Lista de cobertura integral de medicamentos de Medicaid 2017

Transcripción

1 HorizonBlue.com Lista de cobertura integral de medicamentos de Medicaid 2017 VIGENTE A PARTIR DEL 1.º DE ENERO DE 2017 La lista de medicamentos aprobados para Horizon NJ TotalCare (HMO SNP) incluye una lista adicional de medicamentos cubiertos. Lista de cobertura integral de medicamentos de Medicaid La lista de cobertura integral de medicamentos de Medicaid incluye ciertos medicamentos con receta médica y de venta libre genéricos y de marca que tienen cobertura con la parte Medicaid de su plan. La lista también indica si alguno de estos medicamentos tiene algún límite, como límites de cantidad, o requiere autorización previa. Debe solicitarle a un proveedor (un médico u otro profesional que emita recetas) que le emita la receta. Esta lista comienza en la siguiente página del folleto de la lista de medicamentos aprobados. La lista de medicamentos aprobados puede cambiar en cualquier momento. Recibirá un aviso cuando sea necesario. Horizon Healthcare of New Jersey, Inc. ( HHNJ ) tiene contratos con los Centros de Servicios de Medicare y Medicaid y el Programa de Medicaid del estado de Nueva Jersey para brindar un plan de necesidades especiales doble de Medicare Advantage HMO. La inscripción en Horizon NJ TotalCare (HMO SNP) depende de la renovación contractual. Los productos son proporcionados por HHNJ, no obstante, las comunicaciones son emitidas por Horizon Blue Cross Blue Shield of New Jersey en calidad de administrador de programas y relaciones con proveedores para todas sus compañías. Ambas empresas son licenciatarias independientes de Blue Cross and Blue Shield Association. Los nombres y los símbolos de Blue Cross y Blue Shield son marcas registradas de Blue Cross and Blue Shield Association. Los nombres y los símbolos de Horizon son marcas registradas de Horizon Blue Cross Blue Shield of New Jersey Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey Y0090_H8298_CMC SP

2 A continuación se detalla información adicional para ayudarle a comprender la lista de cobertura de medicamentos. Detalle de abreviaturas de las formas galénicas de 2017 desc descarga ap acción prolongada ad adsorbido mcg microgramo aer, aero aerosol meq miliequivalente ar activado con la mg miligramo respiración bau (bioequivalent allergy ml mililitro units) unidades de alergia bioequivalentes cáp cápsulas mu millones de unidades comp mast comprimidos nebu nebules masticables conc concentrado cdo comprimidos de desintegración oral conj conjugado un, ung ungüento lc liberación controlada of, oft oftálmico cris cristales po, pol polvo lr liberación retardada sc sin conservantes imp impedimento ufp unidades formadoras de placa re recubrimiento entérico prec precargado el análisis de recmb, recomb recombinante inmunoabsorción ligado a enzimas (enzymelinked) lp, prolongada, lib liberación prolongada sl sublingual prolongada, g gramo soln solución h hora supos supositorios li liberación inmediata susp suspensión inh, inhal inhalación ll liberación lenta iny inyección jer jeringa im intramuscular comp comprimidos iv intravenoso td transdérmico l litro tl translingual lf unidades de floculación und unidades líq líquido vac vacuna AP: autorización previa

3 Horizon BCBSNJ 210 Silvia Street West Trenton, NJ horizonnjhealth.com Aviso de no discriminación Horizon Blue Cross Blue Shield of New Jersey cumple con las leyes federales vigentes sobre derechos civiles y no discrimina ni excluye a las personas ni las trata de manera diferente por motivos raza, color, género, nacionalidad, edad, discapacidad, embarazo, identidad sexual, sexo, orientación de género o estado de salud en la administración del plan, lo cual incluye la inscripción y las determinaciones de beneficios. Horizon BCBSNJ ofrece equipos y servicios gratuitos a personas con discapacidades para que se puedan comunicar satisfactoriamente con nosotros, por ejemplo, intérpretes calificados en lenguaje de señas e información escrita en otros idiomas. Cómo comunicarse con el Departamento de Servicios para los Miembros Llame al Departamento de Servicios para los Miembros al (TTY/TDD 711) o al número de teléfono que aparece en el reverso de su tarjeta de identificación de miembro, si necesita los equipos y servicios gratuitos mencionados arriba y para todas las otras cuestiones relacionadas con el Departamento de Servicios para los Miembros, incluso las siguientes: Consultas sobre reclamos, beneficios o inscripción Tarjetas de identificación robadas/extraviadas Cambios en la dirección Cualquier otra consulta relacionada con sus beneficios o el plan de salud Cómo presentar un agravio según la Sección 1557 Si considera que Horizon BCBSNJ no ha prestado los equipos o los servicios gratuitos para comunicación o ha discriminado por motivos de raza, color, género, nacionalidad, edad o discapacidad, puede presentar una queja por discriminación, también conocida como Agravio según la Sección Se puede comunicar con el coordinador de derechos civiles de Horizon BCBSNJ llamando al número del Departamento de Servicios para los Miembros que figura en el reverso de su tarjeta de identificación de miembro o escribiendo a la siguiente dirección: Horizon BCBSNJ Civil Rights Coordinator PO Box 820 Newark, NJ También puede presentar en forma electrónica una queja de derechos civiles ante el Departamento de Salud y Servicios Humanos de EE. UU., Oficina de Derechos Civiles (Office for Civil Rights, OCR), a través de su portal de quejas sobre derechos civiles, disponible en o por correo o teléfono a: Office for Civil Rights Headquarters U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C o (TDD) Los formularios para quejas OCR se encuentran disponibles en Para ayuda en español, llame a (TTY/TDD 711). Licenciatarios independientes de Blue Cross and Blue Shield Association* Horizon NJ Health es un producto de Horizon HMO* CMC B_S(0617)

4 Multi-Language Insert Multi language Interpreter Services ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (TTY/TDD 711). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (TTY/TDD 711). 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (TTY/TDD 711). 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 (TTY/TDD 711) 번으로전화해주십시오. ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (TTY/TDD 711). Ʌચન : જ તમ Ȥજર ત બ લત હ, ત ન:Ƀƣક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલƞધ છ. ફ ન કર (TTY/TDD 711). UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (TTY/TDD 711). ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (TTY/TDD 711). إذا كنت تتحدث اذكر اللغة فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم ملحوظة : ھاتف الصم والبكم 711 ).

5 Ʌ ɇ Ʌ Ʌ ɇ PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (TTY/TDD 711). ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (телетайп 711). ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (TTY/TDD 711). Úय न द: य द आप हद ब लत ह त आपक लए मÝत म भ ष सह यत स व ए उपलÞध ह (TTY/TDD 711) पर क ल कर CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (TTY/TDD 711). ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le (ATS 711). خبردار : اگر آپ اردو بولتے ہيں تو آپ کو زبان کی مدد کی خدمات مفت ميں دستياب ہيں کال کريں (TTY/TDD 711). Y0090_MultiLanguage2017

6 Medicamentos de venta sin receta/suplementos nutricionales acetaminophen cap 500 mg acetaminophen chew tab 80 mg acetaminophen chew tab 160 mg acetaminophen dispersible tab 80 mg acetaminophen dispersible tab 160 mg acetaminophen liquid 160 mg/5ml acetaminophen liquid 167 mg/5ml acetaminophen soln 100 mg/ml acetaminophen soln 160 mg/5ml acetaminophen suppos 80 mg acetaminophen suppos 120 mg acetaminophen suppos 325 mg acetaminophen suppos 650 mg acetaminophen susp 80 mg/0.8ml acetaminophen susp 160 mg/5ml acetaminophen tab cr 650 mg acetaminophen tab 325 mg acetaminophen tab 500 mg acetaminophen w/ dm liq mg/5ml acetaminophen w/ dm liq mg/30ml acetaminophen w/ dm susp mg/5ml acetaminophen w/ pamabrom tab mg acetaminophen-caffeine tab mg acetaminophen-caffeine-pyrilamine tab mg acetaminophen-pamabrom-pyrilamine tab mg acetylcysteine cap 600 mg albumin (urine) test strip allantoin cream 0.2% aloe vera lotion alpha-d-galactosidase capsule alpha-d-galactosidase tablets alum & mag hydroxide-simethicone chew tab mg alum & mag hydroxide-simethicone susp mg/5ml alum & mag hydroxide-simethicone susp mg/5ml aluminum & magnesium hydroxides susp mg/5ml aluminum acetate soln aluminum chloride in alcohol solution 6.25% aluminum hydroxide gel susp 320 mg/5ml aluminum hydroxide oint aluminum hydroxide-magnesium carbonate chew tab mg aluminum hydroxide-magnesium carbonate susp mg/10ml aluminum hydroxide-magnesium carbonate susp mg/15ml aluminum hydroxide-magnesium trisilicate chew tab mg aluminum sulfate & calcium acetate powd pack amino acids oral powder amino acids pack amino acids-protein hydrolysate liquid antiseborrheic products misc - liquid arginine hcl (bulk) powder artificial saliva - solution artificial tear ophth ointment artificial tear ophth solution ascorbic acid cap cr 500 mg ascorbic acid chew tab 250 mg ascorbic acid chew tab 500 mg ascorbic acid chew tab 1000 mg ascorbic acid syrup 500 mg/5ml ascorbic acid tab cr 500 mg ascorbic acid tab cr 1000 mg ascorbic acid tab 100 mg ascorbic acid tab 250 mg ascorbic acid tab 500 mg ascorbic acid tab 1000 mg aspirin buffered (ca carb-mg carb-mg ox) tab 325 mg aspirin chew tab 81 mg aspirin effer tab 325 mg aspirin suppos 300 mg aspirin tab delayed release 81 mg aspirin tab delayed release 325 mg aspirin tab 81 mg aspirin tab 325 mg aspirin tab 500 mg aspirin-acetaminophen-caffeine tab mg 1

7 b-complex vitamin cap b-complex vitamin sublingual liquid b-complex vitamin tab b-complex w/ c & calcium tab b-complex w/ c & e + zn tab b-complex w/ c & folic acid liquid 0.9 mg/15ml b-complex w/ c & folic acid liquid 0.9 mg/5ml b-complex w/ c & folic acid tab b-complex w/ c & folic acid tab 0.8 mg b-complex w/ c & folic acid tab 1 mg b-complex w/ c cap b-complex w/ c tab b-complex w/ c tab cr b-complex w/ c-biotin-vit e & folic acid tab 0.4 mg b-complex w/ c-zn & folic acid tab 0.8 mg b-complex w/ folic acid tab b-complex w/ minerals liq b-complex w/ minerals tab b-complex w/biotin & folic acid tab b-complex w/biotin & folic acid tab cr bacitracin oint 500 unit/gm bacitracin zinc oint 500 unit/gm bacitracin-polymyxin b oint bacitracin-pramoxine hcl oint 500 unit/gm-10 mg/gm banana flakes pack benzethonium chloride liquid 0.1% benzethonium chloride liquid 0.13% benzethonium chloride soln 0.2% benzocaine dental cream 20% benzocaine dental for susp 10% benzocaine dental gel 7.5% benzocaine dental gel 10% benzocaine dental gel 20% benzocaine dental liquid 10% benzocaine dental liquid 20% benzocaine oint 20% benzocaine rectal ointment 20% benzocaine-docusate sodium rectal enema mg benzocaine-menthol lozenge mg benzocaine-menthol lozenge mg benzocaine-resorcinol vaginal cream 5-2% benzocaine-resorcinol vaginal cream 20-3% benzocaine-triclosan aerosol % benzoin compound tincture benzonatate cap 150 mg benzonatate cap 100 mg benzonatate cap 200 mg benzoyl peroxide bar 10% benzoyl peroxide creamy wash 4% &benzoyl peroxide bar 5% kit benzoyl peroxide cream 2.5% benzoyl peroxide cream 10% benzoyl peroxide foam 5.3% benzoyl peroxide gel 2.5% benzoyl peroxide gel 7% benzoyl peroxide gel 5% benzoyl peroxide gel 10% benzoyl peroxide liq 4% benzoyl peroxide liq 5% benzoyl peroxide liq 10% benzoyl peroxide lotion 10% benzoyl peroxide lotion 5% benzoyl peroxide lotion 6% bioflavonoid products chew tab bioflavonoid products tab bioflavonoid products tab cr biotin cap 2.5 mg biotin cap 5 mg biotin liquid 5 mg/m biotin tab 10 mg biotin tab 300 mcg biotin tab 1000 mcg biotin tab 5 mg bisacodyl enema 10 mg/30ml bisacodyl suppos 10 mg bisacodyl tab delayed release 5 mg bismuth subsalicylate chew tab 262 mg bismuth subsalicylate susp 262 mg/15ml bismuth subsalicylate susp 525 mg/15ml bismuth subsalicylate tab 262 mg brompheniramine & phenylephrine elixir mg/5ml brompheniramine & pseudoephedrine elixir 1-15 mg/5ml 2

8 caffeine tab 200 mg calamine lotion calamine phenolated lotion calamine-zinc oxide lotion calamine-zinc oxide susp 8-8% calcium & phosphorus w/ vit d chew tab 250 mg-107 mg-500 unt calcium & phosphorus w/ vit d chew tab 250 mg-115 mg-250 unt calcium alginate wound dressing calcium ascorbate tab 500 mg calcium carb-vit d w/ minerals chew tab 600 mg-400 unit calcium carb-vit d w/ minerals chew tab 600 mg-800 unit calcium carb-vit d w/ minerals tabs 600 mg-200 unit calcium carb-vit d w/ minerals tabs 600 mg-400 unit calcium carb-vit d w/ minerals tabs 600 mg-800 unit calcium carbonate (antacid) chew tab 400 mg calcium carbonate (antacid) chew tab 420 mg calcium carbonate (antacid) chew tab 500 mg calcium carbonate (antacid) chew tab 750 mg calcium carbonate (antacid) chew tab 1000 mg calcium carbonate (antacid) tab 648 mg calcium carbonate cap 1250 mg (500 mg elemental ca) calcium carbonate chew tab 1250 mg (500 mg elemental ca) calcium carbonate chew tab 260 mg (elemental ca) calcium carbonate susp 1250 mg/5ml (500 mg/5ml elemental ca) calcium carbonate tab 600 mg calcium carbonate tab 1250 mg (500 mg elemental ca) calcium carbonate tab 1500 mg (600 mg elemental ca) calcium carbonate-cholecalciferol cap 600 mg-400 unit calcium carbonate-cholecalciferol cap 600 mg-500 unit calcium carbonate-cholecalciferol chew tab 600 mg-800 unit calcium carbonate-cholecalciferol chew tab 500 mg-100 unit calcium carbonate-cholecalciferol chew tab 500 mg-400 unit calcium carbonate-cholecalciferol tab 1000 mg-800 unit calcium carbonate-cholecalciferol tab 90 mg-400 unit calcium carbonate-cholecalciferol tab 250 mg-125 unit calcium carbonate-cholecalciferol tab 500 mg-125 unit calcium carbonate-cholecalciferol tab 500 mg-200 unit calcium carbonate-cholecalciferol tab 500 mg-400 unit calcium carbonate-cholecalciferol tab 500 mg-600 unit calcium carbonate-cholecalciferol tab 600 mg-200 unit calcium carbonate-cholecalciferol tab 600 mg-400 unit calcium carbonate-cholecalciferol tab 600 mg-800 unit calcium carbonate-ergocalciferol tab 250 mg-125 unit calcium carbonate-ergocalciferol tab 500mg-200 unit calcium carbonate-mag hydroxide chew tab mg calcium carbonate-mag hydroxide susp mg/5ml calcium carbonate-simethicone chew tab mg calcium carbonate-vitamin d cap 600 mg-200 unit calcium carbonate-vitamin d chew tab 600 mg-400 unit calcium carbonate-vitamin d tab 250 mg-125 unit calcium carbonate-vitamin d tab 500 mg-125 unit calcium carbonate-vitamin d tab 500 mg-200 unit calcium carbonate-vitamin d tab 500 mg-400 unit calcium carbonate-vitamin d tab 600 mg-200 unit calcium carbonate-vitamin d tab 600 mg-400 unit calcium citrate tab 250 mg calcium citrate tab 950 mg (200 mg elemental ca) calcium citrate-vitamin d tab 200 mg-125 unit (elemental ca) calcium citrate-vitamin d tab 250 mg-100 unit (elemental ca) calcium citrate-vitamin d tab 200 mg-250 unit (elemental ca) calcium citrate-vitamin d tab 250 mg-200 unit (elemental ca) calcium citrate-vitamin d tab 315 mg-200 unit (elemental ca) calcium citrate-vitamin d tab 315 mg-250 unit (elemental ca) calcium glubionate syrup 1.8 gm/5ml calcium gluconate tab 500 mg 3

9 calcium pantothenate tab 500 mg calcium phosphate-cholecalciferol chew tab 250 mg-400 unit calcium polycarbophil tab 625 mg calcium w/ magnesium tab mg calcium w/ vitamin c & d chew tab 500 mg-10 mg-250 unit calcium w/ vitamin d & k chew tab 500 mg-100 unit-40 mcg calcium w/ vitamin d & k chew tab 500 mg-200 unit-40 mcg calcium w/ vitamin d & k chew tab 500 mg-500 unit-40 mcg calcium w/ vitamin d & k chew tab 500 mg-1000 unit-40 mcg calcium w/ vitamin d tab 600 mg-200 unit calcium-boron tab mg calcium-cholecalciferol tab 200 mg-250 unit calcium-magnesium w/ vit d tab sr 24hr 600 mg-40 mg-500 unit calcium-magnesium w/ vit d tab 400 mg mg unit calcium-magnesium w/ vitamin d tab 500 mg-250 mg-200 unit calcium-magnesium-zinc tab mg calcium-magnesium-zinc tab mg camphor & menthol gel % camphor & menthol lotion % camphor gel 0.45% camphor-eucalyptus-menthol - oint camphor-menthol-methyl salicylate cream % camphor-menthol-methyl salicylate gel % capsaicin cream 0.025% capsaicin cream 0.075% capsaicin cream 0.1% capsaicin pad 0.025% capsaicin-menthol gel % capsicum oleoresin cream 0.025% carbamide peroxide soln 10% carbamide peroxide 6.5% otic soln carbonyl iron chew tab 15 mg (elemental iron) carbonyl iron tab 25 mg (elemental iron) carbonyl iron tab 45 mg (elemental iron) carboxymethylcell-glycerin-polysorb 80 ophth soln % carboxymethylcellulose sodium ophth gel 1% carboxymethylcellulose sodium ophth soln 0.25% carboxymethylcellulose sodium ophth soln 0.5% carboxymethylcellulose sodium ophth soln 1% carboxymethylcellulose-glycerin ophth soln % carboxymethylcellulose-hypromellose gel % cetirizine hcl chew tab 5 mg cetirizine hcl chew tab 10 mg cetirizine hcl tab 5 mg cetirizine hcl tab 10 mg cetirizine-pseudoephedrine tab sr 12hr mg charcoal activated cap 260 mg chlorhexidine gluconate liquid 2% chlorhexidine gluconate liquid 4% chlorphen-phenylephrine w/ apap tab mg chlorpheniramine & phenylephrine tab 4-10 mg chlorpheniramine maleate syrup 2 mg/5ml chlorpheniramine maleate tab cr 12 mg chlorpheniramine maleate tab 4 mg chlorpheniramine-dm liquid mg/5ml chlorpheniramine-dm liquid 2-15 mg/15ml chlorpheniramine-dm liquid 2-15 mg/5ml chlorpheniramine-dm syrup mg/5ml chlorpheniramine-dm tab 4-30 mg chlorpheniramine-pseudoephedrine-ibuprofen tab mg cholecalciferol cap 4000 unit cholecalciferol cap 400 unit cholecalciferol cap 1000 unit cholecalciferol cap 2000 unit cholecalciferol cap 5000 unit cholecalciferol cap unit cholecalciferol cap unit cholecalciferol chew tab 400 unit cholecalciferol chew tab 1000 unit cholecalciferol chewable wafer unit cholecalciferol chewable wafer unit cholecalciferol drops 5000 unit/ml (1000 unit/0.2ml) cholecalciferol oral liquid 400 unit/ml 4

10 cholecalciferol tab 3000 unit cholecalciferol tab 400 unit cholecalciferol tab 1000 unit cholecalciferol tab 2000 unit cholecalciferol tab 5000 unit cholecalciferol tab unit chromium picolinate cap 200 mcg chromium tab 200 mcg clotrimazole vaginal cream 1% clotrimazole vaginal cream 2% coal tar oint 2% coal tar shampoo 0.5% coal tar shampoo 2.5% coal tar-salicylic acid shamp 10-5% cobalamine combination tab cobalamine combination tab sl cocoa butter cod liver oil cod liver oil cap coenzyme q10 cap 100 mg coenzyme q10 cap 200 mg colloidal oatmeal cream 1% colloidal oatmeal packet control gel formula - dressing corn dextrin oral powder cranberry (vaccinium macrocarpon) cap 200 mg cranberry (vaccinium macrocarpon) cap 250 mg cranberry-vitamin c-probiotic tab mg cromolyn sodium nasal aerosol soln 5.2 mg/act (4%) cyanocobalamin inj 1000 mcg/ml cyanocobalamin liquid 1000 mcg/ml cyanocobalamin lozenge 500 mcg cyanocobalamin orally disintegrating tab 1500 mcg cyanocobalamin sublingual liquid 5000 mcg/ml cyanocobalamin tab cr 1000 mcg cyanocobalamin tab cr 2000 mcg cyanocobalamin tab sl 500 mcg cyanocobalamin tab sl 1000 mcg cyanocobalamin tab sl 2500 mcg cyanocobalamin tab sl 5000 mcg cyanocobalamin tab 2500 mcg cyanocobalamin tab 100 mcg cyanocobalamin tab 250 mcg cyanocobalamin tab 500 mcg cyanocobalamin tab 1000 mcg cyanocobalamin tab 2000 mcg dakin's solution 0.25% (half strength) dextromethorphan hbr cap 15 mg dextromethorphan hbr liquid 10 mg/5ml dextromethorphan hbr liquid 15 mg/5ml dextromethorphan hbr syrup 7.5 mg/5ml dextromethorphan hbr syrup 15 mg/5ml dextromethorphan polistirex liquid cr 30 mg/5ml dextromethorphan-apap-chlorpheniramine susp mg/5ml dextromethorphan-doxylamine-apap cap mg dextromethorphan-doxylamine-apap liquid mg/30ml dextromethorphan-guaifenesin cap mg dextromethorphan-guaifenesin granules packet mg dextromethorphan-guaifenesin liquid mg/5ml dextromethorphan-guaifenesin liquid mg/5ml dextromethorphan-guaifenesin liquid mg/5ml dextromethorphan-guaifenesin liquid mg/5ml dextromethorphan-guaifenesin syrup mg/5ml dextromethorphan-guaifenesin tab sr 12hr mg dextromethorphan-guaifenesin tab sr 12hr mg dextromethorphan-guaifenesin tab mg dextromethorphan-phenylephrine-apap cap mg dextromethorphan-phenylephrine-apap liqd mg/15ml dextromethorphan-phenylephrine-apap tab mg diaper rash products - ointment dibucaine oint 1% dibucaine rectal ointment 1% dietary management product - packet dimenhydrinate tab 50 mg dimethicone cream 1.5% 5

11 dimethicone cream 1% dimethicone cream 5% dimethicone lotion 1% dimethicone lotion 1.3% dimethicone ointment 1% dimethicone-zinc oxide-vitamin a-vitamin d cream 1-10% diphenhydramine hcl (sleep) cap 25 mg diphenhydramine hcl (sleep) cap 50 mg diphenhydramine hcl (sleep) liquid 50 mg/30ml diphenhydramine hcl (sleep) tab 25 mg diphenhydramine hcl (sleep) tab 50 mg diphenhydramine hcl cap 25 mg diphenhydramine hcl cap 50 mg diphenhydramine hcl chew tab 12.5 mg diphenhydramine hcl cream 2% diphenhydramine hcl gel 2% diphenhydramine hcl liquid 12.5 mg/5ml diphenhydramine hcl syrup 12.5 mg/5ml diphenhydramine hcl tab disp 12.5 mg diphenhydramine hcl tab 25 mg diphenhydramine-acetaminophen tab mg (sleep) diphenhydramine-acetaminophen tab mg (sleep) diphenhydramine-phenylephrine liq mg/5ml diphenhydramine-phenylephrine syrup mg/5ml diphenhydramine-phenylephrine tab mg diphenhydramine-phenylephrine-apap tab mg diphenhydramine-zinc acetate cream 1-0.1% diphenhydramine-zinc acetate cream 2-0.1% diphenhydramine-zinc acetate liquid 2-0.1% docosahexaenoic acid cap 200 mg docosanol cream 10% docusate calcium cap 240 mg docusate sodium cap 50 mg docusate sodium cap 100 mg docusate sodium cap 250 mg docusate sodium enema 283 mg docusate sodium liquid 150 mg/15ml docusate sodium syrup 60 mg/15ml docusate sodium tab 100 mg doxylamine succinate (sleep) tab 25 mg doxylamine-dm liquid mg/15ml dyclonine hcl-benzethonium cl liqd % emollient - cream emollient - lotion emollient - ointment ergocalciferol cap unit ergocalciferol soln 8000 unit/ml ergocalciferol tab 2000 unit ergocalciferol tab 400 unit eyelid cleansers - foam eyelid cleansers - pads famotidine tab 10 mg famotidine-ca carbonate-mag hydroxide chew tab mg fe asp gly-fe polysacc-succ ac-c-threon ac cap fe fum-fe polysac-c-b3 cap mg (125 mg fe) ferrous fum-iron polysacch cap mg (106 mg fe) ferrous fumarate tab 325 mg (106 mg elemental fe) ferrous gluconate tab 256 mg (28 mg elemental fe) ferrous gluconate tab 324 mg (38 mg elemental iron) ferrous gluconate tab 240 mg (27 mg elemental fe) ferrous gluconate tab 324 mg (37.5 mg elemental iron) ferrous gluconate tab 325 mg (36 mg elemental fe) ferrous sulfate dried tab cr 45 mg (fe equivalent) ferrous sulfate dried tab cr 160 mg (50 mg fe equivalent) ferrous sulfate dried tab 200 mg (65 mg elemental fe) ferrous sulfate elixir 220 mg/5ml (44 mg/5ml elemental fe) ferrous sulfate liquid 220 mg/5ml (44 mg/5ml elemental fe) ferrous sulfate soln 75 mg/ml (15 mg/ml elemental fe) ferrous sulfate syrup 300 mg/5ml (60 mg/5ml elemental fe) ferrous sulfate tab cr 140 mg (45 mg fe equivalent) ferrous sulfate tab cr 142 mg (45 mg fe equivalent) ferrous sulfate tab cr 143 mg (45 mg fe equivalent) 6

12 ferrous sulfate tab cr 47.5 mg (elemental fe) ferrous sulfate tab cr 50 mg (elemental fe) ferrous sulfate tab ec 324 mg (65 mg fe equivalent) ferrous sulfate tab ec 325 mg (65 mg fe equivalent) ferrous sulfate tab 90 mg (18 mg elemental fe) ferrous sulfate tab 27 mg (elemental fe) ferrous sulfate tab 325 mg (65 mg elemental fe) ferrous sulfate-vit c-folic acid tab cr mg fexofenadine hcl orally disintegrating tab 30 mg fexofenadine hcl susp 30 mg/5ml (6 mg/ml) fexofenadine hcl tab 60 mg fexofenadine hcl tab 180 mg fexofenadine-pseudoephedrine tab sr 12hr mg fexofenadine-pseudoephedrine tab sr 24hr mg fish oil-cholecalciferol cap 1000 mg-1000 unit folic ac-vit b2-vit b6-vit b12-vit d-calc-phosphorus tab folic acid tab 400 mcg folic acid tab 800 mcg folic acid tab 1 mg folic acid-vitamin b6-vitamin b12 tab mg folic acid-vitamin b6-vitamin b12 tab mg fructose-dextrose-phosphoric acid oral soln gentian violet soln 1% gentian violet soln 2% glucose chew tab 1 gm glucose chew tab 4 gm glucose gel 40% glucose gel 77.4% glucose-cholecalciferol oral gel glucose-cholecalciferol oral liquid glucose-vitamin c chew tab gm glucose-vitamin c-vitamin d chew tab glycerin enema adult 5.4 gm/average delivered dose glycerin liquid glycerin liquid suppos 2.8 gm (2.7 ml) glycerin suppos 1 gm glycerin suppos 1.2 gm glycerin suppos 2 gm glycerin suppos 2.1 gm glycerin suppos 80.7% glycerin topical liquid glycerin-hypromellose-peg 400 ophth soln % glycerin-hypromellose-peg 400 ophth soln % guaifenesin granules packet 100 mg guaifenesin liquid 100 mg/5ml guaifenesin syrup 100 mg/5ml guaifenesin tab sr 12hr 600 mg guaifenesin tab sr 12hr 1200 mg guaifenesin tab 200 mg guaifenesin tab 400 mg guaifenesin-codeine soln mg/5ml guar gum oral powder guar gum packet hydroactive (sterile) dressing hydroactive (sterile) gel hydrocortisone acetate cream 0.5% hydrocortisone cream 0.5% hydrocortisone gel 1% hydrocortisone lotion 1% hydrocortisone oint 0.5% hydrocortisone soln 1% hydrocortisone-aloe vera cream 0.5% hydrocortisone-aloe vera cream 1% hyoscyamine sulfate tab mg hypertonic nasal wash - packet hypromellose ophth gel 0.3% hypromellose ophth soln 0.2% hypromellose ophth soln 0.5% hypromellose ophth soln 0.3% hypromellose ophth soln 0.4% ibuprofen cap 200 mg ibuprofen chew tab 100 mg ibuprofen susp 40 mg/ml ibuprofen tab 100 mg ibuprofen tab 200 mg ibuprofen-diphenhydramine citrate tab mg ichthammol oint 20% incontinent cleanser - liquid incontinent cleanser - lotion infant foods conc 7

13 infant foods liquid infant foods packet infant foods powder inositol niacinate cap 500 mg iodine tincture iron succinyl-protein complex soln 40mg/15ml (element fe eq) iron-vit c-vit b12-folic acid tab mg iron-vitamin c tab mg iron-vitamin c tab mg isopropyl alcohol otic liquid 95% isopropyl alcohol wipes 70% ketoconazole shampoo 1% ketotifen fumarate ophth soln 0.025% lactic acid (ammonium lactate) lotion 5% lactobacillus - packet lactobacillus - wafer lactobacillus acidophilus-pectin cap lactobacillus acidophilus-pectin tab lactobacillus cap lactobacillus chew tab lactobacillus rhamnosus (gg) cap lactobacillus rhamnosus (gg) packet lactobacillus tab lactobacillus-inulin cap lanolin cream lidocaine aerosol 0.5% lidocaine anorectal cream 5% lidocaine cream 4% lidocaine cream 4% & transparent dressing kit lidocaine hcl gel 0.5% light mineral oil-mineral oil ophth emulsion % loperamide hcl liq 1 mg/7.5ml loperamide hcl liq 1 mg/5ml (0.2 mg/ml) loperamide hcl tab 2 mg loperamide-simethicone tab mg loratadine & pseudoephedrine tab sr 12hr mg loratadine & pseudoephedrine tab sr 24hr mg loratadine orally disintegrating tab 5 mg loratadine rapidly-disintegrating tab 10 mg loratadine syrup 5 mg/5ml loratadine tab 10 mg magnesium cap 300 mg magnesium chloride tab cr 535 mg (64 mg elemental mg) magnesium chloride-calcium tab dr mg magnesium citrate soln magnesium cl-ca carbonate tab dr mg (elemental) magnesium gluconate liquid 1000 mg/5ml (54 mg/5ml magnesium) magnesium gluconate tab 500 mg magnesium gluconate tab 500 mg (27 mg elemental mg) magnesium gluconate tab 27.5 mg (elemental mg) magnesium hydroxide chew tab 311 mg magnesium hydroxide chew tab 400 mg magnesium hydroxide susp concentrate 2400 mg/10ml magnesium hydroxide susp 400 mg/5ml magnesium lactate tab cr 84 mg (elemental mg) (7 meq) magnesium oxide (laxative) tab 500 mg magnesium oxide cap 140 mg (85 mg elemental mg) magnesium oxide cap 400 mg magnesium oxide cap 400 mg (elemental mg) (mg supplement) magnesium oxide cap 500 mg magnesium oxide cap 500 mg (elemental mg) magnesium oxide tab 250 mg magnesium oxide tab 400 mg magnesium oxide tab 420 mg magnesium oxide tab 400 mg (240 mg elemental mg) magnesium oxide tab 400 mg (241.3 mg elemental mg) magnesium oxide tab 250 mg (mg supplement) magnesium oxide tab 500 mg (mg supplement) magnesium oxide-pyridoxine hcl tab mg magnesium sulfate granules magnesium sulfate oral granules magnesium tab 200 mg magnesium tab 250 mg maltodextrin-xanthan gum oral thickening powder 8

14 meclizine hcl chew tab 25 mg medium chain triglycerides oral emulsion medium chain triglycerides oral oil melatonin cap 5 mg melatonin cap 10 mg melatonin liquid 1 mg/4ml (2.5 mg/10ml) melatonin liquid 5 mg/15ml melatonin liquid 1 mg/ml melatonin sl tab 5 mg melatonin tab cr 10 mg melatonin tab cr 3 mg melatonin tab 300 mcg melatonin tab 1 mg melatonin tab 3 mg melatonin tab 5 mg melatonin-pyridoxine tab cr 3-10 mg melatonin-pyridoxine tab cr 5-10 mg melatonin-pyridoxine tab 1-10 mg melatonin-pyridoxine tab 3-10 mg melatonin-pyridoxine tab 3-1 mg melatonin-pyridoxine tab 3-2 mg melatonin-pyridoxine tab 5-1 mg menthol cream 16% menthol gel 10% menthol gel 7% menthol gel 2% menthol gel 2.5% menthol gel 16% menthol liquid 16% menthol lotion 0.1% menthol lozenge 7 mg menthol patch 5% menthol-methyl salicylate cream menthol-methyl salicylate ointment menthol-zinc oxide oint % menthol-zinc oxide oint % menthol-zinc oxide powder methenamine-sodium salicylate tab mg methylcellulose powder laxative methylcellulose tab 500 mg methylcobalamin tab sl 1000 mcg miconazole nit va app 100 mg (2%) & 2% cream & wipes kit miconazole nitrate aerosol pow 2% miconazole nitrate aerosol 2% miconazole nitrate cream 2% miconazole nitrate kit 2% miconazole nitrate ointment 2% miconazole nitrate powder 2% miconazole nitrate soln 2% miconazole nitrate va supp 1200 mg & 2% cream & wipes kit miconazole nitrate vaginal cream 2% miconazole nitrate vaginal cream 4% (200 mg/5gm) miconazole nitrate vaginal suppos 100 mg miconazole nitrate vaginal supp 200 mg & 2% cream 9 gm kit miconazole nitrate vaginal supp 1200 mg & 2% cream kit mineral oil mineral oil emul 50% mineral oil enema mineral oil light (topical) mineral oil-hydrophilic petrolatum ointment misc natural product nasal soln multiple minerals w/ vitamins chew tab multiple minerals w/ vitamins tab multiple vitamin cap multiple vitamin tab multiple vitamins w/ calcium tab multiple vitamins w/ iron tab multiple vitamins w/ minerals cap multiple vitamins w/ minerals chew tab multiple vitamins w/ minerals effer tab multiple vitamins w/ minerals liquid multiple vitamins w/ minerals lozenge multiple vitamins w/ minerals powder multiple vitamins w/ minerals tab naphazoline w/ pheniramine ophth soln % naphazoline w/ pheniramine ophth soln % naphazoline-glycerin ophth soln % naphazoline-glycerin ophth soln % 9

15 naphazoline-glycerin-zinc sulf ophth soln % naphazoline-polyethylene glycol 300 ophth soln % naproxen sodium cap 220 mg naproxen sodium tab 220 mg neomycin-bacitracin-polymyxin oint neomycin-bacitracin-polymyxin-pramoxine oint 1% neomycin-polymyxin w/ pramoxine cream 1% niacin cap cr 250 mg niacin cap cr 500 mg niacin tab cr 1000 mg niacin tab cr 250 mg niacin tab cr 500 mg niacin tab cr 750 mg niacin tab 50 mg niacin tab 100 mg niacin tab 250 mg niacin tab 500 mg niacin w/ inositol cap mg niacinamide tab 100 mg niacinamide tab 500 mg nicotine polacrilex gum 2 mg nicotine polacrilex gum 4 mg nicotine polacrilex lozenge 2 mg nicotine polacrilex lozenge 4 mg nicotine td patch 24 hr kit mg/24hr nicotine td patch 24hr 7 mg/24hr nicotine td patch 24hr 14 mg/24hr nicotine td patch 24hr 21 mg/24hr nonoxynol-9 film 28% nonoxynol-9 gel 3% nonoxynol-9 gel 4% nutritional supplement bar nutritional supplement caps nutritional supplement chew tab nutritional supplement flavor pack nutritional supplement kit nutritional supplement liquid nutritional supplement liquid (frozen) nutritional supplement misc nutritional supplement pack nutritional supplement powder nutritional supplement pudding nutritional supplement susp nutritional supplement tabs nutritional supplement tabs delayed release nutritional supplement therapy pack omega fatty acids-vitamins - chew tab omega 3-omega 6-omega 9 fatty acids cap omega-3 fatty acids - oral emulsion omega-3 fatty acids cap delayed release 1400 mg omega-3 fatty acids cap 1400 mg omega-3 fatty acids cap mg omega-3 fatty acids chew tab mg omega-3 fatty acids cap 500 mg omega-3 fatty acids cap 300 mg omega-3 fatty acids cap 1000 mg omega-3 fatty acids cap 1200 mg omega-3 fatty acids cap delayed release 1000 mg omega-3 fatty acids cap delayed release 1200 mg omeprazole delayed release tab 20 mg omeprazole magnesium cap dr 20.6 mg (20 mg base equiv) omeprazole magnesium delayed release tab 20 mg ophthalmic irrigation solution oral electrolyte - packet oral electrolyte solution oral electrolyte tab oxymetazoline hcl nasal soln 0.05% oxyquinolone sulfate-ph 4 vaginal gel 0.025% oyster shell calcium tab 500 mg panthenol-glycerin-dimethicone cream pe-dm-apap cap & doxylamine-dm-apap cap day/night ther pack pediatric multiple vitamin chew tab pediatric multiple vitamin liq pediatric multiple vitamin w/ c & fa chew tab pediatric multiple vitamin w/ c soln 35 mg/ml pediatric multiple vitamin w/ extra c & fa chew tab pediatric multiple vitamin w/ minerals & c chew tab pediatric multiple vitamin w/ minerals & c chew tab 60 mg 10

16 pediatric multiple vitamin w/ minerals & c drops 45 mg/ ml pediatric multiple vitamin w/ minerals oral powder pediatric multiple vitamins w/ iron chew tab pediatric multiple vitamins w/ iron chew tab 12 mg pediatric multiple vitamins w/ iron chew tab 15 mg pediatric multiple vitamins w/ iron drops 10 mg/ml pediatric vitamins acd w/ iron susp 10 mg/2ml pediatric vitamins adc drops 1500 unit-400 unit-35 mg/ ml pediatric vitamins adc drops 750 unit-400 unit-35 mg/ ml permethrin aerosol 0.5% permethrin creme rinse 1% permethrin lotion 1% permethrin spray & pyrethins-piperonyl butoxide shamp kit petrolatum ointment petrolatum-zinc oxide oint 49-15% phenazopyridine hcl tab 95 mg phenazopyridine hcl tab 100 mg phenazopyridine hcl tab 200 mg phenazopyridine hcl tab 97.5 mg phenol liquid 0.5% phenol liquid 1.4% phenyleph-chlorphen-dm w/apap susp mg/5ml phenyleph-shark liver oil-cocoa butter suppos % phenylephrine hcl nasal soln 0.125% phenylephrine hcl nasal soln 0.5% phenylephrine hcl nasal soln 0.25% phenylephrine hcl nasal soln 1% phenylephrine hcl soln 2.5 mg/5ml phenylephrine hcl tab 10 mg phenylephrine in hard fat rectal suppos 0.25% phenylephrine w/ acetaminophen tab mg phenylephrine w/ dm-gg liqd mg/5ml phenylephrine w/ dm-gg liqd mg/5ml phenylephrine w/ dm-gg liqd mg/5ml phenylephrine w/ dm-gg liqd mg/5ml phenylephrine w/ dm-gg syrup mg/5ml phenylephrine-apap-gg tab mg phenylephrine-brompheniramine-dm elixir mg/5ml phenylephrine-brompheniramine-dm liquid mg/5ml phenylephrine-brompheniramine-dm syrup mg/5ml phenylephrine-chlorphen-dm liquid mg/5ml phenylephrine-chlorphen-dm liquid mg/ml phenylephrine-cocoa butter suppos % phenylephrine-dm soln mg/5ml phenylephrine-dm syrup mg/5ml phenylephrine-dm-gg w/ apap liq mg/10ml phenylephrine-dm-gg w/ apap tab mg phenylephrine-dm-gg w/ apap tab mg phenylephrine-doxylamine-dm-apap liq mg/15ml phenylephrine-guaifenesin liqd mg/5ml phenylephrine-guaifenesin liqd mg/5ml phenylephrine-guaifenesin tab mg phenylephrine-shark liver oil-glyc-pet cream % phenylephrine-shark liver oil-mo-pet oint % phenylephrine-witch hazel rectal gel % phenyltoloxamine-acetaminophen tab mg phytonadione tab 100 mcg plant sterols and stanols tab 450 mg podiatric products - cream polyethylene glycol-propylene glycol ophth gel % polyethylene glycol-propylene glycol ophth soln % polysacch fe complex-cholecalciferol liq mgunit/5ml polysaccharide fe complex-fe heme polypeptide tab 28 mg polysaccharide iron complex cap 150 mg (iron equivalent) polysaccharide iron complex liquid 15 mg/ml (fe equiv) polyvinyl alcohol ophth soln 1.4% polyvinyl alcohol-povidone ophth soln 2.7-2% 11

17 polyvinyl alcohol-povidone ophth soln 5-6 mg/ml ( %) polyvinyl alcohol-povidone ophth soln % potassium & sodium phosphates powder pack mg potassium gluconate tab 595 mg (99 mg equiv k) potassium tab 99 mg povidone-iodine oint 10% povidone-iodine soln 7.5% povidone-iodine soln 10% povidone-iodine swabs 10% powders pramox-pe-glycerin-petrolatum rectal cream % pramoxine hcl lotion 1% pramoxine hcl rectal foam 1% pramoxine hcl wipes 1% pramoxine-calamine lotion 1-8% pramoxine-menthol cream 1-1% pramoxine-zinc acetate lotion 1-0.1% prenat w/ fe fum-fa tab mg & omega 3 cap 223 mg pak prenat w/ fe fum-fa tab mg & omega 3 cap 440 mg pak prenatal multivitamins & minerals w/iron & fa tab 0.8 mg prenatal vit w/ fe carbonyl-fa-omega 3 cap mg prenatal vit w/ fe fumarate-fa tab mg prenatal vit w/ fe fumarate-fa tab mg prenatal vit w/ fe fumarate-fa tab mg prenatal w/fe fum-fa tab mg & dha cap 200 mg pack probiotic product - cap probiotic product - chew tab probiotic product - tab promethazine w/ codeine syrup mg/5ml promethazine-dm syrup mg/5ml propylene glycol ophth soln 0.6% propylene glycol-glycerin ophth soln % propylene glycol-glycerin ophth soln 1-0.3% protein oral pack protein oral powder protein powder 80% pseudoeph-doxylamine-dm w/apap liq mg/30ml pseudoephed-bromphen-dm elixir mg/5ml pseudoephed-bromphen-dm syrup mg/5ml pseudoephed-chlorphen-dm liq mg/5ml pseudoephedrine hcl liq 15 mg/5ml pseudoephedrine hcl syrup 30 mg/5ml pseudoephedrine hcl tab sr 12hr 120 mg pseudoephedrine hcl tab 30 mg pseudoephedrine hcl tab 60 mg pseudoephedrine w/ cod-gg soln mg/5ml pseudoephedrine w/ dm-gg liquid mg/5ml pseudoephedrine w/ dm-gg liquid mg/5ml pseudoephedrine-guaifenesin tab sr 12hr mg pseudoephedrine-guaifenesin tab sr 12hr mg pseudoephedrine-guaifenesin tab mg pseudoephedrine-ibuprofen cap mg pseudoephedrine-ibuprofen tab mg psyllium cap 0.52 gm psyllium powder packet 100% psyllium powder packet 28.3% psyllium powder packet 58.12% psyllium powder packet 58.6% psyllium powder packet 95% psyllium powder 63% psyllium powder 28.3% psyllium powder 30.9% psyllium powder 48.57% psyllium powder 58.6% psyllium powder 95% psyllium wafer pyrantel pamoate susp 144 mg/ml (50 mg/ml base equiv) pyreth-piperonyl butox sham-permeth aero-nit remover gel kit pyrethrins-piperonyl butoxide liq % pyrethrins-piperonyl butoxide shampoo kit % pyrethrins-piperonyl butoxide shampoo % pyridoxine hcl tab 25 mg 12

18 pyridoxine hcl tab 50 mg pyridoxine hcl tab 100 mg pyridoxine hcl tab 250 mg pyrithione zinc shampoo 1% ranitidine hcl tab 75 mg rectal protectant-emollient suppositories riboflavin tab 25 mg riboflavin tab 50 mg riboflavin tab 100 mg saccharomyces boulardii cap 250 mg saccharomyces boulardii packet 250 mg salicylic acid & sulfur shampoo 2-2% salicylic acid gel 17% salicylic acid liquid 17.6% salicylic acid liquid 2% salicylic acid liquid 3% salicylic acid liquid 17% salicylic acid pad 40% salicylic acid shampoo 2% salicylic acid shampoo 3% salicylic acid soln 12.6% salicylic acid soln 17% salicylic acid strip 40% saline nasal aerosol soln 0.9% saline nasal gel saline nasal gel 0.2% saline nasal soln 0.65% saline nasal soln 2.65% saline nasal spray 0.65% scar treatment products - cream selenium sulfide lotion 1% selenium tab cr 200 mcg selenium tab 50 mcg selenium tab 200 mcg senna syrup 176 mg/5ml sennosides cap 8.6 mg sennosides chew tab 15 mg sennosides syrup 8.8 mg/5ml sennosides tab 8.6 mg sennosides tab 15 mg sennosides tab 17.2 mg sennosides tab 25 mg sennosides-docusate sodium tab mg silver-carboxymethylcellulose sodium dressing 2"x2" silver-carboxymethylcellulose sodium dressing 6"x6" simethicone cap 125 mg simethicone cap 180 mg simethicone chew tab 80 mg simethicone chew tab 125 mg simethicone liquid 40 mg/0.6ml simethicone oral strip 62.5 mg simethicone susp 40 mg/0.6ml skin protectants misc skin protectants misc - cream skin protectants misc - liquid skin protectants misc - lotion skin protectants misc - ointment skin protectants misc - paste soap & cleansers - liquid soap & cleansers - lotion sod chloride soln & sod chloride-sod bicarbonate pack kit sodium bicarbonate tab 325 mg sodium bicarbonate tab 650 mg sodium chloride aero soln 0.9% sodium chloride external soln 0.9% sodium chloride hypertonic ophth oint 5% sodium chloride hypertonic ophth soln 2% sodium chloride hypertonic ophth soln 5% sodium chloride tab 1 gm sodium chloride-sodium bicarbonate packet kit mg sodium chloride-sodium bicarbonate packet 1.57 gm sodium chloride-sodium bicarbonate packet mg sodium chloride-sodium bicarbonate packet mg sodium fluoride cream 1.1% sodium fluoride rinse 0.044% sodium fluoride w/ calcium carb cap mg sodium fluoride w/ calcium carb tab mg sodium phosphates - enema speciality vitamin product tab 13

19 stannous fluoride gel 0.4% starch oral thickening liquid starch oral thickening powder starch oral thickening powder packet starch-maltodextrin oral thickening powder talc topical powder terbinafine gel 1% terbinafine hcl cream 1% tetrahydroz-glycerin-hypromellose-peg 400 ophth soln 0.05% tetrahydrozoline hcl ophth soln 0.05% tetrahydrozoline w/ zinc sulfate ophth soln % thiamine hcl tab 50 mg thiamine hcl tab 100 mg thiamine mononitrate tab 100 mg throat lozenges - lozenges tioconazole vaginal oint 6.5% tolnaftate aerosol pow 1% tolnaftate aerosol 1% tolnaftate cream 1% tolnaftate powder 1% tolnaftate soln 1% triclosan liq 0.15% triprolidine & pseudoephedrine tab mg trolamine salicylate cream 10% trolamine salicylate lotion 10% undecylenic acid liqd 25% undecylenic acid soln 25% urea cream 10% urea cream 20% urea lotion 10% vaginal cleanser - liquid vaginal lubricant - gel vitamin a cap 8000 unit vitamin a cap unit vitamin a tab unit vitamin a tab unit vitamin e cap 100 unit vitamin e cap 200 unit vitamin e cap 400 unit vitamin e cap 1000 unit vitamin e cream vitamin e cream 100 unit/gm vitamin e oil vitamin e oral oil 100 unit/0.25ml vitamin e soln 15 unit/0.3ml (50 unit/ml) vitamin e w/ a & d cream vitamins a & d oint vitamins w/ lipotropics cap vitamins w/ lipotropics tab vitamins w/ lipotropics tab cr wheat dextrin oral powder wheat dextrin packet white petrolatum gel white petrolatum ointment white petrolatum topical gel white petrolatum-mineral oil ophth ointment witch hazel (hamamelis virginiana) cleansing pads witch hazel-glycerin cleansing pads wound cleansers - liquid wound dressings - gel wound dressings - pads xanthan gum oral thickening gel zinc cap 30 mg zinc gluconate lozenge 10 mg (elemental zn) zinc gluconate tab 30 mg zinc gluconate tab 50 mg (elemental zn) zinc oxide cream 11.3% zinc oxide cream 13% zinc oxide oint 12.8% zinc oxide oint 16% zinc oxide oint 20% zinc oxide oint 40% zinc oxide oint 10% zinc oxide paste 25% zinc oxide paste 40% zinc oxide topical powder zinc sulfate cap 220 mg (50 mg elemental zn) zinc sulfate tab 220 mg (50 mg zinc equivalent) zinc tab 50 mg 14