Pain Medications, Topical

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PDL Reference Documents

Drug Use Review Documents

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
46122075355 CAPSAICIN capsaicin ADH. PATCH 0.025 % N Y  
70000055601 CAPSAICIN HEAT PATCH capsaicin ADH. PATCH 0.025 % N Y  
70512001610 CAPSIMIDE capsaicin ADH. PATCH 0.025 % N Y  
51824009415 ARTHRITIS AND MUSCLE capsaicin CREAM (G) 0.025 % Y N  
50090229300 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
50488102501 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
50488102502 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
50488102505 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
52959137002 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
52959137003 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
52959137005 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
62174001429 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
69420602501 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
69420602505 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
70645002512 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
70645002525 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
70645002550 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
87701091081 CAPSAICIN capsaicin CREAM (G) 0.025 % Y N  
00536252525 CAPSAICIN capsaicin CREAM (G) 0.025 % Y Y  
45802033010 CAPSAICIN capsaicin CREAM (G) 0.025 % Y Y  
45802033023 CAPSAICIN capsaicin CREAM (G) 0.025 % Y Y  
50268019560 CAPSAICIN capsaicin CREAM (G) 0.025 % Y Y  
49614041216 MEDI-GEN capsaicin CREAM (G) 0.025 % Y N  
62436060202 ZOSTRIX capsaicin CREAM (G) 0.025 % Y N  
60569044202 ZOSTRIX capsaicin CREAM (G) 0.033 % Y N  
61787044202 ZOSTRIX capsaicin CREAM (G) 0.033 % Y N  
79643001101 CAPSAICIN capsaicin CREAM (G) 0.035 % Y N  
41167012142 CAPZASIN-P capsaicin CREAM (G) 0.035 % Y N  
00536111825 ARTHRITIS PAIN RELIEVING capsaicin CREAM (G) 0.075 % Y Y  
50488107501 CAPSAICIN capsaicin CREAM (G) 0.075 % Y N  
52959137103 CAPSAICIN capsaicin CREAM (G) 0.075 % Y N  
62174005029 CAPSAICIN capsaicin CREAM (G) 0.075 % Y N  
85231020260 CAPSAICIN capsaicin CREAM (G) 0.075 % Y N  
45861007505 CAPSAICIN capsaicin CREAM (G) 0.075 % Y Y  
50268019657 CAPSAICIN capsaicin CREAM (G) 0.075 % Y Y  
45802032903 CAPSAICIN-HP capsaicin CREAM (G) 0.075 % Y Y  
45802032910 CAPSAICIN-HP capsaicin CREAM (G) 0.075 % Y Y  
62436060102 ZOSTRIX-HP capsaicin CREAM (G) 0.075 % Y N  
11917006938 ARTHRITIS PAIN RELIEF capsaicin CREAM (G) 0.1 % Y N  
11917009588 ARTHRITIS PAIN RELIEF capsaicin CREAM (G) 0.1 % Y N  
50428034819 CAPSAICIN capsaicin CREAM (G) 0.1 % Y N  
50488106006 CAPSAICIN capsaicin CREAM (G) 0.1 % Y N  
73141055802 CAPSAICIN capsaicin CREAM (G) 0.1 % Y N  
00536126456 CAPSAICIN capsaicin CREAM (G) 0.1 % Y Y  
45861007404 CAPSAICIN capsaicin CREAM (G) 0.1 % Y Y  
50268019756 CAPSAICIN capsaicin CREAM (G) 0.1 % Y Y  
50268019842 CAPSAICIN capsaicin CREAM (G) 0.1 % Y Y  
70000054901 CAPSAICIN capsaicin CREAM (G) 0.1 % Y Y  
69375000660 CAPSAICIN HP capsaicin CREAM (G) 0.1 % Y N  
81533020015 CAPSAID ES capsaicin CREAM (G) 0.1 % Y N  
41167075142 CAPZASIN-HP capsaicin CREAM (G) 0.1 % Y N  
41167075146 CAPZASIN-HP capsaicin CREAM (G) 0.1 % Y N  
72847031620 CAPZIX capsaicin CREAM (G) 0.1 % Y N  
60569044302 ZOSTRIX HP capsaicin CREAM (G) 0.1 % Y N  
61787044302 ZOSTRIX HP capsaicin CREAM (G) 0.1 % Y N  
60569055602 ZOSTRIX HP FOOT capsaicin CREAM (G) 0.1 % Y N  
61787055602 ZOSTRIX HP FOOT capsaicin CREAM (G) 0.1 % Y N  
24385067746 CAPSAICIN capsaicin LOTION 0.025 % N Y  
99207060504 ZOSTRIX capsaicin STICK (EA) 0.025 % N Y  
45861000405 MEDROX capsaicin/me-salicylate/menth ADH. PATCH 0.0375 %-20 %-5 % N Y  
45861000101 MEDROX capsaicin/me-salicylate/menth OINT. (G) 0.0375 %-20 %-5 % N Y  
45861000160 MEDROX capsaicin/me-salicylate/menth OINT. (G) 0.0375 %-20 %-5 % N Y  
45861000501 MEDROX capsaicin/me-salicylate/menth OINT. (G) 0.05 %-20 %-7 % N Y  
72512092000 QUTENZA capsaicin/skin cleanser KIT 8 % N Y  
72512092801 QUTENZA capsaicin/skin cleanser KIT 8 % N Y  
72512092901 QUTENZA capsaicin/skin cleanser KIT 8 % N Y  
72512093001 QUTENZA capsaicin/skin cleanser KIT 8 % N Y  
00093372750 DICLOFENAC EPOLAMINE diclofenac epolamine PATCH TD12 1.3 % N Y  
00093372755 DICLOFENAC EPOLAMINE diclofenac epolamine PATCH TD12 1.3 % N Y  
24208045705 DICLOFENAC SODIUM diclofenac sodium DROPS 0.1 % Y Y  
61314001405 DICLOFENAC SODIUM diclofenac sodium DROPS 0.1 % Y Y  
61314001425 DICLOFENAC SODIUM diclofenac sodium DROPS 0.1 % Y Y  
72888015021 DICLOFENAC SODIUM diclofenac sodium DROPS 0.1 % Y Y  
72888015022 DICLOFENAC SODIUM diclofenac sodium DROPS 0.1 % Y Y  
45861006205 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
51672135802 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
59088037210 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
59088043510 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
65162091174 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
68180053801 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
70512003805 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
70512081005 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
71085000205 DICLOFENAC SODIUM diclofenac sodium DROPS 1.5 % N Y  
25866059361 ALEVE ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
41163008701 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
49035026201 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
49035026935 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00113118901 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y Y  
00113118903 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y Y  
70677112501 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y Y  
70677127701 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y Y  
70677129301 ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y Y  
63981059903 ARTHRITIS PAIN RELIEF diclofenac sodium GEL (GRAM) 1 % Y N  
63981059905 ARTHRITIS PAIN RELIEF diclofenac sodium GEL (GRAM) 1 % Y N  
70000055501 ARTHRITIS PAIN RELIEVER diclofenac sodium GEL (GRAM) 1 % Y Y  
70000055502 ARTHRITIS PAIN RELIEVER diclofenac sodium GEL (GRAM) 1 % Y Y  
70000055503 ARTHRITIS PAIN RELIEVER diclofenac sodium GEL (GRAM) 1 % Y Y  
41167057302 ASPERCREME ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
41167057303 ASPERCREME ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
41167057304 ASPERCREME ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
50090725000 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
57896014001 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
57896014701 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
58602060407 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
62379040101 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
63868073001 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
63981087005 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
69842072902 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
69842097417 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
69842097435 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
69842097453 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
71205067000 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
71205074700 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
81877072310 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y N  
00536129434 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
00536129497 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
21922000909 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
21922004409 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
43598097710 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
45802095301 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
46122075237 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
46122075252 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
46122075253 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
68001062145 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
69097052444 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
69097072044 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
69238205301 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
70512010610 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
76282010339 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
76282066339 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
82429031410 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
83324030601 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 1 % Y Y  
50580057401 MOTRIN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
50580057402 MOTRIN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067120176 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067120282 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067293340 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815201 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815202 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815203 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815204 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815205 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815208 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00067815301 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
50090620200 VOLTAREN ARTHRITIS PAIN diclofenac sodium GEL (GRAM) 1 % Y N  
00472178310 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
45802011101 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
45861006301 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
51672136307 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
62332058131 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
68462035594 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
71085000300 DICLOFENAC SODIUM diclofenac sodium GEL (GRAM) 3 % N Y PA Document
13107026947 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
51672136908 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
60505040603 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
62332048712 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
65162068312 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
68180053701 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
70748033501 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
72603020701 DICLOFENAC SODIUM diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
75987004005 PENNSAID diclofenac sodium SOL MD PMP 20 mg/gram per actuation (2 %) N Y  
75987004074 PENNSAID diclofenac sodium SOLN PK(G) 2 % N Y  
59088080400 LIXOFEN diclofenac/kinesiology tape KIT 1.5 % N Y  
59088080200 DICLOGEN diclofenac/menthol/camphor KIT 1.5 %-10 %-4 % N Y  
00037682410 EPIFOAM hydrocortisone/pramoxine FOAM 1 %-1 % N Y  
69557011101 ZTLIDO lidocaine ADH. PATCH 1.8 % N Y PA Document
69557011130 ZTLIDO lidocaine ADH. PATCH 1.8 % N Y PA Document
68001062589 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
68001062593 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
68001062595 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
70512001430 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
70512081201 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
70512081230 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
85477030210 LIDOCAINE lidocaine ADH. PATCH 4 % N Y PA Document
59088090554 DERMACINRX LIDOCAN lidocaine ADH. PATCH 5 % N Y PA Document
59088090584 DERMACINRX LIDOCAN lidocaine ADH. PATCH 5 % N Y PA Document
00378905516 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00378905593 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00591267911 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00591267930 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00591352511 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00591352530 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00603188010 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
00603188016 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
42858011830 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
59088039654 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
59088039682 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
65162079104 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
65162079108 LIDOCAINE lidocaine ADH. PATCH 5 % N Y PA Document
59088090854 LIDOCAN II lidocaine ADH. PATCH 5 % N Y PA Document
59088090884 LIDOCAN II lidocaine ADH. PATCH 5 % N Y PA Document
59088090754 LIDOCAN III lidocaine ADH. PATCH 5 % N Y PA Document
59088090784 LIDOCAN III lidocaine ADH. PATCH 5 % N Y PA Document
59088091054 LIDOCAN IV lidocaine ADH. PATCH 5 % N Y PA Document
59088091084 LIDOCAN IV lidocaine ADH. PATCH 5 % N Y PA Document
59088090954 LIDOCAN V lidocaine ADH. PATCH 5 % N Y PA Document
59088090984 LIDOCAN V lidocaine ADH. PATCH 5 % N Y PA Document
63481068701 LIDODERM lidocaine ADH. PATCH 5 % N Y PA Document
63481068706 LIDODERM lidocaine ADH. PATCH 5 % N Y PA Document
73352083001 TRIDACAINE II lidocaine ADH. PATCH 5 % N Y PA Document
73352083015 TRIDACAINE II lidocaine ADH. PATCH 5 % N Y PA Document
73352083501 TRIDACAINE III lidocaine ADH. PATCH 5 % N Y PA Document
73352083515 TRIDACAINE III lidocaine ADH. PATCH 5 % N Y PA Document
73352084501 TRIDACAINE XL lidocaine ADH. PATCH 5 % N Y PA Document
73352084530 TRIDACAINE XL lidocaine ADH. PATCH 5 % N Y PA Document
00168020437 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
16714087801 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
16714087802 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
33342040530 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
33342040535 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
33342040550 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
45861006130 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
45861006501 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
45861006502 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
45861006560 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
51672300803 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
51672300805 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
51672302002 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
51672302009 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
62332042430 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
62332042435 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
62332042450 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
64380078923 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
64380078932 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
64380078933 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
65162091838 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
65162091853 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
67877047379 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
67877047380 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
68462041820 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
68462041827 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
69680012035 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
70752011303 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
70752011304 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
71085000130 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
71085001150 LIDOCAINE lidocaine OINT. (G) 5 % N Y  
70512001230 LIDAFLEX lidocaine HCl ADH. PATCH 4 % N Y  
59088024107 DERMACINRX LIDOCAINE lidocaine HCl CREAM (G) 3 % Y  
13925015901 LIDOCAINE HCL lidocaine HCl CREAM (G) 3 % Y Y  
13925015903 LIDOCAINE HCL lidocaine HCl CREAM (G) 3 % Y Y  
69367020201 LIDOCAINE HCL lidocaine HCl CREAM (G) 3 % Y Y  
69367020285 LIDOCAINE HCL lidocaine HCl CREAM (G) 3 % Y Y  
59088037107 LIDOTRAL lidocaine HCl CREAM (G) 3.88 % N Y  
41167005660 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005862 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005877 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005878 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005884 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005970 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167058208 ASPERCREME LIDOCAINE lidocaine HCl CREAM (G) 4 % Y N  
41167005050 GOLD BOND MEDICATED PAIN-ITCH lidocaine HCl CREAM (G) 4 % Y N  
41167005290 GOLD BOND MEDICATED PAIN-ITCH lidocaine HCl CREAM (G) 4 % Y N  
50428028323 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
50428059002 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
50428061154 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
50488626201 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
69420626201 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
70645026211 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
71436002601 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y N  
46122061410 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y Y  
50268049030 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y Y  
70000009801 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y Y  
83035113003 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y Y  
83324000627 LIDOCAINE HCL lidocaine HCl CREAM (G) 4 % Y Y  
50488626301 LIDOCAINE PLUS lidocaine HCl CREAM (G) 4 % Y N  
82944020102 LIDOCORE lidocaine HCl CREAM (G) 4 % Y N  
85231020030 LIDOGUARD lidocaine HCl CREAM (G) 4 % Y N  
72835011415 LIDOZALL PLUS lidocaine HCl CREAM (G) 4 % Y N  
50428054208 PAIN RELIEF lidocaine HCl CREAM (G) 4 % Y N  
70000053701 BURN RELIEF lidocaine HCl GEL (GRAM) 1 % Y  
59088022107 DERMACINRX LIDOEASE lidocaine HCl GEL (GRAM) 2 % N Y  
59088046607 DERMACINRX LIDOGEL lidocaine HCl GEL (GRAM) 2.8 % N Y  
59088047507 DERMACINRX LIDOREX lidocaine HCl GEL (GRAM) 2.8 % N Y  
73352062001 TRILOGEL lidocaine HCl GEL (GRAM) 2.8 % N Y  
25021067376 GLYDO lidocaine HCl JEL/PF APP 2 % Y Y  
25021067377 GLYDO lidocaine HCl JEL/PF APP 2 % Y Y  
76329301105 LIDOCAINE HCL lidocaine HCl JEL/PF APP 2 % Y Y  
76329301205 LIDOCAINE HCL lidocaine HCl JEL/PF APP 2 % Y Y  
76329301305 LIDOCAINE HCL lidocaine HCl JEL/PF APP 2 % Y Y  
76329301505 LIDOCAINE HCL lidocaine HCl JEL/PF APP 2 % Y Y  
72485061130 LIDOCAINE HCL lidocaine HCl JELLY(ML) 2 % N Y  
54859051302 DOLOGESIC PAIN RELIEF lidocaine HCl LIQD ROLON 4 % N Y  
70000009901 LIDOCAINE lidocaine HCl LIQD ROLON 4 % N Y  
00054350049 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
00121095003 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
00121495015 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
00121495040 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
62135071242 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
62135087124 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
62135087151 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
72888012526 LIDOCAINE HCL VISCOUS lidocaine HCl SOLUTION 2 % Y Y  
76329630005 LIDOCAINE HCL lidocaine HCl SOLUTION 4 % Y Y  
00054350547 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
00116402550 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
00121097251 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
00527600480 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
51672141103 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
63739099764 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
70954051810 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
83148004350 LIDOCAINE HCL lidocaine HCl SOLUTION 40 mg/mL Y Y  
13925016001 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
13925016003 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
59088081903 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
59088081907 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
69367039701 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
69367039785 LIDOCAINE-HYDROCORTISONE lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
59088043005 LIDOCORT lidocaine/hydrocortisone ac CREAM (G) 3 %-0.5 % N Y  
59088073100 XYLIDERM lidocaine/kinesiology tape KIT 5 % N Y  
00121100230 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00168035705 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00168035730 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00168035755 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00574204205 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00574204213 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00574204230 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
21922007605 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
62332058204 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
62332058231 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
72578016506 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
81033002501 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
81033002505 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
81033002550 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
81033002551 LIDOCAINE-PRILOCAINE lidocaine/prilocaine CREAM (G) 2.5 %-2.5 % Y Y  
00168035756 LIDOCAINE-PRILOCAINE lidocaine/prilocaine KIT 2.5 %-2.5 % N Y  
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