Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS ABBVIE US LLC DUOPA (MISCELL) ANTIPARKINSON'S AGENTS ABBVIE US LLC VENCLEXTA (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC ABBVIE US LLC VENCLEXTA STARTING PACK (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC ACADIA PHARMACE NUPLAZID (ORAL) ANTIPSYCHOTICS ACORDA THERAPEU QUTENZA KIT (TOPICAL) NEUROPATHIC PAIN U.S. BR AQUADEKS DROPS OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS ACTAVIS U.S. BR CRINONE (VAGINAL) PROGESTATIONAL AGENTS ACTAVIS U.S. BR FETZIMA (ORAL) ANTIDEPRESSANTS, OTHER ACTAVIS U.S. BR NAMENDA XR (ORAL) ALZHEIMER'S AGENTS ACTAVIS U.S. BR SAPHRIS (SUBLINGUAL) ANTIPSYCHOTICS ACTAVIS U.S. BR SAVELLA (ORAL) NEUROPATHIC PAIN ACTAVIS U.S. BR SAVELLA DOSE PACK (ORAL) NEUROPATHIC PAIN ACTAVIS U.S. BR VIIBRYD (ORAL) ANTIDEPRESSANTS, OTHER ACTAVIS U.S. BR VRAYLAR (ORAL) ANTIPSYCHOTICS ACTAVIS/ALLERGA CRINONE (VAGINAL) PROGESTATIONAL AGENTS PHARMA VALCHLOR (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL ACTELION PHARMA ZAVESCA (ORAL) ENZYME REPLACEMENT, GAUCHERS DISEASE ACTIENT PHARMAC SEMPREX-D (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING ADAMAS PHARMA, GOCOVRI (ORAL) ANTIPARKINSON'S AGENTS AERIE PHARMACEU RHOPRESSA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS AKORN INC. AZASITE (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS AKORN INC. COSOPT PF (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS AKORN INC. PAREMYD (OPHTHALMIC) OPHTHALMICS, MYDRIATIC AKORN INC. XOPENEX NEB SOLN (INHALATION) BRONCHODILATORS, BETA AGONIST AKORN INC. ZIOPTAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS LABS. ALOMIDE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. AZOPT (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. BETOPTIC S (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. CILOXAN OINTMENT (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. CIPRO HC (OTIC) OTIC ANTIBIOTICS ALCON LABS. CIPRODEX (OTIC) OTIC ANTIBIOTICS ALCON LABS. CYCLOMYDRIL (OPHTHALMIC) OPHTHALMICS, MYDRIATIC ALCON LABS. DUREZOL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. EMADINE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. FLAREX (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. ILEVRO (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. ISOPTO HYOSCINE (OPHTHALMIC) OPHTHALMICS, MYDRIATIC ALCON LABS. MAXIDEX (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. MOXEZA (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. NATACYN (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. NEVANAC (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. PATADAY (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. PATANASE (NASAL) INTRANASAL RHINITIS AGENTS ALCON LABS. PAZEO (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. PILOPINE HS (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. SIMBRINZA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TOBRADEX OINTMENT (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALCON LABS. TOBRADEX ST (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALCON LABS. TOBREX OINTMENT (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. TRAVATAN Z 2.5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TRAVATAN Z 5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TRIESENCE (INTRAOCULR) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. VEXOL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. VIGAMOX (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALIMERA SCIENCE ILUVIEN (INTRAOCULAR) OPHTHALMICS, ANTI-INFLAMMATORIES ALK-ABELLO, INC GRASTEK (SUBLINGUAL) ANTI-ALLERGENS, ORAL ALK-ABELLO, INC RAGWITEK (SUBLINGUAL) ANTI-ALLERGENS, ORAL INC ARISTADA (INTRAMUSC) ANTIPSYCHOTICS ALKERMES INC ARISTADA INITIO (INTRAMUSC) ANTIPSYCHOTICS ALLEGIS PHARMAC ACTIVE FE TABLET (ORAL) IRON, ORAL ALLEGIS PHARMAC DURAVENT DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ALLEGIS PHARMAC DURAVENT PE TABLET OTC (ORAL) COUGH AND COLD, COLD ALLEGIS PHARMAC HISTEX CHEW OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION ALLEGIS PHARMAC HISTEX LIQUID OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION ALLEGIS PHARMAC HISTEX PD DROPS OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION ALLEGIS PHARMAC HISTEX PDX DROPS OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION ALLEGIS PHARMAC HISTEX-DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ALLEGIS PHARMAC HISTEX-PE LIQUID OTC (ORAL) COUGH AND COLD, COLD ALLEGIS PHARMAC OTOZIN (OTIC) OTIC ANTI-INFECTIVES & ANESTHETICS ALLEGIS PHARMAC SYNAGEX (ORAL) VITAMIN B PREPARATIONS INC. ACUVAIL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. ALOCRIL (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. ALPHAGAN P 0.1% (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. BLEPHAMIDE (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALLERGAN INC. BLEPHAMIDE S.O.P. (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALLERGAN INC. COMBIGAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. CONDYLOX GEL (TOPICAL) KERATOLYTICS ALLERGAN INC. CORDRAN TAPE (TOPICAL) STEROIDS, TOPICAL MEDIUM ALLERGAN INC. FML FORTE (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. FML S.O.P. (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. LASTACAFT (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. LUMIGAN 2.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 7.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. NAMZARIC (ORAL) ALZHEIMER'S AGENTS

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS ALLERGAN INC. NAMZARIC DOSE PACK (ORAL) ALZHEIMER'S AGENTS ALLERGAN INC. OZURDEX (INTRAOCULR) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. PRED MILD (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. PRED-G DROPS SUSP (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALLERGAN INC. PRED-G OINT. (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS ALLERGAN INC. RESTASIS (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORY/IMMUNOMODULATOR ALLERGAN INC. RESTASIS MULTIDOSE (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORY/IMMUNOMODULATOR ALLERGAN INC. RHOFADE (TOPICAL) ROSACEA AGENTS, TOPICAL ALLERGAN INC. ZYMAXID (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALLOS THERAPEUT FOLOTYN (INTRAVEN) ONCOLOGY, INJECTABLE ALMATICA PHARMA FORFIVO XL (ORAL) ANTIDEPRESSANTS, OTHER AMAG PHARMACEUT FERAHEME (INJECTION) IRON, PARENTERAL AMAG PHARMACEUT MAKENA AUTO INJECTOR (SUBCUTANEOUS) PROGESTATIONAL AGENTS AMAG PHARMACEUT MAKENA MDV (INTRAMUSC) PROGESTATIONAL AGENTS AMAG PHARMACEUT MAKENA SDV (INTRAMUSC) PROGESTATIONAL AGENTS AMEDRA PHARMACE ALBENZA (ORAL) ANTHELMINTICS AMEDRA PHARMACE EMVERM (ORAL) ANTHELMINTICS AMER. REGENT BUSULFAN (INTRAVEN) ONCOLOGY, INJECTABLE AMER. REGENT DEXFERRUM (INJECTION) IRON, PARENTERAL AMER. REGENT INJECTAFER (INTRAVENOUS) IRON, PARENTERAL AMER. REGENT VENOFER (INJECTION) IRON, PARENTERAL AMERISOURCEBERG MUCUS DM MAX TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC AMERISOURCEBERG SALICYLIC ACID LIQUID OTC (TOPICAL) KERATOLYTICS AIMOVIG (SUBCUTANEOUS) ANTIMIGRAINE AGENTS, OTHER AMGEN ARANESP DISP SYRIN (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS AMGEN ARANESP VIAL (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS AMGEN BLINCYTO (INTRAVEN) ONCOLOGY, INJECTABLE AMGEN EPOGEN (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS AMGEN IMLYGIC (INJECTION) ONCOLOGY, INJECTABLE AMGEN KYPROLIS (INTRAVEN) ONCOLOGY, INJECTABLE AMGEN NEULASTA KIT (INJECTION) COLONY STIMULATING FACTORS AMGEN NEULASTA SYRINGE (INJECTION) COLONY STIMULATING FACTORS AMGEN NEUPOGEN DISP SYRIN (INJECTION) COLONY STIMULATING FACTORS AMGEN NEUPOGEN VIAL (INJECTION) COLONY STIMULATING FACTORS AMGEN NPLATE (SUB-Q) THROMBOPOIESIS STIMULATING PROTEINS AMGEN VECTIBIX (INTRAVEN) ONCOLOGY, INJECTABLE AMPHASTAR PHARM AMPHADASE (INJECTION) TOPICAL, MUCOUS MEMB/SUBCUT ENZYME ANGELINI LABOPH OLEPTRO ER (ORAL) ANTIDEPRESSANTS, OTHER ANTARES PHARMA OTREXUP AUTO INJECTOR (SUBCUT.) METHOTREXATE APOPHARMA USA I ALKERAN (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC APP PHARMACEUTI VINBLASTINE SULFATE (INTRAVEN) ONCOLOGY, INJECTABLE APRECIA PHARMAC SPRITAM (ORAL) ANTICONVULSANTS APTEVO BIOTHERA HEPAGAM B (INTRAMUSC) IMMUNE GLOBULINS APTEVO BIOTHERA VARIZIG (INTRAMUSC) IMMUNE GLOBULINS AQUA PHARMACEUT VERDESO (TOPICAL) STEROIDS, TOPICAL LOW ARBOR PHARMACEU EVEKEO (ORAL) STIMULANTS AND RELATED AGENTS ARBOR PHARMACEU FLUOR-A-DAY DROPS (ORAL) FLUORIDE PREPARATIONS ARBOR PHARMACEU FLUOR-A-DAY TAB CHEW (ORAL) FLUORIDE PREPARATIONS ARBOR PHARMACEU GLIADEL (IMPLANT) ANTINEOPLASTIC AGENTS, TOPICAL ARBOR PHARMACEU OTOVEL (OTIC) OTIC ANTIBIOTICS ARBOR PHARMACEU PEDIADERM HC (TOPICAL) STEROIDS, TOPICAL LOW ARBOR PHARMACEU PEDIADERM TA (TOPICAL) STEROIDS, TOPICAL LOW ARBOR PHARMACEU ZENZEDI (ORAL) STIMULANTS AND RELATED AGENTS ARIAD PHARMACEU ICLUSIG (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC ASPEN/PRASCO LA LEUKERAN (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC ASTELLAS PHARMA XTANDI (ORAL) ONCOLOGY, ORAL - PROSTATE ASTRAZENECA BEVESPI AEROSPHERE (INHALATION) COPD AGENTS ASTRAZENECA CALQUENCE (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC ASTRAZENECA DALIRESP (ORAL) COPD AGENTS ASTRAZENECA FASENRA (SUB-Q) IMMUNOMODULATORS, ASTHMA ASTRAZENECA FASLODEX (INTRAMUSC) ONCOLOGY, ORAL - BREAST ASTRAZENECA IRESSA (ORAL) ONCOLOGY, ORAL - LUNG ASTRAZENECA LYNPARZA (ORAL) ONCOLOGY, ORAL - OTHER ASTRAZENECA PULMICORT 0.25, 0.5 MG RESPULES (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA PULMICORT 1 MG RESPULES (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA PULMICORT FLEXHALER (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA SEROQUEL XR (ORAL) ANTIPSYCHOTICS ASTRAZENECA SYMBICORT (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA TAGRISSO (ORAL) ONCOLOGY, ORAL - LUNG ASTRAZENECA TUDORZA PRESSAIR (INHALATION) COPD AGENTS AVANIR PHARMACE NUEDEXTA (ORAL) PSEUDOBULBAR AFFECT (PBA) AGENTS AVION PHARMACEU CHROMAGEN CAPSULE OTC (ORAL) IRON, ORAL AVION PHARMACEU FERIVA 21-7 (ORAL) IRON, ORAL AVION PHARMACEU FERIVA CAP MPHASE (ORAL) IRON, ORAL AVION PHARMACEU FERIVA FA CAPSULE (ORAL) IRON, ORAL AVION PHARMACEU NIFEREX TABLET OTC (ORAL) IRON, ORAL B.F ASCHER & CO BENZEDREX INHALER OTC (NASAL) COUGH AND COLD, COLD BAUSCH & LOMB ALREX (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB BEPREVE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB BESIVANCE (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS BAUSCH & LOMB ISTALOL (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS BAUSCH & LOMB LOTEMAX DROPS (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB LOTEMAX GEL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB LOTEMAX OINTMENT (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB PROLENSA (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS BAUSCH & LOMB RETISERT (INTRAOCULR) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB ZYLET (OPHTHALMIC) OPHTHALMIC ANTIBIOTIC-STEROID COMBINATIONS BAXTER HEALTHCA MESNEX (ORAL) CHEMOTHERAPY RESCUE BAYER,PHARM DIV ALIQOPA (INTRAVEN) ONCOLOGY, INJECTABLE BAYER,PHARM DIV BILTRICIDE (ORAL) ANTHELMINTICS BAYER,PHARM DIV DESONATE GEL (TOPICAL) STEROIDS, TOPICAL LOW BAYER,PHARM DIV FINACEA (TOPICAL) ROSACEA AGENTS, TOPICAL BAYER,PHARM DIV FINACEA FOAM (TOPICAL) ROSACEA AGENTS, TOPICAL BAYER,PHARM DIV NEXAVAR (ORAL) ONCOLOGY, ORAL - RENAL CELL BAYER,PHARM DIV STIVARGA (ORAL) ONCOLOGY, ORAL - OTHER BIO PRODUCTS LA GAMMAPLEX (INTRAVEN) IMMUNE GLOBULINS BIOMARIN PHARMA NAGLAZYME (INTRAVEN) MUCOPOLYSACCHARIDOSIS BIOMARIN PHARMA VIMIZIM (INTRAVEN) MUCOPOLYSACCHARIDOSIS BIOTEST PHARMAC BIVIGAM (INTRAVEN) IMMUNE GLOBULINS BMS ONCO/IMMUN ETOPOPHOS (INTRAVEN) ONCOLOGY, INJECTABLE BMS PRIMARYCARE EMPLICITI (INTRAVEN) ONCOLOGY, INJECTABLE BMS PRIMARYCARE OPDIVO (INTRAVEN) ONCOLOGY, INJECTABLE BMS PRIMARYCARE SPRYCEL (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC BOEHRINGER ING. ATROVENT HFA (INHALATION) COPD AGENTS BOEHRINGER ING. COMBIVENT (INHALATION) COPD AGENTS BOEHRINGER ING. COMBIVENT RESPIMAT (INHALATION) COPD AGENTS BOEHRINGER ING. GILOTRIF (ORAL) ONCOLOGY, ORAL - LUNG BOEHRINGER ING. MIRAPEX ER (ORAL) ANTIPARKINSON'S AGENTS BOEHRINGER ING. OFEV (ORAL) IDIOPATHIC PULMONARY FIBROSIS BOEHRINGER ING. SPIRIVA (INHALATION) COPD AGENTS BOEHRINGER ING. SPIRIVA RESPIMAT (INHALATION) COPD AGENTS BOEHRINGER ING. STIOLTO RESPIMAT (INHALATION) COPD AGENTS BOEHRINGER ING. STRIVERDI RESPIMAT (INHALATION) BRONCHODILATORS, BETA AGONIST BONGEO PHARMACE FLORIVA CHEW (ORAL) PEDIATRIC VITAMIN PREPARATIONS BONGEO PHARMACE FLORIVA DROPS (ORAL) FLUORIDE PREPARATIONS BONGEO PHARMACE FLORIVA PLUS DROPS (ORAL) PEDIATRIC VITAMIN PREPARATIONS BONGEO PHARMACE FLORIVA PLUS DROPS OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS BRECKENRIDGE FOLBEE AR OTC (ORAL) VITAMIN B PREPARATIONS CAPELLON CERTUSS-D TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPELLON LIQUITUSS GG LIQUID OTC (ORAL) COUGH AND COLD, COLD CAPELLON RESCON TABLET OTC (ORAL) COUGH AND COLD, COLD CAPELLON RESCON-DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPELLON TREXBROM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC AQUANAZ OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC CAPMIST DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC CAPRON DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC CAPRON DMT OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC DOSOQUIN OTC (ORAL) VITAMIN D PREPARATIONS CARWIN ASSOCIAT ATUSS DA LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CARWIN ASSOCIAT NUFERA TABLET (ORAL) IRON, ORAL CARWIN ASSOCIAT PEDIAVENT LIQUID OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION CARWIN ASSOCIAT PEDIAVENT TAB CHEW OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION CARWIN ASSOCIAT QUFLORA (ORAL) PEDIATRIC VITAMIN PREPARATIONS CARWIN ASSOCIAT QUFLORA FE (ORAL) PEDIATRIC VITAMIN PREPARATIONS CARWIN ASSOCIAT QUFLORA OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS CARWIN ASSOCIAT RU-HIST-D LIQUID OTC (ORAL) COUGH AND COLD, COLD CARWIN ASSOCIAT RU-HIST-D TABLET OTC (ORAL) COUGH AND COLD, COLD CARWIN ASSOCIAT RYVENT TABLET (ORAL) ANTIHISTAMINES, FIRST GENERATION CELGENE ABRAXANE (INTRAVEN) ONCOLOGY, INJECTABLE CELGENE IDHIFA (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC CELGENE ISTODAX (INTRAVEN) ONCOLOGY, INJECTABLE CELGENE POMALYST (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC CELGENE REVLIMID (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC CELGENE THALOMID (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC CENTURION LABS LUSAIR LIQUID (ORAL) COUGH AND COLD, COLD CENTURION LABS NINJACOF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS NINJACOF-A LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS RYDEX G TABLET OTC (ORAL) COUGH AND COLD, COLD CENTURION LABS TRYMINE CD LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ,INC.-T BENDEKA (INTRAVEN) ONCOLOGY, INJECTABLE CEPHALON,INC.-T GRANIX (INJECTION) COLONY STIMULATING FACTORS CEPHALON,INC.-T SYNRIBO (SUB-Q) ONCOLOGY, INJECTABLE CEPHALON,INC.-T TREANDA (INTRAVEN) ONCOLOGY, INJECTABLE CEPHALON,INC.-T TRISENOX (INTRAVEN) ONCOLOGY, INJECTABLE CERECOR KARBINAL ER SUSPENSION (ORAL) ANTIHISTAMINES, FIRST GENERATION CHIESI ZYFLO (ORAL) LEUKOTRIENE MODIFIERS CHIESI ZYFLO CR (ORAL) LEUKOTRIENE MODIFIERS CLOVIS ONCOLOGY RUBRACA (ORAL) ONCOLOGY, ORAL - OTHER CONCORDIA PHARM KAPVAY (ORAL) STIMULANTS AND RELATED AGENTS CONCORDIA PHARM ORAPRED ODT (ORAL) GLUCOCORTICOIDS, ORAL CONTRACT PHARM B-PLEX (ORAL) VITAMIN B PREPARATIONS COVIS PHARMACEU ALVESCO (INHALATION) GLUCOCORTICOIDS, INHALED COVIS PHARMACEU ZANTAC PB (INJECTION) HISTAMINE II RECEPTOR BLOCKER CROWN LABORATOR DERMASORB HC (TOPICAL) STEROIDS, TOPICAL LOW CROWN LABORATOR DERMASORB TA (TOPICAL) STEROIDS, TOPICAL HIGH CROWN LABORATOR DERMASORB XM (TOPICAL) KERATOLYTICS CSL BEHRING LLC CARIMUNE NF NANOFILTERED (INTRAVEN) IMMUNE GLOBULINS CSL BEHRING LLC CYTOGAM (INTRAVEN) IMMUNE GLOBULINS CSL BEHRING LLC HIZENTRA (SUBCUT.) IMMUNE GLOBULINS CSL BEHRING LLC PRIVIGEN (INTRAVEN) IMMUNE GLOBULINS

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS CSL BEHRING LLC ZEMAIRA (INTRAVEN) ENZYME INHIBITORS, SYSTEMIC CUMBERLAND PHAR TOTECT (INTRAVEN) CHEMOTHERAPY RESCUE CUMBERLAND PHAR VAPRISOL (INTRAVEN) VASOPRESSIN RECEPTOR ANTAGONISTS CUMBERLAND PHAR VAPRISOL-5% DEXTROSE (INTRAVEN) VASOPRESSIN RECEPTOR ANTAGONISTS DENDREON CORPOR PROVENGE (INTRAVEN) ONCOLOGY, INJECTABLE DEPOMED, INC. GRALISE (ORAL) NEUROPATHIC PAIN DEPOMED, INC. ZIPSOR (ORAL) NSAIDS DOAK DERM. SOLARAZE (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL DOAK DERM. VEREGEN (TOPICAL) IMMUNOMODULATORS, TOPICAL DOPRESTIUM PHARMA ZONALON (TOPICAL) ANTIPRURITICS, TOPICAL ECR PHARM. DEXPAK (ORAL) GLUCOCORTICOIDS, ORAL ECR PHARM. LODRANE D CAPSULE OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC ED A-HIST LIQUID OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST PSE TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED BRON GP LIQUID OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED CHLORPED D DROPS OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED CHLORPED DROPS OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION EDWARDS PHARMAC ED-A-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC MUCAPHED TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYMED TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYNEX DM SOLUTION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC RYNEX PE SOLUTION OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYNEX PSE LIQUID OTC (ORAL) COUGH AND COLD, COLD EGALET US INC. SPRIX (NASAL) NSAIDS EISAI INC. BANZEL SUSPENSION (ORAL) ANTICONVULSANTS EISAI INC. BANZEL TABLET (ORAL) ANTICONVULSANTS EISAI INC. FYCOMPA SUSPENSION (ORAL) ANTICONVULSANTS EISAI INC. FYCOMPA TABLET (ORAL) ANTICONVULSANTS EISAI INC. FYCOMPA TABLET DOSE PACK (ORAL) ANTICONVULSANTS EISAI INC. HALAVEN (INTRAVEN) ONCOLOGY, INJECTABLE EISAI INC. HEXALEN (ORAL) ONCOLOGY, ORAL - OTHER EISAI INC. LENVIMA (ORAL) ONCOLOGY, ORAL - RENAL CELL EISAI INC. PANRETIN (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL ELI LILLY & CO. ALIMTA (INTRAVEN) ONCOLOGY, INJECTABLE ELI LILLY & CO. CYRAMZA (INTRAVEN) ONCOLOGY, INJECTABLE ELI LILLY & CO. ERBITUX (INTRAVEN) ONCOLOGY, INJECTABLE ELI LILLY & CO. LARTRUVO (INTRAVEN) ONCOLOGY, INJECTABLE ELI LILLY & CO. PORTRAZZA (INTRAVEN) ONCOLOGY, INJECTABLE ELI LILLY & CO. VERZENIO (ORAL) ONCOLOGY, ORAL - BREAST ELI LILLY & CO. ZYPREXA RELPREVV (INTRAMUSC) ANTIPSYCHOTICS EMD SERONO, INC BAVENCIO (INTRAVEN) ONCOLOGY, INJECTABLE ENDO PHARM INC. COLY-MYCIN S (OTIC) OTIC ANTIBIOTICS ENDO PHARM INC. VALSTAR (INTRAVESIC) ONCOLOGY, INJECTABLE ENDO PHARM INC. VOLTAREN (TOPICAL) NSAIDS EQUALINE VITAMI IBUPROFEN/PHENYLEPHRINE TABLET OTC (ORAL) COUGH AND COLD, COLD EVERETT VITAFOL TABLET (ORAL) IRON, ORAL EXELIXIS, INC. CABOMETYX (ORAL) ONCOLOGY, ORAL - RENAL CELL EXELIXIS, INC. COMETRIQ (ORAL) ONCOLOGY, ORAL - OTHER FERRING PH INC FIRMAGON (SUB-Q) ONCOLOGY, INJECTABLE FLEXION THERAPE ZILRETTA (INTRAARTICULAR) GLUCOCORTICOIDS, INJECTABLE FOREST PHARMACE VIIBRYD DOSE PACK (ORAL) ANTIDEPRESSANTS, OTHER FREEDA VITAMINS QUIN B STRONG OTC (ORAL) VITAMIN B PREPARATIONS FREEDA VITAMINS VITALETS CHEW OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS FRESENIUS KABI BORTEZOMIB (INTRAVEN) ONCOLOGY, INJECTABLE G.M. PHARM ESCAVITE (ORAL) PEDIATRIC VITAMIN PREPARATIONS G.M. PHARM ESCAVITE D CHEW TAB (ORAL) PEDIATRIC VITAMIN PREPARATIONS G.M. PHARM ESCAVITE LQ (ORAL) PEDIATRIC VITAMIN PREPARATIONS G.M. PHARM MYOXIN (OTIC) OTIC ANTI-INFECTIVES & ANESTHETICS G.M. PHARM NASOPEN LIQUID OTC (ORAL) COUGH AND COLD, COLD G.M. PHARM NASOPEN PE LIQUID OTC (ORAL) COUGH AND COLD, COLD G.M. PHARM TEXAVITE LQ DROPS (ORAL) PEDIATRIC VITAMIN PREPARATIONS G.M. PHARM VANACLEAR PD DROPS OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION G.M. PHARM VANACOF AC LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF APE LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF DX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF G LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF GPE LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF-8 LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANAMINE PD DROPS OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION G.M. PHARM VANATAB AC TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANATAB DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANATABLET DX TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC GALDERMA LABORA CAPEX SHAMPOO (TOPICAL) STEROIDS, TOPICAL LOW GALDERMA LABORA CETAPHIL RESTORADERM LOTION OTC (TOPICAL) EMOLLIENTS GALDERMA LABORA METROGEL (TOPICAL) ROSACEA AGENTS, TOPICAL GALDERMA LABORA MIRVASO (TOPICAL) ROSACEA AGENTS, TOPICAL GALDERMA LABORA SOOLANTRA (TOPICAL) ROSACEA AGENTS, TOPICAL GALEN US INCORP ADASUVE (INHALATION) ANTIPSYCHOTICS , INC. ALECENSA (ORAL) ONCOLOGY, ORAL - LUNG GENENTECH, INC. AVASTIN (INTRAVEN) ONCOLOGY, INJECTABLE GENENTECH, INC. COTELLIC (ORAL) ONCOLOGY, ORAL - SKIN

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS GENENTECH, INC. ERIVEDGE (ORAL) ONCOLOGY, ORAL - SKIN GENENTECH, INC. ESBRIET (ORAL) IDIOPATHIC PULMONARY FIBROSIS GENENTECH, INC. HERCEPTIN (INTRAVEN) ONCOLOGY, INJECTABLE GENENTECH, INC. KADCYLA (INTRAVEN) ONCOLOGY, INJECTABLE GENENTECH, INC. LUCENTIS SYRINGE (INTRAOCULAR) MACULAR DEGENERATION AGENTS GENENTECH, INC. LUCENTIS VIAL (INTRAOCULAR) MACULAR DEGENERATION AGENTS GENENTECH, INC. MIRCERA (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS GENENTECH, INC. PERJETA (INTRAVEN) ONCOLOGY, INJECTABLE GENENTECH, INC. PULMOZYME (INHALATION) MUCOLYTICS GENENTECH, INC. TARCEVA (ORAL) ONCOLOGY, ORAL - LUNG GENENTECH, INC. XELODA (ORAL) ONCOLOGY, ORAL - BREAST GENENTECH, INC. XOLAIR (SUB-Q) IMMUNOMODULATORS, ASTHMA GENENTECH, INC. ZELBORAF (ORAL) ONCOLOGY, ORAL - SKIN GENZYME ALDURAZYME (INTRAVEN) MUCOPOLYSACCHARIDOSIS GENZYME CAPRELSA (ORAL) ONCOLOGY, ORAL - OTHER GENZYME CERDELGA (ORAL) ENZYME REPLACEMENT, GAUCHERS DISEASE GENZYME CEREZYME 400 UNITS (INTRAVEN) ENZYME REPLACEMENT, GAUCHERS DISEASE GENZYME LEUKINE (INJECTION) COLONY STIMULATING FACTORS ZYDELIG (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC GLAXOSMITHKLINE ADVAIR DISKUS (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE ADVAIR HFA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE ANORO ELLIPTA (INHALATION) COPD AGENTS GLAXOSMITHKLINE ARNUITY ELLIPTA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE ARRANON (INTRAVEN) ONCOLOGY, INJECTABLE GLAXOSMITHKLINE BECONASE AQ (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE BREO ELLIPTA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE FLONASE (FUROATE) OTC (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE FLONASE (PROPIONATE) OTC (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE FLOVENT DISKUS (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE FLOVENT HFA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE INCRUSE ELLIPTA (INHALATION) COPD AGENTS GLAXOSMITHKLINE NUCALA (SUB-Q) IMMUNOMODULATORS, ASTHMA GLAXOSMITHKLINE POTIGA (ORAL) ANTICONVULSANTS GLAXOSMITHKLINE SEREVENT (INHALATION) BRONCHODILATORS, BETA AGONIST GLAXOSMITHKLINE TRELEGY ELLIPTA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE VENTOLIN HFA (INHALATION) BRONCHODILATORS, BETA AGONIST GLAXOSMITHKLINE VERAMYST (NASAL) INTRANASAL RHINITIS AGENTS GLENDALE INC GLEN PE LIQUID OTC (ORAL) COUGH AND COLD, COLD GLENDALE INC GLENMAX PEB LIQUID OTC (ORAL) COUGH AND COLD, COLD GREER LABORATOR ORALAIR (SUBLINGUAL) ANTI-ALLERGENS, ORAL GRIFOLS FLEBOGAMMA DIF (INTRAVEN) IMMUNE GLOBULINS GRIFOLS THERAPE GAMASTAN S-D VIAL (INTRAMUSC) IMMUNE GLOBULINS GRIFOLS THERAPE GAMUNEX (INTRAVEN) IMMUNE GLOBULINS GRIFOLS THERAPE GAMUNEX-C (INJECTION) IMMUNE GLOBULINS GRIFOLS THERAPE HYPERHEP B S-D SYRINGE (INTRAMUSC) IMMUNE GLOBULINS GRIFOLS THERAPE HYPERHEP B S-D VIAL (INTRAMUSC) IMMUNE GLOBULINS GRIFOLS THERAPE HYPERRAB S-D (INTRAMUSC) IMMUNE GLOBULINS GRIFOLS THERAPE HYPERRAB VIAL (INTRAMUSC) IMMUNE GLOBULINS GRIFOLS THERAPE PROLASTIN C 1 GM VIAL (INTRAVEN) ENZYME INHIBITORS, SYSTEMIC HALOZYME INC HYLENEX (INJECTION) TOPICAL, MUCOUS MEMB/SUBCUT ENZYME HAWTHORN PHARM BICLORA LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC HAWTHORN PHARM BICLORA TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC HAWTHORN PHARM BICLORA-D LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC HAWTHORN PHARM BICLORA-D TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC HAWTHORN PHARM NASOHIST DM DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC HAWTHORN PHARM NASOHIST DROPS OTC (ORAL) COUGH AND COLD, COLD HERITAGE PHARMA BICNU (INTRAVEN) ONCOLOGY, INJECTABLE HIKMA AMERICAS, MITIGARE (ORAL) ANTIHYPERURICEMICS HILL DERM DERMA-SMOOTHE-FS (TOPICAL) STEROIDS, TOPICAL LOW HILLESTAD PHARM DIALYVITE (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM DIALYVITE 3000 (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM DIALYVITE 5000 (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM DIALYVITE 800 PLUS D OTC (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM DIALYVITE SUPREME D (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM DIALYVITE VITAMIN D3 MAX OTC (ORAL) VITAMIN D PREPARATIONS HILLESTAD PHARM DIALYVITE ZINC (ORAL) VITAMIN B PREPARATIONS HILLESTAD PHARM FERRIMIN 150 TABLET OTC (ORAL) IRON, ORAL HORIZON PHARMA ACTIMMUNE (SUB-Q) IMMUNOMODULATORS, MISCELLANEOUS HORIZON PHARMA BUPHENYL POWDER (ORAL) UREA CYCLE DISORDERS, ORAL HORIZON PHARMA BUPHENYL TABLET (ORAL) UREA CYCLE DISORDERS, ORAL HORIZON PHARMA DUEXIS (ORAL) NSAIDS HORIZON PHARMA KRYSTEXXA (INTRAVEN) ANTIHYPERURICEMICS HORIZON PHARMA PENNSAID PUMP (TOPICAL) NSAIDS HORIZON PHARMA PENNSAID SOLUTION PACKET (TOPICAL) NSAIDS HORIZON PHARMA RAVICTI (ORAL) UREA CYCLE DISORDERS, ORAL HORIZON PHARMA RAYOS TABLET DR (ORAL) GLUCOCORTICOIDS, ORAL HORIZON PHARMA VIMOVO (ORAL) NSAIDS A-HYDROCORT (INJECTION) GLUCOCORTICOIDS, INJECTABLE HOSPIRA NIPENT (INTRAVEN) ONCOLOGY, INJECTABLE HOSPIRA/NOVAPLU NIPENT (INTRAVEN) ONCOLOGY, INJECTABLE HYPERION/HORIZO RAVICTI (ORAL) UREA CYCLE DISORDERS, ORAL IMPAX GENERICS EPINEPHRINE 0.15 MG (ADRENACLICK) (AG) (INJECTION) EPINEPHRINE, SELF-INJECTED IMPAX PHARMACEU EMVERM (ORAL) ANTHELMINTICS IMPAX PHARMACEU RYTARY (ORAL) ANTIPARKINSON'S AGENTS INCYTE CORPORAT JAKAFI (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS INDEPENDENCE PH PROCENTRA (ORAL) STIMULANTS AND RELATED AGENTS INNOCUTIS HOLDI HALONATE (TOPICAL) STEROIDS, TOPICAL VERY HIGH INNOCUTIS HOLDI MOMEXIN (TOPICAL) STEROIDS, TOPICAL MEDIUM INNOCUTIS HOLDI UMECTA EMULSION (TOPICAL) KERATOLYTICS INNOCUTIS HOLDI UMECTA FOAM (TOPICAL) KERATOLYTICS INNOCUTIS HOLDI UMECTA KIT (TOPICAL) KERATOLYTICS INNOCUTIS HOLDI UMECTA PD EMULSION (TOPICAL) KERATOLYTICS INNOCUTIS HOLDI UMECTA PD SUSPENSION (TOPICAL) KERATOLYTICS INNOCUTIS HOLDI UMECTA SUSPENSION (TOPICAL) KERATOLYTICS INTERCEPT PHARM OCALIVA (ORAL) BILE SALTS INTERSECT ENT SINUVA (SINUS IMPLANT) INTRANASAL RHINITIS AGENTS IPSEN BIOPHARMA ONIVYDE (INTRAVEN) ONCOLOGY, INJECTABLE IROKO PHARMACEU INDOCIN SUSPENSION (ORAL) NSAIDS IROKO PHARMACEU TIVORBEX (ORAL) NSAIDS IROKO PHARMACEU VIVLODEX (ORAL) NSAIDS IROKO PHARMACEU ZORVOLEX (ORAL) NSAIDS IRONWOOD PHARMA DUZALLO (ORAL) ANTIHYPERURICEMICS IRONWOOD PHARMA ZURAMPIC (ORAL) ANTIHYPERURICEMICS DARZALEX (INTRAVEN) ONCOLOGY, INJECTABLE JANSSEN BIOTECH ERLEADA (ORAL) ONCOLOGY, ORAL - PROSTATE JANSSEN BIOTECH SYLVANT (INTRAVEN) ONCOLOGY, INJECTABLE JANSSEN BIOTECH ZYTIGA (ORAL) ONCOLOGY, ORAL - PROSTATE JANSSEN PHARM. INVEGA SUSTENNA (INTRAMUSC) ANTIPSYCHOTICS JANSSEN PHARM. INVEGA TRINZA (INTRAMUSC) ANTIPSYCHOTICS JANSSEN PHARM. RISPERDAL CONSTA (INTRAMUSC.) ANTIPSYCHOTICS JANSSEN PHARM. ZYTIGA (ORAL) ONCOLOGY, ORAL - PROSTATE JANSSEN PRODUCT PROCRIT (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS JANSSEN PRODUCT YONDELIS (INTRAVEN) ONCOLOGY, INJECTABLE JAYMAC PHARMA DRYMAX AF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC JAYMAC PHARMA DRYMAX AF TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC JAYMAC PHARMA J-MAX SYRUP OTC (ORAL) COUGH AND COLD, COLD JAYMAC PHARMA J-TAN PD (ORAL) ANTIHISTAMINES, FIRST GENERATION JAZZ PHARMACEUT ERWINAZE (INJECTION) ONCOLOGY, INJECTABLE JAZZ PHARMACEUT FAZACLO (ORAL) ANTIPSYCHOTICS JAZZ PHARMACEUT VERSACLOZ (ORAL) ANTIPSYCHOTICS JAZZ PHARMACEUT VYXEOS (INTRAVEN.) ONCOLOGY, INJECTABLE JAZZ PHARMACEUT XYREM (ORAL) NARCOLEPSY AGENTS JHP PHARMACEUTI CORTISPORIN-TC (OTIC) OTIC ANTIBIOTICS KALEO, INC. AUVI-Q 0.15 MG (INTRAMUSC) EPINEPHRINE, SELF-INJECTED KALEO, INC. AUVI-Q 0.3 MG (INTRAMUSC) EPINEPHRINE, SELF-INJECTED KEDRION BIOPHAR GAMMAKED (INTRAVEN) IMMUNE GLOBULINS KEDRION BIOPHAR KEDRAB (INTRAMUSC) IMMUNE GLOBULINS KITE PHARMA, IN YESCARTA PLAST. BAG (INTRAVEN) ONCOLOGY, INJECTABLE KROGER/ MUCUS DM MAX TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS LOHIST-D LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS LOHIST-DM LIQUID (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS LOHIST-PEB LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS LOHIST-PSB LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS NOHIST-DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS NOHIST-LQ LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS PINNACAINE (OTIC) OTIC ANTI-INFECTIVES & ANESTHETICS LARKEN LABS SUDATEX-DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LASER PHARMACEU DALLERGY DROPS OTC (ORAL) COUGH AND COLD, COLD LASER PHARMACEU DALLERGY LIQUID OTC (ORAL) COUGH AND COLD, COLD LASER PHARMACEU DALLERGY TABLET CHEWABLE OTC (ORAL) COUGH AND COLD, COLD LASER PHARMACEU DALLERGY TABLET OTC (ORAL) COUGH AND COLD, COLD LASER PHARMACEU DONATUSSIN DM DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LASER PHARMACEU DONATUSSIN LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LASER PHARMACEU RESPAIRE-30 CAPSULE OTC (ORAL) COUGH AND COLD, COLD LASER PHARMACEU RONDEC-D (ORAL) COUGH AND COLD, NON-NARCOTIC LEADER DAY MULTI-SYMP FLU-SEVERE COLD POWDER PACK OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LEO PHARMA INC. ENSTILAR (TOPICAL) ANTIPSORIATICS, TOPICAL LEO PHARMA INC. PICATO (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL LEO PHARMA INC. PROTOPIC (TOPICAL) IMMUNOMODULATORS, ATOPIC DERMATITIS LEO PHARMA INC. TACLONEX SCALP (TOPICAL) ANTIPSORIATICS, TOPICAL LLORENS PHARM DERMAGESIC CREAM OTC (TOPICAL) ANTIPRURITICS, TOPICAL LLORENS PHARM DERMAGESIC LOTION OTC (TOPICAL) ANTIPRURITICS, TOPICAL LLORENS PHARM TUSNEL PEDIATRIC DROPS OTC (ORAL) COUGH AND COLD, COLD LLORENS PHARM TUSNEL TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LLORENS PHARM TUSNEL-DM PEDIATRIC DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LUNDBECK INC. ONFI SUSPENSION (ORAL) ANTICONVULSANTS LUNDBECK INC. ONFI TABLET (ORAL) ANTICONVULSANTS LUNDBECK INC. SABRIL POWDER PACK (ORAL) ANTICONVULSANTS LUNDBECK INC. SABRIL TABLET (ORAL) ANTICONVULSANTS LUPIN PHARMA IRENKA (ORAL) NEUROPATHIC PAIN MACOVEN PHARMAC AKEDAMINS CHEW OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS MACOVEN PHARMAC BP 8 COUGH ORAL SUSPENSION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC BROM-PSE-DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC PYRIL D ORAL SUSPENSION (ORAL) COUGH AND COLD, COLD MAGNA PHARM AHIST TABLET OTC (ORAL) ANTIHISTAMINES, FIRST GENERATION MAGNA PHARM ATUSS DA LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MAGNA PHARM NUFOLA (ORAL) VITAMIN B PREPARATIONS MAGNA PHARM STAHIST AD LIQUID OTC (ORAL) COUGH AND COLD, COLD MAGNA PHARM STAHIST AD TABLET OTC (ORAL) COUGH AND COLD, COLD MAGNA PHARM STAHIST LIQUID OTC (ORAL) COUGH AND COLD, COLD

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS MAGNA PHARM ZOLPIMIST (ORAL) SEDATIVE HYPNOTICS MAJOR PHARMACEU BREWER'S YEAST TABLET OTC (ORAL) VITAMIN B PREPARATIONS MAJOR PHARMACEU FERATE TABLET OTC (ORAL) IRON, ORAL MANCHESTER PHAR CHOLBAM (ORAL) BILE SALTS MAYNE PHARMA IN SORILUX (TOPICAL) ANTIPSORIATICS, TOPICAL MCR/AMERICAN PH BROVEX PEB LIQUID OTC (ORAL) COUGH AND COLD, COLD MEDA PHARMACEUT AEROSPAN (INHALATION) GLUCOCORTICOIDS, INHALED MEDA PHARMACEUT ASTEPRO (NASAL) INTRANASAL RHINITIS AGENTS MEDA PHARMACEUT DYMISTA (NASAL) INTRANASAL RHINITIS AGENTS MEDA PHARMACEUT EDLUAR (SUBLINGUAL) SEDATIVE HYPNOTICS MEDAC PHARMA, I RASUVO AUTO INJECTOR (SUBCUT.) METHOTREXATE MEDECOR PHARMA DECARA CAPSULE OTC (ORAL) VITAMIN D PREPARATIONS MEDICIS DERM ALDARA (TOPICAL) IMMUNOMODULATORS, TOPICAL MEDICIS DERM MAXAIR (INHALATION) BRONCHODILATORS, BETA AGONIST MEDICIS DERM ZYCLARA (TOPICAL) IMMUNOMODULATORS, TOPICAL MEDIMETRIKS PHA CLODAN KIT (TOPICAL) STEROIDS, TOPICAL VERY HIGH MEDIMETRIKS PHA KERADAN OTC (TOPICAL) EMOLLIENTS MEDIMETRIKS PHA ROSADAN KIT (TOPICAL) ROSACEA AGENTS, TOPICAL MEDIMETRIKS PHA SYNALAR CREAM KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR OINTMENT KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR TS KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA URAMAXIN GT (TOPICAL) KERATOLYTICS MEDLINE INDUS. REMEDY CLEAR-AID OTC (TOPICAL) EMOLLIENTS MERCK SHARP & D ASMANEX (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D ASMANEX HFA (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D BELSOMRA (ORAL) SEDATIVE HYPNOTICS MERCK SHARP & D CELESTONE (ORAL) GLUCOCORTICOIDS, ORAL MERCK SHARP & D CLARINEX SYRUP (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING MERCK SHARP & D CLARINEX-D 12 HOUR (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING MERCK SHARP & D CLARINEX-D 24 HOUR (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING MERCK SHARP & D DULERA (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D FORADIL (INHALATION) BRONCHODILATORS, BETA AGONIST MERCK SHARP & D KEYTRUDA (INTRAVEN) ONCOLOGY, INJECTABLE MERCK SHARP & D NASONEX (NASAL) INTRANASAL RHINITIS AGENTS MERCK SHARP & D PROVENTIL HFA (INHALATION) BRONCHODILATORS, BETA AGONIST MERCK SHARP & D SYLATRON (SUBCUTANE.) IMMUNOMODULATORS, ANTINEOPLASTIC MERCK SHARP & D TEMODAR (INTRAVEN) ONCOLOGY, INJECTABLE MERCK SHARP & D TEMODAR (ORAL) ONCOLOGY, ORAL - OTHER MERCK SHARP & D ZOLINZA (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC MERRIMACK PHARM ONIVYDE (INTRAVEN) ONCOLOGY, INJECTABLE MERZ APPEAREX OTC (ORAL) VITAMIN B PREPARATIONS MERZ AQUA GLYCOLIC HC (TOPICAL) STEROIDS, TOPICAL LOW MILLENNIUM PHAR ICLUSIG (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC MILLENNIUM PHAR NINLARO (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC MILLENNIUM PHAR VELCADE (INJECTION) ONCOLOGY, INJECTABLE MISSION PHARM. FERRALET 90 DUAL-IRON TABLET (ORAL) IRON, ORAL MISSION PHARM. TEXACORT (TOPICAL) STEROIDS, TOPICAL LOW MJ NUTRITIONAL POLY-VI-SOL DROPS OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS MJ NUTRITIONAL POLY-VI-SOL WITH IRON DROPS OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS MJ NUTRITIONAL TRI-VI-SOL DROPS OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS MORTON GROVE PH BROMFED DM SYRUP (ORAL) COUGH AND COLD, NON-NARCOTIC CLORPRES (ORAL) ANTIHYPERTENSIVES, SYMPATHOLYTICS MYLAN PHENYTEK (ORAL) ANTICONVULSANTS MYLAN INSTITUTI GRANULEX (TOPICAL) TOPICAL, MUCOUS MEMB/SUBCUT ENZYME MYLAN SPECIALTY EMSAM (TRANSDERMAL) ANTIDEPRESSANTS, OTHER MYLAN SPECIALTY EPIPEN (INTRAMUSC) EPINEPHRINE, SELF-INJECTED MYLAN SPECIALTY EPIPEN JR (INTRAMUSC) EPINEPHRINE, SELF-INJECTED MYLAN SPECIALTY PERFOROMIST (INHALATION) BRONCHODILATORS, BETA AGONIST NEOS THERAPEUTI ADZENYS ER SUSPENSION (ORAL) STIMULANTS AND RELATED AGENTS NEOS THERAPEUTI ADZENYS XR ODT (ORAL) STIMULANTS AND RELATED AGENTS NEOS THERAPEUTI COTEMPLA XR ODT (ORAL) STIMULANTS AND RELATED AGENTS NEPHRO-TECH NEPHPLEX RX (ORAL) VITAMIN B PREPARATIONS NEPHRO-TECH NEPHRON FA TABLET (ORAL) IRON, ORAL NEPHRO-TECH RENAPLEX OTC (ORAL) VITAMIN B PREPARATIONS NEPHRO-TECH RENAPLEX-D OTC (ORAL) VITAMIN B PREPARATIONS NEPHRO-TECH VITAL-D RX (ORAL) VITAMIN B PREPARATIONS NEUROCRINE BIOS INGREZZA (ORAL) MOVEMENT DISORDERS NEXTSOURCE BIOT GLEOSTINE (ORAL) ONCOLOGY, ORAL - OTHER NNODUM CORP HEMATOGEN CAPSULE (ORAL) IRON, ORAL NNODUM CORP HEMATOGEN FA CAPSULE (ORAL) IRON, ORAL NOVA LABORATORI PURIXAN (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC NOVARTIS AFINITOR (ORAL) ONCOLOGY, ORAL - RENAL CELL NOVARTIS AFINITOR DISPERZ (ORAL) ONCOLOGY, ORAL - RENAL CELL NOVARTIS ARRANON (INTRAVEN) ONCOLOGY, INJECTABLE NOVARTIS EXELON (TRANSDERM.) ALZHEIMER'S AGENTS NOVARTIS EXELON SOLUTION (ORAL) ALZHEIMER'S AGENTS NOVARTIS FARYDAK (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC NOVARTIS FOCALIN (ORAL) STIMULANTS AND RELATED AGENTS NOVARTIS FOCALIN XR (ORAL) STIMULANTS AND RELATED AGENTS NOVARTIS GLEEVEC (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC NOVARTIS HYCAMTIN (ORAL) ONCOLOGY, ORAL - LUNG NOVARTIS KISQALI (ORAL) ONCOLOGY, ORAL - BREAST NOVARTIS KISQALI/FEMARA KIT (ORAL) ONCOLOGY, ORAL - BREAST NOVARTIS KYMRIAH (INTRAVEN) ONCOLOGY, INJECTABLE NOVARTIS MEKINIST (ORAL) ONCOLOGY, ORAL - SKIN

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS NOVARTIS PROMACTA (ORAL) THROMBOPOIESIS STIMULATING PROTEINS NOVARTIS RITALIN LA (ORAL) STIMULANTS AND RELATED AGENTS NOVARTIS RYDAPT (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC NOVARTIS TAFINLAR (ORAL) ONCOLOGY, ORAL - SKIN NOVARTIS TASIGNA (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC NOVARTIS TYKERB (ORAL) ONCOLOGY, ORAL - BREAST NOVARTIS VOTRIENT (ORAL) ONCOLOGY, ORAL - RENAL CELL NOVARTIS ZYKADIA (ORAL) ONCOLOGY, ORAL - LUNG NOVARTIS CONSUM CHILD TRIAMINIC COUGH-CONGEST SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC NOVARTIS CONSUM THERAFLU MAX-D SEVERE COLD-FLU PACKET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC NOVARTIS CONSUM TRIAMINIC COLD-ALLERGY PE LIQUID OTC (ORAL) COUGH AND COLD, COLD NOVARTIS CONSUM TRIAMINIC LIQUID OTC (C) (ORAL) COUGH AND COLD, COLD NOVEN THERAPEUT DAYTRANA (TRANSDERMAL) STIMULANTS AND RELATED AGENTS NOVEN THERAPEUT STAVZOR (ORAL) ANTICONVULSANTS OAK PHARMACEUTI BETIMOL (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS OCTAPHARMA USA OCTAGAM (INTRAVEN) IMMUNE GLOBULINS ONYX PHARMACEUT KYPROLIS (INTRAVEN) ONCOLOGY, INJECTABLE OPTINOSE US, IN XHANCE (NASAL) INTRANASAL RHINITIS AGENTS ORGANON PHARM. BCG (TICE STRAIN) (INTRAVESIC) ONCOLOGY, INJECTABLE ORPHAN EUROPE S CARBAGLU (ORAL) UREA CYCLE DISORDERS, ORAL OTONOMY, INC. OTIPRIO (OTIC) OTIC ANTIBIOTICS OTSUKA AMERICA ABILIFY (INTRAMUSC) ANTIPSYCHOTICS OTSUKA AMERICA ABILIFY MAINTENA (INTRAMUSC.) ANTIPSYCHOTICS OTSUKA AMERICA BUSULFEX (INTRAVEN) ONCOLOGY, INJECTABLE OTSUKA AMERICA JYNARQUE (ORAL) VASOPRESSIN RECEPTOR ANTAGONISTS OTSUKA AMERICA REXULTI (ORAL) ANTIPSYCHOTICS OTSUKA AMERICA SAMSCA (ORAL) VASOPRESSIN RECEPTOR ANTAGONISTS PAR PHARMACEUTI NASCOBAL (NASAL) VITAMIN B PREPARATIONS PERNIX THERAPEU ALDEX GS DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PERNIX THERAPEU ALDEX GS TABLET OTC (ORAL) COUGH AND COLD, COLD PERNIX THERAPEU ALDEX-CT TABLET CHEWABLE OTC (ORAL) COUGH AND COLD, COLD PERNIX THERAPEU KHEDEZLA (ORAL) ANTIDEPRESSANTS, OTHER PERNIX THERAPEU PEDIATEX TDM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PERNIX THERAPEU Z-COF 12DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC DEPO-PROVERA 400 MG/ML (INJECTION) PROGESTATIONAL AGENTS PFIZER EUCRISA (TOPICAL) IMMUNOMODULATORS, ATOPIC DERMATITIS PFIZER US PHARM BOSULIF (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC PFIZER US PHARM CELONTIN (ORAL) ANTICONVULSANTS PFIZER US PHARM DILANTIN 30 MG CAPSULE (ORAL) ANTICONVULSANTS PFIZER US PHARM ELELYSO (INTRAVEN) ENZYME REPLACEMENT, GAUCHERS DISEASE PFIZER US PHARM FLECTOR (TOPICAL) NSAIDS PFIZER US PHARM GEODON (INTRAMUSC) ANTIPSYCHOTICS PFIZER US PHARM IBRANCE (ORAL) ONCOLOGY, ORAL - BREAST PFIZER US PHARM INLYTA (ORAL) ONCOLOGY, ORAL - RENAL CELL PFIZER US PHARM LYRICA CAPSULE (ORAL) NEUROPATHIC PAIN PFIZER US PHARM LYRICA CR (ORAL) NEUROPATHIC PAIN PFIZER US PHARM LYRICA SOLUTION (ORAL) NEUROPATHIC PAIN PFIZER US PHARM QUILLICHEW ER (ORAL) STIMULANTS AND RELATED AGENTS PFIZER US PHARM QUILLIVANT XR (ORAL) STIMULANTS AND RELATED AGENTS PFIZER US PHARM RETACRIT (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS PFIZER US PHARM SOLU-CORTEF (INJECTION) GLUCOCORTICOIDS, INJECTABLE PFIZER US PHARM SOLU-MEDROL (INJECTION) GLUCOCORTICOIDS, INJECTABLE PFIZER US PHARM SUTENT (ORAL) ONCOLOGY, ORAL - RENAL CELL PFIZER US PHARM XALKORI (ORAL) ONCOLOGY, ORAL - LUNG PHARMACEUTICAL CYPROHEPTADINE SYRUP (ORAL) ANTIHISTAMINES, FIRST GENERATION PHARMACIA/UPJHN EMCYT (ORAL) ONCOLOGY, ORAL - PROSTATE PHARMACYCLICS, IMBRUVICA CAPSULE (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC PHARMACYCLICS, IMBRUVICA TABLET (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC PHARMADERM/SAND PANDEL (TOPICAL) STEROIDS, TOPICAL MEDIUM PHAR-PREP/PFIZE SOLU-MEDROL (INJECTION) GLUCOCORTICOIDS, INJECTABLE PIERRE FABRE PH TOLAK (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL PLUS PHARMA,INC CHILDREN'S CHEW MULTIVIT-IRON OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS POLY PHARM. ALAHIST CF TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. ALA-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. ALA-HIST IR TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. ALA-HIST PE TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. DECONEX CAPSULE OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. DECONEX DM CAPSULE OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. DECONEX DMX TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. DECONEX IR TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. DURAFLU TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY HIST FORTE TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. POLY-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-HIST PD DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLYTUSSIN DM OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-VENT DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-VENT IR TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. POLY-VENT PLUS TABLET OTC (ORAL) COUGH AND COLD, COLD PRASCO LABS MYLERAN (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC PRASCO LABS TABLOID (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC PRESTIUM PHARMA PRUDOXIN (TOPICAL) ANTIPRURITICS, TOPICAL PRESTIUM PHARMA ZONALON (TOPICAL) ANTIPRURITICS, TOPICAL PROMETHEUS PROLEUKIN (INTRAVEN) IMMUNOMODULATORS, MISCELLANEOUS PROMIUS PHARMA CLODERM (TOPICAL) STEROIDS, TOPICAL MEDIUM PROMIUS PHARMA PROMISEB COMPLETE (TOPICAL) EMOLLIENTS

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS PROMIUS PHARMA SERNIVO SPRAY (TOPICAL) STEROIDS, TOPICAL HIGH PRO-PHARMA LLC FOLINIC-PLUS OTC (ORAL) VITAMIN B PREPARATIONS PRO-PHARMA LLC PRO-CHLO LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PROSTRAKAN INC. FARESTON (ORAL) ONCOLOGY, ORAL - BREAST PTC THERAPEUTICS EMFLAZA SUSPENSION (ORAL) GLUCOCORTICOIDS, ORAL PTC THERAPEUTICS EMFLAZA TABLET (ORAL) GLUCOCORTICOIDS, ORAL PUMA BIOTECHNOL NERLYNX (ORAL) ONCOLOGY, ORAL - BREAST L INTERMEZZO (SUBLINGUAL) SEDATIVE HYPNOTICS PURETEK CORPORA DERMACINRX CINLONE-I CPI (MISCELL.) GLUCOCORTICOIDS, INJECTABLE PURETEK CORPORA DERMACINRX PHN PAK (TOPICAL) NEUROPATHIC PAIN PURETEK CORPORA ELLZIA PAK (TOPICAL) STEROIDS, TOPICAL HIGH QUALITEST RHEUMATREX TABLET DOSE PACK (ORAL) METHOTREXATE R.A.MC NEIL CO. CHLO HIST SOLUTION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. CHLO TUSS EX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. CHLO TUSS LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. M-END DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. M-END DMX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RANBAXY/SUN PHA ULTRAVATE LOTION (TOPICAL) STEROIDS, TOPICAL VERY HIGH RECKITT BENCKIS CHILD DELSYM COUGH+COLD LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS CHILD DELSYM NIGHTTIME C-C LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS CHILD MUCINEX M-S COLD DAY-NTE LIQUID SEQUELES OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS CHILDREN'S MUCINEX LIQUID OTC (C) (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS CHILDREN'S MUCINEX LIQUID OTC (NN) (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM COUGH & COLD LIQUID OTC (C) (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS DELSYM COUGH & COLD LIQUID OTC (NN) (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM COUGH RELIEF PLUS LOZENGE OTC (MUCOUS MEMBRANE) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM NIGHTTIME COUGH-COLD LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS DELSYM NIGHTTIME MULTI-SYMPTOM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM SUSPENSION ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX COLD & SINUS LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX COLD-FLU & SORE THROAT LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX COUGH GRAN PACK OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX D TABLET ER 12H OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX DM TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX DM TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX ER TABLET OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX COLD-FLU TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX COLD-FLU-THROAT CAPSULE OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX COLD-SINUS CAPSULE OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX COLD-SINUS TABLET OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX CONGEST-COLD TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX CONGEST-COUGH TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DAY-NITE COLD LIQUID SEQ OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DAY-NITE COLD POWDER PACK OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DAY-NITE COLD TABLET SEQUELS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DAY-NITE CONG LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DAY-NITE CONG TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DM MAX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX NITE COLD-FLU CAPSULE OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX NITE COLD-FLU LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX SEVERE COLD LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX GRAN PACK OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SEVERE CONGEST-COUGH LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX SINUS-MAX SPRAY OTC (NASAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX CONGESTION RELIEF CAPSULE OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX SINUS-MAX DAY-NIGHT LIQUID SEQ OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX DAY-NIGHT TABLET SEQUELS OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX TABLET OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SPRAY OTC (NASAL) COUGH AND COLD, COLD RECORDATI RARE COSMEGEN (INTRAVEN) ONCOLOGY, INJECTABLE RECORDATI RARE MUSTARGEN (INJECTION) ONCOLOGY, INJECTABLE RECORDATI RARE PEGANONE (ORAL) ANTICONVULSANTS REGENERON PHARM EYLEA (INTRAOCULAR) MACULAR DEGENERATION AGENTS RETROPHIN, INC. CHENODAL (ORAL) BILE SALTS RHODES PHARMACE APTENSIO XR (ORAL) STIMULANTS AND RELATED AGENTS RIGEL PHARMACEU TAVALISSE (ORAL) THROMBOPOIESIS STIMULATING PROTEINS ROCKWELL MEDICA TRIFERIC (HEMODIALYSIS) IRON, PARENTERAL ROCKWELL MEDICA TRIFERIC (INJECTION) IRON, PARENTERAL ROXANE LABS. ALPRAZOLAM INTENSOL (ORAL) ANXIOLYTICS ROXANE LABS. DEXAMETHASONE INTENSOL (ORAL) GLUCOCORTICOIDS, ORAL ROYAL PHARMACEU DERMOTIC (OTIC) OTICS, ANTI-INFLAMMATORY R-PHARM US IXEMPRA (INTRAVEN) ONCOLOGY, INJECTABLE SALLUS LABORATO LORTUSS LQ LIQUID OTC (ORAL) COUGH AND COLD, COLD SALLUS LABORATO PAIN RELIEF COLLECTION KIT (MISCELL.) NSAIDS SANCILIO & COMP MVC-FLUORIDE CHEW (ORAL) PEDIATRIC VITAMIN PREPARATIONS SANDOZ APEXICON E (TOPICAL) STEROIDS, TOPICAL VERY HIGH SANDOZ ARISTOSPAN (INJECTION) GLUCOCORTICOIDS, INJECTABLE SANDOZ ZARXIO (INJECTION) COLONY STIMULATING FACTORS SANOFI-AVENTIS DUPIXENT (SUBCUTANE.) IMMUNOMODULATORS, ATOPIC DERMATITIS SANOFI-AVENTIS FERRLECIT (INJECTION) IRON, PARENTERAL SANOFI-AVENTIS JEVTANA (INTRAVEN) ONCOLOGY, INJECTABLE SANOFI-AVENTIS ZALTRAP (INTRAVEN) ONCOLOGY, INJECTABLE SANOFI-PASTEUR IMOGAM RABIES-HT (INTRAMUSC) IMMUNE GLOBULINS SANOFI-PASTEUR THERACYS (INTRAVESIC) ONCOLOGY, INJECTABLE

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS SCHWARZ PHARMAC VIMPAT TABLET (ORAL) ANTICONVULSANTS SEATTLE GENETIC ADCETRIS (INTRAVEN) ONCOLOGY, INJECTABLE SEBELA PHARMACE BRISDELLE (ORAL) ANTIDEPRESSANTS, SSRIs SEBELA PHARMACE MICORT-HC (TOPICAL) STEROIDS, TOPICAL LOW SEBELA PHARMACE PEXEVA (ORAL) ANTIDEPRESSANTS, SSRIs SETON PHARMACEU MULTI-VITAMIN W-FLUORIDE (ORAL) PEDIATRIC VITAMIN PREPARATIONS SHIONOGI PHARMA KAPVAY DOSE PACK (ORAL) STIMULANTS AND RELATED AGENTS SHIRE US INC. ADDERALL XR (ORAL) STIMULANTS AND RELATED AGENTS SHIRE US INC. ARALAST NP (INTRAVEN) ENZYME INHIBITORS, SYSTEMIC SHIRE US INC. CARBATROL (ORAL) ANTICONVULSANTS SHIRE US INC. CUVITRU (SUBCUT.) IMMUNE GLOBULINS SHIRE US INC. ELAPRASE (INTRAVEN) MUCOPOLYSACCHARIDOSIS SHIRE US INC. GAMMAGARD LIQUID (INJECTION) IMMUNE GLOBULINS SHIRE US INC. GAMMAGARD S-D (INTRAVEN) IMMUNE GLOBULINS SHIRE US INC. GLASSIA 1 GM/50 ML VIAL (INTRAVEN) ENZYME INHIBITORS, SYSTEMIC SHIRE US INC. HYQVIA (SUBCUT.) IMMUNE GLOBULINS SHIRE US INC. MYDAYIS ER (ORAL) STIMULANTS AND RELATED AGENTS SHIRE US INC. ONCASPAR (INJECTION) ONCOLOGY, INJECTABLE SHIRE US INC. VPRIV 400 UNITS (INTRAVEN) ENZYME REPLACEMENT, GAUCHERS DISEASE SHIRE US INC. VYVANSE CAPSULE (ORAL) STIMULANTS AND RELATED AGENTS SHIRE US INC. VYVANSE CHEWABLE TABLET (ORAL) STIMULANTS AND RELATED AGENTS SHIRE US INC. XIIDRA (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORY/IMMUNOMODULATOR SIGMA-TAU DEPOCYT (INTRATHEC) ONCOLOGY, INJECTABLE SIGMA-TAU MATULANE (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC SIGMA-TAU/LEADI MATULANE (ORAL) ONCOLOGY, ORAL - HEMATOLOGIC SILVERGATE PHAR XATMEP SOLUTION (ORAL) METHOTREXATE SIRCLE LABORATO VOPAC MDS (TOPICAL) NSAIDS SMITH&N/UNITED SANTYL (TOPICAL) TOPICAL, MUCOUS MEMB/SUBCUT ENZYME SOMAXON PHARMAC SILENOR (ORAL) SEDATIVE HYPNOTICS SPECTRUM PHARMA BELEODAQ (INTRAVEN) ONCOLOGY, INJECTABLE SPECTRUM PHARMA FUSILEV (INTRAVEN) CHEMOTHERAPY RESCUE SPECTRUM PHARMA ZEVALIN (INTRAVEN) ONCOLOGY, INJECTABLE STIEFEL LABS. SORIATANE (ORAL) ANTIPSORIATICS, ORAL SUN PHARMA GLOB ODOMZO (ORAL) ONCOLOGY, ORAL - SKIN SUN PHARMA GLOB YONSA (ORAL) ONCOLOGY, ORAL - PROSTATE SUN PHARMACEUTICALS BROMSITE (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES SUN PHARMACEUTICALS DESVENLAFAXINE ER (NO BRAND) (ORAL) ANTIDEPRESSANTS, OTHER SUN PHARMACEUTICALS DOCEFREZ (INTRAVEN) ONCOLOGY, INJECTABLE SUN PHARMACEUTICALS HALOG CREAM (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS HALOG OINTMENT (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS KENALOG AEROSOL (TOPICAL) STEROIDS, TOPICAL HIGH SUN PHARMACEUTICALS ULTRAVATE LOTION (TOPICAL) STEROIDS, TOPICAL VERY HIGH SUN PHARMACEUTICALS ULTRAVATE X PAC CREAM (TOPICAL) STEROIDS, TOPICAL VERY HIGH SUN PHARMACEUTICALS ULTRAVATE X PAC OINTMENT (TOPICAL) STEROIDS, TOPICAL VERY HIGH SUNOVION ARCAPTA NEOHALER (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION SEEBRI NEOHALER (INHALATION) COPD AGENTS SUNOVION UTIBRON NEOHALER (INHALATION) COPD AGENTS SUNOVION PHARMA ALVESCO (INHALATION) GLUCOCORTICOIDS, INHALED SUNOVION PHARMA APTIOM (ORAL) ANTICONVULSANTS SUNOVION PHARMA ARCAPTA NEOHALER (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA BROVANA (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA LATUDA (ORAL) ANTIPSYCHOTICS SUNOVION PHARMA LONHALA MAGNAIR (INHALATION) COPD AGENTS SUNOVION PHARMA OMNARIS (NASAL) INTRANASAL RHINITIS AGENTS SUNOVION PHARMA SEEBRI NEOHALER (INHALATION) COPD AGENTS SUNOVION PHARMA UTIBRON NEOHALER (INHALATION) COPD AGENTS SUNOVION PHARMA XOPENEX HFA (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA ZETONNA (NASAL) INTRANASAL RHINITIS AGENTS SUPERNUS PHARMA OXTELLAR XR (ORAL) ANTICONVULSANTS SUPERNUS PHARMA TROKENDI XR (ORAL) ANTICONVULSANTS TAIHO ONCOLOGY LONSURF (ORAL) ONCOLOGY, ORAL - OTHER TAKEDA PHARMACE ALUNBRIG (ORAL) ONCOLOGY, ORAL - LUNG TAKEDA PHARMACE COLCRYS (ORAL) ANTIHYPERURICEMICS TAKEDA PHARMACE ROZEREM (ORAL) SEDATIVE HYPNOTICS TAKEDA PHARMACE TRINTELLIX (ORAL) ANTIDEPRESSANTS, OTHER TAKEDA PHARMACE ULORIC (ORAL) ANTIHYPERURICEMICS TALON THERAPEUT MARQIBO (INTRAVEN) ONCOLOGY, INJECTABLE TARO PHARM USA FLO-PRED (ORAL) GLUCOCORTICOIDS, ORAL TARO PHARM USA TOPICORT SPRAY (TOPICAL) STEROIDS, TOPICAL HIGH TESARO, INC. ZEJULA (ORAL) ONCOLOGY, ORAL - OTHER TEVA PARENTERAL CALCIUM FOLINATE (INJECTION) CHEMOTHERAPY RESCUE TEVA PARENTERAL IFOSFAMIDE-MESNA (INTRAVEN) ONCOLOGY, INJECTABLE TEVA PARENTERAL ZANOSAR (INTRAVEN) ONCOLOGY, INJECTABLE TEVA PHARMACEUTICALS AZILECT (ORAL) ANTIPARKINSON'S AGENTS TEVA PHARMACEUTICALS NUVIGIL (ORAL) STIMULANTS AND RELATED AGENTS TEVA PHARMACEUTICALS PROAIR HFA (INHALATION) BRONCHODILATORS, BETA AGONIST TEVA PHARMACEUTICALS PROAIR RESPICLICK (INHALATION) BRONCHODILATORS, BETA AGONIST TEVA PHARMACEUTICALS QNASL 40 (NASAL) INTRANASAL RHINITIS AGENTS TEVA PHARMACEUTICALS QNASL 80 (NASAL) INTRANASAL RHINITIS AGENTS TEVA PHARMACEUTICALS QVAR (INHALATION) GLUCOCORTICOIDS, INHALED TEVA PHARMACEUTICALS TREXALL TABLET (ORAL) METHOTREXATE TEVA SPECIALTY AIRDUO RESPICLICK (INHALATION) GLUCOCORTICOIDS, INHALED TEVA SPECIALTY ARMONAIR RESPICLICK (INHALATION) GLUCOCORTICOIDS, INHALED TEVA SPECIALTY CINQAIR (INTRAVEN) IMMUNOMODULATORS, ASTHMA TEVA SPECIALTY QVAR REDIHALER (INHALATION) GLUCOCORTICOIDS, INHALED

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS TEVA USA AUSTEDO (ORAL) MOVEMENT DISORDERS THERATECHNOLOGI TROGARZO (INTRAVEN) HIV / AIDS TRIGEN LABORATO CORVITA 150 TABLET (ORAL) IRON, ORAL TRIGEN LABORATO FERRAPLUS 90 TABLET (ORAL) IRON, ORAL TRIGEN LABORATO FOLIVANE-F CAPSULE (ORAL) IRON, ORAL TRIGEN LABORATO MESEHIST DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC TRIGEN LABORATO TARON FORTE CAPSULE (ORAL) IRON, ORAL TRIGEN LABORATO TL-FLUORIVITE CHEW (ORAL) PEDIATRIC VITAMIN PREPARATIONS TRIGEN LABORATO TL-HEM 150 TABLET ER 24H (ORAL) IRON, ORAL TRIS PHARMA INC DYANAVEL XR (ORAL) STIMULANTS AND RELATED AGENTS TRIS PHARMA INC MYKIDZ IRON OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS TRUPHARMA, LLC. VERSACLOZ (ORAL) ANTIPSYCHOTICS TYCHASIS CORPOR COATS ALOE CREAM OTC (TOPICAL) EMOLLIENTS TYCHASIS CORPOR COATS ALOE JELLY OTC (TOPICAL) EMOLLIENTS TYCHASIS CORPOR COATS ALOE LIQUID OTC (TOPICAL) EMOLLIENTS TYCHASIS CORPOR COATS ALOE MOISTURIZING LOTION OTC (TOPICAL) EMOLLIENTS UCB PHARMA BRIVIACT SOLUTION (ORAL) ANTICONVULSANTS UCB PHARMA BRIVIACT TABLET (ORAL) ANTICONVULSANTS UCB PHARMA NEUPRO (TRANSDERM) ANTIPARKINSON'S AGENTS UCB PHARMA VIMPAT SOLUTION (ORAL) ANTICONVULSANTS UCB PHARMA VIMPAT TABLET DOSE PACK (ORAL) ANTICONVULSANTS PHAR CRYSVITA (SUBCUTANEOUS) HYPOPHOSPHATEMIA TREATMENTS ULTRAGENYX PHAR MEPSEVII (INTRAVEN) MUCOPOLYSACCHARIDOSIS UNITED THERAP UNITUXIN (INTRAVEN) ONCOLOGY, INJECTABLE UPSHER SMITH AMLACTIN ULTRA OTC (TOPICAL) EMOLLIENTS UPSHER SMITH FOLGARD OTC (ORAL) VITAMIN B PREPARATIONS UPSHER SMITH QUDEXY XR (ORAL) ANTICONVULSANTS US PHARMACEUTIC FUSION PLUS CAPSULE (ORAL) IRON, ORAL US PHARMACEUTIC FUSION SPRINKLES POWDER PACK (ORAL) IRON, ORAL US PHARMACEUTIC HEMOCYTE PLUS CAPSULE (ORAL) IRON, ORAL US PHARMACEUTIC HEMOCYTE-F TABLET (ORAL) IRON, ORAL US PHARMACEUTIC INTEGRA F CAPSULE (ORAL) IRON, ORAL US PHARMACEUTIC INTEGRA PLUS CAPSULE (ORAL) IRON, ORAL US PHARMACEUTIC NOREL AD TABLET OTC (ORAL) COUGH AND COLD, COLD US PHARMACEUTIC NOREL CS LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC US PHARMACEUTIC TANDEM PLUS CAPSULE (ORAL) IRON, ORAL US WORLDMEDS XADAGO (ORAL) ANTIPARKINSON'S AGENTS VALEANT 8-MOP (ORAL) ANTIPSORIATICS, ORAL VALEANT APLENZIN (ORAL) ANTIDEPRESSANTS, OTHER VALEANT CARAC (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL VALEANT CERAVE MOISTURIZING LOTION OTC (TOPICAL) EMOLLIENTS VALEANT CERAVE PM OTC (TOPICAL) EMOLLIENTS VALEANT DIASTAT (RECTAL) ANTICONVULSANTS VALEANT DIASTAT ACUDIAL (RECTAL) ANTICONVULSANTS VALEANT ELIDEL (TOPICAL) IMMUNOMODULATORS, ATOPIC DERMATITIS VALEANT HYDRISALIC OTC (TOPICAL) KERATOLYTICS VALEANT MACUGEN (INTRAOCULAR) MACULAR DEGENERATION AGENTS VALEANT NORITATE (TOPICAL) ROSACEA AGENTS, TOPICAL VALEANT TARGRETIN (TOPICAL) ANTINEOPLASTIC AGENTS, TOPICAL VALEANT VITRASE (INJECTION) TOPICAL, MUCOUS MEMB/SUBCUT ENZYME VALEANT VYZULTA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS VALEANT ZELAPAR (ORAL) ANTIPARKINSON'S AGENTS VALEANT ZIRGAN (OPHTHALMIC) OPHTHALMICS, ANTIVIRAL VALIDUS PHARMAC EQUETRO (ORAL) ANTICONVULSANTS VALIDUS PHARMAC MARPLAN (ORAL) ANTIDEPRESSANTS, OTHER VANDA PHARMACEU HETLIOZ (ORAL) SEDATIVE HYPNOTICS VANDA PHARMACEUTICALS FANAPT TABLET (ORAL) ANTIPSYCHOTICS VANDA PHARMACEUTICALS FANAPT TITRATION PACK (ORAL) ANTIPSYCHOTICS VERTICAL PHARM CORVITE 150 TABLET (ORAL) IRON, ORAL VERTICAL PHARM CORVITE FE TABLET (ORAL) IRON, ORAL VERTICAL PHARM OSMOLEX ER (ORAL) ANTIPARKINSON'S AGENTS VERTICAL PHARM ZONATUSS CAPSULE (ORAL) COUGH AND COLD, NON-NARCOTIC VIFOR (INTERNAT RETACRIT (INJECTION) ERYTHROPOIESIS STIMULATING PROTEINS VIRTUS PHARMACE L-METHYL-MC (ORAL) VITAMIN B PREPARATIONS VIRTUS PHARMACE VIRT-VITE PLUS (ORAL) VITAMIN B PREPARATIONS WATSON PHARMA CONDYLOX GEL (TOPICAL) KERATOLYTICS WATSON PHARMA INFED (INJECTION) IRON, PARENTERAL WC PROF PRODS MOISTUREL OTC (TOPICAL) EMOLLIENTS WG CRITICAL CAR TENIPOSIDE (INTRAVEN) ONCOLOGY, INJECTABLE WOMEN'S CHOICE IROSPAN TABLET (ORAL) IRON, ORAL PHARM NEUMEGA (SUB-Q) THROMBOPOIESIS STIMULATING PROTEINS WYETH PHARM PHOSPHOLINE IODIDE (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS WYETH PHARM PRISTIQ (ORAL) ANTIDEPRESSANTS, OTHER WYETH PHARM TORISEL (INTRAVEN) ONCOLOGY, INJECTABLE WYETH/PFIZER BESPONSA (INTRAVEN) ONCOLOGY, INJECTABLE XENOPORT HORIZANT (ORAL) NEUROPATHIC PAIN XSPIRE PHARMA NALFON (ORAL) NSAIDS XSPIRE PHARMA TAPERDEX (ORAL) GLUCOCORTICOIDS, ORAL XSPIRE PHARMA ZODEX (ORAL) GLUCOCORTICOIDS, ORAL ZYLERA MILLIPRED DP TAB DS PK (ORAL) GLUCOCORTICOIDS, ORAL ZYLERA MILLIPRED SOLUTION (ORAL) GLUCOCORTICOIDS, ORAL ZYLERA MILLIPRED TABLET (ORAL) GLUCOCORTICOIDS, ORAL ZYLERA POLY-VI-FLOR CHEW (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA POLY-VI-FLOR DROPS (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA POLY-VI-FLOR FS FILM (ORAL) PEDIATRIC VITAMIN PREPARATIONS

November Meeting Magellan Rx Management Georgia Medicaid Meeting November 6, 2018

MANUFACTURER BRAND NAME THERAPEUTIC CLASS ZYLERA POLY-VI-FLOR FS FILM OTC (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA POLY-VI-FLOR WITH IRON CHEW (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA POLY-VI-FLOR WITH IRON DROPS (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA TRI-VI-FLORO DROPS (ORAL) PEDIATRIC VITAMIN PREPARATIONS ZYLERA VERIPRED 20 (ORAL) GLUCOCORTICOIDS, ORAL

November Meeting Magellan Rx Management