Maintenance Medication List. Effective January 1, 2018

UnitedHealthcare Medication List Maintenance Medication List. Effective January 1, 2018

Below is a list of all the therapeutic classes of medications included in home delivery programs. The most commonly prescribed medications are included under each therapeutic class. It is not inclusive of all maintenance medications that may be included in home delivery programs. The maintenance medication list was determined by taking into consideration chronic, long-term use of a medication, frequency of dose changes and other clinical factors. If you have questions or are not sure if your medication needs to be filled with OptumRx® home delivery, call Customer Service at the phone number listed on your plan ID card.

Drug Name Drug Name Drug Name ADHD ARCAPTA NEOHALER SYMBICORT GUANFACINE ER ARNUITY ELLIPTA THEO-24 INTUNIV+ ASMANEX TWISTHALER THEOCHRON Agents used for Dry Mouth ASMANEX HFA THEOPHYLLINE ANHYDROUS CAPHOSOL ATROVENT HFA TUDORZA PRESSAIR CEVIMELINE BEVESPI AEROSPHERE UTIBRON NEOHALER* EVOXAC BREO ELLIPTA ZILEUTON ER GELCLAIR BROVANA ZAFIRLUKAST NEUTRASAL BUDESONIDE NEB ZYFLO NUMOISYN COMBIVENT RESPIMAT ZYFLO CR ORAFATE DALIRESP Blood Clots/Prevention PILOCARPINE DULERA* ELIQUIS SALAGEN DUONEB PRADAXA Alzheimer’s Disease DYLIX SAVAYSA ARICEPT ELIXOPHYLLIN XARELTO ARICEPT 23 MG* FLOVENT DISKUS Benign Prostatic Hyperplasia (BPH) ARICEPT ODT FLOVENT HFA ALFUZOSIN HCL DONEPEZIL HCL FLUTICASONE/SALMETEROL (GENERIC AVODART+ EXELON+ AIRDUO RESPICLICK) CARDURA XL GALANTAMINE HBR INCRUSE ELLIPTA DOXAZOSIN MEMANTINE IPRATROPIUM BROMIDE DUTASTERIDE NAMENDA IPRATROPIUM-ALBUTEROL DUTASTERIDE/TAMSULOSIN* NAMENDA XR* LUFYLLIN FINASTERIDE NAMZARIC* MONTELUKAST SODIUM FLOMAX+ RAZADYNE PERFOROMIST JALYN* RAZADYNE ER PULMICORT PROSCAR RIVASTIGMINE PULMICORT FLEXHALER RAPAFLO Asthma/Chronic Obstructive Pulmonary QVAR TAMSULOSIN HCL Disease (COPD) SEEBRI NEOHALER* TERAZOSIN ACCOLATE SEREVENT DISKUS UROXATRAL + ADVAIR DISKUS SINGULAIR Breast Cancer Prevention ADVAIR HFA SPIRIVA HANDIHALER ANASTROZOLE AIRDUO RESPICLICK* SPIRIVA RESPIMAT ARIMIDEX+ ALVESCO STIOLTO RESPIMAT* AROMASIN ANORO ELLIPTA STRIVERDI RESPIMAT

Page 1 of 7 Drug Name Drug Name Drug Name Breast Cancer Prevention continued… ROSUVASTAIN ENSKYCE FARESTON QUESTRAN ERRIN FEMARA+ QUESTRAN LIGHT ESTARYLLA LETROZOLE ROSUVASTATIN ESTRADIOL-FOLIC ACID* SOLTAMOX* SIMVASTATIN ESTROSTEP FE TAMOXIFEN CITRATE TRICOR* FALESSA KIT* Chest Pain TRIGLIDE* FALMINA IMDUR TRILIPIX* FAYOSIM* ISORDIL VASCEPA FEMYNOR ISOSORBIDE DINITRATE VYTORIN* GENERESS FE* ISOSORBIDE MONONITRATE WELCHOL GIANVI MINITRAN ZETIA+ GILDAGIA NITROGLYCERIN ZOCOR HEATHER NITROGLYCERIN PATCH Constipation INTROVALE NITRO-DUR AMITIZA ISIBLOOM RANEXA LINZESS JENCYCLA Cholesterol/Lipid Lowering MOVANTIK JOLESSA ALTOPREV* RELISTOR TABLET* JOLIVETTE ANTARA* TRULANCE JULEBER ATORVASTATIN CALCIUM Contraceptive JUNEL 24 FE CHOLESTYRAMINE ALTAVERA JUNEL CHOLESTYRAMINE LIGHT ALYACEN JUNEL FE COLESTID AMETHIA KARIVA COLESTIPOL HCL AMETHIA LO KELNOR 1-35 CRESTOR+ APRI KIMIDESS EZETIMIBE ARANELLE KURVELO EZETIMIBE/SIMVASTATIN AVIANE LARISSIA FENOFIBRATE 43, 50, 67, 130, AZURETTE LEENA 134, 150, 200 MG CAPSULE* BALZIVA LESSINA FENOFIBRATE 40 MG, 45 MG, 120MG, BEKYREE LEVONEST 145 MG TABLET* BEYAZ* LEVONORGESTREL-ETHINYL ESTRADIOL FENOFIBRATE 54, 160 MG TABLET BLISOVI 24 FE LEVONORGESTREL-ETHINYL ESTRADIOL FENOFIBRIC ACID* BLISOVI FE 150-30 (84) FENOGLIDE BREVICON LEVORA-28 FLOLIPID BRIELLYN LILLOW FLUVASTATIN ER CAMILA LO LOESTRIN FE FLUVASTATIN SODIUM CAMRESE LO MEDIA 24 FE GEMFIBROZIL CAMRESE LO LOESTRIN LESCOL CAZIANT LOESTRIN FE LESCOL XL+ CHATEAL LORYNA LIPITOR+ CRYSELLE LOSEASONIQUE LIPOFEN* CYCLAFEM LOW-OGESTREL LIVALO CYCLESSA LUTERA LOPID CYRED MARLISSA LOVASTATIN DASETTA MIBELAS 24 FE* LOVAZA+ DAYSEE MICROGESTIN MEVACOR DESOGEN MICROGESTIN FE NIACOR DROSPIRENONE-ETHINYL ESTRADIOL-FOLIC MICRONOR NIASPAN ACID* MIRCETTE OMEGA-3-ACID ETHYL ESTERS DROSPIRENONE-ETHINYL ESTRADIOL MONO-LINYAH PRAVACHOL ELINEST MONONESSA PRAVASTATIN SODIUM EMOQUETTE MYZILRA PREVALITE ENPRESSE NATAZIA

Page 2 of 7 Drug Name Drug Name Drug Name Contraceptive continued… VIENVA WELLBUTRIN SR+ NECON VIORELE WELLBUTRIN XL+ NORA-BE WERA ZOLOFT+ NORETHINDRONE WYMZYA FE Diabetes NORETHINDRONE-ETHINYL ESTRADIOL- XULANE ACARBOSE FERROUS FUMARATE YASMIN ACTOPLUS MET XR NORGESTIMATE-ETHINYL ESTADIOL YAZ ACTOS+ NORGESTIMATE ETHINYL ESTRADIOL LO ZARAH ADLYXIN NORGESTREL-ETHINY ESTRADIOL ZENCHENT AFREZZA* NORINYL ZENCHENT FE ALOGLIPTIN* NORLYDA ZEOSA ALOGLIPTIN-METFORMIN* NORTREL ZOVIA 1-35E ALOGLIPTIN-PIOGLITAZONE* NUVARING ZOVIA 1-50E AMARYL OCELLA Depression APIDRA OGESTREL APLENZIN* APIDRA SOLOSTAR ORSYTHIA BUDEPRION BASAGLAR ORTHO TRI-CYCLEN BUDEPRION XL BYDUREON + ORTHO TRI-CYCLEN LO BUPROPION BYETTA ORTHO-CEPT CELEXA+ CYCLOSET ORTHO-CYCLEN CITALOPRAM DIABETA ORTHO-NOVUM CYMBALTA+ DUETACT OVCON-35 DESVENLAFAXINE (GENERIC PRISTIQ) FARXIGA PHILITH DULOXETINE FORTAMET* PORTIA EFFEXOR GLIMEPIRIDE PREVIFEM EFFEXOR XR+ GLIPIZIDE QUARTETTE* ESCITALOPRAM GLIPIZIDE ER QUASENSE FETZIMA GLIPIZIDE-METFORMIN RANJANI* FLUVOXAMINE GLUCOPHAGE RECLIPSEN FORFIVO XL* GLUCOPHAGE XR RIVELSA* KHEDEZLA* GLUCOTROL SAFYRAL* LEXAPRO+ GLUCOTROL XL SEASONIQUE LUVOX CR GLUCOVANCE SETLAKIN MAPROTILINE GLUMETZA* SPRINTEC MIRTAZAPINE GLYBURIDE SRONYX NEFAZODONE GLYBURIDE MICRONIZED SYEDA OLEPTRO* GLYBURIDE-METFORMIN TAYTULLA* PAROXETINE GLYNASE TILIA FE PAROXETINE ER GLYSET TRI-ESTARYLLA PAXIL GLYXAMBI* TRI-FEMYNOR PAXIL CR HUMALOG TRI-LEGEST FE PEXEVA HUMALOG MIX 50-50 TRI-LINYAH PRISTIQ HUMALOG MIX 75-25 TRINESSA PROZAC+ HUMULIN 70-30 TRI-LO-ESTARYLLA REMERON HUMULIN N TRI-LO-MARZIA REMERON SOLUTAB HUMULIN R TRI-LO SPRINTEC SERTRALINE INVOKAMET TRI-NORINYL TRAZODONE INVOKAMET XR TRI-PREVIFEM TRINTELLIX* INVOKANA TRI-SPRINTEC VENLAFAXINE JANUMET TRINESSA LO VENLAFAXINE ER CAPSULE JANUMET XR TRIVORA-28 VIIBRYD JANUVIA VELIVET WELLBUTRIN+ JARDIANCE VESTURA

Page 3 of 7 Drug Name Drug Name Drug Name Diabetes continued… TAPAZOLE Heart Failure JENTADUETO Fibromyalgia CORLANOR JENTADUETO XR* SAVELLA ENTRESTO KAZANO Glaucoma Heart Rhythm KOMBIGLYZE XR ALPHAGAN P AMIODARONE HCL LANTUS* APRACLONIDINE HCL BETAPACE+ LANTUS SOLOSTAR* AZOPT BETAPACE AF LEVEMIR BETAGAN CORDARONE LEVEMIR FLEXPEN BETAXOLOL HCL 0.5% DIGOXIN METFORMIN HCL BETIMOL DISOPYRAMIDE PHOSPHATE METFORMIN HCL ER BETOPTIC S 0.25 % DOFETILIDE METFORMIN SR MODIFIED-RELEASE* BIMATOPROST 0.03%* FLECAINIDE ACETATE MIGLITOL BRIMONIDINE TARTRATE OPHTHALMIC LANOXIN NATEGLINIDE SOLUTION MEXILETINE HCL NESINA CARTEOLOL HCL 1% MULTAQ NOVOLOG COMBIGAN 0.2%-0.5% NORPACE NOVOLOG FLEXPEN COSOPT 2%-0.5% NORPACE CR NOVOLOG MIX 70-30 COSOPT PF 2%-0.5%* PACERONE NOVOLOG MIX 70-30 FLEXPEN DORZOLAMIDE HCL 2 % PROPAFENONE HCL ONGLYZA DORZOLAMIDE-TIMOLOL 2%-0.5% QUINIDINE GLUCONATE OSENI IOPIDINE QUINIDINE SULFATE PIOGLITAZONE HCL ISOPTO CARBACHOL OPHTHALMIC RYTHMOL PIOGLITAZONE-GLIMEPIRIDE ISOPTO CARPINE RYTHMOL SR PIOGLITAZONE-METFORMIN LATANOPROST SOTALOL AF PRANDIMET LEVOBUNOLOL HCL OPHTHALMIC SOLUTION TAMBOCOR PRANDIN LUMIGAN 0.01% TIKOSYN PRECOSE METIPRANOLOL 0.3% High Blood Pressure REPAGLINIDE-METFORMIN MIOSTAT 0.01% ACCUPRIL RIOMET PHOSPHOLINE IODIDE ACCURETIC SOLIQUA PILOCARPINE HCL ACEBUTOLOL HCL STARLIX PILOPINE HS ACEON SYNJARDY SIMBRINZA* ADALAT CC SYNJARDY XR TIMOLOL MALEATE OPHTHALMIC SOLUTION ALDACTAZIDE TANZEUM TIMOPTIC ALDACTONE TOUJEO* TIMOPTIC OCUDOSE ALTACE TRADJENTA TIMOPTIC-XE AMILORIDE HCL TRESIBA* TRAVATAN Z AMILORIDE-HYDROCHLOROTHIAZIDE TRULICITY TRAVOPROST AMLODIPINE BESYLATE VICTOZA TRUSOPT 2% AMLODIPINE BESYLATE-BENAZAPRIL XIGDUO XR* XALATAN AMLODIPINE BESYLATE-VALARTAN XULTOPHY* ZIOPTAN AMLODIPINE BESYLATE-VALARTAN- Diabetic Supplies Gout HYDROCHLOROTHIAZIDE* INSULIN SYRINGE ALLOPURINOL AMLODIPINE-OLMESARTAN* LANCETS COLCHICINE CAPSULE* AMLODIPINE-OLMESARTAN- HYDROCHLOROHTHIZIE* PEN NEEDLE COLCHICINE TABLET* AMTURNIDE* TEST STRIPS COLCRYS* ATACAND Diarrhea DUZALLO* ATACAND HCT ALOSETRON MITIGARE ATENOLOL LOTRONEX PROBENECID ATENOLOL-CHLORTHALIDONE VIBERZI PROBENECID-COLCHICINE AVALIDE Elevated Thyroid Hormone ULORIC AVAPRO METHIMAZOLE ZURAMPIC AZOR* PROPYLTHIOURACIL ZYLOPRIM

Page 4 of 7 Drug Name Drug Name Drug Name High Blood Pressure continued… EDARBI MINIPRESS BENAZEPRIL HCL EDARBYCLOR MINOXIDIL BENAZEPRIL-HYDROCHLOROTHIAZIDE EDECRIN MOEXIPRIL HCL BENICAR+ ENALAPRIL MALEATE MOEXIPRIL-HYDROCHLOROTHIAZIDE BENICAR HCT+ ENALAPRIL-HYDROCHLOROTHIAZIDE NADOLOL BETAXOLOL HCL EPLERENONE NADOLOL-BENDROFLUMETHIAZIDE BISOPROLOL FUMARATE EPROSARTAN NEPTAZANE BISOPROLOL-HYDROCHLOROTHIAZIDE ETHACRYNIC ACID NICARDIPINE HCL BUMETANIDE EXFORGE+ NIFEDIPINE BYVALSON* EXFORGE HCT* NIFEDIPINE ER CALAN FELODIPINE ER NIMODIPINE CALAN SR FOSINOPRIL SODIUM NISOLDIPINE CANDESARTAN CILEXETIL FOSINOPRIL-HYDROCHLOROTHIAZIDE NORVASC CANDESARTAN-HYDROCHLOROTHIZIDE FUROSEMIDE OLMESARTAN CAPTOPRIL GUANFACINE HCL OLMESARTAN-HYDROCHLOROTHIAZIDE CAPTOPRIL-HYDROCHLOROTHIAZIDE HYDRALAZINE HCL PERINDOPRIL ERBUMINE CARDENE SR HYDROCHLOROTHIAZIDE PINDOLOL CARDIZEM+ HYZAAR PRAZOSIN HCL CARDIZEM CD+ INDAPAMIDE PRINIVIL CARDIZEM LA+ INDERAL LA* PROCARDIA CARDURA INNOPRAN XL PROCARDIA XL CARTIA XT INSPRA PROPRANOLOL HCL CARVEDILOL IRBESARTAN PROPRANOLOL-HYDROCHLOROTHIAZIDE CATAPRES IRBESARTAN-HYDROCHLOROTHIAZIDE QBRELIS* CATAPRES -TTS ISRADIPINE QUINAPRIL HCL CHLOROTHIAZIDE KERLONE QUINAPRIL-HYDROCHLOROTHIAZIDE CHLORTHALIDONE LABETALOL HCL RAMIPRIL CLONIDINE PATCH LASIX RESERPINE CLONIDINE HCL LEVATOL SECTRAL CLORPRES LISINOPRIL SOTALOL COREG LISINOPRIL-HYDROCHLOROTHIAZIDE SPIRONOLACTONE COREG CR* LOPRESSOR SPIRONOLACTONE-HCTZ CORGARD LOPRESSOR HCT SULAR CORZIDE LOSARTAN POTASSIUM TARKA COZAAR LOSARTAN-HYDROCHLOROTHIAZIDE TAZTIA XT DEMADEX LOTENSIN TEKTURNA DIAMOX SEQUELS LOTENSIN HCT TEKTURNA HCT DIBENZYLINE LOTREL TENEX DILACOR XR MATZIM LA TENORETIC+ DILT-CD MAVIK TENORMIN+ DILTIA XT MAXZIDE TERAZOSIN HCL DILTIAZEM 24HR CD METHYCLOTHIAZIDE TEVETEN DILTIAZEM 24HR ER METHYLDOPA TEVETEN HCT DILTIAZEM HCL METHYLDOPA-HYDROCHLOROTHIAZIDE TIAZAC DILT-XR METOLAZONE TIMOLOL MALEATE DILTZAC ER METOPROLOL EXTENDED-RELEASE/ TOPROL XL DIOVAN+ HYDROCHLOROTHIAZIDE* TORSEMIDE DIOVAN HCT+ METOPROLOL SUCCINATE TRANDATE DOXAZOSIN MESYLATE METOPROLOL TARTRATE TRANDOLAPRIL DUTOPROL* METOPROLOL-HYDROCHLOROTIAZIDE TRANDOLAPRIL-VERAPAMIL + DYAZIDE MICARDIS TRIAMTERENE + DYRENIUM MICARDIS HCT TRIAMTERENE-HCTZ MICROZIDE

Page 5 of 7 Drug Name Drug Name Drug Name High Blood Pressure continued… PREMPRO MYRBETRIQ* TRIBENZOR* PROGESTERONE OXYBUTYNIN TWYNSTA* PROMETRIUM OXYBUTYNIN CHLORIDE ER UNIRETIC PROVERA OXYTROL* UNIVASC VAGIFEM+ SANCTURA* VALSARTAN VIVELLE-DOT TOLTERODINE TARTRATE* VALSARTAN-HYDROCHLOROTHIAZIDE YUVAFEM TOLTERODINE TARTRATE ER* VASERETIC+ Inflammatory Bowel Disease TOVIAZ VASOTEC+ APRISO TROSPIUM CHLORIDE* VERAPAMIL ER ASACOL HD* VESICARE* VERAPAMIL ER PM AZULFIDINE Pancreatic Enzyme Replacement VERAPAMIL HCL BALSALAZIDE DISODIUM CREON VERELAN CANASA PANCREAZE VERELAN PM COLAZAL PERTZYE ZAROXOLYN DELZICOL* ULTRESA ZEBETA DIPENTUM VIOKACE ZESTORETIC+ GIAZO* ZENPEP ZESTRIL+ LIALDA Parkinson’s Disease ZIAC MESALAMINE ENEMA AZILECT Hormone Replacement MESALAMINE TABLET* BENZTROPINE MESYLATE ACTIVELLA PENTASA* BROMOCRIPTINE MESYLATE ALORA ROWASA CARBIDOPA ANGELIQ SF ROWASA CARBIDOPA-LEVODOPA CLIMARA SULFASALAZINE CARBIDOPA-LEVODOPA-ENTACAPONE CLIMARA PRO Irritable Bowel Disease COMTAN COMBIPATCH HYOSCYAMINE SR ELDEPRYL COVARYX H.S. Myasthenia Gravis ENTACAPONE DIVIGEL MESTINON GABAPENTIN EEMT H.S. MYTELASE LODOSYN ESTRACE PROSTIGMIN LYRICA ESTRACE CREAM PYRIDOSTIGMINE BROMIDE MIRAPEX ESTRADIOL Neuropathic Pain MIRAPEX ER* ESTRADIOL TRANSDERMAL PATCH* GABAPENTIN NEUPRO ESTRADIOL-NORETHINDRONE PATCH GRALISE* PARCOPA ESTRASORB HORIZANT* PARLODEL* ESTRING LYRICA PRAMIPEXOLE DIHYDROCHLORIDE ER* ESTROGEL Osteoporosis PRAMIPEXOLE DIHYDROCHLORIDE ESTROGEN METHYLTESTOSTERONE ACTONEL RASAGILINE ESTROPIPATE ALENDRONATE SODIUM REQUIP EVAMIST ATELVIA* REQUIP XL* FEMHRT BINOSTO* ROPINIROLE HCL FEMRING BONIVA ROPINIROLE HCL ER* JINTELI ETIDRONATE DISODIUM RYTARY* MEDROXYPROGESTERONE EVISTA + SELEGILINE HCL MENEST IBANDRONATE SODIUM SINEMET MENOSTAR RISEDRONATE SINEMET CR MIMVEY Overactive Bladder STALEVO MINIVELLE DARIFENACIN ER* TASMAR NORETHINDRONE ACETATE DETROL* TRIHEXYPHENIDYL HCL OGEN DETROL LA* XADAGO* PREFEST DITROPAN XL ZELAPAR PREMARIN ENABLEX* Phosphate Binding Agents PREMPHASE GELNIQUE* AURYXIA

Page 6 of 7 Drug Name Drug Name Drug Name Phosphate Binding Agents continued... LAMICTAL XR YOSPRALA* CALCIUM ACETATE LAMOTRIGINE ZONTIVITY ELIPHOS LAMOTRIGINE ER Testosterone Replacement FOSRENOL LAMOTRIGINE ODT ANDRODERM LANTHANUM LEVETIRACETAM ANDROID PHOSLO LEVETIRACETAM ER METHYLTESTOSTERONE CAPSULE PHOSLYRA LYRICA TESTRED RENAGEL MYSOLINE Thyroid Hormone Replacement RENVELA NEURONTIN ARMOUR THYROID SEVELAMER OXCARBAZEPINE CYTOMEL VELPHORO OXTELLAR XR* LEVOTHROID Potassium Replacement PEGANONE LEVOTHYROXINE SODIUM KLOR-CON PHENYTOIN LEVOXYL K-TAB POTIGA LIOTHYRONINE SODIUM POTASSIUM CHLORIDE PRIMIDONE SYNTHROID Rheumatoid Arthritis SPRITAM* THYROLAR ARAVA STAVZOR TIROSINT* HYDROXYCHLOROQUINE TEGRETOL Ulcers, Heartburn and Reflux LEFLUNOMIDE TEGRETOL XR ACIPHEX+ PLAQUENIL TIAGABINE HCL ACIPHEX SPRINKLE* RIDAURA TOPAMAX DEXILANT Seizures TOPIRAMATE LANSOPRAZOLE* APTIOM TOPIRAMATE ER SPRINKLE* ESOMEPRAZOLE* BANZEL TROKENDI XR* NEXIUM* BRIVACT TRILEPTAL OMEPRAZOLE CARBAMAZEPINE VALPROIC ACID OMEPRAZOLE/SODIUM BICARBONATE* CARBAMAZEPINE ER VIMPAT PANTOPRAZOLE CARBATROL ZARONTIN PREVACID* CELONTIN ZONEGRAN PREVACID SOLUTAB DEPAKENE ZONISAMIDE PRILOSEC+ DEPAKOTE Stroke and Heart Attack Prevention RABEPRAZOLE DEPAKOTE ER AGGRENOX ZEGERID* DEPAKOTE SPRINKLE ASPIRIN-DIPYRIDAMOLE Vitamins DILANTIN BRILINTA DECARA DIVALPROEX SODIUM CILOSTAZOL DRISDOL DIVALPROEX SODIUM ER CLOPIDOGREL FOLIC ACID ETHOSUXIMIDE DIPYRIDAMOLE NASCOBAL FELBAMATE EFFIENT Women's Health FELBATOL PENTOXIFYLLINE BRISDELLE* GABAPENTIN PERSANTINE DUAVEE GABITRIL PLAVIX+ INTRAROSA KEPPRA PLETAL OSPHENA KEPPRA XR PRASUGREL SARAFEM LAMICTAL TICLOPIDINE HCL LAMICTAL ODT TRENTAL

*Brand and/or generic may be excluded from coverage. Lower-cost options are available and covered. + Brand may be excluded from coverage. Lower-cost options are available and covered. This is not a complete list of medications, and not all medications listed may be covered under your plan. Medications subject to change without notice. Not all medications listed may be covered under your benefit plan. Review your benefit plan documents to see what medications are covered under your plan. Where differences are noted between this list and your benefit plan documents, the benefit plan documents will govern. UnitedHealthcare and the dimensional U logo are registered trademarks owned by UnitedHealth Group Incorporated. All branded medications are trademarks or registered trademarks of their respective owners. This list is subject to change. Please refer to myuhc.com for information on specific drugs included in these programs or call the member phone number listed on your member ID card.

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