Generic Name Brand Name Drug Strength Drug Volume
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Generic Name ABACAVIR ABACAVIR ABACAVIR SULFATE/LAMIVUDINE ABATACEPT/MALTOSE ABCIXIMAB ABSORBABLE HEMOSTAT 2X3* ABSORBABLE HEMOSTAT 4X8* ACAMPROSATE ACARBOSE ACARBOSE HALFTAB ACEBUTOLOL ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN ACETAMINOPHEN 5ML UD ACETAMINOPHEN CHLDN CHEW ACETAMINOPHEN INFANT DROPS ACETAMINOPHEN INJ *10MG/ML* ACETAMINOPHEN SOLN ACETAMINOPHEN/CAFFEINE/BUTALB ACETAMINOPHEN/COD 120MG/12MG ACETAMINOPHEN/COD 120MG/12MG ACETAMINOPHEN/COD 300MG/30MG* ACETAMINOPHEN/CODEINE PHOS. ACETAZOLAMIDE ACETAZOLAMIDE ACETAZOLAMIDE ACETIC ACID 0.25% ACETIC ACID 1% ACETIC ACID 3% IRR* ACETIC ACID 4% ACETIC ACID 5% ACETIC ACID 5%* ACETIC ACID GLACIAL* Brand Name ZIAGEN ZIAGEN EPZICOM 600-300MG ORENCIA REOPRO SURGICEL 2X3 (EQUIV)* SURGICEL 4X8 (EQUIV)* CAMPRAL PRECOSE PRECOSE HALFTAB SECTRAL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV) TYLENOL (EQUIV)5ML UD CHILDREN'S TYLENOL TYLENOL INFANT DROPS OFIRMEV INJ *10MG/ML* TYLENOL (EQUIV) FIORICET (EQUIV) TYLENOL/COD 120MG/12MG (EQUIV) TYLENOL/W CODEINE (EQUIV) TYLENOL #3 (ER VIAL) (EQUIV)* TYLENOL #3 (EQUIV) DIAMOX (EQUIV) DIAMOX (EQUIV) DIAMOX (EQUIV) ACETIC ACID 0.25% ACETIC ACID 1% ACETIC ACID 3% IRR* ACETIC ACID 4% ACETIC ACID 5% ACETIC ACID 5%* ACETIC ACID GLACIAL* Drug Strength 20 MG 300 MG 1 TAB 250 MG 10 MG 1 EA 1 EA 333 MG 50 MG 25 MG 200 MG 120 MG 160 MG 325 MG 325 MG 325 MG 650 MG 80 MG 160 MG 80 MG 80 MG 1000 MG 650 MG 1 TAB 1 ML 5 ML 2 TAB 1 TAB 125 MG 250 MG 500 MG 1 APP 1000 ML 1 ML 1 APP 1000 ML 1 ML 1 ML Drug Volume 1 ML 1 TAB 1 TAB 1 VIAL 5 ML 1 EA 1 EA 1 TAB EC 1 TAB 1 TAB 1 CAP 1 SUPP 5 ML 10.15 ML 1 TAB 1 SUPP 1 SUPP 1 SUPP 5 ML 1 TAB 0.8 ML 100 ML 20.3 ML 1 TAB 1 ML 5 ML 2 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1000 ML 1000 ML 1 ML 1 APP 1000 ML 1 ML 1 ML Package Desc ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 5 ML VIAL 1 EA PACKAGE 1 EA PACKAGE 1 TAB EC PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 SUPP PACKAGE 120 ML BOTTLE 10.15 ML UD CUP 1 TAB PACKAGE 1 SUPP PACKAGE 1 SUPP PACKAGE 1 SUPP PACKAGE 5 ML UD CUP 1 TAB PACKAGE 0.8 ML BOTTLE 100 ML VIAL 20.3 ML UD CUP 1 TAB PACKAGE ML ORAL SYRINGE 5 ML UD CUP 2 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1000 ML BOTTLE 1000 ML BOTTLE 1 ML BOTTLE 1000 ML BOTTLE 1000 ML BOTTLE 1 ML BOTTLE 1 ML BOTTLE Dosage Form SOLN TAB TAB VIAL VIAL MISC MISC TAB EC TAB TAB CAP SUPP ELIXIR SOLN TAB SUPP SUPP SUPP SOLN TAB DROPS VIAL SOLN TAB ELIXIR ELIXIR TAB TAB TAB TAB VIAL IRRIG IRRIG SOLN SOLN IRRIG SOLN LIQUID Route PO PO PO IV IV TOP TOP PO PO PO PO PR PO PO PO PR PR PR PO PO PO INJ PO PO PO PO PO PO PO PO INJ IRR IRR IRR TOP IRR MSC MSC Formulary Status? F F NF F F F F F NF NF NF F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 05 05 03 03 00 00 00 00 00 00 00 00 00 00 Drug Code 2893 1039 3061 3142 20 2317 2318 2984 335 3527 1289 1534 3203 3228 1775 1537 1538 2319 1381 2730 2320 4137 920 888 2726 465 2321 1800 1992 1957 2047 1253 3037 3010 3075 2322 3012 2951 AHFS Code 08:18.08 08:18.08 08:18.08 92:36.00 20:12.18 20:28.16 20:28.16 28:92.00 68:20.02 68:20.02 24:24.00 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.92 28:08.08 28:08.08 28:08.08 28:08.08 52:40.12 52:40.12 52:40.12 40:36.00 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 Generic Name ACETIC ACID OTIC 2% ACETIC ACID/ALUMINUM ACETATE ACETIC ACID/HYDROCORTISONE ACETYLCHOLINE ACETYLCYSTEINE ACETYLCYSTEINE *INH* 20% ACETYLCYSTEINE *IV* 20% ACETYLCYSTEINE 10% ACETYLCYSTEINE 20% ACIDOPHILUS/BULGARICUS ACITRETIN ACYCLOVIR ACYCLOVIR ACYCLOVIR ACYCLOVIR ACYCLOVIR 5% OINT 15GM ACYCLOVIR 5% OINT 30GM ACYCLOVIR SUSP ADENOSINE ADENOSINE AEROCHAMBER AEROCHAMBER W/MASK LARGE AEROCHAMBER W/MASK MED AEROCHAMBER W/MASK SMALL AGALSIDASE BETA AGALSIDASE BETA ALBUMIN 25%(12.5GM)50 ML (ADD) ALBUMIN 5% 12.5GM/250 ML (ADD) ALBUMIN HUM 25% (12.5GM) 50 ML ALBUMIN HUM 25% (25 GM) 100 ML ALBUMIN HUM 5% (25GM) 500 ML ALBUMIN HUM 5%(12.5 GM) 250 ML ALBUMIN HUMAN,MI-SPHERES ALBUTEROL ALBUTEROL ALBUTEROL 0.083% ALBUTEROL 5MG/ML ALBUTEROL HFA (INTUBATED PT.) Brand Name VOSOL OTIC (EQUIV) ACETIC ACID 2% OTIC ACETASOL HC MIOCHOL-E (EQUIV) ACETYLCYSTEINE MUCOMYST-20 (EQUIV) ACETADOTE *IV* 20% MUCOMYST-10 (EQUIV) MUCOMYST-20 (EQUIV) LACTOBACILLUS SORIATANE ZOVIRAX (EQUIV) ZOVIRAX (EQUIV) ZOVIRAX (EQUIV) ZOVIRAX (EQUIV) ZOVIRAX 5% (EQUIV) ZOVIRAX 5% (EQUIV) ZOVIRAX (EQUIV) ADENOSCAN ADENOCARD (EQUIV) AEROCHAMBER AEROCHAMBER W/MASK LARGE AEROCHAMBER W/MASK MED AEROCHAMBER W/MASK SMALL FABRAZYME FABRAZYME ALBUMIN 25%(12.5GM)50 ML (ADD) ALBUMIN 5% 12.5GM/250 ML (ADD) ALBUMIN 25% 50 ML ALBUMIN 25% ALBUMARC 5% 500 ML ALBUMARC OPTISON (EQUIV) VENTOLIN (EQUIV) VENTOLIN (EQUIV) VENTOLIN (EQUIV) 0.083% VENTOLIN 5MG/ML (EQUIV) PROVENTIL HFA Drug Strength 1 DRP 1 DRP 1 DRP 20 MG 100 MG 6000 MG 6000 MG 1000 MG 2000 MG 1 TAB 25 MG 1000 MG 200 MG 400 MG 500 MG 1 APP 1 APP 200 MG 3 MG 6 MG 1 EA 1 KIT 1 KIT 1 KIT 35 MG 5 MG 0.25 GM 50 MG 12.5 GM 25 GM 25 GM 12.5 GM 3 ML 2 MG 2 MG 2.5 MG 5 MG 1 PUF Drug Volume 1 DRP 1 DRP 1 DRP 2 ML 1 ML 30 ML 30 ML 10 ML 10 ML 1 TAB 1 CAP 20 ML 1 CAP 1 TAB 5 ML 1 APP 1 APP 5 ML 1 ML 2 ML 1 EA 1 KIT 1 KIT 1 KIT 1 VIAL 1 VIAL 1 ML 1 ML 1 BTL 1 BTL 1 BTL 1 BTL 3 ML 1 TAB 5 ML 3 ML 1 ML 1 PUF Package Desc 15 ML BOTTLE 60 ML BOTTLE 10 ML BOTTLE 2 ML VIAL 30 ML BOTTLE 30 ML VIAL 30 ML BOTTLE 10 ML VIAL 10 ML VIAL 1 TAB PACKAGE 1 CAP PACKAGE 20 ML VIAL 1 CAP PACKAGE 1 TAB PACKAGE 5 ML PACKAGE 15 GM PACKAGE 30 GM PACKAGE ML ORAL SYRINGE 30 ML BOTTLE 2 ML VIAL 1 EA PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BOTTLE 250 ML BOTTLE 1 BTL BOTTLE 1 BTL BOTTLE 1 BTL BOTTLE 1 BTL BOTTLE 3 ML VIAL 1 TAB PACKAGE ML ORAL SYRINGE 3 ML BOTTLE ML BOTTLE 6.7 GM PACKAGE Dosage Form SOLN DROPS DROPS VIAL VIAL INH VIAL INH VIAL TAB CAP VIAL CAP TAB VIAL OINT OINT SUSP VIAL VIAL MISC MISC MISC MISC VIAL VIAL SOLN SOLN SOLN PREMIX PREMIX PREMIX VIAL TAB SYRUP SOLN SOLN AER Route EAR EAR EAR EYE MSC MSC INJ MSC MSC PO PO INJ PO PO IV TOP TOP PO INJ IV ORD MSC MSC MSC IV IV IV IV IV IV IV IV IV PO PO INH INH INH Formulary Status? F F F F F F F F F F NF F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2174 2723 1371 2125 3063 853 2895 854 1425 3972 3429 709 1908 1909 2057 1049 4158 1355 4024 1348 2323 2327 2325 2326 3458 3459 3523 3532 2328 1980 3522 1978 298 1866 885 1729 1751 3519 AHFS Code 52:04.92 52:04.92 52:04.92 52:40.20 48:24.00 48:24.00 92:12.00 48:24.00 48:24.00 56:08.00 84:92.00 08:18.32 08:18.32 08:18.32 08:18.32 84:04.06 84:04.06 08:18.32 24:04.92 24:04.04 94:00.00 94:00.00 94:00.00 94:00.00 44:00.00 44:00.00 16:00.00 16:00.00 16:00.00 16:00.00 16:00.00 16:00.00 92:92.00 12:12.08 12:12.08 12:12.08 12:12.08 12:12.08 Generic Name ALBUTEROL HFA INHALER ALBUTEROL/IPRATROPIUM ALBUTEROL/IPRATROPIUM INHALER ALCOHOL 100% DEHYDRATED ALCOHOL 100% DEHYDRATED* ALCOHOL 95%* ALDESLEUKIN ALENDRONATE ALENDRONATE ALENDRONATE ALISKIREN ALLOPURINOL ALLOPURINOL ALLOPURINOL ALLOPURINOL HALFTAB ALLOPURINOL HALFTAB ALLOPURINOL QUARTERTAB ALPRAZOLAM ALPRAZOLAM ALPRAZOLAM ALPROSTADIL ALPROSTADIL ALTEPLASE ALTEPLASE 100MG/100ML SW ALTEPLASE 2MG/2ML SYR ALTEPLASE BOLUS ALUM POWDER* ALUMINUM ACETATE ALUMINUM ACETATE ALUMINUM CHLORIDE 20% SOLN ALUMINUM CHLORIDE 50%* ALUMINUM CHLORIDE POWDER ALUMINUM HYDROXIDE (AMPHOGEL) ALUMINUM HYDROXIDE (BULK) AMANTADINE AMANTADINE AMIFOSTINE AMIKACIN Brand Name VENTOLIN HFA DUONEB COMBIVENT (EQUIV) ETHANOL ETHANOL* ALCOHOL 95%* PROLEUKIN FOSAMAX FOSAMAX FOSAMAX TEKTURNA ZYLOPRIM (EQUIV) ZYLOPRIM (EQUIV) ALOPRIM (EQUIV) ZYLOPRIM (EQUIV) HALFTAB ZYLOPRIM (EQUIV) HALFTAB ZYLOPRIM (EQUIV) QUARTERTAB XANAX (EQUIV) XANAX (EQUIV) XANAX (EQUIV) MUSE (EQUIV) MUSE (EQUIV) ACTIVASE ALTEPLASE 100MG/100ML SW CATHFLO 2MG/2ML SYR ACTIVASE BOLUS ALUM POWDER* DOMEBORO (EQUIV) DOMEBORO (EQUIV) HYPERCARE ALUMINUM CHLORIDE 50%* ALUMINUM CHLORIDE POWDER AMPHOGEL (EQUIV) AMPHOGEL (EQUIV) SYMMETREL (EQUIV) SYMMETREL (EQUIV) ETHYOL AMIKIN (EQUIV) Drug Strength 1 PUF 3 ML 1 PUF 1 ML 5 ML 1 ML 22000000 10 MG 35 MG 70 MG 150 MG 100 MG 300 MG 500 MG 150 MG 50 MG 75 MG 0.25 MG 0.5 MG 1 MG 1000 MCG 500 MCG 1 MG 100 MG 2 MG 15 MG 1 GM 1 APP 1 EA 37.5 ML 1 ML 1 GM 320 MG 64 MG 100 MG 100 MG 500 MG 100 MG Drug Volume 1 PUF 3 ML 1 PUF 1 ML 5 ML 1 ML 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 SUPP 1 ML 1 ML 100 ML 2 ML 15 ML 1 GM 1 APP 1 EA 37.5 ML 1 ML 1 GM 5 ML 1 ML 1 CAP 10 ML 1 VIAL 2 ML Package Desc 8 GM PACKAGE 3 ML BOTTLE 14.7 GM PACKAGE 1 ML BOTTLE 5 ML AMPUL 1 ML BOTTLE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 SUPP PACKAGE 1 ML AMPUL 50 ML PACKAGE 100 ML PACKAGE 2 ML PACKAGE 15 ML SYRINGE 120 GM PACKAGE 480 ML BOTTLE 1 EA PACKAGE 37.5 ML BOTTLE 1 ML BOTTLE 1 GM PACKAGE 360 ML BOTTLE ML ORAL SYRINGE 1 CAP PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 2 ML VIAL Dosage Form AER SOLN AER INJ INJ LIQUID VIAL TAB TAB TAB TAB TAB TAB VIAL TAB TAB TAB TAB TAB TAB SUPP INJ VIAL VIAL SYRINGE SYRINGE MISC SOLN PACKET BOTTLE SOLN POWDER SUSP SUSP CAP SYRUP VIAL VIAL Route INH INH INH IV IV MSC IV PO PO PO PO PO PO IV PO PO PO PO PO PO UR INJ IV IV IV IV MSC TOP TOP TOP MSC MSC PO PO PO PO IV INJ Formulary Status? F F F F F F NF F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3498 2618 1481 3416 1427 2228 1993 122 3064 103 3497 1806 1807 2153 2731 3295 3501 1885 1886 1887 2223 2052 1741 1744 3016 3534 2329 1296 2844 3464 3011 2703 2790 923 1830 917 2101 2032 AHFS Code 12:12.08 12:12.08 12:12.08 92:92.00 92:92.00 96:00.00 10:00.00 92:24.00 92:24.00 92:24.00 24:32.40 92:16.00 92:16.00 92:16.00 92:16.00 92:16.00 92:16.00 28:24.08 28:24.08 28:24.08 24:12.92 24:12.92 20:12.20 20:12.20 20:12.20 20:12.20 84:12.00 84:12.00 84:12.00 84:12.00 96:00.00 96:00.00 56:04.00 56:04.00 28:36.04 28:36.04 92:56.00 08:12.02 Generic Name AMIKACIN AMIKACIN AMILORIDE AMILORIDE HALFTAB AMINO ACIDS 10%* AMINO ACIDS 8%* AMINOCAPROIC ACID AMINOCAPROIC ACID AMINOCAPROIC ACID AMINOCAPROIC ACID* AMINOPHYLLINE SDV AMIODARONE AMIODARONE 450MG/250ML D5W AMIODARONE HALFTAB AMIODARONE HCL AMIODARONE HCL MDV AMIODARONE HCL* AMIODARONE HCL* AMIODARONE QUARTERTAB AMIODARONE SUSP AMIODARONE* AMITRIPTYLINE AMITRIPTYLINE AMITRIPTYLINE AMITRIPTYLINE AMITRIPTYLINE AMITRIPTYLINE *NEO* 2MG/ML LIQ AMLODIPINE AMLODIPINE AMLODIPINE AMLODIPINE SUSPENSION AMMONIA AROMATIC AMMONIUM CHLORIDE AMMONIUM LACTATE 12% AMMONIUM LACTATE 12% CRM 140GM AMOX TR/POTASSIUM CLAVULANATE AMOX TR/POTASSIUM CLAVULANATE AMOX/POTAS CLAV 250MG/125MG Brand Name AMIKIN (EQUIV) AMIKIN (EQUIV) MIDAMOR (EQUIV) MIDAMOR (EQUIV) HALFTAB PREMASOL* HEPATAMINE 8%* AMICAR (EQUIV) AMICAR (EQUIV) AMICAR (EQUIV) AMICAR (EQUIV)* AMINOPHYLLINE CORDARONE (EQUIV) AMIODARONE 450MG/250ML D5W CORDARONE (EQUIV) HALFTAB CORDARONE (EQUIV) AMIODARONE HCL MDV AMIODARONE HCL* AMIODARONE HCL* CORDARONE (EQUIV) QUARTERTAB CORDARONE SUSP CORDARONE (EQUIV)* ELAVIL (EQUIV) ELAVIL (EQUIV) ELAVIL (EQUIV) ELAVIL (EQUIV) ELAVIL (EQUIV) ELAVIL(EQUIV) *NEO* 2MG/ML LIQ NORVASC (EQUIV) NORVASC (EQUIV) NORVASC (EQUIV) NORVASC SUSPENSION AMMONIA AROMATIC AMMONIUM CHLORIDE LAC-HYDRIN 12% (EQUIV) LAC-HYDRIN 12% (EQUIV) AUGMENTIN (EQUIV) AUGMENTIN (EQUIV) AUGMENTIN 250MG/125MG (EQUIV) Drug Strength 1000 MG 500 MG 5 MG 2.5 MG 1 ML 500 ML 250 MG 250 MG 500 MG 250 MG 250 MG 50 MG 450 MG 100 MG 200 MG 50 MG 150 MG 50 MG 50 MG 200 MG 50 MG 10 MG 100 MG 25 MG 50 MG 75 MG 2 MG 10 MG 2.5 MG 5 MG 5 MG 1 EA 100 MEQ 1 APP 1 APP 25 MG 50 MG 250 MG Drug Volume 4 ML 2 ML 1 TAB 1 TAB 1 ML 500 ML 1 ML 1 ML 1 TAB 1 ML 10 ML 1 ML 250 ML 1 TAB 1 TAB 1 ML 3 ML 1 ML 1 TAB 40 ML 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 5 ML 1 EA 20 ML 1 APP 1 APP 1 ML 1 ML 1 TAB Package Desc 4 ML VIAL 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE ML BAG ML ORAL SYRINGE 20 ML VIAL 1 TAB PACKAGE 20 ML VIAL 10 ML VIAL 3 ML VIAL 250 ML BAG 1 TAB PACKAGE 1 TAB PACKAGE ML VIAL 3 ML SYRINGE 9 ML BOTTLE 1 TAB PACKAGE 40 ML ORAL SYRINGE 3 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 EACH AMPUL 20 ML VIAL 385 GM PACKAGE 140 GM PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE 1 TAB PACKAGE Dosage Form VIAL VIAL TAB TAB INJ INJ SYRUP VIAL TAB VIAL VIAL VIAL PREMIX TAB TAB VIAL SYRINGE VIAL TAB SUSP VIAL TAB TAB TAB TAB TAB LIQUID TAB TAB TAB SUSP INH VIAL CREAM CREAM SUSP SUSP TAB Route INJ INJ PO PO IV IV PO IV PO IV IV IV IV PO PO INJ INJ IV PO PO IV PO PO PO PO PO PO PO PO PO PO INH IV TOP TOP PO PO PO Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2034 2033 1731 3901 2988 1156 2214 1430 2215 3230 1412 2272 4045 2732 207 3197 3283 3288 3489 3065 3231 1796 1840 1790 1797 1799 3493 579 577 578 3444 1694 727 2843 1151 358 360 356 AHFS Code 08:12.02 08:12.02 40:28.16 40:28.16 40:20.00 40:20.00 20:28.16 20:28.16 20:28.16 20:28.16 86:16.00 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 24:04.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 24:28.08 24:28.08 24:28.08 24:28.08 28:20.92 40:04.00 84:24.12 84:24.12 08:12.16 08:12.16 08:12.16 Generic Name AMOX/POTAS/CLAV 500MG/125MG AMOX/POTAS/CLAV 875MG/125MG AMOXICILLIN AMOXICILLIN AMOXICILLIN AMPHET ASP/AMPHET/D-AMPHET AMPHET ASP/AMPHET/D-AMPHET AMPHOTERICIN B AMPHOTERICIN B LIPID COMPLEX AMPHOTERICIN B LIPOSOME AMPICILLIN AMPICILLIN AMPICILLIN AMPICILLIN AMPICILLIN AMPICILLIN AMPICILLIN AMPICILLIN SODIUM/SULBACTAM NA AMPICILLIN SODIUM/SULBACTAM NA AMPICILLIN/SULBACTAM 1.5G/50ML AMPICILLIN/SULBACTAM 3GM/100ML AMYL NITRITE AMYLASE/LIPASE/PROTEASE AMYLASE/LIPASE/PROTEASE AMYLASE/LIPASE/PROTEASE AMYLASE/LIPASE/PROTEASE ANASTROZOLE ANTIHEMOPHILIC FACTOR 8 ANTI-INHIBITOR COAGULANT COMP. ANTIPYRINE/BENZOCAINE/GLYCERIN ANTITHROMBIN III,HUMAN ANTIVENIN,CROTALIDAE (EQUINE) APRACLONIDINE 0.5% APREPITANT APREPITANT APREPITANT 125MG/80MG TRIPAK APROTININ 10,000UNT/100 ML ARGATROBAN Brand Name AUGMENTIN 500MG/125MG (EQUIV) AUGMENTIN 875MG/125MG (EQUIV) AMOXIL (EQUIV) TRIMOX 250 AMOXIL (EQUIV) ADDERALL (EQUIV) ADDERALL (EQUIV) AMPHOTERICIN B N+ ABELCET AMBISOME AMPICILLIN AMPICILLIN AMPICILLIN PRINCIPEN (EQUIV) AMPICILLIN AMPICILLIN AMPICILLIN UNASYN (EQUIV) UNASYN (EQUIV) UNASYN 1.5G/50ML NS UNASYN 3GM/100ML NS AMYL NITRITE KU-ZYME HP PANCREAZE PANCREAZE PANCREAZE ARIMIDEX HUMATE-P FEIBA VH IMMUNO (EQUIV) AURALGAN EAR DROPS (EQUIV) THROMBATE III ANTIVENIN POLYVALENT IOPIDINE 0.5% EMEND EMEND EMEND 125MG/80MG TRIPAK TRASYLOL 10,000UNT/100 ML ARGATROBAN Drug Strength 500 MG 875 MG 250 MG 250 MG 500 MG 10 MG 5 MG 50 MG 100 MG 50 MG 1 GM 2 GM 250 MG 250 MG 250 MG 500 MG 500 MG 1.5 GM 3 GM 1.5 GM 3 GM 1 INH 1 CAP 10500 UNT 16800 UNT 4200 UNT 1 MG 1 UNT 1 UNT 1 DRP 1 EA 1 KIT 1 DRP 125 MG 80 MG 1 EA 10000 UNT 250 MG Drug Volume 1 TAB 1 TAB 1 CAP 5 ML 1 CAP 1 TAB 1 TAB 10 ML 20 ML 1 VIAL 1 VIAL 1 VIAL 1 VIAL 5 ML 1 CAP 1 VIAL 1 CAP 1 VIAL 1 VIAL 50 ML 100 ML 1 INH 1 CAP 1 CAP 1 CAP 1 CAP 1 TAB 1 UNT 1 UNT 1 DRP 1 EA 1 KIT 1 DRP 1 CAP 1 CAP 1 EA 100 ML 2.5 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 5 ML ORAL SYRINGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML PACKAGE 20 ML VIAL 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 100 ML BAG 1 INH AMPUL 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 UNT PACKAGE 1 UNT UNT 10 ML BOTTLE 1 VIAL PACKAGE 1 KIT PACKAGE 5 ML BOTTLE 1 CAP PACKAGE 1 CAP PACKAGE 1 EA PACKAGE 100 ML VIAL 2.5 ML VIAL Dosage Form TAB TAB CAP SUSP CAP TAB TAB VIAL VIAL VIAL VIAL VIAL VIAL SUSP CAP VIAL CAP VIAL VIAL PB PB INH CAP CAP CAP CAP TAB KIT VIAL DROPS VIAL KIT DROPS CAP CAP CAP INFUSN VIAL Route PO PO PO PO PO PO PO INJ IV IV INJ INJ INJ PO PO INJ PO INJ INJ IV IV INH PO PO PO PO PO IV IV EAR IV INJ EYE PO PO PO IV IV Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F NF NF NF F F Controlled Substance? NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 357 359 1854 56 1855 2118 2117 49 2216 1350 2266 2267 2264 53 41 2265 2013 423 424 4267 4268 1695 3170 4075 4076 4074 1179 462 2296 1577 328 189 561 3133 3108 2850 337 2990 AHFS Code 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 28:20.04 28:20.04 08:14.28 08:14.28 08:14.28 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 24:12.08 56:16.00 56:16.00 56:16.00 56:16.00 10:00.00 20:28.16 20:28.16 52:16.00 20:12.04 80:04.00 52:92.00 56:22.92 56:22.92 56:22.92 20:28.16 20:12.04 Generic Name ARGATROBAN 250MG/250 ML NS ARGININE ARIPIPRAZOLE ARIPIPRAZOLE ARIPIPRAZOLE ARIPIPRAZOLE ARIPIPRAZOLE ARIPIPRAZOLE ARIPIPRAZOLE HALFTAB ARTIFICIAL TEARS ASCORBATE SODIUM ASCORBIC ACID ASCORBIC ACID ASCORBIC ACID ASENAPINE ASENAPINE MALEATE ASPARAGINASE ASPIRIN ASPIRIN ASPIRIN CHEWABLE ASPIRIN EC ASPIRIN EC ASPIRIN/CALCIUM CARB/MAGNESIUM ASPIRIN/DIPYRIDAMOLE ATAZANAVIR SULFATE ATAZANAVIR SULFATE ATENOLOL ATENOLOL ATENOLOL ATENOLOL HALFTAB ATENOLOL QUARTERTAB ATOMOXETINE HCL ATOMOXETINE HCL ATOMOXETINE HCL ATOMOXETINE HCL ATORVASTATIN CALCIUM ATORVASTATIN CALCIUM ATORVASTATIN CALCIUM Brand Name ARGATROBAN 250MG/250 ML NS R-GENE 10 ABILIFY ABILIFY ABILIFY ABILIFY ABILIFY ABILIFY ABILIFY HALFTAB ISOPTO TEARS CENOLATE VITAMIN C VITAMIN C VITAMIN C SAPHRIS SAPHRIS ELSPAR ASPIRIN ASPIRIN ASPIRIN CHEWABLE ASPIRIN EC ASPIRIN EC ASPIRIN BUFFERED (EQUIV) AGGRENOX (EQUIV) REYATAZ REYATAZ TENORMIN (EQUIV) TENORMIN (EQUIV) TENORMIN (EQUIV) TENORMIN (EQUIV) HALFTAB TENORMIN (EQUIV) STRATTERA STRATTERA STRATTERA STRATTERA LIPITOR (EQUIV) LIPITOR (EQUIV) LIPITOR (EQUIV) Drug Strength 250 MG 300 ML 1 MG 10 MG 15 MG 2 MG 5 MG 9.75 MG 2.5 MG 1 DRP 1000 MG 250 MG 500 MG 500 MG 5 MG 10 MG 10000 UNT 300 MG 325 MG 81 MG 325 MG 81 MG 325 MG 1 CAP MP 150 MG 200 MG 100 MG 25 MG 50 MG 12.5 MG 6.25 MG 10 MG 25 MG 40 MG 60 MG 10 MG 20 MG 40 MG Drug Volume 250 ML 300 ML 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1.3 ML 1 TAB 1 DRP 2 ML 1 TAB 5 ML 1 TAB 1 SL TAB 1 SL TAB 1 EA 1 SUPP 1 TAB 1 TAB 1 TAB EC 1 TAB EC 1 TAB 1 CAP MP 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 CAP 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB Package Desc 250 ML BAG 300 ML BOTTLE 1 ML SYRING 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1.3 ML VIAL 1 TAB PACKAGE 15 ML BOTTLE 2 ML AMPUL 1 TAB PACKAGE 5 ML ORAL SYRINGE 1 TAB PACKAGE 1 SL TAB PACKAGE 1 SL TAB PACKAGE 1 VIAL PACKAGE 1 SUPP PACKAGE 1 TAB PACKAGE 1 TAB CHW PACKAGE 1 TAB EC PACKAGE 1 TAB EC PACKAGE 1 TAB PACKAGE 1 CAP MP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form PREMIX PREMIX SOLN TAB TAB TAB TAB VIAL TAB DROPS INJ TAB SYRUP TAB SL TAB SL TAB VIAL SUPP TAB TAB CHW TAB EC TAB EC TAB CAP MP CAP CAP TAB TAB TAB TAB TAB CAP CAP CAP CAP TAB TAB TAB Route IV IV PO PO PO PO PO INJ PO EYE INJ PO PO PO SL SL INJ PR PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO Formulary Status? F F NF F F F F NF F F F F F F F F F F F F F F F F NF NF F F F F F NF NF NF NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 4047 232 4169 2638 2143 4043 2966 3201 3961 1621 688 2331 1747 1574 4012 4293 148 1706 1777 2290 1449 2294 1081 1480 2669 2653 1873 1882 1872 2733 3958 2889 2650 2629 3888 592 593 4299 AHFS Code 20:12.04 36:66.00 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 52:92.00 88:12.00 88:12.00 88:12.00 88:12.00 28:16.08 28:16.08 10:00.00 28:08.04 28:08.04 28:08.04 28:08.04 28:08.04 28:08.04 24:12.92 08:18.08 08:18.08 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 28:92.00 28:92.00 28:92.00 28:92.00 24:06.08 24:06.08 24:06.08 Generic Name ATORVASTATIN CALCIUM ATORVASTATIN CALCIUM HALFTAB ATOVAQUONE ATOVAQUONE/PROGUANIL HCL ATROPINE ATROPINE 0.5% ATROPINE 1% ATROPINE 1% ATROPINE 1MG SYR ATROPINE SULFATE AURANOFIN AZACITIDINE AZATHIOPRINE AZATHIOPRINE HALFTAB AZATHIOPRINE SODIUM AZITHROMYCIN AZITHROMYCIN AZITHROMYCIN AZITHROMYCIN AZITHROMYCIN AZITHROMYCIN 500MG/250ML D5W AZITHROMYCIN* AZTREONAM AZTREONAM AZTREONAM AZTREONAM 250MG/50ML D5W AZTREONAM 500MG/50ML D5W BACITRACIN BACITRACIN OINT 28.35GM BACITRACIN OINT 454GM BACITRACIN OPTH OINT BACITRACIN ZINC OINT BACITRACIN/POLYMYXIN B BACITRACIN/POLYMYXIN B SULFATE BACLOFEN BACLOFEN BACLOFEN HALFTAB BACLOFEN INTRATHECAL Brand Name LIPITOR (EQUIV) LIPITOR (EQUIV) HALFTAB MEPRON MALARONE ATROPINE ATROPINE 0.5% ATROPINE 1% ATROPINE 1% ATROPINE 1MG SYR ATROPINE SULFATE RIDAURA VIDAZA IMURAN (EQUIV) IMURAN (EQUIV) HALFTAB IMURAN (EQUIV) ZITHROMAX (EQUIV) ZITHROMAX (EQUIV) ZITHROMAX (EQUIV) ZITHROMAX (EQUIV) ZITHROMAX (EQUIV) ZITHROMAX 500MG/250ML D5W AZITHROMYCIN* AZACTAM 1GM/D5W 50ML AZACTAM AZACTAM AZACTAM 250MG/50ML D5W AZACTAM 500MG/50ML D5W BACITRACIN STERILE BACITRACIN BACITRACIN BACITRACIN OPTH OINT BACITRACIN ZINC OINT POLYSPORIN (EQUIV) 28.35GM AK-POLY-BAC LIORESAL (EQUIV) LIORESAL (EQUIV) LIORESAL (EQUIV) HALFTAB LIORESAL INTRATHECAL Drug Strength 80 MG 5 MG 750 MG 1 TAB 1 MG 1 DRP 1 APP 1 DRP 1 MG 0.4 MG 3 MG 100 MG 50 MG 25 MG 100 MG 1 GM 200 MG 250 MG 500 MG 600 MG 500 MG 500 MG 1 GM 1 GM 2 GM 250 MG 500 MG 50000 UNT 1 APP 1 APP 1 APP 1 EA 1 APP 1 APP 10 MG 20 MG 5 MG 50 MCG Drug Volume 1 TAB 1 TAB 5 ML 1 TAB 1 ML 1 DRP 1 APP 1 DRP 10 ML 1 ML 1 CAP 1 VIAL 1 TAB 1 TAB 1 VIAL 1 PACKET 5 ML 1 TAB 1 VIAL 1 TAB 250 ML 1 TAB 50 ML 1 VIAL 1 VIAL 50 ML 50 ML 1 EA 1 APP 1 APP 1 APP 1 EA 1 APP 1 APP 1 TAB 1 TAB 1 TAB 1 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 5 ML PKT 1 TAB PACKAGE 1 ML VIAL 10 ML BOTTLE 3.5 GM PACKAGE 5 ML BOTTLE 10 ML SYRINGE 20 ML BOTTLE 1 CAP PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 PACKET PACKAGE 5 ML ORAL SYRINGE 1 TAB PACKAGE 1 VIAL VIAL 1 TAB PACKAGE 250 ML BAG 9 TAB PACKAGE 50 ML BAG 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG 1 VIAL PACKAGE 28.35 GM PACKAGE 454 GM PACKAGE 3.5 GM PACKAGE 1 EA PACKAGE 28.35 GM PACKAGE 3.5 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML PACKAGE Dosage Form TAB TAB SUSP TAB VIAL OPTH OINT DROPS SYRINGE VIAL CAP VIAL TAB TAB VIAL PACKET SUSP TAB VIAL TAB PB TAB PB VIAL VIAL PREMIX BAG VIAL OINT OINT OINT MISC OINT OINT TAB TAB TAB KIT Formulary Route Status? PO F PO F PO F NF INJ F EYE F EYE F EYE F INJ F INJ F PO F IV NF PO F PO F INJ F PO F PO F PO F IV F PO F IV F PO F IV F INJ F INJ F IV F IV F INJ F TOP F TOP F EYE F TOP F TOP F EYE NF PO F PO F PO F IT F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3066 3934 1040 3289 1396 2897 964 1680 722 4281 2231 2973 492 3511 3267 582 585 583 586 584 4224 3135 3938 1944 1945 4212 4210 220 946 945 953 2814 952 4062 1067 1068 2734 2104 AHFS Code 24:06.08 24:06.08 08:30.92 08:30.08 12:08.08 52:24.00 52:24.00 52:24.00 12:08.08 12:08.08 60:00.00 10:00.00 92:44.00 92:44.00 92:44.00 08:12.12 08:12.12 08:12.12 08:12.12 08:12.12 08:12.12 08:12.12 08:12.07 08:12.07 08:12.07 08:12.07 08:12.07 08:12.28 84:04.04 84:04.04 52:04.04 84:04.04 84:04.04 52:04.04 12:20.12 12:20.12 12:20.12 12:20.12 Generic Name BACLOFEN IT KIT BACLOFEN IT KIT BACLOFEN REFILL KIT BACLOFEN SUSPENSION BACTERIOSTATIC SOD CHLOR 0.9%* BALSALAZIDE DISODIUM BARIUM SULFATE BCG VACCINE BECAPLERMIN 0.1% GEL 15GM BECLOMETHASONE DIPR 0.042% BELLADONNA ALKALOIDS/PHENOBARB BELLADONNA ALKALOIDS/PHENOBARB BELLADONNA/OPIUM 60MG BENAZEPRIL BENAZEPRIL HALFTAB BENDAMUSTINE BENOXINATE HCL/FLUORESCEIN NA BENZOCAINE 20% AEROSOL BENZOCAINE 7.5% GEL 10GM BENZONATATE BENZOYL PEROXIDE 10% BENZOYL PEROXIDE 5% BENZOYL PEROXIDE 5% BENZTROPINE BENZTROPINE BENZTROPINE BETAMETHASONE DIPR 0.05% BETAMETHASONE DIPR 0.05% BETAMETHASONE DIPR 0.05% BETAMETHASONE SOLUSPAN BETAMETHASONE VALERATE 0.1% BETAMETHASONE VALERATE 0.1% BETAMETHASONE VALERATE 0.1% BETAMETHASONE VALERATE 0.1% BETAMETHASONE VALERATE 0.1% BETAPACE AF BETAXOLOL BETAXOLOL 0.25% Brand Name LIORESAL IT KIT LIORESAL INTRATHECAL KIT LIORESAL INTRATHECAL BACLOFEN SUSPENSION BACTERIOSTATIC SOD CHLOR 0.9%* COLAZAL HD 85 TICE BCG REGRANEX BECONASE AQ 0.042% DONNATAL (EQUIV) DONNATAL (EQUIV) B&O SUPP LOTENSIN (EQUIV) LOTENSIN (EQUIV) HALFTAB TREANDA FLURATE 0.25% (EQUIV) DERMOPLAST (EQUIV) ORAJEL 7.5% (BABY) TESSALON PERLE (EQUIV) BENZOYL PEROXIDE 10% BENZOYL PEROXIDE 5% OXY-5 (EQUIV) COGENTIN (EQUIV) COGENTIN (EQUIV) COGENTIN (EQUIV) DIPROSONE (EQUIV) DIPROSONE 0.05% (EQUIV) DIPROSONE 0.05% (EQUIV) CELESTONE VALISONE 0.1% (EQUIV) VALISONE 0.1% (EQUIV) VALISONE 0.1% (EQUIV) VALISONE 0.1% (EQUIV) VALISONE 0.1% (EQUIV) BETAPACE AF KERLONE (EQUIV) BETOPTIC S Drug Strength 40 MG 500 MCG 2000 MCG 5 MG 30 ML 750 MG 1900 ML 1 ML 1 APP 1 SPR 1 TAB 10 ML 60 MG 10 MG 5 MG 100 MG 1 DRP 1 EA 1 APP 100 MG 1 APP 1 APP 1 APP 0.5 MG 1 MG 2 MG 1 APP 1 APP 1 APP 1 MG 1 APP 1 APP 1 APP 1 APP 1 APP 80 MG 10 MG 1 DRP Drug Volume 20 ML 1 ML 1 ML 1 ML 30 ML 1 CAP 1900 ML 1 ML 1 APP 1 SPR 1 TAB 10 ML 1 SUPP 1 TAB 1 TAB 1 VIAL 1 DRP 1 EA 1 APP 1 CAP 1 APP 1 APP 1 APP 1 TAB 1 TAB 2 ML 1 APP 1 APP 1 APP 0.166 ML 1 APP 1 APP 1 APP 1 APP 1 APP 1 TAB 1 TAB 1 DRP Package Desc 1 KIT PACKAGE 20 ML PACKAGE 1 ML PACKAGE ML ORAL SYRINGE 30 ML VIAL 1 CAP PACKAGE 1900 ML BOTTLE 1 VIAL PACKAGE 15 GM PACKAGE 25 GM PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 SUPP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 5 ML BOTTLE 1 EA PACKAGE 10 GM PACKAGE 1 CAP PACKAGE 45 GM PACKAGE 30 ML BOTTLE 45 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML AMPUL 15 GM PACKAGE 45 GM PACKAGE 15 GM PACKAGE 0.166 ML VIAL 60 ML BOTTLE 15 GM PACKAGE 45 GM PACKAGE 15 GM PACKAGE 15 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML BOTTLE Dosage Form KIT KIT KIT SUSP VIAL CAP SUSP VIAL GEL INH TAB ELIXIR SUPP TAB TAB VIAL DROPS SPRAY GEL CAP GEL LOTION GEL TAB TAB INJ OINT OINT CREAM VIAL LOTION OINT CREAM CREAM OINT TAB TAB DROPS Route IT IT IT PO INJ PO PO INJ TOP NAS PO PO PR PO PO IV EYE TOP MM PO TOP TOP TOP PO PO INJ TOP TOP TOP INJ TOP TOP TOP TOP TOP PO PO EYE Formulary Status? F F F F F NF F F NF NF F F F NF NF NF F F F F NF NF NF F F F F F F F F F F F F NF NF F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3193 2102 2103 2830 663 3188 2140 459 402 1014 1492 2166 1461 820 3423 3524 1679 2336 1638 1740 2683 1704 1495 1808 1578 126 3347 1366 962 835 3346 1364 1363 1362 955 4087 1962 546 AHFS Code 12:20.12 12:20.12 12:20.12 12:20.12 40:12.00 56:36.00 36:68.00 80:12.00 84:92.00 52:08.08 12:08.08 12:08.08 28:08.08 24:32.04 24:32.04 10:00.00 52:16.00 52:16.00 52:16.00 48:08.00 84:28.00 84:28.00 84:28.00 28:36.08 28:36.08 28:36.08 84:06.00 84:06.00 84:06.00 68:04.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 24:24.00 24:24.00 52:40.08 Generic Name BETAXOLOL 0.5% BETHANECHOL BETHANECHOL BETHANECHOL HALFTAB BEVACIZUMAB BICALUTAMIDE BIMATOPROST 0.03% BIOTIN/FA/ NIACIN/PANT/BCOMP/C BIOTIN/FOLIC ACID/VIT BCOMP&C BIPERIDEN BISACODYL BISACODYL BISMUTH SUBSALICYLATE BISMUTH SUBSALICYLATE CHEW BIVALIRUDIN BLEOMYCIN BLEOMYCIN SULFATE 30 UNIT VIAL BORIC ACID BORTEZOMIB BORTEZOMIB MDV BOSENTAN BOTULINUM TOXIN TYPE A BRIMONIDINE 0.15% BROMOCRIPTINE MESYLATE BROMOCRIPTINE MESYLATE BUDESONIDE EC BUDESONIDE INHALATION SOLN BUMETANIDE BUMETANIDE BUMETANIDE BUMETANIDE BUMETANIDE 2MG/50ML D5W BUPIVACAINE 0.1%/NS 250ML EPID BUPIVACAINE 0.125%/NS 250 ML BUPIVACAINE 0.25% BUPIVACAINE 0.25% SDPF BUPIVACAINE 0.25%/EPI 1:200000 BUPIVACAINE 0.25%/NS 250 ML Brand Name BETOPTIC 0.5% (EQUIV) URECHOLINE (EQUIV) URECHOLINE (EQUIV) URECHOLINE (EQUIV) HALFTAB AVASTIN CASODEX LUMIGAN 0.03% FOLBEE PLUS SF DF BIOTIN FORTE AKINETON BISAC-EVAC BISACODYL PEPTO-BISMOL PEPTO BISMAL CHEW (EQUIV) ANGIOMAX BLENOXANE BLEOMYCIN SULFATE BORIC ACID VELCADE VELCADE MDV TRACLEER BOTOX, THERAPEUTIC ALPHAGAN P PARLODEL (EQUIV) PARLODEL (EQUIV) ENTOCORT EC PULMICORT BUMEX (EQUIV) BUMEX (EQUIV) BUMEX (EQUIV) BUMEX (EQUIV) BUMEX 2MG/50ML D5W MARCAINE 0.1%/NS 250ML EPID MARCAINE 0.125%/NS 250ML SOL SENSORCAINE 0.25% MARCAINE 0.25% (EQUIV) MARCAINE 0.25%/EPI 1:200,000 MARCAINE 0.25%/NS 250ML SOL Drug Strength 1 DRP 10 MG 25 MG 12.5 MG 100 MG 50 MG 1 DRP 1 TAB 1 TAB 2 MG 10 MG 5 MG 262 MG 262 MG 250 MG 15 UNT 30 UNIT 1 GM 3.5 MG 0.1 MG 125 MG 100 UNT 1 DRP 2.5 MG 5 MG 3 MG 0.5 MG 0.5 MG 1 MG 1 MG 2.5 MG 2 MG 250 ML 250 ML 50 ML 30 ML 30 ML 250 ML Drug Volume 1 DRP 1 TAB 1 TAB 1 TAB 4 ML 1 TAB 1 DRP 1 TAB 1 TAB 1 TAB 1 SUPP 1 TAB EC 15 ML 1 TAB 5 ML 1 VIAL 1 VIAL 1 GM 1 VIAL 0.29 ML 1 TAB 1 EA 1 DRP 1 TAB 1 CAP 1 CAP 2 ML 1 TAB 4 ML 1 TAB 10 ML 50 ML 250 ML 250 ML 50 ML 30 ML 30 ML 250 ML Package Desc 5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 4 ML BOTTLE 1 TAB PACKAGE 2.5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 SUPP PACKAGE 1 TAB EC PACKAGE ML ORAL SYRINGE 1 TAB CHW PACKAGE 5 ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 GM PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 5 ML BOTTLE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 2 ML BOTTLE 1 TAB PACKAGE 4 ML VIAL 1 TAB PACKAGE 10 ML VIAL 50 ML BAG 250 ML BAG 250 ML BAG 50 ML VIAL 30 ML VIAL 30 ML VIAL 250 ML BAG Dosage Form DROPS TAB TAB TAB VIAL TAB DROPS TAB TAB TAB SUPP TAB EC SUSP TAB CHW VIAL VIAL VIAL POWDER VIAL VIAL TAB VIAL DROPS TAB CAP CAP NEB TAB VIAL TAB VIAL PB PREMIX PREMIX VIAL VIAL VIAL PREMIX Route EYE PO PO PO INJ PO EYE PO PO PO PR PO PO PO IV INJ INJ MSC IVP IV PO IM EYE PO PO PO INH PO IV PO INJ IV EPD EPD INJ INJ INJ RNB Formulary Status? F F F F NF NF NF NF NF NF F F F F F F F NF NF F NF NF F F F NF F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2188 2305 2306 4069 3095 1197 2595 2934 2608 2901 1708 2087 2987 2519 2304 278 3041 2626 2630 3307 4206 302 306 1563 787 2997 3165 1915 2049 1916 2050 4241 4027 4028 1114 631 765 4030 AHFS Code 52:40.08 12:04.00 12:04.00 12:04.00 10:00.00 10:00.00 52:40.28 88:08.00 88:08.00 28:36.08 56:12.00 56:12.00 56:08.00 56:08.00 20:12.04 10:00.00 10:00.00 52:04.92 10:00.00 10:00.00 24:12.92 92:92.00 52:40.04 28:36.20 28:36.20 68:04.00 48:10.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 Generic Name BUPIVACAINE 0.5% BUPIVACAINE 0.5% BUPIVACAINE 0.5%/EPI 1:200,000 BUPIVACAINE 0.5%/EPI 1:200,000 BUPIVACAINE 0.75% BUPIVACAINE 0.75%/DEXTROSE BUPIVACAINE 0.75%/EPI 1:200000 BUPRENORPHINE BUPRENORPHINE HCL BUPRENORPHINE/NALOXONE 2/0.5MG BUPRENORPHINE/NALOXONE 8MG/2MG BUPROPION BUPROPION BUPROPION HALFTAB BUPROPION HALFTAB BUPROPION QUARTER-TAB BUPROPION SR BUPROPION SR BUSPIRONE BUSPIRONE BUSPIRONE HALFTAB BUSULFAN BUTORPHANOL BUTORPHANOL NASAL CABAZITAXEL CABERGOLINE CAFFEINE CITRATE CAFFEINE CITRATED *STUDY DRUG* CAFFEINE/SODIUM BENZOATE CALAMINE LOTION CALCIPOTRIENE 0.005% CREAM CALCITONIN NASAL 200U CALCITONIN SALMON CALCITRIOL CALCITRIOL CALCITRIOL CALCITRIOL CALCIUM 500MG/VITAMIN D200U Brand Name MARCAINE 0.5% (EQUIV) SENSORCAINE 0.5% MARCAINE 0.5%/EPI 1:200,000 SENSORCAINE 0.5%/EPI 1:200,000 MARCAINE 0.75% (EQUIV) MARCAINE SPINAL SENSORCAINE 0.75%/EPI 1:200000 SUBUTEX BUPRENORPHINE HCL SUBOXONE SUBOXONE 8MG TAB WELLBUTRIN (EQUIV) WELLBUTRIN (EQUIV) WELLBUTRIN (EQUIV) HALFTAB WELLBUTRIN (EQUIV) HALFTAB WELLBUTRIN (EQUIV) QUARTER-TAB WELLBUTRIN SR (EQUIV) WELLBUTRIN SR (EQUIV) BUSPAR (EQUIV) BUSPAR (EQUIV) BUSPAR (EQUIV) HALFTAB MYLERAN STADOL (EQUIV) STADOL NASAL (EQUIV) JEVTANA DOSTINEX CAFCIT CAFFEINE CITRATE *STUDY DRUG* CAFFEINE SOD BENZ CALAMINE LOTION DOVONEX 0.005% CREAM MIACALCIN 200U NASAL (EQUIV) MIACALCIN ROCALTROL (EQUIV) ROCALTROL (EQUIV) ROCALTROL (EQUIV) CALCIJEX OSCAL 500/W VIT D Drug Strength 30 ML 5 MG 30 ML 50 ML 7.5 MG 2 ML 30 ML 8 MG 2 MG 2 MG 8 MG 100 MG 75 MG 37.5 MG 50 MG 25 MG 100 MG 150 MG 10 MG 5 MG 2.5 MG 2 MG 1 MG 10 MG 60 MG 0.5 MG 60 MG 60 MG 500 MG 1 APP 1 APP 1 SPR 200 UNT 0.25 MCG 0.5 MCG 1 MCG 1 MCG 1 TAB Drug Volume 30 ML 1 ML 30 ML 50 ML 1 ML 2 ML 30 ML 1 SL TAB 1 TAB SL 1 TAB 1 TAB SL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB SR 1 TAB SR 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 ML 1.5 ML 1 TAB 3 ML 3 ML 2 ML 1 APP 1 APP 1 SPR 1 ML 1 CAP 1 CAP 1 ML 1 ML 1 TAB Package Desc 30 ML VIAL 50 ML VIAL 30 ML VIAL 50 ML VIAL 30 ML VIAL 2 ML AMPUL 30 ML VIAL 1 TAB SL PACKAGE 1 TAB SL PACKAGE 1 TAB PACKAGE 1 TAB SL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 2.5 ML BOTTLE 1.5 ML VIAL 1 TAB PACKAGE 3 ML VIAL 3 ML BOTTLE 2 ML VIAL 120 ML BOTTLE 60 GM PACKAGE 3.7 ML BOTTLE 2 ML VIAL 1 CAP PACKAGE 1 CAP PACKAGE 1 ML ORAL SYRINGE 1 ML AMPUL 1 TAB PACKAGE Dosage Form VIAL VIAL VIAL VIAL VIAL INJ VIAL TAB SL TAB SL TAB SL TAB SL TAB TAB TAB TAB TAB TAB SR TAB SR TAB TAB TAB TAB VIAL SPRAY VIAL TAB VIAL VIAL VIAL LOTION CREAM SPRAY VIAL CAP CAP SOLN INJ TAB Route INJ INJ INJ INJ INJ INJ INJ SL SL SL SL PO PO PO PO PO PO PO PO PO PO PO INJ NAS IV PO INJ PO INJ TOP TOP NAS INJ PO PO PO IV PO Formulary Status? F F F F F F F NF F NF NF F F F F F F F F F F F F NF NF NF F F F F NF F F F F F F F Controlled Substance? NO NO NO NO NO NO NO YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 03 02 03 03 00 00 00 00 00 00 00 00 00 00 00 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 632 1115 766 1113 633 1112 1116 3138 4298 3092 2962 1926 1925 2735 2736 4008 1048 1000 1939 1938 2737 1044 653 859 4073 2821 1488 4155 2058 2338 4291 799 792 63 884 3058 763 1086 AHFS Code 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 28:08.12 28:08.12 28:08.12 28:08.12 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:24.92 28:24.92 28:24.92 10:00.00 28:08.12 28:08.12 10:00.00 28:36.20 28:20.92 28:20.92 28:20.92 84:24.12 84:92.00 68:24.00 68:24.00 88:16.00 88:16.00 88:16.00 88:16.00 40:12.00 Generic Name CALCIUM ACETATE CALCIUM ACETATE/AL SULFATE CALCIUM CARB* CALCIUM CARBONATE CALCIUM CARBONATE CALCIUM CARBONATE CALCIUM CARBONATE* CALCIUM CHLORIDE 10% CALCIUM CHLORIDE ABBJCT CALCIUM CITRATE CALCIUM GLUCONATE 10% CALCIUM GLUCONATE 10%* CALCIUM GLUCONATE SDV* CALCIUM POLYCARBOPHIL CANDESARTAN CANDESARTAN CILEXETIL CANDIDA 1:100 MOLD EXTRACTS CAPECITABINE CAPECITABINE CAPSAICIN 0.025% CAPTOPRIL CAPTOPRIL CAPTOPRIL CAPTOPRIL HALFTAB CAPTOPRIL QUARTERTAB CAPTOPRIL SUSPENSION CARBACHOL CARBACHOL 1.5% CARBAMAZEPINE CARBAMAZEPINE CARBAMAZEPINE HALFTAB CARBAMAZEPINE SUSP CARBAMAZEPINE XR CARBAMAZEPINE XR CARBAMIDE PEROXIDE 10% CARBAMIDE PEROXIDE 6.5% CARBIDOPA/LEVODOPA 10/100 CARBIDOPA/LEVODOPA 12.5-50 HT Brand Name PHOSLO DOMEBORO (EQUIV) TUMS* OSCAL (EQUIV) CALCIUM CARBONATE TUMS (EQUIV) CALTRATE* CALCIUM CHLORIDE 10% CALCIUM CHLORIDE ABBJCT CALCITRATE CALCIUM GLUCONATE 10% CALCIUM GLUCONATE 10%* CALCIUM GLUCONATE SDV* FIBER TABLET ATACAND ATACAND CANDIN XELODA XELODA CAPSICUM OLEORESIN 0.025% CAPOTEN (EQUIV) CAPOTEN (EQUIV) CAPOTEN (EQUIV) CAPOTEN (EQUIV) HALFTAB CAPOTEN (EQUIV) QUARTERTAB CAPOTEN SUSPENSION (EQUIV) MIOSTAT ISOPTO CARBACHOL 1.5% TEGRETOL (EQUIV) TEGRETOL (EQUIV) TEGRETOL (EQUIV) HALFTAB TEGRETOL SUSP (EQUIV) TEGRETOL XR TEGRETOL XR GLY-OXIDE DEBROX (EQUIV) SINEMET 10/100 (EQUIV) SINEMET 12.5-50 (EQUIV) HT Drug Strength 667 MG 1 TAB EFF 500 MG 1.25 GM 250 MG 500 MG 600 MG 1 GM 100 MG 200 MG 1 GM 5000 MG 10000 MG 1 TAB 16 MG 4 MG 1 APP 150 MG 500 MG 1 APP 12.5 MG 25 MG 50 MG 6.25 MG 3.125 MG 0.125 MG 1.5 ML 1 DRP 100 MG 200 MG 50 MG 100 MG 100 MG 400 MG 1 APP 1 DRP 1 TAB 1 TAB Drug Volume 1 CAP 1 TAB EFF 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 10 ML 1 ML 1 TAB 10 ML 50 ML 100 ML 1 TAB 1 TAB 1 TAB 1 APP 1 TAB 1 TAB 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1.5 ML 1 DRP 1 TAB 1 TAB 1 TAB 5 ML 1 TAB SR 1 TAB SR 1 APP 1 DRP 1 TAB 1 TAB Package Desc 1 CAP PACKAGE 1 TAB EFF PACKAGE 150 TAB CHW 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB CHW PACKAGE 150 TAB BOTTLE 10 ML VIAL 10 ML SYRINGE 1 TAB PACKAGE 10 ML VIAL 50 ML VIAL 100 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 60 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1.5 ML VIAL 15 ML BOTTLE 1 TAB CHW PACKAGE 1 TAB PACKAGE 1 TAB CHW PACKAGE ML ORAL SYRINGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE 15 ML BOTTLE 15 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form CAP TAB EFF TAB CHW TAB SUSP TAB CHW TAB VIAL SYRINGE TAB VIAL VIAL VIAL TAB TAB TAB VIAL TAB TAB CREAM TAB TAB TAB TAB TAB SUSP VIAL DROPS TAB CHW TAB TAB CHW SUSP TAB SR TAB SR SOLN DROPS TAB TAB Route PO TOP PO PO PO PO PO IV INJ PO IV IV IV PO PO PO ID PO PO TOP PO PO PO PO PO PO OPH EYE PO PO PO PO PO PO MM EAR PO PO Formulary Status? F F F F F F F F F NF F F F F NF NF F NF NF NF F F F F F F NF F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1964 1652 3080 493 466 1580 3089 1407 2684 4103 2261 2262 3340 2989 2576 3878 1690 86 87 2621 1902 1903 2344 2738 3517 2539 3939 1617 1069 1065 2739 1958 2345 2346 866 1590 1881 4013 AHFS Code 40:18.19 84:12.00 56:04.00 40:12.00 40:12.00 56:04.00 56:04.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 56:12.00 24:32.08 24:32.08 36:32.00 10:00.00 10:00.00 84:92.00 24:32.04 24:32.04 24:32.04 24:32.04 24:32.04 24:32.04 52:40.20 52:40.20 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 52:04.92 52:04.92 28:36.16 28:36.16 Generic Name CARBIDOPA/LEVODOPA 25-100 CARBIDOPA/LEVODOPA 25-250 CARBIDOPA/LEVODOPA 25MG/100MG CARBIDOPA/LEVODOPA 6.25-25 QT CARBIDOPA/LEVODOPA CR 25-100 CARBIDOPA/LEVODOPA CR 50/200 CARBOPLATIN CARBOPROST TROMETHAMINE CARFILZOMIB CARISOPRODOL CARMUSTINE CARMUSTINE 7.7 MG BX OF 8 CARVEDILOL CARVEDILOL CARVEDILOL CARVEDILOL CARVEDILOL HALFTAB CASCARA SAGRADA CASPOFUNGIN CASPOFUNGIN CASPOFUNGIN 50MG/250ML NS CASPOFUNGIN 70MG/250ML NS CASTOR OIL CASTOR OIL CEFAZOLIN CEFAZOLIN CEFAZOLIN CEFAZOLIN 1.5GM/50ML D5W CEFAZOLIN 1GM/50ML D5W,ISO CEFAZOLIN 2GM/50ML D5W,ISO CEFAZOLIN OPTH SOLN CEFAZOLIN* CEFDINIR CEFEPIME CEFEPIME CEFEPIME 1GM/50ML D5W CEFEPIME 250MG/50ML D5W CEFEPIME 2GM/50ML D5W Brand Name SINEMET 25-100 (EQUIV) SINEMET 25-250 (EQUIV) PARCOPA 25MG/100MG OD SINEMET 6.25-25 (EQUIV) QT SINEMET CR 25-100 (EQUIV) SINEMET CR 50/200 PARAPLATIN HEMABATE KYPROLIS CARISOPRODOL BICNU GLIADEL WAFER 7.7MG BX OF 8 COREG COREG COREG COREG COREG HALFTAB CASCARA SAGRADA CANCIDAS CANCIDAS CANCIDAS 50MG/250ML NS CANCIDAS 70MG/250ML NS CASTOR OIL CASTOR OIL ANCEF (EQUIV) ANCEF (EQUIV) ANCEF (EQUIV) ANCEF 1.5GM/50ML D5W ANCEF (EQUIV) ANCEF (EQUIV) CEFAZOLIN OPTH SOLN ANCEF (EQUIV)* CEFDINIR MAXIPIME MAXIPIME CEFEPIME 1GM/50ML D5W CEFEPIME 250MG/50ML D5W CEFEPIME 2GM/50ML D5W Drug Strength 1 TAB 1 TAB 1 TAB LN 1 TAB 1 TAB 1 TAB 50 MG 250 MCG 60 MG 350 MG 100 MG 1 BX 12.5 MG 25 MG 3.125 MG 6.25 MG 1.56 MG 325 MG 50 MG 70 MG 50 MG 70 MG 30 ML 60 ML 1 GM 1 GM 500 MG 1.5 GM 1 GM 2 GM 33 MG 1 GM 250 MG 1 GM 2 GM 1 GM 250 MG 2 GM Drug Volume 1 TAB 1 TAB 1 TAB LN 1 TAB 1 TAB 1 TAB 1 VIAL 1 ML 1 VIAL 1 TAB 1 VIAL 1 BX 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 5 ML 1 VIAL 1 VIAL 250 ML 250 ML 30 ML 60 ML 10 ML 1 VIAL 1 VIAL 50 ML 50 ML 50 ML 1 ML 1 VIAL 5 ML 1 VIAL 1 VIAL 50 ML 50 ML 50 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB LN PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 ML AMPUL 1 SDV VIAL 1 TAB PACKAGE 1 VIAL PACKAGE 1 BX PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 250 ML BAG 250 ML BAG ML ORAL SYRINGE 60 ML BOTTLE 10 ML SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG 50 ML BAG 15 ML BOTTLE 1 VIAL PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG 50 ML BAG Dosage Form TAB TAB TAB LN TAB TAB CR TAB CR VIAL INJ VIAL TAB VIAL MISC TAB TAB TAB TAB TAB SOLN VIAL INJ PB PB OIL OIL SYRINGE VIAL VIAL PB PB PB OPTHSOL VIAL SUSP INJ VIAL PB PB PB Route PO PO PO PO PO PO IV IM IV PO IV MSC PO PO PO PO PO PO IV IV IV IV PO PO IV INJ INJ IV IV IV EYE INJ PO IPB INJ IV IV IV Formulary Status? F F NF F F F F F F NF F NF F F F F F F F F F F F F F F F F F F F F NF NF NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1082 1883 3137 4325 536 2833 281 242 4313 2685 279 2634 3306 2667 2577 169 3503 1297 144 2349 4227 4228 2686 1460 3922 159 2787 4229 3380 4265 2351 3232 3889 1946 1947 4225 4247 4226 AHFS Code 28:36.16 28:36.16 28:36.16 28:36.16 28:36.16 28:36.16 10:00.00 76:00.00 10:00.00 12:20.04 10:00.00 10:00.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 56:12.00 08:14.16 08:14.16 08:14.16 08:14.16 84:24.08 56:12.00 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 Generic Name CEFEPIME 500MG/50ML D5W CEFOTAXIME D10W NEO 50MG/ML CEFOTAXIME SODIUM CEFOTAXIME* CEFOXITIN 1GM/50ML D5W,ISO CEFOXITIN 2GM/50ML D5W,ISO CEFOXITIN SODIUM CEFOXITIN SODIUM CEFPODOXIME PROXETIL CEFTAZIDIME CEFTAZIDIME D10W NEO 50MG/ML CEFTAZIDIME* CEFTAZIDIME* CEFTAZIDIME* CEFTRIAXONE CEFTRIAXONE CEFTRIAXONE CEFTRIAXONE CEFTRIAXONE 1GM/50ML D5W ISO CEFTRIAXONE 2GM/50ML D5W,ISO CEFTRIAXONE* CEFTRIAXONE* CEFUROXIME CEFUROXIME CEFUROXIME CEFUROXIME CEFUROXIME 1.5GM/100ML D5W CEFUROXIME 750MG/100ML D5W CEFUROXIME AXETIL CEFUROXIME* CEFUROXIME* CELECOXIB CELECOXIB CEPHALEXIN CEPHALEXIN CEPHALEXIN CERTOLIZUMAB PEGOL CETUXIMAB SDPF Brand Name CEFEPIME 500MG/50ML D5W CEFOTAXIME D10W NEO 50MG/ML CLAFORAN CLAFORAN* MEFOXIN (EQUIV) MEFOXIN (EQUIV) MEFOXIN (EQUIV) MEFOXIN (EQUIV) CEFPODOXIME PROXETIL FORTAZ CEFTAZIDIME D10W NEO 50MG/ML FORTAZ* FORTAZ* TAZICEF 2GM* ROCEPHIN (EQUIV) ROCEPHIN (EQUIV) ROCEPHIN (EQUIV) ROCEPHIN (EQUIV) ROCEPHIN (EQUIV) ROCEPHIN (EQUIV) ROCEPHIN (EQUIV)* ROCEPHIN (EQUIV)* KEFUROX CEFTIN CEFTIN KEFUROX KEFUROX 1.5GM/100ML D5W KEFUROX 750MG/100ML D5W CEFTIN KEFUROX* KEFUROX* CELEBREX CELEBREX KEFLEX (EQUIV) KEFLEX (EQUIV) KEFLEX (EQUIV) CIMZIA ERBITUX Drug Strength 500 MG 50 MG 1 GM 100 MG 1 GM 2 GM 1 GM 2 GM 200 MG 1 GM 50 MG 1 GM 1 GM 2 GM 1 GM 2 GM 250 MG 500 MG 1 GM 2 GM 1 GM 10 GM 1.5 GM 25 MG 250 MG 750 MG 1.5 GM 750 MG 50 MG 1.5 GM 750 MG 100 MG 200 MG 250 MG 50 MG 500 MG 200 MG 100 MG Drug Volume 50 ML 1 ML 1 VIAL 1 ML 50 ML 50 ML 1 VIAL 1 VIAL 1 TAB 1 VIAL 1 ML 1 VIAL 16.6 ML 1 VIAL 1 VIAL 1 VIAL 1 VIAL 1 VIAL 50 ML 50 ML 1 VIAL 1 VIAL 1 VIAL 1 ML 1 TAB 1 VIAL 100 ML 100 ML 1 ML 1 VIAL 1 VIAL 1 CAP 1 CAP 1 CAP 1 ML 1 CAP 1 ML 50 ML Package Desc 50 ML BAG 1 ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 ML PACKAGE 1 VIAL PACKAGE ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 VIAL PACKAGE 100 ML BAG 100 ML BAG ML ORAL SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 1 ML SYRING 50 ML VIAL Dosage Form PB SOLN VIAL VIAL PB PB VIAL VIAL TAB VIAL SOLN VIAL VIAL VIAL VIAL VIAL VIAL VIAL PB PB VIAL VIAL VIAL SUSP TAB VIAL PB PB SUSP VIAL VIAL CAP CAP CAP SUSP CAP SYRING VIAL Route IV IV INJ INJ IV IV INJ IV PO INJ IV INJ INJ INJ INJ INJ INJ INJ IV IV INJ INJ INJ PO PO INJ IV IV PO INJ INJ PO PO PO PO PO SC IV Formulary Status? F F F F F F F F NF F F F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 4246 2716 382 383 3381 3382 3428 129 4287 23 2717 3233 1010 3361 90 91 88 89 3378 3379 3247 92 26 1015 1012 24 4270 4269 3147 3248 3236 324 325 1856 891 1858 4090 2994 AHFS Code 08:12.06 08:12.06 08:12.06 08:12.06 08:12.07 08:12.07 08:12.07 08:12.07 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 08:12.06 28:08.04 28:08.04 08:12.06 08:12.06 08:12.06 56:92.00 10:00.00 Generic Name CETUXIMAB SDPF CHARCOAL/ACTIVATED AQUA 50GM CHARCOAL/SORBITOL SOLUTION CHLORAMBUCIL CHLORAMPHENICOL SOD SUCC CHLORASEPTIC LOZENGE CHLORDIAZEPOXIDE CHLORDIAZEPOXIDE CHLORDIAZEPOXIDE CHLORHEX GL/GLYCERIN/HE-CELL CHLORHEX GL/GLYCERIN/HE-CELL CHLORHEXIDINE 0.12% RINSE CHLOROPROCAINE 2% CHLOROPROCAINE 3% CHLOROQUINE CHLOROTHIAZIDE CHLOROTHIAZIDE CHLOROTHIAZIDE CHLOROTHIAZIDE 1000MG/50ML D5W CHLOROTHIAZIDE 500MG/50ML D5W CHLOROTHIAZIDE SUSP *NEO* CHLORPHENIRAMINE CHLORPHENIRAMINE HALFTAB CHLORPHENIRAMINE SYRUP CHLORPROMAZINE CHLORPROMAZINE CHLORPROMAZINE CHLORPROMAZINE CHLORPROMAZINE CHLORPROMAZINE CHLORTHALIDONE CHLORTHALIDONE HALFTAB CHOLESTEROL SUSP CHOLESTYRAMINE/SUCROSE CHONDRO SU A/HYALUR SOD CIDOFOVIR CILOSTAZOL CILOSTAZOL Brand Name ERBITUX ACTIDOSE-AQUA 50GM ACTIDOSE 50GM (W/SORBITOL) LEUKERAN CHLOROMYCETIN (EQUIV) CHLORASEPTIC LOZENGE LIBRIUM (EQUIV) LIBRIUM (EQUIV) LIBRIUM (EQUIV) SURGILUBE SURGILUBE (EQUIV) 120.5GM PERIDEX (EQUIV) CHLOROPROCAINE 2% CHLOROPROCAINE 3% ARALEN DIURIL DIURIL (EQUIV) DIURIL DIURIL 1000MG/50ML D5W DIURIL 500MG/50ML D5W DIURIL (EQUIV) SUSP *NEO* CORICIDIN (EQUIV) CORICIDIN (EQUIV) HALFTAB ALLER-CHLOR SYRUP THORAZINE (EQUIV) THORAZINE (EQUIV) THORAZINE (EQUIV) THORAZINE (EQUIV) THORAZINE (EQUIV) THORAZINE (EQUIV) HYGROTON (EQUIV) HYGROTON (EQUIV) HALFTAB CHOLESTEROL SUSP QUESTRAN (EQUIV) DUOVISC (EQUIV) VISTIDE PLETAL PLETAL Drug Strength 200 MG 50 GM 50 GM 2 MG 1 GM 1 LOZ 10 MG 25 MG 5 MG 1 APP 1 APP 15 ML 20 ML 20 ML 500 MG 250 MG 250 MG 500 MG 1000 MG 500 MG 50 MG 4 MG 2 MG 0.4 MG 10 MG 100 MG 25 MG 25 MG 50 MG 50 MG 25 MG 12.5 MG 150 MG 4 GM 1 KIT 375 MG 100 MG 50 MG Drug Volume 100 ML 240 ML 240 ML 1 TAB 1 VIAL 1 LOZ 1 CAP 1 CAP 1 CAP 1 APP 1 APP 15 ML 20 ML 20 ML 1 TAB 5 ML 1 TAB 1 VIAL 50 ML 50 ML 1 ML 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 2 ML 1 TAB 1 TAB 1 ML 1 PKT 1 KIT 5 ML 1 TAB 1 TAB Package Desc 100 ML VIAL 240 ML BOTTLE 240 ML BOTTLE 1 TAB PACKAGE 1 VIAL PACKAGE 1 LOZ PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 5 GM PACKAGE 120.5 GM PACKAGE 473 ML BOTTLE 20 ML VIAL 20 ML VIAL 1 TAB PACKAGE 237 ML BOTTLE 1 TAB PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML AMPUL 1 TAB PACKAGE 2 ML AMPUL 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 PKT PACKAGE 1 KIT PACKAGE 5 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form VIAL LIQUID LIQUID TAB VIAL LOZ CAP CAP CAP JELLY GEL LIQUID VIAL VIAL TAB SUSP TAB VIAL PB PB SUSP TAB TAB SYRUP TAB TAB TAB INJ TAB INJ TAB TAB SUSP PACKET KIT VIAL TAB TAB Route IV PO PO PO IV LOZ PO PO PO TOP TOP MM INJ INJ PO PO PO IV IV IV PO PO PO PO PO PO PO INJ PO INJ PO PO PO PO MSC IV PO PO Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F NF NF Controlled Substance? NO NO NO NO NO NO YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 04 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3292 1455 1454 1035 2237 2352 1820 1798 1819 2811 975 1354 2039 2040 309 4168 1287 139 4271 4242 125 1801 2740 2687 1837 1836 1838 1509 1795 1510 1783 3371 3004 855 1627 2217 2141 2142 AHFS Code 10:00.00 56:04.00 56:04.00 10:00.00 08:12.08 52:16.00 28:24.08 28:24.08 28:24.08 84:92.00 84:92.00 52:04.92 72:00.00 72:00.00 08:30.08 40:28.20 40:28.20 40:28.20 40:28.20 40:28.20 40:28.20 04:04.20 04:04.20 04:04.20 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 40:28.24 40:28.24 84:20.00 24:06.04 94:00.00 08:18.32 20:12.18 20:12.18 Generic Name CIMETIDINE CIMETIDINE SOLN CINACALCET CIPROFLOXACIN CIPROFLOXACIN CIPROFLOXACIN CIPROFLOXACIN CIPROFLOXACIN 0.3% CIPROFLOXACIN 0.3% CIPROFLOXACIN 200MG/100ML D5W CIPROFLOXACIN 400MG/200ML D5W CIPROFLOXACIN HCL/DEXAMETH CIPROFLOXACIN HCL/HC CISATRACURIUM CISATRACURIUM 100MG/100ML D5W CISPLATIN CITALOPRAM CITALOPRAM CITALOPRAM CITALOPRAM CITRIC ACID/SODIUM CITRATE CITRIC ACID/SODIUM CITRATE CLADRIBINE CLARITHROMYCIN CLARITHROMYCIN CLARITHROMYCIN CLARITHROMYCIN CLINDAMYCIN CLINDAMYCIN CLINDAMYCIN CLINDAMYCIN CLINDAMYCIN CLINDAMYCIN CLINDAMYCIN 1% GEL CLINDAMYCIN 1% TOPICAL CLINDAMYCIN 2% VAGINAL CLINDAMYCIN 300MG/50ML D5W CLINDAMYCIN 900MG/50ML D5W Brand Name TAGAMET (EQUIV) TAGAMET SOLN (EQUIV) SENSIPAR CIPRO I.V. CIPRO CIPRO I.V. CIPRO CILOXAN 0.3% CILOXAN 0.3% CIPROFLOXACIN 200MG/100ML D5W CIPROFLOXACIN 400MG/200ML D5W CIPRODEX OTIC SUSPENSION CIPRO HC NIMBEX NIMBEX 100MG/100ML D5W CISPLATIN CELEXA CELEXA CELEXA CELEXA BICITRA (EQUIV) BICITRA (EQUIV) LEUSTATIN BIAXIN (EQUIV) BIAXIN (EQUIV) BIAXIN (EQUIV) BIAXIN (EQUIV) CLEOCIN (EQUIV) CLEOCIN CLEOCIN CLEOCIN (EQUIV) CLEOCIN CLEOCIN CLEOCIN 1% GEL (EQUIV) CLEOCIN 1% TOPICAL (EQUIV) CLEOCIN 2% VAG CLEOCIN 300MG/50ML D5W CLEOCIN 900MG/50ML D5W Drug Strength 300 MG 60 MG 30 MG 200 MG 250 MG 400 MG 500 MG 1 APP 1 DRP 200 MG 400 MG 1 DROP 1 DRP 2 MG 100 MG 10 MG 10 MG 2 MG 20 MG 40 MG 1 ML 30 ML 1 MG 25 MG 250 MG 50 MG 500 MG 150 MG 150 MG 300 MG 600 MG 75 MG 900 MG 1 APP 1 APP 1 APP 300 MG 900 MG Drug Volume 1 TAB 1 ML 1 TAB 20 ML 1 TAB 40 ML 1 TAB 1 APP 1 DRP 100 ML 200 ML 1 DROP 1 DRP 1 ML 100 ML 10 ML 1 TAB 1 ML 1 TAB 1 TAB 1 ML 30 ML 1 ML 1 ML 1 TAB 1 ML 1 TAB 1 CAP 1 ML 2 ML 4 ML 5 ML 6 ML 1 APP 1 APP 1 APP 50 ML 50 ML Package Desc 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 20 ML VIAL 1 TAB PACKAGE 40 ML VIAL 1 TAB PACKAGE 3.5 GM PACKAGE 2.5 ML BOTTLE 100 ML BOTTLE 200 ML BOTTLE 7.5 ML BOTTLE 10 ML BOTTLE 1 ML VIAL 100 ML BAG 10 ML VIAL 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 30 ML UD CUP 10 ML VIAL ML ORAL SYRINGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 CAP PACKAGE ML VIAL 2 ML VIAL 4 ML VIAL ML ORAL SYRINGE 6 ML VIAL 30 GM PACKAGE 60 ML BOTTLE 40 GM PACKAGE 50 ML BAG 50 ML BAG Dosage Form TAB LIQUID TAB VIAL TAB VIAL TAB OINT DROPS PREMIX PREMIX DROPS DROPS INJ PREMIX VIAL TAB SOLN TAB TAB SOLN SOLN VIAL SUSP TAB SUSP TAB CAP VIAL VIAL VIAL SOLN VIAL GEL SOLN CREAM PB PB Route PO PO PO IV PO IV PO EYE EYE IV IV EAR EAR IV IV IV PO PO PO PO PO PO IV PO PO PO PO PO INJ INJ INJ PO INJ TOP TOP VAG IV IV Formulary Status? NF NF NF NF NF NF NF F F NF NF NF F F F F F F F F F F NF F F F F F F F F F F F NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1895 918 2940 341 338 343 340 559 560 3473 3474 3538 2832 2354 3899 2042 1338 1342 1339 1340 915 916 2151 674 686 681 670 1853 235 243 239 238 245 2158 2155 248 4230 4232 AHFS Code 56:28.12 56:28.12 92:92.00 08:12.18 08:12.18 08:12.18 08:12.18 52:04.04 52:04.04 08:12.18 08:12.18 52:04.04 52:04.04 12:20.20 12:20.20 10:00.00 28:16.04 28:16.04 28:16.04 28:16.04 40:08.00 40:08.00 10:00.00 08:12.12 08:12.12 08:12.12 08:12.12 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 84:04.04 84:04.04 84:04.04 08:12.28 08:12.28 Generic Name CLINDAMYCIN D10W NEO 12MG/ML CLINDAMYCIN* CLINDAMYCIN* CLINDAMYCIN* CLOBETASOL 0.05% CR CLOBETASOL 0.05% OINT CLOBETASOL 0.05% OINT 30GM CLOBETASOL 0.05% SOLN 50ML CLOFARABINE 20MG/20ML INJ CLOMIPRAMINE CLOMIPRAMINE CLOMIPRAMINE HCL CLONAZEPAM CLONAZEPAM CLONAZEPAM CLONAZEPAM SUSP CLONIDINE CLONIDINE CLONIDINE CLONIDINE HCL CLONIDINE PATCH 0.1MG CLONIDINE PATCH 0.2MG CLONIDINE PATCH 0.3MG CLONIDINE SUSPENSION CLOPIDOGREL CLOTRIMAZOLE 1% CLOTRIMAZOLE 1% CLOTRIMAZOLE 1% CLOTRIMAZOLE TROCHE CLOTRIMAZOLE/BETAMET DIPROP CLOTRIMAZOLE/BETAMET DIPROP CLOTRIMAZOLE/BETAMET DIPROP CLOZAPINE CLOZAPINE CLOZAPINE HALFTAB COAL TAR 0.5% COAL TAR 20% COAL TAR SHAMPOO Brand Name CLINDAMYCIN D10W NEO 12MG/ML CLEOCIN* CLEOCIN* CLEOCIN* TEMOVATE 0.05% CR (EQUIV) TEMOVATE 0.05% OINT (EQUIV) TEMOVATE 0.05% (EQUIV) TEMOVATE 0.05% CLOLAR ANAFRANIL (EQUIV) ANAFRANIL ANAFRANIL KLONOPIN (EQUIV) KLONOPIN (EQUIV) KLONOPIN (EQUIV) KLONAPIN SUSP CATAPRES (EQUIV) CATAPRES (EQUIV) DURACLON DURACLON CATAPRES-TTS 1 CATAPRES-TTS 2 CATAPRES-TTS 3 CATAPRES (EQUIV) SUSPENSION PLAVIX LOTRIMIN 1%(EQUIV) MYCELEX 1% (EQUIV) GYNE-LOTRIMIN 1% MYCELEX TROCHE LOTRISONE (EQUIV)45GM LOTRISONE (EQUIV)15GM LOTRISONE (EQUIV) CR 45GM CLOZARIL (EQUIV) CLOZARIL (EQUIV) CLOZARIL (EQUIV) HALFTAB TERA-GEL TAR SHAMPOO COAL TAR 20% NEUTROGENA T/GEL Drug Strength 12 MG 300 MG 600 MG 900 MG 1 APP 1 APP 1 APP 1 APP 1 MG 25 MG 50 MG 50 MG 0.5 MG 1 MG 2 MG 0.1 MG 0.1 MG 0.2 MG 1000 MCG 5000 MCG 1 EA 1 EA 1 EA 10 MCG 75 MG 1 APP 1 APP 1 APP 10 MG 1 APP 1 APP 1 APP 100 MG 25 MG 12.5 MG 1 APP 1 ML 1 APP Drug Volume 1 ML 2 ML 4 ML 6 ML 1 APP 1 APP 1 APP 1 APP 1 ML 1 CAP 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 10 ML 10 ML 1 EA 1 EA 1 EA 1 ML 1 TAB 1 APP 1 APP 1 APP 1 TROCHE 1 APP 1 APP 1 APP 1 TAB 1 TAB 1 TAB 1 APP 1 ML 1 APP Package Desc 1 ML PACKAGE 2 ML VIAL 4 ML VIAL 6 ML VIAL 30 GM PACKAGE 15 GM PACKAGE 30 GM PACKAGE 50 ML BOTTLE 20 ML VIAL 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML VIAL 10 ML VIAL 1 EA PACKAGE 1 EA PACKAGE 1 EA PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 15 GM PACKAGE 30 ML BOTTLE 45 GM PACKAGE 1 TROCHE PACKAGE 45 GM PACKAGE 15 GM PACKAGE 45 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 120 ML BOTTLE 473 ML BOTTLE 132 ML BOTTLE Dosage Form SOLN VIAL VIAL VIAL CREAM OINT OINT SOLN VIAL CAP CAP CAP TAB TAB TAB SUSP TAB TAB VIAL VIAL PATCH PATCH PATCH SUSP TAB CREAM SOLN CREAM TROCHE CREAM CREAM CREAM TAB TAB TAB SHAMPO SOLN SHAMPO Route IV INJ INJ INJ TOP TOP TOP TOP IV PO PO PO PO PO PO PO PO PO EPD EPD TD TD TD PO PO TOP TOP VAG MM TOP TOP TOP PO PO PO TOP MSC TOP Formulary Status? F F F F NF NF NF NF F F F NF F F F F F F F F F F F F F F F F F NF NF NF F F F NF NF NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 04 04 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2718 3238 3239 3240 1367 1368 973 1016 2955 1956 800 4079 1911 1912 1913 2853 1813 1814 506 507 1483 1484 1485 3363 2289 1953 1951 838 1657 979 978 840 791 790 2741 2689 1298 2312 AHFS Code 08:12.28 08:12.28 08:12.28 08:12.28 84:06.00 84:06.00 84:06.00 84:06.00 10:00.00 28:16.04 28:16.04 28:16.04 28:12.08 28:12.08 28:12.08 28:12.08 24:08.16 24:08.16 28:08.92 28:08.92 24:08.16 24:08.16 24:08.16 24:08.16 20:12.18 84:04.08 84:04.08 84:04.08 84:04.08 84:04.08 84:04.08 84:04.08 28:16.08 28:16.08 28:16.08 84:32.00 84:32.00 84:32.00 Generic Name COCAINE 4% COD LIVER OIL/ZINC OXIDE CODEINE CODEINE PHOSPHATE COENZYME Q10 COLCHICINE COLCHICINE COLCHICINE HALFTAB COLESEVELAM COLESTIPOL COLESTIPOL HCL COLISTIMETHATE COLLAGEN ABSORB HEMOSTAT 3X4 COLLAGENASE 15 GM COLLAGENASE 30 GM COLLODION COLLYRIUM EYE WASH CORTICORELIN OVINE TRIFLUTATE CORTISONE ACETATE CORTISONE ACETATE HALFTAB COSYNTROPIN CRITIC-AID CLEAR AF 2% OINT CROMOLYN SODIUM CROMOLYN SODIUM 4% CROTAMITON 10% 60GM CUPRIC CHLORIDE CYANOCOBALAMIN CYANOCOBALAMIN CYCLOBENZAPRINE CYCLOBENZAPRINE CYCLOPENTOLATE 0.5% CYCLOPENTOLATE 2% CYCLOPENTOLATE HCL 1% CYCLOPENTOLATE HCL 1% CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE CYCLOPHOSPHAMIDE Brand Name COCAINE 4% DESITIN DIAPER RASH (EQUIV) CODEINE CODEINE COENZYME Q10 COLCHICINE COLCHICINE COLCHICINE HALFTAB WELCHOL COLESTID COLESTID (EQUIV) COLY-MYCIN M HELISTAT 3X4 SANTYL SANTYL COLLODION FLEXIBLE COLLYRIUM EYE WASH ACTHREL CORTONE (EQUIV) CORTISONE HALFTAB CORTROSYN CRITIC-AID CLEAR AF 2% OINT INTAL (EQUIV) NASALCROM 4% EURAX 10% COPPER CHLORIDE VITAMIN B-12 CYANOCOBALAMIN FLEXERIL (EQUIV) FLEXERIL (EQUIV) CYCLOGYL 0.5% CYCLOGYL 2% CYCLOGYL 1% AK-PENTOLATE CYTOXAN LYOPHILIZED CYTOXAN LYOPHILIZED CYTOXAN CYTOXAN Drug Strength 1 DRP 1 APP 15 MG 60 MG 30 MG 0.6 MG 1 MG 0.3 MG 625 MG 5 GM 1 GM 150 MG 1 EA 1 APP 1 APP 1 ML 1 APP 100 MCG 25 MG 12.5 MG 250 MCG 1 APP 20 MG 1 PUF 1 APP 4 MG 100 MCG 1000 MCG 10 MG 5 MG 1 DRP 1 DRP 1 DRP 1 DRP 1 GM 2 GM 25 MG 50 MG Drug Volume 1 DRP 1 APP 1 TAB 2 ML 1 CAP 1 TAB 2 ML 1 TAB 1 TAB 1 PACKET 1 TAB 1 VIAL 1 EA 1 APP 1 APP 1 ML 1 APP 1 VIAL 1 TAB 1 TAB 1 VIAL 1 APP 2 ML 1 PUF 1 APP 10 ML 1 TAB 1 ML 1 TAB 1 TAB 1 DRP 1 DRP 1 DRP 1 DRP 1 VIAL 1 VIAL 1 TAB 1 TAB Package Desc 4 ML BOTTLE 30 GM PACKAGE 1 TAB PACKAGE 2 ML SYRINGE 1 CAP PACKAGE 1 TAB PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 PACKET PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 EA PACKAGE 15 GM PACKAGE 30 GM PACKAGE 1 ML BOTTLE 1 EACH BOTTLE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 57 GM PACKAGE 2 ML AMPUL-NEB. 13 ML BOTTLE 60 GM PACKAGE 10 ML VIAL 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 15 ML BOTTLE 2 ML BOTTLE 5 ML BOTTLE 2 ML BOTTLE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form SOLN OINT TAB SYRINGE CAP TAB VIAL TAB TAB PACKET TAB VIAL MISC OINT OINT LIQUID OPTSOLN VIAL TAB TAB VIAL OINT INH SPRAY CREAM VIAL TAB VIAL TAB TAB DROPS DROPS DROPS DROPS VIAL VIAL TAB TAB Route TOP TOP PO INJ PO IV PO PO PO PO INJ TOP TOP TOP MSC IRR IV PO PO INJ TOP INH NAS TOP IV PO INJ PO PO EYE EYE EYE EYE IV IV PO PO Formulary Status? F NF F F NF F F F NF F F F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? YES NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 02 00 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 497 2315 495 626 3373 926 2056 4305 2941 221 4129 2207 2355 1772 4118 1311 2375 2081 1523 3983 460 4053 1728 262 614 701 2924 1393 1863 2742 550 553 3396 551 275 276 274 3443 AHFS Code 52:16.00 84:24.12 28:08.08 28:08.08 92:92.00 92:16.00 92:16.00 92:16.00 24:06.04 24:06.04 24:06.04 08:12.28 84:92.00 84:92.00 84:92.00 96:00.00 52:92.00 36:04.00 68:04.00 68:04.00 36:04.00 84:04.08 48:10.32 48:10.32 84:04.12 40:12.00 88:08.00 88:08.00 12:20.04 12:20.04 52:24.00 52:24.00 52:24.00 52:24.00 10:00.00 10:00.00 10:00.00 10:00.00 Generic Name CYCLOSPORINE CYCLOSPORINE CYCLOSPORINE CYCLOSPORINE CYCLOSPORINE 0.05% CYCLOSPORINE, MODIFIED CYCLOSPORINE, MODIFIED CYPROHEPTADINE CYSTEINE CYSTEINE CYTARABINE CYTARABINE CYTARABINE CYTARABINE CYTARABINE LIPOSOME CYTOMEGALOVIRUS IMMUNE GLOB DABIGATRAN ETEXILATE DABIGATRAN ETEXILATE DACARBAZINE DACLIZUMAB DACTINOMYCIN DAKINS 1/4 STRENGTH DALTEPARIN DALTEPARIN DALTEPARIN DANAZOL DANAZOL DANTROLENE DANTROLENE DANTROLENE DAPSONE DAPSONE DAPTOMYCIN DARBEPOETIN ALFA NON-ESRD 340B DARBEPOETIN ALFA NON-ESRD 340B DARUNAVIR DARUNAVIR ETHANOLATE DARUNAVIR ETHANOLATE Brand Name SANDIMMUNE SANDIMMUNE SANDIMMUNE CYCLOSPORINE RESTASIS NEORAL NEORAL PERIACTIN (EQUIV) L-CYSTEINE L-CYSTEINE CYTOSAR (EQUIV) CYTOSAR (EQUIV) CYTOSAR (EQUIV) CYTOSAR (EQUIV) DEPOCYT CYTOGAM PRADAXA PRADAXA DTIC-DOME IV (EQUIV) ZENAPAX COSMEGEN DAKINS 1/4 STRENGTH FRAGMIN FRAGMIN FRAGMIN DANAZOL DANAZOL DANTRIUM DANTRIUM IV DANTRIUM DAPSONE DAPSONE CUBICIN ARANESP [NON-ESRD] (340B) ARANESP [NON-ESRD] (340B) PREZISTA PREZISTA PREZISTA Drug Strength 100 MG 100 MG 25 MG 250 MG 1 DRP 100 MG 25 MG 4 MG 2500 MG 50 MG 1 GM 100 MG 2 GM 500 MG 50 MG 2500 MG 150 MG 75 MG 200 MG 25 MG 0.5 MG 1000 ML 2500 UNT 25000 UNT 5000 UNT 100 MG 200 MG 100 MG 20 MG 25 MG 100 MG 25 MG 500 MG 40 MCG 60 MCG 600 MG 300 MG 400 MG Drug Volume 1 CAP 1 ML 1 CAP 5 ML 1 DRP 1 CAP 1 CAP 1 TAB 50 ML 1 ML 1 VIAL 1 ML 1 VIAL 1 VIAL 5 ML 50 ML 1 CAP 1 CAP 1 VIAL 5 ML 1 VIAL 1000 ML 0.2 ML 1 ML 0.2 ML 1 CAP 1 CAP 1 CAP 1 VIAL 1 CAP 1 TAB 1 TAB 1 VIAL 1 ML 1 ML 1 TAB 1 TAB 1 TAB Package Desc 1 CAP PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 5 ML VIAL .4 ML BOTTLE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 50 ML VIAL 10 ML VIAL 1 VIAL PACKAGE ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 5 ML BOTTLE 50 ML VIAL 1 CAP PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 5 ML VIAL 1 VIAL PACKAGE 1000 ML BOTTLE 0.2 ML SYRINGE 3.8 ML BOTTLE 0.2 ML SYRINGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 ML BOTTLE 1 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form CAP SOLN CAP VIAL DROPS CAP CAP TAB VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL CAP CAP VIAL VIAL VIAL TOPICAL SYRINGE VIAL SYRINGE CAP CAP CAP VIAL CAP TAB TAB VIAL VIAL VIAL TAB TAB TAB Route PO PO PO IV EYE PO PO PO IV IV INJ INJ INJ INJ INJ IV PO PO IV IV IV IRR SC SC SC PO PO PO IV PO PO PO INJ INJ INJ PO PO PO Formulary Status? F F F F NF NF NF F F F F F F F NF F F F F F F F F F F F F F F F F F F F F NF NF NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 798 788 797 2019 3153 2610 2609 1063 1529 1528 2025 2059 2061 2060 2696 2178 4111 4124 336 84 127 2361 266 4104 267 1445 1446 931 936 930 1736 1737 3110 4135 4136 3937 3334 4096 AHFS Code 92:44.00 92:44.00 92:44.00 92:44.00 52:08.92 92:44.00 92:44.00 04:04.92 40:20.00 40:20.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 80:04.00 20:12.04 20:12.04 10:00.00 92:44.00 10:00.00 38:00.00 20:12.04 20:12.04 20:12.04 68:08.00 68:08.00 12:20.08 12:20.08 12:20.08 08:16.92 08:16.92 08:12.28 20:16.00 20:16.00 08:18.08 08:18.08 08:18.08 Generic Name DASATINIB DAUNORUBICIN DECITABINE DEFERASIROX DEFEROXAMINE DEFEROXAMINE MESYLATE DELAVIRDINE MESYLATE DEMECLOCYCLINE DENILEUKIN DIFTITOX DENOSUMAB DENOSUMAB (340B) DESFLURANE DESIPRAMINE DESIPRAMINE DESIPRAMINE HCL DESIPRAMINE HCL DESMOPRESSIN DESMOPRESSIN DESMOPRESSIN 0.1% NASAL DESMOPRESSIN ACETATE DESMOPRESSIN NASAL DESMOPRESSIN NASAL DESVENLAFAXINE SUCCINATE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE DEXAMETHASONE (FOR OUTPT'S) DEXAMETHASONE 0.1% DEXAMETHASONE D10W *0.4MG/ML* DEXAMETHASONE HALFTAB DEXAMETHASONE INTENSOL DEXAMETHASONE LIQ DEXAMETHASONE PRES FREE DEXAMETHASONE* Brand Name SPRYCEL CERUBIDINE DACOGEN EXJADE DESFERAL DESFERRAL RESCRIPTOR DECLOMYCIN ONTAK PROLIA XGEVA (340B) SUPRANE NORPRAMINE (EQUIV) NORPRAMINE (EQUIV) NORPRAMINE (EQUIV) NORPRAMINE (EQUIV) DDAVP DDAVP DDAVP NASAL 0.1% DDAVP DESMOPRESSIN NASAL STIMATE PRISTIQ DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) DECADRON (EQUIV) MAXIDEX DEXAMETHASONE D10W NEO DECADRON (EQUIV) HALFTAB DEXAMETHASONE INTENSOL DECADRON LIQ (EQUIV) DEXAMETHASONE PRES FREE DEXAMETHASONE* Drug Strength 70 MG 20 MG 50 MG 500 MG 500 MG 2 GM 200 MG 150 MG 300 MCG 60 MG 120 MG 240 ML 25 MG 75 MG 10 MG 50 MG 4 MCG 40 MCG 1 DRP 0.1 MG 0.1 MG 1.5 MG 50 MG 0.5 MG 1 MG 1.5 MG 2 MG 20 MG 4 MG 4 MG 10 MG 1 DRP 0.4 MG 0.25 MG 1 MG 0.5 MG 10 MG 4 MG Drug Volume 1 TAB 1 VIAL 1 VIAL 1 TABDISP 1 VIAL 1 VIAL 1 TAB 1 TAB 2 ML 1 ML 1.7 ML 240 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 10 ML 1 DRP 1 TAB 1 ML 1 ML 1 TAB SR 1 TAB 1 TAB 1 TAB 1 TAB 5 ML 1 ML 1 TAB 1 ML 1 DRP 1 ML 1 TAB 1 ML 5 ML 1 ML 1 ML Package Desc 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TABDISP PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML VIAL 1 ML SYRINGE 1.7 ML BOTTLE 240 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 10 ML VIAL 2.5 ML BOTTLE 1 TAB PACKAGE 5 ML BOTTLE 2.5 ML BOTTLE 1 TAB SR PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML VIAL 1 ML VIAL 1 TAB PACKAGE 1 ML VIAL 5 ML BOTTLE 1 ML PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE 1 ML BOTTLE 30 ML BOTTLE Dosage Form TAB VIAL VIAL TABDISP VIAL VIAL TAB TAB VIAL SYRING VIAL LIQUID TAB TAB TAB TAB INJ VIAL SOLN TAB SPRAY SPRAY TAB SR TAB TAB TAB TAB VIAL VIAL TAB VIAL DROPS SOLN TAB DROPS SOLN VIAL VIAL Route PO IV IV PO INJ INJ PO PO IV INJ INJ INH PO PO PO PO IV INJ NAS PO NAS NAS PO PO PO PO PO INJ INJ PO INJ EYE IV PO PO PO INJ INJ Formulary Status? NF F NF F F F F NF F F NF F F F F F F F F NF F F F F F F F F F F NF F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 4035 2036 3226 4015 824 3398 3891 101 2298 4092 4147 1633 1566 1567 1565 1835 2364 779 778 772 2682 461 4140 502 499 503 501 1418 1417 500 1498 1623 2719 2743 470 471 4143 3008 AHFS Code 10:00.00 10:00.00 10:00.00 64:00.00 64:00.00 64:00.00 08:18.08 08:12.24 10:00.00 92:24.00 92:24.00 28:04.16 28:16.04 28:16.04 28:16.04 28:16.04 68:28.00 68:28.00 68:28.00 68:28.00 68:28.00 68:28.00 28:16.04 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 52:08.08 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 Generic Name DEXMEDETOMIDINE DEXRAZOXANE DEXTRAN 40/D5W DEXTRAN 70/HP-M-CELL DEXTROAMPHETAMINE DEXTROSE 10%-NS DEXTROSE 10%-W DEXTROSE 10%-W DEXTROSE 10%-W DEXTROSE 10%-W SYRINGE DILUENT DEXTROSE 20 % IN WATER DEXTROSE 25%-W PEDI DEXTROSE 40% GEL DEXTROSE 5%/W (SYR DILUENT) DEXTROSE 5%-0.2% SALINE DEXTROSE 5%-0.2% SALINE DEXTROSE 5%-0.33% SALINE DEXTROSE 5%-0.45% SALINE DEXTROSE 5%-0.45% SALINE DEXTROSE 5%-LACTATED RINGERS DEXTROSE 5%-LACTATED RINGERS DEXTROSE 5%-NORMAL SALINE DEXTROSE 5%-NORMAL SALINE DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W GLASS DEXTROSE 5%-WATER GLASS DEXTROSE 50%-W SYRINGE DEXTROSE 50%-W VIAL DEXTROSE 70%-WATER* DEXTROSE CHEW TAB DIALYSIS SOLN 2L IN 1.5% DEX. DIALYSIS SOLN 2L IN 2.5% DEX. DIALYSIS SOLN 2L IN 4.25% DEX. Brand Name PRECEDEX ZINECARD GENTRAN 40 IN D5W TEARS NATURALE FREE DEXEDRINE (EQUIV) DEXTROSE 10%-NS DEXTROSE 10%-W DEXTROSE 10%-W DEXTROSE 10%-W DEXTROSE 10%-W DEXTROSE IN WATER DEXTROSE 25-W PEDI GLUTOSE-45 GEL DEXTROSE 5%/W (SYR DILUENT) DEXTROSE 5%-0.2% SALINE DEXTROSE 5%-0.2% SALINE DEXTROSE 5%-0.33% SALINE DEXTROSE 5%/0.45% SALINE DEXTROSE 5%-0.45% SALINE DEXTROSE 5%-LACTATED RINGERS DEXTROSE 5%-LACTATED RINGERS DEXTROSE 5%-NORMAL SALINE DEXTROSE 5%-NORMAL SALINE DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W DEXTROSE 5%-W GLASS DEXTROSE 5%-WATER GLASS DEXTROSE 50%-W SYRINGE DEXTROSE 50%-W VIAL DEXTROSE 70%-WATER* B-D GLUCOSE CHEW TAB DIANEAL W/1.5% DEXTROSE DIANEAL W/2.5% DEXTROSE DIANEAL W/4.25% DEXTROSE Drug Strength 200 MCG 500 MG 500 ML 1 DRP 5 MG 1000 ML 1000 ML 5 ML 500 ML 50 ML 500 ML 2.5 GM 1 APP 50 ML 1000 ML 500 ML 1000 ML 1000 ML 500 ML 1000 ML 500 ML 1000 ML 500 ML 100 ML 1000 ML 150 ML 250 ML 50 ML 500 ML 250 ML 500 ML 50 ML 0.5 GM 2000 ML 5 GM 2000 ML 2000 ML 2000 ML Drug Volume 2 ML 1 VIAL 500 ML 1 DRP 1 TAB 1000 ML 1000 ML 5 ML 500 ML 50 ML 500 ML 10 ML 1 APP 50 ML 1000 ML 500 ML 1000 ML 1000 ML 500 ML 1000 ML 500 ML 1000 ML 500 ML 100 ML 1000 ML 150 ML 250 ML 50 ML 500 ML 250 ML 500 ML 50 ML 1 ML 2000 ML 1 TAB 2000 ML 2000 ML 2000 ML Package Desc 2 ML BOTTLE 1 VIAL PACKAGE 500 ML BAG 1 ML PACKAGE 1 TAB PACKAGE 1000 ML BAG 1000 ML BAG 5 ML AMPUL 500 ML BAG 50 ML SYRINGE 500 ML BAG 10 ML SYRINGE 45 GM PACKAGE 50 ML BAG 1000 ML BAG 500 ML BAG 1000 ML BAG 1000 ML BAG 500 ML BAG 1000 ML BAG 500 ML BAG 1000 ML BAG 500 ML BAG 100 ML BAG 1000 ML BAG 150 ML BAG 250 ML BAG 50 ML BAG 500 ML BAG 250 ML BOTTLE 500 ML BOTTLE 50 ML SYRINGE 50 ML VIAL 2000 ML BAG 6 TAB CHW PACKAGE 2000 ML BOTTLE 2000 ML BOTTLE 2000 ML BOTTLE Dosage Form VIAL VIAL SOLN DROPS TAB SOLN SOLN INJ SOLN SOLN SOLN SYRINGE GEL SOLN SOLN SOLN SOLN SOLN SOLN SOLN SOLN SOLN SOLN SOLN SOLN INJ INJ SOLN SOLN INJ INJ SYRINGE VIAL SOLN TAB CHW IP SOL IP SOL IP SOL Route IV IV IV EYE PO IV IV IV IV IV IV IV PO IPB IV IV IV IV IV IV IV IV IV IPB IV IPB IPB IPB IV IV IV IV IV IV PO IP IP IP Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3018 273 1242 554 165 1235 1214 700 1213 3918 4328 761 1452 1212 1229 1228 1230 1232 1231 1239 1238 1234 1233 1211 1210 1207 1208 2849 1209 1205 2516 720 746 1260 2948 1606 1610 1611 AHFS Code 28:24.92 92:56.00 40:12.00 52:92.00 28:20.04 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:12.00 40:12.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:36.00 40:36.00 40:36.00 Generic Name DIATR MEGLU/DIATRIZOATE DIATR MEGLU/DIATRIZOATE SODIUM DIATRIZOATE MEGLUMINE* DIATRIZOATE SODIUM 50% DIAZEPAM DIAZEPAM DIAZEPAM DIAZEPAM MDV DIAZOXIDE DIAZOXIDE DIBUCAINE OINT 30GM DICLOFENAC DICLOFENAC 0.1% DICLOFENAC SODIUM DICLOXACILLIN DICLOXACILLIN SODIUM DICYCLOMINE DICYCLOMINE DICYCLOMINE DIDANOSINE EC DIFLUNISAL DIGOXIN DIGOXIN DIGOXIN DIGOXIN ELIXIR DIGOXIN HALFTAB DIGOXIN IMMUNE FAB DIGOXIN PEDIATRIC DIHYDROERGOTAMINE DILTIAZEM DILTIAZEM DILTIAZEM DILTIAZEM DILTIAZEM DILTIAZEM 125MG/D5W 125ML DILTIAZEM CD DILTIAZEM CD DILTIAZEM CD Brand Name GASTROGRAFIN (EQUIV) RENOGRAFIN-60 CYSTOGRAFIN-DILUTE* HYPAQUE SODIUM 50% VALIUM VALIUM (EQUIV) VALIUM (EQUIV) DIAZEPAM MDV HYPERSTAT I.V. PROGLYCEM DIBUCAINE VOLTAREN (EQUIV) VOLTAREN 0.1% VOLTAREN DYCILL (EQUIV) DICLOXACILLIN BENTYL (EQUIV) BENTYL BENTYL (EQUIV) VIDEX EC DOLOBID (EQUIV) LANOXIN LANOXIN DIGOXIN LANOXIN PEDIATRIC LANOXIN HALFTAB DIGIBIND LANOXIN PEDIATRIC D.H.E.45 CARDIZEM (EQUIV) CARDIZEM (EQUIV) CARDIZEM (EQUIV) CARDIZEM (EQUIV) CARDIZEM (EQUIV) CARDIZEM 125MG/D5W 125ML CARDIZEM CD CARDIZEM CD (EQUIV) CARDIZEM CD (EQUIV) Drug Strength 120 ML 10 ML 300 ML 50 ML 10 MG 2 MG 5 MG 50 MG 300 MG 50 MG 1 APP 25 MG 1 DRP 1 APP 250 MG 500 MG 10 MG 2 MG 20 MG 125 MG 500 MG 0.125 MG 0.25 MG 500 MCG 0.25 MG 0.0625 MG 40 MG 100 MCG 1 MG 25 MG 30 MG 50 MG 60 MG 90 MG 125 MG 120 MG 180 MG 240 MG Drug Volume 120 ML 10 ML 300 ML 50 ML 2 ML 1 TAB 1 TAB 10 ML 20 ML 1 ML 1 APP 1 TAB EC 1 DRP 1 APP 1 CAP 1 CAP 1 CAP 1 ML 1 TAB 1 CAP 1 TAB 1 TAB 1 TAB 2 ML 5 ML 1 TAB 1 VIAL 1 ML 1 ML 5 ML 1 TAB 10 ML 1 TAB 1 TAB 125 ML 1 CAP CD 1 CAP CD 1 CAP CD Package Desc 120 ML BOTTLE 10 ML VIAL 300 ML BOTTLE 50 ML VIAL 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 10 ML BOTTLE 20 ML AMPUL ML ORAL SYRINGE 30 GM PACKAGE 1 TAB EC PACKAGE 2.5 ML BOTTLE 100 GM PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML AMPUL ML ORAL SYRINGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 ML AMPUL 1 ML AMPUL 5 ML VIAL 1 TAB PACKAGE 10 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 125 ML BAG 1 CAP CD PACKAGE 1 CAP CD PACKAGE 1 CAP CD PACKAGE Dosage Form SOLN VIAL INFUSN VIAL VIAL TAB TAB VIAL INJ SUSP OINT TAB EC DROPS GEL CAP CAP CAP SYRUP TAB CAP TAB TAB TAB INJ ELIXIR TAB VIAL INJ INJ VIAL TAB VIAL TAB TAB BAG CAP CD CAP CD CAP CD Route PO INJ UR INJ INJ PO PO INJ IV PO TOP PO EYE TOP PO PO PO PO PO PO PO PO PO INJ PO PO IV INJ INJ IV PO IV PO PO IV PO PO PO Formulary Status? F F F F F F F F F F F F F NF F F F F F NF F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 04 04 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1158 1161 1162 1319 1499 1810 1811 4252 829 1465 958 1562 2119 3491 2159 890 1792 573 1793 2611 886 1003 1004 1511 1006 2744 1002 1005 2311 2054 1878 2055 1879 1880 3516 869 2224 870 AHFS Code 36:68.00 36:68.00 36:68.00 36:68.00 28:24.08 28:24.08 28:24.08 28:24.08 24:08.20 24:08.20 84:08.00 28:08.04 52:08.20 28:08.04 08:12.16 08:12.16 12:08.08 12:08.08 12:08.08 08:18.08 28:08.04 24:04.08 24:04.08 24:04.08 24:04.08 24:04.08 80:04.00 24:04.08 12:16.04 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 Generic Name DILTIAZEM HALFTAB DILTIAZEM* DIMENHYDRINATE DIMERCAPROL DIMETHYL SULFOXIDE 50% DINOPROSTONE DIPHENHYDRAMINE DIPHENHYDRAMINE DIPHENHYDRAMINE DIPHENHYDRAMINE ELIX DIPHENHYDRAMINE HCL/ZINC 2% DIPHENHYDRAMINE U/D LIQUID DIPHENHYDRAMINE UD DIPHENOXYLATE 2.5MG/ATROPINE DIPHENOXYLATE/ATROP LIQ DIPHTH,PERTUSS(ACELL),TET PED DIPYRIDAMOLE DIPYRIDAMOLE DIPYRIDAMOLE DIPYRIDAMOLE DISOPYRAMIDE DISOPYRAMIDE DISULFIRAM DIVALPROEX DIVALPROEX DIVALPROEX **ER DIVALPROEX **ER DIVALPROEX SPRINKLE DOBUTAMINE DOBUTAMINE 1 GM/250ML D5W DOBUTAMINE 250MG/250ML D5W DOBUTAMINE 500 MG/250 ML D5W DOCETAXEL DOCETAXEL DOCUSATE SODIUM DOCUSATE SODIUM DOFETILIDE DOFETILIDE Brand Name CARDIZEM (EQUIV) HALFTAB CARDIZEM (EQUIV)* DRAMAMINE (EQUIV) BAL IN OIL RIMSO-50 CERVIDIL BENADRYL (EQUIV) BENADRYL (EQUIV) BENADRYL (EQUIV) BENADRYL (EQUIV) ANTI-ITCH 2% BENADRYL U/D LIQUID DIPHENHYDRAMINE UD LOMOTIL (EQUIV) LOMOTIL (EQUIV) 60ML BOTTLE INFANRIX (EQUIV) PERSANTINE (EQUIV) PERSANTINE (EQUIV) PERSANTINE (EQUIV) PERSANTINE (EQUIV) NORPACE (EQUIV) NORPACE (EQUIV) ANTABUSE DEPAKOTE DEPAKOTE DEPAKOTE **ER DEPAKOTE **ER DEPAKOTE SPRINKLE DOBUTREX DOBUTAMINE 1 GM/250 ML D5W DOBUTAMINE 250MG/250ML D5W DOBUTAMINE 500 MG/250 ML D5W TAXOTERE (EQUIV) DOCETAXEL COLACE (EQUIV) COLACE (EQUIV) TIKOSYN TIKOSYN Drug Strength 45 MG 25 MG 50 MG 300 MG 50 ML 10 MG 25 MG 50 MG 50 MG 2.5 MG 1 APP 12.5 MG 25 MG 1 TAB 1 ML 0.5 ML 25 MG 50 MG 50 MG 75 MG 100 MG 150 MG 250 MG 250 MG 500 MG 250 MG 500 MG 125 MG 250 MG 4000 MCG 1000 MCG 2000 MCG 20 MG 80 MG 100 MG 100 MG 0.125 MG 0.25 MG Drug Volume 1 TAB 5 ML 1 TAB 3 ML 50 ML 1 SUPP 1 TAB 1 CAP 1 ML 1 ML 1 APP 5 ML 10 ML 1 TAB 1 ML 0.5 ML 1 TAB 10 ML 1 TAB 1 TAB 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB EC 1 TAB 1 TAB 1 CAP 20 ML 1 ML 1 ML 1 ML 1 ML 4 ML 1 CAP 25 ML 1 CAP 1 CAP Package Desc 1 TAB PACKAGE 5 ML VIAL 1 TAB PACKAGE 3 ML AMPUL 50 ML BOTTLE 1 SUPP PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 ML VIAL ML ORAL SYRINGE 28 GM PACKAGE 5 ML UD CUP 10 ML BOTTLE 1 TAB PACKAGE ML ORAL SYRINGE 0.5 ML VIAL 1 TAB PACKAGE 10 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB EC PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 20 ML VIAL 250 ML BOTTLE 250 ML BAG 250 ML BOTTLE 1 ML VIAL 4 ML VIAL 1 CAP PACKAGE 25 ML UD CUP 1 CAP PACKAGE 1 CAP PACKAGE Dosage Form TAB VIAL TAB INJ SOLN SUPP TAB CAP VIAL LIQUID CREAM LIQUID ELIXIR TAB LIQUID VIAL TAB VIAL TAB TAB CAP CAP TAB TAB TAB EC TAB ER TAB ER CAP VIAL PREMIX INJ PREMIX VIAL VIAL CAP SYRUP CAP CAP Route PO IV PO IM UR VAG PO PO INJ PO TOP PO PO PO PO IM PO IV PO PO PO PO PO PO PO PO PO PO IV IV IV IV IV IV PO PO PO PO Formulary Status? F F F F F F F F F F NF F F F F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 05 05 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3500 3241 1054 1646 1332 1341 1932 1784 612 1087 2617 3365 3124 1785 472 2095 2366 2271 1074 1579 1477 1273 2308 1404 732 2659 2625 2693 21 3410 3021 3409 4187 4188 2291 505 588 589 AHFS Code 24:28.92 24:28.92 56:22.08 64:00.00 84:06.00 76:00.00 04:04.04 04:04.04 04:04.04 04:04.04 84:08.00 04:04.04 04:04.04 56:08.00 56:08.00 80:08.00 24:12.92 24:12.92 24:12.92 24:12.92 24:04.04 24:04.04 92:04.00 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 12:12.08 12:12.08 12:12.08 12:12.08 10:00.00 10:00.00 56:12.00 56:12.00 24:04.04 24:04.04 Generic Name DOFETILIDE DONEPEZIL HCL DONEPEZIL HCL DOPAMINE DOPAMINE DOPAMINE DOPAMINE 200 MG/250ML D5W DOPAMINE 400MG/D5W 500ML DOPAMINE 800MG/D5W 500ML DOPAMINE HCL/DEXTROSE 5%-WATER DOPAMINE HCL/DEXTROSE 5%-WATER DORNASE ALFA DORZOLAMIDE HCL DOXAPRAM DOXAZOSIN DOXAZOSIN DOXAZOSIN MESYLATE DOXEPIN DOXEPIN DOXEPIN DOXEPIN DOXEPIN DOXEPIN DOXERCALCIFEROL DOXERCALCIFEROL DOXERCALCIFEROL DOXORUBICIN DOXORUBICIN HCL LYOPHILIZED DOXORUBICIN LIPOSOMAL DOXORUBICIN LIPOSOMAL DOXYCYCLINE DOXYCYCLINE DOXYCYCLINE DOXYCYCLINE SUSP DP(A)T-POLIO/HIB CONJ-TET/PF DRONABINOL DRONEDARONE HYDROCHLORIDE DROPERIDOL Brand Name TIKOSYN ARICEPT ARICEPT DOPAMINE DOPAMINE DOPAMINE DOPAMINE 200 MG/250ML D5W DOPAMINE 400MG/500ML DW5 DOPAMINE 800MG/D5W 500ML DOPAMINE HCL IN 5% DEXTROSE DOPAMINE HCL IN 5% DEXTROSE PULMOZYME TRUSOPT 2% DOPRAM (EQUIV) CARDURA (EQUIV) CARDURA (EQUIV) DOXAZOSIN SINEQUAN (EQUIV) SINEQUAN (EQUIV) SINEQUAN (EQUIV) SINEQUAN (EQUIV) SINEQUAN (EQUIV) SINEQUAN (EQUIV) HECTOROL HECTOROL HECTOROL ADRIAMYCIN (EQUIV) ADRIAMYCIN LYOPHILIZED SDV LIPODOX DOXIL VIBRAMYCIN (EQUIV) VIBRAMYCIN (EQUIV) VIBRAMYCIN VIBRAMYCIN PENTACEL MARINOL MULTAQ DROPERIDOL Drug Strength 0.5 MG 10 MG 5 MG 200 MG 40 MG 400 MG 800 MCG 400 MG 800 MG 1600 MCG 3200 MCG 2.5 MG 1 DRP 20 MG 1 MG 2 MG 4 MG 10 MG 10 MG 100 MG 25 MG 50 MG 75 MG 0.5 MCG 2.5 MCG 4 MCG 10 MG 50 MG 2 MG 20 MG 100 MG 100 MG 50 MG 5 MG 1 KIT 2.5 MG 400 MG 5 MG Drug Volume 1 CAP 1 TAB 1 TAB 5 ML 1 ML 5 ML 1 ML 500 ML 500 ML 1 ML 1 ML 2.5 ML 1 DRP 1 ML 1 TAB 1 TAB 1 TAB 1 ML 1 CAP 1 CAP 1 CAP 1 CAP 1 CAP 1 CAP 1 CAP 2 ML 5 ML 1 VIAL 1 ML 10 ML 1 VIAL 1 CAP 1 CAP 1 ML 1 KIT 1 CAP 1 TAB 2 ML Package Desc 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML VIAL 10 ML BOTTLE 5 ML VIAL 250 ML BOTTLE 500 ML BAG 500 ML BAG 250 ML BOTTLE 250 ML BOTTLE 2.5 ML BOTTLE 10 ML BOTTLE 20 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 2 ML AMP 5 ML VIAL 1 VIAL PACKAGE 10 ML VIAL 10 ML VIAL 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 KIT PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 2 ML AMPUL Dosage Form CAP TAB TAB VIAL VIAL VIAL PREMIX PREMIX PREMIX PREMIX PREMIX SOLN DROPS VIAL TAB TAB TAB SOLN CAP CAP CAP CAP CAP CAP CAP INJ VIAL VIAL VIAL VIAL VIAL CAP CAP SUSP KIT CAP TAB INJ Route PO PO PO IV IV IV IV IV IV IV IV INH EYE IV PO PO PO PO PO PO PO PO PO PO PO INJ IV IV IV IV IV PO PO PO IM PO PO INJ Formulary Status? F F F F F F F F F F F NF F NF F F F F F F F F F NF F F F F NF F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 03 00 00 Drug Code 590 3126 2227 1400 3151 1401 3411 1263 1264 3412 3413 1745 3359 362 1930 1931 2587 2011 1829 1865 1828 1581 1864 3190 2300 2953 2035 4307 4290 1658 2017 1475 575 576 4003 443 3969 638 AHFS Code 24:04.04 12:04.00 12:04.00 12:12.08 12:12.08 12:12.08 12:12.08 12:12.08 12:12.08 12:12.08 12:12.08 44:00.00 52:40.12 28:20.92 24:20.00 24:20.00 24:20.00 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 88:16.00 88:16.00 88:16.00 10:00.00 10:00.00 10:00.00 10:00.00 08:12.24 08:12.24 08:12.24 08:12.24 80:12.00 56:22.92 24:04.04 28:24.92 Generic Name DROTRECOGIN ALFA (ACTIVATED) DROTRECOGIN ALFA (ACTIVATED) DULOXETINE DULOXETINE DULOXETINE ECONAZOLE NITRATE 1% EDROPHONIUM EFAVIRENZ EFAVIRENZ/EMTRICITAB/TENOFOVIR ELECARE DIETARY POWDER ELECARE DIETARY POWDER ELECTROLYTE-A SOLUTION* ELETRIPTAN HYDROBROMIDE EMTRICITABINE EMTRICITABINE/TENOFOVIR ENALAPRIL ENALAPRIL ENALAPRIL ENALAPRIL HALFTAB ENALAPRILAT ENALAPRILAT IV ENOXAPARIN ENOXAPARIN ENOXAPARIN ENOXAPARIN ENOXAPARIN ENOXAPARIN ENOXAPARIN ENOXAPARIN WHEN EPIDURAL DC'D ENTACAPONE ENTECAVIR EPHEDRINE SULFATE EPHEDRINE SULFATE EPINEPHRINE EPINEPHRINE EPINEPHRINE PEN ADULT EPINEPHRINE PEN JR. EPINEPHRINE PF Brand Name XIGRIS XIGRIS CYMBALTA CYMBALTA CYMBALTA ECONAZOLE NITRATE 1% ENLON SUSTIVA ATRIPLA ELECARE DIETARY POWDER ELECARE DIETARY POWDER PLASMA-LYTE A PH 7.4 (EQUIV)* RELPAX EMTRIVA TRUVADA VASOTEC (EQUIV) VASOTEC (EQUIV) VASOTEC (EQUIV) VASOTEC (EQUIV) HALFTAB ENALAPRILAT VASOTEC IV (EQUIV) LOVENOX LOVENOX LOVENOX LOVENOX LOVENOX LOVENOX LOVENOX LOVENOX WHEN EPIDURAL DC'D COMTAN BARACLUDE EPHEDRINE SULFATE EPHEDRINE SULFATE EPINEPHRINE EPINEPHRINE EPIPEN ADULT EPIPEN JR. EPINEPHRINE PF Drug Strength 20 MG 5 MG 20 MG 30 MG 60 MG 1 APP 10 MG 200 MG 1 TAB 1 EA 1 SCOOP 1000 ML 40 MG 200 MG 1 TAB 10 MG 2.5 MG 5 MG 1.25 MG 1.25 MG 2.5 MG 100 MG 120 MG 150 MG 30 MG 40 MG 60 MG 80 MG 1 EA 200 MG 0.5 MG 25 MG 50 MG 1 MG 1 MG 0.3 MG 0.15 MG 1 MG Drug Volume 1 VIAL 1 VIAL 1 CAP 1 CAP 1 CAP EC 1 APP 1 ML 1 CAP 1 TAB 1 EA 1 SCOOP 1000 ML 1 TAB 1 CAP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 2 ML 1 ML 0.8 ML 1 ML 0.3 ML 0.4 ML 0.6 ML 0.8 ML 1 EA 1 TAB 1 TAB 5 ML 1 ML 1 ML 1 ML 1 SYR 1 SYR 1 ML Package Desc 1 VIAL PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP EC PACKAGE 15 GM PACKAGE 1 ML BOTTLE 1 CAP PACKAGE 1 TAB PACKAGE 1 EA POWDER 1 SCOOP POWDER 1000 ML BAG 1 TAB PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 2 ML VIAL 1 ML SYRINGE 0.8 ML SYRINGE 1 ML BOTTLE 0.3 ML SYRINGE 0.4 ML SYRINGE 0.6 ML SYRINGE 0.8 ML SYRINGE 1 EA SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML SYRINGE 1 ML AMPUL ML VIAL 1 ML AMPUL 1 SYR SYRINGE 1 SYR SYRINGE 1 ML AMPUL Dosage Form VIAL VIAL CAP CAP CAP EC CREAM VIAL CAP TAB POWDER POWDER SOLN TAB CAP TAB TAB TAB TAB TAB VIAL VIAL SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE MISC TAB TAB SYRINGE INJ VIAL INJ SYRINGE SYRINGE INJ Route IV IV PO PO PO TOP INJ PO PO PO PO IV PO PO PO PO PO PO PO IV IV SC SC SC SC SC SC SC MSC PO PO IV INJ INJ INJ IM IM INJ Formulary Status? NF NF F F F NF F F NF F F F NF NF NF NF NF NF NF F F F F F F F F F F F NF NF F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 33 32 2908 2909 3111 3952 2912 535 3330 3087 3088 1241 2866 2673 3020 1929 1927 1928 2745 3286 1631 775 2970 2894 776 774 2546 2547 3167 805 4085 3923 672 1399 755 1725 1726 1398 AHFS Code 92:92.00 92:92.00 28:16.04 28:16.04 28:16.04 84:04.08 36:56.00 08:18.08 08:18.08 40:20.00 40:20.00 40:12.00 28:32.28 08:18.08 08:18.08 24:32.04 24:32.04 24:32.04 24:32.04 24:32.04 24:32.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 28:36.12 08:18.32 12:12.12 12:12.12 12:12.12 12:12.12 12:12.12 12:12.12 12:12.12 Generic Name EPINEPHRINE RACEMIC 2.25% EPINEPHRINE RACEMIC 2.25% EPINEPHRINE SYRINGE EPINEPHRINE* (MULTI-DOSE VIAL) EPIRUBICIN EPIRUBICIN EPLERENONE EPOETIN ALFA (ESRD) EPOETIN ALFA (ESRD) EPOETIN ALFA (ESRD) EPOETIN ALFA (ESRD) EPOETIN ALFA (ESRD) EPOETIN ALFA (ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA (NON-ESRD) EPOETIN ALFA CLINIC (NON-ESRD) EPOETIN ALFA CLINIC USE (ESRD) EPOPROSTENOL NA EPOPROSTENOL NA EPOPROSTENOL RM TEMP INFUSION EPTIFIBATIDE EPTIFIBATIDE 75 MG/100 ML ERGOCALCIFEROL ERGOCALCIFEROL ERGOTAMINE TARTRATE/CAFFEINE ERIBULIN MESYLATE ERLOTINIB ERTAPENEM ERTAPENEM 1GM/50ML NS ERYTHROMYCIN ERYTHROMYCIN 125MG/100ML NS ERYTHROMYCIN 2% GEL ERYTHROMYCIN 2% SOLN ERYTHROMYCIN BASE Brand Name RACEPINEPHRINE 2.25% RACINE EPINEPHRINE SYRINGE EPINEPHRINE* (MULTI-DOSE VIAL) ELLENCE (EQUIV) ELLENCE (EQUIV) INSPRA PROCRIT (ESRD) PROCRIT (ESRD) PROCRIT (ESRD) PROCRIT (ESRD) PROCRIT (ESRD) PROCRIT (ESRD) PROCRIT (NON-ESRD) PROCRIT (NON-ESRD) PROCRIT (NON-ESRD) PROCRIT (NON-ESRD) PROCRIT (NON-ESRD) PROCRIT (NON-ESRD) PROCRIT CLINIC (NON-ESRD) PROCRIT CLINIC USE (ESRD) FLOLAN FLOLAN EPOPROSTENOL RM TEMP INFUSION INTEGRILIN INTEGRILIN VITAMIN D CALCIFEROL CAFERGOT (EQUIV) HALAVEN TARCEVA INVANZ INVANZ 1GM/50ML NS ERYTHROCIN ERYTHROCIN 125MG/100ML NS ERYTHROMYCIN 2% GEL ERYTHROMYCIN 2% E-MYCIN (EQUIV) Drug Strength 0.5 ML 11.25 MG 1 MG 1 MG 200 MG 50 MG 25 MG 10000 UNT 2000 UNT 20000 UNT 3000 UNT 4000 UNT 40000 UNT 10000 UNT 2000 UNT 20000 UNT 3000 UNT 4000 UNT 40000 UNT 1000 UNT 1000 UNT 0.5 MG 1.5 MG 1.5 MG 20 MG 75 MG 50000 UNT 8000 UNT 1 SUP 1 MG 150 MG 1 GM 1 GM 500 MG 125 MG 1 APP 1 APP 250 MG Drug Volume 0.5 ML 1 ML 10 ML 1 ML 100 ML 25 ML 1 TAB 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 0.5 ML 0.5 ML 1 VIAL 1 VIAL 1 VIAL 10 ML 100 ML 1 CAP 1 ML 1 SUP 2 ML 1 TAB 1 VIAL 50 ML 1 VIAL 100 ML 1 APP 1 APP 1 TAB Package Desc 0.5 ML BOTTLE 15 ML BOTTLE 10 ML SYRINGE ML VIAL 100 ML VIAL 25 ML VIAL 1 TAB PACKAGE 1 ML BOTTLE 1 ML BOTTLE 1 ML BOTTLE 1 ML VIAL 1 ML BOTTLE 1 ML BOTTLE 1 ML VIAL 1 ML VIAL 1 ML VIAL 1 ML VIAL 1 ML VIAL 1 ML VIAL 0.5 ML BOTTLE 0.5 ML BOTTLE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL VIAL 10 ML VIAL 100 ML VIAL 1 CAP PACKAGE ML ORAL SYRINGE 1 SUP PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 VIAL PACKAGE 50 ML BAG 1 VIAL PACKAGE 100 ML BAG 30 GM PACKAGE 60 ML BOTTLE 1 TAB PACKAGE Dosage Form SOLN SOLN SYRINGE VIAL VIAL VIAL TAB VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL PREMIX CAP DROPS SUPP VIAL TAB VIAL PB VIAL PB GEL SOLN TAB Route INH INH IV INJ IV IV PO INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ IV IV IV IV IV PO PO PR IV PO INJ IV IV IV TOP TOP PO Formulary Status? F F F F F NF NF F F F F F F F F F F F F F F F F F F F F F F NF F NF NF F F NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1390 1389 723 3488 256 255 2884 3034 3036 3033 2152 3035 3032 3434 3431 3435 3432 3433 3436 3438 3437 2840 1032 4064 843 842 1572 882 783 4150 4006 2910 4272 737 4245 977 976 734 AHFS Code 12:12.12 12:12.12 12:12.12 12:12.12 10:00.00 10:00.00 24:32.20 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 20:16.00 24:12.92 24:12.92 24:12.92 20:12.18 20:12.18 88:16.00 88:16.00 12:16.04 10:00.00 10:00.00 08:12.07 08:12.07 08:12.12 08:12.12 84:04.04 84:04.04 08:12.12 Generic Name ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN OPTH OINT ERYTHROMYCIN OPTH OINT ERYTHROMYCIN STEARATE ESCITALOPRAM ESCITALOPRAM OXALATE ESCITALOPRAM OXALATE ESCITALOPRAM OXALATE HALFTAB ESMOLOL ESMOLOL 2.5GM/250ML NS ESMOLOL HCL ESOMEPRAZOLE ESOMEPRAZOLE ESOMEPRAZOLE ESOMEPRAZOLE ESOMEPRAZOLE* ESTRADIOL ESTRADIOL ESTRADIOL ESTRADIOL 0.01% ESTRADIOL HALFTAB ESTRADIOL PATCH 0.0375MG ESTRADIOL PATCH 0.05MG ESTRADIOL PATCH 0.1MG ESTRADIOL VALERATE ESTRADIOL/NORETH AC PATCH ESTROGENS,CONJUGATED ESTROGENS,CONJUGATED ESTROGENS,CONJUGATED ESTROGENS,CONJUGATED ESTROGENS,CONJUGATED ESTROGENS,ESTERIFIED ESTROGENS,ESTERIFIED ESTROPIPATE ESZOPICLONE ESZOPICLONE ETHACRYNATE ETHACRYNIC ACID Brand Name EES 200 SUSP ERYTHROMYCIN OPTH OINT ERYTHROMYCIN OPTH OINT ERYTHROCIN STEARATE LEXAPRO LEXAPRO LEXAPRO LEXAPRO HALFTAB BREVIBLOC BREVIBLOC 2.5GM/250ML NS BREVIBLOC NEXIUM NEXIUM NEXIUM NEXIUM NEXIUM* ESTRACE (EQUIV) ESTRACE ESTRACE ESTRACE 0.01% ESTRADIOL HALFTAB VIVELLE-DOT PATCH ESTRADERM PATCH VIVELLE PATCH DELESTROGEN COMBIPATCH (EQUIV) PREMARIN PREMARIN PREMARIN PREMARIN PREMARIN MENEST MENEST OGEN LUNESTA LUNESTA EDECRIN SODIUM EDECRIN Drug Strength 200 MG 1 APP 1 APP 250 MG 20 MG 10 MG 5 MG 2.5 MG 2500 MG 2.5 GM 100 MG 20 MG 20 MG 40 MG 40 MG 40 MG 0.5 MG 1 MG 2 MG 1 APP 0.25 MG 1 EA 1 EA 1 EA 100 MG 1 EA 0.3 MG 0.625 MG 0.9 MG 1 APP 25 MG 0.3 MG 0.625 MG 0.625 MG 1 MG 2 MG 50 MG 25 MG Drug Volume 5 ML 1 APP 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 10 ML 250 ML 10 ML 5 ML 1 CAP DR 5 ML 1 CAP DR 5 ML 1 TAB 1 TAB 1 TAB 1 APP 1 TAB 1 EA 1 EA 1 EA 5 ML 1 EA 1 TAB 1 TAB 1 TAB 1 APP 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 TAB Package Desc ML ORAL SYRINGE 3.5 GM PACKAGE 1 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML AMPUL 250 ML BOTTLE 10 ML VIAL 5 ML PACKAGE 1 CAP DR PACKAGE 5 ML PACKAGE 1 CAP DR PACKAGE 5 ML PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 42.5 GM PACKAGE 1 TAB PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 5 ML VIAL 1 EA PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 42.5 GM PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE Dosage Form SUSP OINT OINT TAB TAB TAB TAB TAB INJ INJ VIAL VIAL CAP DR VIAL CAP DR VIAL TAB TAB TAB CREAM TAB PATCH PATCH PATCH VIAL PATCH TAB TAB TAB CREAM VIAL TAB TAB TAB TAB TAB VIAL TAB Route PO EYE EYE PO PO PO PO PO IV IV IV IV PO IV PO IV PO PO PO VAG PO TD TD TD IM TD PO PO PO VAG INJ PO PO PO PO PO IV PO Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 04 00 00 Drug Code 1374 1685 965 735 2926 1337 3323 4032 1630 3099 1629 3116 3115 3117 3114 3321 1969 1467 1968 1331 3475 2971 823 811 45 816 413 412 409 414 408 2200 2201 251 3071 3072 140 105 AHFS Code 08:12.12 52:04.04 52:04.04 08:12.12 28:16.04 28:16.04 28:16.04 28:16.04 24:24.00 24:24.00 24:24.00 56:28.36 56:28.36 56:28.36 56:28.36 56:28.36 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 68:16.04 28:24.92 28:24.92 40:28.08 40:28.08 Generic Name ETHACRYNIC ACID HALFTAB ETHAMBUTOL HCL ETHAMBUTOL HCL ETHANOLAMINE OLEATE 5% ETHINYL ESTRADIOL/NORETH AC ETHIODIZED OIL ETHOSUXIMIDE ETHYL CHLORIDE 100% ETIDRONATE ETOMIDATE ETOMIDATE ETOPOSIDE ETRAVIRINE EXENATIDE EZETIMIBE FACTOR 8 RECOMBINATE FACTOR IX HUMAN RECOMB 500IU FACTOR VIIA, RECOMB FACTOR VIIA,RECOMB FACTOR VIIA,RECOMB(BHK CELLS) FAMCICLOVIR FAMCICLOVIR FAMOTIDINE FAMOTIDINE FAMOTIDINE FAMOTIDINE SUSP FAT EMULSIONS 10% FAT EMULSIONS 20% FAT EMULSIONS* 20% FE FUMARATE/DOSS/FA/BCOMP&C FELODIPINE FELODIPINE ER FENOFIBRATE FENOFIBRATE,MICRONIZED FENOFIBRATE,MICRONIZED HALFTAB FENOLDOPAM FENOLDOPAM FENTANYL Brand Name EDECRIN HALFTAB MYAMBUTAL (EQUIV) MYAMBUTOL ETHAMOLIN 5% FEMHRT TAB ETHIODOL ZARONTIN (EQUIV) ETHYL CHLORIDE 100% DIDRONEL AMIDATE (EQUIV) AMIDATE (EQUIV) ETOPOSIDE INTELENCE BYETTA ZETIA HELIXATE FS BENEFIX 500IU NOVOSEVEN RT NOVOSEVEN RT NOVOSEVEN RT FAMCICLOVIR FAMVIR PEPCID (EQUIV) PEPCID FAMOTIDINE PEPCID INTRALIPID 10% INTRALIPID 20% INTRALIPID* 20% NEPHRON FA (EQUIV) PLENDIL (EQUIV) PLENDIL (EQUIV) TRICOR TRICOR TRICOR HALFTAB CORLOPAM CORLOPAM FENTANYL Drug Strength 12.5 MG 100 MG 400 MG 2 ML 1 TAB 4750 MG 250 MG 1 APP 400 MG 20 MG 40 MG 20 MG 100 MG 10 MCG 10 MG 1 UNT 1 UNT 5000 MCG 2000 MCG 1000 MCG 125 MG 500 MG 20 MG 20 MG 40 MG 8 MG 250 ML 250 ML 250 ML 1 TAB 2.5 MG 5 MG 145 MG 48 MG 24 MG 10 MG 20 MG 100 MCG Drug Volume 1 TAB 1 TAB 1 TAB 2 ML 1 TAB 10 ML 1 CAP 1 APP 1 TAB 10 ML 20 ML 1 ML 1 TAB 0.04 ML 1 TAB 1 UNT 1 UNT 1 VIAL 1 VIAL 1 VIAL 1 TAB 1 TAB 1 TAB 2 ML 4 ML 1 ML 250 ML 250 ML 250 ML 1 TAB 1 TAB 1 TAB ER 1 TAB 1 TAB 1 TAB 1 ML 2 ML 2 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML AMPUL 1 TAB TAB 2 AMP BOX 1 CAP PACKAGE 103.5 ML BOTTLE 1 TAB PACKAGE 10 ML AMPUL 20 ML AMPUL 1 ML BOTTLE 1 TAB PACKAGE 2.4 ML PEN 1 TAB PACKAGE 1 UNT UNT 1 UNT PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML VIAL 4 ML BOTTLE 1 ML ORAL SYRINGE 250 ML BOTTLE 250 ML BOTTLE 250 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 2 ML AMPUL 2 ML VIAL Dosage Form TAB TAB TAB INJ TAB AMP CAP SPRAY TAB INJ INJ VIAL TAB PEN TAB VIAL KIT VIAL VIAL VIAL TAB TAB TAB VIAL VIAL SUSP PREMIX PREMIX PREMIX TAB TAB TAB ER TAB TAB TAB INJ INJ VIAL Route PO PO PO IV PO INJ PO TOP PO IV IV IV PO SC PO IV IV IV INJ IV PO PO PO IV IV PO IV IV IV PO PO PO PO PO PO IV IV INJ Formulary Status? F F F F NF F NF F F F F F NF NF F F F F F F NF F F F F NF F F F F NF NF F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 Drug Code 3510 2213 1943 2229 3067 1164 594 1294 932 762 4215 3161 3492 3941 2628 3940 2106 983 2905 982 4326 168 4001 137 4170 136 1246 1247 3470 2146 2698 1108 2982 2981 4083 2530 667 767 AHFS Code 40:28.08 08:16.04 08:16.04 24:16.00 68:16.04 36:68.00 28:12.20 84:08.00 92:24.00 28:04.92 28:04.92 10:00.00 08:18.08 68:20.06 24:06.05 20:28.16 20:28.16 20:28.16 20:28.16 20:28.16 08:18.32 08:18.32 56:28.12 56:28.12 56:28.12 56:28.12 40:20.00 40:20.00 40:20.00 20:04.04 24:28.08 24:28.08 24:06.06 24:06.06 24:06.06 24:08.92 24:08.92 28:08.08 Generic Name FENTANYL FENTANYL FENTANYL *10MCG/ML* NS PCA FENTANYL *50MCG/ML* NS PCA FENTANYL 100MCG PATCH SPEC ORD FENTANYL 12.5MCG/ML/D10W 40ML FENTANYL 2500 MCG/250 ML NS FENTANYL 2MCG/ML-BUPIV 0.1% FENTANYL 4MCG/ML/D5W 25ML FENTANYL 4MCG/ML-BUPIV 0.1%EPI FENTANYL 5000 MCG/500 ML NS FENTANYL BUCCAL FENTANYL CITRATE FENTANYL CITRATE BUCCAL FENTANYL PATCH 100MCG FENTANYL PATCH 12 MCG FENTANYL PATCH 25MCG FENTANYL PATCH 50MCG FENTANYL PATCH 75MCG FENTANYL* FENTANYL* FERRIC SUBSULFATE PASTE FERRIC SUBSULFATE* FERROUS GLUCONATE FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE *NEO* FERROUS SULFATE LIQ FEXOFENADINE FIDAXOMICIN FILGRASTIM FILGRASTIM FINASTERIDE FINE CHEMICAL* FLECAINIDE FLECAINIDE ACETATE FLECAINIDE HALFTAB FLECANIDE SUSPENSION Brand Name FENTANYL FENTANYL FENTANYL *10MCG/ML* NS PCA FENTANYL *50MCG/ML* NS PCA FENTANYL 100MCG PATCH SPEC ORD FENTANYL 12.5MCG/ML/D10W 40ML FENTANYL 2500 MCG/250 ML NS FENTANYL 2MCG/ML-BUPIV 0.1% FENTANYL 4MCG/ML/D5W 25ML FENTANYL 4MCG/ML-BUPIV 0.1%EPI FENTANYL 5000 MCG/500 ML NS FENTORA FENTANYL CITRATE FENTORA DURAGESIC PATCH 100MCG DURAGESIC PATCH 12 MCG DURAGESIC PATCH 25MCG DURAGESIC (EQUIV) PATCH 50MCG DURAGESIC PATCH 75MCG FENTANYL* FENTANYL* MONSOL'S PASTE (EQUIV) MONSELLS SOLN* FERGON (EQUIV) FERROUS SULFATE FERROUS SULFATE FERROUS SULFATE *NEO* FERROUS SULF LIQ ALLEGRA DIFICID NEUPOGEN NEUPOGEN PROSCAR (EQUIV) ORA-PLUS (EQUIV)* TAMBOCOR (EQUIV) TAMBOCOR (EQUIV) TAMBOCOR (EQUIV) HALFTAB FLECANIDE SUSPENSION Drug Strength 1000 MCG 250 MCG 500 MCG 2500 MCG 1 EA 12.5 MCG 2500 MCG 100 ML 4 MCG 250 ML 5000 MCG 800 MCG 200 MCG 100 MCG 1 EA 1 EA 1 EA 1 EA 1 EA 100 MCG 250 MCG 1 APP 1 ML 325 MG 220 MG 324 MG 7.5 MG 300 MG 60 MG 200 MG 300 MCG 480 MCG 5 MG 1 ML 50 MG 100 MG 25 MG 5 MG Drug Volume 20 ML 5 ML 50 ML 50 ML 1 EA 1 ML 250 ML 100 ML 1 ML 250 ML 500 ML 1 EFFTAB 1 EA 1 EFFTAB 1 EA 1 EA 1 EA 1 EA 1 EA 2 ML 5 ML 1 APP 1 ML 1 TAB 5 ML 1 TAB 0.5 ML 5 ML 1 TAB 1 TAB 1 ML 1.6 ML 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 1 ML Package Desc 20 ML VIAL 5 ML VIAL 50 ML PACKAGE 50 ML SYRINGE 1 EA PACKAGE 40 ML PACKAGE 250 ML BAG 100 ML BAG 25 ML VIAL 250 ML BAG 500 ML BAG 1 EFFTAB PACKAGE 1 LOLLIPOP PACKAGE 1 EFFTAB PACKAGE 1 EA PACKAGE 1 EA PACKAGE 1 EA PACKAGE 1 EA PACKAGE 1 EA PACKAGE 2 ML VIAL 5 ML VIAL 8 ML PACKAGE 1 ML BOTTLE 1 TAB PACKAGE 5 ML ORAL SYRINGE 1 TAB PACKAGE 0.5 ML ORAL 5 ML UD-CUP 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1.6 ML VIAL 1 TAB PACKAGE ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML ORAL SYRINGE Dosage Form VIAL VIAL SYRINGE SYRINGE PATCH SYRINGE BAG PREMIX VIAL PREMIX BAG EFFTAB LOLLIPOP EFFTAB PATCH PATCH PATCH PATCH PATCH VIAL VIAL TOPICAL SOLN TAB ELIXIR TAB DROPS LIQUID TAB TAB VIAL VIAL TAB LIQUID TAB TAB TAB SUSP Route INJ INJ IV IV TD IV IV EPD IV EPD IV BUC BUC BUC TD TD TD TD TD INJ INJ TOP MSC PO PO PO PO PO PO PO SC SC PO PO PO PO PO PO Formulary Status? F F F F NF F F F F F F NF NF NF F F F F F F F F F F F F F F NF NF F F F F F F F F Controlled Substance? YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 769 768 4044 4071 4286 3130 3507 3451 3129 4033 4302 3225 4262 4218 1761 3025 1758 1759 1760 3242 3243 2376 3009 1458 1382 4016 4142 909 867 4309 2072 2074 106 1457 874 875 4070 2930 AHFS Code 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 96:00.00 96:00.00 20:04.04 20:04.04 20:04.04 20:04.04 20:04.04 04:08.00 08:12.12 20:16.00 20:16.00 92:08.00 96:00.00 24:04.04 24:04.04 24:04.04 24:04.04 Generic Name FLEET ENEMA MINERAL OIL 133ML FLOLAN DILUENT FLOXURIDINE FLUCONAZOLE FLUCONAZOLE FLUCONAZOLE FLUCONAZOLE FLUCONAZOLE 100MG/50ML NS FLUCONAZOLE 200MG/100ML NS FLUCONAZOLE 400MG/200ML NS FLUCONAZOLE HALFTAB FLUCYTOSINE FLUCYTOSINE FLUCYTOSINE SUSP 500MG/10ML FLUDARABINE FLUDROCORTISONE FLUDROCORTISONE HALFTAB FLUMAZENIL MDV FLUNISOLIDE 0.025% FLUNISOLIDE 250MCG FLUOCINOLONE ACET 0.01% OIL FLUOCINONIDE 0.05% FLUOCINONIDE 0.05% GEL FLUOCINONIDE 0.05% OINT 60GM FLUOCINONIDE 0.05% SOLN 60ML FLUOCINONIDE E 0.05% FLUORESCEIN 10% FLUORESCEIN 25% FLUORESCEIN SODIUM FLUORIDE 0.4% FLUORIDE ION/IRON/VIT A,C&D FLUOROMETHOLONE 0.1% FLUOROURACIL FLUOXETINE FLUOXETINE FLUOXETINE HCL FLUPHENAZINE FLUPHENAZINE Brand Name FLEET ENEMA MINERAL OIL FLOLAN DILUENT FLOXURIDINE DIFLUCAN (EQUIV) DIFLUCAN DIFLUCAN DIFLUCAN FLUCONAZOLE 100MG/50ML NS FLUCONAZOLE 200MG/100ML NS DIFLUCAN 400MG/200ML NS DIFLUCAN HALFTAB ANCOBON ANCOBON ANCOBON SUSP FLUDARA FLORINEF FLORINEF HALFTAB ROMAZICON MDV NASALIDE 0.025% AEROBID DERMA-SMOOTHE/FS 0.01% LIDEX 0.05% (EQUIV) LIDEX 0.05% (EQUIV) LIDEX 0.05% (EQUIV)OINT 60GM LIDEX 0.05% (EQUIV) LIDEX E 0.05% (EQUIV) AK-FLUOR FLUORESCITE 25% FUL-GLO GEL-KAM 0.4% VI-DAYLIN/F ADC PLUS IRON FLUOR-OP 0.1% 5-FU (EQUIV) PROZAC PROZAC PROZAC (EQUIV) PROLIXIN (EQUIV) PROLIXIN (EQUIV) Drug Strength 1 EA 1 ML 500 MG 10 MG 100 MG 200 MG 40 MG 100 MG 200 MG 400 MG 50 MG 250 MG 500 MG 500 MG 50 MG 0.1 MG 0.05 MG 0.5 MG 1 SPR 1 PUF 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 5 ML 2 ML 1 EA 1 APP 1 ML 1 DRP 500 MG 10 MG 20 MG 4 MG 1 MG 10 MG Drug Volume 1 EA 1 ML 1 VIAL 1 ML 1 TAB 1 TAB 1 ML 50 ML 100 ML 200 ML 1 TAB 1 CAP 1 CAP 10 ML 1 VIAL 1 TAB 1 TAB 5 ML 1 SPR 1 PUF 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 AMPUL 2 ML 1 EA 1 APP 1 ML 1 DRP 10 ML 1 CAP 1 CAP 1 ML 1 TAB 1 TAB Package Desc 1 EA BOTTLE 50 ML VIAL 1 VIAL PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 50 ML BAG 100 ML BAG 200 ML BAG 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML VIAL 25 ML BOTTLE 7 GM PACKAGE 118.28 ML BOTTLE 60 GM PACKAGE 60 GM PACKAGE 60 GM PACKAGE 60 ML BOTTLE 60 GM PACKAGE 5 ML AMPUL 2 ML VIAL 1 EA PACKAGE 129 GM PACKAGE ML ORAL SYRINGE 5 ML BOTTLE 10 ML VIAL 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form MISC VIAL VIAL SUSP TAB TAB SUSP PREMIX PREMIX PREMIX TAB CAP CAP SUSP VIAL TAB TAB VIAL SPRAY AER OIL CREAM GEL OINT SOLN CREAM INJ INJ STRIP GEL DROPS DROPS VIAL CAP CAP SOLN TAB TAB Route PR IV INJ PO PO PO PO IV IV IV PO PO PO PO IV PO PO IV NAS INH TOP TOP TOP TOP TOP TOP IV IV EYE DEN PO EYE IV PO PO PO PO PO Formulary Status? F F F F F F F F F F F F F F F F F F F NF NF F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2796 1031 2026 434 432 433 435 2873 430 431 2785 1132 3366 4005 1757 47 3441 93 1942 1336 1687 1949 969 883 968 1950 544 545 1663 924 2560 2120 1134 1543 1544 1545 1831 1834 AHFS Code 56:12.00 96:00.00 10:00.00 08:14.08 08:14.08 08:14.08 08:14.08 08:14.08 08:14.08 08:14.08 08:14.08 08:14.32 08:14.32 08:14.32 10:00.00 68:04.00 68:04.00 28:92.00 52:08.08 48:10.08 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 36:58.00 36:58.00 36:58.00 92:28.00 88:28.00 52:08.08 10:00.00 28:16.04 28:16.04 28:16.04 28:16.08 28:16.08 Generic Name FLUPHENAZINE FLUPHENAZINE FLUPHENAZINE FLUPHENAZINE FLUPHENAZINE DECANOATE FLURBIPROFEN 0.03% FLUTAMIDE FLUTICASONE HFA 110MCG FLUTICASONE HFA 220MCG FLUTICASONE HFA 44MCG FLUTICASONE NASAL 0.05% FLUTICASONE/SALMETEROL 100/50 FLUTICASONE/SALMETEROL 250/50 FLUTICASONE/SALMETEROL 500/50 FLUVOXAMINE FLUVOXAMINE HALFTAB FLUVOXAMINE MALEATE FOLIC ACID FOLIC ACID FOLIC ACID MDV FOLIC ACID ORAL SOLN FOLLITROPIN ALPHA,RECOMB FOMEPIZOLE FONDAPARINUX SODIUM FONDAPARINUX SODIUM FONDAPARINUX SODIUM FOSAMPRENAVIR CALCIUM FOSAPREPITANT DIMEGLUMINE FOSAPREPITANT DIMEGLUMINE FOSCARNET 12,000MG/500 ML FOSCARNET 6000MG/250 ML FOSINOPRIL FOSINOPRIL SODIUM FOSINOPRIL SODIUM HALFTAB FOSPHENYTOIN FOSPHENYTOIN FULVESTRANT FUROSEMIDE Brand Name PROLIXIN (EQUIV) PROLIXIN (EQUIV) PROLIXIN (EQUIV) PROLIXIN (EQUIV) PROLIXIN DECANOATE (EQUIV) OCUFEN 0.03% (EQUIV) EULEXIN (EQUIV) FLOVENT HFA 110MCG FLOVENT HFA 220MCG FLOVENT HFA 44MCG FLONASE 0.05% ADVAIR DISKUS 100/50 ADVAIR DISKUS 250/50 ADVAIR DISKUS 500/50 LUVOX LUVOX HALFTAB LUVOX (EQUIV) FOLIC ACID FOLIC ACID FOLIC ACID MDV FOLIC ACID GONAL-F (EQUIV) ANTIZOL ARIXTRA PF ARIXTRA ARIXTRA LEXIVA EMEND EMEND FOSCAVIR FOSCAVIR 6000MG/250 ML MONOPRIL MONOPRIL (EQUIV) MONOPRIL (EQUIV) HALFTAB CEREBYX (EQUIV) CEREBYX FASLODEX LASIX (EQUIV) Drug Strength 2.5 MG 2.5 MG 5 MG 5 MG 25 MG 1 DRP 125 MG 1 PUF 1 PUF 1 PUF 1 SPR 1 PUF 1 PUF 1 PUF 50 MG 25 MG 100 MG 1 MG 1 MG 5 MG 1 MG 75 UNT 1.5 GM 2.5 MG 5 MG 7.5 MG 700 MG 115 MG 150 MG 24 MG 6000 MG 20 MG 10 MG 5 MG 100 MG 500 MG 250 MG 10 MG Drug Volume 1 ML 1 TAB 1 TAB 1 ML 1 ML 1 DRP 1 CAP 1 PUF 1 PUF 1 PUF 1 SPR 1 PUF 1 PUF 1 PUF 1 TAB 1 TAB 1 TAB 0.2 ML 1 TAB 1 ML 1 ML 1 AMP 1.5 ML 0.5 ML 0.4 ML 0.6 ML 1 TAB 1 VIAL 1 VIAL 1 ML 250 ML 1 TAB 1 TAB 1 TAB 2 ML 10 ML 5 ML 1 ML Package Desc 10 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 5 ML VIAL 2.5 ML BOTTLE 1 CAP PACKAGE 12 GM PACKAGE 10.6 GM PACKAGE 10.6 GM PACKAGE 16 GM PACKAGE 28 DISK PACKAGE 28 DISK PACKAGE 28 DISK PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 0.2 ML SYRINGE 1 TAB PACKAGE ML VIAL 1 ML ORAL SYRINGE 1 AMP PACKAGE 1.5 ML VIAL 0.5 ML SYRINGE 0.4 ML SYRINGE .6 ML SYRINGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 500 ML BOTTLE 250 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML VIAL 10 ML VIAL 5 ML SYRINGE ML ORAL SYRINGE Dosage Form VIAL TAB TAB SOLN VIAL DROPS CAP MISC MISC MSC SPRAY DISK DISK DISK TAB TAB TAB SYRINGE TAB VIAL SOLN AMP VIAL SYRINGE SYRINGE SYRING TAB VIAL VIAL PREMIX PREMIX TAB TAB TAB VIAL VIAL SYRINGE SOLN Route IM PO PO PO IM EYE PO INH INH INH NAS INH INH INH PO PO PO INJ PO INJ PO SC INJ INJ SC SC PO INJ INJ IV IV PO PO PO INJ INJ IM PO Formulary Status? F F F F F NF F F F F F F F F F F F F F F F F NF NF NF NF NF NF F F F NF NF NF F F NF F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2259 1832 1833 919 2258 1666 834 3014 3015 3013 1022 2633 2632 2631 371 370 372 3919 1056 2249 2937 1698 3263 2599 3455 4084 2711 3904 4141 1124 1123 856 851 2746 4163 611 1198 473 AHFS Code 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 52:08.20 10:00.00 48:10.08 48:10.08 48:10.08 52:08.08 48:10.08 48:10.08 48:10.08 28:16.04 28:16.04 28:16.04 88:08.00 88:08.00 88:08.00 88:08.00 68:18.00 92:12.00 20:12.04 20:12.04 20:12.04 08:18.08 56:22.92 56:22.92 08:18.92 08:18.92 24:32.04 24:32.04 24:32.04 28:12.12 28:12.12 10:00.00 40:28.08 Generic Name FUROSEMIDE FUROSEMIDE FUROSEMIDE FUROSEMIDE FUROSEMIDE FUROSEMIDE FUROSEMIDE *NEO* FUROSEMIDE 100MG/100ML D5W FUROSEMIDE 200MG/100ML D5W FUROSEMIDE D10W NEO FUROSEMIDE HALFTAB FUROSEMIDE* GABAPENTIN GABAPENTIN GABAPENTIN GABAPENTIN GABAPENTIN LIQUID GADOBENATE DIMEGLUMINE* GADOBENATE DIMEGLUMINE* GADOBENATE DIMEGLUMINE* GADODIAMIDE GADODIAMIDE* GADODIAMIDE* GADODIAMIDE* GALANTAMINE HYDROBROMIDE GALANTAMINE HYDROBROMIDE GANCICLOVIR GANCICLOVIR GELATIN CAP CLR NO.0* GELATIN CAP NO.00* GELATIN CAP NO.1* GELATIN CAP NO.3* GELATIN OPTH 25X50MM GELATIN SPONGE 12-7MM GELATIN SPONGE SIZE 100* GELATIN SPONGE,ABSORB POWD 1GM GEMCITABINE HCL GEMCITABINE HCL Brand Name LASIX (EQUIV) LASIX (EQUIV) LASIX (EQUIV) LASIX (EQUIV) LASIX (EQUIV) LASIX (EQUIV) LASIX (EQUIV) *NEO* LASIX 100 MG/100 ML D5W LASIX 200 MG/100 ML D5W FUROSEMIDE 1MG/ML D10W NEO DIL LASIX (EQUIV) HALFTAB LASIX (EQUIV)* NEURONTIN NEURONTIN NEURONTIN NEURONTIN NEURONTIN LIQUID MULTIHANCE* MULTIHANCE* MULTIHANCE* OMNISCAN OMNISCAN* OMNISCAN* OMNISCAN* RAZADYNE RAZADYNE CYTOVENE CYTOVENE CAPSULES, EMPTY NO.0 GELATIN* CAPSULES, EMPTY NO.00 GELATIN* CAPSULES, EMPTY NO.1 GELATIN* CAPSULES, EMPTY NO.3 GELATIN* GELFILM 25X50MM GELFOAM 12-7MM GELFOAM SIZE 100* SURGIFOAM POWDER GEMZAR GEMZAR Drug Strength 100 MG 20 MG 20 MG 40 MG 40 MG 80 MG 5 MG 100 MG 200 MG 1 MG 10 MG 100 MG 100 MG 300 MG 400 MG 600 MG 300 MG 529 MG 529 MG 529 MG 287 MG 287 MG 287 MG 287 ML 4 MG 8 MG 250 MG 500 MG 1 CAP 1 CAP 1 CAP 1 CAP 1 EA 1 EA 1 EA 1 APP 1 GM 200 MG Drug Volume 10 ML 2 ML 1 TAB 4 ML 1 TAB 1 TAB 0.5 ML 100 ML 100 ML 1 ML 1 TAB 10 ML 1 CAP 1 CAP 1 CAP 1 TAB 6 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 TAB 1 TAB 1 CAP 1 VIAL 1 CAP 1 CAP 1 CAP 1 CAP 1 EA 1 EA 1 EA 1 APP 1 VIAL 1 VIAL Package Desc 10 ML VIAL 2 ML VIAL 1 TAB PACKAGE 4 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 0.5 ML ORAL 100 ML BAG 100 ML BAG 1 ML PACKAGE 1 TAB PACKAGE 10 ML VIAL 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 20 ML VIAL 15 ML VIAL 10 ML VIAL 20 ML VIAL 5 ML BOTTLE 10 ML VIAL 15 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 EA PACKAGE 1 EA PACKAGE 1 EA PACKAGE 1 GM PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE Dosage Form VIAL VIAL TAB VIAL TAB TAB SOLN PREMIX PREMIX SOLN TAB VIAL CAP CAP CAP TAB SOLN VIAL VIAL VIAL VIAL VIAL VIAL VIAL TAB TAB CAP VIAL CAP CAP CAP CAP EACH SPONGE SPONGE TOP PWD VIAL VIAL Route INJ INJ PO INJ PO PO PO IV IV IV PO INJ PO PO PO PO PO IV IV IV IV IV IV IV PO PO PO IV PO PO PO PO TOP TOP TOP TOP IV IV Formulary Status? F F F F F F F F F F F F F F F F F NF NF NF F F F F NF NF F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1422 1420 509 1421 1064 510 4119 3913 3915 2713 2747 3244 605 606 607 2956 608 3282 3281 3280 1316 3205 1314 1315 1770 3445 81 94 6 9 7 8 2943 225 227 231 30 29 AHFS Code 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 40:28.08 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 12:04.00 12:04.00 08:18.32 08:18.32 96:00.00 96:00.00 96:00.00 96:00.00 52:92.00 94:00.00 94:00.00 20:28.16 10:00.00 10:00.00 Generic Name GEMFIBROZIL GEMFIBROZIL HALFTAB GENTAMICIN GENTAMICIN GENTAMICIN GENTAMICIN GENTAMICIN GENTAMICIN *NEO* 2MG/1ML GENTAMICIN 0.1% OINT GENTAMICIN 0.3% GENTAMICIN 0.3% GENTAMICIN 120MG/100ML D5W GENTAMICIN D10W NEO GENTAMICIN* GENTAMICIN/NS GENTIAN VIOLET 1% GENTIAN VIOLET 2% GLATIRAMER GLIMEPIRIDE GLIMEPIRIDE GLIMEPIRIDE HALFTAB GLIPIZIDE GLIPIZIDE GLIPIZIDE HALFTAB GLIPIZIDE QUARTERTAB GLUCAGON GLUCOSE 40% GLYBURIDE GLYBURIDE GLYBURIDE GLYBURIDE MICRO GLYCERIN GLYCERIN GLYCERIN 100% GLYCERIN 50% GLYCERIN PEDIATRIC GLYCERIN* GLYCOPYRROLATE Brand Name LOPID (EQUIV) LOPID (EQUIV) HALFTAB GENTAMICIN/NS GENTAMICIN GENTAMICIN MDV* GENTAMICIN/NS GENTAMICIN GENTAMICIN GENTAMICIN 0.1% OINT GENTAK 0.3% GENTAK 0.3% GENTAMICIN 120MG/100ML D5W GENTAMICIN D10W NEO GENTAMICIN* GENTAMICIN/NS GENTIAN VIOLET 1% GENTIAN VIOLET 2% COPAXONE AMARYL AMARYL AMARYL HALFTAB GLIPIZIDE GLIPIZIDE GLIPIZIDE HALFTAB GLIPIZIDE QUARTERTAB GLUCAGON GLUTOSE 40% GLYBURIDE MICRONASE (EQUIV) MICRONASE (EQUIV) GLYNASE (EQUIV) GLYCERIN SUPP GLYCERIN GLYCERIN 100% OSMOGLYN 50% GLYCERIN PEDIATRIC SUPP GLYCERIN* GLYCOPYRROLATE Drug Strength 600 MG 300 MG 100 MG 20 MG 40 MG 80 MG 80 MG 2 MG 1 APP 1 APP 1 DRP 120 MG 2 MG 80 MG 60 MG 1 APP 1 APP 20 MG 1 MG 2 MG 0.5 MG 10 MG 5 MG 2.5 MG 1.25 MG 1 MG 1 APP 1.25 MG 2.5 MG 5 MG 1.5 MG 1 EA 1 ML 1 ML 1 ML 1 EA 1 ML 0.2 MG Drug Volume 1 TAB 1 TAB 50 ML 2 ML 1 ML 50 ML 2 ML 1 ML 1 APP 1 APP 1 DRP 100 ML 1 ML 2 ML 50 ML 1 APP 1 APP 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 KIT 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 SUPP 1 ML 1 ML 1 ML 1 SUPP 1 ML 1 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 50 ML BAG 2 ML VIAL 1 ML BOTTLE 50 ML BAG 2 ML VIAL 1 ML SYRING 15 GM PACKAGE 3.5 GM PACKAGE 5 ML BOTTLE 100 ML BAG 1 ML PACKAGE 2 ML VIAL 50 ML BOTTLE 59 ML BOTTLE 30 ML BOTTLE 1 ML PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 KIT PACKAGE 15 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 SUPP PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE ML ORAL SYRINGE 1 SUPP PACKAGE 120 ML BOTTLE 1 ML VIAL Dosage Form TAB TAB INJ VIAL VIAL INJ VIAL SYRING OINT OINT DROPS PB SOLN VIAL INJ SOLN SOLN EACH TAB TAB TAB TAB TAB TAB TAB KIT GEL TAB TAB TAB TAB SUPP LIQUID LIQUID SOLN SUPP LIQUID VIAL Route PO PO IPB INJ INJ IPB INJ IV TOP EYE EYE IV IV INJ IPB TOP TOP INJ PO PO PO PO PO PO PO INJ PO PO PO PO PR PO MSC PO REC MSC INJ Formulary Status? F F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1884 2748 1251 2268 3204 1250 640 3944 1701 1662 2192 4273 2714 3245 1249 4153 1301 2707 384 385 3494 1897 1896 2749 2750 34 1451 2551 1906 1907 894 3324 1636 1302 542 3325 3074 3399 AHFS Code 24:06.06 24:06.06 08:12.02 08:12.02 08:12.02 08:12.02 08:12.02 08:12.02 84:04.04 52:04.04 52:04.04 08:12.02 08:12.02 08:12.02 08:12.02 84:04.08 84:04.08 92:20.00 68:20.20 68:20.20 68:20.20 68:20.20 68:20.20 68:20.20 68:20.20 68:22.12 40:20.00 68:20.20 68:20.20 68:20.20 68:20.20 56:12.00 96:00.00 84:24.00 52:92.00 56:12.00 96:00.00 12:08.08 Generic Name GLYCOPYRROLATE GLYCOPYRROLATE GLYCOPYRROLATE HALFTAB GOLD SODIUM THIOMALATE GONADORELIN GOSERELIN GOSERELIN IMPLANT GRANISETRON GRANISETRON GRISEOFULVIN ULTRAMICROSIZE GRISEOFULVIN ULTRAMICROSIZE GRISEOFULVIN,MICROSIZE GUAIFENESIN GUAIFENESIN GUAIFENESIN GUAIFENESIN GUAIFENESIN ALCOHOL FREE GUAIFENESIN DM 100/10/5ML UD GUAIFENESIN DM 200/20/10ML UD GUAIFENESIN UD GUAIFENESIN/CODEINE GUAIFENESIN/CODEINE 100/10/5ML GUAIFENESIN/DM 20/2/1ML SYR GUANFACINE HCL HAEMOPHILUS B CONJ VACCINE HALOPERIDOL HALOPERIDOL HALOPERIDOL HALOPERIDOL HALOPERIDOL HALOPERIDOL HALOPERIDOL CONC HALOPERIDOL DECANOATE HALOPERIDOL DECANOATE HALOPERIDOL HALFTAB HALOPERIDOL HALFTAB HALOPERIDOL QUARTERTAB HC ACETATE/PRAMOXINE HCL Brand Name ROBINUL (EQUIV) ROBINUL (EQUIV) ROBINUL (EQUIV) HALFTAB MYOCHRYSINE FACTREL ZOLADEX ZOLADEX IMPLANT KYTRIL KYTRIL GRIS-PEG GRIS-PEG GRIFULVIN V ROBITUSSIN (EQUIV) ROBITUSSIN ROBITUSSIN MUCINEX ROBITUSSIN ALCOHOL FREE ROBITUSSIN DM (EQUIV) ROBITUSSIN DM (EQUIV) ROBITUSSIN UD(EQUIV) ROBITUSSIN AC ROBITUSSIN AC(EQUIV)UD ROBITUSSIN DM (EQUIV) TENEX (EQUIV) ACTHIB HALDOL (EQUIV) HALDOL (EQUIV) HALDOL (EQUIV) HALDOL (EQUIV) HALDOL (EQUIV) HALDOL HALDOL CONC (EQUIV) HALDOL DECANOATE (EQUIV) HALDOL DECANOATE HALDOL (EQUIV) HALFTAB HALDOL (EQUIV) HALFTAB HALOPERIDOL QUARTERTAB PROCTOFOAM-HC (EQUIV) Drug Strength 1 MG 1 MG 0.5 MG 50 MG 100 MCG 10.8 MG 3.6 MG 1 MG 1 MG 125 MG 250 MG 25 MG 100 MG 20 MG 300 MG 600 MG 20 MG 5 ML 10 ML 200 MG 1 ML 5 ML 1 ML 2 MG 10 MCG 0.5 MG 1 MG 10 MG 2 MG 5 MG 5 MG 2 MG 100 MG 50 MG 0.25 MG 2.5 MG 0.125 MG 1 APP Drug Volume 1 TAB 5 ML 1 TAB 1 ML 1 VIAL 1 IMPLAN 1 EA 1 TAB 1 ML 1 TAB 1 TAB 1 ML 5 ML 1 ML 15 ML 1 TAB 1 ML 5 ML 10 ML 10 ML 1 ML 5 ML 1 ML 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 ML 1 ML 1 ML 1 TAB 1 TAB 1 TAB 1 APP Package Desc 1 TAB PACKAGE 5 ML VIAL 1 TAB PACKAGE 1 ML VIAL 1 VIAL PACKAGE 1 IMPLAN PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 ML ORAL SYRINGE 5 ML UD CUP ML ORAL SYRINGE 15 ML UD CUP 1 TAB PACKAGE ML ORAL SYRINGE 5 ML UD CUP 10 ML UD CUP 10 ML UD CUP 1 ML BOTTLE 5 ML UD CUP 1 ML ORAL SYRINGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML AMPUL ML ORAL SYRINGE 1 ML VIAL 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 GM PACKAGE Dosage Form TAB VIAL TAB VIAL VIAL IMPLANT IMPLANT TAB VIAL TAB TAB SUSP SYRUP SYRUP SYRUP TAB SYRUP SYRUP SYRUP SYRUP SYRUP SYRUP SYRUP TAB VIAL TAB TAB TAB TAB TAB INJ SOLN VIAL VIAL TAB TAB TAB AER Route PO INJ PO INJ INJ SC MSC PO IV PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO IM PO PO PO PO PO IM PO IM INJ PO PO PO PR Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 05 05 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2149 1415 4046 4060 407 1199 2929 73 72 1569 1570 537 1816 363 905 2597 2945 4009 1817 904 2817 2939 1378 365 4002 1553 1554 1557 1555 1556 395 914 2041 2044 3502 2751 3526 878 AHFS Code 12:08.08 12:08.08 12:08.08 60:00.00 68:18.00 10:00.00 10:00.00 56:22.20 56:22.20 08:14.92 08:14.92 08:14.92 48:16.00 48:16.00 48:16.00 48:16.00 48:16.00 48:08.00 48:08.00 48:16.00 48:08.00 48:08.00 48:08.00 24:08.16 80:12.00 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 84:06.00 Generic Name HC ACETATE/PRAMOXINE HCL 10GM HEP B VACCINE/DP(A)T-POLIO HEPARIN HEPARIN HEPARIN HEPARIN HEPARIN HEPARIN 0.5UNT/ML D10W 500ML HEPARIN 0.5UNT/ML D5W 500ML HEPARIN 1000 UNITS/500 ML NS HEPARIN 1000 UNT/ML HEPARIN 25000U/ 0.45% NS 500ML HEPARIN 25000UNT/D5W 500ML HEPARIN LOCK FLUSH HEPARIN SODIUM,PORCINE HEPATITIS A ADULT VACCINE HEPATITIS A PEDI VACCINE HEPATITIS A VIRUS VACCINE HEPATITIS A VIRUS VACCINE/PF HEPATITIS B IMMUNE GLOBULIN HEPATITIS B IMMUNE GLOBULIN HEPATITIS B VIR VACC PEDI HERPES-ZOSTER VACCINE* HETASTARCH 6%/NACL 0.9% HEXACHLOROPHENE 3% 148ML HOMATROPINE 2% HOMATROPINE 5% HUMULIN INSULIN 70/30 HYALURONATE PFS HYALURONATE SODIUM HYALURONATE SODIUM HYALURONATE SODIUM HYALURONATE SODIUM HYALURONATE SODIUM* HYALURONATE* HYALURONIDASE HYALURONIDASE,OVINE HYDRALAZINE Brand Name EPIFOAM (EQUIV)10GM PEDIARIX HEPARIN HEPARIN HEPARIN HEPARIN HEPARIN HEPARIN 0.5UNT/ML D10W 500ML HEPARIN 0.5UNT/ML D5W 500ML HEPARIN 1000 UNITS/500 ML NS HEPARIN 1000 UNT/ML HEPARIN 25000U/ 0.45% NS 500ML HEPARIN 25000UNT/D5W 500ML HEPARIN LOCK FLUSH HEPARIN LOCK FLUSH HAVRIX ADULT VAQTA PEDI HAVRIX HAVRIX HEPATITIS B IMMUNE GLOBULIN BAYHEP B ENGERIX-B PEDI ZOSTAVAX VACCINE* HESPAN (EQUIV) PHISOHEX ISOPTO HOMATROPINE 2% HOMATROPINE 5% INSULIN HUMULIN 70/30 SYNVISC PFS PROVISC HEALON HYALGAN SYNVISC ONE SUPARTZ* EUFLEXXA* AMPHADASE VITRASE APRESOLINE (EQUIV) Drug Strength 1 APP 0.5 ML 1000 UNT 1000 UNT 10000 UNT 10000 UNT 5000 UNT 250 UNT 250 UNT 1000 UNIT 30000 UNT 25000 UNT 25000 UNT 10 UNT 100 UNT 50 UNT 25 UNT 1440 UNIT 720 UNITS 312 UNIT 5 ML 10 MCG 1 EA 500 ML 1 APPLIC 1 DRP 1 DRP 100 UNT 16 MG 10 MG 10 MG 20 MG 48 MG 10 MG 10 MG 150 U 200 UNIT 10 MG Drug Volume 1 APP 0.5 ML 1 ML 1 ML 1 ML 1 ML 1 ML 500 ML 500 ML 500 ML 30 ML 500 ML 500 ML 1 ML 1 ML 1 ML 0.5 ML 1 ML 1 SYRING 1 ML 5 ML 0.5 ML 1 EA 500 ML 1 APPLIC 1 DRP 1 DRP 1 ML 2 ML 1 ML 0.85 ML 2 ML 6 ML 2.5 ML 2 ML 1 ML 1 ML 1 TAB Package Desc 10 GM PACKAGE 0.5 ML BOTTLE 1 ML VIAL 10 ML VIAL 1 ML VIAL 4 ML VIAL 1 ML VIAL 500 ML BAG 500 ML BAG 500 ML BAG 30 ML VIAL 500 ML BAG 500 ML BAG 10 ML VIAL 5 ML VIAL 1 ML SYRINGE 0.5 ML SYRINGE 1 ML BOTTLE .5 ML BOTTLE 1 ML VIAL 5 ML VIAL 0.5 ML VIAL 1 EA PACKAGE 500 ML BAG 148 ML BOTTLE 5 ML BOTTLE 5 ML BOTTLE 1 ML VIAL 2 ML SYRINGE 0.55 ML SYRINGE 0.85 ML SYRINGE 2 ML SYRINGE 6 ML SYRINGE 2.5 ML SYR 2 ML BOTTLE 1 ML BOTTLE 1.2 ML BOTTLE 1 TAB PACKAGE Dosage Form AER VIAL VIAL VIAL VIAL VIAL VIAL PREMIX PREMIX PREMIX VIAL PREMIX PREMIX VIAL VIAL SYRINGE SYRINGE VIAL SYRINGE VIAL VIAL VIAL VIAL PREMIX LIQUID DROPS DROPS VIAL SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE SYRINGE VIAL VIAL TAB Route TOP INJ INJ INJ INJ INJ INJ IV IV IV INJ IV IV INJ IV IM IM IM IM IM IM IM SC IV TOP EYE EYE SC IV INJ IO INJ INJ INJ INJ INJ INJ PO Formulary Status? F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F NF NF F NF F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 879 2642 2269 1518 2270 1520 2256 4201 4202 3998 1519 4048 1252 2842 4089 153 154 3290 3291 331 332 157 3154 756 318 1619 2121 40 209 1626 295 1625 3882 3185 3121 2965 3059 1060 AHFS Code 84:06.00 80:12.00 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 80:12.00 80:12.00 80:12.00 80:12.00 80:04.00 80:04.00 80:12.00 80:12.00 40:12.00 84:04.92 52:24.00 52:24.00 68:20.08 94:00.00 94:00.00 94:00.00 94:00.00 94:00.00 94:00.00 94:00.00 44:00.00 44:00.00 24:08.20 Generic Name HYDRALAZINE HYDRALAZINE HYDRALAZINE HALFTAB HYDRALAZINE LIQUID HYDROCERIN CREAM HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE HYDROCHLOROTHIAZIDE QUARTERTAB HYDROCODONE /APAP 5/325 *ED* HYDROCODONE /APAP 5/500* HYDROCODONE 10MG / APAP 325MG HYDROCODONE 5MG / APAP 325MG HYDROCODONE 5MG/ APAP 334MG HYDROCODONE BIT/ACETAMINOPHEN HYDROCODONE BIT/ACETAMINOPHEN HYDROCODONE/HOMATROPINE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE HYDROCORTISONE 0.5% 28.35GM CR HYDROCORTISONE 0.5% OINT 28GM HYDROCORTISONE 1% HYDROCORTISONE 1% CR HYDROCORTISONE 1% CR 454GM HYDROCORTISONE 1% OINT 454GM HYDROCORTISONE 2.5% HYDROCORTISONE 2.5% CR HYDROCORTISONE 2.5% CR 30GM HYDROCORTISONE 2.5% OINT 28GM HYDROCORTISONE ACETATE HYDROCORTISONE ENEMA HYDROCORTISONE HALFTAB HYDROCORTISONE NA SUC PRES FRE HYDROCORTISONE NA SUCC HYDROCORTISONE SOD SUCCINATE HYDROCORTISONE SOD SUCCINATE HYDROCORTISONE SUSP Brand Name HYDRALAZINE APRESOLINE (EQUIV) APRESOLINE (EQUIV) HALFTAB APRESOLINE(EQUIV)LIQUID EUCERIN (EQUIV) HYDROCHLOROTHIAZIDE HYDRODIURIL (EQUIV) HYDRODIURIL (EQUIV) HYDRODIURIL (EQUIV) QUARTERTAB HYDROCODONE /APAP 5/325 *ED* HYDROCODONE /APAP 5/500* LORTAB 10MG / 325MG (EQUIV) LORTAB 5MG / 325MG (EQUIV) HYDROCODONE 5MG/ APAP 334MG VICODIN ES (EQUIV) VICODIN (EQUIV) HYCODAN (EQUIV)5MG/1.5MG/5ML CORTEF HYDROCORTISONE CORTEF HYDROCORTISONE 0.5% HYDROCORTISONE 0.5% HYDROCORTISONE 1% HYDROCORTISONE 1% HYDROCORTISONE 1% HYDROCORTISONE 1% PROCTOZONE-HC ANUSOL-HC 2.5% CR HYDROCORTISONE 2.5% HYDROCORTISONE 2.5% ANUSOL HC (EQUIV) COLOCORT ENEMA CORTEF HALFTAB SOLU-CORTEF A-HYDROCORT SOLU-CORTEF SOLU-CORTEF HYDROCORTISONE SUSP Drug Strength 20 MG 25 MG 12.5 MG 2 MG 1 APP 12.5 MG 25 MG 50 MG 6.25 MG 2 TAB 2 TAB 1 TAB 1 TAB 10 ML 1 TAB 15 ML 1 ML 10 MG 20 MG 5 MG 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 30 GM 1 APP 1 APP 1 APP 25 MG 100 MG 2.5 MG 100 MG 100 MG 250 MG 500 MG 2 MG Drug Volume 1 ML 1 TAB 1 TAB 1 ML 1 APP 1 CAP 1 TAB 1 TAB 1 TAB 2 TAB 2 TAB 1 TAB 1 TAB 10 ML 1 TAB 15 ML 1 ML 1 TAB 1 TAB 1 TAB 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 30 GM 1 APP 1 APP 1 APP 1 SUPP 60 ML 1 TAB 1 VIAL 2 ML 2 ML 4 ML 1 ML Package Desc 1 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 454 GM PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 TAB PACKAGE 2 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML UD CUP 1 TAB PACKAGE 15 ML BOTTLE ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 28.35 GM PACKAGE 28.35 GM PACKAGE 30 GM PACKAGE 28.4 GM PACKAGE 454 GM PACKAGE 454 GM PACKAGE 30 GM PACKAGE 30 GM PACKAGE 30 GM PACKAGE 28.35 GM PACKAGE 1 SUPP PACKAGE 60 ML BOTTLE 1 TAB PACKAGE 1 VIAL PACKAGE 2 ML PACKAGE 2 ML PACKAGE 4 ML PACKAGE ML ORAL SYRINGE Dosage Form VIAL TAB TAB SOLN CREAM CAP TAB TAB TAB TAB TAB TAB TAB UD CUP TAB ELIXIR SYRUP TAB TAB TAB CREAM OINT OINT CREAM CREAM OINT CREAM CREAM CREAM OINT SUPP ENEMA TAB VIAL VIAL VIAL VIAL SUSP Route INJ PO PO PO TOP PO PO PO PO PO PO PO PO PO PO PO PO PO PO PO TOP TOP TOP TOP TOP TOP PR PR TOP TOP PR PR PO INJ INJ INJ INJ PO Formulary Status? F F F F F F F F F F F F F NF NF NF F F F F F F F F F F F NF F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 03 03 03 03 03 03 03 03 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2725 1057 3942 2827 959 2961 1782 1058 3367 4156 3262 4171 4125 4278 3266 3265 1377 115 1588 212 948 950 2145 1361 949 951 2236 2205 967 971 1369 897 3936 240 244 246 3360 2828 AHFS Code 24:08.20 24:08.20 24:08.20 24:08.20 84:24.12 40:28.20 40:28.20 40:28.20 40:28.20 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 48:08.00 68:04.00 68:04.00 68:04.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 Generic Name HYDROCORTISONE/IODOQUINOL HYDROMORPH 10MCG/ML-BUPIV 0.1% HYDROMORPHONE HYDROMORPHONE HYDROMORPHONE (MDV) HYDROMORPHONE *0.2MG/ML* PCA HYDROMORPHONE *1MG/1ML* PCA HYDROMORPHONE 10MCG/ML EPID HYDROMORPHONE 10MG/ML SC INFUS HYDROMORPHONE 1MG/ML ORAL SOLN HYDROMORPHONE 20 MG/D5W 100 ML HYDROMORPHONE 250MG/D5W 250ML HYDROMORPHONE 50 MG/D5W 250 ML HYDROMORPHONE AVERAGE ADULT HYDROMORPHONE FRAIL ADULT HYDROMORPHONE HALFTAB HYDROMORPHONE HCL HYDROMORPHONE HCL HYDROMORPHONE HCL HYDROMORPHONE HCL HYDROMORPHONE HP HYDROMORPHONE HP HYDROMORPHONE QUARTERTAB HYDROMORPHONE TOLERANT ADULT HYDROXOCOBALAMIN HYDROXYCHLOROQUINE HYDROXYPROPYL 2.5% OPTH HYDROXYUREA HYDROXYZINE HCL HYDROXYZINE HCL HYDROXYZINE PAMOATE HYDROXYZINE PAMOATE HYDROXYZINE PAMOATE SUSP HYOSCYAMINE IBANDRONATE* IBUPROFEN IBUPROFEN IBUPROFEN Brand Name VYTONE (EQUIV) 28.4GM HYDROMORPH 10MCG/ML-BUPIV 0.1% DILAUDID (EQUIV) DILAUDID (EQUIV) DILAUDID (EQUIV) DILAUDID *0.2MG/ML* PCA HYDROMORPHONE *1MG/1ML* PCA DILAUDID 10MCG/ML IN NS EPID DILAUDID 10MG/ML SC INFUSION HYDROMORPHONE 1MG/ML ORAL DILAUDID 20 MG/D5W 100 ML HYDROMORPHONE 250MG/D5W DILAUDID 50 MG/D5W 250 ML HYDROMORPHONE AVERAGE ADULT HYDROMORPHONE FRAIL ADULT DILAUDID HALFTAB DILAUDID (EQUIV) DILAUDID (EQUIV) DILAUDID (EQUIV) DILAUDID DILAUDID-HP (EQUIV) DILAUDID-HP DILAUDID QUARTERTAB HYDROMORPHONE TOLERANT ADULT CYANOKIT PLAQUENIL (EQUIV) GONIOSOL OPTH HYDREA (EQUIV) HYDROXYZINE HCL ATARAX (EQUIV) VISTARIL (EQUIV) VISTARIL (EQUIV) VISTARIL SUSP LEVSIN (EQUIV) BONIVA* ADVIL (EQUIV) MOTRIN (EQUIV) MOTRIN (EQUIV) Drug Strength 1 APP 250 ML 3 MG 4 MG 2 MG 10 MG 50 MG 250 ML 10 MG 1 MG 20 MG 250 MG 50 MG 1 EA 1 EA 1 MG 1 MG 2 MG 2 MG 4 MG 10 MG 50 MG 0.5 MG 1 EA 5 GM 200 MG 1 DRP 500 MG 10 MG 10 MG 25 MG 50 MG 5 MG 0.125 MG 3 MG 200 MG 400 MG 600 MG Drug Volume 1 APP 250 ML 1 SUPP 1 ML 1 ML 50 ML 50 ML 250 ML 1 ML 1 ML 100 ML 250 ML 250 ML 1 EA 1 EA 1 TAB 1 ML 1 TAB 1 ML 1 TAB 1 ML 5 ML 1 TAB 1 EA 1 KIT 1 TAB 1 DRP 1 CAP 5 ML 1 TAB 1 CAP 1 CAP 1 ML 1 TAB 3 ML 1 TAB 1 TAB 1 TAB Package Desc 28.4 GM PACKAGE 250 ML BAG 1 SUPP PACKAGE 1 ML SYRINGE 1 ML VIAL 50 ML SYRINGE 50 ML SYRINGE 250 ML BAG 25 ML BAG 1 ML BOTTLE 100 ML BAG 250 ML BAG 250 ML BAG 1 EA PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 1 ML SYRINGE 1 TAB PACKAGE 1 ML SYRINGE 1 TAB PACKAGE 1 ML AMPUL 5 ML AMPUL 1 TAB PACKAGE 1 EA PACKAGE 1 KIT PACKAGE 1 TAB PACKAGE 15 ML BOTTLE 1 CAP PACKAGE ML BOTTLE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 3 ML PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form CREAM PREMIX SUPP SYRINGE VIAL PCA SYRINGE PREMIX PREMIX SOLN BAG BAG BAG MISC MISC TAB SYRINGE TAB SYRINGE TAB INJ INJ TAB MISC VIAL TAB DROPS CAP SYRUP TAB CAP CAP SUSP TAB SYR TAB TAB TAB Route TOP EPD PR INJ INJ IV IV EPD SC PO IV IV IV INJ INJ PO INJ PO INJ PO INJ INJ PO INJ INJ PO EYE PO PO PO PO PO PO PO INJ PO PO PO Formulary Status? F F NF F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F Controlled Substance? NO YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 565 4034 1463 646 1516 3046 3971 4026 3890 4275 3514 4072 3515 3052 3053 3104 3356 2522 647 389 387 388 3973 3054 3456 2588 2123 508 2552 1071 1061 1062 587 1961 3155 1089 1582 1595 AHFS Code 84:04.92 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 92:12.00 08:30.08 52:92.00 10:00.00 28:24.92 28:24.92 28:24.92 28:24.92 28:24.92 12:08.08 92:24.00 28:08.04 28:08.04 28:08.04 Generic Name IBUPROFEN IBUPROFEN INFANT DROPS IBUPROFEN LYSINE/PF IBUPROFEN SUSP (CHILDREN'S) IBUPROFEN SUSPENSION IBUPROFEN SUSPENSION IBUTILIDE IDARUBICIN IDARUBICIN IDARUBICIN IFOSFAMIDE IFOSFAMIDE IMATINIB IMATINIB MESYLATE IMIGLUCERASE 400 UNITS/VIAL IMIPRAMINE HCL IMIPRAMINE HCL IMIPRAMINE HCL IMIQUIMOD 5% 0.25GM IMMU GLOBULIN (IVIG) 1GM/10ML IMMU GLOBULIN,GAMMA (IGG) IMMUNE GLOBULIN,GAMMA (IGG) INDAPAMIDE INDAPAMIDE INDIGOTINDISULFONATE 0.8% INDOCYANINE GREEN INDOMETHACIN INDOMETHACIN INDOMETHACIN INDOMETHACIN SA INDOMETHACIN SUSP INFLIXIMAB INFLUENZA VACC INTRANASAL SPR INFLUENZA VACC SDV LATEX FREE INFLUENZA VACCINE ADULT INSULIN GLARGINE,HUMAN(LANTUS) INSULIN HUMULIN 70/30 INSULIN LISPRO Brand Name MOTRIN (EQUIV) MOTRIN (EQUIV) DROPS NEOPROFEN CHILDREN'S MOTRIN SUSP (EQUIV) IBUPROFEN SUSPENSION MOTRIN SUSPENSION CORVERT IDAMYCIN PFS IDAMYCIN PFS (EQUIV) IDAMYCIN PFS (EQUIV) IFEX (EQUIV) IFEX (EQUIV) GLEEVEC GLEEVEC CEREZYME 400 UNITS/VIAL TOFRANIL (EQUIV) TOFRANIL (EQUIV) TOFRANIL (EQUIV) ALDARA 5% GAMMAGARD LIQUID GAMMAGARD S/D BAYGAM INDAPAMIDE INDAPAMIDE INDIGO CARMINE 0.8% (EQUIV) IC GREEN INDOCIN I.V. INDOCIN (EQUIV) INDOCIN (EQUIV) INDOCIN SA (EQUIV) INDOCIN SUSP REMICADE FLUMIST INTRANASAL SPR FLUZONE VACC SDV LATEX FREE FLUARIX PFS ADULT LANTUS (INSULIN GLARGINE) HUMULIN INSULIN 70-30 HUMALOG Drug Strength 800 MG 40 MG 20 MG 100 MG 100 MG 20 MG 1 MG 1 MG 10 MG 5 MG 1 GM 3 GM 100 MG 400 MG 400 UNIT 10 MG 25 MG 50 MG 1 APP 1 GM 1 GM 2 ML 1.25 MG 2.5 MG 5 ML 25 MG 1 MG 25 MG 50 MG 75 MG 25 MG 100 MG 0.2 ML 0.5 ML 0.5 ML 100 UNT 100 UNT 100 UNT Drug Volume 1 TAB 1 ML 1 VIAL 5 ML 5 ML 1 ML 10 ML 1 ML 10 ML 5 ML 1 VIAL 1 VIAL 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 APP 10 ML 10 ML 2 ML 1 TAB 1 TAB 5 ML 1 VIAL 1 ML 1 CAP 1 CAP 1 CAP SR 5 ML 1 VIAL 0.2 ML 0.5 ML 0.5 ML 1 ML 1 ML 1 ML Package Desc 1 TAB PACKAGE ML ORAL SYRINGE 2 ML BOTTLE 120 ML BOTTLE 5 ML UD CUP ML ORAL SYRINGE 10 ML VIAL 20 ML VIAL 10 ML VIAL 5 ML VIAL 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 0.25 GM PACKAGE 10 ML BOTTLE 10 ML PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 5 ML AMPUL 1 VIAL PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP SR PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 0.2 ML SPRAY 0.5 ML VIAL 0.5 ML SYRINGE 10 ML VIAL 3 ML BOTTLE 3 ML BOTTLE Dosage Form TAB DROPS VIAL SUSP UD CUP SUSP VIAL VIAL VIAL VIAL VIAL VIAL TAB TAB VIAL TAB TAB TAB PACKET VIAL VIAL VIAL TAB TAB INJ VIAL VIAL CAP CAP CAP SR SUSP VIAL SPRAY VIAL SYRING VIAL VIAL VIAL Route PO PO INJ PO PO PO IV IV IV IV IV IV PO PO INJ PO PO PO TOP IV IV IM PO PO INJ INJ IV PO PO PO PO IV NAS IM IM SC SC SC Formulary Status? F F F F F F F F F F F F NF NF F F F F NF F NF F NF F F NF F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1596 2580 3287 3377 4223 398 252 270 269 268 2246 277 814 4091 3040 1730 1560 1561 877 3122 3023 330 2679 2829 1643 2623 131 1802 1803 2181 2553 2092 4320 4319 4321 872 4335 4333 AHFS Code 28:08.04 28:08.04 28:08.04 28:08.04 28:08.04 28:08.04 24:04.04 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 44:00.00 28:16.04 28:16.04 28:16.04 84:92.00 80:04.00 80:04.00 80:04.00 40:28.24 40:28.24 36:40.00 36:44.00 28:08.04 28:08.04 28:08.04 28:08.04 28:08.04 92:36.00 80:12.00 80:12.00 80:12.00 68:20.08 68:20.08 68:20.08 Generic Name INSULIN LISPRO INSULIN NPH HUMAN INSULIN NPH HUMAN INSULIN NPH HUMAN 300U/3ML PEN INSULIN NPL/INS LISPRO 75/25 INSULIN REG 100UNT/100ML NS INSULIN REGULAR HUMAN INSULIN REGULAR HUMAN* INSULIN REGULAR, HUMAN INSULIN REGULAR, HUMAN U-500 INTERFERON ALFA-2B MDV INTERFERON ALFA-2B,RECOMB. INTERFERON ALFA-2B,RECOMB. INTERFERON BETA-1A/ALBUMIN INTERFERON BETA-1B W/DILUENT IODINE/POTASSIUM IODIDE 5% IODIPAMIDE 52% IODIPAMIDE MEG/DIATR MEGLU* IODIXANOL* IODIXANOL* IODIXANOL* IOHEXOL IOHEXOL 180 IOHEXOL 240 IOHEXOL 300 IOHEXOL 300 IOHEXOL 350 IOHEXOL 350 IOPANOIC ACID IOTHALAMATE MEGLUMINE* IPILIMUMAB IPILIMUMAB IPRATROPIUM BROMIDE IPRATROPIUM BROMIDE IPRATROPIUM BROMIDE 0.02% UD IRBESARTAN IRINOTECAN IRINOTECAN Brand Name HUMALOG HUMULIN N HUMULIN N HUMULIN N 300U/3ML PEN HUMALOG MIX 75/25 INSULIN REG 100UNT/100ML NS HUMULIN R HUMULIN R* HUMULIN R HUMULIN R INTRON A MDV INTRON A INTRON A AVONEX BETASERON STRONG IODINE 5% CHOLOGRAFIN 52% SINOGRAFIN (EQUIV)* VISIPAQUE* VISIPAQUE* VISIPAQUE* OMNIPAQUE OMNIPAQUE OMNIPAQUE OMNIPAQUE OMNIPAQUE OMNIPAQUE OMNIPAQUE TELEPAQUE CONRAY* YERVOY YERVOY ATROVENT HFA ATROVENT ATROVENT(EQUIV)0.02% UD AVAPRO IRINOTECAN IRINOTECAN Drug Strength 100 UNT 100 UNT 100 UNT 300 UNT 100 UNT 100 UNT 100 UNT 100 UNT 100 UNT 10 UNT 10000000 10 MMU 50000000 30 MCG 0.3 MG 1 ML 20 ML 10 ML 270 MG 320 MG 32000 MG 300 MG 20 ML 1 ML 300 MG 500 ML 100 ML 100 ML 500 MG 50 ML 200 MG 50 MG 1 PUF 1 SPR 0.5 MG 150 MG 100 MG 40 MG Drug Volume 1 ML 1 ML 1 ML 3 ML 1 ML 100 ML 1 ML 1 ML 1 ML 0.02 ML 1 ML 1 VIAL 1 ML 1 VIAL 1 VIAL 1 ML 20 ML 10 ML 1 ML 1 ML 100 ML 1 ML 20 ML 1 ML 1 ML 500 ML 100 ML 100 ML 1 TAB 50 ML 40 ML 10 ML 1 PUF 1 SPR 2.5 ML 1 TAB 5 ML 2 ML Package Desc 1 ML VIAL 3 ML BOTTLE 1 ML VIAL 3 ML BOTTLE 10 ML BOTTLE 100 ML BAG 1 ML VIAL 1 ML VIAL 3 ML BOTTLE ML SYRINGE ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE ML ORAL SYRINGE 20 ML VIAL 10 ML VIAL 100 ML BOTTLE 50 ML BOTTLE 100 ML BOTTLE 100 ML BOTTLE 20 ML VIAL 1 ML BOTTLE 50 ML VIAL 500 ML BOTTLE 100 ML BOTTLE 100 ML BOTTLE 1 TAB PACKAGE 50 ML BOTTLE 40 ML SDV 10 ML SDV 12.9 GM PACKAGE 15 ML BOTTLE 2.5 ML UD PACKAGE 1 TAB PACKAGE 5 ML VIAL 2 ML VIAL Dosage Form VIAL VIAL VIAL SYRINGE VIAL PREMIX VIAL VIAL VIAL SYRING VIAL VIAL VIAL VIAL VIAL SOLN VIAL VIAL PREMIX SOLN PREMIX INFUSN VIAL VIAL VIAL SOLN BOTTLE INFUSN TAB VIAL VIAL VIAL AER SPRAY SOLN TAB VIAL VIAL Route SC SC SC INJ SC IV SC SC SC SC INJ INJ INJ IM INJ PO IV INJ IV MSC IV IV MSC MSC IV IV IV IV PO INJ INJ INJ INH NAS INH PO IV IV Formulary Status? F F F NF F F F F F NF F F F F NF F F F F F F F F F F F F F F F F F F NF F NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 31 4332 37 2950 2603 4036 35 3246 4331 4179 830 837 3333 2148 2920 1309 1157 1159 1325 3084 1327 1322 1320 3393 1321 3946 3953 1323 1324 3005 4295 4294 3163 1491 511 857 3424 3422 AHFS Code 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 68:20.08 08:18.20 08:18.20 08:18.20 92:20.00 92:20.00 68:36.08 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 36:68.00 10:00.00 10:00.00 12:08.08 52:92.00 12:08.08 24:32.08 10:00.00 10:00.00 Generic Name IRON DEXTRAN COMPLEX IRON GLUCONATE *12.5MG/ML* IRON POLYSACCHARIDES COMPLEX IRON SUCROSE COMPLEX ISOCAL DIETARY SUPPLEMENT* ISOCAL HM* ISOFLURANE* ISOMETHEPTENE/APAP/DICHLPHEN ISONIAZID ISONIAZID ISONIAZID ISOPROTERENOL ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE SL ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE ISOSORBIDE MONONITRATE HALFTAB ISOSULFAN BLUE 1% ISOTRETINOIN ISRADIPINE CR ITRACONAZOLE ITRACONAZOLE IVERMECTIN IXABEPILONE IXABEPILONE KCL 20 MEQ/SODIUM CL 0.45% KCL 20MEQ/D5/O.45NS KCL 20MEQ/D5NS KCL 40MEQ D5-1/2NS KETAMINE HCL KETAMINE HCL KETOCONAZOLE KETOCONAZOLE 1% SHAMPOO KETOCONAZOLE 2% CR 15GM KETOCONAZOLE SHAMPOO 2% Brand Name INFED FERRLECIT FE-TINIC (EQUIV) VENOFER ISOCAL* ISOCAL HM* ISOFLURANE* MIGRATINE ISONIAZID NYDRAZID ISONIAZID ISUPREL (EQUIV) ISORDIL (EQUIV) ISORDIL (EQUIV) ISORDIL (EQUIV) ISORDIL SL (EQUIV) IMDUR (EQUIV) IMDUR (EQUIV) IMDUR (EQUIV) IMDUR (EQUIV) HALFTAB LYMPHAZURIN 1% ACCUTANE DYNACIRC CR SPORANOX SPORANOX STROMECTOL IXEMPRA IXEMPRA SODIUM CL 0.45% W/ KCL 20 MEQ D5/0.45% NACL W/ KCL 20MEQ D5/0.9% NACL W/ KCL 20MEQ D5/0.45% NACL W/ KCL 40 MEQ KETALAR KETALAR (EQUIV) NIZORAL (EQUIV) NIZORAL A-D NIZORAL 2% (EQUIV)CR 15GM NIZORAL SHAMPOO 2% Drug Strength 100 MG 62.5 MG 150 MG 100 MG 1 EA 1 EA 100 ML 1 CAP 100 MG 100 MG 300 MG 0.2 MG 10 MG 20 MG 5 MG 5 MG 120 MG 30 MG 60 MG 15 MG 5 ML 20 MG 10 MG 10 MG 100 MG 3 MG 15 MG 45 MG 20 MEQ 20 MEQ 20 MEQ 1000 ML 200 MG 500 MG 200 MG 1 APP 1 APP 1 APP Drug Volume 2 ML 5 ML 1 CAP 5 ML 1 EA 1 EA 100 ML 1 CAP 1 TAB 1 ML 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 1 TAB SL 1 TAB SR 1 TAB 1 TAB 1 TAB 5 ML 1 CAP 1 TAB 1 ML 1 CAP 1 TAB 1 VIAL 1 VIAL 1000 ML 1000 ML 1000 ML 1000 ML 20 ML 5 ML 1 TAB 1 APP 1 APP 1 APP Package Desc 2 ML VIAL 5 ML VIAL 1 CAP PACKAGE 5 ML VIAL 1 EA PACKAGE 1 EA PACKAGE 100 ML BOTTLE 1 CAP PACKAGE 1 TAB PACKAGE 10 ML VIAL 1 TAB PACKAGE 5 ML AMPULE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SL PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML BOTTLE 1 CAP PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1000 ML BAG 1000 ML BAG 1000 ML BAG 1000 ML BAG 20 ML VIAL 5 ML VIAL 1 TAB PACKAGE 120 ML BOTTLE 15 GM PACKAGE 120 ML BOTTLE Dosage Form VIAL VIAL CAP VIAL LIQUID LIQUID INH CAP TAB VIAL TAB AMPULE TAB TAB TAB TAB SL TAB SR TAB TAB TAB VIAL CAP TAB SOLN CAP TAB VIAL VIAL INJ INJ INJ SOLN VIAL VIAL TAB SHAMPO CREAM SHAMPO Route INJ IV PO IV PO PO INH PO PO INJ PO INJ PO PO PO SL PO PO PO PO INJ PO PO PO PO PO INJ INJ IV IV IV IV INJ INJ PO TOP TOP TOP Formulary Status? F F F F F F F NF F F F F F F F F F F F F NF F NF F F NF NF F F F F F F F F NF F F Controlled Substance? NO NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO DEA Code 00 00 00 00 00 00 00 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 03 03 00 00 00 00 Drug Code 1281 4149 2097 1403 2388 2389 682 3216 1786 51 1787 1512 1584 1059 1583 928 2165 2099 2100 3332 2390 66 2857 1764 1763 3320 4022 4023 3528 2446 1261 1254 2209 664 1527 2944 887 1762 AHFS Code 20:04.04 20:04.04 20:04.04 20:04.04 40:20.00 40:20.00 28:04.16 28:08.92 08:16.04 08:16.04 08:16.04 12:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 36:00.00 84:92.00 24:28.08 08:14.08 08:14.08 08:08.00 10:00.00 10:00.00 40:12.00 40:12.00 40:12.00 40:12.00 28:04.92 28:04.92 08:14.08 84:04.08 84:04.08 84:04.08 Generic Name KETOROLAC KETOROLAC KETOROLAC KETOROLAC KETOROLAC TROMETHAMINE 0.4% LABETALOL LABETALOL LABETALOL LABETALOL LABETALOL HCL HALFTAB LABETALOL SUSP LABETALOL* LACOSAMIDE LACOSAMIDE 200MG/50ML NS LACTASE LACTASE LIQUID LACTATED RINGERS LACTATED RINGERS LACTOBACILUS ACIDOPHILUS LACTOSE POWDER 50GM LACTOSE POWDER* LACTOSE-FREE FOOD/FIBER LACTULOSE LACTULOSE UD LAMIVUDINE LAMIVUDINE LAMIVUDINE LAMIVUDINE HALFTAB LAMIVUDINE HALFTAB LAMOTRIGINE LAMOTRIGINE LAMOTRIGINE HALFTAB LANOLIN/MIN OIL/PETROLAT,WHT LANOLIN/MINERAL OIL/SOD BORATE LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE LANSOPRAZOLE SUSP UD Brand Name TORADOL (EQUIV) TORADOL (EQUIV) TORADOL (EQUIV) TORADOL (EQUIV) ACULAR LS 0.4% NORMODYNE (EQUIV) NORMODYNE (EQUIV) NORMODYNE (EQUIV) NORMODYNE (EQUIV) LABETALOL HCL HALFTAB LABETALOL SUSP NORMODYNE (EQUIV)* VIMPAT VIMPAT 200MG/50ML NS LACTASE LACTAID LIQUID LACTATED RINGERS LACTATED RINGERS ACIDOPHILUS LACTOSE POWDER 50GM LACTOSE HYDROUS POWDER* ISOSOURCE VHN LACTULOSE LACTULOSE UD EPIVIR EPIVIR HBV EPIVIR EPIVIR HBV HALFTAB EPIVIR HALFTAB LAMICTAL (EQUIV) LAMICTAL (EQUIV) LAMICTAL (EQUIV) HALFTAB ARTIFICIAL TEARS (EQUIV) NIVEA OIL (EQUIV) PREVACID PREVACID PREVACID PREVACID SUSP UD Drug Strength 10 MG 15 MG 30 MG 60 MG 1 DRP 100 MG 200 MG 300 MG 5 MG 50 MG 10 MG 5 MG 200 MG 200 MG 3000 UNT 5000 UNT 1000 ML 500 ML 1 CAP 1 GM 1 GM 250 ML 300 ML 20 GM 10 MG 100 MG 150 MG 50 MG 75 MG 100 MG 25 MG 12.5 MG 1 APP 240 ML 15 MG 30 MG 30 MG 15 MG Drug Volume 1 TAB 1 ML 1 ML 2 ML 1 DRP 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 ML 1 ML 20 ML 50 ML 1 TAB 1 ML 1000 ML 500 ML 1 CAP 1 GM 1 GM 250 ML 300 ML 30 ML 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 APP 240 ML 1 CAP EC 1 PKT 1 CAP EC 7.5 ML Package Desc 1 TAB PACKAGE 1 ML VIAL 1 ML VIAL 2 ML VIAL 5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE ML ORAL SYRINGE 1 ML VIAL 20 ML BOTTLE 50 ML BAG 1 TAB PACKAGE 7 ML BOTTLE 1000 ML BAG 500 ML BAG 1 CAP PACKAGE 50 GM PACKAGE 454 GM PACKAGE 250 ML BOTTLE 480 ML BOTTLE 30 ML UD CUP ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 3.5 GM PACKAGE 240 ML BOTTLE 1 CAP EC PACKAGE 1 PKT PACKAGE 1 CAP EC PACKAGE 7.5 ML UD CUP Dosage Form TAB VIAL VIAL VIAL DROPS TAB TAB TAB VIAL TAB SUSP VIAL VIAL PREMIX TAB DROPS SOLN SOLN CAP PWD PO PWD PO LIQUID SYRUP SYRUP SOLN TAB TAB TAB TAB TAB TAB TAB OINT OIL CAP EC PACKET CAP EC SUSP Route PO INJ INJ IM EYE PO PO PO IV PO PO IV IV IV PO PO IV IV PO PO PO PO PR PO PO PO PO PO PO PO PO PO EYE TOP PO PO PO PO Formulary Status? F F F F F F F F F F F F F NF F F F F F F F F F F F NF F NF F F F F F F NF NF NF NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 05 05 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 82 692 693 694 3298 1920 1921 993 2023 3518 2922 3260 4113 4114 1598 1696 1237 2415 2416 2788 1303 3085 1279 2549 1027 2671 1026 3485 2753 1036 1034 2754 3979 2314 1169 1177 1170 2960 AHFS Code 28:08.04 28:08.04 28:08.04 28:08.04 52:08.20 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 28:12.92 28:12.92 56:16.00 56:16.00 40:12.00 40:12.00 56:08.00 96:00.00 96:00.00 40:20.00 40:10.00 40:10.00 08:18.08 08:18.08 08:18.08 08:18.08 08:18.08 28:12.92 28:12.92 28:12.92 52:92.00 84:24.08 56:28.36 56:28.36 56:28.36 56:28.36 Generic Name LANSOPRAZOLE SUSP UD LANSOPRAZOLE SUSPENSION LANTHANUM LANTHANUM HALF-CHEWTAB LATANOPROST 0.005% LEFLUNOMIDE LEFLUNOMIDE LEPIRUDIN 100MG/250ML NS LEPIRUDIN,RECOMBINANT LETROZOLE LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LEUPROLIDE LEUPROLIDE ACETATE LEUPROLIDE ACETATE LEUPROLIDE ACETATE LEUPROLIDE ACETATE 3 MONTH LEUPROLIDE ACETATE 4 MONTH LEVALBUTEROL LEVETIRACETAM LEVETIRACETAM LEVETIRACETAM LEVETIRACETAM 500MG/100ML NS LEVETIRACETAM ORAL LIQUID LEVOBUNOLOL 0.25% LEVOBUNOLOL 0.5% LEVOCARNITINE LEVOCARNITINE LEVOCARNITINE LEVOFLOXACIN LEVOFLOXACIN LEVOFLOXACIN LEVOFLOXACIN 250MG/50ML D5W LEVOFLOXACIN 500MG/100ML D5W LEVOFLOXACIN 750MG/150 ML D5W LEVOFLOXACIN ORAL SOLUTION Brand Name PREVACID SUSP UD PREVACID SUSPENSION FOSRENOL FOSRENOL HALF-CHEWTAB XALATAN 0.005% ARAVA ARAVA REFULDAN 100MG/250ML NS REFLUDAN FEMARA LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM LUPRON DEPOT LEUPROLIDE ACETATE LUPRON DEPOT LUPRON DEPOT LUPRON DEPOT 3 MONTH LUPRON DEPOT 4 MONTH XOPENEX KEPPRA(EQUIV) KEPPRA KEPPRA LEVETIRACETAM-NACL KEPPRA LEVOBUN 0.25% (EQUIV) LEVOBUN 0.5% (EQUIV) CARNITOR CARNITOR CARNITOR LEVAQUIN LEVAQUIN LEVAQUIN LEVAQUIN 250MG/50ML D5W LEVAQUIN 500MG/100ML D5W LEVOFLOXACIN 750MG/150 ML D5W LEVAQUIN ORAL SOLUTION Drug Strength 30 MG 2 MG 500 MG 250 MG 1 DRP 10 MG 20 MG 100 MG 50 MG 2.5 MG 100 MG 15 MG 200 MG 5 MG 7.5 MG 1 MG 22.5 MG 3.75 MG 11.25 MG 30 MG 1.25 MG 250 MG 500 MG 500 MG 500 MG 100 MG 1 DRP 1 DRP 100 MG 200 MG 330 MG 250 MG 500 MG 750 MG 250 MG 500 MG 750 MG 25 MG Drug Volume 15 ML 1 ML 1 TABCHW 1 TABCHW 1 DRP 1 TAB 1 TAB 250 ML 1 VIAL 1 TAB 10 ML 1 TAB 1 VIAL 1 TAB 1 SYR 0.2 ML 1 SYR 1 KIT 1 KIT 1 KIT 0.5 ML 1 TAB 5 ML 1 TAB 100 ML 1 ML 1 DRP 1 DRP 1 ML 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 50 ML 100 ML 150 ML 1 ML Package Desc 15 ML UD CUP ML ORAL SYRINGE 1 TABCHW PACKAGE 1 TABCHW PACKAGE 2.5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 250 ML BAG 1 VIAL PACKAGE 1 TAB PACKAGE 10 ML PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 SYR SYRINGE 0.2 ML PACKAGE 1 SYR SYRINGE 1 KIT PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 0.5 ML BOTTLE 1 TAB PACKAGE 5 ML VIAL 1 TAB PACKAGE 100 ML BAG ML ORAL SYRINGE 5 ML BOTTLE 5 ML BOTTLE ML ORAL SYRINGE 5 ML AMPUL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 50 ML BAG 100 ML BOTTLE 150 ML BAG ML SYRINGE Dosage Form SUSP SUSP TABCHW TABCHW DROPS TAB TAB PREMIX VIAL TAB VIAL TAB VIAL TAB SYRINGE KIT SYRINGE KIT KIT KIT SOLN TAB VIAL TAB BAG SOLN DROPS DROPS LIQUID INJ TAB TAB TAB TAB PREMIX PREMIX PB SOLN Route PO PO PO PO EYE PO PO IV IV PO INJ PO INJ PO IM SC IM IM INJ IM INH PO INJ PO IVPB PO EYE EYE PO IV PO PO PO PO IV IV IV PO Formulary Status? NF NF NF NF F F F F F F F F F F F NF F F F F F F F F F F F F F F F F F F F F F NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2959 2538 3148 4336 272 3480 871 4037 1754 3017 2062 3196 2015 1847 1174 4220 1171 1173 2928 1175 4283 3505 3277 1771 4303 3387 1670 2186 2009 2010 2008 403 404 3900 392 393 3028 4203 AHFS Code 56:28.36 56:28.36 40:18.19 40:18.19 52:40.28 92:36.00 92:36.00 20:12.04 20:12.04 10:00.00 92:12.00 92:12.00 92:12.00 92:12.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 12:12.08 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 52:40.08 52:40.08 92:92.00 92:92.00 92:92.00 08:12.18 08:12.18 08:12.18 08:12.18 08:12.18 08:12.18 08:12.18 Generic Name LEVONORGESTREL LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE LEVOTHYROXINE HALFTAB LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM LID/EPI/TET/METHYLCEL GEL LIDO/EPI/TETRACAINE SOLUTION LIDOCAINE 0.5%/EPI 1:2000,000 LIDOCAINE 1% (10ML MDV) LIDOCAINE 1% MDV LIDOCAINE 1% MPF LIDOCAINE 1% STERIPAK LIDOCAINE 1%/EPI 1:100000 LIDOCAINE 1%/EPI 1:100000 LIDOCAINE 1%/EPI 1:200000 SDV LIDOCAINE 1.5%/EPI 1:200000 LIDOCAINE 2% LIDOCAINE 2% ABBOJECT SYRINGE LIDOCAINE 2% JELLY LIDOCAINE 2% MDV LIDOCAINE 2% SDV LIDOCAINE 2% SYRINGE LIDOCAINE 2% UROJECT LIDOCAINE 2% UROJECT LIDOCAINE 2% UROJECT LIDOCAINE 2% VISCOUS LIDOCAINE 2% VISCOUS LIDOCAINE 2% W/EPINEPHRINE Brand Name PLAN B SYNTHROID SYNTHROID SYNTHROID SYNTHROID SYNTHROID SYNTHROID SYNTHROID (EQUIV) SYNTHROID SYNTHROID HALFTAB LEVOTHYROXINE SODIUM SYNTHROID SYNTHROID SYNTHROID SYNTHROID LET GEL LET SOLUTION LIDOCAINE 0.5% W/EPI 1:200,000 LIDOCAINE 1% LIDOCAINE 1% XYLOCAINE 1% XYLOCAINE 1% STERIPAK LIDOCAINE 1% W/EPI 1:100000 LIDOCAINE 1% W/EPI1:100000 XYLOCAINE 1%W/EPI 1:200000 XYLOCAINE 1.5% W/EPI1:200000 LIDOCAINE 2% LIDOCAINE 2% ABBOJECT SYRINGE XYLOCAINE 2% JELLY LIDOCAINE 2% LIDOCAINE 2% XYLOCAINE 2% SYRINGE LIDOCAINE 2% UROJECT LIDOCAINE 2% UROJECT LIDOCAINE 2% UROJECT LIDOCAINE 2% VISCOUS LIDOCAINE 2% VISCOUS XYLOCAINE 2% W/EPINEPHRINE Drug Strength 1.5 MG 100 MCG 125 MCG 150 MCG 175 MCG 200 MCG 50 MCG 500 MCG 75 MCG 12.5 MCG 100 MCG 112 MCG 137 MCG 25 MCG 88 MCG 3 ML 3 ML 50 ML 10 MG 50 ML 30 ML 10 MG 20 ML 30 ML 30 ML 30 ML 30 ML 5 ML 1 APP 50 ML 200 MG 100 MG 1 APP 1 APP 400 MG 100 ML 20 ML 20 ML Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 3 ML 3 ML 50 ML 1 ML 50 ML 30 ML 1 ML 20 ML 30 ML 30 ML 30 ML 30 ML 5 ML 1 APP 50 ML 10 ML 5 ML 1 APP 1 APP 20 ML 100 ML 20 ML 20 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 3 ML BOTTLE 3 ML BOTTLE 50 ML VIAL 10 ML VIAL 50 ML VIAL 30 ML VIAL 30 ML BOTTLE 20 ML VIAL 30 ML VIAL 30 ML VIAL 30 ML VIAL 30 ML VIAL 5 ML SYRINGE 5 ML TUBE 50 ML VIAL 10 ML AMPUL 5 ML AMPUL 5 ML BOTTLE 10 ML BOTTLE 20 ML BOTTLE 100 ML BOTTLE 20 ML UD CUP 20 ML BOTTLE Dosage Form TAB TAB TAB TAB TAB TAB TAB VIAL TAB TAB VIAL TAB TAB TAB TAB GEL SOLN VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL VIAL SYRINGE JELLY VIAL INJ SYRINGE JELLY GEL SYRINGE SOLN SOLN VIAL Route PO PO PO PO PO PO PO INJ PO PO INJ PO PO PO PO TOP TOP INJ INJ INJ INJ INJ INJ INJ INJ INJ INJ IV MM INJ INJ IV MM MM MM MM MM INJ Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3949 741 752 753 422 754 713 2255 724 2755 4249 3369 3337 420 421 3128 3152 676 2251 703 1094 2878 677 678 1095 1096 1517 721 1103 704 705 1100 3213 1439 1440 476 513 3414 AHFS Code 68:12.00 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 68:36.04 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 72:00.00 24:04.04 52:16.00 72:00.00 72:00.00 24:04.04 52:16.00 52:16.00 52:16.00 52:16.00 52:16.00 72:00.00 Generic Name LIDOCAINE 2%/EPI 1:100000 LIDOCAINE 2%/EPI 1:200000 LIDOCAINE 2.5% OINT 35GM LIDOCAINE 2.5%/PRILOCAINE 2.5% LIDOCAINE 2GM/D5W LIDOCAINE 4% LIDOCAINE 4% LIDOCAINE 4% LIDOCAINE 4% (LARYNGOJET) LIDOCAINE 5% OINT 37GM LIDOCAINE 5% PATCH LIDOCAINE 5%/D7.5W LIDOCAINE HCL 0.5% SDPF LIDOCAINE MPF 1% LINDANE 1% LINDANE 1% SHAMPOO LINEZOLID LINEZOLID LINEZOLID LIOTHYRONINE LIOTHYRONINE LIOTHYRONINE HALFTAB LISINOPRIL LISINOPRIL LISINOPRIL LISINOPRIL LISSAMINE GREEN LITHIUM CARB LITHIUM CARBONATE LITHIUM CR LITHIUM CR LITHIUM ORAL SOLUTION LITHIUM ORAL SOLUTION UD LODOXAMIDE 0.1% LOMUSTINE LOMUSTINE LOPERAMIDE LOPERAMIDE Brand Name LIDOCAINE 2%W/EPI 1:100000 LIDOCAINE 2%W/EPI 1:200000 XYLOCAINE 2.5% EMLA (EQUIV) LIDOCAINE 2GM IN 5% DEXTROSE ELA-MAX LIDOCAINE 4% LIDOCAINE 4% LIDOCAINE 4% (LARYNGOJET) LIDOCAINE 5% LIDODERM 5% PATCH LIDOCAINE 5% IN 7.5% DEXTROSE LIDOCAINE HCL 0.5% SDPF XYLOCAINE-MPF 1% KWELL 1% (EQUIV) KWELL 1% SHAMPOO (EQUIV) ZYVOX ZYVOX ZYVOX CYTOMEL CYTOMEL CYTOMEL HALFTAB PRINIVIL (EQUIV) PRINIVIL (EQUIV) PRINIVIL (EQUIV) PRINIVIL (EQUIV) LISSAMINE LITHIUM CARB LITHIUM CARBONATE LITHOBID ESKALITH CR LITHIUM ORAL SOLUTION LITHIUM ORAL SOLUTION UD ALOMIDE 0.1% CEENU CEENU IMODIUM A/D (EQUIV) IMODIUM Drug Strength 30 ML 20 ML 1 APP 1 KIT 2 GM 1 APP 40 MG 50 ML 40 MG 1 APP 1 EA 2 ML 250 MG 5 ML 60 ML 1 APP 20 MG 600 MG 600 MG 25 MCG 5 MCG 12.5 MCG 10 MG 2.5 MG 20 MG 5 MG 1.5 MG 150 MG 300 MG 300 MG 450 MG 300 MG 300 MG 1 DRP 100 MG 40 MG 1 MG 2 MG Drug Volume 30 ML 20 ML 1 APP 1 KIT 500 ML 1 APP 1 ML 50 ML 1 ML 1 APP 1 EA 2 ML 50 ML 5 ML 60 ML 1 APP 1 ML 300 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 STRIP 1 CAP 1 CAP 1 TAB SR 1 TAB SR 5 ML 5 ML 1 DRP 1 CAP 1 CAP 5 ML 1 CAP Package Desc 30 ML VIAL 20 ML VIAL 35 GM PACKAGE 1 KIT PACKAGE 500 ML BAG 30 GM PACKAGE 5 ML AMPUL 50 ML BOTTLE 4 ML BOTTLE 37 GM PACKAGE 1 EA PACKAGE 2 ML AMPUL 50 ML VIAL 5 ML VIAL 60 ML BOTTLE 60 ML BOTTLE ML BOTTLE 300 ML BAG 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 100 STRIP BOX 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE ML ORAL SYRINGE 5 ML UD CUP 10 ML BOTTLE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE Dosage Form VIAL VIAL OINT KIT PREMIX CREAM INJ SOLN SOLN OINT PATCH INJ VIAL VIAL LOTION SHAMPO SUSP PREMIX TAB TAB TAB TAB TAB TAB TAB TAB STRIP CAP CAP TAB SR TAB SR SYRUP SYRUP DROPS CAP CAP LIQUID CAP Route INJ INJ TOP TOP IV TOP INJ MM MM TOP TD IT INJ INJ TOP TOP PO IV PO PO PO PO PO PO PO PO EYE PO PO PO PO PO PO EYE PO PO PO PO Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F NF NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 679 680 1105 1119 1245 1391 706 477 1442 974 2288 714 702 1102 2168 2169 3308 258 257 1974 1973 2756 2554 3300 1937 1936 3276 2963 514 373 167 478 515 548 3339 2872 1748 1874 AHFS Code 72:00.00 72:00.00 84:08.00 84:08.00 24:04.04 84:08.00 72:00.00 52:16.00 84:08.00 84:08.00 84:08.00 72:00.00 72:00.00 72:00.00 84:04.12 84:04.12 08:12.28 08:12.28 08:12.28 68:36.04 68:36.04 68:36.04 24:32.04 24:32.04 24:32.04 24:32.04 36:58.00 28:28.00 28:28.00 28:28.00 28:28.00 28:28.00 28:28.00 52:02.00 10:00.00 10:00.00 56:08.00 56:08.00 Generic Name LOPINAVIR/RITONAVIR 200/50 LORATADINE LORAZEPAM LORAZEPAM LORAZEPAM LORAZEPAM LORAZEPAM LORAZEPAM 100MG/100ML D5W INFS LORAZEPAM INFUSION* LORAZEPAM INTENSOL LORAZEPAM* LOSARTAN LOSARTAN LOSARTAN POTASSIUM HALFTAB LOTEPREDNOL ETABONATE LOVASTATIN LOXAPINE LOXAPINE LOXAPINE LUBIPROSTONE LYMPHOCYTE IMMUNE GLOBULIN MAALOX/NYSTATIN/BENADRYL 1:1 MAFENIDE MAG CARB/CITRIC ACID/G-LACTONE MAG HYDROX/AL HYDROX/SIMETH MAG HYDROX/AL HYDROX/SIMETH MAGNESIUM CITRATE MAGNESIUM HYDROXIDE MAGNESIUM OXIDE MAGNESIUM OXIDE MAGNESIUM SO4 40GMS/1000ML D5W MAGNESIUM SULF MAGNESIUM SULF 2GM/100ML NS*O MAGNESIUM SULF* MAGNESIUM SULFATE MAGNESIUM SULFATE (1 POUND) MAGNESIUM SULFATE (4 POUND) MAGNESIUM SULFATE 1GM/50ML D5W Brand Name KALETRA 200/50 TAB CLARITIN (EQUIV) ATIVAN (EQUIV) ATIVAN (EQUIV) ATIVAN ATIVAN (EQUIV) LORAZEPAM ATIVAN 100MG/100ML D5W INFS ATIVAN INFUSION* ATIVAN INTENSOL (EQUIV) ATIVAN* COZAAR COZAAR COZAAR HALFTAB ALREX MEVACOR LOXITANE (EQUIV) LOXITANE C LOXITANE (EQUIV) AMITIZA ATGAM MAALOX/NYSTATIN/BENADRYL 1:1 SULFAMYLON RENACIDIN IRRIGATION SOLN MAALOX PLUS (EQUIV) MAALOX PLUS (EQUIV) CITRATE OF MAGNESIA PHILLIPS' MILK OF MAGNESIA URO-MAG MAG-OX 400 MAGNESIUM SO4 40GMS/1000ML D5W MAGNESIUM SULF MAGNESIUM SULF 2GM/100ML NS*O MAGNESIUM SULF* MAGNESIUM SULFATE EPSOM SALT (EQUIV) EPSOM SALT (EQUIV) MAGNESIUM SULFATE 1GM/50ML D5W Drug Strength 1 TAB 10 MG 0.5 MG 1 MG 2 MG 2 MG 4 MG 1 MG 2 MG 2 MG 4 MG 25 MG 50 MG 12.5 MG 1 DRP 20 MG 10 MG 25 MG 5 MG 24 MCG 250 MG 15 ML 50 GM 500 ML 1 EA 30 ML 300 ML 400 MG 140 MG 400 MG 40 MG 1 GM 2 GM 1 GM 500 MG 1 GM 1816 GM 1 GM Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 ML 1 ML 1 ML 1 ML 1 ML 1 TAB 1 TAB 1 TAB 1 DRP 1 TAB 1 CAP 1 ML 1 CAP 1 CAP 5 ML 15 ML 1 PKT 500 ML 1 EA 30 ML 300 ML 5 ML 1 CAP 1 TAB 1 ML 2 ML 100 ML 2 ML 1 ML 2 ML 1816 GM 50 ML Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 ML VIAL 100 ML BAG 10 ML BOTTLE ML ORAL SYRINGE 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML BOTTLE 1 TAB PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 CAP PACKAGE 1 CAP PACKAGE 5 ML BOTTLE 150 ML BOTTLE 1 PKT PACKAGE 500 ML BOTTLE 1 TAB CHW PACKAGE 30 ML BOTTLE 300 ML BOTTLE 120 ML BOTTLE 1 CAP PACKAGE 1 TAB PACKAGE 1000 ML BAG 2 ML VIAL 100 ML BAG 2 ML VIAL 10 ML VIAL 454 GM PACKAGE 1816 GM PACKAGE 50 ML BAG Dosage Form TAB TAB TAB TAB VIAL TAB VIAL BAG VIAL SOLN VIAL TAB TAB TAB DROPS TAB CAP SOLN CAP CAP INJ SUSP PACKET IRRIG TAB CHW SUSP SOLN SUSP CAP TAB BAG VIAL PREMIX VIAL VIAL MISC MISC PREMIX Route PO PO PO PO INJ PO INJ IV IV PO INJ PO PO PO EYE PO PO PO PO PO IV PO TOP IRR PO PO PO PO PO PO IV INJ IV INJ INJ MSC MSC IV Formulary Status? F F F F F F F F F F F NF NF NF NF NF F F F NF NF F NF F F F F F F F F F F F F F F F Controlled Substance? NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 04 04 04 04 04 04 04 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3109 2555 1823 1821 3093 1822 2847 3895 2957 479 2581 123 124 3975 2602 119 1966 1971 1965 3932 3326 2892 3136 1201 1434 3440 1310 1650 939 938 749 2242 3893 3249 1405 1300 1299 3447 AHFS Code 08:18.08 04:08.00 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 24:32.08 24:32.08 24:32.08 52:08.08 24:06.08 28:16.08 28:16.08 28:16.08 56:12.00 92:44.00 08:14.28 84:04.92 40:36.00 56:04.00 56:04.00 56:12.00 56:12.00 56:04.00 56:04.00 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 56:12.00 28:12.92 Generic Name MAGNESIUM SULFATE 2GM/100ML NS MAGNESIUM SULFATE 4GM/50ML MAGNESIUM SULFATE 50% MANGAFODIPIR MANNITOL 20% MANNITOL 25% MEASLES,MUMPS&RUBELLA VACCINE MEASLES,MUMPS,RUB,VARICELLA/PF MECHLORETHAMINE MECLIZINE MECLIZINE MEDIUM CHAIN TRIGLYCERIDES MEDROXYPROGESTERONE MEDROXYPROGESTERONE MEDROXYPROGESTERONE MEDROXYPROGESTERONE MEDROXYPROGESTERONE ACETATE MEFLOQUINE HCL MEGESTROL MEGESTROL ACETATE MEGESTROL ACETATE MELATONIN MELOXICAM MELPHALAN MEMANTINE HCL MENINGOCCAL VAC ACY W-135 MENINGOCOCCAL VAC 10 DOSE VIAL MENINGOCOCCAL VAC A,C,Y,W-135 MENINGOCOCCAL VACC A,C,Y,W-135 MENOTROPINS MEPERIDINE MEPERIDINE MEPERIDINE MEPERIDINE MEPERIDINE MEPERIDINE 500MG/50ML D5W PCA MEPERIDINE AVERAGE ADULT MEPERIDINE FRAIL ADULT Brand Name MAGNESIUM SULFATE 2GM/100ML NS MAGNESIUM SULFATE 4GM/50ML MAGNESIUM SULFATE 50% TESLASCAN OSMITROL 20% MANNITOL 25% MMR II VACCINE W/DILUENT *PROQUAD MUSTARGEN ANTIVERT (EQUIV) ANTIVERT (EQUIV) MCT OIL (EQUIV) PROVERA (EQUIV) PROVERA (EQUIV) DEPO-PROVERA PROVERA (EQUIV) DEPO-PROVERA (EQUIV) LARIAM (EQUIV) MEGACE (EQUIV) MEGACE (EQUIV) MEGESTROL ACETATE MELATONIN MOBIC ALKERAN NAMENDA MENACTRA MENOMUNE 10 DOSE VIAL* MENOMUNE SINGLE DOSE MENVEO VACCINE A,C,Y,W-135 REPRONEX DEMEROL DEMEROL DEMEROL DEMEROL DEMEROL DEMEROL 500MG/50ML D5W PCA MEPERIDINE AVERAGE ADULT MEPERIDINE FRAIL ADULT Drug Strength 2 GM 4 GRAM 25 GM 37.9 MG 50 GM 12.5 GM 1 EA 1 VIAL 10 MG 12.5 MG 25 MG 1 ML 10 MG 2.5 MG 400 MG 5 MG 150 MG 250 MG 400 MG 20 MG 400 MG 3 MG 7.5 MG 2 MG 5 MG 4 MCG 1 EA 1 EA 0.5 ML 75 UNT 100 MG 100 MG 25 MG 50 MG 75 MG 10 MG 1 EA 1 EA Drug Volume 100 ML 50 ML 50 ML 1 ML 250 ML 50 ML 1 EA 1 VIAL 1 VIAL 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 1 ML 1 TAB 1 ML 1 TAB 10 ML 1 TAB 10 ML 1 TAB 1 TAB 1 TAB 1 TAB 0.5 ML 1 EA 1 EA 0.5 ML 1 VIAL 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML 1 EA 1 EA Package Desc 100 ML BAG 50 ML IVPB 50 ML VIAL 10 ML VIAL 250 ML BAG 50 ML VIAL 1 VIAL PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 2.5 ML VIAL 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 10 ML UD CUP 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 0.5 ML VIAL 1 VIAL PACKAGE 1 VIAL PACKAGE 1 PACKAGE PACKAGE 1 VIAL PACKAGE 1 ML VIAL 1 ML SYRINGE 1 ML SYRINGE 1 ML SYRINGE 1 ML SYRINGE 50 ML PCA 1 EA PACKAGE 1 EA PACKAGE Dosage Form PREMIX PIGGYBACK VIAL VIAL SOLN VIAL VIAL VIAL VIAL TAB TAB OIL TAB TAB VIAL TAB VIAL TAB SUSP TAB UD CUP TAB TAB TAB TAB VIAL VIAL VIAL VIAL VIAL VIAL SYRINGE SYRINGE SYRINGE SYRINGE PCA MISC MISC Route IV IV INJ IV IV IV SC INJ PO PO PO PO PO IM PO IM PO PO PO PO PO PO PO PO IM SC SC IM INJ INJ INJ INJ INJ INJ IV INJ INJ Formulary Status? F NF F F F F F F F F F F F F F F F F F F F NF NF F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 02 02 02 02 02 02 02 Drug Code 3536 4315 1406 1317 1243 699 150 3172 158 1552 1788 852 2157 1447 233 2156 236 67 1735 519 4222 2423 3022 994 2712 2972 1718 1717 4059 2082 639 637 634 635 636 2525 3055 3056 AHFS Code 28:12.92 28:12.92 28:12.92 36:44.00 40:28.12 40:28.12 80:12.00 80:12.00 10:00.00 56:22.08 56:22.08 40:20.00 68:32.00 68:32.00 68:32.00 68:32.00 68:32.00 08:30.08 10:00.00 10:00.00 10:00.00 92:92.00 28:08.04 10:00.00 28:92.00 80:12.00 80:12.00 80:12.00 80:12.00 68:18.00 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 Generic Name MEPERIDINE HALFTAB MEPERIDINE TOLERANT ADULT MEPIVACAINE 1.5% MEPIVACAINE HCL MEPIVACAINE MPF 2% MERCAPTOPURINE MEROPENEM MEROPENEM MEROPENEM 1GM/100ML NS MEROPENEM 500MG/100ML NS MESALAMINE MESALAMINE MESALAMINE MESALAMINE ENEMA MESNA MESNA ME-TESTOSTERONE/ESTROGEN,ESTER ME-TESTOSTERONE/ESTROGEN,ESTER METFORMIN METFORMIN METFORMIN HALFTAB METHACHOLINE METHADONE METHADONE METHADONE METHADONE METHADONE METHADONE METHADONE METHADONE 10MG/50ML NS METHADONE HCL METHADONE HCL DISKET METHADONE HCL HALFTAB METHADONE QUARTERTAB METHAZOLAMIDE METHAZOLAMIDE METHENAMINE HIPPURATE METHIMAZOLE Brand Name MEPERIDINE HALFTAB MEPERIDINE TOLERANT ADULT POLOCAINE 1.5% POLOCAINE MPF POLOCAINE 2% PURINETHOL MERREM MERREM MERREM 1GM/100ML NS MERREM 500MG/100ML NS CANASA PENTASA ASACOL ROWASA MESNA MESNA ESTRATEST (EQUIV) ESTRATEST H.S. (EQUIV) GLUCOPHAGE (EQUIV) GLUCOPHAGE (EQUIV) GLUCOPHAGE (EQUIV) HALFTAB PROVOCHOLINE METHADONE METHADONE DOLOPHINE METHADONE METHADONE METHADONE METHADONE DOLOPHINE 10MG/50ML NS METHADONE METHADONE METHADONE HCL HALFTAB METHADONE QUARTERTAB NEPTAZANE (EQUIV) METHAZOLAMIDE METHENAMINE HIPPURATE METHIMAZOLE Drug Strength 25 MG 1 EA 30 ML 10 MG 20 ML 50 MG 1 GM 500 MG 1 GM 500 MG 1000 MG 250 MG 400 MG 4 GM 100 MG 200 MG 1 TAB 1 TAB 500 MG 850 MG 250 MG 100 MG 1 MG 10 MG 10 MG 10 MG 20 MG 5 MG 60 MG 10 MG 5 MG 40 MG 20 MG 10 MG 25 MG 50 MG 1 GM 10 MG Drug Volume 1 TAB 1 EA 30 ML 1 ML 20 ML 1 TAB 1 VIAL 1 VIAL 100 ML 100 ML 1 SUPP 1 CAP SR 1 TAB EC 60 ML 1 ML 2 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 ML 10 ML 1 ML 1 TAB 20 ML 5 ML 60 ML 50 ML 1 TAB 1 TAB 1 DISPTAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB Package Desc 1 TAB PACKAGE 1 EA PACKAGE 30 ML VIAL 30 ML BOTTLE 20 ML VIAL 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 100 ML BAG 100 ML BAG 1 SUPP PACKAGE 1 CAP SR PACKAGE 1 TAB EC PACKAGE 60 ML BOTTLE 1 ML VIAL 2 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE ML BOTTLE 10 ML SYRINGE 1 ML VIAL 1 TAB PACKAGE 20 ML SYRINGE 5 ML SYRINGE 60 ML BOTTLE 50 ML BAG 1 TAB PACKAGE 1 TAB PACKAGE 1 DISPTAB PACKAGE 1 DISPTAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form TAB MISC VIAL VIAL VIAL TAB VIAL VIAL PB PB SUPP CAP SR TAB EC ENEMA VIAL VIAL TAB TAB TAB TAB TAB VIAL SOLN SYRINGE VIAL TAB SYRINGE SYRINGE BOTTLE PB TAB TAB DISPTAB DISPTAB TAB TAB TAB TAB Route PO INJ INJ INJ INJ PO IV IV IV IV PR PO PO PR IV IV PO PO PO PO PO INH PO PO INJ PO PO PO PO IV PO PO PO PO PO PO PO PO Formulary Status? F F F F F F F F F F NF F F F F F NF NF F F F F F F F F F F F F F F F F NF F NF F Controlled Substance? YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO DEA Code 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 02 02 02 02 02 02 02 02 02 02 02 00 00 00 00 Drug Code 3134 3057 624 3338 1107 1045 1190 1191 4274 4233 3982 2000 937 369 2273 3194 367 366 1934 1935 2758 2297 480 3990 2523 517 3978 3991 3992 4234 516 487 3461 3462 1551 4280 4213 3530 AHFS Code 28:08.08 28:08.08 72:00.00 72:00.00 72:00.00 10:00.00 08:12.07 08:12.07 08:12.07 08:12.07 56:36.00 56:36.00 56:36.00 56:36.00 92:56.00 92:56.00 68:08.00 68:08.00 68:20.04 68:20.04 68:20.04 36:00.00 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 52:40.12 52:40.12 08:36.00 68:36.08 Generic Name METHIMAZOLE METHIMAZOLE HALFTAB METHOCARBAMOL METHOCARBAMOL METHOHEXITAL SODIUM MDV METHOTREXATE METHOTREXATE PF METHOTREXATE SODIUM/PF METHOXSALEN, RAPID METHYL SALICYLATE/MENTHOL METHYLDOPA METHYLDOPA METHYLDOPATE METHYLENE BLUE 1% METHYLERGONOVINE METHYLERGONOVINE METHYLNALTREXONE BROMIDE METHYLPHENIDATE METHYLPHENIDATE METHYLPHENIDATE METHYLPHENIDATE METHYLPHENIDATE ER METHYLPHENIDATE SR METHYLPREDNISOLONE METHYLPREDNISOLONE (DEPO) METHYLPREDNISOLONE (DEPO) METHYLPREDNISOLONE DOSPAK METHYLPREDNISOLONE HALFTAB METHYLPREDNISOLONE SOD SUCC METHYLPREDNISOLONE SOD SUCC METHYLPREDNISOLONE SOD SUCC METHYLPREDNISOLONE SOD SUCC METHYLPREDNISOLONE* METOCLOPRAMIDE METOCLOPRAMIDE METOCLOPRAMIDE METOCLOPRAMIDE METOCLOPRAMIDE Brand Name TAPAZOLE (EQUIV) TAPAZOLE (EQUIV) HALFTAB ROBAXIN (EQUIV) ROBAXIN (EQUIV) BREVITAL SODIUM MDV METHOTREXATE METHOTREXATE PF METHOTREXATE PF OXSORALEN-ULTRA ANALGESIC BALM (EQUIV) 30GM ALDOMET (EQUIV) ALDOMET (EQUIV) ALDOMET (EQUIV) METHYLENE BLUE 1% METHERGINE METHERGINE RELISTOR RITALIN (EQUIV) RITALIN (EQUIV) RITALIN (EQUIV) RITALIN (EQUIV) METHYLIN ER CONCERTA MEDROL (EQUIV) DEPO-MEDROL DEPO-MEDROL MEDROL 4MG DOSEPAK (EQUIV) MEDROL (EQUIV) HALFTAB SOLU-MEDROL SOLU-MEDROL SOLU-MEDROL (EQUIV) SOLU-MEDROL (EQUIV) SOLU-MEDROL* REGLAN (EQUIV) REGLAN (EQUIV) REGLAN (EQUIV) REGLAN (EQUIV) REGLAN (EQUIV) Drug Strength 5 MG 2.5 MG 500 MG 750 MG 10 MG 2.5 MG 1 GM 50 MG 10 MG 1 APP 250 MG 500 MG 50 MG 100 MG 0.2 MG 0.2 MG 12 MG 10 MG 2.5 MG 20 MG 5 MG 20 MG 18 MG 4 MG 40 MG 80 MG 4 MG 2 MG 1000 MG 125 MG 40 MG 500 MG 1000 MG 1 MG 10 MG 10 MG 10 MG 5 MG Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 VIAL 2 ML 1 CAP 1 APP 1 TAB 1 TAB 1 ML 10 ML 1 TAB 1 ML 0.6 ML 1 TAB 0.5 TAB 1 TAB 1 TAB 1 TAB 1 TAB SR 1 TAB 1 ML 1 ML 1 TAB 1 TAB 1 VIAL 2 ML 1 VIAL 1 VIAL 16 ML 1 ML 1 TAB 10 ML 2 ML 1 TAB Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 VIAL PACKAGE 2 ML VIAL 1 CAP PACKAGE 30 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML VIAL 10 ML VIAL 1 TAB PACKAGE 1 ML AMPUL 1 ML VIAL 1 TAB PACKAGE 0.5 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 ML VIAL 21 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 2 ML PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 16 ML VIAL ML ORAL SYRINGE 1 TAB PACKAGE 10 ML UD CUP 2 ML VIAL 1 TAB PACKAGE Dosage Form TAB TAB TAB TAB VIAL TAB VIAL VIAL CAP OINT TAB TAB VIAL VIAL TAB INJ VIAL TAB TAB TAB TAB TAB TAB SR TAB VIAL VIAL TAB TAB VIAL VIAL VIAL VIAL VIAL SOLN TAB SOLN VIAL TAB Route PO PO PO PO INJ PO INJ INJ PO TOP PO PO IV INJ PO INJ SC PO PO PO PO PO PO PO IM IM PO PO INJ INJ INJ INJ INJ PO PO PO IV PO Formulary Status? F F F F F F F F F F F F F F F F NF F F F F NF F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 04 00 00 00 00 00 00 00 00 00 00 00 00 02 02 02 02 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1734 2759 1272 927 3180 1869 2245 2310 1128 957 1804 1805 1429 2212 785 784 3483 1984 2854 1986 1985 2874 2709 2558 247 249 1493 3960 234 219 217 237 3250 913 1077 912 689 1861 AHFS Code 68:36.08 68:36.08 12:20.04 12:20.04 28:04.04 10:00.00 10:00.00 10:00.00 84:50.06 28:08.04 24:08.16 24:08.16 24:08.16 92:12.00 76:00.00 76:00.00 56:92.00 28:20.92 28:20.92 28:20.92 28:20.92 28:20.92 28:20.92 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 56:32.00 56:32.00 56:32.00 56:32.00 56:32.00 Generic Name METOCLOPRAMIDE 10 ML VIAL METOCLOPRAMIDE HALFTAB METOLAZONE METOLAZONE METOPROLOL METOPROLOL METOPROLOL METOPROLOL METOPROLOL HALFTAB METOPROLOL SUSP METOPROLOL XL METOPROLOL XL METOPROLOL XL METOPROLOL XL HALFTAB METRONIDAZOLE METRONIDAZOLE METRONIDAZOLE 0.75% METRONIDAZOLE 500MG/100ML NACL METRONIDAZOLE SUSP METYROSINE MEXILETINE MEXILETINE MICONAZOLE 2% CR 30GM MICONAZOLE 2% POWDER 45GM MICONAZOLE NITRATE MICONAZOLE-3 (200MG/SUPP/2%CR) MICROFIBRILLAR COLLAGEN MIDAZOLAM MIDAZOLAM MIDAZOLAM MIDAZOLAM MIDAZOLAM 100MG/100ML INFUSION MIDODRINE HCL MIDODRINE HCL MILNACIPRAN HCL MILRINONE MILRINONE 40MG/D5W 200ML MINERAL OIL (HEAVY) Brand Name REGLAN (EQUIV) 10 ML VIAL REGLAN (EQUIV) HALFTAB ZAROXOLYN ZAROXOLYN LOPRESSOR (EQUIV) LOPRESSOR (EQUIV) LOPRESSOR (EQUIV) LOPRESSOR (EQUIV) LOPRESSOR (EQUIV) HALFTAB LOPRESSOR (EQUIV) SUSP TOPROL XL (EQUIV) TOPROL XL TOPROL XL TOPROL XL HALFTAB FLAGYL (EQUIV) FLAGYL (EQUIV) METROGEL-VAGINAL 0.75% FLAGYL (EQUIV) FLAGYL SUSP DEMSER MEXITIL (EQUIV) MEXITIL (EQUIV) MONISTAT DERM (EQUIV) DESENEX POWDER 2% FUNGOID TINCTURE NAIL KIT MONISTAT-3 AVITENE (EQUIV) VERSED (EQUIV) MIDAZOLAM VERSED (EQUIV) VERSED (EQUIV) VERSED (EQUIV) 100 MG/100 ML MIDODRINE HCL MIDODRINE HCL SAVELLA MILRINONE PRIMACOR 40MG/D5W 200ML MINERAL OIL (HEAVY) Drug Strength 5 MG 2.5 MG 2.5 MG 5 MG 100 MG 25 MG 5 MG 50 MG 12.5 MG 50 MG 100 MG 25 MG 50 MG 12.5 MG 250 MG 500 MG 1 APP 500 MG 500 MG 250 MG 150 MG 200 MG 1 APP 1 APP 1 KIT 1 KIT 1 APP 10 MG 2 MG 2 MG 5 MG 1 MG 2.5 MG 5 MG 12.5 MG 1 MG 40 MG 1 ML Drug Volume 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 5 ML 1 TAB 1 TAB 10 ML 1 TAB XL 1 TAB XL 1 TAB XL 1 TAB XL 1 TAB 1 TAB 1 APP 100 ML 10 ML 1 CAP 1 CAP 1 CAP 1 APP 1 APP 1 KIT 1 KIT 1 APP 10 ML 1 ML 2 ML 5 ML 1 ML 1 TAB 1 TAB 1 TAB 1 ML 200 ML 1 ML Package Desc 10 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML AMPUL 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB XL PACKAGE 1 TAB XL PACKAGE 1 TAB XL PACKAGE 1 TAB XL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 70 GM PACKAGE 100 ML BAG ML ORAL SYRINGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 30 GM PACKAGE 45 GM PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 1 GM PACKAGE 10 ML VIAL 1 ML BOTTLE 2 ML VIAL 5 ML VIAL 100 ML BAG 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML BOTTLE 200 ML BAG ML ORAL SYRINGE Dosage Form VIAL TAB TAB TAB TAB TAB INJ TAB TAB SUSP TAB XL TAB SR TAB XL TAB SR TAB TAB GEL PREMIX SUSP CAP CAP CAP CREAM POW KIT KIT TOP PWD VIAL SYRUP VIAL VIAL PREMIX TAB TAB TAB VIAL PREMIX OIL Route INJ PO PO PO PO PO IV PO PO PO PO PO PO PO PO PO VAG IV PO PO PO PO TOP TOP TOP VAG TOP INJ PO INJ INJ IV PO PO PO IV IV MSC Formulary Status? F F F F F F F F F F F F F F F F NF F F F F F F F NF F F F F F F F F F NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 04 04 04 04 00 00 00 00 00 00 Drug Code 2210 2760 1989 1988 1891 2762 665 1890 2761 2822 2986 1117 1118 3322 1794 1073 873 1267 2424 117 2085 2086 970 263 3209 2425 2333 2021 2645 2027 2028 3531 3495 2583 4066 2559 311 1304 AHFS Code 56:32.00 56:32.00 40:28.24 40:28.24 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 08:30.92 08:30.92 84:04.04 08:30.92 08:30.92 92:92.00 24:04.04 24:04.04 84:04.08 84:04.08 84:04.08 84:04.08 20:28.16 28:24.08 28:24.08 28:24.08 28:24.08 28:24.08 12:12.04 12:12.04 28:40.00 24:04.08 24:04.08 84:24.08 Generic Name MINERAL OIL (LIGHT) MINERAL OIL ORAL MINERAL OIL/PET HY-PHL MINERAL OIL/PET HY-PHL MINERAL OIL/PET HY-PHL MINOCYCLINE HCL MINOCYCLINE HCL MINOXIDIL MINOXIDIL MIRTAZAPINE MIRTAZAPINE MIRTAZAPINE MIRTAZAPINE MIRTAZAPINE ODT MISOPROSTOL MISOPROSTOL MISOPROSTOL QUARTER TAB MITOMYCIN MITOMYCIN MITOXANTRONE MITOXANTRONE MIVACURIUM MODAFINIL MODAFINIL MOM MOMETASONE FUROATE MOMETASONE FUROATE 0.1%CR 15GM MOMETASONE FUROATE OINT 15GM MONOCTANOIN MONTELUKAST MORICIZINE MORICIZINE MORPHINE MORPHINE MORPHINE MORPHINE MORPHINE MORPHINE Brand Name MINERAL OIL (LIGHT) MINERAL OIL ORAL AQUAPHOR (EQUIV) AQUAPHOR (EQUIV) AQUAPHOR NEONATE ONLY MINOCIN (EQUIV) MINOCYCLINE HCL LONITEN (EQUIV) LONITEN REMERON REMERON (EQUIV) MIRTAZAPINE MIRTAZAPINE REMERON ODT (EQUIV) CYTOTEC (EQUIV) CYTOTEC CYTOTEC (EQUIV) QUARTER TAB MITOMYCIN MITOMYCIN (EQUIV) NOVANTRONE (EQUIV) NOVANTRONE (EQUIV) MIVACRON PROVIGIL PROVIGIL MILK OF MAGNESIA (EQUIV) NASONEX ELOCON 0.1% CREAM ELOCON 0.1% OINT 15GM MOC-KIT SINGULAIR ETHMOZINE ETHMOZINE MORPHINE MORPHINE MORPHINE MORPHINE MORPHINE MORPHINE Drug Strength 30 ML 30 ML 1 APP 1 APP 1 APPLIC 100 MG 50 MG 10 MG 2.5 MG 15 MG 30 MG 45 MG 7.5 MG 15 MG 100 MCG 200 MCG 25 MCG 20 MG 5 MG 20 MG 30 MG 2 MG 100 MG 200 MG 30 ML 1 SPR 1 APP 1 APP 120 ML 10 MG 200 MG 300 MG 10 MG 15 MG 15 MG 2 MG 25 MG 4 MG Drug Volume 30 ML 30 ML 1 APP 1 APP 1 APPLIC 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 VIAL 10 ML 15 ML 1 ML 1 TAB 1 TAB 30 ML 1 SPR 1 APP 1 APP 120 ML 1 TAB 1 TAB 1 TAB 1 ML 1 ML 1 ML 1 ML 1 ML 1 ML Package Desc ML ORAL SYRINGE 30 ML UD CUP 100 GM PACKAGE 454 GM PACKAGE 396 GM PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 10 ML VIAL 15 ML BOTTLE 10 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 30 ML UD CUP 17 GM PACKAGE 15 GM PACKAGE 15 GM PACKAGE 120 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML SYRINGE 1 ML VIAL 1 ML SYRINGE 1 ML SYRINGE 1 ML VIAL 1 ML SYRINGE Dosage Form OIL OIL OINT OINT OINT CAP CAP TAB TAB TAB TAB TAB TAB TAB LN TAB TAB TAB VIAL VIAL VIAL VIAL VIAL TAB TAB SUSP NASAL CREAM OINT VIAL TAB TAB TAB SYRINGE VIAL SYRINGE SYRINGE VIAL SYRINGE Route PO PO TOP TOP TOP PO PO PO PO PO PO PO PO PO PO PO VAG IV IV IV INJ INJ PO PO PO INH TOP TOP MSC PO PO PO INJ INJ INJ INJ INJ IV Formulary Status? F F F F F F NF F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO YES YES YES YES YES YES DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 04 00 00 00 00 00 00 00 00 02 02 02 02 02 02 Drug Code 518 907 2969 2001 2968 1278 3996 1479 2426 446 448 3186 3439 447 322 323 4292 2046 2045 2111 3120 2585 2278 2279 1818 2620 836 832 2428 109 1995 1996 2727 1632 645 656 628 644 AHFS Code 56:12.00 56:12.00 84:24.12 84:24.12 84:24.12 08:12.24 08:12.24 24:08.20 24:08.20 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 56:28.28 56:28.28 56:28.28 10:00.00 10:00.00 10:00.00 10:00.00 12:20.20 28:20.92 28:20.92 56:12.00 52:08.08 84:06.00 84:06.00 56:14.00 48:10.24 24:04.04 24:04.04 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 Generic Name MORPHINE *1MG/1ML* PCA MORPHINE *5MG/1ML* PCA MORPHINE 1MG/ML/D5W 100ML MORPHINE 1MG/ML/D5W 100ML* MORPHINE AVERAGE ADULT MORPHINE CR MORPHINE CR MORPHINE CR MORPHINE CR MORPHINE FRAIL ADULT MORPHINE SOLN MORPHINE SULF PF MORPHINE SULFATE 15MG I.R. MORPHINE SULFATE SOLN MORPHINE SULFATE SOLN MORPHINE TOLERANT ADULT MORPHINE* MORPHINE* MOXIFLOXACIN MOXIFLOXACIN 0.5% MOXIFLOXACIN 400MG/250ML NS MULTIVITAMIN *NEO* MULTIVITAMIN CHILDREN'S CHEW MULTIVITAMINS MULTIVITAMINS ADULT MULTIVITAMINS OUTPT* MULTIVITAMINS PEDI MULTIVITAMINS PEDI MULTIVITAMINS W-IRON MULTIVITAMINS W-IRON PEDI MULTIVITAMINS,THER W-MINERALS MULTIVITAMINS,THERAPEUTIC MULTIVITAMINS,THERAPEUTIC MULTIVITAMINS/ZINC GLUCONATE MULTIVITAMINS/ZINC SULFATE MUPIROCIN 2% CR 30GM MUPIROCIN 2% OINT MUPIROCIN CREAM 2% 15GM Brand Name MORPHINE *1MG/1ML* PCA MORPHINE *5MG/1ML* PCA MORPHINE 1MG/ML/D5W 100ML MORPHINE 1MG/ML/D5W 100ML* MORPHINE AVERAGE ADULT MS CONTIN MS CONTIN MS CONTIN (EQUIV) MS CONTIN MORPHINE FRAIL ADULT MORPHINE SOLN INFUMORPH PF MORPHINE SULFATE 15MG I.R. MORPHINE SULFATE SOLN MORPHINE SULFATE SOLN MORPHINE TOLERANT ADULT DURAMORPH* MORPHINE* AVELOX VIGAMOX 0.5% AVELOX 400 MG/250ML NS POLY-VITAMIN *NEO* VI-DAYLIN CHEWABLE ONE-TABLET-DAILY CERNEVIT ADULT MULTIVITAMIN* M.V.I. PEDIATRIC POLY-VITAMIN CHILD CHEW + IRON MULTIVITAMINS W/IRON PEDI THERAPEUTIC-M THERAGRAN (EQUIV) THERA-PLUS ADEKS MVI WITH ZINC CHEW TAB ADEKS PEDIATRIC DROPS (EQUIV) BACTROBAN 2% CR BACTROBAN (EQUIV) 2% OINT BACTROBAN CREAM Drug Strength 50 MG 250 MG 100 MG 100 MG 1 EA 100 MG 15 MG 30 MG 60 MG 1 EA 2 MG 10 MG 15 MG 10 MG 20 MG 1 EA 10 MG 10 MG 400 MG 1 DRP 400 MG 0.5 ML 1 TAB 1 TAB 1 EA 1 TAB 1 EA 1 ML 1 TAB 1 ML 1 TAB 1 TAB 5 ML 1 TAB 1 ML 1 APP 1 APP 1 APP Drug Volume 50 ML 50 ML 100 ML 100 ML 1 EA 1 TAB CR 1 TAB SR 1 TAB CR 1 TAB CR 1 EA 1 ML 1 ML 1 TAB 5 ML 10 ML 1 EA 10 ML 1 ML 1 TAB 1 DRP 250 ML 0.5 ML 1 TAB 1 TAB 1 EA 1 TAB 1 EA 1 ML 1 TAB 1 ML 1 TAB 1 TAB 5 ML 1 TAB 1 ML 1 APP 1 APP 1 APP Package Desc 50 ML PACKAGE 50 ML SYRINGE 100 ML BOTTLE 100 ML BOTTLE 1 EA PACKAGE 1 TAB CR PACKAGE 1 TAB SR PACKAGE 1 TAB CR PACKAGE 1 TAB CR PACKAGE 1 EA PACKAGE 1 ML PACKAGE 20 ML AMP 1 TAB PACKAGE 5 ML PACKAGE 10 ML PACKAGE 1 EA PACKAGE 10 ML AMPUL 1 ML VIAL 1 TAB PACKAGE 3 ML BOTTLE 250 ML BAG 0.5 ML ORAL 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 100 TAB PACKAGE 5 ML VIAL ML ORAL SYRINGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 30 GM PACKAGE 22 GM PACKAGE 15 GM PACKAGE Dosage Form SYRINGE SYRINGE PREMIX PREMIX MSC TAB SR TAB CR TAB CR TAB CR MISC SOLN INJ TAB SOLN SOLN MISC INJ VIAL TAB DROPS PREMIX DROPS TAB TAB VIAL TAB VIAL DROPS TAB DROPS TAB TAB LIQUID TAB CHW DROPS CREAM OINT CREAM Route IV IV IV IV INJ PO PO PO PO INJ PO INJ PO PO PO INJ IV INJ PO EYE IV PO PO PO IV PO IV PO PO PO PO PO PO PO PO TOP TOP TOP Formulary Status? F F F F F F F F F F F F F F F F F F NF F NF F F F F F F F F F F F F F F F F F Controlled Substance? YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1269 3986 729 3251 3049 377 374 375 376 3050 484 2932 3217 4054 4055 3051 1505 1497 3097 2655 3962 4121 2864 1085 1262 3090 1122 620 2575 1749 2561 1575 1750 2543 2127 348 2562 3394 AHFS Code 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 08:12.18 52:04.04 08:12.18 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 88:28.00 84:04.04 84:04.04 84:04.04 Generic Name MYCOPHENOLATE MYCOPHENOLATE MYCOPHENOLATE SUSP NA PHOS,M-B/NA PHOS,DI-BA NA PHOS,M-B/NA PHOS,DI-BA NABUMETONE NADOLOL NADOLOL NADOLOL HALFTAB NALBUPHINE NALBUPHINE MDV *10MG/0.5ML* NALOXONE NALOXONE NALTREXONE NALTREXONE HALFTAB NAPHAZOLINE 0.012% NAPHAZOLINE 0.012% NAPHAZOLINE HCL/PHENIR MAL NAPROXEN NARC'S HELD UNTIL EPIDURAL DC NATEGLINIDE NEDOCROMIL NEFAZODONE NEFAZODONE 100MG TAB NELFINAVIR NELFINAVIR MESYLATE NEO/POLYMYX B SULF/DEXAMETH NEO/POLYMYX B SULF/DEXAMETH NEOMY SULF/BACITRA/POLYMYXIN B NEOMY SULF/BACITRA/POLYMYXIN B NEOMY SULF/BACITRA/POLYMYXIN B NEOMY SULF/BACITRAC ZN/POLY/HC NEOMY SULF/GRAMICID D/POLY NEOMY SULF/POLYMYX B SULF/HC NEOMY SULF/POLYMYX B SULF/HC NEOMY SULF/POLYMYXIN B SULFATE NEOMY/POLYMYX B/HC OTIC NEOMYCIN Brand Name CELLCEPT CELLCEPT CELLCEPT SUSP FLEET ENEMA FLEET PHOSPHO-SODA (EQUIV) NABUMETONE CORGARD (EQUIV) CORGARD (EQUIV) CORGARD (EQUIV) HALFTAB NUBAIN NALBUPHINE MDV *10MG/0.5ML* NARCAN (EQUIV) NARCAN (EQUIV) REVIA (EQUIV) REVIA (EQUIV) HALFTAB CLEAR EYES CLEAR EYES NAPHCON-A NAPROSYN (EQUIV) NARC'S HELD UNTIL EPIDURAL DC STARLIX TILADE NEFAZODONE NEFAZODONE 100MG TABLET VIRACEPT VIRACEPT MAXITROL (EQUIV) MAXITROL (EQUIV) TRIPLE ANTIBIOTIC OINTMENT NEOSPORIN OPTH (EQUIV) TRIPLE ANTIBIOTIC (EQUIV)28GM CORTISPORIN (EQUIV) NEOSPORIN (EQUIV) CORTISPORIN OPTH (EQUIV) CORTISPORIN OTIC SUSP (EQUIV) NEOSPORIN G.U.IRRIGANT (EQUIV) CORTISPORIN OTIC (EQUIV) NEOMYCIN Drug Strength 250 MG 500 MG 200 MG 1 EA 45 ML 500 MG 20 MG 40 MG 10 MG 10 MG 20 MG 0.4 MG 4 MG 50 MG 25 MG 1 DRP 1 DRP 15 ML 250 MG 1 EA 60 MG 1 PUF 50 MG 100 MG 625 MG 250 MG 1 APP 5 ML 1 APP 1 APP 1 APP 1 APP 1 DRP 1 DRP 1 DRP 20 ML 10 ML 500 MG Drug Volume 1 CAP 1 VIAL 1 ML 1 EA 45 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 ML 1 ML 10 ML 1 TAB 1 TAB 1 DRP 1 DRP 15 ML 1 TAB 1 EA 1 TAB 1 PUF 1 TAB 1 TAB 1 TAB 1 TAB 1 APP 5 ML 1 APP 1 APP 1 APP 1 APP 1 DRP 1 DRP 1 DRP 20 ML 10 ML 1 TAB Package Desc 1 CAP PACKAGE 1 VIAL PACKAGE ML ORAL SYRINGE 66.6 ML BOTTLE 45 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML AMPUL 1 ML VIAL 1 ML AMPUL 10 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 30 ML BOTTLE 15 ML BOTTLE 15 ML BOTTLE 1 TAB PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 16.2 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 3.5 GM PACKAGE 5 ML BOTTLE 0.9 GM PACKAGE 3.5 GM PACKAGE 28.35 GM PACKAGE 3.5 GM PACKAGE 10 ML BOTTLE 7.5 ML BOTTLE 10 ML BOTTLE 20 ML VIAL 10 ML BOTTLE 1 TAB PACKAGE Dosage Form CAP VIAL SUSP ENEMA SOLN TAB TAB TAB TAB INJ VIAL INJ VIAL TAB TAB DROPS DROPS DROPS TAB TAB TAB AER TAB TAB TAB TAB OINT DROPS OINT OINT OINT OINT DROPS DROPS DROPS VIAL SOLN TAB Route PO IV PO PR PO PO PO PO PO INJ INJ INJ INJ PO PO EYE EYE EYE PO MSC PO INH PO PO PO PO EYE EYE TOP TOP EYE EYE EYE EAR IRR EAR PO Formulary Status? F F F F F NF F F F F F F F F F F F F F F NF F NF NF F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 76 83 2430 2548 3038 3935 1898 3376 3974 2286 4337 642 643 1313 2764 669 668 543 1888 3169 2918 1466 2967 3294 3143 2230 2191 2190 4154 1661 947 954 1681 2195 1675 2197 1674 1779 AHFS Code 92:44.00 92:44.00 92:44.00 56:12.00 56:12.00 28:08.04 24:24.00 24:24.00 24:24.00 28:08.12 28:08.12 28:10.00 28:10.00 28:10.00 28:10.00 52:32.00 52:32.00 52:32.00 28:08.04 28:08.08 68:20.16 48:10.32 28:16.04 28:16.04 08:18.08 08:18.08 52:04.04 52:04.04 84:04.04 52:04.04 84:04.04 52:04.04 52:04.04 52:04.04 52:04.04 84:04.04 52:04.04 08:12.02 Generic Name NEOMYCIN HALFTAB NEOMYCIN ORAL SOLUTION NEOMYCIN/BACITRA/POLYMYXIN/HC NEOSTIGMINE NESIRITIDE NEVIRAPINE NEVIRAPINE NEVIRAPINE HALFTAB NIACIN NIACIN NIACIN NIACIN HALFTAB NIACIN SR NIACINAMIDE NICARDIPINE NICOTINE GUM NICOTINE GUM NICOTINE GUM * NICOTINE PATCH 14MG NICOTINE PATCH 21MG NICOTINE PATCH 7MG NICOTINE POLACRILEX* NICOTINE POLACRILEX* NICOTINE* PATCH 14MG NICOTINE* PATCH 21MG NICOTINE* PATCH 7MG NIFEDIPINE NIFEDIPINE NIFEDIPINE ER NIFEDIPINE ER NIMODIPINE NITAZOXANIDE NITROFURANTOIN NITROFURANTOIN MACRO/MONO NITROFURANTOIN SUSP NITROGLYCERIN NITROGLYCERIN 0.1MG/HR PATCH NITROGLYCERIN 0.2MG/HR PATCH Brand Name NEOMYCIN HALFTAB NEOMYCIN ORAL SOLUTION CORTISPORIN (EQUIV) PROSTIGMIN NATRECOR VIRAMUNE VIRAMUNE VIRAMUNE HALFTAB NIACIN NIACIN NIACIN NIACIN HALFTAB NIACIN SR NIACINAMIDE CARDENE I.V. NICORETTE GUM (EQUIV) NICORETTE GUM NICORETTE GUM* NICOTINE TRANSDERMAL NICOTINE TRANSDERMAL NICOTINE TRANSDERMAL COMMIT* COMMIT* NICODERM CQ* NICODERM CQ* NICODERM CQ* PROCARDIA (EQUIV) PROCARDIA (EQUIV) PROCARDIA ER (EQUIV) PROCARDIA ER (EQUIV) NIMOTOP (EQUIV) ALINIA MACRODANTIN (EQUIV) MACROBID (EQUIV) FURADANTIN SUSP NITROGLYCERIN NITROGLYCERIN PATCH NITRO-DUR PATCH Drug Strength 250 MG 25 MG 1 APP 1 MG 1.5 MG 10 MG 200 MG 100 MG 100 MG 50 MG 500 MG 250 MG 500 MG 500 MG 25 MG 2 MG 4 MG 2 MG 1 EA 1 EA 1 EA 2 MG 4 MG 14 MG/24h 21 MG/24h 7 MG/24h 10 MG 20 MG 30 MG 60 MG 30 MG 500 MG 50 MG 100 MG 25 MG 5 MG 1 EA 1 EA Drug Volume 1 TAB 1 ML 1 APP 1 ML 1 VIAL 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 TAB 10 ML 1 GUM 1 GUM 1 GUM 1 EA 1 EA 1 EA 1 LOZ 1 LOZ 1 PAT 24H 1 PAT 24H 1 PAT 24H 1 CAP 1 CAP 1 TAB ER 1 TAB ER 1 CAP 1 TAB 1 CAP 1 CAP 5 ML 1 ML 1 PATCH 1 PATCH Package Desc 1 TAB PACKAGE ML ORAL SYRINGE 15 GM PACKAGE 1 ML VIAL 1 VIAL PACKAGE ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 10 ML AMPUL 1 GUM PACKAGE 1 GUM PACKAGE 48 GUM PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 72 LOZ PACKAGE 72 LOZ PACKAGE 14 PAT 24H BOX 14 PAT 24H PACKAGE 14 PAT 24H PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB ER PACKAGE 1 TAB ER PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 10 ML VIAL 1 PATCH PACKAGE 1 EA PACKAGE Dosage Form TAB SOLN OINT VIAL VIAL SUSP TAB TAB TAB TAB TAB TAB CAP TAB INJ GUM GUM GUM PATCH PATCH PATCH LOZ LOZ PAT 24H PAT 24H PAT 24H CAP CAP TAB ER TAB ER CAP TAB CAP CAP SUSP VIAL PATCH PATCH Route PO PO TOP INJ IV PO PO PO PO PO PO PO PO PO IV BUC BUC BUC TD TD TD PO PO TD TD TD PO PO PO PO PO PO PO PO PO IV TD TD Formulary Status? F F F F F F F F F F F F F F NF F F F F F F F F F F F F F F F F NF F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3988 2836 2194 1394 2309 3171 1486 2765 1050 1585 1586 3533 2708 1594 197 1541 1542 3078 568 569 567 3175 3176 3177 3178 3264 1573 1147 580 581 334 3215 984 985 1941 1416 1291 848 AHFS Code 08:12.02 08:12.02 84:04.04 12:04.00 24:12.92 08:18.08 08:18.08 08:18.08 24:06.92 24:06.92 24:06.92 24:06.92 24:06.92 88:08.00 24:28.08 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 12:92.00 24:28.08 24:28.08 24:28.08 24:28.08 24:28.08 08:30.92 08:36.00 08:36.00 08:36.00 24:12.08 24:12.08 24:12.08 Generic Name NITROGLYCERIN 0.3MG/HR PATCH NITROGLYCERIN 0.4MG/HR PATCH NITROGLYCERIN 0.6MGHR PATCH NITROGLYCERIN 1/100GR NITROGLYCERIN 1/150GR NITROGLYCERIN 1/150GR* NITROGLYCERIN 1/200GR NITROGLYCERIN 2% OINT NITROGLYCERIN 50MG/250ML D5W NITROGLYCERIN OINT 2% NITROGLYCERIN SPRAY NITROPRUSSIDE NITROPRUSSIDE* NOREPINEPHRINE NOREPINEPHRINE 16 MG/250ML D5W NOREPINEPHRINE 4MG/250ML D5W NOREPINEPHRINE 8 MG/250ML D5W NOREPINEPHRINE* NORETHINDRONE ACETATE NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-ETHINYL ESTRAD NORETHINDRONE-ETHINYL ESTRAD NORFLOXACIN NORFLOXACIN 0.3% NORGESTREL-ETHINYL ESTRADIOL NORTRIPTYLINE NORTRIPTYLINE NORTRIPTYLINE NORTRIPTYLINE SOLN NUT.TX.IMPAIRED DIGEST FXN,SOY NUT.TX.IMPAIRED DIGEST FXN,SOY NUT.TX.IMPAIRED RENAL FXN,SOY* NUT.TX.IMPAIRED RENAL FXN,SOY* NUT.TX.PULM.DISORD.SOY,LAC-FR* NUTRITIONAL SUPPLEMENT NUTRITIONAL SUPPLEMENT NUTRIVENT DIETARY SUPPLEMENT* NYSTATIN CREAM Brand Name NITRO-DUR PATCH NITROGLYCERIN PATCH NITROGLYCERIN PATCH NITROSTAT NITROQUICK NITROSTAT* NITROSTAT (EQUIV) NITRO-BID 2% OINT NITROGLYCERIN 50MG/250ML D5W NITRO-BID OINT 2% NITROLINGUAL SPRAY NITROPRESS NITROPRESS* LEVOPHED (EQUIV) NOREPINEPHRINE 16 MG/250ML D5W NOREPINEPHRINE 4MG/250ML D5W NOREPINEPHRINE 8 MG/250ML D5W LEVOPHED (EQUIV)* NORETHINDRONE ACETATE BALZIVA (OVCON-35 EQUIV) NECON (EQUIV) ORTHO-NOVUM 777 (EQUIV) NOROXIN CHIBROXIN 0.3% LO/OVRAL-28 (EQUIV) PAMELOR (EQUIV) PAMELOR (EQUIV) PAMELOR (EQUIV) AVENTYL SOLN PEPTINEX DT VIVONEX RTF MAGNACAL RENAL* SUPLENA* RESPALOR* NUTREN 1.5 RESOURCE (EQUIV)* NUTRIVENT DIETARY SUPPLEMENT NYSTATIN CREAM Drug Strength 1 EA 1 EA 1 EA 0.6 MG 0.4 MG 0.4 MG 0.3 MG 1 IN 50 MG 1 IN. 1 SPR 50 MG 50 MG 4 MG 16 MG 4 MG 8 MG 4 MG 5 MG 1 TAB 1 TAB 1 TAB 400 MG 1 DRP 1 TAB 10 MG 25 MG 50 MG 10 MG 250 ML 250 ML 1 EA 240 ML 1 EA 11 240 ML 1 EA 1 APP Drug Volume 1 PATCH 1 PATCH 1 PATCH 1 TAB SL 1 TAB SL 1 TAB SL 1 TAB SL 1 IN 250 ML 1 IN. 1 SPR 2 ML 2 ML 4 ML 250 ML 250 ML 250 ML 4 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 DRP 1 TAB 1 CAP 1 CAP 1 CAP 5 ML 250 ML 250 ML 1 EA 240 ML 1 EA 1 LIQUID 240 ML 1 EA 1 APP Package Desc 1 PATCH PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 TAB SL PACKAGE 1 TAB SL PACKAGE 25 TAB SL PACKAGE 1 TAB SL PACKAGE 1 GM PACKAGE 250 ML BOTTLE 30 GM PACKAGE 12 GM PACKAGE 2 ML VIAL 2 ML VIAL 4 ML AMPUL 250 ML BAG 250 ML BAG 250 ML BAG 4 ML AMPUL 1 TAB PACKAGE 28 TAB PACKAGE 28 TAB PACKAGE 28 TAB PACKAGE 1 TAB PACKAGE 5 ML BOTTLE 28 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 250 ML CAN 250 ML BOTTLE 237 ML BOTTLE 240 ML BOTTLE 237 ML BOTTLE 240 ML BOTTLE 240 ML BOTTLE 1 EA PACKAGE 15 GM PACKAGE Dosage Form PATCH PATCH PATCH TAB SL TAB SL TAB SL TAB SL OINT PREMIX OINT SPRAY VIAL VIAL INJ PREMIX PREMIX PREMIX INJ TAB TAB TAB TAB TAB DROPS TAB CAP CAP CAP SOLN LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID CREAM Route TD TD TD SL SL SL SL TD IV TD SL IV IV INJ IV IV IV INJ PO PO PO PO PO EYE PO PO PO PO PO PO PO PO PO PO PO PO PO TOP Formulary Status? F F F F F F F F F F F F F F F F F F NF F F F NF F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 849 1292 1293 601 600 599 598 3102 1266 980 2150 671 3252 751 3897 3450 3896 3253 4253 3357 1970 539 118 135 206 1892 1893 1894 10 3107 3086 2635 2793 2636 3127 1143 2432 3401 AHFS Code 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:12.08 24:08.20 24:08.20 12:12.12 12:12.12 12:12.12 12:12.12 12:12.12 68:32.00 68:12.00 68:12.00 68:12.00 08:12.18 52:04.04 68:12.00 28:16.04 28:16.04 28:16.04 28:16.04 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 40:20.00 84:04.08 Generic Name NYSTATIN CREAM NYSTATIN OINT 15GM NYSTATIN POWDER NYSTATIN SUSP NYSTATIN SUSP UD NYSTATIN TABLET NYSTATIN VAG NYSTATIN/TRIAMCIN CRM NYSTATIN/TRIAMCIN OINT OCTREOTIDE OCTREOTIDE OCTREOTIDE OCTREOTIDE 1250MCG/250ML NS OCTREOTIDE 500MCG/100ML NS OCTREOTIDE LAR OCTREOTIDE LAR OCTREOTIDE LAR OFLOXACIN OFLOXACIN 0.3% OFLOXACIN 0.3% OTIC OLANZAPINE OLANZAPINE OLANZAPINE OLANZAPINE OLANZAPINE ZYDIS OLANZAPINE ZYDIS OLANZAPINE ZYDIS OLIVE OIL* OLOPATADINE 0.1% OMALIZUMAB OMEPRAZOLE EC OMEPRAZOLE SUSP ONDANSETRON ONDANSETRON ONDANSETRON ONDANSETRON ONDANSETRON ODT OPIUM DEODORIZED TINCTURE Brand Name NYSTATIN CREAM NYSTATIN OINT NYSTATIN POWDER NYSTATIN SUSP NYSTATIN SUSP UD NYSTATIN TABLET NYSTATIN VAG MYCOSTATIN II (EQUIV)CRM MYCOSTATIN II (EQUIV) OINT SANDOSTATIN SANDOSTATIN SANDOSTATIN OCTREOTIDE 1250MCG/250ML NS OCTREOTIDE 500MCG/100ML NS SANDOSTATIN LAR SANDOSTATIN LAR SANDOSTATIN LAR FLOXIN OCUFLOX 0.3% FLOXIN 0.3% OTIC ZYPREXA ZYPREXA ZYPREXA ZYPREXA ZYPREXA ZYDIS ZYPREXA ZYDIS ZYPREXA ZYDIS OLIVE OIL* PATANOL 0.1% XOLAIR PRILOSEC PRILOSEC SUSP ZOFRAN ZOFRAN ZOFRAN (EQUIV) ZOFRAN ZOFRAN ODT OPIUM DEODORIZED TINCTURE Drug Strength 1 APP 1 APP 1 APP 100000 500000 500000 100000 1 APP 1 APP 100 MCG 50 MCG 500 MCG 1250 MCG 500 MCG 10 MG 20 MG 30 MG 400 MG 1 DRP 1 DRP 10 MG 10 MG 2.5 MG 5 MG 10 MG 15 MG 5 MG 1 ML 1 DRP 150 MG 20 MG 20 MG 2 MG 4 MG 4 MG 8 MG 4 MG 60 MG Drug Volume 1 APP 1 APP 1 APP 1 ML 5 ML 1 TAB 1 TAB 1 APP 1 APP 1 ML 1 ML 1 ML 250 ML 100 ML 1 KIT 1 KIT 1 KIT 1 TAB 1 DRP 1 DRP 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 DRP 1 VIAL 1 CAP EC 10 ML 1 ML 1 TAB 2 ML 1 TAB 1 TAB 0.6 ML Package Desc 30 GM PACKAGE 15 GM PACKAGE 15 GM PACKAGE ML ORAL SYRINGE 5 ML UD CUP 1 TAB PACKAGE 1 TAB PACKAGE 15 GM PACKAGE 15 GM PACKAGE 1 ML AMPUL 1 ML AMPUL 1 ML AMPUL 250 ML BAG 100 ML BAG 1 KIT PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 1 TAB PACKAGE 5 ML BOTTLE 10 ML BOTTLE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 5 ML BOTTLE 1 VIAL PACKAGE 1 CAP EC PACKAGE ML ORAL SYRINGE ML VIAL 1 TAB PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 0.6 ML ORAL Dosage Form CREAM OINT TOP PWD SUSP SUSP TAB TAB CREAM OINT INJ INJ INJ PREMIX PREMIX KIT KIT KIT TAB DROPS DROPS VIAL TAB TAB TAB TAB TAB TAB OIL DROPS VIAL CAP EC SUSP VIAL TAB VIAL TAB TAB TINCT Route TOP TOP TOP PO PO PO VAG TOP TOP INJ INJ INJ IV IV IM INJ IM PO EYE EAR IV PO PO PO PO PO PO MSC EYE INJ PO PO IV PO IV PO PO PO Formulary Status? F F F F F F F F F F F F F F NF NF F F NF F F F F F F F F F F NF NF F F F F F F NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 Drug Code 1955 944 1459 1380 1815 889 2307 1356 1357 795 794 796 4040 4039 3083 3029 809 538 1648 2913 2876 16 14 15 19 3389 18 1305 547 2704 1111 2435 1017 1019 1018 1020 1033 2234 AHFS Code 84:04.08 84:04.08 84:04.08 08:14.28 08:14.28 08:14.28 84:04.08 84:04.08 84:04.08 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 92:92.00 08:12.18 52:04.04 52:04.04 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 84:24.08 52:02.00 48:92.00 56:28.36 56:28.36 56:22.20 56:22.20 56:22.20 56:22.20 56:22.20 56:08.00 Generic Name OPIUM TINCTURE 10%* OPRELVEKIN OSELTAMIVIR OSELTAMIVIR PHOSPHATE OXACILLIN OXACILLIN OXACILLIN 1 GM/ 50 ML D5W OXACILLIN 2 GM/100 ML D5W OXACILLIN 500MG/50ML D5W OXACILLIN* OXALIPLATIN OXALIPLATIN OXANDROLONE OXAZEPAM OXAZEPAM OXCARBAZEPINE OXCARBAZEPINE OXCARBAZEPINE OXCARBAZEPINE OXCARBAZEPINE HALFTAB OXICONAZOLE 1% OXYBUTYNIN OXYBUTYNIN CHLORIDE SYRUP OXYBUTYNIN HALFTAB OXYBUTYNIN PATCH 3.9MG/24HR OXYCODONE 5MG/APAP 325MG OXYCODONE 5MG/APAP 325MG/5ML OXYCODONE CR OXYCODONE CR OXYCODONE CR OXYCODONE CR OXYCODONE HCL OXYCODONE SOLN UD OXYCODONE SOLUTION OXYCODONE/APAP 5MG/325MG SOLN OXYCODONE/APAP ER 2TAB* OXYMETAZOLINE 12HR NASAL SPRAY OXYMORPHONE HCL Brand Name OPIUM TINCTURE 10%* NEUMEGA TAMIFLU TAMIFLU OXACILLIN OXACILLIN OXACILLIN 1 GM/ 50 ML D5W OXACILLIN 2 GM/100 ML D5W OXACILLIN 500MG/50ML D5W OXACILLIN* ELOXATIN (EQUIV) ELOXATIN OXANDRIN SERAX (EQUIV) SERAX (EQUIV) TRILEPTAL TRILEPTAL TRILEPTAL TRILEPTAL TRILEPTAL HALFTAB OXISTAT 1% DITROPAN (EQUIV) DITROPAN (EQUIV) DITROPAN (EQUIV) HALFTAB OXYTROL PATCH (EQUIV) PERCOCET 5/325MG PERCOCET 5/325 PER 5ML SOLN OXYCONTIN OXYCONTIN OXYCONTIN OXYCONTIN OXYCODONE HCL ROXICODONE SOLN UD ROXICODONE SOLUTION ROXICET PERCOCET ER 2TAB* AFRIN (EQUIV) OPANA ER Drug Strength 10 MG 5 MG 75 MG 12 MG 1 GM 2 GM 1 GM 2 GM 500 MG 100 MG 100 MG 50 MG 10 MG 10 MG 15 MG 150 MG 300 MG 300 MG 600 MG 75 MG 1 APP 5 MG 1 MG 2.5 MG 1 EA 1 TAB 1 ML 10 MG 20 MG 40 MG 80 MG 5 MG 5 MG 1 MG 5 ML 2 TAB 1 SPR 40 MG Drug Volume 1 ML 1 VIAL 1 CAP 1 ML 1 VIAL 1 VIAL 50 ML 100 ML 50 ML 1 ML 1 VIAL 10 ML 1 TAB 1 CAP 1 CAP 1 TAB 5 ML 1 TAB 1 TAB 1 TAB 1 APP 1 TAB 1 ML 1 TAB 1 EA 1 TAB 1 ML 1 TAB CR 1 TAB CR 1 TAB CR 1 TAB CR 1 TAB 5 ML 1 ML 5 ML 2 TAB 1 SPR 1 TAB ER Package Desc 1 ML BOTTLE 1 VIAL PACKAGE 1 CAP PACKAGE 1 ML SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 50 ML BAG 100 ML BAG 50 ML BAG 1 ML PACKAGE 1 VIAL PACKAGE 10 ML PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 30 GM PACKAGE 1 TAB PACKAGE ML BOTTLE 1 TAB PACKAGE 1 PATCH PACKAGE 1 TAB PACKAGE ML BOTTLE 1 TAB CR PACKAGE 1 TAB CR PACKAGE 1 TAB CR PACKAGE 1 TAB CR PACKAGE 1 TAB PACKAGE 5 ML BOTTLE ML BOTTLE 5 ML UD CUP 2 TAB PACKAGE 15 ML BOTTLE 1 TAB ER PACKAGE Dosage Form TINCT VIAL CAP SUSP VIAL VIAL PB PB VIAL VIAL VIAL VIAL TAB CAP CAP TAB SUSP TAB TAB TAB CREAM TAB SYRUP TAB PATCH TAB SOLN TAB CR TAB CR TAB CR TAB CR TAB SOLN SOLN SOLN TAB SPRAY TAB ER Route PO SC PO PO INJ INJ IV IV IV INJ IV IV PO PO PO PO PO PO PO PO TOP PO PO PO TD PO PO PO PO PO PO PO PO PO PO PO NAS PO Formulary Status? NF F NF NF F F F F F F NF NF NF F F F NF F F F F F F F F F F F F F F F F F F F F NF Controlled Substance? YES NO NO NO NO NO NO NO NO NO NO NO YES YES YES NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES YES NO YES DEA Code 02 00 00 00 00 00 00 00 00 00 00 00 03 04 04 00 00 00 00 00 00 00 00 00 00 02 02 02 02 02 02 02 02 02 02 02 00 02 Drug Code 2233 2107 85 3892 294 292 4257 4258 4256 289 2532 2531 2004 2161 2162 806 3999 807 2919 2767 1948 1066 2564 2768 4161 2287 482 2129 2130 2131 3207 520 3103 481 4180 2869 1070 4297 AHFS Code 56:08.00 20:16.00 08:18.28 08:18.28 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 10:00.00 10:00.00 68:08.00 28:24.08 28:24.08 28:12.92 28:12.92 28:12.92 28:12.92 28:12.92 84:04.08 86:12.00 86:12.00 86:12.00 86:12.00 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 28:08.08 52:32.00 28:08.08 Generic Name OXYTOCIN OXYTOCIN* PACLITAXEL *6MG/ML* PACLITAXEL PROTEIN BOUND* PALIFERMIN PALIPERIDONE PALMITATE PALIPERIDONE PALMITATE PALIPERIDONE PALMITATE PALIPERIDONE PALMITATE PALIVIZUMAB PALONOSETRON PAMIDRONATE PANCURONIUM MDV PANITUMUMAB (340B) PANTOPRAZOLE PANTOPRAZOLE PANTOPRAZOLE PANTOPRAZOLE* PAPAVERINE PAPILLOMAVIRUS VACC,QVAL HUMAN PARICALCITOL PARICALCITOL PAROXETINE PAROXETINE PAROXETINE PAROXETINE CR PAROXETINE CR PAROXETINE HALFTAB PEGFILGRASTIM PEGINTERFERON ALFA-2A PEMETREXED PEMETREXED DISODIUM PEN G BENZ/PEN G PROCAINE PEN G BENZ/PEN G PROCAINE PEN G BENZ/PEN G PROCAINE PEN G POT 3MMU/D5W/50ML PEN G POT 3MMU/D5W/50ML* PENICILLAMINE Brand Name PITOCIN (EQUIV) PITOCIN (EQUIV)* TAXOL (EQUIV) *6MG/ML* ABRAXANE* KEPIVANCE INVEGA SUSTENNA INVEGA SUSTENNA INVEGA SUSTENNA INVEGA SUSTENNA SYNAGIS ALOXI AREDIA (EQUIV) PAVULON (EQUIV) MDV VECTIBIX (340B) PROTONIX PROTONIX IV PROTONIX PROTONIX IV* PAVABID (EQUIV) GARDASIL* ZEMPLAR ZEMPLAR PAXIL PAXIL PAXIL PAXIL CR PAXIL CR PAXIL HALFTAB NEULASTA PEGASYS ALIMTA SUV ALIMTA BICILLIN C-R (EQUIV) BICILLIN C-R (EQUIV) BICILLIN C-R (EQUIV) PENICILLIN 3MMU/D5W/50ML PENICILLIN 3MMU/D5W/50ML* CUPRIMINE Drug Strength 10 UNT 10 UNT 30 MG 100 MG 6.25 MG 117 MG 156 MG 234 MG 78 MG 50 MG 0.25 MG 30 MG 1 MG 100 MG 20 MG 40 MG 40 MG 40 MG 30 MG 0.5 ML 1 MCG 5 MCG 10 MG 20 MG 40 MG 12.5 MG 25 MG 5 MG 6 MG 180 MCG 500 MG 100 MG 1.2 MMU 1.2 MMU 2.4 MMU 3 MMU 3 MMU 250 MG Drug Volume 1 ML 1 ML 5 ML 1 VIAL 1 VIAL 0.75 ML 1 ML 1.5 ML 0.5 ML 0.5 ML 5 ML 1 VIAL 1 ML 5 ML 1 TAB 1 VIAL 1 TAB DR 1 VIAL 1 ML 0.5 ML 1 CAP 1 ML 1 TAB 1 TAB 1 TAB 1 TAB SR 1 TAB SR 1 TAB 0.6 ML 1 ML 20 ML 4 ML 2 ML 2 ML 4 ML 50 ML 50 ML 1 CAP Package Desc 1 ML VIAL 1 ML VIAL 5 ML VIAL 1 VIAL VIAL 1 VIAL VIAL 0.75 ML SYRINGE 1 ML BOTTLE 1.5 ML BOTTLE 0.5 ML BOTTLE 0.5 ML BOTTLE 5 ML BOTTLE 1 VIAL PACKAGE 10 ML VIAL 5 ML BOTTLE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 2 ML VIAL 0.5 ML VIAL 1 CAP PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 0.6 ML SYRINGE 1 ML BOTTLE 20 ML VIAL 4 ML VIAL 2 ML SYRINGE 2 ML SYRINGE 4 ML SYRINGE 50 ML BOTTLE 50 ML BOTTLE 1 CAP PACKAGE Dosage Form VIAL VIAL VIAL VIAL VIAL SYRING SYRING SYRING SYRING VIAL VIAL VIAL VIAL VIAL TAB DR VIAL TAB DR VIAL VIAL VIAL CAP VIAL TAB TAB TAB TAB SR TAB SR TAB SYRINGE VIAL VIAL VIAL SYRINGE SYRINGE SYRINGE PREMIX PREMIX CAP Route INJ INJ IV IV IVP IM IM IM IM INJ IV IV INJ INJ PO IV PO IV INJ IM PO IV PO PO PO PO PO PO SC INJ IV IV IM IM IM IV IV PO Formulary Status? F F F F NF F F F F F NF F F NF F F F F F F NF F F F F NF NF F F NF NF F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2238 3254 991 2992 3484 4164 4077 4078 4209 3098 3027 2031 1521 4138 3329 4301 201 202 1413 3173 3352 655 353 354 355 351 352 2769 2069 2648 2903 3886 182 181 180 1265 3255 114 AHFS Code 76:00.00 76:00.00 10:00.00 10:00.00 84:16.00 28:16.08 28:16.08 28:16.08 28:16.08 08:18.24 56:22.20 92:24.00 12:20.20 10:00.00 56:28.36 56:28.36 56:28.36 56:28.36 24:12.92 80:12.00 88:16.00 88:16.00 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 20:16.00 08:18.20 10:00.00 10:00.00 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 64:00.00 Generic Name PENICILLIN G BENZ 1.2MMU PENICILLIN G BENZATHINE PENICILLIN G POTASSIUM PENICILLIN G POTASSIUM PENICILLIN G PROCAINE PENICILLIN G SODIUM PENICILLIN VK PENICILLIN VK PENICILLIN VK 25MG/ML SUSP PENICILLIN VK SUSP PENTAMIDINE PENTAMIDINE ISETHIONATE INH PENTOBARBITAL PENTOSAN POLYSULFATE SODIUM PENTOSTATIN PENTOXIFYLLINE SR P-EPHED HCL/TRIPROLIDINE HCL PEPPERMINT OIL PEPTAMEN DIETARY SUPPLEMENT* PERCOCET WHEN EPIDURAL DC'D PERFLUTREN LIPID MICROSPHERE PERINDOPRIL ERBUMINE PERMETHRIN 5% PERPHENAZINE PERPHENAZINE PERPHENAZINE PETROLATUM,WHITE PETROLATUM,WHITE 30GM PETROLATUM,WHITE 454GM PHENAZOPYRIDINE PHENAZOPYRIDINE HCL PHENELZINE SULFATE PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL Brand Name BICILLIN 1.2MMU(EQUIV) BICILLIN L-A (EQUIV) PFIZERPEN PENICILLIN G POTASSIUM WYCILLIN (EQUIV) PENICILLIN G SODIUM PENICILLIN VK PENICILLIN VK PENICILLIN VK 25MG/ML SUSP PENICILLIN VK SUSP PENTAM 300 NEBUPENT NEMBUTAL ELMIRON NIPENT TRENTAL SR (EQUIV) ACTIFED PEPPERMINT OIL PEPTAMEN DIETARY SUPPLEMENT PERCOCET WHEN EPIDURAL DC'D DEFINITY ACEON ACTICIN 5% TRILAFON (EQUIV) TRILAFON (EQUIV) TRILAFON (EQUIV) WHITE PETROLATUM PETROLATUM JELLY PETROLATUM JELLY PYRIDIUM (EQUIV) PYRIDIUM (EQUIV) NARDIL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL PHENOBARBITAL Drug Strength 1.2 MMU 2.4 MMU 20 MMU 5 MMU 600000 5 MMU 250 MG 500 MG 25 MG 250 MG 300 MG 300 MG 50 MG 100 MG 10 MG 400 MG 1 ML 30 ML 1 EA 1 EA 2 ML 2 MG 1 APP 2 MG 4 MG 8 MG 1 APP 1 APP 1 APP 200 MG 100 MG 15 MG 100 MG 130 MG 15 MG 30 MG 60 MG 65 MG Drug Volume 2 ML 4 ML 1 VIAL 1 VIAL 1 ML 1 VIAL 1 TAB 1 TAB 1 ML 5 ML 1 VIAL 1 VIAL 1 ML 1 CAP 1 VIAL 1 TAB SR 1 ML 30 ML 1 EA 1 EA 2 ML 1 TAB 1 APP 1 TAB 1 TAB 1 TAB 1 APP 1 APP 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 1 ML Package Desc 2 ML SYRINGE 4 ML SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 ML SYRINGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 20 ML VIAL 1 CAP PACKAGE 1 VIAL PACKAGE 1 TAB SR PACKAGE ML ORAL SYRINGE 30 ML BOTTLE 1 EA PACKAGE 1 EA PACKAGE 2 ML BOTTLE 1 TAB PACKAGE 60 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 GM PACKAGE 28.35 GM PACKAGE 454 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL Dosage Form SYRINGE SYRINGE VIAL VIAL SYRINGE VIAL TAB TAB SUS REC SUSP VIAL VIAL VIAL CAP VIAL TAB SR SYRUP SPIRIT LIQUID TAB VIAL TAB CREAM TAB TAB TAB JELLY GEL GEL TAB TAB TAB TAB VIAL TAB TAB TAB VIAL Route IM IM INJ INJ IM INJ PO PO PO PO INJ INH INJ PO IV PO PO PO PO PO INJ PO TOP PO PO PO TOP TOP TOP PO PO PO PO INJ PO PO PO INJ Formulary Status? F F F F F F F F NF F F F F NF NF F F F F F F NF F NF F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 02 00 00 00 00 00 00 02 00 00 00 00 00 00 00 00 00 00 00 00 04 04 04 04 04 04 Drug Code 427 179 3402 1568 177 2565 1859 1860 2995 892 2244 2942 691 3019 2533 1599 1431 1306 2442 3168 2637 2676 2225 1548 1549 1550 2810 961 960 1605 1604 595 2805 1502 2088 2566 2831 1501 AHFS Code 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:30.92 08:30.92 28:24.04 92:92.00 10:00.00 20:24.00 04:04.20 92:92.00 40:20.00 28:08.08 92:92.00 24:32.04 84:04.12 28:16.08 28:16.08 28:16.08 96:00.00 96:00.00 96:00.00 84:08.00 84:08.00 28:16.04 28:24.04 28:24.04 28:24.04 28:24.04 28:24.04 28:24.04 Generic Name PHENOBARBITAL ELIX PHENOL TOPICAL* PHENOL/SODIUM PHENOLATE PHENOXYBENZAMINE PHENTOLAMINE PHENYLEPHRINE PHENYLEPHRINE PHENYLEPHRINE PHENYLEPHRINE 0.25% PHENYLEPHRINE 0.5% PHENYLEPHRINE 1% PHENYLEPHRINE 1% NASAL PHENYLEPHRINE 10% PHENYLEPHRINE HCL PHENYLEPHRINE HCL 2.5% PHENYLEPHRINE OINT PHENYLEPHRINE* PHENYLEPHRINE/SHK LV/MO/PET,WH PHENYTOIN PHENYTOIN PHENYTOIN CHEW TAB PHENYTOIN EXTENDED PHENYTOIN EXTENDED PHENYTOIN SODIUM EXTENDED PHENYTOIN SUSP PHENYTOIN SUSP U/D PHOSPHORUS PHYSOSTIGMINE PHYTONADIONE PHYTONADIONE PHYTONADIONE HALFTAB PHYTONADIONE NEONATAL PHYTONADIONE NEONATAL PHYTONADIONE ORAL SUSP PHYTONADIONE QUARTERTAB PILOCARPINE PILOCARPINE 1% PILOCARPINE 2% Brand Name PHENOBARBITAL ELIX PHENOL TOPICAL* CHLORASEPTIC (EQUIV) DIBENZYLINE PHENTOLAMINE PHENYLEPHRINE PHENYLEPHRINE PHENYLEPHRINE NEO-SYNEPHRINE 0.25% NEO-SYNEPHRINE 0.5% NEO-SYNEPHRINE 1% NEO-SYNEPHRINE 1% (EQUIV) AK-DILATE 10% PHENYLEPHRINE HCL AK-DILATE 2.5% FORMULATION R OINT PHENYLEPHRINE* PREPARATION H DILANTIN (EQUIV) DILANTIN (EQUIV) DILANTIN CHEW TAB DILANTIN DILANTIN PHENYTEK DILANTIN-125 SUSP DILANTIN SUSP (EQUIV) K-PHOS NEUTRAL (EQUIV) ANTILIRIUM (EQUIV) VITAMIN K MEPHYTON MEPHYTON HALFTAB VITAMIN K NEONATAL VITAMIN K NEONATAL VITAMIN K SUSP MEPHYTON QUARTERTAB SALAGEN (EQUIV) PILOCARPINE 1% PILOCARPINE 2% Drug Strength 20 MG 1 ML 1 SPR 10 MG 5 MG 10 MG 10 MG 400 MCG 1 EA 1 SPR 1 SPR 1 DRP 1 DRP 10 MG 1 DRP 1 APP 10 MG 1 APP 100 MG 250 MG 50 MG 100 MG 30 MG 300 MG 100 MG 100 MG 250 MG 2 MG 10 MG 5 MG 2.5 MG 1 MG 1 MG 2.5 MG 1.25 MG 5 MG 1 DRP 1 DRP Drug Volume 5 ML 1 ML 1 SPR 1 CAP 1 VIAL 250 ML 1 ML 10 ML 1 EA 1 SPR 1 SPR 1 DRP 1 DRP 1 ML 1 DRP 1 APP 1 ML 1 APP 2 ML 5 ML 1 TAB 1 CAP 1 CAP 1 CAP 4 ML 4 ML 1 TAB 2 ML 1 ML 1 TAB 1 TAB 0.5 ML 0.5 ML 1 ML 1 TAB 1 TAB 1 DRP 1 DRP Package Desc 5 ML BOTTLE 1 ML BOTTLE 180 ML BOTTLE 1 CAP PACKAGE 1 VIAL PACKAGE 250 ML PREMIX 1 ML VIAL 10 ML SYRINGE 15 ML BOTTLE 15 ML BOTTLE 15 ML BOTTLE 30 ML BOTTLE 5 ML BOTTLE 5 ML VIAL 2 ML BOTTLE 30 GM PACKAGE 1 ML VIAL 30 GM PACKAGE 2 ML VIAL 5 ML AMPUL 1 TAB CHW PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 100 CAP PACKAGE ML ORAL SYRINGE 4 ML UD CUP 1 TAB PACKAGE 2 ML AMPUL 1 ML AMPUL 1 TAB PACKAGE 1 TAB PACKAGE 0.5 ML AMPUL 0.5 ML AMPUL 1 ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 15 ML BOTTLE 15 ML BOTTLE Dosage Form ELIXIR LIQUID SOLN CAP VIAL PREMIX VIAL SYRINGE SPRAY SPRAY SPRAY DROPS DROPS VIAL DROPS OINT VIAL OINT VIAL INJ TAB CHW CAP CAP CAP SUSP SUSP TAB INJ INJ TAB TAB SYRINGE INJ SUSP TAB TAB DROPS DROPS Route PO MSC MM PO INJ IV INJ INJ NAS NAS NAS NAS EYE INJ EYE PR INJ TOP INJ INJ PO PO PO PO PO PO PO INJ INJ PO PO INJ INJ PO PO PO EYE EYE Formulary Status? F F F F F NF F NF F F F F F F F NF F NF F F F F F NF F F F F F F F F F F F NF F F Controlled Substance? YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1376 1634 1433 2302 2018 3924 1395 3921 312 315 314 316 1660 3403 4127 1540 3256 2891 1504 648 591 596 597 3963 609 1870 1387 1644 771 104 3328 3425 770 2443 3442 2094 2183 1677 AHFS Code 28:24.04 84:04.92 52:92.00 12:16.04 12:16.04 12:12.04 12:12.04 12:12.04 52:32.00 52:32.00 52:32.00 52:32.00 52:32.00 12:12.04 52:32.00 84:92.00 12:12.04 84:92.00 28:12.12 28:12.12 28:12.12 28:12.12 28:12.12 28:12.12 28:12.12 28:12.12 40:04.00 12:04.00 88:24.00 88:24.00 88:24.00 88:24.00 88:24.00 88:24.00 88:24.00 12:04.00 52:40.20 52:40.20 Generic Name PILOCARPINE 4% PILOCARPINE GEL 4% PIMECROLIMUS 1% 30GM PIMOZIDE PIMOZIDE PINDOLOL PINDOLOL PINDOLOL HALFTAB PIOGLITAZONE PIOGLITAZONE PIPERACILL/TAZOBACTAM PIPERACILL/TAZOBACTAM PIPERACILL/TAZOBACTAM 4.5GM PIPERACILL/TAZOBACTAM 4.5GM PIPERACILL/TAZOBACTAM BULK* PIPERACILLIN PIPERACILLIN/TAZOBACTAM/DEX-IS PIPERACILLIN/TAZOBACTAM/DEX-IS PIPERACILLIN/TAZOBACTAM/DEX-IS PIPERONYL BUTOXIDE/PYRETHRINS PIPERONYL BUTOXIDE/PYRETHRINS PIROXICAM PIROXICAM PNEUMOCOCCAL 13 CONJUGATE VACC PNEUMOCOCCAL 23 VAL PSAC VACC PODOPHYLLUM RESIN POLIOMYELITIS VAC,KILLED POLYCITRA-K ORAL SOLUTION POLYETHYLENE GLYCOL 3350 POLYETHYLENE GLYCOL 3350 POLYMYXIN B POLYMYXIN B SULFATE/TMP PORACTANT ALFA POSACONAZOLE POTASS CIT/SOD CIT/CITRIC AC POTASSIUM ACETATE POTASSIUM CHL BAG POTASSIUM CHLORIDE Brand Name PILOCARPINE 4% PILOPINE HS 4% ELIDEL 1% ORAP ORAP VISKEN (EQUIV) VISKEN (EQUIV) VISKEN (EQUIV) HALFTAB ACTOS ACTOS ZOSYN ZOSYN ZOSYN 4.5GM/ 100ML D5W ZOSYN (EQUIV) ZOSYN* PIPERACILLIN ZOSYN 0.75GM IN 50ML D5W ZOSYN 2.25GM IN 50ML D5W ZOSYN 3.375GM IN 50ML D5W RID (EQUIV) PYRINYL SHAMPOO (EQUIV) FELDENE (EQUIV) FELDENE (EQUIV) PREVNAR 13 PNEUMOVAX 23 PODOCON-25 IPOL POLYCITRA-K ORAL SOLUTION MIRALAX MIRALAX POLYMYXIN B POLYTRIM (EQUIV) CUROSURF NOXAFIL TRICITRATES POTASSIUM ACETATE POTASSIUM CHL BAG KLOR-CON Drug Strength 1 DRP 1 APP 1 APP 1 MG 2 MG 10 MG 5 MG 2.5 MG 15 MG 30 MG 2.25 GM 3.375 GM 4.5 GM 4.5 GM 1 GM 2 GM 0.75 GM 2.25 GM 3.375 GM 1 APP 1 APP 10 MG 20 MG 0.5 ML 25 MCG 1 APP 0.5 ML 1 ML 17 GM 17 GM 500000 1 DRP 240 MG 200 MG 30 ML 40 MEQ 20 MEQ 20 MEQ Drug Volume 1 DRP 1 APP 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 VIAL 100 ML 1 VIAL 5 ML 1 VIAL 50 ML 50 ML 50 ML 1 APP 1 APP 1 CAP 1 CAP 0.5 ML 0.5 ML 1 APP 0.5 ML 1 ML 17 GM 1 PACKET 1 VIAL 1 DRP 3 ML 5 ML 30 ML 20 ML 50 ML 1 PACKET Package Desc 15 ML BOTTLE 4 GM PACKAGE 30 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 100 ML BAG 1 VIAL PACKAGE 1 GM PACKAGE 1 VIAL PACKAGE 50 ML BAG 50 ML BAG 50 ML BAG 60 ML BOTTLE 120 ML BOTTLE 1 CAP PACKAGE 1 CAP PACKAGE 0.5 ML SYRINGE 0.5 ML VIAL 15 ML BOTTLE 0.5 ML BOTTLE ML ORAL SYRINGE 238 GM BOTTLE 1 PACKET PACKAGE 1 VIAL PACKAGE 10 ML BOTTLE 3 ML BOTTLE 105 ML BOTTLE ML ORAL SYRINGE 20 ML VIAL 50 ML BOTTLE 1 PACKET PACKAGE Dosage Form DROPS GEL CREAM TAB TAB TAB TAB TAB TAB TAB VIAL VIAL PB VIAL VIAL INJ PB PB PB SHAMPO SHAMPO CAP CAP SYR VIAL LIQUID VIAL SOLN POWDER PACKET VIAL DROPS VIAL SUSP SOLN VIAL INJ PACKET Route EYE EYE TOP PO PO PO PO PO PO PO IV IV IV IV IV IV IV IV IV TOP TOP PO PO IM IM TOP SC PO PO PO INJ EYE INJ PO PO IV IV PO Formulary Status? F NF NF NF NF F F F F F F F F F F NF F F F F F F F F F F F F F F F NF F NF F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1678 3364 815 2090 2091 1285 992 3362 2299 2980 1137 1139 4235 1141 1142 2899 4277 4051 4052 2316 1385 1876 1877 4058 156 2544 1722 2444 3388 2824 2030 304 2641 3221 3905 764 1255 3024 AHFS Code 52:40.20 52:40.20 84:92.00 28:16.08 28:16.08 24:24.00 24:24.00 24:24.00 68:20.28 68:20.28 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 08:12.16 84:04.12 84:04.12 28:08.04 28:08.04 80:12.00 80:12.00 84:92.00 80:12.00 40:08.00 56:12.00 56:12.00 08:12.28 52:04.04 48:36.00 08:14.08 40:08.00 40:12.00 40:12.00 40:12.00 Generic Name POTASSIUM CHLORIDE POTASSIUM CHLORIDE SR POTASSIUM CHLORIDE SR POTASSIUM CHLORIDE* POTASSIUM CHLORIDE/SW POTASSIUM CHLORIDE/SW POTASSIUM CHLORIDE/SW POTASSIUM HYDROXIDE 10% POTASSIUM IODIDE POTASSIUM PHOSPHATE POTASSIUM PHOSPHATE POVIDONE-IODINE POVIDONE-IODINE 10% 473 ML POVIDONE-IODINE 5% POVIDONE-IODINE SCRUB 7.5% PRALATREXATE PRALIDOXIME CHLORIDE PRAMIPEXOLE PRAMIPEXOLE PRAMIPEXOLE HALFTAB PRAMOXINE HCL PRASUGREL HYDROCHLORIDE PRAVASTATIN PRAVASTATIN PRAZIQUANTEL PRAZOSIN HCL PRAZOSIN HCL PRAZOSIN HCL PREDNISOLONE PREDNISOLONE ACETATE 0.12% OPH PREDNISOLONE ACETATE 1% PREDNISOLONE SYRUP PREDNISONE PREDNISONE PREDNISONE PREDNISONE PREDNISONE PREDNISONE Brand Name POTASSIUM CHLORIDE POTASSIUM CHLORIDE SR POTASSIUM CHLORIDE SR POTASSIUM CHLORIDE* POTASSIUM CHLORIDE/SW POTASSIUM CHLORIDE/SW POTASSIUM CHLORIDE/SW POTASSIUM HYDROXIDE 10% SSKI POTASSIUM PHOSPHATE POTASSIUM PHOSPHATE (EQUIV) BETADINE BETADINE 10% (EQUIV) BETADINE BETADINE SCRUB 7.5% FOLOTYN PROTOPAM MIRAPEX MIRAPEX MIRAPEX HALFTAB SARNA SENSITIVE EFFIENT PRAVACHOL PRAVACHOL BILTRICIDE PRAZOSIN PRAZOSIN HCL MINIPRES (EQUIV) PEDIAPRED PRED MILD 0.12% OPH SUSP PREDNISOLONE ACETATE 1% PRELONE SYRUP PREDNISONE PREDNISONE DELTASONE PREDNISONE PREDNISONE PREDNISONE Drug Strength 40 MEQ 10 MEQ 20 MEQ 500 MEQ 10 MEQ 20 MEQ 40 MEQ 1 ML 1 GM 15 MM 45 MM 1 EA 1 APP 1 DRP 1 APP 20 MG 1 GM 0.25 MG 1 MG 0.125 MG 1 APP 10 MG 10 MG 20 MG 600 MG 1 MG 2 MG 5 MG 1 MG 1 DRP 1 DRP 3 MG 1 MG 10 MG 2.5 MG 20 MG 5 MG 50 MG Drug Volume 20 ML 1 CAP SR 1 TAB SR 250 ML 100 ML 100 ML 100 ML 1 ML 1 ML 5 ML 15 ML 1 EA 1 APP 1 DRP 1 APP 1 ML 1 VIAL 1 TAB 1 TAB 1 TAB 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 CAP 1 CAP 1 ML 1 DRP 1 DRP 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB Package Desc 20 ML VIAL 1 CAP SR PACKAGE 1 TAB SR PACKAGE 250 ML BAG 100 ML BAG 100 ML BAG 100 ML BAG ML ORAL SYRINGE ML ORAL SYRINGE 5 ML VIAL 15 ML VIAL 1 EA PACKAGE 473 ML BOTTLE 30 ML BOTTLE 473 ML BOTTLE 1 ML PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 222 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 5 ML BOTTLE 5 ML BOTTLE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE Dosage Form VIAL CAP SR TAB SR PREMIX PREMIX PREMIX PREMIX SOLN SOLN VIAL VIAL SWAB SOLN DROPS SOLN INJ VIAL TAB TAB TAB LOTION TAB TAB TAB TAB CAP CAP CAP SOLN DROPS DROPS SYRUP TAB TAB TAB TAB TAB TAB Route IV PO PO IV IV IV IV MSC PO IV IV TOP TOP EYE TOP IV INJ PO PO PO TOP PO PO PO PO PO PO PO PO EYE EYE PO PO PO PO PO PO PO Formulary Status? F F F F F F F F F F F F F F F F F F NF NF NF F NF NF F NF NF NF F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 747 1587 2098 650 1259 1258 1256 2447 1148 758 757 2809 378 3199 379 4011 405 210 211 3977 3335 3970 2448 60 2528 2567 3909 1862 2545 3521 2542 893 524 521 215 522 1055 523 AHFS Code 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 84:28.00 68:36.08 40:12.00 40:12.00 84:04.92 84:04.92 52:04.92 84:04.92 10:00.00 92:12.00 28:36.20 28:36.20 28:36.20 84:08.00 20:12.18 24:06.08 24:06.08 08:08.00 24:20.00 24:20.00 24:20.00 68:04.00 52:08.08 52:08.08 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 68:04.00 Generic Name PREDNISONE HALFTAB PREGABALIN PREGABALIN PRENATAL VIT/FE FUMARATE/FA PRIMIDONE PRIMIDONE PRIMIDONE HALFTAB PROBENECID PROCAINAMIDE PROCAINAMIDE PROCAINE 10% PROCARBAZINE PROCHLORPERAZINE PROCHLORPERAZINE PROCHLORPERAZINE PROCHLORPERAZINE PROCYCLIDINE PROGESTERONE IN OIL PROGESTERONE,MICRONIZED PROGESTERONE,MICRONIZED PROMETHAZINE PROMETHAZINE PROMETHAZINE PROMETHAZINE PROMETHAZINE PROMETHAZINE PROMETHAZINE HCL HALFTAB PROMETHAZINE SYR PROPAFENONE PROPAFENONE PROPAFENONE HALFTAB PROPANTHELINE BROMIDE PROPANTHELINE HALFTAB PROPARACAINE 0.5% PROPOFOL 1000MG/100ML PROPOFOL 200MG/20ML PROPOFOL 500MG/50ML PROPRANOLOL Brand Name PREDNISONE HALFTAB LYRICA LYRICA VINATAL FORTE MYSOLINE (EQUIV) MYSOLINE PRIMIDONE HALFTAB PROBENECID PROCAN (EQUIV) PROCAN (EQUIV) NOVOCAIN 10% MATULANE COMPAZINE (EQUIV) COMPAZINE (EQUIV) COMPAZINE (EQUIV) COMPAZINE (EQUIV) KEMADRIN PROGESTERONE IN OIL PROCHIEVE VAGINAL GEL PROMETRIUM PHENERGAN (EQUIV) PHENERGAN (EQUIV) PHENERGAN (EQUIV) PHENERGAN (EQUIV) PHENERGAN (EQUIV) PHENERGAN (EQUIV) PROMETHAZINE HCL HALFTAB PHENERGAN SYR (EQUIV) RYTHMOL RYTHMOL RYTHMOL HALFTAB PROBANTHINE PRO-BANTHINE HALFTAB ALACAINE 0.5% (EQUIV) DIPRIVAN 1000MG/100ML DIPRIVAN 200MG/20ML DIPRIVAN 500MG/50ML INDERAL (EQUIV) Drug Strength 25 MG 25 MG 50 MG 1 TAB 250 MG 50 MG 25 MG 500 MG 1000 MG 500 MG 100 MG 50 MG 10 MG 10 MG 25 MG 5 MG 5 MG 50 MG 1 APP 100 MG 12.5 MG 25 MG 25 MG 25 MG 50 MG 50 MG 12.5 MG 25 MG 150 MG 300 MG 75 MG 15 MG 7.5 MG 1 DRP 1000 MG 200 MG 500 MG 1 MG Drug Volume 1 TAB 1 CAP 1 CAP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 10 ML 1 ML 1 ML 1 CAP 1 TAB 2 ML 1 SUPP 1 TAB 1 TAB 1 ML 1 APP 1 CAP 1 SUPP 1 ML 1 SUPP 1 TAB 1 SUPP 1 ML 1 TAB 20 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 DRP 100 ML 20 ML 50 ML 1 ML Package Desc 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML VIAL 2 ML VIAL 2 ML AMPUL 1 CAP PACKAGE 1 TAB PACKAGE 2 ML VIAL 1 SUPP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML VIAL 1.45 GM PACKAGE 1 CAP PACKAGE 1 SUPP PACKAGE 1 ML AMPUL 1 SUPP PACKAGE 1 TAB PACKAGE 1 SUPP PACKAGE 1 ML AMPUL 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 15 ML BOTTLE 100 ML VIAL 20 ML VIAL 50 ML VIAL 1 ML AMPUL Dosage Form TAB CAP CAP TAB TAB TAB TAB TAB VIAL VIAL INJ CAP TAB VIAL SUPP TAB TAB VIAL GEL CAP SUPP INJ SUPP TAB SUPP INJ TAB SYRUP TAB TAB TAB TAB TAB DROPS VIAL VIAL VIAL INJ Route PO PO PO PO PO PO PO PO INJ INJ INJ PO PO INJ PR PO PO IM VAG PO PR INJ PR PO PR IM PO PO PO PO PO PO PO EYE IV IV IV IV Formulary Status? F F F F F F F F F F F F F F F F F NF NF NF F F F F F F F F F F F F F F F F F F Controlled Substance? NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 05 05 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3512 3125 3119 100 1472 2138 4133 986 660 661 657 2007 1839 1503 1536 2729 2198 1282 4117 368 192 1513 187 183 1535 1514 3341 2172 390 391 3908 488 1998 2182 1187 1188 1189 419 AHFS Code 68:04.00 28:12.92 28:12.92 88:28.00 28:12.04 28:12.04 28:12.04 40:40.00 24:04.04 24:04.04 72:00.00 10:00.00 56:22.08 56:22.08 56:22.08 56:22.08 28:36.08 68:32.00 68:32.00 68:32.00 04:04.12 04:04.12 04:04.12 04:04.12 04:04.12 04:04.12 04:04.12 04:04.12 24:04.04 24:04.04 24:04.04 12:08.08 12:08.08 52:16.00 28:04.92 28:04.92 28:04.92 24:24.00 Generic Name PROPRANOLOL PROPRANOLOL PROPRANOLOL PROPRANOLOL PROPRANOLOL HALFTAB PROPRANOLOL HCL PROPRANOLOL LA PROPRANOLOL QUARTER-TAB PROPRANOLOL SOLUTION PROPYLTHIOURACIL PROPYLTHIOURACIL HALFTAB PROTAMINE PROTAMINE PROTAMINE 50MG/50 ML D5W PROTEINASE ALPHA-1-INHIBITOR PSEUDOEPHEDRINE PSEUDOEPHEDRINE PSEUDOEPHEDRINE SYRUP PSUEDOEPHIDRINE-TRIPROLIDINE PSYLLIUM PYRAZINAMIDE PYRAZINAMIDE HALFTAB PYRIDOSTIGMINE PYRIDOSTIGMINE PYRIDOSTIGMINE HALFTAB PYRIDOSTIGMINE SR PYRIDOSTIGMINE SR HALFTAB PYRIDOSTIGMINE SYRUP PYRIDOXINE PYRIDOXINE PYRIDOXINE HCL PYRIDOXINE HCL PYRIMETHAMINE PYXIS CEFOTETAN* PYXIS CEFUROXIME* PYXIS CEPHALEXIN* PYXIS LACTATED RINGERS* QUETIAPINE Brand Name INDERAL (EQUIV) INDERAL (EQUIV) INDERAL (EQIUV) INDERAL (EQUIV) INDERAL (EQUIV) HALFTAB INDERAL LA (EQUIV) INDERAL LA INDERAL (EQUIV) QUARTER-TAB INDERAL SOLUTION (EQUIV) PROPYLTHIOURACIL PROPYLTHIOURACIL HALFTAB PROTAMINE PROTAMINE PROTAMINE 50MG/50 ML D5W PROLASTIN SUDAFED (EQUIV) SUDAFED (EQUIV) SUDAFED (EQUIV) ACTIFED (EQUIV) METAMUCIL PYRAZINAMIDE PYRAZINAMIDE HALFTAB REGONOL MESTINON (EQUIV) MESTINON (EQUIV) HALFTAB MESTINON (EQUIV) MESTINON (EQUIV) HALFTAB MESTINON SYRUP VITAMIN B6 VITAMIN B-6 VITAMIN B-6 PYRIDOXINE HCL DARAPRIM PYXIS CEFOTAN* PYXIS KEFUROX* PYXIS CEPHALEXIN* PYXIS LACTATED RINGERS* SEROQUEL Drug Strength 10 MG 20 MG 40 MG 80 MG 5 MG 60 MG 80 MG 2.5 MG 20 MG 50 MG 25 MG 250 MG 50 MG 50 MG 10 MG 30 MG 60 MG 30 MG 1 TAB 1 PKT 500 MG 250 MG 10 MG 60 MG 30 MG 180 MG 90 MG 60 MG 25 MG 50 MG 100 MG 100 MG 25 MG 1 GM 750 MG 250 MG 1000 ML 100 MG Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP SA 1 CAP SR 1 TAB 5 ML 1 TAB 1 TAB 25 ML 5 ML 50 ML 1 UNT 1 TAB 1 TAB 5 ML 1 TAB 1 PKT 1 TAB 1 TAB 2 ML 1 TAB 1 TAB 1 TAB SR 1 TAB SR 5 ML 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 VIAL 1 VIAL 1 CAP 1000 ML 1 TAB Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP SA PACKAGE 1 CAP SR PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 25 ML VIAL 5 ML VIAL 50 ML BAG 1 UNT PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 PKT PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 2 ML AMPULE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML VIAL 1 TAB PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1000 ML BAG 1 TAB PACKAGE Dosage Form TAB TAB TAB TAB TAB CAP SA CAP SR TAB SOLN TAB TAB VIAL VIAL PB VIAL TAB TAB SYRUP TAB PACKET TAB TAB INJ TAB TAB TAB SR TAB SR SYRUP TAB TAB TAB VIAL TAB VIAL VIAL CAP SOLN TAB Route PO PO PO PO PO PO PO PO PO PO PO IV IV IV IV PO PO PO PO PO PO PO INJ PO PO PO PO PO PO PO PO INJ PO INJ INJ PO IRR PO Formulary Status? F F F F F NF NF F F F F F F F NF F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1078 1809 1079 1080 2770 4088 406 4112 483 99 2771 2253 2252 4239 3191 489 490 1384 2451 1688 1875 2772 455 1471 2773 1130 3950 1129 2452 1052 3419 2248 1001 2880 25 2871 1236 1182 AHFS Code 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 24:24.00 68:36.08 68:36.08 20:28.08 20:28.08 20:28.08 48:92.00 12:12.12 12:12.12 12:12.12 04:04.20 56:12.00 08:16.04 08:16.04 12:04.00 12:04.00 12:04.00 12:04.00 12:04.00 12:04.00 88:08.00 88:08.00 88:08.00 88:08.00 08:30.08 08:12.07 08:12.06 08:12.06 40:36.00 28:16.08 Generic Name QUETIAPINE QUETIAPINE QUETIAPINE QUETIAPINE QUETIAPINE HALFTAB QUETIAPINE QUARTERTAB QUINAPRIL HCL QUINAPRIL HCL QUINAPRIL HCL QUINAPRIL HCL HALFTAB QUINIDINE GLUCONATE QUINIDINE GLUCONATE SR QUINIDINE SULFATE QUININE SULFATE QUINUPRISTIN/DALFOPRISTIN RABIES IMMUNE GLOBULIN RABIES IMMUNE GLOBULIN 10ML RABIES VACCINE,HUMAN DIPLOID RABIES VACCINE,HUMAN PRE/POST RABIES VACCINE,PRE/POST RALOXIFENE RALTEGRAVIR RAMELTEON RAMIPRIL RAMIPRIL RAMIPRIL RANITIDINE RANITIDINE RANITIDINE RANITIDINE D10W NEO 1MG/ML RANITIDINE HALFTAB RANITIDINE HCL RANITIDINE ORAL SYR *NEO* RANITIDINE SYR RANITIDINE* RANOLAZINE SR RASAGILINE MESYLATE RASBURICASE Brand Name SEROQUEL SEROQUEL SEROQUEL SEROQUEL SEROQUEL HALFTAB SEROQUEL QUARTERTAB QUINAPRIL HCL ACCUPRIL ACCUPRIL ACCUPRIL (EQUIV) HALFTAB QUINIDINE GLUCONATE QUINIDINE GLUCONATE QUINIDINE SULFATE QUALAQUIN SYNERCID IMOGAM RABIES-HT IMOGAM RABIES-HT 150U/ML 10ML IMOVAX RABIES I.D. IMOVAX RABIES VACCINE RABAVERT VACCINE PRE/POST EVISTA ISENTRESS ROZEREM ALTACE ALTACE ALTACE ZANTAC (EQUIV) ZANTAC (EQUIV) ZANTAC (EQUIV) RANITIDINE D10W NEO 1MG/ML ZANTAC (EQUIV) HALFTAB ZANTAC ZANTAC (EQUIV) ORAL SYR *NEO* ZANTAC (EQUIV) SYR ZANTAC (EQUIV)* RANEXA SR AZILECT ELITEK Drug Strength 200 MG 25 MG 300 MG 50 MG 12.5 MG 6.25 MG 10 MG 20 MG 40 MG 5 MG 80 MG 324 MG 300 MG 5 GRAINS 500 MG 300 UNT 150 UNT 0.25 UNT 2.5 UNIT 2.5 UNT 60 MG 400 MG 8 MG 1.25 MG 2.5 MG 5 MG 150 MG 150 MG 50 MG 1 MG 75 MG 25 MG 7.5 MG 15 MG 25 MG 500 MG 0.5 MG 7.5 MG Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB SR 1 TAB 1 CAP 1 VIAL 2 ML 1 ML 1 SYR 1 VIAL 1 VIAL 1 TAB 1 TAB 1 TAB 1 CAP 1 CAP 1 CAP 10 ML 1 TAB 2 ML 1 ML 1 TAB 1 ML 0.5 ML 1 ML 1 ML 1 TAB 1 TAB 1 VIAL Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML VIAL 1 TAB SR PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 2 ML VIAL 10 ML VIAL 1 SYR PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB TAB 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 10 ML UD-CUP 1 TAB PACKAGE 2 ML VIAL 1 ML PACKAGE 1 TAB PACKAGE 6 ML VIAL 0.5 ML ORAL ML ORAL SYRINGE 40 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE Dosage Form TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB VIAL TAB SR TAB CAP VIAL VIAL VIAL SYRINGE VIAL VIAL TAB TAB TAB CAP CAP CAP SYRUP TAB VIAL SOLN TAB VIAL SYRUP SYRUP VIAL TAB SR TAB VIAL Route PO PO PO PO PO PO PO PO PO PO INJ PO PO PO IV IM IM ID IM IM PO PO PO PO PO PO PO PO INJ IV PO INJ PO PO INJ PO PO IV Formulary Status? F F F F F F NF NF NF NF F F F F NF F F F F F NF NF NF NF NF NF F NF NF F NF NF F F NF F NF NF Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1183 1185 1184 3141 2792 4146 3336 603 604 602 2 1780 1476 3446 782 1712 1711 2568 3343 1714 17 3383 3091 3192 2202 2203 1774 1564 1008 2721 2774 3995 4120 1011 1009 3181 3271 3482 AHFS Code 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 24:32.04 24:32.04 24:32.04 24:32.04 24:04.04 24:04.04 24:04.04 08:30.08 08:12.28 80:04.00 80:04.00 80:12.00 80:12.00 80:12.00 68:16.12 08:18.08 28:24.92 24:32.04 24:32.04 24:32.04 56:28.12 56:28.12 56:28.12 56:28.12 56:28.12 56:28.12 56:28.12 56:28.12 56:28.12 24:04.92 28:36.32 44:00.00 Generic Name REGADENOSON REMIFENTANIL REMIFENTANIL RENALCAL DIETARY SUPPLEMENT* REPAGLINIDE REPAGLINIDE REPAGLINIDE HALFTAB RESERPINE RESERPINE RESOURCE BENEPROTEIN RETEPLASE RHO(D) IMMUNE GLOBULIN RHO(D) IMMUNE GLOBULIN RHO(D) IMMUNE GLOBULIN RIBAVIRIN RIBOFLAVIN RIBOFLAVIN RIFABUTIN RIFAMPIN RIFAMPIN RIFAMPIN RIFAMPIN 600MG/500ML NS RIFAMPIN SUSPENSION RIFAXIMIN RIFAXIMIN RILUZOLE RIMEXOLONE 1% RISEDRONATE RISEDRONATE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE RISPERIDONE Brand Name LEXISCAN ULTIVA ULTIVA RENALCAL DIETARY SUPPLEMENT PRANDIN PRANDIN PRANDIN HALFTAB RESERPINE RESERPINE RESOURCE BENEPROTEIN RETAVASE WINRHO SDF (EQUIV) RHOGAM (EQUIV) WINRHO SDF (EQUIV) REBETOL (EQUIV) RIBOFLAVIN RIBOFLAVIN MYCOBUTIN RIFAMPIN RIFAMPIN RIFAMPIN RIFAMPIN 600MG/500ML NS RIFAMPIN SUSPENSION XIFAXAN XIFAXAN RILUTEK VEXOL 1% ACTONEL ACTONEL RISPERDAL RISPERDAL RISPERIDONE RISPERDAL RISPERDAL CONSTA RISPERDAL RISPERDAL CONSTA RISPERDAL RISPERDAL CONSTA Drug Strength 0.4 MG 1 MG 2 MG 1 EA 1 MG 2 MG 0.5 MG 0.1 MG 0.25 MG 1 PKT 1 KIT 1500 UNT 300 MCG 5000 UNT 200 MG 100 MG 25 MG 150 MG 150 MG 300 MG 600 MG 600 MG 10 MG 200 MG 550 MG 50 MG 5 ML 30 MG 5 MG 0.25 MG 0.5 MG 1 MG 1 MG 12.5 MG 2 MG 25 MG 3 MG 37.5 MG Drug Volume 5 ML 1 VIAL 1 VIAL 1 EA 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 PKT 1 KIT 1 VIAL 1 SYR 1 VIAL 1 CAP 1 TAB 1 TAB 1 CAP 1 CAP 1 CAP 1 VIAL 500 ML 1 ML 1 TAB 1 TAB 1 TAB 5 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 SYRINGE 1 TAB 2 ML 1 TAB 2 ML Package Desc 5 ML SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 PKT PACKAGE 1 KIT PACKAGE 1 VIAL PACKAGE 1 SYR SYRINGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 500 ML BAG ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML ORAL SYRINGE 1 TAB PACKAGE 1 SYRINGE SYRINGE 1 TAB PACKAGE 2 ML SYRINGE 1 TAB PACKAGE 2 ML SYRINGE Dosage Form SYRINGE VIAL VIAL LIQUID TAB TAB TAB TAB TAB POWDER KIT VIAL SYRINGE VIAL CAP TAB TAB CAP CAP CAP VIAL PB SUSP TAB TAB TAB DROPS TAB TAB TAB TAB SOLN TAB SYRINGE TAB SYRINGE TAB SYRINGE Route IV IV IV PO PO PO PO PO PO PO IV INJ IM INJ PO PO PO PO PO PO IV IV PO PO PO PO EYE PO PO PO PO PO PO IM PO INJ PO INJ Formulary Status? F F F F NF F NF F F F F F F F F NF F F F F F F F NF NF NF F F F F F F F F F F F F Controlled Substance? NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 4018 711 712 2483 2606 981 3980 1090 1092 3106 2093 2175 1448 2176 847 4162 2484 271 1093 1914 2020 4238 2485 3272 4128 780 2529 933 934 3463 1766 3943 2569 3319 1768 2681 1769 2907 AHFS Code 36:18.00 28:08.08 28:08.08 40:20.00 68:20.16 68:20.16 68:20.16 24:08.32 24:08.32 40:20.00 20:12.20 80:04.00 80:04.00 80:04.00 08:18.32 88:08.00 88:08.00 08:16.04 08:16.04 08:16.04 08:16.04 08:16.04 08:16.04 08:12.28 08:12.28 28:92.00 52:08.08 92:24.00 92:24.00 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 Generic Name RISPERIDONE RISPERIDONE HALFTAB RISPERIDONE ODT RISPERIDONE ODT RISPERIDONE ODT RITONAVIR RITONAVIR RITONAVIR/LOPINAVIR 80/20 RITUXIMAB RITUXIMAB RIVAROXABAN RIVASTIGMINE RIVASTIGMINE 4.6 MG/DAY RIVASTIGMINE 9.5 MG/DAY RIVASTIGMINE ORAL SOLN RIVASTIGMINE TARTRATE RIZATRIPTAN MLT RIZATRIPTAN ODT ROCURONIUM ROFLUMILAST ROMIPLOSTIM ROPINIROLE ROPINIROLE ROPINIROLE ROPINIROLE ROPINIROLE ROPIVACAINE 0.2%/NS 250ML SOL ROPIVACAINE 0.5% 20ML AMP ROPIVACAINE 0.5% 20ML AMP* ROPIVACAINE 0.75% HCL ROSE BENGAL STRIP ROSIGLITAZONE ROSIGLITAZONE ROSUVASTATIN CALCIUM ROSUVASTATIN CALCIUM HALFTAB SACCHAROMYCES BOULARDII SALICYLIC ACID/COAL TAR/SULFUR SALICYLIC ACID/SULFUR Brand Name RISPERDAL CONSTA RISPERDAL HALFTAB RISPERDAL ODT RISPERDAL ODT RISPERDAL ODT NORVIR NORVIR KALETRA 80/20 RITUXAN RITUXAN XARELTO 10MG EXELON EXELON 4.6 MG/DAY EXELON 9.5 MG/DAY EXELON ORAL SOLN EXELON MAXALT MLT MAXALT MLT ZEMURON DALIRESP NPLATE REQUIP (EQUIV) REQUIP (EQUIV) REQUIP (EQUIV) REQUIP (EQUIV) REQUIP (EQUIV) ROPIVACAINE 0.2%/NS 250ML SOL NAROPIN NAROPIN* NAROPIN ROSE BENGAL STRIP AVANDIA AVANDIA CRESTOR CRESTOR HALFTAB FLORASTOR SEBUTONE SHAMPOO 200ML SEBEX Drug Strength 50 MG 0.125 MG 0.5 MG 1 MG 2 MG 100 MG 80 MG 1 ML 100 MG 500 MG 10 MG 1.5 MG 1 EA 1 EA 2 MG 3 MG 5 MG 10 MG 50 MG 500 MCG 250 MCG 0.25 MG 0.5 MG 1 MG 2 MG 4 MG 250 ML 5 MG 5 MG 150 MG 1 EA 2 MG 4 MG 10 MG 5 MG 250 MG 1 APP 1 APP Drug Volume 2 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 ML 1 ML 10 ML 50 ML 1 TAB 1 CAP 1 EA 1 EA 1 ML 1 CAP 1 TAB LN 1 ODT 5 ML 1 TAB 0.5 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 250 ML 1 ML 1 ML 20 ML 1 EA 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 APP 1 APP Package Desc 2 ML SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE 10 ML VIAL 50 ML VIAL 1 TAB PACKAGE 1 CAP PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 ML ORAL SYRINGE 1 CAP PACKAGE 1 TAB LN PACKAGE 1 ODT PACKAGE 5 ML VIAL 1 TAB PACKAGE 250 MCG VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 250 ML BAG 20 ML AMP 20 ML AMP 20 ML BOTTLE 1 EA PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 200 ML BOTTLE 120 ML BOTTLE Dosage Form SYRINGE TAB TAB TAB TAB CAP SOLN SOLN VIAL VIAL TAB CAP PATCH PATCH SOLN CAP TAB LN ODT VIAL TAB VIAL TAB TAB TAB TAB TAB PREMIX INJ INJ INJ STRIP TAB TAB TAB TAB CAP SHAMPO SHAMPO Route INJ PO PO PO PO PO PO PO IV IV PO PO TD TD PO PO PO PO INJ PO SC PO PO PO PO PO RNB INJ INJ INJ MSC PO PO PO PO PO TOP TOP Formulary Status? F F F F F F F NF F F F F NF NF NF F NF NF F NF NF F F F F F F F F NF F F F NF NF NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2906 3525 2657 2658 2900 744 2570 695 1742 1743 4183 802 4207 4086 3504 803 143 4007 454 4263 3486 172 3907 3112 173 3506 4031 2964 3212 2705 2487 349 350 2666 3490 3301 616 1432 AHFS Code 28:16.08 28:16.08 28:16.08 28:16.08 28:16.08 08:18.08 08:18.08 08:18.08 10:00.00 10:00.00 20:12.04 12:04.00 12:04.00 12:04.00 12:04.00 12:04.00 28:32.28 28:32.28 12:20.20 48:32.00 92:92.00 28:36.20 28:36.20 28:36.20 28:36.20 28:36.20 72:00.00 72:00.00 72:00.00 72:00.00 36:58.00 68:20.28 68:20.28 24:06.08 24:06.08 92:92.00 84:28.00 84:28.00 Generic Name SALICYLIC ACID/SULFUR SALIVA SUBSTITUTE SALMETEROL XINAFOATE INHALER SALSALATE SAQUINAVIR SARGRAMOSTIM SARGRAMOSTIM (GM-CSF) SCHIRMER TEAR TEST STRIP SCOPOLAMINE SCOPOLAMINE 0.25% SCOPOLAMINE 1.5MG PATCH SECOBARBITAL SECRETIN ACETATE SELEGILINE SELEGILINE HALFTAB SELEGILINE PATCH 12MG SELEGILINE PATCH 6MG SELEGILINE PATCH 9MG SELENIUM SELENIUM SULFIDE 1% 120ML SELENIUM SULFIDE 1% 210ML SELENIUM SULFIDE 2.5% SELENIUM* SENNOSIDES 8.6 MG SENNOSIDES 8.8 MG/5 ML SYR SENNOSIDES/DOCUSATE SODIUM SERTRALINE SERTRALINE SERTRALINE SERTRALINE CONC SERTRALINE HALFTAB SEVELAMER SEVELAMER SEVELAMER CARBONATE SEVELAMER HALFTAB SEVOFLURANE SILDENAFIL *NEO* SUSP SILDENAFIL CIT Brand Name SEBULEX SHAMPOO 200ML MOUTHKOTE SEREVENT DISKUS SALSALATE INVIRASE LEUKINE LEUKINE SCHIRMER TEAR TEST STRIP SCOPOLAMINE ISOPTO HYOSCINE 0.25% TRANSDERM-SCOP 1.5MG SECONAL SECREFLO ELDEPRYL (EQUIV) SELEGILINE HALFTAB EMSAM PATCH EMSAM PATCH EMSAM PATCH SELENIUM SELSUN BLUE SHAMPOO SELSUN BLUE SHAMPOO SELSUN 2.5% SELENIUM* SENNA 8.6 MG TAB SENNA 8.8 MG/5 ML SYR SENOKOT S (EQUIV) ZOLOFT ZOLOFT ZOLOFT ZOLOFT CONC ZOLOFT HALFTAB RENAGEL RENAGEL RENVELA RENAGEL HALFTAB ULTANE REVATIO *NEO* SUSP REVATIO Drug Strength 1 APP 1 SPRAY 50 MCG 500 MG 200 MG 50 MCG 250 MCG 1 EA 0.4 MG 1 DRP 1 PAT 100 MG 16 MCG 5 MG 2.5 MG 1 EA 1 EA 1 EA 50 MCG 1 APP 1 APP 1 APP 40 MCG 1 TAB 5 ML 1 TAB 100 MG 25 MG 50 MG 20 MG 12.5 MG 400 MG 800 MG 0.8 GM 200 MG 250 ML 2 MG 20 MG Drug Volume 1 APP 1 SPRAY 1 DISK 1 TAB 1 CAP 0.1 ML 1 VIAL 1 EA 1 ML 1 DRP 1 PAT 1 CAP 1 VIAL 1 TAB 1 TAB 1 EA 1 EA 1 EA 1 TAB 1 APP 1 APP 1 APP 1 ML 1 TAB 5 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 TAB 1 TAB 1 PKT 1 TAB 250 ML 1 ML 1 TAB Package Desc 200 ML BOTTLE 60 ML BOTTLE 28 DISK PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 0.1 ML BOTTLE 1 VIAL PACKAGE 1 EA PACKAGE 1 ML VIAL 5 ML BOTTLE 1 PATCH PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 PATCH PACKAGE 1 TAB PACKAGE 120 ML BOTTLE 210 ML BOTTLE 120 ML BOTTLE 10 ML VIAL 1 TAB PACKAGE 5 ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 PKT PACKAGE 1 TAB PACKAGE 250 ML BOTTLE ML ORAL SYRINGE 1 TAB PACKAGE Dosage Form SHAMPO SPRAY DISK TAB CAP VIAL VIAL STRIP VIAL DROPS PATCH CAP VIAL TAB TAB PATCH PATCH PATCH TAB SHAMPO SHAMPO SHAMPO VIAL TAB SYRUP TAB TAB TAB TAB SOLN TAB TAB TAB PACKET TAB LIQUID SUSP TAB Route TOP MM INH PO PO INJ INJ MSC INJ EYE TD PO INJ PO PO TD TD TD PO TOP TOP TOP IV PO PO PO PO PO PO PO PO PO PO PO PO INH PO PO Formulary Status? F F F NF F F F F F F F F NF F F NF NF NF NF F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 615 3454 2643 3297 74 3195 2109 2488 2257 1620 572 2489 2706 1733 4324 3200 3206 3520 2914 739 740 2167 1424 2293 1600 2622 441 2777 440 442 2776 2697 2952 4329 3933 710 3509 3062 AHFS Code 84:28.00 40:12.00 12:12.08 28:08.04 08:18.08 20:16.00 20:16.00 94:00.00 12:08.08 52:24.00 56:22.92 28:24.04 36:61.00 28:36.32 28:36.32 28:36.32 28:36.32 28:36.32 40:12.00 84:04.92 84:04.92 84:04.92 40:12.00 56:12.00 56:12.00 56:12.00 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 40:18.19 40:18.19 40:18.19 40:18.19 28:04.16 24:12.12 24:12.12 Generic Name SILDENAFIL CITRATE SILDENAFIL CITRATE HALFTAB SILVER NITRATE SILVER SULFADIAZINE 1% SILVER SULFADIAZINE 1% SIMETHICONE SIMETHICONE DROPS SIMETHICONE HALFTAB SIMPLE SYRUP CHERRY FLAVOR* SIMPLE SYRUP* SIMVASTATIN SIMVASTATIN SIMVASTATIN SIMVASTATIN SINCALIDE SIROLIMUS SITAGLIPTIN PHOSPHATE SITAGLIPTIN PHOSPHATE SMZ/TMP 200MG/40MG SMZ/TMP 200MG/40MG SMZ/TMP 400MG/80MG SMZ/TMP 800MG/160MG SMZ/TMP DS BULK* SOD CHLORIDE/LAN/MO/PET,WH SOD SULF/SOD/NAHCO3/KCL/PEG'S SOD THIOSULF/SOD NIT/AMYL NIT SODIUM ACETATE SODIUM ACETATE SODIUM ACETATE SODIUM BICARBONATE SODIUM BICARBONATE SODIUM BICARBONATE 5%* SODIUM BICARBONATE 8.4% SYR SODIUM BICARBONATE 8.4% SYR SODIUM BICARBONATE* SODIUM CHL 0.9% DILUENT USE* SODIUM CHLORIDE SODIUM CHLORIDE 0.45% Brand Name REVATIO REVATIO HALFTAB SILVER NITRATE APPLICATOR SILVADENE 1% THERMAZENE MYLICON (EQUIV) MYLICON (EQUIV) DROPS MYLICON (EQUIV) HALFTAB SIMPLE SYRUP CHERRY FLAVOR* SIMPLE SYRUP* ZOCOR (EQUIV) ZOCOR (EQUIV) ZOCOR (EQUIV) ZOCOR (EQUIV) KINEVAC RAPAMUNE JANUVIA JANUVIA BACTRIM SUSP 200MG/40MG(EQUIV) BACTRIM SUSP 200MG/40MG(EQUIV) BACTRIM 400MG/80MG (EQUIV) BACTRIM 800MG/160MG (EQUIV) BACTRIM DS (EQUIV) BULK* LUBRIDERM GOLYTELY (EQUIV) CYANIDE ANTIDOTE PACKAGE (EQ) SODIUM ACETATE SODIUM ACETATE SODIUM ACETATE SODIUM BICARBONATE SODIUM BICARBONATE SODIUM BICARBONATE 5%* SODIUM BICARBONATE 8.4% SYR SODIUM BICARBONATE 8.4% SYR SODIUM BICARBONATE* SODIUM CHL 0.9% DILUENT USE* SODIUM CHLORIDE SODIUM CHLORIDE 0.45% Drug Strength 10 MG 10 MG 1 EA 1 APP 1 APP 80 MG 20 MG 40 MG 1 ML 1 ML 10 MG 20 MG 40 MG 5 MG 5 MCG 1 MG 25 MG 50 MG 160 MG 40 MG 80 MG 160 MG 1 TAB 1 APP 4000 ML 1 KIT 100 MEQ 2 MEQ 40 MEQ 50 MEQ 650 MG 500 ML 10 ML 50 ML 50 MEQ 50 ML 1 GM 1000 ML Drug Volume 12.5 ML 1 TAB 1 EA 1 APP 1 APP 1 TAB 0.3 ML 1 TAB 1 ML 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 ML 1 TAB 1 TAB 20 ML 5 ML 5 ML 10 ML 1 TAB 1 APP 4000 ML 1 KIT 50 ML 1 ML 20 ML 50 ML 1 TAB 500 ML 10 ML 50 ML 50 ML 50 ML 1 TAB 1000 ML Package Desc 12.5 ML BOTTLE 1 TAB PACKAGE 1 EA PACKAGE 50 GM PACKAGE 400 GM PACKAGE 1 TAB CHW PACKAGE 30 ML ORAL SYRINGE 1 TAB CHW PACKAGE ML BOTTLE ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 20 ML UD CUP ML ORAL SYRINGE 5 ML VIAL 10 ML VIAL 1 TAB PACKAGE 180 ML BOTTLE 4000 ML BOTTLE 1 KIT PACKAGE 50 ML VIAL ML VIAL 20 ML VIAL 50 ML VIAL 1 TAB PACKAGE 500 ML BOTTLE 10 ML SYRINGE 50 ML SYRINGE 50 ML VIAL 50 ML VIAL 1 TAB PACKAGE 1000 ML BAG Dosage Form VIAL TAB EACH CREAM CREAM TAB CHW DROPS TAB CHW SYRUP SYRUP TAB TAB TAB TAB VIAL SOLN TAB TAB SUSP SUSP VIAL VIAL TAB LOTION SOL REC KIT VIAL VIAL VIAL VIAL TAB INJ SYRINGE SYRINGE VIAL VIAL TAB SOLN Route INJ PO TOP TOP TOP PO PO PO PO PO PO PO PO PO INJ PO PO PO PO IV IV PO TOP PO IV IV IV IV IV PO IV IV IV IV INJ PO IV Formulary Status? NF F F F F F F F F F NF NF NF NF F F F F F F F F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 4134 3989 1651 1732 1628 1088 1083 3353 1308 1307 120 121 2902 3906 1160 205 3268 3269 2859 1379 1530 1522 2860 3296 1963 1642 683 3404 1402 742 1524 1244 719 745 3372 2885 5 1216 AHFS Code 24:12.12 24:12.12 84:28.00 84:04.92 84:04.92 56:10.00 56:10.00 56:10.00 96:00.00 96:00.00 24:06.08 24:06.08 24:06.08 24:06.08 36:34.00 92:44.00 68:20.05 68:20.05 08:12.20 08:12.20 08:12.20 08:12.20 08:12.20 84:24.04 56:12.00 92:12.00 40:12.00 40:12.00 40:12.00 40:08.00 56:04.00 40:08.00 40:08.00 40:08.00 40:08.00 40:12.00 40:12.00 40:12.00 Generic Name SODIUM CHLORIDE 0.45% SODIUM CHLORIDE 0.65% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% FLUSH SYR SODIUM CHLORIDE 0.9% PF SODIUM CHLORIDE 0.9% SDV SODIUM CHLORIDE 0.9%(DILUENT)* SODIUM CHLORIDE 2% SODIUM CHLORIDE 3% SODIUM CHLORIDE 3% SODIUM CHLORIDE 5% SODIUM CHLORIDE CONC 23.4%* SODIUM CHLORIDE CONC 23.4%* SODIUM CHLORIDE HALFTAB SODIUM CITRATE UD SODIUM CL IRRIG SOLN 0.9% SODIUM CL IRRIG SOLN 0.9% SODIUM HYPOCHLORITE 0.125% SODIUM HYPOCHLORITE 0.25% SODIUM HYPOCHLORITE 0.5% SODIUM IODIDE 10% SODIUM MORRHUATE SODIUM PHOS/POT PHOS SODIUM PHOSPHATE SODIUM PHOSPHATE SODIUM POLYST SULF ORAL SODIUM POLYSTYRENE SULFONATE SODIUM THIOSULFATE 10% SODIUM/POTASSIUM/CAL/MAGNES* SODIUM/POTASSIUM/CAL/MAGNESIUM SORBITOL 3% IRRIGATION SOLN SORBITOL SOLUTION 70% Brand Name SODIUM CHLORIDE 0.45% SALINE MIST SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% SODIUM CHLORIDE 0.9% NORMAL SALINE FLUSH SYRINGE SODIUM CHLORIDE 0.9% PF SODIUM CHLORIDE 0.9% SDV SODIUM CHLORIDE 0.9%(DILUENT)* MURO-128 SODIUM CHLORIDE 3% SODIUM CHLORIDE 3% MURO-128 SODIUM CHLORIDE CONC 23.4%* SODIUM CHLORIDE CONC 23.4%* SODIUM CHLORIDE HALFTAB CITRA PH UD SODIUM CHLORIDE 0.9% IRRIG SODIUM CHLOR IRRIG SOLN 0.9% DAKIN'S QUARTER STR 0.125% DAKIN'S HALF STRENGTH 0.25% DAKIN'S FULL STRENGTH 0.5% IODOPEN 10# MORRHUATE SODIUM PHOS-NAK (NEUTRA-PHOS EQUIV) SODIUM PHOSPHATE (EQUIV) SODIUM PHOSPHATE KAYEXALATE (EQUIV) KAYEXALATE (EQUIV) SODIUM THIOSULFATE 10% BSS (EQUIV)* BSS (EQUIV) SORBITOL 3% IRRIGATION SOLN SORBITOL 70% Drug Strength 500 ML 1 SPR 100 ML 1000 ML 150 ML 250 ML 250 ML 50 ML 500 ML 1 SYRING 20 ML 10 ML 50 ML 1 DRP 15 ML 500 ML 1 APP 120 MEQ 4 MEQ 500 MG 30 ML 1000 ML 3000 ML 1 APP 1 APP 1 APP 1 EA 50 MG 1 PKT 15 MM 45 MM 1 GM 15 GM 10 ML 500 ML 1 DRP 1 EA 1 ML Drug Volume 500 ML 1 SPR 100 ML 1000 ML 150 ML 250 ML 250 ML 50 ML 500 ML 1 SYRING 20 ML 10 ML 50 ML 1 DRP 15 ML 500 ML 1 APP 30 ML 1 ML 1 TAB 30 ML 1000 ML 3000 ML 1 APP 1 APP 1 APP 1 EA 1 ML 1 PKT 5 ML 15 ML 4 ML 60 ML 10 ML 500 ML 1 DRP 1 EA 1 ML Package Desc 500 ML BAG 45 ML BOTTLE 100 ML BAG 1000 ML BAG 150 ML BAG 250 ML BAG 250 ML BOTTLE 50 ML BAG 500 ML BAG 10 ML SYRINGE 20 ML BOTTLE 10 ML VIAL 50 ML VIAL 15 ML BOTTLE 15 ML BOTTLE 500 ML BAG 3.5 GM PACKAGE 30 ML VIAL 250 ML BAG 1 TAB PACKAGE 30 ML UD CUP 1000 ML BAG 3000 ML BAG 473 ML BOTTLE 480 ML BOTTLE 480 ML BOTTLE 10 ML VIAL 1 ML BOTTLE 1 PKT PACKAGE 5 ML VIAL 15 ML VIAL ML BOTTLE 60 ML BOTTLE 10 ML VIAL 500 ML BOTTLE 15 ML BOTTLE 3000 ML BOTTLE ML ORAL SYRINGE Dosage Form SOLN SPRAY SOLN SOLN SOLN SOLN SOLN SOLN SOLN SYRINGE VIAL VIAL VIAL DROPS VIAL SOLN OINT VIAL VIAL TAB SOLN SOLN SOLN LIQUID LIQUID LIQUID VIAL VIAL PACKET VIAL VIAL SUSP SUSP VIAL SOLN SOLN IRRIG SOLN Route IV NAS IPB IV IPB IPB IPB IPB IV INJ INJ INJ INJ EYE INH IV EYE IV IV PO PO IRR IRR MSC MSC MSC INJ INJ PO IV IV PR PO IV EYE EYE IRR MSC Formulary Status? F F F F F F F F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1215 1705 1225 1223 1220 1221 1217 1224 1222 4042 2571 1408 717 1665 3279 1226 1668 1409 627 3948 2572 1219 1218 3945 3030 3031 2240 2656 3368 1411 2247 485 1710 1397 564 563 2904 2002 AHFS Code 40:12.00 52:92.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 40:12.00 52:92.00 40:12.00 40:12.00 52:92.00 40:12.00 40:12.00 40:12.00 56:04.00 40:36.00 40:36.00 38:00.00 38:00.00 38:00.00 68:36.08 24:16.00 40:12.00 40:12.00 40:12.00 40:18.18 40:18.18 92:12.00 52:92.00 52:92.00 40:36.00 56:12.00 Generic Name SORBITOL SOLUTION 70% 30 ML UD SORBITOL SOLUTION/SACCHARIN* SOTALOL SOTALOL HCL SOTALOL HCL HALFTAB SOTALOL HCL HALFTAB SPIRONOLACTONE SPIRONOLACTONE SPIRONOLACTONE HALFTAB STAVUDINE STAVUDINE STAVUDINE STREPTOMYCIN STREPTOZOCIN SUBDUE UNFLAVORED SUCCIMER SUCCINYLCHOLINE 100MG/5ML SYR SUCCINYLCHOLINE MDV SUCRALFATE SUCRALFATE SUSP SUCRALFATE SUSPENSION UD SUFENTANIL SUFENTANIL CITRATE SULFACETAMIDE 10% SULFACETAMIDE 10% TOPICAL SULFADIAZINE SULFAMETHOXAZOLE/TMP 400/80MG SULFASALAZINE SUMATRIPTAN SUMATRIPTAN SUMATRIPTAN SUMATRIPTAN NASAL TACROLIMUS TACROLIMUS TACROLIMUS TACROLIMUS ANHYDROUS TACROLIMUS SUSP TADALAFIL Brand Name SORBITOL 70% 30ML UD ORA-SWEET-SF (EQUIV)* BETAPACE SOTALOL BETAPACE (EQUIV) HALFTAB SOTALOL HALFTAB SPIRONOLACTONE ALDACTONE (EQUIV) ALDACTONE (EQUIV) HALFTAB ZERIT ZERIT ZERIT STREPTOMYCIN ZANOSAR STERILE POWDER SUBDUE UNFLAVORED CHEMET SUCCINYLCHOLINE 100MG/5ML SYR QUELICIN FLIPTOP MDV CARAFATE CARAFATE SUSP CARAFATE SUSPENSION UD SUFENTA (EQUIV) SUFENTA SULFACETAMIDE 10% KLARON 10% SULFADIAZINE BACTRIM SS 400MG/80MG (EQUIV) AZULFIDINE (EQUIV) IMITREX IMITREX IMITREX IMITREX NASAL PROGRAF PROGRAF PROGRAF PROGRAF PROGRAF SUSP ADCIRCA Drug Strength 1 EA 1 ML 80 MG 120 MG 40 MG 60 MG 100 MG 25 MG 12.5 MG 15 MG 20 MG 40 MG 1 GM 1 GM 1 EA 100 MG 100 MG 200 MG 1 GM 100 MG 1000 MG 100 MCG 50 MCG 1 DRP 1 APP 500 MG 1 TAB 500 MG 25 MG 50 MG 6 MG 20 MG 1 MG 5 MG 5 MG 0.5 MG 0.5 MG 20 MG Drug Volume 1 EA 1 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 CAP 1 CAP 1 VIAL 1 VIAL 1 EA 1 CAP 5 ML 10 ML 1 TAB 1 ML 10 ML 2 ML 1 ML 1 DRP 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 0.5 ML 1 SPRAY 1 CAP 1 ML 1 CAP 1 CAP 1 ML 1 TAB Package Desc 1 EA UD CUP ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 EA PACKAGE 1 CAP PACKAGE 5 ML SYRINGE 10 ML VIAL 1 TAB PACKAGE ML ORAL SYRINGE 10 ML UD CUP 2 ML AMPUL 1 ML BOTTLE 15 ML BOTTLE 118 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 0.5 ML VIAL 1 SPRAY PACKAGE 1 CAP PACKAGE 1 ML AMPUL 1 CAP PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE Dosage Form SOLN SYRUP TAB TAB TAB TAB TAB TAB TAB CAP CAP CAP VIAL VIAL MISC CAP SYRINGE VIAL TAB SUSP SUSP INJ AMPUL DROPS LOTION TAB TAB TAB TAB TAB VIAL SPRAY CAP INJ CAP CAP SUSP TAB Route MSC PO PO PO PO PO PO PO PO PO PO PO IM IV MSC PO IV INJ PO PO PO IV INJ EYE TOP PO PO PO PO PO SC INH PO IV PO PO PO PO Formulary Status? F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F F F NF F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 02 02 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 921 1456 1149 4081 2778 4082 2644 1789 2779 57 58 3405 1693 241 2493 310 3920 743 1905 868 2494 1508 4219 1676 566 1900 2534 1470 1024 1023 1021 2710 1346 1349 1347 4010 2863 4157 AHFS Code 56:12.00 96:00.00 24:24.00 24:24.00 24:24.00 24:24.00 24:32.20 24:32.20 24:32.20 08:18.08 08:18.08 08:18.08 08:12.02 10:00.00 40:20.00 64:00.00 12:20.20 12:20.20 56:28.32 56:28.32 56:28.32 28:08.08 28:08.08 52:04.04 84:04.92 04:04.20 08:12.20 08:12.20 28:32.28 28:32.28 28:32.28 28:32.28 92:44.00 92:44.00 92:44.00 92:44.00 92:44.00 24:12.12 Generic Name TALC STERILE 4GM AEROSOL TALC STERILE 5GM POWDER TAMOXIFEN TAMSULOSIN TAPENTADOL HCL TAPENTADOL HCL HALFTAB TEMAZEPAM TEMOZOLOMIDE TEMOZOLOMIDE TEMOZOLOMIDE TEMOZOLOMIDE TEMOZOLOMIDE TEMSIROLIMUS TENOFOVIR DISOPROXIL FUMARATE TERAZOSIN TERAZOSIN TERAZOSIN TERBINAFINE TERBINAFINE TERBUTALINE TERBUTALINE TERBUTALINE TESTOSTERONE 1% GEL 2.5GM TESTOSTERONE 2.5 MG PATCH TESTOSTERONE CYPIONATE TESTOSTERONE CYPIONATE TESTOSTERONE CYPIONATE MDV TESTOSTERONE ENANTHATE TETANUS DIPHTH TOXOID ADULT TETANUS DIPHTHER TOXOID A SYR TETANUS IMMUNE GLOBULIN TETANUS TOXOID, 5ML VIAL TETANUS, DIPTH, ACELL, PERT TETRACAINE 0.5% TETRACAINE 1% TETRADECYL 3%* TETRADECYL NA 1%* THALIDOMIDE Brand Name SCLEROSOL INTRAPLEURAL AERO TALC STERILE 5GM POWDER TAMOXIFEN FLOMAX NUCYNTA NUCYNTA HALFTAB RESTORIL (EQUIV) TEMODAR TEMODAR TEMODAR TEMODAR TEMODAR TORISEL VIREAD HYTRIN (EQUIV) HYTRIN (EQUIV) HYTRIN (EQUIV) LAMISIL AT LAMISIL BRETHINE (EQUIV) BRETHINE (EQUIV) BRETHINE (EQUIV) ANDROGEL 1% ANDRODERM 2.5 MG PATCH DEPO-TESTOSTERONE TESTOSTERONE DEPO-TESTOSTERONE MDV DELATESTRYL TETANUS DIPHTH TOXOID ADULT TETANUS DIPHTHER TOXOID A SYR BAYTET TETANUS TOXOID 5ML VIAL ADACEL VACCINE TETRACAINE 0.5% PONTOCAINE 1% SOTRADECOL 3%* SOTRADECOL 1%* THALOMID Drug Strength 1 APP 1 APP 10 MG 0.4 MG 50 MG 25 MG 15 MG 100 MG 100 MG 20 MG 250 MG 5 MG 25 MG 300 MG 1 MG 2 MG 5 MG 1 APP 250 MG 1 MG 2.5 MG 5 MG 1 APP 1 EA 100 MG 200 MG 200 MG 200 MG 0.5 ML 0.5 ML 250 UNT 0.5 ML 0.5 ML 1 DRP 2 ML 2 ML 2 ML 100 MG Drug Volume 4 GM 1 APP 1 TAB 1 CAP 1 TAB 1 TAB 1 CAP 1 VIAL 1 CAP 1 CAP 1 CAP 1 CAP 1 KIT 1 TAB 1 CAP 1 CAP 1 CAP 1 APP 1 TAB 1 ML 1 TAB 1 TAB 1 APP 1 EA 1 ML 1 ML 1 ML 1 ML 0.5 ML 0.5 ML 1 SYR 0.5 ML 0.5 ML 1 DRP 2 ML 2 ML 2 ML 1 CAP Package Desc 4 GM PACKAGE 5 GM PKG 1 TAB PACKAGE 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 KIT PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 12 GM PACKAGE 1 TAB PACKAGE 1 ML AMPUL 1 TAB PACKAGE 1 TAB PACKAGE 2.5 GM PACKAGE 1 EA PACKAGE 1 ML VIAL 1 ML VIAL ML VIAL 5 ML VIAL 0.5 ML SYRINGE 0.5 ML SYR 1 SYR SYRINGE 5 ML VIAL 0.5 ML VIAL 2 ML BOTTLE 2 ML AMPUL 2 ML PACKAGE 2 ML PACKAGE 1 CAP PACKAGE Dosage Form AER POWDER TAB CAP TAB TAB CAP VIAL CAP CAP CAP CAP KIT TAB CAP CAP CAP CREAM TAB INJ TAB TAB GEL PATCH VIAL VIAL VIAL VIAL SYRINGE SYRINGE SYRINGE VIAL VIAL DROPS INJ VIAL VIAL CAP Route IP IP PO PO PO PO PO IV PO PO PO PO IV PO PO PO PO TOP PO INJ PO PO TOP TD IM IM IM IM IM INJ IM SC IM EYE INJ INJ INJ PO Formulary Status? F F F F NF NF F NF F F F F NF F F F F F F F F F NF NF F F F F F F F F F F F F F NF Controlled Substance? NO NO NO NO YES YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 02 02 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 03 03 03 03 03 03 00 00 00 00 00 00 00 00 00 00 Drug Code 2232 3039 1444 1487 4204 4205 1824 4327 846 844 3079 845 3302 2218 1922 1923 1924 2845 793 346 901 902 445 1967 228 229 230 2005 1715 2949 329 2954 3042 562 658 3007 3006 3187 AHFS Code 24:16.00 24:16.00 10:00.00 12:16.04 28:08.08 28:08.08 28:24.08 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 10:00.00 08:18.08 24:20.00 24:20.00 24:20.00 84:04.08 08:14.04 12:12.08 12:12.08 12:12.08 68:08.00 68:08.00 68:08.00 68:08.00 68:08.00 68:08.00 80:04.00 80:08.00 80:04.00 80:08.00 80:08.00 52:16.00 72:00.00 24:16.00 24:16.00 92:20.00 Generic Name THEOPHYLLINE SOLUTION THEOPHYLLINE SR THEOPHYLLINE SR THIAMINE THIAMINE THIAMINE THIAMINE 100 MG/50 ML D5W THIOGUANINE THIORIDAZINE THIORIDAZINE THIORIDAZINE HCL THIOTEPA THIOTHIXENE THIOTHIXENE THIOTHIXENE THROMBIN THROMBIN THROMBIN/CA/CMC/GEL/DRESS, HEM THROMBIN/FIBRINOGEN/APRO/CAL THROMBIN/FIBRINOGEN/APRO/CAL THYROID THYROID THYROID THYROTROPIN ALFA TIAGABINE TIAGABINE HCL HALFTAB TICAGRELOR TICARCILLIN/K CLAVULANATE TICLOPIDINE TIGECYCLINE TIGECYCLINE 100MG/100ML NS TIGECYCLINE 50MG/100ML NS TIMOLOL 0.25% TIMOLOL 0.5% TIMOLOL MAL/DORZOLAM TIMOLOL XE 0.25% TIMOLOL XE 0.5% TIOTROPIUM BROMIDE INHALER Brand Name THEOPHYLLINE THEOCHRON SR THEOCHRON SR VITAMIN B1 THIAMINE VITAMIN B-1 THIAMINE 100 MG/50 ML D5W THIOGUANINE MELLARIL (EQUIV) MELLARIL (EQUIV) MELLARIL (EQUIV) THIOPLEX NAVANE (EQUIV) NAVANE (EQUIV) NAVANE (EQUIV) THROMBIN-JMI THROMBIN-JMI THROMBI-GEL TISSEEL VH 10ML (EQUIV) TISSEEL VH 4ML (EQUIV) ARMOUR THYROID ARMOUR THYROID ARMOUR THYROID THYROGEN GABITRIL GABITRIL HALFTAB BRILINTA TIMENTIN TICLID (EQUIV) TYGACIL TYGACIL 100MG/100ML NS TYGACIL 50MG/100ML NS TIMOPTIC 0.25% (EQUIV) TIMOPTIC 0.5% (EQUIV) COSOPT TIMOPTIC-XE 0.25% TIMOPTIC-XE 0.5% SPIRIVA HANDIHALER Drug Strength 80 MG 100 MG 200 MG 100 MG 200 MG 50 MG 100 MG 40 MG 10 MG 50 MG 25 MG 15 MG 1 MG 10 MG 2 MG 20000 UNT 5000 UNT 1 EA 1 KIT 1 KIT 15 MG 30 MG 60 MG 1.1 MG 4 MG 2 MG 90 MG 3.1 GM 250 MG 50 MG 100 MG 50 MG 1 DRP 1 DRP 1 DRP 1 DRP 1 DRP 18 MCG Drug Volume 15 ML 1 TAB SR 1 TAB SR 1 TAB 2 ML 1 TAB 50 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 CAP 1 CAP 1 CAP 1 KIT 1 VIAL 1 EA 1 KIT 1 KIT 1 TAB 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 EA 1 TAB 1 VIAL 100 ML 100 ML 1 DRP 1 DRP 1 DRP 1 DRP 1 DRP 1 CAP Package Desc ML ORAL SYRINGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE 1 TAB PACKAGE 2 ML VIAL 1 TAB PACKAGE 50 ML BAG 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 KIT PACKAGE 1 VIAL PACKAGE 1 PAD PACKAGE 1 KIT PACKAGE 1 KIT PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 100 ML BAG 100 ML BAG 5 ML BOTTLE 5 ML BOTTLE 10 ML BOTTLE 5 ML BOTTLE 5 ML BOTTLE 1 KIT PACKAGE Dosage Form SOLN TAB SR TAB SR TAB VIAL TAB PB TAB TAB TAB TAB VIAL CAP CAP CAP KIT VIAL PAD KIT KIT TAB TAB TAB VIAL TAB TAB TAB VIAL TAB VIAL PB PB DROPS DROPS DROPS SOL GEL OPTHGEL CD Route PO PO PO PO INJ PO IV PO PO PO PO INJ PO PO PO INJ TOP TOP TOP TOP PO PO PO IM PO PO PO INJ PO INJ IV IV EYE EYE EYE EYE EYE INH Formulary Status? F F F F F F F F F F F F F F F F F NF F F F F F F F F NF NF F NF NF NF F F NF NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 486 1343 1344 1051 2239 1436 4237 1046 1841 1843 1842 2114 1849 1852 1850 3100 1975 3397 1615 1614 1333 1334 1335 2115 2280 3348 4288 2607 1091 3370 4255 4254 2185 1667 3157 2911 138 2974 AHFS Code 86:16.00 86:16.00 86:16.00 88:08.00 88:08.00 88:08.00 88:08.00 10:00.00 28:16.08 28:16.08 28:16.08 10:00.00 28:16.08 28:16.08 28:16.08 20:28.16 20:28.16 94:00.00 20:28.16 20:28.16 68:36.04 68:36.04 68:36.04 36:60.00 28:12.92 28:12.92 20:12.18 08:12.16 20:12.18 08:12.24 08:12.24 08:12.24 52:40.08 52:40.08 52:40.12 52:40.08 52:40.08 12:08.08 Generic Name TIPRANAVIR TIZANIDINE TIZANIDINE TIZANIDINE HALFTAB TOBRAMYCIN TOBRAMYCIN TOBRAMYCIN 0.3% TOBRAMYCIN 0.3% TOBRAMYCIN 100 MG/ 50 ML D5W TOBRAMYCIN 120MG/ 50 ML D5W TOBRAMYCIN 80MG/50ML D5W TOBRAMYCIN BULK* TOBRAMYCIN FORTIFIED OPTH TOBRAMYCIN IN NA CHLOR 0.2% TOBRAMYCIN* TOBRAMYCIN/DEXAMETH TOBRAMYCIN/DEXAMETH TOCILIZUMAB TOLCAPONE TOLNAFTATE 1% TOLNAFTATE 1% POWDER 45GM TOLTERODINE TOLTERODINE TOLVAPTAN TOPIRAMATE TOPIRAMATE TOPIRAMATE SPRINKLE TOPIRAMATE SUSP TOPOTECAN TORSEMIDE TORSEMIDE TORSEMIDE TORSEMIDE QUARTERTAB TRAMADOL TRANEXAMIC ACID TRANYLCYPROMINE SULFATE TRASTUZUMAB TRAZODONE Brand Name APTIVUS ZANAFLEX (EQUIV) ZANAFLEX (EQUIV) ZANAFLEX (EQUIV) NEBCIN (EQUIV) NEBCIN (EQUIV) TOBREX 0.3% TOBREX 0.3% (EQUIV) NEBCIN 100 MG/ 50 ML D5W NEBCIN 120MG/ 50 ML D5W NEBCIN 80MG/50ML D5W TOBRAMYCIN BULK* TOBRAMYCIN FORTIFIED OPTH TOBI IN 0.2%NS NEBCIN (EQUIV)* TOBRADEX (EQUIV) TOBRADEX (EQUIV) ACTEMRA TASMAR TINACTIN (EQUIV) TINACTIN POWDER 1% (EQUIV) DETROL DETROL SAMSCA TOPAMAX TOPAMAX TOPAMAX SPRINKLE TOPAMAX SUSP HYCAMTIN DEMADEX (EQUIV) DEMADEX (EQUIV) DEMADEX DEMADEX (EQUIV) ULTRAM (EQUIV) CYKLOKAPRON PARNATE HERCEPTIN DESYREL (EQUIV) Drug Strength 250 MG 2 MG 4 MG 1 MG 1.2 GM 80 MG 1 APP 5 ML 100 MG 120 MG 80 MG 40 MG 1 DRP 300 MG 80 MG 1 APP 1 DRP 80 MG 100 MG 1 APP 1 APP 1 MG 2 MG 15 MG 100 MG 25 MG 25 MG 6 MG 4 MG 10 MG 20 MG 5 MG 2.5 MG 50 MG 100 MG 10 MG 10 MG 100 MG Drug Volume 1 CAP 1 TAB 1 TAB 1 TAB 1 VIAL 2 ML 1 APP 5 ML 50 ML 50 ML 50 ML 1 ML 1 DRP 5 ML 2 ML 1 APP 1 DRP 4 ML 1 TAB 15 APP 1 APP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 CAP 1 ML 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 0.47 ML 1 TAB Package Desc 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 2 ML VIAL 3.5 GM PACKAGE 5 ML BOTTLE 50 ML BAG 2 ML VIAL 50 ML BAG 50 ML BOTTLE 7 ML BOTTLE 5 ML AMPUL-NEB. 2 ML VIAL 3.5 GM PACKAGE 5 ML BOTTLE 4 ML VIAL 1 TAB PACKAGE 15 GM PACKAGE 45 GM PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE ML ORAL SYRINGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 10 ML AMPUL 1 TAB PACKAGE 0.47 ML PACKAGE 1 TAB PACKAGE Dosage Form CAP TAB TAB TAB VIAL VIAL OINT DROPS PB PB PB VIAL OPTHSOL INH VIAL OINT DROPS VIAL TAB CREAM TOP PWD TAB TAB TAB TAB TAB CAP SUSP VIAL TAB TAB TAB TAB TAB INJ TAB VIAL TAB Route PO PO PO PO INJ INJ EYE EYE IV IV IV INJ IO INH INJ EYE EYE IV PO TOP TOP PO PO PO PO PO PO PO IV PO PO PO PO PO IV PO IV PO Formulary Status? NF NF NF NF F F F F F F F F F F F F F F NF F F F F NF F F NF F F NF NF NF NF F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 3096 3481 2133 3951 1692 690 556 2193 4260 4261 4259 2518 2499 2277 3257 558 557 4063 4014 1699 1075 253 254 4116 400 399 2677 4020 170 78 79 77 4095 1940 265 171 1746 1826 AHFS Code 08:18.08 12:20.04 12:20.04 12:20.04 08:12.02 08:12.02 52:04.04 52:04.04 08:12.02 08:12.02 08:12.02 08:12.02 08:12.02 08:12.02 08:12.02 52:04.04 52:04.04 92:36.00 28:36.12 84:04.08 84:04.08 86:12.00 86:12.00 40:28.28 28:12.92 28:12.92 28:12.92 28:12.92 10:00.00 40:28.08 40:28.08 40:28.08 40:28.08 28:08.08 20:28.16 28:16.04 10:00.00 28:16.04 Generic Name TRAZODONE TRAZODONE TRAZODONE HALFTAB TRAZODONE QUARTERTAB TREPROSTINIL TREPROSTINIL *0.6MG/ML* TREPROSTINIL 10 MG/ML TRETINOIN TRETINOIN TOP GEL 0.025% TRIAMCINOLONE 0.1% IN ORABASE TRIAMCINOLONE ACET 0.025% CR TRIAMCINOLONE ACET 0.025% CR TRIAMCINOLONE ACET 0.025% LOT TRIAMCINOLONE ACET 0.025% OINT TRIAMCINOLONE ACET 0.025% OINT TRIAMCINOLONE ACET 0.025% OINT TRIAMCINOLONE ACET 0.1% CR TRIAMCINOLONE ACET 0.1% CR TRIAMCINOLONE ACET 0.1% LOT TRIAMCINOLONE ACET 0.1% OINT TRIAMCINOLONE ACET 0.1% OINT TRIAMCINOLONE ACET 0.1%* TRIAMCINOLONE ACET 0.5% CR TRIAMCINOLONE ACET 0.5% OINT TRIAMCINOLONE ACET INJ SUSP PF TRIAMCINOLONE ACETE 0.1% CR TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE 100MCG TRIAMCINOLONE ACETONIDE-10 TRIAMCINOLONE ACETONIDE-10 TRIAMCINOLONE ACETONIDEN 55MCG TRIAMCINOLONE HEXACETONIDE TRIAMTERENE TRIAMTERENE 37.5MG/HCTZ 25MG TRIAZOLAM TRICHLOROACETIC ACID 80% TRIFLUOPERAZINE Brand Name DESYREL (EQUIV) DESYREL (EQUIV) DESYREL (EQUIV) HALFTAB DESYREL (EQUIV) QUARTERTAB REMODULIN TYVASO REMODULIN TRETINOIN RETIN A (EQUIV) KENALOG IN ORABSE 0.1% (EQUIV) KENALOG 0.025% CR (EQUIV) KENALOG 0.025% CR (EQUIV) KENALOG 0.025% LOT (EQUIV) KENALOG 0.025% OINT (EQUIV) KENALOG 0.025% OINT (EQUIV) KENALOG 0.025% OINT (EQUIV) KENALOG 0.1% CR (EQUIV) KENALOG 0.1% CR (EQUIV) KENALOG 0.1% LOT (EQUIV) KENALOG 0.1% OINT (EQUIV) KENALOG 0.1% OINT (EQUIV) KENALOG 0.1% (EQUIV)* KENALOG 0.5% CR (EQUIV) KENALOG 0.5% OINT(EQUIV) TRIESENCE KENALOG 0.1% CR (EQUIV) KENALOG-40 KENALOG-40 AZMACORT KENALOG-10 KENALOG-10 NASACORT AQ ARISTOSPAN DYRENIUM MAXZIDE-25MG (EQUIV) HALCION (EQUIV) TRI-CHLOR 80% STELAZINE (EQUIV) Drug Strength 150 MG 50 MG 25 MG 12.5 MG 2.5 MG 1 INH 10 MG 10 MG 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 40 MG 1 APP 40 MG 400 MG 1 PUF 10 MG 50 MG 1 SPR 5 MG 50 MG 1 TAB 0.125 MG 1 APP 10 MG Drug Volume 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 INH 1 ML 1 CAP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 APP 1 ML 1 APP 1 ML 10 ML 1 PUF 1 ML 5 ML 1 SPR 1 ML 1 CAP 1 TAB 1 TAB 1 APP 1 TAB Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML BOTTLE 2.9 ML BOTTLE 20 ML VIAL 1 CAP PACKAGE 15 GM PACKAGE 5 GM PACKAGE 15 GM PACKAGE 80 GM PACKAGE 60 ML BOTTLE 15 GM PACKAGE 454 GM PACKAGE 80 GM PACKAGE 454 GM PACKAGE 80 GM PACKAGE 60 ML BOTTLE 15 GM PACKAGE 80 GM PACKAGE 454 GM PACKAGE 15 GM PACKAGE 15 GM PACKAGE 1 ML BOTTLE 15 GM PACKAGE 1 ML VIAL 10 ML VIAL 20 GM PACKAGE 1 ML VIAL 5 ML VIAL 10 GM PACKAGE 5 ML VIAL 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 15 ML BOTTLE 1 TAB PACKAGE Dosage Form TAB TAB TAB TAB VIAL SOLN VIAL CAP GEL PASTE CREAM CREAM LOTION OINT OINT OINT CREAM CREAM LOTION OINT OINT OINT CREAM OINT VIAL CREAM VIAL VIAL AER VIAL VIAL AER VIAL CAP TAB TAB SOLN TAB Route PO PO PO PO INJ INH INJ PO TOP DEN TOP TOP TOP TOP TOP TOP TOP TOP TOP TOP TOP TOP TOP TOP EYE TOP INJ INJ INH INJ INJ NAS INJ PO PO PO TOP PO Formulary Status? F F F F F F F NF NF F F F F F F F F F F F F F F F F F F F NF F F NF F F F NF F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 00 00 Drug Code 1738 1825 2781 2782 4159 4151 4000 3967 3499 1952 1496 941 2170 1703 1589 942 1359 1329 2171 1360 943 1328 940 1702 4304 1358 43 44 773 4181 50 777 1353 2303 2226 491 1640 1547 AHFS Code 28:16.04 28:16.04 28:16.04 28:16.04 24:12.92 24:12.92 24:12.92 10:00.00 84:16.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 84:06.00 52:08.08 84:06.00 68:04.00 68:04.00 48:10.08 68:04.00 68:04.00 52:08.08 68:04.00 40:28.16 40:28.16 28:24.08 84:92.00 28:16.08 Generic Name TRIFLUOPERAZINE TRIFLUOPERAZINE HCL TRIFLURIDINE 1% TRIHEXYPHENIDYL TRIHEXYPHENIDYL TRIHEXYPHENIDYL HALFTAB TRIHEXYPHENIDYL HALFTAB TRIMETHOPRIM TRIMETHOPRIM SOLN TROMETHAMINE 18GM/500 ML TROPICAMIDE 0.5% TROPICAMIDE 1% TROPICAMIDE 1% TRYPAN BLUE 0.06% TRYPSIN/BALSAM PERU/CASTOR OIL TUBERCULIN PURIF PROT SINGLE TUBERCULIN,PURIF.PROT.DERIV* TUBERCULIN,PURIF.PROT.DERIV.* TYPHOID VACC VI CAP POLYSACC* TYPHOID VACC VI CAPSU POLYSACC TYPHOID VACC,LIVE,ATTENUATED UBIDECARENONE UREA UREA 10% LOTION 236 ML UROFOLLITROPIN (FSH) UROKINASE UROKINASE 5000U/SYRINGE URSODIOL URSODIOL URSODIOL SUSP VALACYCLOVIR VALGANCICLOVIR VALGANCICLOVIR HYDROCHLORIDE VALPROATE NA 500MG/100ML D5W VALPROATE SODIUM VALPROIC ACID SYR UD VALPROIC ACID SYRUP VALSARTAN Brand Name STELAZINE STELAZINE (EQUIV) VIROPTIC 1% ARTANE (EQUIV) ARTANE (EQUIV) ARTANE (EQUIV) HALFTAB ARTANE (EQUIV) HALFTAB TRIMPEX (EQUIV) PRIMSOL (EQUIV) THAM MYDRIACYL 0.5% (EQUIV) MYDRIACYL 1% (EQUIV) MYDRIACYL1% VISIONBLUE 0.06% VASOLEX TUBERSOL SINGLE TEST TUBERSOL 10 TEST VIAL* TUBERSOL* TYPHIM VI* TYPHIM VI VIVOTIF BERNA COENZYME Q10 (EQUIV) CARMOL 20 NUTRAPLUS 10% BRAVELLE ABBOKINASE UROKINASE 5000U/SYRINGE ACTIGALL URSO FORTE ACTIGALL (EQUIV) SUSP VALTREX VALCYTE VALCYTE DEPACON 500MG/100ML D5W DEPACON (EQUIV) VALPROIC ACID SYR UD DEPAKENE SYRUP (EQUIV) DIOVAN Drug Strength 2 MG 5 MG 1 DRP 2 MG 5 MG 1 MG 2.5 MG 100 MG 10 MG 500 ML 1 DRP 1 DRP 1 DRP 0.5 ML 1 APP 5 TU 5 TU 5 TU 25 MCG 25 MCG 1 CAP 60 MG 1 APP 1 APP 75 UNT 250000 5000 UNT 300 MG 500 MG 300 MG 500 MG 450 MG 50 MG 500 MG 500 MG 250 MG 250 MG 160 MG Drug Volume 1 TAB 1 TAB 1 DRP 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 500 ML 1 DRP 1 DRP 1 DRP 0.5 ML 1 APP 0.1 ML 0.1 ML 0.1 ML 0.5 ML 0.5 ML 1 CAP 1 TAB 1 APP 1 APP 1 AMP 10 ML 1 SYR 1 CAP 1 TAB 12 ML 1 TAB 1 TAB 1 ML 100 ML 5 ML 5 ML 5 ML 1 TAB Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 7.5 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 500 ML BOTTLE 15 ML BOTTLE 15 ML BOTTLE 3 ML BOTTLE 0.5 ML SYRINGE 30 GM PACKAGE 0.1 ML VIAL 1 ML VIAL 5 ML VIAL 10 ML VIAL 0.5 ML SYRINGE 1 CAP PACKAGE 1 TAB PACKAGE 90 GM PACKAGE 236 ML BOTTLE 1 AMP PACKAGE 10 ML PACKAGE 1 SYR SYRINGE 1 CAP PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 TAB PACKAGE 1 ML ORAL SYRINGE 100 ML BAG 5 ML VIAL 5 ML BOTTLE ML ORAL SYRINGE 1 TAB PACKAGE Dosage Form TAB TAB DROPS TAB TAB TAB TAB TAB SOLN PREMIX DROPS DROPS DROPS SYRINGE OINT VIAL VIAL VIAL VIAL SYRINGE CAP EC TAB CREAM LOTION AMP VIAL SYRINGE CAP TAB SUSP TAB TAB SOLN PB VIAL SYRUP SYRUP TAB Route PO PO EYE PO PO PO PO PO PO IV EYE EYE EYE INJ TOP ID ID ID IM IM PO PO TOP TOP SC INJ INJ PO PO PO PO PO PO IV IV PO PO PO Formulary Status? F F F F F F F F NF F F F F F F F F F F F F NF NF F NF F F F NF F F F NF F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1844 1845 2196 1473 1494 2783 2786 1478 2503 652 1672 1671 549 3208 4216 3345 3344 1719 1721 1720 2105 1994 2639 541 1697 730 2825 801 3487 2826 1047 61 4144 4236 651 2898 922 3144 AHFS Code 28:16.08 28:16.08 52:04.20 28:36.08 28:36.08 28:36.08 28:36.08 08:36.00 08:36.00 40:08.00 52:24.00 52:24.00 52:24.00 36:58.00 84:92.00 36:84.00 36:84.00 36:84.00 80:12.00 80:12.00 80:12.00 92:92.00 84:28.00 84:28.00 68:18.00 20:12.20 20:12.20 56:14.00 56:14.00 56:14.00 08:18.32 08:18.32 08:18.32 28:12.92 28:12.92 28:12.92 28:12.92 24:32.08 Generic Name VALSARTAN VALSARTAN VALSARTAN HALFTAB VANCOMYCIN VANCOMYCIN VANCOMYCIN VANCOMYCIN 1000MG/200ML D5W VANCOMYCIN 1250MG/250ML D5W VANCOMYCIN 1500MG/250ML D5W VANCOMYCIN 1750MG/250ML D5W VANCOMYCIN 2000MG/250ML D5W VANCOMYCIN 2250MG/250ML D5W VANCOMYCIN 2500MG/250ML D5W VANCOMYCIN 500MG/100ML D5W VANCOMYCIN 750MG/250ML D5W VANCOMYCIN HCL VANCOMYCIN MDV* VANCOMYCIN SOLN VANCOMYCIN* VANCOMYCIN* VARENICLINE TARTRATE VARICELLA VIRUS VACCINE LIVE VARICELLA-ZOSTER IMMUNE GLOB VASOPRESSIN VASOPRESSIN* VECURONIUM VENLAFAXINE VENLAFAXINE VENLAFAXINE HCL VENLAFAXINE XR VENLAFAXINE XR VENLAFAXINE XR VERAPAMIL VERAPAMIL VERAPAMIL VERAPAMIL HCL SR HALFTAB VERAPAMIL SR VERAPAMIL SR Brand Name DIOVAN DIOVAN DIOVAN HALFTAB VANCOCIN VANCOCIN VANCOMYCIN VANCOMYCIN 1000MG/200ML D5W VANCOMYCIN 1250MG/250ML D5W VANCOMYCIN 1500MG/250ML D5W VANCOMYCIN 1750MG/250ML D5W VANCOMYCIN 2000MG/250ML D5W VANCOMYCIN 2250MG/250ML D5W VANCOMYCIN 2500MG/250ML D5W VANCOMYCIN 500MG/100ML D5W VANCOMYCIN 750MG/250ML D5W VANCOCIN HCL VANCOMYCIN MDV* VANCOMYCIN SOLN VANCOCIN* VANCOMYCIN* CHANTIX VARIVAX VACCINE VARICELLA-ZOSTER IMM GLOBULIN VASOPRESSIN VASOPRESSIN* VECURONIUM EFFEXOR (EQUIV) EFFEXOR (EQUIV) EFFEXOR (EQUIV) EFFEXOR XR EFFEXOR XR EFFEXOR XR CALAN (EQUIV) VERAPAMIL CALAN (EQUIV) VERAPAMIL HCL SR HALFTAB CALAN SR (EQUIV) CALAN SR (EQUIV) Drug Strength 40 MG 80 MG 20 MG 1000 MG 125 MG 500 MG 1 GM 1250 MG 1500 MG 1750 MG 2000 MG 2250 MG 2500 MG 500 MG 750 MG 250 MG 1 GM 500 MG 1 GM 500 MG 0.5 MG 1 EA 625 UNIT 20 UNT 20 UNT 10 MG 25 MG 50 MG 37.5 MG 150 MG 37.5 MG 75 MG 40 MG 5 MG 80 MG 90 MG 120 MG 180 MG Drug Volume 1 TAB 1 TAB 1 TAB 1 VIAL 1 CAP 1 VIAL 200 ML 250 ML 250 ML 250 ML 250 ML 250 ML 250 ML 100 ML 250 ML 1 CAP 10 ML 10 ML 1 VIAL 1 VIAL 1 TAB 1 EA 1 VIAL 1 ML 1 ML 1 VIAL 1 TAB 1 TAB 1 TAB 1 CAP SR 1 CAP SR 1 CAP SR 1 TAB 2 ML 1 TAB 1 TAB SR 1 TAB SR 1 TAB SR Package Desc 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 CAP PACKAGE 1 VIAL PACKAGE 200 ML BAG 250 ML BAG 250 ML BAG 250 ML BAG 250 ML BAG 250 ML BAG 250 ML BAG 100 ML BAG 250 ML BAG 1 CAP PACKAGE ML VIAL ML ORAL SYRINGE 1 VIAL PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 EA PACKAGE 1 VIAL PACKAGE 1 ML VIAL 1 ML VIAL 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP SR PACKAGE 1 CAP SR PACKAGE 1 CAP SR PACKAGE 1 TAB PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE 1 TAB SR PACKAGE Dosage Form TAB TAB TAB VIAL CAP VIAL PREMIX PREMIX PREMIX PREMIX PREMIX PREMIX PREMIX PREMIX PREMIX CAP VIAL SOLN VIAL VIAL TAB VIAL VIAL VIAL VIAL VIAL TAB TAB TAB CAP SR CAP SR CAP SR TAB VIAL TAB TAB ER TAB SR TAB SR Route PO PO PO INJ PO IV IV IV IV IV IV IV IV IV IV PO IV PO INJ IV PO SC INJ INJ INJ IV PO PO PO PO PO PO PO IV PO PO PO PO Formulary Status? F F F F F F F F F F F F F F F F F F F F NF F F F F F F F F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2649 813 3965 2868 11 2517 3374 4197 4198 4199 4200 4250 4251 4195 4196 12 2263 2505 3258 3261 3303 152 3045 2260 3259 654 194 195 196 199 200 198 1546 629 1871 3479 1917 1918 AHFS Code 24:32.08 24:32.08 24:32.08 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 08:12.28 12:92.00 80:12.00 80:04.00 68:28.00 68:28.00 12:20.20 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 28:16.04 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 24:28.92 Generic Name VERAPAMIL SR VERAPAMIL SUSP VERAPAMIL SUSPENSION VIDARABINE 3% VILAZODONE HYDROCHLORIDE VINBLASTINE SULFATE VINCRISTINE VINCRISTINE SULFATE VINORELBINE VIT B COMP W-C/FA (NEPHROCAP) VIT BCOMP/FA/C VITAMIN A VITAMIN A PALMITATE VITAMIN B COMP W/C VITAMIN B COMPLEX/W B12 VITAMIN D3 (CHOLECALCIFEROL) VITAMIN D3 (CHOLECALCIFEROL) VITAMIN D3 (CHOLECALCIFEROL) VITAMIN D3 (CHOLECALCIFEROL) VITAMIN E VITAMIN E Brand Name CALAN SR (EQUIV) VERAPAMIL SUSP VERAPAMIL SUSPENSION VIRA-A VIIBRYD VINBLASTINE SULFATE VINCRISTINE VINCRISTINE SULFATE NAVELBINE NEPHROCAPS (EQUIV) DIATX VITAMIN A AQUASOL A THERAPEUTIC B COMPLEX W/C(EQ) B-COMPLEX W/VITAMIN B-12 VITAMIN D3 (CHOLECALCIFEROL) VITAMIN D3 (CHOLECALCIFEROL) D-VI-SOL *CCMC* VITAMIN D3 (CHOLECALCIFEROL) VITAMIN E VITAMIN E Drug Strength 240 MG 50 MG 1 MG 3.5 GM 40 MG 1 MG 2 MG 1 MG 10 MG 1 CAP 1 TAB 10000 UNT 100000 1 TAB 1 TAB 1000 UNT 200 UNT 400 UNT 400 UNT 1 APP 100 UNT Drug Volume 1 TAB SR 1 ML 1 ML 3.5 GM 1 TAB 1 ML 2 ML 1 ML 1 ML 1 CAP 1 TAB 1 CAP 2 ML 1 TAB 1 TAB 1 TAB 1 TAB 1 ML 1 TAB 1 APP 1 CAP Package Desc 1 TAB SR PACKAGE ML ORAL SYRINGE ML ORAL SYRINGE 3.5 GM PACKAGE 1 TAB PACKAGE 1 ML SYR 2 ML VIAL 1 ML BOTTLE 1 ML VIAL 1 CAP PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 2 ML VIAL 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 60 GM PACKAGE 1 CAP PACKAGE Dosage Form TAB SR SUSP SUSP OINT TAB SYRINGE VIAL VIAL VIAL CAP TAB CAP VIAL TAB TAB TAB TAB DROPS TAB CREAM CAP Route PO PO PO EYE PO IV IV IV IV PO PO PO IV PO PO PO PO PO PO TOP PO Formulary Status? F F F F NF F F F F F NF F F F F F F F F NF F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 1904 2887 2722 2206 4306 3457 2211 3305 1037 1153 2923 2979 3496 1150 1084 3879 3467 4214 2983 2665 1437 AHFS Code 24:28.92 24:28.92 24:28.92 52:04.20 28:16.04 10:00.00 10:00.00 10:00.00 10:00.00 88:08.00 88:08.00 88:04.00 88:04.00 88:08.00 88:08.00 88:16.00 88:16.00 88:16.00 88:16.00 84:24.12 88:20.00 VITAMIN E VITAMIN E VITAMINS A AND D 60GM VITAMINS A,C,AND D VORICONAZOLE VORICONAZOLE VORICONAZOLE HALFTAB WARFARIN WARFARIN WARFARIN WARFARIN WARFARIN WARFARIN WARFARIN WARFARIN WARFARIN VITAMIN E AQUASOL E VITAMIN A AND D TRI-VITAMIN VFEND VFEND IV VFEND HALFTAB COUMADIN COUMADIN COUMADIN COUMADIN COUMADIN COUMADIN COUMADIN COUMADIN COUMADIN 400 UNT 50 UNT 1 APP 1 ML 200 MG 200 MG 100 MG 1 MG 10 MG 2 MG 2.5 MG 3 MG 4 MG 5 MG 5 MG 7.5 MG 1 CAP 1 ML 1 APP 1 ML 1 TAB 1 VIAL 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 TAB 1 VIAL 1 TAB 1 TAB 1 CAP PACKAGE ML ORAL SYRINGE 56.7 GM PACKAGE ML ORAL SYRINGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 VIAL PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE CAP DROPS OINT DROPS TAB VIAL TAB TAB TAB TAB TAB TAB TAB VIAL TAB TAB PO PO TOP PO PO IV PO PO PO PO PO PO PO IV PO PO F F F F NF F NF F F F F F F NF F F NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 2292 1125 956 3149 2647 429 3421 525 533 527 534 3926 4338 3069 528 530 88:20.00 88:20.00 84:24.12 88:28.00 08:14.08 08:14.08 08:14.08 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 20:12.04 Generic Name WARFARIN DAILY DOSE CALL H.O.* WARFARIN HALFTAB WARFARIN HALFTAB WARFARIN NO DOSE DUE TODAY WATER FOR INJ.,BACTERIOSTATIC* WATER FOR INJECTION DILUENT WATER FOR INJECTION,STERILE WATER FOR INJECTION,STERILE* WATER FOR INJECTION,STERILE* WATER FOR INJECTION,STERILE* WATER FOR INJECTION,STERILE* WATER FOR INJECTION,STERILE* WATER FOR IRRIGATION,STERILE WATER FOR IRRIGATION,STERILE* WITCH HAZEL PADS YELLOW FEVER VAC 5 DOSE VIAL YELLOW FEVER VACCINE YOHIMBINE ZAFIRLUKAST ZALEPLON ZALEPLON ZANAMIVIR 5MG ZIDOVUDINE ZIDOVUDINE ZIDOVUDINE ZIDOVUDINE HALFTAB ZIDOVUDINE/LAMIVUDINE ZIDOVUDINE/LAMIVUDINE/ABACAVIR ZILEUTON ZINC OXIDE (UNNA-BOOT) ZINC OXIDE 11.3% ZINC OXIDE 20% ZINC OXIDE 20% OINT 454GM ZINC SULFATE ZINC SULFATE ZINC SULFATE ZIPRASIDONE ZIPRASIDONE Brand Name WARFARIN DAILY DOSE* COUMADIN HALFTAB COUMADIN HALFTAB COUMADIN NO DOSE TODAY WATER STERILE BACTERIOSTATIC* WATER STERILE DILUENT WATER WATER* WATER* WATER FOR INJECTION,STERILE* WATER FOR INJECTION, STERILE* WATER* WATER FOR IRRIGATION,STERILE WATER FOR IRRIGATION* TUCKS (EQUIV) YF-VAX YF-VAX YOHIMBINE ACCOLATE SONATA SONATA RELENZA 5MG RETROVIR (EQUIV) RETROVIR (EQUIV) IV RETROVIR (EQUIV) RETROVIR (EQUIV) HALFTAB COMBIVIR TRIZIVIR (EQUIV) ZYFLO UNNA-BOOT FLEX 4 IN X 10 YD BALMEX (EQUIV) ZINC OXIDE 20% ZINC OXIDE 20% ZINC SULFATE ZINC SULFATE ZINC SULFATE GEODON GEODON Drug Strength 1 EA 0.5 MG 1.25 MG 1 EA 30 ML 1 ML 20 ML 10 ML 100 ML 1000 ML 2000 ML 50 ML 1000 ML 3000 ML 1 EA 0.2 ML 1 EA 5.4 MG 20 MG 10 MG 5 MG 1 EA 10 MG 10 MG 100 MG 150 MG 1 TAB 1 TAB 600 MG 1 EA 1 APP 1 APP 1 APP 10 MG 220 MG 25 MG 20 MG 40 MG Drug Volume 1 EA 1 TAB 1 TAB 1 EA 30 ML 1 ML 20 ML 10 ML 100 ML 1000 ML 2000 ML 50 ML 1000 ML 3000 ML 1 EA 0.2 ML 1 EA 1 TAB 1 TAB 1 CAP 1 CAP 1 EA 1 ML 1 ML 1 CAP 1 TAB 1 TAB 1 TAB 1 TAB 1 EA 1 APP 1 APP 1 APP 10 ML 1 CAP 5 ML 1 ML 1 CAP Package Desc 1 EA PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 EA PACKAGE 30 ML VIAL 1 ML VIAL 20 ML VIAL 10 ML VIAL 100 ML VIAL 1000 ML BAG 2000 ML BAG 50 ML VIAL 1000 ML BAG 3000 ML BOTTLE 40 PAD PACKAGE 1 VIAL PACKAGE 1 EA PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PACKAGE 1 EA PACKAGE ML ORAL SYRINGE 20 ML VIAL 1 CAP PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 TAB PACKAGE 1 EA PACKAGE 60 GM TUBE 28.4 GM PACKAGE 454 GM PACKAGE 10 ML VIAL 1 CAP PACKAGE 5 ML VIAL 1 ML PACKAGE 1 CAP PACKAGE Dosage Form MISC TAB TAB TAB VIAL SOLN VIAL VIAL VIAL SOLN SOLN VIAL SOLN IRRIG PAD VIAL VIAL TAB TAB CAP CAP DISK SYRUP VIAL CAP TAB TAB TAB TAB BNDG OINT OINT OINT VIAL CAP VIAL VIAL CAP Route INFO PO PO INFO INJ IV INJ INJ INJ IV IV INJ IRR IRR TOP SC SC PO PO PO PO INH PO IV PO PO PO PO PO TOP TOP TOP TOP IV PO IV IM PO Formulary Status? F F F F F F F F F F F F F F F F F F NF NF NF NF F F F F F NF F F F F F F F F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO YES YES NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 04 04 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 00 Drug Code 2510 2784 4056 3211 697 3968 715 1410 716 1203 1204 2250 1202 2672 1990 2512 1723 1959 1196 204 203 2699 997 995 996 3884 2604 1043 3275 4094 2513 1386 963 1423 1525 1426 2728 438 AHFS Code 20:12.04 20:12.04 20:12.04 20:12.04 96:00.00 96:00.00 96:00.00 96:00.00 96:00.00 96:00.00 96:00.00 96:00.00 40:36.00 40:36.00 84:12.00 80:12.00 80:12.00 12:16.04 48:10.24 28:24.92 28:24.92 08:18.28 08:18.08 08:18.08 08:18.08 08:18.08 08:18.08 08:18.08 48:10.24 96:00.00 84:24.12 84:24.12 84:24.12 40:12.00 40:12.00 40:12.00 28:16.08 28:16.08 Generic Name ZIPRASIDONE HCL ZIPRASIDONE HCL ZIV-AFLIBERCEPT *25 MG/ML* ZIV-AFLIBERCEPT *25 MG/ML* ZNSO4 HEP/CUSO4 P-HYD/MANG/CH* ZNSO4 HEP/CUSO4 P-HYD/MANG/CH* ZNSO4 HEP/CUSO4 P-HYD/MANG/CH* ZOLEDRONIC ACID ZOLEDRONIC ACID ACCU DOSE ZOLEDRONIC ACID/MANNITOL/WATER ZOLEDRONIC ACID/MANNITOL/WATER ZOLMITRIPTAN ZOLPIDEM ZONISAMIDE ZONISAMIDE Brand Name GEODON GEODON ZALTRAP *25 MG/ML* ZALTRAP *25 MG/ML* TRACE-4 NEONATE* TRACE-4 ADULT* TRACE PEDI P.T.E.-4 (EQUIV)* ZOMETA ZOMETA AACU DOSE ZOMETA RECLAST ZOMIG AMBIEN ZONEGRAN (EQUIV) ZONEGRAN (EQUIV) Drug Strength 20 MG 60 MG 100 MG 200 MG 1 EA 1 EA 3 ML 4 MG 2 MG 4 MG 5 MG 5 MG 5 MG 100 MG 25 MG Drug Volume 1 CAP 1 CAP 4 ML 8 ML 1 EA 1 EA 3 ML 5 ML 2.5 ML 100 ML 100 ML 1 TAB 1 TAB 1 CAP 1 CAP Package Desc 1 CAP PACKAGE 1 CAP PACKAGE 4 ML VIAL 8 ML VIAL 2 ML BOTTLE 1 ML BOTTLE 3 ML VIAL 5 ML PACKAGE 5 ML PACKAGE 100 ML BOTTLE 100 ML BOTTLE 1 TAB PACKAGE 1 TAB PACKAGE 1 CAP PACKAGE 1 CAP PKG Dosage Form CAP CAP VIAL VIAL VIAL VIAL VIAL VIAL VIAL INFUS INFUS TAB TAB CAP CAP Route PO PO IV IV IV IV IV INJ IV IV IV PO PO PO PO Formulary Status? F F NF NF F F F NF NF F NF NF F F F Controlled Substance? NO NO NO NO NO NO NO NO NO NO NO NO YES NO NO DEA Code 00 00 00 00 00 00 00 00 00 00 00 00 04 00 00 Drug Code 437 439 4322 4323 2541 2540 2243 2596 812 4217 3304 1181 327 2137 3044 AHFS Code 28:16.08 28:16.08 10:00.00 10:00.00 40:12.00 40:12.00 40:12.00 92:24.00 92:24.00 92:24.00 92:24.00 28:32.28 28:24.92 28:12.92 28:12.92
