Large Group Tier 4 HMO and PPO Prescription Drug List DMHC Version

Pharmacy | PDL | California

2021 California Advantage Large Group 4-Tier HMO and PPO Prescription Drug List

Please note: This Prescription Drug List (PDL) is accurate as of August 1, 2021 and is subject to change after this date. All previous versions of this PDL are no longer in effect. Your estimated coverage and copay/coinsurance may vary based on the benefit plan you choose and the effective date of the plan.

This PDL can also be accessed online at myuhc.com > Pharmacy Information > Prescription Drug Lists > California plans > Large Group - Advantage. Plan-specific coverage documents may be accessed online at uhc.com/statedruglists > Large Group Plans > California. If you are a UnitedHealthcare member, please register or log on to myuhc.com, or call the toll-free number on your health plan ID card to find pharmacy information specific to your benefit plan. This PDL is applicable to the following health insurance products offered by UnitedHealthcare: • Navigate • Options PPO • Navigate Plus • Non-Differential PPO • Choice • SignatureValue • Choice Plus • SignatureValue Advantage • Select • SignatureValue Alliance • Select Plus • SignatureValue Focus • Core • SignatureValue Harmony • Core Essential • Doctors Plan

Please refer to your ID card for plan type (HMO or PPO).

Updated 6/17/2021

At UnitedHealthcare, we want to help you better understand your medication options...... 3

How do I use my PDL? ...... 4

What are tiers? ...... 5

When does the PDL change? ...... 5

Utilization Management Programs ...... 6

Your Right to Request Access to a Non-formulary Drug ...... 6

Requesting a Prior Authorization or Step Therapy Exception ...... 7

How do I locate and fill a prescription through a retail network pharmacy? ...... 7

How do I locate and fill a prescription through the mail order pharmacy? ...... 7

How do I locate and fill a prescription at a specialty pharmacy? ...... 8

How do I get updated information about my pharmacy benefit? ...... 8

Nondiscrimination notice and access to communication services ...... 9

Prescription Drug List ...... 13

2 At UnitedHealthcare, we want to help you better understand your medication options. Your pharmacy benefit offers flexibility and choice in determining the right medication for you. To help you get the most out of your pharmacy benefit, we’ve included some of the most commonly used terms and their definitions as well as frequently asked questions: Brand-name drug means a Prescription Drug Product (1) which is manufactured and marketed under a trademark or name by a specific drug manufacturer; or (2) that we identify as a brand-name product, based on available data resources. This includes data sources such as Medi-Span, that classify drugs as either brand or generic based on a number of factors. Not all products identified as a “brand-name” by the manufacturer, pharmacy, or your Physician will be classified as brand-name by us. A brand- name drug is listed in this PDL in all CAPITAL letters. Coinsurance means a percentage of the cost of a covered health care benefit that you pay after you have paid the deductible, if a deductible applies to the health care benefit. Copayment means a fixed dollar amount that you pay for a covered health care benefit after you have paid the deductible, if a deductible applies to the health care benefit. Deductible means the amount you pay for covered health care benefits that are subject to the deductible before your health insurer begins to pay. If your health insurance policy has a deductible, it may have either 1 deductible or separate deductibles for medical benefits and prescription drug benefits. After you pay your deductible, you usually pay only a copayment or coinsurance for covered health care benefits. Your insurance company pays the rest. Drug Tier means a group of Prescription Drug Products that correspond to a specified cost sharing tier in your health insurance policy. The drug tier in which a Prescription Drug Product is placed determines your portion of the cost for the drug. Enrollee is a person enrolled in a health plan who is entitled to receive services from the plan. All references to enrollees in this formulary template shall also include subscribers as defined in this section below. Exception request means a request for coverage of a non-formulary drug. If you, your designee, or your prescribing health care provider submits a request for coverage of a non-formulary drug, your insurer must cover the non-formulary drug when it is medically necessary for you to take the drug. Exigent circumstances means when you are suffering from a medical condition that may seriously jeopardize your life, health, or ability to regain maximum function, or when you are undergoing a current course of treatment using a non-formulary drug. Formulary or Prescription Drug List (PDL) means a list that categorizes into tiers medications or products that have been approved by the U.S. Food and Drug Administration (FDA). This list is subject to our periodic review and modification (generally quarterly, but no more than 6 times per calendar year). Generic drug means a Prescription Drug Product: (1) that is chemically equivalent to a brand-name drug; or (2) that we identify as a generic product based on available data resources. This includes data sources such as Medi-Span, that classify drugs as either brand or generic based on a number of factors. Not all products identified as a “generic” by the manufacturer, pharmacy or your Physician will be classified as a generic by us. A generic drug is listed in this PDL in bold and italicized lowercase letters. Non-formulary drug means a Prescription Drug Product that is not listed on this PDL. Out-of-pocket costs means your expenses for health care benefits that aren’t reimbursed by your health insurance. Out-of- pocket costs include deductibles, copayments and coinsurance for covered health care benefits, plus all costs for health care benefits that are not covered. Prescribing provider means a health care provider who can write a prescription for a drug to diagnose, treat, or prevent a medical condition. Prescription means an oral, written, or electronic order from a prescribing provider authorizing a Prescription Drug Product to be provided to a specific individual. Prescription Drug Product means a medication or product that has been approved by the U.S. Food and Drug Administration (FDA) and that can, under federal or state law, be dispensed only according to a Prescription Order or Refill. A Prescription Drug Product includes a medication that, due to its characteristics, is appropriate for self-administration or administration by a non-skilled caregiver. We will provide coverage for a Prescription Drug Product which includes a medication that, due to its characteristics, is appropriate for self-administration or administration by a non-skilled caregiver. This definition includes: Inhalers (with spacers);

3 Insulin; the following diabetic supplies: standard insulin syringes with needles; blood-testing strips - glucose; urine-testing strips - glucose; ketone-testing strips and tablets; lancets and lancet devices; and glucose meters (including continuous glucose monitors [applies to PPO plans only]); disposable devices which are medically necessary for the administration of a covered outpatient Prescription Drug Product. Benefits also include FDA-approved contraceptive drugs, devices and products available over-the-counter when prescribed by a Network provider. Prior Authorization means a process by your health insurer to determine that a health care benefit is medically necessary for you. If a Prescription Drug Product is subject to prior authorization in this PDL, your prescribing provider must request approval from your health insurer to cover the drug. Your health insurer must grant a prior authorization request when it is medically necessary for you to take the drug. Step therapy means a specific sequence in which Prescription Drug Products for a particular medical condition must be tried. If a drug is subject to step therapy in this PDL, you may have to try 1 or more other drugs before your health insurance policy will cover that drug for your medical condition. If your prescribing provider submits a request for an exception to the step therapy requirement, your health insurer must grant the request when it is medically necessary for you to take the drug. Subscriber means the person who is responsible for payment to a plan or whose employment or other status, except for family dependency, is the basis for eligibility for membership in the plan. How do I use my PDL? When choosing a medication, you and your doctor should consult the PDL. It will help you and your doctor choose the most cost-effective prescription drugs. This guide tells you if special programs apply. Bring this list with you when you see your doctor. It is organized by therapeutic category and class. The therapeutic category and class are based on the American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification. You may also find a drug by its brand or generic name in the alphabetical index. If a generic equivalent for a brand-name drug is not available on the market or is not covered, the drug will not be separately listed by its generic name. This is the way Prescription Drug Products appear in the PDL: 1. A drug is listed alphabetically by its brand and generic names in the therapeutic category and class to which it belongs; 2. The generic name for a brand-name drug is included after the brand-name in parentheses and all lowercase bold and italicized letters; 3. If a generic equivalent for a brand-name drug is both available and covered, the generic drug will be listed separately from the brand-name drug in all lowercase bold and italicized letters; and 4. If a generic drug is marketed under a proprietary, trademark-protected brand-name, the brand-name will be listed after the generic name in parentheses and regular typeface with the first letter of each word capitalized. Example:

Prescription Drug Name Drug Tier Coverage Requirements & Limits AVAPRO ORAL TABLET 150 MG, 300 MG, 75 MG (irbesartan) 4 irbesartan oral tablet 150 mg, 300 mg, 75 mg 1

If your medication is not listed in this document, please visit myuhc.com or call the toll-free member phone number on your health plan ID card. Below is a list of drug tier numbers, abbreviations and designations used in the PDL as well as an explanation for each.

Drug Tier 1 Your lowest cost medications H-N May be part of health care reform preventive when used for appropriate Drug Tier 2 Your mid-range cost medications preventive purposes Drug Tier 3 Your mid-range cost medications SP Specialty medication Drug Tier 4 Your highest cost medications CM Orally administered anti-cancer medication PA Prior authorization required M May be covered under the medical benefit SL Supply Limit with prior authorization for HMO plans ST Step Therapy SMCS Specialty medication cost share may apply (for HMO plans, does not apply to injectables H May be part of health care reform preventive covered under the medical benefit)

4 What are tiers? Tiers are the different cost levels you pay for a medication. Each tier is assigned a cost, which is determined by your employer or health plan. This is how much you will pay when you fill a prescription. Tier 1 medications are your lowest-cost options. If your medication is placed in Tier 2, 3 or 4, look to see if there is a Tier 1 option available. Discuss these options with your doctor. For orally administered anti-cancer medications on any Tier, the total amount of copayments and/or coinsurance shall not exceed $250 for an individual prescription of up to a 30-day supply. For high deductible health plans, the $250 maximum only applies once the deductible has been met. Check your benefit plan documents to find out your specific pharmacy plan costs, including any maximum dollar amount of cost sharing that may apply to a drug. Preferred medications are found in Tier 1, Tier 2 or Tier 3 and may vary depending on the medication and the condition it treats.

$ Drug Tier Includes Helpful Tips Tier 1 Medications that provide the highest Use Tier 1 drugs for the lowest $ Your lowest cost overall value. Mostly generic drugs. Some out-of-pocket costs. brand-name drugs may also be included.

Tier 2 and 3 Medications that provide good Use Tier 2 or Tier 3 drugs instead $$ Your mid-range cost overall value. A mix of brand-name of Tier 4 to help reduce your and generic drugs. out-of-pocket costs.

Tier 4 Medications that provide the lowest Many Tier 4 drugs have lower-cost $$$ Your highest cost overall value. Mostly brand-name drugs, options in Tier 1, 2 or 3. Ask your as well as some generics. doctor if they could work for you.

Please note: If you have a high deductible plan, the tier cost levels may apply once you reach your deductible. Refer to your enrollment and plan materials on myuhc.com, or call the toll-free number on your health plan ID card for more information about your benefit plan. For HMO plans, please reference your Schedule of Benefits for costs associated with medications covered under the medical benefit. For information related to specialty medication cost share, please refer to the Specialty Medication Cost Share (SMCS) section below.

When does the PDL change? This PDL is required to be updated on a monthly basis. • Medications may move to a lower tier at any time. • Medications may move to a higher tier when a generic becomes available. • Medications may move to a higher tier or become non-formulary most often on Jan. 1, May 1, or Sept. 1. • Medications may become subject to new or revised utilization management procedures, such as prior authorization, step therapy or supply limits, at any time but most often upon FDA approval of the medication or its generic, Jan. 1, May 1, or Sept. 1. When a medication changes tiers, you may have to pay a different amount for that medication. The presence of a Prescription Drug Product on the PDL does not guarantee that you will be prescribed that Prescription Drug Product by your provider for a particular medical condition.

5 Utilization Management Programs

Prior authorization required—Your doctor is required to provide additional information to us to determine coverage. For specific prior authorization requirements, please refer to your Evidence of Coverage. Supply limit—Amount of medication covered per copayment or in a specific time period. Step therapy—Requires you to try 1 or more other medications before the medication you are requesting may be covered. For specific step therapy requirements, please refer to your Evidence of Coverage. Health Care Reform Preventive when used for appropriate preventive purposes—This medication is part of a health care reform preventive benefit and may be available at no cost to you when used for appropriate preventive purposes. For more information, please refer to the California Advantage and Essential HMO and PPO Prescription Drug List (PDL) PPACA $0 Cost-Share Preventive Care Medications list. Designated specialty program—For certain Specialty Prescription Drug Products, we may direct you to a Designated Pharmacy with whom we have an arrangement to provide those Prescription Drug Products, which are identified in the Coverage Requirements and Limits column of the Prescription Drug List (PDL). If you choose not to obtain your Prescription Drug Product from the Designated Pharmacy, you may opt-out of the Designated Pharmacy program by contacting us at myuhc.com or the telephone number on your ID card. Specialty Medication Cost Share (SMCS)—Specialty medication cost share may apply. Please refer to the Pharmacy Schedule of Benefits for specific cost share. For HMO plans, does not apply to injectable medications covered under the medical benefit.

To learn more about a pharmacy program or to find out if it applies to you, please visit myuhc.com or call the toll-free member phone number on your health plan ID card. If you are a pre-enrollee and you would like to learn more about your specific pharmacy benefit, please contact your employer. Drugs administered by a health care professional are generally covered under the medical benefit while drugs that are self- administered are covered under the pharmacy benefit. In order to obtain medical benefits for drugs that are administered by a health care professional, your provider may also be required to obtain a prior authorization. The provider may contact UnitedHealthcare for more information or uhcprovider.com. Your Right to Request Access to a Non-formulary Drug This plan must cover all Medically Necessary Prescription Drug Products. When a Prescription Drug Product is not on our PDL, you or your representative may request an exception to gain access to that Prescription Drug Product. To make a request, contact us in writing or call the toll-free number on your ID card. We will notify you of our determination within 72 hours. If approved, we will cover the Prescription Drug Product for the duration of the prescription, including refills.

Urgent Requests If your request requires immediate action and a delay could significantly increase the risk to your health, or the ability to regain maximum function, call us as soon as possible. We will provide a written or electronic determination within 24 hours. If approved, we will cover the Prescription Drug Product for the duration of the exigency.

External Review If you are not satisfied with our determination of your exception request, you may be entitled to request an external review. You or your representative may request an external review by sending a written request to us to the address set out in the determination letter or by calling the toll-free number on your ID card. The Independent Review Organization (IRO) will notify you of its determination within 72 hours.

Expedited External Review If you are not satisfied with our determination of your exception request and it involves an urgent situation, you or your representative may request an expedited external review by calling the toll-free number on your ID card or by sending a written request to the address set out in the determination letter. The IRO will notify you of our determination within 24 hours. If we deny your exception request, you may appeal. Please refer to your Evidence of Coverage for details. The complaint and appeals process, including independent review, is described under Section 6: Questions, Complaints and Appeals. You may also call the telephone number listed on your identification (ID) card.

6 Requesting a Prior Authorization or Step Therapy Exception Before certain Prescription Drug Products are dispensed to you, your prescribing provider or your pharmacist is required to obtain prior authorization or step therapy exception from us. Your prescribing provider can submit a request by phone to OptumRx or electronically by contacting us at uhcprovider.com. The Prior Authorization staff of qualified pharmacists and technicians is available Monday – Friday from 5 a.m. – 10 p.m. PST and Saturday from 6 a.m. – 3 p.m. PST to assist licensed physicians. Most authorizations are completed within 24 hours. The most common reason for delay in the authorization process is insuﬃcient information. Your licensed physician may need to provide information on diagnosis and medication history and/or evidence in the form of documents, records or lab tests which establish that the use of the requested Prescription Drug Product meets plan criteria. You may determine whether a particular Prescription Drug Product is subject to prior authorization or step therapy requirements by going online at myuhc.com or by calling at the toll-free phone number on the back of your health plan ID card. If you are changing policies, we will not require you to repeat step therapy when you are already being treated for a medical condition by a Prescription Drug Product provided the Prescription Drug Product is appropriately prescribed and considered safe and effective for your medical condition. However, we may impose a prior authorization requirement for the continued coverage of a Prescription Drug Product prescribed pursuant to step therapy requirements imposed by the former policy. Your prescribing provider may also prescribe another Prescription Drug Product covered under your policy that is medically appropriate for your medical condition. If you are currently taking a Prescription Drug Product which was approved by UnitedHealthcare for a specific medical condition and that drug is removed from the Prescription Drug List (PDL) and the prescribing provider continues to prescribe the Prescription Drug Product for your medical condition, we will continue to cover the Prescription Drug Product provided that the drug is appropriately prescribed and is considered safe and effective for treating your medical condition. In the case of a standard prior authorization or step therapy exception request, we will notify you, your designee, or your prescribing provider of the Benefit determination no later than 72 hours following receipt of the request. In the case of an expedited prior authorization or step therapy exception request based on exigent circumstances, we will notify you, your designee, or your prescribing provider of the Benefit determination no later than 24 hours following receipt of the request. If we fail to respond to you, your designee, or your prescribing provider within the prescribed time limits, the request is deemed approved and we may not deny the request thereafter. If you disagree with a determination, you can request an appeal. The complaint and appeals process, including independent medical review, is described in the Evidence of Coverage under Section 6: Questions, Complaints and Appeals. You may also call at the telephone number on your ID card.

How do I locate and fill a prescription through a retail network pharmacy? UnitedHealthcare has a well-established network of pharmacies including most major pharmacy and supermarket chains as well as many independent pharmacies. For a listing of network pharmacies, call the toll-free phone number on your health plan ID card to help locate a network pharmacy near you or visit our website at myuhc.com for an up-to-date list.

How do I locate and fill a prescription through the mail order pharmacy? UnitedHealthcare offers a Mail Order Pharmacy Program through OptumRx®. Here’s how to fill prescriptions through the Mail Order Pharmacy Program. 1. Call your prescribing provider to obtain a new prescription for each medication. When you call, ask the Physician to write the prescription for a 90-day supply which represents 3 prescription units with up to 3 additional refills. The doctor will tell you when to pick up the written prescription. (Note: OptumRx must have a new prescription to process any new Mail Order request.)

7 2. After picking up the prescription, complete the Mail Order Form included in your enrollment materials. (To obtain additional forms or for assistance in completing the form, contact UnitedHealthcare’s Customer Service Department by calling the telephone number on the back of your ID card. You can also find the form atoptumrx.com .) 3. Enclose the prescription and appropriate copayment via check, money order, or credit card. Your Pharmacy Schedule of Benefits will have the applicable copayment for the Mail Order Pharmacy Program. Make the check or money order payable to OptumRx. No cash please. Important Tip: If you are starting a new Prescription Drug Product, please request 2 prescriptions from your physician. Have 1 filled immediately at a network pharmacy while mailing the second prescription to UnitedHealthcare’s Mail Order Pharmacy. Once you receive your medication through the Mail Order Pharmacy Program, you should stop filling the prescription at the network pharmacy.

How do I locate and fill a prescription at a specialty pharmacy? Call the phone number on the back of your health plan ID card or visit specialty.optumrx.com to locate a designated specialty pharmacy for your medication.

Designated Pharmacies If you require certain Specialty Prescription Drug Products, we may direct you to a Designated Pharmacy with whom we have an arrangement to provide those Specialty Prescription Drug Products. There are both retail and mail pharmacies in the Designated Pharmacy network. Note that not all contracted retail pharmacies are in the Designated Pharmacy network. Only retail pharmacies that are in the Designated Pharmacy network will provide access to these Specialty Prescription Drug Products. If you choose not to obtain your Specialty Prescription Drug Product from the Designated Pharmacy, you may opt-out of the Designated Pharmacy program through the Internet at myuhc.com or by calling the telephone number on your ID card. If you want to opt-out of the program and fill your Specialty Prescription Drug Product at a non-Designated Pharmacy but do not inform us, you will be responsible for the entire cost of the Specialty Prescription Drug Product and no Benefits will be paid. In urgent or emergent circumstances, you may contact Customer Service by calling the telephone number on the back of your ID card. This will allow you access to the retail network override process and allow the urgent or emergent prescription claim to pay at your local pharmacy for same day access if they have the Prescription Drug Product available.

How do I get updated information about my pharmacy benefit? Since the PDL may change during your plan year, we encourage you to visit myuhc.com or call the toll-free member phone number on your health plan ID card for more current information.

Log in to myuhc.com for the following pharmacy information and tools: • Pharmacy benefit and coverage information • Possible lower-cost medication options • Medication interactions and side effects • Participating retail pharmacies by ZIP code • Your prescription history

And, if mail order services are included in your pharmacy benefit, you can also: • Refill prescriptions • Check the status of your order • Set up reminders for refills • Manage your account

Learn more Call the toll-free member phone number on your health plan ID card, or visit myuhc.com.

8 Nondiscrimination notice and access to communication services UnitedHealthcare Services, Inc. on behalf of itself and its affiliates does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. If you think you were treated unfairly for any of these reasons, you can send a complaint to: Online: [email protected] Mail: Civil Rights Coordinator UnitedHealthcare Civil Rights Grievance P.O. Box 30608 Salt Lake City, UT 84130 You must send the complaint within 60 days of when you found out about it. A decision will be sent to you within 30 days. If you disagree with the decision, you have 15 days to ask us to look at it again. If you need help with your complaint, please call the toll- free phone number listed on your ID card. If you think you were treated unfairly because of your race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability, you can also send a complaint to the California Department of Managed Health Care: DMHC California Help Center 980 9th Street, Suite 500 Sacramento, CA 95814-2725 1-888-HMO-2219 (1-888-466-2219) 1-800-735-2929 or 1-888-877-5378 (TTY) Internet Website: www.hmohelp.ca.gov If you think you were treated unfairly because of your sex, age, race, color, national origin, or disability, you can also file a complaint with the U.S. Dept. of Health and Human Services: Online: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html. Phone: Toll-free 1-800-368-1019, 1-800-537-7697 (TDD) Mail: U.S. Dept. of Health and Human Services 200 Independence Avenue SW Room 509F, HHH Building Washington, D.C. 20201

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Spanish INFORMACIÓN IMPORTANTE SOBRE IDIOMAS: Es probable que usted disponga de los derechos y servicios a continuación. Puede pedir un intérprete o servicios de traducción sin cargo. Es posible que tenga disponible documentación impresa en algunos idiomas sin cargo. Para recibir ayuda en su idioma, llame a su plan de salud de UnitedHealthcare of California al 1-800- 624-8822 / TTY: 711. Si necesita más ayuda, llame a la línea de ayuda de la HMO al 1-888-466-2219.

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Armenian ԿԱՐԵՎՈՐ ԼԵԶՎԱԿԱՆ ՏԵՂԵԿՈՒԹՅՈՒՆ՝ Հավանական է, որ Ձեզ հասանելի լինեն հետևյալ իրավունքներն ու ծառայությունները: Կարող եք ստանալ բանավոր թարգմանչի կամ թարգմանության անվճար ծառայություններ: Հնարավոր է, որ մի շարք լեզուներով նաև առկա լինի անվճար գրավոր տեղեկություն: Ձեր լեզվով օգնություն ստանալու համար խնդրում ենք զանգահարել Ձեր առողջապահական ծրագիր՝ UnitedHealthcare of California 1-800-624-8822 / TTY 711 համարով: Հավելյալ օգնության կարիքի դեպքում, զանգահարեք HMO-ի Օգնության հեռախոսագիծ 1-888-466-2219 համարով:

10 Hmong COV NTAUB NTAWV LUS TSEEM CEEB: Tej zaum koj yuav muaj cai rau cov cai pab cuam hauv qab no. Koj tuaj yeem tau txais ib tug kws txhais lus los sis txhais ntawv pub dawb. Cov ntaub ntawv sau no muaj sau ua qee yam ntaub ntawv pub dawb rau sawd daws. Yuav tau txais kev cov ntaub ntawv sau ua koj lus, thov hu rau qhov chaw npaj kho mob rau ntawm: UnitedHealthcare of California 1-800-624-8822 / TTY: 711. Yog koj xav tau kev pab ntxiv, hu rau HMO Help Line ntawm tus xov tooj 1-888-466-2219.

Japanese 言語支援サービスについての重要なお知らせ：お客様には、以下権利があり、必要なサービスをご利用いただける可能性があります。お客様は、通訳または翻訳のサービスを無料でご利用いただけます。言語によっては、文書化された情報を無料でご利用できる場合もあります。ご希望の言語による援助をご希望の方は、お客様の医療保険プランにご連絡ください。UnitedHealthcare of California 1-800-624-8822 / TTY: 711。この他のサポートが必要な場合には、HMO Help Line に 1-888-466-2219 にてお問い合わせください。

Korean 중요 언어 정보: 귀하는 아래와 같은 권리 및 서비스를 누리실 수 있습니다. 귀하는 통역 혹은 번역 서비스를 비용 부담없이 이용하실 수 있습니다. 일부 언어의 경우 서면 번역 서비스 또한 비용 부담없이 제공될 수도 있습니다. 귀하의 언어 지원 서비스가 필요하시면 귀하의 건강보험에 다음 전화번호로 문의하십시오. UnitedHealthcare of California 1-800-624-8822 / TTY: 711. 더 많은 도움이 필요하신 분은 HMO 헬프 라인(안내번호: 1-888-466-2219)으로 문의하십시오.

Punjabi ਮਹੱ ਤਵਪੂਰਨ ਭਾ,ਾ ਦੀ ਜਾਣਕਾਰੀ: ਤੁਸ4 ਹੇਠ7 ਿਦੱ ਤੇ ਅਿਧਕਾਰ ਅਤੇ ਸੇਵਾਵ7 ਦੇ ਹੱ ਕਦਾਰ ਹੋ ਸਕਦੇ ਹੋ। ਤੁਸ4 ਿਬਨਾ ਿਕਸੇ ਲਾਗਤ 'ਤੇ ਦੁਭਾ,ੀਆ ਜ7 ਅਨੁਵਾਦ ਸੇਵਾਵ7 ਪ@ਾਪਤ ਕਰ ਸਕਦੇ ਹੋ। ਿਲਖਤੀ ਜਾਣਕਾਰੀ ਕੁਝ ਭਾ,ਾਵ7 ਿਵਚ ਿਬਨਾ ਿਕਸੇ ਖਰਚੇ ਦੇ ਿਮਲ ਸਕਦੀ ਹੈ। ਆਪਣੀ ਭਾ,ਾ ਿਵਚ ਸਹਾਇਤਾ ਪ@ਾਪਤ ਕਰਨ ਲਈ, ਿਕਰਪਾ ਕਰਕੇ ਆਪਣੀ ਿਸਹਤ ਯੋਜਨਾ ਨੂੰ ਇੱ ਥੇ ਕਾਲ ਕਰੋ: UnitedHealthcare of California 1-800-624-8822 / TTY: 711। ਜੇ ਤੁਹਾ ੰਨੂ ਹੋਰ ਮਦਦ ਚਾਹੀਦੀ ਹੈ, ਤ7 HMO ਹੈਲਪ ਲਾਈਨ 'ਤੇ ਕਾਲ ਕਰੋ 1-888-466-2219।

11 Russian ВАЖНАЯ ЯЗЫКОВАЯ ИНФОРМАЦИЯ: Вам могут полагаться следующие права и услуги. Вы можете получить бесплатную помощь устного переводчика или письменный перевод. Письменная информация может быть также доступна на ряде языков бесплатно. Чтобы получить помощь на вашем языке, пожалуйста, позвоните по номеру вашего плана: UnitedHealthcare of California 1-800-624-8822 / линия TTY: 711. Если вам все еще требуется помощь, позвоните в службу поддержки HMO по телефону 1-888-466-2219.

Tagalog MAHALAGANG IMPORMASYON SA WIKA: Maaaring kwalipikado ka sa mga karapatan at serbisyo sa ibaba. Maaari kang kumuha ng interpreter o mga serbisyo sa pagsasalin nang walang bayad. Maaaring may available ding libreng nakasulat na impormasyon sa ilang wika. Upang makatanggap ng tulong sa iyong wika, mangyaring tumawag sa iyong planong pangkalusugan sa: UnitedHealthcare of California 1-800-624-8822 / TTY: 711. Kung kailangan mo ng higit pang tulong, tumawag sa HMO Help Line sa 1-888-466-2219.

Vietnamese THÔNG TIN QUAN TRỌNG VỀ NGÔN NGỮ: Quý vị có thể được hưởng các quyền và dịch vụ dưới đây. Quý vị có thể yêu cầu được cung cấp một thông dịch viên hoặc các dịch vụ dịch thuật miễn phí. Thông tin bằng văn bản cũng có thể sẵn có ở một số ngôn ngữ miễn phí. Để nhận trợ giúp bằng ngôn ngữ của quý vị, vui lòng gọi cho chương trình bảo hiểm y tế của quý vị tại: UnitedHealthcare of California 1-800-624-8822 / TTY: 711. Nếu quý vị cần trợ giúp thêm, xin gọi Đường dây hỗ trợ HMO theo số 1-888-466-2219.

12 Table of Contents of Prescription Drug List Informational Section...... 1 ANTIHISTAMINE DRUGS - Drugs for Allergy...... 13 ANTI-INFECTIVE AGENTS - Drugs for Infections...... 14 ANTINEOPLASTIC AGENTS - Drugs for Cancer ...... 34 ANTITOXINS,IMMUNE GLOB,TOXOIDS,VACCINES - DRUGS FOR THE IMMUNE SYSTEM...... 45 AUTONOMIC DRUGS - Drugs for the Nervous System ...... 48 BLOOD FORMATION, COAGULATION, THROMBOSIS - Drugs for the Blood ...... 57 CARDIOVASCULAR DRUGS - Drugs for the Heart...... 67 CENTRAL NERVOUS SYSTEM AGENTS - Drugs for the Nervous System ...... 98 DEVICES - Medical Supplies and Durable Medical Equipment...... 137 DIAGNOSTIC AGENTS...... 140 DISINFECTANTS (FOR NON-DERMATOLOGIC USE) - Disinfectants ...... 141 ELECTROLYTIC, CALORIC, AND WATER BALANCE ...... 141 ENZYMES...... 149 EYE, EAR, NOSE AND THROAT (EENT) PREPS...... 149 GASTROINTESTINAL DRUGS ...... 159 GASTROINTESTINAL DRUGS - Drugs for the Stomach ...... 159 GOLD COMPOUNDS...... 166 HEAVY METAL ANTAGONISTS - Drugs to Reduce Iron ...... 166 HORMONES AND SYNTHETIC SUBSTITUTES - Hormones ...... 166 MISCELLANEOUS THERAPEUTIC AGENTS ...... 197 NONHORMONAL CONTRACEPTIVES - Drugs for Women ...... 217 OXYTOCICS - Drugs for Women...... 218 PHARMACEUTICAL AIDS...... 218 RESPIRATORY TRACT AGENTS - Drugs for the Lungs ...... 219 SKIN AND MUCOUS MEMBRANE AGENTS - Drugs for the Skin ...... 228 SMOOTH MUSCLE RELAXANTS - Drugs to Relax Muscles ...... 254 VITAMINS...... 254

TOC-1 Coverage Requirements & Prescription Drug Name Drug Tier Limits ANTIHISTAMINE DRUGS - Drugs for Allergy ETHANOLAMINE DERIVATIVES - Drugs for Allergy carbinoxamine maleate oral solution 4 mg/5ml 1 carbinoxamine maleate oral tablet 4 mg 1 clemastine fumarate oral tablet 2.68 mg 1 DICOPANOL FUSEPAQ ORAL SUSPENSION 3 PA RECONSTITUTED 5 MG/ML (diphenhydramine hcl) diphen oral elixir 12.5 mg/5ml 1 di-phen oral elixir 12.5 mg/5ml 4 diphenhydramine hcl oral elixir 12.5 mg/5ml 1 FIRST GEN. ANTIHIST. DERIVATIVES, MISC. - Drugs for Allergy cyproheptadine hcl oral syrup 2 mg/5ml 1 cyproheptadine hcl oral tablet 4 mg 1 FIRST GENERATION ANTIHISTAMINES - Drugs for Allergy carbinoxamine maleate oral solution 4 mg/5ml 1 carbinoxamine maleate oral tablet 4 mg 1 clemastine fumarate oral tablet 2.68 mg 1 cyproheptadine hcl oral syrup 2 mg/5ml 1 cyproheptadine hcl oral tablet 4 mg 1 DICOPANOL FUSEPAQ ORAL SUSPENSION 3 PA RECONSTITUTED 5 MG/ML (diphenhydramine hcl) diphen oral elixir 12.5 mg/5ml 1 di-phen oral elixir 12.5 mg/5ml 4 diphenhydramine hcl oral elixir 12.5 mg/5ml 1 PHENOTHIAZINE DERIVATIVES - Drugs for Allergy promethazine hcl oral solution 6.25 mg/5ml 1 promethazine hcl oral syrup 6.25 mg/5ml 1 promethazine hcl oral tablet 12.5 mg, 25 mg, 50 mg 1 promethazine hcl rectal suppository 12.5 mg, 25 mg 1 promethazine vc oral syrup 6.25-5 mg/5ml 1 promethazine vc/codeine oral syrup 6.25-5-10 mg/5ml 1 PA; SL (360 ml per month.) promethazine-dm oral syrup 6.25-15 mg/5ml 1

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 22 Coverage Requirements & Prescription Drug Name Drug Tier Limits HCV REPLICATION COMPLEX INHIBITORS - Drugs for Viral Infections EPCLUSA ORAL TABLET 200-50 MG (sofosbuvir- PA; SL (1 tablet per day.); 2 velpatasvir) SMCS EPCLUSA ORAL TABLET 400-100 MG (sofosbuvir- PA; SL (84 tablets per 720 2 velpatasvir) days.); SMCS HARVONI ORAL PACKET 33.75-150 MG, 45-200 MG SL (1 pellet per day and 84 2 (ledipasvir-sofosbuvir) pellets per 720 days.); SMCS PA; ST; SL (84 tablets per HARVONI ORAL TABLET 45-200 MG (ledipasvir-sofosbuvir) 2 720 days.); SMCS PA; ST; SL (56 tablets per HARVONI ORAL TABLET 90-400 MG (ledipasvir-sofosbuvir) 2 720 days.); SMCS PA; ST; SL (56 tablets per LEDIPASVIR-SOFOSBUVIR ORAL TABLET 90-400 MG 2 720 days.); SMCS MAVYRET ORAL TABLET 100-40 MG (glecaprevir- PA; SL (168 tablets per 720 2 pibrentasvir) days.); SMCS; SP PA; SL (84 tablets per 720 SOFOSBUVIR-VELPATASVIR ORAL TABLET 400-100 MG 2 days.); SMCS VIEKIRA PAK ORAL TABLET THERAPY PACK 12.5-75-50 PA; ST; SL (336 tablets per 4 &250 MG (ombitas-paritapre-ritona-dasab) 720 days.); SMCS; SP VOSEVI ORAL TABLET 400-100-100 MG (sofosbuv- PA; SL (84 tablets per 720 2 velpatasv-voxilaprev) days.); SMCS; SP PA; SL (84 tablets per 720 ZEPATIER ORAL TABLET 50-100 MG (elbasvir-grazoprevir) 2 days (12 weeks).); SMCS; SP HIV ENTRY AND FUSION INHIBITORS - Drugs for Viral Infections FUZEON SUBCUTANEOUS SOLUTION RECONSTITUTED 90 4 M MG (enfuvirtide) RUKOBIA ORAL TABLET EXTENDED RELEASE 12 HOUR 4 PA 600 MG (fostemsavir tromethamine) SELZENTRY ORAL SOLUTION 20 MG/ML (maraviroc) 2 PA SELZENTRY ORAL TABLET 150 MG, 25 MG, 300 MG, 75 MG 2 PA (maraviroc) HIV INTEGRASE INHIBITOR ANTIRETROVIRALS - Drugs for Viral Infections BIKTARVY ORAL TABLET 50-200-25 MG (bictegravir- 3 SL (1 tablet per day.) emtricitab-tenofov) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 23 Coverage Requirements & Prescription Drug Name Drug Tier Limits DOVATO ORAL TABLET 50-300 MG (dolutegravir- 2 SL (1 tablet per day.) lamivudine) GENVOYA ORAL TABLET 150-150-200-10 MG (elviteg-cobic- 2 SL (1 tablet per day.) emtricit-tenofaf) ISENTRESS HD ORAL TABLET 600 MG (raltegravir 2 potassium) ISENTRESS ORAL PACKET 100 MG (raltegravir potassium) 2 ISENTRESS ORAL TABLET 400 MG (raltegravir potassium) 2 ISENTRESS ORAL TABLET CHEWABLE 100 MG, 25 MG 2 (raltegravir potassium) JULUCA ORAL TABLET 50-25 MG (dolutegravir-rilpivirine) 2 SL (1 tablet per day.) STRIBILD ORAL TABLET 150-150-200-300 MG (elviteg- 2 SL (1 tablet per day.) cobic-emtricit-tenofdf) TIVICAY ORAL TABLET 50 MG (dolutegravir sodium) 3 TIVICAY PD ORAL TABLET SOLUBLE 5 MG (dolutegravir 3 sodium) TRIUMEQ ORAL TABLET 600-50-300 MG (abacavir- 2 SL (1 tablet per day.) dolutegravir-lamivud) HIV NONNUCLEOSIDE REV.TRANSCRIP. INHIB. - Drugs for Viral Infections COMPLERA ORAL TABLET 200-25-300 MG (emtricitab- 3 SL (1 tablet per day.) rilpivir-tenofovir) DELSTRIGO ORAL TABLET 100-300-300 MG (doravirin- 2 SL (1 tablet per day.) lamivudin-tenofov df) EDURANT ORAL TABLET 25 MG (rilpivirine hcl) 2 efavirenz oral capsule 200 mg, 50 mg 2 efavirenz oral tablet 600 mg 2 efavirenz-emtricitab-tenofovir oral tablet 600-200-300 mg 2 SL (1 tablet per day.) efavirenz-lamivudine-tenofovir oral tablet 400-300-300 mg, 600-300-300 mg 2 SL (1 tablet per day.) etravirine oral tablet 100 mg, 200 mg 1 INTELENCE ORAL TABLET 100 MG, 200 MG ( etravirine) 3 INTELENCE ORAL TABLET 25 MG ( etravirine) 2 JULUCA ORAL TABLET 50-25 MG (dolutegravir-rilpivirine) 2 SL (1 tablet per day.) nevirapine oral suspension 50 mg/5ml 1 nevirapine oral tablet 200 mg 1 Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 24 Coverage Requirements & Prescription Drug Name Drug Tier Limits ODEFSEY ORAL TABLET 200-25-25 MG (emtricitab-rilpivir- 3 SL (1 tablet per day.) tenofov af) PIFELTRO ORAL TABLET 100 MG (doravirine) 3 SUSTIVA ORAL TABLET 600 MG (efavirenz) 4 SYMFI LO ORAL TABLET 400-300-300 MG (efavirenz- 2 SL (1 tablet per day.) lamivudine-tenofovir) SYMFI ORAL TABLET 600-300-300 MG (efavirenz- 2 SL (1 tablet per day.) lamivudine-tenofovir) VIRAMUNE ORAL SUSPENSION 50 MG/5ML (nevirapine) 4 HIV NUCLEOSIDE, NUCLEOTIDE RT INHIBITORS - Drugs for Viral Infections abacavir sulfate oral solution 20 mg/ml 1 abacavir sulfate oral tablet 300 mg 1 abacavir sulfate-lamivudine oral tablet 600-300 mg 2 SL (1 tablet per day.) abacavir-lamivudine-zidovudine oral tablet 300-150-300 mg 1 BIKTARVY ORAL TABLET 50-200-25 MG (bictegravir- 3 SL (1 tablet per day.) emtricitab-tenofov) CIMDUO ORAL TABLET 300-300 MG (lamivudine-tenofovir) 2 SL (1 tablet per day.) COMBIVIR ORAL TABLET 150-300 MG (lamivudine- 4 zidovudine) COMPLERA ORAL TABLET 200-25-300 MG (emtricitab- 3 SL (1 tablet per day.) rilpivir-tenofovir) DELSTRIGO ORAL TABLET 100-300-300 MG (doravirin- 2 SL (1 tablet per day.) lamivudin-tenofov df) DESCOVY ORAL TABLET 200-25 MG (emtricitabine- 3 SL (1 tablet per day.); H-N tenofovir af) DOVATO ORAL TABLET 50-300 MG (dolutegravir- 2 SL (1 tablet per day.) lamivudine) efavirenz-emtricitab-tenofovir oral tablet 600-200-300 mg 2 SL (1 tablet per day.) efavirenz-lamivudine-tenofovir oral tablet 400-300-300 mg, 600-300-300 mg 2 SL (1 tablet per day.) emtricitabine oral capsule 200 mg 2 emtricitabine-tenofovir df oral tablet 100-150 mg, 133-200 mg, 167-250 mg 1 SL (1 tablet per day.) emtricitabine-tenofovir df oral tablet 200-300 mg 1 SL (1 tablet per day.); H EMTRIVA ORAL CAPSULE 200 MG (emtricitabine) 4

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 40 Coverage Requirements & Prescription Drug Name Drug Tier Limits PANRETIN EXTERNAL GEL 0.1 % (alitretinoin) 3 PEMAZYRE ORAL TABLET 13.5 MG, 4.5 MG, 9 MG PA; SL (14 tablets per 21 4 (pemigatinib) days.); SMCS; SP; CM PIQRAY ORAL TABLET THERAPY PACK 2 X 150 MG, 200 & PA; SL (2 tablets per day.); 2 50 MG (alpelisib) SMCS; SP; CM PA; SL (1 tablet per day.); PIQRAY ORAL TABLET THERAPY PACK 200 MG (alpelisib) 2 SMCS; SP; CM PA; SL (21 capsules per POMALYST ORAL CAPSULE 1 MG, 2 MG, 3 MG, 4 MG 3 prescription.); SMCS; SP; (pomalidomide) CM PURIXAN ORAL SUSPENSION 2000 MG/100ML 4 PA; SMCS; SP (mercaptopurine) PA; SL (3 tablets per day.); QINLOCK ORAL TABLET 50 MG (ripretinib) 4 SMCS; SP; CM RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 10 M; SL (0.8 ml (4 auto- 2 MG/0.2ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR M; SL (1 ml (4 auto-injectors) 2 12.5 MG/0.25ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 15 M; SL (1.2 ml (4 auto- 2 MG/0.3ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR M; SL (1.4 ml (4 auto- 2 17.5 MG/0.35ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 20 M; SL (1.6 ml (4 auto- 2 MG/0.4ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR M; SL (1.8 ml (4 auto- 2 22.5 MG/0.45ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 25 M; SL (2 ml (4 auto-injectors) 2 MG/0.5ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 30 M; SL (2.4 ml (4 auto- 2 MG/0.6ML (methotrexate (anti-rheumatic)) injectors) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 7.5 M; SL (0.6 ml (4 auto- 2 MG/0.15ML (methotrexate (anti-rheumatic)) injectors) per month.) PA; SL (6 capsules per day.); RETEVMO ORAL CAPSULE 40 MG (selpercatinib) 4 SMCS; SP; CM RETEVMO ORAL CAPSULE 80 MG (selpercatinib) 4 PA; SMCS; SP; CM PA; SL (28 capsules per REVLIMID ORAL CAPSULE 10 MG, 2.5 MG, 5 MG 2 prescription.); SMCS; SP; (lenalidomide) CM Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 41 Coverage Requirements & Prescription Drug Name Drug Tier Limits PA; SL (21 capsules per REVLIMID ORAL CAPSULE 15 MG, 20 MG, 25 MG 2 prescription.); SMCS; SP; (lenalidomide) CM PA; SL (1 capsule per day.); ROZLYTREK ORAL CAPSULE 100 MG (entrectinib) 2 SMCS; SP; CM PA; SL (3 capsules per day.); ROZLYTREK ORAL CAPSULE 200 MG (entrectinib) 2 SMCS; SP; CM PA; ST; SL (2 tablets per RUBRACA ORAL TABLET 200 MG (rucaparib camsylate) 3 day.); SMCS; SP; CM RUBRACA ORAL TABLET 250 MG, 300 MG (rucaparib PA; ST; SL (4 tablets per 3 camsylate) day.); SMCS; SP; CM PA; SL (8 capsules per day.); RYDAPT ORAL CAPSULE 25 MG (midostaurin) 2 SMCS; SP; CM SPRYCEL ORAL TABLET 100 MG, 140 MG, 50 MG, 70 MG, PA; ST; SL (1 tablet per 4 80 MG (dasatinib) day.); SMCS; SP; CM PA; ST; SL (2 tablets per SPRYCEL ORAL TABLET 20 MG (dasatinib) 4 day.); SMCS; SP; CM PA; SL (84 tablets per STIVARGA ORAL TABLET 40 MG (regorafenib) 2 prescription.); SMCS; SP; CM SUTENT ORAL CAPSULE 12.5 MG, 25 MG, 37.5 MG, 50 MG PA; SL (1 capsule per day.); 2 (sunitinib malate) SMCS; SP; CM SYNRIBO SUBCUTANEOUS SOLUTION RECONSTITUTED PA; M; SL (28 vials per 2 3.5 MG (omacetaxine mepesuccinate) month.); SMCS; SP TABLOID ORAL TABLET 40 MG (thioguanine) 2 SMCS; SP PA; SL (4 tablets per day.); TABRECTA ORAL TABLET 150 MG, 200 MG ( capmatinib hcl) 4 SMCS; SP; CM TAFINLAR ORAL CAPSULE 50 MG, 75 MG (dabrafenib PA; SL (4 capsules per day.); 3 mesylate) SMCS; SP; CM TAGRISSO ORAL TABLET 40 MG, 80 MG (osimertinib PA; SL (1 tablet per day.); 3 mesylate) SMCS; SP; CM PA; ST; SL (3 capsules per TALZENNA ORAL CAPSULE 0.25 MG (talazoparib tosylate) 4 day.); SMCS; SP; CM PA; ST; SL (1 capsule per TALZENNA ORAL CAPSULE 1 MG (talazoparib tosylate) 4 day.); SMCS; SP; CM tamoxifen citrate oral tablet 10 mg 1 tamoxifen citrate oral tablet 20 mg 1 H-N

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 225 Coverage Requirements & Prescription Drug Name Drug Tier Limits ADVAIR HFA INHALATION AEROSOL 115-21 MCG/ACT, 230- 3 SL (0.4 grams per day.) 21 MCG/ACT, 45-21 MCG/ACT (fluticasone-salmeterol) albuterol sulfate hfa aerosol solution 108 (90 base) mcg/act SL (1 inhaler per 2 inhalation 108 (90 base) mcg/act prescription.) albuterol sulfate hfa aerosol solution 108 (90 base) mcg/act SL (6.7 grams per 2 inhalation 108 (90 base) mcg/act prescription.) albuterol sulfate hfa aerosol solution 108 (90 base) mcg/act SL (8.5 grams per 2 inhalation 108 (90 base) mcg/act prescription.) albuterol sulfate inhalation nebulization solution (2.5 mg/3ml) 0.083%, 0.63 mg/3ml, 1.25 mg/3ml, 2.5 mg/0.5ml 1 albuterol sulfate inhalation nebulization solution (5 mg/ml) 0.5% 1 albuterol sulfate oral syrup 2 mg/5ml 1 albuterol sulfate oral tablet 2 mg, 4 mg 3 PA ANORO ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED 62.5-25 MCG/INH (umeclidinium- 3 SL (2 blisters per day.) vilanterol) arformoterol tartrate inhalation nebulization solution 15 mcg/2ml 1 SL (2 nebules per day) BEVESPI AEROSPHERE INHALATION AEROSOL 9-4.8 2 SL (0.36 grams per day.) MCG/ACT (glycopyrrolate-formoterol) BREO ELLIPTA INHALATION AEROSOL POWDER BREATH 3 SL (2 inhalers per day.) ACTIVATED 100-25 MCG/INH (fluticasone furoate-vilanterol) BREO ELLIPTA INHALATION AEROSOL POWDER BREATH 3 SL (2 blisters per day.) ACTIVATED 200-25 MCG/INH (fluticasone furoate-vilanterol) BREZTRI AEROSPHERE INHALATION AEROSOL 160-9-4.8 3 SL (0.36 grams per day.) MCG/ACT (budeson-glycopyrrol-formoterol) BROVANA INHALATION NEBULIZATION SOLUTION 15 3 SL (2 nebules per day) MCG/2ML (arformoterol tartrate) COMBIVENT RESPIMAT INHALATION AEROSOL SOLUTION 3 SL (0.28 grams per day.) 20-100 MCG/ACT (ipratropium-albuterol) DUAKLIR PRESSAIR INHALATION AEROSOL POWDER BREATH ACTIVATED 400-12 MCG/ACT (aclidinium br- 4 SL (0.04 mcg per day.) formoterol fum) FLUTICASONE-SALMETEROL INHALATION AEROSOL POWDER BREATH ACTIVATED 113-14 MCG/ACT, 232-14 2 SL (0.04 mcg per day.) MCG/ACT, 55-14 MCG/ACT ipratropium-albuterol inhalation solution 0.5-2.5 (3) mg/3ml 2 Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 226 Coverage Requirements & Prescription Drug Name Drug Tier Limits levalbuterol hcl inhalation nebulization solution 0.31 mg/3ml, 0.63 mg/3ml, 1.25 mg/3ml 3 SL (90 ml per prescription.) levalbuterol hcl inhalation nebulization solution 1.25 mg/0.5ml 3 SL (30 vials per prescription) SL (15 grams per LEVALBUTEROL HFA INHALATION AEROSOL 45 MCG/ACT 3 prescription.) PERFOROMIST INHALATION NEBULIZATION SOLUTION 20 3 SL (2 vials per day) MCG/2ML (formoterol fumarate) SEREVENT DISKUS INHALATION AEROSOL POWDER 2 SL (2 blisters per day.) BREATH ACTIVATED 50 MCG/DOSE (salmeterol xinafoate) STRIVERDI RESPIMAT INHALATION AEROSOL SOLUTION 2 SL (0.14 grams per day.) 2.5 MCG/ACT (olodaterol hcl) SYMBICORT INHALATION AEROSOL 160-4.5 MCG/ACT, 80- 3 SL (0.34 grams per day.) 4.5 MCG/ACT (budesonide-formoterol fumarate) terbutaline sulfate oral tablet 2.5 mg, 5 mg 1 TRELEGY ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED 100-62.5-25 MCG/INH, 200-62.5-25 3 SL (2 blisters per day.) MCG/INH (fluticasone-umeclidin-vilant) XOPENEX HFA INHALATION AEROSOL 45 MCG/ACT SL (15 grams per 3 (levalbuterol tartrate) prescription.) VASODILATING AGENTS (RESPIRATORY TRACT) - Drugs for the Lungs ADEMPAS ORAL TABLET 0.5 MG, 1 MG, 1.5 MG, 2 MG, 2.5 PA; SL (3 tablets per day.); 2 MG (riociguat) SMCS; SP PA; SL (2 tablets per day); tadalafil (pah) (Alyq Oral Tablet 20 Mg) 3 SMCS; SP PA; SL (1 tablet per day.); ambrisentan oral tablet 10 mg, 5 mg 2 SMCS; SP PA; SL (2 tablets per day.); bosentan oral tablet 125 mg, 62.5 mg 2 SMCS; SP PA; SL (1 tablet per day.); OPSUMIT ORAL TABLET 10 MG (macitentan) 2 SMCS; SP ORENITRAM ORAL TABLET EXTENDED RELEASE 0.125 PA; SL (6 tablets per day.); 4 MG, 0.25 MG, 1 MG, 2.5 MG, 5 MG (treprostinil diolamine) SMCS; SP PA; SL (186 ml per month.); sildenafil citrate oral suspension reconstituted 10 mg/ml 3 SMCS; SP SL (0.5 tablet per day.); sildenafil citrate oral tablet 20 mg 1 SMCS Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 227 Coverage Requirements & Prescription Drug Name Drug Tier Limits PA; SL (2 tablets per day); tadalafil (pah) oral tablet 20 mg 3 SMCS; SP PA; SL (2 tablets per day.); TRACLEER ORAL TABLET 125 MG, 62.5 MG ( bosentan) 2 SMCS; SP PA; SL (4 tablets per day.); TRACLEER ORAL TABLET SOLUBLE 32 MG ( bosentan) 2 SMCS; SP TYVASO INHALATION SOLUTION 0.6 MG/ML (treprostinil) 2 PA; SMCS TYVASO REFILL INHALATION SOLUTION 0.6 MG/ML 2 PA; SMCS (treprostinil) TYVASO STARTER INHALATION SOLUTION 0.6 MG/ML 2 PA; SMCS (treprostinil) UPTRAVI ORAL TABLET 1000 MCG, 1200 MCG, 1400 MCG, PA; SL (2 tablets per day.); 1600 MCG, 200 MCG, 400 MCG, 600 MCG, 800 MCG 4 SMCS; SP (selexipag) UPTRAVI ORAL TABLET THERAPY PACK 200 & 800 MCG PA; SL (200 tablets per 4 (selexipag) year.); SMCS; SP VENTAVIS INHALATION SOLUTION 10 MCG/ML, 20 MCG/ML 2 PA; SMCS; SP (iloprost) XANTHINE DERIVATIVES - Drugs for Asthma/COPD ELIXOPHYLLIN ORAL ELIXIR 80 MG/15ML (theophylline) 3 THEO-24 ORAL CAPSULE EXTENDED RELEASE 24 HOUR 3 100 MG, 200 MG, 300 MG, 400 MG (theophylline) theophylline er oral tablet extended release 12 hour 300 mg, 450 mg 1 theophylline er oral tablet extended release 24 hour 400 mg, 600 mg 1 theophylline oral solution 80 mg/15ml 1 SKIN AND MUCOUS MEMBRANE AGENTS - Drugs for the Skin ANTIBACTERIALS (SKIN, MUCOUS MEMBRANE) - Drugs for the Skin SL (60 grams per ACZONE EXTERNAL GEL 5 % (dapsone) 4 prescription.) SL (60 grams per ACZONE EXTERNAL GEL 7.5 % (dapsone) 3 prescription.) SL (15 grams per ALTABAX EXTERNAL OINTMENT 1 % ( retapamulin) 3 prescription)

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 244 Coverage Requirements & Prescription Drug Name Drug Tier Limits sulfacetamide sodium-sulfur (Avar Cleanser External 4 Emulsion 10-5 %) sulfacetamide sodium-sulfur (Avar-E Emollient External 3 Cream 10-5 %) sulfacetamide sodium-sulfur (Avar-E Green External Cream 3 10-5 %) AVAR-E LS EXTERNAL CREAM 10-2 % (sulfacetamide 3 sodium-sulfur) bp 10-1 external emulsion 10-1 % 1 bp cleansing wash external emulsion 10-4 % 1 urea (Cerovel External Lotion 40 %) 1 SL (1 bottle (45 grams) per clindamycin phos-benzoyl perox external gel 1.2-5 % 3 month.) GORDOFILM EXTERNAL SOLUTION 16.7-16.7 % (salicylic 2 acid-lactic acid) HYDRO 40 EXTERNAL FOAM 40 % (urea) 3 INOVA 4/1 ACNE CONTROL THERAPY EXTERNAL KIT 4 & 1 3 & 5 % (benzoyl perox-salicyl ac-vit e) INOVA 8/2 ACNE CONTROL THERAPY EXTERNAL KIT 8 & 2 3 & 5 % (benzoyl perox-salicyl ac-vit e) INOVA EXTERNAL KIT 4 & 5 %, 8 & 5 % (benzoyl peroxide- 3 vitamin e) SL (1 bottle (45 grams) per clindamycin-benzoyl per (refr) (Neuac External Gel 1.2-5 %) 3 month.) salicylic acid external solution 26 % 1 salimez external cream 6 % 1 SALVAX DUO PLUS EXTERNAL KIT 6 & 35 % (salicylic acid- 3 urea in lactac) silver nitrate external solution 10 % 1 sss 10-5 external cream 10-5 % 1 sss 10-5 external foam 10-5 % 1 sulfacetamide sodium-sulfur external cream 10-2 %, 10-5 % 1 sulfacetamide sodium-sulfur external emulsion 10-5 % 1 sulfacetamide sodium-sulfur external liquid 9-4 %, 9-4.5 % 1 sulfacetamide sodium-sulfur external lotion 10-5 % 1 sulfacetamide sodium-sulfur external pad 10-4 % 1 Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 245 Coverage Requirements & Prescription Drug Name Drug Tier Limits sulfacetamide sodium-sulfur external suspension 10-5 % 1 sulfacetamide sod-sulfur wash external liquid 9-4 %, 9-4.5 % 1 sulfacetamide-sulfur in urea external emulsion 10-5 % 1 SUMAXIN EXTERNAL PAD 10-4 % (sulfacetamide sodium- 4 sulfur) SUMAXIN WASH EXTERNAL LIQUID 9-4 % (sulfacetamide 3 sodium-sulfur) urea external cream 40 %, 45 % 1 urea external lotion 40 % 1 urea nail external gel 45 % 1 ZACARE EXTERNAL KIT 4 & 0.2 %, 8 & 0.2 % (benzoyl 3 peroxide-hyaluronate) zaclir cleansing external lotion 8 % 1 KERATOPLASTIC AGENTS - Drugs for the Skin COAL TAR EXTERNAL SOLUTION 20 % 3 LOCAL ANTI-INFECTIVES, MISCELLANEOUS - Drugs for the Skin sulfacetamide sodium-sulfur (Avar Cleanser External 4 Emulsion 10-5 %) sulfacetamide sodium-sulfur (Avar-E Emollient External 3 Cream 10-5 %) sulfacetamide sodium-sulfur (Avar-E Green External Cream 3 10-5 %) AVAR-E LS EXTERNAL CREAM 10-2 % (sulfacetamide 3 sodium-sulfur) BENZALKONIUM CHLORIDE EXTERNAL SOLUTION 2 benzalkonium chloride external solution 50 % 1 bp 10-1 external emulsion 10-1 % 1 bp cleansing wash external emulsion 10-4 % 1 FEM PH VAGINAL GEL 0.9-0.025 % (acetic acid- 4 oxyquinoline) hydrocortisone-iodoquinol external cream 1-1 % 1 iodine tincture external tincture 2 % 1 KLARON EXTERNAL LOTION 10 % (sulfacetamide sodium 4 (acne)) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost medi cations; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care ref orm preventive; H-N: May be part of health care reform preventive when used for appropriate preventive pur poses; SP: Specialty medication; CM: Orally administered anticancer medication; M: May be covered under th e medical benefit with prior authorization for HMO plans; SMCS: Specialty medication cost share may apply (f or HMO plans, does not apply to injectables covered under the medical benefit). 246 Coverage Requirements & Prescription Drug Name Drug Tier Limits LUGOLS STRONG IODINE EXTERNAL SOLUTION 5-10 % 3 mafenide acetate external packet 5 % 3 OVACE PLUS EXTERNAL CREAM 10 % (sulfacetamide 3 sodium) OVACE PLUS EXTERNAL SHAMPOO 10 % (sulfacetamide 3 sodium) OVACE PLUS WASH EXTERNAL GEL 10 % (sulfacetamide 3 sodium) OVACE PLUS WASH EXTERNAL LIQUID 10 % 4 (sulfacetamide sodium) OVACE WASH EXTERNAL LIQUID 10 % (sulfacetamide 4 sodium) selenium sulfide external lotion 2.5 % 1 selenium sulfide external shampoo 2.25 % 4 SILVADENE EXTERNAL CREAM 1 % (silver sulfadiazine) 4 silver nitrate external solution 0.5 %, 25 %, 50 % 1 silver sulfadiazine external cream 1 % 1 sodium sulfacetamide external shampoo 10 % 1 sodium sulfacetamide wash external liquid 10 % 1 SODIUM SULFACETAMIDE-BAKUCHIOL EXTERNAL LIQUID 3 10 % silver sulfadiazine (Ssd External Cream 1 %) 1 sss 10-5 external cream 10-5 % 1 sss 10-5 external foam 10-5 % 1 sulfacetamide sodium (acne) external lotion 10 % 1 sulfacetamide sodium external gel 10 % (cleans) 1 sulfacetamide sodium external liquid 10 % 1 sulfacetamide sodium-sulfur external cream 10-2 %, 10-5 % 1 sulfacetamide sodium-sulfur external emulsion 10-5 % 1 sulfacetamide sodium-sulfur external liquid 9-4 %, 9-4.5 % 1 sulfacetamide sodium-sulfur external lotion 10-5 % 1 sulfacetamide sodium-sulfur external pad 10-4 % 1 sulfacetamide sodium-sulfur external suspension 10-5 % 1 sulfacetamide sod-sulfur wash external liquid 9-4 %, 9-4.5 % 1

260 ampicillin...... 16 ASTRINGYN...... 61 baclofen...... 52 AMZEEQ...... 229 ATACAND HCT .... 68, 69, 94, 146 BACTRIM...... 32 anagrelide hcl...... 67 atazanavir sulfate ...... 27 BACTRIM DS...... 32 ANALPRAM HC ...... 230, 236, 239 atenolol...... 56, 73, 74, 83 BAFIERTAM...... 207, 215 ANALPRAM HC SINGLES atenolol-chlorthalidone BALCOLTRA ...... 173 ...... 230, 236, 239 ...... 56, 73, 74, 83, 95, 148 balsalazide disodium ...... 160 ANALPRAM-HC ...... 230, 236, 239 atomoxetine hcl ...... 119 balsam peru-castor oil...... 249 ANASPAZ...... 49 atorvastatin calcium ...... 88 BALVERSA...... 35 anastrozole ...... 35, 170 atovaquone...... 18 Balziva...... 173 ANCOBON...... 31 atovaquone-proguanil hcl ...... 17 BANZEL...... 102 ANDRODERM...... 169 atropine sulfate...... 158 BAQSIMI ONE PACK..... 186, 198 ANGELIQ...... 184, 192 ATROVENT HFA ...... 49, 219 BAQSIMI TWO PACK.....186, 198 ANNOVERA ...... 172 AUBAGIO...... 207 BARACLUDE...... 29 ANORO ELLIPTA49, 55, 219, 226 Aubra...... 173 BAXDELA...... 32 ANTICOAGULANT SODIUM Aubra Eq...... 173 Bekyree...... 173 CITRATE ...... 57, 142 Aurovela 1.5/30...... 173 BELBUCA...... 127 anucort-hc ...... 230, 239 Aurovela 1/20...... 173 belladonna alkaloids-opium .123 ANUSOL-HC...... 231, 239 Aurovela 24 Fe...... 173 BELSOMRA ...... 111 apap-caff-dihydrocodeine Aurovela Fe 1.5/30...... 173 benazepril hcl...... 70, 71 ...... 100, 123, 130 Aurovela Fe 1/20...... 173 benazepril- APEXICON E...... 231, 239 AURYXIA...... 143 hydrochlorothiazide APOKYN...... 123 AUSTEDO...... 119, 136 ...... 70, 71, 94, 147 apraclonidine hcl...... 156 AUTOLET LANCING DEVICE 137 BENEFIX...... 61 aprepitant...... 164 AVALIDE...... 68, 69, 94, 146 BENLYSTA ...... 213 Apri...... 172 Avar Cleanser...... 245, 246 BENZALKONIUM CHLORIDE 246 APRISO...... 160 Avar-E Emollient...... 245, 246 benzalkonium chloride ...... 246 APTIOM...... 102 Avar-E Green...... 245, 246 BENZAMYCIN...... 229 APTIVUS...... 27 AVAR-E LS...... 245, 246 BENZHYDROCODONE- ARAKODA...... 17 Aviane...... 173 ACETAMINOPHEN...... 100, 123 Aranelle...... 173 avidoxy...... 33 BENZNIDAZOLE ...... 18 ARANESP (ALBUMIN FREE) AVIDOXY DK...... 33 BENZOIN...... 218, 249 ...... 59, 60 AVONEX PEN...... 207 benzoin compound ...... 218, 238 ARAVA...... 203, 207 AVONEX PREFILLED...... 207 benzonatate ...... 220 ARCALYST...... 215 AYGESTIN...... 192 benzoyl peroxide- arformoterol tartrate ...... 55, 226 Ayuna...... 173 erythromycin...... 229 ARICEPT...... 54 AYVAKIT...... 35 benzphetamine hcl ...... 99 ARIKAYCE...... 16 AZASAN...... 203, 207, 213 benztropine mesylate ..... 51, 102 aripiprazole...... 107, 112 AZASITE...... 150 BERINERT...... 203 ARIXTRA...... 58, 59 azathioprine...... 203, 207, 213 Beser...... 231, 239 armodafinil...... 136 azelaic acid...... 249 BESIVANCE...... 150 ARMOUR THYROID...... 197 azelastine hcl...... 149, 150 BETADINE OPHTHALMIC ARNUITY ELLIPTA ...... 167, 224 AZELEX...... 249 PREP...... 156 ARTHROTEC ...... 128, 165 azithromycin...... 30 betamethasone dipropionate ARTISS...... 249 AZOPT...... 154 ...... 231, 239 ARZOL SILVER NIT AZULFIDINE..... 32, 160, 203, 207 betamethasone dipropionate APPLICATORS...... 244 AZULFIDINE EN-TABS aug...... 231, 239 Ascomp-Codeine ...... 32, 160, 203, 207 betamethasone valerate ...... 110, 114, 123, 130, 132 Azurette...... 173 ...... 231, 239 Ashlyna...... 173 Bac...... 100, 110, 114, 130 BETAPACE AF aspirin-dipyridamole er bacitracin...... 150 ...... 52, 73, 74, 83, 85, 89 ...... 67, 96, 132 bacitracin-polymyxin b ...... 150 BETASERON...... 208 ASTRAZENECA COVID-19 bacitra-neomycin- VACCINE...... 46 polymyxin-hc...... 150, 154

261 betaxolol hcl bupropion hcl ...... 106 CARBATROL...... 102, 107 ...... 56, 73, 74, 84, 89, 153 bupropion hcl er (smoking carbidopa...... 119 bethanechol chloride ...... 54 det)...... 106 carbidopa-levodopa ...... 120 BETIMOL...... 153 bupropion hcl er (sr) ...... 106 CARBIDOPA-LEVODOPA...... 120 BETOPTIC-S...... 153 bupropion hcl er (xl) ...... 106 carbidopa-levodopa er ...... 120 BEVESPI AEROSPHERE buspirone hcl ...... 112 carbidopa-levodopa- ...... 49, 55, 219, 226 butalbital-acetaminophen entacapone ...... 118, 120 BEXSERO...... 47 ...... 100, 114 carbinoxamine maleate.. 13, 222 bicalutamide...... 35 butalbital-apap-caff-cod CARDURA...... 53, 67, 68, 89 BIDIL...... 88, 91 ...... 100, 110, 115, 123, 130 CARDURA XL...... 53, 67, 68, 89 BIJUVA...... 184, 192 butalbital-apap-caffeine CARETOUCH BIKTARVY...... 23, 25 ...... 100, 110, 115, 130 LANCING/EJECTOR...... 137 BILTRICIDE...... 17 butalbital-asa-caff-codeine carisoprodol...... 52 bisoprolol fumarate ...... 110, 115, 124, 130, 132 carisoprodol-aspirin-codeine ...... 57, 73, 74, 84 butalbital-aspirin-caffeine ...... 52, 124, 132 bisoprolol- ...... 67, 110, 115, 130, 132 CARNITOR...... 215 hydrochlorothiazide butorphanol tartrate ...... 128 CARNITOR SF...... 215 ...... 57, 73, 74, 84, 94, 147 BYDUREON BCISE CAROSPIR...... 91, 93, 144 BLEPH-10...... 150 AUTOINJECTOR...... 188 carteolol hcl...... 153 BLEPHAMIDE...... 150 BYETTA 10 MCG PEN ...... 188 Cartia Xt...... 76, 77, 79, 80, 85, 96 BLEPHAMIDE S.O.P...... 150 BYETTA 5 MCG PEN ...... 188 carvedilol... 52, 54, 67, 73, 84, 89 Blisovi 24 Fe...... 173 cabergoline...... 121 cascara sagrada...... 160 Blisovi Fe 1.5/30...... 173 CABLIVI...... 58 CASODEX...... 36 Blisovi Fe 1/20...... 173 CABOMETYX ...... 35 CATAPRES-TTS-1...... 48, 82 BONIVA...... 200 CAFERGOT...... 53, 110 CATAPRES-TTS-2...... 48, 82 BOOSTRIX...... 46 caffeine citrate...... 130 CATAPRES-TTS-3...... 48, 82 bosentan...... 96, 227 CALAN SR.. 76, 77, 79, 80, 85, 96 Cavarest...... 201 BOSULIF...... 35 calcipotriene...... 249 CAVERJECT...... 96 bp 10-1...... 245, 246 calcipotriene-betameth CAVERJECT IMPULSE...... 96 bp cleansing wash...... 245, 246 diprop...... 231, 240, 249 CAYA...... 217 BRAFTOVI ...... 35 calcitonin (salmon)171, 191, 200 CAYSTON...... 29 BREO ELLIPTA 55, 167, 224, 226 Calcitrene...... 249 Caziant...... 174 BREZTRI AEROSPHERE calcitriol...... 249, 259 cefaclor...... 15 ...... 49, 55, 167, 219, 224, 226 calcium acetate...... 143 cefaclor er...... 15 briellyn...... 173 calcium acetate (phos cefadroxil...... 14 BRILINTA ...... 67 binder)...... 143, 145 cefdinir...... 15 brimonidine tartrate ...... 149 calcium-folic acid plus d ...... 145 cefixime...... 15 brinzolamide ...... 154 CALQUENCE...... 35 cefpodoxime proxetil ...... 15 BRIVIACT...... 102 Camila...... 174 cefprozil...... 15 bromocriptine mesylate ...... 121 Camrese...... 174 cefuroxime axetil...... 15 BRONCHITOL ...... 225 Camrese Lo...... 174 celecoxib...... 120 BRONCHITOL TOLERANCE candesartan cilexetil...... 68, 69 CELONTIN...... 135 TEST...... 225 candesartan cilexetil-hctz CENTANY ...... 229 BROVANA...... 56, 226 ...... 68, 69, 94, 147 cephalexin...... 14 BRUKINSA...... 35 capecitabine...... 36 CERDELGA...... 215 budesonide ...... 167, 224 CAPEX...... 231, 240 Cerovel...... 245 bumetanide ...... 90, 143 CAPLYTA...... 112 CERVIDIL...... 218 BUNAVAIL...... 127 CAPRELSA...... 36 CETRAXAL...... 150 Bupap...... 100, 114 captopril...... 70, 71 cevimeline hcl...... 54 BUPHENYL...... 142 CARAC...... 36, 249 CHANTIX...... 51 buprenorphine hcl ...... 128 CARBAGLU...... 142 CHANTIX CONTINUING buprenorphine hcl-naloxone carbamazepine...... 102, 107 MONTH PAK ...... 51 hcl...... 128 carbamazepine er...... 102, 107

262 CHANTIX STARTING MONTH clindamycin phos-benzoyl CONTOUR NEXT TEST ...... 141 PAK...... 51 perox...... 229, 245 CONTRAVE...... 102 Charlotte 24 Fe ...... 174 clindamycin phosphate ...... 229 COPASIL...... 218 Chateal...... 174 CLINDESSE...... 229 COPIKTRA...... 36 Chateal Eq...... 174 Clinpro 5000...... 201 CORDRAN...... 232, 240 CHEMET...... 166, 198 clobazam...... 115, 116 COREG...... 52, 55, 67, 73, 84, 89 CHENODAL...... 162 clobetasol prop emollient CORGARD...... 52, 73, 74, 84 chlordiazepoxide hcl ...... 116 base...... 231, 240 CORIFACT...... 62 chlordiazepoxide- clobetasol propionate ...231, 240 CORLANOR...... 81 amitriptyline...... 116, 135 clobetasol propionate e 231, 240 CORTANE-B...... 154 chlordiazepoxide-clidinium CLOBETAVIX...... 240 CORTEF...... 167 ...... 49, 116 clocortolone pivalate .... 231, 240 CORTENEMA ...... 232, 240 chlorhexidine gluconate ...... 156 clomipramine hcl...... 135 CORTIFOAM...... 232, 240 chloroquine phosphate ...... 17 clonazepam ...... 115, 116 CORTISPORIN-TC...... 150 chlorpromazine hcl ...... 130 clonidine...... 49, 82 CORTROSYN...... 140 chlorthalidone ...... 95, 148 clonidine hcl...... 48, 82 COSENTYX (300 MG DOSE).250 chlorzoxazone ...... 52 clopidogrel bisulfate ...... 67 COSENTYX 150 MG/ML ...... 250 CHOLBAM...... 162 clorazepate dipotassium COSENTYX SENSOREADY cholestyramine...... 75 ...... 115, 116 (300 MG)...... 250 cholestyramine light...... 75 clotrimazole...... 237 COSENTYX SENSOREADY Ciclodan...... 244 clotrimazole-betamethasone PEN...... 250 ciclopirox...... 244 ...... 231, 237, 240 COSOPT...... 153, 154 ciclopirox olamine...... 244 Clovique...... 166 cosyntropin...... 140 cilostazol...... 67, 92 clozapine...... 113 Covaryx...... 169, 184 CILOXAN...... 150 CLOZARIL...... 113 Covaryx Hs...... 169, 184 CIMDUO...... 25 COAGADEX...... 61 CREON...... 162 cimetidine...... 164 COAL TAR...... 246 CRESEMBA...... 20 cimetidine hcl...... 164 COARTEM...... 17 CRINONE...... 192 CIMZIA PREFILLED KIT codeine sulfate ...... 124, 220 CRIXIVAN...... 27 ...... 162, 203, 208 colchicine-probenecid ..148, 199 cromolyn sodium ...... 150, 223 CIMZIA STARTER KIT COLESTID...... 75, 76 crotan...... 248 ...... 162, 203, 208 COLESTID FLAVORED...... 75 Cryselle-28...... 174 cinacalcet hcl...... 171, 215 colestipol hcl...... 76 CUTIVATE...... 232, 240 CIPRO...... 19, 32 colistimethate sodium (cba) .. 31 CUVPOSA...... 49 CIPRO HC...... 150, 154 COLY-MYCIN M...... 31 cyanocobalamin...... 257 CIPRODEX...... 150, 154 COMBIGAN...... 149, 153 Cyclafem 1/35...... 174 ciprofloxacin hcl...... 19, 32, 150 COMBIPATCH...... 184, 192 Cyclafem 7/7/7...... 174 citalopram hydrobromide .....134 COMBIVENT RESPIMAT cyclobenzaprine hcl...... 52 CITRANATAL BLOOM ...... 49, 56, 219, 226 CYCLOGYL...... 158 ...... 65, 257, 258 COMBIVIR...... 25 CYCLOMYDRIL...... 158 Claravis...... 250 COMETRIQ...... 36 cyclopentolate hcl ...... 158 clarithromycin...... 19, 30 COMPLERA...... 24, 25 cyclophosphamide ...... 36, 213 clarithromycin er...... 19, 30 Compro...... 130, 160 CYCLOPHOSPHAMIDE... 36, 213 clemastine fumarate ...... 13, 222 COMTAN...... 118 cycloserine...... 19 CLENPIQ...... 161 CONCERTA ...... 131 CYCLOSET...... 121 CLEOCIN...... 28, 229 CONDYLOX...... 250 cyclosporine...... 203, 208, 213 CLEOCIN-T...... 229 constulose ...... 142 cyclosporine modified CLIMARA PRO...... 184 CONTOUR CONTROL ...... 137 ...... 203, 208, 213 Clindacin Etz...... 229 CONTOUR NEXT CONTROL .137 cyproheptadine hcl ...... 13, 222 Clindacin-P...... 229 CONTOUR NEXT EZ ...... 137 Cyred...... 174 clindamycin hcl...... 28 CONTOUR NEXT LINK ...... 137 Cyred Eq...... 174 clindamycin palmitate hcl ...... 28 CONTOUR NEXT MONITOR . 137 CYSTADANE ...... 215 CONTOUR NEXT ONE ...... 137 CYSTADROPS...... 156

263 CYSTAGON...... 215 desogestrel-ethinyl estradiol DILAUDID...... 124 CYSTARAN...... 157 ...... 174 diltiazem hcl CYTOTEC...... 165 DESONATE...... 232, 240 ...... 76, 78, 79, 80, 85, 96 cytra k crystals...... 142 desonide...... 232, 241 diltiazem hcl er dalfampridine er...... 215 DESOWEN...... 232, 241 ...... 76, 78, 79, 80, 85, 96 DALIRESP...... 225 desoximetasone ...... 232, 241 diltiazem hcl er beads danazol...... 169 DESOXYN...... 99 ...... 76, 77, 79, 80, 85, 96 DANTRIUM...... 52 Desrx...... 232, 241 diltiazem hcl er coated dantrolene sodium ...... 52 desvenlafaxine succinate er 132 beads...... 76, 77, 79, 80, 85, 96 dapsone...... 18 dexamethasone ...... 167 dilt-xr...... 76, 78, 79, 80, 85, 96 DAPTACEL...... 46 dexamethasone intensol ...... 167 dimethyl fumarate ...... 208 DARAPRIM...... 17 dexamethasone sodium dimethyl fumarate starter Dasetta 1/35...... 174 phosphate ...... 154 pack...... 208 Dasetta 7/7/7...... 174 DEXCOM G4 / G5 / G6 DIPENTUM...... 160 DAURISMO...... 36 RECEIVER, TRANSMITTER, diphen...... 13, 222 DAYPRO...... 128 SENSOR (INCLUDING di-phen...... 13, 222 Daysee...... 174 PLATINUM, PLATINUM diphenhydramine hcl ...... 13, 222 DAYVIGO...... 112 PEDIATRIC)...... 137, 138 diphenoxylate-atropine DDAVP...... 62, 191 DEXILANT...... 165 ...... 49, 50, 159, 219 DDAVP PF...... 62, 192 dexmethylphenidate hcl ...... 131 DIPROLENE...... 233, 241 DEBACTEROL...... 157, 250 dexmethylphenidate hcl er ...131 DIPROLENE AF...... 233, 241 Deblitane...... 174 DEXTENZA ...... 154 dipyridamole...... 67, 96 deferasirox...... 166 dextroamphetamine sulfate ... 99 disopyramide phosphate ...... 83 deferasirox granules...... 166 dextroamphetamine sulfate disulfiram...... 198 deferiprone...... 166 er...... 99 DITROPAN XL...... 254 DELESTROGEN...... 184 DIACOMIT...... 103 DIURIL...... 94, 147 DELSTRIGO...... 24, 25 DIASTAT ACUDIAL...... 115, 117 divalproex sodium 103, 107, 110 Delyla...... 174 DIASTAT PEDIATRIC.....115, 117 divalproex sodium er demeclocycline hcl...... 33 diazepam...... 115, 116, 117 ...... 103, 107, 110 DEMSER...... 215 Diazepam Intensol...... 115, 117 DIVIGEL...... 184 Denta 5000 Plus...... 201 diazoxide...... 171 dofetilide...... 85 Dentagel...... 201 diclofenac potassium ...... 128 DOJOLVI...... 143 DEPAKOTE...... 103, 107, 110 diclofenac sodium Dolishale...... 174 DEPAKOTE ER...... 102, 107, 110 ...... 36, 128, 157, 248, 250 donepezil hcl ...... 54 DEPAKOTE SPRINKLES diclofenac sodium er ...... 128 DOPTELET...... 60 ...... 103, 107, 110 diclofenac-misoprostol 128, 165 DORZOLAMIDE HCL...... 154 DEPEN TITRATABS ...... 166, 203 dicloxacillin sodium...... 31 dorzolamide hcl ...... 154 DEPO-ESTRADIOL...... 184 DICOPANOL FUSEPAQ...13, 222 dorzolamide hcl-timolol mal DEPO-PROVERA...... 193 dicyclomine hcl...... 49 ...... 153, 154 DEPO-SUBQ PROVERA 104.193 diethylpropion hcl ...... 99 DOVATO...... 24, 25 DEPO-TESTOSTERONE ...... 169 diethylpropion hcl er ...... 99 DOVONEX...... 250 DERMA-SMOOTHE/FS BODY DIFICID...... 30 doxazosin mesylate ...... 232, 240 diflorasone diacetate .... 232, 241 ...... 53, 67, 68, 89 DERMA-SMOOTHE/FS DIFLUCAN...... 20 doxepin hcl ...... 135, 236 SCALP...... 232, 240 diflunisal...... 128 doxercalciferol...... 259 DERMOTIC...... 154 Digitek...... 72, 82 doxycycline hyclate...... 33, 150 DESCOVY...... 25 Digox...... 72, 82 doxycycline monohydrate ...... 33 desipramine hcl...... 135 digoxin...... 72, 82 DRISDOL...... 259 desmopressin ace spray dihydroergotamine mesylate DRIZALMA SPRINKLE... 121, 132 refrig...... 62, 192 ...... 53, 110 dronabinol...... 159 desmopressin acetate .... 62, 192 DILANTIN...... 83, 121, 122 drospiren-eth estrad- desmopressin acetate pf 62, 192 DILANTIN INFATABS ...... 83, 121 levomefol...... 175 desmopressin acetate spray 192 DILATRATE-SR...... 91

264 drospirenone-ethinyl EMEND ...... 164 ergoloid mesylates...... 53 estradiol...... 175 EMEND TRI-PACK...... 164 ERGOMAR...... 53, 111 DROXIA...... 36 EMGALITY...... 110, 118 ergotamine-caffeine ...... 53, 111 droxidopa...... 48 EMGALITY (300 MG DOSE).. 118 ERIVEDGE...... 37 DRYSOL...... 237 Emoquette...... 175 ERLEADA...... 37 DUAKLIR PRESSAIR EMSAM...... 122 erlotinib hcl...... 37 ...... 50, 56, 219, 226 emtricitabine...... 25 Errin...... 175 DUAVEE...... 184, 185 emtricitabine-tenofovir df ...... 25 ery...... 229 DUETACT...... 196 EMTRIVA...... 25, 26 ERYGEL...... 229 duloxetine hcl ...... 121, 132 EMVERM...... 17 ERYPED 200...... 21, 28 DUOPA...... 120 enalapril maleate...... 70, 71 ERYPED 400...... 21, 28 DUPIXENT...... 223, 250 enalapril- Ery-Tab...... 21, 28 DUREZOL...... 154 hydrochlorothiazide ERYTHROCIN STEARATE 21, 28 dutasteride...... 197 ...... 70, 71, 94, 147 erythromycin..... 21, 29, 151, 229 DYRENIUM...... 93, 144 ENBRACE HR ...... 65, 254, 257 erythromycin base...... 21, 29 E.E.S. GRANULES...... 21, 28 ENBREL...... 203, 204, 208, 250 erythromycin ethylsuccinate EASIVENT...... 138 ENBREL MINI ...... 203, 208, 250 ...... 21, 29 EASYMAX CONTROL...... 138 ENBREL SURECLICK ESBRIET...... 220 EC-NAPROSYN...... 129, 199 ...... 204, 208, 250 escitalopram oxalate...... 134 ec-naproxen...... 129, 199 ENDARI...... 162, 215 Esgic...... 100, 111, 115, 131 econazole nitrate ...... 237 Endocet...... 100, 124 ESGIC...... 100, 111, 115, 131 EDARBI...... 68, 69 ENDOMETRIN...... 193 esomeprazole magnesium ... 165 EDARBYCLOR..... 68, 69, 95, 148 ENGERIX-B...... 47 est estrogens-methyltest EDECRIN...... 90, 143 ENLITE GLUCOSE SENSOR.138 ...... 170, 185 EDEX...... 97 enovarx-amitriptyline...... 135 est estrogens-methyltest ds ED-SPAZ...... 50 enovarx-baclofen...... 250 ...... 170, 185 EDURANT...... 24 enovarx-cyclobenzaprine hcl est estrogens-methyltest hs Eemt...... 170, 185 ...... 250 ...... 170, 185 Eemt Hs...... 169, 185 enovarx-ibuprofen ...... 233, 248 Estarylla...... 175 efavirenz...... 24 enovarx-lidocaine hcl ...... 236 estazolam...... 117 efavirenz-emtricitab- enovarx-naproxen...... 233, 248 ESTRACE...... 185 tenofovir ...... 24, 25 enoxaparin sodium ...... 64 estradiol...... 185 efavirenz-lamivudine- Enpresse-28...... 175 estradiol valerate...... 185 tenofovir ...... 24, 25 Enskyce...... 175 estradiol-norethindrone acet EFFER-K...... 145 ENSPRYNG...... 208 ...... 185, 193 Effer-K...... 145 ENSTILAR...... 233, 241, 251 ESTRING...... 185 EFUDEX...... 36, 250 entacapone ...... 118 ESTROGEL...... 185 EGATEN...... 17 entecavir...... 29 ESTROSTEP FE...... 175 EGRIFTA SV...... 195 ENTEREG ...... 162 eszopiclone...... 112 ELESTRIN...... 185 ENTRESTO ...... 69, 94 ethacrynic acid...... 90, 143 eletriptan hydrobromide ...... 133 enulose...... 142 ethambutol hcl ...... 19 ELIGARD...... 36, 37, 187 EPANED...... 70, 71 ethosuximide...... 135 ELIMITE...... 248 EPCLUSA...... 22, 23 ethynodiol diac-eth estradiol Elinest...... 175 EPIDIOLEX...... 103 ...... 175 ELIQUIS...... 59 EPIFOAM...... 233, 236, 241 etodolac...... 129 ELIQUIS DVT/PE STARTER epinephrine...... 48, 219 etodolac er...... 129 PACK...... 59 Epitol...... 103, 107 etoposide...... 37 ELITE-OB...... 65, 254, 257 EPIVIR...... 26 etravirine...... 24 ELIXOPHYLLIN 88, 143, 228, 254 EPIVIR HBV...... 26 EUCRISA...... 233, 236 ELLA...... 175 eplerenone...... 91, 93 Euthyrox...... 197 ELMIRON...... 217 EQUETRO...... 103, 108 EVAMIST...... 185 ELOCTATE ...... 62 ERGOCAL...... 259 everolimus...... 37, 213 EMCYT...... 37 ergocalciferol...... 259 EVOCLIN...... 229

265 EVOTAZ...... 27, 215 FLEXICHAMBER CHILD FORTISCARE CONTROL...... 138 EVOXAC...... 54 MASK/LARGE...... 138 FOSAMAX...... 200 EVRYSDI...... 200, 216 FLEXICHAMBER CHILD FOSAMAX PLUS D...... 200, 259 EXELDERM...... 237 MASK/SMALL...... 138 fosamprenavir calcium...... 27 exemestane...... 37, 170 FLOLIPID...... 88 fosfomycin tromethamine ...... 33 EXTINA...... 237 FLORIVA...... 201, 259 fosinopril sodium ...... 70, 71 EZALLOR SPRINKLE ...... 88 FLORIVA PLUS...... 201, 254 fosinopril sodium-hctz ezetimibe...... 82 FLOVENT DISKUS. 167, 224, 225 ...... 70, 71, 94, 147 ezetimibe-simvastatin ...... 82, 88 FLOVENT HFA ...... 167, 225 FOSRENOL...... 144, 198 Falmina...... 175 fluconazole ...... 20 FRAGMIN...... 64, 65 famciclovir...... 29, 30 flucytosine ...... 31 FREESTYLE LIBRE 14 DAY famotidine...... 164 fludrocortisone acetate ...... 168 READER...... 138 FANAPT...... 113 flunisolide ...... 154, 224 FREESTYLE LIBRE 14 DAY FANAPT TITRATION PACK ... 113 fluocinolone acetonide SENSOR...... 138 FARYDAK...... 37 ...... 154, 233, 241 FREESTYLE LIBRE 2 FASENRA PEN...... 223 fluocinolone acetonide body READER...... 138 Fayosim...... 175 ...... 233, 241 FREESTYLE LIBRE 2 febuxostat...... 199 fluocinolone acetonide scalp SENSOR...... 138 FEIBA...... 62 ...... 233, 241 FREESTYLE LIBRE READER 138 felbamate...... 103 fluocinonide ...... 233, 242 FREESTYLE LIBRE SENSOR FELBATOL ...... 103 fluocinonide emulsified base SYSTEM...... 138 FELDENE ...... 129 ...... 233, 241 FROTEK...... 233, 248 felodipine er.....78, 86, 87, 89, 97 Fluoridex...... 201 frovatriptan succinate ...... 133 FEM PH...... 246 Fluoridex Sensitivity Relief...... 201 furosemide...... 90, 143 FEMHRT...... 185, 193 fluoritab...... 201 FUZEON...... 23 FEMRING ...... 185 fluorometholone ...... 154 Fyavolv...... 185, 193 Femynor...... 175 FLUOROPLEX...... 37, 251 FYCOMPA...... 103 fenofibrate ...... 88 FLUOROURACIL...... 37, 251 gabapentin...... 101, 103 fentanyl...... 124 fluorouracil...... 37, 251 GABITRIL...... 103 fentanyl citrate ...... 124 fluoxetine hcl...... 134 GALAFOLD...... 216 FERRIPROX...... 166 fluphenazine hcl ...... 130 galantamine hydrobromide ....54 FERRIPROX TWICE-A-DAY.. 166 flurandrenolide...... 233, 242 galantamine hydrobromide FETZIMA ...... 132 flurazepam hcl ...... 117 er...... 54 FETZIMA TITRATION ...... 132 flurbiprofen...... 129 GALZIN...... 166 FINACEA...... 251 flurbiprofen sodium ...... 157 GARDASIL 9...... 47 finasteride...... 197 flutamide ...... 37 GASTROCROM...... 224 FINTEPLA ...... 103 fluticasone propionate gatifloxacin...... 151 FIORICET...... 100, 111, 115, 131 ...... 155, 224, 233, 242 GATTEX ...... 163 FIRAZYR...... 203 FLUTICASONE- gavilyte-c...... 161 FIRMAGON...... 37, 170, 207 SALMETEROL..56, 168, 225, 226 Gavilyte-G...... 161 FIRMAGON (240 MG DOSE) fluvastatin sodium ...... 88 Gavilyte-N With Flavor Pack... 161 ...... 37, 170, 207 fluvastatin sodium er ...... 88 GAVRETO...... 37 FIRST-LANSOPRAZOLE...... 165 fluvoxamine maleate...... 134 GELFILM...... 157 FIRST-MOUTHWASH BLM .... 251 fluvoxamine maleate er ...... 134 gemfibrozil...... 88 FIRST-OMEPRAZOLE...... 165 FML...... 155 Gemmily...... 175 FIRVANQ...... 21 FML FORTE ...... 155 generlac...... 142 Flac...... 154 FML LIQUIFILM...... 155 Gengraf...... 204, 208, 213 FLAGYL...... 16, 18 FOCALIN...... 131 gentak...... 151 FLAREX...... 154 folic acid...... 257 gentamicin sulfate ...... 151, 229 flavoxate hcl...... 254 fondaparinux sodium ...... 58, 59 GENVOYA...... 24, 26 flecainide acetate...... 83 FORANE...... 122 GILENYA...... 208 FLEXICHAMBER ADULT formaldehyde ...... 218, 251 GILOTRIF...... 37 MASK/SMALL...... 138 FORMALDEHYDE...... 218 GILPHEX TR...... 49, 222

266 glatiramer acetate...... 208, 209 HALUCORT...... 238 HUMULIN R U-500 KWIKPEN Glatopa...... 209 HARVONI...... 22, 23 ...... 189, 194 GLEOSTINE...... 37 HAVRIX...... 47 HUMULIN R U-500 VIAL 189, 195 glimepiride...... 196 Heather...... 175 HUMULIN R VIAL...... 189, 195 glipizide...... 196 hematinic/folic acid...... 65, 257 HYCAMTIN...... 37 glipizide er...... 196 HEMLIBRA...... 62 hydralazine hcl...... 88 glipizide xl...... 196 Hemocyte-F...... 65, 257 HYDREA...... 38 glipizide-metformin hcl .171, 196 HEMOFIL M...... 62 HYDRO 40...... 245 GLOPERBA...... 199 heparin lock flush...... 65, 138 hydrochlorothiazide ...... 94, 147 GLUCAGEN HYPOKIT... 186, 198 heparin sodium (porcine) ...... 65 hydrocodone bitartrate er .... 124 glucagon emergency kit heparin sodium (porcine) pf .. 65 hydrocodone polst- ...... 186, 198 heparin sodium lock flush chlorphen polst er susp GLUCAGON EMERGENCY ...... 65, 138 ...... 14, 124, 220, 222 KIT...... 187, 198 HEPLISAV-B...... 47 hydrocodone- GLUCOTROL XL...... 196 HEPSERA...... 30 acetaminophen...... 101, 124 GLUTARALDEHYDE...... 141 HETLIOZ...... 112 hydrocodone-homatropine glyburide...... 196 HIBERIX...... 47 ...... 50, 124, 220 glyburide micronized ...... 196 HIPREX...... 33 hydrocodone-ibuprofen 124, 129 glyburide-metformin ..... 171, 196 homatropaire...... 158 hydrocortisone...... 168, 234, 242 glycopyrrolate...... 50 HUMALOG KWIKPEN.... 188, 194 hydrocortisone (perianal) Glydo...... 157 HUMALOG MIX 50/50 ...... 234, 242 GLYNASE...... 196 KWIKPEN...... 188, 190, 194 hydrocortisone ace- GLYXAMBI...... 183, 195 HUMALOG MIX 50/50 VIAL pramoxine...... 234, 236, 242 GOLYTELY ...... 161 ...... 189, 190, 194 hydrocortisone acetate 234, 242 goodsense nicotine ...... 51 HUMALOG MIX 75/25 hydrocortisone butyrate GORDOFILM...... 245 KWIKPEN...... 189, 190, 194 ...... 234, 242 GRALISE...... 101 HUMALOG MIX 75/25 VIAL hydrocortisone valerate granisetron hcl...... 159 ...... 189, 190, 194 ...... 234, 242, 243 GRASTEK...... 45, 216 HUMALOG U-100 JUNIOR hydrocortisone-acetic acid griseofulvin microsize ...... 17 KWIKPEN...... 189, 194 ...... 155, 156 griseofulvin ultramicrosize .... 17 HUMALOG VIAL...... 189, 194 hydrocortisone-iodoquinol guaiatussin ac...... 124, 220, 222 HUMATE-P...... 62 ...... 243, 246 guaifenesin ac...... 124, 220, 222 HUMIRA...... 163, 204, 209, 251 hydrocort-pramoxine guanfacine hcl ...... 82, 119 HUMIRA PEDIATRIC (perianal)...... 234, 236, 243 guanfacine hcl er ...... 82, 119 CROHNS START hydromet...... 50, 124, 220 GUARDIAN SENSOR (3)...... 138 ...... 163, 204, 209, 251 hydromorphone hcl ...... 125 GVOKE HYPOPEN 1-PACK HUMIRA PEN. 163, 204, 209, 251 hydromorphone hcl er ..124, 125 ...... 187, 198 HUMIRA PEN-CD/UC/HS hydroxychloroquine sulfate GVOKE HYPOPEN 2-PACK STARTER ...... 163, 204, 209, 251 ...... 17, 204, 209 ...... 187, 198 HUMIRA PEN-PEDIATRIC UC hydroxyurea...... 38 GVOKE PFS...... 187, 198 START...... 163, 204, 209, 251 hydroxyzine hcl...... 14, 112 GYNAZOLE-1...... 238 HUMIRA PEN-PS/UV/ADOL hydroxyzine pamoate ..... 14, 112 HAEGARDA...... 203 HS START...... 163, 204, 209, 251 HYOPHEN...... 33 Hailey 1.5/30...... 175 HUMIRA PEN-PSOR/UVEIT hyoscyamine sulfate...... 50 Hailey 24 Fe...... 175 STARTER ...... 163, 204, 209, 251 hyoscyamine sulfate er...... 50 Hailey Fe 1.5/30...... 175 HUMULIN 70/30 KWIKPEN hyoscyamine sulfate sl...... 50 Hailey Fe 1/20...... 175 ...... 189, 190, 194 hyosyne...... 50 halcinonide ...... 233, 242 HUMULIN 70/30 VIAL HYPERSAL...... 138, 145 HALCION...... 117 ...... 189, 190, 194 HYPOCYN...... 139 halobetasol propionate 234, 242 HUMULIN N KWIKPEN.. 189, 190 HYZAAR...... 68, 69, 94, 147 HALOG...... 234, 242 HUMULIN N VIAL...... 189, 190 ibandronate sodium ...... 200 haloperidol...... 118 IBRANCE...... 38 haloperidol lactate ...... 117 Ibuprofen...... 129

267 Iclevia...... 176 irbesartan- KAZANO...... 171, 183 ICLUSIG...... 38 hydrochlorothiazide KEFLEX...... 14 IDELVION...... 62 ...... 68, 69, 94, 147 Kelnor 1/35...... 176 IDHIFA...... 38 IRESSA...... 38 Kelnor 1/50...... 176 imatinib mesylate ...... 38 ISENTRESS...... 24 KEPPRA...... 103 IMBRUVICA...... 38 ISENTRESS HD...... 24 KEPPRA XR...... 103 IMCIVREE...... 102 Isibloom...... 176 KERYDIN...... 248 imipramine hcl...... 135 isoflurane...... 122 KESIMPTA...... 209 imipramine pamoate ...... 135 isoniazid...... 19 ketoconazole ...... 20, 238 imiquimod...... 251 ISOPTO ATROPINE...... 158 Ketodan...... 238 IMITREX...... 133 ISOPTO CARPINE...... 158 KETONE TEST ...... 141 IMPAVIDO...... 18 ISORDIL TITRADOSE...... 91 KETOROLAC IMVEXXY MAINTENANCE isosorbide dinitrate ...... 91 TROMETHAMINE ...... 129 PACK...... 185, 186 isosorbide mononitrate ...... 91 ketorolac tromethamine129, 157 IMVEXXY STARTER PACK... 186 isosorbide mononitrate er ...... 91 KETOSTIX...... 141 INBRIJA...... 120 isotretinoin ...... 251, 252 KEVEYIS...... 154 Incassia...... 176 isoxsuprine hcl...... 97 KEVZARA...... 204, 210 INCRELEX...... 195 isradipine...... 78, 86, 87, 89, 97 KINERET...... 204, 210 indapamide ...... 95, 148 ISTALOL...... 153 KISQALI...... 39 INDOCIN...... 129, 199 ISTURISA...... 216 KISQALI FEMARA...... 39, 170 indomethacin ...... 129, 199 itraconazole...... 20 KLARON...... 246 indomethacin er ...... 129, 199 ivermectin...... 17, 249, 252 Klor-Con...... 145 INFANRIX...... 46 Jaimiess...... 176 Klor-Con 10...... 145 INGREZZA...... 119, 136 JAKAFI...... 39 Klor-Con M10...... 145 INLYTA ...... 38 JANSSEN COVID-19 KLOR-CON M15...... 145 INOVA...... 245 VACCINE...... 47 Klor-Con M20...... 145 INOVA 4/1 ACNE CONTROL Jantoven...... 58 Klor-Con/Ef...... 145 THERAPY...... 245 JARDIANCE...... 195 KOATE...... 62 INOVA 8/2 ACNE CONTROL Jasmiel...... 176 KOATE-DVI...... 62 THERAPY...... 245 Jencycla...... 176 KOGENATE FS...... 63 INQOVI...... 38 JENTADUETO ...... 171, 183 KOMBIGLYZE XR...171, 172, 183 INREBIC...... 38 JENTADUETO XR...... 171, 183 KORLYM...... 170 INSPIREASE RESERVOIR Jinteli...... 186, 193 KOSELUGO...... 39 BAGS...... 139 JIVI...... 62 KOVALTRY...... 63 INSPRA...... 91, 93 Jolessa...... 176 K-PHOS...... 141 INSULIN PEN NEEDLES ...... 139 JUBLIA...... 238 K-PHOS NO 2...... 141 INSULIN SYRINGES...... 139 Juleber...... 176 K-PHOS-NEUTRAL...... 141 INTELENCE ...... 24 JULUCA...... 24 K-Prime...... 145 INTRAROSA...... 168 Junel 1.5/30...... 176 KRINTAFEL...... 17 INTRON A ...... 28, 38, 209 Junel 1/20...... 176 KRISTALOSE...... 142 Introvale...... 176 Junel Fe 1.5/30...... 176 K-TAB...... 145 INVELTYS...... 155 Junel Fe 1/20...... 176 Kurvelo...... 177 INVIRASE...... 27 Junel Fe 24...... 176 KYNMOBI...... 123 IODINE STRONG JUXTAPID...... 72 KYNMOBI TITRATION KIT .....123 ...... 17, 171, 198, 222 JYNARQUE...... 148 labetalol hcl iodine tincture ...... 246 Kaitlib Fe...... 176 ...... 53, 55, 67, 68, 73, 74, 84 IOPIDINE...... 157 KALETRA...... 27 LACRISERT...... 157 IPOL...... 47 Kalliga...... 176 lactulose...... 142 ipratropium bromide KALYDECO...... 221 lactulose encephalopathy .... 142 ...... 50, 157, 219 KAPSPARGO SPRINKLE LAMICTAL...... 104, 108 ipratropium-albuterol ...... 57, 73, 74, 84 LAMICTAL ODT ...... 103, 104, 108 ...... 50, 56, 219, 226 Kariva...... 176 LAMICTAL STARTER .....104, 108 irbesartan...... 68, 69 KATERZIA...... 78, 86, 87, 89, 97 LAMICTAL XR...... 104

268 lamivudine...... 26 Levonest...... 177 LOPID...... 88 lamivudine-zidovudine ...... 26 levonorgest-eth est & eth est lopinavir-ritonavir ...... 27 lamotrigine...... 104, 108 ...... 177 LOPRESSOR...... 57, 73, 74, 84 lamotrigine er...... 104 levonorgest-eth estrad 91- lorazepam...... 116, 117 lamotrigine starter kit-blue day...... 177 Lorazepam Intensol...... 116, 117 ...... 104, 108 levonorgestrel...... 177 LORBRENA ...... 39 lamotrigine starter kit-green levonorgestrel-ethinyl estrad LORTAB ...... 101, 125 ...... 104, 108 ...... 177 Loryna...... 178 lamotrigine starter kit- levonorg-eth estrad triphasic losartan potassium ...... 69 orange...... 104, 108 ...... 177 losartan potassium-hctz LAMPIT...... 18 Levora 0.15/30 (28)...... 177 ...... 69, 94, 147 LANOXIN...... 72, 82 levorphanol tartrate...... 125 LOSEASONIQUE...... 178 lansoprazole...... 165 Levo-T...... 197 LOTEMAX ...... 155 lanthanum carbonate ....144, 198 levothyroxine sodium ...... 197 LOTEMAX SM...... 155 LANTUS SOLOSTAR ..... 189, 190 Levoxyl ...... 197 LOTENSIN...... 71, 72 LANTUS U-100 VIAL...... 189, 191 LEVSIN...... 50 LOTENSIN HCT ....70, 72, 95, 147 lapatinib ditosylate ...... 39 LEVSIN/SL...... 50 loteprednol etabonate ...... 155 Larin 1.5/30...... 177 LEVULAN KERASTICK...... 252 lovastatin...... 88 Larin 1/20...... 177 LEXIVA...... 27 Low-Ogestrel...... 178 Larin 24 Fe...... 177 LIALDA...... 160 loxapine succinate...... 111 Larin Fe 1.5/30...... 177 lidocaine...... 236 Lo-Zumandimine...... 178 Larin Fe 1/20...... 177 lidocaine hcl...... 157, 236 LUBIPROSTONE...... 161 Larissia...... 177 lidocaine hcl LUCEMYRA...... 49 LASIX...... 90, 143 urethral/mucosal...... 157 LUGOLS STRONG IODINE....247 LASTACAFT...... 150 lidocaine viscous hcl...... 157 LUMAKRAS...... 39 latanoprost ...... 158 lidocaine-prilocaine ...... 236 LUMIGAN...... 158 LATUDA...... 113 LIDOPIN...... 236 LUPKYNIS...... 205, 214 Layolis Fe...... 177 LIDTOPIC MAX...... 237 Lutera ...... 178 LAZANDA ...... 125 Lillow...... 177 Lyleq...... 178 L-CYSTINE...... 143 lindane...... 249 LYNPARZA...... 39 LEDIPASVIR-SOFOSBUVIR linezolid...... 31 LYRICA...... 101, 104, 121 ...... 22, 23 LINZESS...... 163 LYSODREN...... 39 Leena...... 177 liothyronine sodium ...... 197 LYSTEDA...... 63 leflunomide ...... 205, 210 lisinopril...... 70, 72 LYUMJEV KWIKPEN...... 189, 194 LENVIMA...... 39 lisinopril- LYUMJEV VIAL...... 189, 194 Lessina...... 177 hydrochlorothiazide Lyza...... 178 letrozole...... 39, 170 ...... 70, 72, 94, 147 MACROBID...... 34 lets...... 236 L-ISOLEUCINE...... 218 MACRODANTIN...... 34 leucovorin calcium...... 198 lithium...... 108 mafenide acetate...... 247 LEUKERAN...... 39 lithium carbonate ...... 108 MALARONE...... 17 LEUKINE...... 60 lithium carbonate er ...... 108 malathion...... 249 leuprolide acetate...... 39, 187 LITHOBID...... 108 maprotiline hcl...... 136 levalbuterol hcl...... 56, 227 LITHOSTAT...... 142 MARINOL...... 159 LEVALBUTEROL HFA ...... 56, 227 LO LOESTRIN FE ...... 178 marlissa...... 178 LEVBID...... 50 Loestrin 1.5/30 (21)...... 178 MARPLAN...... 122 levetiracetam...... 104 Loestrin 1/20 (21)...... 178 MATULANE ...... 39 levetiracetam er...... 104 Loestrin Fe 1.5/30...... 178 Matzim La... 76, 78, 79, 81, 86, 97 levobunolol hcl ...... 153 Loestrin Fe 1/20...... 178 MAVENCLAD ...... 214 levocarnitine...... 216 Lojaimiess...... 178 MAVYRET...... 22, 23 levocarnitine sf...... 216 LOKELMA ...... 144 MAXIDEX...... 155 levocetirizine LOMAIRA...... 99 MAXITROL...... 151, 155 dihydrochloride ...... 14, 225 LOMOTIL...... 50, 159, 219 maxi-tuss ac...... 125, 220, 222 levofloxacin...... 19, 32, 151 LONSURF...... 39 MAXZIDE...... 93, 95, 145, 147

269 MAXZIDE-25...... 93, 95, 145, 147 methscopolamine bromide .... 50 MIRVASO...... 252 MAYZENT...... 210 methyl salicylate...... 132 misoprostol...... 165 me/naphos/mb/hyo1 ...... 34 methyldopa...... 49, 82 MITIGARE...... 199 meclofenamate sodium ...... 129 methyldopa- MITOSOL...... 152 MEDERMA SPF 30...... 238 hydrochlorothiazide M-M-R II...... 47 MEDROL...... 168 ...... 49, 82, 95, 147 M-NATAL PLUS 65, 145, 254, 257 medroxyprogesterone methylergonovine maleate ...218 MOBIC...... 129 acetate...... 193 METHYLIN...... 131 modafinil...... 136 mefenamic acid...... 129 methylphenidate hcl ...... 131 MODERNA COVID-19 mefloquine hcl ...... 18 methylphenidate hcl er ...... 131 VACCINE...... 47 megestrol acetate...... 40, 193 methylphenidate hcl er (cd) . 131 moexipril hcl...... 71, 72 MEKINIST...... 40 methylphenidate hcl er (la) .. 131 molindone hcl ...... 111 MEKTOVI...... 40 methylprednisolone ...... 168 mometasone furoate .....234, 243 meloxicam...... 129 methyltestosterone ...... 170 Mondoxyne Nl ...... 33 melphalan...... 40 metoclopramide hcl ...... 164, 165 Mono-Linyah...... 179 memantine hcl ...... 119 metolazone ...... 95, 148 MONONINE ...... 63 MENACTRA ...... 47 metoprolol succinate er monsels ferric subsulfate MENEST...... 186 ...... 57, 73, 75, 84 ...... 63, 218 MENOSTAR ...... 186 metoprolol tartrate 57, 73, 75, 84 montelukast sodium ...... 223 MENQUADFI...... 47 metoprolol- MONUROL...... 34 MENTAX ...... 238 hydrochlorothiazide Morgidox...... 33 MENVEO ...... 47 ...... 57, 73, 75, 84, 95, 147 morphine sulfate ...... 126 meperidine hcl...... 125 METROCREAM...... 229 morphine sulfate MEPHYTON...... 198, 259 METROLOTION ...... 230 (concentrate)...... 125 meprobamate ...... 112 metronidazole ...... 16, 18, 230 morphine sulfate er ...... 125, 126 mercaptopurine ...... 40, 214 metyrosine...... 216 morphine sulfate er beads ... 125 Merzee...... 178 mexiletine hcl...... 83 MOTEGRITY...... 165 mesalamine...... 160 MIACALCIN...... 171, 191, 200 MOVIPREP...... 161 mesalamine-cleanser...... 160 Mibelas 24 Fe...... 178 MOXEZA...... 151 MESNEX...... 217 miconazole 3 ...... 238 moxifloxacin hcl...... 19, 32, 151 MESTINON...... 54 Microgestin 1.5/30...... 178 moxifloxacin hcl (2x day) ..... 151 metaxalone...... 52 Microgestin 1/20...... 178 MOZOBIL...... 60 metformin hcl ...... 172 Microgestin 24 Fe...... 178 MS CONTIN...... 126 metformin hcl er ...... 172 Microgestin Fe 1.5/30...... 178 MUCOSITISRX...... 139 methadone hcl ...... 125 Microgestin Fe 1/20...... 179 MULPLETA ...... 60 Methadone Hcl Intensol...... 125 MICROLET NEXT LANCING MULTAQ...... 85 methadose ...... 125 DEVICE...... 139 multi-vit/iron/fluoride Methadose...... 125 midazolam hcl...... 117 ...... 65, 201, 254 methadose sugar-free ...... 125 midodrine hcl ...... 49 multivitamin/fluoride methamphetamine hcl ...... 99 MIGERGOT...... 54, 111 ...... 201, 254, 255 methazolamide ...... 154 miglitol...... 169 multi-vitamin/fluoride ... 201, 254 methenamine hippurate ...... 34 miglustat...... 216 multi-vitamin/fluoride/iron methenamine mandelate ...... 34 Mili...... 179 ...... 65, 201, 255 Methergine ...... 218 MILLIPRED...... 168 mupirocin...... 230 methimazole ...... 171 Mimvey...... 186, 193 mupirocin calcium...... 230 METHITEST ...... 170 mineral oil heavy...... 161 MUSE...... 97 methocarbamol ...... 52 MINIPRESS...... 53, 68 MYALEPT...... 190 methotrexate ... 40, 205, 210, 214 Minitran...... 92 MYAMBUTOL ...... 19 methotrexate sodium minocycline hcl...... 33 MYCOBUTIN...... 19, 32 ...... 40, 205, 210, 214 minoxidil...... 88 mycophenolate mofetil ...... 214 methotrexate sodium (pf) MIRAPEX...... 123 mycophenolate sodium ...... 214 ...... 40, 205, 210, 214 MIRCETTE ...... 179 MYLERAN...... 40 methoxsalen rapid ...... 248 mirtazapine ...... 106 Myorisan...... 252

270 MYSOLINE...... 114 niacin er Nortrel 0.5/35 (28)...... 179 MYTESI...... 159 (antihyperlipidemic) ...... 73 Nortrel 1/35 (21) ...... 180 nabumetone ...... 129 NIASPAN...... 73 Nortrel 1/35 (28) ...... 180 n-acetyl-l-cysteine ...... 216 nicardipine hcl.78, 86, 87, 89, 97 Nortrel 7/7/7 ...... 180 nadolol...... 53, 73, 75, 84 NICORETTE ...... 51 nortriptyline hcl...... 136 NAFRINSE DAILY/NEUTRAL .201 nicotine polacrilex...... 51 NORVIR...... 27 naloxone hcl...... 127, 198, 199 nicotine polacrilex mini...... 51 NOURIANZ...... 119 naltrexone hcl...... 127, 198 nicotine step 1 ...... 51 NOVOEIGHT...... 63 NAMENDA ...... 119 nicotine step 2 ...... 51 NOVOFINE AUTOCOVER NAMENDA TITRATION PAK ..119 nicotine step 3 ...... 52 PEN NEEDLE ...... 139 NAPROSYN...... 129, 200 NICOTROL...... 52 NOVOFINE PEN NEEDLE ..... 139 naproxen...... 129, 200 NICOTROL NS ...... 52 NOVOFINE PLUS PEN naproxen sodium ...... 129, 200 nifedipine ...... 78, 87, 89, 97 NEEDLE ...... 139 naratriptan hcl...... 133 nifedipine er.....78, 86, 87, 89, 97 NOVOLOG FLEXPEN NARCAN...... 127, 199 nifedipine er osmotic release RELION...... 190, 194 NARDIL...... 122 ...... 78, 87, 89, 97 NOVOLOG RELION...... 190, 194 NASCOBAL...... 257 Nikki...... 179 NOVOPEN ECHO...... 139 NATACYN...... 152 NILANDRON...... 40 NOVOSEVEN RT...... 63 NATAZIA...... 179 nilutamide ...... 40 NOVOTWIST PEN NEEDLE .. 139 nateglinide ...... 191 nimodipine...... 78, 87, 90, 97 NOXAFIL...... 20 NATPARA ...... 191, 200 NINLARO ...... 40 np thyroid...... 197 NATURE-THROID...... 197 nisoldipine er...... 78, 87, 90, 97 NUBEQA...... 40 NAYZILAM...... 116, 117 nitazoxanide ...... 18 NUCALA...... 223 NEBUPENT ...... 18 NITRO-BID...... 92 NUCORT...... 234, 243 Necon 0.5/35 (28)...... 179 NITRO-DUR...... 92 NUCYNTA ...... 126 nefazodone hcl ...... 135 nitrofurantoin ...... 34 NUCYNTA ER ...... 126 neomycin sulfate ...... 16 nitrofurantoin macrocrystal ... 34 NUEDEXTA...... 119, 220 neomycin-bacitracin zn- nitrofurantoin monohydrate Nulev...... 50 polymyx...... 151 macrocrystals...... 34 NULYTELY LEMON-LIME ...... 161 neomycin-polymyxin- nitroglycerin...... 92 NUPLAZID...... 113 dexameth...... 151, 155 NITROMIST...... 92 NUTRIDOX...... 33 neomycin-polymyxin- NITROSTAT ...... 92 NUTROPIN AQ NUSPIN 10... 192 gramicidin...... 151 NITRO-TIME ...... 92 NUTROPIN AQ NUSPIN 20... 192 neomycin-polymyxin-hc nizatidine...... 164 NUTROPIN AQ NUSPIN 5..... 192 ...... 151, 155 NOCDURNA...... 63, 192 NUVAIL...... 139 NEONATAL + DHA ...65, 255, 257 Nolix...... 234, 243 NUVARING...... 180 Neo-Polycin...... 151 Nora-Be...... 179 NUWIQ...... 63 Neo-Polycin Hc...... 151, 155 norethin ace-eth estrad-fe ....179 NUZYRA...... 16 NERLYNX ...... 40 norethindrone ...... 179 Nyamyc...... 248 NESINA...... 183 norethindrone acetate ...... 193 Nylia 7/7/7...... 180 NESTABS ...... 65, 145, 255, 257 norethindrone acet-ethinyl NYMALIZE...... 78, 87, 90, 97 Neuac...... 230, 245 est...... 179 Nymyo ...... 180 NEULASTA ...... 60 norethindrone-eth estradiol nystatin...... 31, 248 NEUPRO...... 123 ...... 186, 193 Nystop ...... 248 NEURAPTINE...... 252 norethin-eth estradiol-fe ...... 179 OCALIVA...... 163 NEURONTIN...... 101, 105 norgestimate-eth estradiol ...179 Ocella...... 180 NEVANAC...... 157 norgestimate-ethinyl octreotide acetate...... 195, 216 nevirapine...... 24 estradiol triphasic...... 179 OCUFLOX...... 151 NEXAVAR...... 40 Norlyda ...... 179 ODACTRA...... 45 NEXIUM...... 165 Norlyroc ...... 179 ODEFSEY...... 25, 26 NEXLETOL ...... 72 NORPACE...... 83 ODOMZO...... 40 NEXLIZET...... 73, 82 NORPACE CR...... 83 OFEV...... 220 NEXTSTELLIS ...... 179 NORPRAMIN...... 136 ofloxacin...... 32, 151

271 olanzapine ...... 108, 113 ORKAMBI...... 221 PEDVAX HIB...... 47 olanzapine-fluoxetine hcl orphenadrine citrate er ...... 57 peg 3350-kcl-na bicarb-nacl .161 ...... 113, 134 orphenadrine-asa-caffeine peg-3350/electrolytes...... 161 olmesartan medoxomil .....69, 70 ...... 57, 132 peg- olmesartan medoxomil-hctz Orsythia...... 180 3350/electrolytes/ascorbat... 161 ...... 69, 70, 95, 147 oscimin...... 50, 51 PEGASYS...... 28 olopatadine hcl ...... 150 oscimin sr...... 51 peg-kcl-nacl-nasulf-na asc-c 161 OLUMIANT...... 205, 210 oseltamivir phosphate ...... 29 peg-prep...... 161 OMECLAMOX-PAK.... 17, 31, 165 OSENI...... 183, 196 PEMAZYRE...... 41 omega-3-acid ethyl esters ...... 73 OSMOLEX ER...... 15, 99 penicillamine...... 166, 205 omeprazole ...... 165 OSMOPREP...... 161 penicillin v potassium ...... 29 OMEPRAZOLE+SYRSPEND OSPHENA...... 184 pentamidine isethionate ...... 19 SF ALKA...... 166 OTEZLA ...... 205, 210, 252 pentazocine-naloxone hcl .... 128 ondansetron hcl ...... 159 OVACE PLUS...... 247 pentoxifylline er ...... 61 ondansetron odt ...... 159 OVACE PLUS WASH...... 247 PERFOROMIST...... 56, 227 ONETOUCH DELICA OVACE WASH...... 247 PERIDEX...... 156 LANCING DEV...... 139 OVIDE...... 249 perindopril erbumine ...... 71, 72 ONETOUCH DELICA PLUS oxandrolone ...... 170 Periogard...... 156 LANCING ...... 139 oxaprozin...... 129 permethrin...... 249 ONETOUCH ULTRA ...... 141 oxazepam...... 117 perphenazine...... 130 ONETOUCH ULTRA 2...... 139 OXBRYTA...... 58 perphenazine-amitriptyline ONETOUCH ULTRA MINI ...... 139 oxcarbazepine...... 105 ...... 130, 136 ONETOUCH VERIO...... 140, 141 OXERVATE...... 157 PERTZYE...... 162 ONETOUCH VERIO FLEX oxiconazole nitrate ...... 238 PFIZER-BIONTECH COVID- SYSTEM KIT W/DEVICE...... 139 OXISTAT...... 238 19 VACC...... 47 ONETOUCH VERIO IQ oxybutynin chloride ...... 254 Phenazo...... 237 SYSTEM...... 140 oxybutynin chloride er ...... 254 phenazopyridine hcl ...... 237 ONETOUCH VERIO oxycodone hcl ...... 126 phendimetrazine tartrate ...... 99 REFLECT...... 140 oxycodone-acetaminophen phendimetrazine tartrate er ....99 ONETOUCH VERIO SYNC ...... 101, 126 phenelzine sulfate ...... 122 SYSTEM KIT W/DEVICE...... 140 oxycodone-aspirin ...... 126, 132 phenobarbital ...... 114, 115 ONEVITE...... 255, 257 oxymorphone hcl ...... 126 phenoxybenzamine hcl .... 54, 90 ONFI...... 116, 117 oxymorphone hcl er ...... 126 phentermine hcl...... 99 ONGLYZA ...... 183 OZEMPIC...... 188 phenylephrine hcl...... 159 ONUREG...... 40 OZOBAX...... 52 PHENYTEK...... 83, 122 opium...... 126, 159 Pacerone...... 85 phenytoin...... 83, 122 OPSUMIT...... 97, 227 PALFORZIA...... 45, 46 Phenytoin Infatabs...... 83, 122 ORACIT...... 142 paliperidone er...... 113 phenytoin sodium extended ORALAIR...... 45, 216 PALYNZIQ...... 149 ...... 83, 122 ORALAIR ADULT STARTER PAMELOR...... 136 PHEXXI...... 217 PACK...... 45, 216 PANCREAZE...... 162 Philith...... 180 ORALAIR CHILDRENS PANDEL...... 234, 243 PHOSLYRA...... 144 STARTER PACK ...... 45, 216 PANRETIN...... 41, 252 Phospha 250 Neutral...... 141 Oralone...... 234, 243 pantoprazole sodium ...... 166 Phosphasal...... 34 ORAPRED ODT...... 168 paricalcitol...... 259 phosphorous ...... 141 ORAVIG...... 238 PARNATE ...... 122 Phospho-Trin 250 Neutral ...... 141 ORENCIA...... 205, 210 paromomycin sulfate ...... 16 phytonadione ...... 199, 259 ORENCIA CLICKJECT... 205, 210 paroxetine hcl...... 134 PIFELTRO...... 25 ORENITRAM...... 97, 227 paroxetine hcl er...... 134 pilocarpine hcl...... 54, 158 ORFADIN...... 216 PASER...... 19 pimecrolimus...... 214, 252 ORGOVYX...... 40, 170 PATANASE...... 150 pimozide...... 111 ORIAHNN...... 170, 186, 193 PAXIL...... 134 Pimtrea...... 180 ORILISSA...... 170, 171 PEDIAPRED...... 168 pindolol...... 53, 74, 75, 84, 90

272 pioglitazone hcl ...... 196 prednisone intensol ...... 168 PROCARDIA XL..... 78, 87, 90, 97 pioglitazone hcl-glimepiride 196 PREFEST...... 186 Procentra...... 100 pioglitazone hcl-metformin pregabalin...... 101, 105, 121 prochlorperazine...... 130, 160 hcl...... 172, 197 PREMARIN...... 186 prochlorperazine maleate PIQRAY...... 41 PREMPHASE...... 186 ...... 130, 160 Pirmella 1/35...... 180 PREMPRO...... 186 PROCTOFOAM HC 235, 237, 243 Pirmella 7/7/7...... 180 PRENAISSANCE Procto-Med Hc...... 235, 243 piroxicam...... 129 ...... 66, 146, 161, 255, 257 Procto-Pak...... 235, 243 PLAN B ONE-STEP ...... 180 prenatal...... 66, 146, 255, 257 Proctozone-Hc...... 235, 243 PLEGRIDY...... 211 prenatal plus iron PROCYSBI...... 216, 217 PLEGRIDY STARTER PACK. 211 ...... 66, 146, 255, 257 PROFILNINE...... 63 PLENVU...... 161 prenatal vitamin plus low progesterone ...... 193 PNEUMOVAX 23...... 47 iron...... 66, 146, 255, 257 PROGLYCEM...... 171 podocon...... 252 PRENATE ...... 146, 255, 257 PROGRAF...... 214 podofilox ...... 252 PRENATE DHA ...... 66, 255, 257 PROMACTA...... 60 Polycin...... 151 PRENATE ELITE ...... 66, 255, 257 promethazine hcl .... 13, 112, 222 polymyxin b-trimethoprim ....151 PRENATE ENHANCE promethazine vc ...... 13, 49, 222 POLYTRIM...... 152 ...... 66, 255, 257 promethazine vc/codeine POLY-VI-FLOR...... 201, 255 PRENATE ESSENTIAL ...... 13, 49, 126, 220, 222 POLY-VI-FLOR/IRON ...... 66, 255, 257 promethazine-codeine ...... 65, 66, 201, 255 PRENATE MINI ...... 66, 255, 257 ...... 126, 220, 222 POMALYST...... 41, 211 PRENATE PIXIE...... 66, 255, 258 promethazine-dm .... 13, 220, 223 Portia-28...... 180 PRENATE RESTORE promethazine-phenyleph- posaconazole ...... 20 ...... 66, 255, 258 codeine...... 14, 49, 127, 221, 223 POTABA...... 216 PREPIDIL...... 218 promethazine-phenylephrine potassium chloride ...... 146 preplus...... 66, 146, 255, 258 ...... 14, 49, 223 potassium chloride crys er .. 146 PRETAB...... 66, 146, 256, 258 Promethegan...... 14, 112 potassium chloride er ...... 146 PRETOMANID...... 19 promethegan...... 14, 112 potassium citrate er ...... 142 Prevalite...... 76 PROMISEB...... 140 potassium citrate-citric acid 142 PREVIDENT...... 202 propafenone hcl ...... 83 PRADAXA...... 59 PREVIDENT 5000 BOOSTER propafenone hcl er ...... 83 PRALUENT...... 92 PLUS...... 201 proparacaine hcl...... 157 pramipexole dihydrochloride PREVIDENT 5000 DRY propranolol hcl ...... 123 MOUTH...... 201 ...... 53, 74, 75, 84, 90, 111 pramosone...... 234, 237, 243 PREVIDENT 5000 ENAMEL propranolol hcl er PRAMOSONE.234, 235, 237, 243 PROTECT...... 202 ...... 53, 74, 75, 84, 90, 111 PRAMOTIC...... 156, 157 PREVIDENT 5000 ORTHO propranolol-hctz pramox...... 237 DEFENSE...... 202 ...... 53, 74, 75, 84, 95, 147 prasugrel hcl...... 67 PREVIDENT 5000 PLUS...... 202 propylthiouracil...... 171 pravastatin sodium ...... 88 PREVIDENT 5000 SENSITIVE PROSCAR...... 197 praziquantel ...... 17 ...... 202 PROSTIN E2...... 218 prazosin hcl...... 53, 68 Previfem...... 180 protriptyline hcl...... 136 PRECOSE...... 169 PREVNAR 13...... 47 PROVERA...... 193 PRED FORTE...... 155 PREVYMIS...... 20, 30 PRUDOXIN...... 237 PRED MILD...... 155 PREZCOBIX...... 27, 216 pseudoephedrine- PRED-G...... 152, 155 PREZISTA...... 27 bromphen-dm ..48, 219, 221, 223 PRED-G S.O.P...... 152, 156 PRIFTIN...... 19, 32 PSORCON...... 235, 243 prednicarbate...... 235, 243 PRIMACARE...... 66, 256, 258 PULMICORT FLEXHALER prednisolone ...... 168 primaquine phosphate ...... 18 ...... 168, 225 prednisolone acetate ...... 156 primidone...... 114 PULMOZYME...... 149, 224 prednisolone sodium PRIMSOL...... 34 PURIXAN...... 41, 214 phosphate ...... 156, 168 PRINIVIL...... 71, 72 PYLERA....16, 18, 19, 31, 33, 160 prednisone...... 168 probenecid...... 148, 200 pyrazinamide...... 19

273 PYRIDIUM...... 237 RENVELA...... 144, 199 salicylic acid...... 245 pyridostigmine bromide ...... 54 repaglinide...... 191 salimez...... 245 pyridostigmine bromide er .....54 REPATHA...... 92 salsalate...... 132 pyrimethamine ...... 18 REPATHA PUSHTRONEX SALVAX DUO PLUS...... 245 PYROGALLIC ACID...... 252 SYSTEM...... 92 SAMSCA...... 148 QBRELIS...... 71, 72 REPATHA SURECLICK...... 92 SANDIMMUNE...... 206, 212, 215 QINLOCK...... 41 RESTASIS...... 156 SANTYL...... 252 QSYMIA...... 99, 102, 105 RESTORIL...... 117 SAPHRIS...... 109, 114 QUALAQUIN...... 18 RETACRIT...... 60, 61 sapropterin dihydrochloride 217 QUESTRAN...... 76 RETEVMO...... 41 SAVAYSA...... 59 QUESTRAN LIGHT...... 76 RETROVIR...... 26 SAVELLA...... 121, 132 quetiapine fumarate ...... 109, 114 REVLIMID...... 41, 42, 212 SAVELLA TITRATION PACK quetiapine fumarate er . 109, 113 REXULTI...... 114 ...... 121, 132 QUFLORA PEDIATRIC.. 202, 256 REYATAZ...... 27 SAXENDA...... 188 quinapril hcl...... 71, 72 REYVOW...... 133 SCALACORT DK...... 235, 243 quinapril- RHOFADE...... 252 scopolamine...... 159 hydrochlorothiazide RHOPRESSA...... 152, 158 SELECT-OB...... 66, 256, 258 ...... 71, 72, 95, 147 ribavirin...... 30 selegiline hcl...... 122 quinidine gluconate er ...... 18, 83 RIDAURA...... 166, 206, 212 selenium sulfide...... 247 quinidine sulfate ...... 18, 83 rifabutin...... 19, 32 SELZENTRY ...... 23 quinine sulfate ...... 18 rifampin...... 19, 32 SEREVENT DISKUS...... 56, 227 rabeprazole sodium ...... 166 RILUTEK...... 119 SEROSTIM...... 192 RADIOGARDASE...... 143, 199 riluzole...... 119 sertraline hcl...... 134 RAGWITEK...... 46, 217 rimantadine hcl ...... 15 Setlakin...... 180 raloxifene hcl...... 184, 200 RINVOQ...... 206, 212 sevelamer carbonate.... 144, 199 ramelteon...... 112 risedronate sodium...... 200, 201 sevelamer hcl...... 144, 199 ramipril...... 71, 72 risperidone...... 109, 114 sevoflurane...... 122 ranolazine er...... 81 RITALIN...... 131 sf...... 202 RAPAMUNE...... 214 ritonavir...... 27 sf 5000 plus...... 202 rasagiline mesylate...... 122 rivastigmine...... 54 SFROWASA...... 160 RASUVO rivastigmine tartrate...... 54 Sharobel...... 180 ...... 41, 205, 206, 211, 214, 215 Rivelsa...... 180 SHARPS CONTAINER...... 140 RAVICTI...... 142 RIXUBIS...... 63 SHINGRIX...... 48 RAZADYNE ER...... 54 rizatriptan benzoate ...... 133 SIGNIFOR...... 195 REBIF...... 212 ROCALTROL...... 259 sildenafil citrate...... 92, 227 REBIF REBIDOSE...... 211 ROCKLATAN...... 152, 158 silodosin...... 55 REBIF REBIDOSE ropinirole hcl...... 123 SILVADENE...... 247 TITRATION PACK ...... 211 Rosadan...... 230 silver nitrate...... 245, 247 REBIF TITRATION PACK ...... 212 rosuvastatin calcium ...... 89 silver sulfadiazine...... 247 Reclipsen...... 180 ROWASA...... 160 Simliya...... 180 RECOMBINATE ...... 63 Roweepra...... 105 Simpesse...... 181 RECOMBIVAX HB...... 47 ROZEREM...... 112 SIMPONI...... 163, 164, 206, 212 RECOTHROM...... 63 ROZLYTREK ...... 42 simvastatin...... 89 RECOTHROM SPRAY KIT...... 63 RUBRACA...... 42 SINEMET...... 120 RECTIV...... 252 RUCONEST...... 203 SINGULAIR...... 223 REGLAN...... 165 rufinamide...... 105 sirolimus...... 215 REGRANEX...... 238, 252 RUKOBIA...... 23 SIRTURO...... 19 RELENZA DISKHALER...... 29 RUZURGI...... 217 SIVEXTRO...... 31 RELISTOR...... 163 RYBELSUS...... 188 SKYRIZI...... 252 RELNATE DHA ...... 66, 256, 258 RYDAPT...... 42 SKYRIZI (150 MG DOSE)...... 252 REMERON...... 107 RYTHMOL SR ...... 83 SKYRIZI PEN...... 252 REMERON SOLTAB ...... 107 SABRIL...... 105 SLYND...... 181, 193 RENAGEL...... 144, 199 SALAGEN...... 54 sod citrate-citric acid...... 142

274 SODIUM BICARBONATE STALEVO 200...... 118, 120 SURESTEP PRO NORMAL ...... 142, 159 STALEVO 50...... 118, 120 GLUCOSE...... 140 sodium chloride ...... 140, 146 STALEVO 75...... 118, 121 SUSTIVA...... 25 sodium fluoride ...... 202 stavudine...... 26 SUTAB...... 161 sodium fluoride 5000 enamel STELARA...... 206, 212, 253 SUTENT...... 42 ...... 202 STENDRA ...... 92 Syeda...... 181 sodium fluoride 5000 plus ....202 STIMATE...... 64, 192 SYMAX DUOTAB...... 51 sodium fluoride 5000 ppm ... 202 STIVARGA...... 42 Symax-Sl...... 51 sodium fluoride 5000 STRENSIQ...... 149 Symax-Sr...... 51 sensitive...... 202 STRIBILD...... 24, 26 SYMBICORT.....56, 168, 225, 227 sodium phenylbutyrate 142, 143 STRIVERDI RESPIMAT... 56, 227 SYMBYAX...... 114, 134 sodium polystyrene STROMECTOL ...... 17 SYMDEKO...... 221 sulfonate ...... 144, 199 SUBOXONE...... 128 SYMFI...... 25, 26 sodium sulfacetamide ...... 247 Subvenite...... 105, 109 SYMFI LO...... 25, 26 sodium sulfacetamide wash 247 Subvenite Starter Kit-Blue SYMJEPI...... 48, 219 SODIUM SULFACETAMIDE- ...... 105, 109 SYMLINPEN 120...... 169 BAKUCHIOL...... 247 Subvenite Starter Kit-Green SYMLINPEN 60...... 169 SOFOSBUVIR-VELPATASVIR ...... 105, 109 SYMPROIC...... 164 ...... 22, 23 Subvenite Starter Kit-Orange SYMTUZA...... 26, 27, 30, 217 solifenacin succinate ...... 254 ...... 105, 109 SYNAPRYN FUSEPAQ...... 127 SOLIQUA...... 188, 190, 191 SUCRAID...... 149 SYNAREL...... 187 SOLOSEC...... 19 sucralfate...... 165 SYNDROS...... 159 SOMA...... 52 SULAR...... 78, 87, 88, 90, 97 SYNJARDY...... 172, 195 SOMATULINE DEPOT...... 195 SULCONAZOLE NITRATE .....238 SYNJARDY XR...... 172, 195 SOMAVERT...... 196 sulfacetamide sodium .. 152, 247 SYNRIBO...... 42 SOOLANTRA ...... 252 sulfacetamide sodium (acne) TABLOID...... 42 SORIATANE...... 253 ...... 247 TABRECTA ...... 42 sotalol hcl.. 53, 74, 75, 84, 85, 90 sulfacetamide sodium-sulfur TACLONEX ...... 235, 243, 253 sotalol hcl (af) ...... 245, 246, 247 tacrolimus...... 215, 253 ...... 53, 74, 75, 84, 85, 90 sulfacetamide sod-sulfur tadalafil...... 93 SOTYLIZE...53, 74, 75, 84, 85, 90 wash...... 246, 247 tadalafil (pah) ...... 93, 228 SOVALDI...... 22 sulfacetamide-prednisolone 152 TAFINLAR ...... 42 spinosad...... 249 sulfacetamide-sulfur in urea TAGRISSO...... 42 SPIRIVA HANDIHALER....51, 219 ...... 246, 248 TAKHZYRO...... 203 SPIRIVA RESPIMAT...... 51, 220 sulfadiazine ...... 32 TALZENNA ...... 42 spironolactone ...... 91, 93, 145 sulfamethoxazole- tamoxifen citrate...... 42, 184 spironolactone-hctz trimethoprim...... 32 tamsulosin hcl...... 55 ...... 91, 93, 95, 145, 147 SULFAMYLON...... 248 TAPAZOLE...... 171 SPORANOX...... 20 sulfasalazine....33, 160, 206, 212 TAPERDEX 12-DAY...... 169 SPORANOX PULSEPAK...... 20 Sulfatrim Pediatric...... 33 Taperdex 6-Day...... 169 SPRAVATO (56 MG DOSE)... 107 sulindac...... 130 TAPERDEX 7-DAY...... 169 SPRAVATO (84 MG DOSE)... 107 sumatriptan ...... 133 TARGRETIN...... 43, 253 Sprintec 28...... 181 sumatriptan succinate ...... 133 Tarina 24 Fe...... 181 SPRIX...... 130 sumatriptan succinate refill . 133 Tarina Fe 1/20...... 181 SPRYCEL...... 42 SUMAXIN...... 246, 248 Tarina Fe 1/20 Eq...... 181 sps...... 144, 199 SUMAXIN WASH...... 246, 248 TARKA...... 71, 72, 76, 78, 81, 97 Sronyx...... 181 SUNOSI...... 136 TASIGNA...... 43 Ssd...... 247 SUPRAX...... 15 tavaborole...... 248 SSKI...... 17, 171, 199, 222 SUPREP BOWEL PREP KIT..161 TAVALISSE...... 58 sss 10-5...... 245, 247 SURESTEP PRO HIGH tazarotene...... 253 STALEVO 100...... 118, 120 GLUCOSE...... 140 TAZORAC...... 253 STALEVO 125...... 118, 120 SURESTEP PRO LOW Taztia Xt...... 77, 78, 80, 81, 86, 97 STALEVO 150...... 118, 120 GLUCOSE...... 140 TAZVERIK...... 43

275 TEGRETOL...... 105, 109 TIMOPTIC-XE...... 153 TRETTEN ...... 64 TEGRETOL-XR...... 105, 109 tinidazole...... 19 TREXALL...... 43, 206, 213, 215 TEGSEDI...... 200 tiopronin...... 217 TREZIX...... 101, 127, 131 TEKTURNA ...... 93 TIROSINT-SOL...... 197 Tri Femynor ...... 181 TEKTURNA HCT ...... 93, 95, 147 TISSEEL...... 253 triamcinolone acetonide telmisartan...... 69, 70 TIVICAY...... 24 ...... 235, 236, 244 telmisartan-hctz .. 69, 70, 95, 148 TIVICAY PD...... 24 triamterene...... 93, 145 temazepam ...... 117 tizanidine hcl ...... 52 triamterene-hctz 93, 95, 145, 148 TEMOVATE ...... 235, 243, 244 TOBI PODHALER...... 16 triazolam...... 117 temozolomide ...... 43 TOBRADEX...... 152, 156 TRICARE PRENATAL DHA TENCON...... 101, 115 tobramycin...... 16, 152 ONE...... 66, 161, 256, 258 TENIVAC...... 46 tobramycin-dexamethasone TRI-CHLOR...... 253 tenofovir disoproxil fumarate 26 ...... 152, 156 TRICITRASOL...... 57, 142 TEPMETKO ...... 43 TOBREX...... 152 tricitrates...... 142 terazosin hcl...... 53, 68, 90 tolbutamide ...... 196 Triderm...... 236, 244 terbinafine hcl ...... 15 tolcapone ...... 118 TRIDESILON...... 236, 244 terbutaline sulfate ...... 56, 227 tolmetin sodium ...... 130 trientine hcl...... 166 terconazole ...... 238 TOLVAPTAN ...... 148 Tri-Estarylla...... 181 TERIPARATIDE tolvaptan...... 148 trifluoperazine hcl ...... 130 (RECOMBINANT) ...... 191, 200 TOPAMAX...... 105 trifluridine...... 152 Terrell...... 122 TOPAMAX SPRINKLE...... 105 trihexyphenidyl hcl...... 51, 102 TESSALON PERLES ...... 221 TOPICORT...... 235, 244 TRIJARDY XR 172, 183, 184, 195 TESTIM...... 170 topiramate...... 106 TRIKAFTA...... 221, 222 testosterone cypionate ...... 170 TOPROL XL...... 57, 74, 75, 84 Tri-Legest Fe ...... 181 testosterone enanthate ...... 170 toremifene citrate ...... 43, 184 TRILEPTAL...... 106 tetrabenazine ...... 119, 136 torsemide...... 90, 143 Tri-Linyah...... 181 tetracaine hcl...... 157 TOUJEO MAX SOLOSTAR Tri-Lo-Estarylla...... 181 tetracycline hcl...... 33 ...... 190, 191 Tri-Lo-Marzia...... 181 TETRIX...... 238 TOUJEO SOLOSTAR.....190, 191 Tri-Lo-Mili...... 181 TEXACORT...... 235, 244 TOVIAZ...... 254 Tri-Lo-Sprintec...... 181 THALOMID ...... 212, 213 TRACLEER...... 98, 228 trimethobenzamide hcl ...... 160 THEO-24...... 88, 143, 228, 254 TRADJENTA ...... 183 trimethoprim...... 34 theophylline .....88, 143, 228, 254 tramadol hcl...... 127 Tri-Mili...... 181 theophylline er 88, 143, 228, 254 tramadol hcl er...... 127 trimipramine maleate...... 136 THIOLA...... 217 tramadol-acetaminophen TRINATE ...... 66, 146, 256, 258 THIOLA EC...... 217 ...... 101, 111, 127 TRINTELLIX ...... 135 thioridazine hcl ...... 130 trandolapril...... 71, 72 Tri-Nymyo ...... 181 thiothixene ...... 135 trandolapril-verapamil hcl er Tri-Previfem...... 182 THROMBIN-JMI ...... 64 ...... 71, 72, 77, 79, 81, 98 Tri-Sprintec...... 182 THROMBIN-JMI EPISTAXIS.... 64 tranexamic acid...... 64 TRISTART DHA ...... 66, 256, 258 Tiadylt Er.....77, 78, 80, 81, 86, 97 TRANSDERM SCOP (1.5 MG) TRIUMEQ...... 24, 26 tiagabine hcl...... 105 ...... 159 TRI-VI-FLOR...... 202, 256 TIAZAC...... 77, 79, 80, 81, 86, 98 TRANSDERM-SCOP (1.5 MG) TRI-VI-FLORO...... 202, 256 TIBSOVO...... 43 ...... 160 tri-vite/fluoride TIGLUTIK...... 119 TRANXENE-T ...... 116, 117 ...... 202, 256, 258, 259 TIKOSYN...... 85 tranylcypromine sulfate ...... 122 Trivora (28) ...... 182 Tilia Fe...... 181 travoprost (bak free)...... 158 Tri-Vylibra...... 182 timolol maleate trazodone hcl ...... 135 Tri-Vylibra Lo...... 182 ...... 53, 74, 75, 84, 90, 111, 153 TRECATOR ...... 20 TRIZIVIR...... 26 timolol maleate ocudose ...... 153 TRELEGY ELLIPTA TRUE METRIX LEVEL 1 ...... 140 timolol maleate pf ...... 153 ...... 51, 56, 169, 220, 225, 227 TRUE METRIX LEVEL 2 ...... 140 TIMOPTIC...... 153 TREMFYA ...... 253 TRUE METRIX LEVEL 3 ...... 140 TIMOPTIC OCUDOSE...... 153 tretinoin...... 43, 239 TRULANCE ...... 164

276 TRULICITY...... 188 valsartan- VIRAZOLE...... 30 TRUMENBA ...... 48 hydrochlorothiazide VIREAD...... 26 TRUSOPT...... 154 ...... 69, 70, 95, 148 virt-phos 250 neutral...... 141 TRUVADA...... 26 VALTOCO...... 116, 117 virtussin ac w/alc.. 127, 221, 222 TUKYSA...... 43 Vanadom...... 52 VISTARIL...... 14, 112 Tulana...... 182 VANCOCIN...... 21 VISTOGARD...... 199 TURALIO...... 43 VANCOCIN HCL...... 21 VITAFOL FE+...... 66, 256, 258 TURPENTINE ...... 218 vancomycin hcl...... 21 VITAFOL-NANO...... 67, 256, 258 TUSSICAPS...... 14, 127, 221, 223 Vandazole...... 230 VITAFOL-OB+DHA TWINRIX...... 48 VAQTA...... 48 ...... 67, 146, 256, 258 TWIRLA...... 182 vardenafil hcl...... 93 vitamin d (ergocalciferol)..... 259 tyblume...... 182 VARIVAX...... 48 vitamins acd-fluoride TYBOST...... 217 VECAMYL...... 90 ...... 202, 256, 257, 258, 259 Tydemy...... 182 Velivet...... 182 VITRAKVI...... 44 TYKERB...... 43 VELPHORO...... 144 VIVELLE-DOT...... 186 TYMLOS ...... 191, 200 VELTASSA...... 144 VIZIMPRO...... 44 TYVASO...... 98, 228 VEMLIDY...... 30 Volnea...... 182 TYVASO REFILL...... 98, 228 VENCLEXTA ...... 43 VONVENDI...... 64 TYVASO STARTER...... 98, 228 VENCLEXTA STARTING voriconazole...... 20, 21 UBRELVY...... 118 PACK...... 43 VOSEVI...... 22, 23 UCERIS...... 169 VENELEX...... 253 VOTRIENT...... 44 UDAMIN SP...... 256, 258 venlafaxine hcl...... 133 vp-pnv-dha ...... 67, 256, 258 UKONIQ...... 43 venlafaxine hcl er...... 133 VRAYLAR...... 114 ULTANE ...... 122 VENTAVIS...... 98, 228 VTOL LQ ...... 102, 111, 115, 132 ULTRACET...... 101, 111, 127 VENTRIXYL...... 256, 258 Vyfemla...... 182 ULTRAM...... 127 verapamil hcl VYLEESI...... 119 UNISTRIP CONTROL...... 140 ...... 77, 79, 80, 81, 86, 98 Vylibra...... 182 Unithroid...... 197 verapamil hcl er VYNDAMAX...... 81 UPNEEQ...... 159 ...... 77, 79, 80, 81, 86, 98 VYNDAQEL...... 82 UPTRAVI...... 98, 228 VEREGEN...... 253 VYVANSE...... 100 urea...... 246 VERELAN... 77, 79, 80, 81, 86, 98 WAKIX...... 136 urea nail...... 246 VERELAN PM warfarin sodium...... 58 Urelle...... 34 ...... 77, 79, 80, 81, 86, 98 WELCHOL...... 76, 170 Uribel...... 34 VERZENIO...... 44 Wera...... 182 urin ds...... 34 Vestura...... 182 WESTGEL DHA...... 67, 256, 258 URO-458...... 34 VFEND...... 20 WESTHROID...... 197 UROCIT-K 10...... 142 VIBERZI...... 164 WHEAT GERM OIL...... 259 UROCIT-K 15...... 142 VIBRAMYCIN...... 33 WIDE-SEAL DIAPHRAGM 60 217 UROCIT-K 5...... 142 VICTOZA...... 188 WIDE-SEAL DIAPHRAGM 65 218 UROGESIC-BLUE...... 34 VIEKIRA PAK...... 22, 23, 28 WIDE-SEAL DIAPHRAGM 70 218 uro-mp...... 34 Vienva...... 182 WIDE-SEAL DIAPHRAGM 75 218 URSO 250...... 162 vigabatrin...... 106 WIDE-SEAL DIAPHRAGM 80 218 URSO FORTE...... 162 Vigadrone...... 106 WIDE-SEAL DIAPHRAGM 85 218 ursodiol...... 162 VIIBRYD...... 135 WIDE-SEAL DIAPHRAGM 90 218 USTELL...... 34 VIIBRYD STARTER PACK..... 135 WIDE-SEAL DIAPHRAGM 95 218 Utira-C...... 34 Vilamit Mb...... 34 WILATE...... 64 valacyclovir hcl...... 30 Vilevev Mb...... 34 WILZIN...... 166 VALCHLOR...... 43, 253 VIMPAT...... 106 WP THYROID...... 197 VALCYTE...... 30 VINATE ONE.... 66, 146, 256, 258 Wymzya Fe...... 182 valganciclovir hcl...... 30 VIOKACE...... 162 XALKORI...... 44 valproic acid...... 106, 109, 111 viorele...... 182 XARELTO...... 59 valsartan...... 69, 70 VIRACEPT...... 28 XARELTO STARTER PACK .....59 VIRAMUNE...... 25 XATMEP...... 44, 206, 213, 215

277 XCOPRI...... 106 ZELBORAF...... 45 XELJANZ...... 207, 213 ZELNORM...... 164, 165 XELJANZ XR...... 207, 213 ZEMPLAR...... 259 XELPROS...... 158 Zenatane...... 253 XENICAL...... 164 ZENPEP...... 162 XENLETA ...... 31 ZEPATIER...... 22, 23 XEPI...... 230 ZEPOSIA...... 213 XERMELO...... 159 ZEPOSIA 7-DAY STARTER XIFAXAN...... 32 PACK...... 213 XIIDRA...... 156 ZEPOSIA STARTER KIT...... 213 XOFLUZA (40 MG DOSE)...... 20 ZETONNA ...... 156, 224 XOFLUZA (80 MG DOSE)...... 20 ZIAC...... 57, 74, 75, 85, 95, 148 XOLEGEL...... 238 ZIAGEN...... 26, 27 XOPENEX HFA...... 56, 227 zidovudine ...... 27 XOSPATA...... 44 ZIEXTENZO...... 61 XPOVIO (100 MG ONCE zileuton er ...... 223 WEEKLY)...... 44 ZILXI...... 230 XPOVIO (40 MG ONCE ZIOPTAN...... 158 WEEKLY)...... 44 ziprasidone hcl ...... 109, 114 XPOVIO (40 MG TWICE ZIRGAN...... 152 WEEKLY)...... 44 ZITHROMAX...... 31 XPOVIO (60 MG ONCE ZITHROMAX TRI-PAK...... 31 WEEKLY)...... 44 ZITHROMAX Z-PAK...... 31 XPOVIO (60 MG TWICE ZOCOR...... 89 WEEKLY)...... 44 ZOFRAN...... 159 XPOVIO (80 MG ONCE ZOKINVY...... 217 WEEKLY)...... 44, 45 ZOLINZA...... 45 XPOVIO (80 MG TWICE zolmitriptan ...... 133 WEEKLY)...... 45 zolpidem tartrate ...... 112 XTAMPZA ER...... 127 zolpidem tartrate er ...... 112 XTANDI ...... 45 ZOLPIMIST...... 112 Xulane...... 182 ZOMIG...... 134 XURIDEN...... 217 ZOMIG ZMT...... 134 XYNTHA ...... 64 ZONEGRAN...... 106 XYNTHA SOLOFUSE...... 64 zonisamide ...... 106 XYREM...... 120 ZONTIVITY...... 67 XYWAV...... 120 ZORBTIVE...... 192 YASMIN 28...... 182 Zovia 1/35 (28)...... 183 YAZ...... 183 Zovia 1/35E (28)...... 183 YUPELRI...... 51 ZOVIRAX...... 30 Yuvafem...... 186 ZUBSOLV...... 128 ZACARE...... 246 Zumandimine...... 183 zaclir cleansing...... 246 ZYDELIG...... 45 Zafemy...... 183 ZYFLO...... 223 zafirlukast...... 223 ZYKADIA...... 45 zaleplon...... 112 ZYLET...... 152, 156 ZANAFLEX ...... 52 ZYLOPRIM...... 200 Zarah...... 183 ZYMAXID...... 152 ZARONTIN...... 135 ZYVOX...... 31 ZARXIO...... 61 Zebutal...... 102, 111, 115, 132 ZEJULA...... 45 ZELAPAR...... 122, 123

278