Appendix E-Medical Formulary and Supplies List_08242022.xlsx
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Initial Build This Formulary and Supply List is provided for planning purposes and does not require pricing prior to contract award.
| Item | Unit | QTY | Vendor | Unit Price | Total | Package |
| 1ML Insulin Syringes 100 CT | BX | 3 | ||||
| AA Batteries | PK | 3 | ||||
| AAA Batteries | PK | 3 | ||||
| Acetaminophen 160mg/5ml 16oz (Liquid) | BT | 3 | ||||
| Acetaminophen 500 MG 100 count / Tylenol | BT | 3 | ||||
| Acetaminophen 80 MG Tablets Chew 30 Count | BT | 3 | ||||
| Acetaminophen Infant Drops Grape 1oz | EA | 3 | ||||
| AED | Ea | 1 | ||||
| AED Pediatric Pads | EA | 1 | ||||
| Airway Kit 6 CT | EA | 1 | ||||
| Albuterol Inhaler | EA | 3 | ||||
| Alcohol Pads 100 CT | BX | 5 | ||||
| Ambu Bag Adult | EA | 1 | ||||
| Ambu Bag Infant | EA | 1 | ||||
| Ambu Bag Pediatric | EA | 1 | ||||
| Amoxicillin/CLAV 500MG/125MG 20 CT | BT | 1 | ||||
| Amoxicillin/Clavulanate 400/57MG 20 CT | BT | 1 | ||||
| Amoxicillin/Clavulanate 875/125MG 20 CT | BT | 1 | ||||
| Ankle Support Large | EA | 3 | ||||
| Antacid tablets (500MG 250 X 2/box) Alcalak | BX | 3 | ||||
| Antiseptic Spray Can 3oz | BT | 1 | ||||
| Arm Sling Ace | EA | 5 | ||||
| Artificial Tears Opth Solution | BT | 3 | ||||
| Aspirin 325 mg | BT | 3 | ||||
| Azithromycin Tablets | 1 card | 5 | ||||
| Bacitracin Zinc Ointment 1 oz | TU | 3 | ||||
| Backboard Transport | EA | 1 | ||||
| Bandage Gauze LF Sterile Fluff - Roll | EA | 5 | ||||
| Bandages Triangle 40" X 40" | EA | 5 | ||||
| Bandaids 100 CT | BX | 5 | ||||
| Battery 2032 | EA | 1 | ||||
| BD Veritor Flu Test Kit | EA | 2 | ||||
| BD Veritor Flu Test Kit Anylyzer | EA | 1 | ||||
| Benadryl Chewable 18 Count | BT | 3 | ||||
| Benadryl Cream Allergy | TU | 3 | ||||
| Benadryl Gel Stop Itch 3.5. oz Tube | EA | 3 | ||||
| Benadryl Liquid 1.8 ML 4 oz | BT | 3 | ||||
| Bio Needle Bucket Container | EA | 1 | ||||
| Bio Waste Container 10 Gal | EA | 1 | ||||
| Bisacodyl Tablets 5mg 100 Count | BT | 3 | ||||
| Blood Pressure Cuff - MED | EA | 1 | ||||
| Blood Pressure Cuff - SM | EA | 1 | ||||
| Blood Pressure Cuff Monitor | EA | 1 | ||||
| Board, Cork 30X50 | EA | 1 | ||||
| Braun Thermoscan- Electronic Thermometer | EA | 2 | ||||
| Cabinet, File | EA | 1 | ||||
| Calaclear Lotion - Skin 6 oz | BT | 3 | ||||
| Calamine Lotion | BT | 3 | ||||
| Chair, Metal Folding | EA | 1 | ||||
| Chair, Office | EA | 2 | ||||
| Clip Boards | EA | 3 | ||||
| Clotrimazole 1% Cream 1 oz | TU | 5 | ||||
| Corban Wrap Latex NS 4"X5Y Roll | EA | 3 | ||||
| CPR - D PADZ / AED Unit (Adult and Child) | EA | 1 | ||||
| Cups, 5oz Disp 100/sleeve | EA | 3 | ||||
| Cups, Medicine 1oz Disp 100/Sleeve | EA | 3 | ||||
| Dayquil Cold and Flu Liquid (12oz) | BT | 3 | ||||
| Desk, Office | Ea | 2 | ||||
| Diamode antidiarrheal 100 X 1 | BX | 3 | ||||
| Diphenhydramine HCL 25MG 100 Caplet | BT | 3 | ||||
| Disposable Under-pads 200 CT | BX | 1 | ||||
| Docusate Sodium cap 100 mg 100 count | BT | 3 | ||||
| Dry Erase Board | EA | 1 | ||||
| Dry Erase Eraser | EA | 1 | ||||
| Dry Erase Markers | EA | 1 | ||||
| Emergency Response Bag | EA | 1 | ||||
| EPI Pen 0.3 mg Autoinjector - Junior | EA | 4 | ||||
| Erythromycin Opth 0.5% 3.5gm | EA | 5 | ||||
| Erythromycin Topical 2% | TU | 1 | ||||
| Eye Drops Clear 1/2oz | BT | 3 | ||||
| Eye Wash Irrigating Saline 4oz | BT | 3 | ||||
| Gauze Alginate Dressing - 5 CT | BX | 5 | ||||
| Gauze Sponge Non-Sterile 2x2 (200/SL) | SQ | 5 | ||||
| Gauze Sponge Non-Sterile 4X4 (200/SL) | SQ | 5 | ||||
| Gloves Nitrile - Large | BX | 12 | ||||
| Gloves Nitrile Medium | BX | 12 | ||||
| Gloves Nitrile Small | BX | 12 | ||||
| Gloves Nitrile X-Large | BX | 12 | ||||
| Glucometer, Trumetrix Pro | EA | 2 | ||||
| Glucose Control Solution Level 1 True Metrix | BT | 3 | ||||
| Glucose Test Strips, True Metrix | BT | 3 | ||||
| Guaifenesin IR 400 MG Tablets 60 CT | BT | 3 | ||||
| Hand Sanitizer 2L | BT | 3 | ||||
| Hanging File Folders | BX | 2 | ||||
| HCG Test Cassette, Urine | BX | 3 | ||||
| Hydrocortisone 1% Cream | TU | 3 | ||||
| Hydrocortisone 1% Cream (144/BX) | BX | 3 | ||||
| Hydrogen Peroxide 3% 16oz | BT | 3 | ||||
| Ibuprofen 100 mg Junior Chewable 24 CT | BX | 3 | ||||
| Ibuprofen 200 mg Tablets CT 50 | BT | 3 | ||||
| Ibuprofen Suspension 100/5 ml 4 0Z / Children | BT | 3 | ||||
| Imodium A-D 8 fluid oz | BT | 3 | ||||
| Inhaler Spacer, Child | EA | 3 | ||||
| Inhaler Spacer, Infant | EA | 3 | ||||
| Inhaler Spacer-Chamber Adult | EA | 3 | ||||
| Isolation Gowns | Pk | 2 | ||||
| Lancet Safety 23G X 1.8 mm Med Flow | BX | 3 | ||||
| Lidocaine & Prilocaine Cream 2.5% | TU | 1 | ||||
| Locker, Medical Storage | EA | 1 | ||||
| Lysol 12.5oz | EA | 3 | ||||
| Magnetic Dry Erase Board 60X40 | EA | 1 | ||||
| Manilla Folders | BX | 2 | ||||
| Mask Face, Adult Procedure 50/box | BX | 3 | ||||
| Mask Face, Child / 50 CT | BX | 3 | ||||
| Massage Table | EA | 1 | ||||
| Milk of Magnesia | BT | 3 | ||||
| Mupirocin 2% Ointment | TU | 5 | ||||
| Muscle Rub (Tubes) | TU | 3 | ||||
| N95 | EA | 100 | ||||
| Narcan | Ea | 1 | ||||
| Neck Braces Adult | EA | 1 | ||||
| Neck Braces Fits - All | EA | 1 | ||||
| Neck Braces Pedi | EA | 1 | ||||
| Nix - Lice Shampoo (2 Bottles/box) | BX | 48 | ||||
| Nyquil Cold and Flu Liquid | BT | 3 | ||||
| OBGYN - KIT | EA | 1 | ||||
| Ofloxacin Ophthalmic | TU | 3 | ||||
| Ondansetron HCL Oral Solution 4mg/5ml | BT | 3 | ||||
| Ondansetron Oral Tab | BOX | 1 | ||||
| Oto/Ophthalmoscope | EA | 2 | ||||
| Paper Table 21"X225' Roll | RL | 5 | ||||
| Paper Tape | EA | 3 | ||||
| Paper Towels | EA | 3 | ||||
| Paper, Copy | CS | 1 | ||||
| Pedialyte | BT | 16 | ||||
| Pens | BX | 3 | ||||
| Pepto Bismol Suspension | BT | 3 | ||||
| Permethrin 5% Cream | TU | 10 | ||||
| Petroleum Jelly | JAR | 1 | ||||
| Post it notes | Pk | 2 | ||||
| Printer, Brother | Ea | 1 | ||||
| Pseudoephedrine HCL 30 mg 100 CT | BT | 3 | ||||
| Pulse Oximeter, Adult | EA | 2 | ||||
| Pulse Oximeter, Pedeatric | EA | 2 | ||||
| Push Pins | BX | 1 | ||||
| Sani-Cloth Plus Germicidal Wipes Tube | TUB | 3 | ||||
| Scale | EA | 1 | ||||
| Scissors | EA | 1 | ||||
| Silver Sulfadiazine Cream 1 % | TU | 1 | ||||
| Sodium Chloride .9% Irrigation Solution 100ml | BT | 3 | ||||
| Splint 36" SAM Brand | EA | 3 | ||||
| Stapler | EA | 1 | ||||
| Staples | BX | 1 | ||||
| Sterile Water 1000 ml | BT | 3 | ||||
| Steri-Strips 25 CT | BX | 3 | ||||
| Stethescope | EA | 2 | ||||
| Storge Shelf | EA | 1 | ||||
| Sulfa-Trimethoprim Tabs 800/160 mg - 100 CT | BT | 1 | ||||
| Suture Removal Kit | EA | 5 | ||||
| Swab-Stick Cotton Tip 6 IN 100 CT | BX | 3 | ||||
| Syringe Blue Caps +/- 500 bag | BAG | 3 | ||||
| Syringe Disposable 3ML 100 CT | BX | 3 | ||||
| Syringe, 5ML for medication Dispense | BAG | 3 | ||||
| Tape Surgical 1" 12 CT | BX | 3 | ||||
| Terbinafine 1 % Cream - Hydrochloride 1oz | TU | 3 | ||||
| The Five Minute Clinical Consultation Manual | EA | 1 | ||||
| Thermascan covers Pro - 4000 Braun 200 CT | BX | 5 | ||||
| Tip Ear HST Otoscope 2.5 MMDISP 1000 CT (Child) | ROLL | 10 | ||||
| Tip Ear HST Otoscope 4 MMDISP 1000 CT | ROLL | 10 | ||||
| Tissue, Facial | EA | 3 | ||||
| Tongue Depressors Adult 500 CT | BX | 3 | ||||
| Transport Chair | Ea | 1 | ||||
| Triple Antibiotic Ointment 0.9gm 144 Unit | BX | 3 | ||||
| Two hole punch | EA | 1 | ||||
| Wheel Chair/Patient Transport | EA | 1 | ||||
| Zinc Oxide 1oz | TU | 1 |
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