APPENDIX C. EXCLUSIONS BASED ON MEDICATIONS (continued)Class
Code Class Name Generic Drug Name
ANTIARRHYTHMIC/*Antiarrhythmics Type I-A
351000 Quinidineluconate CR QUINIDINE GLUCONATE SR
351000 Quinidine Sulfate QUINIDINE SULFATE
351000 Quinidine Sulfate CR QUINIDINE SULFATE CR
351000 Quinidine Sulfate CR QUINIDINE SULFATE ER
351000 Quinidine Sulfate THSC QUINIDINE SULFATE
ANTIARRHYTHMIC/*Antiarrhythmics Type I-B*
352000 Lidocaine IV Infusion in D W LIDOCAINE HCL /D5W
352000 Lidocaine IV Infusion in D W LIDOCAINE HCL IN D5W
352000 Lidocaine HCl IV LIDOCAINE HCL IV
352000 Lidocaine HCl IV Admixture LIDOCAINE HCL IV ADMIXTURE
352000 Lidocaine HCl IV Admixture LIDOCAINE HCL PTV
352000 Lidocaine IV Infusion in D W LIDOCAINE IV INFUSION IN D5W
352000 Mexiletine HCl MEXILETINE HCL
352000 Mexiletine HCl MEXITIL
352000 Tocainide HCl TOCAINIDE HCL
352000 Tocainide HCl TONOCARD
ANTIARRHYTHMIC/Antiarrhythmics Type I-C
353000 Flecainide Acetate FLECAINIDE ACETATE
353000 Propafenone HCl PROPAFENONE HCL
353000 Propafenone HCl RYTHMOL
353000 Flecainide Acetate TAMBOCOR
ANTIARRHYTHMIC/*Antiarrhythmics Type III*
354000 Amiodarone HCl AMIODARONE HCL
354000 Bretylium Tosylate BRETYLIUM TOSYLATE
354000 Bretylium Tosylate in D W BRETYLIUM TOSYLATE IN D5W
354000 Bretylium Tosylate BRETYLIUM TOSYLATE SDV
354000 Bretylium Tosylate in D W BRETYLIUM TOSYLATE/D5W
354000 Amiodarone HCl CORDARONE
354000 Amiodarone HCl CORDARONE I.V.
354000 Ibutilide Fumarate CORVERT
354000 Dofetilide DOFETILIDE
354000 Ibutilide Fumarate IBUTILIDE FUMARATE
354000 Amiodarone HCl PACERONE
354000 Dofetilide TIKOSYN
ANTIARRHYTHMIC/Misc. Antiarrhythmic**
355000 Adenosine IV ADENOCARD