Attachment_II_-_NOAA_Fleet_Formulary_and_Medical_Inventory_Price_Schedule.xlsx

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NOAA Health Services Formulary
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1305M219QNMAN0355
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NOAA Health Services Fleet Formulary/Price Schedule

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GenericBrand Name (Example Only, Not Required)DoseVolumeCountPackagingACCEPTABLE ALTERNATIVETotal Quantity needed per NOAA ship. (May vary per ship)
(15 NOAA Ships)COMMENT(S)Unit PriceExtended Price
ALLERGY
Epinephrine Auto-Injector(EpiPen)0.3 mg2Box1 Box of 2 Pens
ANALGESICS
Acetaminophen suppositories(Tylenol)650 mg12 suppBox1 Box of 12 Suppositories
Acetaminophen tablets(Tylenol)325 mg100Bottle2 Bottles of 100 tablets
Aspirin tablets(Bayer)325 mg100Bottle2 Bottles of 100 tablets
Benzocaine 20% topical swabs(Orajel)-8 swabsPackage1 Package of 8 swabs
Ibuprofen tablets(Motrin)200 mg100Bottle2 Bottles of 100 tablets
Ketorolac injection(Toradol)30 mg/ml1VialVials or Pre-Filled Syringe5 Vials or Prefilled Syringes
ANESTHETICS
Lidocaine HCl injection, 1%, 20 ml1%, 10 mg/ml20ml1Vial20ml/50mlEither 3 20ml vials or 1 50ml vial
ANTI-ASTHMATICS
Albuterol inhalation aerosol, MDI(Proventil or Ventolin)-1Each1 Inhaler
Albuterol inhalation solution,(Proventil or Ventolin)0.083%3ml1Box1 Box of 25 doses
ANTIBIOTICS
Amoxicillin/Clavulanate tablets(Augmentin)875/125 mg20Bottle3 Bottles of 20 tablets
Azithromycin HCL tablets(Zithromax)250 mg6 tabletsPackage2 Packages of 6
Cephalexin capsules(Keflex)500 mg100Bottle1 Bottle of 100 capsules
Cephtriaxone Sodium injection(Rocephin)1 g1Vial3 vials
Clindamycin HCL capsules150mg100Bottle2 Bottles 100 capsules
Ciprofloxacin HCl tablets(Cipro)500 mg40Bottle1 Bottle of 40 tablets
Doxycycline capsules100 mg100Bottle1 Bottle of 100 capsules
Metronidazole tablets(Flagyl)500 mg100Bottle1 Bottle of 100 capsules
Sulfamethoxazole/Trimethoprim DS tablets(Bactrim, Septra)800/160 mg100Bottle1 Bottle of 100 tablets
ANTI-CONVULSANTS
Phenytoin Sodium capsules(Dilatin)100 mg100Bottle1 Bottle of 100 capsules
ANTI-DIARRHEALS
Loperamide HCl capsules(Imodium)2 mg100Bottle
Bismuth subsalicylate (individually sealed) tablets(Pepto-Bismol)-48Box3 Boxes of 48 tablets
ANTI-ECTOPARASITES
Permethrin topical cream, 5%(Elimite)5%60g1Tube2 Tubes
Permethrin cream shampoo rinse, 1%(Nix)1%1 TreatmentPer Box2 Boxes
ANTIFUNGALS
Fluconazole tablets(Diflucan)150 mg12 tabletsPackage1 Package of 12 tablets
Clotrimazole cream, 1%(Lotrimin)1%30g1Tube5 Tubes
Clotrimazole vaginal cream (with applicator)(Vagisil)45g1Box2 Boxes
Tolnaftate powder, 1%(Tinactin)1%1Bottle5 Bottles
ANTIHEMORRHOIDALS
Hydrocortisone acetate (Hemorrhoidal suppositories)-12 suppBox1 Box of 12
ANTIHISTAMINES
Diphenhydramine HCl capsules(Benadryl)25mg100Bottle1 Bottle of 100 capsules
Diphenhydramine HCl injection(Benadryl)50mg/ml1ml1Vial5 vials
Loratadine tablets(Claratin)10mg100Bottle1 Bottle of 100 tablets
ANTI-MOTION SICKNESS
Meclizine HCl tablets(Bonine)25 mg100Bottlechewable or nonchewable3 Bottle of 100 tablets
Promethazine HCl injection (single dose ampules, 1 ml)50 mg/ml1ml5Ampules1 Package of 5 Ampules
Promethazine HCl tablets(Phenergan)25 mg100Bottle1 Bottle of 100 tablets
Ondansetron ODT tablets(Zofran)4mg30Bottle1 Bottle of 30 tablets
ANTI-NARCOTIC AGENTS
Naloxone HCl injection, (single dose ampules, 1 ml)(Narcan)0.4mg/ml1ml1VialNarcan Nasal Spray3 Vials (or 2 Boxes of Narcan Nasal Spray alternatively)
ANTI-POISONING AGENTS
Activated charcoal, aqueous suspension (single dose, 240 ml bottle)50g/240ml1Tube/Bottleor equiv2 Tubes
ANTI-PSYCHOTIC AGENTS
Haloperidol injection, (single dose vials)(Haldol)5mg/ml1ml5Ampules1 Package of 5 Ampules
ANTISEPTICS / DISINFECTANTS
Povidone-Iodine 10% solution(Betadine)-8oz1Bottle2 Bottles
Chlorhexidine Gluconate 4%(Hibiclens)-120ml1Bottle2 Bottles
Hydrogen peroxide (H2O2) solution-16oz1Bottle2 Bottles
ANTI-ULCER/GERD AGENTS
Ranitidine tablets(Zantac)150 mg50Bottle1 Bottle of 50 tablets
ANTI-VIRAL AGENTS
Acyclovir tablets800 mg100Bottle1 Bottle of 100 tablets
BURN TREATMENT
Silver Sulfadiazine cream, 1%(Silvadene)50 g1Jaror equiv2 Jars
Burn Jel (Kit of various sized presoaked guaze)(Water-Jel)-1Kitor equiv1 Kit of various sized presoaked guaze
CARDIOVASCULAR & ANTIHYPERTENSIVES
* Adenosine Sulfate injection, (single dose prefilled syringe)(Adenocard)3 mg/ml1Syringe6 syringes per ship
* Amiodarone HCl intravenous50 mg/ml3ml1Vial10 Vials
* Atropine Sulfate injection (single dose prefilled syringe)(Luer-Jet)0.1 mg/ml3ml1Syringe10 Syringes
Lisinopril tablets10 mg100Bottle1 Bottle of 100 tablets
Clonidine tablets0.1 mg100Bottle1 Bottle of 100 tablets
* Diltiazem injection (Refrigeration Required)50mg/10ml10ml1Vial10 Vials
* Diltiazem tablets30 mg100Bottle1 Bottle of 100 tablets
* Dopamine HCl injection40 mg/ml10ml1Vial15 Vials
* Epinephrine injection 1:10,000 (single dose prefilled syringe)1 mg/ 10ml10ml1Syringe10 Syringes
* Lidocaine Hydrochloride injection 2%, (single dose prefilled syringe) (I.V. For Cardiac Arrhythmias)(LifeSheild/Abboject, Ansyr)20mg/ml10ml1Each10 Syringes
* Lidocaine Hydrochloride injection 4%, (single dose prefilled syringe) (I.V. For Cardiac Arrhythmias)4% (Cardiac)1Vial
* Magnesium Sulfate injection (single dose prefilled syringe)5g/10ml101Each2 Syringes
*Metoprolol injection1mg/1ml5ml1Vial10 Vials
*Metoprolol tablets50 mg100Bottle1 Bottle of 100 tablets
Nitroglycerin ointment, 2%20 g1Tube2 Tubes
Nitroglycerin tablets, sublingual0.4 mg25Bottle1 Bottle of 25 tablets
* Procainamide HCl injection500 mg/ml2ml1Vial6 Vials
COUGH AND COLDS
Cetylpyridinium Chloride throat lozenges (individually sealed)(Cepacol)-16 lozengesCard5 Boxes of 16 Lozenges
Guaifenesin/Dextromethorphan Cough syrup-120ml1Bottle5 Bottles
Pseudoephedrine HCl tablets30 mg48BoxPhenylephrine1 Box of 48
Saline nasal spray-3ml1Bottle5 Bottles
DENTAL
Emergency Dental Kit-1KitAny basic DENTAL kit containing: temp cement, temp fillings, dental wax1 Kit per ship
DIABETIC AGENTS
Dextrose injection, 50% ,(single dose prefilled syringe)LifeShield/Abboject, Ansyr)-50ml1Syringe3 Syringes
Glucagon injection kit, (single dose prefilled syringe)(Lilly, GlucaGen)1 mg1ml1Syringe1 Kit
Glucose, Liquid Gel, 40%(Glucagel)30 g1Tube2 Tubes
Insulin, injection, human regular (multi-dose vial), (Refrigeration Required)10 ml1Vial1 Vial
DIURETICS
* Furosemide injection(Lasix)10 mg/ml4ml1Vial5 Vials
Furosemide tablets(Lasix)40 mg100Bottle1 Bottle of 100 tablets
Hydrochlorothiazide tablets (HCTZ)25 mg100Bottle1 Bottle of 100 tablets
EAR
Curettes, plastic, disposable1Each5 Currettes
Neomycin/Polymyxin/Hydrocortizone Otic Drops(Cortisporin)10ml1Bottle2 Bottles
ELECTROLYTE REPLACEMENT
Oral Rehydration Salts, WHO formula (individually sealed packets)1eaPacket10 Packets
ENVIRONMENTAL DECONTAMINATION
BENZALKONIUM (BZK) Towelette, Antiseptic1Box1 Box
EYES
Isotonic Eye Wash, Buffered Solution(Ocusoft, Dacriose)120ml1Bottle2 Bottles
Saline Eye Wash16oz1Bottle8 Bottles
Fluorescein Sodium ophthalmic strips (individually sealed envelopes)10Individually sealed Envelopes
Bacitracin-polymyxin B ophthalmic ointment(Polycin, (AK-POLY-BAC)500u/10,000gm3.5g1Tube2 Tubes
Trimethoprim-Polymyxin B ophthalmic solution/drops (0.1%-10,000 units/mL)0.1%-10,000 u/ml10ml1Bottle2 Bottles
Prednisolone Acetate 1% ophthalmic solution/drops1%5ml1Bottle1 Bottle
Proparacaine HCl 0.5% ophthalmic solution/drops (Refrigeration Required)0.50%15ml1Bottle1 Bottle
Ciprofloxacin 0.3%, ophthalmic solution/drops0.30%2.5ml1Bottle2 Bottles
Timolol Maleate 0.25%, ophthalmic solution/drops(Timoptic)0.25%5ml1Bottle1 Bottle
GYNECOLOGIC
Pregnancy test1Test3 Tests Per Ship
IMMUNIZATIONS
Tetanus and Diptheria Toxoid (Multi-Dose Vial) (Refrigeration Required)0.5ml10 vialsBox1 box of 10 vials
Tuberculin Purified Protein Derivative, Tubersol®, TB Testing (multi dose vial) (Refrigeration Required)1ml1Vial1 Vial Per Ship
INTRAVENOUS FLUIDS
Lactated Ringers solution1000ml1Bag6-12 per ship
Sodium Chloride 0.9%, (single dose vial for injection, sterile)10ml1Vial10 vials
Sodium Chloride 0.9%250ml1Bag500ml3-6 per ship
Sodium Chloride 0.9%1000ml1Bag6-12 per ship
* D5W solution, 500ml500ml1Bag12
LAXATIVES/STOOL SOFTENERS
Bisacodyl(Dulcolax)5 mg100Bottle1 Bottle of 100 tablets
Docusate Sodium capsules(Colace)100 mg100Bottle1 Bottle of 100 tablets
Magnesium Hydroxide, (individually sealed cups)(Milk of Magnesia)30 ml10 cupsPackage1 Package of 10 cups
Sodium Phosphate enema(Fleets)4.5oz1Box2 Boxes
MUSCLE RELAXANTS
Cyclobenzaprine(Flexeril)10mg100Bottle1 Bottle of 100 tablets
Menthol/Methyl Salicylate & Eucalyptus ointment(Ben-Gay, Icy-hot)1Tube5 Tubes
SKIN PREPARATIONS
Bacitracin topical ointment, (individually sealed packets)0.9 g144 packetsBox1 Box of 144 Packets
Benzoin Tincture compound60 ml1Bottle1 Bottle
Hydrocortisone cream, 1%, (individually sealed packets)1 g144 packetsBox1 Box of 144 Packets
Isopropyl Alcohol-16oz1Bottle2 Bottles
Isopropyl Alcohol, pads-1Box2 Boxes
Lubricant, surgical, sterile, (Surgilube), (individually sealed packets)-144Boxor 1 large tube1 Box of 144 Packets
Triamcinolone Acetonide cream 0.1%0.1%15g1Tube
Water, sterile for irrigation1000 ml1Bottle4 Bottles
Zinc Oxide ointment30 g1Tube2 Tubes
STEROIDS
Methylprednisolone Sodium injection (2 ml single dose vial)125mg2ml1Vial5 Vials
Prednisone tablets10mg100Bottle1 Bottle of 100 tablets
DRESSINGS
Adhesive tape, surgical, 2" x 10 yds(Dynarex, 3M)6 RollsBox1 Box of 6
Adhesive tape, surgical, 1" x 10 yds(Dynarex, 3M)12 RollsBox1 Box of 12
Bandage, adhesive 1" x 3"(Band-Aid)100 BandagesBox2 Boxes of 100 bandages
Bandage, fabric fingertip, 2" x 1½"100 BandagesBox1 Box of 100 bandages
Bandage, fabric knuckle, 1½" x 3"100 BandagesBox1 Box of 100 bandages
Bandage, cotton elastic, 2" x 5 yds(ACE)10 WrapsBox1 Box of 10 wraps
Bandage, cotton elastic, 4" x 5 yds(ACE)10 WrapsBox1 Box of 10 wraps
Bandage, cotton elastic, 6" x 5 yds(ACE)10 WrapsBox1 Box of 10 wraps
Bandage, sterile, "Kling" roll, 2" x 131"(Kerlix)12 RollsBox1 Box of 12 Rolls
Bandage, sterile, "Kling" roll, 4" x 131"(Kerlix)12 RollsBox1 Box of 12 Rolls
Bandage, tubular, ⅞" x 5 yds1Box1 Box (Cut to size)
Bandage, triangular, with pins12 perBox1 Box
Pad, eye, sterile50 BandagesBox1 Box of 50 Bandages
Pad, Telfa, sterile 3" x 4" (non-stick)100 BandagesBox1 Box of 100 bandages
Trauma Pad, (Extra Large, sterile), 10" x 30"1ea5 Trauma Pads per ship
Skin closure, adhesive strips ¼" x 4"(Steri-Strips)1Box1 Box
Sponge, surgical, sterile 4" x 4"1Box1 Box
Sponge, surgical, non-sterile 4" x 4"1Package1 Package of 200 non-sterile pads
AED
AED pads (BRAND SPECIFIC: DeFibtech)*Brand Specific*1Set2 Sets of extra pads per ship
DENTAL
Mirror and handle (disposable)1ea10 per ship
EMT
Airway, Nasopharyngeal Set (assorted sizes, disposable), Adult1Box1 Box of several sizes
Airway, Oropharyngeal Set (assorted sizes, disposable), Adult1Box1 Box of several Sizes
QuikClot EMS 4x4 Dressing1 PackagePackage of 3 4x4 dressingsQuickclot gauze roll1 Package of 3 individually sealed 4x4 dressings (or one Roll)
Ring cutter1ea1
Suction catheters, 16 Fr1ea2
Suction catheters, 18 Fr1ea2
Suction catheter, Yankauer1ea2
Suction connecting tubing1ea2 tubing sets
Tube, Nasogastric, Feeding No. 161ea2
Tube, Nasogastric, Feeding No. 181ea2
Salum Sump Pump NG Tube1ea2 ea
INSTRUMENTS
Endotracheal Tube Cuffed (7.0mm)1ea1
Endotracheal Tube Cuffed (7.5mm)1ea1
Endotracheal Tube Cuffed (8.0mm)1ea1
Endotracheal Tube Cuffed (8.5mm)1ea1
Applicator, wood, cotton tipped, sterile1Box1 Box
* End Tidal CO₂ detector(Mallinckrodt)1eaor equiv2 per ship
King LT-D supraglottic airway, size 31ea2 per ship
King LT-D supraglottic airway, size 41ea2 per ship
King LT-D supraglottic airway, size 51ea2 per ship
Foley bag/Urinary Drain Bag Anti-Reflux Valve 2000 mL Vinyl(AMSure)2000ml1eaor equiv2 per ship
Foley, catheter, sterile, 14 Fr1ea2 per ship
Foley, catheter, sterile , 16 Fr1ea2 per ship
Foley Insertion Tray (w/o bag or catheter), Catheter Insertion Tray, Basic, bag/catheters not included(AMSure)1ea2 per ship
Forceps, curved, 5½", Non-Sterile Stainless Steel1ea1
Forceps, straight, 5½", Non-Sterile Stainless Steel1ea1
Forceps, splinter, 3½", Non-Sterile Stainless Steel1ea1
Forceps, tissue, 5", Non-Sterile Stainless Steel1ea1
Forceps, Magill (adult size), Non-Sterile Stainless Steel1ea1
* Laryngoscope kit, (handle, light bulb, sizes 2,3,4 Macintosh; 0,1,2,3 Miller blades)(GreenLine)1Kitor equiv1 Kit per ship
Nebulizer Tubing Kit, (w/ mouthpiece, tubing, single use)1ea5 per ship
Syringe, bulb, disposable1ea2 per ship
INTRAVENOUS ACCESS DEVICES
Dressing, transparent (individually wrapped), ~3x3in(Tegaderm)1eaor equiv5 per ship
Multi-Setting IV Administration Set (10, 15, 60 drops/ml) (Biomedix Selec-3®) (B32-102) *Brand Specific**Brand Specific*1ea5 per ship
IV Angiocaths , 16 gauge1ea10
IV Angiocaths , 18 gauge1ea10
IV Angiocaths , 20 gauge1ea10
IV Angiocaths , 22 gauge1ea5
Bone Injector Gun – Adult (Brand Specific B.I.G.)*Brand Specific*1ea2 per ship
Tourniquet Bands 18"x 1"1box1 Box
Combat Tourniquet(C-A-T)1ea2 per ship
Saline lock/Hep Lock Set, 6 Inch Tubing 1 Port 0.2 mL Priming Volume DEHP1eaor equiv6 per ship
IV pressure bag1ea1 per ship
OXYGEN ADMINISTRATION
Cannula, Nasal O₂ (single use)1ea5 per ship
Disposable Bubble Humidifier (single use)1ea350-500ml2 per ship
Mask, O₂, non-rebreathing (single use)1ea5 per ship
Resuscitator Bag-AdultAmbu-Bag1ea2 per ship
CPR Mask, resuscitation, pocket w/valve(Laerdal Pocket Mask)1ea2 per ship
PERSONAL PROTECTIVE EQUIPMENT
Condom, lubricated, latex144144/Boxor equiv packaging144 per ship
Face Shield, Full (Single Use, Disposable)1Box1 Box
Gloves, exam, non-sterile, Nitrile, Medium1Box2 Boxes
Gloves, exam, non-sterile, Nitrile, Large1Box2 Boxes
Gloves, sterile, 7.55Pairs5 Pairs per Ship
Gloves, sterile, 8.05Pairs5 Pairs per Ship
Mask, surgical, disposable1Box1 Box
PHYSICAL EXAMINATION EQUIPMENT
Chart, visual acuity, distant1eaor equiv1
Chart, visual acuity, near1eaor equiv1
Depressor, tongue, sterile1Box1 Box
EKG Electrodes, Resting Tab (not snap)(3M Red Dot)1Package2 Packages of 100
Penlight1eaor equiv1
Saftey Lancets 1.8mm 23 Gauge (Finger Stick)50ea50 per ship
Hammer, reflex1ea1
Occult blood stool test kit, Colocare *Brand Specific*10ea10 tests per ship
pH Testing Strips (Litmus Acid/Base Testing) (For Gastric Content)100 testsbottle1 bottle
Fingertip, Portable Pulse oximeter1eaBasic2 per ship
Speculum, ear, 4mm adult (disposable)125specula5 bags of 25 specula (125 total)
* Speculum, vaginal, adult, (disposable), Medium, without light source3ea3 per ship
Sphygmomanometer, size regular adult1ea2
Sphygmomanometer, size large adult1ea2
Stethoscope, combination (bell/diaphragm), Basic/Simple1eaequiv2
Thermometer, clinical, oral1ea2
Thermometer, clinical, rectal1ea2
Thermometer, clinical, hypothermic1ea1
Disposable Thermometer sheaths1Box1 Box
Urine test strips(Chemstrip 10)1Bottle100 Tests per bottle
RESTRAINTS
Restraining Devices, Cuff (leather or cloth)(McKesson#1112397)1Eachor equiv1 set
SHARPS
Blade, surgical knife, #11, Disposable1Each6 Blades
Blade, surgical knife, #15, Disposable1Each6 Blades
Holder, needle, 5"1Each1
Laceration tray (disposable)1Each3 trays
Needle, hypodermic 18G, 1½"1Box1
Needle, hypodermic 21G, 1½"1Box1
Needle, hypodermic 25G, ⅝"1Box1
Scissors, bandage, 5½"1Each1
Sharps container1Each2
Suture, absorbable w/ needle, size 3-01Box1 Box of 12 sutures
Suture, absorbable w/ needle, size 4-01Box1 Box of 12 sutures
Suture, nylon w/ needle , size 3-01Box1 Box of 12 sutures
Suture, nylon w/ needle, size 4-01Box1 Box of 12 sutures
Suture, nylon w/ needle, Size 5-01Box1 Box of 12 sutures
Syringe, Carpuject Holder1Each2 Carpuject Holders
Syringe, hypodermic 3 cc1Each25 3cc syringes per ship
Syringe, hypodermic 20 cc1Each20 20cc syrgines per ship
Syringe, hypodermic 60 cc1Each5 60cc syringes per ship
Syringe, insulin 1 cc, w/ needle, safety1Each50 1cc insulin syringes w/needle, safety
SPLINTS
Air splint SET (Hand, Wrist, Arm, Leg, Ankle)1Set1 Set per ship
Cervical collar (hard)1Each2 per ship
Cervical collar (soft)1Each1 per ship
Crutches, wooden with cushions and tip, Adult (adjustable)1Pair1 pair per ship
Splint, leg immobilizer, adult, velcro straps1Eachor equiv1 per ship
Splint, structural aluminum malleable(SAM)1Eachor equiv2 per ship
MISCELLANEOUS
Reusuable Ice Bag1Each1 per ship
Rubber hot water bottle, 2 quart1Each1 per ship
Body Bag, (for mortuary transfer)1Each1 per ship
Bag, trash, Biohazard1Each5 per ship
Basin, Emesis, plastic, disposable1Each5 per ship
Basin, wash, plastic, reusable 8qt8qt1Each2 per ship
Bedpan, plastic, disposable1Each1 per ship
Empty Prescription Bottles, plastic, medication with lid (10 Dram)1Each10, 13, or 16 Dram acceptable5 per ship
30ML (1 oz) Amber Bottle W/ Calibrated Dropper1Eachor equiv5 per ship
Surgical Hand and Nail Scrub Brush1Each1 per ship
Medicine Cups, Paper, disposable souffle50Cups50 cups per ship
Envelope, drug dispensing 2½" x 4½"50Envelopes50 Envelopes
Eye magnet with loop, first aid instrument1Eachequiv1 per ship
Magnifying glass1EachBasic1 per ship
Pill cutter1Each2 per ship
Suture removal kit1Each3per ship
Body Ruler Cloth Measure1Each1per ship
Instrument Tray, stainless steel with lid. Medium 12 X 8 X 21Eachor approx size1per ship
Ultraviolet light, diagnostic, portable1Eachany equiv1per ship
Urinal, male, plastic, disposable1Each1 per ship
TOTAL ALL PRICE0

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