2021 California Access Large Group 3-Tier PPO Prescription Drug List

Pharmacy | PDL | California

Please note: This Prescription Drug List (PDL) is accurate as of September 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 All previous versions of this PDL are no longer in effect.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 - Access. 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 • Navigate Plus • Choice • Choice Plus • Select • Select Plus • Core • Core Essential • Options PPO • Non-Differential PPO

Updated 7/13/2021

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 ...... 12

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. 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 italicized lowercase letters. Medically Necessary means health care benefits needed to diagnose, treat, or prevent a medical condition or its symptoms and that meet accepted standards of medicine. Health insurance usually does not cover health care benefits that are not medically necessary. 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.

3 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); 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); 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.

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 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 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) 3 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 May be part of health care reform preventive Drug Tier 2 Your mid-range cost medications H-N May be part of health care reform preventive when used for appropriate Drug Tier 3 Your highest cost medications preventive purposes PA Prior authorization required SP Specialty medication SL Supply Limit CM Orally administered anti-cancer medication ST Step Therapy

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 or 3, 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 or Tier 2 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 out-of- $ Your lowest cost overall value. Mostly generic drugs. Some pocket costs. brand-name drugs may also be included.

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

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

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 Traditional, Access, and Enhanced 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.

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 Insurance: California Department of Insurance Consumer Communications Bureau 300 South Spring Street, South Tower Los Angeles, CA 90013 1-800-927-HELP (1-800-927-4357) 1-800-482-4833 (TTY) Internet Website: www.insurance.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

9 English IMPORTANT: You can get an interpreter at no cost to talk to your doctor or health insurance company. To get an interpreter or to ask about written information in your language, first call your insurance company’s phone number at 1-800-842-2656. Someone who speaks your language can help you. If you need more help, call the Department of Insurance Hotline at 1-800-927-4357.

Español IMPORTANTE: Puede obtener la ayuda de un intérprete sin costo alguno para hablar con su médico o con su compañía de seguros. Para obtener la ayuda de un intérprete o preguntar sobre información escrita en español, primero llame al número de teléfono de su compañía de seguros al 1-800-842-2656. Alguien que habla español puede ayudarle. Si necesita ayuda adicional, llame a la línea directa del Departamento de seguros al 1-800-927-4357. (Spanish)

中文

重要事項﹕您與您的醫生或醫療保險公司交談時，可獲得免費口譯服務。如欲請翻譯員提供口譯，或欲查詢中文書面資料，請先致電您的保險公司，電話號碼1-800-842-2656

說中文人士將為您提供協助。如需更多協助，請致電保險部熱線 1-800-927-4357 (Chinese)

10 11 Table of Contents of Prescription Drug List Informational Section...... 1 ANTIHISTAMINE DRUGS - Drugs for Allergy...... 12 ANTI-INFECTIVE AGENTS - Drugs for Infections...... 14 ANTINEOPLASTIC AGENTS - Drugs for Cancer ...... 33 ANTITOXINS,IMMUNE GLOB,TOXOIDS,VACCINES - DRUGS FOR THE IMMUNE SYSTEM...... 42 AUTONOMIC DRUGS - Drugs for the Nervous System ...... 45 BLOOD FORMATION, COAGULATION, THROMBOSIS - Drugs for the Blood ...... 55 CARDIOVASCULAR DRUGS - Drugs for the Heart...... 64 CENTRAL NERVOUS SYSTEM AGENTS - Drugs for the Nervous System ...... 85 DENTAL AGENTS - Oral Care ...... 123 DEVICES - Medical Supplies and Durable Medical Equipment...... 123 DIAGNOSTIC AGENTS...... 126 DISINFECTANTS (FOR NON-DERMATOLOGIC USE) - Disinfectants ...... 127 ELECTROLYTIC, CALORIC, AND WATER BALANCE ...... 127 ENZYMES...... 134 EYE, EAR, NOSE AND THROAT (EENT) PREPS...... 135 GASTROINTESTINAL DRUGS ...... 145 GASTROINTESTINAL DRUGS - Drugs for the Stomach ...... 145 GOLD COMPOUNDS...... 153 HEAVY METAL ANTAGONISTS - Drugs to Reduce Iron ...... 153 HORMONES AND SYNTHETIC SUBSTITUTES - Hormones ...... 153 LOCAL ANESTHETICS (PARENTERAL) - Drugs for Numbing ...... 189 MISCELLANEOUS THERAPEUTIC AGENTS ...... 189 NONHORMONAL CONTRACEPTIVES - Drugs for Women ...... 208 OXYTOCICS - Drugs for Women...... 208 PHARMACEUTICAL AIDS...... 208 RESPIRATORY TRACT AGENTS - Drugs for the Lungs ...... 209 SKIN AND MUCOUS MEMBRANE AGENTS - Drugs for the Skin ...... 216 SMOOTH MUSCLE RELAXANTS - Drugs to Relax Muscles ...... 239 VITAMINS...... 240

TOC-1 Coverage Requirements & Prescription Drug Name Drug Tier Limits ANTIHISTAMINE DRUGS - Drugs for Allergy ANTIHISTAMINE DRUGS - Drugs for Allergy promethazine hcl oral tablet 25 mg 1 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) DICOPANOL RAPIDPAQ 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 3 diphenhydramine hcl oral elixir 12.5 mg/5ml 1 FIRST-MOUTHWASH BLM MOUTH/THROAT SUSPENSION 3 PA (dph-lido-alhydr-mghydr-simeth) KARBINAL ER ORAL SUSPENSION EXTENDED RELEASE 4 3 MG/5ML (carbinoxamine maleate) 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 ANTIVERT ORAL TABLET 50 MG ( meclizine hcl) 2 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) DICOPANOL RAPIDPAQ 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 3 diphenhydramine hcl oral elixir 12.5 mg/5ml 1 hydroxyzine hcl oral syrup 10 mg/5ml 1

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 52 Coverage Requirements & Prescription Drug Name Drug Tier Limits labetalol hcl oral tablet 100 mg, 200 mg, 300 mg 1 silodosin oral capsule 4 mg, 8 mg 1 tamsulosin hcl oral capsule 0.4 mg 1 SELECTIVE BETA-2-ADRENERGIC AGONISTS - Drugs for Heart and Lungs ADVAIR DISKUS INHALATION AEROSOL POWDER BREATH ACTIVATED 100-50 MCG/DOSE, 250-50 MCG/DOSE, 500-50 1 SL (2 blisters per day) MCG/DOSE (fluticasone-salmeterol) ADVAIR HFA INHALATION AEROSOL 115-21 MCG/ACT, 230- 2 SL (0.4 grams per day.) 21 MCG/ACT, 45-21 MCG/ACT (fluticasone-salmeterol) albuterol sulfate hfa inhalation aerosol solution 108 (90 base) 1 mcg/act albuterol sulfate inhalation nebulization solution (2.5 mg/3ml) 1 0.083%, 0.63 mg/3ml, 1.25 mg/3ml, 2.5 mg/0.5ml 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 1 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 2 SL (2 inhalers per day.) ACTIVATED 100-25 MCG/INH (fluticasone furoate-vilanterol) BREO ELLIPTA INHALATION AEROSOL POWDER BREATH 2 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 2 SL (0.28 grams per day.) 20-100 MCG/ACT (ipratropium-albuterol) DULERA INHALATION AEROSOL 100-5 MCG/ACT, 200-5 3 ST; SL (0.44 grams per day.) MCG/ACT (mometasone furo-formoterol fum) DULERA INHALATION AEROSOL 50-5 MCG/ACT 3 ST; SL (0.44 mcg per day.) (mometasone furo-formoterol fum) FLUTICASONE-SALMETEROL INHALATION AEROSOL POWDER BREATH ACTIVATED 113-14 MCG/ACT, 232-14 1 SL (0.04 mcg per day.) MCG/ACT, 55-14 MCG/ACT Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 53 Coverage Requirements & Prescription Drug Name Drug Tier Limits ipratropium-albuterol inhalation solution 0.5-2.5 (3) mg/3ml 1 levalbuterol hcl inhalation nebulization solution 0.31 mg/3ml, 1 0.63 mg/3ml, 1.25 mg/0.5ml, 1.25 mg/3ml LEVALBUTEROL HFA INHALATION AEROSOL 45 MCG/ACT 3 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- 2 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 (fluticasone- 3 SL (2 blisters per day) umeclidin-vilant) TRELEGY ELLIPTA INHALATION AEROSOL POWDER BREATH ACTIVATED 200-62.5-25 MCG/INH (fluticasone- 3 SL (2 blisters per day.) umeclidin-vilant) XOPENEX HFA INHALATION AEROSOL 45 MCG/ACT 3 (levalbuterol tartrate) SELECTIVE BETA-ADRENERGIC BLOCKING AGENT - Drugs for the Heart acebutolol hcl oral capsule 200 mg, 400 mg 1 atenolol oral tablet 100 mg, 25 mg, 50 mg 1 ATENOLOL+SYRSPEND SF ORAL SUSPENSION 1 MG/ML 3 PA (atenolol) betaxolol hcl oral tablet 10 mg, 20 mg 1 bisoprolol fumarate oral tablet 10 mg, 5 mg 1 KAPSPARGO SPRINKLE ORAL CAPSULE ER 24 HOUR SPRINKLE 100 MG, 200 MG, 25 MG, 50 MG (metoprolol 3 succinate) LOPRESSOR ORAL TABLET 100 MG, 50 MG (metoprolol 3 tartrate) metoprolol succinate er oral tablet extended release 24 hour 1 100 mg, 200 mg, 25 mg, 50 mg metoprolol tartrate oral tablet 100 mg, 25 mg, 37.5 mg, 50 mg, 1 75 mg TOPROL XL ORAL TABLET EXTENDED RELEASE 24 HOUR 3 100 MG, 200 MG, 25 MG, 50 MG (metoprolol succinate) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 54 Coverage Requirements & Prescription Drug Name Drug Tier Limits SKELETAL MUSCLE RELAXANTS, MISCELLANEOUS - Drugs for Relaxing Muscles orphenadrine citrate er oral tablet extended release 12 hour 100 1 mg orphenadrine-asa-caffeine oral tablet 50-770-60 mg 1 BLOOD FORMATION, COAGULATION, THROMBOSIS - Drugs for the Blood ANTIANEMIA DRUGS - Vitamins and Minerals ARANESP (ALBUMIN FREE) INJECTION SOLUTION 100 SL (2 syringes per month); 2 MCG/ML, 300 MCG/ML (darbepoetin alfa) SP ARANESP (ALBUMIN FREE) INJECTION SOLUTION 200 SL (4 syringes per month); MCG/ML, 25 MCG/ML, 40 MCG/ML, 60 MCG/ML ( darbepoetin 2 SP alfa) ARANESP (ALBUMIN FREE) INJECTION SOLUTION 2 SL (1.6 ml per month.); SP PREFILLED SYRINGE 10 MCG/0.4ML (darbepoetin alfa) ARANESP (ALBUMIN FREE) INJECTION SOLUTION SL (1 prefill syringe per 2 PREFILLED SYRINGE 100 MCG/0.5ML (darbepoetin alfa) month); SP ARANESP (ALBUMIN FREE) INJECTION SOLUTION PREFILLED SYRINGE 150 MCG/0.3ML, 60 MCG/0.3ML 2 SL (2 vials per month); SP (darbepoetin alfa) ARANESP (ALBUMIN FREE) INJECTION SOLUTION PREFILLED SYRINGE 200 MCG/0.4ML, 25 MCG/0.42ML, 40 2 SL (4 vials per month); SP MCG/0.4ML (darbepoetin alfa) ARANESP (ALBUMIN FREE) INJECTION SOLUTION SL (2 vials per prescription); 2 PREFILLED SYRINGE 300 MCG/0.6ML (darbepoetin alfa) SP ARANESP (ALBUMIN FREE) INJECTION SOLUTION SL (2 syringes per month); 2 PREFILLED SYRINGE 500 MCG/ML (darbepoetin alfa) SP RETACRIT INJECTION SOLUTION 10000 UNIT/ML (epoetin 2 SL (8 ml per 21 days.); SP alfa-epbx) RETACRIT INJECTION SOLUTION 2000 UNIT/ML, 3000 2 SL (12 ml per 21 days.); SP UNIT/ML, 4000 UNIT/ML (epoetin alfa-epbx) RETACRIT INJECTION SOLUTION 20000 UNIT/ML (epoetin 2 alfa-epbx) RETACRIT INJECTION SOLUTION 40000 UNIT/ML (epoetin 2 SL (4 ml per 21 days.); SP alfa-epbx) ANTICOAGULANTS, MISCELLANEOUS - Drugs to Prevent Blood Clots ACD-A NOCLOT-50 IN VITRO SOLUTION 0.73-2.45-2.2 3 GM/100ML (anticoagulant cit dext soln a)

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 93 Coverage Requirements & Prescription Drug Name Drug Tier Limits SPRAVATO (84 MG DOSE) NASAL SOLUTION THERAPY PA; SL (12 devices (4 kits) 3 PACK 28 MG/DEVICE (esketamine hcl) per month.) ANTIMANIC AGENTS - Drugs for Personality Disorder aripiprazole oral solution 1 mg/ml 1 aripiprazole oral tablet 10 mg, 15 mg, 20 mg, 30 mg 1 SL (1 tablet per day) aripiprazole oral tablet 2 mg 1 SL (2 tablets per day.) aripiprazole oral tablet 5 mg 1 SL (1.5 tablets per day.) aripiprazole oral tablet dispersible 10 mg, 15 mg 1 SL (1 tablet per day.) carbamazepine er oral capsule extended release 12 hour 100 1 mg, 200 mg, 300 mg carbamazepine er oral tablet extended release 12 hour 100 mg, 1 200 mg, 400 mg carbamazepine oral suspension 100 mg/5ml 1 carbamazepine oral tablet 200 mg 1 carbamazepine oral tablet chewable 100 mg 1 CARBATROL ORAL CAPSULE EXTENDED RELEASE 12 3 HOUR 100 MG, 200 MG, 300 MG (carbamazepine) DEPAKOTE ER ORAL TABLET EXTENDED RELEASE 24 3 ST HOUR 250 MG, 500 MG (divalproex sodium) DEPAKOTE ORAL TABLET DELAYED RELEASE 125 MG, 250 3 MG, 500 MG (divalproex sodium) DEPAKOTE SPRINKLES ORAL CAPSULE DELAYED 3 RELEASE SPRINKLE 125 MG (divalproex sodium) divalproex sodium er oral tablet extended release 24 hour 250 1 mg, 500 mg divalproex sodium oral capsule delayed release sprinkle 125 mg 1 divalproex sodium oral tablet delayed release 125 mg, 250 mg, 1 500 mg epitol oral tablet 200 mg 1 EQUETRO ORAL CAPSULE EXTENDED RELEASE 12 HOUR 3 100 MG, 200 MG, 300 MG (carbamazepine (antipsychotic)) LAMICTAL ODT ORAL KIT 21 X 25 MG & 7 X 50 MG, 25 & 50 3 ST & 100 MG, 42 X 50 MG & 14X100 MG (lamotrigine) LAMICTAL ODT ORAL TABLET DISPERSIBLE 100 MG, 200 3 ST MG, 25 MG, 50 MG (lamotrigine) LAMICTAL ORAL TABLET 100 MG, 150 MG, 200 MG, 25 MG 3 ST (lamotrigine) LAMICTAL ORAL TABLET CHEWABLE 25 MG, 5 MG 3 ST (lamotrigine) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 94 Coverage Requirements & Prescription Drug Name Drug Tier Limits LAMICTAL STARTER ORAL KIT 35 X 25 MG, 42 X 25 MG & 7 3 ST X 100 MG, 84 X 25 MG & 14X100 MG (lamotrigine) LAMICTAL XR ORAL KIT 21 X 25 MG & 7 X 50 MG, 25 & 50 & 3 ST 100 MG, 50 & 100 & 200 MG (lamotrigine) LAMICTAL XR ORAL TABLET EXTENDED RELEASE 24 HOUR 100 MG, 200 MG, 25 MG, 250 MG, 300 MG, 50 MG 3 ST (lamotrigine) lamotrigine er oral tablet extended release 24 hour 100 mg, 200 1 ST mg, 25 mg, 250 mg, 300 mg, 50 mg lamotrigine oral kit 25 & 50 & 100 mg 1 lamotrigine oral tablet 100 mg, 150 mg, 200 mg, 25 mg 1 lamotrigine oral tablet chewable 25 mg, 5 mg 1 lamotrigine oral tablet dispersible 100 mg, 200 mg, 25 mg, 50 1 ST mg lamotrigine starter kit-blue oral kit 35 x 25 mg 1 lamotrigine starter kit-green oral kit 84 x 25 mg & 14x100 mg 1 lamotrigine starter kit-orange oral kit 42 x 25 mg & 7 x 100 mg 1 lithium carbonate er oral tablet extended release 300 mg, 450 1 mg lithium carbonate oral capsule 150 mg, 300 mg, 600 mg 1 lithium carbonate oral tablet 300 mg 1 LITHOBID ORAL TABLET EXTENDED RELEASE 300 MG 3 (lithium carbonate) olanzapine oral tablet 10 mg, 15 mg, 20 mg, 7.5 mg 1 SL (1 tablet per day) olanzapine oral tablet 2.5 mg 1 SL (2 tablets per day.) olanzapine oral tablet 5 mg 1 SL (3 tablets per day) olanzapine oral tablet dispersible 10 mg, 15 mg, 20 mg 1 SL (1 tablet per day) olanzapine oral tablet dispersible 5 mg 1 SL (3 tablets per day) quetiapine fumarate er oral tablet extended release 24 hour 150 1 SL (31 tablets per 31 days.) mg quetiapine fumarate er oral tablet extended release 24 hour 200 1 SL (1 tablet per day.) mg quetiapine fumarate er oral tablet extended release 24 hour 300 1 SL (62 tablets per 31 days.) mg, 400 mg SL (13 tablets per year for quetiapine fumarate er oral tablet extended release 24 hour 50 1 initial fill 3 tablets per day for mg maintenance fill.) quetiapine fumarate oral tablet 100 mg, 200 mg, 25 mg, 300 1 mg, 400 mg, 50 mg Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 95 Coverage Requirements & Prescription Drug Name Drug Tier Limits risperidone oral solution 1 mg/ml 1 risperidone oral tablet 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg 1 risperidone oral tablet dispersible 0.25 mg, 0.5 mg, 1 mg, 2 mg, 1 3 mg, 4 mg SAPHRIS SUBLINGUAL TABLET SUBLINGUAL 10 MG, 5 MG 1 SL (2 tablets per day) (asenapine maleate) SAPHRIS SUBLINGUAL TABLET SUBLINGUAL 2.5 MG 1 SL (2 tablets per day.) (asenapine maleate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (31 tablets per 31 days.) HOUR 150 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (1 tablet per day.) HOUR 200 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (62 tablets per 31 days.) HOUR 300 MG, 400 MG (quetiapine fumarate) SL (13 tablets per year for SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 initial fill 3 tablets per day for HOUR 50 MG (quetiapine fumarate) maintenance fill.) subvenite oral tablet 100 mg, 150 mg, 200 mg, 25 mg 1 subvenite starter kit-blue oral kit 35 x 25 mg 1 subvenite starter kit-green oral kit 84 x 25 mg & 14x100 mg 1 subvenite starter kit-orange oral kit 42 x 25 mg & 7 x 100 mg 1 TEGRETOL ORAL SUSPENSION 100 MG/5ML 3 (carbamazepine) TEGRETOL ORAL TABLET 200 MG ( carbamazepine) 3 TEGRETOL-XR ORAL TABLET EXTENDED RELEASE 12 3 HOUR 100 MG, 200 MG, 400 MG (carbamazepine) valproic acid oral capsule 250 mg 1 valproic acid oral solution 250 mg/5ml 1 SL (62 capsules per 31 ziprasidone hcl oral capsule 20 mg, 40 mg, 60 mg, 80 mg 1 days.) ANTIMIGRAINE AGENTS, MISCELLANEOUS - Migraine Treatment butorphanol tartrate nasal solution 10 mg/ml 1 CAFERGOT ORAL TABLET 1-100 MG (ergotamine-caffeine) 3 caffeine citrate oral solution 20 mg/ml, 60 mg/3ml 1 CAMBIA ORAL PACKET 50 MG (diclofenac 3 potassium(migraine)) DEPAKOTE ER ORAL TABLET EXTENDED RELEASE 24 3 ST HOUR 250 MG, 500 MG (divalproex sodium) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 96 Coverage Requirements & Prescription Drug Name Drug Tier Limits DEPAKOTE ORAL TABLET DELAYED RELEASE 125 MG, 250 3 MG, 500 MG (divalproex sodium) DEPAKOTE SPRINKLES ORAL CAPSULE DELAYED 3 RELEASE SPRINKLE 125 MG (divalproex sodium) dihydroergotamine mesylate injection solution 1 mg/ml 1 dihydroergotamine mesylate nasal solution 4 mg/ml 1 divalproex sodium er oral tablet extended release 24 hour 250 1 mg, 500 mg divalproex sodium oral capsule delayed release sprinkle 125 mg 1 divalproex sodium oral tablet delayed release 125 mg, 250 mg, 1 500 mg EC-NAPROSYN ORAL TABLET DELAYED RELEASE 375 MG, 3 500 MG (naproxen) ec-naproxen oral tablet delayed release 375 mg, 500 mg 1 ERGOMAR SUBLINGUAL TABLET SUBLINGUAL 2 MG 3 (ergotamine tartrate) ergotamine-caffeine oral tablet 1-100 mg 1 ibuprofen oral tablet 400 mg, 600 mg, 800 mg 1 INDERAL LA ORAL CAPSULE EXTENDED RELEASE 24 3 HOUR 120 MG, 160 MG, 60 MG, 80 MG (propranolol hcl) MIGERGOT RECTAL SUPPOSITORY 2-100 MG (ergotamine- 3 caffeine) naproxen oral suspension 125 mg/5ml 1 naproxen oral tablet 250 mg, 375 mg, 500 mg 1 naproxen oral tablet delayed release 375 mg, 500 mg 1 naproxen sodium er oral tablet extended release 24 hour 375 1 mg, 500 mg naproxen sodium oral tablet 275 mg, 550 mg 1 propranolol hcl er oral capsule extended release 24 hour 120 1 mg, 160 mg, 60 mg, 80 mg propranolol hcl oral solution 20 mg/5ml, 40 mg/5ml 1 propranolol hcl oral tablet 10 mg, 20 mg, 40 mg, 60 mg, 80 mg 1 timolol maleate oral tablet 10 mg, 20 mg, 5 mg 1 TOPAMAX ORAL TABLET 100 MG, 200 MG, 25 MG, 50 MG 3 ST (topiramate) TOPAMAX SPRINKLE ORAL CAPSULE SPRINKLE 15 MG, 25 3 ST MG (topiramate) topiramate oral capsule sprinkle 15 mg, 25 mg 1

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 98 Coverage Requirements & Prescription Drug Name Drug Tier Limits ramelteon oral tablet 8 mg 1 SL (1 tablet per day) VISTARIL ORAL CAPSULE 25 MG, 50 MG (hydroxyzine 3 pamoate) zaleplon oral capsule 10 mg, 5 mg 1 SL (1 tablet per day) zolpidem tartrate er oral tablet extended release 12.5 mg, 6.25 1 SL (31 tablets per month) mg zolpidem tartrate oral tablet 10 mg, 5 mg 1 SL (1 tablet per day) SL (1 sublingual tablet per zolpidem tartrate sublingual tablet sublingual 1.75 mg, 3.5 mg 1 day) SL (8 ml (1 canister) per ZOLPIMIST ORAL SOLUTION 5 MG/ACT (zolpidem tartrate) 3 month) ATYPICAL ANTIPSYCHOTICS - Drugs for Depression & Psychosis aripiprazole oral solution 1 mg/ml 1 aripiprazole oral tablet 10 mg, 15 mg, 20 mg, 30 mg 1 SL (1 tablet per day) aripiprazole oral tablet 2 mg 1 SL (2 tablets per day.) aripiprazole oral tablet 5 mg 1 SL (1.5 tablets per day.) aripiprazole oral tablet dispersible 10 mg, 15 mg 1 SL (1 tablet per day.) CAPLYTA ORAL CAPSULE 42 MG (lumateperone tosylate) 3 PA; SL (1 capsule per day.) clozapine oral tablet 100 mg, 200 mg, 25 mg, 50 mg 1 clozapine oral tablet dispersible 100 mg, 12.5 mg, 150 mg, 200 1 mg, 25 mg CLOZARIL ORAL TABLET 100 MG, 200 MG, 25 MG, 50 MG 3 (clozapine) FANAPT ORAL TABLET 1 MG ( iloperidone) 3 SL (86 tablets per year.) FANAPT ORAL TABLET 10 MG, 12 MG, 4 MG, 6 MG, 8 MG 3 SL (2 tablets per day) (iloperidone) FANAPT ORAL TABLET 2 MG ( iloperidone) 3 SL (56 tablets per year.) FANAPT TITRATION PACK ORAL TABLET 1 & 2 & 4 & 6 MG SL (8 tablets (1 pack) per 3 (iloperidone) 365 days.) LATUDA ORAL TABLET 120 MG, 20 MG, 60 MG (lurasidone 2 SL (1 tablet per day.) hcl) LATUDA ORAL TABLET 40 MG (lurasidone hcl) 2 SL (1 tablet per day) LATUDA ORAL TABLET 80 MG (lurasidone hcl) 2 SL (2 tablets per day.) NUPLAZID ORAL CAPSULE 34 MG (pimavanserin tartrate) 3 PA NUPLAZID ORAL TABLET 10 MG (pimavanserin tartrate) 3 PA olanzapine oral tablet 10 mg, 15 mg, 20 mg, 7.5 mg 1 SL (1 tablet per day) olanzapine oral tablet 2.5 mg 1 SL (2 tablets per day.) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 99 Coverage Requirements & Prescription Drug Name Drug Tier Limits olanzapine oral tablet 5 mg 1 SL (3 tablets per day) olanzapine oral tablet dispersible 10 mg, 15 mg, 20 mg 1 SL (1 tablet per day) olanzapine oral tablet dispersible 5 mg 1 SL (3 tablets per day) olanzapine-fluoxetine hcl oral capsule 12-25 mg, 12-50 mg, 3- 1 SL (1 capsule per day) 25 mg, 6-25 mg, 6-50 mg paliperidone er oral tablet extended release 24 hour 1.5 mg, 3 1 SL (1 tablet per day) mg, 9 mg paliperidone er oral tablet extended release 24 hour 6 mg 1 SL (2 tablets per day) quetiapine fumarate er oral tablet extended release 24 hour 150 1 SL (31 tablets per 31 days.) mg quetiapine fumarate er oral tablet extended release 24 hour 200 1 SL (1 tablet per day.) mg quetiapine fumarate er oral tablet extended release 24 hour 300 1 SL (62 tablets per 31 days.) mg, 400 mg SL (13 tablets per year for quetiapine fumarate er oral tablet extended release 24 hour 50 1 initial fill 3 tablets per day for mg maintenance fill.) quetiapine fumarate oral tablet 100 mg, 200 mg, 25 mg, 300 1 mg, 400 mg, 50 mg REXULTI ORAL TABLET 0.25 MG, 0.5 MG, 1 MG, 2 MG, 3 3 ST; SL (1 tablet per day.) MG, 4 MG (brexpiprazole) risperidone oral solution 1 mg/ml 1 risperidone oral tablet 0.25 mg, 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg 1 risperidone oral tablet dispersible 0.25 mg, 0.5 mg, 1 mg, 2 mg, 1 3 mg, 4 mg SAPHRIS SUBLINGUAL TABLET SUBLINGUAL 10 MG, 5 MG 1 SL (2 tablets per day) (asenapine maleate) SAPHRIS SUBLINGUAL TABLET SUBLINGUAL 2.5 MG 1 SL (2 tablets per day.) (asenapine maleate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (31 tablets per 31 days.) HOUR 150 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (1 tablet per day.) HOUR 200 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 SL (62 tablets per 31 days.) HOUR 300 MG, 400 MG (quetiapine fumarate) SL (13 tablets per year for SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 3 initial fill 3 tablets per day for HOUR 50 MG (quetiapine fumarate) maintenance fill.) SYMBYAX ORAL CAPSULE 3-25 MG, 6-25 MG (olanzapine- 3 SL (1 capsule per day) fluoxetine hcl) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your highest cost medications; PA: Prior authorization required; SL: Supply Limit; ST: Step Therapy; H: May be part of health care reform preventive; H-N: May be part of health care reform preventive when used for appropriate preventive purposes; SP: Specialty medication; CM: Orally administered anticancer medication. 100 Coverage Requirements & Prescription Drug Name Drug Tier Limits VERSACLOZ ORAL SUSPENSION 50 MG/ML (clozapine) 3 VRAYLAR ORAL CAPSULE 1.5 MG, 3 MG, 4.5 MG, 6 MG 3 SL (1 capsule per day.) (cariprazine hcl) VRAYLAR ORAL CAPSULE THERAPY PACK 1.5 & 3 MG 3 SL (7 capsules per year.) (cariprazine hcl) SL (62 capsules per 31 ziprasidone hcl oral capsule 20 mg, 40 mg, 60 mg, 80 mg 1 days.) BARBITURATES (ANTICONVULSANTS) - Drugs for Seizures MYSOLINE ORAL TABLET 250 MG, 50 MG (primidone) 2 ST phenobarbital oral elixir 20 mg/5ml 1 phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 32.4 1 mg, 60 mg, 64.8 mg, 97.2 mg primidone oral tablet 250 mg, 50 mg 1 BARBITURATES (ANXIOLYTIC, SEDATIVE/HYP) - Drugs for Anxiety & Sleep Disorder ALLZITAL ORAL TABLET 25-325 MG ( butalbital- 3 acetaminophen) ascomp-codeine oral capsule 50-325-40-30 mg 1 bac oral tablet 50-325-40 mg 1 SL (6 tablets per day) BUPAP ORAL TABLET 50-300 MG (butalbital-acetaminophen) 3 butalbital-acetaminophen oral tablet 25-325 mg, 50-300 mg, 50- 1 325 mg butalbital-apap-caff-cod oral capsule 50-300-40-30 mg, 50-325- 1 SL (6 capsules per day.) 40-30 mg butalbital-apap-caffeine oral capsule 50-300-40 mg 1 SL (6 capsules per day.) butalbital-apap-caffeine oral capsule 50-325-40 mg 1 SL (6 capsules per day) butalbital-apap-caffeine oral tablet 50-325-40 mg 1 SL (6 tablets per day) butalbital-asa-caff-codeine oral capsule 50-325-40-30 mg 1 butalbital-aspirin-caffeine oral capsule 50-325-40 mg 1 ESGIC ORAL CAPSULE 50-325-40 MG (butalbital-apap- 3 SL (6 capsules per day) caffeine) ESGIC ORAL TABLET 50-325-40 MG (butalbital-apap-caffeine) 3 SL (6 tablets per day) FIORICET ORAL CAPSULE 50-300-40 MG (butalbital-apap- 3 SL (6 capsules per day.) caffeine) phenobarbital oral elixir 20 mg/5ml 1 phenobarbital oral tablet 100 mg, 15 mg, 16.2 mg, 30 mg, 32.4 1 mg, 60 mg, 64.8 mg, 97.2 mg

247 amlodipine besylate-benazepril ARAKODA...... 17 avidoxy...... 17, 31 hcl...... 67, 77 aranelle...... 159, 167, 178 AVIDOXY DK...... 31, 230, 238 amlodipine besylate-valsartan ARANESP (ALBUMIN FREE) AVITA...... 223 ...... 65, 77 ...... 55, 57 AVONEX PEN...... 199 amlodipine-atorvastatin...... 77, 79 ARAVA...... 196, 199, 203 AVONEX PREFILLED...... 199 amlodipine-olmesartan...... 65, 77 ARCALYST...... 204 AYGESTIN...... 178 amlodipine-valsartan-hctz arformoterol tartrate...... 53 ayuna...... 159, 167, 178 ...... 65, 77, 132 ARIKAYCE...... 16 AYVAKIT...... 34 amnesteem...... 235 aripiprazole...... 94, 99 AZASAN...... 196, 199, 203 amoxapine...... 122 armodafinil...... 122 AZASITE...... 136 amoxicill-clarithro-lansopraz ARMOUR THYROID...... 188 azathioprine...... 196, 199, 203 ...... 16, 29, 152 ARNUITY ELLIPTA ...... 153, 213 azelaic acid...... 235 amoxicillin...... 16, 147 ARTISS...... 235 azelastine hcl...... 135, 214 amoxicillin-potassium ARZOL SILVER NIT azelastine-fluticasone clavulanate...... 16 APPLICATORS...... 142 ...... 135, 140, 213, 214 amoxicillin-potassium ascomp-codeine AZELEX...... 235 clavulanate er...... 16 ...... 101, 109, 116, 118 AZILECT...... 108 AMPHETAMINE ER...... 85 ashlyna...... 159, 167, 178 azithromycin...... 29 amphetamine sulfate...... 85 aspirin-dipyridamole er...... 64, 118 AZOPT...... 139 amphetamine- ASTRAZENECA COVID-19 AZULFIDINE..... 31, 146, 196, 199 dextroamphetamine...... 85 VACCINE...... 43 AZULFIDINE EN-TABS ampicillin...... 16 ASTRINGYN...... 58 ...... 31, 146, 196, 199 AMZEEQ...... 216 ATABEX OB...... 61, 240, 243 azurette...... 159, 167, 178 anagrelide hcl...... 64 atazanavir sulfate...... 27 bac...... 86, 101, 116 ANALPRAM HC ...... 220, 224 atenolol...... 54, 68, 69, 75 bacitracin...... 136 ANALPRAM HC SINGLES ATENOLOL+SYRSPEND SF bacitracin-polymyxin b...... 136 ...... 220, 224 ...... 54, 68, 69, 75 bacitra-neomycin-polymyxin-hc ANALPRAM-HC ...... 220, 224 atenolol-chlorthalidone...... 68, 133 ...... 136, 140 ANASPAZ...... 46 atomoxetine hcl...... 105 BACLOFEN...... 50 anastrozole...... 34, 157 ATOPADERM...... 235 baclofen...... 50 ANCOBON...... 30 atorvastatin calcium...... 80 BACTRIM...... 18, 31, 32 ANDRODERM...... 156 atovaquone...... 18 BACTRIM DS...... 18, 31, 32 ANGELIQ...... 167, 178 atovaquone-proguanil hcl...... 17 BAFIERTAM...... 199 ANNOVERA ...... 159, 167, 178 atropine sulfate...... 144 BALCOLTRA ...... 159, 167, 178 ANORO ELLIPTA ...... 46, 53 ATROVENT HFA ...... 46, 209 balsalazide disodium...... 146 ANTARA ...... 79 AUBAGIO...... 199 balsam peru-castor oil...... 235 ANTICOAGULANT SODIUM aubra...... 159, 167, 178 BALVERSA...... 34 CITRATE ...... 56 aubra eq...... 159, 167, 178 balziva...... 159, 167, 178 ANTIVERT...... 12, 146 AUGMENTIN...... 16 BANZEL...... 89 anucort-hc...... 224 aurovela 1.5/30...... 159, 167, 178 BAQSIMI ONE PACK..... 174, 190 ANUSOL-HC...... 224 aurovela 1/20...... 159, 167, 178 BAQSIMI TWO PACK.....174, 190 apap-caff-dihydrocodeine aurovela 24 fe...... 159, 167, 178 BARACLUDE...... 28 ...... 86, 109, 116 aurovela fe 1.5/30... 159, 167, 178 BAXDELA...... 30 APEXICON E...... 224 aurovela fe 1/20...... 159, 167, 178 BECONASE AQ...... 140, 213 APLENZIN...... 93 AURYXIA...... 129 BELBUCA...... 113 APOKYN...... 108 AUSTEDO...... 122 belladonna alkaloids-opium apraclonidine hcl...... 143 AUTOLET LANCING DEVICE 123 ...... 46, 109 aprepitant...... 151 AVAR CLEANSER...... 216, 230 BELSOMRA ...... 98 apri...... 159, 167, 178 AVAR LS CLEANSER.... 216, 230 benazepril hcl...... 66, 67 APRISO...... 146 AVAR-E EMOLLIENT..... 216, 230 benazepril-hydrochlorothiazide APTENSIO XR...... 116 AVAR-E GREEN...... 216, 230 ...... 67, 132 APTIOM...... 89 AVAR-E LS...... 216, 230 BENEFIX...... 58 APTIVUS...... 27 aviane...... 159, 167, 178 BENLYSTA ...... 203

248 BENZALKONIUM CHLORIDE 232 BRAFTOVI ...... 34 CALAN SR...... 71, 72, 76, 83 benzalkonium chloride...... 232 BREO ELLIPTA ...... 53, 153 CALCIFOL...... 130, 243, 246 BENZAMYCIN ...... 216, 232 BREZTRI AEROSPHERE calcipotriene...... 235 BENZHYDROCODONE- ...... 46, 53, 154 CALCIPOTRIENE...... 235 ACETAMINOPHEN...... 86, 109 briellyn...... 159, 167, 178 calcipotriene-betameth diprop BENZNIDAZOLE ...... 19 BRILINTA ...... 64 ...... 224, 235 BENZOIN...... 223 brimonidine tartrate...... 135 calcitonin (salmon)...... 157, 192 benzoin compound...... 223 brinzolamide...... 139 CALCITRENE ...... 235 benzonatate...... 210 BRIVIACT...... 89 calcitriol...... 235, 246 benzoyl peroxide-erythromycin bromfenac sodium (once-daily) calcium acetate...... 129, 130 ...... 217, 232 ...... 143 calcium acetate (phos binder) benzphetamine hcl...... 85 bromocriptine mesylate...... 106 ...... 129, 130 benztropine mesylate...... 49, 89 BROMSITE...... 143 calcium-folic acid plus d bepotastine besilate...... 135 BROVANA...... 53 ...... 130, 243, 246 BERINERT...... 195 BRUKINSA...... 34 CALQUENCE...... 34 beser...... 224 BRYHALI...... 224 CAMBIA...... 96, 114 BESIVANCE...... 136 budesonide...... 154, 213 camila...... 159, 178 BETADINE OPHTHALMIC bumetanide...... 80, 129 camrese...... 159, 167, 178 PREP...... 142 BUMEX...... 80, 129 camrese lo...... 159, 167, 178 betamethasone dipropionate.. 224 BUNAVAIL...... 112, 113 candesartan cilexetil...... 65 betamethasone dipropionate BUPAP...... 86, 101 candesartan cilexetil-hctz..65, 132 aug...... 224 BUPHENYL...... 128 capecitabine...... 34 betamethasone valerate...... 224 buprenorphine hcl...... 113 CAPEX...... 225 BETAPACE AF. 50, 68, 69, 75, 76 buprenorphine hcl-naloxone CAPLYTA...... 99 BETASERON...... 200 hcl...... 112, 113, 114 CAPRELSA...... 34 betaxolol hcl.... 54, 68, 70, 75, 138 bupropion hcl...... 93 captopril...... 66, 67 bethanechol chloride...... 52 bupropion hcl er (smoking det). 93 CARAC...... 235 BETIMOL...... 138 bupropion hcl er (sr)...... 93 CARBAGLU...... 128 BETOPTIC-S...... 138 bupropion hcl er (xl)...... 93 carbamazepine...... 89, 94 BEVESPI AEROSPHERE...46, 53 BUPROPION HCL ER (XL)...... 93 carbamazepine er...... 89, 94 BEXSERO...... 43 buspirone hcl...... 98 CARBATROL...... 89, 94 bicalutamide...... 34 butalbital-acetaminophen..86, 101 carbidopa...... 106 BIDIL...... 79, 81 butalbital-apap-caff-cod carbidopa-levodopa...... 106 BIJUVA...... 167, 178 ...... 86, 101, 109, 116 carbidopa-levodopa er...... 106 BIKTARVY...... 24, 25 butalbital-apap-caffeine carbidopa-levodopa- BILTRICIDE...... 17 ...... 86, 87, 101, 117 entacapone...... 104, 106 bimatoprost...... 144 butalbital-asa-caff-codeine carbinoxamine maleate.....12, 212 BINOSTO...... 192 ...... 101, 109, 117, 118 CARDURA...... 51, 64 bisoprolol fumarate. 54, 68, 70, 75 butalbital-aspirin-caffeine CARDURA XL...... 51, 64, 65 bisoprolol-hydrochlorothiazide ...... 101, 117, 118 CARETOUCH CONTROL SOL ...... 68, 132 butorphanol tartrate...... 96, 114 LEVEL 2...... 123 BLEPH-10...... 136 BYDUREON BCISE CARETOUCH BLEPHAMIDE...... 136, 140 AUTOINJECTOR...... 175 LANCING/EJECTOR...... 123 BLEPHAMIDE S.O.P...... 136, 140 BYETTA 10 MCG PEN ...... 175 carisoprodol...... 49 blisovi 24 fe...... 159, 167, 178 BYETTA 5 MCG PEN ...... 175 carisoprodol-aspirin-codeine blisovi fe 1.5/30...... 159, 167, 178 BYLVAY...... 149 ...... 49, 109, 119 blisovi fe 1/20...... 159, 167, 178 BYLVAY (PELLETS) ...... 149 CARNITOR...... 204 BONIVA...... 192 BYSTOLIC...... 51, 68 CARNITOR SF...... 204 BOOSTRIX...... 43 cabergoline...... 107 CAROSPIR...... 81, 82, 130 bosentan...... 215 CABLIVI...... 56 carteolol hcl...... 138 BOSULIF...... 34 CABOMETYX ...... 34 cartia xt...... 71, 72, 76, 83 bp 10-1...... 217, 230 CAFERGOT...... 51, 96, 117 bp cleansing wash...... 217, 230 caffeine citrate...... 96, 117

249 carvedilol ciclopirox...... 229 clobetasol propionate e...... 225 ...... 51, 52, 64, 65, 68, 70, 75 ciclopirox olamine...... 229 clobetasol propionate emulsion carvedilol phosphate er ciclopirox treatment...... 229 ...... 225 ...... 51, 52, 64, 65, 69, 70, 75 cilostazol...... 64, 82 CLOBETAVIX...... 225 cascara sagrada ...... 147 CILOXAN...... 136 clocortolone pivalate...... 225 CASODEX...... 34 CIMDUO...... 25 CLODAN...... 225, 229 cavarest ...... 193 cimetidine...... 13, 151 clodan...... 225 CAVERJECT...... 83 cimetidine hcl...... 13, 151 clomipramine hcl...... 122 CAVERJECT IMPULSE...... 83 CIMZIA PREFILLED KIT clonazepam...... 102, 103 CAYA...... 208 ...... 149, 196, 200 clonidine...... 46, 74 CAYSTON...... 28 CIMZIA STARTER KIT clonidine hcl...... 46, 74 caziant...... 159, 167, 178 ...... 149, 196, 200 clonidine hcl er...... 46, 74 cefaclor...... 15 cinacalcet hcl...... 157 clopidogrel bisulfate...... 64 cefaclor er...... 14 CIPRO...... 19, 30 clorazepate dipotassium. 102, 103 cefadroxil...... 14 CIPRO HC...... 136, 140 clotrimazole...... 221 cefdinir...... 15 CIPRODEX...... 136, 140 clotrimazole-betamethasone cefixime...... 15 ciprofloxacin hcl...... 19, 30, 136 ...... 221, 222, 225 cefpodoxime proxetil...... 15 CIPROFLOXACIN- clovique...... 153 cefprozil...... 15 FLUOCINOLONE PF...... 136, 140 clozapine...... 99 cefuroxime axetil...... 15 citalopram hydrobromide...... 120 CLOZARIL...... 99 celecoxib...... 106 CITRANATAL BLOOM COAGADEX...... 59 CELONTIN...... 121 ...... 61, 148, 243, 245 COAL TAR...... 231 CENTANY ...... 217 CITRANATAL ESSENCE COARTEM...... 17 CENTANY AT ...... 217 ...... 62, 130, 204, 240, 243 codeine sulfate...... 109, 210 cephalexin...... 14 CITRANATAL MEDLEY colchicine-probenecid..... 134, 191 CERDELGA...... 204 ...... 62, 204, 240, 243 COLESTID...... 71 cerovel ...... 230 claravis...... 235 COLESTID FLAVORED...... 71 CERVIDIL...... 208 CLARINEX-D 12 HOUR...... 14, 45 colestipol hcl...... 71 CETRAXAL...... 136 clarithromycin...... 19, 29, 147 colistimethate sodium (cba)...... 30 cevimeline hcl...... 52 clarithromycin er...... 19, 29, 147 COLY-MYCIN M...... 30 CHANTIX...... 49 clemastine fumarate...... 12, 212 COMBIGAN...... 135, 138 CHANTIX CONTINUING CLENPIQ...... 148 COMBIPATCH...... 168, 179 MONTH PAK ...... 49 CLEOCIN...... 28, 217 COMBIVENT RESPIMAT CHANTIX STARTING MONTH CLEOCIN-T...... 217 ...... 46, 53, 209 PAK...... 49 CLIMARA PRO...... 167, 178 COMBIVIR...... 25 charlotte 24 fe...... 160, 167, 178 CLINDACIN ETZ ...... 217 COMETRIQ...... 34 chateal...... 160, 167, 178 clindacin etz...... 217 COMPLERA...... 24, 25 chateal eq...... 160, 167, 178 CLINDACIN PAC...... 217 compro...... 116, 146 CHEMET...... 153, 190 clindacin-p...... 217 COMTAN...... 104 CHENODAL...... 148 CLINDAGEL...... 217 CONCERTA ...... 117 chlordiazepoxide hcl...... 103 clindamycin hcl...... 28 CONDYLOX...... 235 chlordiazepoxide-amitriptyline clindamycin palmitate hcl...... 28 constulose...... 128 ...... 103, 122 clindamycin phos-benzoyl CONTOUR CONTROL ... 123, 124 chlordiazepoxide-clidinium 46, 103 perox...... 217, 232 CONTOUR NEXT CONTROL .124 chlorhexidine gluconate.. 142, 232 clindamycin phosphate...... 217 CONTOUR NEXT EZ ...... 124 chloroquine phosphate...... 17 CLINDAMYCIN PHOSPHATE 217 CONTOUR NEXT LINK ...... 124 chlorpromazine hcl...... 116 clindamycin-tretinoin217, 223, 235 CONTOUR NEXT MONITOR . 124 chlorthalidone...... 83, 133 CLINDESSE...... 217 CONTOUR NEXT ONE ...... 124 chlorzoxazone ...... 49 CLINOIN...... 70, 217, 223, 235 CONTOUR NEXT TEST ...... 127 CHOLBAM...... 149 CLINPRO 5000...... 193 CONTRAVE...... 88 cholestyramine...... 70 clobazam...... 102, 103 CONZIP...... 109 cholestyramine light...... 70 clobetasol prop emollient base225 COPASIL...... 235 ciclodan...... 229 clobetasol propionate...... 225 COPIKTRA...... 35

250 CORDRAN...... 225 CYSTADANE ...... 205 desmopressin ace spray refrig CORGARD...... 51, 69, 70 CYSTADROPS...... 143 ...... 59, 177 CORIFACT...... 59 CYSTAGON...... 205 desmopressin acetate...... 59, 177 CORLANOR...... 73, 83 CYSTARAN...... 143 desmopressin acetate pf...59, 177 CORTANE-B ...... 220, 225, 232 CYTOTEC...... 151 desmopressin acetate spray CORTEF...... 154 cytra k crystals ...... 127 ...... 59, 177 CORTENEMA ...... 225 dalfampridine er...... 205 desogestrel-ethinyl estradiol cortic-nd...... 140, 142, 144 DALIRESP...... 214 ...... 160, 168, 179 CORTIFOAM...... 225 danazol...... 156 DESONATE...... 225 CORTI-SAV...... 225, 232 DANTRIUM...... 50 desonide...... 225, 226 CORTISPORIN-TC...... 136, 140 dantrolene sodium...... 50 DESOWEN...... 226 CORTROSYN...... 126 dapsone...... 18, 19 desoximetasone...... 226 COSENTYX (300 MG DOSE).235 DAPTACEL...... 43 desrx...... 226 COSENTYX 150 MG/ML ...... 235 DARAPRIM...... 17 DESVENLAFAXINE ER...... 119 COSENTYX SENSOREADY darifenacin hydrobromide er... 239 desvenlafaxine succinate er....119 (300 MG)...... 235 dasetta 1/35...... 160, 168, 179 dexamethasone...... 154 COSENTYX SENSOREADY dasetta 7/7/7...... 160, 168, 179 dexamethasone intensol...... 154 PEN...... 235 DAURISMO...... 35 dexamethasone sodium COSOPT...... 139 DAYPRO...... 114 phosphate...... 140 cosyntropin...... 126 daysee...... 160, 168, 179 dexchlorpheniramine maleate...14 COTELLIC ...... 35 DAYTRANA ...... 117 DEXCOM G4 / G5 / G6 COTEMPLA XR-ODT...... 117 DAYVIGO...... 98 RECEIVER, TRANSMITTER, COVARYX...... 156, 168 DEBACTEROL...... 143, 232 SENSOR (INCLUDING COVARYX HS...... 156, 168 deblitane...... 160, 179 PLATINUM, PLATINUM CREON...... 134, 149 deferasirox...... 153 PEDIATRIC)...... 124 CRESEMBA...... 20 deferasirox granules...... 153 DEXILANT...... 152 CRINONE...... 179 deferiprone...... 153 dexmethylphenidate hcl...... 117 CRIXIVAN...... 27 DELESTROGEN...... 168, 192 dexmethylphenidate hcl er...... 117 cromolyn sodium DELSTRIGO...... 24, 25 DEXTENZA ...... 140 ...... 135, 136, 143, 213 delyla...... 160, 168, 179 dextroamphetamine sulfate.85, 86 crotan...... 234 demeclocycline hcl...... 31 dextroamphetamine sulfate er.. 85 cryselle-28...... 160, 168, 179 DEMSER...... 205 DIACOMIT...... 90 CUTIVATE...... 225 DENAVIR...... 221 DIASTAT ACUDIAL...... 102, 103 CUVPOSA...... 46 DENTA 5000 PLUS...... 193 DIASTAT PEDIATRIC.....102, 103 cyanocobalamin...... 63, 243 DENTAGEL...... 193 diazepam...... 102, 103 CYANOCOBALAMIN...... 64, 243 DEPAKOTE...... 90, 94, 97 diazepam intensol...... 102, 103 cyclafem 1/35...... 160, 168, 179 DEPAKOTE ER...... 89, 94, 96 diazoxide...... 157 cyclafem 7/7/7...... 160, 168, 179 DEPAKOTE SPRINKLES DICLOFENAC CAP...... 114 cyclobenzaprine hcl ...... 49 ...... 90, 94, 97 diclofenac potassium...... 114 CYCLOGYL...... 144 DEPEN TITRATABS ...... 153, 196 diclofenac sodium... 114, 143, 233 CYCLOMYDRIL...... 144, 145 DEPO-ESTRADIOL...... 168, 192 diclofenac sodium er...... 114 cyclopentolate hcl...... 144 DEPO-PROVERA...... 160, 179 diclofenac-misoprostol.... 115, 151 CYCLOPHENE RAPIDPAQ...... 50 DEPO-SUBQ PROVERA 104 dicloxacillin sodium...... 30 cyclophosphamide...... 35, 203 ...... 160, 179 DICOPANOL FUSEPAQ CYCLOPHOSPHAMIDE... 35, 203 DEPO-TESTOSTERONE ...... 156 ...... 12, 49, 89, 98, 210, 212 cycloserine ...... 20 DERMA-SMOOTHE/FS BODY DICOPANOL RAPIDPAQ CYCLOSET...... 157 ...... 225 ...... 12, 49, 89, 98, 210, 212 cyclosporine ...... 196, 200, 203 DERMA-SMOOTHE/FS dicyclomine hcl...... 46 cyclosporine modified SCALP...... 225 diethylpropion hcl...... 85 ...... 196, 200, 203 DERMOTIC...... 140 diethylpropion hcl er...... 85 cyproheptadine hcl...... 12, 212 DESCOVY...... 25 DIFICID...... 29 cyred...... 160, 168, 179 desipramine hcl...... 122 diflorasone diacetate...... 226 cyred eq...... 160, 168, 179 desloratadine...... 14, 214 DIFLUCAN...... 20

251 diflunisal...... 115 DOXYCYCLINE HYCLATE .17, 31 efavirenz-emtricitab-tenofovir digitek...... 68, 73 doxycycline monohydrate ...... 24, 25 digox...... 68, 73 ...... 17, 18, 31 efavirenz-lamivudine-tenofovir digoxin...... 68, 73 DRISDOL...... 246 ...... 24, 25 dihydroergotamine mesylate DRIZALMA SPRINKLE...... 119 EFFER-K...... 130 ...... 51, 97 dronabinol...... 146 effer-k...... 130 DILANTIN...... 74, 107 drospiren-eth estrad-levomefol EFUDEX...... 236 DILANTIN INFATABS ...... 74, 107 ...... 160, 168, 179, 243 EGATEN...... 17 DILATRATE-SR...... 81 drospirenone-ethinyl estradiol EGRIFTA SV...... 187 DILAUDID...... 109 ...... 160, 168, 179 ELESTRIN...... 168, 192 diltiazem hcl...... 71, 72, 76, 84 DROXIA...... 35 eletriptan hydrobromide...... 119 diltiazem hcl er.. 71, 72, 76, 83, 84 droxidopa...... 45 ELIGARD...... 35, 175 diltiazem hcl er beads DRYSOL...... 221 elinest...... 160, 168, 179 ...... 71, 72, 76, 83 DUAL COMPLEX FORMULA 1 ELIQUIS...... 56 diltiazem hcl er coated beads KIT...... 50, 233, 235 ELIQUIS DVT/PE STARTER ...... 71, 72, 76, 83 DUAVEE...... 166, 168 PACK...... 56 dilt-xr...... 71, 72, 76, 84 DUETACT...... 187, 188 ELITE-OB...... 62, 240, 243 dimethyl fumarate...... 200 DULERA...... 53, 154 ELIXOPHYLLIN DIPENTUM...... 146 duloxetine hcl...... 107, 119 ...... 79, 117, 128, 216, 239 diphen..... 12, 49, 89, 98, 210, 212 DUOPA...... 106 ELLA...... 160, 179 di-phen.... 12, 49, 89, 98, 210, 212 DUPIXENT...... 212, 236 ELMIRON...... 205 diphenhydramine hcl DUREZOL...... 140 ELOCTATE ...... 59 ...... 12, 49, 89, 98, 210, 212 dutasteride...... 189 EMCYT...... 35 diphenoxylate-atropine...... 47, 145 dutasteride-tamsulosin hcl 52, 189 EMEND...... 151 DIPROLENE...... 226 DYANAVEL XR...... 86 EMEND TRI-PACK...... 151 DIPROLENE AF...... 226 DYMISTA...... 136, 140, 213, 214 EMGALITY...... 104 dipyridamole...... 64, 84 DYRENIUM...... 82, 130 EMGALITY (300 MG DOSE).. 104 disopyramide phosphate...... 74 E.E.S. GRANULES...... 21 emoquette...... 160, 169, 179 disulfiram...... 189 EASIVENT...... 124 EMSAM...... 108 DITROPAN XL...... 239 easygel...... 193 emtricitabine...... 25 DIURIL...... 83, 132 EASYMAX 15 LEVEL 2-3 emtricitabine-tenofovir df...... 26 divalproex sodium...... 90, 94, 97 CONTROL...... 124 EMTRIVA...... 26 divalproex sodium er.....90, 94, 97 EASYMAX CONTROL...... 124 EMVERM...... 17 DIVIGEL...... 168, 192 EASYMAX CONTROL enalapril maleate...... 66, 67 dofetilide...... 76 NORMAL/HIGH...... 124 enalapril-hydrochlorothiazide DOJOLVI...... 128 EC-NAPROSYN...... 97, 115, 191 ...... 67, 133 dolishale...... 160, 168, 179 ec-naproxen...... 97, 115, 191 ENBRACE HR.. 62, 205, 240, 243 donepezil hcl...... 52 econazole nitrate...... 222 ENBREL...... 196, 200 DOPTELET...... 57 ECOZA...... 222 ENBREL MINI ...... 196, 200 DORYX...... 17, 31 EC-RX DHEA...... 205 ENBREL SURECLICK.... 196, 200 DORYX MPC...... 17, 31 EC-RX ESTRADIOL...... 168, 192 ENDARI...... 205 DORZOLAMIDE HCL...... 139 EC-RX PROGESTERONE..... 179 endocet...... 87, 109 dorzolamide hcl...... 139 EC-RX TESTOSTERONE ...... 156 ENDOMETRIN...... 179 dorzolamide hcl-timolol mal.... 139 EDARBI...... 65 ENGERIX-B...... 43 dorzolamide hcl-timolol mal pf 139 EDARBYCLOR...... 65, 133 ENLITE GLUCOSE SENSOR.124 DOUBLE PM...... 136, 140 EDECRIN...... 80, 129 enovarx-amitriptyline...... 122 DOVATO...... 24, 25 EDEX...... 84 enovarx-baclofen...... 50 DOVONEX...... 235 EDLUAR...... 98 enovarx-cyclobenzaprine hcl .... 50 doxazosin mesylate...... 51, 64, 65 ED-SPAZ...... 47 enovarx-ibuprofen...... 233 doxepin hcl...... 122, 220 EDURANT...... 24 enovarx-lidocaine hcl...... 220 doxercalciferol ...... 246 EEMT...... 156, 168 enovarx-naproxen ...... 233 doxycycline ...... 31, 235 EEMT HS ...... 156, 168 enovarx-tramadol ...... 236 doxycycline hyclate ...... 17, 31 efavirenz...... 24 enoxaparin sodium...... 61

252 enpresse-28...... 160, 169, 179 estradiol-norethindrone acet fenofibrate micronized...... 79 enskyce ...... 160, 169, 179 ...... 169, 180 fenofibric acid...... 79 ENSPRYNG ...... 200 ESTRING...... 169, 192 fentanyl...... 110 ENSTILAR ...... 226, 236 ESTROGEL...... 169, 192 fentanyl citrate...... 109 entacapone...... 104 ESTROSTEP FE.....160, 169, 180 FENTANYL CITRATE ...... 110 entecavir...... 28 eszopiclone...... 98 FENTORA ...... 110 ENTEREG ...... 149 ethacrynic acid...... 80, 129 FERRIPROX...... 153 ENTRESTO ...... 65, 83 ethambutol hcl...... 20 FETZIMA ...... 119 enulose...... 128 ethosuximide...... 121 FETZIMA TITRATION ...... 119 EPANED...... 66, 67 ethynodiol diac-eth estradiol FIBRICOR...... 79 EPCLUSA...... 22, 23 ...... 161, 169, 180 FINACEA...... 236 EPIDIOLEX...... 90 etodolac...... 115 finasteride...... 189 EPIDUO...... 232, 236 etodolac er...... 115 FINTEPLA ...... 90 EPIDUO FORTE...... 232, 236 etoposide...... 35 FIORICET...... 87, 101, 117 EPIFOAM...... 220, 226 etravirine...... 24 FIRAZYR...... 195 epinastine hcl...... 136 EUCRISA...... 220 FIRMAGON...... 35, 157 epinephrine...... 45, 209 euthyrox...... 188 FIRMAGON (240 MG DOSE) epitol...... 90, 94 EVAMIST...... 169, 192 ...... 35, 157 EPIVIR...... 26 EVEKEO...... 86 FIRST-BACLOFEN...... 50 EPIVIR HBV...... 26 EVEKEO ODT...... 86 FIRST-LANSOPRAZOLE...... 152 eplerenone...... 81, 82, 130 everolimus...... 35, 203 FIRST-METRONIDAZOLE EQUETRO...... 90, 94 EVOCLIN...... 217 ...... 15, 19, 147 ERGOCAL...... 246 EVOTAZ...... 27, 205 FIRST-MOUTHWASH BLM ergocalciferol...... 246 EVRYSDI...... 205 ...... 12, 144, 145, 146, 148, 220 ergoloid mesylates...... 51 EXELDERM...... 222 FIRST-OMEPRAZOLE...... 152 ERGOMAR...... 51, 97 exemestane...... 35, 157 FIRST-PROGESTERONE ergotamine-caffeine.... 52, 97, 117 EXTINA...... 222 VGS...... 180 ERIVEDGE...... 35 EZALLOR SPRINKLE ...... 80 FIRVANQ...... 22 ERLEADA...... 35 ezetimibe...... 74 flac...... 140 erlotinib hcl...... 35 ezetimibe-simvastatin...... 74, 80 FLAGYL...... 15, 19, 147 errin...... 160, 179 FABIOR...... 236 FLAREX...... 140 ery...... 217 falmina...... 161, 169, 180 flavoxate hcl...... 239 ERYGEL...... 217 famciclovir...... 28 flecainide acetate...... 75 ERYPED 200...... 21 famotidine...... 13, 151 FLEXICHAMBER ADULT ERYPED 400...... 21 FANAPT...... 99 MASK/SMALL...... 124 ERY-TAB...... 21 FANAPT TITRATION PACK ..... 99 FLEXICHAMBER CHILD ERYTHROCIN STEARATE ...... 21 FANATREX FUSEPAQ...... 87, 90 MASK/LARGE...... 124 erythromycin ...... 21, 136, 217 FARYDAK...... 35 FLEXICHAMBER CHILD erythromycin base ...... 21 FASENRA PEN...... 212 MASK/SMALL...... 124 erythromycin ethylsuccinate ...... 21 FAVIPIRAVIR...... 20 FLOLIPID...... 80 ESBRIET...... 209 fayosim...... 161, 169, 180 FLORIVA...... 193, 246 escitalopram oxalate...... 120 FBL KIT...... 50, 220, 233, 236 FLORIVA PLUS...... 193, 240 ESGIC...... 87, 101, 117 febuxostat...... 191 FLOVENT DISKUS. 154, 213, 214 esomeprazole magnesium...... 152 FEIBA...... 59 FLOVENT HFA ...... 154, 214 est estrogens-methyltest .156, 169 felbamate...... 90 FLUAD QUADRIVALENT...... 43 est estrogens-methyltest ds FELBATOL ...... 90 FLUARIX QUADRIVALENT...... 43 ...... 156, 169 FELDENE...... 115 FLUCELVAX est estrogens-methyltest hs felodipine er...... 77, 78 QUADRIVALENT...... 43 ...... 156, 169 FEM PH...... 232, 236 fluconazole...... 20 estarylla...... 160, 169, 179 FEMHRT...... 169, 180 flucytosine...... 30 estazolam...... 103 FEMRING...... 169, 192 fludrocortisone acetate...... 154 estradiol...... 169, 192 femynor...... 161, 169, 180 FLULAVAL QUADRIVALENT... 44 estradiol valerate...... 169, 192 fenofibrate...... 79 flunisolide...... 140, 154, 213

253 fluocinolone acetonide.... 140, 226 FRAGMIN...... 61 glipizide-metformin hcl.... 158, 187 fluocinolone acetonide body... 226 FREESTYLE LIBRE 14 DAY GLOPERBA...... 191 fluocinolone acetonide scalp...226 READER...... 124 GLUCAGEN HYPOKIT... 174, 190 fluocinonide...... 226 FREESTYLE LIBRE 14 DAY glucagon emergency kit.. 174, 190 fluocinonide emulsified base...226 SENSOR...... 125 GLUCAGON EMERGENCY FLUORIDEX...... 193 FREESTYLE LIBRE 2 KIT...... 174, 175, 190 fluoridex daily renewal...... 193 READER...... 125 GLUCOTROL XL...... 188 FLUORIDEX ENHANCED FREESTYLE LIBRE 2 GLUTARALDEHYDE...... 127 WHITENING...... 193 SENSOR...... 125 glyburide...... 188 FLUORIDEX SENSITIVITY FREESTYLE LIBRE READER 125 glyburide micronized...... 188 RELIEF...... 123, 194 FREESTYLE LIBRE SENSOR glyburide-metformin...... 158, 188 fluoritab...... 194 SYSTEM...... 125 glycopyrrolate...... 47 fluorometholone...... 140 FROTEK...... 233 glydo...... 220 FLUOROPLEX...... 236 frovatriptan succinate...... 119 GLYNASE...... 188 FLUOROURACIL...... 236 furosemide...... 80, 129 GLYXAMBI...... 165, 186 fluorouracil...... 236 FUZEON...... 23 GOLYTELY ...... 148 fluoxetine hcl...... 120 fyavolv...... 169, 180 GONITRO...... 81 fluoxetine hcl (pmdd)...... 120 FYCOMPA...... 90 goodsense nicotine...... 49 fluphenazine hcl...... 116 gabapentin...... 87, 90 GORDOFILM...... 223, 230 flurandrenolide...... 226 GABITRIL...... 90 GRALISE...... 87, 90 flurazepam hcl...... 103 GALAFOLD...... 205 granisetron hcl...... 145 flurbiprofen...... 115 galantamine hydrobromide...... 52 GRASTEK...... 42 flurbiprofen sodium...... 143 galantamine hydrobromide er... 52 griseofulvin microsize...... 17 flutamide...... 35 GALZIN...... 130 griseofulvin ultramicrosize...... 17 fluticasone propionate GARDASIL 9...... 44 guaiatussin ac...... 210, 211 ...... 140, 154, 213, 226 gatifloxacin...... 137 guaifenesin ac...... 210, 211 FLUTICASONE- GATTEX ...... 149 guanfacine hcl...... 74, 105 SALMETEROL ...... 53, 154 gavilyte-c...... 148 guanfacine hcl er...... 105 fluvastatin sodium...... 80 gavilyte-g...... 148 GUARDIAN SENSOR (3)...... 125 fluvastatin sodium er...... 80 gavilyte-n with flavor pack...... 148 GVOKE HYPOPEN 1-PACK fluvoxamine maleate...... 120 GAVRETO...... 35 ...... 175, 190 fluvoxamine maleate er...... 120 GELFILM...... 59 GVOKE HYPOPEN 2-PACK FLUZONE HIGH-DOSE GEL-FLOW...... 59 ...... 175, 190 QUADRIVALENT...... 44 GELFOAM-JMI POWDER...... 59 GVOKE PFS...... 175, 190 FLUZONE QUADRIVALENT.... 44 GELFOAM-JMI SPONGE...... 59 GYNAZOLE-1...... 222 FML...... 140 GELNIQUE...... 239 habitrol...... 49 FML FORTE ...... 140 gemfibrozil...... 79 HAEGARDA...... 195 FML LIQUIFILM...... 140 gemmily...... 161, 169, 180 hailey 1.5/30...... 161, 169, 180 FOCALIN...... 117 generlac...... 128 hailey 24 fe...... 161, 169, 180 folic acid...... 243 gengraf...... 196, 200, 203 hailey fe 1.5/30...... 161, 170, 180 fondaparinux sodium...... 56 gentak...... 137 hailey fe 1/20...... 161, 170, 180 FORANE...... 107 gentamicin sulfate... 137, 217, 218 halcinonide...... 226 FORFIVO XL...... 93 GENVOYA...... 24, 26 HALCION...... 103 formaldehyde...... 127 GILENYA...... 200 halobetasol propionate....226, 227 FORMALDEHYDE...... 127 GILOTRIF...... 36 HALOG...... 227 FORTISCARE CONTROL ...... 124 GILPHEX TR...... 46, 211 haloperidol...... 104 FOSAMAX...... 192 glatiramer acetate...... 200 haloperidol lactate...... 104 FOSAMAX PLUS D...... 192, 246 glatopa...... 200 HALUCORT...... 236 fosamprenavir calcium...... 27 GLEOSTINE...... 36 HARVONI...... 22, 23 fosfomycin tromethamine...... 32 glimepiride...... 187 HAVRIX...... 44 fosinopril sodium...... 66, 67 glipizide...... 187 heather...... 161, 180 fosinopril sodium-hctz...... 67, 133 glipizide er...... 187 hematinic/folic acid...... 62, 243 FOSRENOL...... 129, 190 glipizide xl...... 187 HEMLIBRA...... 59

254 hemocyte-f...... 62, 243 hydrocodone-acetaminophen INBRIJA...... 106 HEMOFIL M...... 59 ...... 87, 110 incassia...... 161, 180 heparin lock flush...... 61 hydrocodone-homatropine 47, 210 INCRELEX...... 187 heparin sodium (porcine)...... 61 hydrocodone-ibuprofen... 110, 115 indapamide...... 83, 133 heparin sodium (porcine) pf...... 61 hydrocortisone ...... 154, 227 INDERAL LA ..... 51, 69, 70, 75, 97 heparin sodium lock flush...... 61 hydrocortisone (perianal)...... 227 INDOCIN...... 115, 191 HEPLISAV-B...... 44 hydrocortisone ace-pramoxine INDOMETHACIN...... 115 HETLIOZ...... 98 ...... 220, 227 indomethacin...... 115, 191 HIBERIX...... 44 hydrocortisone acetate...... 227 indomethacin er...... 115, 191 HIPREX...... 32 hydrocortisone butyr lipo base 227 INFANRIX...... 43, 44 homatropaire...... 144 hydrocortisone butyrate ...... 227 INLYTA...... 36 hpr plus...... 236 hydrocortisone valerate...... 227 INOVA...... 229, 232 HUMALOG...... 185, 186 hydrocortisone-acetic acid INOVA 4/1 ACNE CONTROL HUMALOG KWIKPEN...... 185 ...... 140, 143 THERAPY...... 229, 230, 232 HUMALOG MIX 50/50 hydrocortisone-iodoquinol INOVA 8/2 ACNE CONTROL KWIKPEN...... 185 ...... 227, 232 THERAPY...... 229, 230, 232 HUMALOG MIX 50/50 VIAL....185 hydrocort-pramoxine (perianal) INQOVI...... 36 HUMALOG MIX 75/25 ...... 220, 227 INREBIC...... 36 KWIKPEN...... 185 hydromet...... 47, 210 INSPIREASE RESERVOIR HUMALOG MIX 75/25 VIAL....185 hydromorphone hcl...... 110 BAGS...... 125 HUMALOG U-100 JUNIOR hydromorphone hcl er...... 110 INSULIN PEN NEEDLES...... 125 KWIKPEN...... 186 hydroxychloroquine sulfate INSULIN SYRINGES...... 125 HUMATE-P...... 59 ...... 18, 197, 201 INTELENCE ...... 24, 25 HUMIRA...... 150, 197, 201 hydroxyurea ...... 36 INTRAROSA...... 154 HUMIRA PEDIATRIC hydroxyzine hcl ...... 12, 13, 98 INTRON A ...... 27, 28, 36, 201 CROHNS START hydroxyzine pamoate ...... 13, 98 introvale...... 161, 170, 180 ...... 149, 150, 196, 200 HYOPHEN...... 32, 47, 87 INVELTYS...... 141 HUMIRA PEN. 150, 196, 197, 201 hyoscyamine sulfate...... 47 INVIRASE...... 27 HUMIRA PEN-CD/UC/HS hyoscyamine sulfate er...... 47 IODINE STRONG...... 211 STARTER ...... 150, 197, 201 hyoscyamine sulfate sl ...... 47 iodine tincture...... 232 HUMIRA PEN-PEDIATRIC UC hyosyne...... 47 IOPIDINE...... 143 START...... 150, 197, 201 HYPERSAL...... 213 IPOL...... 44 HUMIRA PEN-PS/UV/ADOL HYPOCYN...... 236 ipratropium bromide...... 47, 209 HS START...... 150, 197, 201 ibandronate sodium...... 192 ipratropium-albuterol... 47, 54, 209 HUMIRA PEN-PSOR/UVEIT IBRANCE...... 36 irbesartan...... 65 STARTER ...... 150, 197, 201 ibuprofen...... 97, 115 irbesartan-hydrochlorothiazide HUMULIN 70/30 KWIKPEN iclevia...... 161, 170, 180 ...... 66, 133 ...... 176, 186 ICLUSIG...... 36 IRESSA...... 37 HUMULIN 70/30 VIAL.....176, 186 IDELVION...... 59 ISENTRESS...... 24 HUMULIN N KWIKPEN...... 176 IDHIFA...... 36 ISENTRESS HD...... 24 HUMULIN N VIAL...... 176 ILEVRO...... 143 isibloom...... 161, 170, 180 HUMULIN R U-500 KWIKPEN 186 ILUMYA...... 236 isoflurane...... 107 HUMULIN R U-500 VIAL...... 186 imatinib mesylate...... 36 isoniazid...... 20 HUMULIN R VIAL...... 186 IMBRUVICA...... 36 ISOPTO ATROPINE...... 144 HYCAMTIN...... 36 IMCIVREE...... 88 ISOPTO CARPINE...... 144 hydralazine hcl...... 79 imipramine hcl...... 122 ISORDIL TITRADOSE...... 81 HYDREA...... 36 imipramine pamoate...... 122 isosorbide dinitrate...... 81 HYDRO 40...... 230 imiquimod...... 236 isosorbide mononitrate...... 81 hydrochlorothiazide...... 83, 133 IMITREX...... 120 isosorbide mononitrate er...... 81 hydrocodone bitartrate er...... 110 IMPAVIDO...... 19 isotretinoin...... 236 hydrocodone polst-chlorphen IMVEXXY MAINTENANCE isoxsuprine hcl...... 84 polst er susp...... 14, 210 PACK...... 170 isradipine...... 77, 78 IMVEXXY STARTER PACK... 170 ISTALOL...... 139

255 ISTURISA...... 205 KETOROLAC lanthanum carbonate...... 129, 190 itraconazole...... 21 TROMETHAMINE ...... 115, 233 LANTUS SOLOSTAR ...... 176 ivermectin...... 17, 234 ketorolac tromethamine.. 115, 143 LANTUS U-100 VIAL...... 176 jaimiess...... 161, 170, 180 KETOSTIX...... 127 lapatinib ditosylate...... 37 JAKAFI...... 37 KEVEYIS...... 193 larin 1.5/30...... 161, 170, 181 JANSSEN COVID-19 KEVZARA...... 197 larin 1/20...... 161, 170, 181 VACCINE...... 44 KINERET...... 197, 201 larin 24 fe...... 161, 170, 181 jantoven...... 56 KISQALI...... 37 larin fe 1.5/30...... 161, 170, 181 JARDIANCE...... 186 KISQALI FEMARA...... 37, 157 larin fe 1/20...... 162, 170, 181 jasmiel...... 161, 170, 180 KLARON...... 218 larissia...... 162, 170, 181 jencycla...... 161, 180 klor-con...... 130 LASIX...... 80, 129 JENTADUETO ...... 158, 165 klor-con 10...... 130 LASTACAFT...... 13, 136 JENTADUETO XR.. 158, 165, 166 klor-con m10...... 130 latanoprost...... 144 jinteli...... 170, 180 klor-con m15...... 130 LATUDA...... 99 JIVI...... 59 klor-con m20...... 130 layolis fe...... 162, 170, 181 jolessa...... 161, 170, 180 klor-con/ef...... 131 LAZANDA...... 110 JORNAY PM...... 117 KOATE...... 59 L-CYSTINE...... 128 JUBLIA...... 222 KOATE-DVI...... 59 LEDIPASVIR-SOFOSBUVIR juleber...... 161, 170, 180 KOGENATE FS...... 60 ...... 22, 23 JULUCA...... 24, 25 KOMBIGLYZE XR...... 158, 166 leena...... 162, 170, 181 junel 1.5/30...... 161, 170, 180 KORLYM...... 157 leflunomide...... 197, 201, 203 junel 1/20...... 161, 170, 180 KOSELUGO...... 37 LENVIMA...... 37 junel fe 1.5/30...... 161, 170, 180 KOVALTRY...... 60 lessina...... 162, 170, 181 junel fe 1/20...... 161, 170, 180 K-PHOS...... 131 letrozole...... 37, 157 junel fe 24...... 161, 170, 180 K-PHOS NO 2...... 127 lets...... 45, 189 JUXTAPID...... 68 K-PHOS-NEUTRAL...... 131 leucovorin calcium...... 190, 243 JYNARQUE...... 134 k-prime...... 131 LEUKERAN...... 37 K.B.G.L IN TERODERM KRINTAFEL...... 18 LEUKINE...... 57 ...... 50, 115, 220, 233, 236 KRISTALOSE...... 128 leuprolide acetate...... 37, 175 kaitlib fe...... 161, 170, 180 K-TAB...... 131 levalbuterol hcl...... 54, 214 KALETRA...... 27 kurvelo...... 161, 170, 181 LEVALBUTEROL HFA ...... 54, 214 kalliga...... 161, 170, 180 KYNMOBI...... 108 LEVBID...... 47 KALYDECO...... 211 KYNMOBI TITRATION KIT .....108 levetiracetam...... 91 KAPSPARGO SPRINKLE labetalol hcl levetiracetam er...... 91 ...... 54, 69, 70, 75 ...... 51, 53, 64, 65, 69, 70, 75 levobunolol hcl...... 139 KARBINAL ER...... 12, 13, 212 LACRISERT...... 143 levocarnitine...... 205 kariva...... 161, 170, 181 lactulose...... 128 levocarnitine sf...... 205 KATERZIA...... 77, 78, 84 lactulose encephalopathy...... 128 levocetirizine dihydrochloride....14 KAZANO...... 158, 166 LAMICTAL...... 91, 94 levofloxacin...... 20, 30, 137 KEFLEX...... 14 LAMICTAL ODT ...... 91, 94 levonest...... 162, 170, 181 kelnor 1/35...... 161, 170, 181 LAMICTAL STARTER ...... 91, 95 levonorgest-eth est & eth est kelnor 1/50...... 161, 170, 181 LAMICTAL XR ...... 91, 95 ...... 162, 170, 181 KEPPRA...... 90 lamivudine...... 26 levonorgest-eth estrad 91-day KEPPRA XR...... 90 lamivudine-zidovudine...... 26 ...... 162, 171, 181 KERALYT SCALP ...... 230 lamotrigine...... 91, 95 levonorgestrel...... 162, 181 KERAMATRIX REPLICINE lamotrigine er...... 91, 95 levonorgestrel-ethinyl estrad 5CMX5CM...... 208 lamotrigine starter kit-blue...91, 95 ...... 162, 171, 181 KERYDIN...... 234 lamotrigine starter kit-green 91, 95 levonorg-eth estrad triphasic KESIMPTA...... 201 lamotrigine starter kit-orange ...... 162, 171, 181 ketoconazole...... 21, 222 ...... 91, 95 levora 0.15/30 (28)..162, 171, 181 ketodan...... 222 LAMPIT...... 19 levorphanol tartrate...... 110 KETONE TEST ...... 127 LANOXIN...... 68, 74 levo-t...... 188 KETOPHENE RAPIDPAQ...... 233 lansoprazole...... 152 LEVOTHYROXINE SODIUM.. 188

256 levothyroxine sodium...... 188 LOTEMAX ...... 141 MEKINIST...... 38 levoxyl...... 188 LOTEMAX SM ...... 141 MEKTOVI...... 38 LEVSIN...... 47 LOTENSIN...... 66, 67 meloxicam...... 115 LEVSIN/SL...... 47 LOTENSIN HCT ...... 67, 133 melphalan...... 38 LEVULAN KERASTICK...... 236 loteprednol etabonate...... 141 memantine hcl...... 105 LEXIVA...... 27 lovastatin...... 80 memantine hcl er...... 105 LIALDA...... 147 low-ogestrel...... 162, 171, 181 MENACTRA ...... 44 lidocaine...... 220 loxapine succinate...... 98 MENEST...... 171, 193 lidocaine hcl...... 144, 220 lo-zumandimine...... 162, 171, 182 MENOSTAR ...... 171, 193 lidocaine hcl urethral/mucosal.220 LUBIPROSTONE...... 150 MENQUADFI...... 44 lidocaine viscous hcl...... 144 LUCEMYRA...... 46 MENTAX ...... 223 lidocaine-prilocaine...... 220 LUGOLS STRONG IODINE....232 MENVEO...... 44 LIDTOPIC MAX...... 221 LULICONAZOLE...... 222 meperidine hcl...... 110 lillow...... 162, 171, 181 LUMAKRAS...... 37 MEPHYTON...... 190, 246 lindane...... 234 LUMIGAN...... 144 meprobamate...... 98 linezolid...... 29 LUPKYNIS...... 203 mercaptopurine...... 38, 204 LINZESS...... 150 lutera...... 162, 171, 182 merzee...... 163, 171, 182 liothyronine sodium...... 188 LUZU...... 222 mesalamine...... 147 LIPOFEN...... 79 lyleq...... 162, 182 mesalamine-cleanser...... 147 lisinopril...... 66, 67 LYNPARZA ...... 37 MESNEX...... 208 lisinopril-hydrochlorothiazide LYRICA...... 91, 107 MESTINON...... 52 ...... 67, 133 LYSODREN...... 37 metaxalone...... 50 L-ISOLEUCINE...... 128 LYSTEDA...... 60 metformin hcl...... 158 lithium carbonate...... 95 LYUMJEV KWIKPEN...... 186 metformin hcl er...... 158 lithium carbonate er...... 95 LYUMJEV VIAL...... 186 methadone hcl...... 110, 111 LITHOBID...... 95 lyza...... 162, 182 methadone hcl intensol...... 110 LITHOSTAT...... 128 MACROBID...... 32 methadose...... 111 LIVALO...... 80 MACRODANTIN...... 32 methadose sugar-free...... 111 LO LOESTRIN FE ...162, 171, 181 mafenide acetate...... 232 methamphetamine hcl...... 86 LOESTRIN 1.5/30 (21) MALARONE ...... 18 methazolamide...... 73, 139 ...... 162, 171, 181 malathion...... 234 methenamine hippurate...... 32 LOESTRIN 1/20 (21) MARINOL...... 146 methenamine mandelate...... 32 ...... 162, 171, 181 marlissa...... 162, 171, 182 methergine...... 208 LOESTRIN FE 1.5/30 MARPLAN...... 108 methimazole...... 158 ...... 162, 171, 181 MATULANE ...... 37 METHITEST ...... 156 lojaimiess...... 162, 171, 181 matzim la...... 71, 72, 77, 84 methocarbamol...... 50 LOKELMA ...... 129 MAVENCLAD ...... 203 methotrexate..... 38, 197, 201, 204 LOMAIRA...... 85 MAVYRET...... 23 methotrexate sodium LOMOTIL...... 47, 145 MAXIDEX...... 141 ...... 38, 197, 201, 204 LONSURF...... 37 MAXITROL...... 137, 141 methotrexate sodium (pf) LOPID...... 79 maxi-tuss ac...... 210, 211 ...... 38, 197, 201, 204 lopinavir-ritonavir...... 27 MAXZIDE...... 130, 133 methoxsalen rapid...... 234 LOPRESSOR...... 54, 69, 70, 75 MAXZIDE-25...... 130, 133 methscopolamine bromide...... 47 LOPROX...... 230, 237 MAYZENT...... 201 methyl salicylate...... 223 lorazepam...... 102, 103 me/naphos/mb/hyo1... 32, 47, 205 methyldopa...... 46, 74 lorazepam intensol...... 102, 103 meclofenamate sodium...... 115 methylergonovine maleate...... 208 LORBRENA ...... 37 MEDERMA SPF 30...... 237 METHYLIN...... 117 LORTAB ...... 87, 110 MEDROL...... 155 methylphenidate hcl...... 118 loryna...... 162, 171, 181 medroxyprogesterone acetate methylphenidate hcl er...... 118 LORZONE...... 50 ...... 162, 182 methylphenidate hcl er (cd).....117 losartan potassium...... 65, 66 mefenamic acid...... 115 methylphenidate hcl er (la) losartan potassium-hctz.... 66, 133 mefloquine hcl...... 18 ...... 117, 118 LOSEASONIQUE... 162, 171, 181 megestrol acetate...... 37, 38, 182 methylphenidate hcl er (xr)..... 118

257 methylprednisolone...... 155 MOBIC...... 115 NAFRINSE DAILY methyltestosterone...... 156 modafinil...... 122 ACIDULATED...... 123, 194 metoclopramide hcl...... 151 MODERNA COVID-19 NAFRINSE DAILY/NEUTRAL.194 metolazone...... 83, 134 VACCINE...... 44 nafrinse drops...... 194 metoprolol succinate er moexipril hcl...... 66, 67 NAFRINSE WEEKLY...... 194 ...... 54, 69, 70, 75 molindone hcl...... 98 naftifine hcl...... 216 metoprolol tartrate...54, 69, 70, 75 mometasone furoate NAFTIN...... 216 metoprolol-hydrochlorothiazide ...... 141, 155, 213, 227 naloxone hcl...... 113, 190 ...... 69, 133 mondoxyne nl...... 18, 32 naltrexone hcl...... 113, 189, 190 METROCREAM...... 218 mono-linyah...... 163, 172, 182 NAMENDA TITRATION PAK ..105 METROLOTION ...... 218 MONONINE ...... 60 NAMZARIC...... 52, 105 metronidazole..... 15, 19, 147, 218 monsels ferric subsulfate ...... 60 naproxen...... 97, 115, 191 METRONIDAZOLE montelukast sodium...... 212 naproxen sodium...... 97, 115, 191 BENZO+SYRSPEND ..15, 19, 147 MONUROL...... 32 naproxen sodium er.. 97, 115, 191 metyrosine...... 205 morgidox...... 18, 32 naratriptan hcl...... 120 mexiletine hcl...... 74 MORGIDOX...... 32, 237 NARCAN...... 113 MIACALCIN...... 157, 193 morphine sulfate...... 111 NARDIL...... 108 mibelas 24 fe...... 163, 171, 182 morphine sulfate (concentrate)111 NASCOBAL...... 64, 243 miconazole 3...... 222 morphine sulfate er...... 111 NATACYN...... 138 MICONAZOLE-ZINC OXIDE- morphine sulfate er beads...... 111 NATAZIA...... 163, 172, 182 PETROLAT...... 221, 222, 229 MOTEGRITY...... 150 nateglinide...... 176 microgestin 1.5/30...163, 171, 182 MOTOFEN...... 47, 145 NATPARA...... 177, 191 microgestin 1/20...... 163, 171, 182 MOVIPREP...... 148, 245 NATURE-THROID...... 189 microgestin 24 fe.....163, 171, 182 MOXEZA...... 137 NAYZILAM...... 102 microgestin fe 1.5/30 moxifloxacin hcl...... 20, 30, 137 NEBUPENT...... 19 ...... 163, 171, 182 moxifloxacin hcl (2x day)...... 137 necon 0.5/35 (28)....163, 172, 182 microgestin fe 1/20..163, 171, 182 MOZOBIL...... 57 nefazodone hcl...... 121 MICROLET NEXT LANCING MS CONTIN...... 111 neomycin sulfate...... 16 DEVICE...... 125 MUCOSITISRX...... 143 neomycin-bacitracin zn- midazolam hcl...... 103 MULPLETA ...... 57 polymyx...... 137 MIDAZOLAM+SYRSPEND SF MULTAQ ...... 76 neomycin-polymyxin-dexameth ...... 103 multi-vit/iron/fluoride..62, 194, 240 ...... 137, 141 midodrine hcl...... 46 multivitamin/fluoride...... 194, 240 neomycin-polymyxin- MIGERGOT...... 52, 97, 118 multi-vitamin/fluoride...... 194, 240 gramicidin...... 137 miglitol...... 156 multi-vitamin/fluoride/iron neomycin-polymyxin-hc .. 137, 141 miglustat...... 205 ...... 62, 194, 240 NEONATAL + DHA mili...... 163, 171, 182 mupirocin...... 218 ...... 62, 131, 205, 240, 243 MILLIPRED...... 155 mupirocin calcium...... 218 NEONATAL 19 ...... 240 mimvey...... 171, 182 MUSE...... 84 NEONATAL COMPLETE mineral oil heavy...... 148 MYALEPT...... 176 ...... 62, 240, 243 MINIPRESS...... 51, 64, 65 MYAMBUTOL ...... 20 NEONATAL FE ...... 62, 240, 243 minitran...... 81 MYCOBUTIN...... 20, 30 NEONATAL PLUS .... 62, 240, 243 minocycline hcl...... 18, 32 mycophenolate mofetil...... 204 neo-polycin...... 137 minoxidil...... 79 mycophenolate sodium...... 204 neo-polycin hc...... 137, 141 MIRAPEX...... 108 MYDAYIS...... 86 NEO-SYNALAR...... 218, 223, 227 MIRCETTE ...... 163, 172, 182 MYLERAN...... 38 NERLYNX ...... 38 mirtazapine...... 93 myorisan...... 237 NESINA...... 166 MIRVASO...... 237 MYRBETRIQ...... 240 NESTABS ...... 62, 240, 243 misoprostol...... 152 MYSOLINE...... 101 neuac...... 218, 232 MITIGARE...... 191 MYTESI...... 145 NEUAC...... 218, 223, 232 MITOSOL...... 137 nabumetone...... 115 NEULASTA...... 57 M-M-R II...... 44 nadolol...... 51, 69, 70 NEUPRO...... 109 M-NATAL PLUS ...... 62, 240, 243 nafrinse...... 194 NEURAPTINE...... 87

258 NEURONTIN...... 87, 91 norethindrone-eth estradiol NUVARING...... 164, 172, 183 NEVANAC...... 143 ...... 172, 183 NUVESSA...... 16, 218 nevirapine...... 25 norethin-eth estradiol-fe NUWIQ...... 60 nevirapine er...... 25 ...... 163, 172, 183 NUZYRA...... 16 NEXAVAR...... 38 norgestimate-eth estradiol nyamyc...... 234 NEXIUM...... 152 ...... 163, 172, 183 nylia 7/7/7...... 164, 172, 183 NEXLETOL ...... 68 norgestimate-ethinyl estradiol NYMALIZE...... 78, 84 NEXLIZET...... 68, 74 triphasic...... 163, 172, 183 nymyo...... 164, 172, 183 NEXTSTELLIS ...... 163, 172, 182 norlyda...... 163, 183 nystatin...... 30, 234 niacin er (antihyperlipidemic).... 68 norlyroc...... 163, 183 nystatin-triamcinolone..... 227, 234 NIASPAN...... 68 NORPACE...... 74 nystop...... 234 nicardipine hcl...... 78, 84 NORPACE CR...... 74 OCALIVA...... 150 NICORETTE ...... 49 NORPRAMIN...... 122 ocella...... 164, 172, 183 nicotine polacrilex...... 49 nortrel 0.5/35 (28)... 163, 172, 183 octreotide acetate...... 150, 187 nicotine polacrilex mini...... 49 nortrel 1/35 (21)...... 163, 172, 183 OCUFLOX...... 137 nicotine step 1...... 49 nortrel 1/35 (28)...... 163, 172, 183 ODACTRA...... 42 nicotine step 2...... 49 nortrel 7/7/7...... 163, 172, 183 ODEFSEY...... 25, 26 nicotine step 3...... 49 nortriptyline hcl...... 122 ODOMZO...... 38 NICOTROL...... 49 NORVIR...... 27 OFEV...... 209 NICOTROL NS ...... 49 NOURIANZ...... 105 ofloxacin...... 30, 137 nifedipine...... 78, 84 NOVOEIGHT...... 60 olanzapine...... 95, 99, 100 nifedipine er...... 78, 84 NOVOFINE AUTOCOVER olanzapine-fluoxetine hcl 100, 121 nifedipine er osmotic release PEN NEEDLE ...... 125 olmesartan medoxomil...... 65, 66 ...... 78, 84 NOVOFINE PEN NEEDLE ..... 125 olmesartan medoxomil-hctz nikki...... 163, 172, 182 NOVOFINE PLUS PEN ...... 66, 133 NILANDRON ...... 38 NEEDLE ...... 125 olmesartan-amlodipine-hctz nilutamide...... 38 NOVOPEN ECHO...... 125 ...... 66, 78, 133 nimodipine...... 78, 84 NOVOSEVEN RT...... 60 olopatadine hcl...... 13, 136 NINLARO ...... 38 NOVOTWIST PEN NEEDLE .. 125 OLUMIANT...... 197 nisoldipine er...... 78 NOXAFIL...... 21 OMECLAMOX-PAK.... 16, 29, 152 nitazoxanide...... 19 NP #2 DRUG PREPARATION omega-3-acid ethyl esters...... 68 NITRO-BID...... 81 KIT omeprazole...... 152 NITRO-DUR...... 81 46, 74, 87, 111, 115, 122, 221, OMEPRAZOLE+SYRSPEND nitrofurantoin...... 32 233, 237 SF ALKA...... 152 nitrofurantoin macrocrystal ...... 32 np thyroid...... 189 OMNARIS...... 141 nitrofurantoin monohydrate NUBEQA...... 38 ondansetron hcl...... 145 macrocrystals ...... 32 NUCALA...... 209 ondansetron odt...... 145 nitroglycerin...... 81 NUCORT...... 227 ONE VITE WOMENS PLUS NITROMIST...... 81 NUCYNTA ...... 111 ...... 62, 240, 243 NITROSTAT ...... 82 NUCYNTA ER ...... 111 ONETOUCH DELICA NITRO-TIME ...... 82 NUEDEXTA...... 105 LANCING DEVICE...... 125 nizatidine...... 13, 151 NULEV...... 47 ONETOUCH DELICA PLUS NOCDURNA...... 60, 177 NULYTELY LEMON-LIME ...... 148 LANCING DEVICE...... 125 nolix...... 227 NUPLAZID...... 99 ONETOUCH ULTRA ...... 127 nora-be...... 163, 182 NUTRASEB...... 230 ONETOUCH ULTRA 2...... 125 norethin ace-eth estrad-fe NUTRIDOX...... 32, 205, 246 ONETOUCH ULTRA MINI ...... 125 ...... 163, 172, 182 NUTROPIN AQ NUSPIN 10 ONETOUCH VERIO...... 126, 127 norethindrone...... 163, 183 ...... 177, 187 ONETOUCH VERIO FLEX norethindrone acetate...... 182 NUTROPIN AQ NUSPIN 20 SYSTEM KIT W/DEVICE...... 126 norethindrone acet-ethinyl est ...... 177, 187 ONETOUCH VERIO IQ ...... 163, 172, 183 NUTROPIN AQ NUSPIN 5 SYSTEM...... 126 ...... 177, 187 ONETOUCH VERIO NUVAIL...... 237 REFLECT...... 126

259 ONETOUCH VERIO SYNC oxycodone hcl ...... 111, 112 PFIZER-BIONTECH COVID- SYSTEM KIT W/DEVICE...... 126 oxycodone-acetaminophen 19 VACC...... 45 ONEVITE...... 131, 240, 243 ...... 87, 112 phenazo...... 221 ONEXTON...... 218, 233 OXYCODONE- phenazopyridine hcl...... 221 ONFI...... 102, 103 ACETAMINOPHEN...... 87, 112 phendimetrazine tartrate...... 85 ONGLYZA ...... 166 oxymorphone hcl...... 112 phendimetrazine tartrate er...... 85 ONUREG...... 38 oxymorphone hcl er...... 112 phenelzine sulfate...... 108 ONZETRA XSAIL...... 120 OZEMPIC...... 175 phenobarbital...... 101 opium...... 146 OZOBAX...... 50 phenoxybenzamine hcl...... 52, 80 OPSUMIT...... 215 PACERONE...... 76 phentermine hcl...... 85 ORACIT...... 127 PALFORZIA...... 42 phenylephrine hcl...... 144, 145 ORALAIR...... 42 paliperidone er...... 100 PHENYTEK...... 74, 107 ORALAIR ADULT STARTER PALYNZIQ...... 134 phenytoin...... 75, 107 PACK...... 42 PANCREAZE...... 134, 149 phenytoin infatabs...... 74, 107 ORALAIR CHILDRENS PANDEL...... 227 phenytoin sodium extended STARTER PACK ...... 42 PANRETIN...... 237 ...... 75, 107 oralone...... 227 pantoprazole sodium...... 152 philith...... 164, 172, 183 ORAPRED ODT...... 155 paricalcitol...... 246 PHOSLYRA...... 129, 131 ORAVIG...... 222 PARNATE ...... 108 PHOSPHA 250 NEUTRAL...... 131 ORENCIA...... 197, 198, 202 paromomycin sulfate...... 16 PHOSPHASAL...... 32, 48, 87, 205 ORENCIA CLICKJECT... 197, 202 paroxetine hcl...... 121 phosphorous...... 131 ORENITRAM...... 215 paroxetine hcl er...... 121 phospho-trin 250 neutral...... 131 ORFADIN...... 205 paroxetine mesylate...... 121 phytonadione...... 190, 246 ORGOVYX...... 38, 157 PASER...... 20 PIFELTRO...... 25 ORIAHNN...... 157, 172, 183 PATANASE...... 13, 136 pilocarpine hcl...... 52, 144 ORILISSA...... 157 PAXIL...... 121 pimecrolimus...... 204, 237 ORKAMBI...... 210, 211 PCP 100...... 131, 148, 151, 229 pimozide...... 98 orphenadrine citrate er...... 55, 89 PEDIAPRED...... 155 pimtrea...... 164, 172, 183 orphenadrine-asa-caffeine PEDVAX HIB...... 44 pindolol...... 51, 69, 70, 75 ...... 55, 118, 119 peg 3350-kcl-na bicarb-nacl ....148 pioglitazone hcl...... 188 orsythia...... 164, 172, 183 peg-3350/electrolytes...... 148 pioglitazone hcl-glimepiride.....188 oscimin...... 47 peg-3350/electrolytes/ascorbat pioglitazone hcl-metformin hcl oscimin sr...... 47 ...... 148, 245 ...... 158, 188 oseltamivir phosphate...... 28 PEGASYS...... 28 PIQRAY...... 38 OSENI...... 166, 188 peg-kcl-nacl-nasulf-na asc-c pirmella 1/35...... 164, 172, 183 OSMOPREP...... 148 ...... 148, 245 pirmella 7/7/7...... 164, 173, 183 OSPHENA...... 166 peg-prep...... 148 piroxicam...... 116 OTEZLA ...... 198, 202, 237 PEMAZYRE...... 38 PLAN B ONE-STEP ...... 164, 183 OTOVEL...... 137, 141 penicillamine...... 153, 198 PLEGRIDY...... 202 OVACE PLUS...... 218 penicillin v potassium...... 28 PLEGRIDY STARTER PACK. 202 OVACE PLUS WASH...... 218 pentamidine isethionate...... 19 PLENVU...... 148, 245 OVACE WASH...... 218 pentazocine-naloxone hcl113, 114 PLEXION...... 219, 230 OVIDE...... 234 pentoxifylline er...... 58 PLEXION CLEANSER.... 218, 230 oxandrolone...... 156 PERFOROMIST...... 54, 214 PLEXION CLEANSING oxaprozin...... 116 PERIDEX...... 142, 233 CLOTH ...... 218, 230 oxazepam...... 103 perindopril erbumine...... 66, 67 PNEUMOVAX 23...... 45 OXBRYTA ...... 56 periogard...... 142, 233 podocon...... 237 oxcarbazepine...... 91, 92 permethrin...... 234 podofilox...... 237 OXERVATE...... 143 perphenazine...... 116 polycin...... 137 oxiconazole nitrate...... 222 perphenazine-amitriptyline polymyxin b-trimethoprim...... 137 OXISTAT...... 222 ...... 116, 122 POLYTRIM...... 137 oxybutynin chloride...... 239 PERTZYE...... 134, 149 POLY-VI-FLOR...... 194, 240 oxybutynin chloride er...... 239 PEXEVA...... 121

260 POLY-VI-FLOR/IRON PRENATE ESSENTIAL PROCYSBI...... 206 ...... 62, 194, 241 ...... 62, 131, 206, 241, 244 PROFILNINE...... 60 POMALYST...... 39, 202 PRENATE MINI progesterone...... 184 portia-28...... 164, 173, 183 ...... 63, 131, 206, 241, 244 PROGESTERONE posaconazole...... 21 PRENATE PIXIE MICRONIZED...... 184 POTABA...... 243 ...... 63, 132, 206, 241, 244 PROGRAF...... 204 potassium chloride...... 131 PRENATE RESTORE PROLATE...... 87, 112 potassium chloride crys er ...... 131 ...... 63, 132, 206, 241, 244 PROLENSA...... 143 potassium chloride er...... 131 PRENATVITE COMPLETE PROMACTA...... 57 potassium citrate er...... 127 ...... 63, 132, 241, 244 promethazine hcl potassium citrate-citric acid .....127 PRENATVITE PLUS ...... 12, 13, 98, 146, 212 PRADAXA...... 57 ...... 63, 132, 241, 244 promethazine vc...... 13, 46 pramipexole dihydrochloride... 109 PRENATVITE RX promethazine vc/codeine pramosone...... 221, 227 ...... 63, 132, 241, 244 ...... 13, 46, 210 PRAMOSONE...... 221, 227, 228 PREPIDIL...... 208 promethazine-codeine...... 13, 210 PRAMOTIC...... 142, 144 preplus...... 63, 241, 244 promethazine-dm...... 13, 210 pramox...... 221 PRETAB...... 63, 241, 244 promethazine-phenyleph- prasugrel hcl...... 64 PRETOMANID...... 20 codeine...... 13, 46, 210 pravastatin sodium...... 80 prevalite...... 71 promethazine-phenylephrine praziquantel...... 17 PREVIDENT...... 194, 195 ...... 14, 46 prazosin hcl ...... 51, 64, 65 PREVIDENT 5000 BOOSTER promethegan.13, 14, 98, 146, 212 PRECOSE...... 156 PLUS...... 194 PROMISEB...... 230 PRED MILD...... 141 PREVIDENT 5000 DRY propafenone hcl...... 75 PRED-G...... 137, 141 MOUTH...... 194 propafenone hcl er...... 75 PRED-G S.O.P...... 138, 141 PREVIDENT 5000 ENAMEL proparacaine hcl...... 144 prednicarbate...... 228 PROTECT...... 123, 194 propranolol hcl.. 51, 69, 70, 75, 97 prednisolone...... 155 PREVIDENT 5000 ORTHO propranolol hcl er prednisolone acetate...... 141 DEFENSE...... 194 ...... 51, 69, 70, 75, 97 prednisolone sodium PREVIDENT 5000 PLUS...... 194 propylthiouracil...... 158 phosphate...... 141, 155 PREVIDENT 5000 SENSITIVE PROSCAR...... 189 prednisone...... 155 ...... 123, 194 PROSTIN E2...... 208 prednisone intensol...... 155 previfem...... 164, 173, 183 PROTONIX...... 152 PREFEST...... 173, 183 PREVNAR 13...... 45 protriptyline hcl...... 122 pregabalin...... 92, 107 PREVYMIS...... 20 PROVERA...... 184 pregabalin er...... 87 PREZCOBIX...... 27, 206 pseudoephedrine-bromphen- PREMARIN...... 173, 193 PREZISTA...... 27 dm...... 14, 45, 210 PREMESISRX 131, 205, 241, 244 PRIFTIN...... 20, 30 PSORCON...... 228 premium lidocaine...... 221 PRILOSEC...... 152 PULMICORT FLEXHALER PREMPHASE...... 173, 183 PRIMACARE.....63, 206, 241, 244 ...... 155, 214 PREMPRO...... 173, 183 primaquine phosphate...... 18 PULMOZYME...... 135, 213 PRENAISSANCE primidone...... 101 PURIXAN...... 39, 204 ...... 62, 148, 206, 241, 244 PRIMSOL...... 32 PYLERA...... 17, 19, 32, 146, 147 prenatal...... 62, 241, 244 PRINIVIL...... 66, 67 pyrazinamide...... 20 prenatal plus iron...... 62, 241, 244 probenecid...... 134, 191 PYRIDIUM...... 221 prenatal vitamin plus low iron PROCENTRA ...... 86 pyridostigmine bromide...... 52 ...... 62, 241, 244 prochlorperazine...... 116, 146 pyridostigmine bromide er...... 52 PRENATE ...... 131, 241, 244 prochlorperazine maleate116, 146 pyrimethamine...... 18 PRENATE DHA PROCORT...... 221, 228 PYROGALLIC ACID208, 230, 237 ...... 62, 131, 206, 241, 244 PROCTOCORT...... 228 QBRELIS...... 67 PRENATE ELITE ...... 62, 241, 244 PROCTOFOAM HC...... 221, 228 QINLOCK...... 39 PRENATE ENHANCE procto-med hc...... 228 QMIIZ ODT...... 116 ...... 62, 131, 206, 241, 244 procto-pak...... 228 QNASL...... 141, 213 proctozone-hc...... 228 QNASL CHILDRENS ...... 141, 213

261 QSYMIA...... 88 REPATHA PUSHTRONEX SALAGEN...... 52 QUALAQUIN...... 18 SYSTEM...... 82 salicylic acid...... 230 QUDEXY XR...... 92 REPATHA SURECLICK...... 82 salimez...... 231 QUESTRAN...... 71 RESTASIS...... 142 SALIVAMAX...... 143 QUESTRAN LIGHT...... 71 RESTASIS MULTIDOSE...... 142 salsalate...... 119 quetiapine fumarate...... 95, 100 RESTORIL...... 103 SALVAX DUO PLUS...... 223, 231 quetiapine fumarate er...... 95, 100 RETACRIT...... 55, 58 SAMSCA...... 134 QUFLORA PEDIATRIC.. 195, 241 RETEVMO...... 39 SANDIMMUNE...... 198, 202, 204 QUILLICHEW ER...... 118 RETIN-A MICRO PUMP...... 223 SANDOSTATIN...... 150, 187 QUILLIVANT XR...... 118 RETROVIR...... 26 SANTYL...... 135, 237 quinapril hcl...... 66, 67 REVLIMID...... 39, 202 SAPHRIS...... 96, 100 quinapril-hydrochlorothiazide REXULTI...... 100 sapropterin dihydrochloride.....206 ...... 67, 133 REYATAZ...... 27 SAVAYSA...... 56 quinidine gluconate er...... 18, 74 REYVOW...... 120 SAVELLA...... 107, 119 quinidine sulfate...... 18, 74 REZUROCK...... 206 SAVELLA TITRATION PACK quinine sulfate...... 18 RHOFADE...... 237 ...... 107, 119 RABEPRAZOLE SODIUM...... 152 RHOPRESSA...... 145 SAXENDA...... 175 rabeprazole sodium...... 152 ribavirin...... 28, 29 SCALACORT DK...... 228, 231 RADIOGARDASE...... 129, 190 RIDAURA...... 153, 198, 202 SCARCIN...... 237 RAGWITEK...... 42 rifabutin...... 20, 30 scopolamine...... 48, 146 raloxifene hcl...... 166, 193 rifampin...... 20, 30 SELECT-OB...... 63, 242, 244 ramelteon...... 99 RIFAMPIN+SYRSPEND SF20, 30 selegiline hcl...... 108 ramipril...... 66, 67 RILUTEK...... 105 selenium sulfide...... 231, 233 ranolazine er...... 73 riluzole...... 105 SELZENTRY ...... 23, 24 RAPAMUNE...... 204 rimantadine hcl...... 15 SEREVENT DISKUS...... 54, 214 rasagiline mesylate...... 108 RINVOQ...... 198 SERNIVO...... 228 RASUVO...... 198 risedronate sodium...... 193 SEROQUEL XR...... 96, 100 RAVICTI...... 128 risperidone...... 96, 100 SEROSTIM...... 177, 187 RAZADYNE ER...... 52 RITALIN...... 118 sertraline hcl...... 121 REBIF...... 202 ritonavir...... 27 setlakin...... 164, 173, 184 REBIF REBIDOSE...... 202 rivastigmine...... 52 sevelamer carbonate...... 129, 190 REBIF REBIDOSE rivastigmine tartrate...... 52 sevelamer hcl...... 129, 190 TITRATION PACK ...... 202 rivelsa...... 164, 173, 184 sevoflurane...... 107 REBIF TITRATION PACK ...... 202 RIXUBIS...... 60 sf...... 195 reclipsen...... 164, 173, 184 rizatriptan benzoate...... 120 sf 5000 plus...... 195 RECOMBINATE ...... 60 ROCALTROL...... 246 SFROWASA...... 147 RECOMBIVAX HB...... 45 ROCKLATAN...... 144, 145 sharobel...... 164, 184 RECOTHROM...... 60 ropinirole hcl...... 109 SHARPS CONTAINER...... 126 RECOTHROM SPRAY KIT...... 60 ropinirole hcl er...... 109 SHINGRIX...... 45 RECTIV...... 237 rosadan...... 219 SIGNIFOR...... 187 REGLAN...... 151 ROSADAN...... 219 sildenafil citrate...... 82, 215, 239 REGRANEX...... 237 rosuvastatin calcium...... 80 SILENOR...... 122 RELENZA DISKHALER...... 28 ROWASA...... 147 silodosin...... 53 RELISTOR...... 113, 150 roweepra...... 92 SILVADENE...... 233 RELNATE DHA .63, 206, 241, 244 ROZLYTREK ...... 39 silver nitrate...... 142 REMERON...... 93 RUBRACA...... 39 silver sulfadiazine...... 233 REMERON SOLTAB ...... 93 RUCONEST...... 195 SIMBRINZA...... 135, 139 REMIGEN...... 237 rufinamide...... 92 simliya...... 164, 173, 184 RENAGEL...... 129, 190 RUKOBIA...... 23 simpesse...... 164, 173, 184 RENVELA...... 129, 190 RUZURGI...... 206 SIMPONI.150, 151, 198, 202, 203 repaglinide...... 176 RYBELSUS...... 175 simvastatin...... 80 REPATHA...... 82 RYDAPT...... 39 SINEMET...... 106 SABRIL...... 92 SINGULAIR...... 212

262 sirolimus...... 204 sronyx...... 164, 173, 184 sumatriptan succinate...... 120 SIRTURO...... 20 ssd...... 233 sumatriptan succinate refill..... 120 SIVEXTRO...... 29 SSKI...... 211 SUMAXIN...... 219, 231 SKYRIZI...... 237 sss 10-5...... 219, 231 SUMAXIN CP...... 219, 231 SKYRIZI (150 MG DOSE)...... 237 STALEVO 100...... 104, 106 SUNOSI...... 122 SKYRIZI PEN...... 237 STALEVO 125...... 104, 106 SUPRAX...... 15 SLYND ...... 164, 184 STALEVO 150...... 104, 106 SUPREP BOWEL PREP KIT..148 sod citrate-citric acid ...... 127 STALEVO 200...... 104, 106 SURESTEP PRO HIGH SODIUM BICARBONATE STALEVO 50...... 104, 106 GLUCOSE...... 126 ...... 145, 147 STALEVO 75...... 104, 106 SURESTEP PRO LOW sodium chloride...... 213 stavudine...... 26 GLUCOSE...... 126 sodium fluoride...... 195 STELARA...... 237 SURESTEP PRO NORMAL sodium fluoride 5000 enamel STENDRA ...... 82 GLUCOSE...... 126 ...... 123, 195 STIMATE...... 60, 177 SUSTIVA...... 25 sodium fluoride 5000 plus...... 195 STIVARGA...... 39 SUTAB...... 148 sodium fluoride 5000 ppm...... 195 STRATA CTX ...... 238 SUTENT...... 39 sodium fluoride 5000 sensitive STRATA XRT ...... 238 syeda...... 164, 173, 184 ...... 123, 195 STRATTERA ...... 105 SYMAX DUOTAB...... 48 sodium phenylbutyrate...... 128 STRENSIQ...... 135 SYMAX-SL...... 48 sodium polystyrene sulfonate STRIBILD...... 24, 26, 206 SYMAX-SR...... 48 ...... 130, 191 STRIVERDI RESPIMAT... 54, 215 SYMBICORT...... 54, 155 sodium sulfacetamide...... 219 STROMECTOL ...... 17 SYMBYAX...... 100, 121 sodium sulfacetamide wash....219 SUBOXONE...... 113, 114 SYMDEKO...... 211 SODIUM SULFACETAMIDE- subvenite...... 92, 96 SYMFI...... 25, 26 BAKUCHIOL...... 206, 219 subvenite starter kit-blue.....92, 96 SYMFI LO...... 25, 26 SOFOSBUVIR-VELPATASVIR subvenite starter kit-green .. 92, 96 SYMJEPI...... 45, 209 ...... 22, 23 subvenite starter kit-orange 92, 96 SYMLINPEN 120...... 156 solifenacin succinate...... 239 SUCRAID...... 135 SYMLINPEN 60...... 156 SOLIQUA...... 175, 176 sucralfate...... 152 SYMPROIC...... 151 SOLOSEC...... 19 SULAR...... 78 SYMTUZA...... 26, 27, 206 SOLTAMOX ...... 39, 166 SULCONAZOLE NITRATE .....222 SYNALAR...... 228 SOMATULINE DEPOT...... 187 sulfacetamide sodium..... 138, 219 SYNALAR (CREAM)...... 223, 228 SOMAVERT...... 187 sulfacetamide sodium (acne).. 219 SYNALAR (OINTMENT) . 223, 228 SOOLANTRA ...... 234 sulfacetamide sodium-sulfur SYNALAR TS ...... 228, 238 SORILUX...... 237 ...... 219, 231 SYNAPRYN FUSEPAQ...... 112 sotalol hcl...... 51, 69, 70, 76 sulfacetamide sod-sulfur wash SYNAREL...... 175 sotalol hcl (af)...... 51, 69, 70, 76 ...... 219, 231 SYNDROS...... 146 SOTYLIZE...... 51, 69, 70, 76 sulfacetamide-prednisolone SYNJARDY...... 158, 186 SOVALDI...... 22 ...... 138, 142 SYNJARDY XR...... 158, 186 spinosad...... 234 sulfacetamide-sulfur in urea SYNRIBO...... 39 SPIRIVA HANDIHALER....48, 209 ...... 219, 231 TABLOID...... 39 SPIRIVA RESPIMAT...... 48, 209 SULFACLEANSE 8/4...... 219, 231 TABRADOL FUSEPAQ...... 50 spironolactone...... 81, 82, 130 sulfadiazine...... 31 TABRADOL RAPIDPAQ...... 50 spironolactone-hctz...... 81, 133 sulfamethoxazole-trimethoprim TABRECTA ...... 39 SPORANOX...... 21 ...... 19, 31, 33 TACLONEX ...... 228, 238 SPORANOX PULSEPAK...... 21 sulfamez wash...... 219, 231 tacrolimus...... 204, 238 SPRAVATO (56 MG DOSE)..... 93 SULFAMYLON...... 233 tadalafil...... 82 SPRAVATO (84 MG DOSE)..... 94 sulfasalazine..... 31, 147, 199, 203 tadalafil (pah)...... 82, 215 sprintec 28...... 164, 173, 184 sulfatrim pediatric...... 19, 31, 33 TAFINLAR ...... 39 SPRITAM...... 92 SULFURATED LIME...... 234 TAGRISSO...... 39 SPRIX...... 116 sulindac...... 116 TAKHZYRO...... 195 SPRYCEL...... 39 SUMADAN XLT...... 219, 231, 238 TALZENNA ...... 39, 40 sps...... 130, 191 sumatriptan...... 120 tamoxifen citrate...... 40, 166

263 tamsulosin hcl...... 53 theophylline toremifene citrate...... 40, 166 TAPAZOLE...... 158 ...... 79, 118, 129, 216, 239 torsemide...... 80, 129 TAPERDEX 12-DAY...... 155 theophylline er TOSYMRA...... 120 TAPERDEX 6-DAY...... 155 ...... 79, 118, 128, 216, 239 TOUJEO MAX SOLOSTAR.... 176 TAPERDEX 7-DAY...... 155 THIOLA...... 206 TOUJEO SOLOSTAR...... 176 TARGRETIN...... 40, 238 THIOLA EC...... 206 tovet...... 229 tarina 24 fe...... 164, 173, 184 thioridazine hcl...... 116 TOVIAZ...... 239 tarina fe 1/20...... 164, 173, 184 thiothixene...... 121 TRACLEER...... 215 tarina fe 1/20 eq...... 164, 173, 184 THROMBIN-JMI ...... 61 TRADJENTA ...... 166 TARKA...... 67, 72 THROMBIN-JMI EPISTAXIS.... 60 tramadol hcl...... 112 TASIGNA...... 40 THROMBOGEN...... 61 TRAMADOL HCL ER ...... 112 tavaborole...... 234 tiadylt er...... 72, 73, 77, 84 tramadol hcl er...... 112 TAVALISSE...... 56 tiagabine hcl...... 92 tramadol hcl er (biphasic)...... 112 tazarotene...... 238 TIAZAC...... 72, 73, 77, 84 tramadol-acetaminophen.. 88, 112 TAZAROTENE ...... 238 TIBSOVO...... 40 trandolapril...... 66, 67 TAZORAC...... 238 TIGLUTIK...... 105 trandolapril-verapamil hcl er67, 73 taztia xt...... 72, 73, 77, 84 TIKOSYN...... 76 tranexamic acid...... 61 TAZVERIK...... 40 tilia fe...... 164, 173, 184 TRANXENE-T ...... 102, 104 TEGRETOL...... 92, 96 timolol maleate tranylcypromine sulfate...... 108 TEGRETOL-XR...... 92, 96 ...... 51, 69, 70, 76, 97, 139 travoprost (bak free) ...... 144 TEGSEDI...... 191 timolol maleate ocudose...... 139 trazodone hcl...... 121 TEKTURNA ...... 83 timolol maleate pf...... 139 TRECATOR ...... 20 TEKTURNA HCT ...... 82, 133 TIMOPTIC...... 139 TRELEGY ELLIPTA telmisartan...... 65, 66 TIMOPTIC OCUDOSE...... 139 ...... 48, 54, 155, 156 telmisartan-amlodipine...... 66, 78 TIMOPTIC-XE...... 139 TREMFYA ...... 238 telmisartan-hctz...... 66, 133 tinidazole...... 19 tretinoin...... 40, 223 temazepam...... 103 tiopronin...... 207 tretinoin microsphere...... 223 TEMOVATE ...... 228 TIROSINT...... 189 tretinoin microsphere pump.... 224 temozolomide...... 40 TIROSINT-SOL...... 189 TRETTEN ...... 61 TENCON...... 88, 102 TISSEEL...... 238 TREXALL...... 40, 199, 203, 204 TENIVAC...... 43 TIVICAY...... 24 TREZIX...... 88, 112, 118 tenofovir disoproxil fumarate.....26 TIVICAY PD...... 24 tri femynor...... 164, 173, 184 TEPMETKO ...... 40 TIVORBEX...... 116 triamcinolone acetonide...... 229 terazosin hcl ...... 51, 64, 65 tizanidine hcl...... 50 triamterene...... 82, 130 terbinafine hcl...... 15 TOBI PODHALER...... 16 triamterene-hctz...... 130, 133 terbutaline sulfate...... 54, 215 TOBRADEX...... 138, 142 triazolam...... 104 terconazole...... 222 TOBRADEX ST...... 138, 142 TRICARE PRENATAL DHA TERIPARATIDE tobramycin...... 16, 138 ONE...... 63, 148, 207, 242, 244 (RECOMBINANT) ...... 177, 191 tobramycin-dexamethasone TRI-CHLOR...... 207 terrell...... 107 ...... 138, 142 TRICITRASOL...... 56 TESSALON PERLES ...... 210 TOBREX...... 138 tricitrates...... 127 TESTIM...... 156 tolbutamide...... 127, 188 triderm...... 229 testosterone cypionate...... 157 tolcapone...... 104 TRIDESILON...... 229 testosterone enanthate...... 157 tolterodine tartrate...... 239 trientine hcl...... 153 tetrabenazine...... 122 tolterodine tartrate er...... 239 tri-estarylla...... 164, 173, 184 tetracaine hcl...... 144 TOLVAPTAN ...... 134 trifluoperazine hcl...... 116 tetracycline hcl...... 18, 32, 147 tolvaptan...... 134 trifluridine...... 138 TETRIX...... 238 TOPAMAX...... 92, 97 trihexyphenidyl hcl...... 49, 89 TEXACORT...... 228 TOPAMAX SPRINKLE...... 92, 97 TRIJARDY XR 158, 159, 166, 186 THALOMID ...... 203 TOPICORT...... 228 TRIKAFTA...... 211 THEO-24...79, 118, 128, 216, 239 topiramate...... 92, 97, 98 tri-legest fe...... 164, 173, 184 topiramate er...... 92 TRILEPTAL...... 92 TOPROL XL...... 54, 69, 70, 76 tri-linyah...... 164, 173, 184

264 tri-lo-estarylla...... 164, 173, 184 TYVASO...... 215 velivet...... 165, 174, 185 tri-lo-marzia...... 164, 173, 184 TYVASO REFILL...... 215 VELPHORO...... 129 tri-lo-mili...... 164, 173, 184 TYVASO STARTER...... 215 VELTASSA...... 130 tri-lo-sprintec...... 164, 173, 184 UBRELVY...... 104 VELTIN...... 219, 224, 238 trimethobenzamide hcl...... 146 UCERIS...... 156, 229 VEMLIDY...... 29 trimethoprim...... 33 UDAMIN SP...... 132, 242, 245 VENCLEXTA ...... 40 tri-mili...... 165, 173, 184 UKONIQ...... 40 VENCLEXTA STARTING trimipramine maleate...... 122 ULTANE ...... 108 PACK...... 40 TRINATE ...... 63, 242, 244 ULTRACET...... 88, 112 VENELEX...... 238 TRINTELLIX ...... 121 UMECTA MOUSSE...... 231 venlafaxine hcl...... 119 tri-nymyo...... 165, 173, 184 UNISTRIP CONTROL...... 126 venlafaxine hcl er...... 119 TRIPLE COMPLEX FORMULA unithroid...... 189 VENTAVIS...... 216 3 KIT...... 221, 233, 238 UPNEEQ...... 145 VENTRIXYL...... 132, 242, 245 TRIPLE PMB...... 138, 142, 143 UPTRAVI...... 215, 216 verapamil hcl...... 72, 73, 77, 84 TRIPLE PMK...... 138, 142, 143 URAMAXIN...... 231 verapamil hcl er...... 72, 73, 77, 84 tri-previfem...... 165, 173, 184 urea...... 231 VERDESO...... 229 tri-sprintec...... 165, 174, 184 urea nail...... 231 VEREGEN...... 238 TRISTART DHA URELLE...... 33, 48, 88, 207 VERELAN...... 72, 73, 77, 84 ...... 63, 132, 207, 242, 244 UREMEZ-40...... 231 VERELAN PM...... 72, 73, 77, 84 TRISTART FREE URIBEL...... 33, 48, 88, 207 VERSACLOZ...... 101 ...... 63, 132, 207, 242, 244 URIMAR-T...... 33, 48, 88, 207 VERZENIO...... 40 TRISTART ONE urin ds...... 33, 48, 88, 207 VESICARE...... 239 ...... 63, 132, 207, 242, 245 URO-458...... 33, 48, 88, 207 vestura...... 165, 174, 185 TRIUMEQ...... 24, 26 UROCIT-K 10...... 127 VFEND...... 21 TRI-VI-FLOR...195, 242, 245, 246 UROCIT-K 15...... 127 VIBERZI...... 151 TRI-VI-FLORO 195, 242, 245, 246 UROCIT-K 5...... 128 VIBRAMYCIN...... 18, 32 tri-vite/fluoride. 195, 242, 245, 246 UROGESIC-BLUE...... 33, 48, 207 VICTOZA...... 176 trivora (28)...... 165, 174, 184 uro-mp...... 33, 48, 88, 207 VIEKIRA PAK...... 22, 23 tri-vylibra...... 165, 174, 184 URSO 250...... 148 vienva...... 165, 174, 185 tri-vylibra lo...... 165, 174, 184 URSO FORTE...... 148 vigabatrin...... 93 trospium chloride...... 239 ursodiol...... 149 vigadrone...... 93 trospium chloride er...... 239 URSODIOL+SYRSPEND SF..149 VIGAMOX...... 138 TRUE METRIX LEVEL 1 ...... 126 USTELL...... 33, 48, 88, 207 VIIBRYD...... 121 TRUE METRIX LEVEL 2 ...... 126 UTIRA-C...... 33, 48, 88, 207 VIIBRYD STARTER PACK..... 121 TRUE METRIX LEVEL 3 ...... 126 UTOPIC...... 231 VILAMIT MB...... 33, 48, 88, 207 TRULANCE ...... 151 valacyclovir hcl ...... 29 VILEVEV MB...... 33, 48, 88, 207 TRULICITY...... 176 VALCHLOR...... 238 VIMPAT...... 93 TRUMENBA ...... 45 valganciclovir hcl...... 29 VINATE ONE...... 63, 242, 245 TRUSOPT...... 139 valproic acid...... 92, 93, 96, 98 VIOKACE...... 135, 149 TRUVADA...... 26 valsartan...... 65, 66 viorele...... 165, 174, 185 TUKYSA...... 40 valsartan-hydrochlorothiazide VIRACEPT...... 27 tulana...... 165, 184 ...... 66, 133 VIRAMUNE...... 25 TURALIO...... 40 VALTOCO...... 102 VIRAZOLE...... 29 TURPENTINE ...... 223 VANCOCIN...... 22 VIREAD...... 26 TUSSICAPS...... 14, 210 VANCOCIN HCL...... 22 virt-phos 250 neutral...... 132 TUXARIN ER...... 14, 210 vancomycin hcl ...... 22 virtussin ac w/alc...... 210, 211 TUZISTRA XR...... 14, 210 VANCOMYCIN+SYRSPEND VISTARIL...... 13, 99 TWINRIX...... 45 SF...... 22 VISTOGARD...... 191 tyblume...... 165, 174, 185 vandazole...... 16, 219 VITAFOL FE+ TYBOST...... 207 VAQTA...... 45 ...... 63, 132, 207, 242, 245 tydemy...... 165, 174, 185, 245 vardenafil hcl...... 82 VITAFOL STRIPS...... 242 TYKERB...... 40 VARIVAX...... 45 VITAFOL-NANO...... 63, 242, 245 TYMLOS ...... 177, 191 VECAMYL...... 80

265 VITAFOL-OB+DHA XCOPRI...... 93 ZARONTIN...... 121 ...... 63, 132, 207, 242, 245 XELJANZ...... 199 ZARXIO...... 58 vitamin d (ergocalciferol)...... 246 XELJANZ XR...... 199 ZEBUTAL...... 88, 102, 118 vitamins acd-fluoride XELPROS...... 144 ZEJULA...... 41 ...... 195, 242, 243, 245, 246 XENICAL...... 151 ZELAPAR...... 108 VITATHELY WITH GINGER XENLETA ...... 30 ZELBORAF...... 41 ...... 63, 242, 245 XEPI...... 220 ZELNORM...... 151 VITRAKVI...... 40, 41 XERMELO...... 146 ZEMBRACE SYMTOUCH ...... 120 VIVELLE-DOT...... 174, 193 XIFAXAN...... 30, 31 ZEMPLAR...... 246 VIZIMPRO...... 41 XIIDRA...... 142 zenatane...... 238 volnea...... 165, 174, 185 XOFLUZA (40 MG DOSE)...... 20 ZENPEP...... 135, 149 VONVENDI...... 61 XOFLUZA (80 MG DOSE)...... 20 ZEPATIER...... 23 voriconazole...... 21 XOLEGEL...... 222 ZEPOSIA...... 203 VOSEVI...... 22, 23 XOLEGEL COREPAK.....222, 229 ZEPOSIA 7-DAY STARTER VOTRIENT...... 41 XOLEGEL DUO/HEAD & PACK...... 203 VP FC KIT...... 50, 234, 238 SHOULDERS...... 222, 233 ZEPOSIA STARTER KIT...... 203 VP GKL KIT...... 221, 234, 238 XOLEGEL DUO/XOLEX. 222, 233 ZETONNA ...... 142 vp-pnv-dha ...... 63, 207, 242, 245 XOPENEX HFA...... 54, 215 ZIAC...... 69, 133 VRAYLAR...... 101 XOSPATA...... 41 ZIAGEN...... 26 VTOL LQ ...... 88, 102, 118 XPOVIO (100 MG ONCE zidovudine...... 27 VUSION...... 221, 222, 229 WEEKLY)...... 41 ZIEXTENZO...... 58 vyfemla...... 165, 174, 185 XPOVIO (40 MG ONCE zileuton er...... 212 VYLEESI...... 105 WEEKLY)...... 41 ZILXI...... 220 vylibra...... 165, 174, 185 XPOVIO (40 MG TWICE ZIOPTAN...... 145 VYNDAMAX...... 73, 105 WEEKLY)...... 41 ziprasidone hcl...... 96, 101 VYNDAQEL...... 73 XPOVIO (60 MG ONCE ZIPSOR...... 116 VYTORIN...... 74, 80 WEEKLY)...... 41 ZIRGAN...... 138 VYVANSE...... 86 XPOVIO (60 MG TWICE ZITHROMAX...... 29 WAKIX...... 123 WEEKLY)...... 41 ZITHROMAX TRI-PAK...... 29 warfarin sodium...... 56 XPOVIO (80 MG ONCE ZITHROMAX Z-PAK...... 29 WEGOVY...... 176 WEEKLY)...... 41 ZOKINVY...... 207, 208 WELCHOL...... 71, 157 XPOVIO (80 MG TWICE ZOLINZA...... 41 wera...... 165, 174, 185 WEEKLY)...... 41 zolmitriptan...... 120 WESTGEL DHA XTAMPZA ER...... 112 zolpidem tartrate...... 99 ...... 63, 132, 207, 242, 245 XTANDI ...... 41 zolpidem tartrate er...... 99 WESTHROID...... 189 xulane...... 165, 174, 185 ZOLPIMIST...... 99 WHEAT GERM OIL...... 246 XURIDEN...... 207 ZOMIG...... 120 WIDE-SEAL DIAPHRAGM 60 208 XYNTHA...... 61 ZONEGRAN...... 93 WIDE-SEAL DIAPHRAGM 65 208 XYNTHA SOLOFUSE...... 61 zonisamide...... 93 WIDE-SEAL DIAPHRAGM 70 208 XYOSTED...... 157 ZONTIVITY...... 64 WIDE-SEAL DIAPHRAGM 75 208 XYREM...... 105 ZORBTIVE...... 177, 187 WIDE-SEAL DIAPHRAGM 80 208 XYWAV...... 106 ZORVOLEX...... 116 WIDE-SEAL DIAPHRAGM 85 208 YASMIN 28...... 165, 174, 185 zovia 1/35 (28)...... 165, 174, 185 WIDE-SEAL DIAPHRAGM 90 208 YAZ...... 165, 174, 185 zovia 1/35e (28)...... 165, 174, 185 WIDE-SEAL DIAPHRAGM 95 208 YUPELRI...... 48 ZOVIRAX...... 29, 221 WILATE...... 61 yuvafem...... 174, 193 ZTLIDO...... 189 WILZIN...... 132 ZACARE...... 223, 233 ZUBSOLV...... 113, 114 WP THYROID...... 189 zaclir cleansing...... 233 zumandimine...... 165, 174, 185 wymzya fe ...... 165, 174, 185 zafemy...... 165, 174, 185 ZUPLENZ...... 145 XALKORI...... 41 zafirlukast...... 212 ZYDELIG...... 41 XARELTO...... 56 zaleplon...... 99 ZYFLO...... 212 XARELTO STARTER PACK .....56 ZANAFLEX...... 50 ZYKADIA...... 42 XATMEP...... 41, 199, 203, 204 zarah...... 165, 174, 185 ZYLET...... 138, 142

266 ZYLOPRIM...... 191 ZYMAXID...... 138 ZYPITAMAG...... 80 ZYVOX...... 30

267