Access Tier 4 PPO Prescription Drug List CDI Version

Pharmacy | PDL | California

2021 California Access Large Group 4-Tier PPO Prescription Drug List

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 All previous versions of this PDL are no longer in effect.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) 4 irbesartan oral tablet 150 mg, 300 mg, 75 mg 1

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

Drug Tier 1 Your lowest cost medications ST Step Therapy Drug Tier 2 Your mid-range cost medications H May be part of health care reform preventive Drug Tier 3 Your mid-range cost medications H-N May be part of health care reform preventive when used for appropriate Drug Tier 4 Your highest cost medications preventive purposes PA Prior authorization required SP Specialty medication SL Supply Limit CM Orally administered anti-cancer medication

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

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

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

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

Please note: If you have a high deductible plan, the tier cost levels may apply once you reach your deductible. Refer to your enrollment and plan materials on myuhc.com, or call the toll-free number on your health plan ID card for more information about your benefit plan.

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 ...... 34 ANTITOXINS,IMMUNE GLOB,TOXOIDS,VACCINES - DRUGS FOR THE IMMUNE SYSTEM...... 42 AUTONOMIC DRUGS - Drugs for the Nervous System ...... 46 BLOOD FORMATION, COAGULATION, THROMBOSIS - Drugs for the Blood ...... 56 CARDIOVASCULAR DRUGS - Drugs for the Heart...... 66 CENTRAL NERVOUS SYSTEM AGENTS - Drugs for the Nervous System ...... 86 DENTAL AGENTS - Oral Care ...... 126 DEVICES - Medical Supplies and Durable Medical Equipment...... 126 DIAGNOSTIC AGENTS...... 129 DISINFECTANTS (FOR NON-DERMATOLOGIC USE) - Disinfectants ...... 130 ELECTROLYTIC, CALORIC, AND WATER BALANCE ...... 130 ENZYMES...... 137 EYE, EAR, NOSE AND THROAT (EENT) PREPS...... 138 GASTROINTESTINAL DRUGS ...... 149 GASTROINTESTINAL DRUGS - Drugs for the Stomach ...... 149 GOLD COMPOUNDS...... 156 HEAVY METAL ANTAGONISTS - Drugs to Reduce Iron ...... 156 HORMONES AND SYNTHETIC SUBSTITUTES - Hormones ...... 157 LOCAL ANESTHETICS (PARENTERAL) - Drugs for Numbing ...... 194 MISCELLANEOUS THERAPEUTIC AGENTS ...... 194 NONHORMONAL CONTRACEPTIVES - Drugs for Women ...... 213 OXYTOCICS - Drugs for Women...... 213 PHARMACEUTICAL AIDS...... 213 RESPIRATORY TRACT AGENTS - Drugs for the Lungs ...... 214 SKIN AND MUCOUS MEMBRANE AGENTS - Drugs for the Skin ...... 221 SMOOTH MUSCLE RELAXANTS - Drugs to Relax Muscles ...... 244 VITAMINS...... 245

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 4 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 4 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 4 diphenhydramine hcl oral elixir 12.5 mg/5ml 1

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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 REMERON SOLTAB ORAL TABLET DISPERSIBLE 15 MG, 30 4 MG, 45 MG (mirtazapine) SPRAVATO (56 MG DOSE) NASAL SOLUTION THERAPY PA; SL (8 devices (4 kits) per 4 PACK 28 MG/DEVICE (esketamine hcl) month.) SPRAVATO (84 MG DOSE) NASAL SOLUTION THERAPY PA; SL (12 devices (4 kits) 4 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 4 HOUR 100 MG, 200 MG, 300 MG (carbamazepine) DEPAKOTE ER ORAL TABLET EXTENDED RELEASE 24 4 ST HOUR 250 MG, 500 MG (divalproex sodium) DEPAKOTE ORAL TABLET DELAYED RELEASE 125 MG, 250 4 MG, 500 MG (divalproex sodium) DEPAKOTE SPRINKLES ORAL CAPSULE DELAYED 4 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, 42 X 50 3 ST MG & 14X100 MG (lamotrigine) LAMICTAL ODT ORAL KIT 25 & 50 & 100 MG (lamotrigine) 4 ST Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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 LAMICTAL ODT ORAL TABLET DISPERSIBLE 100 MG, 200 4 ST MG, 25 MG, 50 MG (lamotrigine) LAMICTAL ORAL TABLET 100 MG, 150 MG, 200 MG, 25 MG 4 ST (lamotrigine) LAMICTAL ORAL TABLET CHEWABLE 25 MG, 5 MG 4 ST (lamotrigine) LAMICTAL STARTER ORAL KIT 35 X 25 MG, 42 X 25 MG & 7 4 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 4 (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 Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 97 Coverage Requirements & Prescription Drug Name Drug Tier Limits 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 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 4 SL (31 tablets per 31 days.) HOUR 150 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 4 SL (1 tablet per day.) HOUR 200 MG (quetiapine fumarate) SEROQUEL XR ORAL TABLET EXTENDED RELEASE 24 4 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 4 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 4 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.)

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 147 Coverage Requirements & Prescription Drug Name Drug Tier Limits tetracaine hcl ophthalmic solution 0.5 % 1 MIOTICS - Drugs for the Eye ISOPTO CARPINE OPHTHALMIC SOLUTION 1 %, 2 % 4 (pilocarpine hcl) ISOPTO CARPINE OPHTHALMIC SOLUTION 4 % (pilocarpine 3 hcl) pilocarpine hcl ophthalmic solution 1 %, 2 %, 4 % 1 MYDRIATICS - Drugs for the Eye altafrin ophthalmic solution 10 %, 2.5 % 1 atropine sulfate ophthalmic ointment 1 % 1 atropine sulfate ophthalmic solution 1 % 1 CYCLOGYL OPHTHALMIC SOLUTION 0.5 %, 1 %, 2 % 4 (cyclopentolate hcl) CYCLOMYDRIL OPHTHALMIC SOLUTION 0.2-1 % 3 (cyclopentolate-phenylephrine) cyclopentolate hcl ophthalmic solution 0.5 %, 1 %, 2 % 1 homatropaire ophthalmic solution 5 % 1 ISOPTO ATROPINE OPHTHALMIC SOLUTION 1 % (atropine 3 sulfate) phenylephrine hcl ophthalmic solution 10 %, 2.5 % 1 PROSTAGLANDIN ANALOGS - Drugs for the Eye bimatoprost ophthalmic solution 0.03 % 1 latanoprost ophthalmic solution 0.005 % 1 LUMIGAN OPHTHALMIC SOLUTION 0.01 % (bimatoprost) 2 ROCKLATAN OPHTHALMIC SOLUTION 0.02-0.005 % 3 (netarsudil-latanoprost) travoprost (bak free) ophthalmic solution 0.004 % 1 XELPROS OPHTHALMIC EMULSION 0.005 % (latanoprost) 3 ZIOPTAN OPHTHALMIC SOLUTION 0.0015 % (tafluprost) 3 ST RHO KINASE INHIBITORS - Drugs for the Eye RHOPRESSA OPHTHALMIC SOLUTION 0.02 % (netarsudil 3 dimesylate) ROCKLATAN OPHTHALMIC SOLUTION 0.02-0.005 % 3 (netarsudil-latanoprost) VASOCONSTRICTORS ADRENALIN NASAL SOLUTION 0.1 % (epinephrine hcl 2 (nasal)) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 148 Coverage Requirements & Prescription Drug Name Drug Tier Limits altafrin ophthalmic solution 10 %, 2.5 % 1 CYCLOMYDRIL OPHTHALMIC SOLUTION 0.2-1 % 3 (cyclopentolate-phenylephrine) phenylephrine hcl ophthalmic solution 10 %, 2.5 % 1 UPNEEQ OPHTHALMIC SOLUTION 0.1 % (oxymetazoline hcl) 4 PA GASTROINTESTINAL DRUGS ANTACIDS AND ADSORBENTS FIRST-MOUTHWASH BLM MOUTH/THROAT SUSPENSION 3 PA (dph-lido-alhydr-mghydr-simeth) SODIUM BICARBONATE ORAL POWDER 3 GASTROINTESTINAL DRUGS - Drugs for the Stomach 5-HT3 RECEPTOR ANTAGONISTS - Drugs for Vomiting and Nausea AKYNZEO ORAL CAPSULE 300-0.5 MG (netupitant- 4 palonosetron) granisetron hcl oral tablet 1 mg 1 ondansetron hcl oral solution 4 mg/5ml 1 ondansetron hcl oral tablet 24 mg, 4 mg, 8 mg 1 ondansetron odt oral tablet dispersible 4 mg, 8 mg 1 ZUPLENZ ORAL FILM 4 MG, 8 MG (ondansetron) 4 ANTIDIARRHEA AGENTS - Drugs for Diarrhea diphenoxylate-atropine oral liquid 2.5-0.025 mg/5ml 1 diphenoxylate-atropine oral tablet 2.5-0.025 mg 1 LOMOTIL ORAL TABLET 2.5-0.025 MG (diphenoxylate- 4 atropine) MOTOFEN ORAL TABLET 1-0.025 MG (difenoxin-atropine) 4 MYTESI ORAL TABLET DELAYED RELEASE 125 MG 4 PA; SL (2 tablets per day.) (crofelemer) opium oral tincture 10 mg/ml (1%) 1 PYLERA ORAL CAPSULE 140-125-125 MG (bis subcit- SL (120 capsules per 180 3 metronid-tetracyc) days.) PA; SL (3 tablets per day); XERMELO ORAL TABLET 250 MG (telotristat etiprate) 3 SP ANTIEMETICS, MISCELLANEOUS - Drugs for Vomiting and Nausea dronabinol oral capsule 10 mg, 2.5 mg, 5 mg 1 MARINOL ORAL CAPSULE 10 MG, 2.5 MG, 5 MG (dronabinol) 4 Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 149 Coverage Requirements & Prescription Drug Name Drug Tier Limits promethazine hcl oral solution 6.25 mg/5ml 1 promethazine hcl oral syrup 6.25 mg/5ml 1 promethazine hcl oral tablet 12.5 mg, 25 mg, 50 mg 1 promethazine hcl rectal suppository 12.5 mg, 25 mg 1 promethegan rectal suppository 12.5 mg, 25 mg, 50 mg 1 scopolamine transdermal patch 72 hour 1 mg/3days 1 SYNDROS ORAL SOLUTION 5 MG/ML (dronabinol) 4 SL (4 ml per day) ANTIFLATULENTS - Drugs for Gas FIRST-MOUTHWASH BLM MOUTH/THROAT SUSPENSION 3 PA (dph-lido-alhydr-mghydr-simeth) ANTIHISTAMINES (GI DRUGS) - Drugs for Vomiting and Nausea ANTIVERT ORAL TABLET 50 MG ( meclizine hcl) 2 compro rectal suppository 25 mg 1 prochlorperazine maleate oral tablet 10 mg, 5 mg 1 prochlorperazine rectal suppository 25 mg 1 trimethobenzamide hcl oral capsule 300 mg 1 ANTI-INFLAMMATORY AGENTS (GI DRUGS) - Drugs for Inflammation alosetron hcl oral tablet 0.5 mg, 1 mg 1 PA; SL (2 tablets per day) APRISO ORAL CAPSULE EXTENDED RELEASE 24 HOUR 1 0.375 GM (mesalamine) AZULFIDINE EN-TABS ORAL TABLET DELAYED RELEASE 4 500 MG (sulfasalazine) AZULFIDINE ORAL TABLET 500 MG (sulfasalazine) 4 balsalazide disodium oral capsule 750 mg 1 DIPENTUM ORAL CAPSULE 250 MG (olsalazine sodium) 3 LIALDA ORAL TABLET DELAYED RELEASE 1.2 GM 1 (mesalamine) mesalamine rectal enema 4 gm 1 mesalamine rectal suppository 1000 mg 1 SL (1 suppository per day.) mesalamine-cleanser rectal kit 4 gm 1 SL (4 grams per month.) ROWASA RECTAL KIT 4 GM (mesalamine-cleanser) 4 SL (4 grams per month.) SFROWASA RECTAL ENEMA 4 GM/60ML (mesalamine) 4 sulfasalazine oral tablet 500 mg 1 sulfasalazine oral tablet delayed release 500 mg 1

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 191 Coverage Requirements & Prescription Drug Name Drug Tier Limits NUTROPIN AQ NUSPIN 5 SUBCUTANEOUS SOLUTION PA; SL (36 ml (18 cartridges) 2 PEN-INJECTOR 5 MG/2ML (somatropin) per month.); SP SEROSTIM SUBCUTANEOUS SOLUTION RECONSTITUTED 4 PA; SL (1 tablet per day); SP 4 MG, 5 MG, 6 MG (somatropin (non-refrigerated)) ZORBTIVE SUBCUTANEOUS SOLUTION RECONSTITUTED 3 PA; SL (1 tablet per day); SP 8.8 MG (somatropin (non-refrigerated)) SOMATOTROPIN ANTAGONISTS - Hormones SOMAVERT SUBCUTANEOUS SOLUTION RECONSTITUTED 3 PA; SL (1 vial per day.); SP 10 MG, 15 MG, 20 MG, 25 MG, 30 MG (pegvisomant) SULFONYLUREAS - Drugs for Diabetes AMARYL ORAL TABLET 1 MG, 2 MG, 4 MG (glimepiride) 4 DUETACT ORAL TABLET 30-2 MG, 30-4 MG (pioglitazone hcl- 3 SL (1 tablet per day) glimepiride) glimepiride oral tablet 1 mg, 2 mg, 4 mg 1 glipizide er oral tablet extended release 24 hour 10 mg, 2.5 mg, 1 5 mg glipizide oral tablet 10 mg, 5 mg 1 glipizide xl oral tablet extended release 24 hour 10 mg, 2.5 mg, 1 5 mg glipizide-metformin hcl oral tablet 2.5-250 mg, 2.5-500 mg, 5- 1 500 mg GLUCOTROL XL ORAL TABLET EXTENDED RELEASE 24 4 HOUR 10 MG, 2.5 MG, 5 MG (glipizide) glyburide micronized oral tablet 1.5 mg, 3 mg, 6 mg 1 glyburide oral tablet 1.25 mg, 2.5 mg, 5 mg 1 glyburide-metformin oral tablet 1.25-250 mg, 2.5-500 mg, 5-500 1 mg GLYNASE ORAL TABLET 1.5 MG (glyburide micronized) 3 GLYNASE ORAL TABLET 3 MG, 6 MG (glyburide micronized) 4 pioglitazone hcl-glimepiride oral tablet 30-2 mg, 30-4 mg 1 SL (1 tablet per day) tolbutamide oral tablet 500 mg 1 THIAZOLIDINEDIONES - Drugs for Diabetes ACTOPLUS MET ORAL TABLET 15-500 MG, 15-850 MG 4 SL (3 tablets per day) (pioglitazone hcl-metformin hcl) DUETACT ORAL TABLET 30-2 MG, 30-4 MG (pioglitazone hcl- 3 SL (1 tablet per day) glimepiride) OSENI ORAL TABLET 12.5-15 MG, 12.5-30 MG, 12.5-45 MG, 2 SL (1 tablet per day.) 25-15 MG, 25-30 MG, 25-45 MG (alogliptin-pioglitazone) Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 192 Coverage Requirements & Prescription Drug Name Drug Tier Limits pioglitazone hcl oral tablet 15 mg, 30 mg, 45 mg 1 SL (1 tablet per day) pioglitazone hcl-glimepiride oral tablet 30-2 mg, 30-4 mg 1 SL (1 tablet per day) pioglitazone hcl-metformin hcl oral tablet 15-500 mg, 15-850 mg 1 SL (3 tablets per day) THYROID AGENTS - Drugs for the Thyroid ARMOUR THYROID ORAL TABLET 120 MG, 15 MG, 180 MG, 2 240 MG, 30 MG, 300 MG, 60 MG, 90 MG (thyroid) euthyrox oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 1 mcg, 175 mcg, 200 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg levo-t oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 1 mcg LEVOTHYROXINE SODIUM ORAL CAPSULE 100 MCG, 112 MCG, 125 MCG, 13 MCG, 137 MCG, 150 MCG, 175 MCG, 200 4 MCG, 25 MCG, 50 MCG, 75 MCG, 88 MCG levothyroxine sodium oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 1 mcg, 75 mcg, 88 mcg levoxyl oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 1 mcg, 175 mcg, 200 mcg, 25 mcg, 50 mcg, 75 mcg, 88 mcg liothyronine sodium oral tablet 25 mcg, 5 mcg, 50 mcg 1 NATURE-THROID ORAL TABLET 113.75 MG, 130 MG, 146.25 MG, 16.25 MG, 162.5 MG, 195 MG, 260 MG, 32.5 MG, 325 2 MG, 48.75 MG, 81.25 MG (thyroid) NATURE-THROID TABLET 65 MG ORAL 65 MG (thyroid) 3 NATURE-THROID TABLET 65 MG ORAL 65 MG (thyroid) 2 NATURE-THROID TABLET 97.5 MG ORAL 97.5 MG (thyroid) 3 NATURE-THROID TABLET 97.5 MG ORAL 97.5 MG (thyroid) 2 np thyroid oral tablet 120 mg, 15 mg, 30 mg, 60 mg, 90 mg 1 TIROSINT ORAL CAPSULE 100 MCG, 112 MCG, 125 MCG, 13 MCG, 137 MCG, 150 MCG, 175 MCG, 200 MCG, 25 MCG, 4 50 MCG, 75 MCG, 88 MCG (levothyroxine sodium) TIROSINT-SOL ORAL SOLUTION 100 MCG/ML, 112 MCG/ML, 125 MCG/ML, 13 MCG/ML, 137 MCG/ML, 150 MCG/ML, 175 MCG/ML, 200 MCG/ML, 25 MCG/ML, 37.5 MCG/ML, 44 2 MCG/ML, 50 MCG/ML, 62.5 MCG/ML, 75 MCG/ML, 88 MCG/ML (levothyroxine sodium) unithroid oral tablet 100 mcg, 112 mcg, 125 mcg, 137 mcg, 150 mcg, 175 mcg, 200 mcg, 25 mcg, 300 mcg, 50 mcg, 75 mcg, 88 1 mcg

Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 202 Coverage Requirements & Prescription Drug Name Drug Tier Limits RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 10 SL (0.8 ml (4 auto-injectors) 2 MG/0.2ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR SL (1 ml (4 auto-injectors) 2 12.5 MG/0.25ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 15 SL (1.2 ml (4 auto-injectors) 2 MG/0.3ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR SL (1.4 ml (4 auto-injectors) 2 17.5 MG/0.35ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 20 SL (1.6 ml (4 auto-injectors) 2 MG/0.4ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR SL (1.8 ml (4 auto-injectors) 2 22.5 MG/0.45ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 25 SL (2 ml (4 auto-injectors) 2 MG/0.5ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 30 SL (2.4 ml (4 auto-injectors) 2 MG/0.6ML (methotrexate (anti-rheumatic)) per month.) RASUVO SUBCUTANEOUS SOLUTION AUTO-INJECTOR 7.5 SL (0.6 ml (4 auto-injectors) 2 MG/0.15ML (methotrexate (anti-rheumatic)) per month.) RIDAURA ORAL CAPSULE 3 MG (auranofin) 3 SP RINVOQ ORAL TABLET EXTENDED RELEASE 24 HOUR 15 PA; SL (1 tablet per day.); 2 MG (upadacitinib) SP SANDIMMUNE ORAL SOLUTION 100 MG/ML (cyclosporine) 4 SIMPONI SUBCUTANEOUS SOLUTION AUTO-INJECTOR PA; SL (1 syringe per 21 2 100 MG/ML (golimumab) days.); SP SIMPONI SUBCUTANEOUS SOLUTION AUTO-INJECTOR 50 PA; SL (0.5 ml (1 syringe) 2 MG/0.5ML (golimumab) per month); SP SIMPONI SUBCUTANEOUS SOLUTION PREFILLED PA; SL (1 syringe per 21 2 SYRINGE 100 MG/ML (golimumab) days.); SP SIMPONI SUBCUTANEOUS SOLUTION PREFILLED PA; SL (0.5 ml (1 syringe) 2 SYRINGE 50 MG/0.5ML (golimumab) per month); SP sulfasalazine oral tablet 500 mg 1 sulfasalazine oral tablet delayed release 500 mg 1 TREXALL ORAL TABLET 10 MG, 15 MG, 5 MG, 7.5 MG 2 (methotrexate sodium) XATMEP ORAL SOLUTION 2.5 MG/ML (methotrexate) 4 SL (4 ml per day) PA; ST; SL (8 mL per day.); XELJANZ ORAL SOLUTION 1 MG/ML (tofacitinib citrate) 2 SP PA; ST; SL (2 tablets per XELJANZ ORAL TABLET 10 MG (tofacitinib citrate) 2 day); SP Drug Tier 1: Your lowest cost medications; Drug Tier 2: Your mid-range cost medications; Drug Tier 3: Your mid-range cost medications; Drug Tier 4: Your highest cost 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. 203 Coverage Requirements & Prescription Drug Name Drug Tier Limits PA; ST; SL (2 tablets per XELJANZ ORAL TABLET 5 MG (tofacitinib citrate) 2 day.); SP XELJANZ XR ORAL TABLET EXTENDED RELEASE 24 HOUR PA; ST; SL (1 tablet per 2 11 MG (tofacitinib citrate) day.); SP XELJANZ XR ORAL TABLET EXTENDED RELEASE 24 HOUR 2 PA; ST; SL (1 tablet per day.) 22 MG (tofacitinib citrate) IMMUNOMODULATORY AGENTS - DRUGS FOR THE IMMUNE SYSTEM ACTEMRA ACTPEN SUBCUTANEOUS SOLUTION AUTO- PA; ST; SL (3.6 ml per 21 3 INJECTOR 162 MG/0.9ML (tocilizumab) days.); SP ACTEMRA SUBCUTANEOUS SOLUTION PREFILLED PA; ST; SL (4 syringes (36 3 SYRINGE 162 MG/0.9ML (tocilizumab) mL) per month); SP ACTIMMUNE SUBCUTANEOUS SOLUTION 2000000 PA; SL (6.5 ml (13 vials) per 2 UNIT/0.5ML (interferon gamma-1b) month.); SP ALFERON N INJECTION SOLUTION 5000000 UNIT/ML 2 (interferon alfa-n3) ARAVA ORAL TABLET 10 MG, 20 MG (leflunomide) 4 AUBAGIO ORAL TABLET 14 MG, 7 MG (teriflunomide) 3 PA; SL (1 tablet per day.) AVONEX PEN INTRAMUSCULAR AUTO-INJECTOR KIT 30 PA; SL (4 pens (1 box) per 2 MCG/0.5ML (interferon beta-1a) month.); SP AVONEX PREFILLED INTRAMUSCULAR PREFILLED PA; SL (4 syringes (1 box) 2 SYRINGE KIT 30 MCG/0.5ML (interferon beta-1a) per month.); SP AZASAN ORAL TABLET 100 MG, 75 MG (azathioprine) 3 azathioprine oral tablet 50 mg 1 AZULFIDINE EN-TABS ORAL TABLET DELAYED RELEASE 4 500 MG (sulfasalazine) AZULFIDINE ORAL TABLET 500 MG (sulfasalazine) 4 BAFIERTAM ORAL CAPSULE DELAYED RELEASE 95 MG PA; SL (4 capsules per day.); 2 (monomethyl fumarate) SP BETASERON SUBCUTANEOUS KIT 0.3 MG (interferon beta- 2 PA; SL (15 vials per month) 1b) CIMZIA PREFILLED KIT SUBCUTANEOUS KIT 2 X 200 PA; SL (1 kit per 21 days.); 2 MG/ML (certolizumab pegol) SP CIMZIA STARTER KIT SUBCUTANEOUS KIT 6 X 200 MG/ML PA; SL (6 mL per 365 days.); 2 (certolizumab pegol) SP cyclosporine modified oral capsule 100 mg, 25 mg, 50 mg 1 cyclosporine modified oral solution 100 mg/ml 1 cyclosporine oral capsule 100 mg, 25 mg 1

253 amlodipine besylate-benazepril ARAKODA...... 17 avidoxy...... 17, 31 hcl...... 68, 79 aranelle...... 163, 171, 182 AVIDOXY DK...... 31, 235, 244 amlodipine besylate-valsartan ARANESP (ALBUMIN FREE) AVITA...... 228 ...... 67, 79 ...... 56, 58 AVONEX PEN...... 204 amlodipine-atorvastatin...... 79, 81 ARAVA...... 200, 204, 208 AVONEX PREFILLED...... 204 amlodipine-olmesartan...... 67, 79 ARCALYST...... 209 AYGESTIN...... 182 amlodipine-valsartan-hctz arformoterol tartrate...... 54 ayuna...... 163, 171, 182 ...... 67, 79, 136 ARIKAYCE...... 16 AYVAKIT...... 34 amnesteem...... 240 aripiprazole...... 96, 101 AZASAN...... 200, 204, 208 amoxapine...... 124 armodafinil...... 125 AZASITE...... 139 amoxicill-clarithro-lansopraz ARMOUR THYROID...... 193 azathioprine...... 200, 204, 208 ...... 16, 29, 156 ARNUITY ELLIPTA ...... 157, 218 azelaic acid...... 240 amoxicillin...... 16, 151 ARTISS...... 240 azelastine hcl...... 139, 219 amoxicillin-potassium ARZOL SILVER NIT azelastine-fluticasone clavulanate...... 16 APPLICATORS...... 146 ...... 139, 143, 218, 219 amoxicillin-potassium ascomp-codeine AZELEX...... 240 clavulanate er...... 16 ...... 103, 112, 119, 121 AZILECT...... 110 AMPHETAMINE ER...... 87 ashlyna...... 163, 171, 182 azithromycin...... 29 amphetamine sulfate...... 87 aspirin-dipyridamole er...... 65, 121 AZOPT...... 143 amphetamine- ASTRAZENECA COVID-19 AZULFIDINE..... 31, 150, 200, 204 dextroamphetamine...... 87 VACCINE...... 44 AZULFIDINE EN-TABS ampicillin...... 16 ASTRINGYN...... 60 ...... 31, 150, 200, 204 AMZEEQ...... 221 ATABEX OB...... 63, 245, 248 azurette...... 163, 171, 182 anagrelide hcl...... 65 atazanavir sulfate...... 27 bac...... 88, 103, 119 ANALPRAM HC ...... 225, 229 atenolol...... 55, 70, 71, 76 bacitracin...... 139 ANALPRAM HC SINGLES ATENOLOL+SYRSPEND SF bacitracin-polymyxin b...... 139 ...... 225, 229 ...... 55, 70, 71, 77 bacitra-neomycin-polymyxin-hc ANALPRAM-HC ...... 225, 229 atenolol-chlorthalidone...... 70, 137 ...... 139, 143 ANASPAZ...... 47 atomoxetine hcl...... 107 BACLOFEN...... 51 anastrozole...... 34, 161 ATOPADERM...... 240 baclofen...... 51 ANCOBON...... 30 atorvastatin calcium...... 81 BACTRIM...... 19, 31, 32 ANDRODERM...... 160 atovaquone...... 19 BACTRIM DS...... 19, 31, 32 ANGELIQ...... 171, 182 atovaquone-proguanil hcl...... 17 BAFIERTAM...... 204 ANNOVERA ...... 163, 171, 182 atropine sulfate...... 148 BALCOLTRA ...... 163, 171, 182 ANORO ELLIPTA ...... 47, 54 ATROVENT HFA ...... 47, 214 balsalazide disodium...... 150 ANTARA ...... 81 AUBAGIO...... 204 balsam peru-castor oil...... 240 ANTICOAGULANT SODIUM aubra...... 163, 171, 182 BALVERSA...... 34 CITRATE ...... 57 aubra eq...... 163, 171, 182 balziva...... 163, 171, 182 ANTIVERT...... 12, 150 AUGMENTIN...... 17 BANZEL...... 91 anucort-hc...... 229 aurovela 1.5/30...... 163, 171, 182 BAQSIMI ONE PACK..... 179, 194 ANUSOL-HC...... 229 aurovela 1/20...... 163, 171, 182 BAQSIMI TWO PACK.....179, 194 apap-caff-dihydrocodeine aurovela 24 fe...... 163, 171, 182 BARACLUDE...... 29 ...... 88, 112, 119 aurovela fe 1.5/30... 163, 171, 182 BAXDELA...... 30 APEXICON E...... 229 aurovela fe 1/20...... 163, 171, 182 BECONASE AQ...... 143, 218 APLENZIN...... 95 AURYXIA...... 132 BELBUCA...... 116 APOKYN...... 111 AUSTEDO...... 125 belladonna alkaloids-opium apraclonidine hcl...... 146 AUTOLET LANCING DEVICE 126 ...... 47, 112 aprepitant...... 155 AVAR CLEANSER...... 221, 235 BELSOMRA ...... 100 apri...... 163, 171, 182 AVAR LS CLEANSER.... 221, 235 benazepril hcl...... 68 APRISO...... 150 AVAR-E EMOLLIENT..... 221, 235 benazepril-hydrochlorothiazide APTENSIO XR...... 119 AVAR-E GREEN...... 222, 235 ...... 68, 136 APTIOM...... 91 AVAR-E LS...... 222, 235 BENEFIX...... 60 APTIVUS...... 27 aviane...... 163, 171, 182 BENLYSTA ...... 208

254 BENZALKONIUM CHLORIDE 237 BRAFTOVI ...... 35 CALAN SR...... 73, 74, 78, 85 benzalkonium chloride...... 237 BREO ELLIPTA ...... 54, 157 CALCIFOL...... 133, 248, 251 BENZAMYCIN ...... 222, 237 BREZTRI AEROSPHERE calcipotriene...... 240 BENZHYDROCODONE- ...... 47, 54, 157 CALCIPOTRIENE...... 240 ACETAMINOPHEN...... 88, 112 briellyn...... 163, 171, 183 calcipotriene-betameth diprop BENZNIDAZOLE ...... 19 BRILINTA ...... 65 ...... 230, 240 BENZOIN...... 228 brimonidine tartrate...... 138 calcitonin (salmon)...... 161, 196 benzoin compound...... 228 brinzolamide...... 143 CALCITRENE ...... 241 benzonatate...... 215 BRIVIACT...... 91 calcitriol...... 241, 251 benzoyl peroxide-erythromycin bromfenac sodium (once-daily) calcium acetate...... 132, 133 ...... 222, 237 ...... 147 calcium acetate (phos binder) benzphetamine hcl...... 87 bromocriptine mesylate...... 109 ...... 132, 133 benztropine mesylate...... 49, 91 BROMSITE...... 147 calcium-folic acid plus d bepotastine besilate...... 139 BROVANA...... 54 ...... 133, 248, 251 BERINERT...... 200 BRUKINSA...... 35 CALQUENCE...... 35 beser...... 229 BRYHALI...... 230 CAMBIA...... 99, 117 BESIVANCE...... 139 budesonide...... 157, 218 camila...... 163, 183 BETADINE OPHTHALMIC bumetanide...... 82, 132 camrese...... 163, 171, 183 PREP...... 146 BUMEX...... 82, 132 camrese lo...... 163, 171, 183 betamethasone dipropionate.. 230 BUNAVAIL...... 115, 116 candesartan cilexetil...... 66, 67 betamethasone dipropionate BUPAP...... 88, 103 candesartan cilexetil-hctz..67, 136 aug...... 229, 230 BUPHENYL...... 131 capecitabine...... 35 betamethasone valerate...... 230 buprenorphine hcl...... 116 CAPEX...... 230 BETAPACE AF...... 52, 70, 71, 77 buprenorphine hcl-naloxone CAPLYTA...... 101 BETASERON...... 204 hcl...... 115, 116 CAPRELSA...... 35 betaxolol hcl.... 55, 70, 71, 77, 142 bupropion hcl...... 95 captopril...... 68 bethanechol chloride...... 53 bupropion hcl er (smoking det). 95 CARAC...... 241 BETIMOL...... 142 bupropion hcl er (sr)...... 95 CARBAGLU...... 131 BETOPTIC-S...... 142 bupropion hcl er (xl)...... 95 carbamazepine...... 91, 96 BEVESPI AEROSPHERE...47, 54 BUPROPION HCL ER (XL)...... 95 carbamazepine er...... 91, 96 BEXSERO...... 44 buspirone hcl...... 100 CARBATROL...... 91, 96 bicalutamide...... 34 butalbital-acetaminophen..88, 103 carbidopa...... 108 BIDIL...... 80, 83 butalbital-apap-caff-cod carbidopa-levodopa...... 108 BIJUVA...... 171, 182 ...... 88, 104, 112, 119 carbidopa-levodopa er...... 108 BIKTARVY...... 24, 25 butalbital-apap-caffeine carbidopa-levodopa- BILTRICIDE...... 17 ...... 88, 104, 119 entacapone...... 107, 108 bimatoprost...... 148 butalbital-asa-caff-codeine carbinoxamine maleate.....12, 217 BINOSTO...... 196 ...... 104, 112, 119, 121 CARDURA...... 52, 66 bisoprolol fumarate. 55, 70, 71, 77 butalbital-aspirin-caffeine CARDURA XL...... 52, 66 bisoprolol-hydrochlorothiazide ...... 104, 119, 121 CARETOUCH CONTROL SOL ...... 70, 136 butorphanol tartrate...... 99, 116 LEVEL 2...... 126 BLEPH-10...... 139 BYDUREON BCISE CARETOUCH BLEPHAMIDE...... 139, 143 AUTOINJECTOR...... 179 LANCING/EJECTOR...... 126 BLEPHAMIDE S.O.P...... 139, 143 BYETTA 10 MCG PEN ...... 179 carisoprodol...... 50 blisovi 24 fe...... 163, 171, 182 BYETTA 5 MCG PEN ...... 180 carisoprodol-aspirin-codeine blisovi fe 1.5/30...... 163, 171, 182 BYLVAY...... 153 ...... 50, 112, 121 blisovi fe 1/20...... 163, 171, 183 BYLVAY (PELLETS) ...... 153 CARNITOR...... 209 BONIVA...... 196 BYSTOLIC...... 52, 70 CARNITOR SF...... 209 BOOSTRIX...... 43, 44 cabergoline...... 109 CAROSPIR...... 82, 83, 84, 133 bosentan...... 220 CABLIVI...... 57 carteolol hcl...... 142 BOSULIF...... 34, 35 CABOMETYX ...... 35 cartia xt...... 73, 74, 78, 85 bp 10-1...... 222, 235 CAFERGOT...... 52, 99, 119 carvedilol.....52, 54, 66, 70, 71, 77 bp cleansing wash...... 222, 235 caffeine citrate...... 99, 120

255 carvedilol phosphate er ciclopirox treatment...... 235 clobetasol propionate emulsion ...... 52, 54, 66, 70, 71, 77 cilostazol...... 65, 84 ...... 230 cascara sagrada ...... 151 CILOXAN...... 140 CLOBETAVIX...... 230 CASODEX...... 35 CIMDUO...... 25 clocortolone pivalate...... 230 cavarest ...... 198 cimetidine...... 13, 155 CLODAN...... 230, 234 CAVERJECT...... 85 cimetidine hcl...... 13, 155 clodan...... 230 CAVERJECT IMPULSE...... 85 CIMZIA PREFILLED KIT clomipramine hcl...... 125 CAYA...... 213 ...... 153, 201, 204 clonazepam...... 104, 105 CAYSTON...... 28 CIMZIA STARTER KIT clonidine...... 46, 75 caziant...... 163, 171, 183 ...... 153, 201, 204 clonidine hcl...... 46, 75 cefaclor...... 15 cinacalcet hcl...... 161 clonidine hcl er...... 46, 75 cefaclor er...... 15 CIPRO...... 19, 20, 30, 31 clopidogrel bisulfate...... 65 cefadroxil...... 14 CIPRO HC...... 140, 143 clorazepate dipotassium. 104, 105 cefdinir...... 15 CIPRODEX...... 140, 143 clotrimazole...... 227 cefixime...... 15 ciprofloxacin hcl...... 20, 31, 140 clotrimazole-betamethasone cefpodoxime proxetil...... 15 CIPROFLOXACIN- ...... 227, 230 cefprozil...... 15 FLUOCINOLONE PF...... 140, 143 clovique...... 156 cefuroxime axetil...... 15 citalopram hydrobromide...... 123 clozapine...... 101 celecoxib...... 108 CITRANATAL BLOOM CLOZARIL...... 101 CELONTIN...... 124 ...... 63, 151, 248, 251 COAGADEX...... 60 CENTANY ...... 222 CITRANATAL ESSENCE COAL TAR...... 237 CENTANY AT ...... 222 ...... 63, 133, 209, 245, 248 COARTEM...... 17 cephalexin...... 14 CITRANATAL MEDLEY codeine sulfate...... 112, 215 CERDELGA...... 209 ...... 63, 209, 245, 249 colchicine-probenecid..... 137, 195 cerovel ...... 235 claravis...... 241 COLESTID...... 72 CERVIDIL...... 213 CLARINEX-D 12 HOUR...... 14, 46 COLESTID FLAVORED...... 72 CETRAXAL...... 139 clarithromycin...... 20, 29, 151 colestipol hcl...... 72 cevimeline hcl...... 53 clarithromycin er...... 20, 29, 151 colistimethate sodium (cba)...... 30 CHANTIX...... 50 clemastine fumarate...... 12, 217 COLY-MYCIN M...... 30 CHANTIX CONTINUING CLENPIQ...... 151 COMBIGAN...... 139, 142 MONTH PAK ...... 50 CLEOCIN...... 28, 222 COMBIPATCH...... 172, 183 CHANTIX STARTING MONTH CLEOCIN-T...... 222 COMBIVENT RESPIMAT PAK...... 50 CLIMARA PRO...... 172, 183 ...... 47, 55, 214 charlotte 24 fe...... 163, 171, 183 CLINDACIN ETZ ...... 222 COMBIVIR...... 25 chateal...... 163, 171, 183 clindacin etz...... 222 COMETRIQ...... 35 chateal eq...... 163, 171, 183 CLINDACIN PAC...... 222 COMPLERA...... 24, 26 CHEMET...... 156, 194 clindacin-p...... 222 compro...... 119, 150 CHENODAL...... 152 CLINDAGEL...... 222 COMTAN...... 107 chlordiazepoxide hcl...... 105 clindamycin hcl...... 28 CONCERTA ...... 120 chlordiazepoxide-amitriptyline clindamycin palmitate hcl...... 28 CONDYLOX...... 241 ...... 105, 125 clindamycin phos-benzoyl constulose...... 131 chlordiazepoxide-clidinium 47, 105 perox...... 222, 237 CONTOUR CONTROL ... 126, 127 chlorhexidine gluconate.. 146, 237 clindamycin phosphate...... 222 CONTOUR NEXT CONTROL .127 chloroquine phosphate...... 17 CLINDAMYCIN PHOSPHATE 222 CONTOUR NEXT EZ ...... 127 chlorpromazine hcl...... 119 clindamycin-tretinoin222, 229, 241 CONTOUR NEXT LINK ...... 127 chlorthalidone...... 85, 137 CLINDESSE...... 222 CONTOUR NEXT MONITOR . 127 chlorzoxazone ...... 50 CLINOIN...... 72, 222, 229, 241 CONTOUR NEXT ONE ...... 127 CHOLBAM...... 153 CLINPRO 5000...... 198 CONTOUR NEXT TEST ...... 130 cholestyramine...... 72 clobazam...... 104, 105 CONTRAVE...... 90 cholestyramine light...... 72 clobetasol prop emollient base230 CONZIP...... 112 ciclodan...... 235 clobetasol propionate...... 230 COPASIL...... 241 ciclopirox...... 235 clobetasol propionate e...... 230 COPIKTRA...... 35 ciclopirox olamine...... 235 CORDRAN...... 230

256 CORGARD...... 52, 70, 71 CYSTAGON...... 209 desmopressin ace spray refrig CORIFACT...... 60 CYSTARAN...... 146 ...... 60, 181 CORLANOR...... 75, 85 CYTOTEC...... 155 desmopressin acetate...... 60, 181 CORTANE-B ...... 225, 230, 237 cytra k crystals ...... 130 desmopressin acetate pf...60, 181 CORTEF...... 157 dalfampridine er...... 209 desmopressin acetate spray CORTENEMA ...... 231 DALIRESP...... 219 ...... 60, 181 cortic-nd...... 143, 146, 147 danazol...... 160 desogestrel-ethinyl estradiol CORTIFOAM...... 231 DANTRIUM...... 51 ...... 164, 172, 183 CORTI-SAV...... 231, 237 dantrolene sodium...... 51 DESONATE...... 231 CORTISPORIN-TC...... 140, 143 dapsone...... 18, 19 desonide...... 231 CORTROSYN...... 129 DAPTACEL...... 43, 44 DESOWEN...... 231 COSENTYX (300 MG DOSE).241 DARAPRIM...... 17 desoximetasone...... 231 COSENTYX 150 MG/ML ...... 241 darifenacin hydrobromide er... 244 desrx...... 231 COSENTYX SENSOREADY dasetta 1/35...... 164, 172, 183 DESVENLAFAXINE ER...... 122 (300 MG)...... 241 dasetta 7/7/7...... 164, 172, 183 desvenlafaxine succinate er....122 COSENTYX SENSOREADY DAURISMO...... 35 dexamethasone...... 158 PEN...... 241 DAYPRO...... 117 dexamethasone intensol...... 157 COSOPT...... 142, 143 daysee...... 164, 172, 183 dexamethasone sodium cosyntropin...... 129 DAYTRANA ...... 120 phosphate...... 144 COTELLIC ...... 35 DAYVIGO...... 100 dexchlorpheniramine maleate...14 COTEMPLA XR-ODT...... 120 DEBACTEROL...... 146, 238 DEXCOM G4 / G5 / G6 COVARYX...... 160, 172 deblitane...... 164, 183 RECEIVER, TRANSMITTER, COVARYX HS...... 160, 172 deferasirox...... 156, 157 SENSOR (INCLUDING CREON...... 137, 152 deferasirox granules...... 156 PLATINUM, PLATINUM CRESEMBA...... 20 deferiprone...... 157 PEDIATRIC)...... 127 CRINONE...... 183 DELESTROGEN...... 172, 196 DEXILANT...... 156 CRIXIVAN...... 27 DELSTRIGO...... 25, 26 dexmethylphenidate hcl...... 120 cromolyn sodium.....139, 146, 218 delyla...... 164, 172, 183 dexmethylphenidate hcl er...... 120 crotan...... 240 demeclocycline hcl...... 32 DEXTENZA ...... 144 cryselle-28...... 163, 172, 183 DEMSER...... 210 dextroamphetamine sulfate...... 87 CUTIVATE...... 231 DENAVIR...... 226 dextroamphetamine sulfate er.. 87 CUVPOSA...... 47 DENTA 5000 PLUS...... 198 DIACOMIT...... 92 cyanocobalamin...... 65, 249 DENTAGEL...... 198 DIASTAT ACUDIAL...... 104, 105 CYANOCOBALAMIN...... 65, 249 DEPAKOTE...... 92, 96, 99 DIASTAT PEDIATRIC.....104, 105 cyclafem 1/35...... 163, 172, 183 DEPAKOTE ER...... 91, 96, 99 diazepam...... 104, 105, 106 cyclafem 7/7/7...... 164, 172, 183 DEPAKOTE SPRINKLES diazepam intensol...... 104, 105 cyclobenzaprine hcl ...... 50 ...... 92, 96, 99 diazoxide...... 161 CYCLOGYL...... 148 DEPEN TITRATABS ...... 157, 201 DICLOFENAC CAP...... 117 CYCLOMYDRIL...... 148, 149 DEPO-ESTRADIOL...... 172, 196 diclofenac potassium...... 117 cyclopentolate hcl...... 148 DEPO-PROVERA...... 164, 183 diclofenac sodium... 117, 147, 239 CYCLOPHENE RAPIDPAQ...... 51 DEPO-SUBQ PROVERA 104 diclofenac sodium er...... 117 cyclophosphamide...... 35, 208 ...... 164, 183 diclofenac-misoprostol.... 117, 155 CYCLOPHOSPHAMIDE... 35, 208 DEPO-TESTOSTERONE ...... 160 dicloxacillin sodium...... 30 cycloserine ...... 20 DERMA-SMOOTHE/FS BODY DICOPANOL FUSEPAQ CYCLOSET...... 161 ...... 231 ...... 12, 50, 91, 100, 215, 217 cyclosporine ...... 201, 204, 208 DERMA-SMOOTHE/FS DICOPANOL RAPIDPAQ cyclosporine modified SCALP...... 231 ...... 12, 50, 91, 100, 215, 217 ...... 201, 204, 208 DERMOTIC...... 144 dicyclomine hcl...... 47 cyproheptadine hcl...... 12, 217 DESCOVY...... 26 diethylpropion hcl...... 87 cyred...... 164, 172, 183 desipramine hcl...... 125 diethylpropion hcl er...... 87 cyred eq...... 164, 172, 183 desloratadine...... 14, 219 DIFICID...... 29, 30 CYSTADANE ...... 209 diflorasone diacetate...... 231 CYSTADROPS...... 146 DIFLUCAN...... 21

257 diflunisal...... 117 doxycycline...... 32, 241 efavirenz...... 25 digitek...... 69, 75 doxycycline hyclate ...... 17, 18, 32 efavirenz-emtricitab-tenofovir digox...... 69, 75 DOXYCYCLINE HYCLATE .18, 32 ...... 25, 26 digoxin...... 69, 75 doxycycline monohydrate ... 18, 32 efavirenz-lamivudine-tenofovir dihydroergotamine mesylate DRISDOL...... 252 ...... 25, 26 ...... 53, 99 DRIZALMA SPRINKLE...... 122 EFFER-K...... 133 DILANTIN...... 76, 110 dronabinol...... 149 effer-k...... 133 DILANTIN INFATABS ...... 76, 110 drospiren-eth estrad-levomefol EFUDEX...... 241 DILATRATE-SR...... 83 ...... 164, 172, 184, 249 EGATEN...... 17 DILAUDID...... 112 drospirenone-ethinyl estradiol EGRIFTA SV...... 191 diltiazem hcl...... 73, 74, 78, 85 ...... 164, 172, 184 ELESTRIN...... 173, 197 diltiazem hcl er...... 73, 74, 78, 85 DROXIA...... 35 eletriptan hydrobromide...... 122 diltiazem hcl er beads droxidopa...... 46 ELIGARD...... 35, 36, 179 ...... 73, 74, 78, 85 DRYSOL...... 227 elinest...... 164, 173, 184 diltiazem hcl er coated beads DUAL COMPLEX FORMULA 1 ELIQUIS...... 57 ...... 73, 74, 78, 85 KIT...... 51, 239, 241 ELIQUIS DVT/PE STARTER dilt-xr...... 73, 74, 78, 85 DUAVEE...... 170, 172 PACK...... 57 dimethyl fumarate...... 205 DUETACT...... 192 ELITE-OB...... 63, 245, 249 DIPENTUM...... 150 DULERA...... 55, 158 ELIXOPHYLLIN diphen... 12, 50, 91, 100, 215, 217 duloxetine hcl...... 109, 122 ...... 80, 120, 131, 221, 245 di-phen.. 12, 50, 91, 100, 215, 217 DUOPA...... 109 ELLA...... 164, 184 diphenhydramine hcl DUPIXENT...... 217, 241 ELMIRON...... 210 ...... 12, 50, 91, 100, 215, 217 DUREZOL...... 144 ELOCTATE ...... 60 diphenoxylate-atropine...... 47, 149 dutasteride...... 194 EMCYT...... 36 DIPROLENE...... 231 dutasteride-tamsulosin hcl 54, 194 EMEND...... 155 DIPROLENE AF...... 231 DYANAVEL XR...... 87 EMEND TRI-PACK...... 155 dipyridamole...... 65, 86 DYMISTA...... 139, 144, 218, 219 EMGALITY...... 106 disopyramide phosphate...... 76 DYRENIUM...... 84, 133 EMGALITY (300 MG DOSE).. 106 disulfiram...... 194 E.E.S. GRANULES...... 21 emoquette...... 164, 173, 184 DITROPAN XL...... 244 EASIVENT...... 127 EMSAM...... 110, 111 DIURIL...... 85, 136 easygel...... 198 emtricitabine...... 26 divalproex sodium...... 92, 96, 99 EASYMAX 15 LEVEL 2-3 emtricitabine-tenofovir df...... 26 divalproex sodium er.....92, 96, 99 CONTROL...... 127 EMTRIVA...... 26 DIVIGEL...... 172, 197 EASYMAX CONTROL...... 127 EMVERM...... 17 dofetilide...... 77 EASYMAX CONTROL enalapril maleate...... 68 DOJOLVI...... 131 NORMAL/HIGH...... 127 enalapril-hydrochlorothiazide dolishale...... 164, 172, 183 EC-NAPROSYN...... 99, 117, 195 ...... 68, 136 donepezil hcl...... 53 ec-naproxen...... 99, 117, 195 ENBRACE HR.. 63, 210, 246, 249 DOPTELET...... 58 econazole nitrate...... 227 ENBREL...... 201, 205 DORYX...... 17, 32 ECOZA...... 227 ENBREL MINI ...... 201, 205 DORYX MPC...... 17, 32 EC-RX DHEA...... 210 ENBREL SURECLICK.... 201, 205 DORZOLAMIDE HCL...... 143 EC-RX ESTRADIOL...... 172, 197 ENDARI...... 210 dorzolamide hcl...... 143 EC-RX PROGESTERONE..... 184 endocet...... 89, 112 dorzolamide hcl-timolol mal EC-RX TESTOSTERONE ...... 160 ENDOMETRIN...... 184 ...... 142, 143 EDARBI...... 66, 67 ENGERIX-B...... 44 dorzolamide hcl-timolol mal pf EDARBYCLOR...... 67, 136 ENLITE GLUCOSE SENSOR.127 ...... 142, 143 EDECRIN...... 82, 132 enovarx-amitriptyline...... 125 DOUBLE PM...... 140, 144 EDEX...... 86 enovarx-baclofen...... 51 DOVATO...... 24, 26 EDLUAR...... 100 enovarx-cyclobenzaprine hcl .... 51 DOVONEX...... 241 ED-SPAZ...... 47 enovarx-ibuprofen...... 239 doxazosin mesylate...... 52, 66 EDURANT...... 25 enovarx-lidocaine hcl...... 225 doxepin hcl...... 125, 225 EEMT...... 160, 172 enovarx-naproxen ...... 239 doxercalciferol ...... 252 EEMT HS ...... 160, 172 enovarx-tramadol ...... 241

258 enoxaparin sodium...... 62 estradiol valerate...... 173, 197 fenofibrate...... 81 enpresse-28...... 164, 173, 184 estradiol-norethindrone acet fenofibrate micronized...... 81 enskyce ...... 164, 173, 184 ...... 173, 184 fenofibric acid...... 81 ENSPRYNG ...... 205 ESTRING...... 173, 197 fentanyl...... 112 ENSTILAR ...... 231, 241 ESTROGEL...... 173, 197 fentanyl citrate...... 112 entacapone...... 107 ESTROSTEP FE.....164, 173, 184 FENTANYL CITRATE ...... 112 entecavir...... 29 eszopiclone...... 100 FENTORA ...... 112 ENTEREG ...... 153 ethacrynic acid...... 82, 132 FERRIPROX...... 157 ENTRESTO ...... 67, 84 ethambutol hcl...... 20 FETZIMA ...... 122 enulose...... 131 ethosuximide...... 124 FETZIMA TITRATION ...... 122 EPANED...... 68 ethynodiol diac-eth estradiol FIBRICOR...... 81 EPCLUSA...... 22, 23 ...... 164, 173, 184 FINACEA...... 242 EPIDIOLEX...... 92 etodolac...... 117, 118 finasteride...... 194 EPIDUO...... 238, 241 etodolac er...... 117 FINTEPLA ...... 92 EPIDUO FORTE...... 238, 241 etoposide...... 36 FIORICET...... 89, 104, 120 EPIFOAM...... 225, 231 etravirine...... 25 FIRAZYR...... 200 epinastine hcl...... 139 EUCRISA...... 225 FIRMAGON...... 36, 161 epinephrine...... 46, 214 euthyrox...... 193 FIRMAGON (240 MG DOSE) epitol...... 92, 96 EVAMIST...... 173, 197 ...... 36, 161 EPIVIR...... 26 EVEKEO...... 88 FIRST-BACLOFEN...... 51 EPIVIR HBV...... 26 EVEKEO ODT...... 88 FIRST-LANSOPRAZOLE...... 156 eplerenone...... 82, 83, 84, 133 everolimus...... 36, 208 FIRST-METRONIDAZOLE EQUETRO...... 92, 96 EVOCLIN...... 223 ...... 15, 19, 151 ERGOCAL...... 252 EVOTAZ...... 27, 210 FIRST-MOUTHWASH BLM ergocalciferol...... 252 EVRYSDI...... 210 ...... 12, 147, 149, 150, 151, 225 ergoloid mesylates...... 53 EXELDERM...... 227 FIRST-OMEPRAZOLE...... 156 ERGOMAR...... 53, 99 exemestane...... 36, 161 FIRST-PROGESTERONE ergotamine-caffeine.... 53, 99, 120 EXTINA...... 227 VGS...... 184 ERIVEDGE...... 36 EZALLOR SPRINKLE ...... 81 FIRVANQ...... 22 ERLEADA...... 36 ezetimibe...... 75 flac...... 144 erlotinib hcl...... 36 ezetimibe-simvastatin...... 76, 81 FLAGYL...... 15, 19, 151 errin...... 164, 184 FABIOR...... 241 FLAREX...... 144 ery...... 223 falmina...... 164, 173, 184 flavoxate hcl...... 244 ERYGEL...... 223 famciclovir...... 29 flecainide acetate...... 76 ERYPED 200...... 21 famotidine...... 13, 155 FLEXICHAMBER ADULT ERYPED 400...... 21 FANAPT...... 101, 102 MASK/SMALL...... 127 ERY-TAB...... 21 FANAPT TITRATION PACK ... 102 FLEXICHAMBER CHILD ERYTHROCIN STEARATE ...... 21 FANATREX FUSEPAQ...... 89, 92 MASK/LARGE...... 127 erythromycin ...... 22, 140, 223 FARYDAK...... 36 FLEXICHAMBER CHILD erythromycin base ...... 21, 22 FASENRA PEN...... 217 MASK/SMALL...... 127 erythromycin ethylsuccinate ...... 22 FAVIPIRAVIR...... 20 FLOLIPID...... 81 ESBRIET...... 214 fayosim...... 164, 173, 184 FLORIVA...... 198, 252 escitalopram oxalate...... 123 FBL KIT...... 51, 225, 239, 242 FLORIVA PLUS...... 198, 246 ESGIC...... 89, 104, 120 febuxostat...... 195 FLOVENT DISKUS...... 158, 219 esomeprazole magnesium...... 156 FEIBA...... 60 FLOVENT HFA ...... 158, 219 est estrogens-methyltest .160, 173 felbamate...... 92 FLUAD QUADRIVALENT...... 44 est estrogens-methyltest ds FELBATOL ...... 92 FLUARIX QUADRIVALENT...... 44 ...... 160, 173 FELDENE...... 118 FLUCELVAX est estrogens-methyltest hs felodipine er...... 79, 80 QUADRIVALENT...... 44 ...... 160, 173 FEM PH...... 238, 242 fluconazole...... 21 estarylla...... 164, 173, 184 FEMHRT...... 173, 184 flucytosine...... 30 estazolam...... 106 FEMRING...... 173, 197 fludrocortisone acetate...... 158 estradiol...... 173, 197 femynor...... 164, 173, 184 FLULAVAL QUADRIVALENT... 44

259 flunisolide...... 144, 158, 218 fosinopril sodium-hctz...... 68, 136 glipizide er...... 192 fluocinolone acetonide.... 144, 231 FOSRENOL...... 132, 194 glipizide xl...... 192 fluocinolone acetonide body... 231 FRAGMIN...... 63 glipizide-metformin hcl.... 162, 192 fluocinolone acetonide scalp...231 FREESTYLE LIBRE 14 DAY GLOPERBA...... 195 fluocinonide...... 232 READER...... 127 GLUCAGEN HYPOKIT... 179, 194 fluocinonide emulsified base...231 FREESTYLE LIBRE 14 DAY glucagon emergency kit.. 179, 194 FLUORIDEX...... 198 SENSOR...... 128 GLUCAGON EMERGENCY fluoridex daily renewal...... 198 FREESTYLE LIBRE 2 KIT...... 179, 194 FLUORIDEX ENHANCED READER...... 128 GLUCOTROL XL...... 192 WHITENING...... 198 FREESTYLE LIBRE 2 GLUTARALDEHYDE...... 130 FLUORIDEX SENSITIVITY SENSOR...... 128 glyburide...... 192 RELIEF...... 126, 198 FREESTYLE LIBRE READER 128 glyburide micronized...... 192 fluoritab...... 198 FREESTYLE LIBRE SENSOR glyburide-metformin...... 162, 192 fluorometholone...... 144 SYSTEM...... 128 glycopyrrolate...... 47 FLUOROPLEX...... 242 FROTEK...... 239 glydo...... 225 FLUOROURACIL...... 242 frovatriptan succinate...... 122 GLYNASE...... 192 fluorouracil...... 242 furosemide...... 82, 132 GLYXAMBI...... 169, 191 fluoxetine hcl...... 123 FUZEON...... 24 GOLYTELY ...... 152 fluoxetine hcl (pmdd)...... 123 fyavolv...... 173, 184 GONITRO...... 83 fluphenazine hcl...... 119 FYCOMPA...... 92 goodsense nicotine...... 50 flurandrenolide...... 232 gabapentin...... 89, 92 GORDOFILM...... 228, 235 flurazepam hcl...... 106 GABITRIL...... 92 GRALISE...... 89, 92 flurbiprofen...... 118 GALAFOLD...... 210 granisetron hcl...... 149 flurbiprofen sodium...... 147 galantamine hydrobromide...... 53 GRASTEK...... 42 flutamide...... 36 galantamine hydrobromide er... 53 griseofulvin microsize...... 17 fluticasone propionate GALZIN...... 134 griseofulvin ultramicrosize...... 17 ...... 144, 158, 218, 232 GARDASIL 9...... 45 guaiatussin ac...... 215, 216 FLUTICASONE- gatifloxacin...... 140 guaifenesin ac...... 215, 216 SALMETEROL ...... 55, 158 GATTEX ...... 153 guanfacine hcl...... 75, 107 fluvastatin sodium...... 82 gavilyte-c...... 151 guanfacine hcl er...... 107 fluvastatin sodium er...... 82 gavilyte-g...... 151 GUARDIAN SENSOR (3)...... 128 fluvoxamine maleate...... 123 gavilyte-n with flavor pack...... 151 GVOKE HYPOPEN 1-PACK fluvoxamine maleate er...... 123 GAVRETO...... 36 ...... 179, 194 FLUZONE HIGH-DOSE GELFILM...... 60 GVOKE HYPOPEN 2-PACK QUADRIVALENT...... 44 GEL-FLOW...... 60 ...... 179, 195 FLUZONE QUADRIVALENT GELFOAM-JMI POWDER...... 60 GVOKE PFS...... 179, 195 ...... 44, 45 GELFOAM-JMI SPONGE...... 60 GYNAZOLE-1...... 227 FML...... 144 GELNIQUE...... 244 habitrol...... 50 FML FORTE ...... 144 gemfibrozil...... 81 HAEGARDA...... 200 FML LIQUIFILM...... 144 gemmily...... 164, 174, 184 hailey 1.5/30...... 165, 174, 184 FOCALIN...... 120 generlac...... 131 hailey 24 fe...... 165, 174, 184 folic acid...... 249 gengraf...... 201, 205, 208 hailey fe 1.5/30...... 165, 174, 184 fondaparinux sodium...... 57 gentak...... 140 hailey fe 1/20...... 165, 174, 184 FORANE...... 110 gentamicin sulfate...... 140, 223 halcinonide...... 232 FORFIVO XL...... 95 GENVOYA...... 24, 26 HALCION...... 106 formaldehyde...... 130 GILENYA...... 205 halobetasol propionate...... 232 FORMALDEHYDE...... 130 GILOTRIF...... 36 HALOG...... 232 FORTISCARE CONTROL ...... 127 GILPHEX TR...... 47, 216 haloperidol...... 106 FOSAMAX...... 197 glatiramer acetate...... 205 haloperidol lactate...... 106 FOSAMAX PLUS D...... 197, 252 glatopa...... 205 HALUCORT...... 242 fosamprenavir calcium...... 27 GLEOSTINE...... 36 HARVONI...... 22, 23 fosfomycin tromethamine...... 33 glimepiride...... 192 HAVRIX...... 45 fosinopril sodium...... 68 glipizide...... 192 heather...... 165, 184

260 hematinic/folic acid...... 63, 249 hydrocodone-acetaminophen IMVEXXY STARTER PACK... 174 HEMLIBRA...... 60 ...... 89, 112 INBRIJA...... 109 hemocyte-f...... 63, 249 hydrocodone-homatropine incassia...... 165, 184 HEMOFIL M...... 60 ...... 47, 48, 215 INCRELEX...... 191 heparin lock flush...... 63 hydrocodone-ibuprofen... 112, 118 indapamide...... 85, 137 heparin sodium (porcine)...... 63 hydrocortisone ...... 158, 232 INDERAL LA ..... 52, 70, 71, 77, 99 heparin sodium (porcine) pf...... 63 hydrocortisone (perianal)...... 232 INDOCIN...... 118, 195 heparin sodium lock flush...... 63 hydrocortisone ace-pramoxine INDOMETHACIN...... 118 HEPLISAV-B...... 45 ...... 225, 232 indomethacin...... 118, 196 HETLIOZ...... 101 hydrocortisone acetate...... 232 indomethacin er...... 118, 196 HIBERIX...... 45 hydrocortisone butyr lipo base 232 INFANRIX...... 43, 45 HIPREX...... 33 hydrocortisone butyrate ...... 232 INLYTA...... 37 homatropaire...... 148 hydrocortisone valerate...... 232 INOVA...... 235, 238 hpr plus...... 242 hydrocortisone-acetic acid INOVA 4/1 ACNE CONTROL HUMALOG...... 190 ...... 144, 146 THERAPY...... 234, 236, 238 HUMALOG KWIKPEN...... 190 hydrocortisone-iodoquinol INOVA 8/2 ACNE CONTROL HUMALOG MIX 50/50 ...... 232, 238 THERAPY...... 235, 236, 238 KWIKPEN...... 190 hydrocort-pramoxine (perianal) INQOVI...... 37 HUMALOG MIX 50/50 VIAL....190 ...... 226, 232 INREBIC...... 37 HUMALOG MIX 75/25 hydromet...... 48, 215 INSPIREASE RESERVOIR KWIKPEN...... 190 hydromorphone hcl...... 113 BAGS...... 128 HUMALOG MIX 75/25 VIAL....190 hydromorphone hcl er...... 113 INSULIN PEN NEEDLES...... 128 HUMALOG U-100 JUNIOR hydroxychloroquine sulfate INSULIN SYRINGES...... 128 KWIKPEN...... 190 ...... 18, 202, 206 INTELENCE ...... 25 HUMATE-P...... 61 hydroxyurea ...... 36 INTRAROSA...... 158 HUMIRA...... 154, 202, 206 hydroxyzine hcl ...... 13, 101 INTRON A ...... 28, 37, 206 HUMIRA PEDIATRIC hydroxyzine pamoate ...... 13, 101 introvale...... 165, 174, 184 CROHNS START....153, 201, 205 HYOPHEN...... 33, 48, 89 INVELTYS...... 144 HUMIRA PEN...... 153, 201, 205 hyoscyamine sulfate...... 48 INVIRASE...... 27 HUMIRA PEN-CD/UC/HS hyoscyamine sulfate er...... 48 IODINE STRONG...... 216 STARTER ...... 153, 154, 201, 205 hyoscyamine sulfate sl ...... 48 iodine tincture...... 238 HUMIRA PEN-PEDIATRIC UC hyosyne...... 48 IOPIDINE...... 146 START...... 154, 201, 206 HYPERSAL...... 218 IPOL...... 45 HUMIRA PEN-PS/UV/ADOL HYPOCYN...... 242 ipratropium bromide...... 48, 214 HS START...... 154, 201, 206 ibandronate sodium...... 197 ipratropium-albuterol... 48, 55, 214 HUMIRA PEN-PSOR/UVEIT IBRANCE...... 36 irbesartan...... 66, 67 STARTER ...... 154, 202, 206 ibuprofen...... 99, 118 irbesartan-hydrochlorothiazide HUMULIN 70/30 KWIKPEN iclevia...... 165, 174, 184 ...... 67, 136 ...... 180, 190 ICLUSIG...... 36 IRESSA...... 37 HUMULIN 70/30 VIAL.....180, 190 IDELVION...... 61 ISENTRESS...... 24 HUMULIN N KWIKPEN...... 180 IDHIFA...... 37 ISENTRESS HD...... 24 HUMULIN N VIAL...... 180 ILEVRO...... 147 isibloom...... 165, 174, 184 HUMULIN R U-500 KWIKPEN 190 ILUMYA...... 242 isoflurane...... 110 HUMULIN R U-500 VIAL...... 190 imatinib mesylate...... 37 isoniazid...... 20 HUMULIN R VIAL...... 191 IMBRUVICA...... 37 ISOPTO ATROPINE...... 148 HYCAMTIN...... 36 IMCIVREE...... 90 ISOPTO CARPINE...... 148 hydralazine hcl...... 80 imipramine hcl...... 125 ISORDIL TITRADOSE...... 83 HYDREA...... 36 imipramine pamoate...... 125 isosorbide dinitrate...... 83 HYDRO 40...... 236 imiquimod...... 242 isosorbide mononitrate...... 83 hydrochlorothiazide...... 85, 136 IMITREX...... 122 isosorbide mononitrate er...... 83 hydrocodone bitartrate er...... 112 IMPAVIDO...... 19 isotretinoin...... 242 hydrocodone polst-chlorphen IMVEXXY MAINTENANCE isoxsuprine hcl...... 86 polst er susp...... 14, 215 PACK...... 174 isradipine...... 79, 80

261 ISTALOL...... 142 KETOPHENE RAPIDPAQ...... 239 lanthanum carbonate...... 132, 195 ISTURISA...... 210 KETOROLAC LANTUS SOLOSTAR ...... 180 itraconazole...... 21 TROMETHAMINE ...... 118, 239 LANTUS U-100 VIAL...... 180 ivermectin...... 17, 240 ketorolac tromethamine.. 118, 147 lapatinib ditosylate...... 38 jaimiess...... 165, 174, 185 KETOSTIX...... 130 larin 1.5/30...... 165, 174, 185 JAKAFI...... 37 KEVEYIS...... 198 larin 1/20...... 165, 174, 185 JANSSEN COVID-19 KEVZARA...... 202 larin 24 fe...... 165, 174, 185 VACCINE...... 45 KINERET...... 202, 206 larin fe 1.5/30...... 165, 174, 185 jantoven...... 57 KISQALI...... 37, 38 larin fe 1/20...... 165, 174, 185 JARDIANCE...... 191 KISQALI FEMARA...... 37, 161 larissia...... 165, 174, 185 jasmiel...... 165, 174, 185 KLARON...... 223 LASIX...... 82, 132 jencycla...... 165, 185 klor-con...... 134 LASTACAFT...... 13, 139 JENTADUETO ...... 162, 169 klor-con 10...... 134 latanoprost...... 148 JENTADUETO XR.. 162, 169, 170 klor-con m10...... 134 LATUDA...... 102 jinteli...... 174, 185 klor-con m15...... 134 layolis fe...... 165, 174, 185 JIVI...... 61 klor-con m20...... 134 LAZANDA...... 113 jolessa...... 165, 174, 185 klor-con/ef...... 134 L-CYSTINE...... 131 JORNAY PM...... 120 KOATE...... 61 LEDIPASVIR-SOFOSBUVIR JUBLIA...... 227 KOATE-DVI...... 61 ...... 22, 23 juleber...... 165, 174, 185 KOGENATE FS...... 61 leena...... 165, 175, 185 JULUCA...... 24, 25 KOMBIGLYZE XR...... 162, 170 leflunomide...... 202, 206, 208 junel 1.5/30...... 165, 174, 185 KORLYM...... 161 LENVIMA...... 38 junel 1/20...... 165, 174, 185 KOSELUGO...... 38 lessina...... 165, 175, 185 junel fe 1.5/30...... 165, 174, 185 KOVALTRY...... 61 letrozole...... 38, 161 junel fe 1/20...... 165, 174, 185 K-PHOS...... 134 lets...... 46, 194 junel fe 24...... 165, 174, 185 K-PHOS NO 2...... 130 leucovorin calcium...... 195, 249 JUXTAPID...... 69 K-PHOS-NEUTRAL...... 134 LEUKERAN...... 38 JYNARQUE...... 137 k-prime...... 134 LEUKINE...... 58 K.B.G.L IN TERODERM KRINTAFEL...... 18 leuprolide acetate...... 38, 179 ...... 51, 118, 226, 239, 242 KRISTALOSE...... 131 levalbuterol hcl...... 55, 219 kaitlib fe...... 165, 174, 185 K-TAB...... 134 LEVALBUTEROL HFA ...... 55, 219 KALETRA...... 27 kurvelo...... 165, 174, 185 LEVBID...... 48 kalliga...... 165, 174, 185 KYNMOBI...... 111 levetiracetam...... 93 KALYDECO...... 216 KYNMOBI TITRATION KIT .....111 levetiracetam er...... 93 KAPSPARGO SPRINKLE labetalol hcl. 52, 54, 66, 70, 71, 77 levobunolol hcl...... 142 ...... 56, 70, 71, 77 LACRISERT...... 146 levocarnitine...... 210 KARBINAL ER...... 12, 13, 217 lactulose...... 131 levocarnitine sf...... 210 kariva...... 165, 174, 185 lactulose encephalopathy...... 131 levocetirizine dihydrochloride....14 KATERZIA...... 79, 80, 86 LAMICTAL...... 93, 97 levofloxacin...... 20, 31, 140 KAZANO...... 162, 170 LAMICTAL ODT ...... 93, 96, 97 levonest...... 166, 175, 185 KEFLEX...... 14 LAMICTAL STARTER ...... 93, 97 levonorgest-eth est & eth est kelnor 1/35...... 165, 174, 185 LAMICTAL XR ...... 93, 97 ...... 166, 175, 185 kelnor 1/50...... 165, 174, 185 lamivudine...... 26 levonorgest-eth estrad 91-day KEPPRA...... 92 lamivudine-zidovudine...... 26 ...... 166, 175, 185 KEPPRA XR...... 92 lamotrigine...... 93, 97 levonorgestrel...... 166, 185 KERALYT SCALP ...... 236 lamotrigine er...... 93, 97 levonorgestrel-ethinyl estrad KERAMATRIX REPLICINE lamotrigine starter kit-blue...93, 97 ...... 166, 175, 185 5CMX5CM...... 213 lamotrigine starter kit-green 93, 97 levonorg-eth estrad triphasic KERYDIN...... 239 lamotrigine starter kit-orange ...... 166, 175, 185 KESIMPTA...... 206 ...... 93, 97 levora 0.15/30 (28)..166, 175, 186 ketoconazole...... 21, 227 LAMPIT...... 19 levorphanol tartrate...... 113 ketodan...... 227 LANOXIN...... 69, 75 levo-t...... 193 KETONE TEST ...... 130 lansoprazole...... 156 LEVOTHYROXINE SODIUM.. 193

262 levothyroxine sodium...... 193 LOTEMAX ...... 144 MEKINIST...... 38 levoxyl...... 193 LOTEMAX SM ...... 144 MEKTOVI...... 38 LEVSIN...... 48 LOTENSIN...... 68, 69 meloxicam...... 118 LEVSIN/SL...... 48 LOTENSIN HCT ...... 69, 136 melphalan...... 38 LEVULAN KERASTICK...... 242 loteprednol etabonate...... 144 memantine hcl...... 107 LEXIVA...... 27 lovastatin...... 82 memantine hcl er...... 107 LIALDA...... 150 low-ogestrel...... 166, 175, 186 MENACTRA ...... 45 lidocaine...... 226 loxapine succinate...... 100 MENEST...... 175, 197 lidocaine hcl...... 147, 226 lo-zumandimine...... 166, 175, 186 MENOSTAR ...... 175, 197 lidocaine hcl urethral/mucosal.226 LUBIPROSTONE...... 154 MENQUADFI...... 45 lidocaine viscous hcl...... 147 LUCEMYRA...... 47 MENTAX ...... 228 lidocaine-prilocaine...... 226 LUGOLS STRONG IODINE....238 MENVEO...... 45 LIDTOPIC MAX...... 226 LULICONAZOLE...... 227 meperidine hcl...... 113 lillow...... 166, 175, 186 LUMAKRAS...... 38 MEPHYTON...... 195, 252 lindane...... 240 LUMIGAN...... 148 meprobamate...... 101 linezolid...... 30 LUPKYNIS...... 208 mercaptopurine...... 38, 208 LINZESS...... 154 lutera...... 166, 175, 186 merzee...... 166, 175, 186 liothyronine sodium...... 193 LUZU...... 227 mesalamine...... 150 LIPOFEN...... 81 lyleq...... 166, 186 mesalamine-cleanser...... 150 lisinopril...... 68 LYNPARZA ...... 38 MESNEX...... 213 lisinopril-hydrochlorothiazide LYRICA...... 93, 109 MESTINON...... 53 ...... 69, 136 LYSODREN...... 38 metaxalone...... 51 L-ISOLEUCINE...... 131 LYSTEDA...... 61 metformin hcl...... 162 lithium carbonate...... 97 LYUMJEV KWIKPEN...... 190 metformin hcl er...... 162 lithium carbonate er...... 97 LYUMJEV VIAL...... 190 methadone hcl...... 113 LITHOBID...... 97 lyza...... 166, 186 methadone hcl intensol...... 113 LITHOSTAT...... 131 MACROBID...... 33 methadose...... 113 LIVALO...... 82 MACRODANTIN...... 33 methadose sugar-free...... 113 LO LOESTRIN FE ...166, 175, 186 mafenide acetate...... 238 methamphetamine hcl...... 88 LOESTRIN 1.5/30 (21) MALARONE ...... 18 methazolamide...... 75, 143 ...... 166, 175, 186 malathion...... 240 methenamine hippurate...... 33 LOESTRIN 1/20 (21) MARINOL...... 149 methenamine mandelate...... 33 ...... 166, 175, 186 marlissa...... 166, 175, 186 methergine...... 213 LOESTRIN FE 1.5/30 MARPLAN...... 111 methimazole...... 161 ...... 166, 175, 186 MATULANE ...... 38 METHITEST ...... 160 lojaimiess...... 166, 175, 186 matzim la...... 73, 74, 78, 86 methocarbamol...... 51 LOKELMA ...... 133 MAVENCLAD ...... 208 methotrexate..... 38, 202, 206, 208 LOMAIRA...... 87 MAVYRET...... 23 methotrexate sodium LOMOTIL...... 48, 149 MAXIDEX...... 144 ...... 39, 202, 206, 208, 209 LONSURF...... 38 MAXITROL...... 140, 144 methotrexate sodium (pf) LOPID...... 81 maxi-tuss ac...... 215, 216 ...... 38, 202, 206, 208 lopinavir-ritonavir...... 27 MAXZIDE...... 133, 136 methoxsalen rapid...... 239 LOPRESSOR...... 56, 70, 71, 77 MAXZIDE-25...... 133, 136 methscopolamine bromide...... 48 LOPROX...... 235, 242 MAYZENT...... 206 methyl salicylate...... 228 lorazepam...... 105, 106 me/naphos/mb/hyo1... 33, 48, 210 methyldopa...... 47, 75 lorazepam intensol...... 104, 106 meclofenamate sodium...... 118 methylergonovine maleate...... 213 LORBRENA ...... 38 MEDERMA SPF 30...... 242 METHYLIN...... 120 LORTAB ...... 89, 113 MEDROL...... 158 methylphenidate hcl...... 121 loryna...... 166, 175, 186 medroxyprogesterone acetate methylphenidate hcl er....120, 121 LORZONE...... 51 ...... 166, 186 methylphenidate hcl er (cd).....120 losartan potassium...... 66, 67 mefenamic acid...... 118 methylphenidate hcl er (la)...... 120 losartan potassium-hctz.... 67, 136 mefloquine hcl...... 18 methylphenidate hcl er (xr)..... 120 LOSEASONIQUE... 166, 175, 186 megestrol acetate...... 38, 186 methylprednisolone...... 158

263 methyltestosterone...... 160 modafinil...... 125 NAFRINSE DAILY metoclopramide hcl...... 155 MODERNA COVID-19 ACIDULATED...... 126, 198 metolazone...... 85, 137 VACCINE...... 45 NAFRINSE DAILY/NEUTRAL.199 metoprolol succinate er moexipril hcl...... 68, 69 nafrinse drops...... 199 ...... 56, 70, 71, 77 molindone hcl...... 100 NAFRINSE WEEKLY...... 199 metoprolol tartrate...56, 70, 72, 77 mometasone furoate naftifine hcl...... 221 metoprolol-hydrochlorothiazide ...... 144, 158, 218, 232 NAFTIN...... 221 ...... 70, 136 mondoxyne nl...... 18, 32 naloxone hcl...... 115, 195 METROCREAM...... 223 mono-linyah...... 167, 176, 187 naltrexone hcl...... 115, 194, 195 METROLOTION ...... 223 MONONINE ...... 61 NAMENDA TITRATION PAK ..107 metronidazole..... 16, 19, 151, 223 monsels ferric subsulfate ...... 61 NAMZARIC...... 53, 108 METRONIDAZOLE montelukast sodium...... 217 naproxen...... 99, 118, 196 BENZO+SYRSPEND ..16, 19, 151 MONUROL...... 33 naproxen sodium.... 100, 118, 196 metyrosine...... 210 morgidox...... 18, 32 naproxen sodium er.. 99, 118, 196 mexiletine hcl...... 76 MORGIDOX...... 32, 242 naratriptan hcl...... 122 MIACALCIN...... 161, 197 morphine sulfate...... 114 NARCAN...... 115 mibelas 24 fe...... 166, 175, 186 morphine sulfate (concentrate)113 NARDIL...... 111 miconazole 3...... 227 morphine sulfate er...... 113, 114 NASCOBAL...... 65, 249 MICONAZOLE-ZINC OXIDE- morphine sulfate er beads...... 113 NATACYN...... 142 PETROLAT...... 227, 235 MOTEGRITY...... 154 NATAZIA...... 167, 176, 187 microgestin 1.5/30...166, 175, 186 MOTOFEN...... 48, 149 nateglinide...... 181 microgestin 1/20...... 166, 175, 186 MOVIPREP...... 152, 251 NATPARA...... 181, 196 microgestin 24 fe.....167, 175, 186 MOXEZA...... 140 NATURE-THROID...... 193 microgestin fe 1.5/30 moxifloxacin hcl...... 20, 31, 140 NAYZILAM...... 105 ...... 167, 176, 186 moxifloxacin hcl (2x day)...... 140 NEBUPENT...... 19 microgestin fe 1/20..167, 176, 186 MOZOBIL...... 59 necon 0.5/35 (28)....167, 176, 187 MICROLET NEXT LANCING MS CONTIN...... 114 nefazodone hcl...... 124 DEVICE...... 128 MUCOSITISRX...... 147 neomycin sulfate...... 16 midazolam hcl...... 106 MULPLETA ...... 59 neomycin-bacitracin zn- MIDAZOLAM+SYRSPEND SF MULTAQ ...... 78 polymyx...... 140 ...... 106 multi-vit/iron/fluoride..63, 198, 246 neomycin-polymyxin-dexameth midodrine hcl...... 47 multivitamin/fluoride...... 198, 246 ...... 140, 145 MIGERGOT...... 53, 99, 121 multi-vitamin/fluoride...... 198, 246 neomycin-polymyxin- miglitol...... 159 multi-vitamin/fluoride/iron gramicidin...... 140 miglustat...... 210 ...... 63, 198, 246 neomycin-polymyxin-hc mili...... 167, 176, 186 mupirocin...... 223 ...... 140, 141, 145 MILLIPRED...... 158 mupirocin calcium...... 223 NEONATAL + DHA mimvey...... 176, 186 MUSE...... 86 ...... 63, 134, 210, 246, 249 mineral oil heavy...... 152 MYALEPT...... 180 NEONATAL 19 ...... 246 MINIPRESS...... 52, 66 MYAMBUTOL ...... 20 NEONATAL COMPLETE minitran...... 83 MYCOBUTIN...... 20, 31 ...... 63, 246, 249 minocycline hcl...... 18, 32 mycophenolate mofetil...... 209 NEONATAL FE ...... 63, 246, 249 minoxidil...... 80 mycophenolate sodium...... 209 NEONATAL PLUS .... 63, 246, 249 MIRAPEX...... 111 MYDAYIS...... 88 neo-polycin...... 141 MIRCETTE ...... 167, 176, 187 MYLERAN...... 39 neo-polycin hc...... 141, 145 mirtazapine...... 95 myorisan...... 242 NEO-SYNALAR MIRVASO...... 242 MYRBETRIQ...... 245 ...... 223, 228, 232, 233 misoprostol...... 155 MYSOLINE...... 103 NERLYNX ...... 39 MITIGARE...... 196 MYTESI...... 149 NESINA...... 170 MITOSOL...... 140 nabumetone...... 118 NESTABS ...... 63, 246, 249 M-M-R II...... 45 nadolol...... 52, 70, 72 neuac...... 223, 238 M-NATAL PLUS ...... 63, 246, 249 nafrinse...... 199 NEUAC...... 223, 228, 238 MOBIC...... 118 NEULASTA...... 59

264 NEUPRO...... 111 norethindrone acet-ethinyl est NUTROPIN AQ NUSPIN 5 NEURAPTINE...... 89 ...... 167, 176, 187 ...... 181, 192 NEURONTIN...... 89, 93, 94 norethindrone-eth estradiol NUVAIL...... 242 NEVANAC...... 147 ...... 176, 187 NUVARING...... 167, 176, 187 nevirapine...... 25 norethin-eth estradiol-fe NUVESSA...... 16, 223 nevirapine er...... 25 ...... 167, 176, 187 NUWIQ...... 61 NEXAVAR...... 39 norgestimate-eth estradiol NUZYRA...... 16 NEXIUM...... 156 ...... 167, 176, 187 nyamyc...... 239 NEXLETOL ...... 69 norgestimate-ethinyl estradiol nylia 7/7/7...... 167, 176, 187 NEXLIZET...... 69, 76 triphasic...... 167, 176, 187 NYMALIZE...... 80, 86 NEXTSTELLIS ...... 167, 176, 187 norlyda...... 167, 187 nymyo...... 167, 176, 187 niacin er (antihyperlipidemic).... 69 norlyroc...... 167, 187 nystatin...... 30, 239 NIASPAN...... 70 NORPACE...... 76 nystatin-triamcinolone..... 233, 239 nicardipine hcl...... 79, 80, 86 NORPACE CR...... 76 nystop...... 240 NICORETTE ...... 50 NORPRAMIN...... 125 OCALIVA...... 154 nicotine polacrilex...... 50 nortrel 0.5/35 (28)... 167, 176, 187 ocella...... 168, 176, 187 nicotine polacrilex mini...... 50 nortrel 1/35 (21)...... 167, 176, 187 octreotide acetate...... 154, 191 nicotine step 1...... 50 nortrel 1/35 (28)...... 167, 176, 187 OCUFLOX...... 141 nicotine step 2...... 50 nortrel 7/7/7...... 167, 176, 187 ODACTRA...... 43 nicotine step 3...... 50 nortriptyline hcl...... 125 ODEFSEY...... 25, 26 NICOTROL...... 50 NORVIR...... 27 ODOMZO...... 39 NICOTROL NS ...... 50 NOURIANZ...... 108 OFEV...... 214 nifedipine...... 79, 80, 86 NOVOEIGHT...... 61 ofloxacin...... 31, 141 nifedipine er...... 79, 80, 86 NOVOFINE AUTOCOVER olanzapine...... 97, 102 nifedipine er osmotic release PEN NEEDLE ...... 128 olanzapine-fluoxetine hcl 102, 123 ...... 79, 80, 86 NOVOFINE PEN NEEDLE ..... 128 olmesartan medoxomil...... 67 nikki...... 167, 176, 187 NOVOFINE PLUS PEN olmesartan medoxomil-hctz NILANDRON ...... 39 NEEDLE ...... 128 ...... 67, 136 nilutamide...... 39 NOVOPEN ECHO...... 128 olmesartan-amlodipine-hctz nimodipine...... 79, 80, 86 NOVOSEVEN RT...... 61 ...... 67, 80, 136 NINLARO ...... 39 NOVOTWIST PEN NEEDLE .. 128 olopatadine hcl...... 13, 139 nisoldipine er...... 79, 80 NOXAFIL...... 21 OLUMIANT...... 202 nitazoxanide...... 19 NP #2 DRUG PREPARATION OMECLAMOX-PAK.... 17, 30, 156 NITRO-BID...... 83 KIT omega-3-acid ethyl esters...... 70 NITRO-DUR...... 83 47, 75, 89, 114, 118, 125, 226, omeprazole...... 156 nitrofurantoin...... 33 239, 242 OMEPRAZOLE+SYRSPEND nitrofurantoin macrocrystal ...... 33 np thyroid...... 193 SF ALKA...... 156 nitrofurantoin monohydrate NUBEQA...... 39 OMNARIS...... 145 macrocrystals ...... 33 NUCALA...... 214 ondansetron hcl...... 149 nitroglycerin...... 83 NUCORT...... 233 ondansetron odt...... 149 NITROMIST...... 83 NUCYNTA ...... 114 ONE VITE WOMENS PLUS NITROSTAT ...... 83 NUCYNTA ER ...... 114 ...... 63, 246, 249 NITRO-TIME ...... 83 NUEDEXTA...... 108 ONETOUCH DELICA nizatidine...... 13, 155 NULEV...... 48 LANCING DEVICE...... 128 NOCDURNA...... 61, 181 NULYTELY LEMON-LIME ...... 152 ONETOUCH DELICA PLUS nolix...... 233 NUPLAZID...... 102 LANCING DEVICE...... 128 nora-be...... 167, 187 NUTRASEB...... 236 ONETOUCH ULTRA ...... 130 norethin ace-eth estrad-fe NUTRIDOX...... 32, 210, 252 ONETOUCH ULTRA 2...... 128 ...... 167, 176, 187 NUTROPIN AQ NUSPIN 10 ONETOUCH ULTRA MINI ...... 129 norethindrone...... 167, 187 ...... 181, 191 ONETOUCH VERIO...... 129, 130 norethindrone acetate...... 187 NUTROPIN AQ NUSPIN 20 ONETOUCH VERIO FLEX ...... 181, 191 SYSTEM KIT W/DEVICE...... 129

265 ONETOUCH VERIO IQ OXISTAT...... 227 perphenazine-amitriptyline SYSTEM...... 129 oxybutynin chloride...... 244 ...... 119, 125 ONETOUCH VERIO oxybutynin chloride er...... 244 PERTZYE...... 138, 153 REFLECT...... 129 oxycodone hcl ...... 114 PEXEVA...... 124 ONETOUCH VERIO SYNC oxycodone-acetaminophen PFIZER-BIONTECH COVID- SYSTEM KIT W/DEVICE...... 129 ...... 89, 114 19 VACC...... 45 ONEVITE...... 134, 246, 249 OXYCODONE- phenazo...... 226 ONEXTON...... 223, 238 ACETAMINOPHEN...... 89, 114 phenazopyridine hcl...... 226 ONFI...... 105, 106 oxymorphone hcl...... 114 phendimetrazine tartrate...... 87 ONGLYZA ...... 170 oxymorphone hcl er...... 114 phendimetrazine tartrate er...... 87 ONUREG...... 39 OZEMPIC...... 180 phenelzine sulfate...... 111 ONZETRA XSAIL...... 123 OZOBAX...... 51 phenobarbital...... 103, 104 opium...... 149 PACERONE...... 78 phenoxybenzamine hcl...... 53, 82 OPSUMIT...... 220 PALFORZIA...... 43 phentermine hcl...... 87 ORACIT...... 130 paliperidone er...... 102 phenylephrine hcl...... 148, 149 ORALAIR...... 43 PALYNZIQ...... 138 PHENYTEK...... 76, 110 ORALAIR ADULT STARTER PANCREAZE...... 138, 153 phenytoin...... 76, 110 PACK...... 43 PANDEL...... 233 phenytoin infatabs...... 76, 110 ORALAIR CHILDRENS PANRETIN...... 243 phenytoin sodium extended STARTER PACK ...... 43 pantoprazole sodium...... 156 ...... 76, 110 oralone...... 233 paricalcitol...... 252 PHEXXI...... 213 ORAPRED ODT...... 159 PARNATE ...... 111 philith...... 168, 177, 188 ORAVIG...... 227 paromomycin sulfate...... 16 PHOSLYRA...... 132, 134 ORENCIA...... 202, 206 paroxetine hcl...... 124 PHOSPHA 250 NEUTRAL...... 134 ORENCIA CLICKJECT... 202, 206 paroxetine hcl er...... 124 PHOSPHASAL...... 33, 48, 89, 210 ORENITRAM...... 220 paroxetine mesylate...... 124 phosphorous...... 134 ORFADIN...... 210 PASER...... 20 phospho-trin 250 neutral...... 134 ORGOVYX...... 39, 161 PATANASE...... 13, 139 phytonadione...... 195, 252 ORIAHNN...... 161, 177, 188 PAXIL...... 124 PIFELTRO...... 25 ORILISSA...... 161 PCP 100...... 134, 152, 155, 235 pilocarpine hcl...... 53, 148 ORKAMBI...... 215, 216 PEDIAPRED...... 159 pimecrolimus...... 209, 243 orphenadrine citrate er...... 56, 91 PEDVAX HIB...... 45 pimozide...... 100 orphenadrine-asa-caffeine 56, 121 peg 3350-kcl-na bicarb-nacl ....152 pimtrea...... 168, 177, 188 orsythia...... 168, 177, 188 peg-3350/electrolytes...... 152 pindolol...... 52, 70, 72, 77 oscimin...... 48 peg-3350/electrolytes/ascorbat pioglitazone hcl...... 193 oscimin sr...... 48 ...... 152, 251 pioglitazone hcl-glimepiride oseltamivir phosphate...... 28 PEGASYS...... 28 ...... 192, 193 OSENI...... 170, 192 peg-kcl-nacl-nasulf-na asc-c pioglitazone hcl-metformin hcl OSMOPREP...... 152 ...... 152, 251 ...... 162, 193 OSPHENA...... 170 peg-prep...... 152 PIQRAY...... 39 OTEZLA ...... 202, 207, 242 PEMAZYRE...... 39 pirmella 1/35...... 168, 177, 188 OTOVEL...... 141, 145 penicillamine...... 157, 202 pirmella 7/7/7...... 168, 177, 188 OVACE PLUS...... 223 penicillin v potassium...... 28 piroxicam...... 118 OVACE PLUS WASH..... 223, 224 pentamidine isethionate...... 19 PLAN B ONE-STEP ...... 168, 188 OVACE WASH...... 224 pentazocine-naloxone hcl115, 116 PLEGRIDY...... 207 OVIDE...... 240 pentoxifylline er...... 59 PLEGRIDY STARTER PACK. 207 oxandrolone...... 160 PERFOROMIST...... 55, 220 PLENVU...... 152, 251 oxaprozin...... 118 PERIDEX...... 146, 238 PLEXION...... 224, 236 oxazepam...... 106 perindopril erbumine...... 68, 69 PLEXION CLEANSER.... 224, 236 OXBRYTA ...... 57 periogard...... 146, 238 PLEXION CLEANSING oxcarbazepine...... 94 permethrin...... 240 CLOTH ...... 224, 236 OXERVATE...... 147 perphenazine...... 119 PNEUMOVAX 23...... 45 oxiconazole nitrate...... 227 podocon...... 243

266 podofilox...... 243 PRENATE DHA PROCTOCORT...... 233 polycin...... 141 ...... 64, 135, 210, 246, 249 PROCTOFOAM HC...... 226, 233 polymyxin b-trimethoprim...... 141 PRENATE ELITE ...... 64, 247, 250 procto-med hc...... 233 POLYTRIM...... 141 PRENATE ENHANCE procto-pak...... 233 POLY-VI-FLOR...... 199, 246 ...... 64, 135, 211, 247, 250 proctozone-hc...... 233 POLY-VI-FLOR/IRON PRENATE ESSENTIAL PROCYSBI...... 211 ...... 64, 199, 246 ...... 64, 135, 211, 247, 250 PROFILNINE...... 61 POMALYST...... 39, 207 PRENATE MINI progesterone...... 188 portia-28...... 168, 177, 188 ...... 64, 135, 211, 247, 250 PROGESTERONE posaconazole...... 21 PRENATE PIXIE MICRONIZED...... 188 POTABA...... 249 ...... 64, 135, 211, 247, 250 PROGRAF...... 209 potassium chloride...... 134 PRENATE RESTORE PROLATE...... 89, 114 potassium chloride crys er ...... 134 ...... 64, 135, 211, 247, 250 PROLENSA...... 147 potassium chloride er...... 134 PRENATVITE COMPLETE PROMACTA...... 59 potassium citrate er...... 130 ...... 64, 135, 247, 250 promethazine hcl potassium citrate-citric acid .....130 PRENATVITE PLUS ...... 12, 13, 101, 150, 217 PRADAXA...... 58 ...... 64, 135, 247, 250 promethazine vc...... 13, 47 pramipexole dihydrochloride... 111 PRENATVITE RX promethazine vc/codeine pramosone...... 226, 233 ...... 64, 135, 247, 250 ...... 13, 47, 215 PRAMOSONE...... 226, 233 PREPIDIL...... 213 promethazine-codeine...... 13, 215 PRAMOTIC...... 146, 147 preplus...... 64, 247, 250 promethazine-dm...... 14, 215 pramox...... 226 PRETAB...... 64, 247, 250 promethazine-phenyleph- prasugrel hcl...... 65 PRETOMANID...... 20 codeine...... 14, 47, 215 pravastatin sodium...... 82 prevalite...... 72 promethazine-phenylephrine praziquantel...... 17 PREVIDENT...... 199 ...... 14, 47 prazosin hcl ...... 52, 66 PREVIDENT 5000 BOOSTER promethegan PRECOSE...... 160 PLUS...... 199 ...... 13, 14, 101, 150, 217 PRED MILD...... 145 PREVIDENT 5000 DRY PROMISEB...... 236 PRED-G...... 141, 145 MOUTH...... 199 propafenone hcl...... 76 PRED-G S.O.P...... 141, 145 PREVIDENT 5000 ENAMEL propafenone hcl er...... 76 prednicarbate...... 233 PROTECT...... 126, 199 proparacaine hcl...... 147 prednisolone...... 159 PREVIDENT 5000 ORTHO propranolol hcl 52, 71, 72, 77, 100 prednisolone acetate...... 145 DEFENSE...... 199 propranolol hcl er prednisolone sodium PREVIDENT 5000 PLUS...... 199 ...... 52, 71, 72, 77, 100 phosphate...... 145, 159 PREVIDENT 5000 SENSITIVE propylthiouracil...... 161 prednisone...... 159 ...... 126, 199 PROSCAR...... 194 prednisone intensol...... 159 previfem...... 168, 177, 188 PROSTIN E2...... 213 PREFEST...... 177, 188 PREVNAR 13...... 45 PROTONIX...... 156 pregabalin...... 94, 109 PREVYMIS...... 20 protriptyline hcl...... 125 pregabalin er...... 89 PREZCOBIX...... 27, 211 PROVERA...... 188 PREMARIN...... 177, 197 PREZISTA...... 27, 28 pseudoephedrine-bromphen- PREMESISRX 134, 210, 246, 249 PRIFTIN...... 20, 31 dm...... 14, 46, 215 premium lidocaine...... 226 PRILOSEC...... 156 PSORCON...... 233 PREMPHASE...... 177, 188 PRIMACARE.....64, 211, 247, 250 PULMICORT FLEXHALER PREMPRO...... 177, 188 primaquine phosphate...... 18 ...... 159, 219 PRENAISSANCE primidone...... 103 PULMOZYME...... 138, 218 ...... 64, 152, 210, 246, 249 PRIMSOL...... 33 PURIXAN...... 39, 209 prenatal...... 64, 246, 249 PRINIVIL...... 68, 69 PYLERA...... 17, 19, 32, 149, 151 prenatal plus iron...... 64, 246, 249 probenecid...... 137, 196 pyrazinamide...... 20 prenatal vitamin plus low iron PROCENTRA ...... 88 PYRIDIUM...... 226 ...... 64, 246, 249 prochlorperazine...... 119, 150 pyridostigmine bromide...... 53 PRENATE ...... 135, 247, 250 prochlorperazine maleate119, 150 pyridostigmine bromide er...... 53 PROCORT...... 226, 233 pyrimethamine...... 18

267 PYROGALLIC ACID213, 236, 243 REMIGEN...... 243 RUKOBIA...... 24 QBRELIS...... 69 RENAGEL...... 132, 195 RUZURGI...... 211 QINLOCK...... 39 RENVELA...... 132, 195 RYBELSUS...... 180 QMIIZ ODT...... 118 repaglinide...... 181 RYDAPT...... 40 QNASL...... 145, 218 REPATHA...... 84 SABRIL...... 94 QNASL CHILDRENS ...... 145, 218 REPATHA PUSHTRONEX SALAGEN...... 53 QSYMIA...... 90 SYSTEM...... 83 salicylic acid...... 236 QUALAQUIN...... 18 REPATHA SURECLICK...... 84 salimez...... 236 QUDEXY XR...... 94 RESTASIS...... 146 SALIVAMAX...... 147 QUESTRAN...... 72 RESTASIS MULTIDOSE...... 146 salsalate...... 121 QUESTRAN LIGHT...... 72 RESTORIL...... 106 SALVAX DUO PLUS...... 228, 236 quetiapine fumarate...... 98, 102 RETACRIT...... 56, 57, 59 SAMSCA...... 137 quetiapine fumarate er 97, 98, 102 RETEVMO...... 39 SANDIMMUNE...... 203, 207, 209 QUFLORA PEDIATRIC.. 199, 247 RETIN-A MICRO PUMP...... 229 SANDOSTATIN...... 154, 191 QUILLICHEW ER...... 121 RETROVIR...... 26 SANTYL...... 138, 243 QUILLIVANT XR...... 121 REVLIMID...... 39, 207 SAPHRIS...... 98, 103 quinapril hcl...... 68, 69 REXULTI...... 102 sapropterin dihydrochloride.....211 quinapril-hydrochlorothiazide REYATAZ...... 28 SAVAYSA...... 57 ...... 69, 136 REYVOW...... 123 SAVELLA...... 110, 122 quinidine gluconate er...... 18, 76 REZUROCK...... 211 SAVELLA TITRATION PACK quinidine sulfate...... 18, 76 RHOFADE...... 243 ...... 110, 122 quinine sulfate...... 18 RHOPRESSA...... 148 SAXENDA...... 180 RABEPRAZOLE SODIUM...... 156 ribavirin...... 29 SCALACORT DK...... 233, 236 rabeprazole sodium...... 156 RIDAURA...... 156, 203, 207 SCARCIN...... 243 RADIOGARDASE...... 132, 195 rifabutin...... 20, 31 scopolamine...... 48, 150 RAGWITEK...... 43 rifampin...... 20, 31 SELECT-OB...... 64, 247, 250 raloxifene hcl...... 170, 197 RIFAMPIN+SYRSPEND SF20, 31 selegiline hcl...... 110, 111 ramelteon...... 101 RILUTEK...... 108 selenium sulfide...... 236, 238 ramipril...... 68, 69 riluzole...... 108 SELZENTRY ...... 24 ranolazine er...... 75 rimantadine hcl...... 15 SEREVENT DISKUS...... 55, 220 RAPAMUNE...... 209 RINVOQ...... 203 SERNIVO...... 233 rasagiline mesylate...... 110, 111 risedronate sodium...... 197, 198 SEROQUEL XR...... 98, 103 RASUVO...... 203 risperidone...... 98, 102 SEROSTIM...... 181, 192 RAVICTI...... 131 RITALIN...... 121 sertraline hcl...... 124 RAZADYNE ER...... 53 ritonavir...... 28 setlakin...... 168, 177, 188 REBIF...... 207 rivastigmine...... 53 sevelamer carbonate...... 132, 195 REBIF REBIDOSE...... 207 rivastigmine tartrate...... 53 sevelamer hcl...... 132, 195 REBIF REBIDOSE rivelsa...... 168, 177, 188 sevoflurane...... 110 TITRATION PACK ...... 207 RIXUBIS...... 62 sf...... 199 REBIF TITRATION PACK ...... 207 rizatriptan benzoate...... 123 sf 5000 plus...... 199 reclipsen...... 168, 177, 188 ROCALTROL...... 252 SFROWASA...... 150 RECOMBINATE ...... 62 ROCKLATAN...... 148 sharobel...... 168, 188 RECOMBIVAX HB...... 46 ropinirole hcl...... 111 SHARPS CONTAINER...... 129 RECOTHROM...... 62 ropinirole hcl er...... 111 SHINGRIX...... 46 RECOTHROM SPRAY KIT...... 62 rosadan...... 224 SIGNIFOR...... 191 RECTIV...... 243 ROSADAN...... 224 sildenafil citrate...... 84, 220, 245 REGLAN...... 155 rosuvastatin calcium...... 82 SILENOR...... 125 REGRANEX...... 243 ROWASA...... 150 silodosin...... 54 RELENZA DISKHALER...... 29 roweepra...... 94 SILVADENE...... 238 RELISTOR...... 115, 116, 154 ROZLYTREK ...... 40 silver nitrate...... 146 RELNATE DHA .64, 211, 247, 250 RUBRACA...... 40 silver sulfadiazine...... 238 REMERON...... 95 RUCONEST...... 200 SIMBRINZA...... 139, 143 REMERON SOLTAB ...... 96 rufinamide...... 94 simliya...... 168, 177, 188

268 simpesse...... 168, 177, 188 SPRAVATO (84 MG DOSE)..... 96 sulfasalazine SIMPONI...... 154, 203, 207 sprintec 28...... 168, 177, 188 ...... 31, 150, 203, 207, 208 simvastatin...... 82 SPRITAM...... 94 sulfatrim pediatric...... 19, 31, 33 SINEMET...... 109 SPRIX...... 118 SULFURATED LIME...... 240 SINGULAIR...... 217 SPRYCEL...... 40 sulindac...... 118 sirolimus...... 209 sps...... 133, 195 SUMADAN XLT...... 225, 237, 244 SIRTURO...... 20 sronyx...... 168, 177, 188 sumatriptan...... 123 SIVEXTRO...... 30 ssd...... 238 sumatriptan succinate...... 123 SKYRIZI...... 243 SSKI...... 216 sumatriptan succinate refill..... 123 SKYRIZI (150 MG DOSE)...... 243 sss 10-5...... 224, 236 SUMAXIN...... 225, 237 SKYRIZI PEN...... 243 STALEVO 100...... 107, 109 SUMAXIN CP...... 225, 237 SLYND ...... 168, 188 STALEVO 125...... 107, 109 SUNOSI...... 125 sod citrate-citric acid ...... 130 STALEVO 150...... 107, 109 SUPRAX...... 15 SODIUM BICARBONATE STALEVO 200...... 107, 109 SUPREP BOWEL PREP KIT..152 ...... 149, 151 STALEVO 50...... 107, 109 SURESTEP PRO HIGH sodium chloride...... 218 STALEVO 75...... 107, 109 GLUCOSE...... 129 sodium fluoride...... 200 stavudine...... 26 SURESTEP PRO LOW sodium fluoride 5000 enamel STELARA...... 243 GLUCOSE...... 129 ...... 126, 199 STENDRA ...... 84 SURESTEP PRO NORMAL sodium fluoride 5000 plus...... 199 STIMATE...... 62, 181 GLUCOSE...... 129 sodium fluoride 5000 ppm STIVARGA...... 40 SUSTIVA...... 25 ...... 199, 200 STRATA CTX ...... 243 SUTAB...... 152 sodium fluoride 5000 sensitive STRATA XRT ...... 243 SUTENT...... 40 ...... 126, 200 STRATTERA ...... 108 syeda...... 168, 177, 188 sodium phenylbutyrate...... 131 STRENSIQ...... 138 SYMAX DUOTAB...... 49 sodium polystyrene sulfonate STRIBILD...... 24, 26, 211 SYMAX-SL...... 49 ...... 133, 195 STRIVERDI RESPIMAT... 55, 220 SYMAX-SR...... 49 sodium sulfacetamide...... 224 STROMECTOL ...... 17 SYMBICORT...... 55, 159 sodium sulfacetamide wash....224 SUBOXONE...... 116, 117 SYMBYAX...... 103, 124 SODIUM SULFACETAMIDE- subvenite...... 94, 98 SYMDEKO...... 216 BAKUCHIOL...... 211, 224 subvenite starter kit-blue.....94, 98 SYMFI...... 25, 26 SOFOSBUVIR-VELPATASVIR subvenite starter kit-green .. 94, 98 SYMFI LO...... 25, 26 ...... 22, 23 subvenite starter kit-orange 94, 98 SYMJEPI...... 46, 214 solifenacin succinate...... 244 SUCRAID...... 138 SYMLINPEN 120...... 160 SOLIQUA...... 180, 181 sucralfate...... 155 SYMLINPEN 60...... 160 SOLOSEC...... 19 SULAR...... 80 SYMPROIC...... 154 SOLTAMOX ...... 40, 170 SULCONAZOLE NITRATE .....227 SYMTUZA...... 27, 28, 211 SOMATULINE DEPOT...... 191 sulfacetamide sodium..... 141, 224 SYNALAR...... 233, 234 SOMAVERT...... 192 sulfacetamide sodium (acne).. 224 SYNALAR (CREAM)...... 228, 233 SOOLANTRA ...... 240 sulfacetamide sodium-sulfur SYNALAR (OINTMENT) . 228, 233 SORILUX...... 243 ...... 224, 236 SYNALAR TS ...... 234, 243 sotalol hcl...... 52, 71, 72, 77, 78 sulfacetamide sod-sulfur wash SYNAPRYN FUSEPAQ...... 115 sotalol hcl (af)....52, 71, 72, 77, 78 ...... 224, 236 SYNAREL...... 179 SOTYLIZE...... 52, 71, 72, 77, 78 sulfacetamide-prednisolone SYNDROS...... 150 SOVALDI...... 22, 23 ...... 141, 145 SYNJARDY...... 162, 191 spinosad...... 240 sulfacetamide-sulfur in urea SYNJARDY XR...... 162, 191 SPIRIVA HANDIHALER....49, 214 ...... 224, 237 SYNRIBO...... 40 SPIRIVA RESPIMAT...... 49, 214 SULFACLEANSE 8/4...... 224, 237 TABLOID...... 40 spironolactone...... 82, 83, 84, 133 sulfadiazine...... 31 TABRADOL FUSEPAQ...... 51 spironolactone-hctz...... 83, 136 sulfamethoxazole-trimethoprim TABRADOL RAPIDPAQ...... 51 SPORANOX...... 21 ...... 19, 31, 33 TABRECTA ...... 40 SPORANOX PULSEPAK...... 21 sulfamez wash...... 225, 237 TACLONEX ...... 234, 243 SPRAVATO (56 MG DOSE)..... 96 SULFAMYLON...... 238 tacrolimus...... 209, 243

269 tadalafil...... 84 tetracycline hcl...... 18, 32, 151 TOPAMAX SPRINKLE...... 94, 100 tadalafil (pah)...... 84, 220 TETRIX...... 244 TOPICORT...... 234 TAFINLAR ...... 40 TEXACORT...... 234 topiramate...... 94, 100 TAGRISSO...... 40 THALOMID...... 208 topiramate er...... 94 TAKHZYRO...... 200 THEO-24...81, 121, 132, 221, 245 TOPROL XL...... 56, 71, 72, 77 TALZENNA ...... 40 theophylline toremifene citrate...... 41, 170 tamoxifen citrate...... 40, 170 ...... 81, 121, 132, 221, 245 torsemide...... 82, 132 tamsulosin hcl...... 54 theophylline er TOSYMRA...... 123 TAPAZOLE...... 161 ...... 81, 121, 132, 221, 245 TOUJEO MAX SOLOSTAR.... 181 TAPERDEX 12-DAY...... 159 THIOLA...... 211 TOUJEO SOLOSTAR...... 181 TAPERDEX 6-DAY...... 159 THIOLA EC...... 211 tovet...... 234 TAPERDEX 7-DAY...... 159 thioridazine hcl...... 119 TOVIAZ...... 245 TARGRETIN...... 40, 243 thiothixene...... 124 TRACLEER...... 220 tarina 24 fe...... 168, 177, 188 THROMBIN-JMI ...... 62 TRADJENTA ...... 170 tarina fe 1/20...... 168, 177, 188 THROMBIN-JMI EPISTAXIS.... 62 tramadol hcl...... 115 tarina fe 1/20 eq...... 168, 177, 188 THROMBOGEN...... 62 TRAMADOL HCL ER ...... 115 TARKA...... 69, 74 tiadylt er...... 73, 74, 78, 86 tramadol hcl er...... 115 TASIGNA...... 40 tiagabine hcl...... 94 tramadol hcl er (biphasic)...... 115 tavaborole...... 239 TIAZAC...... 73, 74, 78, 86 tramadol-acetaminophen.. 90, 115 TAVALISSE...... 57 TIBSOVO...... 41 trandolapril...... 68, 69 tazarotene...... 243 TIGLUTIK...... 108 trandolapril-verapamil hcl er69, 74 TAZAROTENE ...... 243 TIKOSYN...... 78 tranexamic acid...... 62 TAZORAC...... 243, 244 tilia fe...... 168, 177, 188 TRANXENE-T ...... 105, 106 taztia xt...... 73, 74, 78, 86 timolol maleate tranylcypromine sulfate...... 111 TAZVERIK...... 40 ...... 52, 71, 72, 77, 100, 142 travoprost (bak free) ...... 148 TEGRETOL...... 94, 98 timolol maleate ocudose...... 142 trazodone hcl...... 124 TEGRETOL-XR...... 94, 98 timolol maleate pf...... 142 TRECATOR ...... 20 TEGSEDI...... 196 TIMOPTIC...... 142 TRELEGY ELLIPTA ....49, 55, 159 TEKTURNA ...... 84 TIMOPTIC OCUDOSE...... 142 TREMFYA ...... 244 TEKTURNA HCT ...... 84, 136 TIMOPTIC-XE...... 142 tretinoin...... 41, 229 telmisartan...... 67 tinidazole...... 19 tretinoin microsphere...... 229 telmisartan-amlodipine...... 67, 80 tiopronin...... 211 tretinoin microsphere pump.... 229 telmisartan-hctz...... 67, 136 TIROSINT...... 193 TRETTEN ...... 62 temazepam...... 106 TIROSINT-SOL...... 193 TREXALL...... 41, 203, 208, 209 TEMOVATE ...... 234 TISSEEL...... 244 TREZIX...... 90, 115, 121 temozolomide...... 41 TIVICAY...... 24 tri femynor...... 168, 177, 189 TENCON...... 90, 104 TIVICAY PD...... 24 triamcinolone acetonide...... 234 TENIVAC...... 44 TIVORBEX...... 118 triamterene...... 84, 133 tenofovir disoproxil fumarate.....27 tizanidine hcl...... 51 triamterene-hctz...... 133, 137 TEPMETKO ...... 41 TOBI PODHALER...... 16 triazolam...... 106 terazosin hcl ...... 52, 66 TOBRADEX...... 141, 145 TRICARE PRENATAL DHA terbinafine hcl...... 15 TOBRADEX ST...... 141, 145 ONE...... 64, 152, 211, 247, 250 terbutaline sulfate...... 55, 220 tobramycin...... 16, 141 TRI-CHLOR...... 212 terconazole...... 227 tobramycin-dexamethasone TRICITRASOL...... 57 TERIPARATIDE ...... 141, 145 tricitrates...... 130 (RECOMBINANT) ...... 181, 196 TOBREX...... 141 triderm...... 234 terrell...... 110 tolbutamide...... 130, 192 TRIDESILON...... 234 TESSALON PERLES ...... 215 tolcapone...... 107 trientine hcl...... 157 TESTIM...... 160 tolterodine tartrate...... 245 tri-estarylla...... 168, 177, 189 testosterone cypionate...... 160 tolterodine tartrate er...... 245 trifluoperazine hcl...... 119 testosterone enanthate...... 160 TOLVAPTAN ...... 137 trifluridine...... 142 tetrabenazine...... 125 tolvaptan...... 137 trihexyphenidyl hcl...... 50, 91 tetracaine hcl...... 148 TOPAMAX...... 94, 100 TRIJARDY XR...... 162, 170, 191

270 TRIKAFTA...... 216 TWINRIX...... 46 VANCOMYCIN+SYRSPEND tri-legest fe...... 168, 177, 189 TWIRLA...... 169, 178, 189 SF...... 22 TRILEPTAL ...... 94, 95 tyblume...... 169, 178, 189 vandazole...... 16, 225 tri-linyah...... 168, 177, 189 TYBOST...... 212 VAQTA...... 46 tri-lo-estarylla...... 168, 177, 189 tydemy...... 169, 178, 189, 250 vardenafil hcl...... 84 tri-lo-marzia...... 168, 178, 189 TYKERB...... 41 VARIVAX...... 46 tri-lo-mili...... 168, 178, 189 TYMLOS ...... 181, 196 VECAMYL...... 82 tri-lo-sprintec...... 168, 178, 189 TYVASO...... 220 velivet...... 169, 178, 189 trimethobenzamide hcl...... 150 TYVASO REFILL...... 220 VELPHORO...... 133 trimethoprim...... 33 TYVASO STARTER...... 221 VELTASSA...... 133 tri-mili...... 168, 178, 189 UBRELVY...... 106 VELTIN...... 225, 229, 244 trimipramine maleate...... 125 UCERIS...... 159, 234 VEMLIDY...... 29 TRINATE ...... 64, 247, 250 UDAMIN SP...... 135, 248, 250 VENCLEXTA ...... 41 TRINTELLIX ...... 124 UKONIQ...... 41 VENCLEXTA STARTING tri-nymyo...... 168, 178, 189 ULTANE ...... 110 PACK...... 41 TRIPLE COMPLEX FORMULA ULTRACET...... 90, 115 VENELEX...... 244 3 KIT...... 226, 239, 244 UMECTA MOUSSE...... 237 venlafaxine hcl...... 122 TRIPLE PMB...... 141, 145, 147 UNISTRIP CONTROL...... 129 venlafaxine hcl er...... 122 TRIPLE PMK...... 141, 145, 147 unithroid...... 193 VENTAVIS...... 221 tri-previfem...... 168, 178, 189 UPNEEQ...... 149 VENTRIXYL...... 135, 248, 251 tri-sprintec...... 169, 178, 189 UPTRAVI...... 221 verapamil hcl...... 73, 74, 79, 86 TRISTART DHA URAMAXIN...... 237 verapamil hcl er.73, 74, 78, 79, 86 ...... 64, 135, 212, 247, 250 urea...... 237 VERDESO...... 234 TRISTART FREE urea nail...... 237 VEREGEN...... 244 ...... 64, 135, 212, 247, 250 URELLE...... 33, 49, 90, 212 VERELAN...... 73, 74, 79, 86 TRISTART ONE UREMEZ-40...... 237 VERELAN PM...... 73, 75, 79, 86 ...... 65, 135, 212, 247, 250 URIBEL...... 33, 49, 90, 212 VERSACLOZ...... 103 TRIUMEQ...... 24, 27 URIMAR-T...... 33, 49, 90, 212 VERZENIO...... 41 TRI-VI-FLOR urin ds...... 33, 49, 90, 212 VESICARE...... 245 ...... 200, 247, 248, 250, 251, 252 URO-458...... 33, 49, 90, 212 vestura...... 169, 178, 189 TRI-VI-FLORO UROCIT-K 10...... 131 VFEND...... 21 ...... 200, 248, 250, 251, 252 UROCIT-K 15...... 131 VIBERZI...... 154 tri-vite/fluoride. 200, 248, 251, 252 UROCIT-K 5...... 131 VIBRAMYCIN...... 18, 32 trivora (28)...... 169, 178, 189 UROGESIC-BLUE...... 33, 49, 212 VICTOZA...... 180 tri-vylibra...... 169, 178, 189 uro-mp...... 33, 49, 90, 212 VIEKIRA PAK...... 23 tri-vylibra lo...... 169, 178, 189 URSO 250...... 152 vienva...... 169, 178, 189 trospium chloride...... 245 URSO FORTE...... 152 vigabatrin...... 95 trospium chloride er...... 245 ursodiol...... 152 vigadrone...... 95 TRUE METRIX LEVEL 1 ...... 129 URSODIOL+SYRSPEND SF..152 VIGAMOX...... 141 TRUE METRIX LEVEL 2 ...... 129 USTELL...... 33, 49, 90, 212 VIIBRYD...... 124 TRUE METRIX LEVEL 3 ...... 129 UTIRA-C...... 34, 49, 90, 212 VIIBRYD STARTER PACK..... 124 TRULANCE ...... 154 UTOPIC...... 237 VILAMIT MB...... 34, 49, 90, 212 TRULICITY...... 180 valacyclovir hcl ...... 29 VILEVEV MB...... 34, 49, 90, 212 TRUMENBA ...... 46 VALCHLOR...... 244 VIMPAT...... 95 TRUSOPT...... 143 valganciclovir hcl...... 29 VINATE ONE...... 65, 248, 251 TRUVADA...... 27 valproic acid...... 95, 98, 100 VIOKACE...... 138, 153 TUKYSA...... 41 valsartan...... 67 viorele...... 169, 178, 189 tulana...... 169, 189 valsartan-hydrochlorothiazide VIRACEPT...... 28 TURALIO...... 41 ...... 67, 137 VIRAMUNE...... 25 TURPENTINE ...... 228 VALTOCO...... 105 VIRAZOLE...... 29 TUSSICAPS...... 14, 215 VANCOCIN...... 22 VIREAD...... 27 TUXARIN ER...... 14, 215 VANCOCIN HCL...... 22 virt-phos 250 neutral...... 135 TUZISTRA XR...... 14, 215 vancomycin hcl ...... 22 virtussin ac w/alc...... 215, 216

271 VISTARIL...... 13, 101 WP THYROID...... 194 zaclir cleansing...... 239 VISTOGARD...... 195 wymzya fe ...... 169, 178, 189 zafemy...... 169, 178, 189 VITAFOL FE+ XALKORI...... 41 zafirlukast...... 217 ...... 65, 135, 212, 248, 251 XARELTO...... 58 zaleplon...... 101 VITAFOL STRIPS...... 248 XARELTO STARTER PACK .....58 ZANAFLEX...... 51 VITAFOL-NANO ...... 65, 248, 251 XATMEP...... 42, 203, 208, 209 zarah...... 169, 178, 189 VITAFOL-OB+DHA XCOPRI...... 95 ZARONTIN...... 124 ...... 65, 135, 212, 248, 251 XELJANZ...... 203, 204 ZARXIO...... 59 vitamin d (ergocalciferol)...... 252 XELJANZ XR...... 204 ZEBUTAL...... 90, 104, 121 vitamins acd-fluoride XELPROS...... 148 ZEJULA...... 42 ...... 200, 248, 251, 252 XENICAL...... 155 ZELAPAR...... 110, 111 VITATHELY WITH GINGER XENLETA ...... 30 ZELBORAF...... 42 ...... 65, 248, 251 XEPI...... 225 ZELNORM...... 155 VITRAKVI...... 41 XERMELO...... 149 ZEMBRACE SYMTOUCH ...... 123 VIVELLE-DOT...... 178, 198 XIFAXAN...... 31 ZEMPLAR...... 252 VIZIMPRO...... 41 XIIDRA...... 146 zenatane...... 244 volnea...... 169, 178, 189 XOFLUZA (40 MG DOSE)...... 20 ZENPEP...... 138, 153 VONVENDI...... 62 XOFLUZA (80 MG DOSE)...... 20 ZEPATIER...... 23, 24 voriconazole...... 21 XOLEGEL...... 228 ZEPOSIA...... 208 VOSEVI...... 23 XOLEGEL COREPAK.....228, 234 ZEPOSIA 7-DAY STARTER VOTRIENT...... 41 XOLEGEL DUO/HEAD & PACK...... 208 VP FC KIT...... 51, 239, 244 SHOULDERS...... 228, 238 ZEPOSIA STARTER KIT...... 208 VP GKL KIT...... 226, 239, 244 XOLEGEL DUO/XOLEX. 228, 238 ZETONNA ...... 145 vp-pnv-dha ...... 65, 212, 248, 251 XOPENEX HFA...... 55, 220 ZIAC...... 71, 137 VRAYLAR...... 103 XOSPATA...... 42 ZIAGEN...... 27 VTOL LQ ...... 90, 104, 121 XPOVIO (100 MG ONCE zidovudine...... 27 VUSION...... 227, 228, 235 WEEKLY)...... 42 ZIEXTENZO...... 59 vyfemla...... 169, 178, 189 XPOVIO (40 MG ONCE zileuton er...... 217 VYLEESI...... 108 WEEKLY)...... 42 ZILXI...... 225 vylibra...... 169, 178, 189 XPOVIO (40 MG TWICE ZIOPTAN...... 148 VYNDAMAX...... 75, 108 WEEKLY)...... 42 ziprasidone hcl...... 98, 103 VYNDAQEL...... 75 XPOVIO (60 MG ONCE ZIPSOR...... 119 VYTORIN...... 76, 82 WEEKLY)...... 42 ZIRGAN...... 142 VYVANSE...... 88 XPOVIO (60 MG TWICE ZITHROMAX...... 30 WAKIX...... 125 WEEKLY)...... 42 ZITHROMAX TRI-PAK...... 30 warfarin sodium...... 57 XPOVIO (80 MG ONCE ZITHROMAX Z-PAK...... 30 WEGOVY...... 180 WEEKLY)...... 42 ZOKINVY...... 212 WELCHOL...... 73, 161 XPOVIO (80 MG TWICE ZOLINZA...... 42 wera...... 169, 178, 189 WEEKLY)...... 42 zolmitriptan...... 123 WESTGEL DHA XTAMPZA ER...... 115 zolpidem tartrate...... 101 ...... 65, 135, 212, 248, 251 XTANDI ...... 42 zolpidem tartrate er...... 101 WESTHROID...... 194 xulane...... 169, 178, 189 ZOLPIMIST...... 101 WHEAT GERM OIL...... 252 XURIDEN...... 212 ZOMIG...... 123 WIDE-SEAL DIAPHRAGM 60 213 XYNTHA...... 62 ZONEGRAN...... 95 WIDE-SEAL DIAPHRAGM 65 213 XYNTHA SOLOFUSE...... 62 zonisamide...... 95 WIDE-SEAL DIAPHRAGM 70 213 XYOSTED...... 160 ZONTIVITY...... 65 WIDE-SEAL DIAPHRAGM 75 213 XYREM...... 108 ZORBTIVE...... 182, 192 WIDE-SEAL DIAPHRAGM 80 213 XYWAV...... 108 ZORVOLEX...... 119 WIDE-SEAL DIAPHRAGM 85 213 YASMIN 28...... 169, 178, 189 zovia 1/35 (28)...... 169, 178, 190 WIDE-SEAL DIAPHRAGM 90 213 YAZ...... 169, 178, 189 zovia 1/35e (28)...... 169, 178, 190 WIDE-SEAL DIAPHRAGM 95 213 YUPELRI...... 49 ZOVIRAX...... 29, 226 WILATE...... 62 yuvafem...... 178, 198 ZTLIDO...... 194 WILZIN...... 135 ZACARE...... 228, 239 ZUBSOLV...... 116, 117

272 zumandimine...... 169, 179, 190 ZUPLENZ...... 149 ZYDELIG...... 42 ZYFLO ...... 217 ZYKADIA...... 42 ZYLET...... 141, 146 ZYLOPRIM...... 196 ZYMAXID...... 142 ZYPITAMAG...... 82 ZYVOX...... 30

273