Prior Authorization Drug Criteria Cross Reference PA Drug Name Generic Name PA Summary Name Epaned enalapril ACE Inhibitors and Combinations Perindopril perindopril ACE Inhibitors and Combinations Prestalia perindopril/amlodipine ACE Inhibitors and Combinations Qbrelis lisinopril ACE Inhibitors and Combinations Trandolapril/Verapamil ER by Greenstone trandolapril/verapamil ER ACE Inhibitors and Combinations Absorica/LD, Amnesteem, Claravis, isotretinoin Acne Agents, Oral Isotretinoin, Myorisan, Zenatane Acanya clindamycin/benzoyl peroxide Acne and Rosacea Agents, Topical Aczone dapsone Acne and Rosacea Agents, Topical Aklief trifarotene Acne and Rosacea Agents, Topical Altreno, Avita, Tretinoin, Retin-A Micro tretinoin Acne and Rosacea Agents, Topical Amzeeq, Zilxi minocycline Acne and Rosacea Agents, Topical Arazlo, Fabior, Tazorac tazarotene Acne and Rosacea Agents, Topical Azelex, Finacea azelaic acid Acne and Rosacea Agents, Topical Clindamycin, Clindacin, Evoclin clindamycin Acne and Rosacea Agents, Topical Clindamycin 1%/Benzoyl Peroxide 5%, clindamycin/benzoyl peroxide Acne and Rosacea Agents, Topical Neuac, Onexton Differin, Adapalene adapalene Acne and Rosacea Agents, Topical Adapalene/Benzoyl Peroxide, Epiduo Forte adapalene/benzoyl peroxide Acne and Rosacea Agents, Topical Ery Pad, erythromycin pad erythromycin Acne and Rosacea Agents, Topical Erythromycin/Benzoyl Peroxide erythromycin/benzoyl peroxide Acne and Rosacea Agents, Topical Metronidazole, Noritate, Rosadan metronidazole Acne and Rosacea Agents, Topical Soolantra ivermectin Acne and Rosacea Agents, Topical Ziana tretinoin/clindamycin Acne and Rosacea Agents, Topical BP 10-1%, Sulfacetamide Sodium/Sulfur, sodium sulfacetamide/sulfur Acne and Rosacea Agents, Topical Sumaxin Sulfacetamide sodium sulfacetamide sodium Acne and Rosacea Agents, Topical Tekturna aliskiren Aliskiren and Combinations Tekturna HCT aliskiren/HCTZ Aliskiren and Combinations Donepezil 23 mg donepezil Alzheimer's Agents Memantine oral solution memantine Alzheimer's Agents Memantine ER, Namenda XR Titration Pak memantine extended-release Alzheimer's Agents Namzaric, Titration Pak memantine/donepezil Alzheimer's Agents Tiglutik riluzole Amyotrophic Lateral Sclerosis Agents Arymo ER, Kadian, Morphabond ER, morphine ER Analgesics, Narcotics Long Morphine ER capsules Belbuca buprenorphine Analgesics, Narcotics Long Fentanyl Patch 37.5, 62.5, 87.5 mcg/hour fentanyl Analgesics, Narcotics Long Hydromorphone ER hydromorphone ER Analgesics, Narcotics Long Hysingla ER, Zohydro ER hydrocodone ER Analgesics, Narcotics Long Levorphanol levorphanol Analgesics, Narcotics Long Nucynta ER tapentadol ER Analgesics, Narcotics Long OxyContin, Xtampza ER oxycodone ER Analgesics, Narcotics Long Oxymorphone ER oxymorphone ER Analgesics, Narcotics Long Acetaminophen/Caffeine/Dihydrocodeine acetaminophen/caffeine/dihydrocodeine Analgesics, Narcotics Short Benzhydrocodone/Acetaminophen benzhydrocodone/acetaminophen Analgesics, Narcotics Short Butalbital/Acetaminophen/Caffeine/Codeine butalbital/acetaminophen/caffeine/codeine Analgesics, Narcotics Short Butalbital/Aspirin/Caffeine/Codeine butalbital/aspirin/caffeine/codeine Analgesics, Narcotics Short Butorphanol Nasal Spray QLL butorphanol Analgesics, Narcotics Short Codeine codeine Analgesics, Narcotics Short Dilaudid Oral Liquid, Hydromorphone Rectal hydromorphone Analgesics, Narcotics Short Suppository Hydrocodone/Ibuprofen, Ibudone hydrocodone/ibuprofen Analgesics, Narcotics Short Meperidine meperidine Analgesics, Narcotics Short Morphine Rectal Suppository morphine Analgesics, Narcotics Short Nalocet, Primlev, Prolate oxycodone/acetaminophen Analgesics, Narcotics Short Nucynta tapentadol Analgesics, Narcotics Short Oxaydo, Oxycodone QLL, Oxycodone oxycodone Analgesics, Narcotics Short Concentrate Oral Solution Oxycodone/Aspirin oxycodone/aspirin Analgesics, Narcotics Short Oxycodone/Ibuprofen oxycodone/ibuprofen Analgesics, Narcotics Short Oxymorphone oxymorphone Analgesics, Narcotics Short Diflunisal diflunisal Analgesics, Salicylates Salsalate salsalate Analgesics, Salicylates Testosterone Injection testosterone cypionate Androgenic Agents, Injectable Testosterone Injection, Xyosted testosterone enanthate Androgenic Agents, Injectable Anadrol-50 oxymetholone Androgenic Agents, Oral Danazol danazol Androgenic Agents, Oral Jatenzo testosterone undecanoate Androgenic Agents, Oral Methitest, Methyltestosterone methyltestosterone Androgenic Agents, Oral Oxandrolone oxandrolone Androgenic Agents, Oral Androderm, Androgel, Striant, Testosterone testosterone Androgenic Agents, Topical Trandermal Candesartan candesartan Angiotensin Receptor Blockers and Combinations Edarbi azilsartan Angiotensin Receptor Blockers and Combinations Eprosartan eprosartan Angiotensin Receptor Blockers and Combinations Micardis, Telmisartan telmisartan Angiotensin Receptor Blockers and Combinations Amlodipine/Valsartan amlodipine/valsartan Angiotensin Receptor Blockers and Combinations Amlodipine/Valsartan/HCTZ amlodipine/valsartan/HCTZ Angiotensin Receptor Blockers and Combinations Amlodipine/olmesartan amlodipine/olmesartan Angiotensin Receptor Blockers and Combinations Entresto sacubitril/valsartan Angiotensin Receptor Blockers and Combinations Tribenzor olmesartan/amlodipine/HCTZ Angiotensin Receptor Blockers and Combinations Candesartan/HCTZ candesartan/HCTZ Angiotensin Receptor Blockers and Combinations Edarbyclor azilsartan/HCTZ Angiotensin Receptor Blockers and Combinations Micardis, Telmisartan/HCTZ telmisartan/HCTZ Angiotensin Receptor Blockers and Combinations Telmisartan/Amlodipine, Twynsta telmisartan/amlodipine Angiotensin Receptor Blockers and Combinations Albendazole albendazole Anthelmintics Emverm mebendazole Anthelmintics Stromectol ivermectin Anthelmintics Oralair mixed grass pollen allergen extract Antiallergens, Oral peanut [Arachis hypogaea] allergen powder- Palforzia Antiallergens, Oral dnfp Multaq dronedarone Antiarrhythmics, Oral Dificid fidaxomicin Antibiotics, GI Paromomycin paromomycin Antibiotics, GI Xifaxan rifamixin Antibiotics, GI Arikayce amikacin liposome inhalation suspension Antibiotics, Inhaled Cayston aztreonam inhalation solution Antibiotics, Inhaled Tobi Podhaler, Tobramycin Nebulized tobramycin Antibiotics, Inhaled Mupirocin Cream mupirocin Antibiotics, Topical Neo-Synalar neomycin/fluocinolone Antibiotics, Topical Neo-Synalar Kit neomycin/fluocinolone/emollient cream Antibiotics, Topical Xepi ozenoxacin Antibiotics, Topical Cleocin Ovules, Clindamycin Vaginal Cream clindamycin Antibiotics, Vaginal (7-day) Solosec secnidazole Antibiotics, Vaginal Chlordiazepoxide/Clidinium chlordiazepoxide/clidinium Anticholinergics-Antispasmodics Cuvposa, Glycate, Glycopyrrolate Injection glycopyrrolate Anticholinergics-Antispasmodics Methscopolamine methscopolamine Anticholinergics-Antispasmodics Proprantheline proprantheline Anticholinergics-Antispasmodics Savaysa edoxaban Anticoagulants Fondaparinux fondaparinux Anticoagulants Fragmin Syringes dalteparin Anticoagulants Diacomit stiripentol Anticonvulsants Valtoco Nasal Spray diazepam Anticonvulsants Epidiolex cannabidiol Anticonvulsants Vimpat Injection lacosamide Anticonvulsants Aptiom eslicarbazepine Anticonvulsants Banzel rufinamide Anticonvulsants Briviact brivaracetam Anticonvulsants Clobazam oral suspension, Sympazan clobazam Anticonvulsants Equetro carbamazepine extended-release Anticonvulsants Felbamate felbamate Anticonvulsants Fintepla fenfluramine Anticonvulsants Fycompa perampanel Anticonvulsants Gabitril, Tiagabine tiagabine Anticonvulsants Lamictal Kits/ODT, Lamotrigine ER/ODT/kits lamotrigine Anticonvulsants Levetiracetam ER levetiracetam extended-release Anticonvulsants Lyrica CR pregabalin extended-release Anticonvulsants Nayzilam midazolam Anticonvulsants Oxtellar XR oxcarbazepine Anticonvulsants Qudexy XR, Topiramate ER, Trokendi XR topiramate extended-release Anticonvulsants Sabril vigabatrin Anticonvulsants Stavzor, Valproic Acid Capsules valproic acid Anticonvulsants Xcopri cenobamate Anticonvulsants Brisdelle, Paxil Suspension, Pexeva paroxetine Antidepressants Escitalopram Oral Solution escitalopram Antidepressants Fluoxetine 10 mg, 20 mg Tablets fluoxetine Antidepressants Fluoxetine 90 mg Delayed-Release fluoxetine DR Antidepressants Fluoxetine [PMDD], Sarafem fluoxetine [PMDD] Antidepressants Fluvoxamine ER fluvoxamine extended-release Antidepressants Paroxetine ER paroxetine extended-release Antidepressants Desvenlafaxine ER desvenlafaxine extended-release Antidepressants Drizalma, Duloxetine 40 mg duloxetine Antidepressants Fetzima levomilnacipran Antidepressants Savella milnacipran Antidepressants Trintellix (previously Brintellix) vortioxetine Antidepressants Venlafaxine ER Tablets venlafaxine extended-release Antidepressants Nefazodone nefazodone Antidepressants Trazodone 300 mg trazodone Antidepressants Viibryd viladazone Antidepressants Emsam selegiline Antidepressants Marplan isocarboxazid Antidepressants Phenylzine phenylzine Antidepressants Tranylcypromine tranylcypromine Antidepressants Imipramine Capsules imipramine pamoate Antidepressants Protriptyline protriptyline Antidepressants Trimipramine trimipramine Antidepressants Aplenzin, Forfivo XL bupropion extended-release Antidepressants Maprotiline maprotiline Antidepressants Spravato esketamine Antidepressants Alogliptin, Nesina alogliptin Antidiabetic Agents Alogliptin/Metformin alogliptin/metformin Antidiabetic Agents Alogliptin/Pioglitazone alogliptin/pioglitazone Antidiabetic Agents Janumet XR sitagliptin/metformin ER Antidiabetic Agents Jentadueto XR linagliptin/metformin ER Antidiabetic Agents Fortamet, Metformin ER (generic Fortamet), metformin ER Antidiabetic Agents Riomet ER Glyxambi empagliflozin/linagliptin Antidiabetic Agents Invokamet XR canagliflozin/metformin ER Antidiabetic Agents Qtern dapagliflozin/saxagliptin Antidiabetic Agents Segluromet ertugliflozin/metformin Antidiabetic Agents Steglatro ertugliflozin Antidiabetic Agents Steglujan ertugliflozin/sitagliptin Antidiabetic Agents Synjardy, Synjardy XR empaglifozin/metformin, ER Antidiabetic Agents Trijardy XR empagliflozin/linagliptin/metformin ER Antidiabetic Agents Tolbutamide tolbutamide Antidiabetic Agents Avandia rosiglitazone Antidiabetic Agents Pioglitazone/Glimepride pioglitazone/glimepiride Antidiabetic Agents Pioglitazone/Metformin pioglitazone/metformin Antidiabetic Agents Symlin Pen pramlintide acetate Antidiabetic Agents Adlyxin lixisenatide Antidiabetic Agents Bydureon BCise exenatide ER Antidiabetic Agents Cycloset bromocriptine Antidiabetic Agents Ozempic, Rybelsus semaglutide Antidiabetic Agents Soliqua insulin glargine/lixisenatide Antidiabetic Agents Trulicity dulaglutide Antidiabetic Agents Xultophy insulin degludec/liraglutide Antidiabetic Agents Alosetron alosetron Antidiarrheals Motofen difenoxin/atropine Antidiarrheals Mytesi crofelemer Antidiarrheals Opium Tincture opium tincture Antidiarrheals Viberzi eluxadoline Antidiarrheals Akynzeo netupitant/palonosetron Antiemetic/Antivertigo Agents Anzemet dolasetron Antiemetic/Antivertigo Agents Compro prochlorperazine Antiemetic/Antivertigo Agents Dimenhydrinate Injection dimenhydrinate Antiemetic/Antivertigo Agents Dronabinol, Syndros dronabinol Antiemetic/Antivertigo Agents Emend Suspension aprepitant Antiemetic/Antivertigo Agents Gimoti metoclopramide nasal spray Antiemetic/Antivertigo Agents Granisetron, Sancuso granisetron Antiemetic/Antivertigo Agents Metoclopramide ODT metoclopramide Antiemetic/Antivertigo Agents Ondansetron Injection, Zuplenz ondansetron Antiemetic/Antivertigo Agents Promethazine 50 mg Suppository promethazine Antiemetic/Antivertigo Agents Trimethobenzamide trimethobenzamide Antiemetic/Antivertigo Agents Varubi rolapitant Antiemetic/Antivertigo Agents Tranexamic Acid tranexamic acid Antifibrinolytic Agents Fluconazole Injection fluconazole Antifungals, Injectable Ambisome amphotericin B liposome Antifungals, Injectable Cancidas caspofungin Antifungals, Injectable Voriconazole Injection voriconazole Antifungals, Injectable Cresemba isavuconazonium Antifungals, Oral Flucytosine flucytosine Antifungals, Oral Griseofulvin griseofulvin Antifungals, Oral Lamisil Granules terbinafine Antifungals, Oral Noxafil posaconazole Antifungals, Oral Itraconazole, Omnel, Sporanox Solution Itraconazole Antifungals, Oral Oravig miconazole Antifungals, Oral Vfend Suspension voriconazole Antifungals, Oral Bensal HP salicylic acid Antifungals, Topical Ciclopirox, Ciclodan Kit, Loprox Kit ciclopirox Antifungals, Topical Clotrimazole/Betamethasone Lotion clotrimazole/betamethasone Antifungals, Topical Extina, Ketoconazole Foam , Ketodan Kit ketoconazole Antifungals, Topical Jublia efinaconazole Antifungals, Topical Kerydin tavaborole Antifungals, Topical Luzu luliconazole Antifungals, Topical Naftifine Cream, Naftin Gel naftifine Antifungals, Topical Nystatin/Triamcinolone Cream nystatin/triamcinolone Antifungals, Topical Vusion miconazole/zinc oxide/petrolatum Antifungals, Topical Clarinex-D desloratadine/pseudoephedrine Antihistamines Clarinex Syrup, Desloratadine desloratadine Antihistamines Karbinal ER, Ryvent carbinoxamine ER Antihistamines Levocetirizine Solution levocetirizine Antihistamines Ryvent carbinoxamine Antihistamines Clonidine TTS clonidine TTS Antihypertensives, Sympatholytics Colchicine QLL, Colchicine Tablets, Gloperba colchicine Antihyperuricemics Febuxostat febuxostat Antihyperuricemics Krintafel tafenoquine Antimalarials Atovaquone/Proguanil, Malarone atovaquone/proguanil Antimalarials Coartem artemether/lumefantrine Antimalarials Quinine Sulfate quinine sulfate Antimalarials Aimovig erenumab-aooe Antimigraine Agents, Other Ajovy fremanezumab-vfrm Antimigraine Agents, Other Nurtec ODT rimegepant Antimigraine Agents, Other Emgality galcanezumab-gnlm Antimigraine Agents, Other Reyvow lasmiditan Antimigraine Agents, Other Ubrelvy ubrogepant Antimigraine Agents, Other Almotriptan almotriptan Antimigraine Agents, Triptans Dihydroergotamine, Migranal dihydroergotamine mesylate Antimigraine Agents, Triptans Eletriptan eletriptan Antimigraine Agents, Triptans Ergomar ergotamine Antimigraine Agents, Triptans Frova frovatriptan Antimigraine Agents, Triptans Migergot ergotamine/caffeine Antimigraine Agents, Triptans Nazatriptan nazatriptan Antimigraine Agents, Triptans Onzetra Xsail, Sumatriptan Injection, sumatriptan Antimigraine Agents, Triptans Tosymra, Zembrace Treximet sumatriptan/naproxen Antimigraine Agents, Triptans Zolmitriptan, Zomig, Zomig ZMT zolmitriptan Antimigraine Agents, Triptans Pretomanid pretomanid Antimycobacterium Agents Sirturo bedaquiline Antimycobacterium Agents Eurax crotamiton Antiparasitics, Topical Ivermectin ivermectin Antiparasitics, Topical Lindane lindane Antiparasitics, Topical Malathion, Ovide malathion Antiparasitics, Topical Natroba, Spinosad spinosad Antiparasitics, Topical Apokyn, Kynmobi apomorphine Antiparkinson Agents Carbidopa/Levodopa ODT, Rytary carbidopa/levodopa Antiparkinson Agents Gocovri amantadine extended-release Antiparkinson Agents Inbrija levodopa Antiparkinson Agents Mirapex ER, Pramipexole ER pramipexole Antiparkinson Agents Neupro rotigotine Antiparkinson Agents Nourianz istradefylline Antiparkinson Agents Ropinirole ER ropinirole Antiparkinson Agents Tolcapone tolcapone Antiparkinson Agents Xadago safinamide Antiparkinson Agents Zelapar selegiline Antiparkinson Agents Zontivity vorapaxar Antiplatelet Drugs Benznidazole benznidazole Antiprotozoals Daraprim pyrimethamine Antiprotozoals Lampit nifurtimox Antiprotozoals Flagyl 375 mg, Metronidazole 375 mg metronidazole Antiprotozoals Nitazoxanide Nitazoxanide Antiprotozoals Doxepin Cream, Prudoxin, Zonalon doxepin Antipruritics, Topical Calcipotriene ointment, Sorilux calcipotriene Antipsoriatic Agents Calcipotriene/betamethasone, Enstilar, calcipotriene/betamethasone Antipsoriatic Agents Taclonex Calcitriol, Vectical calcitriol Antipsoriatic Agents Methoxsalen methoxsalen Antipsoriatic Agents Cytovene Injection, Ganciclovir Injection ganciclovir Antivirals, General Prevymis letermovir Antivirals, General Valcyte Powder, Valganciclovir Powder valganciclovir Antivirals, General Valacyclovir QLL valacyclovir Antivirals, Oral Sitavig acyclovir Antivirals, Oral Xofluza baloxivir Antivirals, Oral Acyclovir Ointment acyclovir Antivirals, Topical Denavir penciclovir Antivirals, Topical Xerese acyclovir/hydrocortisone Antivirals, Topical Meprobamate meprobamate Anxiolytics Benzodiazepines and Barbiturates Alprazolam, Alprazolam ER, ODT alprazolam Anxiolytics Benzodiazepines and Barbiturates Chlordiazepoxide chlordiazepoxide Anxiolytics Benzodiazepines and Barbiturates Clonazepam ODT clonazepam Anxiolytics Benzodiazepines and Barbiturates Clorazepate clorazepate Anxiolytics Benzodiazepines and Barbiturates Diazepam diazepam Anxiolytics Benzodiazepines and Barbiturates Lorazepam lorazepam Anxiolytics Benzodiazepines and Barbiturates Oxazepam oxazepam Anxiolytics Benzodiazepines and Barbiturates Estazolam estazolam Anxiolytics Benzodiazepines and Barbiturates Flurazepam flurazepam Anxiolytics Benzodiazepines and Barbiturates Midazolam midazolam Anxiolytics Benzodiazepines and Barbiturates Temazepam temazepam Anxiolytics Benzodiazepines and Barbiturates Triazolam triazolam Anxiolytics Benzodiazepines and Barbiturates Amytal amobarbital Anxiolytics Benzodiazepines and Barbiturates Butisol butabarbital Anxiolytics Benzodiazepines and Barbiturates Phenobarbital Injection phenobarbital Anxiolytics Benzodiazepines and Barbiturates Seconal secobarbital Anxiolytics Benzodiazepines and Barbiturates Bevespi Aerosphere glycopyrrolate/formoterol Asthma and COPD Agents Duaklir Pressair aclidinium/formotoerol Asthma and COPD Agents Incruse Ellipta umeclidinium Asthma and COPD Agents Lonhala Magnair glycopyrrolate Asthma and COPD Agents Spiriva Respimat tiotropium Asthma and COPD Agents Tudorza Pressair aclidinium Asthma and COPD Agents Yupelri revefenacin Asthma and COPD Agents Albuterol Inhalation 0.021%, 0.042% albuterol Asthma and COPD Agents Albuterol Tablets albuterol Asthma and COPD Agents Brovana aformoterol Asthma and COPD Agents Levalbuterol, Xopenex HFA levalbuterol Asthma and COPD Agents Metaproterenol metaproterenol Asthma and COPD Agents Perforomist formoterol Asthma and COPD Agents ProAir Digihaler and Respiclick albuterol Asthma and COPD Agents Striverdi Respimat oladaterol Asthma and COPD Agents Terbutaline terbutaline Asthma and COPD Agents Alvesco ciclesonide Asthma and COPD Agents Armonair Digihaler fluticasone propionate Asthma and COPD Agents Arnuity Ellipta fluticasone furoate Asthma and COPD Agents Asmanex Twisthaler/HFA mometasone Asthma and COPD Agents Qvar Redihaler beclomethasone Asthma and COPD Agents AirDuo, Fluticasone/Salmeterol fluticasone/salmeterol Asthma and COPD Agents Breo Ellipta fluticasone/vilanterol Asthma and COPD Agents Breztri Aerosphere budesonide/glycopyrrolate/formoterol Asthma and COPD Agents Trelegy Ellipta fluticasone/umeclidinium/vilanterol Asthma and COPD Agents Daliresp roflumilast Asthma and COPD Agents Abilify Maintena, Aripiprazole, aripiprazole Atypical Antipsychotics Aristada/Aristada Initio Caplyta lumateperone Atypical Antipsychotics Clozapine, Clozapine ODT, Versacloz clozapine Atypical Antipsychotics Fanapt iloperidone Atypical Antipsychotics Invega Sustenna, Invega Trinza, Paliperidone paliperidone Atypical Antipsychotics Latuda lurasidone Atypical Antipsychotics Nuplazid pimavanserin Atypical Antipsychotics Olanzapine, Zyprexa Relprevv olanzapine Atypical Antipsychotics Olanzapine/Fluoxetine olanzapine/fluoxetine Atypical Antipsychotics Quetiapine IR and ER quetiapine Atypical Antipsychotics Rexulti brexpiprazole Atypical Antipsychotics Risperdal Consta, Risperidone risperidone Atypical Antipsychotics Secuado, Asenapine asenapine Atypical Antipsychotics Vraylar cariprazine Atypical Antipsychotics Ziprasidone ziprasidone Atypical Antipsychotics Amoxicillin/Clavulanate chewable tablets, amoxicillin/clavulanate Augmentin Products 250/125 mg tablets Amoxicillin/Clavulanate ER amoxicillin/clavulanate extended-release Augmentin Products Amoxicillin/clavulanate 250-62.5 mg/5 ml, amoxicillin/clavulanate Augmentin Products Augmentin 125-31.25 mg/5 mL Aztreonam injection, Azactam Injection aztreonam Aztreonam Bystolic nebivolol Beta Blockers Coreg CR carvedilol extended-release Beta Blockers Corzide nadolol/bendroflurmethiazide Beta Blockers Innopran XL propranolol extended-release Beta Blockers Metoprolol/Hydrochlorothiazide metoprolol/hydrochlorothiazide Beta Blockers Sotylize sotalol Beta Blockers Timolol timolol Beta Blockers Cholestyramine, cholestyramine lite, cholestyramine Bile Acid Sequestrants Prevalite powder packets Colestid and colestipol granules and packets colestipol Bile Acid Sequestrants Welchol colesevelam Bile Acid Sequestrants Chenodal chenodiol Bile Salts Cholbam cholic acid Bile Salts Ocaliva obeticholic acid Bile Salts Arcalyst rilonacept Biologic Immunomodulators Benlysta Subcutaneous belimumab Biologic Immunomodulators Enbrel etanercept Biologic Immunomodulators Humira adalimumab Biologic Immunomodulators Ilaris canakinumab Biologic Immunomodulators Xeljanz tofacitinib Biologic Immunomodulators Xeljanz XR tofacitinib extended-release Biologic Immunomodulators Actemra Subcutaneous tocilizumab Biologic Immunomodulators Cimzia certolizumab Biologic Immunomodulators Cosentyx secukinumab Biologic Immunomodulators Dupixent dupilumab Biologic Immunomodulators Enspryng satralizumab-mwge Biologic Immunomodulators Fasenra Pen benralizumab Biologic Immunomodulators Kevzara sarilumab Biologic Immunomodulators Kineret anakinra Biologic Immunomodulators Nucala Pen mepolizumab Biologic Immunomodulators Olumiant baricitinib Biologic Immunomodulators Orencia Subcutaneous abatacept Biologic Immunomodulators Otezla apremilast Biologic Immunomodulators Rinvoq upadacitinib Biologic Immunomodulators Siliq brodalumab Biologic Immunomodulators Simponi golimumab Biologic Immunomodulators Skyrizi risankizumab Biologic Immunomodulators Stelara ustekinumab Biologic Immunomodulators Taltz ixekizumab Biologic Immunomodulators Tremfya guselkumab Biologic Immunomodulators Vesicare LS solifenacin Bladder Relaxant Preparations Darifenacin darifenacin Bladder Relaxant Preparations Flavoxate flavoxate Bladder Relaxant Preparations Gelnique oxybutunin Bladder Relaxant Preparations Myrbetriq mirabegron Bladder Relaxant Preparations Tolterodine IR, Tolterodine ER tolterodine Bladder Relaxant Preparations Trospium IR, Trospium ER trospium Bladder Relaxant Preparations Actonel 5 mg and 30 mg, Atelvia, risedronate Bone Resorption Suppression and Related Agents Risedronate Alendronate Oral Solution alendronate Bone Resorption Suppression and Related Agents Forteo teriparatide Bone Resorption Suppression and Related Agents Fosamax Plus D alendronate with vitamin D Bone Resorption Suppression and Related Agents Ibandronate ibandronate Bone Resorption Suppression and Related Agents Miacalcin Injection calcitonin-salmon Bone Resorption Suppression and Related Agents Risedronate Delayed-Release risedronate DR Bone Resorption Suppression and Related Agents Tymlos abaloparatide Bone Resorption Suppression and Related Agents Cardura XL doxazosin BPH Agents Cialis 2.5 mg, 5 mg tadalafil BPH Agents Dutasteride/Tamsulosin dutasteride/tamsulosin BPH Agents Rapaflo silodosin BPH Agents Nymalize nimodipine Calcium Channel Blockers Isradipine isradipine Calcium Channel Blockers Katerzia amlodipine Calcium Channel Blockers Nisoldipine ER nisoldipine ER Calcium Channel Blockers Diltiazem CD 360 mg, Matzim LA diltiazem ER Calcium Channel Blockers Verapamil ER PM verapamil ER Calcium Channel Blockers Capecitabine capecitabine Capecitabine Carbaglu carglumic acid Carbaglu Doribax doripenem Carbapenems Meropenem meropenem Carbapenems Meropenem/Sodium Chloride meropenem/sodium chloride Carbapenems Primaxin, Imipenem/Cilastin imipenem/cilastin Carbapenems Celestone Soluspan betamethasone Celestone Soluspan Cefadroxil Tablets cefadroxil Cephalosporins and Related Antibiotics Cephalexin 750 mg and Tablets cephalexin Cephalosporins and Related Antibiotics Cefaclor ER, Suspension cefaclor Cephalosporins and Related Antibiotics Cefixime, Suprax cefixime Cephalosporins and Related Antibiotics Cefpodoxime cefpodoxime Cephalosporins and Related Antibiotics Avycaz ceftazidime/avibactam Cephalosporins, Injectable Teflaro ceftaroline Cephalosporins, Injectable Zerbaxa ceftolozane/tazobactam Cephalosporins, Injectable Depen Titratabs penicillamine Chelating Agents Ferriprox deferiprone Chelating Agents Jadenu Tablets, Deferasirox Granules deferasirox Chelating Agents Fulphila, Neulasta, Nyvepria, Udenyca, Colony Stimulating Factors Ziextenzo pegfilgrastim Granix tbo filgrastrim Colony Stimulating Factors Leukine sargramostim Colony Stimulating Factors Neupogen, Nivestym, Zarxio filgrastim Colony Stimulating Factors Amethia, Amethia Lo, Amethyst, Camrese, levonorgestrel/ethinyl estradiol Contraceptives Camrese Lo, Quartette, Twirla, generics Annovera segesterone acetate/ethinyl estradiol Contraceptives Aranelle, Leena, generics norethindrone /ethinyl estradiol Contraceptives levonorgestrel/ethinyl estradiol/ferrous Balcoltra Contraceptives biglycinate drospirenone/ ethinyl estradiol/ Generics, Safyral Contraceptives levomefolate calcium Gianvi, Ocella, Zarah, generics drospirenone/ethinyl estradiol/ Contraceptives norethindrone acetate/ethinyl Layolis FE, Wymza FE, generics Contraceptives estradiol/ferrous fumarate norethindrone acetate/ethinyl Lo Loestrin FE, Minastrin 24 FE Contraceptives estradiol/ferrous fumarate Natazia estradiol valerate/dienogest Contraceptives Phexxi lactic acid/citric acid/potassium bitartrate Contraceptives 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Supplies Insulin Pens Tresiba Pens insulin degludec Diabetic Supplies Insulin Pens Carospir spirinolactone suspension Diuretics Eplerenone eplerenone Diuretics Ethacrynic Acid ethacryinic acid Diuretics Triamterene triamterene Diuretics Egrifta tesamorelin Egrifta Elaprase idursulfase Elaprase Aralast-NP alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic Glassia alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic Prolastin-C alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic Zemaira alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic Zokinvy lonafarnib Enzyme Inhibitors, Systemic Cerdelga eliglustat Enzyme Replacement, Gauchers Disease Cerezyme imiglucerase Enzyme Replacement, Gauchers Disease Elelyso taliglucerase Enzyme Replacement, Gauchers Disease VPRIV velaglucerase Enzyme Replacement, Gauchers Disease Epinephrine injection generics EXCEPT by epinephrine Epinephrine Injection Mylan, EpiPen, Symjepi Epogen, Procrit epoetin alfa Erythropoiesis Stimulating 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Firmagon Baxdela delafloxacin Fluoroquinolones Levofloxacin oral solution, injection levofloxacin Fluoroquinolones Gattex teduglitide Gattex Amitiza lubiprostone GI Motility, Chronic Kristalose lactulose GI Motility, Chronic Linzess linaclotide GI Motility, Chronic Motegrity prucalopride GI Motility, Chronic Movantik naloxegol GI Motility, Chronic Relistor methylnaltrexone GI Motility, Chronic Symproic naldemedine GI Motility, Chronic Trulance plecanatide GI Motility, Chronic Dalvance dalbavancin Glycopeptides Firvanq vancomycin Glycopeptides Vibativ telavancin Glycopeptides Genotropin, Humatrope, Norditropin, Nutropin AQ, Omnitrope, Saizen, Zomacton, somatotropin (recombinant) Growth Hormone Zorbtive bismuth subcitrate/metronidazole/ Pylera H Pylori Treatment tetracycline Amoxicillin/Clarithromycin/Lansoprazole amoxicillin/clarithromycin/ lansoprazole H Pylori Treatment Omeclamox amoxicillin/clarithromycin/omeprazole H Pylori Treatment Talicia omeprazole/amoxicillin/rifabutin H Pylori Treatment Famotidine Oral Suspenion famotidine H2 Antagonists Nizatidine Capsules, Oral Solution nizatidine H2 Antagonists Orladeyo berotralstat HAE Treatments Cinryze, Ruconest C1 esterase inhibitor HAE Treatments Takhzyro lanadelumab-flyo HAE Treatments Adynovate, Eloctate, Esperoct, Jivi, Kovaltry, factor VIII recombinant Hemophilia Treatment Recombinate Alprolix, Idelvion, Ixinity, Rebinyn, Rixubis factor IX recombinant Hemophilia Treatment Humate-P von Willebrand factor complex human Hemophilia Treatment Vonvedi von Willebrand factor recombinant Hemophilia Treatment FEIBA antiinhibitor factor complex Hemophilia Treatment Hemlibra emicizumab Hemophilia Treatment Novoseven RT factor VIIa recombinant Hemophilia Treatment Tretten factor VIII A-subunit recombinant Hemophilia Treatment Adefovir adefovir Hepatitis B Agents Vemlidy tenofovir alafenamide Hepatitis B Agents Mavyret glecaprevir/pibrentasvir Hepatitis C Agents Sofosbuvir/Velpatasvir sofosbuvir/velpatasvir Hepatitis C Agents 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Lexiva fosamprenavir HIV-AIDS Nevirapine ER nevirapine extended-release HIV-AIDS Norvir Powder and Solution ritonavir HIV-AIDS Pifeltro doravirine HIV-AIDS Reyataz Powder atazanavir HIV-AIDS Rukobia fostemsavir HIV-AIDS Selzentry maraviroc HIV-AIDS elvitegravir/cobicistat/emtricitabine/tenofovi Stribild HIV-AIDS r disoproxil fumarate efavirenz/lamivudine/tenofovir disoproxil Symfi/Symfi Lo HIV-AIDS fumarate Temixys HIV-AIDS lamivudine/tenofovir disoproxil fumarate Vitekta elvitegravir HIV-AIDS HP Acthar Gel respiratory corticotropin injection HP Acthar Gel Amphadase bovine hyaluronidase Hyaluronidase Hylenex recombinant hyaluronidase Hyaluronidase Vitrase ovine hyaluronidase Hyaluronidase Qbrexza glycopyrronium Hyperhidrosis Agents Lokelma sodium zirconium cyclosilicate Hyperkalemia Agents Veltassa patiromer Hyperkalemia Agents Natpara parathyroid hormone Hyperparathyroid Agents Afrezza insulin inhaled Hypoglycemics, Insulin and Related Agents Apidra vials insulin glulisine 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Immunosuppressives, Oral Prograf Granules tacrolimus for oral suspension Immunosuppressives, Oral Zortress everolimus Immunosuppressives, Oral Increlex mecasermin Increlex Invanz ertapenem Invanz Feriva 21-7 and FA iron vitamin Iron, Oral Infed iron dextran Iron, Parenteral Venofer iron sucrose Iron, Parenteral Feraheme ferumoxytol Iron, Parenteral Injectafer ferric carboxymaltose Iron, Parenteral Monoferric ferric derisomal Iron, Parenteral Sodium Ferric Gluconate Complex sodium ferric gluconate complex Iron, Parenteral Keveyis dichlorphenamide Keveyis Firdase, Ruzurgi amifampridine Lambert-Eaton Myasthenic Syndrome Agents Lanoxin 0.0625mg, 0.1875mg digoxin Lanoxin Clenpiq, Prepopik sodium picosulfate, magnesium, citric acid Laxatives and Cathartics Gavilyte-H polyethylene glycol, electrolytes, bisacodyl Laxatives and Cathartics polyethylene glycol, sodium, ascorbic acid, Plenvu Laxatives and Cathartics potassium Suprep sodium, potassium, magnesium Laxatives and Cathartics Montelukast Granules montelukast Leukotriene Modifiers Zafirlukast zafirlukast Leukotriene Modifiers Zileuton ER zileuton extended-release Leukotriene Modifiers Zyflo zileuton Leukotriene Modifiers Cubicin, Daptomycin 350 mg daptomycin Lipopeptides Juxtapid lomitapide Lipotropics, Other Nexletol bempedoic acid Lipotropics, Other Nexlizet bempedoic acid and ezetimibe Lipotropics, Other Praluent alirocumab Lipotropics, Other Repatha evolocumab Lipotropics, Other Vascepa icosapent ethyl Lipotropics, Other Ezetimibe/Simvasting 10/80 mg ezetimibe/simvastatin Lipotropics, Statins Simvastatin 80mg simvastatin Lipotropics, Statins Altoprev lovastatin Lipotropics, Statins Amlodipine/Atorvastatin amlodipine/atorvastatin Lipotropics, Statins Ezallor rosuvastatin Lipotropics, Statins Fluvastatin fluvastatin Lipotropics, Statins Livalo, Zypitamag pitavastatin Lipotropics, Statins Erythromycin Oral erythromycin Macrolides-Ketolides Makena hydroxyprogesterone caproate Makena Megace ES, Megestrol ES megestrol acetate Megace ES Otrexup, Rasuvo, Reditrex, Xatmep methotrexate Methotrexate Milrinone milrinone Milrinone Bupap, Butalbital/Acetaminophen 50-300 mg butalbital/acetaminophen Miscellaneous Analgesics Butalbital/Acetaminophen/Caffeine butalbital/acetaminophen/caffeine Miscellaneous Analgesics Capsules, Zebutal Conzip, Tramadol ER tramadol ER Miscellaneous Analgesics Austedo deutetrabenazine Movement Disorder Agents Ingrezza valbenazine Movement Disorder Agents Tetrabenazine tetrabenazine Movement Disorder Agents Mozobil plerixafor Mozobil Dalfampridine dalfampridine Multiple Sclerosis Agents Aubagio teriflunamide Multiple Sclerosis Agents Bafiertam monomethyl fumarate Multiple Sclerosis Agents Betaseron, Extavia interferon beta-1b Multiple Sclerosis Agents Copaxone 40mg, Glatiramer 20mg glatiramer Multiple Sclerosis Agents Gilenya fingolimod Multiple Sclerosis Agents Kesimpta ofatumumab Multiple Sclerosis Agents Mavenclad cladribine Multiple Sclerosis Agents Mayzent siponimod Multiple Sclerosis Agents Plegridy peginterferon beta-1a Multiple Sclerosis Agents Rebif interferon beta-1a Multiple Sclerosis Agents Vumerity diroximel fumarate Multiple Sclerosis Agents Zeposia ozanimod Multiple Sclerosis Agents Myalept metreleptin Myalept Narcotic Fill Limit n/a Narcotic Fill Limit Xyrem sodium oxybate Narcolepsy Agents calcium/magnesium/potassium/sodium Xywav Narcolepsy Agents oxybates Azelastine 0.15% azelastine Nasal Antihistamines Dymista azelastine/fluticasone Nasal Antihistamines Olopatadine 0.6% olopatadine Nasal Antihistamines Beconase AQ, Qnasl beclomethasone Nasal Steroids Budesonide budesonide Nasal Steroids Flunisolide flunisolide Nasal Steroids Mometasone Furoate mometasone furoate Nasal Steroids Omnaris, Zetonna ciclesonide Nasal Steroids Veramyst fluticasone furoate Nasal Steroids Xhance fluticasone propionate Nasal Steroids Gralise, Horizant gabapentin Neuropathic Pain Lidoderm, Lidocaine Patch, Lidocaine lidocaine Neuropathic Pain Ointment Northera droxidopa Northera Cambia, Zipsor diclofenac potassium NSAIDs and COX II Celecoxib celecoxib NSAIDs and COX II Diclofenac/Misoprostol diclofenac/misoprostol NSAIDs and COX II Diclofenac ER, Zorvolex diclofenac NSAIDs and COX II Duexis ibuprofen/famotidine NSAIDs and COX II Etodolac ER etodolac NSAIDs and COX II Fenoprofen, Nalfon fenoprofen NSAIDs and COX II Indomethacin ER, Tivorbex indomethacin NSAIDs and COX II Ketoprofen IR, ER ketoprofen NSAIDs and COX II Meclofenamate meclofenamate NSAIDs and COX II Mefenamic Acid mefenamic acid NSAIDs and COX II Naprelan, Naproxen CR, DR naproxen NSAIDs and COX II Oxaprozin oxaprozin NSAIDs and COX II Relafen DS nabumetone NSAIDs and COX II Sprix ketorolac NSAIDs and COX II Tolmetin tolmetin NSAIDs and COX II Vimovo naproxen/esomeprazole NSAIDs and COX II Vivlodex meloxicam NSAIDs and COX II Diclofenac Patch, Diclofenac Solution, Licart, diclofenac NSAIDs, Topical Pennsaid 2% Nuedexta dextromethorphan/quinidine Nuedexta Dojolvi triheptanoin Nutritionals, Triglycerides Bynfezia, Mycapssa, Octreotide octreotide Octreotide and Related Agents Isturisa osilodrostat Octreotide and Related Agents Korlym mifepristone Octreotide and Related Agents Sandostatin LAR octreotide ER Octreotide and Related Agents Xermelo telotristat Octreotide and Related Agents Signifor pasireotide Octreotide and Related Agents Signifor LAR pasireotide ER Octreotide and Related Agents Somatuline Depot lanreotide ER Octreotide and Related Agents Somavert pegvisomant Octreotide and Related Agents Ibrance palbociclib Oncology, Oral - Breast Kisqali riociclib Oncology, Oral - Breast Kisqali Femara riociclib/letrozole Oncology, Oral - Breast Nerlynx neratinib Oncology, Oral - Breast Phesgo pertuzumab/trastuzumab/hyaluronidase Oncology, Oral - Breast Pigray alpelisib Oncology, Oral - Breast Talzenna talazoparib Oncology, Oral - Breast Tukysa tucatinib Oncology, Oral - Breast Verzenio abemaciclib Oncology, Oral - Breast Bosulif bosutinib Oncology, Oral - Hematologic Brukinsa zanubrutinib Oncology, Oral - Hematologic Calquence acalabrutinib Oncology, Oral - Hematologic Copiktra duvelisib Oncology, Oral - Hematologic Daurismo glasdegib Oncology, Oral - Hematologic Farydak panobinostat Oncology, Oral - Hematologic Iclusig ponatinib Oncology, Oral - Hematologic Idhifa enasidenib Oncology, Oral - Hematologic Imbruvica ibrutinib Oncology, Oral - Hematologic Inqovi decitabine/cedazuridine Oncology, Oral - Hematologic Inrebic fedratinib Oncology, Oral - Hematologic Ninlaro ixazomib Oncology, Oral - Hematologic Onureg azacitidine Oncology, Oral - Hematologic Pomalyst pomalidomide Oncology, Oral - Hematologic Purixan mercaptopurine Oncology, Oral - Hematologic Rydapt midostaurin Oncology, Oral - Hematologic Sprycel dasatinib Oncology, Oral - Hematologic Tasigna nilotinib Oncology, Oral - Hematologic Tibsovo ivosidenib Oncology, Oral - Hematologic Ukoniq umbralisib Oncology, Oral - Hematologic Venclexta venetoclax Oncology, Oral - Hematologic Xpovio selinexor Oncology, Oral - Hematologic Zolinza vorinostat Oncology, Oral - Hematologic Zydelig idelalisib Oncology, Oral - Hematologic Alecensa alectinib Oncology, Oral - Lung Alunbrig brigatinib Oncology, Oral - Lung Gavreto pralsetinib Oncology, Oral - Lung Gilotrif afatinib Oncology, Oral - Lung Iressa gefitinib Oncology, Oral - Lung Lobrena lorlatinib Oncology, Oral - Lung Retevmo selpercatinib Oncology, Oral - Lung Rozlytrek entrectinib Oncology, Oral - Lung Tabrecta capmatinib Oncology, Oral - Lung Tagrisso osimertinib Oncology, Oral - Lung Tarceva erlotinib Oncology, Oral - Lung Tepmetko tepotinib Oncology, Oral - Lung Vizimpro dacomitinib Oncology, Oral - Lung Xalkori crizotinib Oncology, Oral - Lung Zykadia ceritinib Oncology, Oral - Lung Ayvakit avapritinib Oncology, Oral - Other Balversa larotrectinib Oncology, Oral - Other Cometriq cabozantinib Oncology, Oral - Other Koselugo selumetinib Oncology, Oral - Other Lonsurf trifluridine/tipiracil Oncology, Oral - Other Nexavar sorafenib Oncology, Oral - Other Pemazyre pemigatinib Oncology, Oral - Other Qinlock ripretinib Oncology, Oral - Other Stivarga regorafenib Oncology, Oral - Other Tazverik tazemetostat Oncology, Oral - Other Temozolomide temozolomide Oncology, Oral - Other Turalio pexidartinib Oncology, Oral - Other Vitrakvi larotrectinib Oncology, Oral - Other Caprelsa vandetanib Oncology, Oral - Other Lynparza olaparib Oncology, Oral - Ovarian Rubraca rucaparib Oncology, Oral - Ovarian Zejula niraparib Oncology, Oral - Ovarian Abiraterone, Yonsa, Zytiga abiraterone Oncology, Oral - Prostate Erleada apalutamide Oncology, Oral - Prostate Nubeqa darolutamide Oncology, Oral - Prostate Orgovyx relugolix Oncology, Oral - Prostate Xtandi enzalutamide Oncology, Oral - Prostate Afinitor, Afinitor Disperz everolimus Oncology, Oral - Renal Cabometyx cabozantinib Oncology, Oral - Renal Inlyta axitinib Oncology, Oral - Renal Lenvima levatinib Oncology, Oral - Renal Sutent sunitinib Oncology, Oral - Renal Votrient pazopanib Oncology, Oral - Renal Braftovi encorafenib Oncology, Oral - Skin Cotellic cobimetinib Oncology, Oral - Skin Erivedge vismodegib Oncology, Oral - Skin Mekinist trametinib Oncology, Oral - Skin Mektovi binimetinib Oncology, Oral - Skin Odomzo sonidegib Oncology, Oral - Skin Tafinlar dabrafenib Oncology, Oral - Skin Zelboraf vemurafenib Oncology, Oral - Skin AzaSite azithromycin Ophthalmic Antibiotics Bacitracin bacitracin Ophthalmic Antibiotics Besivance besifloxacin Ophthalmic Antibiotics Gatifloxacin Ophthalmic gatifloxacin Ophthalmic Antibiotics Levofloxacin Ophthalmic levofloxacin Ophthalmic Antibiotics Natacyn natamycin Ophthalmic Antibiotics Neomycin/Polymyxin B/Gramicidin neomycin/polymyxin B/gramicidin Ophthalmic Antibiotics Ofloxacin Ophthalmic ofloxacin Ophthalmic Antibiotics Lotemax Gel, Lotemax SM Gel loteprednol Ophthlamics, Antiinflammatories Acuvail ketorolac Ophthlamics, Antiinflammatories Bromfenac, Bromsite, Prolensa bromfenac Ophthlamics, Antiinflammatories Nevanac nepafanac Ophthlamics, Antiinflammatories Cequa, Restatis Multidose cyclosporine Ophthalmics, Antiinflammatory Immunomodulators Eysuvis loteprednol Ophthalmics, Antiinflammatory Immunomodulators Zirgan ganciclovir Ophthalmic Antivirals Apraclonidine 0.5% apraclonidine Ophthalmics, Glaucoma Agents Brimonidine P 0.15% brimonidine Ophthalmics, Glaucoma Agents Simbrinza brinzolamide/brimonidine Ophthalmics, Glaucoma Agents Istalol, Timoptic Ocudose timolol Ophthalmics, Glaucoma Agents Combigan 10mL timolol/brimonidine Ophthalmics, Glaucoma Agents Cosopt PF timolol/dorzolamide Ophthalmics, Glaucoma Agents Azopt brinzolamide Ophthalmics, Glaucoma Agents Pilocarpine pilocarpine Ophthalmics, Glaucoma Agents Bimatoprost 0.03% bimatoprost Ophthalmics, Glaucoma Agents Vyzulta latanoprostene bunod Ophthalmics, Glaucoma Agents Xelpros latanoprost emulsion Ophthalmics, Glaucoma Agents Zioptan tafluprost Ophthalmics, Glaucoma Agents Rhopressa netarsudil Ophthalmics, Glaucoma Agents Rocklatan netarsudil/latanoprost Ophthalmics, Glaucoma Agents Blephamide SOP sulfacetamide/prednisolone ointment Ophthalmic Steroid-Antibiotic Combinations Neomycin/Polymyxin neomycin/polymyxin Ophthalmic Steroid-Antibiotic Combinations B/Bacitracin/Hydrocortisone B/bacitracin/hydrocortisone Neomycin/Polymyxin B/Hydrocortisone neomycin/polymyxin B/hydrocortisone Ophthalmic Steroid-Antibiotic Combinations TobraDex ST, Tobramycin/Dexamethasone tobramycin/dexamethasone Ophthalmic Steroid-Antibiotic Combinations Alocril nedocromil sodium Ophthalmics for Allergic Conjuctivitis Alomide lodoxamide tromethamine Ophthalmics for Allergic Conjuctivitis Azelastine azelastine Ophthalmics for Allergic Conjuctivitis Epinastine epinastine Ophthalmics for Allergic Conjuctivitis Lastacaft alcaftadine Ophthalmics for Allergic Conjuctivitis Olopatadine, Pataday olopatadine Ophthalmics for Allergic Conjuctivitis Zerviate cetirizine Ophthalmics for Allergic Conjuctivitis Oxervate cenegermin-bkbj Ophthalmics for Neurotrophic Keratitis Narcan Nasal Spray naloxone Opiate Dependence Agents Lucemyra lofexidine Opiate Dependence Agents Zubsolv buprenorphine/naloxone Opiate Dependence Agents Orfadin Suspension nitisinone Orfadin Ciprofloxacin Otic ofloxacin Otic Antibiotics Otovel ciprofloxacin/fluocinolone Otic Antibiotics Linezolid, Zyvox linezolid Oxazolidinones Sivextro tedizolid Oxazolidinones Palynziq pegvaliase-pqpz Palyzniq Pancreaze, Pertzye, Viokace pancrelipase Pancreatic Enzymes Panretin alitretinoin Panretin Kabiven, Perikabiven amino acid/electrolytes/dextrose/lipid Parenteral Nutrition Products Clinolipid, Intralipid, Omegaven, Smoflipid lipid emulsion Parenteral Nutrition Products Metyrosine metyrosine Pheochromocytoma Agents Phenoxybenzamine phenoxybenzamine Pheochromocytoma Agents Auryxia ferric citrate Phosphate Binders Calcium Acetate Tablets, Phoslyra calcium acetate Phosphate Binders Fosrenol Powder, Lanthanum Carbonate lanthanum carbonate Phosphate Binders Renvela Tablets, Sevelamer Carbonate sevelamer carbonate Phosphate Binders Powder Sevelamer Hydrochloride 400 mg sevelamer hydrochloride Phosphate Binders Velphoro sucroferric oxyhyroxide Phosphate Binders Oriahnn elagolix/estradiol/norethindrone Pituitary Suppressive Agents, LHRH Orilissa elagolix Pituitary Suppressive Agents, LHRH Fensolvi, Lupron Depot, Lupron Depot-Ped leuprolide Pituitary Suppressive Agents, LHRH Xenleta lefamulin Pleuromutilin Antibiotics Oxlumo lumasiran Primary Hyperoxaluria Agents Aciphex Sprinkles, Raberprazole rabeprazole Proton Pump Inhibitors Dexilant dexlansoprazole Proton Pump Inhibitors Esomeprazole Rx esomeprazole Proton Pump Inhibitors Lansoprazole Rx, Prevacid Rx Solutab lansoprazole Proton Pump Inhibitors Prilosec Rx Powder for Oral Suspension omeprazole Proton Pump Inhibitors Omeprazole/Sodium Bicarbonate Rx, Zegerid omeprazole/sodium bicarbonate Proton Pump Inhibitors Rx Powder Protonix Pak pantoprazole Proton Pump Inhibitors Adempas riociguat Pulmonary Arterial Hypertension Agents Epoprostenol, Flolan epoprostenol Pulmonary Arterial Hypertension Agents Opsumit macitentan Pulmonary Arterial Hypertension Agents Orenitram, Remodulin, Tyvaso trepostinil Pulmonary Arterial Hypertension Agents Revatio Suspension, Sildenafil 20 mg sildenafil Pulmonary Arterial Hypertension Agents Tadalafil 20 mg tadalafil Pulmonary Arterial Hypertension Agents Tracleer for Oral Suspension bosentan Pulmonary Arterial Hypertension Agents Uptravi selexipag Pulmonary Arterial Hypertension Agents Ventavis iloprost Pulmonary Arterial Hypertension Agents Esbriet pirfenidone Pulmonary Fibrosis Agents Ofev nintedinab Pulmonary Fibrosis Agents Pyridostigmine pyridostigmine Pyridostigmine Pyridostigmine Extended-Release pyridostigmine extended-release Pyridostigmine Ranolazine ranolazine Ranolazine Ravicti glycerol phenylbutyrate Ravicti Sodium Phenylbutyrate Powder sodium phenylbutyrate Ravicti Rectiv nitroglycerin Rectiv Regranex becaplermin Regranex Santyl collagenase Santyl Ambien, Edular, Zolpidem Sublingual zolpidem Sedative Hypnotics Ambien CR zolpidem ER Sedative Hypnotics Belsomra suvorexant Sedative Hypnotics Dayvigo lemborexant Sedative Hypnotics Lunesta eszopiclone Sedative Hypnotics Rozerem ramelteon Sedative Hypnotics Hetlioz tasimelteon Sedative Hypnotics Serostim somatotropin(recombinant) Serostim Endari l-glutamine Sickle Cell Agents Oxbryta voxelotor Sickle Cell Agents Sicklos hydroxyurea tablets Sickle Cell Agents Amrix cyclobenzaprine ER Skeletal Muscle Relaxants Carisoprodol 250 mg carisoprodol Skeletal Muscle Relaxants Carisoprodol/Aspirin/Codeine carisoprodol/aspirin/codeine Skeletal Muscle Relaxants Cyclobenzaprine 7.5 mg cyclobenzaprine Skeletal Muscle Relaxants Lorzone chlorzoxazone Skeletal Muscle Relaxants Tizanidine capsules, Zanaflex Capsules tizanidine Skeletal Muscle Relaxants Evrysdi risdiplam Spinal Muscular Atrophy Adzenys XR, Amphetamine ER oral amphetamine Stimulants and Related Agents suspension, Dyanavel XR, Evekeo Adderall XR, Amphetamine/Dextroamphetamine IR, amphetamine/dextroamphetamine IR/ER Stimulants and Related Agents Mydayis Dextroamphetamine IR/ER, Zenzedi dextroamphetamine IR/ER Stimulants and Related Agents Adhansia XR, Aptensio XR, Concerta, Cotempla XR, Daytrana, Jornay PM, methylphenidate IR/ER Stimulants and Related Agents Methylin, Methylphenidate IR/ER, Quillichew ER, Quillivant XR, Ritalin LA 10 mg Armodafinil armodafinil Stimulants and Related Agents Atomoxetine atomoxetine Stimulants and Related Agents Clonidine ER clonidine ER Stimulants and Related Agents Desoxyn, Methamphetamine methamphetamine Stimulants and Related Agents Dexmethylphenidate IR/ER, Focalin XR dexmethylphenidate IR/ER Stimulants and Related Agents Guanfacine ER guanfacine ER Stimulants and Related Agents Modafinil modafinil Stimulants and Related Agents Sunosi solriamfetol Stimulants and Related Agents Vyvanse lisdexamfetamine Stimulants and Related Agents Wakix pitolisant Stimulants and Related Agents Strensiq asfotase alfa Strensiq Sulfadiazine sulfadiazine Sulfonamides Synagis palivizumab Synagis Synribo omacetaxine Synribo Demeclocycline demeclocycline Tetracyclines Doryx, Doryx MCP, Doxycycline Hyclate DR doxycycline hyclate delayed-release Tetracyclines Doxycycline Hyclate IR 75, 150 mg tablets doxycycline hyclate immediate-release Tetracyclines Doxycycline Monohydrate 75 mg and 150 mg doxycycline monohydrate Tetracyclines capsules Doxycycline [rosacea] DR, Oracea doxycycline [rosacea] delayed-release Tetracyclines Minocycline IR tablets, Minocycline ER, minocycline Tetracyclines Minolira, Solodyn Morgidox Kit doxycycline and cleanser Tetracyclines Nuzyra omadacycline Tetracyclines Thiola and Thiola EC tiopronin/tiopronin delayed-release Thiola Doptelet avatrombopag Thrombopoiesis Stimulating Proteins Mulpleta lusutrombopag Thrombopoiesis Stimulating Proteins Promacta eltrombopag Thrombopoiesis Stimulating Proteins Tavalisse fostamatinib Thrombopoiesis Stimulating Proteins Nplate romisplostim Thrombopoiesis Stimulating Proteins Levothyroxine Injection, Thyquidity, Tirosint levothyroxine Thyroid Hormones Liothyronine Injection liothyronine Thyroid Hormones Bupropion [smoking deterrent] bupropion SR Tobacco Cessation Nicotrol Inhaler, Nicotrol Nasal Spray nicotine Tobacco Cessation Valchlor mechlorethamine Topical Antineoplastic and Genital Warts Therapy Diclofenac 3% Gel diclofenac Topical Antineoplastic and Genital Warts Therapy Picato ingenol mebutate Topical Antineoplastic and Genital Warts Therapy Podofilox Solution podofilox Topical Antineoplastic and Genital Warts Therapy Veregen sinecatechins Topical Antineoplastic and Genital Warts Therapy Zyclara imiquimod Topical Antineoplastic and Genital Warts Therapy Tacrolimus Ointment tacrolimus Topical Immunomodulators Actiq, Fentanyl Oral Lozenges fentanyl oral lozenges Transmucosal Fentanyl Fentora fentanyl buccal tablets Transmucosal Fentanyl Lazanda fentanyl nasal spray Transmucosal Fentanyl Subsys fentanyl sublingual spray Transmucosal Fentanyl Trelstar Depot, Trelstar LA triptorelin pamoate Trelstar Tygacil tigecycline Tygacil Mesalamine DR mesalamine delayed-release Ulcerative Colitis Agents Mesalamine Rectal Enema, SFRowasa mesalamine Ulcerative Colitis Agents Giazo balsalazide Ulcerative Colitis Agents Uceris budesonide Ulcerative Colitis Agents Kerafoam, Kerol, Laxtrix, Umecta, Uralytic, urea Urea Products Uramaxin, Urea Methenamine hippurate methenamine hippurate Urinary Antiinfectives Nitrofurantoin Suspension nitrofurantoin Urinary Antiinfectives Urimar-T, Urogesic Blue hyoscamine combination Urinary Antiinfectives Potassium Citrate ER, Urocit-K potassium citrate Urocit-K Femring QLL, Imvexxy estradiol Vaginal Estrogen Preparations Intrarosa prasterone Vaginal Estrogen Preparations BiDil isosorbide dinitrate/hydralazine HCl Vasodilators, Coronary GoNitro, Nitroglycerin Spray nitroglycerin Vasodilators, Coronary Verquvo vericiguat Vasodilators, Coronary Jynarque tolvaptan Vasopressor Receptor Antagonists Vecamyl mecamylamine Vecamyl Vimizim elosulfase alfa Vimizim Doxercalciferol doxercalciferol Vitamin D and ESRD Products Paricalcitol 4 mcg paricalcitol Vitamin D and ESRD Products Rayaldee calcifediol Vitamin D and ESRD Products Sensipar cinacalet Vitamin D and ESRD Products Aluminum Hydroxide aluminum hydroxide Vitamin D and ESRD Products Calcium Carbonate calcium carbonate Vitamin D and ESRD Products Calcium Lactate calcium lactate Vitamin D and ESRD Products Docusate Calcium docusate calcium Vitamin D and ESRD Products Docusate Sodium docusate sodium Vitamin D and ESRD Products Magnebind calcium carbonate/magnesium carbonate Vitamin D and ESRD Products Magnesium Carbonate magnesium carbonate Vitamin D and ESRD Products Niacin niacin Vitamin D and ESRD Products Pyridoxine pyridoxine Vitamin D and ESRD Products Sodium Bicarbonate sodium bicarbonate Vitamin D and ESRD Products Thiamine Hydrochloride thiamine hydrochloride Vitamin D and ESRD Products Dialyvite, Nephplex Rx, Nephron FA, Renal, Reno Caps, Triphrocaps, Virt-Caps, Virt-Vite vitamin B complex/folic acid and/or zinc Vitamin D and ESRD Products Plus, Vital-D Rx, VP-Vite Rx Vyndaqel, Vyndamax tafamidis Vyndaqel-Vyndamax Xenical orlistat Xenical Xospata gilteritinib Xospata