88:00 Vitamins

88:04.00 VITAMIN A

VITAMIN A

Table: VITAMIN A
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST10,000IU Capsule	80054130	JAMP-VITAMIN A	JMP
^ST10,000IU Capsule	00557447	VITAMIN A	VTH

88:08.00 VITAMIN B COMPLEX

CYANOCOBALAMIN

Table: CYANOCOBALAMIN
Drug strength and dosage form	DIN	Brand name	Manufacturer code
100MCG/ML Liquid	02241500	VITAMIN B12	SDZ
^ST200MCG/ML Liquid	80039903	BEDUZIL	ORM
^ST200MCG/ML Liquid	80026092	JAMP-VITAMIN B12	JMP
1,000MCG/ML Liquid	00626112	B-12	OMG
1,000MCG/ML Liquid	02052717	CYANOCOBALAMIN	TAR
1,000MCG/ML Liquid	02413795	CYANOCOBALAMIN	MYL
1,000MCG/ML Liquid	02420147	JAMP-CYANOCOBALAMIN	JMP
1,000MCG/ML Solution	01987003	CYANOCOBALAMIN	RAX
1,000MCG/ML Solution	00521515	VITAMIN B12	SDZ
^ST250MCG Tablet	80015294	JAMP-VITAMIN B12	JMP
^ST250MCG Tablet	80055743	M-B12	MAN
^ST250MCG Tablet	00335940	VITAMIN B12	JAM
^ST250MCG Tablet	02239695	VITAMIN B12	PMT
^ST250MCG Tablet	80004053	VITAMIN B12	WNP
^ST1000MCG Tablet	80028902	JAMP VITAMIN B12	JMP
^ST1000MCG Tablet	80015276	JAMP-VITAMIN B12	JMP
^ST1000MCG Tablet	80055741	M-B12	MAN
^ST1000MCG Tablet	02237736	VITAMIN B12	VAE
^ST1000MCG Tablet	80003575	VITAMIN B12	PMT
^ST1000MCG Tablet	80006939	VITAMIN B12	WNP
^ST1000MCG Tablet	80012952	VITAMIN B12 SUBLINGUAL	JAM

FOLIC ACID

Table: FOLIC ACID
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST1MG Tablet	00318973	FOLIC ACID	JAM
^ST1MG Tablet	00647039	FOLIC ACID	VTH
^ST1MG Tablet	02048841	FOLIC ACID	PMT
^ST1MG Tablet	80000273	FOLIC ACID	WNP
^ST1MG Tablet	80053274	JAMP FOLIC ACID	JMP
^ST1MG Tablet	80061488	M-FOLIQUE	MAN
^ST1MG Tablet	02236747	WAMPOLE FOLIC ACID	WAM
^ST5MG Tablet	00426849	FOLIC ACID	APX
^ST5MG Tablet	02366061	JAMP-FOLIC ACID	JMP
^ST5MG Tablet	02285673	SANDOZ FOLIC ACID	SDZ
^ST1000MCG Tablet	02239882	FOLIC ACID	UNK

NIACIN

Table: NIACIN
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST500MG Caplet	00309737	NIACIN	JAM
^ST50MG Tablet	00041084	NIACIN	ADA
^ST500MG Tablet	00557412	NIACIN	VTH
^ST500MG Tablet	01939130	NIACIN	ODN
^ST500MG Tablet	02247004	NIACIN	PMT

PYRIDOXINE HYDROCHLORIDE

Table: PYRIDOXINE HYDROCHLORIDE
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST25MG Tablet	80056458	M-B6	MAN
^ST25MG Tablet	00122645	VITAMIN B6	JAM
^ST25MG Tablet	00232475	VITAMIN B6	ADA
^ST25MG Tablet	01943200	VITAMIN B6	ODN
^ST25MG Tablet	80002890	VITAMIN B6	JMP
^ST50MG Tablet	00305227	VITAMIN B6	JAM
50MG Tablet	00608599	VITAMIN B6	ADA
^ST100MG Tablet	00450677	B6	VTH
^ST100MG Tablet	00263958	VITAMIN B6	VAE
^ST100MG Tablet	00329185	VITAMIN B6	JAM
^ST100MG Tablet	02239348	VITAMIN B6	PMT

THIAMINE HYDROCHLORIDE

Table: THIAMINE HYDROCHLORIDE
Drug strength and dosage form	DIN	Brand name	Manufacturer code
100MG/ML Liquid	02193221	THIAMIJECT	OMG
100MG/ML Liquid	02243525	THIAMINE	RAX
100MG/ML Solution	00816078	VITAMIN B1	SDZ
^ST50MG Tablet	02245506	EURO VITAMIN B1	EUR
^ST50MG Tablet	80054199	M-B1	MAN
^ST50MG Tablet	00268631	THIAMINE	VAE
^ST50MG Tablet	80009633	VITAMIN B1	JMP
^ST100MG Tablet	80054205	M-B1	MAN
^ST100MG Tablet	00232467	VITAMIN B1	PED
^ST100MG Tablet	00407011	VITAMIN B1	JAM
^ST100MG Tablet	02239350	VITAMIN B1	PMT
^ST100MG Tablet	80000352	VITAMIN B1	WNP
^ST100MG Tablet	80009588	VITAMIN B1	JMP

88:12.00 VITAMIN C

ASCORBIC ACID

Table: ASCORBIC ACID
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST500MG Caplet	02163268	VITAMIN C	JAM
^ST250MG Tablet	00162515	VITAMIN C	PMT
^ST250MG Tablet	00221244	VITAMIN C	ADA
^ST250MG Tablet	00266051	VITAMIN C	PMT
^ST250MG Tablet	00557811	VITAMIN C	VTH
^ST500MG Tablet	00266086	ASCORBIC ACID	PMT
^ST500MG Tablet	00041114	VITAMIN C	ADA
^ST500MG Tablet	00322326	VITAMIN C	ADA
^ST500MG Tablet	00557838	VITAMIN C	VTH
^ST500MG Tablet	00784591	VITAMIN C	VTH
^ST500MG Tablet	01922378	VITAMIN C	VAE
^ST500MG Tablet	02243893	VITAMIN C	PMT
^ST500MG Tablet	02244469	VITAMIN C	PMT
^ST500MG Tablet	02245348	VITAMIN C	WNP
^ST500MG Tablet	02245721	VITAMIN C	PMT
500MG Tablet	00322997	VITAMINE C	LAL
^ST500MG Tablet	00036188	WAMPOLE VITAMIN C	WAM
^ST500MG Tablet	00274240	WAMPOLE VITAMIN C	WAM

VITAMIN C

Table: VITAMIN C
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST500MG Tablet	80003328	VITAMIN C	WNP
500MG Tablet	80085369	VITAMIN C	WAM

88:16.00 VITAMIN D

ALFACALCIDOL

Table: ALFACALCIDOL
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST0.25MCG Capsule	00474517	ONE ALPHA	LEO
^ST1MCG Capsule	00474525	ONE ALPHA	LEO
^ST2MCG/ML Drop	02240329	ONE-ALPHA	LEO

CALCITRIOL

Table: CALCITRIOL
Drug strength and dosage form	DIN	Brand name	Manufacturer code
0.25MCG Capsule	02495899	CALCITRIOL	STS
^ST0.25MCG Capsule	02431637	CALCITRIOL-ODAN	ODN
^ST0.25MCG Capsule	00481823	ROCALTROL	HLR
^ST0.25MCG Capsule	02485710	TARO-CALCITRIOL	TAR
0.5MCG Capsule	02495902	CALCITRIOL	STS
^ST0.5MCG Capsule	02431645	CALCITRIOL-ODAN	ODN
^ST0.5MCG Capsule	00481815	ROCALTROL	HLR
^ST0.5MCG Capsule	02485729	TARO-CALCITRIOL	TAR

CHOLECALCIFEROL

Table: CHOLECALCIFEROL
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST400IU Capsule	80006629	DGEL	JMP
^ST400IU Capsule	02242651	EURO D	EUR
^ST400IU Capsule	80005560	RIVA-D	RIV
^ST800IU Capsule	80007769	DGEL	JMP
1,000IU Capsule	80027592	DGEL	OPU
^ST1,000IU Capsule	80009635	VITAMIN D3	WAM
^ST10,000IU Capsule	02253178	EURO D	SDZ
^ST400IU Liquid	80001869	BABY DDROPS	DDP
^ST400IU Liquid	80001792	DDROPS	DDP
^ST400IU/ML Liquid	00762881	D VI INFANTS	MJO
^ST400IU/ML Liquid	80003038	JAMP VITAMIN D	JMP
^ST400IU/ML Liquid	02231624	PEDIAVIT D	EUR
^ST1,000IU Liquid	80001791	DDROPS	DDP
^ST400IU Tablet	02238729	VITAMIN D	VTH
^ST400IU Tablet	02240858	VITAMIN D	PMT
^ST400IU Tablet	00765384	VITAMINE D	LAL
^ST400IU Tablet	02240624	WAMPOLE VITAMIN D	WAM
^ST1,000IU Tablet	02245842	VITAMIN D3	PMT
^ST10,000IU Tablet	00821772	D-TABS	RIV
^ST10,000IU Tablet	02417995	VITAMINE D	PDL

ERGOCALCIFEROL

Table: ERGOCALCIFEROL
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST50,000IU Capsule	02237450	SANDOZ D-FORTE	SDZ
^ST8,288IU/ML Solution	80020776	D2-DOL	JMP
^ST8,288IU/ML Solution	80003615	ERDOL	ODN

VITAMIN D

Table: VITAMIN D
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST10MCG Capsule	80063895	VIT D 400	UNK
^ST25MCG Capsule	80063899	VIT D 1000	UNK
^ST25MCG Capsule	80068574	VITACELL VITAMIN D3 SOFTGELS	UNK
^ST200U Capsule	02442256	VITAMIN D3	ORM
^ST400IU Capsule	80055196	M-D	MAN
^ST400IU Capsule	80001145	PHARMA-D	PED
400U Capsule	80090840	BIO-VITAMIN D3	BMI
^ST800IU Capsule	80003010	EURO D	EUR
^ST800IU Capsule	80008446	VITAMINE D	BMI
^ST1,000IU Capsule	80007766	DGEL	JMP
1,000IU Capsule	80003707	EURO-D	EUR
^ST1,000IU Capsule	80055204	M-D	MAN
^ST1,000IU Capsule	80008496	PHARMA-D	PMS
^ST10,000IU Capsule	02371499	EURO-D	PMS
^ST10,000IU Capsule	02449099	JAMP-VITAMIN D	JMP
^ST15MCG Liquid	80013189	DDROPS BOOSTER	DDP
^ST400IU Liquid	80019649	D3-DOL	JMP
^ST400IU Liquid	80038155	DECAXIL	ORM
^ST400IU Liquid	80041145	DECAXIL	ORM
^ST800IU Liquid	80003285	PEDIAVIT D	EUR
^ST1,000IU Liquid	80007346	JAMP VITAMIN D	JMP
^ST1,000IU Liquid	80028362	JAMP VITAMIN D	JMP
^ST1,000IU Liquid	80028371	JAMP VITAMIN D	JMP
^ST25MCG Tablet	80031157	VITAMIN D	WNP
^ST400IU Tablet	80002452	VITAMIN D	WNP
^ST400IU Tablet	80009578	VITAMIN D	VAE
^ST1,000IU Tablet	80002169	PHARMA-D	PMS
^ST1,000IU Tablet	80051562	RIVA-D	RIV
^ST1,000IU Tablet	80000131	VITAMIN D	VTH
^ST1,000IU Tablet	80000436	VITAMIN D	JAM
^ST1,000IU Tablet	80003663	VITAMIN D	WNP
^ST1,000IU Tablet	80009580	VITAMIN D	VAE
^ST1,000IU Tablet	80015278	WAMPOLE VITAMIN D	WAM
^ST10,000IU Tablet	02379007	JAMP-VITAMIN D	JMP
^ST10,000IU Tablet	02417685	VIDEXTRA	ORM

88:20.00 VITAMIN E

VITAMIN E

Limited use benefit (prior approval required).

For use in malabsorption

Table: VITAMIN E
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST100IU Capsule (Softgel)	00122823	VITAMIN E	JAM
^ST200IU Capsule (Softgel)	00122831	VITAMIN E	JAM
^ST400IU Capsule (Softgel)	00122858	VITAMIN E	JAM
^ST800IU Capsule (Softgel)	00330191	VITAMIN E	JAM
^ST20U/ML Liquid	09991656	AQUA-E/ML	UNK
^ST75U/ML Liquid	09991652	AQUA-E	UNK
^ST50IU Oral Liquid	00480215	AQUASOL E	NVC
^ST50IU/ML Oral Liquid	02162075	AQUASOL E VITAMIN E	CLC

88:24.00 VITAMIN K

PHYTONADIONE

Table: PHYTONADIONE
Drug strength and dosage form	DIN	Brand name	Manufacturer code
2MG/ML Emulsion	00781878	VITAMIN K1	SDZ
10MG/ML Emulsion	00804312	VITAMIN K1	SDZ

88:28.00 MULTIVITAMIN PREPARATIONS

CALCIUM, VITAMIN D

Table: CALCIUM, VITAMIN D
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST500-400MGU Tablet	80088060	BIO-CAL DR FORTE	BIO

MULTIVITAMINS (CHILDREN AND YOUTH)

Limited use benefit (prior approval is not required).

Multivitamins are benefits for children up to 19 years of age.

Table: MULTIVITAMINS (CHILDREN AND YOUTH)
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST Drop	00762946	ENFAMIL POLYVISOL	MJO
^ST450MG & 10MG & 30MG Liquid	80008471	JAMP VITAMIN A, D AND C	JMP
^ST2,500IU & 666.67IU & 50MG/ML Liquid	00762903	ENFAMIL TRIVISOL	MJO
^ST2,500IU & 666.67IU & 50MG/ML Liquid	02229790	PEDIAVIT	EUR
0MG Tablet	02246362	CENTRUM	PFI
0MG Tablet	80021452	CENTRUM	PFI
0MG Tablet	80024482	CENTRUM FOR WOMEN	PFI
2MG Tablet	80045908	ONE A DAY WOMEN	BAY
10MG Tablet	80039441	STRESSTABS FOR WOMEN	PFI
^ST Tablet (Chewable)	80011134	CENTRUM JUNIOR COMPLETE	PFI
^ST Tablet (Chewable)	80020794	CENTRUM JUNIOR COMPLETE	PFI
^ST Tablet (Chewable)	02247995	FLINTSTONES MULTIPLE VITAMINS PLUS IRON	BAY
^ST Tablet (Chewable)	02247975	FLINTSTONES MULTIPLE VITAMINS WITH EXTRA C	BAY

MULTIVITAMINS (PRENATAL)

Limited use benefit (prior approval is not required.).

Prenatal and postnatal vitamins are benefits only for clients of childbearing age (12 to 50 years).

Table: MULTIVITAMINS (PRENATAL)
Drug strength and dosage form	DIN	Brand name	Manufacturer code
^ST Capsule	80042704	CENTRUM DHA	PFI
^ST Tablet	80045822	CENTRUM PRENATAL	PFI
^ST Tablet	80080882	MATERNA	NES
^ST Tablet	80082297	MATERNA	NES
^ST Tablet	80001842	NESTL MATERNA	NES
^ST Tablet	02241235	PRENATAL AND POSTPARTUM VITAMINS AND MINERALS	VTH
^ST Tablet	80005770	PRENATAL AND POSTPARTUM VITAMINS AND MINERALS	PMT
^ST Tablet	02229535	WAMPOLE COMPLETE MULT-PRE AND POST NATAL WITH FOLIC ACID	WAM
2MG Tablet	80004919	NATURES BOUNTY PRENATAL VITAMINS	VTH

THIAMINE HYDROCHLORIDE

Table: THIAMINE HYDROCHLORIDE
Drug strength and dosage form	DIN	Brand name	Manufacturer code
50MG Tablet	80049777	OPUS VITAMINE B1	OPU
100MG Tablet	80049780	OPUS VITAMINE B1	OPU

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Date modified:: 2020-10-15