Anticoagulants, Intravenous
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.
| NDC | Brand Name | Generic Name | Form | Strength | PDL Status |
Rebate | Current Drug Use Criteria |
|---|---|---|---|---|---|---|---|
| 00143967401 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 00409114001 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 42023018201 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 42023018289 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 63323052603 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 67457021202 | ARGATROBAN | argatroban | VIAL | 100 mg/mL | Y | ||
| 00143937701 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 00143955901 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 16729043011 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 16729043043 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 25021041450 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 55150024101 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 55150024110 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 65145012601 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 65219042950 | ARGATROBAN-0.9% NACL | argatroban in 0.9 % sod chlor | VIAL | 50 mg/50 mL (1 mg/mL) | Y | ||
| 00781315894 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 00781315895 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 00781915894 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 00781915895 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 16729027503 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 16729027567 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 55111065207 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 55111065237 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 55150021010 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 63323056210 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 63323056215 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 63323056241 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 67457025600 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 67457025610 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 70436002580 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 70436002582 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 71288042710 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 71288042711 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 71288042791 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 71288042792 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 72572003501 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 72572003510 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 83634040010 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 83634040041 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg | Y | ||
| 42023062201 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg/50 mL (5 mg/mL) | Y | ||
| 42023062210 | BIVALIRUDIN | bivalirudin | VIAL | 250 mg/50 mL (5 mg/mL) | Y | ||
| 10122062001 | KENGREAL | cangrelor tetrasodium | VIAL | 50 mg | N | Y | |
| 10122062010 | KENGREAL | cangrelor tetrasodium | VIAL | 50 mg | N | Y | |
| 00409196703 | CITRATE PHOSPHATE DEXTROSE | citrate phosphate dextros soln | SOLUTION | 299 mg-2.63 gram-222 mg-2.55 gram/100 mL | Y | ||
| 00338955810 | EPTIFIBATIDE | eptifibatide | PLAST. BAG | 75 mg/100 mL (0.75 mg/mL) | N | Y | |
| 55150021910 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 55150022099 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 67457062910 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 67457063010 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 70436002680 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 70436016280 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 71288041210 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 72078002510 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 72078002710 | EPTIFIBATIDE | eptifibatide | VIAL | 2 mg/mL | Y | ||
| 25021040851 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 55150021899 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 67457063110 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 70436002780 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 70436016380 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 71288041351 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 72078002610 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 83634030151 | EPTIFIBATIDE | eptifibatide | VIAL | 75 mg/100 mL (0.75 mg/mL) | Y | ||
| 00074128202 | HEP-PAK | heparin sod,porcine/0.9 % NaCl | KIT | 10 unit/mL | Y | ||
| 00074138902 | HEP-PAK CVC | heparin sod,porcine/0.9 % NaCl | KIT | 100 unit/mL | Y | ||
| 00074138932 | HEP-PAK LKFL | heparin sod,porcine/0.9 % NaCl | KIT | 100 unit/mL | Y | ||
| 00409001202 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 12,500 unit/250 mL | Y | ||
| 00409001230 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 12,500 unit/250 mL | Y | ||
| 00264346220 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409765005 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409765030 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409765052 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409765062 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 63323051701 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 63323051774 | HEPARIN SODIUM IN 0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00264330110 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 00409315005 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 00409315020 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 63323051801 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 63323051877 | HEPARIN SODIUM-0.45% NACL | heparin sod,pork in 0.45% NaCl | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 00409140212 | HEPARIN SODIUM | heparin sodium,porcine | CARTRIDGE | 5,000 unit/mL (1 mL) | Y | ||
| 00409140227 | HEPARIN SODIUM | heparin sodium,porcine | CARTRIDGE | 5,000 unit/mL (1 mL) | Y | ||
| 00409128032 | HEPARIN LOCK | heparin sodium,porcine | SYRINGE | 10 unit/mL | Y | ||
| 00409128033 | HEPARIN LOCK | heparin sodium,porcine | SYRINGE | 10 unit/mL | Y | ||
| 00074128002 | HEPARIN LOCK FLUSH | heparin sodium,porcine | SYRINGE | 10 unit/mL | Y | ||
| 00074128005 | HEPARIN LOCK FLUSH | heparin sodium,porcine | SYRINGE | 10 unit/mL | Y | ||
| 00074482201 | HEPARIN LOCK FLUSH | heparin sodium,porcine | SYRINGE | 10 unit/mL | Y | ||
| 71288040681 | HEPARIN SODIUM | heparin sodium,porcine | SYRINGE | 5,000 unit/mL | Y | ||
| 71288040682 | HEPARIN SODIUM | heparin sodium,porcine | SYRINGE | 5,000 unit/mL | Y | ||
| 00409128135 | HEPARIN LOCK | heparin sodium,porcine | SYRINGE | 500 unit/5 mL (100 unit/mL) | Y | ||
| 00409272001 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409272002 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409272003 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409272030 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409272031 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409272032 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00641039112 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00641039137 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00641245030 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00641245055 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781353810 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781353825 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781354010 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781354025 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781354310 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00781354325 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040001 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040010 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040030 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040066 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040067 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 25021040068 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054003 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054005 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054007 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054013 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054015 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054033 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054036 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 63323054067 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457037212 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457037299 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457038431 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457038499 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457038510 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 67457038599 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040201 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040202 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040210 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040211 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040230 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288040231 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288041995 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288041996 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288042095 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288042096 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288042195 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 71288042196 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72572025001 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72572025025 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603017901 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603017925 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603023401 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603023425 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603025001 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603025025 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603026701 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 72603026725 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81565020301 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81565020302 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011201 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011204 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011205 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011206 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011209 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 81952011210 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 1,000 unit/mL | Y | ||
| 00409115170 | HEPARIN LOCK | heparin sodium,porcine | VIAL | 10 unit/mL | Y | ||
| 63323054401 | HEPARIN LOCK | heparin sodium,porcine | VIAL | 10 unit/mL | Y | ||
| 63323054411 | HEPARIN LOCK | heparin sodium,porcine | VIAL | 10 unit/mL | Y | ||
| 00409272101 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 00409272130 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 00641041012 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 00641041037 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 25021040301 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 25021040304 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 25021040366 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 63323054204 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 63323054209 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 63323054213 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 63323054214 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 67457060202 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 67457060299 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 67457060305 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 67457060399 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288040401 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288040402 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288040404 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288040405 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288042495 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 71288042496 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 72603050101 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 72603050125 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 72603057901 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 72603057925 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 81952011301 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 81952011303 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 81952011306 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 81952011308 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 10,000 unit/mL | Y | ||
| 00409115270 | HEPARIN LOCK | heparin sodium,porcine | VIAL | 100 unit/mL | Y | ||
| 63323054501 | HEPARIN LOCK | heparin sodium,porcine | VIAL | 100 unit/mL | Y | ||
| 25021040401 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 63323091503 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 63323091513 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 71288040101 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 71288040102 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 72603022401 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 72603022425 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 81952011601 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 81952011606 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 20,000 unit/mL | Y | ||
| 00409272301 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00409272302 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00409272330 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00409272331 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00641040012 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00641040037 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00641246030 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00641246055 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00781354510 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00781354525 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00781355010 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00781355025 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 25021040201 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 25021040210 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 25021040266 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323004701 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323004710 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026203 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026206 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026209 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026211 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026226 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 63323026236 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 67457037412 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 67457037499 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 67457038310 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 67457038399 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288040301 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288040302 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288040310 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288040311 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288042295 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 71288042296 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72572025501 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72572025525 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603021401 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603021425 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603041201 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603041225 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603045601 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 72603045625 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 81952011101 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 81952011106 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 81952011404 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 81952011409 | HEPARIN SODIUM | heparin sodium,porcine | VIAL | 5,000 unit/mL | Y | ||
| 00074781323 | HEPARIN SODIUM IN 5% DEXTROSE | heparin sodium,porcine/D5W | IV SOLN | 100 unit/mL | Y | ||
| 00074781362 | HEPARIN SODIUM IN 5% DEXTROSE | heparin sodium,porcine/D5W | IV SOLN | 100 unit/mL | Y | ||
| 00264956710 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 20,000 unit/500 mL (40 unit/mL) | Y | ||
| 00409776013 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 20,000 unit/500 mL (40 unit/mL) | Y | ||
| 00264958720 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409452002 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00409452030 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 63323052301 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 63323052374 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/250 mL (100 unit/mL) | Y | ||
| 00264957710 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 00409776113 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 63323052201 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 63323052277 | HEPARIN SODIUM-D5W | heparin sodium,porcine/D5W | IV SOLN | 25,000 unit/500 mL (50 unit/mL) | Y | ||
| 00074781462 | HEPARIN SODIUM IN 5% DEXTROSE | heparin sodium,porcine/D5W | IV SOLN | 50 unit/mL | Y | ||
| 00264987210 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00338042418 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00338043103 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00409100501 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00409100520 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00409762003 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00409762013 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 63323051902 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 63323051977 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 1,000 unit/500 mL (2 unit/mL) | Y | ||
| 00264987200 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00338043304 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00409222201 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00409222212 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00409762049 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00409762059 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 63323051901 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 63323051910 | HEPARIN SODIUM-0.9% NACL | heparin sodium,porcine/NS/PF | IV SOLN | 2,000 unit/1,000 mL (2 unit/mL) | Y | ||
| 00409131611 | HEPARIN SODIUM | heparin sodium,porcine/PF | CARTRIDGE | 5,000 unit/0.5 mL | Y | ||
| 00409131632 | HEPARIN SODIUM | heparin sodium,porcine/PF | CARTRIDGE | 5,000 unit/0.5 mL | Y | ||
| 00641620401 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 00641620410 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 63323011801 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 63323011805 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 71288040580 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 71288040581 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/0.5 mL | Y | ||
| 00641619901 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/mL | Y | ||
| 00641619910 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/mL | Y | ||
| 76045010800 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/mL | Y | ||
| 76045010810 | HEPARIN SODIUM | heparin sodium,porcine/PF | SYRINGE | 5,000 unit/mL | Y | ||
| 00069004301 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 00069004302 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 00781355510 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 00781355525 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 25021040102 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 63323027601 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 63323027602 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 71288040002 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 71288040003 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 71839011701 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 71839011725 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 72603033601 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 72603033625 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 81952011502 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 81952011507 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 1,000 unit/mL | Y | ||
| 63323054303 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 5,000 unit/0.5 mL | Y | ||
| 63323054313 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 5,000 unit/0.5 mL | Y | ||
| 71839011801 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 5,000 unit/0.5 mL | Y | ||
| 71839011825 | HEPARIN SODIUM | heparin sodium,porcine/PF | VIAL | 5,000 unit/0.5 mL | Y | ||
| 63323050574 | ANTICOAGULANT SODIUM CITRATE | sodium citrate | SOLUTION | 4 gram/100 mL (4 %) | Y | ||
| 25208000104 | AGGRASTAT | tirofiban HCl monohydrate | VIAL | 3.75 mg/15 mL (250 mcg/mL) | N | Y | |
| 25208090104 | AGGRASTAT | tirofiban HCl monohydrate | VIAL | 3.75 mg/15 mL (250 mcg/mL) | N | Y | |
| 25208000202 | AGGRASTAT | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 25208090202 | AGGRASTAT | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 14789010202 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 14789010205 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 14789010210 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 25021041784 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 55150043001 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 12.5 mg/250 mL (50 mcg/mL) | Y | ||
| 25208000201 | AGGRASTAT | tirofiban-0.9% sodium chloride | PLAST. BAG | 5 mg/100 mL (50 mcg/mL) | Y | ||
| 25208090201 | AGGRASTAT | tirofiban-0.9% sodium chloride | PLAST. BAG | 5 mg/100 mL (50 mcg/mL) | Y | ||
| 14789010101 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 5 mg/100 mL (50 mcg/mL) | Y | ||
| 55150042901 | TIROFIBAN HCL | tirofiban-0.9% sodium chloride | PLAST. BAG | 5 mg/100 mL (50 mcg/mL) | Y | ||
| 25208000203 | AGGRASTAT | tirofiban-0.9% sodium chloride | VIAL | 5 mg/100 mL (50 mcg/mL) | N | Y |