibitorsATORVASTATIN CALCIUM80MGTablet-
HMG-CoA Reductase InhibitorsPRAVASTATIN SODIUM10MGTablet-
HMG-CoA Reductase InhibitorsPRAVASTATIN SODIUM20MGTablet-
HMG-CoA Reductase InhibitorsPRAVASTATIN SODIUM40MGTablet-
HMG-CoA Reductase InhibitorsPRAVASTATIN SODIUM80MGTablet-
HMG-CoA Reductase InhibitorsSIMVASTATIN10MGTablet-
HMG-CoA Reductase InhibitorsSIMVASTATIN20MGTablet-
HMG-CoA Reductase InhibitorsSIMVASTATIN5MGTablet-
HMG-CoA Reductase InhibitorsSIMVASTATIN - HIGH DOSE (40 MG and HIGHER)40MGTablet-
HydantoinsPHENYTOIN125MG/5MLSuspension-
HydantoinsPHENYTOIN50MGTablet Chewable-
HydantoinsPHENYTOIN SODIUM100MGCapsule-
InsulinsINSULIN ASPART (HUMAN ANALOG)100UNIT/MLSolution-
InsulinsINSULIN ASPART (HUMAN ANALOG); INSULIN ASPART PROTAMINE30UNIT/ML; 70UNIT/MLSuspension-
InsulinsINSULIN GLARGINE100UNIT/MLSolution-
InsulinsINSULIN HUMAN (REGULAR)100UNIT/MLSolution-
InsulinsINSULIN HUMAN (REGULAR); INSULIN HUMAN, ISOPHANE (NPH)30UNIT/ML; 70UNIT/MLSuspension-
InsulinsINSULIN HUMAN, ISOPHANE (NPH)100UNIT/MLSuspension-
Leukotriene ModifiersMONTELUKAST SODIUM10MGTablet-
Leukotriene ModifiersMONTELUKAST SODIUM4MGPacket-
Leukotriene ModifiersMONTELUKAST SODIUM4MGTablet Chewable-
Leukotriene ModifiersMONTELUKAST SODIUM5MGTablet Chewable-
LincomycinsCLINDAMYCIN HYDROCHLORIDE150MGCapsule-
Local AnestheticsANTIPYRINE; BENZOCAINE5.4%; 1.4%Solution-
Local AnestheticsANTIPYRINE; BENZOCAINE54MG/ML; 14MG/MLSolution-
Local Anti-infectives, MiscellaneousSELENIUM SULFIDE2.5%Lotion-
Local Anti-infectives, MiscellaneousSILVER SULFADIAZINE1%Cream-
Loop DiureticsFUROSEMIDE10MG/MLSolution-
Loop DiureticsFUROSEMIDE20MGTablet-
Loop DiureticsFUROSEMIDE40MGTablet-
Mineralocorticoid (Aldost) Recept AntagSPIRONOLACTONE25MGTablet-
MioticsPILOCARPINE HYDROCHLORIDE1%Solution-
MioticsPILOCARPINE HYDROCHLORIDE2%Solution-
MioticsPILOCARPINE HYDROCHLORIDE4%Gel-
MioticsPILOCARPINE HYDROCHLORIDE4%Solution-
Miscellaneous AntidepressantsBUPROPION HCL100MGTablet-
Miscellaneous AntidepressantsBUPROPION HCL100MGTablet Extended Release 12 Hour-
Miscellaneous AntidepressantsBUPROPION HCL150MGTablet Extended Release 12 Hour-
Miscellaneous AntidepressantsBUPROPION HCL150MGTablet Extended Release 24 Hour-
Miscellaneous AntidepressantsBUPROPION HCL300MGTablet Extended Release 24 Hour-
Miscellaneous AntidepressantsBUPROPION HCL75MGTablet-
Multivitamin PreparationsASCORBIC ACID; BIOTIN; CALCIUM; CHOLINE; COPPER; CYANOCOBALAMIN; ERGOCALCIFEROL; FERROUS FUMARATE; FOLIC ACID; INOSITOL; MAGNESIUM; NIACINAMIDE; PANTOTHENIC ACID; PHOSPHORUS; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN120MG; 10MCG; 200MG; 30MG; 2MG; 12MCG; 400UNIT; 75MG; 1MG; 25MG; 50MG; 20MG; 5MG; 50MG; 15MG; 3.5MG; 2MG; 4000UNIT; 15UNIT; 25MGTablet-
Natural PenicillinsPENICILLIN V POTASSIUM125MG/5MLSolution Reconstituted-
Natural PenicillinsPENICILLIN V POTASSIUM250MGTablet-
Natural PenicillinsPENICILLIN V POTASSIUM250MG/5MLSolution Reconstituted-
Natural PenicillinsPENICILLIN V POTASSIUM500MGTablet-
Nitrates and NitritesISOSORBIDE DINITRATE10MGTablet-
Nitrates and NitritesISOSORBIDE DINITRATE20MGTablet-
Nitrates and NitritesISOSORBIDE DINITRATE30MGTablet-
Nitrates and NitritesISOSORBIDE DINITRATE40MGTablet Extended Release-
Nitrates and NitritesISOSORBIDE DINITRATE5MGTablet-
Nitrates and NitritesISOSORBIDE MONONITRATE120MGTablet Extended Release 24 Hour-
Nitrates and NitritesISOSORBIDE MONONITRATE30MGTablet Extended Release 24 Hour-
Nitrates and NitritesISOSORBIDE MONONITRATE60MGTablet Extended Release 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.1MG/HRPatch 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.2MG/HRPatch 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.3MG/HRPatch 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.4MGTablet Sublingual-
Nitrates and NitritesNITROGLYCERIN0.4MG/HRPatch 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.4MG/SPRAYSolution-
Nitrates and NitritesNITROGLYCERIN0.6MG/HRPatch 24 Hour-
Nitrates and NitritesNITROGLYCERIN0.8MG/HRPatch 24 Hour-
Nucleosides and NucleotidesACYCLOVIR200MGCapsule-
Nucleosides and NucleotidesACYCLOVIR200MG/5MLSuspension-
Nucleosides and NucleotidesACYCLOVIR400MGTablet-
Nucleosides and NucleotidesACYCLOVIR800MGTablet-
Opiate AgonistsACETAMINOPHEN; CODEINE PHOSPHATE120MG/5ML; 12MG/5MLSolution-
Opiate AgonistsACETAMINOPHEN; CODEINE PHOSPHATE300MG; 30MGTablet-
Opiate AgonistsACETAMINOPHEN; OXYCODONE HYDROCHLORIDE325MG; 5MGTablet-
Opiate AgonistsMORPHINE SULFATE100MGTablet Extended Release 12 Hour-
Opiate AgonistsMORPHINE SULFATE15MGTablet Extended Release 12 Hour-
Opiate AgonistsMORPHINE SULFATE200MGTablet Extended Release 12 Hour-
Opiate AgonistsMORPHINE SULFATE30MGTablet Extended Release 12 Hour-
Opiate AgonistsMORPHINE SULFATE60MGTablet Extended Release 12 Hour-
Opiate AgonistsTRAMADOL HCL50MGTablet240.00 per 30 days
Other MacrolidesAZITHROMYCIN100MG/5MLSuspension Reconstituted-
Other MacrolidesAZITHROMYCIN1GMPacket-
Other MacrolidesAZITHROMYCIN250MGTablet-
Other MacrolidesAZITHROMYCIN500MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsIBUPROFEN400MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsIBUPROFEN600MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsIBUPROFEN800MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsINDOMETHACIN25MGCapsule-
Other Nonsteroidal Anti-inflammatory AgentsINDOMETHACIN50MGCapsule-
Other Nonsteroidal Anti-inflammatory AgentsMELOXICAM15MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsMELOXICAM7.5MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsNAPROXEN125MG/5MLSuspension-
Other Nonsteroidal Anti-inflammatory AgentsNAPROXEN250MGTablet-
Other Nonsteroidal Anti-inflammatory AgentsNAPROXEN500MGTablet-
Penicillinase-resistant PenicillinsDICLOXACILLIN SODIUM250MGCapsule-
Penicillinase-resistant PenicillinsDICLOXACILLIN SODIUM500MGCapsule-
Phenothiazine DerivativesPROMETHAZINE HYDROCHLORIDE12.5MGSuppository-
Phenothiazine DerivativesPROMETHAZINE HYDROCHLORIDE25MGSuppository-
Phenothiazine DerivativesPROMETHAZINE HYDROCHLORIDE25MGTablet-
Phenothiazine DerivativesPROMETHAZINE HYDROCHLORIDE6.25MG/5MLSolution-
Phenothiazine DerivativesPROMETHAZINE HYDROCHLORIDE6.25MG/5MLSyrup-
Phosphodiesterase Type 5 InhibitorsSILDENAFIL CITRATE100MGTablet6.00 per 30 days
Phosphodiesterase Type 5 InhibitorsSILDENAFIL CITRATE25MGTablet6.00 per 30 days
Phosphodiesterase Type 5 InhibitorsSILDENAFIL CITRATE50MGTablet6.00 per 30 days
Platelet-Aggregation InhibitorsCLOPIDOGREL BISULFATE300MGTablet-
Platelet-Aggregation InhibitorsCLOPIDOGREL BISULFATE75MGTablet-
PolyenesNYSTATIN100000UNIT/GMCream-
PolyenesNYSTATIN100000UNIT/GMOintment-
PolyenesNYSTATIN100000UNIT/MLSuspension-
Potassium-sparing DiureticsHYDROCHLOROTHIAZIDE; TRIAMTERENE25MG; 37.5MGTablet-
Potassium-sparing DiureticsHYDROCHLOROTHIAZIDE; TRIAMTERENE50MG; 75MGTablet-
ProgestinsMEDROXYPROGESTERONE ACETATE10MGTablet-
ProgestinsMEDROXYPROGESTERONE ACETATE2.5MGTablet-
ProgestinsMEDROXYPROGESTERONE ACETATE5MGTablet-
Prokinetic AgentsMETOCLOPRAMIDE HYDROCHLORIDE10MGTablet-
Prokinetic AgentsMETOCLOPRAMIDE HYDROCHLORIDE10MG/10MLSolution-
Prokinetic AgentsMETOCLOPRAMIDE HYDROCHLORIDE5MG/5MLSolution-
Prostaglandin AnalogsLATANOPROST0.005%Solution-
Proton-pump InhibitorsESOMEPRAZOLE MAGNESIUM TRIHYDRATE20MGCapsule Delayed Release-
Proton-pump InhibitorsESOMEPRAZOLE MAGNESIUM TRIHYDRATE40MGCapsule Delayed Release-
Proton-pump InhibitorsOMEPRAZOLE10MGCapsule Delayed Release-
Proton-pump InhibitorsOMEPRAZOLE20MGCapsule Delayed Release-
QuinolonesCIPROFLOXACIN5GM/100MLSuspension Reconstituted-
QuinolonesCIPROFLOXACIN HCL100MGTablet-
QuinolonesCIPROFLOXACIN HCL250MGTablet-
QuinolonesCIPROFLOXACIN HCL500MGTablet-
QuinolonesCIPROFLOXACIN HCL750MGTablet-
QuinolonesLEVOFLOXACIN HEMIHYDRATE250MGTablet-
QuinolonesLEVOFLOXACIN HEMIHYDRATE25MG/MLSolution-
QuinolonesLEVOFLOXACIN HEMIHYDRATE500MGTablet-
QuinolonesLEVOFLOXACIN HEMIHYDRATE750MGTablet-
Replacement PreparationsPOTASSIUM CHLORIDE10%Liquid-
Replacement PreparationsPOTASSIUM CHLORIDE10%Solution-
Replacement PreparationsPOTASSIUM CHLORIDE10MEQCapsule Extended Release-
Replacement PreparationsPOTASSIUM CHLORIDE10MEQTablet Extended Release-
Replacement PreparationsPOTASSIUM CHLORIDE20MEQPacket-
Replacement PreparationsPOTASSIUM CHLORIDE20MEQTablet Extended Release-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE200MGTablet Extended Release 12 Hour-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE300MGCapsule Extended Release 24 Hour-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE300MGTablet Extended Release 12 Hour-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE400MGCapsule Extended Release 24 Hour-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE400MGTablet Extended Release 24 Hour-
Respiratory Smooth Muscle RelaxantsTHEOPHYLLINE80MG/15MLElixir-
SalicylatesSALSALATE500MGTablet-
SalicylatesSALSALATE750MGTablet-
Scabicides and PediculicidesPERMETHRIN5%Cream-
Selective alpha-1-Adrenergic Blocking AgentsALFUZOSIN HYDROCHLORIDE10MGTablet Extended Release 24 Hour-
Selective alpha-1-Adrenergic Blocking AgentsTAMSULOSIN HYDROCHLORIDE0.4MGCapsule-
Selective beta-2-Adrenergic AgonistsALBUTEROL SULFATE0.083%Nebulization Solution600.00 per 30 days
Selective beta-2-Adrenergic AgonistsALBUTEROL SULFATE108MCG/ACTAerosol Solution2.00 per 30 days
Selective beta-2-Adrenergic AgonistsALBUTEROL SULFATE; IPRATROPIUM BROMIDE103MCG/ACT; 18MCG/ACTAerosol-
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE100MCG/DOSE; 50MCG/DOSEAerosol Powder Breath Activated-
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE115MCG/ACT; 21MCG/ACTAerosol24.00 per 30 days
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE230MCG/ACT; 21MCG/ACTAerosol24.00 per 30 days
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE250MCG/DOSE; 50MCG/DOSEAerosol Powder Breath Activated-
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE45MCG/ACT; 21MCG/ACTAerosol24.00 per 30 days
Selective beta-2-Adrenergic AgonistsFLUTICASONE PROPIONATE; SALMETEROL XINAFOATE500MCG/DOSE; 50MCG/DOSEAerosol Powder Breath Activated-
Selective beta-2-Adrenergic AgonistsSALMETEROL XINAFOATE50MCG/DOSEAerosol Powder Breath Activated60.00 per 30 days
Selective Serotonin AgonistsRIZATRIPTAN BENZOATE10MGTablet12.00 per 30 days
Selective Serotonin AgonistsRIZATRIPTAN BENZOATE10MGTablet Dispersible12.00 per 30 days
Selective Serotonin AgonistsRIZATRIPTAN BENZOATE5MGTablet12.00 per 30 days
Selective Serotonin AgonistsRIZATRIPTAN BENZOATE5MGTablet Dispersible12.00 per 30 days
Selective Serotonin AgonistsSUMATRIPTAN SUCCINATE100MGTablet9.00 per 30 days
Selective Serotonin AgonistsSUMATRIPTAN SUCCINATE25MGTablet18.00 per 30 days
Selective Serotonin AgonistsSUMATRIPTAN SUCCINATE50MGTablet18.00 per 30 days
Selective Serotonin AgonistsSUMATRIPTAN SUCCINATE6MG/0.5MLSyringe(s)8.00 per 30 days
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL100MGTablet-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL150MGCapsule Extended Release 24 Hour-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL225MGTablet Extended Release 24 Hour-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL25MGTablet-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL37.5MGCapsule Extended Release 24 Hour-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL37.5MGTablet-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL50MGTablet-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL75MGCapsule Extended Release 24 Hour-
Selective Serotonin- and Norepinephrine-reuptake InhibitorsVENLAFAXINE HCL75MGTablet-
Selective Serotonin-reuptake InhibitorsCITALOPRAM HYDROBROMIDE10MGTablet-
Selective Serotonin-reuptake InhibitorsCITALOPRAM HYDROBROMIDE10MG/5MLSolution-
Selective Serotonin-reuptake InhibitorsCITALOPRAM HYDROBROMIDE20MGTablet-
Selective Serotonin-reuptake InhibitorsCITALOPRAM HYDROBROMIDE40MGTablet-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL10MGCapsule-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL10MGCapsule-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL20MGCapsule-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL20MGCapsule-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL20MG/5MLSolution-
Selective Serotonin-reuptake InhibitorsFLUOXETINE HCL40MGCapsule-
Selective Serotonin-reuptake InhibitorsSERTRALINE HYDROCHLORIDE100MGTablet-
Selective Serotonin-reuptake InhibitorsSERTRALINE HYDROCHLORIDE20MG/MLConcentrate-
Selective Serotonin-reuptake InhibitorsSERTRALINE HYDROCHLORIDE25MGTablet-
Selective Serotonin-reuptake InhibitorsSERTRALINE HYDROCHLORIDE50MGTablet-
Serotonin ModulatorsTRAZODONE HYDROCHLORIDE100MGTablet-
Serotonin ModulatorsTRAZODONE HYDROCHLORIDE150MGTablet-
Serotonin ModulatorsTRAZODONE HYDROCHLORIDE300MGTablet-
Serotonin ModulatorsTRAZODONE HYDROCHLORIDE50MGTablet-
Skin and Mucous Membrane Agents, MiscPIMECROLIMUS1%Cream-
SulfonamidesSULFAMETHOXAZOLE; TRIMETHOPRIM200MG/5ML; 40MG/5MLSuspension-
SulfonamidesSULFAMETHOXAZOLE; TRIMETHOPRIM400MG; 80MGTablet-
SulfonamidesSULFAMETHOXAZOLE; TRIMETHOPRIM800MG/20ML; 160MG/20MLSuspension-
SulfonamidesSULFAMETHOXAZOLE; TRIMETHOPRIM800MG; 160MGTablet-
SulfonamidesSULFASALAZINE500MGTablet-
SulfonamidesSULFASALAZINE500MGTablet Delayed Release-
SulfonylureasGLIPIZIDE10MGTablet-
SulfonylureasGLIPIZIDE5MGTablet-
SulfonylureasGLYBURIDE1.25MGTablet-
SulfonylureasGLYBURIDE1.5MGTablet-
SulfonylureasGLYBURIDE2.5MGTablet-
SulfonylureasGLYBURIDE3MGTablet-
SulfonylureasGLYBURIDE5MGTablet-
SulfonylureasGLYBURIDE6MGTablet-
TetracyclinesDOXYCYCLINE HYCLATE100MGCapsule-
TetracyclinesDOXYCYCLINE HYCLATE100MGTablet-
TetracyclinesTETRACYCLINE HYDROCHLORIDE250MGCapsule-
TetracyclinesTETRACYCLINE HYDROCHLORIDE500MGCapsule-
Thiazide DiureticsHYDROCHLOROTHIAZIDE12.5MGCapsule-
Thiazide DiureticsHYDROCHLOROTHIAZIDE25MGTablet-
Thiazide DiureticsHYDROCHLOROTHIAZIDE50MGTablet-
Thiazide-like DiureticsCHLORTHALIDONE25MGTablet-
Thiazide-like DiureticsCHLORTHALIDONE50MGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM100MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM112MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM125MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM137MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM150MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM175MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM200MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM25MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM300MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM50MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM75MCGTablet-
Thyroid AgentsLEVOTHYROXINE SODIUM88MCGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsAMITRIPTYLINE HYDROCHLORIDE10MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsAMITRIPTYLINE HYDROCHLORIDE25MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsAMITRIPTYLINE HYDROCHLORIDE50MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsAMITRIPTYLINE HYDROCHLORIDE75MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsDOXEPIN HYDROCHLORIDE10MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsDOXEPIN HYDROCHLORIDE10MG/MLConcentrate-
Tricyclics and Other Norepinephrine-reuptake InhibitorsDOXEPIN HYDROCHLORIDE25MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsDOXEPIN HYDROCHLORIDE50MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsDOXEPIN HYDROCHLORIDE75MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsIMIPRAMINE HYDROCHLORIDE10MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsIMIPRAMINE HYDROCHLORIDE25MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsIMIPRAMINE HYDROCHLORIDE50MGTablet-
Tricyclics and Other Norepinephrine-reuptake InhibitorsIMIPRAMINE PAMOATE75MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsNORTRIPTYLINE HYDROCHLORIDE10MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsNORTRIPTYLINE HYDROCHLORIDE25MGCapsule-
Tricyclics and Other Norepinephrine-reuptake InhibitorsNORTRIPTYLINE HYDROCHLORIDE50MGCapsule-
Uricosuric AgentsPROBENECID500MGTablet-
Urinary Anti-infectivesNITROFURANTOIN MACROCRYSTALLINE50MGCapsule-
Urinary Anti-infectivesNITROFURANTOIN MONOHYDRATE MACROCRYSTALS100MGCapsule-
Vitamin B ComplexFOLIC ACID1MGTablet-
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