sign in sign up
<<
Home , Abiraterone acetate, Acetylcysteine, Alpelisib, Apalutamide, Betamethasone valerate, Capsaicin

JUNE 2021 - APPROVED PRODUCT LIST A - 1 APPENDIX A - PRODUCT NAME INDEX

** A ** , ABACAVIR SULFATE ABACAVIR SULFATE AND , ABACAVIR SULFATE ABACAVIR SULFATE, LAMIVUDINE AND , ABACAVIR SULFATE ABELCET, ABILIFY, ABILIFY MAINTENA KIT, ARIPIPRAZOLE ABILIFY MYCITE KIT, ARIPIPRAZOLE ABIRATERONE , ABLYSINOL, ABRAXANE, ABREVA, DOCOSANOL (OTC) ABSORICA, ABSORICA LD, ISOTRETINOIN , ACAMPROSATE CALCIUM ACANYA, BENZOYL ACARBOSE, ACARBOSE ACCOLATE, ACCRUFER, ACCUNEB, ALBUTEROL SULFATE ACCUPRIL, QUINAPRIL HYDROCHLORIDE ACCURETIC, HYDROCHLORIDE, ACEBUTOLOL HYDROCHLORIDE ACEPHEN, ACETAMINOPHEN (OTC) ACETADOTE, ACETAMINOPHEN, ACETAMINOPHEN (OTC) ACETAMINOPHEN, ACETAMINOPHEN ACETAMINOPHEN AND , ACETAMINOPHEN ACETAMINOPHEN, AND , ACETAMINOPHEN (OTC) ACETAMINOPHEN, CAFFEINE AND BITARTRATE, ACETAMINOPHEN , ACETAZOLAMIDE ACETAZOLAMIDE , ACETAZOLAMIDE SODIUM ACETIC , , GLACIAL ACETIC ACID 0.25% IN PLASTIC CONTAINER, ACETIC ACID, GLACIAL ACETYLCYSTEINE, ACETYLCYSTEINE ACHROMYCIN V, HYDROCHLORIDE ACIPHEX, SODIUM ACITRETIN, ACITRETIN ACTICLATE, HYCLATE ACTIGALL, URSODIOL ACTIQ, CITRATE ACTIVELLA, ACTONEL, RISEDRONATE SODIUM ACTOPLUS MET, HYDROCHLORIDE ACTOS, PIOGLITAZONE HYDROCHLORIDE ACULAR, TROMETHAMINE ACULAR LS, KETOROLAC TROMETHAMINE ACUVAIL, KETOROLAC TROMETHAMINE ACYCLOVIR, ACYCLOVIR ACYCLOVIR SODIUM, ACYCLOVIR SODIUM ACZONE, , ADAPALENE (OTC) ADAPALENE, ADAPALENE ADAPALENE AND , ADAPALENE ADASUVE, ADCIRCA, XR 10, ASPARTATE ADDERALL XR 15, AMPHETAMINE ASPARTATE ADDERALL XR 20, AMPHETAMINE ASPARTATE ADDERALL XR 25, AMPHETAMINE ASPARTATE ADDERALL XR 30, AMPHETAMINE ASPARTATE ADDERALL XR 5, AMPHETAMINE ASPARTATE ADDYI, DIPIVOXIL, ADEFOVIR DIPIVOXIL ADEMPAS, RIOCIGUAT , ADENOSINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 2 APPENDIX A - PRODUCT NAME INDEX

** A ** ADHANSIA XR, HYDROCHLORIDE ADIPEX-P, PHENTERMINE HYDROCHLORIDE ADRENACLICK, EPINEPHRINE ADRENALIN, EPINEPHRINE ADREVIEW, SULFATE I-123 ADVAIR DISKUS 100/50, PROPIONATE ADVAIR DISKUS 250/50, ADVAIR DISKUS 500/50, FLUTICASONE PROPIONATE ADVAIR HFA, FLUTICASONE PROPIONATE ADVIL, (OTC) ADVIL, IBUPROFEN SODIUM (OTC) ADVIL AND CONGESTION RELIEF, CHLORPHENIRAMINE MALEATE (OTC) ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC) ADVIL COLD AND SINUS, IBUPROFEN (OTC) ADVIL CONGESTION RELIEF, IBUPROFEN (OTC) ADVIL DUAL ACTION WITH ACETAMINOPHEN, ACETAMINOPHEN (OTC) ADVIL LIQUI-, IBUPROFEN (OTC) ADVIL LIQUI-GELS, IBUPROFEN (OTC) ADVIL MULTI-SYMPTOM COLD & FLU, CHLORPHENIRAMINE MALEATE (OTC) ADVIL PM, CITRATE (OTC) ADVIL PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) ADZENYS ER, AMPHETAMINE ADZENYS XR-ODT, AMPHETAMINE AEMCOLO, SODIUM AFINITOR, AFINITOR DISPERZ, EVEROLIMUS AFIRMELLE, ETHINYL ESTRADIOL AGGRASTAT, TIROFIBAN HYDROCHLORIDE AGGRENOX, ASPIRIN AGRYLIN, HYDROCHLORIDE AIRDUO DIGIHALER, FLUTICASONE PROPIONATE AIRDUO RESPICLICK, FLUTICASONE PROPIONATE AK-FLUOR 10%, SODIUM AK-FLUOR 25%, FLUORESCEIN SODIUM AKBETA, HYDROCHLORIDE AKLIEF, AKOVAZ, SULFATE AKPENTOLATE, HYDROCHLORIDE AKTEN, HYDROCHLORIDE AKTOB, AKYNZEO, FOSNETUPITANT HYDROCHLORIDE AKYNZEO, ALA-CORT, ALA-SCALP, HYDROCORTISONE ALAVERT, (OTC) ALAWAY, FUMARATE (OTC) , ALBENDAZOLE ALBENZA, ALBENDAZOLE ALBUTEROL SULFATE, ALBUTEROL SULFATE ALBUTEROL SULFATE AND IPRATROPIUM , ALBUTEROL SULFATE ALCAINE, PROPARACAINE HYDROCHLORIDE DIPROPIONATE, ALCLOMETASONE DIPROPIONATE ALDACTAZIDE, HYDROCHLOROTHIAZIDE ALDACTONE, ALDARA, ALECENSA, HYDROCHLORIDE ALENDRONATE SODIUM, ALENDRONATE SODIUM ALEVE, SODIUM (OTC) ALEVE PM, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) ALEVE-D SINUS & COLD, NAPROXEN SODIUM (OTC) ALFENTA, HYDROCHLORIDE ALFENTANIL, ALFENTANIL HYDROCHLORIDE HYDROCHLORIDE, ALFUZOSIN HYDROCHLORIDE ALIMTA, DISODIUM ALINIA,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 3 APPENDIX A - PRODUCT NAME INDEX

** A ** ALIQOPA, DIHYDROCHLORIDE HEMIFUMARATE, ALISKIREN HEMIFUMARATE ALKINDI SPRINKLE, HYDROCORTISONE ALLEGRA ALLERGY, HYDROCHLORIDE (OTC) ALLEGRA-D 12 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLEGRA-D 24 HOUR ALLERGY AND CONGESTION, FEXOFENADINE HYDROCHLORIDE (OTC) ALLI, (OTC) , ALLOPURINOL ALLOPURINOL SODIUM, ALLOPURINOL SODIUM ALLZITAL, ACETAMINOPHEN MALATE, ALMOTRIPTAN MALATE ALOCRIL, SODIUM ALOMIDE, TROMETHAMINE ALOPRIM, ALLOPURINOL SODIUM ALORA, ESTRADIOL HYDROCHLORIDE, ALOSETRON HYDROCHLORIDE ALPHAGAN P, , ALPRAZOLAM ALPROSTADIL, ALPROSTADIL ALREX, ETABONATE ALTABAX, ALTACE, RAMIPRIL ALTAFLUOR BENOX, BENOXINATE HYDROCHLORIDE ALTAVERA, ETHINYL ESTRADIOL ALTOPREV, ALTRENO, ALUNBRIG, ALVESCO, ALVIMOPAN, ALVIMOPAN ALYACEN 1/35, ETHINYL ESTRADIOL ALYACEN 7/7/7, ETHINYL ESTRADIOL ALYQ, TADALAFIL AMABELZ, ESTRADIOL HYDROCHLORIDE, AMANTADINE HYDROCHLORIDE AMARYL, AMBIEN, TARTRATE AMBIEN CR, ZOLPIDEM TARTRATE AMBISOME, AMPHOTERICIN B , AMBRISENTAN , AMCINONIDE AMELUZ, HYDROCHLORIDE AMERGE, HYDROCHLORIDE AMICAR, AMINOCAPROIC ACID AMIDATE, AMIFOSTINE, AMIFOSTINE SULFATE, AMIKACIN SULFATE HYDROCHLORIDE, AMILORIDE HYDROCHLORIDE AMILORIDE HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, AMILORIDE HYDROCHLORIDE AMINO , AMINO ACIDS AMINOACETIC ACID 1.5% IN PLASTIC CONTAINER, AMINOCAPROIC ACID, AMINOCAPROIC ACID AMINOCAPROIC ACID IN PLASTIC CONTAINER, AMINOCAPROIC ACID , AMINOPHYLLINE AMINOSYN II 10% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN II 15% IN PLASTIC CONTAINER, AMINO ACIDS AMINOSYN-PF 10%, AMINO ACIDS AMINOSYN-PF 7%, AMINO ACIDS HYDROCHLORIDE, AMIODARONE HYDROCHLORIDE AMITIZA, LUBIPROSTONE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE AND OLMESARTAN MEDOXOMIL, AMLODIPINE BESYLATE AMLODIPINE BESYLATE, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND CALCIUM, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND BENAZEPRIL HYDROCHLORIDE, AMLODIPINE BESYLATE AMLODIPINE BESYLATE AND , AMLODIPINE BESYLATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 4 APPENDIX A - PRODUCT NAME INDEX

** A ** AMLODIPINE BESYLATE, VALSARTAN AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE N 13, AMMONIA N-13 CHLORIDE IN PLASTIC CONTAINER, AMMONIUM LACTATE, AMMONIUM LACTATE AMMONUL, AMNESTEEM, ISOTRETINOIN AMONDYS 45, CASIMERSEN , AMOXAPINE , AMOXICILLIN AMOXICILLIN AND CLAVULANATE , AMOXICILLIN AMOXICILLIN PEDIATRIC, AMOXICILLIN AMOXIL, AMOXICILLIN AMPHETAMINE SULFATE, AMPHETAMINE SULFATE AMPHOTERICIN B, AMPHOTERICIN B AND , AMPICILLIN SODIUM AMPICILLIN SODIUM, AMPICILLIN SODIUM AMPICILLIN TRIHYDRATE, AMPICILLIN/AMPICILLIN TRIHYDRATE AMPYRA, DALFAMPRIDINE LACTATE, INAMRINONE LACTATE AMRIX, HYDROCHLORIDE AMYVID, F-18 AMZEEQ, HYDROCHLORIDE AN- COLLOID, TECHNETIUM TC-99M SULFUR COLLOID KIT ANAFRANIL, HYDROCHLORIDE ANAGRELIDE HYDROCHLORIDE, ANAGRELIDE HYDROCHLORIDE ANAPROX DS, NAPROXEN SODIUM , ANASTROZOLE ANCEF IN PLASTIC CONTAINER, SODIUM ANCOBON, ANDRODERM, ANDROGEL, TESTOSTERONE ANDROID 25, ANECTINE, SUCCINYLCHOLINE CHLORIDE ANEXSIA 5/325, ACETAMINOPHEN ANEXSIA 7.5/325, ACETAMINOPHEN ANGELIQ, ANGIOMAX, BIVALIRUDIN ANGIOMAX RTU, BIVALIRUDIN ANJESO, ANNOVERA, ETHINYL ESTRADIOL ANORO ELLIPTA, UMECLIDINIUM BROMIDE ANTABUSE, ANTARA (MICRONIZED), FENOFIBRATE ANTHELIOS 20, AVOBENZONE (OTC) ANTHELIOS 40, AVOBENZONE (OTC) ANTHELIOS SX, AVOBENZONE (OTC) ANTIVERT, HYDROCHLORIDE ANUSOL HC, HYDROCORTISONE APADAZ, ACETAMINOPHEN APIXABAN, APIXABAN APLENZIN, HYDROBROMIDE APOKYN, HYDROCHLORIDE HYDROCHLORIDE, APRACLONIDINE HYDROCHLORIDE , APREMILAST , APREPITANT APRISO, MESALAMINE APTENSIO XR, METHYLPHENIDATE HYDROCHLORIDE APTIOM, APTIVUS, TIPRANAVIR AQUASOL A, A PALMITATE ARAKODA, SUCCINATE ARANELLE, ETHINYL ESTRADIOL ARAVA, LEFLUNOMIDE ARAZLO, ARESTIN, MINOCYCLINE HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 5 APPENDIX A - PRODUCT NAME INDEX

** A ** TARTRATE, ARFORMOTEROL TARTRATE ARGATROBAN, ARGATROBAN ARGATROBAN IN , ARGATROBAN ARICEPT, HYDROCHLORIDE ARIDOL KIT, ARIKAYCE KIT, AMIKACIN SULFATE ARIMIDEX, ANASTROZOLE ARIPIPRAZOLE, ARIPIPRAZOLE ARISTADA, ARISTADA INITIO KIT, ARIPIPRAZOLE LAUROXIL ARISTOSPAN, HEXACETONIDE ARIXTRA, SODIUM , ARMODAFINIL ARMONAIR DIGIHALER, FLUTICASONE PROPIONATE ARNUITY ELLIPTA, AROMASIN, ARRANON, TRIOXIDE, , ARTESUNATE ARTHROTEC, SODIUM ASACOL HD, MESALAMINE ASCLERA, ASCOR, ASCORBIC ACID MALEATE, ASENAPINE MALEATE ASHLYNA, ETHINYL ESTRADIOL ASMANEX HFA, FUROATE ASMANEX TWISTHALER, MOMETASONE FUROATE ASPIRIN AND , ASPIRIN ASTAGRAF XL, ASTELIN, HYDROCHLORIDE ASTEPRO, AZELASTINE HYDROCHLORIDE ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC) ATACAND, CANDESARTAN CILEXETIL ATACAND HCT, CANDESARTAN CILEXETIL ATAZANAVIR SULFATE, ATAZANAVIR SULFATE ATELVIA, RISEDRONATE SODIUM , ATENOLOL ATENOLOL AND CHLORTHALIDONE, ATENOLOL ATHENTIA , (OTC) ATIVAN, HYDROCHLORIDE, ATOMOXETINE HYDROCHLORIDE ATORVASTATIN CALCIUM, ATORVASTATIN CALCIUM , ATOVAQUONE ATOVAQUONE AND HYDROCHLORIDE, ATOVAQUONE ATRACURIUM BESYLATE, ATRACURIUM BESYLATE ATRACURIUM BESYLATE FREE, ATRACURIUM BESYLATE ATRALIN, TRETINOIN ATRIDOX, DOXYCYCLINE HYCLATE ATRIPLA, ATROPEN, ATROPINE SULFATE, ATROPINE SULFATE ATROVENT HFA, AUBAGIO, TERIFLUNOMIDE AUGMENTIN '125', AMOXICILLIN AUGMENTIN '250', AMOXICILLIN AUGMENTIN '875', AMOXICILLIN AUGMENTIN ES-600, AMOXICILLIN AUROVELA 1.5/30, ETHINYL ESTRADIOL AUROVELA 1/20, ETHINYL ESTRADIOL AUROVELA 24 FE, ETHINYL ESTRADIOL AUROVELA FE 1.5/30, ETHINYL ESTRADIOL AUROVELA FE 1/20, ETHINYL ESTRADIOL AURYXIA, FERRIC CITRATE AUSTEDO, DEUTETRABENAZINE AUVI-Q, EPINEPHRINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 6 APPENDIX A - PRODUCT NAME INDEX

** A ** AVAGARD, ALCOHOL (OTC) AVAGE, TAZAROTENE AVALIDE, HYDROCHLOROTHIAZIDE AVANDIA, MALEATE AVAPRO, IRBESARTAN AVEED, AVIANE-28, ETHINYL ESTRADIOL AVITA, TRETINOIN AVODART, AVYCAZ, SODIUM AXID AR, (OTC) AXUMIN, F-18 AYUNA, ETHINYL ESTRADIOL AYVAKIT, , AZACITIDINE AZACTAM, AZASAN, AZASITE, AZATHIOPRINE, AZATHIOPRINE AZATHIOPRINE SODIUM, AZATHIOPRINE SODIUM AZEDRA, IOBENGUANE I-131 , AZELAIC ACID AZELASTINE HYDROCHLORIDE, AZELASTINE HYDROCHLORIDE AZELASTINE HYDROCHLORIDE AND FLUTICASONE PROPIONATE, AZELASTINE HYDROCHLORIDE AZELEX, AZELAIC ACID AZILECT, MESYLATE AZITHROMYCIN, AZITHROMYCIN AZOPT, BRINZOLAMIDE AZOR, AMLODIPINE BESYLATE AZSTARYS, HYDROCHLORIDE AZTREONAM, AZTREONAM AZULFIDINE, SULFASALAZINE AZULFIDINE EN-TABS, SULFASALAZINE

** B ** , BACITRACIN BACITRACIN AND B SULFATE, BACITRACIN ZINC BACITRACIN--POLYMYXIN W/ , BACITRACIN ZINC , BACLOFEN BACTERIOSTATIC SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE BACTERIOSTATIC FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION BACTOCILL IN PLASTIC CONTAINER, SODIUM BACTRIM, BACTRIM DS, SULFAMETHOXAZOLE BAFIERTAM, MONOMETHYL FUMARATE BAL, BALANCED , BALCOLTRA, ETHINYL ESTRADIOL DISODIUM, BALSALAZIDE DISODIUM BALVERSA, BALZIVA-28, ETHINYL ESTRADIOL BANZEL, BAQSIMI, BARACLUDE, BARHEMSYS, BAXDELA, BECONASE AQ, BECLOMETHASONE DIPROPIONATE MONOHYDRATE BEKYREE, BELBUCA, HYDROCHLORIDE BELEODAQ, BELRAPZO, HYDROCHLORIDE BELSOMRA, BENAZEPRIL HYDROCHLORIDE, BENAZEPRIL HYDROCHLORIDE BENAZEPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, BENAZEPRIL HYDROCHLORIDE BENDEKA, BENDAMUSTINE HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 7 APPENDIX A - PRODUCT NAME INDEX

** B ** BENICAR, OLMESARTAN MEDOXOMIL BENICAR HCT, HYDROCHLOROTHIAZIDE BENTYL, DICYCLOMINE HYDROCHLORIDE BENTYL PRESERVATIVE FREE, DICYCLOMINE HYDROCHLORIDE BENZACLIN, BENZOYL PEROXIDE BENZAMYCIN, BENZOYL PEROXIDE BENZNIDAZOLE, BENZNIDAZOLE , BENZONATATE BENZPHETAMINE HYDROCHLORIDE, BENZPHETAMINE HYDROCHLORIDE BENZTROPINE MESYLATE, BENZTROPINE MESYLATE BESILATE, BEPOTASTINE BESILATE BEPREVE, BEPOTASTINE BESILATE BESIVANCE, HYDROCHLORIDE BETA-VAL, VALERATE BETADINE, POVIDONE- BETAGAN, LEVOBUNOLOL HYDROCHLORIDE AND BETAMETHASONE SODIUM PHOSPHATE, BETAMETHASONE ACETATE BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE , BETAMETHASONE VALERATE BETAPACE, HYDROCHLORIDE BETAPACE AF, SOTALOL HYDROCHLORIDE HYDROCHLORIDE, BETAXOLOL HYDROCHLORIDE CHLORIDE, BETHANECHOL CHLORIDE BETHKIS, TOBRAMYCIN BETIMOL, BETOPTIC, BETAXOLOL HYDROCHLORIDE BETOPTIC S, BETAXOLOL HYDROCHLORIDE BEVESPI AEROSPHERE, FUMARATE , BEXAROTENE BEYAZ, DROSPIRENONE , BICALUTAMIDE BICILLIN C-R, G BENZATHINE BICILLIN C-R 900/300, PENICILLIN G BENZATHINE BICILLIN L-A, PENICILLIN G BENZATHINE BICNU, BIDIL, HYDROCHLORIDE BIJUVA, ESTRADIOL BIKTARVY, BICTEGRAVIR SODIUM BILTRICIDE, BIMATOPROST, BIMATOPROST BINOSTO, ALENDRONATE SODIUM BIORPHEN, HYDROCHLORIDE BIOSCRUB, GLUCONATE (OTC) SUBSALICYLATE, AND TETRACYCLINE HYDROCHLORIDE, BISMUTH SUBSALICYLATE FUMARATE, BISOPROLOL FUMARATE BISOPROLOL FUMARATE AND HYDROCHLOROTHIAZIDE, BISOPROLOL FUMARATE BIVALIRUDIN, BIVALIRUDIN BIVALIRUDIN IN 0.9% SODIUM CHLORIDE, BIVALIRUDIN SULFATE, BLEOMYCIN SULFATE BLEPH-10, SODIUM BLEPHAMIDE, ACETATE BLEPHAMIDE S.O.P., BLISOVI 24 FE, ETHINYL ESTRADIOL BLISOVI FE 1.5/30, ETHINYL ESTRADIOL BLISOVI FE 1/20, ETHINYL ESTRADIOL BLOXIVERZ, NEOSTIGMINE METHYLSULFATE BONIVA, IBANDRONATE SODIUM BONJESTA, SUCCINATE BONSITY, TERIPARATIDE BONTRIL PDM, TARTRATE , BORTEZOMIB , BOSENTAN BOSULIF, MONOHYDRATE BRAFTOVI, BREO ELLIPTA, FLUTICASONE FUROATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 8 APPENDIX A - PRODUCT NAME INDEX

** B ** BRETHINE, SULFATE TOSYLATE, BRETYLIUM TOSYLATE BREVIBLOC, HYDROCHLORIDE BREVIBLOC DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE BREVIBLOC IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE BREVITAL SODIUM, SODIUM BREXAFEMME, CITRATE BREZTRI AEROSPHERE, BRIAN CARE, CHLORHEXIDINE GLUCONATE (OTC) BRIDION, SODIUM BRIELLYN, ETHINYL ESTRADIOL BRILINTA, BRIMONIDINE TARTRATE, BRIMONIDINE TARTRATE BRINZOLAMIDE, BRINZOLAMIDE BRISDELLE, MESYLATE BRIVIACT, BROMFED-DM, MALEATE SODIUM, BROMFENAC SODIUM MESYLATE, BROMOCRIPTINE MESYLATE BROMPHENIRAMINE MALEATE, HYDROCHLORIDE AND HYDROBROMIDE, BROMSITE, BROMFENAC SODIUM BRONCHITOL, MANNITOL BRONCHO , SODIUM CHLORIDE (OTC) BROVANA, ARFORMOTEROL TARTRATE BRUKINSA, BRYHALI, HALOBETASOL PROPIONATE BSS, CALCIUM CHLORIDE BSS PLUS, CALCIUM CHLORIDE BUDESONIDE, BUDESONIDE (OTC) BUDESONIDE, BUDESONIDE , BUMETANIDE BUMEX, BUMETANIDE BUPHENYL, HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE AND EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE BUPIVACAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE BUPRENEX, BUPRENORPHINE HYDROCHLORIDE BUPRENORPHINE, BUPRENORPHINE BUPRENORPHINE HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE BUPRENORPHINE HYDROCHLORIDE AND HYDROCHLORIDE, BUPRENORPHINE HYDROCHLORIDE BUPROPION HYDROCHLORIDE, BUPROPION HYDROCHLORIDE HYDROCHLORIDE, BUSPIRONE HYDROCHLORIDE , BUSULFAN BUSULFEX, BUSULFAN AND ACETAMINOPHEN, ACETAMINOPHEN BUTALBITAL, ACETAMINOPHEN AND CAFFEINE, ACETAMINOPHEN BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE, ACETAMINOPHEN BUTALBITAL, ASPIRIN AND CAFFEINE, ASPIRIN BUTALBITAL, ASPIRIN, CAFFEINE, AND CODEINE PHOSPHATE, ASPIRIN BUTAPAP, ACETAMINOPHEN HYDROCHLORIDE, BUTENAFINE HYDROCHLORIDE (OTC) TARTRATE, BUTORPHANOL TARTRATE BUTORPHANOL TARTRATE PRESERVATIVE FREE, BUTORPHANOL TARTRATE BUTRANS, BUPRENORPHINE BYDUREON BCISE, EXENATIDE BYETTA, EXENATIDE SYNTHETIC BYFAVO, BESYLATE BYSTOLIC, HYDROCHLORIDE

** C ** CABENUVA KIT, , CABERGOLINE CABOMETYX, S-MALATE CADUET, AMLODIPINE BESYLATE CAFCIT,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 9 APPENDIX A - PRODUCT NAME INDEX

** C ** CAFERGOT, CAFFEINE CAFFEINE CITRATE, CAFFEINE CITRATE CALAN SR, HYDROCHLORIDE CALCIPOTRIENE, CALCIPOTRIENE CALCIPOTRIENE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE CALCIPOTRIENE AND BETHAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE -SALMON, CALCITONIN SALMON CALCITRIOL, CALCITRIOL CALCIUM ACETATE, CALCIUM ACETATE CALCIUM CHLORIDE 10%, CALCIUM CHLORIDE CALCIUM CHLORIDE 10% IN PLASTIC CONTAINER, CALCIUM CHLORIDE CALCIUM DISODIUM VERSENATE, EDETATE CALCIUM DISODIUM , CALCIUM GLUCONATE CALCIUM GLUCONATE IN SODIUM CHLORIDE, CALCIUM GLUCONATE CALDOLOR, IBUPROFEN CALQUENCE, CAMBIA, DICLOFENAC POTASSIUM CAMCEVI KIT, LEUPROLIDE MESYLATE CAMILA, NORETHINDRONE CAMPTOSAR, HYDROCHLORIDE CANASA, MESALAMINE CANCIDAS, ACETATE CANDESARTAN CILEXETIL, CANDESARTAN CILEXETIL CANDESARTAN CILEXETIL AND HYDROCHLOROTHIAZIDE, CANDESARTAN CILEXETIL , CAPECITABINE CAPEX, ACETONIDE CAPITAL SOLEIL 15, AVOBENZONE (OTC) CAPLYTA, TOSYLATE CAPRELSA, CAPTOPRIL, CAPTOPRIL CAPTOPRIL AND HYDROCHLOROTHIAZIDE, CAPTOPRIL CARAC, CARAFATE, CARBAGLU, , CARBAMAZEPINE CARBATROL, CARBAMAZEPINE , CARBIDOPA CARBIDOPA AND LEVODOPA, CARBIDOPA CARBIDOPA, LEVODOPA AND , CARBIDOPA MALEATE, CARBINOXAMINE MALEATE CARBOCAINE, HYDROCHLORIDE , CARBOPLATIN CARBOPROST TROMETHAMINE, CARBOPROST TROMETHAMINE CARDENE IN 0.83% SODIUM CHLORIDE IN PLASTIC CONTAINER, HYDROCHLORIDE CARDENE IN 0.86% SODIUM CHLORIDE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDENE IN 4.8% DEXTROSE IN PLASTIC CONTAINER, NICARDIPINE HYDROCHLORIDE CARDIOGEN-82, CHLORIDE RB-82 CARDIOLITE, TECHNETIUM TC-99M SESTAMIBI KIT CARDIOPLEGIC IN PLASTIC CONTAINER, CALCIUM CHLORIDE CARDIZEM, HYDROCHLORIDE CARDIZEM CD, DILTIAZEM HYDROCHLORIDE CARDIZEM LA, DILTIAZEM HYDROCHLORIDE CARDURA, MESYLATE CARDURA XL, DOXAZOSIN MESYLATE , CARFILZOMIB , CARISOPRODOL CARISOPRODOL, ASPIRIN AND CODEINE PHOSPHATE, ASPIRIN CARMUSTINE, CARMUSTINE CARNITOR, LEVOCARNITINE CARNITOR SF, LEVOCARNITINE CAROSPIR, SPIRONOLACTONE HYDROCHLORIDE, CARTEOLOL HYDROCHLORIDE CARTIA XT, DILTIAZEM HYDROCHLORIDE , CARVEDILOL CARVEDILOL PHOSPHATE, CARVEDILOL PHOSPHATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 10 APPENDIX A - PRODUCT NAME INDEX

** C ** CASODEX, BICALUTAMIDE CASPOFUNGIN ACETATE, CASPOFUNGIN ACETATE CASPORYN HC, HYDROCORTISONE CATAFLAM, DICLOFENAC POTASSIUM CATAPRES, HYDROCHLORIDE CATAPRES-TTS-1, CLONIDINE CATAPRES-TTS-2, CLONIDINE CATAPRES-TTS-3, CLONIDINE CAVERJECT, ALPROSTADIL CAVERJECT , ALPROSTADIL CAYSTON, AZTREONAM , CEFACLOR , CEFADROXIL/CEFADROXIL HEMIHYDRATE CEFAZOLIN AND DEXTROSE, CEFAZOLIN SODIUM CEFAZOLIN IN PLASTIC CONTAINER, CEFAZOLIN SODIUM CEFAZOLIN SODIUM, CEFAZOLIN SODIUM , CEFDINIR AND DEXTROSE IN DUPLEX CONTAINER, CEFEPIME HYDROCHLORIDE CEFEPIME HYDROCHLORIDE, CEFEPIME HYDROCHLORIDE CEFEPIME HYDROCHLORIDE IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE CEFEPIME IN PLASTIC CONTAINER, CEFEPIME HYDROCHLORIDE , CEFIXIME CEFOTAN, DISODIUM , CEFOTAXIME SODIUM CEFOTETAN, CEFOTETAN DISODIUM CEFOTETAN AND DEXTROSE IN DUPLEX CONTAINER, CEFOTETAN DISODIUM , CEFOXITIN SODIUM CEFOXITIN AND DEXTROSE IN DUPLEX CONTAINER, CEFOXITIN SODIUM CEFOXITIN IN PLASTIC CONTAINER, CEFOXITIN SODIUM PROXETIL, CEFPODOXIME PROXETIL , CEFPROZIL , CEFTAZIDIME CEFTAZIDIME IN DEXTROSE CONTAINER, CEFTAZIDIME , CEFTRIAXONE SODIUM CEFTRIAXONE AND DEXTROSE IN DUPLEX CONTAINER, CEFTRIAXONE SODIUM CEFTRIAXONE IN PLASTIC CONTAINER, CEFTRIAXONE SODIUM CEFTRIAXONE SODIUM, CEFTRIAXONE SODIUM AND DEXTROSE IN DUPLEX CONTAINER, CEFUROXIME SODIUM , CEFUROXIME AXETIL CEFUROXIME SODIUM, CEFUROXIME SODIUM CELEBREX, CELECOXIB, CELECOXIB CELESTONE SOLUSPAN, BETAMETHASONE ACETATE CELEXA, HYDROBROMIDE CELLCEPT, MYCOPHENOLATE MOFETIL CELLCEPT, MYCOPHENOLATE MOFETIL HYDROCHLORIDE CELONTIN, METHSUXIMIDE CENTANY, CEPHALEXIN, CEPHALEXIN CEQUA, CYCLOSPORINE CERDELGA, TARTRATE CEREBYX, SODIUM CERETEC, TECHNETIUM TC-99M EXAMETAZIME KIT CERIANNA, FLUOROESTRADIOL F-18 CERINTA, ETHINYL ESTRADIOL CERUBIDINE, HYDROCHLORIDE CERVIDIL, DINOPROSTONE CESAMET, HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, CETIRIZINE HYDROCHLORIDE CETIRIZINE HYDROCHLORIDE , CETIRIZINE HYDROCHLORIDE (OTC) CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CETRAXAL, HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 11 APPENDIX A - PRODUCT NAME INDEX

** C ** CETROTIDE, HYDROCHLORIDE, CEVIMELINE HYDROCHLORIDE CHABELINA FE, ETHINYL ESTRADIOL CHANTIX, TARTRATE CHEMET, SUCCIMER CHENODIOL, CHENODIOL CHG SCRUB, CHLORHEXIDINE GLUCONATE (OTC) CHILDREN'S ADVIL, IBUPROFEN (OTC) CHILDREN'S ADVIL ALLERGY SINUS, CHLORPHENIRAMINE MALEATE (OTC) CHILDREN'S ADVIL COLD, IBUPROFEN (OTC) CHILDREN'S ADVIL-FLAVORED, IBUPROFEN (OTC) CHILDREN'S ALLEGRA ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S ASTEPRO ALLERGY, AZELASTINE HYDROCHLORIDE (OTC) CHILDREN'S CETIRIZINE HYDROCHLORIDE ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S CETIRIZINE HYDROCHLORIDE HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S CLARITIN, LORATADINE (OTC) CHILDREN'S FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) CHILDREN'S IBUPROFEN, IBUPROFEN (OTC) CHILDREN'S MOTRIN, IBUPROFEN (OTC) CHILDREN'S MOTRIN COLD, IBUPROFEN (OTC) CHILDREN'S ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) CHILDREN'S ZYRTEC HIVES RELIEF, CETIRIZINE HYDROCHLORIDE (OTC) CHIRHOSTIM, SYNTHETIC SODIUM SUCCINATE, CHLORAMPHENICOL SODIUM SUCCINATE CHLORAPREP ONE-STEP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP ONE-STEP FREPP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP ONE-STEP SEPP, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP SINGLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP TRIPLE SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) CHLORAPREP WITH TINT, CHLORHEXIDINE GLUCONATE (OTC) AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE CHLORDIAZEPOXIDE HYDROCHLORIDE, CHLORDIAZEPOXIDE HYDROCHLORIDE CHLORDIAZEPOXIDE HYDROCHLORIDE AND , CHLORDIAZEPOXIDE HYDROCHLORIDE CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE (OTC) CHLORHEXIDINE GLUCONATE, CHLORHEXIDINE GLUCONATE HYDROCHLORIDE, CHLOROPROCAINE HYDROCHLORIDE PHOSPHATE, CHLOROQUINE PHOSPHATE SODIUM, CHLOROTHIAZIDE SODIUM CHLORPHENIRAMINE MALEATE, CHLORPHENIRAMINE MALEATE (OTC) HYDROCHLORIDE, CHLORPROMAZINE HYDROCHLORIDE CHLORTHALIDONE, CHLORTHALIDONE , CHLORZOXAZONE CHOLAC, CHOLBAM, CHOLESTYRAMINE, CHOLESTYRAMINE CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE CHOLETEC, TECHNETIUM TC-99M MEBROFENIN KIT C-11, CHOLINE C-11 CHROMIC CHLORIDE IN PLASTIC CONTAINER, CHROMIC CHLORIDE CIALIS, TADALAFIL , CICLOPIROX CIDA-STAT, CHLORHEXIDINE GLUCONATE (OTC) , CIDOFOVIR , CILOSTAZOL CILOXAN, CIPROFLOXACIN HYDROCHLORIDE CIMDUO, LAMIVUDINE , CIMETIDINE (OTC) CIMETIDINE, CIMETIDINE CIMETIDINE HYDROCHLORIDE, CIMETIDINE HYDROCHLORIDE CINACALCET HYDROCHLORIDE, CINACALCET HYDROCHLORIDE CINVANTI, APREPITANT CIPRO, CIPROFLOXACIN CIPRO, CIPROFLOXACIN HYDROCHLORIDE CIPRO HC, CIPROFLOXACIN HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 12 APPENDIX A - PRODUCT NAME INDEX

** C ** CIPRODEX, CIPROFLOXACIN CIPROFLOXACIN, CIPROFLOXACIN CIPROFLOXACIN AND , CIPROFLOXACIN CIPROFLOXACIN EXTENDED RELEASE, CIPROFLOXACIN CIPROFLOXACIN HYDROCHLORIDE, CIPROFLOXACIN HYDROCHLORIDE CIPROFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, CIPROFLOXACIN CIS-MDP, TECHNETIUM TC-99M MEDRONATE KIT CIS-PYRO, TECHNETIUM TC-99M PYROPHOSPHATE KIT CISATRACURIUM BESYLATE, CISATRACURIUM BESYLATE CISATRACURIUM BESYLATE PRESERVATIVE FREE, CISATRACURIUM BESYLATE , CISPLATIN CITALOPRAM HYDROBROMIDE, CITALOPRAM HYDROBROMIDE CITANEST FORTE DENTAL, EPINEPHRINE BITARTRATE , CLADRIBINE CLARAVIS, ISOTRETINOIN CLARINEX, CLARINEX-D 12 HOUR, DESLORATADINE CLARISCAN, GADOTERATE MEGLUMINE , CLARITHROMYCIN CLARITIN, LORATADINE (OTC) CLARITIN HIVES RELIEF, LORATADINE (OTC) CLARITIN HIVES RELIEF REDITAB, LORATADINE (OTC) CLARITIN REDITABS, LORATADINE (OTC) CLARITIN-D, LORATADINE (OTC) CLARITIN-D 24 HOUR, LORATADINE (OTC) FUMARATE, CLEMASTINE FUMARATE (OTC) CLEMASTINE FUMARATE, CLEMASTINE FUMARATE CLENPIQ, CLEOCIN, PALMITATE HYDROCHLORIDE CLEOCIN, CLINDAMYCIN PHOSPHATE CLEOCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE CLEOCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE CLEOCIN T, CLINDAMYCIN PHOSPHATE CLEVIPREX, CLIMARA, ESTRADIOL CLIMARA PRO, ESTRADIOL CLINDA-DERM, CLINDAMYCIN PHOSPHATE CLINDAGEL, CLINDAMYCIN PHOSPHATE CLINDAMYCIN HYDROCHLORIDE, CLINDAMYCIN HYDROCHLORIDE CLINDAMYCIN PALMITATE HYDROCHLORIDE, CLINDAMYCIN PALMITATE HYDROCHLORIDE CLINDAMYCIN PHOSPHATE, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE AND BENZOYL PEROXIDE, BENZOYL PEROXIDE CLINDAMYCIN PHOSPHATE AND TRETINOIN, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE IN 0.9% SODIUM CHLORIDE, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE IN 5% DEXTROSE IN PLASTIC CONTAINER, CLINDAMYCIN PHOSPHATE CLINDAMYCIN PHOSPHATE IN DEXTROSE 5%, CLINDAMYCIN PHOSPHATE CLINDESSE, CLINDAMYCIN PHOSPHATE CLINDETS, CLINDAMYCIN PHOSPHATE CLINIMIX 2.75/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 2.75/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 2.75/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 4.25/5 SULFITE FREE IN DEXTROSE 5% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/10 SULFITE FREE IN DEXTROSE 10% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/15 SULFITE FREE IN DEXTROSE 15% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/20 SULFITE FREE IN DEXTROSE 20% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/25 SULFITE FREE IN DEXTROSE 25% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX 5/35 SULFITE FREE IN DEXTROSE 35% IN PLASTIC CONTAINER, AMINO ACIDS CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 2.75/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 2.75/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 4.25/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 4.25/20 SULFITE FREE W/ ELECT IN DEXTROSE 20% W/ CALCIUM IN PLASTIC CONTAINER,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 13 APPENDIX A - PRODUCT NAME INDEX

** C ** CLINIMIX E 4.25/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 4.25/5 SULFITE FREE W/ ELECT IN DEXTROSE 5% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 5/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 5/15 SULFITE FREE W/ ELECT IN DEXTROSE 15% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 5/20 SULFITE FREE W/ ELECT IN 20% DEXTROSE W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 5/25 SULFITE FREE W/ ELECT IN DEXTROSE 25% W/ CALCIUM IN PLASTIC CONTAINER, CLINIMIX E 5/35 SULFITE FREE W/ ELECT IN DEXTROSE 35% W/ CALCIUM IN PLASTIC CONTAINER, CLINISOL 15% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS CLINOLIPID 20%, , CLOBAZAM PROPIONATE, CLOBETASOL PROPIONATE (EMOLLIENT), CLOBETASOL PROPIONATE CLOBEX, CLOBETASOL PROPIONATE CLODERM, PIVALATE , CLOFARABINE CLOLAR, CLOFARABINE CLOMIPHENE CITRATE, CLOMIPHENE CITRATE CLOMIPRAMINE HYDROCHLORIDE, CLOMIPRAMINE HYDROCHLORIDE , CLONAZEPAM CLONIDINE, CLONIDINE CLONIDINE HYDROCHLORIDE, CLONIDINE HYDROCHLORIDE BISULFATE, CLOPIDOGREL BISULFATE DIPOTASSIUM, CLORAZEPATE DIPOTASSIUM CLOROTEKAL, CHLOROPROCAINE HYDROCHLORIDE , CLOTRIMAZOLE (OTC) CLOTRIMAZOLE, CLOTRIMAZOLE CLOTRIMAZOLE AND BETAMETHASONE DIPROPIONATE, BETAMETHASONE DIPROPIONATE , CLOZAPINE CLOZARIL, CLOZAPINE COARTEM, CODEINE SULFATE, CODEINE SULFATE COGENTIN, BENZTROPINE MESYLATE COL-, COLAZAL, BALSALAZIDE DISODIUM COLCHICINE, COLCHICINE COLCRYS, COLCHICINE COLESEVELAM HYDROCHLORIDE, COLESEVELAM HYDROCHLORIDE COLESTID, HYDROCHLORIDE COLESTIPOL HYDROCHLORIDE, COLESTIPOL HYDROCHLORIDE COLISTIMETHATE SODIUM, COLISTIMETHATE SODIUM COLOCORT, HYDROCORTISONE COLY-MYCIN M, COLISTIMETHATE SODIUM COLY-MYCIN S, SULFATE COLYTE WITH PACKS, 3350 COMBIGAN, BRIMONIDINE TARTRATE COMBIPATCH, ESTRADIOL COMBIVENT RESPIMAT, ALBUTEROL SULFATE COMBIVIR, LAMIVUDINE COMETRIQ, CABOZANTINIB S-MALATE COMPLERA, EMTRICITABINE COMPRO, COMTAN, ENTACAPONE CONCERTA, METHYLPHENIDATE HYDROCHLORIDE CONDYLOX, PODOFILOX CONJUPRI, MALEATE CONRAY, IOTHALAMATE MEGLUMINE CONSENSI, AMLODIPINE BESYLATE CONSTILAC, LACTULOSE CONTRAVE, BUPROPION HYDROCHLORIDE CONZIP, HYDROCHLORIDE COPAXONE, GLATIRAMER ACETATE COPIKTRA, CORDRAN, FLURANDRENOLIDE CORDRAN SP, FLURANDRENOLIDE COREG, CARVEDILOL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 14 APPENDIX A - PRODUCT NAME INDEX

** C ** COREG CR, CARVEDILOL PHOSPHATE CORGARD, CORLANOR, CORLANOR, IVABRADINE HYDROCHLORIDE CORLOPAM, MESYLATE CORMAX, CLOBETASOL PROPIONATE CORPHEDRA, EPHEDRINE SULFATE CORTEF, HYDROCORTISONE CORTENEMA, HYDROCORTISONE CORTIFOAM, HYDROCORTISONE ACETATE ACETATE, CORTISPORIN, BACITRACIN ZINC CORTISPORIN, HYDROCORTISONE ACETATE CORTROSYN, COSYNTROPIN CORVERT, FUMARATE CORZIDE, COSELA, TRILACICLIB DIHYDROCHLORIDE COSMEGEN, COSOPT, DORZOLAMIDE HYDROCHLORIDE COSOPT PF, DORZOLAMIDE HYDROCHLORIDE COSYNTROPIN, COSYNTROPIN COTELLIC, FUMARATE COTEMPLA XR-ODT, METHYLPHENIDATE COZAAR, LOSARTAN POTASSIUM CRESEMBA, SULFATE CRESTOR, CALCIUM CRINONE, CROMOLYN SODIUM, CROMOLYN SODIUM (OTC) CROMOLYN SODIUM, CROMOLYN SODIUM CROTAN, CRYSELLE, ETHINYL ESTRADIOL CUBICIN, CUBICIN RF, DAPTOMYCIN CUPRIC CHLORIDE IN PLASTIC CONTAINER, CUPRIC CHLORIDE CUPRIMINE, CUTIVATE, FLUTICASONE PROPIONATE CUVPOSA, GLYCOPYRROLATE , CYANOCOBALAMIN CYANOKIT, CYCLAFEM 1/35, ETHINYL ESTRADIOL CYCLAFEM 7/7/7, ETHINYL ESTRADIOL CYCLESSA, DESOGESTREL CYCLOBENZAPRINE HYDROCHLORIDE, CYCLOBENZAPRINE HYDROCHLORIDE CYCLOGYL, CYCLOPENTOLATE HYDROCHLORIDE CYCLOMYDRIL, CYCLOPENTOLATE HYDROCHLORIDE CYCLOPENTOLATE HYDROCHLORIDE, CYCLOPENTOLATE HYDROCHLORIDE , CYCLOPHOSPHAMIDE CYCLOSET, BROMOCRIPTINE MESYLATE CYCLOSPORINE, CYCLOSPORINE CYKLOKAPRON, TRANEXAMIC ACID CYMBALTA, HYDROCHLORIDE CYONANZ, ETHINYL ESTRADIOL HYDROCHLORIDE, CYPROHEPTADINE HYDROCHLORIDE CYSTADANE, BETAINE CYSTADROPS, HYDROCHLORIDE CYSTAGON, CYSTEAMINE BITARTRATE CYSTARAN, CYSTEAMINE HYDROCHLORIDE CYSTO-CONRAY II, IOTHALAMATE MEGLUMINE CYSTOGRAFIN, MEGLUMINE CYSTOGRAFIN DILUTE, DIATRIZOATE MEGLUMINE CYSVIEW KIT, HEXAMINOLEVULINATE HYDROCHLORIDE , CYTARABINE CYTOMEL, LIOTHYRONINE SODIUM CYTOTEC, CYTOVENE, SODIUM

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 15 APPENDIX A - PRODUCT NAME INDEX

** C ** CYTOXAN, CYCLOPHOSPHAMIDE

** D ** D.H.E. 45, MESYLATE DABIGATRAN ETEXILATE MESYLATE, DABIGATRAN ETEXILATE MESYLATE , DACARBAZINE DACOGEN, DACTINOMYCIN, DACTINOMYCIN DALFAMPRIDINE, DALFAMPRIDINE DALIRESP, DALVANCE, HYDROCHLORIDE , DANAZOL DANTRIUM, SODIUM DANTROLENE SODIUM, DANTROLENE SODIUM DAPSONE, DAPSONE DAPTOMYCIN, DAPTOMYCIN DARAPRIM, , DARIFENACIN HYDROBROMIDE DARIFENACIN HYDROBROMIDE, DARIFENACIN HYDROBROMIDE DARUNAVIR, DARUNAVIR DASETTA 1/35, ETHINYL ESTRADIOL DASETTA 7/7/7, ETHINYL ESTRADIOL DATSCAN, I-123 DAUNORUBICIN HYDROCHLORIDE, DAUNORUBICIN HYDROCHLORIDE DAURISMO, MALEATE DAYPRO, DAYSEE, ETHINYL ESTRADIOL DAYTRANA, METHYLPHENIDATE DAYVIGO, LEMBOREXANT DDAVP, DESMOPRESSIN ACETATE DECITABINE, DECITABINE DEFERASIROX, DEFERASIROX DEFERIPRONE, DEFERIPRONE DEFEROXAMINE MESYLATE, DEFEROXAMINE MESYLATE DEFINITY, PERFLUTREN DEFINITY RT, PERFLUTREN DEFITELIO, DEFIBROTIDE SODIUM DELESTROGEN, DELFLEX W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 1.5% LOW IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 1.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELFLEX W/ DEXTROSE 4.25% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER, CALCIUM CHLORIDE DELSTRIGO, DORAVIRINE DELSYM, DEXTROMETHORPHAN POLISTIREX (OTC) DELZICOL, MESALAMINE HYDROCHLORIDE, DEMECLOCYCLINE HYDROCHLORIDE DEMEROL, MEPERIDINE HYDROCHLORIDE DEMSER, METYROSINE DENAVIR, DEOXYCHOLIC ACID, DEOXYCHOLIC ACID DEPAKOTE, DIVALPROEX SODIUM DEPAKOTE ER, DIVALPROEX SODIUM DEPEN, PENICILLAMINE DEPO-ESTRADIOL, DEPO-MEDROL, ACETATE DEPO-PROVERA, ACETATE DEPO-SUBQ PROVERA 104, MEDROXYPROGESTERONE ACETATE DEPO-TESTOSTERONE, DERMA-SMOOTHE/FS, DERMABET, BETAMETHASONE VALERATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 16 APPENDIX A - PRODUCT NAME INDEX

** D ** DERMOTIC, FLUOCINOLONE ACETONIDE DESCOVY, EMTRICITABINE DESFERAL, DEFEROXAMINE MESYLATE , DESFLURANE HYDROCHLORIDE, DESIPRAMINE HYDROCHLORIDE DESLORATADINE, DESLORATADINE DESLORATADINE AND PSEUDOEPHEDRINE SULFATE 24 HOUR, DESLORATADINE DESMOPRESSIN ACETATE, DESMOPRESSIN ACETATE DESMOPRESSIN ACETATE (NEEDS NO REFRIGERATION), DESMOPRESSIN ACETATE DESOGESTREL AND ETHINYL ESTRADIOL, DESOGESTREL , DESONIDE DESOWEN, DESONIDE , DESOXIMETASONE DESOXYN, HYDROCHLORIDE DESVENLAFAXINE, DESVENLAFAXINE DESVENLAFAXINE SUCCINATE, DESVENLAFAXINE SUCCINATE DETECTNET, DOTATATE CU-64 DETROL, TARTRATE DETROL LA, TOLTERODINE TARTRATE DEXAMETHASONE, DEXAMETHASONE DEXAMETHASONE INTENSOL, DEXAMETHASONE DEXAMETHASONE SODIUM PHOSPHATE, DEXAMETHASONE SODIUM PHOSPHATE DEXAMETHASONE SODIUM PHOSPHATE PRESERVATIVE FREE, DEXAMETHASONE SODIUM PHOSPHATE DEXASPORIN, DEXAMETHASONE MALEATE, DEXCHLORPHENIRAMINE MALEATE DEXEDRINE, SULFATE DEXILANT, DEXLANSOPRAZOLE, DEXLANSOPRAZOLE HYDROCHLORIDE, DEXMEDETOMIDINE HYDROCHLORIDE DEXMETHYLPHENIDATE HYDROCHLORIDE, DEXMETHYLPHENIDATE HYDROCHLORIDE DEXRAZOXANE HYDROCHLORIDE, DEXRAZOXANE HYDROCHLORIDE DEXTENZA, DEXAMETHASONE DEXTROAMP SACCHARATE, AMP ASPARTATE, DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE DEXTROAMP SACCHARATE, AMP ASPARTATE, DEXTROAMP SULFATE AND AMP SULFATE, AMPHETAMINE DEXTROAMPHETAMINE SULFATE, DEXTROAMPHETAMINE SULFATE DEXTROMETHORPHAN HYDROBROMIDE AND SULFATE, DEXTROMETHORPHAN HYDROBROMIDE DEXTROMETHORPHAN POLISTIREX, DEXTROMETHORPHAN POLISTIREX (OTC) DEXTROSE 10% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 10% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 2.5% IN HALF-STRENGTH LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 20% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 25%, DEXTROSE DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 30% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 40% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND NO. 48 IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% AND 0.075% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.224% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND POTASSIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.225%, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, DEXTROSE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 17 APPENDIX A - PRODUCT NAME INDEX

** D ** DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 10MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 15MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 20MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 30MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 40MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ, DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 5MEQ (K), DEXTROSE DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 15MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER, DEXTROSE 5%, SODIUM CHLORIDE 0.45% AND POTASSIUM CHLORIDE 20MEQ (K) IN PLASTIC CONTAINER, DEXTROSE 50%, DEXTROSE DEXTROSE 50% IN PLASTIC CONTAINER, DEXTROSE DEXTROSE 70% IN PLASTIC CONTAINER, DEXTROSE DEXYCU KIT, DEXAMETHASONE DIABETA, GLYBURIDE DIACOMIT, DIANEAL LOW CALCIUM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/DEXTROSE 3.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL LOW CALCIUM W/DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 1.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIANEAL PD-2 W/ DEXTROSE 4.25% IN PLASTIC CONTAINER, CALCIUM CHLORIDE DIASTAT, DIASTAT ACUDIAL, DIAZEPAM DIAZEPAM, DIAZEPAM DIAZEPAM INTENSOL, DIAZEPAM , DIAZOXIDE DIBENZYLINE, HYDROCHLORIDE DICLEGIS, DOXYLAMINE SUCCINATE DICLOFENAC POTASSIUM, DICLOFENAC POTASSIUM DICLOFENAC SODIUM, DICLOFENAC SODIUM (OTC) DICLOFENAC SODIUM, DICLOFENAC SODIUM DICLOFENAC SODIUM AND MISOPROSTOL, DICLOFENAC SODIUM SODIUM, DICLOXACILLIN SODIUM DICYCLOMINE HYDROCHLORIDE, DICYCLOMINE HYDROCHLORIDE DICYCLOMINE HYDROCHLORIDE (PRESERVATIVE FREE), DICYCLOMINE HYDROCHLORIDE DIETHYLPROPION HYDROCHLORIDE, DIETHYLPROPION HYDROCHLORIDE DIFFERIN, ADAPALENE (OTC) DIFFERIN, ADAPALENE DIFICID, DIACETATE, DIFLUCAN, , DIFLUNISAL , DIGOXIN DIHYDROERGOTAMINE MESYLATE, DIHYDROERGOTAMINE MESYLATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 18 APPENDIX A - PRODUCT NAME INDEX

** D ** DILANTIN, DILANTIN, PHENYTOIN SODIUM DILANTIN-125, PHENYTOIN DILAUDID, HYDROCHLORIDE DILTIAZEM HYDROCHLORIDE, DILTIAZEM HYDROCHLORIDE , DIMENHYDRINATE DIMETHYL FUMARATE, DIMETHYL FUMARATE DIOVAN, VALSARTAN DIOVAN HCT, HYDROCHLOROTHIAZIDE DIPENTUM, OLSALAZINE SODIUM DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE DIPHENHYDRAMINE HYDROCHLORIDE PRESERVATIVE FREE, DIPHENHYDRAMINE HYDROCHLORIDE DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE, ATROPINE SULFATE DIPRIVAN, DIPROLENE, BETAMETHASONE DIPROPIONATE DIPYRIDAMOLE, DIPYRIDAMOLE PHOSPHATE, DISOPYRAMIDE PHOSPHATE DISULFIRAM, DISULFIRAM DITROPAN XL, CHLORIDE DIURIL, CHLOROTHIAZIDE DIURIL, CHLOROTHIAZIDE SODIUM DIVALPROEX SODIUM, DIVALPROEX SODIUM DIVIGEL, ESTRADIOL HYDROCHLORIDE, DOBUTAMINE HYDROCHLORIDE DOBUTAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOBUTAMINE HYDROCHLORIDE , DOCETAXEL DOCOSANOL, DOCOSANOL (OTC) DOFETILDE, DOFETILIDE, DOFETILIDE DOJOLVI, DOLISHALE, ETHINYL ESTRADIOL DONEPEZIL HYDROCHLORIDE, DONEPEZIL HYDROCHLORIDE HYDROCHLORIDE, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE AND DEXTROSE 5%, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE AND DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE DOPAMINE HYDROCHLORIDE IN DEXTROSE 5% IN PLASTIC CONTAINER, DOPAMINE HYDROCHLORIDE DOPRAM, HYDROCHLORIDE DOPTELET, AVATROMBOPAG MALEATE DORAL, DORYX, DOXYCYCLINE HYCLATE DORYX MPC, DOXYCYCLINE HYCLATE DORZOLAMIDE HYDROCHLORIDE, DORZOLAMIDE HYDROCHLORIDE DORZOLAMIDE HYDROCHLORIDE AND TIMOLOL MALEATE, DORZOLAMIDE HYDROCHLORIDE DOTAREM, GADOTERATE MEGLUMINE DOVATO, DOLUTEGRAVIR SODIUM DOVONEX, CALCIPOTRIENE DOXAPRAM HYDROCHLORIDE, DOXAPRAM HYDROCHLORIDE DOXAZOSIN MESYLATE, DOXAZOSIN MESYLATE HYDROCHLORIDE, DOXEPIN HYDROCHLORIDE DOXERCALCIFEROL, DOXERCALCIFEROL DOXIL (LIPOSOMAL), HYDROCHLORIDE DOXORUBICIN HYDROCHLORIDE, DOXORUBICIN HYDROCHLORIDE DOXORUBICIN HYDROCHLORIDE (LIPOSOMAL), DOXORUBICIN HYDROCHLORIDE DOXY 100, DOXYCYCLINE HYCLATE DOXY 200, DOXYCYCLINE HYCLATE DOXYCYCLINE, DOXYCYCLINE DOXYCYCLINE, DOXYCYCLINE HYCLATE DOXYCYCLINE HYCLATE, DOXYCYCLINE HYCLATE DOXYLAMINE SUCCINATE, DOXYLAMINE SUCCINATE (OTC) DOXYLAMINE SUCCINATE AND PYRIDOXINE HYDROCHLORIDE, DOXYLAMINE SUCCINATE DRAX EXAMETAZIME, TECHNETIUM TC-99M EXAMETAZIME KIT DRAXIMAGE DTPA, TECHNETIUM TC-99M PENTETATE KIT DRAXIMAGE MDP-25, TECHNETIUM TC-99M MEDRONATE DRISDOL, ERGOCALCIFEROL DRIZALMA SPRINKLE, DULOXETINE HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 19 APPENDIX A - PRODUCT NAME INDEX

** D ** , DRONABINOL , DROPERIDOL DROSPIRENONE AND ETHINYL ESTRADIOL, DROSPIRENONE DROSPIRENONE, ETHINYL ESTRADIOL AND LEVOMEFOLATE CALCIUM, DROSPIRENONE DROXIA, HYDROXYUREA , DROXIDOPA DSUVIA, CITRATE DUAC, BENZOYL PEROXIDE DUAKLIR PRESSAIR, DUAVEE, ACETATE DUETACT, GLIMEPIRIDE DUEXIS, DULERA, FORMOTEROL FUMARATE DULOXETINE HYDROCHLORIDE, DULOXETINE HYDROCHLORIDE DUOBRII, HALOBETASOL PROPIONATE DUODOTE, ATROPINE DUOPA, CARBIDOPA DURACLON, CLONIDINE HYDROCHLORIDE DURAGESIC-100, FENTANYL DURAGESIC-12, FENTANYL DURAGESIC-25, FENTANYL DURAGESIC-37, FENTANYL DURAGESIC-50, FENTANYL DURAGESIC-75, FENTANYL DURAMORPH PF, SULFATE DURAPREP, IODINE POVACRYLEX (OTC) DUREZOL, DURLAZA, ASPIRIN DURYSTA, BIMATOPROST DUTASTERIDE, DUTASTERIDE DUTASTERIDE AND HYDROCHLORIDE, DUTASTERIDE DUVOID, BETHANECHOL CHLORIDE DYANAVEL XR, AMPHETAMINE DYCLOPRO, DYCLONINE HYDROCHLORIDE DYMISTA, AZELASTINE HYDROCHLORIDE DYNACIN, MINOCYCLINE HYDROCHLORIDE DYRENIUM,

** E ** E-Z SCRUB 201, POVIDONE-IODINE (OTC) E-Z SCRUB 241, POVIDONE-IODINE (OTC) E-Z-HD, SULFATE E-Z-PAQUE, E.E.S., ETHYLSUCCINATE E.E.S. 400, ERYTHROMYCIN ETHYLSUCCINATE EC-NAPROSYN, NAPROXEN NITRATE, ECONAZOLE NITRATE ECOZA, ECONAZOLE NITRATE EDARBI, AZILSARTAN KAMEDOXOMIL EDARBYCLOR, AZILSARTAN KAMEDOXOMIL EDECRIN, ETHACRYNATE SODIUM EDECRIN, ETHACRYNIC ACID EDEX, ALPROSTADIL EDLUAR, ZOLPIDEM TARTRATE EDURANT, HYDROCHLORIDE EFAVIRENZ, EFAVIRENZ EFAVIRENZ, EMTRICITABINE, AND FUMARATE, EFAVIRENZ EFAVIRENZ, LAMIVUDINE AND TENOFOVIR DISOPROXIL FUMARATE, EFAVIRENZ EFFEXOR XR, HYDROCHLORIDE EFFIENT, HYDROCHLORIDE , EFINACONAZOLE EFUDEX, FLUOROURACIL EGATEN, TRICLABENDAZOLE ELCYS, HYDROCHLORIDE ELEPSIA XR,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 20 APPENDIX A - PRODUCT NAME INDEX

** E ** ELESTAT, HYDROCHLORIDE ELESTRIN, ESTRADIOL HYDROBROMIDE, ELETRIPTAN HYDROBROMIDE ELIDEL, ELIGARD KIT, LEUPROLIDE ACETATE ELINEST, ETHINYL ESTRADIOL ELIQUIS, APIXABAN ELIXOPHYLLIN, ELLA, ELLENCE, HYDROCHLORIDE ELLIOTTS B , CALCIUM CHLORIDE ELMIRON, SODIUM ELOCON, MOMETASONE FUROATE ELOXATIN, ELURYNG, ETHINYL ESTRADIOL EMBELINE, CLOBETASOL PROPIONATE EMBELINE E, CLOBETASOL PROPIONATE EMCYT, PHOSPHATE SODIUM EMEND, APREPITANT EMEND, DIMEGLUMINE EMERPHED, EPHEDRINE SULFATE EMFLAZA, EMLA, LIDOCAINE EMPAVELI, PEGCETACOPLAN EMSAM, EMTRICITABINE, EMTRICITABINE EMTRICITABINE AND TENOFOVIR DISOPROXIL FUMARATE, EMTRICITABINE EMTRIVA, EMTRICITABINE EMVERM, ENABLEX, DARIFENACIN HYDROBROMIDE MALEATE, ENALAPRIL MALEATE ENALAPRIL MALEATE AND HYDROCHLOROTHIAZIDE, ENALAPRIL MALEATE ENALAPRILAT, ENALAPRILAT ENDARI, L- ENDOMETRIN, PROGESTERONE ENOXAPARIN SODIUM, ENOXAPARIN SODIUM ENOXAPARIN SODIUM (PRESERVATIVE FREE), ENOXAPARIN SODIUM ENPRESSE-28, ETHINYL ESTRADIOL ENSKYCE, DESOGESTREL ENSTILAR, BETAMETHASONE DIPROPIONATE ENTACAPONE, ENTACAPONE ENTECAVIR, ENTECAVIR ENTEREG, ALVIMOPAN ENTERO VU 24%, BARIUM SULFATE ENTOCORT EC, BUDESONIDE ENTRESTO, SACUBITRIL ENVARSUS XR, TACROLIMUS , ENZALUTAMIDE EOVIST, GADOXETATE DISODIUM EPANED, ENALAPRIL MALEATE EPCLUSA, SOFOSBUVIR EPHEDRINE SULFATE, EPHEDRINE SULFATE EPIDIOLEX, EPIDUO, ADAPALENE EPIDUO FORTE, ADAPALENE EPIFOAM, HYDROCORTISONE ACETATE EPINASTINE HYDROCHLORIDE, EPINASTINE HYDROCHLORIDE EPINEPHRINE, EPINEPHRINE EPINEPHRINE (AUTOINJECTOR), EPINEPHRINE EPINEPHRINE (COPACKAGED), EPINEPHRINE EPIPEN, EPINEPHRINE EPIPEN JR., EPINEPHRINE EPIRUBICIN HYDROCHLORIDE, EPIRUBICIN HYDROCHLORIDE EPITOL, CARBAMAZEPINE EPIVIR, LAMIVUDINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 21 APPENDIX A - PRODUCT NAME INDEX

** E ** EPIVIR-HBV, LAMIVUDINE , EPLERENONE EPOPROSTENOL SODIUM, EPOPROSTENOL SODIUM EPTIFIBATIDE, EPTIFIBATIDE EPZICOM, ABACAVIR SULFATE EQUETRO, CARBAMAZEPINE ERAXIS, ERGOCALCIFEROL, ERGOCALCIFEROL MESYLATES, ERGOLOID MESYLATES ERGOMAR, TARTRATE ERGOTAMINE TARTRATE AND CAFFEINE, CAFFEINE ERIVEDGE, ERLEADA, HYDROCHLORIDE, ERLOTINIB HYDROCHLORIDE ERRIN, NORETHINDRONE ERTACZO, NITRATE SODIUM, ERTAPENEM SODIUM ERY-TAB, ERYTHROMYCIN ERYC, ERYTHROMYCIN ERYGEL, ERYTHROMYCIN ERYPED, ERYTHROMYCIN ETHYLSUCCINATE ERYTHRA-DERM, ERYTHROMYCIN ERYTHROCIN, ERYTHROMYCIN LACTOBIONATE ERYTHROCIN STEARATE, ERYTHROMYCIN STEARATE ERYTHROMYCIN, ERYTHROMYCIN ERYTHROMYCIN AND BENZOYL PEROXIDE, BENZOYL PEROXIDE ERYTHROMYCIN ETHYLSUCCINATE, ERYTHROMYCIN ETHYLSUCCINATE ERYTHROMYCIN LACTOBIONATE, ERYTHROMYCIN LACTOBIONATE ESBRIET, , ESCITALOPRAM OXALATE ESLICARBAZEPINE ACETATE, ESLICARBAZEPINE ACETATE ESMOLOL HYDROCHLORIDE, ESMOLOL HYDROCHLORIDE ESMOLOL HYDROCHLORIDE DOUBLE STRENGTH IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE ESMOLOL HYDROCHLORIDE IN PLASTIC CONTAINER, ESMOLOL HYDROCHLORIDE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM (OTC) ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM ESOMEPRAZOLE SODIUM, ESOMEPRAZOLE SODIUM ESTARYLLA, ETHINYL ESTRADIOL , ESTAZOLAM ESTRACE, ESTRADIOL ESTRADIOL, ESTRADIOL ESTRADIOL AND NORETHINDRONE ACETATE, ESTRADIOL ESTRADIOL AND , ESTRADIOL ESTRADIOL VALERATE, ESTRADIOL VALERATE ESTRING, ESTRADIOL ESTROGEL, ESTRADIOL ESTROSTEP FE, ETHINYL ESTRADIOL , ESZOPICLONE ETHACRYNATE SODIUM, ETHACRYNATE SODIUM ETHACRYNIC ACID, ETHACRYNIC ACID ETHAMBUTOL HYDROCHLORIDE, ETHAMBUTOL HYDROCHLORIDE ETHAMOLIN, ETHANOLAMINE OLEATE ETHINYL ESTRADIOL AND , ETHINYL ESTRADIOL ETHINYL ESTRADIOL; , ETHINYL ESTRADIOL , ETHOSUXIMIDE ETHYNODIOL DIACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL ETHYOL, AMIFOSTINE , ETODOLAC ETOMIDATE, ETOMIDATE ETOPOPHOS PRESERVATIVE FREE, PHOSPHATE ETOPOSIDE, ETOPOSIDE ETRAVIRINE, ETRAVIRINE EUCRISA, CRISABOROLE EURAX, CROTAMITON EUTHYROX, SODIUM **

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 22 APPENDIX A - PRODUCT NAME INDEX

** E ** EVAMIST, ESTRADIOL EVEKEO, AMPHETAMINE SULFATE EVEKEO ODT, AMPHETAMINE SULFATE EVEROLIMUS, EVEROLIMUS EVISTA, HYDROCHLORIDE EVOCLIN, CLINDAMYCIN PHOSPHATE EVOMELA, HYDROCHLORIDE EVOTAZ, ATAZANAVIR SULFATE EVOXAC, CEVIMELINE HYDROCHLORIDE EVRYSDI, RISDIPLAM EXCEDRIN (MIGRAINE), ACETAMINOPHEN (OTC) EXELDERM, NITRATE EXELON, RIVASTIGMINE EXEM FOAM KIT, AIR -TYPE A EXEMESTANE, EXEMESTANE EXFORGE, AMLODIPINE BESYLATE EXFORGE HCT, AMLODIPINE BESYLATE EXIDINE, CHLORHEXIDINE GLUCONATE (OTC) EXJADE, DEFERASIROX EXONDYS 51, ETEPLIRSEN EXPAREL, BUPIVACAINE EXSERVAN, EXTENDED PHENYTOIN SODIUM, PHENYTOIN SODIUM EXTINA, EXTRANEAL, EYSUVIS, LOTEPREDNOL ETABONATE EZALLOR SPRINKLE, ROSUVASTATIN CALCIUM EZETIMIBE, EZETIMIBE EZETIMIBE AND , EZETIMIBE

** F ** FABIOR, TAZAROTENE FACTIVE, MESYLATE FALLBACK SOLO, LEVONORGESTREL (OTC) FALMINA, ETHINYL ESTRADIOL , FAMCICLOVIR FAMOTIDINE, FAMOTIDINE (OTC) FAMOTIDINE, FAMOTIDINE FAMOTIDINE PRESERVATIVE FREE, FAMOTIDINE FAMOTIDINE PRESERVATIVE FREE IN PLASTIC CONTAINER, FAMOTIDINE FAMOTIDINE, CALCIUM , AND MAGNESIUM HYDROXIDE, CALCIUM CARBONATE (OTC) FANAPT, FARESTON, CITRATE FARXIGA, DAPAGLIFLOZIN FARYDAK, LACTATE FASLODEX, , FEBUXOSTAT , FELBAMATE FELBATOL, FELBAMATE FELDENE, , FELODIPINE FEMARA, FEMHRT, ETHINYL ESTRADIOL FEMRING, FENOFIBRATE, FENOFIBRATE FENOFIBRATE (MICRONIZED), FENOFIBRATE FENOFIBRIC ACID, CHOLINE FENOFIBRATE FENOGLIDE, FENOFIBRATE FENOLDOPAM MESYLATE, FENOLDOPAM MESYLATE CALCIUM, FENOPROFEN CALCIUM FENSOLVI KIT, LEUPROLIDE ACETATE FENTANYL CITRATE, FENTANYL CITRATE FENTANYL CITRATE PRESERVATIVE FREE, FENTANYL CITRATE FENTANYL-100, FENTANYL FENTANYL-12, FENTANYL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 23 APPENDIX A - PRODUCT NAME INDEX

** F ** FENTANYL-25, FENTANYL FENTANYL-37, FENTANYL FENTANYL-50, FENTANYL FENTANYL-62, FENTANYL FENTANYL-75, FENTANYL FENTANYL-87, FENTANYL FENTORA, FENTANYL CITRATE FERAHEME, FERUMOXYTOL FERRIPROX, DEFERIPRONE FERRLECIT, FERRIC OXYHYDROXIDE FERUMOXYTOL, FERUMOXYTOL FUMARATE, FESOTERODINE FUMARATE FETROJA, SULFATE TOSYLATE FETZIMA, HYDROCHLORIDE FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE (OTC) FEXOFENADINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE FEXOFENADINE HYDROCHLORIDE ALLERGY, FEXOFENADINE HYDROCHLORIDE (OTC) FEXOFENADINE HYDROCHLORIDE AND PSEUDOEPHEDRINE HYDROCHLORIDE, FEXOFENADINE HYDROCHLORIDE FEXOFENADINE HYDROCHLORIDE HIVES, FEXOFENADINE HYDROCHLORIDE (OTC) FIBRICOR, FENOFIBRIC ACID FINACEA, AZELAIC ACID , FINASTERIDE FINGOLIMOD HYDROCHLORIDE, FINGOLIMOD HYDROCHLORIDE FINTEPLA, HYDROCHLORIDE FIORICET W/ CODEINE, ACETAMINOPHEN FIORINAL, ASPIRIN FIORINAL W/CODEINE, ASPIRIN FIRAZYR, ICATIBANT ACETATE FIRDAPSE, PHOSPHATE FIRMAGON, ACETATE FIRVANQ KIT, HYDROCHLORIDE FLAC, FLUOCINOLONE ACETONIDE FLAGYL, METRONIDAZOLE FLAGYL I.V. RTU IN PLASTIC CONTAINER, METRONIDAZOLE FLAREX, ACETATE FLAVORED COLESTID, COLESTIPOL HYDROCHLORIDE HYDROCHLORIDE, FLAVOXATE HYDROCHLORIDE ACETATE, FLECAINIDE ACETATE FLECTOR, DICLOFENAC EPOLAMINE FLOLAN, EPOPROSTENOL SODIUM FLOLIPID, SIMVASTATIN FLOMAX, TAMSULOSIN HYDROCHLORIDE FLONASE ALLERGY RELIEF, FLUTICASONE PROPIONATE (OTC) FLONASE SENSIMIST ALLERGY RELIEF, FLUTICASONE FUROATE (OTC) FLOVENT DISKUS 100, FLUTICASONE PROPIONATE FLOVENT DISKUS 250, FLUTICASONE PROPIONATE FLOVENT DISKUS 50, FLUTICASONE PROPIONATE FLOVENT HFA, FLUTICASONE PROPIONATE , FLOXURIDINE FLUCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE FLUCONAZOLE, FLUCONAZOLE FLUCONAZOLE IN SODIUM CHLORIDE 0.9%, FLUCONAZOLE FLUCONAZOLE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, FLUCONAZOLE FLUCYTOSINE, FLUCYTOSINE PHOSPHATE, FLUDARABINE PHOSPHATE FLUDEOXYGLUCOSE F18, FLUDEOXYGLUCOSE F-18 ACETATE, FLUDROCORTISONE ACETATE FLUMADINE, HYDROCHLORIDE , FLUMAZENIL , FLUNISOLIDE FLUOCINOLONE ACETONIDE, FLUOCINOLONE ACETONIDE , FLUOCINONIDE FLUOCINONIDE ACETONIDE, FLUOCINOLONE ACETONIDE FLUOCINONIDE EMULSIFIED , FLUOCINONIDE FLUORESCEIN SODIUM AND BENOXINATE HYDROCHLORIDE, BENOXINATE HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 24 APPENDIX A - PRODUCT NAME INDEX

** F ** FLUORESCITE, FLUORESCEIN SODIUM FLUOROPLEX, FLUOROURACIL FLUOROURACIL, FLUOROURACIL HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE DECANOATE, FLUPHENAZINE DECANOATE FLUPHENAZINE HYDROCHLORIDE, FLUPHENAZINE HYDROCHLORIDE FLURANDRENOLIDE, FLURANDRENOLIDE HYDROCHLORIDE, FLURAZEPAM HYDROCHLORIDE , FLURBIPROFEN FLURBIPROFEN SODIUM, FLURBIPROFEN SODIUM , FLUTAMIDE FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE (OTC) FLUTICASONE PROPIONATE, FLUTICASONE PROPIONATE FLUTICASONE PROPIONATE AND XINAFOATE, FLUTICASONE PROPIONATE FLUVASTATIN SODIUM, FLUVASTATIN SODIUM MALEATE, FLUVOXAMINE MALEATE FML, FLUOROMETHOLONE FML FORTE, FLUOROMETHOLONE FOCALIN, DEXMETHYLPHENIDATE HYDROCHLORIDE FOCALIN XR, DEXMETHYLPHENIDATE HYDROCHLORIDE FOLIC ACID, FOLIC ACID FOLOTYN, , FOMEPIZOLE FONDAPARINUX SODIUM, FONDAPARINUX SODIUM FORANE, FORFIVO XL, BUPROPION HYDROCHLORIDE FORMOTEROL FUMARATE, FORMOTEROL FUMARATE FORTAMET, METFORMIN HYDROCHLORIDE FORTAZ, CEFTAZIDIME FORTEO, TERIPARATIDE FORTESTA, TESTOSTERONE FOSAMAX, ALENDRONATE SODIUM FOSAMAX PLUS D, ALENDRONATE SODIUM FOSAMPRENAVIR CALCIUM, FOSAMPRENAVIR CALCIUM FOSAPREPITANT DIMEGLUMINE, FOSAPREPITANT DIMEGLUMINE SODIUM, FOSCARNET SODIUM FOSCAVIR, FOSCARNET SODIUM TROMETHAMINE, FOSFOMYCIN TROMETHAMINE FOSINOPRIL SODIUM, FOSINOPRIL SODIUM FOSINOPRIL SODIUM AND HYDROCHLOROTHIAZIDE, FOSINOPRIL SODIUM FOSPHENYTOIN SODIUM, FOSPHENYTOIN SODIUM FOSRENOL, CARBONATE FOTIVDA, HYDROCHLORIDE FRAGMIN, DALTEPARIN SODIUM FREAMINE HBC 6.9%, AMINO ACIDS FREAMINE III 10%, AMINO ACIDS FREAMINE III 3% W/ , AMINO ACIDS FREAMINE III 8.5%, AMINO ACIDS FREAMINE III 8.5% W/ ELECTROLYTES, AMINO ACIDS FROVA, SUCCINATE FROVATRIPTAN SUCCINATE, FROVATRIPTAN SUCCINATE FULVESTRANT, FULVESTRANT FURADANTIN, , FUROSEMIDE FUSILEV, LEVOLEUCOVORIN CALCIUM FUZEON, ENFUVIRTIDE FYAVOLV, ETHINYL ESTRADIOL FYCOMPA,

** G ** , GABAPENTIN GABITRIL, HYDROCHLORIDE GABLOFEN, BACLOFEN GADAVIST, GALAFOLD, HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 25 APPENDIX A - PRODUCT NAME INDEX

** G ** HYDROBROMIDE, GALANTAMINE HYDROBROMIDE CITRATE GA 67, GALLIUM CITRATE GA-67 GALLIUM DOTATOC GA 68, GALLIUM DOTATOC GA-68 GALLIUM GA 68 PSMA-11, GALLIUM GA-68 PSMA-11 GALZIN, GANCICLOVIR SODIUM, GANCICLOVIR SODIUM ACETATE, GANIRELIX ACETATE GANZYK-RTU, GANCICLOVIR GASTROCROM, CROMOLYN SODIUM GASTROGRAFIN, DIATRIZOATE MEGLUMINE , GATIFLOXACIN GATTEX KIT, RECOMBINANT GAVISCON, ALUMINUM HYDROXIDE (OTC) GAVRETO, GELNIQUE, OXYBUTYNIN CHLORIDE HYDROCHLORIDE, GEMCITABINE HYDROCHLORIDE GEMFIBROZIL, GEMFIBROZIL GEMIFLOXACIN MESYLATE, GEMIFLOXACIN MESYLATE GEMMILY, ETHINYL ESTRADIOL GEMTESA, GEN-XENE, CLORAZEPATE DIPOTASSIUM GENERLAC, LACTULOSE GENGRAF, CYCLOSPORINE GENOPTIC, SULFATE GENOSYL, NITRIC GENTAK, GENTAMICIN SULFATE GENTAMICIN SULFATE, GENTAMICIN SULFATE GENTAMICIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, GENTAMICIN SULFATE GENVOYA, COBICISTAT GEODON, HYDROCHLORIDE GEODON, ZIPRASIDONE MESYLATE GIAPREZA, ANGIOTENSIN II ACETATE GILDAGIA, ETHINYL ESTRADIOL GILDESS 1/20, ETHINYL ESTRADIOL GILDESS 24 FE, ETHINYL ESTRADIOL GILDESS FE 1/20, ETHINYL ESTRADIOL GILENYA, FINGOLIMOD HYDROCHLORIDE GILOTRIF, DIMALEATE GIMOTI, HYDROCHLORIDE GIVLAARI, SODIUM GLATIRAMER ACETATE, GLATIRAMER ACETATE GLATOPA, GLATIRAMER ACETATE GLEEVEC, MESYLATE GLEOLAN, AMINOLEVULINIC ACID HYDROCHLORIDE GLEOSTINE, GLIADEL, CARMUSTINE GLIMEPIRIDE, GLIMEPIRIDE , GLIPIZIDE GLIPIZIDE AND METFORMIN HYDROCHLORIDE, GLIPIZIDE GLOFIL-125, IOTHALAMATE SODIUM I-125 GLOPERBA, COLCHICINE GLUCAGEN, GLUCAGON HYDROCHLORIDE GLUCAGON, GLUCAGON GLUCAGON, GLUCAGON HYDROCHLORIDE GLUCOTROL, GLIPIZIDE GLUCOTROL XL, GLIPIZIDE GLUMETZA, METFORMIN HYDROCHLORIDE GLYBURIDE, GLYBURIDE GLYBURIDE (MICRONIZED), GLYBURIDE GLYBURIDE AND METFORMIN HYDROCHLORIDE, GLYBURIDE GLYCINE 1.5% IN PLASTIC CONTAINER, GLYCINE GLYCOLAX, POLYETHYLENE GLYCOL 3350 (OTC) GLYCOPYRROLATE, GLYCOPYRROLATE GLYDO, LIDOCAINE HYDROCHLORIDE GLYNASE, GLYBURIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 26 APPENDIX A - PRODUCT NAME INDEX

** G ** GLYRX-PF, GLYCOPYRROLATE GLYSET, GLYXAMBI, EMPAGLIFLOZIN GOCOVRI, AMANTADINE HYDROCHLORIDE GOLYTELY, POLYETHYLENE GLYCOL 3350 GOPRELTO, HYDROCHLORIDE GRALISE, GABAPENTIN HYDROCHLORIDE, GRANISETRON HYDROCHLORIDE GRANISETRON HYDROCHLORIDE PRESERVATIVE FREE, GRANISETRON HYDROCHLORIDE GRIS-PEG, , ULTRAMICROSIZE GRISEOFULVIN, GRISEOFULVIN, MICROSIZE GRISEOFULVIN, ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE GRISEOFULVIN,ULTRAMICROSIZE, GRISEOFULVIN, ULTRAMICROSIZE , GUAIFENESIN (OTC) GUAIFENESIN AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN HYDROBROMIDE (OTC) GUAIFENESIN AND PSEUDOEPHEDRINE HYDROCHLORIDE, GUAIFENESIN (OTC) HYDROCHLORIDE, GUANFACINE HYDROCHLORIDE GVOKE HYPOPEN, GLUCAGON GVOKE PFS, GLUCAGON GYNAZOLE-1, NITRATE

** H ** H.P. ACTHAR , CORTICOTROPIN HABITROL, (OTC) HAILEY 1.5/30, ETHINYL ESTRADIOL HAILEY FE 1.5/30, ETHINYL ESTRADIOL HAILEY FE 1/20, ETHINYL ESTRADIOL HALAVEN, MESYLATE , HALCINONIDE HALCION, HALDOL, DECANOATE HALOBETASOL PROPIONATE, HALOBETASOL PROPIONATE HALOG, HALCINONIDE HALOPERIDOL, HALOPERIDOL HALOPERIDOL, HALOPERIDOL LACTATE , HALOPERIDOL DECANOATE HARVONI, LEDIPASVIR HEATHER, NORETHINDRONE HECTOROL, DOXERCALCIFEROL HEMABATE, CARBOPROST TROMETHAMINE HEMADY, DEXAMETHASONE HEMANGEOL, HYDROCHLORIDE SODIUM, HEPARIN SODIUM HEPARIN SODIUM 1,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 1,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 10,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 12,500 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 12,500 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 2,000 UNITS AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 2,000 UNITS IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 20,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 25,000 UNITS IN DEXTROSE 5% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM 25,000 UNITS IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM IN PLASTIC CONTAINER, HEPARIN SODIUM HEPARIN SODIUM PRESERVATIVE FREE, HEPARIN SODIUM HEPATAMINE 8%, AMINO ACIDS HEPSERA, ADEFOVIR DIPIVOXIL HER STYLE, LEVONORGESTREL (OTC) HETLIOZ, TASIMELTEON HETLIOZ LQ, TASIMELTEON HIBICLENS, CHLORHEXIDINE GLUCONATE (OTC) HIBISTAT, CHLORHEXIDINE GLUCONATE (OTC) HICON, I-131 METHYLBROMIDE AND BITARTRATE, HOMATROPINE METHYLBROMIDE HORIZANT,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 27 APPENDIX A - PRODUCT NAME INDEX

** H ** HYCAMTIN, HYDROCHLORIDE HYCODAN, HOMATROPINE METHYLBROMIDE HYDRA-ZIDE, HYDRALAZINE HYDROCHLORIDE HYDRALAZINE HYDROCHLORIDE, HYDRALAZINE HYDROCHLORIDE HYDREA, HYDROXYUREA HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE HYDROCODONE BITARTRATE, HYDROCODONE BITARTRATE HYDROCODONE BITARTRATE AND ACETAMINOPHEN, ACETAMINOPHEN HYDROCODONE BITARTRATE AND ASPIRIN, ASPIRIN HYDROCODONE BITARTRATE AND HOMATROPINE METHYLBROMIDE, HOMATROPINE METHYLBROMIDE HYDROCODONE BITARTRATE AND IBUPROFEN, HYDROCODONE BITARTRATE HYDROCODONE BITARTRATE, CHLORPHENIRAMINE MALEATE AND PSEUDOEPHEDRINE HYDROCHLORIDE, HYDROCODONE POLISTIREX AND CHLORPHENIRAMINE POLISTIREX, CHLORPHENIRAMINE POLISTIREX HYDROCODONE POLISTIREX AND CHLORPHENIRAMNE POLISTIREX, CHLORPHENIRAMINE POLISTIREX HYDROCORTISONE, HYDROCORTISONE HYDROCORTISONE AND ACETIC ACID, ACETIC ACID, GLACIAL , HYDROCORTISONE BUTYRATE HYDROCORTISONE IN ABSORBASE, HYDROCORTISONE , HYDROCORTISONE VALERATE HYDROMORPHONE HYDROCHLORIDE, HYDROMORPHONE HYDROCHLORIDE HYDROXOCOBALAMIN, HYDROXOCOBALAMIN SULFATE, HYDROXYCHLOROQUINE SULFATE HYDROXYPROGESTERONE CAPROATE, HYDROXYPROGESTERONE CAPROATE HYDROXYUREA, HYDROXYUREA HYDROCHLORIDE, HYDROXYZINE HYDROCHLORIDE HYDROXYZINE PAMOATE, HYDROXYZINE PAMOATE HYSINGLA ER, HYDROCODONE BITARTRATE HYZAAR, HYDROCHLOROTHIAZIDE

** I ** IBANDRONATE SODIUM, IBANDRONATE SODIUM IBRANCE, , IBRUTINIB IBU-TAB, IBUPROFEN IBU-TAB 200, IBUPROFEN (OTC) IBUPROFEN, IBUPROFEN (OTC) IBUPROFEN, IBUPROFEN IBUPROFEN AND DIPHENHYDRAMINE CITRATE, DIPHENHYDRAMINE CITRATE (OTC) IBUPROFEN AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) IBUPROFEN AND PHENYLEPHRINE HYDROCHLORIDE, IBUPROFEN (OTC) IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE, IBUPROFEN (OTC) IBUPROFEN , IBUPROFEN LYSINE IBUPROHM COLD AND SINUS, IBUPROFEN (OTC) IBUTILIDE FUMARATE, IBUTILIDE FUMARATE IC-, INDOCYANINE GREEN ICATIBANT ACETATE, ICATIBANT ACETATE ICLEVIA, ETHINYL ESTRADIOL ICLUSIG, HYDROCHLORIDE ICOSAPENT ETHYL, ICOSAPENT ETHYL IDAMYCIN PFS, HYDROCHLORIDE IDARUBICIN HYDROCHLORIDE, IDARUBICIN HYDROCHLORIDE IDARUBICIN HYDROCHLORIDE PFS, IDARUBICIN HYDROCHLORIDE IDHIFA, MESYLATE IDKIT:HP, CITRIC ACID IFEX, IFOSFAMIDE, IFOSFAMIDE ILEVRO, NEPAFENAC ILUVIEN, FLUOCINOLONE ACETONIDE IMATINIB MESYLATE, IMATINIB MESYLATE IMBRUVICA, IBRUTINIB IMCIVREE, SETMELANOTIDE ACETATE AND CILASTATIN, CILASTATIN SODIUM HYDROCHLORIDE, IMIPRAMINE HYDROCHLORIDE IMIPRAMINE PAMOATE, IMIPRAMINE PAMOATE IMIQUIMOD, IMIQUIMOD

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 28 APPENDIX A - PRODUCT NAME INDEX

** I ** IMITREX, IMITREX, SUMATRIPTAN SUCCINATE IMITREX STATDOSE, SUMATRIPTAN SUCCINATE IMODIUM A-D, HYDROCHLORIDE (OTC) IMODIUM MULTI-SYMPTOM RELIEF, LOPERAMIDE HYDROCHLORIDE (OTC) IMPAVIDO, IMPEKLO, CLOBETASOL PROPIONATE IMPOYZ, CLOBETASOL PROPIONATE IMURAN, AZATHIOPRINE IMVEXXY, ESTRADIOL INAPSINE, DROPERIDOL INBRIJA, LEVODOPA INCASSIA, NORETHINDRONE INCRUSE ELLIPTA, UMECLIDINIUM BROMIDE , INDAPAMIDE INDERAL LA, PROPRANOLOL HYDROCHLORIDE IN 111 CHLORIDE, INDIUM IN-111 CHLORIDE INDIUM IN 111 OXYQUINOLINE, INDIUM IN-111 OXYQUINOLINE INDOCIN, INDOMETHACIN INDOCYANINE GREEN, INDOCYANINE GREEN INDOMETHACIN, INDOMETHACIN INDOMETHACIN SODIUM, INDOMETHACIN SODIUM INFANT'S ADVIL, IBUPROFEN (OTC) INFANTS' FEVERALL, ACETAMINOPHEN (OTC) INFED, FERRIC OXYHYDROXIDE INFUGEM, GEMCITABINE HYDROCHLORIDE INFUMORPH, MORPHINE SULFATE INFUVITE ADULT, ALPHA- ACETATE INFUVITE PEDIATRIC, ASCORBIC ACID INFUVITE PEDIATRIC (PHARMACY BULK PACKAGE), ASCORBIC ACID INGREZZA, VALBENAZINE TOSYLATE INJECTAFER, FERRIC CARBOXYMALTOSE INLYTA, INNOPRAN XL, PROPRANOLOL HYDROCHLORIDE INOMAX, INQOVI, CEDAZURIDINE INREBIC, HYDROCHLORIDE INSPRA, EPLERENONE INTELENCE, ETRAVIRINE INTRALIPID 10%, OIL INTRALIPID 20%, SOYBEAN OIL INTRALIPID 30%, SOYBEAN OIL INTRAROSA, INTROVALE, ETHINYL ESTRADIOL INTUNIV, GUANFACINE HYDROCHLORIDE INVANZ, ERTAPENEM SODIUM INVEGA, INVEGA SUSTENNA, PALIPERIDONE PALMITATE INVEGA TRINZA, PALIPERIDONE PALMITATE INVELTYS, LOTEPREDNOL ETABONATE INVIRASE, SAQUINAVIR MESYLATE INVOKAMET, INVOKAMET XR, CANAGLIFLOZIN INVOKANA, CANAGLIFLOZIN IONOSOL MB AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE IOPIDINE, APRACLONIDINE HYDROCHLORIDE IOSAT, (OTC) IPRATROPIUM BROMIDE, IPRATROPIUM BROMIDE IRBESARTAN, IRBESARTAN IRBESARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE IRESSA, IRINOTECAN HYDROCHLORIDE, IRINOTECAN HYDROCHLORIDE ISENTRESS, RALTEGRAVIR POTASSIUM ISENTRESS HD, RALTEGRAVIR POTASSIUM ISIBLOOM, DESOGESTREL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 29 APPENDIX A - PRODUCT NAME INDEX

** I ** ISOFLURANE, ISOFLURANE ISOLYTE P IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE ISOLYTE S IN PLASTIC CONTAINER, ISOLYTE S PH 7.4 IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE , ISONIAZID ISOPROTERENOL HYDROCHLORIDE, ISOPROTERENOL HYDROCHLORIDE ISOPTO ATROPINE, ATROPINE SULFATE ISOPTO CARPINE, HYDROCHLORIDE ISORDIL, ISOSORBIDE DINITRATE ISOSORBIDE DINITRATE, ISOSORBIDE DINITRATE , ISOSORBIDE MONONITRATE ISOSULFAN BLUE, ISOSULFAN BLUE ISOTRETINOIN, ISOTRETINOIN ISOVUE-200, ISOVUE-250, IOPAMIDOL ISOVUE-300, IOPAMIDOL ISOVUE-370, IOPAMIDOL ISOVUE-M 200, IOPAMIDOL ISOVUE-M 300, IOPAMIDOL , ISRADIPINE ISTALOL, TIMOLOL MALEATE ISTODAX, ISTURISA, PHOSPHATE ISUPREL, ISOPROTERENOL HYDROCHLORIDE , ITRACONAZOLE , IVERMECTIN (OTC) IVERMECTIN, IVERMECTIN IVY , BENTOQUATAM (OTC) IXEMPRA KIT,

** J ** JADENU, DEFERASIROX JADENU SPRINKLE, DEFERASIROX JAIMIESS, ETHINYL ESTRADIOL JAKAFI, PHOSPHATE JALYN, DUTASTERIDE JANTOVEN, SODIUM JANUMET, METFORMIN HYDROCHLORIDE JANUMET XR, METFORMIN HYDROCHLORIDE JANUVIA, SITAGLIPTIN PHOSPHATE JARDIANCE, EMPAGLIFLOZIN JATENZO, TESTOSTERONE UNDECANOATE JELMYTO, MITOMYCIN JENCYCLA, NORETHINDRONE JENTADUETO, LINAGLIPTIN JENTADUETO XR, LINAGLIPTIN JEVTANA KIT, JORNAY PM, METHYLPHENIDATE HYDROCHLORIDE JUBLIA, EFINACONAZOLE JULUCA, DOLUTEGRAVIR SODIUM JUNEL 1.5/30, ETHINYL ESTRADIOL JUNEL 1/20, ETHINYL ESTRADIOL JUNEL FE 1.5/30, ETHINYL ESTRADIOL JUNEL FE 1/20, ETHINYL ESTRADIOL JUNIOR STRENGTH ADVIL, IBUPROFEN (OTC) JUNIOR STRENGTH IBUPROFEN, IBUPROFEN (OTC) JUNIOR STRENGTH MOTRIN, IBUPROFEN (OTC) JUXTAPID, LOMITAPIDE MESYLATE JYNARQUE,

** K ** K-TAB, POTASSIUM CHLORIDE KABIVEN IN PLASTIC CONTAINER, AMINO ACIDS KADIAN, MORPHINE SULFATE KAITLIB FE, ETHINYL ESTRADIOL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 30 APPENDIX A - PRODUCT NAME INDEX

** K ** KALETRA, LOPINAVIR KALEXATE, SODIUM SULFONATE KALLIGA, DESOGESTREL KALYDECO, KAPSPARGO SPRINKLE, SUCCINATE KAPVAY, CLONIDINE HYDROCHLORIDE KARBINAL ER, CARBINOXAMINE MALEATE KARIVA, DESOGESTREL KATERZIA, AMLODIPINE BENZOATE KAZANO, ALOGLIPTIN BENZOATE KEFLEX, CEPHALEXIN KELNOR, ETHINYL ESTRADIOL KEMEYA, DROSPIRENONE KENALOG, KENALOG-10, TRIAMCINOLONE ACETONIDE KENALOG-40, TRIAMCINOLONE ACETONIDE KENALOG-80, TRIAMCINOLONE ACETONIDE KENGREAL, KEPPRA, LEVETIRACETAM KEPPRA XR, LEVETIRACETAM KERYDIN, KETALAR, HYDROCHLORIDE KETAMINE HYDROCHLORIDE, KETAMINE HYDROCHLORIDE KETOCONAZOLE, KETOCONAZOLE , KETOPROFEN KETOROLAC TROMETHAMINE, KETOROLAC TROMETHAMINE KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE, KETOROLAC TROMETHAMINE KETOTIFEN FUMARATE, KETOTIFEN FUMARATE (OTC) KETOZOLE, KETOCONAZOLE KEVEYIS, DICHLORPHENAMIDE KHAPZORY, LEVOLEUCOVORIN KIMIDESS, DESOGESTREL KIMYRSA, DIPHOSPHATE KINEVAC, KIONEX, SODIUM POLYSTYRENE SULFONATE KISQALI, SUCCINATE KISQALI FEMARA CO-PACK (COPACKAGED), LETROZOLE KITABIS PAK, TOBRAMYCIN KLARON, SULFACETAMIDE SODIUM KLISYRI, TIRBANIBULIN KLONOPIN, CLONAZEPAM KLOR-CON, POTASSIUM CHLORIDE KLOR-CON M10, POTASSIUM CHLORIDE KLOR-CON M15, POTASSIUM CHLORIDE KLOR-CON M20, POTASSIUM CHLORIDE KLOXXADO, NALOXONE HYDROCHLORIDE KOMBIGLYZE XR, METFORMIN HYDROCHLORIDE KORLYM, KOSELUGO, SULFATE KOVANAZE, HYDROCHLORIDE KRINTAFEL, TAFENOQUINE SUCCINATE KURVELO, ETHINYL ESTRADIOL KUVAN, SAPROPTERIN DIHYDROCHLORIDE KYBELLA, DEOXYCHOLIC ACID KYLEENA, LEVONORGESTREL KYNMOBI, APOMORPHINE HYDROCHLORIDE KYPROLIS, CARFILZOMIB KYRA, DROSPIRENONE

** L ** HYDROCHLORIDE, LABETALOL HYDROCHLORIDE LABETALOL HYDROCHLORIDE IN DEXTROSE, LABETALOL HYDROCHLORIDE LABETALOL HYDROCHLORIDE IN SODIUM CHLORIDE, LABETALOL HYDROCHLORIDE LACRISERT, HYDROXYPROPYL CELLULOSE LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER, CALCIUM CHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 31 APPENDIX A - PRODUCT NAME INDEX

** L ** LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE LACTULOSE, LACTULOSE LAMICTAL, LAMICTAL CD, LAMOTRIGINE LAMICTAL ODT, LAMOTRIGINE LAMICTAL XR, LAMOTRIGINE LAMISIL, HYDROCHLORIDE (OTC) LAMISIL, TERBINAFINE HYDROCHLORIDE LAMISIL AT, TERBINAFINE (OTC) LAMISIL AT, TERBINAFINE HYDROCHLORIDE (OTC) LAMIVUDINE, LAMIVUDINE LAMIVUDINE AND ZIDOVUDINE, LAMIVUDINE LAMOTRIGINE, LAMOTRIGINE LAMPIT, NIFURTIMOX LANORINAL, ASPIRIN LANOXIN, DIGOXIN LANOXIN PEDIATRIC, DIGOXIN , LANSOPRAZOLE (OTC) LANSOPRAZOLE, LANSOPRAZOLE LANSOPRAZOLE, AMOXICILLIN AND CLARITHROMYCIN, AMOXICILLIN , LANTHANUM CARBONATE DITOSYLATE, LAPATINIB DITOSYLATE LARIN 1.5/30, ETHINYL ESTRADIOL LARIN 1/20, ETHINYL ESTRADIOL LARIN 24 FE, ETHINYL ESTRADIOL LARIN FE 1.5/30, ETHINYL ESTRADIOL LARIN FE 1/20, ETHINYL ESTRADIOL LAROTID, AMOXICILLIN LARYNG-O-JET KIT, LIDOCAINE HYDROCHLORIDE LASIX, FUROSEMIDE LASTACAFT, LATANOPROST, LATANOPROST LATISSE, BIMATOPROST LATUDA, HYDROCHLORIDE LAX-LYTE WITH FLAVOR PACKS, POLYETHYLENE GLYCOL 3350 LAZANDA, FENTANYL CITRATE LEFLUNOMIDE, LEFLUNOMIDE , LENALIDOMIDE LENVIMA, MESYLATE LERIBANE, ETHINYL ESTRADIOL LESCOL XL, FLUVASTATIN SODIUM LESSINA-28, ETHINYL ESTRADIOL LETAIRIS, AMBRISENTAN LETROZOLE, LETROZOLE LEUCOVORIN CALCIUM, LEUCOVORIN CALCIUM LEUCOVORIN CALCIUM PRESERVATIVE FREE, LEUCOVORIN CALCIUM LEUKERAN, LEUPROLIDE ACETATE, LEUPROLIDE ACETATE LEVALBUTEROL HYDROCHLORIDE, LEVALBUTEROL HYDROCHLORIDE LEVETIRACETAM, LEVETIRACETAM LEVETIRACETAM IN SODIUM CHLORIDE, LEVETIRACETAM LEVITRA, HYDROCHLORIDE LEVO-T, LEVOTHYROXINE SODIUM ** LEVOBUNOLOL HYDROCHLORIDE, LEVOBUNOLOL HYDROCHLORIDE LEVOCARNITINE, LEVOCARNITINE LEVOCARNITINE SF, LEVOCARNITINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC) LEVOCETIRIZINE DIHYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE LEVOCETIRIZINE HYDROCHLORIDE, LEVOCETIRIZINE DIHYDROCHLORIDE , LEVOFLOXACIN LEVOFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER, LEVOFLOXACIN LEVOLEUCOVORIN CALCIUM, LEVOLEUCOVORIN CALCIUM LEVOMILNACIPRAN HYDROCHLORIDE, LEVOMILNACIPRAN HYDROCHLORIDE LEVONEST, ETHINYL ESTRADIOL LEVONORGESTREL, LEVONORGESTREL (OTC)

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 32 APPENDIX A - PRODUCT NAME INDEX

** L ** LEVONORGESTREL, LEVONORGESTREL LEVONORGESTREL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL LEVONORGESTREL AND ETHINYL ESTRADIOL AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL LEVOPHED, BITARTRATE LEVORA 0.15/30-28, ETHINYL ESTRADIOL TARTRATE, LEVORPHANOL TARTRATE LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM LEVOTHYROXINE SODIUM, LEVOTHYROXINE SODIUM ** LEVOXYL, LEVOTHYROXINE SODIUM ** LEVULAN, AMINOLEVULINIC ACID HYDROCHLORIDE LEXAPRO, ESCITALOPRAM OXALATE LEXETTE, HALOBETASOL PROPIONATE LEXISCAN, LEXIVA, FOSAMPRENAVIR CALCIUM LIALDA, MESALAMINE LIBRAX, CHLORDIAZEPOXIDE HYDROCHLORIDE LIBRIUM, CHLORDIAZEPOXIDE HYDROCHLORIDE LICART, DICLOFENAC EPOLAMINE LIDEX, FLUOCINONIDE LIDEX-E, FLUOCINONIDE LIDOCAINE, LIDOCAINE LIDOCAINE AND , LIDOCAINE LIDOCAINE HYDROCHLORIDE, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.2% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.4% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 0.8% AND DEXTROSE 5% IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE 5% AND DEXTROSE 7.5%, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE AND EPINEPHRINE, EPINEPHRINE LIDOCAINE HYDROCHLORIDE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE IN PLASTIC CONTAINER, LIDOCAINE HYDROCHLORIDE LIDOCAINE HYDROCHLORIDE VISCOUS, LIDOCAINE HYDROCHLORIDE LIDOCAINE VISCOUS, LIDOCAINE HYDROCHLORIDE LIDODERM, LIDOCAINE LIGNOSPAN FORTE, EPINEPHRINE BITARTRATE LIGNOSPAN STANDARD, EPINEPHRINE BITARTRATE LILETTA, LEVONORGESTREL LINCOCIN, HYDROCHLORIDE LINCOMYCIN, LINCOMYCIN HYDROCHLORIDE LINCOMYCIN HYDROCHLORIDE, LINCOMYCIN HYDROCHLORIDE , LINDANE , LINEZOLID LINEZOLID IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, LINEZOLID LINZESS, LIORESAL, BACLOFEN LIOTHYRONINE SODIUM, LIOTHYRONINE SODIUM , ETHIODIZED OIL LIPITOR, ATORVASTATIN CALCIUM LIPOFEN, FENOFIBRATE LIQUID E-Z-PAQUE, BARIUM SULFATE LISINOPRIL, LISINOPRIL LISINOPRIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE CARBONATE, , LITHIUM CITRATE LITHOBID, LITHIUM CARBONATE LITHOSTAT, ACETOHYDROXAMIC ACID LIVALO, PITAVASTATIN CALCIUM LO LOESTRIN FE, ETHINYL ESTRADIOL LO SIMPESSE, ETHINYL ESTRADIOL LO-MALMOREDE, ETHINYL ESTRADIOL LO-ZUMANDIMINE, DROSPIRENONE LOCOID, HYDROCORTISONE BUTYRATE LOCOID LIPOCREAM, HYDROCORTISONE BUTYRATE LODOSYN, CARBIDOPA LOESTRIN 21 1.5/30, ETHINYL ESTRADIOL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 33 APPENDIX A - PRODUCT NAME INDEX

** L ** LOESTRIN 21 1/20, ETHINYL ESTRADIOL LOESTRIN 24 FE, ETHINYL ESTRADIOL LOESTRIN FE 1.5/30, ETHINYL ESTRADIOL LOESTRIN FE 1/20, ETHINYL ESTRADIOL LOGILIA, ULIPRISTAL ACETATE LOKELMA, SODIUM CYCLOSILICATE LOMAIRA, PHENTERMINE HYDROCHLORIDE LOMOTIL, ATROPINE SULFATE LONHALA MAGNAIR KIT, GLYCOPYRROLATE LONSURF, TIPIRACIL HYDROCHLORIDE LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE (OTC) LOPERAMIDE HYDROCHLORIDE, LOPERAMIDE HYDROCHLORIDE LOPERAMIDE HYDROCHLORIDE AND SIMETHICONE, LOPERAMIDE HYDROCHLORIDE (OTC) LOPID, GEMFIBROZIL LOPINAVIR AND , LOPINAVIR LOPRESSOR, METOPROLOL TARTRATE LOPRESSOR HCT, HYDROCHLOROTHIAZIDE LOPROX, CICLOPIROX LOPURIN, ALLOPURINOL LORATADINE, LORATADINE (OTC) LORATADINE AND PSEUDOEPHEDRINE SULFATE, LORATADINE (OTC) LORATADINE REDIDOSE, LORATADINE (OTC) LORAZEPAM, LORAZEPAM LORAZEPAM INTENSOL, LORAZEPAM LORBRENA, LORYNA, DROSPIRENONE LOSARTAN POTASSIUM, LOSARTAN POTASSIUM LOSARTAN POTASSIUM AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE LOSEASONIQUE, ETHINYL ESTRADIOL LOTEMAX, LOTEPREDNOL ETABONATE LOTEMAX SM, LOTEPREDNOL ETABONATE LOTENSIN, BENAZEPRIL HYDROCHLORIDE LOTENSIN HCT, BENAZEPRIL HYDROCHLORIDE LOTEPREDNOL ETABONATE, LOTEPREDNOL ETABONATE LOTREL, AMLODIPINE BESYLATE LOTRIMIN ULTRA, BUTENAFINE HYDROCHLORIDE (OTC) LOTRISONE, BETAMETHASONE DIPROPIONATE LOTRONEX, ALOSETRON HYDROCHLORIDE LOVASTATIN, LOVASTATIN LOVAZA, OMEGA-3-ACID ETHYL LOVENOX, ENOXAPARIN SODIUM LOVENOX (PRESERVATIVE FREE), ENOXAPARIN SODIUM LOW-OGESTREL-28, ETHINYL ESTRADIOL LOXAPINE SUCCINATE, LOXAPINE SUCCINATE LUCEMYRA, HYDROCHLORIDE LUMAKRAS, LUMASON, -TYPE A MICROSPHERES LUMI-SPORYN, BACITRACIN ZINC LUMIFY, BRIMONIDINE TARTRATE (OTC) LUMIGAN, BIMATOPROST LUNESTA, ESZOPICLONE LUPANETA PACK, LEUPROLIDE ACETATE LUPKYNIS, VOCLOSPORIN LUPRON DEPOT, LEUPROLIDE ACETATE LUPRON DEPOT-PED KIT, LEUPROLIDE ACETATE LURASIDONE HYDROCHLORIDE, LURASIDONE HYDROCHLORIDE LUTATHERA, LUTETIUM DOTATATE LU-177 LUVOX, FLUVOXAMINE MALEATE LUXIQ, BETAMETHASONE VALERATE LUZU, LYBALVI, LYMPHOSEEK KIT, TECHNETIUM TC-99M TILMANOCEPT LYNPARZA, LYRICA, LYRICA CR, PREGABALIN

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 34 APPENDIX A - PRODUCT NAME INDEX

** L ** LYSODREN, LYSTEDA, TRANEXAMIC ACID

** M ** M-ZOLE 3 COMBINATION PACK, NITRATE (OTC) M.V.I. ADULT, ASCORBIC ACID M.V.I. ADULT (PHARMACY BULK PACKAGE), ASCORBIC ACID M.V.I. PEDIATRIC, ASCORBIC ACID , MACITENTAN MACRILEN, MACIMORELIN ACETATE MACROBID, NITROFURANTOIN MACRODANTIN, NITROFURANTOIN, MACROCRYSTALLINE ACETATE, MAFENIDE ACETATE , MAGNESIUM SULFATE MAGNESIUM SULFATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MAGNESIUM SULFATE MAGNESIUM SULFATE IN PLASTIC CONTAINER, MAGNESIUM SULFATE MAKENA, HYDROXYPROGESTERONE CAPROATE MAKENA (AUTOINJECTOR), HYDROXYPROGESTERONE CAPROATE MAKENA PRESERVATIVE FREE, HYDROXYPROGESTERONE CAPROATE MALARONE, ATOVAQUONE MALARONE PEDIATRIC, ATOVAQUONE , MALATHION MALMOREDE, ETHINYL ESTRADIOL CHLORIDE IN PLASTIC CONTAINER, MANGANESE CHLORIDE MANNITOL 10% IN PLASTIC CONTAINER, MANNITOL MANNITOL 15% IN PLASTIC CONTAINER, MANNITOL MANNITOL 20% IN PLASTIC CONTAINER, MANNITOL MANNITOL 25%, MANNITOL MANNITOL 5% IN PLASTIC CONTAINER, MANNITOL HYDROCHLORIDE, MAPROTILINE HYDROCHLORIDE MARCAINE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE W/ EPINEPHRINE, BUPIVACAINE HYDROCHLORIDE MARCAINE HYDROCHLORIDE W/ EPINEPHRINE PRESERVATIVE FREE, BUPIVACAINE HYDROCHLORIDE MARINOL, DRONABINOL MARLISSA, ETHINYL ESTRADIOL MARPLAN, MARQIBO KIT, SULFATE MATULANE, HYDROCHLORIDE MAVENCLAD, CLADRIBINE MAVYRET, GLECAPREVIR MAXALT, BENZOATE MAXALT-MLT, RIZATRIPTAN BENZOATE MAXIDEX, DEXAMETHASONE MAXIPIME, CEFEPIME HYDROCHLORIDE MAXITROL, DEXAMETHASONE MAXZIDE, HYDROCHLOROTHIAZIDE MAXZIDE-25, HYDROCHLOROTHIAZIDE MAYZENT, SIPONIMOD MD-GASTROVIEW, DIATRIZOATE MEGLUMINE HYDROCHLORIDE, MECAMYLAMINE HYDROCHLORIDE MECLIZINE HYDROCHLORIDE, MECLIZINE HYDROCHLORIDE MECLOFENAMATE SODIUM, MECLOFENAMATE SODIUM MEDROL, METHYLPREDNISOLONE MEDROXYPROGESTERONE ACETATE, MEDROXYPROGESTERONE ACETATE , MEFENAMIC ACID HYDROCHLORIDE, MEFLOQUINE HYDROCHLORIDE MEGACE ES, ACETATE , MEGESTROL ACETATE MEKINIST, MEKTOVI, MELAMISA, DROSPIRENONE MELOXICAM, MELOXICAM MELPHALAN, MELPHALAN

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 35 APPENDIX A - PRODUCT NAME INDEX

** M ** MELPHALAN HYDROCHLORIDE, MELPHALAN HYDROCHLORIDE HYDROCHLORIDE, MEMANTINE HYDROCHLORIDE MEMBRANEBLUE, MEN'S ROGAINE, (OTC) MENEST, , ESTERIFIED MENOSTAR, ESTRADIOL MENTAX, BUTENAFINE HYDROCHLORIDE MEPERIDINE HYDROCHLORIDE, MEPERIDINE HYDROCHLORIDE MEPERIDINE HYDROCHLORIDE PRESERVATIVE FREE, MEPERIDINE HYDROCHLORIDE MEPHYTON, PHYTONADIONE , MEPROBAMATE MEPRON, ATOVAQUONE , MERCAPTOPURINE , MEROPENEM MEROPENEM AND SODIUM CHLORIDE IN DUPLEX CONTAINER, MEROPENEM MERREM, MEROPENEM MERZEE, ETHINYL ESTRADIOL MESALAMINE, MESALAMINE , MESNA MESNEX, MESNA MESTINON, PYRIDOSTIGMINE BROMIDE METADATE CD, METHYLPHENIDATE HYDROCHLORIDE METAPROTERENOL SULFATE, METAPROTERENOL SULFATE METASTRON, CHLORIDE SR-89 METAXALONE, METAXALONE METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE HYDROCHLORIDE, METHADONE HYDROCHLORIDE METHADONE HYDROCHLORIDE INTENSOL, METHADONE HYDROCHLORIDE METHADOSE, METHADONE HYDROCHLORIDE METHAMPHETAMINE HYDROCHLORIDE, METHAMPHETAMINE HYDROCHLORIDE METHAZOLAMIDE, METHAZOLAMIDE METHENAMINE HIPPURATE, METHENAMINE HIPPURATE METHERGINE, METHYLERGONOVINE MALEATE METHIMAZOLE, METHIMAZOLE , METHOCARBAMOL PRESERVATIVE FREE, METHOTREXATE SODIUM METHOTREXATE SODIUM, METHOTREXATE SODIUM METHOTREXATE SODIUM PRESERVATIVE FREE, METHOTREXATE SODIUM METHOXSALEN, METHOXSALEN METHSCOPOLAMINE BROMIDE, METHSCOPOLAMINE BROMIDE , METHYLDOPA METHYLDOPA AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE METHYLERGONOVINE MALEATE, METHYLERGONOVINE MALEATE METHYLIN, METHYLPHENIDATE HYDROCHLORIDE METHYLIN ER, METHYLPHENIDATE HYDROCHLORIDE METHYLPHENIDATE HYDROCHLORIDE, METHYLPHENIDATE HYDROCHLORIDE METHYLPREDNISOLONE, METHYLPREDNISOLONE METHYLPREDNISOLONE ACETATE, METHYLPREDNISOLONE ACETATE METHYLPREDNISOLONE SODIUM SUCCINATE, METHYLPREDNISOLONE SODIUM SUCCINATE METHYLTESTOSTERONE, METHYLTESTOSTERONE METOCLOPRAMIDE, METOCLOPRAMIDE HYDROCHLORIDE METOCLOPRAMIDE HYDROCHLORIDE, METOCLOPRAMIDE HYDROCHLORIDE , METOLAZONE METOPIRONE, METOPROLOL SUCCINATE, METOPROLOL SUCCINATE METOPROLOL TARTRATE, METOPROLOL TARTRATE METOPROLOL TARTRATE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE METRO I.V. IN PLASTIC CONTAINER, METRONIDAZOLE METROCREAM, METRONIDAZOLE METROGEL, METRONIDAZOLE METROGEL-VAGINAL, METRONIDAZOLE METROLOTION, METRONIDAZOLE METRONIDAZOLE, METRONIDAZOLE METRONIDAZOLE IN PLASTIC CONTAINER, METRONIDAZOLE METYROSINE, METYROSINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 36 APPENDIX A - PRODUCT NAME INDEX

** M ** HYDROCHLORIDE, MEXILETINE HYDROCHLORIDE MIACALCIN, CALCITONIN SALMON MIBELAS 24 FE, ETHINYL ESTRADIOL , MICAFUNGIN SODIUM MICAFUNGIN SODIUM, MICAFUNGIN SODIUM MICARDIS, MICARDIS HCT, HYDROCHLOROTHIAZIDE MICONAZOLE 3, MICONAZOLE NITRATE (OTC) MICONAZOLE 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MICONAZOLE 7, MICONAZOLE NITRATE (OTC) MICONAZOLE NITRATE, MICONAZOLE NITRATE (OTC) MICONAZOLE NITRATE, MICONAZOLE NITRATE MICONAZOLE NITRATE COMBINATION PACK, MICONAZOLE NITRATE (OTC) MICORT-HC, HYDROCORTISONE ACETATE MICROGESTIN 1.5/30, ETHINYL ESTRADIOL MICROGESTIN 1/20, ETHINYL ESTRADIOL MICROGESTIN FE 1.5/30, ETHINYL ESTRADIOL MICROGESTIN FE 1/20, ETHINYL ESTRADIOL MICROZIDE, HYDROCHLOROTHIAZIDE MIDAMOR, AMILORIDE HYDROCHLORIDE HYDROCHLORIDE, MIDAZOLAM HYDROCHLORIDE MIDAZOLAM HYDROCHLORIDE PRESERVATIVE FREE, MIDAZOLAM HYDROCHLORIDE MIDAZOLAM IN 0.9% SODIUM CHLORIDE, MIDAZOLAM HYDROCHLORIDE, MIDODRINE HYDROCHLORIDE MIDOL LIQUID GELS, IBUPROFEN (OTC) MIFEPREX, MIFEPRISTONE MIFEPRISTONE, MIFEPRISTONE MIGERGOT, CAFFEINE MIGLITOL, MIGLITOL , MIGLUSTAT MIGRANAL, DIHYDROERGOTAMINE MESYLATE MILI, ETHINYL ESTRADIOL LACTATE, MILRINONE LACTATE MILRINONE LACTATE IN DEXTROSE 5%, MILRINONE LACTATE MILRINONE LACTATE IN DEXTROSE 5% IN PLASTIC CONTAINER, MILRINONE LACTATE MILRINONE LACTATE IN PLASTIC CONTAINER, MILRINONE LACTATE MINASTRIN 24 FE, ETHINYL ESTRADIOL MINIPRESS, HYDROCHLORIDE MINIVELLE, ESTRADIOL MINOCIN, MINOCYCLINE HYDROCHLORIDE MINOCYCLINE HYDROCHLORIDE, MINOCYCLINE HYDROCHLORIDE MINOLIRA, MINOCYCLINE HYDROCHLORIDE MINOXIDIL, MINOXIDIL (OTC) MINOXIDIL, MINOXIDIL MINOXIDIL (FOR MEN), MINOXIDIL (OTC) MINOXIDIL (FOR WOMEN), MINOXIDIL (OTC) MINOXIDIL EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC) MIOCHOL-E, CHLORIDE MIOSTAT, MIRALAX, POLYETHYLENE GLYCOL 3350 (OTC) MIRAPEX, DIHYDROCHLORIDE MIRAPEX ER, PRAMIPEXOLE DIHYDROCHLORIDE MIRENA, LEVONORGESTREL , MIRTAZAPINE MIRVASO, BRIMONIDINE TARTRATE MISOPROSTOL, MISOPROSTOL MITIGARE, COLCHICINE MITIGO, MORPHINE SULFATE MITOMYCIN, MITOMYCIN MITOSOL, MITOMYCIN HYDROCHLORIDE, MITOXANTRONE HYDROCHLORIDE MOBIC, MELOXICAM , MODAFINIL MOEXIPRIL HYDROCHLORIDE, MOEXIPRIL HYDROCHLORIDE MOEXIPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 37 APPENDIX A - PRODUCT NAME INDEX

** M ** HYDROCHLORIDE, MOLINDONE HYDROCHLORIDE MOMETASONE FUROATE, MOMETASONE FUROATE MONISTAT 1 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONISTAT 3, MICONAZOLE NITRATE (OTC) MONISTAT 3, MICONAZOLE NITRATE MONISTAT 3 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONISTAT 3 COMBINATION PACK (PREFILLED), MICONAZOLE NITRATE (OTC) MONISTAT 7, MICONAZOLE NITRATE (OTC) MONISTAT 7 COMBINATION PACK, MICONAZOLE NITRATE (OTC) MONO-LINYAH, ETHINYL ESTRADIOL MONOBASIC SODIUM PHOSPHATE AND DIBASIC SODIUM PHOSPHATE, SODIUM PHOSPHATE, DIBASIC, MONODOX, DOXYCYCLINE MONOFERRIC, FERRIC DERISOMALTOSE MONOKET, ISOSORBIDE MONONITRATE SODIUM, MONTELUKAST SODIUM MONUROL, FOSFOMYCIN TROMETHAMINE MORPHINE SULFATE, MORPHINE SULFATE MOTEGRITY, SUCCINATE MOTOFEN, ATROPINE SULFATE MOTRIN IB, IBUPROFEN (OTC) MOVANTIK, NALOXEGOL OXALATE MOVIPREP, ASCORBIC ACID MOXEZA, HYDROCHLORIDE MOXIDECTIN, MOXIDECTIN MOXIFLOXACIN HYDROCHLORIDE, MOXIFLOXACIN HYDROCHLORIDE MOXIFLOXACIN HYDROCHLORIDE IN SODIUM CHLORIDE 0.8% IN PLASTIC CONTAINER, MOXIFLOXACIN MOZOBIL, MPI INDIUM DTPA IN 111, INDIUM IN-111 PENTETATE DISODIUM MS CONTIN, MORPHINE SULFATE MUCINEX, GUAIFENESIN (OTC) MUCINEX D, GUAIFENESIN (OTC) MUCINEX DM, DEXTROMETHORPHAN HYDROBROMIDE (OTC) MULPLETA, LUSUTROMBOPAG MULTAQ, HYDROCHLORIDE MULTIHANCE, GADOBENATE DIMEGLUMINE MULTIHANCE MULTIPACK, GADOBENATE DIMEGLUMINE MUPIROCIN, MUPIROCIN MUPIROCIN, MUPIROCIN CALCIUM MUSE, ALPROSTADIL MYAMBUTOL, ETHAMBUTOL HYDROCHLORIDE MYCAMINE, MICAFUNGIN SODIUM MYCAPSSA, OCTREOTIDE ACETATE MYCOBUTIN, MYCOPHENOLATE MOFETIL, MYCOPHENOLATE MOFETIL MYCOPHENOLATE MOFETIL HYDROCHLORIDE, MYCOPHENOLATE MOFETIL HYDROCHLORIDE , MYCOPHENOLIC ACID MYDAYIS, AMPHETAMINE ASPARTATE MYDRIACYL, MYFEMBREE, ESTRADIOL MYFORTIC, MYCOPHENOLIC ACID MYKACET, MYLERAN, BUSULFAN MYORISAN, ISOTRETINOIN MYOVIEW 30ML, TECHNETIUM TC-99M TETROFOSMIN KIT MYRBETRIQ, MYRBETRIQ GRANULES, MIRABEGRON MYSOLINE, MYTESI, MYZILRA, ETHINYL ESTRADIOL

** N ** , NABUMETONE NADOLOL, NADOLOL NADOLOL AND BENDROFLUMETHIAZIDE, BENDROFLUMETHIAZIDE SODIUM, NAFCILLIN SODIUM

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 38 APPENDIX A - PRODUCT NAME INDEX

** N ** HYDROCHLORIDE, NAFTIFINE HYDROCHLORIDE NAFTIN, NAFTIFINE HYDROCHLORIDE HYDROCHLORIDE, NALBUPHINE HYDROCHLORIDE NALFON, FENOPROFEN CALCIUM NALLPEN IN PLASTIC CONTAINER, NAFCILLIN SODIUM NALOXONE, NALOXONE HYDROCHLORIDE NALOXONE HYDROCHLORIDE, NALOXONE HYDROCHLORIDE NALOXONE HYDROCHLORIDE AND HYDROCHLORIDE, NALOXONE HYDROCHLORIDE HYDROCHLORIDE, NALTREXONE HYDROCHLORIDE NAMENDA, MEMANTINE HYDROCHLORIDE NAMENDA XR, MEMANTINE HYDROCHLORIDE NAMZARIC, DONEPEZIL HYDROCHLORIDE HYDROCHLORIDE AND MALEATE, NAPHAZOLINE HYDROCHLORIDE (OTC) NAPHCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC) NAPRELAN, NAPROXEN SODIUM NAPROSYN, NAPROXEN NAPROXEN, NAPROXEN NAPROXEN AND ESOMEPRAZOLE MAGNESIUM, ESOMEPRAZOLE MAGNESIUM NAPROXEN SODIUM, NAPROXEN SODIUM (OTC) NAPROXEN SODIUM, NAPROXEN SODIUM NAPROXEN SODIUM AND DIPHENHYDRAMINE HYDROCHLORIDE, DIPHENHYDRAMINE HYDROCHLORIDE (OTC) NAPROXEN SODIUM AND PSEUDOEPHEDRINE HYDROCHLORIDE, NAPROXEN SODIUM (OTC) NARATRIPTAN, NARATRIPTAN HYDROCHLORIDE NARCAN, NALOXONE HYDROCHLORIDE NARDIL, SULFATE NAROPIN, HYDROCHLORIDE NASACORT ALLERGY 24 HOUR, TRIAMCINOLONE ACETONIDE (OTC) NASCOBAL, CYANOCOBALAMIN NATACYN, NATAZIA, , NATEGLINIDE NATESTO, TESTOSTERONE NATROBA, NAYZILAM, MIDAZOLAM NEBIVOLOL HYDROCHLORIDE, NEBIVOLOL HYDROCHLORIDE NEBUPENT, ISETHIONATE NEDOCROMIL SODIUM, NEDOCROMIL SODIUM HYDROCHLORIDE, NEFAZODONE HYDROCHLORIDE NEMBUTAL SODIUM, SODIUM NEO-SYNALAR, FLUOCINOLONE ACETONIDE NEOMYCIN AND SULFATE, NEOMYCIN SULFATE NEOMYCIN AND POLYMYXIN B AND BACITRACIN ZINC, BACITRACIN ZINC NEOMYCIN AND POLYMYXIN B SULFATES AND DEXAMETHASONE, DEXAMETHASONE NEOMYCIN AND POLYMYXIN B SULFATES AND , GRAMICIDIN NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE, HYDROCORTISONE NEOMYCIN AND POLYMYXIN B SULFATES, BACITRACIN ZINC AND HYDROCORTISONE, BACITRACIN ZINC NEOMYCIN SULFATE, NEOMYCIN SULFATE NEOPAP, ACETAMINOPHEN (OTC) NEOPROFEN, IBUPROFEN LYSINE NEORAL, CYCLOSPORINE NEOSPORIN, GRAMICIDIN NEOSPORIN G.U. IRRIGANT, NEOMYCIN SULFATE NEOSTIGMINE METHYLSULFATE, NEOSTIGMINE METHYLSULFATE NEPHRAMINE 5.4%, AMINO ACIDS NERLYNX, MALEATE NESACAINE, CHLOROPROCAINE HYDROCHLORIDE NESACAINE-MPF, CHLOROPROCAINE HYDROCHLORIDE NESINA, ALOGLIPTIN BENZOATE NETSPOT, GALLIUM DOTATATE GA-68 NEUPRO, NEURACEQ, F-18 NEUROLITE, TECHNETIUM TC-99M BICISATE KIT NEURONTIN, GABAPENTIN NEVANAC, NEPAFENAC , NEVIRAPINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 39 APPENDIX A - PRODUCT NAME INDEX

** N ** NEXAVAR, TOSYLATE NEXESTA FE, ETHINYL ESTRADIOL NEXIUM, ESOMEPRAZOLE MAGNESIUM NEXIUM 24HR, ESOMEPRAZOLE MAGNESIUM (OTC) NEXIUM IV, ESOMEPRAZOLE SODIUM NEXLETOL, BEMPEDOIC ACID NEXLIZET, BEMPEDOIC ACID NEXPLANON, ETONOGESTREL NEXTERONE, AMIODARONE HYDROCHLORIDE NEXTSTELLIS, DROSPIRENONE , NIACIN NIACOR, NIACIN NIASPAN, NIACIN NICARDIPINE HYDROCHLORIDE, NICARDIPINE HYDROCHLORIDE NICARDIPINE HYDROCHLORIDE IN 0.9% SODIUM CHLORIDE, NICARDIPINE HYDROCHLORIDE NICODERM CQ, NICOTINE (OTC) , NICOTINE POLACRILEX (OTC) NICORETTE (MINT), NICOTINE POLACRILEX (OTC) NICOTINE, NICOTINE (OTC) NICOTINE POLACRILEX, NICOTINE POLACRILEX (OTC) NICOTROL, NICOTINE , NIFEDIPINE NIKKI, DROSPIRENONE NILANDRON, NILUTAMIDE, NILUTAMIDE NIMBEX, CISATRACURIUM BESYLATE NIMBEX PRESERVATIVE FREE, CISATRACURIUM BESYLATE , NIMODIPINE NINLARO, CITRATE NIPENT, NIPRIDE RTU IN SODIUM CHLORIDE 0.9%, SODIUM NITROPRUSSIDE , NISOLDIPINE NITAZOXANIDE, NITAZOXANIDE NITHIODOTE, SODIUM , NITISINONE NITRO-DUR, NITROGLYCERIN NITROFURANTOIN, NITROFURANTOIN NITROFURANTOIN, NITROFURANTOIN, MACROCRYSTALLINE NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS), NITROFURANTOIN NITROGLYCERIN, NITROGLYCERIN NITROGLYCERIN IN DEXTROSE 5%, NITROGLYCERIN NITROLINGUAL PUMPSPRAY, NITROGLYCERIN NITROMIST, NITROGLYCERIN NITROPRESS, SODIUM NITROPRUSSIDE NITROSTAT, NITROGLYCERIN NITYR, NITISINONE NIX, (OTC) NIZATIDINE, NIZATIDINE NIZORAL ANTI-, KETOCONAZOLE (OTC) NOCDURNA, DESMOPRESSIN ACETATE NOR-QD, NORETHINDRONE NOREPINEPHRINE BITARTRATE, NOREPINEPHRINE BITARTRATE NOREPINEPHRINE BITARTRATE IN 5% DEXTROSE, NOREPINEPHRINE BITARTRATE NORETHINDRONE, NORETHINDRONE NORETHINDRONE ACETATE, NORETHINDRONE ACETATE NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL (10/11), ETHINYL ESTRADIOL NORETHINDRONE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE, ETHINYL ESTRADIOL NORGESTIMATE AND ETHINYL ESTRADIOL, ETHINYL ESTRADIOL NORINYL 1+35 21-DAY, ETHINYL ESTRADIOL NORINYL 1+35 28-DAY, ETHINYL ESTRADIOL NORITATE, METRONIDAZOLE NORMOCARB HF 25, MAGNESIUM CHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 40 APPENDIX A - PRODUCT NAME INDEX

** N ** NORMOCARB HF 35, MAGNESIUM CHLORIDE NORMOSOL-M AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE NORMOSOL-R IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE NORPACE, DISOPYRAMIDE PHOSPHATE NORPACE CR, DISOPYRAMIDE PHOSPHATE NORPRAMIN, DESIPRAMINE HYDROCHLORIDE NORTHERA, DROXIDOPA NORTREL 0.5/35-28, ETHINYL ESTRADIOL NORTREL 1/35-21, ETHINYL ESTRADIOL NORTREL 1/35-28, ETHINYL ESTRADIOL NORTREL 7/7/7, ETHINYL ESTRADIOL HYDROCHLORIDE, NORTRIPTYLINE HYDROCHLORIDE NORVASC, AMLODIPINE BESYLATE NORVIR, RITONAVIR NOURIANZ, NOXAFIL, NOXAFIL POWDERMIX KIT, POSACONAZOLE NOXIVENT, NITRIC OXIDE NUBEQA, NUCYNTA, HYDROCHLORIDE NUCYNTA ER, TAPENTADOL HYDROCHLORIDE NUEDEXTA, DEXTROMETHORPHAN HYDROBROMIDE NULIBRY, FOSDENOPTERIN HYDROBROMIDE NULYTELY, POLYETHYLENE GLYCOL 3350 NULYTELY-FLAVORED, POLYETHYLENE GLYCOL 3350 NUMBRINO, COCAINE HYDROCHLORIDE NUPLAZID, TARTRATE NURTEC ODT, SULFATE NUTRILIPID 10%, SOYBEAN OIL NUTRILIPID 20%, SOYBEAN OIL NUVARING, ETHINYL ESTRADIOL NUVESSA, METRONIDAZOLE NUVIGIL, ARMODAFINIL NUZYRA, TOSYLATE NYLIA 1/35, ETHINYL ESTRADIOL NYLIA 7/7/7, ETHINYL ESTRADIOL NYMALIZE, NIMODIPINE NYSTATIN, NYSTATIN NYSTATIN AND TRIAMCINOLONE ACETONIDE, NYSTATIN NYSTOP, NYSTATIN

** O ** OCALIVA, OBETICHOLIC ACID OCTREOSCAN, INDIUM IN-111 PENTETREOTIDE KIT OCTREOTIDE ACETATE, OCTREOTIDE ACETATE OCTREOTIDE ACETATE (PRESERVATIVE FREE), OCTREOTIDE ACETATE OCUFLOX, ODEFSEY, EMTRICITABINE ODOMZO, PHOSPHATE OFEV, ESYLATE OFIRMEV, ACETAMINOPHEN OFLOXACIN, OFLOXACIN OGEN 5, OLANZAPINE, OLANZAPINE OLANZAPINE AND FLUOXETINE HYDROCHLORIDE, FLUOXETINE HYDROCHLORIDE OLINVYK, OLMESARTAN MEDOXOMIL, OLMESARTAN MEDOXOMIL OLMESARTAN MEDOXOMIL AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE OLMESARTAN MEDOXOMIL, AMLODIPINE AND HYDROCHLOROTHIAZIDE, AMLODIPINE BESYLATE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE (OTC) OLOPATADINE HYDROCHLORIDE, OLOPATADINE HYDROCHLORIDE OLUMIANT, OLUX, CLOBETASOL PROPIONATE OLUX E, CLOBETASOL PROPIONATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 41 APPENDIX A - PRODUCT NAME INDEX

** O ** OMEGA-3-ACID ETHYL ESTERS, OMEGA-3-ACID ETHYL ESTERS OMEGAVEN, TRIGLYCERIDES , OMEPRAZOLE (OTC) OMEPRAZOLE, OMEPRAZOLE OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE (OTC) OMEPRAZOLE AND SODIUM BICARBONATE, OMEPRAZOLE OMEPRAZOLE MAGNESIUM, OMEPRAZOLE MAGNESIUM (OTC) OMIDRIA, KETOROLAC TROMETHAMINE OMNARIS, CICLESONIDE OMNIPAQUE 12, OMNIPAQUE 140, IOHEXOL OMNIPAQUE 180, IOHEXOL OMNIPAQUE 240, IOHEXOL OMNIPAQUE 300, IOHEXOL OMNIPAQUE 350, IOHEXOL OMNIPAQUE 9, IOHEXOL OMNIPRED, PREDNISOLONE ACETATE OMNISCAN, , ONDANSETRON ONDANSETRON HYDROCHLORIDE, ONDANSETRON HYDROCHLORIDE ONDANSETRON HYDROCHLORIDE PRESERVATIVE FREE, ONDANSETRON HYDROCHLORIDE ONEXTON, BENZOYL PEROXIDE ONFI, CLOBAZAM ONGENTYS, ONGLYZA, SAXAGLIPTIN HYDROCHLORIDE ONIVYDE, IRINOTECAN HYDROCHLORIDE ONPATTRO, PATISIRAN SODIUM ONUREG, AZACITIDINE ONZETRA XSAIL, SUMATRIPTAN SUCCINATE OPCICON ONE-STEP, LEVONORGESTREL (OTC) OPCON-A, NAPHAZOLINE HYDROCHLORIDE (OTC) OPSUMIT, MACITENTAN OPTIRAY 240, OPTIRAY 300, IOVERSOL OPTIRAY 320, IOVERSOL OPTIRAY 350, IOVERSOL OPTISON, HUMAN ORABLOC, HYDROCHLORIDE ORACEA, DOXYCYCLINE ORALTAG, IOHEXOL ORAPRED ODT, PREDNISOLONE SODIUM PHOSPHATE ORAQIX, LIDOCAINE ORAVERSE, MESYLATE ORAVIG, MICONAZOLE ORBACTIV, ORITAVANCIN DIPHOSPHATE ORENITRAM, TREPROSTINIL DIOLAMINE ORFADIN, NITISINONE ORGOVYX, ORIAHNN (COPACKAGED), SODIUM,ESTRADIOL,NORETHINDRONE ACETATE ORILISSA, ELAGOLIX SODIUM ORKAMBI, IVACAFTOR ORLADEYO, BEROTRALSTAT HYDROCHLORIDE CITRATE, ORPHENADRINE CITRATE ORPHENGESIC FORTE, ASPIRIN ORTIKOS, BUDESONIDE ORVATEN, MIDODRINE HYDROCHLORIDE OSELTAMIVIR PHOSPHATE, OSELTAMIVIR PHOSPHATE OSENI, ALOGLIPTIN BENZOATE OSMITROL 10% IN WATER, MANNITOL OSMITROL 10% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 15% IN WATER, MANNITOL OSMITROL 15% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 20% IN WATER, MANNITOL OSMITROL 20% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMITROL 5% IN WATER, MANNITOL

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 42 APPENDIX A - PRODUCT NAME INDEX

** O ** OSMITROL 5% IN WATER IN PLASTIC CONTAINER, MANNITOL OSMOLEX ER, AMANTADINE HYDROCHLORIDE OSMOPREP, SODIUM PHOSPHATE, DIBASIC, ANHYDROUS OSPHENA, OTEZLA, APREMILAST OTICAIR, HYDROCORTISONE OTIPRIO, CIPROFLOXACIN OTOVEL, CIPROFLOXACIN HYDROCHLORIDE OTREXUP, METHOTREXATE OXACILLIN SODIUM, OXACILLIN SODIUM OXALIPLATIN, OXALIPLATIN , OXANDROLONE OXAPROZIN, OXAPROZIN OXAYDO, HYDROCHLORIDE , OXAZEPAM OXBRYTA, VOXELOTOR , OXCARBAZEPINE NITRATE, OXICONAZOLE NITRATE OXISTAT, OXICONAZOLE NITRATE OXLUMO, SODIUM OXSORALEN-ULTRA, METHOXSALEN OXTELLAR XR, OXCARBAZEPINE OXYBUTYNIN CHLORIDE, OXYBUTYNIN CHLORIDE OXYCET, ACETAMINOPHEN OXYCODONE AND ACETAMINOPHEN, ACETAMINOPHEN OXYCODONE AND ASPIRIN, ASPIRIN OXYCODONE HYDROCHLORIDE, OXYCODONE HYDROCHLORIDE OXYCONTIN, OXYCODONE HYDROCHLORIDE HYDROCHLORIDE, OXYMORPHONE HYDROCHLORIDE , OXYTOCIN OXYTROL, OXYBUTYNIN OXYTROL FOR WOMEN, OXYBUTYNIN (OTC) OZEMPIC, SEMAGLUTIDE OZOBAX, BACLOFEN OZURDEX, DEXAMETHASONE

** P ** PACERONE, AMIODARONE HYDROCHLORIDE PACITAXEL, PACLITAXEL PACLITAXEL, PACLITAXEL PALIPERIDONE, PALIPERIDONE PALIPERIDONE PALMITATE, PALIPERIDONE PALMITATE HYDROCHLORIDE, PALONOSETRON HYDROCHLORIDE PAMELOR, NORTRIPTYLINE HYDROCHLORIDE PAMIDRONATE DISODIUM, PAMIDRONATE DISODIUM , PANCURONIUM BROMIDE PANDEL, HYDROCORTISONE PROBUTATE PANRETIN, SODIUM, PANTOPRAZOLE SODIUM PARAGARD T 380A, COPPER PAREMYD, HYDROXYAMPHETAMINE HYDROBROMIDE , PARICALCITOL PARLODEL, BROMOCRIPTINE MESYLATE PARNATE, SULFATE PAROEX, CHLORHEXIDINE GLUCONATE SULFATE, PAROMOMYCIN SULFATE PAROXETINE, PAROXETINE HYDROCHLORIDE PAROXETINE HYDROCHLORIDE, PAROXETINE HYDROCHLORIDE PAROXETINE MESYLATE, PAROXETINE MESYLATE PARSABIV, ETELCALCETIDE PASER, AMINOSALICYLIC ACID PATADAY ONCE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC) PATADAY TWICE DAILY RELIEF, OLOPATADINE HYDROCHLORIDE (OTC) PATANASE, OLOPATADINE HYDROCHLORIDE PAXIL, PAROXETINE HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 43 APPENDIX A - PRODUCT NAME INDEX

** P ** PAXIL CR, PAROXETINE HYDROCHLORIDE PEDIAPRED, PREDNISOLONE SODIUM PHOSPHATE PEG 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350 PEG-3350, POTASSIUM CHLORIDE, SODIUM BICARBONATE, SODIUM CHLORIDE, POLYETHYLENE GLYCOL PEG-3350, SODIUM SULFATE, SODIUM CHLORIDE, POTASSIUM CHLORIDE, SODIUM ASCORBATE AND PEMAZYRE, PEMFEXY, PEMETREXED PENICILLAMINE, PENICILLAMINE PENICILLIN G POTASSIUM, PENICILLIN G POTASSIUM PENICILLIN G POTASSIUM IN PLASTIC CONTAINER, PENICILLIN G POTASSIUM PENICILLIN G , PENICILLIN G PROCAINE PENICILLIN G SODIUM, PENICILLIN G SODIUM PENICILLIN V POTASSIUM, PENICILLIN V POTASSIUM PENICILLIN-VK, PENICILLIN V POTASSIUM PENLAC, CICLOPIROX PENNSAID, DICLOFENAC SODIUM PENTAM, PENTAMIDINE ISETHIONATE PENTAMIDINE ISETHIONATE, PENTAMIDINE ISETHIONATE PENTASA, MESALAMINE PENTOBARBITAL SODIUM, PENTOBARBITAL SODIUM PENTOLAIR, CYCLOPENTOLATE HYDROCHLORIDE PENTOSTATIN, PENTOSTATIN , PENTOXIFYLLINE PEPAXTO, MELPHALAN FLUFENAMIDE HYDROCHLORIDE PEPCID AC, FAMOTIDINE (OTC) PEPCID COMPLETE, CALCIUM CARBONATE (OTC) PERCOCET, ACETAMINOPHEN PERCODAN, ASPIRIN PERFOROMIST, FORMOTEROL FUMARATE PERIDEX, CHLORHEXIDINE GLUCONATE PERIKABIVEN IN PLASTIC CONTAINER, AMINO ACIDS PERINDOPRIL ERBUMINE, PERINDOPRIL ERBUMINE PERIOCHIP, CHLORHEXIDINE GLUCONATE PERIOGARD, CHLORHEXIDINE GLUCONATE PERMETHRIN, PERMETHRIN (OTC) PERMETHRIN, PERMETHRIN , PERPHENAZINE PERPHENAZINE AND AMITRIPTYLINE HYDROCHLORIDE, AMITRIPTYLINE HYDROCHLORIDE PERSANTINE, DIPYRIDAMOLE PERSERIS KIT, PEXEVA, PAROXETINE MESYLATE PFIZERPEN, PENICILLIN G POTASSIUM PHENDIMETRAZINE TARTRATE, PHENDIMETRAZINE TARTRATE PHENELZINE SULFATE, PHENELZINE SULFATE PHENOXYBENZAMINE HYDROCHLORIDE, PHENOXYBENZAMINE HYDROCHLORIDE PHENTERMINE HYDROCHLORIDE, PHENTERMINE HYDROCHLORIDE PHENTOLAMINE MESYLATE, PHENTOLAMINE MESYLATE PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PHENYLEPHRINE HYDROCHLORIDE AND HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PHENYTEK, PHENYTOIN SODIUM PHENYTOIN, PHENYTOIN PHENYTOIN SODIUM, PHENYTOIN SODIUM PHEXXI, CITRIC ACID PHILITH, ETHINYL ESTRADIOL PHOSLO GELCAPS, CALCIUM ACETATE PHOSLYRA, CALCIUM ACETATE PHOSPHOLINE IODIDE, ECHOTHIOPHATE IODIDE PHOTOFRIN, PHOTREXA, RIBOFLAVIN 5'-PHOSPHATE SODIUM PHOTREXA VISCOUS IN 20%, RIBOFLAVIN 5'-PHOSPHATE SODIUM PHOXILLUM B22K 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PHOXILLUM BK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PHYSIOLYTE IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PHYSIOSOL IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PHYTONADIONE, PHYTONADIONE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 44 APPENDIX A - PRODUCT NAME INDEX

** P ** PIFELTRO, DORAVIRINE PILOCARPINE HYDROCHLORIDE, PILOCARPINE HYDROCHLORIDE PIMECROLIMUS, PIMECROLIMUS , PIMOZIDE PIMTREA, DESOGESTREL , PINDOLOL PIOGLITAZONE HYDROCHLORIDE, PIOGLITAZONE HYDROCHLORIDE PIOGLITAZONE HYDROCHLORIDE AND GLIMEPIRIDE, GLIMEPIRIDE PIOGLITAZONE HYDROCHLORIDE AND METFORMIN HYDROCHLORIDE, METFORMIN HYDROCHLORIDE , PIPERACILLIN SODIUM PIPERACILLIN AND , PIPERACILLIN SODIUM PIQRAY, PIRMELLA 1/35, ETHINYL ESTRADIOL PIRMELLA 7/7/7, ETHINYL ESTRADIOL PIROXICAM, PIROXICAM PITAVASTATIN CALCIUM, PITAVASTATIN CALCIUM PITOCIN, OXYTOCIN PLAN B ONE-STEP, LEVONORGESTREL (OTC) PLAQUENIL, HYDROXYCHLOROQUINE SULFATE PLASMA-LYTE 148 IN WATER IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PLASMA-LYTE A IN PLASTIC CONTAINER, MAGNESIUM CHLORIDE PLAVIX, CLOPIDOGREL BISULFATE PLEGISOL IN PLASTIC CONTAINER, CALCIUM CHLORIDE PLENVU, ASCORBIC ACID PLIAGLIS, LIDOCAINE PODOFILOX, PODOFILOX POLMON, DEXCHLORPHENIRAMINE MALEATE POLOCAINE, MEPIVACAINE HYDROCHLORIDE POLOCAINE-MPF, MEPIVACAINE HYDROCHLORIDE POLYETHYLENE GLYCOL 3350, POLYETHYLENE GLYCOL 3350 (OTC) POLYETHYLENE GLYCOL 3350 AND ELECTROLYTES, POLYETHYLENE GLYCOL 3350 POLYMYXIN B SULFATE, POLYMYXIN B SULFATE POLYTRIM, POLYMYXIN B SULFATE POMALYST, PONSTEL, MEFENAMIC ACID PONVORY, PONESIMOD PORTIA-28, ETHINYL ESTRADIOL POSACONAZOLE, POSACONAZOLE POTASSIUM ACETATE, POTASSIUM ACETATE POTASSIUM CHLORIDE, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.037% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.075% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER,

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 45 APPENDIX A - PRODUCT NAME INDEX

** P ** POTASSIUM CHLORIDE 0.11% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.149% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.15% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.45%, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 0.15% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.22% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% AND SODIUM CHLORIDE 0.9%, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 0.3% IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 10MEQ, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 10MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 10MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 15MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 20MEQ, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.225% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 20MEQ IN DEXTROSE 5% IN PLASTIC CONTAINER, DEXTROSE POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 20MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 30MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 30MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45%, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9%, DEXTROSE POTASSIUM CHLORIDE 40MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 40MEQ IN PLASTIC CONTAINER, POTASSIUM CHLORIDE POTASSIUM CHLORIDE 40MEQ IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 46 APPENDIX A - PRODUCT NAME INDEX

** P ** POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND LACTATED RINGER'S IN PLASTIC CONTAINER, CALCIUM POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE 5MEQ IN DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, POTASSIUM CHLORIDE IN PLASTIC CONTAINER, POTASSIUM CHLORIDE , POTASSIUM CITRATE POTASSIUM IODIDE, POTASSIUM IODIDE (OTC) POTASSIUM , POTASSIUM PHOSPHATE, DIBASIC POVIDONE IODINE, POVIDONE-IODINE (OTC) PRADAXA, DABIGATRAN ETEXILATE MESYLATE PRAMIPEXOLE DIHYDROCHLORIDE, PRAMIPEXOLE DIHYDROCHLORIDE PRAMOSONE, HYDROCORTISONE ACETATE PRASUGREL, PRASUGREL HYDROCHLORIDE SODIUM, PRAVASTATIN SODIUM PRAZIQUANTEL, PRAZIQUANTEL PRAZOSIN HYDROCHLORIDE, PRAZOSIN HYDROCHLORIDE PRE-OP, PRE-OP II, HEXACHLOROPHENE PRE-PEN, BENZYLPENICILLOYL POLYLYSINE PRECEDEX, DEXMEDETOMIDINE HYDROCHLORIDE PRED FORTE, PREDNISOLONE ACETATE PRED MILD, PREDNISOLONE ACETATE PRED-G, GENTAMICIN SULFATE , PREDNICARBATE PREDNISOLONE, PREDNISOLONE PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE , PREDNISONE PREDNISONE INTENSOL, PREDNISONE PREGABALIN, PREGABALIN PRELONE, PREDNISOLONE PREMARIN, ESTROGENS, CONJUGATED PREMASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS PREMASOL 6% IN PLASTIC CONTAINER, AMINO ACIDS PREMPHASE 14/14, ESTROGENS, CONJUGATED PREMPRO, ESTROGENS, CONJUGATED PREPIDIL, DINOPROSTONE PRESTALIA, AMLODIPINE BESYLATE PRETOMANID, PRETOMANID PREVACID, LANSOPRAZOLE PREVACID 24 HR, LANSOPRAZOLE (OTC) PREVALITE, CHOLESTYRAMINE PREVANTICS MAXI SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) PREVANTICS SWAB, CHLORHEXIDINE GLUCONATE (OTC) PREVANTICS SWABSTICK, CHLORHEXIDINE GLUCONATE (OTC) PREVIFEM, ETHINYL ESTRADIOL PREVYMIS, PREZCOBIX, COBICISTAT PREZISTA, DARUNAVIR PRIALT, ACETATE PRIFTIN, PRILOCAINE HYDROCHLORIDE, PRILOCAINE HYDROCHLORIDE PRILOCAINE HYDROCHLORIDE AND EPINEPHRINE BITARTRATE, EPINEPHRINE BITARTRATE PRILOSEC, OMEPRAZOLE MAGNESIUM PRILOSEC OTC, OMEPRAZOLE MAGNESIUM (OTC) , PRIMAQUINE PHOSPHATE PRIMAQUINE PHOSPHATE, PRIMAQUINE PHOSPHATE PRIMATENE MIST, EPINEPHRINE (OTC) PRIMAXIN, CILASTATIN SODIUM PRIMIDONE, PRIMIDONE PRINIVIL, LISINOPRIL PRISMASOL B22GK 4/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 2/0 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 2/3.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 4/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISMASOL BGK 4/2.5 IN PLASTIC CONTAINER, CALCIUM CHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 47 APPENDIX A - PRODUCT NAME INDEX

** P ** PRISMASOL BK 0/0/1.2 IN PLASTIC CONTAINER, CALCIUM CHLORIDE PRISTIQ, DESVENLAFAXINE SUCCINATE PROAIR DIGIHALER, ALBUTEROL SULFATE PROAIR HFA, ALBUTEROL SULFATE PROAIR RESPICLICK, ALBUTEROL SULFATE PROBALAN, PROBENECID PROBENECID, PROBENECID PROBENECID AND COLCHICINE, COLCHICINE HYDROCHLORIDE, PROCAINAMIDE HYDROCHLORIDE PROCALAMINE, AMINO ACIDS PROCARDIA, NIFEDIPINE PROCARDIA XL, NIFEDIPINE PROCHLORPERAZINE, PROCHLORPERAZINE PROCHLORPERAZINE EDISYLATE, PROCHLORPERAZINE EDISYLATE PROCHLORPERAZINE MALEATE, PROCHLORPERAZINE MALEATE PROCOMP, PROCHLORPERAZINE MALEATE PROCTOFOAM HC, HYDROCORTISONE ACETATE PROCYSBI, CYSTEAMINE BITARTRATE PROGESTERONE, PROGESTERONE PROGLYCEM, DIAZOXIDE PROGRAF, TACROLIMUS PROHANCE, PROHANCE MULTIPACK, GADOTERIDOL PROLENSA, BROMFENAC SODIUM PROMACTA, OLAMINE PROMACTA KIT, ELTROMBOPAG OLAMINE PROMETH HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PHOSPHATE PROMETH VC W/ CODEINE, CODEINE PHOSPHATE PROMETHAZINE DM, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE HYDROCHLORIDE, PROMETHAZINE HYDROCHLORIDE PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE, CODEINE PHOSPHATE PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE, DEXTROMETHORPHAN PROMETHAZINE HYDROCHLORIDE AND PHENYLEPHRINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE PROMETHAZINE HYDROCHLORIDE, PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PROMETHAZINE HYDROCHLORIDE,PHENYLEPHRINE HYDROCHLORIDE W/CODEINE PHOSPHATE, CODEINE PROMETHAZINE PLAIN, PROMETHAZINE HYDROCHLORIDE PROMETHAZINE W/ DEXTROMETHORPHAN, DEXTROMETHORPHAN HYDROBROMIDE PROMETHAZINE WITH CODEINE, CODEINE PHOSPHATE PROMETHEGAN, PROMETHAZINE HYDROCHLORIDE PROMETRIUM, PROGESTERONE HYDROCHLORIDE, PROPAFENONE HYDROCHLORIDE PROPARACAINE HYDROCHLORIDE, PROPARACAINE HYDROCHLORIDE PROPECIA, FINASTERIDE PROPOFOL, PROPOFOL PROPRANOLOL HYDROCHLORIDE, PROPRANOLOL HYDROCHLORIDE PROPRANOLOL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE PROPYLTHIOURACIL, PROPYLTHIOURACIL PROSCAR, FINASTERIDE PROSOL 20% SULFITE FREE IN PLASTIC CONTAINER, AMINO ACIDS PROSTIN E2, DINOPROSTONE PROSTIN VR PEDIATRIC, ALPROSTADIL SULFATE, PROTONIX, PANTOPRAZOLE SODIUM PROTONIX IV, PANTOPRAZOLE SODIUM PROTOPAM CHLORIDE, CHLORIDE PROTOPIC, TACROLIMUS HYDROCHLORIDE, PROTRIPTYLINE HYDROCHLORIDE PROVAYBLUE, BLUE PROVENTIL-HFA, ALBUTEROL SULFATE PROVERA, MEDROXYPROGESTERONE ACETATE PROVIGIL, MODAFINIL PROVOCHOLINE, CHLORIDE PROZAC, FLUOXETINE HYDROCHLORIDE PSEUDOEPHEDRINE HYDROCHLORIDE, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) PULMICORT FLEXHALER, BUDESONIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 48 APPENDIX A - PRODUCT NAME INDEX

** P ** PULMICORT RESPULES, BUDESONIDE PUR-WASH, PURIFIED WATER (OTC) PURINETHOL, MERCAPTOPURINE PURIXAN, MERCAPTOPURINE PYLARIFY, PIFLUFOLASTAT F-18 PYLERA, POTASSIUM PYRAZINAMIDE, PYRAZINAMIDE PYRIDOSTIGMINE BROMIDE, PYRIDOSTIGMINE BROMIDE PYRIDOXINE HYDROCHLORIDE, PYRIDOXINE HYDROCHLORIDE PYRIMETHAMINE, PYRIMETHAMINE PYTEST, , C-14 PYTEST KIT, UREA, C-14

** Q ** QBRELIS, LISINOPRIL QBREXZA, GLYCOPYRRONIUM TOSYLATE QDOLO, TRAMADOL HYDROCHLORIDE QELBREE, HYDROCHLORIDE QINLOCK, QNASL, BECLOMETHASONE DIPROPIONATE QOLIANA, BRIMONIDINE TARTRATE QSYMIA, PHENTERMINE HYDROCHLORIDE QTERN, DAPAGLIFLOZIN QUADRAMET, SM-153 LEXIDRONAM PENTASODIUM QUALAQUIN, SULFATE QUARTETTE, ETHINYL ESTRADIOL QUASENSE, ETHINYL ESTRADIOL QUDEXY XR, QUELICIN, SUCCINYLCHOLINE CHLORIDE FUMARATE, QUETIAPINE FUMARATE QUILLICHEW ER, METHYLPHENIDATE HYDROCHLORIDE QUILLIVANT XR, METHYLPHENIDATE HYDROCHLORIDE QUINAPRIL HYDROCHLORIDE, QUINAPRIL HYDROCHLORIDE QUINAPRIL HYDROCHLORIDE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE QUINARETIC, HYDROCHLOROTHIAZIDE QUINIDINE GLUCONATE, QUINIDINE GLUCONATE QUINIDINE SULFATE, QUINIDINE SULFATE QUININE SULFATE, QUININE SULFATE QUTENZA, QUZYTTIR, CETIRIZINE HYDROCHLORIDE QVAR REDIHALER, BECLOMETHASONE DIPROPIONATE

** R ** R- 10, HYDROCHLORIDE RABEPRAZOLE SODIUM, RABEPRAZOLE SODIUM RADICAVA, RADIOGARDASE (), FERRIC HEXACYANOFERRATE(II) RADIOGENIX SYSTEM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR RALOXIFENE HYDROCHLORIDE, RALOXIFENE HYDROCHLORIDE , RAMELTEON RAMIPRIL, RAMIPRIL RANEXA, HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE (OTC) RANITIDINE HYDROCHLORIDE, RANITIDINE HYDROCHLORIDE RANOLAZINE, RANOLAZINE RAPAFLO, RAPAMUNE, RAPIVAB, PERAMIVIR RASAGILINE MESYLATE, RASAGILINE MESYLATE RASUVO, METHOTREXATE RAVICTI, PHENYLBUTYRATE RAYALDEE, CALCIFEDIOL RAYOS, PREDNISONE RAZADYNE ER, GALANTAMINE HYDROBROMIDE READI-CAT 2, BARIUM SULFATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 49 APPENDIX A - PRODUCT NAME INDEX

** R ** READI-CAT 2 SMOOTHIE, BARIUM SULFATE READYPREP CHG, CHLORHEXIDINE GLUCONATE (OTC) REBETOL, RECARBRIO, CILASTATIN SODIUM RECLAST, ZOLEDRONIC ACID RECTIV, NITROGLYCERIN REDITREX, METHOTREXATE REGLAN, METOCLOPRAMIDE HYDROCHLORIDE REGONOL, PYRIDOSTIGMINE BROMIDE RELENZA, RELISTOR, METHYLNALTREXONE BROMIDE RELPAX, ELETRIPTAN HYDROBROMIDE REMERON, MIRTAZAPINE REMERON SOLTAB, MIRTAZAPINE HYDROCHLORIDE, REMIFENTANIL HYDROCHLORIDE REMODULIN, TREPROSTINIL RENACIDIN, CITRIC ACID RENAGEL, HYDROCHLORIDE RENOVA, TRETINOIN RENVELA, SEVELAMER CARBONATE , REPAGLINIDE REQUIP, HYDROCHLORIDE RESECTISOL IN PLASTIC CONTAINER, MANNITOL RESTASIS, CYCLOSPORINE RESTASIS MULTIDOSE, CYCLOSPORINE RESTORIL, RETEVMO, RETIN-A, TRETINOIN RETIN-A MICRO, TRETINOIN RETIN-A-MICRO, TRETINOIN RETISERT, FLUOCINOLONE ACETONIDE RETROVIR, ZIDOVUDINE REVATIO, CITRATE REVLIMID, LENALIDOMIDE REVONTO, DANTROLENE SODIUM REXULTI, REYATAZ, ATAZANAVIR SULFATE REYVOW, SUCCINATE REZIPRES, EPHEDRINE HYDROCHLORIDE RHINOCORT ALLERGY, BUDESONIDE (OTC) RHOFADE, OXYMETAZOLINE HYDROCHLORIDE RHOPRESSA, NETARSUDIL MESYLATE RIBAVIRIN, RIBAVIRIN RIDAURA, AURANOFIN RIFABUTIN, RIFABUTIN RIFADIN, RIFAMPIN RIFAMPIN, RIFAMPIN RILUTEK, RILUZOLE RILUZOLE, RILUZOLE RIMACTANE, RIFAMPIN RIMANTADINE HYDROCHLORIDE, RIMANTADINE HYDROCHLORIDE RIMSO-50, DIMETHYL SULFOXIDE RINGER'S IN PLASTIC CONTAINER, CALCIUM CHLORIDE RINVOQ, RIOMET, METFORMIN HYDROCHLORIDE RISEDRONATE SODIUM, RISEDRONATE SODIUM RISPERDAL, RISPERIDONE RISPERDAL CONSTA, RISPERIDONE RISPERIDONE, RISPERIDONE RITALIN, METHYLPHENIDATE HYDROCHLORIDE RITALIN LA, METHYLPHENIDATE HYDROCHLORIDE RITONAVIR, RITONAVIR RIVASTIGMINE, RIVASTIGMINE RIVASTIGMINE TARTRATE, RIVASTIGMINE TARTRATE RIZATRIPTAN BENZOATE, RIZATRIPTAN BENZOATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 50 APPENDIX A - PRODUCT NAME INDEX

** R ** ROBAXIN, METHOCARBAMOL ROBINUL, GLYCOPYRROLATE ROBINUL FORTE, GLYCOPYRROLATE ROCALTROL, CALCITRIOL ROCKLATAN, LATANOPROST , ROCURONIUM BROMIDE ROFLUMILAST, ROFLUMILAST ROGAINE (FOR MEN), MINOXIDIL (OTC) ROGAINE (FOR WOMEN), MINOXIDIL (OTC) ROGAINE EXTRA STRENGTH (FOR MEN), MINOXIDIL (OTC) ROMIDEPSIN, ROMIDEPSIN ROPINIROLE HYDROCHLORIDE, ROPINIROLE HYDROCHLORIDE ROPIVACAINE HYDROCHLORIDE, ROPIVACAINE HYDROCHLORIDE ROSUVASTATIN CALCIUM, ROSUVASTATIN CALCIUM ROSZET, EZETIMIBE ROWASA, MESALAMINE ROXICODONE, OXYCODONE HYDROCHLORIDE ROZEREM, RAMELTEON ROZLYTREK, RUBRACA, CAMSYLATE RUBY-FILL, RUBIDIUM CHLORIDE RB-82 RUFINAMIDE, RUFINAMIDE RUKOBIA, FOSTEMSAVIR TROMETHAMINE RUZURGI, AMIFAMPRIDINE RYANODEX, DANTROLENE SODIUM RYBELSUS, SEMAGLUTIDE RYDAPT, RYTARY, CARBIDOPA RYTHMOL SR, PROPAFENONE HYDROCHLORIDE

** S ** SABRIL, SAFYRAL, DROSPIRENONE SALAGEN, PILOCARPINE HYDROCHLORIDE SALONPAS, (OTC) SAMSCA, TOLVAPTAN SANCUSO, GRANISETRON SANDIMMUNE, CYCLOSPORINE SANDOSTATIN, OCTREOTIDE ACETATE SANDOSTATIN LAR, OCTREOTIDE ACETATE SAPHRIS, ASENAPINE MALEATE SAPROPTERIN DIHYDROCHLORIDE, SAPROPTERIN DIHYDROCHLORIDE SAVAYSA, TOSYLATE SAVELLA, HYDROCHLORIDE SAXENDA, LIRAGLUTIDE RECOMBINANT SCANDONEST L, LEVONORDEFRIN SCANDONEST PLAIN, MEPIVACAINE HYDROCHLORIDE SCENESSE, SCLEROSOL, TALC , SCOPOLAMINE SEASONALE, ETHINYL ESTRADIOL SEASONIQUE, ETHINYL ESTRADIOL SECUADO, ASENAPINE SEGLUROMET, ERTUGLIFLOZIN SEIZALAM, MIDAZOLAM HYDROCHLORIDE SELEGILINE HYDROCHLORIDE, SELEGILINE HYDROCHLORIDE SELENIOUS ACID, SELENIOUS ACID , SELENIUM SULFIDE SELZENTRY, MARAVIROC SENSIPAR, CINACALCET HYDROCHLORIDE SENSORCAINE, BUPIVACAINE HYDROCHLORIDE SEPTOCAINE, ARTICAINE HYDROCHLORIDE SEPTRA, SULFAMETHOXAZOLE SEPTRA DS, SULFAMETHOXAZOLE SEREVENT, SALMETEROL XINAFOATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 51 APPENDIX A - PRODUCT NAME INDEX

** S ** SERNIVO, BETAMETHASONE DIPROPIONATE SEROMYCIN, SEROQUEL, QUETIAPINE FUMARATE SEROQUEL XR, QUETIAPINE FUMARATE HYDROCHLORIDE, SERTRALINE HYDROCHLORIDE SESQUIENT, FOSPHENYTOIN SODIUM SETLAKIN, ETHINYL ESTRADIOL SEVELAMER CARBONATE, SEVELAMER CARBONATE SEVELAMER HYDROCHLORIDE, SEVELAMER HYDROCHLORIDE , SEVOFLURANE SEYSARA, HYDROCHLORIDE SFROWASA, MESALAMINE SIGNIFOR, PASIREOTIDE DIASPARTATE SIGNIFOR LAR KIT, PASIREOTIDE PAMOATE SIKLOS, HYDROXYUREA SILDENAFIL CITRATE, SILDENAFIL CITRATE SILENOR, DOXEPIN HYDROCHLORIDE SILODOSIN, SILODOSIN SILVADENE, SIMBRINZA, BRIMONIDINE TARTRATE SIMLIYA, DESOGESTREL SIMPESSE, ETHINYL ESTRADIOL SIMVASTATIN, SIMVASTATIN SINE-AID IB, IBUPROFEN (OTC) SINEMET, CARBIDOPA SINGULAIR, MONTELUKAST SODIUM SINUVA, MOMETASONE FUROATE SIROLIMUS, SIROLIMUS SIRTURO, FUMARATE SITAVIG, ACYCLOVIR SIVEXTRO, PHOSPHATE SKELAXIN, METAXALONE SKLICE, IVERMECTIN (OTC) SKYLA, LEVONORGESTREL SLYND, DROSPIRENONE SMOFLIPID 20%, FISH OIL SOAANZ, TORSEMIDE SODIUM ACETATE, SODIUM ACETATE SODIUM BICARBONATE, SODIUM BICARBONATE SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 0.9%, SODIUM CHLORIDE SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 0.9% IN STERILE PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 14.6%, SODIUM CHLORIDE SODIUM CHLORIDE 23.4%, SODIUM CHLORIDE SODIUM CHLORIDE 3% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM CHLORIDE 5% IN PLASTIC CONTAINER, SODIUM CHLORIDE SODIUM FERRIC GLUCONATE COMPLEX IN , FERRIC OXYHYDROXIDE F-18, SODIUM FLUORIDE F-18 SODIUM IODIDE I 123, SODIUM IODIDE I-123 SODIUM IODIDE I 131, SODIUM IODIDE I-131 , SODIUM NITRITE SODIUM NITROPRUSSIDE, SODIUM NITROPRUSSIDE SODIUM PHENYLACETATE AND SODIUM BENZOATE, SODIUM BENZOATE SODIUM PHENYLBUTYRATE, SODIUM PHENYLBUTYRATE SODIUM PHOSPHATES IN PLASTIC CONTAINER, SODIUM PHOSPHATE, DIBASIC, HEPTAHYDRATE SODIUM POLYSTYRENE SULFONATE, SODIUM POLYSTYRENE SULFONATE SODIUM SULFATE, POTASSIUM SULFATE AND MAGNESIUM SULFATE, MAGNESIUM SULFATE SODIUM TETRADECYL SULFATE, SODIUM TETRADECYL SULFATE SODIUM , SOJOURN, SEVOFLURANE SUCCINATE, SOLIFENACIN SUCCINATE SOLODYN, MINOCYCLINE HYDROCHLORIDE SOLOSEC, SECNIDAZOLE SOLTAMOX, CITRATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 52 APPENDIX A - PRODUCT NAME INDEX

** S ** SOLU-CORTEF, HYDROCORTISONE SODIUM SUCCINATE SOLU-MEDROL, METHYLPREDNISOLONE SODIUM SUCCINATE SOLUPREP, CHLORHEXIDINE GLUCONATE (OTC) SOMA, CARISOPRODOL SOMATULINE DEPOT, LANREOTIDE ACETATE SONATA, SOOLANTRA, IVERMECTIN 3% IN PLASTIC CONTAINER, SORBITOL SORBITOL 3.3% IN PLASTIC CONTAINER, SORBITOL SORBITOL-MANNITOL IN PLASTIC CONTAINER, MANNITOL SORIATANE, ACITRETIN SORILUX, CALCIPOTRIENE SORINE, SOTALOL HYDROCHLORIDE SOTALOL HYDROCHLORIDE, SOTALOL HYDROCHLORIDE SOTRADECOL, SODIUM TETRADECYL SULFATE SOTYLIZE, SOTALOL HYDROCHLORIDE SOVALDI, SOFOSBUVIR SPECTAZOLE, ECONAZOLE NITRATE SPINRAZA, NUSINERSEN SODIUM SPIRIVA, SPIRIVA RESPIMAT, TIOTROPIUM BROMIDE SPIRONOLACTONE, SPIRONOLACTONE SPIRONOLACTONE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE SPORANOX, ITRACONAZOLE SPRAVATO, HYDROCHLORIDE SPRINTEC, ETHINYL ESTRADIOL SPRITAM, LEVETIRACETAM SPRIX, KETOROLAC TROMETHAMINE SPRYCEL, SPS, SODIUM POLYSTYRENE SULFONATE SPY AGENT GREEN KIT, INDOCYANINE GREEN SSD, STALEVO 100, CARBIDOPA STALEVO 125, CARBIDOPA STALEVO 150, CARBIDOPA STALEVO 200, CARBIDOPA STALEVO 50, CARBIDOPA STALEVO 75, CARBIDOPA STAXYN, VARDENAFIL HYDROCHLORIDE STEGLATRO, ERTUGLIFLOZIN STEGLUJAN, ERTUGLIFLOZIN STENDRA, STERILE WATER, STERILE WATER FOR IRRIGATION STERILE WATER FOR INJECTION, STERILE WATER FOR INJECTION STERILE WATER FOR INJECTION IN PLASTIC CONTAINER, STERILE WATER FOR INJECTION STERILE WATER IN PLASTIC CONTAINER, STERILE WATER FOR IRRIGATION STERITALC, TALC STIE-CORT, HYDROCORTISONE STIOLTO RESPIMAT, HYDROCHLORIDE STIVARGA, STRATTERA, ATOMOXETINE HYDROCHLORIDE SULFATE, STREPTOMYCIN SULFATE STRIBILD, COBICISTAT STRIVERDI RESPIMAT, OLODATEROL HYDROCHLORIDE STROMECTOL, IVERMECTIN STRONTIUM CHLORIDE SR-89, STRONTIUM CHLORIDE SR-89 SUBLIMAZE PRESERVATIVE FREE, FENTANYL CITRATE SUBLOCADE, BUPRENORPHINE SUBOXONE, BUPRENORPHINE HYDROCHLORIDE SUBSYS, FENTANYL SUCCINYLCHOLINE CHLORIDE, SUCCINYLCHOLINE CHLORIDE SUCRALFATE, SUCRALFATE SUDAFED 12 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) SUDAFED 24 HOUR, PSEUDOEPHEDRINE HYDROCHLORIDE (OTC) SUFENTA PRESERVATIVE FREE, SUFENTANIL CITRATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 53 APPENDIX A - PRODUCT NAME INDEX

** S ** SUFENTANIL CITRATE, SUFENTANIL CITRATE SULAR, NISOLDIPINE SULFACETAMIDE SODIUM, SULFACETAMIDE SODIUM SULFACETAMIDE SODIUM AND PREDNISOLONE SODIUM PHOSPHATE, PREDNISOLONE SODIUM PHOSPHATE SULFADIAZINE, SULFADIAZINE SULFAMETHOXAZOLE AND , SULFAMETHOXAZOLE SULFAMYLON, MAFENIDE ACETATE SULFASALAZINE, SULFASALAZINE SULFATRIM PEDIATRIC, SULFAMETHOXAZOLE , SULINDAC SUMATRIPTAN, SUMATRIPTAN SUMATRIPTAN, SUMATRIPTAN SUCCINATE SUMATRIPTAN AND NAPROXEN SODIUM, NAPROXEN SODIUM SUMATRIPTAN SUCCINATE, SUMATRIPTAN SUCCINATE SUNOSI, HYDROCHLORIDE SUPPRELIN LA, ACETATE SUPRANE, DESFLURANE SUPRAX, CEFIXIME SUPREP BOWEL PREP KIT, MAGNESIUM SULFATE SUSTIVA, EFAVIRENZ SUSTOL, GRANISETRON SUTAB (COPACKAGED), MAGNESIUM SULFATE SUTENT, MALATE SYEDA, DROSPIRENONE SYLEVIA, ETHINYL ESTRADIOL SYMBICORT, BUDESONIDE SYMBYAX, FLUOXETINE HYDROCHLORIDE SYMDEKO (COPACKAGED), IVACAFTOR SYMFI, EFAVIRENZ SYMFI LO, EFAVIRENZ SYMJEPI, EPINEPHRINE SYMLIN, PRAMLINTIDE ACETATE SYMPAZAN, CLOBAZAM SYMPROIC, TOSYLATE SYMTUZA, COBICISTAT SYNALAR, FLUOCINOLONE ACETONIDE SYNAREL, ACETATE SYNDROS, DRONABINOL SYNERA, LIDOCAINE SYNERCID, DALFOPRISTIN SYNJARDY, EMPAGLIFLOZIN SYNJARDY XR, EMPAGLIFLOZIN SYNRIBO, OMACETAXINE MEPESUCCINATE SYNTHROID, LEVOTHYROXINE SODIUM ** SYPRINE, TRIENTINE HYDROCHLORIDE

** T ** TAB-PROFEN, IBUPROFEN (OTC) TABRECTA, HYDROCHLORIDE TACLONEX, BETAMETHASONE DIPROPIONATE TACROLIMUS, TACROLIMUS TADALAFIL, TADALAFIL TAFINLAR, MESYLATE TAFLUPROST, TAFLUPROST TAGAMET HB, CIMETIDINE (OTC) TAGITOL V, BARIUM SULFATE TAGRISSO, MESYLATE TALC, TALC TALICIA, AMOXICILLIN TALZENNA, TOSYLATE TAMIFLU, OSELTAMIVIR PHOSPHATE TAMOXIFEN CITRATE, TAMOXIFEN CITRATE TAMSULOSIN HYDROCHLORIDE, TAMSULOSIN HYDROCHLORIDE TAPAZOLE, METHIMAZOLE TARCEVA, ERLOTINIB HYDROCHLORIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 54 APPENDIX A - PRODUCT NAME INDEX

** T ** TARGRETIN, BEXAROTENE TARKA, TRANDOLAPRIL TASIGNA, HYDROCHLORIDE TASMAR, TAUVID, FLORTAUCIPIR F-18 TAVABOROLE, TAVABOROLE TAVALISSE, FOSTAMATINIB DISODIUM TAXOTERE, DOCETAXEL TAYTULLA, ETHINYL ESTRADIOL TAZAROTENE, TAZAROTENE TAZICEF, CEFTAZIDIME TAZORAC, TAZAROTENE TAZTIA XT, DILTIAZEM HYDROCHLORIDE TAZVERIK, TAZEMETOSTAT HYDROBROMIDE TECFIDERA, DIMETHYL FUMARATE TECHNELITE, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR TECHNESCAN, TECHNETIUM TC-99M OXIDRONATE KIT TECHNESCAN MAG3, TECHNETIUM TC-99M MERTIATIDE KIT TECHNESCAN PYP KIT, TECHNETIUM TC-99M PYROPHOSPHATE KIT TECHNETIUM TC 99M SESTAMIBI, TECHNETIUM TC-99M SESTAMIBI KIT TECHNETIUM TC-99M MEBROFENIN, TECHNETIUM TC-99M MEBROFENIN KIT TECHNETIUM TC99M MERTIATIDE KIT, TECHNETIUM TC-99M MERTIATIDE KIT TEFLARO, TEGRETOL, CARBAMAZEPINE TEGRETOL-XR, CARBAMAZEPINE TEGSEDI, INOTERSEN SODIUM TEKTURNA, ALISKIREN HEMIFUMARATE TEKTURNA HCT, ALISKIREN HEMIFUMARATE TELMISARTAN, TELMISARTAN TELMISARTAN AND AMLODIPINE, AMLODIPINE BESYLATE TELMISARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE TEMAZEPAM, TEMAZEPAM TEMBEXA, TEMIXYS, LAMIVUDINE TEMODAR, TEMOZOLOMIDE, TEMOZOLOMIDE , TEMSIROLIMUS TENOFOVIR DISOPROXIL FUMARATE, TENOFOVIR DISOPROXIL FUMARATE TENORETIC 100, ATENOLOL TENORETIC 50, ATENOLOL TENORMIN, ATENOLOL TEPADINA, TEPMETKO, HYDROCHLORIDE HYDROCHLORIDE, TERAZOSIN HYDROCHLORIDE TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE (OTC) TERBINAFINE HYDROCHLORIDE, TERBINAFINE HYDROCHLORIDE TERBUTALINE SULFATE, TERBUTALINE SULFATE , TERCONAZOLE TERIFLUNOMIDE, TERIFLUNOMIDE TERIL, CARBAMAZEPINE TESSALON, BENZONATATE TESTIM, TESTOSTERONE TESTOPEL, TESTOSTERONE TESTOSTERONE, TESTOSTERONE TESTOSTERONE CYPIONATE, TESTOSTERONE CYPIONATE , TESTOSTERONE ENANTHATE TETRABENAZINE, TETRABENAZINE HYDROCHLORIDE, TETRACAINE HYDROCHLORIDE TETRACYCLINE HYDROCHLORIDE, TETRACYCLINE HYDROCHLORIDE TEXACORT, HYDROCORTISONE THALITONE, CHLORTHALIDONE THALLOUS CHLORIDE TL 201, THALLOUS CHLORIDE TL-201 THALOMID, THAM, TROMETHAMINE THEO-24, THEOPHYLLINE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 55 APPENDIX A - PRODUCT NAME INDEX

** T ** THEOCHRON, THEOPHYLLINE THEOPHYLLINE, THEOPHYLLINE THEOPHYLLINE 0.04% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.08% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.16% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THEOPHYLLINE 0.32% AND DEXTROSE 5% IN PLASTIC CONTAINER, THEOPHYLLINE THERMAZENE, SILVER SULFADIAZINE THEROXIDIL, MINOXIDIL (OTC) HYDROCHLORIDE, THIAMINE HYDROCHLORIDE THIOGUANINE, THIOGUANINE THIOLA, THIOLA EC, TIOPRONIN HYDROCHLORIDE, THIORIDAZINE HYDROCHLORIDE THIOTEPA, THIOTEPA THIOTHIXENE, THIOTHIXENE THYQUIDITY, LEVOTHYROXINE SODIUM THYRO-TABS, LEVOTHYROXINE SODIUM ** THYROSAFE, POTASSIUM IODIDE (OTC) THYROSHIELD, POTASSIUM IODIDE (OTC) TIAGABINE HYDROCHLORIDE, TIAGABINE HYDROCHLORIDE TIAZAC, DILTIAZEM HYDROCHLORIDE TIBSOVO, TICAGRELOR, TICAGRELOR HYDROCHLORIDE, TICLOPIDINE HYDROCHLORIDE TIGAN, HYDROCHLORIDE , TIGECYCLINE TIGLUTIK KIT, RILUZOLE TIKOSYN, DOFETILIDE TIMOLOL, TIMOLOL TIMOLOL MALEATE, TIMOLOL MALEATE TIMOPTIC, TIMOLOL MALEATE TIMOPTIC IN OCUDOSE, TIMOLOL MALEATE TIMOPTIC-XE, TIMOLOL MALEATE TINDAMAX, TINIDAZOLE, TINIDAZOLE , TIOCONAZOLE (OTC) TIOPRONIN, TIOPRONIN TIROFIBAN HYDROCHLORIDE, TIROFIBAN HYDROCHLORIDE TIROSINT, LEVOTHYROXINE SODIUM TIROSINT-SOL, LEVOTHYROXINE SODIUM TIS-U-SOL, MAGNESIUM SULFATE TIS-U-SOL IN PLASTIC CONTAINER, MAGNESIUM SULFATE TISSUEBLUE, BRILLIANT BLUE G TIVICAY, DOLUTEGRAVIR SODIUM TIVICAY PD, DOLUTEGRAVIR SODIUM HYDROCHLORIDE, TIZANIDINE HYDROCHLORIDE TOBI, TOBRAMYCIN TOBI PODHALER, TOBRAMYCIN TOBRADEX, DEXAMETHASONE TOBRADEX ST, DEXAMETHASONE TOBRAMYCIN, TOBRAMYCIN TOBRAMYCIN AND DEXAMETHASONE, DEXAMETHASONE TOBRAMYCIN SULFATE, TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE (PHARMACY BULK), TOBRAMYCIN SULFATE TOBRAMYCIN SULFATE IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER, TOBRAMYCIN SULFATE TOBREX, TOBRAMYCIN CITRATE, TOFACITINIB CITRATE TOFRANIL, IMIPRAMINE HYDROCHLORIDE TOLAK, FLUOROURACIL , TOLBUTAMIDE TOLCAPONE, TOLCAPONE SODIUM, TOLMETIN SODIUM TOLSURA, ITRACONAZOLE TOLTERODINE TARTRATE, TOLTERODINE TARTRATE TOLVAPTAN, TOLVAPTAN

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 56 APPENDIX A - PRODUCT NAME INDEX

** T ** TOPAMAX, TOPIRAMATE TOPICORT, DESOXIMETASONE TOPIRAMATE, TOPIRAMATE TOPOTECAN HYDROCHLORIDE, TOPOTECAN HYDROCHLORIDE TOPROL-XL, METOPROLOL SUCCINATE TOREMIFENE CITRATE, TOREMIFENE CITRATE TORISEL, TEMSIROLIMUS TORSEMIDE, TORSEMIDE TOSYMRA, SUMATRIPTAN TOTECT, DEXRAZOXANE HYDROCHLORIDE TOVIAZ, FESOTERODINE FUMARATE TPN ELECTROLYTES IN PLASTIC CONTAINER, CALCIUM CHLORIDE TPOXX, TECOVIRIMAT TRACLEER, BOSENTAN TRADJENTA, LINAGLIPTIN TRALEMENT, CUPRIC SULFATE TRAMADOL HYDROCHLORIDE, TRAMADOL HYDROCHLORIDE TRAMADOL HYDROCHLORIDE AND ACETAMINOPHEN, ACETAMINOPHEN TRANDATE, LABETALOL HYDROCHLORIDE TRANDOLAPRIL, TRANDOLAPRIL TRANDOLAPRIL AND VERAPAMIL HYDROCHLORIDE, TRANDOLAPRIL TRANEXAMIC ACID, TRANEXAMIC ACID TRANSDERM SCOP, SCOPOLAMINE TRANXENE, CLORAZEPATE DIPOTASSIUM TRANYLCYPROMINE SULFATE, TRANYLCYPROMINE SULFATE TRAVASOL 10% IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 5.5% IN PLASTIC CONTAINER, AMINO ACIDS TRAVASOL 8.5% IN PLASTIC CONTAINER, AMINO ACIDS TRAVATAN Z, TRAVOPROST TRAVOPROST, TRAVOPROST HYDROCHLORIDE, TRAZODONE HYDROCHLORIDE TREANDA, BENDAMUSTINE HYDROCHLORIDE TRECATOR, ETHIONAMIDE TRELEGY ELLIPTA, FLUTICASONE FUROATE TRELSTAR, PAMOATE TREPROSTINIL, TREPROSTINIL TRETINOIN, TRETINOIN TREXALL, METHOTREXATE SODIUM TREXIMET, NAPROXEN SODIUM TREZIX, ACETAMINOPHEN TRI LO SPRINTEC, ETHINYL ESTRADIOL TRI-ESTARYLLA, ETHINYL ESTRADIOL TRI-LEGEST 21, ETHINYL ESTRADIOL TRI-LEGEST FE, ETHINYL ESTRADIOL TRI-LINYAH, ETHINYL ESTRADIOL TRI-LO-ESTARYLLA, ETHINYL ESTRADIOL TRI-LO-MILI, ETHINYL ESTRADIOL TRI-LUMA, FLUOCINOLONE ACETONIDE TRI-MILI, ETHINYL ESTRADIOL TRI-NORINYL 28-DAY, ETHINYL ESTRADIOL TRI-SPRINTEC, ETHINYL ESTRADIOL TRIACIN-C, CODEINE PHOSPHATE TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE (OTC) TRIAMCINOLONE ACETONIDE, TRIAMCINOLONE ACETONIDE TRIAMCINOLONE ACETONIDE IN ABSORBASE, TRIAMCINOLONE ACETONIDE TRIAMTERENE, TRIAMTERENE TRIAMTERENE AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE TRIAZOLAM, TRIAZOLAM TRIBENZOR, AMLODIPINE BESYLATE TRICOR, FENOFIBRATE TRIDERM, TRIAMCINOLONE ACETONIDE TRIENTINE HYDROCHLORIDE, TRIENTINE HYDROCHLORIDE TRIESENCE, TRIAMCINOLONE ACETONIDE TRIFERIC, FERRIC PYROPHOSPHATE CITRATE TRIFERIC AVNU, FERRIC PYROPHOSPHATE CITRATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 57 APPENDIX A - PRODUCT NAME INDEX

** T ** HYDROCHLORIDE, TRIFLUOPERAZINE HYDROCHLORIDE , TRIFLURIDINE TRIGLIDE, FENOFIBRATE HYDROCHLORIDE, TRIHEXYPHENIDYL HYDROCHLORIDE TRIJARDY XR, EMPAGLIFLOZIN TRIKAFTA (COPACKAGED), ELEXACAFTOR, IVACAFTOR, TEZACAFTOR TRILEPTAL, OXCARBAZEPINE TRILIPIX, CHOLINE FENOFIBRATE TRILYTE, POLYETHYLENE GLYCOL 3350 TRIMETHOBENZAMIDE HYDROCHLORIDE, TRIMETHOBENZAMIDE HYDROCHLORIDE TRIMETHOPRIM, TRIMETHOPRIM TRIMETHOPRIM SULFATE AND POLYMYXIN B SULFATE, POLYMYXIN B SULFATE MALEATE, TRIMIPRAMINE MALEATE TRINTELLIX, HYDROBROMIDE TRIOSTAT, LIOTHYRONINE SODIUM TRIPTODUR KIT, TRIPTORELIN PAMOATE TRISENOX, ARSENIC TRIOXIDE TRIUMEQ, ABACAVIR SULFATE TRIVAGIZOLE 3, CLOTRIMAZOLE (OTC) TRIVORA-28, ETHINYL ESTRADIOL TRIZIVIR, ABACAVIR SULFATE TROKENDI XR, TOPIRAMATE TROPHAMINE, AMINO ACIDS TROPHAMINE 10%, AMINO ACIDS TROPICACYL, TROPICAMIDE TROPICAMIDE, TROPICAMIDE , TROSPIUM CHLORIDE TRULANCE, PLECANATIDE TRUSELTIQ, PHOSPHATE TRUSOPT, DORZOLAMIDE HYDROCHLORIDE TRUVADA, EMTRICITABINE TUDORZA PRESSAIR, ACLIDINIUM BROMIDE TUKYSA, TURALIO, HYDROCHLORIDE TUSSICAPS, CHLORPHENIRAMINE POLISTIREX TUXARIN ER, CHLORPHENIRAMINE MALEATE TUZISTRA XR, CHLORPHENIRAMINE POLISTIREX TWIRLA, ETHINYL ESTRADIOL TWYNSTA, AMLODIPINE BESYLATE TYBLUME, ETHINYL ESTRADIOL TYBOST, COBICISTAT TYDEMY, DROSPIRENONE TYGACIL, TIGECYCLINE TYKERB, LAPATINIB DITOSYLATE , ACETAMINOPHEN (OTC) TYMLOS, ABALOPARATIDE TYVASO, TREPROSTINIL TYZINE, TETRAHYDROZOLINE HYDROCHLORIDE

** U ** U-CORT, HYDROCORTISONE ACETATE UBRELVY, UCERIS, BUDESONIDE UKONIQ, TOSYLATE ULORIC, FEBUXOSTAT ULTANE, SEVOFLURANE ULTIVA, REMIFENTANIL HYDROCHLORIDE ULTRA-TECHNEKOW FM, TECHNETIUM TC-99M SODIUM PERTECHNETATE GENERATOR ULTRACET, ACETAMINOPHEN ULTRAM, TRAMADOL HYDROCHLORIDE ULTRATAG, TECHNETIUM TC-99M RED KIT ULTRAVATE, HALOBETASOL PROPIONATE ULTRAVIST (PHARMACY BULK), ULTRAVIST 300, IOPROMIDE ULTRAVIST 370, IOPROMIDE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 58 APPENDIX A - PRODUCT NAME INDEX

** U ** UNASYN, AMPICILLIN SODIUM UNISOM, DOXYLAMINE SUCCINATE (OTC) UNITHROID, LEVOTHYROXINE SODIUM ** UPNEEQ, OXYMETAZOLINE HYDROCHLORIDE UPTRAVI, SELEXIPAG UREX, METHENAMINE HIPPURATE UROCIT-K, POTASSIUM CITRATE UROXATRAL, ALFUZOSIN HYDROCHLORIDE URSO 250, URSODIOL URSO FORTE, URSODIOL URSODIOL, URSODIOL UVADEX, METHOXSALEN

** V ** VABOMERE, MEROPENEM VAGIFEM, ESTRADIOL VAGISTAT-1, TIOCONAZOLE (OTC) VALACYCLOVIR HYDROCHLORIDE, VALACYCLOVIR HYDROCHLORIDE VALCHLOR, MECHLORETHAMINE HYDROCHLORIDE VALCYTE, HYDROCHLORIDE VALGANCICLOVIR HYDROCHLORIDE, VALGANCICLOVIR HYDROCHLORIDE VALIUM, DIAZEPAM VALNAC, BETAMETHASONE VALERATE SODIUM, VALPROATE SODIUM VALPROIC ACID, VALPROIC ACID , VALRUBICIN VALSARTAN, VALSARTAN VALSARTAN AND HYDROCHLOROTHIAZIDE, HYDROCHLOROTHIAZIDE VALSTAR PRESERVATIVE FREE, VALRUBICIN VALTOCO, DIAZEPAM VALTREX, VALACYCLOVIR HYDROCHLORIDE VANCOCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE VANCOCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE VANCOMYCIN HYDROCHLORIDE, VANCOMYCIN HYDROCHLORIDE VANCOMYCIN HYDROCHLORIDE IN PLASTIC CONTAINER, VANCOMYCIN HYDROCHLORIDE VANDAZOLE, METRONIDAZOLE VANIQA, HYDROCHLORIDE VANOS, FLUOCINONIDE VANTAS, HISTRELIN ACETATE VAPRISOL IN 5% DEXTROSE IN PLASTIC CONTAINER, HYDROCHLORIDE VARDENAFIL HYDROCHLORIDE, VARDENAFIL HYDROCHLORIDE VARIBAR , BARIUM SULFATE VARIBAR , BARIUM SULFATE VARIBAR PUDDING, BARIUM SULFATE VARIBAR THIN HONEY, BARIUM SULFATE VARIBAR THIN LIQUID, BARIUM SULFATE VARITHENA, POLIDOCANOL VARUBI, HYDROCHLORIDE VASCEPA, ICOSAPENT ETHYL VASERETIC, ENALAPRIL MALEATE , VASOPRESSIN VASOSTRICT, VASOPRESSIN VASOTEC, ENALAPRIL MALEATE VAZALORE, ASPIRIN (OTC) VAZCULEP, PHENYLEPHRINE HYDROCHLORIDE VECTICAL, CALCITRIOL , VECURONIUM BROMIDE VEKLURY, VELCADE, BORTEZOMIB VELETRI, EPOPROSTENOL SODIUM VELIVET, DESOGESTREL VELPHORO, FERRIC OXYHYDROXIDE VELTASSA, PATIROMER SORBITEX CALCIUM VELTIN, CLINDAMYCIN PHOSPHATE VEMLIDY, FUMARATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 59 APPENDIX A - PRODUCT NAME INDEX

** V ** VENCLEXTA, VENLAFAXINE HYDROCHLORIDE, VENLAFAXINE HYDROCHLORIDE VENOFER, FERRIC OXYHYDROXIDE VENTAVIS, ILOPROST VENTOLIN HFA, ALBUTEROL SULFATE VERAPAMIL HYDROCHLORIDE, VERAPAMIL HYDROCHLORIDE VERDESO, DESONIDE VEREGEN, SINECATECHINS VERELAN, VERAPAMIL HYDROCHLORIDE VERELAN PM, VERAPAMIL HYDROCHLORIDE VERKAZIA, CYCLOSPORINE VERQUVO, VERICIGUAT VERSACLOZ, CLOZAPINE VERZENIO, VESICARE, SOLIFENACIN SUCCINATE VESICARE LS, SOLIFENACIN SUCCINATE VFEND, VIAGRA, SILDENAFIL CITRATE VIBATIV, HYDROCHLORIDE VIBERZI, ELUXADOLINE VIBISONE, CYANOCOBALAMIN VIBRAMYCIN, DOXYCYCLINE VIBRAMYCIN, DOXYCYCLINE CALCIUM VIBRAMYCIN, DOXYCYCLINE HYCLATE VICTOZA, LIRAGLUTIDE RECOMBINANT VIDAZA, AZACITIDINE VIEKIRA PAK (COPACKAGED), DASABUVIR SODIUM VIENVA, ETHINYL ESTRADIOL VIGABATRIN, VIGABATRIN VIGADRONE, VIGABATRIN VIGAMOX, MOXIFLOXACIN HYDROCHLORIDE VIIBRYD, HYDROCHLORIDE VILAZODONE HYDROCHLORIDE, VILAZODONE HYDROCHLORIDE VILTEPSO, VILTOLARSEN VIMOVO, ESOMEPRAZOLE MAGNESIUM VIMPAT, SULFATE, VINBLASTINE SULFATE VINCRISTINE SULFATE PFS, VINCRISTINE SULFATE TARTRATE, VINORELBINE TARTRATE VIORELE, DESOGESTREL VIRACEPT, MESYLATE VIRAMUNE, NEVIRAPINE VIRAMUNE XR, NEVIRAPINE VIRAZOLE, RIBAVIRIN VIREAD, TENOFOVIR DISOPROXIL FUMARATE VIROPTIC, TRIFLURIDINE , NAPHAZOLINE HYDROCHLORIDE (OTC) VISINE L.R., OXYMETAZOLINE HYDROCHLORIDE (OTC) VISIONBLUE, TRYPAN BLUE VISIPAQUE 270, VISIPAQUE 320, IODIXANOL VISTARIL, HYDROXYZINE PAMOATE VISTOGARD, TRIACETATE VISUDYNE, , ERGOCALCIFEROL VITAMIN K1, PHYTONADIONE VITRAKVI, SULFATE VIVELLE-DOT, ESTRADIOL VIVITROL, NALTREXONE VIZAMYL, F-18 VIZIMPRO, VOCABRIA, CABOTEGRAVIR SODIUM VOGELXO, TESTOSTERONE VOLNEA, DESOGESTREL VOLTAREN, DICLOFENAC SODIUM

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 60 APPENDIX A - PRODUCT NAME INDEX

** V ** VOLTAREN , DICLOFENAC SODIUM (OTC) VORICONAZOLE, VORICONAZOLE VOSEVI, SOFOSBUVIR VOSOL, ACETIC ACID, GLACIAL VOSOL HC, ACETIC ACID, GLACIAL VOSPIRE ER, ALBUTEROL SULFATE VOTRIENT, HYDROCHLORIDE VRAYLAR, HYDROCHLORIDE VUMERITY, DIROXIMEL FUMARATE VUSION, MICONAZOLE NITRATE VYFEMLA, ETHINYL ESTRADIOL VYLEESI (AUTOINJECTOR), ACETATE VYNDAMAX, TAFAMIDIS VYNDAQEL, TAFAMIDIS MEGLUMINE VYONDYS 53, GOLODIRSEN VYTORIN, EZETIMIBE VYVANSE, LISDEXAMFETAMINE DIMESYLATE VYXEOS, CYTARABINE VYZULTA, LATANOPROSTENE BUNOD

** W ** WAKIX, HYDROCHLORIDE WARFARIN SODIUM, WARFARIN SODIUM WEGOVY, SEMAGLUTIDE WELCHOL, COLESEVELAM HYDROCHLORIDE WELLBUTRIN SR, BUPROPION HYDROCHLORIDE WELLBUTRIN XL, BUPROPION HYDROCHLORIDE WERA, ETHINYL ESTRADIOL WIXELA INHUB, FLUTICASONE PROPIONATE WOMEN'S ROGAINE, MINOXIDIL (OTC) WYNZORA, BETAMETHASONE DIPROPIONATE

** X ** XADAGO, MESYLATE XALATAN, LATANOPROST XALKORI, XANAX, ALPRAZOLAM XANAX XR, ALPRAZOLAM XARACOLL, BUPIVACAINE HYDROCHLORIDE XARELTO, RIVAROXABAN XATMEP, METHOTREXATE SODIUM XCOPRI, XELJANZ, TOFACITINIB CITRATE XELJANZ XR, TOFACITINIB CITRATE XELODA, CAPECITABINE XELPROS, LATANOPROST XENAZINE, TETRABENAZINE XENICAL, ORLISTAT XENLETA, ACETATE XE 133, XENON XE-133 XEPI, OZENOXACIN XERAVA, DIHYDROCHLORIDE XERESE, ACYCLOVIR XERMELO, TELOTRISTAT ETIPRATE XHANCE, FLUTICASONE PROPIONATE XIFAXAN, XIGDUO XR, DAPAGLIFLOZIN XIIDRA, LIFITEGRAST XIMINO, MINOCYCLINE HYDROCHLORIDE XOFIGO, RADIUM RA-223 DICHLORIDE XOFLUZA, BALOXAVIR MARBOXIL XOLEGEL, KETOCONAZOLE XOPENEX, LEVALBUTEROL HYDROCHLORIDE XOPENEX HFA, LEVALBUTEROL TARTRATE XOSPATA, FUMARATE

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 61 APPENDIX A - PRODUCT NAME INDEX

** X ** XPOVIO, XTAMPZA ER, OXYCODONE XTANDI, ENZALUTAMIDE XULANE, ETHINYL ESTRADIOL XURIDEN, XYLOCAINE, LIDOCAINE HYDROCHLORIDE XYLOCAINE W/ EPINEPHRINE, EPINEPHRINE XYOSTED (AUTOINJECTOR), TESTOSTERONE ENANTHATE XYREM, XYWAV, CALCIUM OXYBATE XYZAL ALLERGY 24HR, LEVOCETIRIZINE DIHYDROCHLORIDE (OTC)

** Y ** YAELA, DROSPIRENONE YASMIN, DROSPIRENONE YAZ, DROSPIRENONE YONDELIS, YONSA, ABIRATERONE ACETATE YUPELRI, YUTIQ, FLUOCINOLONE ACETONIDE

** Z ** ZADITOR, KETOTIFEN FUMARATE (OTC) ZAFIRLUKAST, ZAFIRLUKAST ZALEPLON, ZALEPLON ZANAFLEX, TIZANIDINE HYDROCHLORIDE ZANOSAR, STREPTOZOCIN ZANTAC, RANITIDINE HYDROCHLORIDE ZARONTIN, ETHOSUXIMIDE ZAVESCA, MIGLUSTAT ZEGALOGUE, DASIGLUCAGON HYDROCHLORIDE ZEGALOGUE (AUTOINJECTOR), DASIGLUCAGON HYDROCHLORIDE ZEGERID, OMEPRAZOLE ZEGERID OTC, OMEPRAZOLE (OTC) ZEJULA, TOSYLATE ZELAPAR, SELEGILINE HYDROCHLORIDE ZELBORAF, ZELNORM, MALEATE ZEMBRACE SYMTOUCH, SUMATRIPTAN SUCCINATE ZEMDRI, SULFATE ZEMPLAR, PARICALCITOL ZENATANE, ISOTRETINOIN ZEPATIER, ELBASVIR ZEPOSIA, OZANIMOD HYDROCHLORIDE ZEPZELCA, LURBINECTEDIN ZERBAXA, CEFTOLOZANE SULFATE ZERVIATE, CETIRIZINE HYDROCHLORIDE ZESTORETIC, HYDROCHLOROTHIAZIDE ZESTRIL, LISINOPRIL ZETIA, EZETIMIBE ZETONNA, CICLESONIDE ZIAC, BISOPROLOL FUMARATE ZIAGEN, ABACAVIR SULFATE ZIANA, CLINDAMYCIN PHOSPHATE ZIDOVUDINE, ZIDOVUDINE , ZILEUTON ZILRETTA, TRIAMCINOLONE ACETONIDE ZILXI, MINOCYCLINE HYDROCHLORIDE ZINACEF, CEFUROXIME SODIUM , ZINC CHLORIDE ZINC CHLORIDE IN PLASTIC CONTAINER, ZINC CHLORIDE , ZINC SULFATE ZINECARD, DEXRAZOXANE HYDROCHLORIDE ZINGO, LIDOCAINE HYDROCHLORIDE ZIOPTAN, TAFLUPROST

JUNE 2021 - APPROVED DRUG PRODUCT LIST A - 62 APPENDIX A - PRODUCT NAME INDEX

** Z ** ZIPRASIDONE HYDROCHLORIDE, ZIPRASIDONE HYDROCHLORIDE ZIPRASIDONE MESYLATE, ZIPRASIDONE MESYLATE ZIPSOR, DICLOFENAC POTASSIUM ZIRGAN, GANCICLOVIR ZITHROMAX, AZITHROMYCIN ZOCOR, SIMVASTATIN ZOFRAN, ONDANSETRON HYDROCHLORIDE ZOFRAN ODT, ONDANSETRON ZOHYDRO ER, HYDROCODONE BITARTRATE ZOKINVY, LONAFARNIB ZOLADEX, ACETATE ZOLEDRONIC, ZOLEDRONIC ACID ZOLEDRONIC ACID, ZOLEDRONIC ACID ZOLINZA, , ZOLMITRIPTAN ZOLOFT, SERTRALINE HYDROCHLORIDE ZOLPIDEM TARTRATE, ZOLPIDEM TARTRATE ZOLPIMIST, ZOLPIDEM TARTRATE ZOMETA, ZOLEDRONIC ACID ZOMIG, ZOLMITRIPTAN ZOMIG-ZMT, ZOLMITRIPTAN ZONALON, DOXEPIN HYDROCHLORIDE ZONEGRAN, ZONISAMIDE, ZONISAMIDE ZONTIVITY, VORAPAXAR SULFATE ZORTRESS, EVEROLIMUS ZORVOLEX, DICLOFENAC ZOSYN IN PLASTIC CONTAINER, PIPERACILLIN SODIUM ZOVIA 1/35E-28, ETHINYL ESTRADIOL ZOVIA 1/50E-28, ETHINYL ESTRADIOL ZOVIRAX, ACYCLOVIR ZTLIDO, LIDOCAINE ZUBSOLV, BUPRENORPHINE HYDROCHLORIDE ZULRESSO, BREXANOLONE ZUMANDIMINE, DROSPIRENONE ZYCLARA, IMIQUIMOD ZYDELIG, ZYFLO, ZILEUTON ZYFLO CR, ZILEUTON ZYKADIA, ZYLET, LOTEPREDNOL ETABONATE ZYLOPRIM, ALLOPURINOL ZYMAR, GATIFLOXACIN ZYMAXID, GATIFLOXACIN ZYNRELEF KIT, BUPIVACAINE ZYPITAMAG, PITAVASTATIN MAGNESIUM ZYPREXA, OLANZAPINE ZYPREXA RELPREVV, OLANZAPINE PAMOATE ZYPREXA ZYDIS, OLANZAPINE ZYRTEC ALLERGY, CETIRIZINE HYDROCHLORIDE (OTC) ZYRTEC-D 12 HOUR, CETIRIZINE HYDROCHLORIDE (OTC) ZYTIGA, ABIRATERONE ACETATE ZYVOX, LINEZOLID