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Vanguard Fully Covered List

Below is a list of the most commonly used generic and the associated therapeutic class that will be fully covered for each qualifying disease state. This list is not all inclusive. For any generic drugs that fall within the disease states below that are not included on the list, contact CVS Caremark ® to confirm eligibility. If you are currently taking a brand-name drug in one of these categories, ask your doctor if a generic option may be appropriate for you.

DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS ACEBUTOLOL HCL Beta Blockers Diuretics/Diuretic Combinations AFEDITAB CR CCB ALISKIREN Direct Renin Inhibitors HCL Diuretics/Diuretic Combinations AMILORIDE- Diuretics/Diuretic Combinations AMLODIPINE BESYLATE Vasodilators AMLODIPINE BESYLATE-BENAZEP Antihypertensives - Misc. AMLODIPINE/ Antihypertensives - Misc. AMLODIPINE/ OLMESARTAN/HYDROCHLOROTHIAZIDE Antihypertensives - Misc. AMLODIPINE- Antihypertensives - Misc. AMLODIPINE-VALSARTAN-HCTZ Antihypertensives - Misc. Beta Blockers ATENOLOL-CHLORTHALIDONE Antihypertensives - Misc. BENAZEPRIL HCL ACE Inhibitors BENAZEPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. BETAXOLOL HCL Beta Blockers BISOPROLOL FUMARATE Beta Blockers BISOPROLOL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. Diuretics/Diuretic Combinations CANDESARTAN CILEXETIL Angiotensin II Receptor Antagonists CANDESARTAN-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. ACE Inhibitors CAPTOPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. CARTIA XT CCB Beta Blockers CARVEDILOL ER Beta Blockers Diuretics/Diuretic Combinations CHLORTHALIDONE Diuretics/Diuretic Combinations CLONIDINE Antiadrenergics CLONIDINE HCL Antiadrenergics DILT-CD CCB DILTIAZEM 12HR ER CCB DILTIAZEM 24HR CD CCB DILTIAZEM 24HR ER CCB DILTIAZEM ER CCB DILTIAZEM HCL CCB DILT-XR CCB MESYLATE Antiadrenergics MALEATE ACE Inhibitors ACE (Angiotensin-converting-enzyme). CCB ( channel blocker). DPP-4 (dipeptidyl peptidase 4). ©2019 CVS Caremark. All rights reserved. 106-36283A 041819 Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The information contained in this communication is provided in summary form. It is not intended for use as the sole basis of clinical treatment, as a substitute for reading the original research, nor as a substitute for the knowledge, skill and judgment of the medical provider. This document contains confidential and proprietary information of CVS Caremark and may not be reproduced, distributed or printed without written permission from CVS Caremark. This list is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark.

DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS Hypertension ENALAPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. EPROSARTAN MESYLATE Angiotensin II Receptor Antagonists FELODIPINE ER CCB ACE Inhibitors FOSINOPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. Diuretics/Diuretic Combinations GUANFACINE HCL Antiadrenergics HCL Vasodilators HYDROCHLOROTHIAZIDE Diuretics/Diuretic Combinations Diuretics/Diuretic Combinations IRBESARTAN Angiotensin II Receptor Antagonists IRBESARTAN-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. ISRADIPINE CCB LABETALOL HCL Beta Blockers ACE Inhibitors LISINOPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. LOSARTAN Angiotensin II Receptor Antagonists LOSARTAN-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. MATZIM LA CCB Diuretics/Diuretic Combinations Diuretics/Diuretic Combinations METHYLDOPA Antiadrenergics Diuretics/Diuretic Combinations

METOPROLOL SUCCINATE Beta Blockers METOPROLOL TARTRATE Beta Blockers METOPROLOL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. MINOXIDIL Vasodilators HCL ACE Inhibitors MOEXIPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. NADOLOL Beta Blockers NADOLOL- Antihypertensives - Misc. NICARDIPINE HCL CCB NIFEDIAC CC CCB NIFEDICAL XL CCB CCB NIFEDIPINE ER CCB NIMODIPINE CCB NISOLDIPINE CCB OLMESARTAN Angiotensin II Receptor Antagonists OLMESARTAN/HYDROCHLOROTHIAZIDE Antihypertensives - Misc. ERBUMINE ACE Inhibitors PINDOLOL Beta Blockers PRAZOSIN HCL Antiadrenergics PROPRANOLOL HCL Beta Blockers PROPRANOLOL HCL ER Beta Blockers PROPRANOLOL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc.

ACE (Angiotensin-converting-enzyme). CCB (). DPP-4 (dipeptidyl peptidase 4). ©2019 CVS Caremark. All rights reserved. 106-36283A 041819 Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The information contained in this communication is provided in summary form. It is not intended for use as the sole basis of clinical treatment, as a substitute for reading the original research, nor as a substitute for the knowledge, skill and judgment of the medical provider. This document contains confidential and proprietary information of CVS Caremark and may not be reproduced, distributed or printed without written permission from CVS Caremark. This list is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark.

DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS Hypertension QUINAPRIL HCL ACE Inhibitors QUINAPRIL-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. RAMIPRIL ACE Inhibitors SOTALOL Beta Blockers SOTALOL AF Beta Blockers Diuretics/Diuretic Combinations SPIRONOLACTONE-HCTZ Diuretics/Diuretic Combinations TAZTIA XT CCB TELMISARTAN Angiotensin II Receptor Antagonists TELMISARTAN-AMLODIPINE Antihypertensives - Misc. TELMISARTAN-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. TERAZOSIN HCL Antiadrenergics TIMOLOL MALEATE Beta Blockers TORSEMIDE Diuretics/Diuretic Combinations ACE Inhibitors TRANDOLAPRIL-VERAPAMIL ER Antihypertensives - Misc. -HYDROCHLOROTHIAZIDE Diuretics/Diuretic Combinations VALSARTAN Angiotensin II Receptor Antagonists VALSARTAN-HYDROCHLOROTHIAZIDE Antihypertensives - Misc. VERAPAMIL ER CCB VERAPAMIL ER PM CCB VERAPAMIL HCL CCB VERAPAMIL SR CCB DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS ACARBOSE Alpha-Glucosidase Inhibitor ALOGLIPTIN DPP-4 Inhibitors ALOGLIPTIN/METFORMIN Combination products ALOGLIPTIN/PIOGLITAZONE Combination products Sulfonylureas GLIPIZIDE Sulfonylureas GLIPIZIDE ER Sulfonylureas GLIPIZIDE XL Sulfonylureas GLIPIZIDE-METFORMIN Combination products GLYBURIDE Sulfonylureas GLYBURIDE MICRONIZED Sulfonylureas GLYBURIDE-METFORMIN HCL Combination products METFORMIN HCL Biguanides METFORMIN HCL ER Biguanides MIGLITOL Alpha-Glucosidase Inhibitor NATEGLINIDE Meglitinide Analogues PIOGLITAZONE HCL DPP-4 Inhibitors PIOGLITAZONE-GLIMEPIRIDE Combination products PIOGLITAZONE-METFORMIN Combination products REPAGLINIDE Meglitinide Analogues TOLBUTAMIDE Sulfonylureas

ACE (Angiotensin-converting-enzyme). CCB (Calcium channel blocker). DPP-4 (dipeptidyl peptidase 4). ©2019 CVS Caremark. All rights reserved. 106-36283A 041819 Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The information contained in this communication is provided in summary form. It is not intended for use as the sole basis of clinical treatment, as a substitute for reading the original research, nor as a substitute for the knowledge, skill and judgment of the medical provider. This document contains confidential and proprietary information of CVS Caremark and may not be reproduced, distributed or printed without written permission from CVS Caremark. This list is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark.

DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS Cholesterol AMLODIPINE-ATORVASTATIN CCB/ Combination ATORVASTATIN CALCIUM HMG CoA Reductase Inhibitors () CHOLESTYRAMINE Bile Acid Sequestrants CHOLESTYRAMINE LIGHT Bile Acid Sequestrants COLESTIPOL HCL Bile Acid Sequestrants COLESEVELAM HCL Bile Acid Sequestrants EZETIMIBE Antihyperlipidemics EZETIMIBE/SIMVASTATIN Antihyperlipidemic Combinations FENOFIBRATE Fibric Acid Derivatives FENOFIBRIC ACID Fibric Acid Derivatives FLUVASTATIN SODIUM HMG CoA Reductase Inhibitors (Statins) GEMFIBROZIL Fibric Acid Derivatives LOVASTATIN HMG CoA Reductase Inhibitors (Statins) NIACIN ER Nicotinic Acid Derivatives OMEGA-3 ACID ETHYL ESTERS Omega-3-acid Ethyl Ester PRAVASTATIN SODIUM HMG CoA Reductase Inhibitors (Statins) PREVALITE Bile Acid Sequestrants ROSUVASTATIN HMG CoA Reductase Inhibitors (Statins) SIMVASTATIN HMG CoA Reductase Inhibitors (Statins) DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS Failure ACETAZOLAMIDE Diuretics/Diuretic Combinations AMILORIDE HCL Diuretics/Diuretic Combinations AMILORIDE-HYDROCHLOROTHIAZIDE Diuretics/Diuretic Combinations BENAZEPRIL HCL ACE Inhibitors BUMETANIDE Diuretics/Diuretic Combinations CANDESARTAN CILEXETIL Angiotensin II Receptor Antagonists CAPTOPRIL ACE Inhibitors CARVEDILOL Beta Blockers CARVEDILOL ER Beta Blockers CHLORTHALIDONE Diuretics/Diuretic Combinations DIGITEK Cardiac Glycosides DIGOX Cardiac Glycosides Cardiac Glycosides ENALAPRIL MALEATE ACE Inhibitors Selective FOSINOPRIL SODIUM ACE Inhibitors FUROSEMIDE Diuretics/Diuretic Combinations HYDROCHLOROTHIAZIDE Diuretics/Diuretic Combinations INDAPAMIDE Diuretics/Diuretic Combinations IRBESARTAN Angiotensin II Receptor Antagonists LISINOPRIL ACE Inhibitors LOSARTAN POTASSIUM Angiotensin II Receptor Antagonists METHAZOLAMIDE Diuretics/Diuretic Combinations METOLAZONE Diuretics/Diuretic Combinations METOPROLOL SUCCINATE Beta Blockers

ACE (Angiotensin-converting-enzyme). CCB (Calcium channel blocker). DPP-4 (dipeptidyl peptidase 4). ©2019 CVS Caremark. All rights reserved. 106-36283A 041819 Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The information contained in this communication is provided in summary form. It is not intended for use as the sole basis of clinical treatment, as a substitute for reading the original research, nor as a substitute for the knowledge, skill and judgment of the medical provider. This document contains confidential and proprietary information of CVS Caremark and may not be reproduced, distributed or printed without written permission from CVS Caremark. This list is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark.

DISEASE STATE GENERIC DRUG NAME THERAPEUTIC CLASS METOPROLOL TARTRATE Beta Blockers PERINDOPRIL ERBUMINE ACE Inhibitors QUINAPRIL HCL ACE Inhibitors RAMIPRIL ACE Inhibitors SPIRONOLACTONE Diuretics/Diuretic Combinations SPIRONOLACTONE-HCTZ Diuretics/Diuretic Combinations TELMISARTAN Angiotensin II Receptor Antagonists TORSEMIDE Diuretics/Diuretic Combinations TRANDOLAPRIL ACE Inhibitors TRIAMTERENE-HYDROCHLOROTHIAZIDE Diuretics/Diuretic Combinations VALSARTAN Angiotensin II Receptor Antagonists

ACE (Angiotensin-converting-enzyme). CCB (Calcium channel blocker). DPP-4 (dipeptidyl peptidase 4). ©2019 CVS Caremark. All rights reserved. 106-36283A 041819 Your privacy is important to us. Our employees are trained regarding the appropriate way to handle your private health information. The information contained in this communication is provided in summary form. It is not intended for use as the sole basis of clinical treatment, as a substitute for reading the original research, nor as a substitute for the knowledge, skill and judgment of the medical provider. This document contains confidential and proprietary information of CVS Caremark and may not be reproduced, distributed or printed without written permission from CVS Caremark. This list is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark.