| 00657387 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 0.25g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00851957 | CEFTRIAXONE DISODIUM | Rocephin (Off-Formulary Interchangeable) 10g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00657409 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 2g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |
| 00657417 | CEFTRIAXONE DISODIUM | Rocephin (Not a Benefit) 1g/Vial Inj Pd-Vial Pk | HLR | N/A | N/A | YES | NO | NO |