TABLE OF CONTENTS
TABLE OF CONTENTS
ANTI-INFECTIVES 5
PENICILLINS 5
TETRACYCLINES 5
CEPHALOSPORINS 5
FIRST GENERATION CEPHALOSPORINS 5
SECOND GENERATION CEPHALOSPORINS 5
THIRD GENERATION CEPHALOSPORINS 5
ERYTHROMYCINS & OTHER MACROLIDES 5
FLOUROQUINOLONES 5
SULFA'S & RELATED AGENTS 6
URINARY TRACT AGENTS 6
ANTIVIRALS 6
HIV/AIDS THERAPY 6
ANTIFUNGAL AGENTS 6
VANCOMYCIN 7
MISC. ANTI-INFECTIVES 7
ANTIPARASITICS 7
ANTIMALARIALS 7
ANTIMYCOBACTERIALS 7
ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS 8
ALKYLATING AGENTS 8
ANTIMETABOLITIES 8
HORMONES 8
ANTIESTROGENS 8
ANTIANDROGENS 8
RADIOPHARMACEUTICALS 8
IMMUNOSUPPRESSANT DRUGS 8
MISC. ANTINEOPLASTIC DRUGS 9
ADJUNCTIVE AGENTS 10
Autonomic & CNS Drugs, Neurology & Psych 10
NARCOTIC ANALGESICS 10
COMBINATION NARCOTIC/ANALGESICS 10
NSAIDS 10
NSAIDS-SPECIFIC COX II INHIBITORS 11
SALICYLATES 11
MISC. ANALGESICS 11
NARCOTIC ANTAGONISTS 11
HEADACHE THERAPY 11
ANTIPARKINSONISM AGENTS 11
ANTICONVULSANTS 11
MISC. NEUROLOGICAL THERAPY 12
MUSCLE RELAXANTS & ANTISPASMODIC AGENTS 12
HYPNOTIC AGENTS 12
TRICYCLICS 13
MISC. ANTIDEPRESSANTS 13
MAO INHIBITORS 13
SELECTIVE SEROTONIN REUPTAKE INHIBITORS 13
PHENOTHIAZINES 13
BUTYROPHENONES 13
MISC. ANTIPSYCHOTICS 13
MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTS 14
ANXIOLYTICS 14
Cardiovascular, Hypertension & Lipids 14
ANTIARRHYTHMIC AGENTS 14
CARDIAC GLYCOSIDES 14
RAPID ACTING NITRATES 14
LONG ACTING NITRATES 14
ANTICOAGULANTS 14
ANTIPLATELET DRUGS 14
HEPARIN 15
VITAMIN K 15
HEMOSTATICS 15
MISC. COAGULATION AGENTS 15
THIAZIDE & RELATED DIURETICS 15
BETA BLOCKERS 15
CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES 16
CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINES 16
ACE INHIBITORS 16
ADRENERGIC ANTAGONISTS & RELATED DRUGS 16
AGENTS FOR PHEOCHROMOCYTOMA 16
VASODILATORS 16
OTHER ANTIHYPERTENSIVE COMBINATIONS 16
ANGIOTENSION II RECEPTOR BLOCKERS & RENIN INHIBITOR 17
LIPID/CHOLESTEROL LOWERING AGENTS 17
MISC. CARDIOVASCULAR AGENTS 17
Dermatological/Topical Therapy 17
TOPICAL CORTICOSTEROIDS VERY HIGH POTENCY 17
TOPICAL CORTICOSTEROIDS HIGH POTENCY 17
TOPICAL CORTICOSTEROIDS MEDIUM POTENCY 17
TOPICAL CORTICOSTEROIDS LOW POTENCY 18
TOPICAL ANESTHETICS 18
THERAPY FOR ACNE 18
TOPICAL ANTIBACTERIALS 18
TOPICAL ANTIFUNGALS 18
TOPICAL ANTIVARALS 18
BURN THERAPY 19
TOPICAL ENZYMES 19
KERATOLYTICS 19
ANTIPSORIATICS/ANTISEBORRHEIC 19
TOPICAL SCABICIDES/PEDICULICIDES 19
MISC. DERMATOLOGICALS 19
EAR, NOSE & THROAT MEDICATIONS 19
MISCELLANEOUS OTIC PREPARATIONS 19
OTIC STEROID / ANTIBIOTIC 19
MISCELLANEOUS AGENTS 20
ENDOCRINE/DIABETES 20
ANTITHYROID AGENTS 20
THYROID HORMONES 20
ADRENAL HORMONES 20
ANDROGENS 20
OVULATORY STIMULANTS 20
MISCELLANEOUS AGENTS 20
GONADOTROPIN & RELATED AGENTS 21
INSULIN THERAPY 21
NON-INSULIN HYPOGLYCEMIC AGENTS 21
GLUCOSE ELEVATING AGENTS 21
INSULIN SYRINGES/MISCELLANEOUS DME 21
BLOOD GLUCOSE MONITORING DEVICES & SUPPLIES 22
GASTROENTEROLOGY 22
H2 ANTAGONISTS 22
PROSTAGLANDINS 22
OTHER ULCER THERAPY 22
PROTON PUMP INHIBITORS 22
ANTIDIARRHEALS 22
ANTISPASMODICS 22
BILE ACIDS 22
DIGESTIVE ENZYMES 22
MISC. GASTROINTESTINAL AGENTS 23
ANTIVERTIGO & ANTIEMETIC AGENTS 23
BOWEL EVACUANTS 23
IMMUNOLOGY, VACCINES & BIOTECHNOLOGY 23
ERYTHROID STIMULANTS 23
MYELOID STIMULANTS 23
INTERFERONS 23
GROWTH HORMONES 23
INTERLEUKINS 24
VACCINES & MISCELLANEOUS IMMUNOLOGICALS 24
MUSCULOSKELETAL & RHEUMATOLOGY 25
GOUT THERAPY 25
OTHER RHEUMATOLOGICALS 25
OSTEOPOROSIS THERAPY 25
OBSTETRICS & GYNECOLOGY 25
MONOPHASIC /BIPHASIC /TRIPHASIC AGENTS 25
OXYTOCICS 26
PROGESTINS 26
ESTROGENS 26
ESTROGEN COMBINATIONS 26
VAGINAL CLEANSER /ANTIINFECTIVES 26
VAGINAL ANTIFUNGALS 26
SPECIALIZED OB/GYN DRUGS 26
DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES 26
OPHTHALMOLOGY 26
BETA-BLOCKERS 26
CHOLINESTERASE INHIBITOR MIOTICS 26
DIRECT ACTING MIOTICS 27
OTHER GLAUCOMA DRUGS 27
ORAL DRUGS FOR GLAUCOMA 27
CYCLOPLEGIC MYDRIATICS 27
NON-STEROIDAL ANTI-INFLAMMATORY AGENTS 27
VASOCONSTRICTOR DECONGESTANTS 27
ANTIBIOTICS 27
SULFONAMIDES 27
STEROIDS 27
STEROID-ANTIBIOTIC COMBINATIONS 27
STEROID-SULFONAMIDE COMBINATIONS 28
SYMPATHOMIMETICS 28
MISCELLANEOUS OPHTHALMOLOGICS 28
ANTIVIRALS 28
RESPIRATORY, ALLERGY, COUGH & COLD 28
ANTIHISTAMINES 28
ADRENERGICS 28
ANTITUSSIVE COMBINATIONS 28
DECONGESTANT / ANTIHISTAMINES 28
XANTHINES 29
BETA AGONISTS ORAL 29
BETA AGONISTS INHALERS 29
INHALED CORTICOSTEROIDS 29
INTRANASAL STEROIDS 29
MISCELLANEOUS PULMONARY AGENTS 29
UROLOGICALS 29
CHOLINERGIC STIMULANTS 29
ANTICHOLINERGICS & ANTISPASMODICS 29
URINARY ANESTHETICS 30
MISCELLANEOUS UROLOGICALS 30
BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPY 30
VITAMINS, HEMATINICS & ELECTROLYTES 30
VITAMINS & HEMATINICS 30
POTASSIUM 32
OTHER ELECTROLYTES 32
MISCELLANEOUS NUTRITION PRODUCTS 32
BLOOD DERIVATIVES 32
DIAGNOSTICS & MISCELLANEOUS AGENTS 33
MISCELLANEOUS AGENTS 33
SMOKING DETERRENTS 33
ANOREXIANTS 33
NEUTRACEUTICALS 33
IRRIGATING SOLUTIONS 33
ANTIDOTES 33
ANTI-INFECTIVES
PENICILLINS
GENERIC
amoxicillin
amoxicillin/clavulanate er
ampicillin
ampicillin/sulbactam
dicloxacillin sodium
nafcill in dextrose
nafcillin sodium
oxacillin sodium
penicillin g potassium
penicillin g procaine
penicillin g sodium
penicillin v potassium
piperacillin-tazobactam
PREFERRED
AMOXICILLIN POWDER
AUGMENTIN 125-31.25 MG/5ML
BICILLIN C-R
BICILLIN L-A
PENICILLIN GK-ISO-OSM DEXTROSE
TIMENTIN
ZOSYN IV SOLUTION
NON PREFERRED
AUGMENTIN
ZOSYN VIAL
TETRACYCLINES
GENERIC
demeclocycline hcl
doxycycline hyclate
doxycycline monohydrate
minocycline hcl
minocycline hcl er
ocudox
PREFERRED
DEMECLOCYCLINE HCL POWDER
DOXYCYCLINE HYCLATE POWDER
MINOCIN 100MG VIAL
MINOCYCLINE HCL POWDER
ORACEA
SOLODYN ER
TETRACYCLINE
NON PREFERRED
DOXYCYCLINE MONOHYDRATE POWDER
MINOCIN
CEPHALOSPORINS
FIRST GENERATION CEPHALOSPORINS
GENERIC
cefazolin
cephalexin
NON PREFERRED
CEFAZOLIN/DEXTROSE
SECOND GENERATION CEPHALOSPORINS
GENERIC
cefaclor
cefoxitin
cefoxitin/dextrose
cefpodoxime proxetil
cefprozil
cefuroxime axetil
cefuroxime sodium
PREFERRED
CEFUROXIME 75G BULK BAG
THIRD GENERATION CEPHALOSPORINS
GENERIC
cefdinir
cefepime
cefotaxime
cefotetan
ceftazidime
ceftibuten
ceftriaxone
PREFERRED
AVYCAZ
CEFTAZIDIME IV PIGGYBACK
FORTAZ IN ISO-OSMOTIC DEXTROSE
TEFLARO
ZERBAXA
NON PREFERRED
CEFEPIME/DEXTROSE
CEFTRIAXONE 100G BULK BAG
ERYTHROMYCINS & OTHER MACROLIDES
GENERIC
azithromycin
clarithromycin
clarithromycin er
erythromycin
erythromycin del rel
erythromycin ethylsuccinate
erythromycin stearate
erythromycin/sulfisoxazole
PREFERRED
AZITHROMYCIN POWDER
CLARITHROMYCIN POWDER
ERYTHROCIN LACTOBIONATE
ERYTHROMYCIN ETHYLSUCCINATE POWDER
ERYTHROMYCIN POWDER
FLOUROQUINOLONES
GENERIC
ciprofloxacin
ciprofloxacin er
ciprofloxacin suspension
ciprofloxacin/dextrose
levofloxacin/d5w
moxifloxacin hcl
ofloxacin tablets
PREFERRED
AVELOX IV
LEVOFLOXACIN HEMIHYDRATE POWDER
MOXIFLOXACIN HCL IV PIGGYBACK
NON PREFERRED
LEVOFLOXACIN HEMIHYDRATE SOLUTION
MOXIFLOXACIN HCL POWDER
SULFA'S & RELATED AGENTS
GENERIC
sulfadiazine
sulfamethoxazole/trimethoprim
PREFERRED
SULFADIAZINE POWDER
URINARY TRACT AGENTS
GENERIC
methenamine hippurate
methenamine mandelate
methylene blue
nitrofurantoin
nitrofurantoin macrocrystal
trimethoprim
PREFERRED
METHENAMINE MANDELATE POWDER
NITROFURANTOIN POWDER
TRIMETHOPRIM POWDER
ANTIVIRALS
GENERIC
acyclovir
adefovir dipivoxil
amantadine hcl
cidofovir
entecavir
famciclovir
foscarnet sodium
ganciclovir
ribavirin
rimantadine hcl
valacyclovir
valganciclovir hcl
PREFERRED
AMANTADINE HCL POWDER
DAKLINZA
RAPIVAB
RELENZA
RIBAVIRIN POWDER
SOVALDI
TECHNIVIE
TYZEKA
VALACYCLOVIR POWDER
VICTRELIS
NON PREFERRED
CIDOFOVIR
HIV/AIDS THERAPY
GENERIC
abacavir
abacavir/lamivudine/zidovudine
didanosine
lamivudine
lamivudine hbv
lamivudine/zidovudine
nevirapine er
stavudine
zidovudine
PREFERRED
APTIVUS
ATRIPLA
COMPLERA
CRIXIVAN
DESCOVY
EDURANT
EMTRIVA
EPZICOM
FUZEON
GENVOYA
INTELENCE
INVIRASE
ISENTRESS
KALETRA
LEXIVA
NORVIR
ODEFSEY
PREZISTA
RESCRIPTOR
RETROVIR VIAL
REYATAZ
SELZENTRY
STRIBILD
SUSTIVA
TIVICAY
TRIUMEQ
TRUVADA
VIDEX
VIRACEPT
VIREAD
ZIAGEN SOLUTION
NON PREFERRED
RETROVIR
VIRAMUNE
ZIAGEN TABLET
ANTIFUNGAL AGENTS
GENERIC
amphotericin
fluconazole
fluconazole in dextrose
fluconazole in saline
flucytosine
griseofulvin
griseofulvin ultramicrosize
itraconazole
ketoconazole
nystatin
terbinafine
voriconazole
PREFERRED
AMBISOME
AMPHOTERICIN POWDER
CANCIDAS
CRESEMBA
FLUCONAZOLE POWDER
FLUCYTOSINE POWDER
GRISEOFULVIN POWDER
ITRACONAZOLE POWDER
KETOCONAZOLE POWDER
LAMISIL
MYCAMINE
NOXAFIL
NYSTATIN
SPORANOX SOLUTION
TERBINAFINE
VIBATIV
VORICONAZOLE POWDER
NON PREFERRED
FLUCONAZOLE 100MG/50ML PIGGYBACK
ITRACONAZOLE 1GM POWDER
KETOCONAZOLE CRYSTALS
LAMISIL 250MG TABLET
NYSTATIN 100MM POWDER
SPORANOX CAPSULE
VANCOMYCIN
GENERIC
vancomycin hcl
PREFERRED
VANCOMYCIN HCL
NON PREFERRED
VANCOMYCIN HCL 750 VIAL W/THREADPORT
MISC. ANTI-INFECTIVES
GENERIC
aztreonam
bacitracin
clindamycin hcl
clindamycin palmitate hcl
clindamycin phosphate
clindamycin phosphate/dextrose
colistimethate
dapsone
gentamicin sulfate
gentamicin sulfate in ns
imipenem-cilastatin
kanamycin sulfate
linezolid
neomycin sulfate
polymyxin b sulfate
tobramycin sulfate
tobramycin sulfate in ns
PREFERRED
AMIKACIN
AMIKACIN POWDER
AZACTAM-ISO-OSMOTIC DEXTROSE
BACITRACIN POWDER
BETHKIS
CAYSTON
CHLORAMPHENICOL
CLINDAMYCIN HCL POWDER
CLINDAMYCIN PHOSPHATE
COLISTIMETHATE POWDER
CUBICIN
DALVANCE
DAPSONE POWDER
DORIBAX
GENTAMICIN SULFATE IN NS 100MG/50ML
INVANZ
KANAMYCIN SULFATE POWDER
MEROPENEM - 0.9% NACL
NEOMYCIN SULFATE POWDER
POLYMYXIN B SULFATE POWDER
SIVEXTRO VIAL
SYNERCID
TOBI PODHALER
TOBRAMYCIN SULFATE POWDER
TYGACIL
XIFAXAN
NON PREFERRED
ACZONE
GENTAMICIN SULFATE 60MG/ML VIAL
GENTAMICIN SULFATE IN NS 120MG/0.1L
ORABACTIV
SIVEXTRO TABLET
TOBRAMYCIN SULFATE 300MG/5ML AMPUL
ANTIPARASITICS
GENERIC
atovaquone
ivermectin
metronidazole
paromomycin sulfate
tinidazole
PREFERRED
ALBENZA
ALINIA
BILTRICIDE
EMVERM
IMPAVIDO
IVERMECTIN POWDER
METRONIDAZOLE POWDER
NEBUPENT
PAROMOMYCIN SULFATE POWDER
TINIDAZOLE POWDER
ANTIMALARIALS
GENERIC
atovaquone/proguanil hcl
chloroquine phosphate
hydroxychloroquine sulfate
mefloquine hcl
quinine sulfate
PREFERRED
CHLOROQUINE PHOSPHATE POWDER
COARTEM
DARAPRIM
HYDROXYCHLOROQUINE SULFATE POWDER
PRIMAQUINE
QUININE SULFATE POWDER
ANTIMYCOBACTERIALS
GENERIC
ethambutol hcl
isoniazid
pyrazinamide
rifabutin
PREFERRED
CAPASTAT SULFATE
ISONIAZID POWDER
PRIFTIN
SIRTURO
STREPTOMYCIN SULFATE
NON PREFERRED
PYRAZINAMIDE POWDER
RIFADIN
ANTINEOPLASTIC & IMMUNOSUPPRESANT DRUGS
ALKYLATING AGENTS
GENERIC
carboplatin
cisplatin
cyclophosphamide
ifosfamide
ifosfamide-mesna
melphalan hcl
oxaliplatin
temozolomide
thiotepa
PREFERRED
ALKERAN 2MG
BENDEKA
BICNU
BUSULFEX
CEENU
CISPLATIN POWDER
CYCLOPHOSPHAMIDE
GLEOSTINE
LEUKERAN
LOMUSTINE
MUSTARGEN
MYLERAN
TEMODAR 100MG VIAL
THIOTEPA POWDER
TREANDA
VALCHLOR
ZANOSAR
NON PREFERRED
ALKERAN 50MG
TEMODAR CAPSULES
ANTIMETABOLITIES
GENERIC
azacitidine
capecitabine
cytarabine
decitabine
floxuridine
fludarabine phosphate
gemcitabine hcl
mercaptopurine
methotrexate
PREFERRED
ALIMTA
ARRANON
CLOLAR
DEPOCYT
FLOXURIDINE POWDER
FOLOTYN
MERCAPTOPURINE POWDER
METHOTREXATE POWDER
TABLOID
TREXALL
NON PREFERRED
FLUOROURACIL 0.005 CREAM
HORMONES
GENERIC
megestrol acetate
PREFERRED
MEGESTROL ACETATE POWDER
ANTIESTROGENS
GENERIC
anastrozole
exemestane
letrozole
tamoxifen citrate
PREFERRED
ANASTROZOLE POWDER
FARESTON
FASLODEX
LETROZOLE POWDER
TAMOXIFEN CITRATE POWDER
ANTIANDROGENS
GENERIC
bicalutamide
flutamide
PREFERRED
NILANDRON
XTANDI
ZYTIGA
RADIOPHARMACEUTICALS
PREFERRED
IODOPEN
XOFIGO
IMMUNOSUPPRESSANT DRUGS
GENERIC
azathioprine
azathioprine sodium
cyclosporine
mycophenolate acid del rel
mycophenolate mofetil
mycophenolic acid del rel
sirolimus
tacrolimus
PREFERRED
AZASAN
AZATHIOPRINE POWDER
CELLCEPT 500MG VIAL
CYCLOSPORINE POWDER
NULOJIX
PROGRAF 5MG/ML AMPUL
RAPAMUNE SOLUTION
SANDIMMUNE SOLUTION 100MG/ML SOLUTION
SIMULECT
SIROLIMUS POWDER
TACROLIMUS POWDER
ZORTRESS
NON PREFERRED
CELLCEPT
PROGRAF CAPSULES
RAPAMUNE
SANDIMMUNE SOLUTION
MISC. ANTINEOPLASTIC DRUGS
GENERIC
bleomycin
cladribine
dacarbazine
dactinomycin
daunorubicin
docetaxel
doxorubicin hcl
doxorubicin hcl liposomal
epirubicin hcl
etoposide
hydroxyurea
idarubicin hcl
imatinib mesylate
irinotecan hcl
leuprolide acetate
mitomycin
mitoxantrone
octreotide acetate
paclitaxel
topotecan hcl
tretinoin
vinblastine sulfate
PREFERRED
ABRAXANE
ADCETRIS
AFINITOR
AFINITOR DISPERZ
ARZERRA
AVASTIN
BEXXAR 14MG/ML
BLINCYTO
BOSULIF
CAPRELSA
CYRAMZA
DARZALEX
DAUNOXOME
DOCEFREZ
DROXIA
ELIGARD
ELSPAR
EMCYT
ERBITUX
ERIVEDGE
ETOPOPHOS
ETOPOSIDE POWDER
FIRMAGON
GAZYVA
GILOTRIF
HALAVEN
HERCEPTIN
HEXALEN
HYCAMTIN CAPSULES
HYDROXYUREA POWDER
IBRANCE
ICLUSIG
IMBRUVICA
INLYTA
ISTODAX
IXEMPRA
JAKAFI
JEVTANA
KADCYLA
KEYTRUDA
KYPROLIS
LENVIMA
LEUPROLIDE ACETATE POWDER
LONSURF
LUPRON DEPOT
LUPRON DEPOT 11.25MG
LUPRON DEPOT-PED
LYNPARZA
LYSODREN
MARQIBO
MATULANE
MEKINIST
MITOMYCIN POWDER
NEXAVAR
NINLARO
ONCASPAR
ONIVYDE
ONTAK
OPDIVO
PERJETA
PHOTOFRIN
POMALYST
PROVENGE
PURIXAN
REVLIMID
RITUXAN
SANDOSTATIN KIT
SANDOSTATIN LAR DEPOT
SIGNIFOR
SOMATULINE DEPOT
SPRYCEL
STIVARGA
SUTENT
SYLVANT
SYNRIBO
TAFINLAR
TAGRISSO
TARCEVA
TARGRETIN GEL
TASIGNA
TENIPOSIDE
THALOMID
TORISEL
TRELSTAR
TRELSTAR DEPOT
TRELSTAR LA
TRETINOIN POWDER
TRISENOX
TYKERB
UNITUXIN
VALSTAR
VANTAS
VECTIBIX
VELCADE
VENCLEXTA
VENCLEXTA STARTER PACK
VOTRIENT
VUMON
XALKORI
YERVOY
YONDELIS
ZALTRAP
ZELBORAF
ZEVALIN
ZOLADEX
ZOLINZA
ZYDELIG
ZYKADIA
NON PREFERRED
BEXXAR
HYCAMTIN 4MG VIAL
SANDOSTATIN
TARGRETIN 75 CAPSULE
ADJUNCTIVE AGENTS
GENERIC
amifostine
calcium folinate
dexrazoxane
leucovorin calcium
levoleucovorin calcium
mesna
PREFERRED
CALCIUM FOLINATE POWDER
ELITEK
KEPIVANCE
LEUCOVORIN CALCIUM POWDER
MESNEX 400MG TABLET
VISTOGARD
VORAXAZE
XGEVA
NON PREFERRED
MESNEX 100MG/ML VIAL
Autonomic & CNS Drugs, Neurology & Psych
NARCOTIC ANALGESICS
GENERIC
alfentanil hcl
buprenorphine
codeine sulfate
fentanyl
fentanyl citrate
hydromorphone hcl
levorphanol tartrate
methadone hcl
morphine sulfate
morphine sulfate cr
morphine sulfate er
oxycodone hcl
oxymorphone hcl
oxymorphone hcl er
sufentil 50mcg/ml ampul
PREFERRED
BUPRENORPHINE POWDER
BUTRANS
DILAUDID-HP 250 MG
FENTANYL CITRATE POWDER
HYDROMORPHONE HCL 1GM POWDER
INFUMORPH
LEVORPHANOL TARTRATE POWDER
MEPERIDINE HCL POWDER
METHADONE HCL POWDER
MORPHINE SULFATE TABLET POWDER
OPANA ER
OXYCODONE HCL POWDER
OXYCONTIN ER
SUFENTIL POWDER
ULTIVA
NON PREFERRED
CODEINE SULFATE SOLUTION
DILAUDID-HP
FENTANYL
FENTANYL CITRATE 100MCG/2ML
HYDROMORPHONE HCL 0.5MG/0.5ML SYRINGE
meperidine hcl
MORPHINE SULFATE
SUFENTIL 50MCG/ML VIAL
COMBINATION NARCOTIC/ANALGESICS
GENERIC
acetaminophen/codeine
butalbital compound
butalbital compound/codeine
butalbital/apap/caffeine
butalbital/aspirin/caffeine
butalbital/caff/apap/codeine
hydrocodone bit/ibuprofen
hydrocodone w/acetaminophen
oxycodone hcl/ibuprofen
oxycodone w/acetaminophen
oxycodone w/aspirin
NON PREFERRED
HYDROCODONE W/ACETAMINOPHEN
NSAIDS
GENERIC
diclofenac potassium
diclofenac sodium
diclofenac sodium/misoprostol del rel
etodolac
etodolac er
fenoprofen calcium
flurbiprofen
ibuprofen
indomethacin
indomethacin er
ketoprofen er
ketorolac tromethamine
meclofenamate sodium
mefenamic acid
meloxicam
nabumetone
naproxen
naproxen sodium
oxaprozin
piroxicam
sulindac
tolmetin sodium
PREFERRED
DICLOFENAC SODIUM POWDER
ETODOLAC POWDER
FLURBIPROFEN POWDER
IBUPROFEN POWDER
INDOMETHACIN POWDER
KETOPROFEN ER POWDER
KETOROLAC TROMETHAMINE POWDER
MECLOFENAMATE SODIUM POWDER
MEFENAMIC ACID POWDER
MELOXICAM POWDER
MITIGARE
NAPROXEN POWDER
NAPROXEN SODIUM POWDER
NEOPROFEN
PIROXICAM POWDER
SULINDAC POWDER
ZORVOLEX
NON PREFERRED
FENOPROFEN CALCIUM
NABUMETONE POWDER
NSAIDS-SPECIFIC COX II INHIBITORS
GENERIC
celecoxib
PREFERRED
CELECOXIB POWDER
SALICYLATES
GENERIC
choline mag trisalicylate
diflunisal
SALICYLAMIDE
salsalate
PREFERRED
CHOLINE MAG TRISALICYLATE POWDER
SALSALATE POWDER
MISC. ANALGESICS
GENERIC
acetaminophen-diphenhydramine
butorphanol
clonidine
nalbuphine hcl
pentazocine lactate
tramadol hcl
tramadol hcl er
tramadol/acetaminophen
PREFERRED
BUTORPHANOL POWDER
MONOVISC
NALBUPHINE HCL POWDER
NUCYNTA
NUCYNTA ER
OFIRMEV
ORTHOVISC
PRIALT
QUADRAMET
SYNVISC
SYNVISC-ONE
TRAMADOL HCL POWDER
NON PREFERRED
TRAMADOL HCL ER
NARCOTIC ANTAGONISTS
GENERIC
buprenorphine/naloxone
naloxone hcl
naltrexone hydrochloride
PREFERRED
MOVANTIK
NALOXONE HCL POWDER
NALTREXONE HYDROCHLORIDE POWDER
NARCAN
SUBOXONE
ZUBSOLV
NON PREFERRED
SUBOXONE TABLET
HEADACHE THERAPY
GENERIC
dihydroergotamine mesylate
ergotamine-caffeine
naratriptan hcl
rizatriptan
rizatriptan disintegrating tablets
sumatriptan succinate
zolmitriptan
zolmitriptan ODT
PREFERRED
DIHYDROERGOTAMINE MESYLATE
ISOMETHEPTENE MUCATE
RELPAX
SUMATRIPTAN SUCCINATE POWDER
SUMAVEL DOSEPRO
VIVITROL
ZOMIG SPRAY
NON PREFERRED
TREXIMET
ZOLMITRIPTAN
ZOMIG TABLET
ANTIPARKINSONISM AGENTS
GENERIC
benztropine
benztropine mesylate
carbidopa/levodopa
carbidopa/levodopa er
carbidopa/levodopa ODT
carbidopa/levodopa/entacapone
entacapone
pramipexole er
ropinirole hcl
ropinirole hcl er
selegiline hcl
trihexyphenidyl hcl
PREFERRED
APOKYN
AZILECT
SELEGILINE HCL POWDER
ANTICONVULSANTS
GENERIC
carbamazepine
carbamazepine er
clonazepam
clonazepam ODT
diazepam
diazepam rectal gel
divalproex sodium
divalproex sodium er
ethosuximide
felbamate
fosphenytoin sodium
gabapentin
lamotrigine
lamotrigine er
levetiracetam
levetiracetam er
oxcarbazepine
phenobarbital
phenobarbital sodium
phenytoin
phenytoin sodium
primidone
tiagabine hcl
topiramate
valproate sodium
valproic acid
zonisamide
PREFERRED
BANZEL
CARBAMAZEPINE POWDER
CELONTIN
CLONAZEPAM POWDER
DIAZEPAM POWDER
DILANTIN 30MG
ETHOSUXIMIDE POWDER
FYCOMPA
GABAPENTIN POWDER
GABITRIL 12MG, 16 MG
GRALISE
LAMICTAL XR
LAMOTRIGINE POWDER
LEVETIRACETAM POWDER
LYRICA
ONFI
OXTELLAR XR
PEGANONE
PHENOBARBITAL POWDER
PHENOBARBITAL SODIUM POWDER
PHENYTOIN POWDER
PHENYTOIN SODIUM POWDER
POTIGA
PRIMIDONE POWDER
SABRIL
TOPIRAMATE POWDER
VALPROATE SODIUM POWDER
VALPROIC ACID
VIMPAT
NON PREFERRED
DILANTIN
FYCOMPA 0.5MG/ML SUSPENSION
GABITRIL 2MG, 4MG
LAMICTAL XR
ZONISAMIDE
MISC. NEUROLOGICAL THERAPY
GENERIC
donepezil hcl
galantamine
glatimer acetate
memantine
rivastigmine
PREFERRED
AMPYRA
COPAXONE 40MG/ML
GILENYA
LEMTRADA
NAMENDA XR
NAMZARIC
NUEDEXTA
TECFIDERA
TYSABRI
NON PREFERRED
ANALPRAM 2.5% LOTION
COPAXONE 20MG/ML
MEMANTINE DOSE PACK
XENAZINE
MUSCLE RELAXANTS & ANTISPASMODIC AGENTS
GENERIC
anectine
baclofen
chlorzoxazone
cyclobenzaprine hcl
dantrolene sodium
methocarbamol
neostigmine methylsulfate
orphenadrine citrate
orphenadrine compound
pyridostigmine bromide
tizanidine hcl
PREFERRED
BACLOFEN POWDER
CYCLOBENZAPRINE HCL
DANTROLENE SODIUM POWDER
EDROPHONIUM CHLORIDE
GABLOFEN
LIORESAL
MESTINON SYRUP
METHOCARBAMOL POWDER
NEOSTIGMINE METHYLSULFATE POWDER
ORPHENADRINE CITRATE POWDER
PYRIDOSTIGMINE BROMIDE POWDER
ROBAXIN VIAL
TIZANIDINE HCL POWDER
NON PREFERRED
MESTINON
MESTINON ER
NEOSTIGMINE METHYLSULFATE
ROBAXIN
HYPNOTIC AGENTS
GENERIC
diphenhydramine hcl
flurazepam hcl
seconal sodium
temazepam
triazolam
zaleplon
zolpidem tartrate
zolpidem tartrate er
PREFERRED
AMYTAL
DOXYLAMINE SUCCINATE
NEMBUTAL SODIUM
ROZEREM
TRICYCLICS
GENERIC
amitriptyline hcl
amoxapine 150mg
amoxapine 25mg
clomipramine hcl
desipramine hcl
doxepin hcl
imipramine hcl
imipramine pamoate
nortriptyline hcl
trimipramine maleate
PREFERRED
AMITRIPTYLINE HCL POWDER
CLOMIPRAMINE HCL POWDER
DESIPRAMINE HCL POWDER
DOXEPIN HCL POWDER
IMIPRAMINE HCL POWDER
NORTRIPTYLINE HCL POWDER
MISC. ANTIDEPRESSANTS
GENERIC
amitriptyline/chlordiazepoxide
bupropion er (12 hour)
bupropion hcl
bupropion hcl xl er
bupropion sr
duloxetine
mirtazapine
mirtazapine disintegrating
perphenazine/amitriptyline
trazodone hcl
venlafaxine hcl
venlafaxine hcl er
PREFERRED
BUPROPION HCL POWDER
FETZIMA
MIRTAZAPINE POWDER
PRISTIQ ER
TRAZODONE HCL POWDER
NON PREFERRED
DULOXETINE POWDER
MAO INHIBITORS
GENERIC
phenelzine sulfate
tranylcypromine sulfate
PREFERRED
PHENELZINE SULFATE POWDER
SELECTIVE SEROTONIN REUPTAKE INHIBITORS
GENERIC
citalopram hbr
escitalopram oxalate
fluoxetine
fluvoxamine maleate er
paroxetine hcl
paroxetine hcl er
PREFERRED
BRISDELLE
FLUOXETINE POWDER
VIIBRYD
NON PREFERRED
FLUOXETINE 60MG
PHENOTHIAZINES
GENERIC
chlorpromazine
fluphenazine decanoate
fluphenazine hcl
perphenazine
thioridazine hcl
trifluoperazine hcl
PREFERRED
CHLORPROMAZINE POWDER
FLUPHENAZINE DECANOATE 2.5%
THIORIDAZINE HCL POWDER
NON PREFERRED
FLUPHENAZINE DECANOATE 1GM LIQUID
PERPHENAZINE
BUTYROPHENONES
GENERIC
haloperidol
haloperidol decanoate
haloperidol lactate
PREFERRED
HALOPERIDOL DECANOATE POWDER
HALOPERIDOL POWDER
MISC. ANTIPSYCHOTICS
GENERIC
aripiprazole ODT
aripiprazole tablets
clozapine
clozapine ODT
loxapine succinate
olanzapine
olanzapine ODT
olanzapine/fluoxetine hcl
quetiapine fumarate
thiothixene
ziprasidone hcl
PREFERRED
ABILIFY MAINTENA, ER
ARISTADA
LATUDA
LOXAPINE SUCCINATE POWDER
RISPERDAL CONSTA
SEROQUEL XR
VIMIZIM
NON PREFERRED
CLOZAPINE ODT
RISPERDAL
RISPERDAL M-TAB DISINTEGRATING
MISCELLANEOUS PSYCHOTHERAPEUTIC AGENTS
GENERIC
amphetamine salt combo,er
armodafinil
clonidine hcl er
dexmethylphenidate er
dextroamphetamine sulfate
dextroamphetamine sulfate er
ergoloid mesylates
flumazenil
guanfacine er
guanidine hcl
lithium carbonate
lithium carbonate er
methamphetamine hcl
methylphenidate er
methylphenidate hcl
modafinil
PREFERRED
DAYTRANA
ERGOLOID MESYLATES POWDER
EVEKEO
LITHIUM CARBONATE POWDER
METHYLPHENIDATE HCL POWDER
QUILLICHEW ER
QUILLIVANT XR
VYVANSE
XYREM
NON PREFERRED
FLUMAZENIL POWDER
ANXIOLYTICS
GENERIC
alprazolam
alprazolam er
alprazolam ODT
buspirone hcl
chlordiazepoxide hcl
clorazepate dipotassium
lorazepam
midazolam hcl
oxazepam
PREFERRED
ALPRAZOLAM POWDER
BUSPIRONE HCL POWDER
LORAZEPAM POWDER
MIDAZOLAM HCL POWDER
NON PREFERRED
midazolam hcl
Cardiovascular, Hypertension & Lipids
ANTIARRHYTHMIC AGENTS
GENERIC
adenosine
amiodarone hcl
dofetilide
flecainide acetate
ibutilide fumarate
lidocaine hcl in 7.5% dextrose
mexiletine hcl
procainamide hcl
propafenone hcl
propafenone hcl er
quinidine gluconate
quinidine gluconate er
quinidine sulfate
sotalol
PREFERRED
ADENOSINE POWDER
AMIODARONE HCL POWDER
MEXILETINE HCL POWDER
NEXTERONE
PROCAINAMIDE HCL POWDER
QUINIDINE SULFATE
SOTALOL HCL
SOTYLIZE
CARDIAC GLYCOSIDES
GENERIC
digoxin
PREFERRED
DIGOXIN POWDER
LANOXIN PEDIATRIC
RAPID ACTING NITRATES
GENERIC
nitroglycerin
nitroglycerin in d5w
nitroglycerin spray
nitroglycerin tablets
PREFERRED
NITROSTAT
LONG ACTING NITRATES
GENERIC
isosorbide dinitrate
isosorbide mononitrate
isosorbide mononitrate er
nitroglycerin er
PREFERRED
DILATRATE-SR
ANTICOAGULANTS
GENERIC
warfarin sodium
PREFERRED
ARGATROBAN
COUMADIN 5MG VIAL
ELIQUIS
PRADAXA
REFLUDAN
WARFARIN SODIUM POWDER
XARELTO
NON PREFERRED
COUMADIN
ANTIPLATELET DRUGS
GENERIC
aspirin / dipyridamole er
cilostazol
clopidogrel
dipyridamole
PREFERRED
AGGRASTAT 5 MG/100ML
BRILINTA
DIPYRIDAMOLE POWDER
EFFIENT
INTEGRILIN
REOPRO
ZONTIVITY
NON PREFERRED
AGGRASTAT 12.5MG/250
HEPARIN
GENERIC
enoxaparin sodium
fondaparinux sodium
heparin lock flush
heparin sodium in 0.45% nacl
heparin sodium in 5% dextrose
PREFERRED
FRAGMIN
NON PREFERRED
HEPARIN SODIUM IN 0.45% NACL 12500/500
VITAMIN K
PREFERRED
MEPHYTON
PHYTONADIONE
HEMOSTATICS
GENERIC
tranexamic acid
PREFERRED
HUMATE-P
NOVOSEVEN RT
NPLATE
PROMACTA
TRANEXAMIC ACID POWDER
WILATE
MISC. COAGULATION AGENTS
GENERIC
pentoxifylline
protamine sulfate
PREFERRED
ADVATE
ADVATE H
ADVATE L
ADVATE N
ADVATE SH
ADVATE UH
ADYNOVATE
ALPHANATE
ALPHANINE SD
ALPROLIX
ANGIOMAX
BEBULIN
BEBULIN VH IMMUNO
BENEFIX
CEPROTIN
COAGADEX
CORIFACT
ELOCTATE
FEIBA NF
HELIXATE FS
HEMOFIL
IXINITY
KOATE-DVI
KOGENATE FS
MONOCLATE-P
MONONINE
OBIZUR
PENTOXIFYLLINE POWDER
PROFILNINE SD
PROTAMINE SULFATE POWDER
RECOMBINATE
RIASTAP
THROMBATE III
TRETTEN
XYNTHA
NON PREFERRED
ATRYN
THIAZIDE & RELATED DIURETICS
GENERIC
amiloride hcl
amiloride hcl w/hctz
bumetanide
chlorothiazide
chlorothiazide sodium
chlorthalidone
eplerenone
furosemide
hydrochlorothiazide
indapamide
mannitol
methyclothiazide
metolazone
spironolactone
spironolactone/hctz
torsemide
PREFERRED
AMILORIDE HCL POWDER
FUROSEMIDE POWDER
HYDROCHLOROTHIAZIDE POWDER
MANNITOL POWDER
RESECTISOL
SPIRONOLACTONE POWDER
NON PREFERRED
EDECRIN
FUROSEMIDE 40MG/4ML SOLUTION
TORSEMIDE
BETA BLOCKERS
GENERIC
acebutolol hcl
atenolol
betaxolol hcl
bisoprolol fumarate
labetalol hcl
metoprolol succinate er
metoprolol tartrate
nadolol
pindolol
propranolol hcl
propranolol hcl er
timolol maleate
PREFERRED
ACEBUTOLOL HCL POWDER
ATENOLOL POWDER
BYSTOLIC
COREG CR
LABETALOL HCL POWDER
METOPROLOL TARTRATE POWDER
NADOLOL POWDER
PROPRANOLOL HCL POWDER
TIMOLOL MALEATE POWDER
CALCIUM CHANNEL BLOCKERS/ NON-DIHYDROPYRIDINES
GENERIC
diltiazem
diltiazem 24hr cd
diltiazem er
diltiazem er 24 hour
diltiazem hcl
nimodipine
verapamil er
verapamil er pm
verapamil hcl
PREFERRED
DILTIAZEM HCL POWDER
VERAPAMIL HCL POWDER
NON PREFERRED
NIMODIPINE POWDER
CALCIUM CHANNEL BLOCKERS/DIHYDROPYRIDINES
GENERIC
amlodipine besylate
felodipine er
isradipine
nicardipine hcl
PREFERRED
AMLODIPINE BESYLATE POWDER
CLEVIPREX 25MG/50ML
NON PREFERRED
CLEVIPREX 50MG/100ML
ACE INHIBITORS
GENERIC
benazepril hcl
captopril
enalapril maleate
enalaprilat
fosinopril sodium
lisinopril
moexipril hcl
perindopril erbumine
quinapril
ramipril
trandolapril
trandolapril/verapamil er
PREFERRED
BENAZEPRIL HCL POWDER
CAPTOPRIL POWDER
ENALAPRIL MALEATE POWDER
LISINOPRIL POWDER
ADRENERGIC ANTAGONISTS & RELATED DRUGS
GENERIC
clonidine hcl
clonidine/chlorthalidone
doxazosin mesylate
guanfacine hcl
methyldopa
methyldopate hcl
prazosin hcl
reserpine
terazosin hcl
PREFERRED
CLONIDINE HCL POWDER
RESERPINE POWDER
NON PREFERRED
PRAZOSIN HCL POWDER
AGENTS FOR PHEOCHROMOCYTOMA
GENERIC
phentolamine mesylate
PREFERRED
DEMSER
PHENTOLAMINE MESYLATE POWDER
NON PREFERRED
PHENTOLAMINE MESYLATE VIAL
VASODILATORS
GENERIC
epoprostenol
epoprostenol diluent
hydralazine hcl
minoxidil
papaverine hcl
papaverine hcl er
PREFERRED
FLOLAN
HYDRALAZINE HCL POWDER
MINOXIDIL POWDER
PAPAVERINE HCL POWDER
REMODULIN
UPTRAVI
OTHER ANTIHYPERTENSIVE COMBINATIONS
GENERIC
amlodipine/valsartan
amlodipine/valsartan/hctz
atenolol/chlorthalidone
benazepril/hctz
bisoprolol fumarate/hctz
captopril/hydrochlorothiazide
enalapril maleate/hctz
fosinopril/hydrochlorothiazide
lisinopril/hctz
methyldopa/hydrochlorothiazide
metoprolol/hydrochlorothiazide
moexipril/hydrochlorothiazide
nadolol-bendroflumethiazide
propranolol/hctz
quinapril/hydrochlorothiazide
PREFERRED
AZOR
TRIBENZOR
ANGIOTENSION II RECEPTOR BLOCKERS & RENIN INHIBITOR
GENERIC
candesartan cilexetil
candesartan/hydrochlorothiazide
irbesartan
irbesartan/hydrochlorothiazide
losartan potassium
losartan/hydrochlorothiazide
valsartan
valsartan/hydrochlorothiazide
PREFERRED
BENICAR
BENICAR HCT
EDARBI
EDARBYCLOR
TEKAMLO
TEKTURNA
TEKTURNA HCT
LIPID/CHOLESTEROL LOWERING AGENTS
GENERIC
amlodipine-atorvastatin
atorvastatin calcium
cholestyramine
cholestyramine light
colestipol hcl
fenofibrate
fenofibric acid
fenofibric acid del rel
fluvastatin sodium
gemfibrozil
lovastatin
niacin er
omega-3-acid ethyl esters
pravastatin sodium
rosuvastatin
simvastatin
PREFERRED
CHOLESTYRAMINE POWDER
GEMFIBROZIL POWDER
JUXTAPID
LIPOFEN
LIPTRUZET
LIVALO
PRALUENT PEN
PRALUENT SYRINGE
REPATHA SURECLICK
REPATHA SYRINGE
SIMCOR ER
SIMVASTATIN POWDER
VASCEPA
VYTORIN
WELCHOL
ZETIA
NON PREFERRED
FENOFIBRATE
MISC. CARDIOVASCULAR AGENTS
GENERIC
dobutamine
dobutamine/dextrose
dopamine hcl
dopamine hcl in 5% dextrose
milrinone in 5% dextrose
milrinone lactate
norepinephrine bitartrate
phenylephrine hcl
PREFERRED
ACTIVASE
CATHFLO ACTIVASE
CORLANOR
DOPAMINE HCL POWDER
ENTRESTO
NATRECOR
PHENYLEPHRINE HCL POWDER
RANEXA
RETAVASE
Dermatological/Topical Therapy
TOPICAL CORTICOSTEROIDS VERY HIGH POTENCY
GENERIC
clobetasol e
clobetasol propionate
diflorason diacetate/emollient
diflorasone diacetate
halobetasol propionate
PREFERRED
CLOBETASOL PROPIONATE POWDER
TOPICAL CORTICOSTEROIDS HIGH POTENCY
GENERIC
amcinonide
betamethasone dipropionate augment
betamethasone valerate
desoximetasone
fluocinonide
PREFERRED
BETAMETHASONE DIPROPIONATE AUGMENT POWDER
BETAMETHASONE VALERATE POWDER
DESOXIMETASONE POWDER
FLUOCINONIDE POWDER
TOPICAL CORTICOSTEROIDS MEDIUM POTENCY
GENERIC
fluocinolone acetonide
fluticasone propionate
hydrocortisone butyrate
hydrocortisone butyrate/emoll
hydrocortisone valerate
mometasone furoate
PREFERRED
FLUOCINOLONE ACETONIDE POWDER
FLUTICASONE PROPIONATE POWDER
MOMETASONE FUROATE POWDER
TRIAMCINOLONE ACETONIDE POWDER
NON PREFERRED
FLUOCINOLONE ACETONIDE POWDER
FLUTICASONE PROPIONATE 50MCG SPRAY
TOPICAL CORTICOSTEROIDS LOW POTENCY
GENERIC
alclometasone dipropionate
desonide
hydrocortisone
hydrocortisone acetate
PREFERRED
DESONIDE POWDER
HYDROCORTISONE ACETATE POWDER
TOPICAL ANESTHETICS
GENERIC
bupivacaine hcl
bupivacaine/epinephrine
carbocaine
chloroprocaine
cocaine hcl
ethyl chloride
lidocaine
lidocaine hcl
lidocaine hcl w/epinephrine
lidocaine/prilocaine
lidocaine-hc
ropivacaine
sensorcaine 5MG/ML VIAL
PREFERRED
BENZOCAINE
BUPIVACAINE HCL POWDER
CARBOCAINE 20MG/ML
COCAINE HCL
LIDOCAINE HCL POWDER
LIDOCAINE POWDER
MEPIVACAINE HCL POWDER
NESACAINE 10MG/ML
ROPIVACAINE POWDER
NON PREFERRED
BUPIVACAINE/EPINEPHRINE CARTRIDGE
CARBOCAINE 10MG/ML
LIDOCAINE
LIDOCAINE HCL
LIDOCAINE HCL W/EPINEPHRINE
LIDOCAINE-HC
MEPIVACAINE HCL 30MG/ML CARTRIDGE
NESACAINE 20MG/ML
SENSORCAINE 2.5MG/ML VIAL
THERAPY FOR ACNE
GENERIC
adapalene
benprox
benzoyl peroxide
clindamycin phos/benzoyl peroxide
clindamycin phosphate topical
clindamycin-benzoyl peroxide
erythromycin solution
erythromycin-benzoyl peroxide
sodium sulfacetamide/sulfur
tretinoin microsphere
PREFERRED
ABSORICA
BENZOYL PEROXIDE POWDER
DIFFERIN 0.1% LOTION
EPIDUO
EPIDUO FORTE
FINACEA
FINACEA PLUS
MIRVASO
ONEXTON
TAZORAC
ZIANA
NON PREFERRED
ADAPALENE LOTION
DIFFERIN
ISOTRETINOIN
SODIUM SULFACETAMIDE/SULFUR GEL
TRETIN-X
TOPICAL ANTIBACTERIALS
GENERIC
bacitracin
bacitracin/polymyxin ophth oint
gentamicin sulfate
mafenide acetate
mupirocin
sulfacetamide sodium
PREFERRED
GENTAMICIN SULFATE POWDER
MAFENIDE ACETATE POWDER
MUPIROCIN POWDER
SULFAMYLON CREAM
NON PREFERRED
SULFACETAMIDE SODIUM
SULFAMYLON PACKET
TOPICAL ANTIFUNGALS
GENERIC
ciclopirox
clotrimazole
clotrimazole/betamethasone
econazole nitrate
nystatin
nystatin w/triamcinolone
PREFERRED
CLOTRIMAZOLE POWDER
ECONAZOLE NITRATE POWDER
NYSTATIN
TOPICAL ANTIVARALS
PREFERRED
ACYCLOVIR POWDER
ZOVIRAX 0.05 CREAm
NON PREFERRED
ZOVIRAX
BURN THERAPY
GENERIC
silver sulfadiazine
PREFERRED
SILVER SULFADIAZINE POWDER
TOPICAL ENZYMES
PREFERRED
SANTYL
KERATOLYTICS
GENERIC
salicylic acid
PREFERRED
SALICYLIC ACID
ANTIPSORIATICS/ANTISEBORRHEIC
GENERIC
acitretin
calcipotriene
selenium sulfide
PREFERRED
ANTHRALIN
CALCIPOTRIENE POWDER
ENSTILAR
SELENIUM SULFIDE POWDER
STELARA
TACLONEX SUSPENSION
NON PREFERRED
CALCITRIOL
COSENTYX
TACLONEX OINTMENT
TOPICAL SCABICIDES/PEDICULICIDES
GENERIC
lindane
malathion
permethrin
spinosad
PREFERRED
PERMETHRIN
MISC. DERMATOLOGICALS
GENERIC
alphaquin hp
aluminum chloride topical
ammonium lactate
avo cream
chlorhexidine gluconate
dexpanthenol
eletone
emulsion sb
fluorouracil
hpr
hpr plus
hydroquinone cream
hydroquinone er cream
imiquimod
lactic acid
lustra-ultra
mb hydrogel
nuquin hp
podofilox
pruclair
prumyx
prutect
sonafine
tl-cermide
urea
PREFERRED
ALUMINUM CHLORIDE POWDER
AMMONIUM LACTATE
CARAC
CHLORHEXIDINE GLUCONATE 0.2 SOLUTION
CONDYLOX GEL
DEXPANTHENOL
ELIDEL
ETHYL ALCOHOL
FLUOROURACIL POWDER
HYDROQUINONE POWDER
IMIQUIMOD POWDER
LACTIC ACID 88 TO 92 %
OXSORALEN 1% LOTION
REGRANEX
UREAM POWDER, BEADS
NON PREFERRED
CHLORHEXIDINE GLUCONATE
CONDYLOX SOLUTION
ETHYL ALCOHOL 1 LIQUID
PODOFILOX POWDER
UREA LOTION
EAR, NOSE & THROAT MEDICATIONS
MISCELLANEOUS OTIC PREPARATIONS
GENERIC
acetic acid otic solution
acetic acid/aluminum otic sol
acetic acid/hydrocortisone otic sol
antipyrine/benzocaine otic sol
antipyrine/benzocaine/poly otic sol
chloroxylenol/benzocaine/hc acetate otic susp
ciprofloxacin hcl
ofloxacin otic drops
PREFERRED
CIPROFLOXACIN HCL
OTIC STEROID / ANTIBIOTIC
GENERIC
neomycin/polymyxin/hc
neomycin/polymyxin/hc drops
PREFERRED
CIPRODEX
MISCELLANEOUS AGENTS
GENERIC
azelastine hcl
ipratropium bromide spray
oxymetazoline hcl 12 hour
sodium chloride
sodium fluoride
PREFERRED
FIRST-BXN
FIRST-MOUTHWASH BLM
MYALEPT
OXYMETAZOLINE HCL POWDER
SODIUM FLUORIDE
SODIUM FLUORIDE POWDER
NON PREFERRED
ATROVENT SPRAY
AZELASTINE HCL POWDER
ENDOCRINE/DIABETES
ANTITHYROID AGENTS
GENERIC
methimazole
propylthiouracil
PREFERRED
METHIMAZOLE POWDER
PROPYLTHIOURACIL POWDER
THYROID HORMONES
GENERIC
levothroid
levothyroxine sodium
liothyronine sodium
PREFERRED
ARMOUR THYROID
LEVOTHYROXINE SODIUM
LIOTHYRONINE SODIUM POWDER
THYROID
ADRENAL HORMONES
GENERIC
a-hydrocort
cortisone acetate
cosyntropin
dexamethasone
dexamethasone sodium phosphate
fludrocortisone acetate
methylprednisolone
methylprednisolone acetate
methylprednisolone sod succ
prednisolone
prednisolone sodium phosphate
prednisone
veripred 20
PREFERRED
ARISTOSPAN
BETAMETHASONE
BETAMETHASONE ACETATE
BETAMETHASONE SODIUM PHOSPHATE
CORTISONE ACETATE POWDER
DEPO-MEDROL 20 MG/ML
DEXAMETHASONE POWDER
DEXAMETHASONE SODIUM PHOSPHATE POWDER
FLUDROCORTISONE ACETATE POWDER
KENALOG 10MG/ML VIAL
METHYLPREDNISOLONE POWDER
METHYLPREDNISOLONE SOD SUCC POWDER
PREDNISOLONE POWDER
PREDNISONE POWDER
SOLU-CORTEF
SOLU-MEDROL 2G VIAL
NON PREFERRED
COSYNTROPIN
DEPO-MEDROL
KENALOG
MEDROL
SOLU-MEDROL
ANDROGENS
GENERIC
danazol
oxandrolone
testosterone cypionate
testosterone enanthate
testosterone gel
PREFERRED
AXIRON
DANAZOL POWDER
FLUOXYMESTERONE
METHITEST
OXANDROLONE POWDER
TESTOSTERONE CYPIONATE POWDER
TESTOSTERONE ENANTHATE POWDER
TESTOSTERONE POWDER
NON PREFERRED
TESTOSTERONE GEL
OVULATORY STIMULANTS
GENERIC
clomiphene citrate
PREFERRED
CLOMIPHENE CITRATE POWDER
FOLLISTIM AQ
GONAL-F
GONAL-F RFF
GONAL-F RFF REDI-JECT
MENOPUR
REPRONEX
NON PREFERRED
BRAVELLE
MISCELLANEOUS AGENTS
GENERIC
cabergoline
calcitonin salmon nasal
calcitriol
desmopressin acetate
doxercalciferol
pamidronate disodium
paricalcitol
vasopressin
zoledronic acid
PREFERRED
ACTHREL
ALDURAZYME
CERDELGA
CEREZYME
DESMOPRESSIN ACETATE POWDER
ELAPRASE
ELELYSO
FABRAZYME
KALYDECO
KUVAN
LUMIZYME
MIACALCIN VIAL
MYOZYME
NAGLAZYME
SAMSCA
SENSIPAR
SOMAVERT
STIMATE SPRAY
SYNAREL
VPRIV
ZAVESCA
ZEMPLAR VIAL
ZOMETA INFUSION BOTTLE
NON PREFERRED
MIACALCIN AEROSOL
PARICALCITOL
ZEMPLAR CAPSULE
ZOLEDRONIC ACID
ZOMETA VIAL
GONADOTROPIN & RELATED AGENTS
GENERIC
chorionic gonadotropin
PREFERRED
CHORIONIC GONADOTROPIN POWDER
INSULIN THERAPY
PREFERRED
HUMALOG
HUMULIN 70/30, KWIKPEN
HUMULIN KWIKPEN
HUMULIN R 500 UNITS
HUMULIN R U-500 KWIKPEN
LANTUS
LANTUS SOLOSTAR
LEVEMIR
LEVEMIR, FLEXTOUCH
NOVOLOG
NOVOLOG FLEXPEN
NOVOLOG MIX 70-30
TOUJEO SOLOSTAR
TRESIBA FLEXTOUCH U-100
TRESIBA FLEXTOUCH U-200
NON-INSULIN HYPOGLYCEMIC AGENTS
GENERIC
acarbose
glimepiride
glipizide
glipizide er
glyburide
glyburide micronized
glyburide/metformin hcl
metformin hcl
metformin hcl er
nateglinide
pioglitazone hcl
pioglitazone/glimepiride
pioglitazone/metformin
repaglinide/metformin
tolazamide
tolbutamide
PREFERRED
ACTOPLUS MET XR
BYDUREON
BYDUREON PEN
BYETTA
GLIPIZIDE POWDER
GLYBURIDE POWDER
GLYXAMBI
INVOKAMET
INVOKANA
JANUMET
JANUMET XR
JANUVIA
JENTADUETO
JUVISYNC
KOMBIGLYZE XR
METFORMIN HCL POWDER
ONGLYZA
RIOMET
SYMLINPEN 60
SYNJARDY
TRADJENTA
VICTOZA
XIGDUO XR
GLUCOSE ELEVATING AGENTS
PREFERRED
GLUCAGEN
PROGLYCEM
NON PREFERRED
GLUCAGON
INSULIN SYRINGES/MISCELLANEOUS DME
PREFERRED
1ST CHOICE LANCETS
ACCU-CHEK FASTCLIX, MULTICLIX, SOFTCLIX, LANCETS
ACCU-CHEK SOFTCLIX LANCETS DEVICE
DEXCOM G4 SENSOR
FEMCAP
FORA LANCING DEVICE
FREESTYLE CONTROL SOLUTION
FREESTYLE FREEDOM LITE
MEDISENSE
MEDISENSE GLUCOSE KETONE CONTR
MINIMED
MINIMED RESERVOIR
NOVOFINE
NOVOFINE AUTOCOVER
ONE TOUCH ULTRA 2
ONE TOUCH ULTRA SMART
ONE TOUCH ULTRA SYSTEM
ONE TOUCH ULTRAMINI
ONE TOUCH VERIO
ONE TOUCH VERIO FLEX
ONE TOUCH VERIO IQ
ONE TOUCH VERIO SYNC
ORTHO-DIAPHRAGM
PARADIGM INFUSION
PARADIGM INSULIN PUMP
PARADIGM SILHOUETTE
POLYFIN QR
PRODIGY INSULIN SYRINGE
PRODIGY PEN NEEDLE
QUICK RELEASE SOFT TEFLON
SILHOUETTE
SOF-SET
SOF-SET MICRO
SOFT TOUCH
SOLOSITE
SURE-T PARADIGM
VGO 20
VGO 30
VGO 40
NON PREFERRED
DEXCOM G4 SENSOR
BLOOD GLUCOSE MONITORING DEVICES & SUPPLIES
PREFERRED
FREESTYLE FREEDOM KIT
FREESTYLE FREEDOM LITE METER
FREESTYLE INSULINX
FREESTYLE INSULINX GLUCOSE SYSTEM
FREESTYLE INSULINX TEST STRIPS
FREESTYLE LITE METER
FREESTYLE LITE TEST STRIPS
FREESTYLE TEST STRIPS
ONE TOUCH ULTRA TEST STRIPS
OPTIUM
OPTIUM EZ
PRECISION PCX, PCX PLUS, POINT OF CARE, Q-I-D
PRECISION XTRA B-KETONE STRIPS
PRECISION XTRA MONITOR
PRECISION XTRA TEST STRIPS
GASTROENTEROLOGY
H2 ANTAGONISTS
GENERIC
cimetidine
famotidine
nizatidine
ranitidine hcl
PREFERRED
CIMETIDINE POWDER
FAMOTIDINE POWDER
RANITIDINE HCL POWDER
PROSTAGLANDINS
GENERIC
misoprostol
PREFERRED
MISOPROSTOL POWDER
OTHER ULCER THERAPY
GENERIC
carafate
lansoprazole/amoxicillin/clarithromycin
sucralfate
PREFERRED
SUCRALFATE POWDER
NON PREFERRED
CARAFATE
PROTON PUMP INHIBITORS
GENERIC
esomeprazole
lansoprazole del rel
omeprazole del rel
omeprazole sodium bicarbonate
pantoprazole sodium
PREFERRED
LANSOPRAZOLE POWDER
OMEPRAZOLE POWDER
NON PREFERRED
NEXIUM
OMEPRAZOLE SODIUM BICARBONATE
ANTIDIARRHEALS
GENERIC
diphenoxylate/atropine
loperamide hcl
opium
paregoric
PREFERRED
LOPERAMIDE HCL
ANTISPASMODICS
GENERIC
dicyclomine hcl
glycopyrrolate
hyoscyamine sulfate
hyoscyamine sulfate disinegrating tablets
hyoscyamine sulfate er
PREFERRED
DICYCLOMINE HCL POWDER
GLYCOPYRROLATE POWDER
HYOSCYAMINE SULFATE POWDER
LEVSIN 0.5MG/ML AMPUL
NON PREFERRED
LEVSIN 0.125MG TABLET
BILE ACIDS
GENERIC
ursodiol
PREFERRED
CHENODAL
CHOLBAM
KINEVAC
URSODIOL POWDER
DIGESTIVE ENZYMES
GENERIC
pancrelipase
PREFERRED
CREON
SUCRAID
VIOKACE
ZENPEP DEL-REL
MISC. GASTROINTESTINAL AGENTS
GENERIC
balsalazide disodium
budesonide
budesonide ec
CITRA PH
hydrocortisone
hydrocortisone/pramoxine
lactulose
mesalamine
metoclopramide hcl
sodium bicarbonate
sulfasalazine
sulfasalazine dr
PREFERRED
AMITIZA
ASACOL HD
CANASA
CORTIFOAM
CYSTADANE
ENTYVIO
HYDROCORTISONE POWDER
LIALDA
LINZESS
MESALAMINE POWDER
METOCLOPRAMIDE HCL POWDER
PENTASA
PROCTOFOAM-HC
RECTIV
RELISTOR
REMICADE
SODIUM BICARBONATE POWDER
SULFASALAZINE POWDER
UCERIS EXTENDED RELEASE
VIBERZI
NON PREFERRED
LOTRONEX
SODIUM BICARBONATE POWDER
sodium chloride/sodium bicarb
UCERIS FOAM
ANTIVERTIGO & ANTIEMETIC AGENTS
GENERIC
dimenhydrinate
dronabinol
droperidol
granisetron hcl
granisol
meclizine hcl
ondansetron hcl
ondansetron ODT
prochlorperazine edisylate
prochlorperazine maleate
trimethobenzamide hcl
PREFERRED
AKYNZEO
ALOXI
DIMENHYDRINATE POWDER
DROPERIDOL POWDER
EMEND
MECLIZINE HCL POWDER
ONDANSETRON HCL POWDER
PROCHLORPERAZINE EDISYLATE POWDER
PROCHLORPERAZINE MALEATE POWDER
SANCUSO
SCOPOLAMINE HYDROBROMIDE
TRIMETHOBENZAMIDE HCL POWDER
BOWEL EVACUANTS
GENERIC
peg 3350-electrolyte
polyethylene glycol
PREFERRED
POLYETHYLENE GLYCOL
PREPOPIK
SUCLEAR
SUPREP
NON PREFERRED
POLYETHYLENE GLYCOL
IMMUNOLOGY, VACCINES & BIOTECHNOLOGY
ERYTHROID STIMULANTS
PREFERRED
ARANESP
PROCRIT
MYELOID STIMULANTS
PREFERRED
GRANIX
LEUKINE
MOZOBIL
NEULASTA
NEUPOGEN
ZARXIO
INTERFERONS
PREFERRED
ACTIMMUNE
ALFERON N
AVONEX
BETASERON
INFERGEN
INTRON A
PEGASYS
PEGASYS PROCLICK
PLEGRIDY
REBIF
REBIF REBIDOSE
SYLATRON
GROWTH HORMONES
PREFERRED
EGRIFTA
GENOTROPIN
HUMATROPE
NORDITROPIN
SEROSTIM
NON PREFERRED
OMNITROPE
INTERLEUKINS
PREFERRED
ARCALYST
ILARIS
NEUMEGA
PROLEUKIN
VACCINES & MISCELLANEOUS IMMUNOLOGICALS
GENERIC
candin
fomepizole
tetanus toxoid
PREFERRED
ACTHIB
ADACEL
AFLURIA
APLISOL
ATGAM
BEXSERO
BIOTHRAX
BOOSTRIX
BOTOX
CERVARIX
COMVAX
CROFAB
CYTOGAM
ENGERIX-B
FLUARIX
FLULAVAL
FLULAVAL QUAD
FLUMIST
FLUVIRIN
FLUZONE
FLUZONE INTRADERM QUAD
GAMASTAN S-D
GAMMAGARD LIQUID
GAMMAGARD S-D
GAMUNEX
GAMUNEX-C
GARDASIL 9
GRASTEK
HAVRIX
HEPAGAM B
HIZENTRA
HYPERHEP B S-D
HYPERRAB S-D
HYPERRHO S-D
HYPERTET S-D
IMOGAM RABIES-HT
IMOVAX RABIES VACCINE
INFANRIX
IPOL
IXIARO
MENACTRA
MENOMUNE-A-C-Y-W-135
M-M-R II VACCINE W/DILUENT
MYOBLOC
PEDIARIX
PEDVAXHIB
PNEUMOVAX 23
PREVNAR 13
PRIVIGEN
PROQUAD
QUADRACEL DTAP-IPV
RABAVERT
RAGWITEK
RECOMBIVAX HB
ROTATEQ
SYNAGIS
TETANUS DIPHTHERIA TOXOIDS
TETANUS DIPHTHERIA TOXOIDS - PED
THERACYS
THYMOGLOBULIN
TICE BCG
TRUMENBA
TUBERSOL
TWINRIX
TYPHIM VI
VAQTA VIAL
VARIVAX VACCINE
VARIZIG
VIVOTIF BERNA DEL REL
YF-VAX
NON PREFERRED
VAQTA SYRINGES
MUSCULOSKELETAL & RHEUMATOLOGY
GOUT THERAPY
GENERIC
allopurinol
allopurinol sodium
probenecid
PREFERRED
ALLOPURINOL POWDER
COLCHICINE POWDER
COLCRYS
KRYSTEXXA
ULORIC
NON PREFERRED
COLCHICINE
OTHER RHEUMATOLOGICALS
GENERIC
leflunomide
PREFERRED
ACTEMRA
BENLYSTA
CUPRIMINE
DEPEN
ENBREL
HUMIRA
ORENCIA
OTREXUP
RIDAURA
SAVELLA
SIMPONI 100MG/ML
NON PREFERRED
SIMPONI 50MG/0.5ML
OSTEOPOROSIS THERAPY
GENERIC
alendronate sodium
ibandronate
ibandronate sodium
risedronate dr
risedronate, sodium
PREFERRED
FORTEO
OBSTETRICS & GYNECOLOGY
MONOPHASIC /BIPHASIC /TRIPHASIC AGENTS
GENERIC
altavera
alyacen
amethia
amethia lo
amethyst
apri
aranelle
aubra
aviane
azurette
balziva
briellyn
camrese
camrese lo
caziant
chateal
cryselle
cyclafem
dasetta
daysee
elinest
emoquette
enpresse
enskyce
estarylla
falmina
gianvi
gildagia
gildess
gildess fe
introvale
jolessa
junel
junel fe
kariva
kelnor 1-35
kurvelo
leena
lessina
levonorgestrel
levora
loryna
low-ogestrel
lutera
marlissa
microgestin
microgestin fe
mono-linyah
mononessa
myzilra
necon
norethindrone/ethinyl estradiol
norethindrone/ethinyl estradiol iron
nortrel
ocella
ogestrel
orsythia
philith
pirmella
portia
quasense
reclipsen
sprintec
sronyx
syeda
tilia fe
tri-estarylla
tri-legest fe
tri-linyah
trinessa
trivora
velivet
vestura
viorele
wera
wymzya fe
zarah
zenchent
zenchent fe
zeosa
zovia
PREFERRED
BEYAZ
LO LOESTRIN FE
NATAZIA
SAFYRAL
OXYTOCICS
GENERIC
methylergonovine maleate
oxytocin
PREFERRED
ERGONOVINE MALEATE
HEMABATE
OXYTOCIN POWDER
NON PREFERRED
METHYLERGONOVINE MALEATE
PROGESTINS
GENERIC
errin
heather
jencycla
jolivette
lyza
medroxyprogesterone acetate
nora-be
norethindrone acetate
progesterone in oil
progesterone micronized
PREFERRED
CALDOLOR
CRINONE
DEPO-PROVERA 400 MG/ML
ENDOMETRIN
MAKENA
NORETHINDRONE ACETATE POWDER
PROGESTERONE MICRONIZED POWDER
NON PREFERRED
DEPO-PROVERA
MEDROXYPROGESTERONE ACETATE POWDER
ESTROGENS
GENERIC
estradiol
estradiol patch
estradiol valerate
estropipate
PREFERRED
CENESTIN
DEPO-ESTRADIOL
DIVIGEL
ENJUVIA
ESTRACE CREAM
ESTRADIOL VALERATE POWDER
MINIVELLE
PREMARIN
PREMARIN CREAM
VAGIFEM
NON PREFERRED
ESTRACE TABLET
ESTROGEN COMBINATIONS
GENERIC
estradiol/norethindrone acetate
estrogen/methyltestosterone
PREFERRED
COMBIPATCH
DUAVEE
PREMPHASE
PREMPRO
VAGINAL CLEANSER /ANTIINFECTIVES
GENERIC
clindamycin phosphate vaginal
VAGINAL ANTIFUNGALS
GENERIC
miconazole 1
terconazole
PREFERRED
MICONAZOLE 1
SPECIALIZED OB/GYN DRUGS
GENERIC
isoxsuprine hcl
PREFERRED
ISOXSUPRINE HCL POWDER
OSPHENA
DIAPHRAGMS AND OTHER NON-ORAL CONTRACEPTIVES
PREFERRED
IMPLANON
MIRENA
NEXPLANON
NUVARING
OPHTHALMOLOGY
BETA-BLOCKERS
GENERIC
betaxolol ophth solution
carteolol hcl
levobunolol hcl drops
metipranolol drops
CHOLINESTERASE INHIBITOR MIOTICS
PREFERRED
PHOSPHOLINE IODIDE DROPS
DIRECT ACTING MIOTICS
GENERIC
pilocarpine hcl
PREFERRED
PILOCARPINE HCL POWDER
PILOPINE HS
OTHER GLAUCOMA DRUGS
GENERIC
bimatoprost
dorzolamide hcl
dorzolamide/timolol
latanoprost drops
physostigmine salicylate
travoprost
PREFERRED
CARBACHOL
COMBIGAN
ISOPTO CARBACHOL 0.015
PHYSOSTIGMINE SALICYLATE
TRAVATAN Z
NON PREFERRED
ISOPTO CARBACHOL 0.03
LATANOPROST DROPS 1GM OIL
ORAL DRUGS FOR GLAUCOMA
GENERIC
acetazolamide
acetazolamide er
methazolamide
PREFERRED
ACETAZOLAMIDE POWDER
METHAZOLAMIDE POWDER
CYCLOPLEGIC MYDRIATICS
GENERIC
atropine sulfate
cyclopentolate ophth solution
homatropine hydrobromide
tropicamide
PREFERRED
ATROPINE SULFATE POWDER
CYCLOPENTOLATE POWDER
HOMATROPINE HYDROBROMIDE
TROPICAMIDE POWDER
NON-STEROIDAL ANTI-INFLAMMATORY AGENTS
GENERIC
bromfenac ophth
flurbiprofen sodium
ketorolac tromethamine drops
PREFERRED
ILEVRO
NEVANAC
PROLENSA
NON PREFERRED
BROMFENAC POWDER
VASOCONSTRICTOR DECONGESTANTS
GENERIC
naphazoline hcl
PREFERRED
NAPHAZOLINE HCL POWDER
ANTIBIOTICS
GENERIC
ciprofloxacin ophth solution
erythromycin ointment
gatifloxacin
gentasol
levofloxacin hemihydrate
neomycin/polymyxin/gramicidin
ofloxacin
tobramycin sulfate drops
PREFERRED
AZASITE
BESIVANCE
MOXEZA
NATACYN
TOBRAMYCIN SULFATE POWDER
VIGAMOX
SULFONAMIDES
GENERIC
sulfacetamide sodium
STEROIDS
GENERIC
fluorometholone
prednisolone acetate
prednisolone sodium phosphate drops
PREFERRED
ALREX
FLUOROMETHOLONE POWDER
FML S.O.P.
LOTEMAX
PRED MILD
PREDNISOLONE ACETATE POWDER
PREDNISOLONE SODIUM PHOSPHATE DROPS POWDER
STEROID-ANTIBIOTIC COMBINATIONS
GENERIC
neomycin/bacitracin/poly/hc
tobramycin/dexamethasone
PREFERRED
TOBRADEX OINTMENT
TOBRADEX ST
ZYLET
NON PREFERRED
TOBRADEX SUSPENSION
STEROID-SULFONAMIDE COMBINATIONS
GENERIC
sulfacetamide w/prednisolone
SYMPATHOMIMETICS
GENERIC
apraclonidine ophth solution
brimonidine ophth solution
PREFERRED
ALPHAGAN P 0.001%
BRIMONIDINE POWDER
NON PREFERRED
ALPHAGAN P 0.0015%
MISCELLANEOUS OPHTHALMOLOGICS
GENERIC
azelastine hcl ophth solution
balanced salt ophth irrigation
cromolyn sodium
epinastine hcl
olopatindine
proparacaine hcl
proparacaine/fluorescein
sodium chloride drops
tetcaine drops
PREFERRED
BEPREVE
CYSTARAN
EYLEA
FLUORESCEIN SODIUM
JETREA
LUCENTIS
PATADAY
PAZEO
PROPARACAINE HCL POWDER
RESTASIS
VISUDYNE
ANTIVIRALS
GENERIC
trifluridine
PREFERRED
TRIFLURIDINE POWDER
RESPIRATORY, ALLERGY, COUGH & COLD
ANTIHISTAMINES
GENERIC
arbinoxa
carbinoxamine
cetirizine syrup
clemastine fumarate
cyproheptadine hcl
desloratadine
desloratadine disintegrating tablets
dexchlorpheniramine maleate er
diphenhydramine
hydroxyzine hcl
hydroxyzine pamoate
levocetirizine dihydrochloride
promethazine hcl
promethegan
PREFERRED
CLEMASTINE FUMARATE POWDER
CYPROHEPTADINE HCL POWDER
DIPHENHYDRAMINE POWDER
HYDROXYZINE HCL POWDER
HYDROXYZINE PAMOATE POWDER
LEVOCETIRIZINE DIHYDROCHLORIDE POWDER
PROMETHAZINE HCL POWDER
PROMETHAZINE HCL TABLETS POWDER
NON PREFERRED
CYPROHEPTADINE HCL 4MG/10ML SYRUP
HYDROXYZINE HCL 50MG/25ML SOLUTION
ADRENERGICS
GENERIC
epinephrine
PREFERRED
EPINEPHRINE POWDER
EPIPEN
EPIPEN JR.
NON PREFERRED
EPINEPHRINE 1MG/ML AMPUL
ANTITUSSIVE COMBINATIONS
GENERIC
benzonatate
chlorphen/pse/dm tannate
D-CHLORPHENIRA/PSE/CHLOPHEDIAN 12.5CPD-1DCPM-30PSE
dihydrocodeine/aspirin/caffeine
dihydrocodeine/bpm/pe
DM/PHENYLEPH/CHLORPHENIRAMINE 10PEH-4CPM-20DM
guaifenesin/codeine
hydrocodone/chlorpheniramine er
hydrocodone/homatropin
promethazine vc/codeine
promethazine/dextromethorphan
PREFERRED
DEXTROMETHORPHAN HBR
TUSSICAPS
NON PREFERRED
GUAIFENESIN/CODEINE
HYDROCODONE/HOMATROPIN
PSEUDOEPH/CHLOPHEDIANOL/GG 12.5CPD-100GFN-30PSE
DECONGESTANT / ANTIHISTAMINES
GENERIC
brompheniramine/pseudoephedrine
phenylephrine/chlorpheniramine 10peh-4cpm
pseudoephedrine hcl
pseudoephedrine hcl er
PREFERRED
PSEUDOEPHEDRINE HCL
NON PREFERRED
pseudoephedrine sulfate er
XANTHINES
GENERIC
aminophylline
caffeine/sodium benzoate
difil-g
theophylline anhydrous drops er 12 hr
theophylline anhydrous er
PREFERRED
AMINOPHYLLINE POWDER
THEOPHYLLINE ANHYDROUS POWDER
NON PREFERRED
AMINOPHYLLINE 500MG/20ML AMPUL
BETA AGONISTS ORAL
GENERIC
albuterol sulfate
ephedrine sulfate
metaproterenol sulfate
terbutaline sulfate
PREFERRED
ALBUTEROL
ALBUTEROL SULFATE POWDER
EPHEDRINE SULFATE POWDER
METAPROTERENOL SULFATE POWDER
TERBUTALINE SULFATE POWDER
BETA AGONISTS INHALERS
GENERIC
levalbuterol hcl
PREFERRED
ARCAPTA NEOHALER
FORADIL
LEVALBUTEROL HCL POWDER
PERFOROMIST
PROAIR HFA
PROAIR RESPICLICK
SEREVENT DISKUS
VENTOLIN HFA
INHALED CORTICOSTEROIDS
GENERIC
budesonide
PREFERRED
ASMANEX, HFA
BUDESONIDE POWDER
FLOVENT DISKUS
FLOVENT HFA
PULMICORT FLEXHALER
QVAR
INTRANASAL STEROIDS
GENERIC
flunisolide
triamcinolone acetonide
PREFERRED
DYMISTA
FLUNISOLIDE POWDER
VERAMYST
MISCELLANEOUS PULMONARY AGENTS
GENERIC
acetylcysteine
cromolyn sodium
ipratropium bromide
ipratropium/albuterol nebulization
montelukast sodium
sildenafil citrate
sodium chloride
zafirlukast
PREFERRED
ACETYLCYSTEINE POWDER
ADCIRCA
ADEMPAS
ADVAIR DISKUS
ADVAIR HFA
ANORO ELLIPTA
ARNUITY ELLIPTA
BERINERT
BREO ELLIPTA
CINRYZE
COMBIVENT RESPIMAT
CROMOLYN SODIUM POWDER
DALIRESP
DULERA
FIRAZYR
IPRATROPIUM BROMIDE POWDER
KALBITOR
LETAIRIS
MONTELUKAST SODIUM POWDER
NUCALA
OPSUMIT
ORKAMBI
PULMOZYME
SILDENAFIL CITRATE POWDER
SPIRIVA RESPIMAT
STIOLTO RESPIMAT
SYMBICORT
TRACLEER
TUDORZA PRESSAIR
TYVASO
VENTAVIS
XOLAIR
UROLOGICALS
CHOLINERGIC STIMULANTS
GENERIC
bethanechol chloride
PREFERRED
BETHANECHOL CHLORIDE POWDER
ANTICHOLINERGICS & ANTISPASMODICS
GENERIC
darifenacin er
flavoxate hcl
oxybutynin chloride
oxybutynin chloride er
tolterodine tartrate
trospium chloride er
PREFERRED
GELNIQUE
MYRBETRIQ ER 24 HR
OXYBUTYNIN CHLORIDE POWDER
TOVIAZ
VESICARE
URINARY ANESTHETICS
GENERIC
phenazopyridine hcl
phenazopyridine plus
PREFERRED
PHENAZOPYRIDINE HCL POWDER
MISCELLANEOUS UROLOGICALS
GENERIC
alprostadil
glycine
hyophen
phosphasal
potassium citrate er
tricitrates
uretron d-s
urimar-t
urin d.s.
urogesic
ustell
PREFERRED
ALPROSTADIL POWDER
AMINOACETIC ACID
AMMONIUM CHLORIDE
CAVERJECT
CIALIS
CYSTAGON
ELMIRON
GLYCINE POWDER
K-PHOS ORIGINAL
MUSE
RENACIDIN
VIAGRA
NON PREFERRED
AMINOACETIC ACID POWDER
BENIGN PROSTATIC HYPERPLASIA (BPH) THERAPY
GENERIC
alfuzosin hcl er
finasteride
tamsulosin hcl er 24 hr
PREFERRED
FINASTERIDE POWDER
RAPAFLO
VITAMINS, HEMATINICS & ELECTROLYTES
VITAMINS & HEMATINICS
GENERIC
advanced am/pm
ascorbic acid
bal-care dha
b-complex
cavan-alpha kit
cavan-ec sod dha
centratex
choice-ob + dha
choice-tabs
complete natal dha
corvita
dailyvite
dexferrum
dialyvite 800
elite ob
elite-ob
elite-ob 400
fabb
fe 90 plus
fe c
ferocon
ferotrinsic
ferraplus 90
ferrex 150 forte
ferrex 150 forte plus
ferrex 28
ferrocite plus
ferrogels forte
folbecal
folbee
folbee plus
folbic
folcaps
folcaps omega-3
folic acid
folic acid/cyancobal/pyridoxine
folivane-f
folivane-ob
folivane-plus
folivane-prx dha nf
folplex 2.2
foltanx
hematinic plus
hematinic with folic acid
hematogen
hematogen fa
hematogen forte
hemenatal ob
hemenatal ob + dha
hemetab
hydroxocobalamin
iferex 150 forte
inatal advance
inatal gt
inatal ultra
infed
l-mefolate-pyridox-mecobalamin
l-methyl-b6-b12
l-methylfolate calcium
m.v.i. adult
macnatal cn dha
mefolate-pyridox-mecobalamin
metafolbic
methyl-b6-b12
multigen
multigen folic
multigen plus
multivitamin w/fluoride & iron
multivitamin with fluoride
mynatal
mynatal advance
mynatal caps
mynatal plus
mynatal-z
mynate 90 plus er
mynephrocaps
natal-v rx
natalvirt 90 dha
natalvirt ca
natalvirt flt
nephplex rx
nephro-vite rx
nutri-tab ob
obstetrix dha
pnv ob+dha
pnv-dha
pnv-first
pnv-omega
pnv-select
pnv-total
poly-iron 150 forte
polysaccharide iron forte
pr natal 400
pr natal 400 ec
pr natal 430
pr natal 430 ec
prefol-dha
prena1
prena1 chew
prena1 plus
prenaissance
prenaissance 90 dha
prenaissance balance
prenaissance dha
prenaissance harmony dha
prenaissance next
prenaissance plus
prenaplus
prenatabs fa
prenatabs rx
prenatal ad
prenatal low iron
prenatal plus
prenatal-u
pyridoxine hcl
relnate dha
renal caps
renalpren
rena-vite rx
reno caps
se-natal 19
se-tan dha prenatal
se-tan plus
setonet
setonet ec
strovite
taron forte
taron prenatal
taron-bc
taron-c dha
taron-duo ec
therapeutic hematinic
therapeutic vitamin/minerals
thiamine hcl
tl gard rx
tl g-fol os
tl icon
tl-care dha
tl-fol 500 er
tl-hem 150 er 24 hr
tl-select
tri rx
triadvance
tricon
trigels-f forte
trinatal gt
trinatal rx 1
trinatal ultra
trinate
triphrocaps
triveen-duo dha
triveen-one
triveen-prx rnf
triveen-ten
triveen-u
trust natal dha
ultimate ob dha
ultimatecare one
ultimatecare one nf
v-c forte
vemavite-prx 2
vena-bal dha
venatal complete dha
venatal-fa
vinacal
vinate az
vinate c
vinate calcium
vinate dha
vinate gt
vinate ic
vinate ii
vinate one
vinate ultra
vinate-m
virt-bal dha
virt-bal dha plus
virt-pn
virt-pn dha
virt-pn plus
virt-select
virt-vite
virt-vite forte
vitacirc-b
vitafol-ob
vitafol-pn
vitamin a
v-natal
vol-care rx
vol-nate
vol-plus
vol-tab rx
vp-ch plus
vp-ch-pnv
vp-era ob plus
vp-ggr-b6
vp-heme one
zatean-ch
zatean-pn
zatean-pn dha
zatean-pn plus
zingiber
PREFERRED
AQUASOL A
ASCORBIC ACID
FERAHEME
FOLIC ACID POWDER
HYDROXOCOBALAMIN POWDER
INFUVITE
L-METHYLFOLATE CALCIUM POWEDER
M.V.I. PEDIATRIC
M.V.I.-12
NASCOBAL
PYRIDOXINE HCL
THIAMINE HCL POWDER
TROPHAMINE
VENOFER
VITAMIN A
NON PREFERRED
B-COMPLEX
CENOLATE
CONCEPTION XR MOTILITY
DIALYVITE 800
DULEEK-MET NEW
folbic rf
FOLIC ACID 20MG CAP
FOLIC ACID-VIT B12
PYRIDOXINE HCL 500MG TABLETS
STUART ONE
THIAMINE HCL
VITAMIN A
vitaspire
vynatal-fa
POTASSIUM
GENERIC
pot chloride/dextrose/ns
potassium acetate
potassium bicarbonate
potassium chloride
potassium chloride/dextrose
PREFERRED
POTASSIUM ACETATE
POTASSIUM BICARBONATE
POTASSIUM CHLORIDE
OTHER ELECTROLYTES
GENERIC
calcium acetate
calcium chloride
calcium gluconate
chromium chloride
copper chloride
eliphos
k-phos neutral
magnesium chloride
magnesium sulfate
manganese
manganese sulfate
multitrace-4
nutrilyte
nutrilyte ii
potassium chl-normal saline
ringers
selenium
sodium acetate
sodium chloride
sodium lactate
zinc chloride
zinc sulfate
PREFERRED
ADDAMEL N
CALCIUM ACETATE POWDER
CALCIUM CHLORIDE
CALCIUM GLUCONATE 61MG
CALCIUM GLUCONATE POWDER
CUPRIC SULFATE
GLYCOPHOS
MAGNESIUM CHLORIDE
MAGNESIUM SULFATE
MAGNESIUM SULFATE IN DEXTROSE
MANGANESE SULFATE POWDER
MULTITRACE-4
MULTITRACE-5
NEUT
NORMOSOL-R AND DEXTROSE
PEDITRACE
SODIUM ACETATE POWDER
SODIUM LACTATE
TPN ELECTROLYTES 18-18-5MEQ
TRACE ELEMENTS
ZINC CHLORIDE
ZINC SULFATE
NON PREFERRED
CALCIUM ACETATE
CALCIUM GLUCONATE 50MG
CUPRIC SULFATE
MAGNESIUM SULFATE 100MG CAPSULE
SELENIUM
TPN ELECTROLYTES 35-20-5MEQ
MISCELLANEOUS NUTRITION PRODUCTS
GENERIC
alz-nac
amino acid
freamine iii
hetastarch w/sodium chloride
intralipid
l-methylfolate-mecobalamin-nac
metafolbic plus
premasol
travasol
vp-zel
PREFERRED
AMINOSYN
BAL IN OIL
CLINIMIX
CLINIMIX E
FREAMINE HBC
FREAMINE III
HEPATAMINE
HEPATASOL
IONOSOL B WITH DEXTROSE 5%
ISOLYTE S
NEPHRAMINE
NORMOSOL-M AND DEXTROSE
NORMOSOL-R PH 7.4
PLASMA-LYTE 148
PREMASOL
PROCALAMINE
PROSOL
NON PREFERRED
AMINO ACID 700MG TABLETS
INTRALIPID
METHYLFOLATE MECOBALAMIN-NAC 6-600-2MG
BLOOD DERIVATIVES
GENERIC
albumin
NON PREFERRED
ALBUMIN
DIAGNOSTICS & MISCELLANEOUS AGENTS
MISCELLANEOUS AGENTS
GENERIC
acamprosate calcium
acetic acid irrigation
anagrelide hydrochloride
bupivacaine/dextrose
caffeine citrated
cevimeline hcl
citric acid
deferoxamine
delflex w/dextrose
dextrose in lactated ringers
dextrose in water
dextrose with sodium chloride
disulfiram
etidronate disodium
etomidate
ketamine hcl
levocarnitine
md-gastroview
midodrine hcl
pilocarpine hcl
propofol
riluzole
sodium chloride
sodium phosphate 3mmol/ml vial
sodium polystyrene sulfonate
sodium thiosulfate
water
water intravenous solution
water solution; irrigation
PREFERRED
ACETIC ACID
ADAGEN
AMMONUL
ARALAST NP
BREVITAL
BROMHEXINE HYDROCHLORIDE
BUPHENYL
CAFFEINE CITRATED POWDER
CARBAGLU
CHEMET
CITRIC ACID POWDER
DISULFIRAM POWDER
EOVIST
ETHAMOLIN
ETOMIDATE POWDER
EXJADE
EXTRANEAL ICODEXTRIN DIALYSIS
FERRIPROX
FOSRENOL
HEXTEND LACTATED ELECTROLYTE
INCRELEX
ISOVUE 0.61ML VIAL
ISOVUE-M 0.61ML VIAL
JADENU
KANUMA
KETAMINE HCL POWDER
LEVOCARNITINE POWDER
LEXISCAN
MAGNEVIST VIAL
NATPARA
OMNIPAQUE
ORFADIN
PANHEMATIN
PROHANCE VIAL
PROLASTIN C
RAVICTI
RENVELA
SEROTONIN HCL
SODIUM PHOSPHATE
SODIUM THIOSULFATE
SOLIRIS
SOTRADECOL
STRENSIQ
THALLOUS CHLORIDE TL-201
THYROGEN
TRYPSIN
VELTASSA
VISIPAQUE 270 MG/ML INFUSION
WATER
XIAFLEX
XURIDEN
ZEMAIRA
NON PREFERRED
BUPHENYL POWDER
DELFLEX W/DEXTROSE
ISOVUE
ISOVUE-M 0.41ML VIAL
KETAMINE HCL 50MG/ML SYRINGE
MAGNEVIST SYRINGE
ORFADIN 4MG/ML SUSPENSION
PROHANCE SYRINGE
PROSTAMEN
SODIUM POLYSTYRENE SULFONATE
VISIPAQUE
SMOKING DETERRENTS
PREFERRED
CHANTIX
ANOREXIANTS
GENERIC
benzphetamine hcl
diethylpropion hcl
phendimetrazine tartrate
phendimetrazine tartrate er
phentermine hcl
PREFERRED
DIETHYLPROPION HCL POWDER
PHENTERMINE HCL POWDER
NEUTRACEUTICALS
PREFERRED
UVA URSI LEAF FLUID EXTRACT
IRRIGATING SOLUTIONS
GENERIC
neomycin-polymyxin b
ringers irrigation
ANTIDOTES
PREFERRED
PROTOPAM CHLORIDE
NON PREFERRED
ATROPEN
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