Misc Antibiotics

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PDL Status Values

Y = preferred
N = non-preferred. Non-preferred drugs listed as N but without clinical drug use criteria are subject to the Non-Preferred Drugs in Select PDL Classes prior authorization criteria. New drugs will be listed as N until reviewed by the P&T Committee and are subject to the New Drug Policy.
V = voluntary non-preferred. Non-preferred mental health drugs are listed as V and prior authorization is not required.
Null (i.e. blank) = indicates the class or specific drug has not been reviewed for PDL placement.

To request a Prior Authorization, please use this form.

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NDC Brand Name Generic Name Form Strength PDL
Status		 Rebate Current Drug Use Criteria
00003256016 AZACTAM aztreonam VIAL 1 gram Y  
00409082901 AZTREONAM aztreonam VIAL 1 gram Y  
00409082911 AZTREONAM aztreonam VIAL 1 gram Y  
63323040101 AZTREONAM aztreonam VIAL 1 gram Y  
63323040120 AZTREONAM aztreonam VIAL 1 gram Y  
63323040121 AZTREONAM aztreonam VIAL 1 gram Y  
63323040124 AZTREONAM aztreonam VIAL 1 gram Y  
63323040126 AZTREONAM aztreonam VIAL 1 gram Y  
63323040141 AZTREONAM aztreonam VIAL 1 gram Y  
00003257016 AZACTAM aztreonam VIAL 2 gram Y  
00409083001 AZTREONAM aztreonam VIAL 2 gram Y  
00409083011 AZTREONAM aztreonam VIAL 2 gram Y  
63323040201 AZTREONAM aztreonam VIAL 2 gram Y  
63323040203 AZTREONAM aztreonam VIAL 2 gram Y  
63323040220 AZTREONAM aztreonam VIAL 2 gram Y  
63323040224 AZTREONAM aztreonam VIAL 2 gram Y  
63323040230 AZTREONAM aztreonam VIAL 2 gram Y  
63323040241 AZTREONAM aztreonam VIAL 2 gram Y  
00074387801 EMBLAVEO aztreonam/avibactam sodium VIAL 2 gram Y  
00074387810 EMBLAVEO aztreonam/avibactam sodium VIAL 2 gram Y  
39822025505 BACI-IM bacitracin VIAL 50,000 unit Y  
00409230001 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 200 mg/100 mL Y  
00409230024 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 200 mg/100 mL Y  
25021011482 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 200 mg/100 mL Y  
25021019282 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 200 mg/100 mL Y  
00409330001 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 400 mg/200 mL Y  
00409330024 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 400 mg/200 mL Y  
25021011487 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 400 mg/200 mL Y  
25021019287 CIPROFLOXACIN-D5W ciprofloxacin in 5 % dextrose PIGGYBACK 400 mg/200 mL Y  
00085176101 CIPRO I.V. ciprofloxacin lactate VIAL 10 mg/mL Y  
00085176303 CIPRO I.V. ciprofloxacin lactate VIAL 200 mg/20 mL Y  
00009022501 CLEOCIN HCL clindamycin HCl CAPSULE 150 mg Y  
00009022502 CLEOCIN HCL clindamycin HCl CAPSULE 150 mg Y  
00904595961 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
42571025101 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
59762332801 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
62135076501 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
62584033801 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
63304069201 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
63304069205 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
65862018501 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
65862018505 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
68084024301 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
68084024311 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
68462014301 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
68462014305 CLINDAMYCIN HCL clindamycin HCl CAPSULE 150 mg Y  
00009039513 CLEOCIN HCL clindamycin HCl CAPSULE 300 mg Y  
00009039514 CLEOCIN HCL clindamycin HCl CAPSULE 300 mg Y  
00904719461 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
42571025201 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
50268018511 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
50268018515 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
59762501001 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
59762501002 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
62135076601 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
63304069301 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
63304069362 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
65862018601 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
68084024401 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
68084024411 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
68462014401 CLINDAMYCIN HCL clindamycin HCl CAPSULE 300 mg Y  
00009033102 CLEOCIN HCL clindamycin HCl CAPSULE 75 mg Y  
42571025001 CLINDAMYCIN HCL clindamycin HCl CAPSULE 75 mg Y  
62135076401 CLINDAMYCIN HCL clindamycin HCl CAPSULE 75 mg Y  
68462014201 CLINDAMYCIN HCL clindamycin HCl CAPSULE 75 mg Y  
00338954524 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 300 mg/50 mL Y  
00338954550 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 300 mg/50 mL Y  
00338954924 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 600 mg/50 mL Y  
00338954950 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 600 mg/50 mL Y  
00338955324 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 900 mg/50 mL Y  
00338955350 CLINDAMYCIN-0.9% NACL clindamycin in 0.9 % sod chlor PIGGYBACK 900 mg/50 mL Y  
00009076004 CLEOCIN PEDIATRIC clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
16714048301 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
16714048302 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
23155060351 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
53746046819 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
64980051110 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
65162046819 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
65862059601 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
65862059602 CLINDAMYCIN (PEDIATRIC) clindamycin palmitate HCl SOLN RECON 75 mg/5 mL Y  
00009072805 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009072809 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009077520 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009077526 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009087021 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009087026 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009090211 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009090218 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009305101 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009305102 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009407303 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009407304 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009509505 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00009509506 CLEOCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
25021011502 CLINDAMYCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
25021011504 CLINDAMYCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
25021011506 CLINDAMYCIN PHOSPHATE clindamycin phosphate VIAL 150 mg/mL Y  
00143926701 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PGGYBK BTL 300 mg/50 mL Y  
00143926801 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PGGYBK BTL 600 mg/50 mL Y  
00143926901 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PGGYBK BTL 900 mg/50 mL Y  
00338341024 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 300 mg/50 mL Y  
00338341050 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 300 mg/50 mL Y  
00781328809 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 300 mg/50 mL Y  
00781328891 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 300 mg/50 mL Y  
00338361224 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00338361250 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00338361624 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00338361650 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00781328909 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00781328991 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
43066099324 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
72572007401 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
72572007424 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 600 mg/50 mL Y  
00338381424 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
00338381450 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
00338411424 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
00338411450 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
00781329009 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
00781329091 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
43066099524 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
72572007601 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
72572007624 CLINDAMYCIN PHOSPHATE-D5W clindamycin phosphate/D5W PIGGYBACK 900 mg/50 mL Y  
14789020105 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
14789020107 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
23155019331 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
23155019341 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
42023013106 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
63323039306 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
70594002301 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
70594002304 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
70594002309 COLISTIMETHATE colistin (colistimethate Na) VIAL 150 mg Y  
42023010701 COLY-MYCIN M PARENTERAL colistin (colistimethate Na) VIAL 150 mg Y  
57970010001 DALVANCE dalbavancin HCl VIAL 500 mg Y  
00409012001 DAPTOMYCIN daptomycin VIAL 350 mg Y  
16729043405 DAPTOMYCIN daptomycin VIAL 350 mg Y  
16729043445 DAPTOMYCIN daptomycin VIAL 350 mg Y  
25021017915 DAPTOMYCIN daptomycin VIAL 350 mg Y  
25021017916 DAPTOMYCIN daptomycin VIAL 350 mg Y  
25021017966 DAPTOMYCIN daptomycin VIAL 350 mg Y  
25021017967 DAPTOMYCIN daptomycin VIAL 350 mg Y  
31722021501 DAPTOMYCIN daptomycin VIAL 350 mg Y  
43598047611 DAPTOMYCIN daptomycin VIAL 350 mg Y  
70594005301 DAPTOMYCIN daptomycin VIAL 350 mg Y  
70594006601 DAPTOMYCIN daptomycin VIAL 350 mg Y  
71288001715 DAPTOMYCIN daptomycin VIAL 350 mg Y  
71288001791 DAPTOMYCIN daptomycin VIAL 350 mg Y  
71839010801 DAPTOMYCIN daptomycin VIAL 350 mg Y  
72572010001 DAPTOMYCIN daptomycin VIAL 350 mg Y  
72603014701 DAPTOMYCIN daptomycin VIAL 350 mg Y  
00409012201 DAPTOMYCIN daptomycin VIAL 500 mg Y  
16714089201 DAPTOMYCIN daptomycin VIAL 500 mg Y  
16729043505 DAPTOMYCIN daptomycin VIAL 500 mg Y  
25021017415 DAPTOMYCIN daptomycin VIAL 500 mg Y  
25021017416 DAPTOMYCIN daptomycin VIAL 500 mg Y  
31722010210 DAPTOMYCIN daptomycin VIAL 500 mg Y  
31722021601 DAPTOMYCIN daptomycin VIAL 500 mg Y  
43598041311 DAPTOMYCIN daptomycin VIAL 500 mg Y  
55150034401 DAPTOMYCIN daptomycin VIAL 500 mg Y  
60505622904 DAPTOMYCIN daptomycin VIAL 500 mg Y  
63323037110 DAPTOMYCIN daptomycin VIAL 500 mg Y  
63323037119 DAPTOMYCIN daptomycin VIAL 500 mg Y  
67457081350 DAPTOMYCIN daptomycin VIAL 500 mg Y  
67457094115 DAPTOMYCIN daptomycin VIAL 500 mg Y  
68001037668 DAPTOMYCIN daptomycin VIAL 500 mg Y  
70377009391 DAPTOMYCIN daptomycin VIAL 500 mg Y  
70594003401 DAPTOMYCIN daptomycin VIAL 500 mg Y  
70594003402 DAPTOMYCIN daptomycin VIAL 500 mg Y  
70594006001 DAPTOMYCIN daptomycin VIAL 500 mg Y  
71288001615 DAPTOMYCIN daptomycin VIAL 500 mg Y  
71288001691 DAPTOMYCIN daptomycin VIAL 500 mg Y  
71288001695 DAPTOMYCIN daptomycin VIAL 500 mg Y  
71839010701 DAPTOMYCIN daptomycin VIAL 500 mg Y  
72572010201 DAPTOMYCIN daptomycin VIAL 500 mg Y  
72603015201 DAPTOMYCIN daptomycin VIAL 500 mg Y  
00338071812 DAPTOMYCIN-0.9% NACL daptomycin in 0.9 % sod chlor FROZ.PIGGY 1,000 mg/100 mL Y  
00338071224 DAPTOMYCIN-0.9% NACL daptomycin in 0.9 % sod chlor FROZ.PIGGY 350 mg/50 mL Y  
00338071424 DAPTOMYCIN-0.9% NACL daptomycin in 0.9 % sod chlor FROZ.PIGGY 500 mg/50 mL Y  
00338071612 DAPTOMYCIN-0.9% NACL daptomycin in 0.9 % sod chlor FROZ.PIGGY 700 mg/100 mL Y  
70842010203 BAXDELA delafloxacin meglumine VIAL 300 mg Y  
00143939801 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
00143939810 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
00143942901 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
00143942910 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
00409351021 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
00409351022 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
16714088901 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
16714088910 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
25021019920 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
42023022101 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
42023022110 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
42023022185 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
42023022189 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
43598090111 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
43598090158 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
44567082001 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
44567082010 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
55150028209 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
55150028220 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
60505619600 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
60505619604 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
63323082301 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
63323082320 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
68001040829 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
68001040831 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
72266015901 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
72266015905 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
72266015910 ERTAPENEM ertapenem sodium VIAL 1 gram Y  
63323034901 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 250 mg Y  
63323034925 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 250 mg Y  
44567070501 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
44567070510 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032201 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032221 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032225 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032241 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032293 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
63323032294 IMIPENEM-CILASTATIN SODIUM imipenem/cilastatin sodium VIAL 500 mg Y  
00006351659 PRIMAXIN imipenem/cilastatin sodium VIAL 500 mg Y  
00006385601 RECARBRIO imipenem/cilastatin/relebactam VIAL 1.25 gram Y  
00006385602 RECARBRIO imipenem/cilastatin/relebactam VIAL 1.25 gram Y  
00009010404 LINCOCIN lincomycin HCl VIAL 300 mg/mL Y  
00009010704 LINCOCIN lincomycin HCl VIAL 300 mg/mL Y  
54859040210 LINCOJECT lincomycin HCl VIAL 300 mg/mL Y  
00121103555 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
25021019302 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
25021019310 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
39822035001 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
39822035002 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
39822035305 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
39822035306 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
72485011401 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
72485011402 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
72485011501 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
72485011510 LINCOMYCIN HCL lincomycin HCl VIAL 300 mg/mL Y  
00409488301 LINEZOLID-0.9% NACL linezolid in 0.9% sodium chlor PIGGYBACK 600 mg/300 mL Y  
00409488303 LINEZOLID-0.9% NACL linezolid in 0.9% sodium chlor PIGGYBACK 600 mg/300 mL Y  
00409488310 LINEZOLID-0.9% NACL linezolid in 0.9% sodium chlor PIGGYBACK 600 mg/300 mL Y  
00009513704 ZYVOX linezolid in dextrose 5% PIGGYBACK 200 mg/100 mL Y  
00143953401 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00143953410 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00781343346 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00781343395 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
55150024251 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
57664068357 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
63323071303 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
63323071313 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
66794021943 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
66794021963 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
66794023643 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
66794023663 LINEZOLID-D5W linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00009499201 ZYVOX linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00009499202 ZYVOX linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00009514004 ZYVOX linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00009780701 ZYVOX linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00009780702 ZYVOX linezolid in dextrose 5% PIGGYBACK 600 mg/300 mL Y  
00310032111 MERREM meropenem INFUS. BTL 1 gram Y  
00310032511 MERREM meropenem INFUS. BTL 500 mg Y  
00143943101 MEROPENEM meropenem VIAL 1 gram Y  
00143943110 MEROPENEM meropenem VIAL 1 gram Y  
00409139121 MEROPENEM meropenem VIAL 1 gram Y  
00409139122 MEROPENEM meropenem VIAL 1 gram Y  
00409341201 MEROPENEM meropenem VIAL 1 gram Y  
00409341210 MEROPENEM meropenem VIAL 1 gram Y  
00781309895 MEROPENEM meropenem VIAL 1 gram Y  
44567014601 MEROPENEM meropenem VIAL 1 gram Y  
44567014610 MEROPENEM meropenem VIAL 1 gram Y  
44567040101 MEROPENEM meropenem VIAL 1 gram Y  
44567040110 MEROPENEM meropenem VIAL 1 gram Y  
55150020830 MEROPENEM meropenem VIAL 1 gram Y  
63323050801 MEROPENEM meropenem VIAL 1 gram Y  
63323050821 MEROPENEM meropenem VIAL 1 gram Y  
63323050825 MEROPENEM meropenem VIAL 1 gram Y  
63323050830 MEROPENEM meropenem VIAL 1 gram Y  
63323050831 MEROPENEM meropenem VIAL 1 gram Y  
63323050845 MEROPENEM meropenem VIAL 1 gram Y  
70121145301 MEROPENEM meropenem VIAL 1 gram Y  
70121145307 MEROPENEM meropenem VIAL 1 gram Y  
70594007601 MEROPENEM meropenem VIAL 1 gram Y  
70594007602 MEROPENEM meropenem VIAL 1 gram Y  
72485041201 MEROPENEM meropenem VIAL 1 gram Y  
72485041210 MEROPENEM meropenem VIAL 1 gram Y  
72572041601 MEROPENEM meropenem VIAL 1 gram Y  
72572041610 MEROPENEM meropenem VIAL 1 gram Y  
44567040201 MEROPENEM meropenem VIAL 2 gram Y  
44567040206 MEROPENEM meropenem VIAL 2 gram Y  
72078008100 MEROPENEM meropenem VIAL 2 gram Y  
72078008106 MEROPENEM meropenem VIAL 2 gram Y  
00143943001 MEROPENEM meropenem VIAL 500 mg Y  
00143943010 MEROPENEM meropenem VIAL 500 mg Y  
00409022201 MEROPENEM meropenem VIAL 500 mg Y  
00409022210 MEROPENEM meropenem VIAL 500 mg Y  
00409139021 MEROPENEM meropenem VIAL 500 mg Y  
00409139051 MEROPENEM meropenem VIAL 500 mg Y  
00781300095 MEROPENEM meropenem VIAL 500 mg Y  
44567014501 MEROPENEM meropenem VIAL 500 mg Y  
44567014510 MEROPENEM meropenem VIAL 500 mg Y  
44567040001 MEROPENEM meropenem VIAL 500 mg Y  
44567040010 MEROPENEM meropenem VIAL 500 mg Y  
55150020720 MEROPENEM meropenem VIAL 500 mg Y  
63323050701 MEROPENEM meropenem VIAL 500 mg Y  
63323050719 MEROPENEM meropenem VIAL 500 mg Y  
63323050720 MEROPENEM meropenem VIAL 500 mg Y  
63323050721 MEROPENEM meropenem VIAL 500 mg Y  
63323050725 MEROPENEM meropenem VIAL 500 mg Y  
70121145401 MEROPENEM meropenem VIAL 500 mg Y  
70121145407 MEROPENEM meropenem VIAL 500 mg Y  
70594007501 MEROPENEM meropenem VIAL 500 mg Y  
70594007502 MEROPENEM meropenem VIAL 500 mg Y  
72485041101 MEROPENEM meropenem VIAL 500 mg Y  
72485041110 MEROPENEM meropenem VIAL 500 mg Y  
72572041501 MEROPENEM meropenem VIAL 500 mg Y  
72572041510 MEROPENEM meropenem VIAL 500 mg Y  
00310032515 MERREM meropenem VIAL PORT 500 mg Y  
00264318511 MEROPENEM-0.9% NACL meropenem-0.9% sodium chloride PIGGYBACK 1 gram/50 mL Y  
00264318311 MEROPENEM-0.9% NACL meropenem-0.9% sodium chloride PIGGYBACK 500 mg/50 mL Y  
70842012001 VABOMERE meropenem/vaborbactam VIAL 2 gram Y  
70842012006 VABOMERE meropenem/vaborbactam VIAL 2 gram Y  
67457032325 MOXIFLOXACIN moxifloxacin-sod.chloride(iso) PIGGYBACK 400 mg/250 mL Y  
63323085004 MOXIFLOXACIN moxifloxacin/sod.ace,sul/water PIGGYBACK 400 mg/250 mL Y  
63323085074 MOXIFLOXACIN moxifloxacin/sod.ace,sul/water PIGGYBACK 400 mg/250 mL Y  
70842022501 KIMYRSA oritavancin diphosphate VIAL 1,200 mg Y  
70842014001 ORBACTIV oritavancin diphosphate VIAL 400 mg Y  
70842014003 ORBACTIV oritavancin diphosphate VIAL 400 mg Y  
55150023410 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
63323032101 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
63323032102 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
63323032112 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
70594004902 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
72266024901 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
72266024910 POLYMYXIN B SULFATE polymyxin B sulfate VIAL 500,000 unit Y  
67919004002 SIVEXTRO tedizolid phosphate VIAL 200 mg Y  
67919004099 SIVEXTRO tedizolid phosphate VIAL 200 mg Y  
66220031511 VIBATIV telavancin HCl VIAL 750 mg Y  
66220031522 VIBATIV telavancin HCl VIAL 750 mg Y  
66220031544 VIBATIV telavancin HCl VIAL 750 mg Y  
59572021015 THALOMID thalidomide CAPSULE 100 mg Y  
59572022016 THALOMID thalidomide CAPSULE 200 mg Y  
59572020514 THALOMID thalidomide CAPSULE 50 mg Y  
55150022810 TIGECYCLINE tigecycline VIAL 50 mg Y  
60505609800 TIGECYCLINE tigecycline VIAL 50 mg Y  
60505609801 TIGECYCLINE tigecycline VIAL 50 mg Y  
63323096010 TIGECYCLINE tigecycline VIAL 50 mg Y  
70121164701 TIGECYCLINE tigecycline VIAL 50 mg Y  
70121164707 TIGECYCLINE tigecycline VIAL 50 mg Y  
71288001910 TIGECYCLINE tigecycline VIAL 50 mg Y  
71288001911 TIGECYCLINE tigecycline VIAL 50 mg Y  
00008499019 TYGACIL tigecycline VIAL 50 mg Y  
00008499020 TYGACIL tigecycline VIAL 50 mg Y  
00008499419 TYGACIL tigecycline VIAL 50 mg Y  
00008499420 TYGACIL tigecycline VIAL 50 mg Y  
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