National/Preferred 4 Tier Split (1779)

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National Drug List Drug list — Four Tier Drug Plan

Your prescription benefit comes with a drug list, which is also called a formulary. This list is made up of brand-name and generic prescription drugs approved by the U.S. Food & Drug Administration (FDA).

The following is a list of plan names to which this formulary may apply. Additional plans may be applicable. If you are a current Anthem member with questions about your pharmacy benefits, we're here to help. Just call us at the Pharmacy Member Services number on your ID card.

Solution PPO 1500/15/20 $5/$15/$50/$65/30% to $250 after deductible Solution PPO 2000/20/20 $5/$20/$30/$50/30% to $250 Solution PPO 2500/25/20 $5/$20/$40/$60/30% to $250 Solution PPO 3500/30/30 $5/$20/$40/$60/30% to $250 Rx ded $150 Solution PPO 4500/30/30 $5/$20/$40/$75/30% to $250 Solution PPO 5500/30/30 $5/$20/$40/$75/30% to $250 Rx ded $250 $5/$15/$25/$45/30% to $250 $5/$20/$50/$65/30% to $250 Rx ded $500 $5/$15/$30/$50/30% to $250 $5/$20/$50/$70/30% to $250 $5/$15/$40/$60/30% to $250 $5/$20/$50/$70/30% to $250 after deductible

Here are a few things to remember:

o You can view and search our current drug lists when you visit anthem.com/ca and choose Prescription Benefits. Please note: The formulary is subject to change and all previous versions of the formulary are no longer in effect.

o Additional tools and resources are available for current Anthem members to view the most up-to-date list of drugs for your plan - including drugs that have been added, generic drugs and more – by logging in at anthem.com/ca.

o Your coverage has limitations and exclusions, which means there are certain rules about what's covered by your plan and what isn't. Already a member? You can view your Certificate/Evidence of Coverage or your Summary Plan Description by logging in at anthem.com/ca and go to My Plan ->Benefits-> Plan Documents.

o You and your doctor can use this list as a guide to choose drugs that are best for you. Drugs that aren’t on this list may not be covered by your plan and may cost you more out of pocket. To help you see how the drug list works with your drug benefit, we've included some frequently asked questions (FAQ) in this document about how the list is set up and what to do if a drug you take isn't on it.

Last Updated: September 1, 2019 LG

National Drug List Four-Tier

Table of Contents

INFORMATIONAL SECTION...... 3 ALTERNATIVE THERAPY - VITAMINS AND MINERALS...... 3 ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC - DRUGS FOR PAIN AND FEVER...... 3 ANESTHETICS - DRUGS FOR PAIN AND FEVER...... 17 ANORECTAL PREPARATIONS - RECTAL PREPARATIONS...... 21 ANTIDOTES AND OTHER REVERSAL AGENTS - DRUGS FOR OVERDOSE OR POISONING...... 21 ANTI-INFECTIVE AGENTS - DRUGS FOR INFECTIONS...... 24 ANTINEOPLASTICS - DRUGS FOR CANCER...... 44 ANTISEPTICS AND DISINFECTANTS - ANTISEPTICS AND DISINFECTANTS...... 60 BIOLOGICALS - BIOLOGICAL AGENTS...... 61 CARDIOVASCULAR THERAPY AGENTS - DRUGS FOR THE HEART...... 74 CENTRAL NERVOUS SYSTEM AGENTS - DRUGS FOR THE NERVOUS SYSTEM...... 96 CHEMICAL DEPENDENCY, AGENTS TO TREAT - DRUGS FOR ADDICTION...... 124 CHEMICALS-PHARMACEUTICAL ADJUVANTS...... 126 COGNITIVE DISORDER THERAPY - DRUGS FOR THE NERVOUS SYSTEM...... 127 CONTRACEPTIVES - DRUGS FOR WOMEN...... 127 DERMATOLOGICAL - DRUGS FOR THE SKIN...... 134 DIAGNOSTIC AGENTS...... 155 DRUGS TO TREAT ERECTILE DYSFUNCTION - DRUGS FOR THE URINARY SYSTEM...... 157 EATING DISORDER THERAPY - DRUGS FOR EATING DISORDERS...... 157 ELECTROLYTE BALANCE-NUTRITIONAL PRODUCTS - DRUGS FOR NUTRITION...... 158 ENDOCRINE - HORMONES...... 175 ENZYMES - VITAMINS AND MINERALS...... 192 FDB CLASS OBSOLETE-NOT USED...... 192 GASTROINTESTINAL THERAPY AGENTS - DRUGS FOR THE STOMACH...... 192 GENITOURINARY THERAPY - DRUGS FOR THE URINARY SYSTEM...... 201 GOUT AND HYPERURICEMIA THERAPY - DRUGS FOR PAIN AND FEVER...... 206 HEMATOLOGICAL AGENTS - DRUGS FOR THE BLOOD...... 206 HEPATOBILIARY SYSTEM TREATMENT AGENTS - DRUGS FOR THE LIVER...... 216 IMMUNOSUPPRESSIVE AGENTS - DRUGS FOR ORGAN TRANSPLANTS...... 216 LOCOMOTOR SYSTEM - DRUGS FOR MUSCLES, LIGAMENTS, TENDONS, AND BONES...... 218 MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT (DME) - MEDICAL SUPPLIES AND DURABLE MEDICAL EQUIPMENT...... 221 MEDICAL SUPPLY, FDB SUPERSET...... 231 METABOLIC DISEASE ENZYME REPLACEMENT AGENTS - DRUGS FOR METABOLIC DISEASE...... 241 METABOLIC MODIFIERS - DRUGS THAT ALTER METABOLISM...... 242 MOUTH-THROAT-DENTAL - PREPARATIONS - DRUGS FOR THE MOUTH AND THROAT...... 244 MULTIPLE SCLEROSIS AGENTS - DRUGS FOR THE NERVOUS SYSTEM...... 246 OPHTHALMIC AGENTS - DRUGS FOR THE EYE...... 247 OTIC (EAR) - DRUGS FOR THE EAR...... 256 PROSTAGLANDINS - HORMONES...... 256 RENAL REPLACEMENT THERAPY - DRUGS FOR THE KIDNEYS...... 256 RESPIRATORY THERAPY AGENTS - DRUGS FOR THE LUNGS...... 258 VAGINAL PRODUCTS - DRUGS FOR WOMEN...... 268

TOC-2 National Drug List – Informational Section

Definitions

“$0” next to a drug means this is a preventive drug. For some members, this product may be covered at 100% with $0 cost share with a prescription from your provider if specified criteria are met.

“BRAND name drug” means a drug that is marketed under a proprietary, trademark-protected name. A BRAND name drug is listed in this formulary in all CAPITAL letters.

“Coinsurance” means a percentage of the cost of a covered health care benefit that you pay after you have paid the deductible, if a deductible applies to the health care benefit.

“Copayment” means a fixed dollar amount that you pay for a covered health care benefit after you have paid the deductible, if a deductible applies to the health care benefit.

“Deductible” means the amount you pay for covered health care benefits that are subject to the deductible before your health insurer begins to pay. If your health insurance policy has a deductible, it may have either one deductible or separate deductibles for medical benefits and prescription drug benefits. After you pay your deductible, you usually pay only a copayment or coinsurance for covered health care benefits. Your insurance company pays the rest.

“Dose Optimization (DO)” means dose optimization. Usually, this means you may have to switch from taking a drug twice a day to taking it once a day at a higher strength.

“Drug Tier” means a group of prescription drugs that correspond to a specified cost sharing tier in your health insurance policy. The drug tier in which a prescription drug is placed determines your portion of the cost for the drug.

“Exception request” means a request for coverage of a non-formulary drug. If you, your designee, or your prescribing health care provider submits a request for coverage of a non-formulary drug, your insurer must cover the non-formulary drug when it is medically necessary for you to take the drug.

“Exigent circumstances” means when you are suffering from a medical condition that may seriously jeopardize your life, health, or ability to regain maximum function, or when you are undergoing a current course of treatment using a non-formulary drug.

“Formulary” or “prescription drug list” means the list of drugs that is covered by your health insurance policy under the prescription drug benefit of the policy.

“Generic drug” means a drug that is the same as its BRAND name drug equivalent in dosage, strength, effect, how it is taken, quality, safety, and intended use. A generic drug is listed in this formulary in italicized lowercase letters.

“Limited Distribution (LD)” means limited distribution. These drugs are available only through certain pharmacies or wholesalers, depending on what the manufacturer decides.

“Medically Necessary” means health care benefits needed to diagnose, treat, or prevent a medical condition or its symptoms and that meet accepted standards of medicine. Health insurance usually does not cover health care benefits that are not medically necessary.

“Non-formulary drug” means a prescription drug that is not listed on this formulary.

“Oral Chemotherapy (OC)” Notwithstanding any deductible, the total amount of copayments and coinsurance an insured is required to pay shall not exceed two hundred dollars ($200) for an individual prescription of up to a 30-day supply of a prescribed orally administered anticancer medication covered by the policy.

“Out-of-pocket costs” means your expenses for health care benefits that aren't reimbursed by your health insurance. Out-of- pocket costs include deductibles, copayments, and coinsurance for covered health care benefits, plus all costs for health care benefits that are not covered.

“Prescribing provider” means a health care provider who can write a prescription for a drug to diagnose, treat, or prevent a medical condition.

“Prescription” means an oral, written, or electronic order from a prescribing provider authorizing a prescription drug to be provided to a specific individual.

“Prescription drug” means a drug that by law requires a prescription.

“Prior Authorization (PA)” means a decision by your health insurer that a health care benefit is medically necessary for you. If a prescription drug is subject to prior authorization in this formulary, your prescribing provider must request approval from your health insurer to cover the drug before you fill your prescription. Your health insurer must grant a prior authorization request when it is medically necessary for you to take the drug.

“Quantity limit (QL)” means a restriction on the number of doses of a prescription drug covered by a health insurance product during a specific time period, or any other limitation on the quantity of a drug that is covered.

“Specialty Drugs (SP)” means specialty drugs. Specialty drugs are used to treat difficult, long-term conditions. You may need to get this drug through a specialty pharmacy.

“Step therapy (ST)” means a specific sequence in which prescription drugs for a particular medical condition must be tried. If a drug is subject to step therapy in this formulary, you may have to try one or more other drugs before your health insurance policy will cover that drug for your medical condition. If your prescribing provider submits a request for an exception to the step therapy requirement, your health insurer must grant the request when it is medically necessary for you to take the drug.

Frequently Asked Questions

How do I know what drugs are covered under my benefits? This is a complete listing of all the drugs on the drug list. But, it’s possible a drug(s) on this list may not be covered, depending on your plan’s design.

Your pharmacy benefit covers prescription drugs, including Specialty Drugs, that may be administered to you as part of a doctor’s visit, home care visit, or at an outpatient Facility when they are Covered Services. Benefits that are administered to you in your provider’s office are typically covered under your medical benefit. This may include Drugs for infusion therapy, chemotherapy, blood products, certain injectables and any drug that must be administered by a Provider.

How can I find a drug on the list? (A) A prescription drug may be located by looking up the therapeutic category and class to which the drug belongs or the BRAND name or generic name of the drug in the alphabetical index; and (B) If a generic equivalent for a BRAND name drug is not available on the market or is not covered, the drug will not be separately listed by its generic name.

You can search the PDF drug list by:

o Drug name, using Ctrl + F on your keyboard, then type in the name of the drug you’re looking for. o Drug class, using the categories listed in alphabetical order.

How are drugs shown on the list? o A drug is listed alphabetically by its BRAND name and generic names in the therapeutic category and class to which it belongs; o The generic name for a BRAND name drug is included after the BRAND name in parentheses and all lowercase italicized letters;

o If a generic equivalent for a BRAND name drug is both available and covered, the generic drug will be listed separately from the BRAND name drug in all lowercase italicized letters; and

o If a generic drug is marketed under a proprietary, trademark-protected BRAND name, the BRAND name will be listed after the generic name in parentheses and regular typeface with the first letter of each word capitalized.

The “Under Coverage Requirements and Limits” section will indicate if you need preapproval before you can take the drug (called prior authorization or PA), or if you need to try other drugs first for your treatment (called step therapy or ST).

Note: The presence of a prescription drug on the formulary does not guarantee that your doctor will prescribe that prescription drug for a particular medical condition.

What are my options for getting my prescriptions? You have plenty of choices about how and where to get your prescription medicines, including local pharmacies in your plan, convenient home delivery or specialty pharmacies. Most plans include our home delivery program at no extra cost to you.

Current Anthem members can find out more by logging in at anthem.com/ca and choose Prescription Benefits or call 833-236-6196. For more details about your coverage, you can call the phone number on your member ID card. What if my drug isn’t on the list? We understand that only you and your doctor know what is best for you. If you want to take a drug that’s not on the drug list, you may have to pay the full cost for it. You can also talk to your doctor or pharmacist to see if there’s another drug covered by your plan that will work just as well, or if generic or OTC drugs are an option. Only you and your doctor can decide what drugs are right for you.

If a drug you’re taking isn’t covered, your doctor can ask us to review the coverage. This process is called preapproval or prior authorization.

Your doctor can get the process started by completing an electronic Prior Authorization, calling the Pharmacy Member Services number on the back of your member ID card or by downloading a prior authorization form from our website and submitting it. If your request is approved, the amount you pay for the drug will depend on your plan’s benefit.

There are a few options for your doctor to start the Prior Authorization (PA) process: 1. Submit an electronic PA request by going to https://www.covermymeds.com/main/partners/anthem. 2. Log in at anthem.com/ca and choose Pharmacy. o Go to Pharmacy Resources and Search Your Drug List for your medication. o Choose the correct medication strength and form. o Scroll down to Definition of Restrictions and locate the applicable Fax Form in the table. o Your doctor completes and faxes the form to us at 844-474-3347. 3. Calling Pharmacy Member Services number on the back of your member ID card.

Who decides what drugs are on the list? The drugs on the list are reviewed through our Pharmacy and Therapeutics (P&T) process. In this process, a group of independent doctors, pharmacists and other health care professionals decides which drugs we include on our lists. This group meets regularly to look at new and existing drugs and recommends drugs based on how safe they are, how well they work and the value they offer our members.

What is a specialty drug and how do I get them? If you’re taking a medicine that is considered a specialty drug, you may need to use a specialty pharmacy in order for your drug to be covered. Specialty drugs come in many forms like pills, liquids, injections (shots), infusions or inhalers and may need special storage and handling. Typically benefits for specialty drugs that are self-administered will be covered under the pharmacy benefit. Benefits for specialty drugs that are administered to you in your provider’s office are typically covered under your medical benefit. If you use pharmacies that are not in the network, your medicine may not be covered and you may have to pay the full cost. For more details about your coverage, you can call the phone number on your member ID card.

Does the drug list change, and how will I know if it does? Drugs on our list are reviewed and updated on a monthly basis. Sometimes, drugs are added, removed, change tiers or have updated requirements. The changes will usually go into effect the first day of the month. But don’t worry, we’ll let you know if a drug you take is taken off the list and, in some cases, if a drug you take is moved to a higher tier.

You can always check the drug list to make sure medicines you take are still on it. You’ll find the most up-to-date drug list when you log in at anthem.com/ca.

What kind of drugs can I find on the formulary? We cover FDA-approved preventive care drugs with zero cost share in compliance with the Affordable Care Act (ACA) and California state regulations. Your doctor may need to write a prescription for these preventive services to be covered by your plan, even if they are listed as over-the-counter. The availability or coverage of these medications without cost-sharing may be subject to criteria established by the health plan.

We cover FDA-approved equipment and supplies for the management and treatment of insulin-using diabetes, non-insulin-using diabetes and gestational diabetes as medically necessary. Medication encompasses insulin, insulin pumps, and oral hypoglycemic agents. Covered supplies and equipment are limited to glucose monitors, test strips, syringes and lancets. Covered benefits also include outpatient self-management and educational services used to treat diabetes if services are provided through a program authorized by the State's Diabetes Control Project within the Bureau of Health.

What drugs can I find in each tier? We place drugs on different tiers based on how well they work to improve health, whether there are over-the-counter (OTC) options and their costs compared to other drugs used for the same type of treatment. The lower the tier, the lower your share of the cost. Here’s a breakdown of the tiers in your plan:

o Tier 1 drugs have the lowest cost share for you. These are usually generic drugs that offer the best value compared to other drugs that treat the same conditions. Some plans split Tier 1 into Tier 1a and Tier 1b:

- Tier 1a drugs have the lowest cost share. These are often generic drugs that offer the greatest value compared to others that treat the same conditions. - Tier 1b drugs have a low cost share. These are typically generic drugs that offer the greatest value compared to others that treat the same conditions.

o Tier 2 drugs have a higher cost share than Tier 1. They may be preferred brand drugs, based on how well they work and their cost compared to other drugs used for the same type of treatment. Some are generic drugs that may cost more because they're newer to the market.

o Tier 3 drugs have a higher cost share. They often include brand and generic drugs that may cost more than drugs on lower tiers that are used to treat the same condition. Tier 3 may also include drugs recently approved by the FDA.

o Tier 4 drugs have the highest cost share and usually include specialty brand and generic drugs. They may cost more than drugs on lower tiers that are used to treat the same condition. Tier 4 may also include drugs recently approved by the FDA or specialty drugs used to treat serious, long-term health conditions and that may need special handling.

How will I know how much my drug will cost? Current Anthem members can go online and with the Price a Medication Tool, get pharmacy-specific pricing from a number of local retail pharmacies in your zip code.

Note: For oral chemotherapy drugs - Notwithstanding any deductible, the total amount of copayments and coinsurance an insured is required to pay shall not exceed two hundred dollars ($200) for an individual prescription of up to a 30- day supply of a prescribed orally administered anticancer medication covered by the policy.

How does Anthem promote safety? When you go to a pharmacy, the pharmacist will get an electronic message from Anthem if a drug needs prior authorization, requires step therapy or has a limit on the amount that can be given. Here’s a closer look at all of the programs we’ve put into place to help make sure you get the care you need, while helping to keep you safe.1

Our clinical edit programs are:  Prior authorization, which requires you to get approval before taking a medicine. This helps make sure a drug is used properly and focuses on drugs that may have: — Risk of side effects. — Risk of harmful effects when taken with other drugs. — Potential for incorrect use or abuse. — Rules for use with certain conditions.  Step therapy, which requires that other drugs be tried first. It focuses on whether a drug is right for your condition.  Dose optimization, which involves changing from taking a dose twice a day to once a day, when medically appropriate. Taking fewer doses may lower your costs; a single higher dose of a drug taken once a day may cost less than a lower dose taken twice a day.  Quantity Limits impose a limit on the amount in a prescription and how often it can be refilled. — If a refill request is submitted too soon or the doctor prescribes an amount that's higher than what is allowed, the drug won't be covered at that time. — If there are medical reasons to prescribe the drug as originally dosed, the doctor can ask for review by our Prior Authorization Center.

Also, If you’re taking a medicine that is considered a specialty drug, you may need to use a specialty pharmacy in order for your drug to be covered. How does my doctor start the Prior Authorization process? If your drug is on our formulary but requires a PA or Step Therapy, there are a few options for your doctor to start the Prior Authorization (PA) process: 1. Submit an electronic PA request by going to https://www.covermymeds.com/main/partners/anthem. 2. Log in at anthem.com/ca and choose Pharmacy. o Go to Pharmacy Resources and Search Your Drug List for your medication. o Choose the correct medication strength and form. o Scroll down to Definition of Restrictions and locate the applicable Fax Form in the table. o Your doctor completes the form and faxes it to Anthem at 844-474-3347. 3. Calling Pharmacy Member Services number on the back of your member ID card.

What is Step Therapy? How does it work? Step therapy requires trying other drugs before certain medications may be covered. The pharmacy will let you know if step therapy is required and you must first try the drug or treatment included in the program. If the drug or treatment does not treat the condition well, the doctor can contact our Prior Authorization Center to ask that we approve the original drug.1

A few more notes about the exception process:

o If we fail to respond to a completed prior authorization or step therapy exception request within 72 hours of receiving a non- urgent request and 24 hours of receiving a request based on exigent circumstances, the request is deemed approved and we may not deny any subsequent requests for this medication.

o Don’t worry, if you’ve changed policies, we won’t ask you to repeat an approved step therapy request that is already being used to treat a medical condition provided that the drug is still appropriately prescribed and is considered safe and effective.

A note about opioid analgesics. The member cost share for certain abuse-deterrent opioid analgesics may be lower in some states because of laws in those states. Opioid analgesics are a type of painkiller. In response to the global opioid epidemic, the U.S. Food and Drug Administration (FDA) has encouraged drug manufacturers to develop opioids with properties that help deter their misuse and abuse.

Drug(s) may be excluded from the list based on your plan's benefit design.

1 If the Prior Authorization Center concludes the prescription claim should be denied, members and their doctors will get letters that explain the appeals and/or grievance process.

KEY Here are some terms and notes you’ll find on the drug list.

Brand name drugs are in UPPER CASE, bold type.

Generic drugs are in lower case, plain type. $0 = preventive drugs. For some members, this Tier 1 = drugs have the lowest cost share for you. product may be covered at 100% with $0 cost share These are usually generic drugs that offer the best with a prescription from your provider if specified value compared to other drugs that treat the same criteria are met. conditions.

DO = dose optimization. Usually, this means you may Tier 1a = drugs have the lowest cost share. These are have to switch from taking a drug twice a day to taking often generic drugs that offer the greatest value it once a day at a higher strength. compared to others that treat the same conditions.

LD = limited distribution. These drugs are available Tier 1b = drugs have a low cost share. These are only through certain pharmacies or wholesalers, typically generic drugs that offer the greatest value depending on what the manufacturer decides. compared to others that treat the same conditions.

OC = oral chemotherapy. These drugs after deductible Tier 2 = drugs have a higher cost share than Tier 1. shall not exceed $200 per an individual prescription for They may be preferred brand drugs, based on how well up to a 30 day supply. they work and their cost compared to other drugs used for the same type of treatment. Some are generic PA = prior authorization. You may need to get benefits drugs that may cost more because they’re newer to the approved before certain prescriptions can be filled. market.

QL = quantity limits. There are limits on the amount of Tier 3 = drugs have a higher cost share. They often medicine covered within a certain amount of time. include brand and generic drugs that may cost more than drugs on lower tiers that are used to treat the SP = specialty drugs. Specialty drugs are used to treat same condition. difficult, long-term conditions. You may need to get this drug through a specialty pharmacy. Tier 4 = drugs have the highest cost share and usually include specialty brand and generic drugs. ST = step therapy. You may need to use another They may cost more than drugs on lower tiers that recommended drug first before a prescribed drug is are used to treat the same condition. covered.

National Drug List

Four-Tier

CURRENT AS OF 8/15/2019

Coverage Requirements and Prescription Drug Name Drug Tier Limits ALTERNATIVE THERAPY - VITAMINS AND MINERALS ALTERNATIVE THERAPY - UNCLASSIFIED - VITAMINS AND MINERALS NUMOISYN MUCOUS MEMBRANE LIQUID (flaxseed) 3 ANALGESIC, ANTI-INFLAMMATORY OR ANTIPYRETIC - DRUGS FOR PAIN AND FEVER ANALGESIC - CENTRAL ALPHA-2 RECEPTOR AGONISTS - ARTHRITIS AND PAIN DRUGS clonidine (pf) epidural solution 1 or 1b* DURACLON (PF) EPIDURAL SOLUTION (clonidine) 3 ANALGESIC - NEURONAL (N)-TYPE CALCIUM CHANNEL BLOCKERS (NCCBS) - ARTHRITIS AND PAIN DRUGS PRIALT INTRATHECAL SOLUTION (ziconotide) 4 PA; LD ANALGESIC OPIOID AGONISTS - ARTHRITIS AND PAIN DRUGS ACTIQ BUCCAL LOZENGE ON A HANDLE (fentanyl) 3 PA; QL (4 lozenge per 1 day) ALFENTANIL INJECTION SOLUTION 3 ASTRAMORPH-PF INJECTION SOLUTION (morphine) 3 QL (6 mL per 1 day) CODEINE SULFATE ORAL TABLET 15 MG, 30 MG (codeine) 3 QL (6 tablets per 1 day) CODEINE SULFATE ORAL TABLET 60 MG (codeine) 3 QL (6 tablet per 1 day) CONZIP ORAL CAPSULE,ER BIPHASE 24 HR 17-83 (tramadol) 3 PA; QL (1 capsule per 1 day) CONZIP ORAL CAPSULE,ER BIPHASE 24 HR 25-75 (tramadol) 3 PA; QL (1 capsule per 1 day) DEMEROL (PF) INJECTION SOLUTION 100 MG/2 ML, 100 MG/ML, 3 QL (4 mL per 1 day) 50 MG/ML (meperidine) DEMEROL (PF) INJECTION SOLUTION 25 MG/0.5 ML, 75 MG/1.5 3 ML (meperidine) DEMEROL (PF) INJECTION SYRINGE (meperidine) 3 QL (4 mL per 1 day) DEMEROL INJECTION SOLUTION 100 MG/ML (meperidine) 3 QL (4 mL per 1 day) DEMEROL INJECTION SOLUTION 50 MG/ML (meperidine) 3 DEMEROL ORAL TABLET (meperidine) 3 QL (6 tablets per 1 day) DILAUDID (PF) INJECTION SYRINGE 0.5 MG/0.5 ML, 1 MG/ML, 2 3 QL (6 mL per 1 day) MG/ML (hydromorphone) DILAUDID (PF) INJECTION SYRINGE 4 MG/ML (hydromorphone) 3 QL (2 mL per 1 day) DILAUDID ORAL LIQUID (hydromorphone) 3 QL (24 mL per 1 day) DILAUDID ORAL TABLET (hydromorphone) 3 QL (6 tablets per 1 day) diskets oral tablet,soluble 1 or 1b* PA; QL (1 tablet per 1 day)

BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 26 Coverage Requirements and Prescription Drug Name Drug Tier Limits DIFLUCAN ORAL SUSPENSION FOR RECONSTITUTION 40 MG/ML 3 QL (10 mL per 1 day) (fluconazole) DIFLUCAN ORAL TABLET 100 MG (fluconazole) 3 QL (4 tablet per 1 day) DIFLUCAN ORAL TABLET 150 MG, 200 MG (fluconazole) 3 QL (2 tablets per 1 day) DIFLUCAN ORAL TABLET 50 MG (fluconazole) 3 QL (8 tablet per 1 day) fluconazole in dextrose(iso-o) intravenous piggyback 1 or 1b* FLUCONAZOLE IN NACL (ISO-OSM) INTRAVENOUS PIGGYBACK 3 100 MG/50 ML (fluconazole) fluconazole in nacl (iso-osm) intravenous piggyback 200 mg/100 ml, 400 1 or 1b* mg/200 ml fluconazole oral suspension for reconstitution 10 mg/ml 1 or 1b* QL (40 mL per 1 day) fluconazole oral suspension for reconstitution 40 mg/ml 1 or 1b* QL (10 mL per 1 day) fluconazole oral tablet 100 mg 1 or 1b* QL (4 tablet per 1 day) fluconazole oral tablet 150 mg, 200 mg 1 or 1b* QL (2 tablets per 1 day) fluconazole oral tablet 50 mg 1 or 1b* QL (8 tablet per 1 day) itraconazole oral capsule 1 or 1b* PA; QL (4.2 capsules per 1 day) itraconazole oral solution 1 or 1b* PA; QL (20 mL per 1 day) NOXAFIL INTRAVENOUS SOLUTION (posaconazole) 3 NOXAFIL ORAL SUSPENSION (posaconazole) 3 PA; QL (20 mL per 1 day) NOXAFIL ORAL TABLET,DELAYED RELEASE (DR/EC) 3 PA; QL (8 tablet per 1 day) (posaconazole) ONMEL ORAL TABLET (itraconazole) 3 PA; QL (1 tablet per 1 day) POSACONAZOLE ORAL SUSPENSION 3 PA; QL (20 mL per 1 day) POSACONAZOLE ORAL TABLET,DELAYED RELEASE (DR/EC) 3 PA; QL (8 tablet per 1 day) SPORANOX ORAL CAPSULE (itraconazole) 3 PA; QL (4.2 capsules per 1 day) SPORANOX ORAL SOLUTION (itraconazole) 3 PA; QL (20 mL per 1 day) SPORANOX PULSEPAK ORAL CAPSULE (itraconazole) 3 PA; QL (4.2 capsules per 1 day) TOLSURA ORAL CAPSULE, SOLID DISPERSION (itraconazole) 3 PA; QL (126 capsules per 30 days) VFEND IV INTRAVENOUS RECON SOLN (voriconazole) 3 VFEND ORAL SUSPENSION FOR RECONSTITUTION (voriconazole) 3 PA; QL (10 mL per 1 day) VFEND ORAL TABLET 200 MG (voriconazole) 3 PA; QL (2 tablets per 1 day) VFEND ORAL TABLET 50 MG (voriconazole) 3 PA; QL (4 tablet per 1 day) voriconazole intravenous recon soln 1 or 1b* voriconazole oral suspension for reconstitution 1 or 1b* PA; QL (10 mL per 1 day) voriconazole oral tablet 200 mg 1 or 1b* PA; QL (2 tablets per 1 day) voriconazole oral tablet 50 mg 1 or 1b* PA; QL (4 tablet per 1 day) ANTIFUNGAL OTHER - DRUGS FOR FUNGUS ANCOBON ORAL CAPSULE (flucytosine) 3 PA flucytosine oral capsule 1 or 1b* PA griseofulvin microsize oral suspension 1 or 1b* BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 27 Coverage Requirements and Prescription Drug Name Drug Tier Limits griseofulvin microsize oral tablet 1 or 1b* griseofulvin ultramicrosize oral tablet 1 or 1b* ANTI-INFECTIVE IMMUNOLOGIC ADJUVANTS - INTERFERONS - DRUGS FOR INFECTIONS ACTIMMUNE SUBCUTANEOUS SOLUTION (interferon gamma- 4 PA; LD; SP 1b,recomb.) ANTILEPROTIC - IMMUNOMODULATORS - ANTIBIOTICS THALOMID ORAL CAPSULE 100 MG, 50 MG (thalidomide) 2; OC PA; SP; QL (1 capsule per 1 day) THALOMID ORAL CAPSULE 150 MG, 200 MG (thalidomide) 2; OC PA; SP; QL (2 capsules per 1 day) ANTILEPROTIC - SULFONE AGENTS - ANTIBIOTICS dapsone oral tablet 1 or 1b* ANTIMALARIAL COMBINATIONS - DRUGS FOR PARASITES atovaquone-proguanil oral tablet 1 or 1b* COARTEM ORAL TABLET (artemether) 3 MALARONE ORAL TABLET (atovaquone) 3 MALARONE PEDIATRIC ORAL TABLET (atovaquone) 3 ANTIMALARIALS - DRUGS FOR PARASITES ARAKODA ORAL TABLET (tafenoquine) 3 QL (56 tablets per 1 year) chloroquine phosphate oral tablet 1 or 1a* DARAPRIM ORAL TABLET (pyrimethamine) 3 PA; LD; QL (3 tablets per 1 day) hydroxychloroquine oral tablet 1 or 1b* KRINTAFEL ORAL TABLET (tafenoquine) 3 QL (2 tablets per 1 fill) mefloquine oral tablet 1 or 1b* PLAQUENIL ORAL TABLET (hydroxychloroquine) 3 PRIMAQUINE ORAL TABLET 2 QUALAQUIN ORAL CAPSULE (quinine) 3 PA; QL (60 capsule per 365 days) quinine sulfate oral capsule 1 or 1b* PA; QL (60 capsule per 365 days) ANTIPROTOZOAL AGENTS - NITROIMIDAZOLE DERIVATIVES - DRUGS FOR PARASITES BENZNIDAZOLE ORAL TABLET (benznidazole) 3 ANTIPROTOZOAL AGENTS - OTHER - DRUGS FOR PARASITES ALINIA ORAL SUSPENSION FOR RECONSTITUTION (nitazoxanide) 3 ALINIA ORAL TABLET (nitazoxanide) 3 atovaquone oral suspension 1 or 1b* IMPAVIDO ORAL CAPSULE (miltefosine) 3 PA; QL (84 capsules per 1 fill) MEPRON ORAL SUSPENSION (atovaquone) 3 ANTIPROTOZOAL AGENTS (ANTIPARASITIC) - 5- NITROTHIAZOLYL DERIVATIVES - DRUGS FOR PARASITES ALINIA ORAL SUSPENSION FOR RECONSTITUTION (nitazoxanide) 3 ALINIA ORAL TABLET (nitazoxanide) 3 BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 28 Coverage Requirements and Prescription Drug Name Drug Tier Limits ANTIPROTOZOAL-ANTIBACTERIAL 1ST GENERATION 2- METHYL-5-NITROIMIDAZOLE - DRUGS FOR INFECTIONS FLAGYL ORAL CAPSULE (metronidazole) 3 FLAGYL ORAL TABLET (metronidazole) 3 METRO I.V. INTRAVENOUS PIGGYBACK (metronidazole) 3 METRONIDAZOLE IN NACL (ISO-OS) INTRAVENOUS PIGGYBACK 3 metronidazole oral capsule 1 or 1a* metronidazole oral tablet 1 or 1a* ANTIPROTOZOAL-ANTIBACTERIAL 2ND GENERATION 2- METHYL-5-NITROIMIDAZOLE - DRUGS FOR INFECTIONS SOLOSEC ORAL GRANULES DEL RELEASE IN PACKET 3 ST; QL (2 grams per 1 fill) (secnidazole) tinidazole oral tablet 1 or 1b* ANTIRETROVIRAL - ANTI-CD4 DOMAIN 2 MONOCLONAL ANTIBODY - DRUGS FOR VIRAL INFECTIONS TROGARZO INTRAVENOUS SOLUTION (ibalizumab-uiyk) 3 PA; LD ANTIRETROVIRAL - CCR5 CO-RECEPTOR ANTAGONIST - DRUGS FOR VIRAL INFECTIONS SELZENTRY ORAL SOLUTION (maraviroc) 3 SELZENTRY ORAL TABLET (maraviroc) 2 ANTIRETROVIRAL - HIV-1 FUSION INHIBITORS - DRUGS FOR VIRAL INFECTIONS FUZEON SUBCUTANEOUS RECON SOLN (enfuvirtide) 2 ANTIRETROVIRAL - HIV-1 INTEGRASE STRAND TRANSFER INHIBITORS - DRUGS FOR VIRAL INFECTIONS ISENTRESS HD ORAL TABLET (raltegravir) 3 ISENTRESS ORAL POWDER IN PACKET (raltegravir) 3 ISENTRESS ORAL TABLET (raltegravir) 2 ISENTRESS ORAL TABLET,CHEWABLE (raltegravir) 2 TIVICAY ORAL TABLET (dolutegravir) 3 ANTIRETROVIRAL - INTEGRASE INHIBITOR AND NNRTI COMBINATIONS - DRUGS FOR VIRAL INFECTIONS JULUCA ORAL TABLET (dolutegravir) 3 ANTIRETROVIRAL - INTEGRASE INHIBITOR AND NRTI COMBINATIONS - DRUGS FOR VIRAL INFECTIONS DOVATO ORAL TABLET (dolutegravir) 3 ANTIRETROVIRAL - NON-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIB (NNRTI) - DRUGS FOR VIRAL INFECTIONS EDURANT ORAL TABLET (rilpivirine) 2 efavirenz oral capsule 1 or 1b* efavirenz oral tablet 1 or 1b* BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 29 Coverage Requirements and Prescription Drug Name Drug Tier Limits INTELENCE ORAL TABLET (etravirine) 2 nevirapine oral suspension 1 or 1b* nevirapine oral tablet 1 or 1b* nevirapine oral tablet extended release 24 hr 1 or 1b* PIFELTRO ORAL TABLET (doravirine) 3 RESCRIPTOR ORAL TABLET (delavirdine) 2 SUSTIVA ORAL CAPSULE (efavirenz) 3 SUSTIVA ORAL TABLET (efavirenz) 3 VIRAMUNE ORAL SUSPENSION (nevirapine) 3 VIRAMUNE ORAL TABLET (nevirapine) 3 VIRAMUNE XR ORAL TABLET EXTENDED RELEASE 24 HR 3 (nevirapine) ANTIRETROVIRAL - NUCLEOSIDE AND NUCLEOTIDE ANALOG RTIS COMBINATIONS - DRUGS FOR VIRAL INFECTIONS CIMDUO ORAL TABLET (lamivudine) 3 DESCOVY ORAL TABLET (emtricitabine) 3 TRUVADA ORAL TABLET (emtricitabine) 2 ANTIRETROVIRAL - NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTI) - DRUGS FOR VIRAL INFECTIONS abacavir oral solution 1 or 1b* abacavir oral tablet 1 or 1b* didanosine oral capsule,delayed release(dr/ec) 1 or 1b* EMTRIVA ORAL CAPSULE (emtricitabine) 2 EMTRIVA ORAL SOLUTION (emtricitabine) 2 EPIVIR ORAL SOLUTION (lamivudine) 3 EPIVIR ORAL TABLET (lamivudine) 3 lamivudine oral solution 1 or 1b* lamivudine oral tablet 1 or 1b* RETROVIR INTRAVENOUS SOLUTION (zidovudine) 2 RETROVIR ORAL CAPSULE (zidovudine) 3 RETROVIR ORAL SYRUP (zidovudine) 3 stavudine oral capsule 1 or 1b* VIDEX 2 GRAM PEDIATRIC ORAL RECON SOLN (didanosine) 2 VIDEX EC ORAL CAPSULE,DELAYED RELEASE(DR/EC) 3 (didanosine) ZIAGEN ORAL SOLUTION (abacavir) 3 ZIAGEN ORAL TABLET (abacavir) 3 zidovudine oral capsule 1 or 1b* zidovudine oral syrup 1 or 1b* zidovudine oral tablet 1 or 1b* BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 30 Coverage Requirements and Prescription Drug Name Drug Tier Limits ANTIRETROVIRAL - NUCLEOTIDE ANALOG REVERSE TRANSCRIPTASE INHIBITORS - DRUGS FOR VIRAL INFECTIONS tenofovir disoproxil fumarate oral tablet 1 or 1b* VIREAD ORAL POWDER (tenofovir) 2 VIREAD ORAL TABLET 150 MG, 200 MG, 250 MG (tenofovir) 2 VIREAD ORAL TABLET 300 MG (tenofovir) 3 ANTIRETROVIRAL COMBINATIONS - PROTEASE INHIBITORS - DRUGS FOR VIRAL INFECTIONS EVOTAZ ORAL TABLET (atazanavir) 3 KALETRA ORAL SOLUTION (lopinavir) 3 KALETRA ORAL TABLET (lopinavir) 2 lopinavir-ritonavir oral solution 1 or 1b* PREZCOBIX ORAL TABLET (darunavir) 3 ANTIRETROVIRAL- NUCLEOSIDE AND NUCLEOTIDE ANALOGS,INTEGRASE INHIBITORS - DRUGS FOR VIRAL INFECTIONS BIKTARVY ORAL TABLET (bictegravir) 2 GENVOYA ORAL TABLET (elvitegravir) 2 STRIBILD ORAL TABLET (elvitegravir) 2 ANTIRETROVIRAL- NUCLEOSIDE AND NUCLEOTIDE ANALOGS,PROTEASE INHIBITORS - DRUGS FOR VIRAL INFECTIONS SYMTUZA ORAL TABLET (darunavir) 3 ANTIRETROVIRAL-NUCLEOSIDE ANALOGS AND INTEGRASE INHIBITOR COMBINATIONS - DRUGS FOR VIRAL INFECTIONS TRIUMEQ ORAL TABLET (abacavir) 2 ANTIRETROVIRAL-NUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITORS (NRTI) COMB - DRUGS FOR VIRAL INFECTIONS abacavir-lamivudine oral tablet 1 or 1b* abacavir-lamivudine-zidovudine oral tablet 1 or 1b* COMBIVIR ORAL TABLET (lamivudine) 3 EPZICOM ORAL TABLET (abacavir) 3 lamivudine-zidovudine oral tablet 1 or 1b* TRIZIVIR ORAL TABLET (abacavir) 3 ANTIRETROVIRAL-NUCLEOSIDE, NUCLEOTIDE ANALOGS AND NON-NUCLEOSIDE RTI - DRUGS FOR VIRAL INFECTIONS ATRIPLA ORAL TABLET (efavirenz) 2 ST COMPLERA ORAL TABLET (emtricitabine) 2 DELSTRIGO ORAL TABLET (doravirine) 3 ODEFSEY ORAL TABLET (emtricitabine) 3 SYMFI LO ORAL TABLET (efavirenz) 2

BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 160 Coverage Requirements and Prescription Drug Name Drug Tier Limits SODIUM LACTATE INTRAVENOUS SOLUTION (sodium lactate) 3 THAM INTRAVENOUS SOLUTION (tromethamine) 3 MINERALS AND ELECTROLYTES - CALCIUM REPLACEMENT - DRUGS FOR NUTRITION calcium acetate oral tablet 1 or 1b* calcium chloride intravenous solution 1 or 1b* CALCIUM CHLORIDE INTRAVENOUS SYRINGE (calcium) 3 CALCIUM GLUC IN NACL, ISO-OSM INTRAVENOUS SOLUTION 3 (calcium) CALCIUM GLUCONATE IN 0.9% NACL INTRAVENOUS SOLUTION 3 (calcium) CALCIUM GLUCONATE IN WATER INTRAVENOUS SYRINGE 3 (calcium) calcium gluconate intravenous solution 1 or 1b* MINERALS AND ELECTROLYTES - ELECTROLYTES AND DEXTROSE - DRUGS FOR NUTRITION dextrose 5 % in ringer's intravenous parenteral solution 1 or 1b* ELECTROLYTE-48 IN D5W INTRAVENOUS PARENTERAL 3 SOLUTION (electrolyte-48 solution) ELLIOTTS B (PF) INTRATHECAL SOLUTION (chemo diluent, e-lytes 3 and dextrose, buffered no.1) IONOSOL-B IN D5W INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-b solution) IONOSOL-MB IN D5W INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-mb solution) ISOLYTE-P IN 5 % DEXTROSE INTRAVENOUS PARENTERAL 3 SOLUTION (electrolyte-p solution) NORMOSOL-M IN 5 % DEXTROSE INTRAVENOUS PARENTERAL 3 SOLUTION (electrolyte-m solution) NORMOSOL-R IN 5 % DEXTROSE INTRAVENOUS PARENTERAL 3 SOLUTION (electrolyte-r solution) MINERALS AND ELECTROLYTES - IODINE - DRUGS FOR NUTRITION IODOPEN INTRAVENOUS SOLUTION (sodium iodide) 3 lugols oral solution 1 or 1b* SSKI ORAL SOLUTION (potassium iodide) 3 MINERALS AND ELECTROLYTES - IRON - DRUGS FOR NUTRITION AURYXIA ORAL TABLET (ferric salts) 3 ST FERAHEME INTRAVENOUS SOLUTION (ferumoxytol) 3 FERRLECIT INTRAVENOUS SOLUTION (sodium ferric gluconate 3 complex) INFED INJECTION SOLUTION (iron) 3 BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 161 Coverage Requirements and Prescription Drug Name Drug Tier Limits INJECTAFER INTRAVENOUS SOLUTION (ferric carboxymaltose) 3 sodium ferric gluconat-sucrose intravenous solution 1 or 1b* TRIFERIC HEMODIALYSIS POWDER IN PACKET (ferric salts) 3 TRIFERIC HEMODIALYSIS SOLUTION (ferric salts) 3 VENOFER INTRAVENOUS SOLUTION (iron) 3 MINERALS AND ELECTROLYTES - IRON COMBINATIONS - DRUGS FOR NUTRITION CITRANATAL BLOOM ORAL TABLET (iron carbonyl-ferrous 3 gluconate) elite-ob oral tablet 1 or 1b* OB COMPLETE ORAL TABLET (prenatal vitamins no.123) 3 OB COMPLETE PREMIER ORAL TABLET (prenatal vitamins with 3 calcium no.83) MINERALS AND ELECTROLYTES - MAGNESIUM - DRUGS FOR NUTRITION magnesium chloride injection solution 1 or 1b* MAGNESIUM SULFATE IN 0.9 %NACL INTRAVENOUS 3 PIGGYBACK (magnesium) MAGNESIUM SULFATE IN 0.9 %NACL INTRAVENOUS SOLUTION 3 (magnesium) MAGNESIUM SULFATE IN D5W INTRAVENOUS PIGGYBACK 3 (magnesium) MAGNESIUM SULFATE IN D5W INTRAVENOUS SOLUTION 3 (magnesium) MAGNESIUM SULFATE IN LR INTRAVENOUS SOLUTION 3 (magnesium) MAGNESIUM SULFATE IN WATER INTRAVENOUS PARENTERAL 3 SOLUTION (magnesium) MAGNESIUM SULFATE IN WATER INTRAVENOUS PIGGYBACK 3 (magnesium) magnesium sulfate injection solution 1 or 1b* magnesium sulfate injection syringe 1 or 1b* MINERALS AND ELECTROLYTES - MANGANESE - DRUGS FOR NUTRITION manganese chloride intravenous solution 1 or 1b* manganese sulfate intravenous solution 1 or 1b* MINERALS AND ELECTROLYTES - PARENTERAL ELECTROLYTE COMBINATIONS - DRUGS FOR NUTRITION HYPERLYTE CR INTRAVENOUS SOLUTION (sodium) 3 ISOLYTE S PH 7.4 INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-s ph 7.4 solution) ISOLYTE-S INTRAVENOUS PARENTERAL SOLUTION (electrolyte-s 3 solution) BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 162 Coverage Requirements and Prescription Drug Name Drug Tier Limits NORMOSOL-R INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-r solution) NORMOSOL-R PH 7.4 INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-r ph 7.4 solution) nutrilyte intravenous solution 1 or 1b* PLASMA-LYTE 148 INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-148 solution) PLASMA-LYTE A INTRAVENOUS PARENTERAL SOLUTION 3 (electrolyte-a solution) TPN ELECTROLYTES II INTRAVENOUS SOLUTION (sodium) 3 TPN ELECTROLYTES INTRAVENOUS SOLUTION (sodium) 3 MINERALS AND ELECTROLYTES - PHOSPHATE - DRUGS FOR NUTRITION GLYCOPHOS INTRAVENOUS SOLUTION (glycerophosphoric acid) 3 SODIUM PHOSPHATE IN 0.9 % NACL INTRAVENOUS SOLUTION 3 (sodium phosphate) SODIUM PHOSPHATE IN D5W INTRAVENOUS SOLUTION (sodium 3 phosphate) sodium phosphate intravenous solution 1 or 1b* MINERALS AND ELECTROLYTES - POTASSIUM FOR INJECTION - DRUGS FOR NUTRITION potassium acetate intravenous solution 1 or 1b* potassium chlorid-d5-0.45%nacl intravenous parenteral solution 1 or 1b* POTASSIUM CHLORIDE IN 0.9%NACL INTRAVENOUS 3 PARENTERAL SOLUTION 20 MEQ/250 ML (80 MEQ/L) (potassium) potassium chloride in 0.9%nacl intravenous parenteral solution 20 meq/l, 40 1 or 1b* meq/l POTASSIUM CHLORIDE IN 0.9%NACL INTRAVENOUS 3 PIGGYBACK (potassium) potassium chloride in 5 % dex intravenous parenteral solution 1 or 1b* POTASSIUM CHLORIDE IN LR-D5 INTRAVENOUS PARENTERAL 3 SOLUTION potassium chloride in water intravenous piggyback 1 or 1b* POTASSIUM CHLORIDE IN WATER INTRAVENOUS SYRINGE 3 (potassium) POTASSIUM CHLORIDE INTRAVENOUS SOLUTION (potassium) 3 potassium chloride-0.45 % nacl intravenous parenteral solution 1 or 1b* potassium chloride-d5-0.2%nacl intravenous parenteral solution 10 meq/l, 30 1 or 1b* meq/l, 40 meq/l POTASSIUM CHLORIDE-D5-0.2%NACL INTRAVENOUS 3 PARENTERAL SOLUTION 20 MEQ/L potassium chloride-d5-0.3%nacl intravenous parenteral solution 1 or 1b* potassium chloride-d5-0.9%nacl intravenous parenteral solution 20 meq/l 1 or 1b* BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 163 Coverage Requirements and Prescription Drug Name Drug Tier Limits POTASSIUM CHLORIDE-D5-0.9%NACL INTRAVENOUS 3 PARENTERAL SOLUTION 40 MEQ/L POTASSIUM CL-LIDO-0.9 % NACL INTRAVENOUS PIGGYBACK 3 (potassium) MINERALS AND ELECTROLYTES - POTASSIUM, ORAL - DRUGS FOR NUTRITION EFFER-K ORAL TABLET, EFFERVESCENT 10 MEQ, 20 MEQ 3 (potassium bicarbonate) effer-k oral tablet, effervescent 25 meq 1 or 1b* klor-con 10 oral tablet extended release 1 or 1b* klor-con 8 oral tablet extended release 1 or 1b* potassium chloride (Klor-Con M10 Oral Tablet,Er Particles/Crystals) 1 or 1a* klor-con m15 oral tablet,er particles/crystals 1 or 1a* potassium chloride (Klor-Con M20 Oral Tablet,Er Particles/Crystals) 1 or 1a* potassium chloride (Klor-Con Oral Packet) 1 or 1b* potassium chloride (Klor-Con Sprinkle Oral Capsule, Extended Release) 1 or 1b* klor-con/ef oral tablet, effervescent 1 or 1b* K-TAB ORAL TABLET EXTENDED RELEASE (potassium) 3 potassium chloride oral capsule, extended release 1 or 1b* potassium chloride oral liquid 1 or 1b* potassium chloride oral packet 1 or 1b* potassium chloride oral tablet extended release 1 or 1b* potassium chloride oral tablet,er particles/crystals 1 or 1a* MINERALS AND ELECTROLYTES - TRACE MINERAL COMBINATIONS - DRUGS FOR NUTRITION ADDAMEL N INTRAVENOUS SOLUTION (trace elements combination 3 no.1) MULTITRACE-4 CONCENTRATE INTRAVENOUS SOLUTION (zinc) 3 MULTITRACE-4 INTRAVENOUS SOLUTION (zinc) 3 MULTITRACE-4 NEONATAL INTRAVENOUS SOLUTION (zinc) 3 MULTITRACE-4 PEDIATRIC INTRAVENOUS SOLUTION (zinc) 3 MULTITRACE-5 CONCENTRATE INTRAVENOUS SOLUTION (zinc) 3 MULTITRACE-5 INTRAVENOUS SOLUTION (zinc) 3 PEDITRACE INTRAVENOUS SOLUTION (zinc) 3 TRACE ELEMENTS 4/PEDIATRIC INTRAVENOUS SOLUTION (zinc) 3 MINERALS AND ELECTROLYTES - TRACE MINERALS - DRUGS FOR NUTRITION chromium chloride intravenous solution 1 or 1b* copper chloride intravenous solution 1 or 1b* SELENIOUS ACID INTRAVENOUS SOLUTION (selenium) 3

BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 176 Coverage Requirements and Prescription Drug Name Drug Tier Limits STRIANT BUCCAL MUCOADHESIVE SYSTEM ER 12 HR 3 PA; QL (2 buccal system per 1 day) (testosterone) TESTOPEL IMPLANT PELLET (testosterone) 3 PA; LD testosterone cypionate intramuscular oil 100 mg/ml 1 or 1b* PA TESTOSTERONE CYPIONATE INTRAMUSCULAR OIL 200 MG/ML 3 PA TESTOSTERONE ENANTHATE INTRAMUSCULAR OIL 3 PA testosterone transdermal gel 1 or 1b* PA; QL (1 bottle per 30 days) testosterone transdermal gel in metered-dose pump 10 mg/0.5 gram /actuation 1 or 1b* PA; QL (1 pump per 30 days) testosterone transdermal gel in metered-dose pump 20.25 mg/1.25 gram (1.62 1 or 1b* PA; QL (2 bottle per 30 days) %) testosterone transdermal gel in packet 1 % (25 mg/2.5gram) 1 or 1b* PA; QL (2 packet per 1 day) testosterone transdermal gel in packet 1.62 % (20.25 mg/1.25 gram), 1.62 % 1 or 1b* PA; QL (1 packet per 1 day) (40.5 mg/2.5 gram) testosterone transdermal solution in metered pump w/app 1 or 1b* PA; QL (1 pump bottle per 30 days) TESTRED ORAL CAPSULE (methyltestosterone) 3 XYOSTED SUBCUTANEOUS AUTO-INJECTOR (testosterone) 3 PA ANTIDIURETIC AND VASOPRESSOR HORMONES - HORMONES DDAVP INJECTION SOLUTION (desmopressin) 3 DDAVP NASAL SOLUTION (desmopressin) 3 DDAVP NASAL SPRAY WITH PUMP (desmopressin) 3 DDAVP ORAL TABLET (desmopressin) 3 desmopressin injection solution 1 or 1b* desmopressin nasal spray with pump 1 or 1b* desmopressin nasal spray,non-aerosol 1 or 1b* desmopressin oral tablet 1 or 1b* NOCDURNA (MEN) SUBLINGUAL TABLET,DISINTEGRATING 4 PA; QL (1 tablet per 1 day) (desmopressin) NOCDURNA (WOMEN) SUBLINGUAL TABLET,DISINTEGRATING 4 PA; QL (1 tablet per 1 day) (desmopressin) NOCTIVA NASAL SPRAY,NON-AEROSOL (desmopressin) 3 PA; QL (1 bottle per 30 days) STIMATE NASAL SPRAY,NON-AEROSOL (desmopressin) 3 VASOPRESSIN IN 0.9 % SOD CHLOR INTRAVENOUS SOLUTION 3 (vasopressin) VASOPRESSIN IN DEXTROSE 5 % INTRAVENOUS SOLUTION 3 (vasopressin) VASOSTRICT INTRAVENOUS SOLUTION (vasopressin) 3 ANTIHYPERGLYCEMIC - ALPHA-GLUCOSIDASE INHIBITORS - DRUGS FOR DIABETES acarbose oral tablet 1 or 1b* GLYSET ORAL TABLET (miglitol) 3 miglitol oral tablet 1 or 1b* BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 177 Coverage Requirements and Prescription Drug Name Drug Tier Limits PRECOSE ORAL TABLET (acarbose) 3 ANTIHYPERGLYCEMIC - DIPEPTIDYL PEPTIDASE-4 (DPP-4) INHIBITORS - DRUGS FOR DIABETES JANUVIA ORAL TABLET (sitagliptin) 2 ST; QL (1 tablet per 1 day) TRADJENTA ORAL TABLET (linagliptin) 2 ST ANTIHYPERGLYCEMIC - DOPAMINE RECEPTOR AGONISTS - DRUGS FOR DIABETES CYCLOSET ORAL TABLET (bromocriptine) 3 ANTIHYPERGLYCEMIC - GLUCOCORTICOID (CORTISOL) RECEPTOR BLOCKER (GR-II) - DRUGS FOR DIABETES KORLYM ORAL TABLET (mifepristone) 4 PA; LD ANTIHYPERGLYCEMIC - MEGLITINIDE ANALOG AND BIGUANIDE COMBINATIONS - DRUGS FOR DIABETES repaglinide-metformin oral tablet 1 or 1b* ANTIHYPERGLYCEMIC - MEGLITINIDE ANALOGS - DRUGS FOR DIABETES nateglinide oral tablet 1 or 1b* PRANDIN ORAL TABLET (repaglinide) 3 repaglinide oral tablet 1 or 1b* STARLIX ORAL TABLET (nateglinide) 3 ANTIHYPERGLYCEMIC - SGLT-2 INHIBITOR AND BIGUANIDE COMBINATIONS - DRUGS FOR DIABETES SYNJARDY ORAL TABLET (empagliflozin) 2 ST; QL (2 tablets per 1 day) SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 10-1,000 2 ST; QL (2 tablets per 1 day) MG, 12.5-1,000 MG, 5-1,000 MG (empagliflozin) SYNJARDY XR ORAL TABLET, IR - ER, BIPHASIC 24HR 25-1,000 2 ST; QL (1 tablet per 1 day) MG (empagliflozin) ANTIHYPERGLYCEMIC - SODIUM GLUCOSE COTRANSPORTER- 2 (SGLT2) INHIBITORS - DRUGS FOR DIABETES JARDIANCE ORAL TABLET (empagliflozin) 2 ST; QL (1 tablet per 1 day) ANTIHYPERGLYCEMIC - SULFONYLUREA AND BIGUANIDE COMBINATIONS - DRUGS FOR DIABETES glipizide-metformin oral tablet 1 or 1b* ST glyburide-metformin oral tablet 1 or 1b* ST ANTIHYPERGLYCEMIC - SULFONYLUREA DERIVATIVES - DRUGS FOR DIABETES AMARYL ORAL TABLET (glimepiride) 3 ST chlorpropamide oral tablet 1 or 1b* ST glimepiride oral tablet 1 or 1b* ST glipizide oral tablet 1 or 1a* ST glipizide oral tablet extended release 24hr 1 or 1a* ST GLUCOTROL ORAL TABLET (glipizide) 3 ST BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 178 Coverage Requirements and Prescription Drug Name Drug Tier Limits GLUCOTROL XL ORAL TABLET EXTENDED RELEASE 24HR 3 ST (glipizide) glyburide micronized oral tablet 1 or 1b* ST glyburide oral tablet 1 or 1b* ST GLYNASE ORAL TABLET (glyburide) 3 ST tolazamide oral tablet 1 or 1b* ST tolbutamide oral tablet 1 or 1b* ST ANTIHYPERGLYCEMIC - THIAZOLIDINEDIONE AND BIGUANIDE COMBINATIONS - DRUGS FOR DIABETES ACTOPLUS MET ORAL TABLET (pioglitazone) 3 ST; QL (3 tablet per 1 day) ACTOPLUS MET XR ORAL TABLET, ER MULTIPHASE 24 HR 2 ST; QL (2 tablets per 1 day) (pioglitazone) pioglitazone-metformin oral tablet 1 or 1b* ST; QL (3 tablets per 1 day) ANTIHYPERGLYCEMIC - THIAZOLIDINEDIONE AND SULFONYLUREA COMBINATIONS - DRUGS FOR DIABETES DUETACT ORAL TABLET (pioglitazone) 3 ST; QL (1 tablet per 1 day) pioglitazone-glimepiride oral tablet 1 or 1b* ST; QL (1 tablet per 1 day) ANTIHYPERGLYCEMIC, AMYLIN ANALOG-TYPE - DRUGS FOR DIABETES SYMLINPEN 120 SUBCUTANEOUS PEN INJECTOR (pramlintide) 2 SYMLINPEN 60 SUBCUTANEOUS PEN INJECTOR (pramlintide) 2 ANTIHYPERGLYCEMIC, INCRETIN MIMETIC,GLP-1 RECEPTOR AGONIST ANALOG-TYPE - DRUGS FOR DIABETES BYDUREON BCISE SUBCUTANEOUS AUTO-INJECTOR (exenatide) 2 ST; QL (4 vial per 28 days) BYDUREON SUBCUTANEOUS PEN INJECTOR (exenatide) 2 ST; QL (4 vial per 28 days) BYETTA SUBCUTANEOUS PEN INJECTOR (exenatide) 2 ST; QL (1 pens per 30 days) OZEMPIC SUBCUTANEOUS PEN INJECTOR 0.25 MG OR 0.5 MG(2 2 ST; QL (1 pen per 28 days) MG/1.5 ML) (semaglutide) OZEMPIC SUBCUTANEOUS PEN INJECTOR 1 MG/DOSE (2 MG/1.5 2 ST; QL (2 pens per 28 days) ML) (semaglutide) TRULICITY SUBCUTANEOUS PEN INJECTOR (dulaglutide) 2 ST; QL (4 pens per 28 days) VICTOZA 2-PAK SUBCUTANEOUS PEN INJECTOR (liraglutide) 2 ST; QL (1 box per 30 days) VICTOZA 3-PAK SUBCUTANEOUS PEN INJECTOR (liraglutide) 2 ST; QL (1 box per 30 days) ANTIHYPERGLYCEMIC-DIPEPTIDYL PEPTIDASE-4 INHIBIT AND THIAZOLIDINEDIONE - DRUGS FOR DIABETES ALOGLIPTIN-PIOGLITAZONE ORAL TABLET 3 ST; QL (1 tablet per 1 day) OSENI ORAL TABLET (alogliptin) 3 ST; QL (1 tablet per 1 day) ANTIHYPERGLYCEMIC-DIPEPTIDYL PEPTIDASE-4(DPP- 4)INHIBITOR AND BIGUANIDE - DRUGS FOR DIABETES JANUMET ORAL TABLET (sitagliptin) 2 ST; QL (2 tablets per 1 day) JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 100-1,000 2 ST; QL (1 tablet per 1 day) MG (sitagliptin) BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 179 Coverage Requirements and Prescription Drug Name Drug Tier Limits JANUMET XR ORAL TABLET, ER MULTIPHASE 24 HR 50-1,000 2 ST; QL (2 tablets per 1 day) MG, 50-500 MG (sitagliptin) JENTADUETO ORAL TABLET (linagliptin) 2 ST; QL (2 tablets per 1 day) JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 2.5-1,000 2 ST; QL (2 tablets per 1 day) MG (linagliptin) JENTADUETO XR ORAL TABLET, IR - ER, BIPHASIC 24HR 5-1,000 2 ST; QL (1 tablet per 1 day) MG (linagliptin) ANTIHYPERGLYCEMIC-INSULIN, LONG ACTING AND GLP-1 RECEPTOR AGONIST COMB - DRUGS FOR DIABETES SOLIQUA 100/33 SUBCUTANEOUS INSULIN PEN (insulin glargine) 3 ST; QL (5 pen per 25 days) XULTOPHY 100/3.6 SUBCUTANEOUS INSULIN PEN (insulin degludec) 3 ST; QL (5 pen per 30 days) ANTITHYROID AGENTS, THIONAMIDES - IMIDAZOLE DERIVATIVES - DRUGS FOR THYROID methimazole oral tablet 1 or 1a* TAPAZOLE ORAL TABLET (methimazole) 3 ANTITHYROID AGENTS, THIONAMIDES - THIOURACIL DERIVATIVES - DRUGS FOR THYROID propylthiouracil oral tablet 1 or 1b* BONE FORMATION AGENTS - SCLEROSTIN INHIBITOR, MONOCLONAL ANTIBODY - DRUGS FOR MENOPAUSE AND BONE LOSS EVENITY SUBCUTANEOUS SYRINGE 105 MG/1.17 ML (romosozumab- 4 PA; SP; QL (2 syringes per 30 days) aqqg) EVENITY SUBCUTANEOUS SYRINGE 210MG/2.34ML ( 4 PA; SP 105MG/1.17MLX2) (romosozumab-aqqg) BONE FORMATION STIMULATING AGENTS - PARATHYROID HORMONE REL PEPTIDES - DRUGS FOR MENOPAUSE AND BONE LOSS TYMLOS SUBCUTANEOUS PEN INJECTOR (abaloparatide) 4 PA; SP; QL (1 mL per 30 days) BONE FORMATION STIMULATING AGENTS - PARATHYROID HORMONE-TYPE - DRUGS FOR MENOPAUSE AND BONE LOSS FORTEO SUBCUTANEOUS PEN INJECTOR (teriparatide) 4 PA; SP; QL (1 pen per 28 days) BONE RESORPTION INHIBITORS - BISPHOSPHONATE AND VITAMIN D COMBINATIONS - DRUGS FOR MENOPAUSE AND BONE LOSS FOSAMAX PLUS D ORAL TABLET 70 MG- 2,800 UNIT (alendronic 2 QL (4 tablets per 28 days) acid) FOSAMAX PLUS D ORAL TABLET 70 MG- 5,600 UNIT (alendronic 2 acid) BONE RESORPTION INHIBITORS - BISPHOSPHONATES - DRUGS FOR MENOPAUSE AND BONE LOSS ACTONEL ORAL TABLET 150 MG (risedronic acid) 3 QL (1 tablet per 30 days) ACTONEL ORAL TABLET 35 MG (risedronic acid) 3 QL (4 tablets per 28 days) ACTONEL ORAL TABLET 5 MG (risedronic acid) 3 QL (1 tablet per 1 day) BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 180 Coverage Requirements and Prescription Drug Name Drug Tier Limits alendronate oral solution 1 or 1b* alendronate oral tablet 10 mg, 40 mg, 5 mg 1 or 1b* QL (1 tablet per 1 day) alendronate oral tablet 35 mg, 70 mg 1 or 1b* QL (4 tablets per 28 days) ATELVIA ORAL TABLET,DELAYED RELEASE (DR/EC) (risedronic 3 QL (4 tablets per 28 days) acid) BINOSTO ORAL TABLET, EFFERVESCENT (alendronic acid) 3 QL (4 tablets per 28 days) BONIVA INTRAVENOUS SYRINGE (ibandronic acid) 4 BONIVA ORAL TABLET (ibandronic acid) 3 ST; QL (1 tablet per 28 days) etidronate disodium oral tablet 1 or 1b* FOSAMAX ORAL TABLET (alendronic acid) 3 QL (4 tablets per 28 days) ibandronate intravenous solution 1 or 1b* ibandronate intravenous syringe 4 ibandronate oral tablet 1 or 1b* ST; QL (1 tablet per 28 days) pamidronate intravenous recon soln 4 SP pamidronate intravenous solution 4 SP RECLAST INTRAVENOUS PIGGYBACK (zoledronic acid) 4 PA; SP risedronate oral tablet 150 mg 1 or 1b* QL (1 tablet per 30 days) risedronate oral tablet 30 mg, 5 mg 1 or 1b* QL (1 tablet per 1 day) risedronate oral tablet 35 mg 1 or 1b* QL (4 tablets per 28 days) risedronate oral tablet,delayed release (dr/ec) 1 or 1b* QL (4 tablets per 28 days) zoledronic acid intravenous recon soln 1 or 1b* PA; SP zoledronic acid intravenous solution 1 or 1b* PA; SP zoledronic acid-mannitol-water intravenous piggyback 4 mg/100 ml 1 or 1b* PA; SP zoledronic acid-mannitol-water intravenous piggyback 5 mg/100 ml 4 SP ZOLEDRONIC AC-MANNITOL-0.9NACL INTRAVENOUS 4 SP PIGGYBACK (zoledronic acid) CALCIMIMETIC, PARATHYROID CALCIUM RECEPTOR SENSITIVITY ENHANCER - DRUGS FOR MENOPAUSE AND BONE LOSS cinacalcet oral tablet 30 mg, 60 mg 4 PA; QL (2 tablets per 1 day) cinacalcet oral tablet 90 mg 4 PA PARSABIV INTRAVENOUS SOLUTION (etelcalcetide) 4 PA SENSIPAR ORAL TABLET 30 MG, 60 MG (cinacalcet) 4 PA; QL (2 tablets per 1 day) SENSIPAR ORAL TABLET 90 MG (cinacalcet) 4 PA CALCITONINS - DRUGS FOR MENOPAUSE AND BONE LOSS calcitonin (salmon) nasal spray,non-aerosol 1 or 1b* QL (1 bottle per 30 days) MIACALCIN INJECTION SOLUTION (calcitonin) 4 ESTROGEN AND PROGESTIN WITH ANTIMINERALOCORTICOID ACTIVITY,COMBINATION - DRUGS FOR WOMEN ANGELIQ ORAL TABLET (drospirenone) 3

BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 233 Coverage Requirements and Prescription Drug Name Drug Tier Limits COMFORT EZ PEN NEEDLES NEEDLE (pen needle, diabetic) 3 ST COMFORT LANCETS (lancets) 2 CONCEPTION KIT (conception assistance supplies combination no.1) 3 DROPLET INSULIN SYR HALF UNIT SYRINGE (syringe with 3 needle,insulin disposable) DROPLET INSULIN SYRINGE SYRINGE 0.3 ML 30 GAUGE X 1/2" 3 (syringe with needle,insulin disposable) DROPLET INSULIN SYRINGE SYRINGE 0.3 ML 30 GAUGE X 15/64", 0.3 ML 30 GAUGE X 5/16", 0.3 ML 31 GAUGE X 15/64", 0.3 ML 31 GAUGE X 5/16", 1 ML 30 GAUGE X 1/2", 1 ML 30 GAUGE X 15/64", 1 3 ST ML 30 GAUGE X 5/16, 1 ML 31 GAUGE X 15/64", 1 ML 31 GAUGE X 5/16 (syringe with needle,insulin disposable) DROPLET LANCETS (lancets) 2 DROPLET PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST DROPSAFE PEN NEEDLE NEEDLE (pen needle, diabetic, safety) 3 EASY COMFORT INSULIN SYRINGE SYRINGE (syringe with 3 ST needle,insulin disposable) EASY COMFORT LANCETS (lancets) 2 EASY COMFORT PEN NEEDLES NEEDLE 31 GAUGE X 1/4", 32 3 ST GAUGE X 5/32" (pen needle, diabetic) EASY COMFORT PEN NEEDLES NEEDLE 31 GAUGE X 3/16", 31 3 GAUGE X 5/16" (pen needle, diabetic) EASY GLIDE PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST EASY TOUCH FLIPLOCK INSULIN SYRINGE (syringe with needle, 3 ST insulin, safety) EASY TOUCH INSULIN SAFETY SYR SYRINGE (syringe with needle, 3 ST insulin, safety) EASY TOUCH INSULIN SYRINGE SYRINGE (syringe with needle,insulin 3 ST disposable) EASY TOUCH LANCETS (lancets) 2 EASY TOUCH LUER LOCK INSULIN SYRINGE (syringe without 3 needle,insulin disposable) EASY TOUCH NEEDLE (pen needle, diabetic) 3 ST EASY TOUCH PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST EASY TOUCH SAFETY LANCETS (lancets) 2 EASY TOUCH SHEATHLOCK INSULIN SYRINGE (syringe with needle, 3 ST insulin, safety) EASY TOUCH TWIST LANCETS (lancets) 2 EASY TOUCH UNI-SLIP SYRINGE (syringe without needle,insulin 3 disposable) EASY TWIST AND CAP LANCETS (lancets) 2 EMBRACE LANCETS (lancets) 2 EXEL INSULIN SYRINGE (syringe with needle,insulin disposable) 3 ST BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 234 Coverage Requirements and Prescription Drug Name Drug Tier Limits E-Z JECT LANCETS (lancets) 2 E-Z JECT THIN LANCETS (lancets) 2 EZ SMART LANCETS (lancets) 2 FEMCAP VAGINAL DEVICE (cervical cap) 2; $0 FIFTY50 SAFETY SEAL LANCETS (lancets) 2 FINE 30 UNIVERSAL LANCETS (lancets) 2 FINGERSTIX LANCETS (lancets) 2 FORA V10-V12-D10-D20 STRP-LNCT COMBO PACK (lancets) 3 FORACARE LANCETS (lancets) 2 FREESTYLE LANCETS (lancets) 2 FREESTYLE PRECISION SYRINGE (syringe with needle,insulin 3 ST disposable) FREESTYLE UNISTIK 2 (lancets) 2 GENTEEL VACUUM LANCING DEVICE COMBO PACK (lancing 2 device, vacuum) GLUCOCOM LANCETS (lancets) 2 HEALTHWISE INSULIN SYRINGE SYRINGE (syringe with 3 needle,insulin disposable) HEALTHWISE PEN NEEDLE NEEDLE (pen needle, diabetic) 3 HEALTHY ACCENTS UNIFINE PENTIP NEEDLE (pen needle, diabetic) 3 ST HEALTHY ACCENTS UNILET LANCET (lancets) 2 HYPOLANCE AST LANCING KIT (lancing device) 2 INCONTROL PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST INCONTROL SUPER THIN LANCETS (lancets) 2 INCONTROL ULTRA THIN LANCETS (lancets) 2 INJECT EASE LANCETS (lancets) 2 INSULIN SYR/NDL U100 HALF MARK SYRINGE 3 ST INSULIN SYRINGE MICROFINE SYRINGE (syringe with needle,insulin 2 disposable) INSULIN SYRINGE NEEDLELESS SYRINGE 2 INSULIN SYRINGE SYRINGE (syringe with needle,insulin disposable) 3 ST INSULIN SYRINGE-NEEDLE U-100 SYRINGE 0.3 ML 29 GAUGE, 0.3 ML 29 GAUGE X 1/2", 0.3 ML 30, 0.3 ML 30 GAUGE X 1/2", 0.3 ML 30 GAUGE X 5/16", 0.3 ML 31 GAUGE X 1/4", 0.3 ML 31 GAUGE X 15/64", 0.3 ML 31 GAUGE X 5/16", 0.5 ML 29 GAUGE X 1/2", 0.5 ML 30 GAUGE X 1/2", 0.5 ML 30 GAUGE X 5/16", 0.5 ML 31 GAUGE X 5/16", 1 ML 27 GAUGE X 1/2", 1 ML 28 GAUGE, 1 ML 28 GAUGE X 1/2", 1 3 ST ML 29 GAUGE X 1/2", 1 ML 29 GAUGE X 7/16", 1 ML 30 GAUGE X 1/2", 1 ML 30 GAUGE X 5/16, 1 ML 30 GAUGE X 7/16", 1 ML 31 GAUGE X 1/4", 1 ML 31 GAUGE X 15/64", 1 ML 31 GAUGE X 5/16, 1/2 ML 27 GAUGE X 1/2", 1/2 ML 28 GAUGE, 1/2 ML 28 GAUGE X 1/2", 1/2 ML 29 , 1/2 ML 30 GAUGE, 1/2 ML 31 GAUGE X 1/4", 1/2 ML 31 GAUGE X 15/64" BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 235 Coverage Requirements and Prescription Drug Name Drug Tier Limits insulin syringe-needle u-100 syringe 1 ml 30 gauge x 3/8" 1 or 1b* INSUPEN NEEDLE (pen needle, diabetic) 3 ST INVACARE LANCETS (lancets) 2 LANCETS 2 LANCETS, SUPER THIN (lancets) 2 LANCETS,THIN (lancets) 2 LANCETS,ULTRA THIN (lancets) 2 LANCING DEVICE WITH LANCETS KIT 2 LANZO LANCING DEVICE KIT (lancing device) 2 LITE TOUCH INSULIN PEN NEEDLES NEEDLE (pen needle, diabetic) 3 ST LITE TOUCH INSULIN SYRINGE SYRINGE (syringe with needle,insulin 3 ST disposable) LITE TOUCH LANCETS (lancets) 2 MAGELLAN INSULIN SAFETY SYRNG SYRINGE (syringe with needle, 3 ST insulin, safety) MAGELLAN SYRINGE SYRINGE (syringe with needle, insulin, safety) 3 ST MAXICOMFORT II PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST MAXICOMFORT INSULIN SYRINGE SYRINGE (syringe with 3 ST needle,insulin disposable) MAXI-COMFORT INSULIN SYRINGE SYRINGE (syringe with 3 ST needle,insulin disposable) MAXICOMFORT SAFETY PEN NEEDLE NEEDLE (pen needle, 3 ST diabetic, safety) MEDISENSE THIN LANCETS (lancets) 2 MEDLANCE PLUS LANCETS (lancets) 2 MEDLANCE PLUS SPECIAL BLADE (blade lancet, safety) 2 MICRO THIN LANCETS (lancets) 2 MICROLET 2 LANCING DEVICE KIT (lancing device) 2 MICROLET LANCET (lancets) 2 MICROLET NEXT LANCING DEVICE KIT (lancing device) 2 MINI ULTRA-THIN II NEEDLE (pen needle, diabetic) 3 ST MONOJECT INSULIN SAFETY SYRING SYRINGE (syringe with 3 ST needle,insulin disposable) MONOJECT INSULIN SYRINGE SYRINGE (syringe with needle,insulin 3 ST disposable) MONOJECT SYRINGE SYRINGE (syringe with needle,insulin disposable) 3 ST MONOJECT ULTRA COMFORT INSULIN SYRINGE (syringe with 3 ST needle,insulin disposable) MONOLET LANCETS (lancets) 2 MONOLET THIN LANCETS (lancets) 2 MULTI-LANCET DEVICE 2 KIT (lancing device) 2 BRAND=Brand drug generic=generic drug *Your plan may include Tiers 1a/1b. Refer to your pharmacy benefit summary for more information Tier 1 or 1a*=Drugs with the lowest cost share Tier 1 or 1b*=drugs with a low cost share Tier 2=Drugs with a higher cost share than Tier 1 Tier 3=Drugs with a higher cost share than Tier 2 Tier 4=Drugs with the highest cost share and usually include specialty brand and generic drugs $0=Preventive Drug DO=Dose Optimization LD=Limited Distribution OC=Oral Chemotherapy PA=Prior Authorization QL=Quantity Limit SP=Specialty Pharmacy ST=Step Therapy Effective 7/1/19 236 Coverage Requirements and Prescription Drug Name Drug Tier Limits MYGLUCOHEALTH LANCETS (lancets) 2 NOVA SAFETY LANCETS (lancets) 2 NOVA SUREFLEX LANCETS (lancets) 2 NOVOFINE 32 NEEDLE (pen needle, diabetic) 3 ST NOVOFINE AUTOCOVER NEEDLE (pen needle, diabetic, safety) 3 ST NOVOFINE PLUS NEEDLE (pen needle, diabetic) 3 ST NOVOTWIST NEEDLE (pen needle, diabetic) 3 ST NUTRIPORT BALLOON KIT (ostomy kit) 2 ON CALL LANCET (lancets) 2 ON CALL PLUS LANCET (lancets) 2 ONETOUCH DELICA LANC DEVICE KIT (lancing device) 2 ONETOUCH DELICA LANCETS (lancets) 2 ONETOUCH DELICA PLUS LANC DEV KIT (lancing device) 2 ONETOUCH DELICA PLUS LANCET (lancets) 2 ONETOUCH SURESOFT LANCING DEV (lancets) 2 ONETOUCH ULTRA BLUE TEST STRIP STRIP (blood sugar diagnostic) 2 QL (204 strips per 30 days) ONETOUCH ULTRASOFT LANCETS (lancets) 2 ONETOUCH VERIO STRIP (blood sugar diagnostic) 2 QL (204 strips per 30 days) ON-THE-GO LANCETS (lancets) 2 PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST PEN NEEDLE, DIABETIC NEEDLE 3 ST PENTIPS NEEDLE (pen needle, diabetic) 3 ST PRESSURE ACTIVATED LANCETS (lancets) 2 PRO COMFORT INSULIN SYRINGE SYRINGE (syringe with 3 ST needle,insulin disposable) PRO COMFORT LANCET (lancets) 2 PRO COMFORT PEN NEEDLE NEEDLE (pen needle, diabetic) 3 ST PRODIGY INSULIN SYRINGE SYRINGE (syringe with needle,insulin 3 ST disposable) PRODIGY LANCETS (lancets) 2 PRODIGY TWIST TOP LANCET (lancets) 2 PUSH BUTTON SAFETY LANCETS (lancets) 2 READYLANCE SAFETY LANCETS (lancets) 2 RELIAMED LANCET (lancets) 2 RELIAMED SAFETY SEAL LANCETS (lancets) 2 RELION NEEDLES NEEDLE (pen needle, diabetic) 3 ST RELION PEN NEEDLES NEEDLE (pen needle, diabetic) 3 ST RELION THIN LANCETS (lancets) 2 RELION ULTRA THIN PLUS LANCETS (lancets) 2

271 ALLERGENIC EXTRACT-FOOD- ALTAFLUOR BENOX...... 252 ammonium lactate...... 144 CORN...... 156 Altavera (28)...... 129 AMMONUL...... 243 ALLERGENIC EXTRACT-FOOD- ALTERNATE SITE LANCET. 223, 232 Amnesteem...... 134 CRAB...... 156 ALTOPREV...... 81 amoxapine...... 105 ALLERGENIC EXTRACT-FOOD- ALTRENO...... 136 amoxicil-clarithromy-lansopraz...... 201 EGG...... 156 ALUNBRIG...... 46 amoxicillin...... 24 ALLERGENIC EXTRACT-FOOD- Alyacen 1/35 (28)...... 129 amoxicillin-pot clavulanate...... 25 OATS...... 156 alyacen 7/7/7 (28)...... 133 AMPHADASE...... 192 ALLERGENIC EXTRACT-FOOD- Alyq...... 95 amphetamine sulfate...... 111, 117, 122 ORANGE...... 156 ALZAIR...... 266 amphotericin b...... 26 ALLERGENIC EXTRACT-FOOD- Amabelz...... 182 ampicillin...... 24 PEANUT...... 156 amantadine hcl...... 107 ampicillin sodium...... 25 ALLERGENIC EXTRACT-FOOD- AMARYL...... 178 ampicillin-sulbactam...... 25 PECAN...... 156 AMBIEN...... 123 AMPYRA...... 246 ALLERGENIC EXTRACT-FOOD- AMBIEN CR...... 123 AMVISC...... 253 PORK...... 156 AMBISOME...... 26 AMVISC PLUS...... 253 ALLERGENIC EXTRACT-FOOD- ambrisentan...... 95 AMYTAL...... 123 RICE...... 156 amcinonide...... 144 ANADROL-50...... 176 ALLERGENIC EXTRACT-FOOD- AMELUZ...... 150 ANAFRANIL...... 106 SHRIMP...... 156 AMERGE...... 120 anagrelide...... 214 ALLERGENIC EXTRACT- Amethia...... 128 ANALPRAM-HC...... 21, 148 MOSQUITO...... 61 amethia lo...... 128 ANAPROX DS...... 16 ALLERGENIC EXTRACT- Amethyst (28)...... 129 ANASCORP...... 67 PISTACHIO...... 156 AMICAR...... 210 ANASPAZ...... 197, 205 ALLERGENIC EXTRACT- AMIDATE...... 18 anastrozole...... 48 SESAME SEED...... 156 amifostine crystalline...... 60 ANAVIP...... 67 ALLERGENIC EXTRACT- amikacin...... 24 ANCOBON...... 27 STRAWBERRY...... 157 amiloride...... 91 ANDEXXA...... 22 ALLERGENIC EXT-RHIZOPUS amiloride-hydrochlorothiazide...... 92 ANDRODERM...... 176 ORYZAE...... 64 aminocaproic acid...... 210 ANDROGEL...... 176 ALLERGENIC XT-EPICOCCUM aminophylline...... 261 ANDROID...... 176 NIGRUM...... 64 AMINOPHYLLINE...... 261 ANECTINE...... 219 ALLERGENIC XT-MOUSE AMINOPROTECT...... 165 ANESTHESIA S/I-40 (PROPOFOL). 18 EPITHELIUM...... 64 AMINOSYN 10 %...... 166 ANESTHESIA S/I-40A ALLERGEN-WEED- AMINOSYN 7 % WITH (PROPOFOL)...... 18 LAMBSQUARTERS...... 65 ELECTROLYTES...... 165 ANESTHESIA S/I-40H ALLERGN EXT-MOUNT.CEDAR AMINOSYN 8.5 %...... 166 (PROPOFOL)...... 18 POLLEN...... 66 AMINOSYN 8.5 %- ANESTHESIA S/I-40S ALLERGN XT-RED MULBERRY ELECTROLYTES...... 165 (PROPOFOL)...... 18 POLLEN...... 66 AMINOSYN II 10 %...... 166 ANGELIQ...... 181 ALLERGN XT-WHT MULBERRY AMINOSYN II 15 %...... 166 ANGIOMAX...... 215 POLLEN...... 66 AMINOSYN II 7 %...... 166 ANNOVERA...... 134 allopurinol...... 206 AMINOSYN II 8.5 %...... 166 ANORO ELLIPTA...... 263 allopurinol sodium...... 206 AMINOSYN II 8.5 %- ANTABUSE...... 125 ALLZITAL...... 10 ELECTROLYTES...... 165 ANTICOAG CITRATE PHOS almotriptan malate...... 120 AMINOSYN M 3.5 %...... 165, 166 DEXTROSE...... 206 ALOCRIL...... 252 AMINOSYN-HBC 7%...... 166 ANTIVENIN LATRODECTUS ALOGLIPTIN-PIOGLITAZONE....179 AMINOSYN-PF 10 %...... 166 MACTANS...... 67 ALOMIDE...... 252 AMINOSYN-PF 7 % (SULFITE- ANTIVENIN, MICRURUS ALOPRIM...... 206 FREE)...... 166 FULVIUS...... 67 ALORA...... 182 AMINOSYN-RF 5.2 %...... 166 Anusol-Hc...... 21, 144 alosetron...... 198, 200 amiodarone...... 80 APADAZ...... 8 ALOXI...... 194 AMIODARONE IN DEXTROSE 5 apexicon e...... 144 ALPHAGAN P...... 255 %...... 80 APLENZIN...... 105 ALPHANATE...... 208 AMITIZA...... 198, 200 APLIGRAF...... 154 ALPHANINE SD...... 208 amitriptyline...... 105 APLISOL...... 155 alprazolam...... 96, 113 amitriptyline-chlordiazepoxide.... 105, 113 APOKYN...... 107 ALPRAZOLAM INTENSOL..... 96, 113 amlodipine...... 86 apraclonidine...... 255 ALPROLIX...... 208 amlodipine-atorvastatin...... 83 aprepitant...... 194 alprostadil...... 93 amlodipine-benazepril...... 74 Apri...... 129 ALREX...... 249 amlodipine-olmesartan...... 75 APRISO...... 198 ALTABAX...... 138 amlodipine-valsartan...... 75 APTENSIO XR...... 111 ALTACE...... 74 amlodipine-valsartan-hcthiazid...... 76 APTIOM...... 99 272 APTIVUS...... 42 atenolol...... 83 AZATHIOPRINE SODIUM...... 13, 217 aqua care sodium chloride...... 160 atenolol-chlorthalidone...... 88 AZEDRA DOSIMETRIC...... 56 aqua care sterile water...... 160 ATGAM...... 69 AZEDRA THERAPEUTIC...... 56 AQUASOL A...... 174 ATIVAN...... 96, 113, 123 azelaic acid...... 134, 151 AQUORAL...... 244 atomoxetine...... 113 azelastine...... 249, 265 ARAKODA...... 28 ATOPADERM...... 143 AZELEX...... 134, 151 ARALAST NP...... 265 ATOPICLAIR...... 143 AZILECT...... 107 aranelle (28)...... 133 atorvastatin...... 81, 82 azithromycin...... 39 ARANESP (IN POLYSORBATE)....207 atovaquone...... 28 AZOPT...... 251 ARAVA...... 14 atovaquone-proguanil...... 28 AZOR...... 75 ARCALYST...... 11 atracurium...... 220 aztreonam...... 41 ARCAPTA NEOHALER...... 262 ATRALIN...... 136 AZULFIDINE...... 14, 198 ARGATROBAN...... 215 ATRAPRO DERMAL SPRAY...... 154 AZULFIDINE EN-TABS...... 14, 198 ARGATROBAN IN 0.9 % SOD ATRIPLA...... 31 Azurette (28)...... 128 CHLOR...... 215 ATROPEN...... 93 Baciim...... 42 ARGATROBAN IN NACL (ISO- atropine...... 93, 197 bacitracin...... 42, 254 OS)...... 215 ATROPINE...... 197, 249 bacitracin-polymyxin b...... 253 ARGININE-LYSINE IN 0.9 % ATROPINE IN 0.9 % SOD baclofen...... 220 NACL...... 165 CHLORIDE...... 93, 249 BACLOFEN...... 220 ARICEPT...... 127 ATROVENT HFA...... 262 BACTERIOSTATIC ARIKAYCE...... 24 AUBAGIO...... 247 WATER(PARABENS)...... 126 ARIMIDEX...... 49 Aubra...... 129 BACTRIM...... 25 aripiprazole...... 111, 116 Aubra Eq...... 129 BACTRIM DS...... 25 ARISTADA...... 111 AUGMENTIN...... 25 BAL IN OIL...... 23 ARISTADA INITIO...... 111 AUGMENTIN ES-600...... 25 Balanced Salt...... 252 ARISTOSPAN INTRA- AUGMENTIN XR...... 25 BAL-CARE DHA...... 168 ARTICULAR...... 184 aurovela 1.5/30 (21)...... 129 BAL-CARE DHA ESSENTIAL...... 168 ARISTOSPAN INTRALESIONAL..184 Aurovela 1/20 (21)...... 129 BALCOLTRA...... 129 ARIXTRA...... 213 Aurovela 24 Fe...... 129 balsalazide...... 198 armodafinil...... 121 aurovela fe 1.5/30 (28)...... 129 BALSAM PERU-CASTOR OIL...... 155 ARMOUR THYROID...... 191 Aurovela Fe 1-20 (28)...... 129 BALVERSA...... 50 ARNUITY ELLIPTA...... 260 AURYXIA...... 161, 202, 203 balziva (28)...... 129 AROMASIN...... 49 AUSTEDO...... 121 BANZEL...... 102 ARRANON...... 47 AUTOLET IMPRESSION LANC BAQSIMI...... 176 ARSENIC TRIOXIDE...... 49 DEV...... 223, 232 BARACLUDE...... 37 ARTHROTEC 50...... 14 AVAGE...... 151 BAVENCIO...... 58 ARTHROTEC 75...... 14 AVALIDE...... 76 BAXDELA...... 36 ARTICADENT DENTAL...... 20, 244 AVANDIA...... 188 BCG VACCINE, LIVE (PF)...... 69, 71 ARTISS...... 152 AVAPRO...... 77 BD AUTOSHIELD DUO PEN ARZERRA...... 49 AVASTIN...... 44 NEEDLE...... 227, 232 ASACOL HD...... 198 AVC VAGINAL...... 269 BD ECLIPSE LUER-LOK...... 227, 232 ASCLERA...... 95 AVEED...... 176 BD INSULIN SYRINGE...... 227, 233 Ascomp With Codeine...... 7 AVELOX IN NACL (ISO- BD INSULIN SYRINGE HALF ASCOR...... 175 OSMOTIC)...... 35 UNIT...... 227, 232 ascorbic acid (vitamin c)...... 175 AVENOVA...... 144 BD INSULIN SYRINGE MICRO- Ashlyna...... 128 Aviane...... 129 FINE...... 227, 232 aspirin-dipyridamole...... 214 Avidoxy...... 43 BD INSULIN SYRINGE SAFETY- ASPIRIN-OMEPRAZOLE...... 215 avita...... 136 LOK...... 227, 232 ASSURE HAEMOLANCE PLUS AVITA...... 136 BD INSULIN SYRINGE SLIP TIP ...... 223, 232 AVITENE...... 210 ...... 227, 233 ASSURE ID INSULIN SAFETY AVITENE FLOUR...... 210 BD INSULIN SYRINGE U-500 227, 233 ...... 226, 232 AVO CREAM...... 143 BD INSULIN SYRINGE ULTRA- ASSURE ID PEN NEEDLE...... 226, 232 AVODART...... 203 FINE...... 227, 233 ASSURE LANCE...... 223, 232 AVONEX...... 246 BD LO-DOSE MICRO-FINE IV ASSURE LANCE PLUS...... 223, 232 AVONEX (WITH ALBUMIN)...... 246 ...... 227, 233 ASTAGRAF XL...... 216 AVYCAZ...... 33 BD LO-DOSE ULTRA-FINE....227, 233 ASTEPRO...... 265 AYGESTIN...... 190 BD MICROTAINER LANCET 223, 233 ASTERO...... 149, 151 Ayuna...... 129 BD NANO 2ND GEN PEN NEEDLE ASTRAMORPH-PF...... 3 azacitidine...... 48 ...... 227, 233 ATACAND...... 77 AZACTAM...... 41 bd posiflush normal saline 0.9..... 173, 174 ATACAND HCT...... 76 AZASAN...... 13, 217 bd pre-filled normal saline...... 173, 174 atazanavir...... 42 AZASITE...... 254 bd pre-filled saline blunt can...... 173, 174 ATELVIA...... 181 azathioprine...... 13, 217 273 BD SAFETYGLIDE INSULIN BETAPACE...... 79, 84 BREVITAL...... 17 SYRINGE...... 227, 233 BETAPACE AF...... 79, 84 BRIDION...... 220 BD SAFETYGLIDE SYRINGE227, 233 BETASERON...... 246 briellyn...... 129 BD ULTRA FINE LANCETS...223, 233 betaxolol...... 83, 251 BRILINTA...... 214 BD ULTRA-FINE II LANCETS bethanechol chloride...... 205 brimonidine...... 255 ...... 223, 233 BETHKIS...... 264 BRIMONIDINE-DORZOLAMIDE BD ULTRA-FINE MICRO PEN BETIMOL...... 251 (PF)...... 247 NEEDLE...... 227, 233 BETOPTIC S...... 251 BRISDELLE...... 189 BD ULTRA-FINE MINI PEN BEVACIZUMAB...... 252, 256 BRIVIACT...... 101 NEEDLE...... 227, 233 BEVESPI AEROSPHERE...... 263 Bromfed Dm...... 266 BD ULTRA-FINE NANO PEN BEVYXXA...... 207 bromfenac...... 250 NEEDLE...... 227, 233 bexarotene...... 56 bromocriptine...... 107 BD ULTRA-FINE ORIG PEN BEXSERO...... 71 brompheniramine-pseudoeph-dm...... 266 NEEDLE...... 227, 233 BEYAZ...... 129 BROMSITE...... 250 BD ULTRA-FINE SHORT PEN BIAFINE EMULSION...... 143 BROVANA...... 262 NEEDLE...... 227, 233 bicalutamide...... 47 BRYHALI...... 141, 145 BD VEO INSULIN SYR HALF BICILLIN C-R...... 42 BSS...... 252 UNIT...... 227, 233 BICILLIN L-A...... 41 BSS PLUS...... 252 BD VEO INSULIN SYRINGE UF BICNU...... 45 budesonide...... 199, 260 ...... 227, 233 BIDIL...... 95 BUFFERED LIDOCAINE...... 19 BEAU RX...... 150 BIJUVA...... 182 BULLSEYE MINI SAFETY BECONASE AQ...... 265 BIKTARVY...... 31 LANCETS...... 223, 233 Bekyree (28)...... 128 BILTRICIDE...... 25 bumetanide...... 91 BELBUCA...... 10 bimatoprost...... 153, 255 buminate 25 %...... 212 BELEODAQ...... 51 BINOSTO...... 181 buminate 5 %...... 212 BELRAPZO...... 46 BIOLON...... 253 BUNAVAIL...... 124 BELSOMRA...... 124 BIONECT...... 151 Bupap...... 10 BELVIQ...... 158 BIOTHRAX...... 72 BUPHENYL...... 243 BELVIQ XR...... 158 bisoprolol fumarate...... 83 bupivacaine...... 19 benazepril...... 74 bisoprolol-hydrochlorothiazide...... 88 bupivacaine (pf)...... 19 benazepril-hydrochlorothiazide...... 74 BIVALIRUDIN...... 215 BUPIVACAINE IN NACL(PF)...... 19 BENDAMUSTINE...... 46 BIVALIRUDIN-0.9 % SODIUM bupivacaine-dextrose-water(pf)...... 19 BENDEKA...... 46 CHLOR...... 215 bupivacaine-epinephrine...... 20 BENEFIX...... 208 BIVIGAM...... 68 bupivacaine-epinephrine (pf)...... 20 BENICAR...... 77 blanche...... 142 BUPIVACAINE-EPINEPHRINE BENICAR HCT...... 76 bleomycin...... 58 BITART...... 244 BENLYSTA...... 14 BLEPH-10...... 255 BUPIVACAINE-KETOROLAC- BENTYL...... 197 BLEPHAMIDE...... 248 KETAMINE...... 21 BENZACLIN...... 135 BLEPHAMIDE S.O.P...... 248 BUPRENEX...... 10 BENZACLIN PUMP...... 135 BLINCYTO...... 59 buprenorphine...... 10 BENZAMYCIN...... 135 Blisovi 24 Fe...... 129 BUPRENORPHINE...... 10 BENZHYDROCODONE- blisovi fe 1.5/30 (28)...... 129 buprenorphine hcl...... 10, 124 ACETAMINOPHEN...... 8 Blisovi Fe 1/20 (28)...... 129 buprenorphine-naloxone...... 124, 125 BENZNIDAZOLE...... 28 BLOXIVERZ...... 218 bupropion hcl...... 105, 125 benzonatate...... 260 BOCASAL...... 244 BUPROPION HCL...... 105 benzphetamine...... 157 BONIVA...... 181 bupropion hcl (smoking deter)...... 125 benztropine...... 107 BONJESTA...... 193 buspirone...... 97 BERINERT...... 207 BOOSTRIX TDAP...... 70 busulfan...... 45 Beser...... 144 BORTEZOMIB...... 55 BUSULFEX...... 45 BESER KIT...... 148 bosentan...... 95 butalbital compound w/codeine...... 7 BESIVANCE...... 254 BOSULIF...... 55 butalbital-acetaminop-caf-cod...... 7 BESPONSA...... 47, 59 BOTOX...... 219 BUTALBITAL- BETADINE OPHTHALMIC PREP 255 BOTOX COSMETIC...... 219 ACETAMINOPHEN...... 10 BETAMETH AC,SOD PHOS(PF)- bp 10-1...... 135 butalbital-acetaminophen...... 10 WATER...... 183 BPCO...... 155 butalbital-acetaminophen-caff...... 11 BETAMETHASONE ACE,SOD BPO...... 136 butalbital-aspirin-caffeine...... 17 PHOS-WTR...... 183 BRAFTOVI...... 49 BUTALBITAL-ASPIRIN- betamethasone acet,sod phos...... 183 BRAVELLE...... 183 CAFFEINE...... 17 betamethasone dipropionate...... 144, 145 BREO ELLIPTA...... 263 BUTISOL...... 123 BETAMETHASONE SOD BREVIBLOC...... 79, 84 butorphanol tartrate...... 10 PHOSPH-WATER...... 184 BREVIBLOC IN NACL (ISO-OSM) BUTRANS...... 10 betamethasone valerate...... 145 ...... 79, 84 BUTYLATED betamethasone, augmented...... 145 BREVICON (28)...... 129 HYDROXYTOLUENE...... 126 274 BYDUREON...... 179 carboplatin...... 54 cefoxitin...... 34 BYDUREON BCISE...... 179 CARBOPROST TROMETHAMINE CEFOXITIN IN DEXTROSE, ISO- BYETTA...... 179 ...... 175 OSM...... 34 BYSTOLIC...... 84 CARDENE IV...... 86 cefpodoxime...... 34 cabergoline...... 190 CARDENE IV IN DEXTROSE...... 86 cefprozil...... 34 CABLIVI...... 206 CARDENE IV IN SODIUM ceftazidime...... 34 CABOMETYX...... 53 CHLORIDE...... 86 CEFTAZIDIME IN D5W...... 34 CADEAU DHA...... 168 CARDIZEM...... 85 ceftriaxone...... 34 CADUET...... 83 CARDIZEM CD...... 85 CEFTRIAXONE...... 34 CAFCIT...... 117 CARDIZEM LA...... 85 CEFTRIAXONE IN CAFERGOT...... 119 CARDURA...... 93 DEXTROSE,ISO-OS...... 34 caffeine citrate...... 117 CARDURA XL...... 93 CEFUROXIME (PF) IN 0.9% CALAN...... 80, 87 CAREFINE PEN NEEDLE...... 227, 233 NACL...... 254 CALAN SR...... 87 CAREONE ULTRA THIN cefuroxime axetil...... 34 calcipotriene...... 141 LANCET...... 223, 233 cefuroxime sodium...... 34 calcipotriene-betamethasone...... 137 CARETOUCH PEN NEEDLE..227, 233 CELEBREX...... 15 calcitonin (salmon)...... 181 CARETOUCH TWIST LANCET celecoxib...... 15 Calcitrene...... 141 ...... 223, 233 CELESTONE SOLUSPAN...... 183 calcitriol...... 141, 175, 242 carisoprodol...... 220 CELEXA...... 102 calcium acetate...... 161, 202 carisoprodol-asa-codeine...... 221 CELLCEPT...... 13, 217 calcium chloride...... 161 carisoprodol-aspirin...... 220 CELLCEPT INTRAVENOUS....13, 217 CALCIUM CHLORIDE...... 161 carmustine...... 45 CELLUGEL...... 253 CALCIUM DISODIUM CARNITOR...... 242 CELLULOSE (BULK)...... 126 VERSENATE...... 23 CARNITOR (SUGAR-FREE)...... 242 CELONTIN...... 101 CALCIUM GLUC IN NACL, ISO- CAROSPIR...... 90 CENTANY...... 138 OSM...... 161 carteolol...... 251 CENTANY AT...... 138 calcium gluconate...... 161 Cartia Xt...... 85 centergy...... 258 CALCIUM GLUCONATE IN 0.9% carvedilol...... 75 centergy dm...... 266 NACL...... 161 carvedilol phosphate...... 75 cephalexin...... 33 CALCIUM GLUCONATE IN CASODEX...... 47 CEPROTIN (BLUE BAR)...... 215 WATER...... 161 CASPOFUNGIN...... 26 CEPROTIN (GREEN BAR)...... 215 CALCIUM PNV...... 168 CAT HAIR STD ALLERGENIC CERAMAX...... 143 CALDOLOR...... 16 EXT...... 61 CERDELGA...... 242 CALQUENCE...... 49, 55 CATAPRES...... 89 CEREBYX...... 99 CAMBIA...... 15, 16, 119 CATAPRES-TTS-1...... 90 CEREZYME...... 241 Camila...... 132 CATAPRES-TTS-2...... 90 CERVIDIL...... 175 CAMPTOSAR...... 57 CATAPRES-TTS-3...... 90 CESAMET...... 117, 193 camrese...... 128 CATHFLO ACTIVASE...... 216 cetirizine...... 259 camrese lo...... 128 CAVERJECT...... 157 CETRAXAL...... 256 CANASA...... 198 CAVERJECT IMPULSE...... 157 CETROTIDE...... 189 CANCIDAS...... 26 CAYA CONTOURED...... 222, 233 cevimeline...... 245 candesartan...... 77 CAYSTON...... 264 CHANTIX...... 125 candesartan-hydrochlorothiazid...... 76 caziant (28)...... 133 CHANTIX CONTINUING MONTH CANDIN...... 61 cefaclor...... 33 BOX...... 125 CAPASTAT...... 32 CEFACLOR...... 33 CHANTIX STARTING MONTH CAPCOF...... 267 cefadroxil...... 33 BOX...... 125 capecitabine...... 48 cefazolin...... 33 Chateal (28)...... 129 CAPEX...... 145 CEFAZOLIN...... 33 Chateal Eq (28)...... 129 CAPHOSOL...... 244 CEFAZOLIN IN DEXTROSE (ISO- CHEMET...... 23 CAPRELSA...... 55 OS)...... 33 CHENODAL...... 195 captopril...... 74 CEFAZOLIN IN STERILE WATER 33 chloramphenicol sod succinate...... 35 captopril-hydrochlorothiazide...... 74 cefdinir...... 34 chlordiazepoxide hcl...... 96, 113 CARAC...... 140 cefditoren pivoxil...... 34 chlordiazepoxide-clidinium...... 113, 197 CARAFATE...... 201 cefepime...... 35 chlorhexidine gluconate...... 244 CARBAGLU...... 243 CEFEPIME IN DEXTROSE 5 %...... 34 chloroprocaine (pf)...... 20 carbamazepine...... 99, 114 CEFEPIME IN DEXTROSE,ISO- chloroquine phosphate...... 28 CARBATROL...... 99, 115 OSM...... 35 chlorothiazide...... 92 carbidopa...... 107 cefixime...... 34 chlorothiazide sodium...... 92 carbidopa-levodopa...... 106 CEFOTAN...... 33 CHLORPROMAZINE...... 109 carbidopa-levodopa-entacapone...... 106 cefotaxime...... 34 chlorpromazine...... 109 carbinoxamine maleate...... 258, 259 cefotetan...... 33 chlorpropamide...... 178 CARBOCAINE...... 19 CEFOTETAN IN DEXTROSE, ISO- chlorthalidone...... 92 CARBOCAINE (PF)...... 19 OSM...... 33 CHLORZOXAZONE...... 220 275 chlorzoxazone...... 220 CLIMARA PRO...... 182 CLOROTEKAL...... 20 CHOLBAM...... 195 clindamycin hcl...... 39 clotrimazole...... 139, 244 cholestyramine (with sugar)...... 80 CLINDAMYCIN IN 0.9 % SOD clotrimazole-betamethasone...... 140 cholestyramine light...... 80 CHLOR...... 39 clozapine...... 109 CHORIONIC GONADOTROPIN, clindamycin in 5 % dextrose...... 39 CLOZAPINE...... 109 HUMAN...... 186 clindamycin palmitate hcl...... 39 CLOZARIL...... 109 chromium chloride...... 164 Clindamycin Pediatric...... 39 C-NATE DHA...... 169 CIALIS...... 157, 203 clindamycin phosphate...39, 134, 135, 268 COAGADEX...... 209 ciclopirox...... 139 clindamycin-benzoyl peroxide...... 135 COAGUCHEK LANCETS...... 223, 233 cidofovir...... 35 clindamycin-tretinoin...... 136 COAL TAR...... 149 cilostazol...... 214 CLINDESSE...... 268 COARTEM...... 28 CILOXAN...... 254 CLINIMIX 5%/D15W SULFITE COCAINE...... 265 CIMDUO...... 30 FREE...... 165 CODEINE SULFATE...... 3 cimetidine...... 196 CLINIMIX 5%/D25W SULFITE- CODEINE-GUAIFENESIN...... 268 cimetidine hcl...... 196 FREE...... 165 CODITUSSIN AC...... 268 cinacalcet...... 181 CLINIMIX 4.25%/D10W SULF CODITUSSIN DAC...... 267 CINQAIR...... 261 FREE...... 165 COGENTIN...... 107 CINRYZE...... 207 CLINIMIX 4.25%/D5W SULFIT COLAZAL...... 198 CINVANTI...... 195 FREE...... 165 COLCHICINE...... 206 CIPRO...... 36 CLINIMIX 4.25%-D25W SULF- COLCRYS...... 206 CIPRO HC...... 256 FREE...... 165 colesevelam...... 80 CIPRO IN D5W...... 36 CLINIMIX 5%-D20W(SULFITE- COLESTID...... 81 CIPRO XR...... 36, 204 FREE)...... 165 COLESTID FLAVORED...... 81 CIPRODEX...... 256 CLINIMIX E 2.75%/D10W SUL colestipol...... 81 ciprofloxacin...... 36 FREE...... 166, 168 colistin (colistimethate na)...... 42 ciprofloxacin (mixture)...... 36, 204 CLINIMIX E 2.75%/D5W SULF COLLATYL...... 155 ciprofloxacin hcl...... 36, 254, 256 FREE...... 166, 168 COLOR LANCETS...... 223, 233 ciprofloxacin in 5 % dextrose...... 36 CLINIMIX E 4.25%/D10W SUL COLY-MYCIN M PARENTERAL....42 cisatracurium...... 220 FREE...... 166, 168 COLY-MYCIN S...... 256 CISPLATIN...... 54 CLINIMIX E 4.25%/D25W SUL COLYTE WITH FLAVOR PACKS 200 cisplatin...... 54 FREE...... 166, 168 COMBIGAN...... 250 citalopram...... 102 CLINIMIX E 4.25%/D5W SULF COMBIPATCH...... 182 CITANEST FORTE DENTAL... 20, 244 FREE...... 166, 168 COMBIVENT RESPIMAT...... 263 CITANEST PLAIN DENTAL.... 19, 244 CLINIMIX E 5%/D15W SULFIT COMBIVIR...... 31 CITRANATAL (DUAL-IRON)...... 168 FREE...... 166, 168 COMETRIQ...... 53 CITRANATAL 90 DHA (ALGAL CLINIMIX E 5%/D20W SULFIT COMFORT EZ INSULIN OIL)...... 168 FREE...... 166, 168 SYRINGE...... 227, 233 CITRANATAL ASSURE...... 168 CLINIMIX E 5%/D25W SULFIT COMFORT EZ LANCETS...... 223, 233 CITRANATAL B-CALM (FE FREE...... 166, 168 COMFORT EZ PEN NEEDLES GLUC)...... 168 CLINIMIX N14G30E 4.25%-D15W ...... 227, 234 CITRANATAL BLOOM...... 162 SF...... 168 COMFORT LANCETS...... 223, 234 CITRANATAL DHA (ALGAL OIL) CLINIMIX N9G15E 2.75%-D7.5W COMPAZINE...... 109, 193 ...... 168 SF...... 168 COMPLERA...... 31 CITRANATAL HARMONY (IRON CLINIMIX N9G20E 2.75%- COMPLETE NATAL DHA...... 169 FUM)...... 169 D10W(SF)...... 166, 168 COMPLETENATE...... 169 cladribine...... 47 CLINISOL SF 15 %...... 167 Compro...... 193 CLAFORAN...... 34 clobazam...... 97, 113 COMTAN...... 106 Claravis...... 134 clobetasol...... 145 CONCEPT DHA...... 169 CLARINEX...... 259, 260 clobetasol-emollient...... 145 CONCEPT OB...... 169 CLARINEX-D 12 HOUR...... 258 CLOBEX...... 145 CONCEPTION...... 222, 234 clarithromycin...... 39 CLOCORTOLONE PIVALATE...... 145 CONCERTA...... 111 cleansing wash...... 135, 151 Clodan...... 145 CONDYLOX...... 149 clemastine...... 258, 259 CLODERM...... 145 Constulose...... 200 CLENPIQ...... 201 clofarabine...... 48 CONTRAVE...... 158 CLEOCIN...... 39, 268 CLOLAR...... 48 CONZIP...... 3 Cleocin...... 39 clomiphene citrate...... 183 COPAXONE...... 246 CLEOCIN HCL...... 39 clomipramine...... 106 COPIKTRA...... 54 CLEOCIN PEDIATRIC...... 39 clonazepam...... 96, 97, 113 copper chloride...... 164 CLEOCIN T...... 134 clonidine...... 90 CORDRAN...... 145 CLEVER CHEK LANCETS.....223, 233 clonidine (pf)...... 3 CORDRAN TAPE LARGE ROLL.. 145 CLEVIPREX...... 86 clonidine hcl...... 90, 111 COREG...... 75 CLICKFINE PEN NEEDLE.....227, 233 clopidogrel...... 214 COREG CR...... 75 CLIMARA...... 182 clorazepate dipotassium...... 96, 113 Coremino...... 43, 134 276 CORGARD...... 84 CYKLOKAPRON...... 210 DELSTRIGO...... 31 CORIFACT...... 209 CYMBALTA...... 104, 118 Deltasone...... 184 CORLANOR...... 92 CYPROHEPTADINE...... 259 DELUO...... 60, 154 CORLOPAM...... 92 cyproheptadine...... 259 Delyla (28)...... 129 Cormax...... 145 CYRAMZA...... 57 DELZICOL...... 198 CORTEF...... 184 Cyred...... 129 DEMADEX...... 91 CORTENEMA...... 199 Cyred Eq...... 129 demeclocycline...... 43 CORTIFOAM...... 199 CYSTADANE...... 243 DEMEROL...... 3 cortisone...... 184 CYSTAGON...... 202 DEMEROL (PF)...... 3 CORTISPORIN...... 138 CYSTARAN...... 251 DEMSER...... 94 CORTISPORIN-TC...... 256 cysteine (l-cysteine)...... 167 DENAVIR...... 142 CORTROSYN...... 155 cytarabine...... 48 dentagel...... 244 CORVERT...... 80 cytarabine (pf)...... 48 DEPACON...... 98 COSENTYX...... 137 CYTOGAM...... 68 DEPAKENE...... 98, 115 COSENTYX (2 SYRINGES)...... 137 CYTOMEL...... 192 DEPAKOTE...... 98, 115 COSENTYX PEN...... 137 CYTOTEC...... 196 DEPAKOTE ER...... 98, 115, 119 COSENTYX PEN (2 PENS)...... 137 CYTOVENE...... 35 DEPAKOTE SPRINKLES...... 98, 115 COSMEGEN...... 57 D.H.E.45...... 119 DEPEN TITRATABS...... 14, 23 COSOPT...... 251 d10 %-0.45 % sodium chloride...... 158 DEPO-ESTRADIOL...... 182 COSOPT (PF)...... 251 d2.5 %-0.45 % sodium chloride...... 159 DEPO-MEDROL...... 184 cosyntropin...... 155 d5 % and 0.9 % sodium chloride...... 159 DEPO-PROVERA...... 55, 128 COTELLIC...... 53 d5 %-0.45 % sodium chloride...... 159 DEPO-SUBQ PROVERA 104...... 128 COTEMPLA XR-ODT...... 112 dacarbazine...... 46 DEPO-TESTOSTERONE...... 176 COUMADIN...... 206 DACOGEN...... 48 DERMAGRAFT...... 154 COZAAR...... 77 dactinomycin...... 58 DERMA-SMOOTHE/FS BODY OIL CREON...... 195 dalfampridine...... 246 ...... 145 CRESEMBA...... 26 DALIRESP...... 262 DERMA-SMOOTHE/FS SCALP CRESTOR...... 82 DALVANCE...... 39 OIL...... 145 CRINONE...... 183, 269 danazol...... 186 DERMATOP...... 145 CRIXIVAN...... 42 DANTRIUM...... 221 DERMOTIC OIL...... 256 CROFAB...... 67 dantrolene...... 221 DERMULCERA...... 155 cromolyn...... 53, 252, 261 dapsone...... 28, 135 DESCOVY...... 30 crotan...... 154 DAPTACEL (DTAP PEDIATRIC) DESFERAL...... 23 CRYOSERV...... 126 (PF)...... 70 desflurane...... 17 Cryselle (28)...... 129 DAPTOMYCIN...... 35 desipramine...... 106 CRYSVITA...... 183 daptomycin...... 35 desloratadine...... 259, 260 CUBICIN...... 35 DARAPRIM...... 28 desmopressin...... 177 CUBICIN RF...... 35 darifenacin...... 205 desog-e.estradiol/e.estradiol...... 128 CUPRIMINE...... 14, 23 DARZALEX...... 50 desogestrel-ethinyl estradiol...... 129 CUROSURF...... 265 Dasetta 1/35 (28)...... 129 desonide...... 146 CUTAQUIG...... 68 dasetta 7/7/7 (28)...... 133 DESOWEN...... 146 CUTIVATE...... 145 daunorubicin...... 58 desoximetasone...... 146 CUVITRU...... 68 DAUNORUBICIN...... 58 DESOXYN...... 112, 117 CUVPOSA...... 246 DAURISMO...... 51 DESVENLAFAXINE...... 104 cyanocobalamin (vitamin b-12)...... 174 DAYPRO...... 16 desvenlafaxine succinate...... 104 CYANOKIT...... 22 Daysee...... 128 DETROL...... 205 Cyclafem 1/35 (28)...... 129 DAYTRANA...... 112 DETROL LA...... 205 cyclafem 7/7/7 (28)...... 133 DDAVP...... 177 dexamethasone...... 184 CYCLESSA (28)...... 133 DEBACTEROL...... 244 DEXAMETHASONE AC, SOD PH- cyclobenzaprine...... 220 Deblitane...... 132 WATER...... 184 CYCLOGYL...... 249 Decadron...... 184 DEXAMETHASONE ACE- CYCLOMYDRIL...... 247 decitabine...... 48 NACL,ISO-OSM...... 184 cyclopentolate...... 249 deferasirox...... 23 DEXAMETHASONE IN 0.9 % SOD CYCLOPEN-TROPIC- deferoxamine...... 23 CHL...... 184 PHENYLEPH-WATR...... 247 DEFITELIO...... 215 DEXAMETHASONE INTENSOL...184 cyclophosphamide...... 13, 45 DELESTROGEN...... 182 dexamethasone sodium phos (pf)...... 184 CYCLOPHOSPHAMIDE...... 13, 45 DELFLEX WITH 2.5 % dexamethasone sodium phosphate184, 249 CYCLOSERINE...... 32 DEXTROSE...... 257 dexchlorpheniramine maleate...... 258, 259 CYCLOSET...... 178 DELFLEX-LC/1.5% DEXTROSE... 257 DEXEDRINE SPANSULE 112, 117, 122 cyclosporine...... 13, 216 DELFLEX-LC/2.5% DEXTROSE... 257 DEXERYL...... 143 cyclosporine modified...... 13, 216 DELFLEX-LC/4.25% DEXTROSE. 257 DEXMEDETOMIDINE...... 124 CYCLOTENS REFILL...... 220 DELFLEX-SM WITH 1.5% DEXMEDETOMIDINE IN 0.9 % CYCLOTENS STARTER...... 220 DEXTROSE...... 257 NACL...... 124 277 dexmedetomidine in 0.9 % nacl...... 124 didanosine...... 30 DORZOLAMIDE (PF)...... 251 DEXMEDETOMIDINE IN diethylpropion...... 157, 158 dorzolamide-timolol...... 251 DEXTROSE 5%...... 124 DIFFERIN...... 136 dorzolamide-timolol (pf)...... 251 dexmethylphenidate...... 112 DIFICID...... 39 DORZOLAMIDE-TIMOLOL (PF). 251 DEXONTO...... 184 diflorasone...... 146 Dotti...... 182 DEXPAK 10 DAY...... 184 DIFLUCAN...... 26, 27 DOVATO...... 29 DEXPAK 13 DAY...... 184 diflunisal...... 17 DOVONEX...... 141 DEXPAK 6 DAY...... 184 DIGIFAB...... 22 doxapram...... 118 dexrazoxane hcl...... 59 Digitek...... 90 doxazosin...... 93 DEXTENZA...... 249 Digox...... 90 doxepin...... 106, 153 dextroamphetamine...... 112, 117, 122 digoxin...... 90 doxercalciferol...... 242 dextroamphetamine-amphetamine dihydroergotamine...... 119 DOXIL...... 58 ...... 112, 117, 122 DILANTIN...... 99 doxorubicin...... 58 DEXTROSE 10 % AND 0.2 % Dilantin Extended...... 99 doxorubicin, peg-liposomal...... 58 NACL...... 159 DILANTIN INFATABS...... 99 Doxy-100...... 43 dextrose 10 % in water (d10w)...... 159 DILANTIN-125...... 99 doxycycline hyclate...... 43, 245 DEXTROSE 20 % IN WATER DILATRATE-SR...... 78 doxycycline monohydrate...... 43 (D20W)...... 159 DILAUDID...... 3 doxylamine-pyridoxine (vit b6)...... 193 dextrose 25 % in water (d25w)...... 159 DILAUDID (PF)...... 3 D-PENAMINE...... 14, 23 dextrose 30 % in water (d30w)...... 159 DILTIAZEM HCL...... 80, 85 DRISDOL...... 175 DEXTROSE 40 % IN WATER diltiazem hcl...... 80, 85, 86 dronabinol...... 117, 158, 193 (D40W)...... 159 DILTIAZEM HCL IN 0.9% NACL... 85 droperidol...... 18 dextrose 5 % in ringer's...... 161 DILTIAZEM IN DEXTROSE 5 %.... 86 DROPLET INSULIN SYR HALF DEXTROSE 5 % IN WATER Dilt-Xr...... 86 UNIT...... 227, 234 (D5W)...... 159 DILUENT FOR DROPLET INSULIN SYRINGE dextrose 5 % in water (d5w)...... 159 EPOPROSTENOL/FLOLA...... 126 ...... 228, 234 dextrose 5 %-lactated ringers...... 158 DILUENT FOR TREPROSTINIL DROPLET LANCETS...... 223, 234 dextrose 5%-0.2 % sod chloride...... 159 (GLY)...... 126 DROPLET PEN NEEDLE...... 228, 234 DEXTROSE 5%-0.3 % DIMENHYDRINATE...... 193 DROPSAFE PEN NEEDLE...... 228, 234 SOD.CHLORIDE...... 159 DIOVAN...... 77 drospirenone-e.estradiol-lm.fa...... 129 dextrose 50 % in water (d50w)...... 159 DIOVAN HCT...... 76 drospirenone-ethinyl estradiol...... 129 dextrose 70 % in water (d70w)...... 159 DIPENTUM...... 198 DROXIA...... 215 DEXYCU (PF)...... 249 diphenhydramine hcl...... 123, 258, 259 DSUVIA...... 4 DIACOMIT...... 102 diphenoxylate-atropine...... 193 DUAC...... 135 DIANEAL LOW CALCIUM/1.5% DIPRIVAN...... 18 DUAVEE...... 182 DEX...... 257 DIPROLENE...... 146 DUET DHA BALANCED...... 169 DIANEAL LOW CALCIUM/4.25% dipyridamole...... 215 DUET DHA WITH OMEGA-3...... 169 DEX...... 257 DISALCID...... 17 DUETACT...... 179 DIANEAL PD-2 WITH 2.5 % DEX. 257 DISCOVISC...... 253 DULERA...... 264 DIANEAL PD-2 WITH 4.25 % DEX diskets...... 3 duloxetine...... 104, 118 ...... 257 disopyramide phosphate...... 79 DUOBRII...... 137 DIANEAL PD-2/1.5% DEXTROSE.257 disulfiram...... 125 DUODOTE...... 22 DIANEAL WITH 1.5% DEXTROSE DITROPAN XL...... 205 DUOPA...... 106 ...... 257 DIURIL...... 92 DUOVISC VISCO ELASTIC...... 253 DIANEAL WITH 2.5 % DIURIL IV...... 92 DUPIXENT...... 137, 260 DEXTROSE...... 257 divalproex...... 98, 115, 119 DURACLON (PF)...... 3 DIANEAL WITH 4.25 % DIVIGEL...... 182 DURAGESIC...... 4 DEXTROSE...... 257 dobutamine...... 89 duramorph (pf)...... 4 DIASTAT...... 97, 113 dobutamine in d5w...... 89 DUREZOL...... 249 DIASTAT ACUDIAL...... 97, 113 DOCEFREZ...... 57 DURLAZA...... 17, 214 diazepam...... 96, 97, 113 DOCETAXEL...... 57 DUROLANE...... 218 DIAZEPAM...... 96, 113 dofetilide...... 80 dutasteride...... 203 diazepam intensol...... 96, 113 DOLOPHINE...... 4 dutasteride-tamsulosin...... 201 DIBENZYLINE...... 93 DOLOTRANZ...... 149 DUTOPROL...... 88 DICLEGIS...... 193 donepezil...... 127 Dvorah...... 8 diclofenac potassium...... 15 dopamine...... 89 DXEVO...... 185 diclofenac sodium...... 16, 141, 150, 250 dopamine in 5 % dextrose...... 89 DYANAVEL XR...... 112, 117 diclofenac-misoprostol...... 14 DOPRAM...... 118 DYAZIDE...... 92 DICLOSAICIN...... 150 DOPTELET (10 TAB PACK)...... 216 DYMISTA...... 265 DICLOVIX...... 150 DOPTELET (15 TAB PACK)...... 216 DYRENIUM...... 91 dicloxacillin...... 41 DOPTELET (30 TAB PACK)...... 216 DYSPORT...... 219 DICLOZOR...... 150 DORAL...... 113, 123 e.e.s. 400...... 39 dicyclomine...... 197 dorzolamide...... 251 E.E.S. GRANULES...... 40 278 EASY COMFORT INSULIN ELLIOTTS B (PF)...... 161 EPINEPHRINE HCL IN 0.9 % SYRINGE...... 228, 234 ELMIRON...... 202 NACL...... 89 EASY COMFORT LANCETS..223, 234 ELOCON...... 146 EPINEPHRINE HCL IN 5% EASY COMFORT PEN NEEDLES ELOCTATE...... 208 DEXTROSE...... 89 ...... 228, 234 ELZONRIS...... 59 EPINEPHRINE IN SOD EASY GLIDE PEN NEEDLE...228, 234 EMBRACE LANCETS...... 223, 234 CHLOR,ISO...... 89 EASY TOUCH...... 228, 234 EMCYT...... 50 epirubicin...... 58 EASY TOUCH FLIPLOCK EMEND...... 195 EPISIL...... 245 INSULIN...... 228, 234 EMEND (FOSAPREPITANT)...... 195 Epitol...... 99, 115 EASY TOUCH INSULIN SAFETY EMFLAZA...... 185 EPIVIR...... 30 SYR...... 228, 234 EMGALITY PEN...... 119 EPIVIR HBV...... 37 EASY TOUCH INSULIN SYRINGE EMGALITY SYRINGE...... 96, 119 eplerenone...... 75, 90 ...... 228, 234 Emoquette...... 129 EPOGEN...... 207 EASY TOUCH LANCETS...... 223, 234 EMPLICITI...... 48 epoprostenol (glycine)...... 94 EASY TOUCH LUER LOCK EMSAM...... 102 eprosartan...... 77 INSULIN...... 228, 234 EMTRIVA...... 30 eptifibatide...... 214 EASY TOUCH PEN NEEDLE. 228, 234 EMULSION SB...... 143 EPTIFIBATIDE...... 214 EASY TOUCH SAFETY LANCETS EMVERM...... 25 EPZICOM...... 31 ...... 223, 234 ENABLEX...... 205 EQUETRO...... 99, 115 EASY TOUCH SHEATHLOCK enalapril maleate...... 74 ERAXIS(WATER DILUENT)...... 26 INSULIN...... 228, 234 enalaprilat...... 74 ERBITUX...... 59 EASY TOUCH TWIST LANCETS enalapril-hydrochlorothiazide...... 74 ergocalciferol (vitamin d2)...... 175 ...... 223, 234 ENBRACE HR...... 169 ergoloid...... 127 EASY TOUCH UNI-SLIP...... 228, 234 ENBREL...... 11, 12 ERGOMAR...... 119 EASY TWIST AND CAP LANCETS ENBREL MINI...... 11, 12 ergotamine-caffeine...... 119 ...... 223, 234 ENBREL SURECLICK...... 11, 12 ERIVEDGE...... 51 EC-NAPROSYN...... 16 ENDARI...... 158, 165, 201, 215 ERLEADA...... 47 EC-NAPROXEN...... 16 ENDO AVITENE...... 210 erlotinib...... 44 econazole...... 139 Endocet...... 9 Errin...... 132 ECOZA...... 139 ENDOFORM...... 154 ERTACZO...... 139 EDARBI...... 77 ENDOFORM FENESTRATED...... 154 ertapenem...... 33 EDARBYCLOR...... 76 ENDOMETRIN...... 183 ERWINAZE...... 49 EDECRIN...... 91 ENGERIX-B (PF)...... 67 Ery Pads...... 135 EDEX...... 157 ENGERIX-B PEDIATRIC (PF)...... 67 ERYGEL...... 135 EDLUAR...... 123 enoxaparin...... 213 ERYPED 200...... 40 EDURANT...... 29 Enpresse...... 133 ERYPED 400...... 40 efavirenz...... 29 Enskyce...... 129 ery-tab...... 40 EFFER-K...... 164 ENSTILAR...... 137 ERY-TAB...... 40 effer-k...... 164 entacapone...... 107 ERYTHROCIN...... 40 EFFEXOR XR...... 104 entecavir...... 37 erythrocin (as stearate)...... 40 EFFIENT...... 214 ENTEREG...... 23 erythromycin...... 40, 254 EFUDEX...... 140 ENTOCORT EC...... 199 erythromycin ethylsuccinate...... 40 EGRIFTA...... 186 ENTRESTO...... 77 erythromycin with ethanol...... 135 ELAPRASE...... 241 ENTTY...... 143 erythromycin-benzoyl peroxide...... 135 ELCYS...... 167 ENTYVIO...... 199 ESBRIET...... 268 ELECTROLYTE-48 IN D5W...... 161 Enulose...... 195 escitalopram oxalate...... 102 ELELYSO...... 241 ENVARSUS XR...... 216 ESGIC...... 11 ELESTRIN...... 182 EPANED...... 75 ESKATA...... 142 ELETONE...... 143 EPCLUSA...... 37 esmolol...... 79, 84 eletriptan...... 120 EPHEDRINE SULFATE...... 89 esmolol in nacl (iso-osm)...... 79, 84 ELIDEL...... 142 EPHEDRINE SULFATE- ESMOLOL IN STERILE WATER ELIGARD...... 52 0.9%NACL(PF)...... 89 ...... 79, 84 ELIGARD (3 MONTH)...... 52 EPICERAM...... 143 esomeprazole sodium...... 196 ELIGARD (4 MONTH)...... 52 EPICYN...... 154 Estarylla...... 129 ELIGARD (6 MONTH)...... 52 EPIDIOLEX...... 97 estazolam...... 113, 123 ELIMITE...... 154 EPIDUO...... 136 ESTRACE...... 182, 269 Elinest...... 129 EPIDUO FORTE...... 136 estradiol...... 182, 269 ELIQUIS...... 207 EPIFIX AMNIOTIC MEMBRANE.153 estradiol valerate...... 182 ELITEK...... 206 EPIFOAM...... 148 estradiol-norethindrone acet...... 182 elite-ob...... 162, 169 epinastine...... 249 ESTRING...... 269 ELIXOPHYLLIN...... 261 EPINEPHRINE...... 88 ESTROGEL...... 182 ELLA...... 134 epinephrine...... 88, 260 ESTROSTEP FE-28...... 133 ELLENCE...... 58 EPINEPHRINE HCL (PF)...... 88, 89 eszopiclone...... 123 279 ethacrynate sodium...... 91 Fayosim...... 132 FLOMAX...... 203 ethacrynic acid...... 91 FAZACLO...... 109 FLOVENT DISKUS...... 260 ethambutol...... 32 febuxostat...... 206 FLOVENT HFA...... 260 ETHAMOLIN...... 95 FEIBA NF...... 207 floxuridine...... 48 ethosuximide...... 101 felbamate...... 97 FLUAD 2019-2020 (65 YR UP)(PF)....72 ETHYL ACETATE...... 126 FELBATOL...... 97, 98 FLUARIX QUAD 2019-2020 (PF)...... 72 ETHYL CHLORIDE...... 150 FELDENE...... 15 FLUBLOK QUAD 2019-2020 (PF).....72 ethynodiol diac-eth estradiol...... 130 felodipine...... 86 FLUCELVAX QUAD 2019-2020...... 72 ETHYOL...... 60 FEMARA...... 49 FLUCELVAX QUAD 2019-2020 etidronate disodium...... 181 FEMCAP...... 222, 235 (PF)...... 72 etodolac...... 16 FEMHRT LOW DOSE...... 182 fluconazole...... 27 etomidate...... 18 FEMRING...... 269 fluconazole in dextrose(iso-o)...... 27 ETOPOPHOS...... 50 Femynor...... 130 FLUCONAZOLE IN NACL (ISO- etoposide...... 50 fenofibrate...... 81 OSM)...... 27 EUCALYPTUS FLAVOR...... 126 fenofibrate micronized...... 81 fluconazole in nacl (iso-osm)...... 27 EUCRISA...... 137 fenofibrate nanocrystallized...... 81 flucytosine...... 27 EUFLEXXA...... 218 fenofibric acid...... 81 fludarabine...... 48 EURAX...... 154 fenofibric acid (choline)...... 81 fludrocortisone...... 190 EUTHYROX...... 192 FENOGLIDE...... 81 FLULAVAL QUAD 2019-2020...... 72 EVAMIST...... 182 fenoprofen...... 16 FLULAVAL QUAD 2019-2020 (PF).. 72 EVEKEO...... 112, 117, 122 fentanyl...... 4 FLUMADINE...... 39 EVEKEO ODT...... 112, 117 FENTANYL (PF)-BUPIVACAINE- flumazenil...... 22 EVENITY...... 180 NACL...... 8 FLUMIST QUAD 2019-2020...... 70, 72 EVICEL...... 211 fentanyl citrate...... 4 flunisolide...... 265 EVISTA...... 191 FENTANYL CITRATE...... 4 fluocinolone...... 146 EVOCLIN...... 135 FENTANYL CITRATE (PF)...... 4, 18 fluocinolone acetonide oil...... 256 EVOMELA...... 45 FENTANYL CITRATE (PF)- fluocinolone and shower cap...... 146 EVOTAZ...... 31, 42 0.9%NACL...... 4 fluocinonide...... 146 EVOXAC...... 245 FENTANYL-ROPIVACAINE- Fluocinonide-E...... 146 EXEL INSULIN...... 228, 234 NACL (PF)...... 8 fluocinonide-emollient...... 146 EXELDERM...... 139 FENTORA...... 4 fluorometholone...... 249 EXELON...... 127 FERAHEME...... 161 FLUOROPLEX...... 140 exemestane...... 49 FERRIPROX...... 23 fluorouracil...... 48, 140 EXFORGE...... 75 FERRLECIT...... 161 FLUOROURACIL...... 140 EXFORGE HCT...... 76 FETZIMA...... 104 FLUOVIX...... 146 EXJADE...... 23 FEXMID...... 220 fluoxetine...... 102, 103 EXODERM...... 139 FIBRICOR...... 81 FLUOXETINE...... 103 EXONDYS 51...... 218 FIBRYGA...... 210 fluphenazine decanoate...... 109 EXPAREL (PF)...... 19 FIFTY50 SAFETY SEAL fluphenazine hcl...... 109, 110 EXTINA...... 139 LANCETS...... 223, 235 flurandrenolide...... 146 EXTRANEAL 7.5 %...... 257 FINACEA...... 135, 151 flurazepam...... 113, 123 EXTRA-VIRT PLUS DHA...... 169 finasteride...... 153, 203 flurbiprofen...... 16 EYLEA...... 252, 256 FINE 30 UNIVERSAL LANCETS flurbiprofen sodium...... 250 E-Z JECT LANCETS...... 223, 235 ...... 223, 235 flutamide...... 47 E-Z JECT THIN LANCETS.....223, 235 FINGERSTIX LANCETS...... 223, 235 fluticasone propionate...... 146 EZ SMART LANCETS...... 223, 235 Fioricet...... 11 FLUTICASONE PROPION- EZALLOR SPRINKLE...... 82 FIORINAL...... 17 SALMETEROL...... 264 ezetimibe...... 83 FIORINAL-CODEINE #3...... 7 fluticasone propion-salmeterol...... 264 ezetimibe-simvastatin...... 83 FIRAZYR...... 85 fluvastatin...... 82 FABIOR...... 136 FIRDAPSE...... 246 fluvoxamine...... 103 FABRAZYME...... 241 FIRMAGON KIT W DILUENT FLUZONE HIGH-DOSE 2019-20 FACTIVE...... 36 SYRINGE...... 52 (PF)...... 72 Falmina (28)...... 130 FIRVANQ...... 36 FLUZONE QUAD 2019-2020...... 73 famciclovir...... 38 Flac Otic Oil...... 256 FLUZONE QUAD 2019-2020 (PF).....72 famotidine...... 196 FLAGYL...... 29 FLUZONE QUAD PEDI 2019-20 famotidine (pf)...... 196 FLAREX...... 249 (PF)...... 73 famotidine (pf)-nacl (iso-os)...... 196 flavoxate...... 205 FML FORTE...... 249 FAMOTIDINE IN 0.9 % NACL...... 196 FLEBOGAMMA DIF...... 68 FML LIQUIFILM...... 249 FANAPT...... 108 flecainide...... 79 FML S.O.P...... 249 FARESTON...... 56 FLEXBUMIN 25 %...... 212 FOCALIN...... 112 FARYDAK...... 51 FLEXBUMIN 5 %...... 212 FOCALIN XR...... 112 FASENRA...... 261 FLOLAN...... 94 FOLET ONE...... 169 FASLODEX...... 50 FLOLIPID...... 82 folic acid...... 175 280 FOLIVANE-OB...... 169 GATTEX 30-VIAL...... 201 GLUCOPHAGE...... 188 FOLOTYN...... 47 GATTEX ONE-VIAL...... 201 GLUCOPHAGE XR...... 188 fomepizole...... 22 Gavilyte-C...... 200 GLUCOTROL...... 178 fondaparinux...... 213 Gavilyte-G...... 200 GLUCOTROL XL...... 179 FORA V10-V12-D10-D20 STRP- Gavilyte-N...... 200 GLUTARALDEHYDE...... 61 LNCT...... 223, 235 GAZYVA...... 49 glyburide...... 179 FORACARE LANCETS...... 223, 235 GELCLAIR...... 245 glyburide micronized...... 179 FORANE...... 17 GELFILM...... 253 glyburide-metformin...... 178 FORFIVO XL...... 105 GEL-FLOW...... 210 GLYCATE...... 197 FORTAMET...... 188 GEL-FLOW NT...... 210 glycine urologic...... 202 FORTAZ...... 34 GELFOAM...... 210 glycine urologic solution...... 202 FORTEO...... 180 GELFOAM COMPRESSED SIZE GLYCOPHOS...... 163 FOSAMAX...... 181 100...... 210 glycopyrrolate...... 197 FOSAMAX PLUS D...... 180 GELFOAM JMI POWDER...... 210 GLYCOPYRROLATE...... 197 fosamprenavir...... 42 GELFOAM JMI SPONGE...... 210 GLYCOPYRROLATE (PF) IN FOSCAVIR...... 35 GELFOAM SPONGE SIZE 100...... 210 WATER...... 197 fosinopril...... 75 GELFOAM SPONGE SIZE 12- Glydo...... 152 fosinopril-hydrochlorothiazide...... 74 7MM...... 210 GLYNASE...... 179 fosphenytoin...... 99 GELFOAM SPONGE SIZE 200...... 210 GLYRX-PF...... 197 FOSRENOL...... 202 GELFOAM SPONGE SIZE 50...... 210 GLYSET...... 177 FRAGMIN...... 213 GELNIQUE...... 205 GOCOVRI...... 107 FREAMINE HBC 6.9 %...... 167 GEL-ONE...... 219 GOLYTELY...... 200 FREAMINE III 10 %...... 167 GELSYN-3...... 219 GONAL-F...... 183 FREESTYLE LANCETS...... 223, 235 GELX...... 245 GONAL-F RFF...... 183 FREESTYLE PRECISION...... 228, 235 gemcitabine...... 48 GONAL-F RFF REDI-JECT...... 183 FREESTYLE UNISTIK 2...... 223, 235 GEMCITABINE...... 48 GONITRO...... 78 FROTEK...... 150 gemfibrozil...... 81 GOPRELTO...... 265 FROVA...... 120 GENADUR...... 154 GORDONS UREA...... 144 frovatriptan...... 120 GENERESS FE...... 130 GRAFIX CORE...... 153 FULPHILA...... 209 Generlac...... 195 GRAFIX PRIME...... 153 fulvestrant...... 50 Gengraf...... 13, 216 GRAFIX XC...... 154 FURADANTIN...... 26, 204 Gentak...... 254 GRALISE...... 122 furosemide...... 91 gentamicin...... 24, 138, 254 GRALISE 30-DAY STARTER FUROSEMIDE IN 0.9 % NACL...... 91 gentamicin in nacl (iso-osm)...... 24 PACK...... 122 FUSILEV...... 60 GENTAMICIN IN NACL (ISO- granisetron (pf)...... 194 FUZEON...... 29 OSM)...... 24 granisetron hcl...... 194 Fyavolv...... 182 gentamicin sulfate (ped) (pf)...... 24 GRANIX...... 209 FYCOMPA...... 97 gentamicin sulfate (pf)...... 24 GRASTEK...... 62 g tussin ac...... 268 GENTAMICIN SULFATE (PF)...... 24 griseofulvin microsize...... 27, 28 gabapentin...... 98 GENTAMICIN-SODIUM griseofulvin ultramicrosize...... 28 GABITRIL...... 98 CITRATE...... 33 GUAIACOL...... 126 GABLOFEN...... 220 GENTEEL VACUUM LANCING guaiatussin ac...... 268 GALAFOLD...... 243 DEVICE...... 223, 235 guaifenesin ac...... 268 galantamine...... 127 GENVISC 850...... 219 guaifenesin dac...... 267 GALZIN...... 22 GENVOYA...... 31 guanfacine...... 90, 111 GAMASTAN...... 68 GEODON...... 108, 116 GUANIDINE...... 218 GAMASTAN S/D...... 68 gianvi (28)...... 130 GYNAZOLE-1...... 269 GAMIFANT...... 216 GIAPREZA...... 191 HAEGARDA...... 207 GAMMAGARD LIQUID...... 68 GILENYA...... 247 Hailey 24 Fe...... 130 GAMMAGARD S-D (IGA < 1 GILOTRIF...... 44 HALAVEN...... 51 MCG/ML) ...... 68 GLASSIA...... 265 HALCION...... 114, 123 GAMMAKED...... 68 glatiramer...... 246 HALDOL...... 109 GAMMAPLEX...... 68 Glatopa...... 246 HALDOL DECANOATE...... 109 GAMMAPLEX (WITH GLEEVEC...... 55 HALOBETASOL PROPIONATE SORBITOL)...... 68 GLEOSTINE...... 46 ...... 141, 146 GAMUNEX-C...... 68 GLIADEL WAFER...... 46 halobetasol propionate...... 146 GANCICLOVIR...... 35 glimepiride...... 178 HALOG...... 146 ganciclovir sodium...... 35 glipizide...... 178 haloperidol...... 109 GANCICLOVIR SODIUM...... 35 glipizide-metformin...... 178 haloperidol decanoate...... 109 GANIRELIX...... 189 GLUCAGEN HYPOKIT...... 176 haloperidol lactate...... 109 GARDASIL 9 (PF)...... 72 GLUCAGON EMERGENCY KIT HARVONI...... 37 GASTROCROM...... 53 (HUMAN)...... 176 HAVRIX (PF)...... 67 gatifloxacin...... 254 GLUCOCOM LANCETS...... 223, 235 HEALON...... 253 281 HEALON GV...... 253 HUMALOG MIX 75-25 KWIKPEN 187 HYDROMORPHONE (PF) IN HEALON5...... 253 HUMALOG MIX 75-25(U- WATER...... 4 HEALTHWISE INSULIN 100)INSULN...... 187 HYDROMORPHONE (PF)-0.9 % SYRINGE...... 228, 235 HUMALOG U-100 INSULIN...... 188 NACL...... 4 HEALTHWISE PEN NEEDLE 228, 235 HUMATE-P...... 208 HYDROMORPHONE IN 0.9 % HEALTHY ACCENTS UNIFINE HUMATROPE...... 186 NACL...... 4, 5 PENTIP...... 228, 235 HUMIRA...... 11, 12, 199 hydroxocobalamin...... 174 HEALTHY ACCENTS UNILET HUMIRA PEDIATRIC CROHNS hydroxychloroquine...... 12, 28 LANCET...... 224, 235 START...... 11, 12, 199 hydroxyprogest(pf)(preg presv)....183, 190 Heather...... 132 HUMIRA PEN...... 11, 12, 199 hydroxyprogesterone cap(ppres)..183, 190 HECTOROL...... 242 HUMIRA PEN CROHNS-UC-HS hydroxyprogesterone caproate...... 190 HELIXATE FS...... 208 START...... 11, 12, 199 hydroxyurea...... 48 HEMABATE...... 175 HUMIRA PEN PSOR-UVEITS- hydroxyzine hcl...... 96 HEMANGEOL...... 84 ADOL HS...... 11, 12, 199 HYDROXYZINE HCL...... 96 HEMENATAL OB...... 169 HUMIRA(CF)...... 12, 200 hydroxyzine pamoate...... 96 HEMENATAL OB + DHA...... 169 HUMIRA(CF) PEDI CROHNS HYGEL...... 150 HEMLIBRA...... 209 STARTER...... 11, 12, 199 HYLATOPIC...... 143 HEMOFIL M HIGH...... 208 HUMIRA(CF) PEN...... 12, 200 HYLATOPICPLUS...... 143 HEMOFIL M LOW...... 208 HUMIRA(CF) PEN CROHNS-UC- HYLENEX...... 192 HEMOFIL M MID...... 208 HS...... 11, 12, 199 HYMOVIS...... 219 HEMOFIL M SUPER HIGH...... 208 HUMIRA(CF) PEN PSOR-UV- hyoscyamine sulfate...... 197, 205 hep flush-10 (pf)...... 211 ADOL HS...... 11, 12, 200 HYPERHEP B S/D...... 69 HEPAGAM B...... 69 HUMULIN 70/30 U-100 INSULIN... 186 HYPERHEP B S-D NEONATAL...... 69 heparin (porcine)...... 211, 212 HUMULIN 70/30 U-100 KWIKPEN 187 HYPERLYTE CR...... 162 HEPARIN (PORCINE) IN 0.9% HUMULIN N NPH INSULIN HYPERRAB (PF)...... 69 NACL...... 211 KWIKPEN...... 187 HYPERRAB S/D (PF)...... 69 heparin (porcine) in 5 % dex...... 211 HUMULIN N NPH U-100 INSULIN 187 HYPERRHO S/D...... 69 HEPARIN (PORCINE) IN 5 % DEX HUMULIN R REGULAR U-100 HYPER-SAL...... 126 ...... 211 INSULN...... 187 HYPERTET S/D (PF)...... 69 HEPARIN (PORCINE) IN NACL HUMULIN R U-500 (CONC) HYPOCYN...... 144 (PF)...... 211 INSULIN...... 187 HYPOLANCE AST LANCING 224, 235 heparin flush(porcine)-0.9nacl.....211, 212 HUMULIN R U-500 (CONC) HYPROMELLOSE...... 126 heparin lock flush...... 211, 212 KWIKPEN...... 187 HYQVIA...... 68 heparin lock flush (porcine)...... 211, 212 HYALGAN...... 219 HYZAAR...... 76 heparin lockflush(porcine)(pf)..... 211, 212 HYALURONIDASE(PF)- ibandronate...... 181 HEPARIN(PORCINE) IN 0.45% SODCHLOR,ISO...... 251 IBRANCE...... 50 NACL...... 212 HYCAMTIN...... 57 Ibu...... 16 heparin, porcine (pf)...... 211, 212 HYCLODEX...... 61, 154 Ibudone...... 9 HEPARIN, PORCINE (PF)...... 212 hydralazine...... 90 ibuprofen...... 16 HEPATAMINE 8%...... 167 HYDREA...... 48 ibuprofen lysine (pf)...... 93 HEPLISAV-B (PF)...... 67, 68 HYDRO 40...... 149 ibuprofen-oxycodone...... 9 HEPSERA...... 37 hydrochlorothiazide...... 92 ibutilide fumarate...... 80 HERCEPTIN...... 59 HYDROCODONE- icatibant...... 85 HERCEPTIN HYLECTA...... 59 ACETAMINOPHEN...... 8, 9 ICLUSIG...... 53 HESPAN 6 % IN NS...... 213 hydrocodone-acetaminophen...... 8, 9 IDAMYCIN PFS...... 58 hetastarch 6 % in 0.9 % nacl...... 213 hydrocodone-chlorpheniramine...... 266 idarubicin...... 58 HETLIOZ...... 118 hydrocodone-homatropine...... 267 IDELVION...... 208 HEXTEND...... 213 HYDROCODONE- IDHIFA...... 53 HIBERIX (PF)...... 71 HOMATROPINE...... 267 IFEX...... 45 HIPREX...... 40, 204 hydrocodone-ibuprofen...... 8, 9 ifosfamide...... 45 HISTEX-AC...... 267 hydrocortisone...... 21, 147, 185, 199 IFOSFAMIDE...... 45 HIZENTRA...... 68 hydrocortisone butyrate...... 146, 147 ifosfamide-mesna...... 45 HORIZANT...... 121 hydrocortisone butyr-emollient...... 147 ILARIS (PF)...... 11 HPR...... 143 hydrocortisone valerate...... 147 ILEVRO...... 250 HPR PLUS...... 143 hydrocortisone-acetic acid...... 256 ILUVIEN...... 249 HPR PLUS HYDROGEL...... 143 hydrocortisone-iodoquinol...... 140 imatinib...... 55 HPR PLUS-MB HYDROGEL...... 143 hydrocortisone-pramoxine...... 21 IMBRUVICA...... 49, 55 HUMALOG JUNIOR KWIKPEN hydrogen peroxide...... 61 IMFINZI...... 58 U-100...... 188 Hydromet...... 267 imipenem-cilastatin...... 32 HUMALOG KWIKPEN INSULIN..188 hydromorphone...... 5 imipramine hcl...... 106 HUMALOG MIX 50-50 INSULN U- HYDROMORPHONE...... 5 imipramine pamoate...... 106 100...... 187 HYDROMORPHONE (PF)...... 4 IMIQUIMOD...... 148 HUMALOG MIX 50-50 KWIKPEN 187 imiquimod...... 148 282 IMITREX...... 120 INVANZ...... 33 Jinteli...... 182 IMITREX STATDOSE PEN...... 120 INVEGA...... 108 JIVI...... 208 IMITREX STATDOSE REFILL...... 120 INVEGA SUSTENNA...... 108 jolessa...... 130 IMLYGIC...... 51, 70 INVEGA TRINZA...... 108 JORNAY PM...... 112 IMOGAM RABIES-HT (PF)...... 69 INVELTYS...... 249 JUBLIA...... 140 IMOVAX RABIES VACCINE (PF)...73 INVIRASE...... 42 Juleber...... 130 IMPAVIDO...... 28 IODINE-SODIUM IODIDE...... 61 JULUCA...... 29 IMPOYZ...... 141, 147 IODOFLEX...... 61 junel 1.5/30 (21)...... 130 IMURAN...... 13, 218 IODOPEN...... 161 Junel 1/20 (21)...... 130 IMVEXXY MAINTENANCE PACK IODOSORB...... 61 junel fe 1.5/30 (28)...... 130 ...... 189 IONOSOL-B IN D5W...... 161 Junel Fe 1/20 (28)...... 130 IMVEXXY STARTER PACK...... 189 IONOSOL-MB IN D5W...... 161 Junel Fe 24...... 130 INBRIJA...... 107 IOPIDINE...... 255 JUXTAPID...... 83 Incassia...... 132 IPOL...... 73 JYNARQUE...... 92, 192, 203 INCONTROL PEN NEEDLE...228, 235 ipratropium bromide...... 262, 265 KABIVEN...... 167 INCONTROL SUPER THIN ipratropium-albuterol...... 263 KADCYLA...... 47, 59 LANCETS...... 224, 235 irbesartan...... 77 Kaitlib Fe...... 130 INCONTROL ULTRA THIN irbesartan-hydrochlorothiazide...... 76 KALBITOR...... 94 LANCETS...... 224, 235 IRESSA...... 44 KALETRA...... 31 INCRELEX...... 188 irinotecan...... 57 Kalliga...... 130 INCRUSE ELLIPTA...... 262 ISENTRESS...... 29 KALYDECO...... 264 indapamide...... 92 ISENTRESS HD...... 29 KAMDOY...... 149 INDERAL LA...... 84 Isibloom...... 130 KANJINTI...... 60 INDERAL XL...... 84 Isochron...... 78 KANUMA...... 241 indomethacin...... 16 isoflurane...... 17 KAPSPARGO SPRINKLE...... 84 indomethacin sodium...... 93 ISOLYTE S PH 7.4...... 162 KAPVAY...... 111 INFANRIX (DTAP) (PF)...... 70 ISOLYTE-P IN 5 % DEXTROSE....161 KARBINAL ER...... 258, 259 INFASURF...... 265 ISOLYTE-S...... 162 Kariva (28)...... 128 INFED...... 161 isoniazid...... 32 KATERZIA...... 87 INFLATHERM...... 15 ISOPROPYL ALCOHOL...... 126 KCENTRA...... 208 INFUGEM...... 48 isopropyl alcohol...... 126 KEDBUMIN...... 212 INFUMORPH P/F...... 5 isoproterenol hcl...... 88 KEDRAB (PF)...... 69 INFUVITE ADULT...... 165 ISOPTO ATROPINE...... 249 KEFLEX...... 33 INFUVITE PEDIATRIC...... 168 ISOPTO CARPINE...... 247 Kelnor 1/35 (28)...... 130 INGREZZA...... 121 ISORDIL...... 78 Kelnor 1-50...... 130 INGREZZA INITIATION PACK....121 ISORDIL TITRADOSE...... 78 KENALOG...... 147, 185 INJECT EASE LANCETS...... 224, 235 isosorbide dinitrate...... 78 KENALOG-80...... 185 INJECTAFER...... 162 isosorbide mononitrate...... 78 KENGREAL...... 214 INLYTA...... 55 isotretinoin...... 134 KEPIVANCE...... 200 INNOPRAN XL...... 84 isradipine...... 86 KEPPRA...... 101 INSPRA...... 75, 90 ISTALOL...... 251 KEPPRA XR...... 101 INSULIN LISPRO...... 188 ISTODAX...... 51 KERAFOAM...... 149 INSULIN SYR/NDL U100 HALF ISUPREL...... 88 KERAMATRIX...... 154 MARK...... 228, 235 itraconazole...... 27 KERYDIN...... 140 INSULIN SYRINGE...... 228, 235 ivermectin...... 25 KETALAR...... 17 INSULIN SYRINGE MICROFINE IXEMPRA...... 50 KETAMINE...... 17 ...... 228, 235 IXIARO (PF)...... 73 ketamine...... 17 INSULIN SYRINGE NEEDLELESS IXINITY...... 208 KETAMINE IN 0.9 % SOD ...... 228, 235 JADENU...... 23 CHLORIDE...... 17 INSULIN SYRINGE-NEEDLE U- JADENU SPRINKLE...... 23 KETAMINE IN NACL, ISO- 100...... 229, 235 JAKAFI...... 51, 52 OSMOTIC...... 17 insulin syringe-needle u-100...... 229, 236 JALYN...... 201 KETAMINE IN STERILE WATER..17 INSUPEN...... 229, 236 Jantoven...... 207 ketoconazole...... 26, 139 INTEGRILIN...... 214 JANUMET...... 179 ketoprofen...... 16 INTELENCE...... 30 JANUMET XR...... 179, 180 ketorolac...... 15, 250 INTERMEZZO...... 123 JANUVIA...... 178 KEVEYIS...... 218 intralipid...... 167 JARDIANCE...... 178 KEYTRUDA...... 58 INTRALIPID...... 167 Jasmiel (28)...... 130 KHAPZORY...... 60 INTRAROSA...... 190 Jencycla...... 132 KINERET...... 13 INTRON A...... 51 JENTADUETO...... 180 KINEVAC...... 155 Introvale...... 130 JENTADUETO XR...... 180 KINRIX (PF)...... 70 INTUNIV ER...... 111 JETREA (PF)...... 253 KISQALI...... 50 INVACARE LANCETS...... 224, 236 JEVTANA...... 57 KISQALI FEMARA CO-PACK...... 52 283 KITABIS PAK...... 264 LANCING DEVICE WITH LEVO-T...... 192 KLARITY-A (AZITHRO- LANCETS...... 224, 236 levothyroxine...... 192 CHONDR)(PF)...... 254 LANOXIN...... 90 LEVOTHYROXINE...... 192 KLARITY-L (LOTEPRED- LANOXIN PEDIATRIC...... 90 levoxyl...... 192 CHOND)(PF)...... 249 lanthanum...... 202 LEVULAN...... 150 KLARON...... 135 LANTUS SOLOSTAR U-100 LEXAPRO...... 103 KLONOPIN...... 96, 97, 114 INSULIN...... 187 LEXIVA...... 42 Klor-Con...... 164 LANTUS U-100 INSULIN...... 188 LIALDA...... 198 klor-con 10...... 164 LANZO LANCING DEVICE... 224, 236 LIBRAX (WITH CLIDINIUM) 114, 197 klor-con 8...... 164 larin 1.5/30 (21)...... 130 LIBTAYO...... 58 Klor-Con M10...... 164 Larin 1/20 (21)...... 130 lidocaine...... 19, 152 klor-con m15...... 164 Larin 24 Fe...... 130 LIDOCAINE (PF) IN D7.5W...... 19 Klor-Con M20...... 164 larin fe 1.5/30 (28)...... 130 lidocaine (pf)...... 19, 79 Klor-Con Sprinkle...... 164 Larin Fe 1/20 (28)...... 130 LIDOCAINE (PF)...... 19, 79 klor-con/ef...... 164 Larissia...... 130 lidocaine hcl...... 19, 152, 245 KOATE...... 208 LASIX...... 91 LIDOCAINE HCL...... 19 KOGENATE FS...... 209 LASTACAFT...... 249 LIDOCAINE HCL(PF) IN 0.9% KORLYM...... 178 latanoprost...... 255 NACL...... 19 KOSHER PRENATAL PLUS IRON169 LATANOPROST (PF)...... 255 LIDOCAINE IN 5 % DEXTROSE KOVALTRY...... 209 LATISSE...... 153 (PF)...... 79 KRINTAFEL...... 28 LATUDA...... 108 lidocaine in 5 % dextrose (pf)...... 79 KRISTALOSE...... 200 layolis fe...... 130 LIDOCAINE IN NACL,ISO- KRYSTEXXA...... 206 LDO PLUS...... 149, 151 OSMO(PF)...... 19, 79 K-TAB...... 164 LEDIPASVIR-SOFOSBUVIR...... 37 Lidocaine Viscous...... 245 Kurvelo (28)...... 130 leena 28...... 133 lidocaine-epinephrine...... 20 KUVAN...... 243 leflunomide...... 14 LIDOCAINE-EPINEPHRINE BIT KYLEENA...... 128 LEMTRADA...... 246 ...... 20, 244 KYPROLIS...... 55 LENVIMA...... 55 lidocaine-prilocaine...... 149 l norgest/e.estradiol-e.estrad...... 128, 132 LESCOL...... 82 LIDOCAINE-RACEPINEP- L.E.T. (LIDO-EPINEPH-TETRA)...152 LESCOL XL...... 82 TETRACAINE...... 152 labetalol...... 75 Lessina...... 130 LIDOCAINE-TETRACAINE...... 152 LABETALOL...... 75 LETAIRIS...... 95 LIDOCAN-PHENYLEPH-BSS lactated ringers...... 160, 173 letrozole...... 49 NO.2(PF)...... 247 lactulose...... 195, 200 leucovorin calcium...... 60 LIDOCIDEX-I...... 184 LAMICTAL...... 100 LEUKERAN...... 45 LIDOCILONE I...... 184 LAMICTAL ODT...... 100, 115 LEUKINE...... 209 LIDODERM...... 152 LAMICTAL ODT STARTER leuprolide...... 52 LIDOPURE PATCH...... 152 (BLUE)...... 100, 115 levalbuterol hcl...... 262 lido-sorb...... 152 LAMICTAL ODT STARTER LEVALBUTEROL TARTRATE..... 263 LIDOTREX...... 152 (GREEN)...... 100, 115 LEVAQUIN...... 36 LIDOTREX (WITH VITAMIN E)...152 LAMICTAL ODT STARTER LEVEMIR FLEXTOUCH U-100 LIDTOPIC MAX...... 152 (ORANGE)...... 100, 115 INSULN...... 188 LILETTA...... 128 LAMICTAL STARTER (BLUE) LEVEMIR U-100 INSULIN...... 188 Lillow (28)...... 130 KIT...... 100, 115 levetiracetam...... 101 LINCOCIN...... 39 LAMICTAL STARTER (GREEN) LEVETIRACETAM IN NACL lincomycin...... 39 KIT...... 100, 115 (ISO-OS)...... 101 lindane...... 154 LAMICTAL STARTER (ORANGE) LEVICYN ANTIPRURITIC.....153, 155 linezolid...... 41 KIT...... 100, 115 LEVICYN ANTIPRURITIC SG...... 143 linezolid in dextrose 5%...... 41 LAMICTAL XR...... 100 LEVICYN DERMAL...... 154 linezolid-0.9% sodium chloride...... 41 LAMICTAL XR STARTER (BLUE) levobunolol...... 251 LINZESS...... 195, 198, 200 ...... 100 levocarnitine...... 158, 242 LIORESAL...... 220 LAMICTAL XR STARTER levocarnitine (with sugar)...... 242 liothyronine...... 192 (GREEN)...... 100 levocetirizine...... 259 LIPOCHOL PLUS...... 83 LAMICTAL XR STARTER levofloxacin...... 36, 254 lipodox...... 58 (ORANGE)...... 100 levofloxacin in d5w...... 36 lipodox 50...... 58 lamivudine...... 30, 37 levoleucovorin calcium...... 60 LIPOFEN...... 81 lamivudine-zidovudine...... 31 Levonest (28)...... 133 LIQUIVIDA HYDRATION KIT...... 174 lamotrigine...... 100, 101, 115 levonorgestrel-ethinyl estrad...... 130 lisinopril...... 75 LANCETS...... 224, 236 levonorg-eth estrad triphasic...... 133 lisinopril-hydrochlorothiazide...... 74 LANCETS, SUPER THIN...... 224, 236 LEVOPHED (BITARTRATE)...... 89 LITE TOUCH INSULIN PEN LANCETS,THIN...... 224, 236 Levora-28...... 130 NEEDLES...... 229, 236 LANCETS,ULTRA THIN...... 224, 236 levorphanol tartrate...... 5 LEVORPHANOL TARTRATE...... 5 284 LITE TOUCH INSULIN SYRINGE lugols...... 61, 161 MAR-COF CG...... 268 ...... 229, 236 LULICONAZOLE...... 139 MARINOL...... 117, 158, 193 LITE TOUCH LANCETS...... 224, 236 LUMIGAN...... 255 Marlissa (28)...... 131 lithium carbonate...... 116 LUMIZYME...... 242 MARNATAL-F...... 169 LITHIUM CITRATE...... 116 LUMOXITI...... 50, 51 MARPLAN...... 102 LITHOBID...... 116 LUNESTA...... 124 MARQIBO...... 57 LITHOSTAT...... 204 LUPANETA PACK (1 MONTH)..... 189 MATULANE...... 45 LIVALO...... 82 LUPANETA PACK (3 MONTH)..... 189 Matzim La...... 86 lmd 10 % in 0.9 % sodium chlor...... 213 LUPRON DEPOT...... 52, 189 MAVENCLAD (10 TABLET PACK) lmd 10 % in 5 % dextrose...... 213 LUPRON DEPOT (3 MONTH).. 52, 189 ...... 247 LO LOESTRIN FE...... 128 LUPRON DEPOT (4 MONTH)...... 52 MAVENCLAD (4 TABLET PACK) 247 LOCOID...... 147 LUPRON DEPOT (6 MONTH)...... 52 MAVENCLAD (5 TABLET PACK) 247 LOCOID LIPOCREAM...... 147 LUPRON DEPOT-PED...... 189 MAVENCLAD (6 TABLET PACK) 247 LODINE...... 17 LUPRON DEPOT-PED (3 MONTH) MAVENCLAD (7 TABLET PACK) 247 LODOSYN...... 107 ...... 189 MAVENCLAD (8 TABLET PACK) 247 LOESTRIN 1.5/30 (21)...... 130 LUTATHERA...... 54, 56 MAVENCLAD (9 TABLET PACK) 247 Loestrin 1/20 (21)...... 130 Lutera (28)...... 131 MAVYRET...... 37 LOESTRIN FE 1.5/30 (28-DAY)...... 130 LUXAMEND...... 143 MAXALT...... 120 Loestrin Fe 1/20 (28-Day)...... 130 LUXIQ...... 147 MAXALT-MLT...... 120 LOKELMA...... 160 LUZU...... 139 MAXICOMFORT II PEN NEEDLE LOMAIRA...... 158 LYNPARZA...... 54 ...... 229, 236 LOMOTIL...... 193 LYRICA...... 98, 118 MAXICOMFORT INSULIN LONHALA MAGNAIR REFILL.....262 LYRICA CR...... 118, 122, 123 SYRINGE...... 229, 236 LONHALA MAGNAIR STARTER.262 LYSODREN...... 46 MAXI-COMFORT INSULIN LONSURF...... 48 LYSTEDA...... 210 SYRINGE...... 229, 236 loperamide...... 192 Lyza...... 132 MAXICOMFORT SAFETY PEN LOPID...... 81 M.V.I. ADULT...... 165 NEEDLE...... 229, 236 lopinavir-ritonavir...... 31 M.V.I. PEDIATRIC...... 168 MAXIDEX...... 250 lopreeza...... 182 M.V.I.-12 (WITHOUT VITAMIN K) MAXIPIME...... 35 LOPRESSOR...... 84 ...... 165 MAXITROL...... 248 LOPRESSOR HCT...... 88 MACROBID...... 26, 204 MAXI-TUSS CD...... 267 LOPROX...... 139 MACRODANTIN...... 26, 204 MAXZIDE...... 92 LOPROX (AS OLAMINE)...... 139 MACUGEN...... 252, 255 MAXZIDE-25MG...... 92 lorazepam...... 96, 114, 123 mafenide acetate...... 142 MAYZENT...... 247 lorazepam intensol...... 96, 114 MAGELLAN INSULIN SAFETY M-CLEAR WC...... 268 LORBRENA...... 46 SYRNG...... 229, 236 meclizine...... 193 Lorcet (Hydrocodone)...... 8, 9 MAGELLAN SYRINGE...... 229, 236 meclofenamate...... 15 Lorcet Hd...... 8, 9 magnesium chloride...... 162 MEDIHONEY (HONEY)...... 155 Lorcet Plus...... 8, 9 magnesium sulfate...... 162 MEDISENSE THIN LANCETS224, 236 LORTAB ELIXIR...... 8, 9 MAGNESIUM SULFATE IN 0.9 MEDLANCE PLUS LANCETS224, 236 LORTUSS EX...... 267 %NACL...... 162 MEDLANCE PLUS SPECIAL Loryna (28)...... 131 MAGNESIUM SULFATE IN D5W. 162 BLADE...... 224, 236 LORZONE...... 220 MAGNESIUM SULFATE IN LR.....162 MEDROL...... 185 losartan...... 77 MAGNESIUM SULFATE IN MEDROL (PAK)...... 185 losartan-hydrochlorothiazide...... 76 WATER...... 162 medroxyprogesterone...... 128, 190 LOSEASONIQUE...... 128 MAKENA...... 183, 190 mefenamic acid...... 15 LOTEMAX...... 249 MAKENA (PF)...... 183, 190 mefloquine...... 28 LOTEMAX SM...... 250 MALARONE...... 28 megestrol...... 55, 158 LOTENSIN...... 75 MALARONE PEDIATRIC...... 28 MEKINIST...... 53 LOTENSIN HCT...... 74 malathion...... 154 MEKTOVI...... 53 loteprednol etabonate...... 250 manganese chloride...... 162 Melodetta 24 Fe...... 131 LOTREL...... 74 manganese sulfate...... 162 meloxicam...... 15 LOTRISONE...... 140 mannitol 10 %...... 91 melphalan...... 45 LOTRONEX...... 198, 200 mannitol 20 %...... 91 melphalan hcl...... 45 LOUTREX...... 142, 143 mannitol 25 %...... 91 memantine...... 127 lovastatin...... 82 mannitol 5 %...... 91 MEMANTINE...... 127 LOVENOX...... 213 maprotiline...... 106 MEMBRANEBLUE...... 253 Low-Ogestrel (28)...... 131 MARCAINE...... 19 MENACTRA (PF)...... 71 loxapine succinate...... 109 MARCAINE (PF)...... 19 M-END PE...... 267 LOYON...... 143 MARCAINE SPINAL (PF)...... 19 MENEST...... 182 Lo-Zumandimine (28)...... 131 MARCAINE-EPINEPHRINE...... 20 MENOPUR...... 183 LUCEMYRA...... 124 MARCAINE-EPINEPHRINE (PF)....20 MENOSTAR...... 182 LUCENTIS...... 252, 256 MAR-COF BP...... 267 MENTAX...... 139 285 MENVEO A-C-Y-W-135-DIP (PF).... 71 methylprednisolone acetate...... 185 milrinone...... 88 meperidine...... 5 METHYLPREDNISOLONE ACET- milrinone in 5 % dextrose...... 88 meperidine (pf)...... 5 WATER...... 185 Mimvey...... 182 MEPHYTON...... 175 methylprednisolone sodium succ...... 185 Mimvey Lo...... 182 MEPIVACAINE (PF)...... 19, 244 methyltestosterone...... 176 MIMYX...... 143 meprobamate...... 97 metipranolol...... 251 MINASTRIN 24 FE...... 131 MEPRON...... 28 metoclopramide hcl...... 196, 197 MINI ULTRA-THIN II...... 229, 236 MEPSEVII...... 241 METOCLOPRAMIDE HCL...... 197 MINIPRESS...... 93 mercaptopurine...... 48 metolazone...... 92 Minitran...... 78 meropenem...... 33 metoprolol succinate...... 84 MINIVELLE...... 183 MEROPENEM-0.9% SODIUM METOPROLOL SU- MINOCIN...... 43 CHLORIDE...... 33 HYDROCHLOROTHIAZ...... 88 minocycline...... 14, 43, 134 MERREM...... 33 metoprolol ta-hydrochlorothiaz...... 88 minoxidil...... 90 mesalamine...... 198 metoprolol tartrate...... 84 MIOCHOL-E...... 247 mesalamine with cleansing wipe...... 199 METRO I.V...... 29 MIOSTAT...... 247 mesna...... 60 METROCREAM...... 135 MIRAPEX...... 108 MESNEX...... 60 METROGEL...... 151 MIRAPEX ER...... 108 MESTINON...... 218 METROGEL VAGINAL...... 269 MIRCERA...... 207 MESTINON TIMESPAN...... 218 METROLOTION...... 135 Mircette (28)...... 128 Metadate Er...... 112 metronidazole...... 29, 135, 151, 269 MIRENA...... 128 metaproterenol...... 263 METRONIDAZOLE IN NACL mirtazapine...... 102 METASTRON...... 56 (ISO-OS)...... 29 MIRVASO...... 151, 152 Metaxall...... 220 mexiletine...... 79 misoprostol...... 196 metaxalone...... 220 MIACALCIN...... 181 MITIGARE...... 206 METFORMIN...... 188 Mibelas 24 Fe...... 131 MITIGO (PF)...... 5 metformin...... 188 MICARDIS...... 77 mitomycin...... 58 METHADONE...... 5 MICARDIS HCT...... 76, 77 MITOMYCIN...... 58 methadone...... 5 MICONAZOLE NITRATE-ZINC MITOSOL...... 249 Methadone Intensol...... 5 OX-PET...... 139 mitoxantrone...... 58 METHADOSE...... 5 miconazole-3...... 269 MKO (MIDAZOLAM-KETAMINE- Methadose...... 5 MICORT-HC...... 21, 147 ONDAN)...... 17, 124 methamphetamine...... 112, 117 MICRHOGAM ULTRA- M-M-R II (PF)...... 70, 73, 74 methazolamide...... 91 FILTERED PLUS...... 69 MOBIC...... 15 methenamine hippurate...... 40, 204 MICRO THIN LANCETS...... 224, 236 modafinil...... 121, 122 methenamine mandelate...... 40, 204 MICROCYN...... 61, 154 Moderiba...... 38 Methergine...... 190 microgestin 1.5/30 (21)...... 131 moexipril...... 75 methimazole...... 180 microgestin 1/20 (21)...... 131 molindone...... 109 METHITEST...... 176 MICROGESTIN 24 FE...... 131 mometasone...... 147, 265 methocarbamol...... 220, 221 microgestin fe 1.5/30 (28)...... 131 Mondoxyne Nl...... 43 METHOCEL E 4 M...... 126 microgestin fe 1/20 (28)...... 131 monoject 0.9% sodium chloride... 173, 174 METHOHEXITAL IN WATER MICROLET 2 LANCING DEVICE MONOJECT INSULIN SAFETY (PF)...... 17 ...... 224, 236 SYRING...... 229, 236 METHOTREXATE SODIUM...... 12, 47 MICROLET LANCET...... 224, 236 MONOJECT INSULIN SYRINGE methotrexate sodium...... 47 MICROLET NEXT LANCING ...... 229, 236 methotrexate sodium (pf)...... 47 DEVICE...... 224, 236 monoject prefill advanced ns...... 173, 174 methoxsalen...... 141 MICROZIDE...... 92 MONOJECT SYRINGE...... 229, 236 methscopolamine...... 197 midazolam...... 18, 114, 123 MONOJECT ULTRA COMFORT methyclothiazide...... 92 midazolam (pf)...... 18, 114 INSULIN...... 229, 236 METHYL SALICYLATE...... 153 MIDAZOLAM (PF)...... 18, 114 MONOLET LANCETS...... 224, 236 methyldopa...... 90 MIDAZOLAM (PF) IN 0.9 % NACL MONOLET THIN LANCETS..224, 236 methyldopa-hydrochlorothiazide...... 89 ...... 18, 114 Mono-Linyah...... 131 methyldopate...... 90 MIDAZOLAM IN 0.9 % SOD MONONINE...... 208 methylene blue (antidote)...... 22 CHLORID...... 18, 114 MONOVISC...... 219 METHYLERGONOVINE...... 190 midodrine...... 89 montelukast...... 261 methylergonovine...... 190 MIFEPREX...... 176 MONUROL...... 26, 204 METHYLIN...... 112, 122 mifepristone...... 176 Morgidox...... 43 methylphenidate hcl...... 112, 122 migergot...... 119 MORPHINE...... 6 METHYLPHENIDATE HCL...... 112 miglitol...... 177 morphine...... 6 METHYLPRED AC(PF)- miglustat...... 242 morphine (pf)...... 6 NACL,ISO-OSM...... 185 MIGRANAL...... 119 MORPHINE (PF)...... 6 METHYLPREDNISOL AC- Mili...... 131 MORPHINE (PF) IN 0.9 % NACL.. 5, 6 BUPIVAC-WAT...... 184 MILLIPRED...... 185 morphine concentrate...... 6 methylprednisolone...... 185 MILLIPRED DP...... 185 286 MORPHINE IN 0.9 % SODIUM NAFCILLIN...... 41 NESTABS ABC...... 169 CHLOR...... 6 NAFCILLIN IN DEXTROSE ISO- NESTABS DHA...... 169 MOTOFEN...... 193 OSM...... 41 NESTABS ONE...... 169 MOVANTIK...... 23 naftifine...... 138 Neuac...... 135 MOVIPREP...... 200 NAFTIN...... 138 NEULASTA...... 209 MOXATAG...... 25 NAGLAZYME...... 241 NEUPOGEN...... 209 MOXEZA...... 254 nalbuphine...... 10 NEUPRO...... 108 moxifloxacin...... 36, 254 NALOCET...... 9 NEURONTIN...... 98 MOXIFLOXACIN (PF)-BSS NO.2.. 254 naloxone...... 23, 24 NEUT...... 160 MOXIFLOXACIN-SOD naltrexone...... 24 NEUTRASAL...... 244 CHLOR,ISO(PF)...... 254 NAMENDA...... 127 NEVANAC...... 250 MOXIFLOXACIN-SOD.ACE,SUL- NAMENDA TITRATION PAK...... 127 nevirapine...... 30 WATER...... 36 NAMENDA XR...... 127 NEXA PLUS...... 170 moxifloxacin-sod.chloride(iso)...... 36 NAMZARIC...... 127 NEXAVAR...... 53 MOZOBIL...... 207 NANDROLONE DECANOATE...... 176 NEXAVIR...... 149 MS CONTIN...... 6 NAPRELAN CR...... 16 NEXIUM IV...... 196 MUGARD...... 245 NAPROSYN...... 16 NEXPLANON...... 127 MULPLETA...... 216 naproxen...... 16 NEXTERONE...... 80 MULTAQ...... 80 naproxen sodium...... 16 niacin...... 82, 175 MULTI-LANCET DEVICE 2...224, 236 naratriptan...... 120 Niacor...... 82 MULTITRACE-4...... 164 NARCAN...... 24 NIASPAN EXTENDED-RELEASE...82 MULTITRACE-4 CONCENTRATE NARDIL...... 102 nicardipine...... 87 ...... 164 NAROPIN (PF)...... 19 NICARDIPINE IN 0.9 % NACL...... 87 MULTITRACE-4 NEONATAL...... 164 NASCOBAL...... 174 NICOTROL...... 125 MULTITRACE-4 PEDIATRIC...... 164 NATACHEW (FE BIS- NICOTROL NS...... 125 MULTITRACE-5...... 164 GLYCINATE)...... 169 nifedipine...... 87 MULTITRACE-5 CONCENTRATE NATACYN...... 255 Nikki (28)...... 131 ...... 164 NATAZIA...... 132 NILANDRON...... 47 mupirocin...... 138 nateglinide...... 178 nilutamide...... 47 mupirocin calcium...... 138 NATPARA...... 190 NIMBEX...... 220 MURI-LUBE...... 126 NATROBA...... 154 nimodipine...... 86 MUSE...... 157 NATURE-THROID...... 191 NINJACOF-XG...... 268 MUTAMYCIN...... 58 NAVELBINE...... 57 NINLARO...... 55 MVASI...... 44 NEBUPENT...... 40 NIPENT...... 48 MYALEPT...... 188 nebusal...... 126 NIPRIDE RTU...... 90 MYAMBUTOL...... 32 NEBUSAL...... 126 nisoldipine...... 87 MYCAMINE...... 26 necon 0.5/35 (28)...... 131 NITHIODOTE...... 22 MYCOBUTIN...... 32, 43 NEEVODHA (WITH ALGAL OIL) 169 NITRO-BID...... 78 mycophenolate mofetil...... 13, 217 nefazodone...... 103 NITRO-DUR...... 78 mycophenolate mofetil hcl...... 13, 217 NEMBUTAL SODIUM...... 123 nitrofurantoin...... 26, 204 mycophenolate sodium...... 217 NEOCERA...... 143 nitrofurantoin macrocrystal...... 26, 204 MYDAYIS...... 112, 117 neomycin...... 24 nitrofurantoin monohyd/m-cryst.....26, 204 MYDRIACYL...... 249 neomycin-bacitracin-poly-hc...... 248 NITROGLYCERIN...... 78 MYFORTIC...... 217 neomycin-bacitracin-polymyxin...... 253 nitroglycerin...... 78 MYGLUCOHEALTH LANCETS neomycin-polymyxin b gu...... 202 nitroglycerin in 5 % dextrose...... 78 ...... 224, 237 neomycin-polymyxin b-dexameth...... 248 NITROLINGUAL...... 78 MYLERAN...... 45 neomycin-polymyxin-gramicidin...... 253 NITROMIST...... 78 MYLOTARG...... 47, 59 neomycin-polymyxin-hc...... 248, 256 NITROPRESS...... 90 MYNATAL...... 169 Neo-Polycin...... 253 NITROSTAT...... 78 MYNATAL ADVANCE...... 169 Neo-Polycin Hc...... 248 Nitro-Time...... 78 MYNATAL PLUS...... 169 NEOPROFEN (IBUPROFEN NITYR...... 243 MYNATAL-Z...... 169 LYSN)(PF)...... 93 NIVATOPIC PLUS...... 143 MYNATE 90 PLUS...... 169 NEORAL...... 13, 216 NIVESTYM...... 209 MYOBLOC...... 219 NEOSALUS...... 143 nizatidine...... 196 Myorisan...... 134 NEOSTIGMINE NIZORAL...... 139 MYRBETRIQ...... 202 METHYLSULFATE...... 218 NOCDURNA (MEN)...... 177 MYSOLINE...... 97 NEO-SYNALAR...... 138 NOCDURNA (WOMEN)...... 177 MYTESI...... 192 NEO-SYNALAR KIT...... 138 NOCTIVA...... 177 NABI-HB...... 69 NEPHRAMINE 5.4 %...... 167 Nolix...... 147 nabumetone...... 15 NERLYNX...... 45 nora-be...... 132 nadolol...... 84 NESACAINE...... 20 NORCO...... 8, 9 nadolol-bendroflumethiazide...... 93 NESACAINE-MPF...... 20 norepinephrine bitartrate...... 89 nafcillin...... 41 NESTABS...... 170 287 NOREPINEPHRINE NUWIQ...... 209 ONETOUCH DELICA LANCETS BITARTRATE-D5W...... 89 NUZYRA...... 24, 44 ...... 224, 237 NOREPINEPHRINE NUZYRA (7 DAY WITH LOAD ONETOUCH DELICA PLUS LANC BITARTRATE-NACL...... 89 DOSE)...... 24, 44 DEV...... 224, 237 noreth-ethinyl estradiol-iron...... 131 NUZYRA (7 DAY)...... 24, 44 ONETOUCH DELICA PLUS norethindrone (contraceptive)...... 132 Nyamyc...... 138 LANCET...... 224, 237 norethindrone acetate...... 190 NYMALIZE...... 86 ONETOUCH SURESOFT norethindrone ac-eth estradiol.....131, 182 nystatin...... 26, 139, 244 LANCING DEV...... 224, 237 norethindrone-e.estradiol-iron...... 131 nystatin-triamcinolone...... 140 ONETOUCH ULTRA BLUE TEST norgestimate-ethinyl estradiol...... 131, 133 Nystop...... 139 STRIP...... 221, 237 NORITATE...... 135 OB COMPLETE...... 162, 170 ONETOUCH ULTRASOFT Norlyda...... 132 OB COMPLETE ONE...... 170 LANCETS...... 224, 237 Norlyroc...... 132 OB COMPLETE PETITE...... 170 ONETOUCH VERIO...... 221, 237 normal saline flush...... 173, 174 OB COMPLETE PREMIER...... 162 ONEXTON...... 135 NORMOSOL-M IN 5 % OB COMPLETE WITH DHA...... 170 ONFI...... 97, 114 DEXTROSE...... 161 OBIZUR...... 209 ONIVYDE...... 57 NORMOSOL-R...... 163 OBREDON...... 268 ONMEL...... 27 NORMOSOL-R IN 5 % OBSTETRIX DHA...... 170 ONPATTRO...... 176 DEXTROSE...... 161 OBSTETRIX EC...... 170 ON-THE-GO LANCETS...... 224, 237 NORMOSOL-R PH 7.4...... 163 OBSTETRIX ONE...... 170 ONZETRA XSAIL...... 120 NORPACE...... 79 OBTREX DHA...... 170 OPANA...... 7 NORPACE CR...... 79 O-CAL PRENATAL...... 170 OPDIVO...... 59 NORPRAMIN...... 106 OCALIVA...... 216 OPSUMIT...... 95 NORTHERA...... 89 ocella...... 131 ORACEA...... 44, 151 nortrel 0.5/35 (28)...... 131 OCTAGAM...... 68 ORALAIR...... 62 nortrel 1/35 (21)...... 131 OCTAPLAS (BLOOD GROUP A)...213 Oralone...... 245 Nortrel 1/35 (28)...... 131 OCTAPLAS (BLOOD GROUP AB) 213 ORAMAGICRX...... 245 nortrel 7/7/7 (28)...... 133 OCTAPLAS (BLOOD GROUP B)...213 ORAP...... 109 nortriptyline...... 106 OCTAPLAS (BLOOD GROUP O)...213 ORAPRED ODT...... 185 NORVASC...... 87 octreotide acetate...... 191, 201 ORAVIG...... 26 NORVIR...... 42 ocucoat...... 253 ORBACTIV...... 39 NOVA SAFETY LANCETS...... 224, 237 OCUFLOX...... 254 ORENITRAM...... 94 NOVA SUREFLEX LANCETS 224, 237 ODACTRA...... 63 ORFADIN...... 243 NOVAREL...... 186 ODEFSEY...... 31 ORILISSA...... 189 NOVOEIGHT...... 209 ODOMZO...... 51 ORKAMBI...... 264 NOVOFINE 32...... 229, 237 OFEV...... 56, 268 orphenadrine citrate...... 221 NOVOFINE AUTOCOVER..... 229, 237 OFIRMEV...... 10 orphenadrine-asa-caffeine...... 220 NOVOFINE PLUS...... 229, 237 ofloxacin...... 36, 254, 256 Orphengesic Forte...... 220 NOVOSEVEN RT...... 208 ogestrel (28)...... 131 Orsythia...... 131 NOVOTWIST...... 229, 237 Okebo...... 44 ORTHO-NOVUM 1/35 (28)...... 131 NOXAFIL...... 27 olanzapine...... 110, 116 ORTHOVISC...... 219 np thyroid...... 191 olanzapine-fluoxetine...... 105, 110, 116 oseltamivir...... 38 NPLATE...... 216 olmesartan...... 77, 78 OSENI...... 179 NUBEQA...... 47 olmesartan-amlodipin-hcthiazid...... 76 OSMITROL 10 %...... 91 NUCALA...... 261, 262 olmesartan-hydrochlorothiazide...... 77 osmitrol 15 %...... 91 NUCYNTA...... 6, 7 olopatadine...... 249, 265 osmitrol 20 %...... 91 NUEDEXTA...... 123 OLUMIANT...... 14 OSMITROL 5 %...... 91 NULOJIX...... 218 OLUX...... 147 OSMOLEX ER...... 108 NULYTELY WITH FLAVOR OLUX-E...... 147 OSMOPREP...... 200 PACKS...... 200 OMEGAVEN...... 167 OSPHENA...... 189 NUMOISYN...... 3, 245 omeprazole...... 196 OTEZLA...... 14, 141 NUPLAZID...... 110 OMIDRIA...... 252 OTEZLA STARTER...... 14, 141 NUSURGEPAK SURGICAL PREP 155 OMNARIS...... 266 OTIPRIO...... 256 NUTRASEB...... 144 ON CALL LANCET...... 224, 237 OTOVEL...... 256 NUTRILIPID...... 167 ON CALL PLUS LANCET...... 224, 237 OTREXUP (PF)...... 12 nutrilyte...... 163 ONCASPAR...... 49 OVACE...... 142 NUTRIPORT BALLOON...... 231, 237 ondansetron...... 194 Ovide...... 154 NUTROPIN AQ NUSPIN...... 186 ondansetron hcl...... 194 OVIDREL...... 186 NUVAIL...... 151 ondansetron hcl (pf)...... 194 oxacillin...... 41 NUVAKAAN...... 150, 231 ONETOUCH DELICA LANC OXACILLIN IN DEXTROSE(ISO- NUVARING...... 134 DEVICE...... 224, 237 OSM)...... 41 NUVESSA...... 269 oxaliplatin...... 54 NUVIGIL...... 122 OXANDRIN...... 176 288 oxandrolone...... 176 PAXIL CR...... 103 phentermine...... 158 oxaprozin...... 16 PEDIARIX (PF)...... 67, 71 phentolamine...... 93 OXAYDO...... 7 PEDITRACE...... 164 PHENYLEPHRINE HCL...... 89 oxazepam...... 96, 114 PEDVAX HIB (PF)...... 71 phenylephrine hcl...... 251 oxcarbazepine...... 99 peg 3350-electrolytes...... 200 PHENYLEPHRINE HCL IN 0.9% OXERVATE...... 251 PEGANONE...... 99 NACL...... 89 oxiconazole...... 139 PEGASYS...... 37 PHENYLEPHRINE HCL IN D5W.... 89 OXISTAT...... 139, 140 PEGASYS PROCLICK...... 37 PHENYTEK...... 99 OXSORALEN ULTRA...... 141 peg-electrolyte soln...... 200 phenytoin...... 99 OXTELLAR XR...... 99 PEGINTRON...... 37 phenytoin sodium...... 79, 99 oxybutynin chloride...... 205 peg-prep...... 201 phenytoin sodium extended...... 99 oxycodone...... 7 PEN NEEDLE...... 229, 237 philith...... 131 OXYCODONE...... 7 PEN NEEDLE, DIABETIC...... 229, 237 PHLAG SPRAY...... 144 oxycodone-acetaminophen...... 9, 10 penicillamine...... 14, 23 PHOSLYRA...... 202, 203 oxycodone-aspirin...... 9, 10 PENICILLIN G POT IN PHOSPHOLINE IODIDE...... 247 OXYCONTIN...... 7 DEXTROSE...... 41 PHOTOFRIN...... 54 oxymorphone...... 7 penicillin g potassium...... 41 PHOTREXA CROSS-LINKING oxytocin...... 190 PENICILLIN G PROCAINE...... 41 KIT...... 248 OXYTOCIN IN 0.9 % SOD penicillin g sodium...... 41 PHOTREXA VISCOUS...... 248 CHLORIDE...... 190 penicillin v potassium...... 41 PHOXILLUM B22K...... 256 OXYTOCIN IN DEXTROSE 5 %....190 PENLAC...... 139 PHOXILLUM BK...... 257 OXYTOCIN IN LACTATED PENLEN...... 144 Phrenilin Forte(With Caffeine)...... 11 RINGERS...... 190 PENTACEL (PF)...... 72 PHYSIOLYTE...... 160 OXYTROL...... 205 PENTACEL ACTHIB PHYSIOSOL IRRIGATION...... 160 OZEMPIC...... 179 COMPONENT (PF)...... 71 phytonadione (vitamin k1)...... 175 OZURDEX...... 250 PENTAM...... 40 PHYTONADIONE (VITAMIN K1).175 Pacerone...... 80 pentamidine...... 40 PICATO...... 140 paclitaxel...... 57 PENTASA...... 199 PIFELTRO...... 30 PAIN EASE MEDIUM STREAM pentazocine-naloxone...... 10 pilocarpine hcl...... 245, 247 SPRAY...... 150 PENTETATE CALCIUM pimecrolimus...... 142 PAIN EASE MIST SPRAY...... 150 TRISODIUM...... 23 pimozide...... 109 paliperidone...... 108 PENTETATE ZINC TRISODIUM.... 23 Pimtrea (28)...... 128 PALONOSETRON...... 194 PENTIPS...... 229, 237 pindolol...... 84 palonosetron...... 194 pentobarbital sodium...... 123 pioglitazone...... 188 PALYNZIQ...... 243 pentoxifylline...... 209 pioglitazone-glimepiride...... 179 PAMELOR...... 106 Pepcid...... 196 pioglitazone-metformin...... 179 pamidronate...... 181 PERCOCET...... 9, 10 PIPERACILLIN-TAZOBACTAM.... 41 PANCREAZE...... 195 PERFOROMIST...... 262 piperacillin-tazobactam...... 41 pancuronium...... 220 PERIDEX...... 244 PIQRAY...... 54 PANDEL...... 147 PERIKABIVEN...... 167 Pirmella...... 131 PANHEMATIN...... 207 perindopril erbumine...... 75 pirmella...... 133 PANRETIN...... 141 Periogard...... 244 piroxicam...... 15 pantoprazole...... 196 PERJETA...... 59 PITOCIN...... 190 PANZYGA...... 68 permethrin...... 154 PLAQUENIL...... 12, 28 papaverine...... 94 perphenazine...... 110 plasbumin 25 %...... 212 PAPAV-PHENTOLAM-ALPROST- perphenazine-amitriptyline...... 105 plasbumin 5 %...... 212 WATER...... 157 PERSERIS...... 108 PLASMA-LYTE 148...... 163 PAPAV-PHENTOLAMINE IN PERTZYE...... 195 PLASMA-LYTE A...... 163 WATER...... 94, 157 PEXEVA...... 103 PLASMANATE...... 213 PARAGARD T 380A...... 128 Pfizerpen-G...... 41 PLAVIX...... 214 PAREMYD...... 247 PH 12 DILUENT FOR FLOLAN..... 126 PLEGRIDY...... 246 PARICALCITOL...... 242 PHARMABASE BARRIER...... 151 PLENAMINE...... 167 paricalcitol...... 242 Phenadoz...... 193, 258, 259 PLENVU...... 200 PARLODEL...... 107 phenazopyridine...... 204 PLIAGLIS...... 153 PARNATE...... 102 phendimetrazine tartrate...... 158 PNEUMOVAX 23...... 71 Paroex Oral Rinse...... 244 phenelzine...... 102 PNV 29-1...... 170 paromomycin...... 24 Phenergan...... 193, 194, 258, 259 PNV OB+DHA...... 170 paroxetine hcl...... 103 phenobarb-hyoscy-atropine-scop...... 198 PNV-DHA + DOCUSATE...... 170 paroxetine mesylate(menop.sym)...... 189 phenobarbital...... 97, 123 PNV-FERROUS FUMARATE- PARSABIV...... 181 phenobarbital sodium...... 97, 123 DOCU-FA...... 170 PASER...... 32 PHENOBARBITAL SODIUM... 97, 123 PNV-OMEGA...... 170 PATANASE...... 265 PHENOL...... 61 PNV-VP-U...... 170 PAXIL...... 103 phenoxybenzamine...... 93 podofilox...... 149 289 POLIVY...... 47, 59 PRED MILD...... 250 PRENATE ESSENTIAL...... 171 polocaine...... 19 PRED-G...... 248 PRENATE ESSENTIAL(IRON- POLOCAINE...... 19 PRED-G S.O.P...... 248 ASP-GL)...... 171 polocaine-mpf...... 19 prednicarbate...... 147 PRENATE MINI (FERR ASP Polycin...... 253 PREDNISOLN SP-MOXIFLOX- GLYCIN)...... 171 polymyxin b sulfate...... 42 BROMFEN...... 248 PRENATE PIXIE...... 171 polymyxin b sulf-trimethoprim...... 253 prednisolone...... 185 PRENATE RESTORE...... 171 POLYSORBATE 80...... 126 prednisolone acetate...... 250 PRENATE STAR...... 171 POLYTRIM...... 253 PREDNISOLONE ACETATE (PF). 250 PRE-PEN...... 157 POLY-TUSSIN AC...... 267 PREDNISOLONE ACETATE- PREPIDIL...... 175 POMALYST...... 57 NEPAFENAC...... 251 PREPLUS...... 171 PONTOCAINE...... 153 PREDNISOLONE SOD PH- PREPOPIK...... 201 Portia 28...... 131 MOXIFLOX...... 248 PRESERA...... 144 PORTRAZZA...... 59 prednisolone sodium phosphate...... 185 PRESSURE ACTIVATED POSACONAZOLE...... 27 PREDNISOLONE SODIUM LANCETS...... 224, 237 potassium acetate...... 163 PHOSPHATE...... 250 PRESTALIA...... 74 potassium chlorid-d5-0.45%nacl...... 163 PREDNISOLONE-MOXIFLO- PRETAB...... 171 POTASSIUM CHLORIDE...... 163 NEPAFENAC...... 248 prevalite...... 81 potassium chloride...... 164 PREDNISOLONE- PREVIDENT...... 244 POTASSIUM CHLORIDE IN MOXIFLOXACIN HCL...... 248 PREVIDENT 5000 BOOSTER 0.9%NACL...... 163 PREDNISOLONE-MOXIFLOX- PLUS...... 244 potassium chloride in 0.9%nacl...... 163 BROMFEN...... 248 PREVIDENT 5000 ENAMEL potassium chloride in 5 % dex...... 163 prednisone...... 185 PROTECT...... 244 POTASSIUM CHLORIDE IN LR- PREDNISONE INTENSOL...... 185 Previfem...... 131 D5...... 163 PREFERA-OB...... 170 PREVNAR 13 (PF)...... 71 potassium chloride in water...... 163 PREFERA-OB ONE...... 170 PREVYMIS...... 35 POTASSIUM CHLORIDE IN PREFERA-OB PLUS DHA...... 170 PREZCOBIX...... 31, 42 WATER...... 163 PREFEST...... 182 PREZISTA...... 42 potassium chloride-0.45 % nacl...... 163 pregabalin...... 98, 118 PRIALT...... 3 potassium chloride-d5-0.2%nacl...... 163 PREGNYL...... 186 PRIFTIN...... 32, 43 POTASSIUM CHLORIDE-D5- PREMARIN...... 183, 269 PRILOVIX LITE PLUS...... 150 0.2%NACL...... 163 PREMASOL 10 %...... 167 PRILOVIX PLUS...... 150 potassium chloride-d5-0.3%nacl...... 163 PREMASOL 6 %...... 167 PRIMACARE...... 171 potassium chloride-d5-0.9%nacl...... 163 PREMPHASE...... 182 PRIMAQUINE...... 28 POTASSIUM CHLORIDE-D5- PREMPRO...... 182 PRIMAXIN IV...... 32 0.9%NACL...... 164 PRENA1 CHEW...... 170 primidone...... 97 potassium citrate...... 204 PRENA1 PEARL...... 170 PRIMLEV...... 9, 10 POTASSIUM CL-LIDO-0.9 % PRENA1 TRUE...... 170 PRIMSOL...... 26 NACL...... 164 PRENAISSANCE...... 170 PRINIVIL...... 75 POTELIGEO...... 49 PRENAISSANCE PLUS...... 171 PRISMASOL B22GK...... 257 PR BENZOYL PEROXIDE...... 136 PRENATA...... 171 PRISMASOL BGK...... 257 PR CREAM...... 150 prenatabs fa...... 171 PRISMASOL BK...... 257 PR NATAL 400...... 170 prenatabs rx...... 171 PRISTIQ...... 104 PR NATAL 400 EC...... 170 PRENATAL 19...... 171 PRIVIGEN...... 69 PR NATAL 430...... 170 PRENATAL 19 (WITH PRIZOTRAL...... 150 PR NATAL 430 EC...... 170 DOCUSATE)...... 171 PRO COMFORT INSULIN PRADAXA...... 215 prenatal low iron...... 171 SYRINGE...... 229, 237 PRALIDOXIME...... 22 PRENATAL PLUS...... 171 PRO COMFORT LANCET...... 224, 237 PRALUENT PEN...... 83 PRENATAL PLUS (CALCIUM PRO COMFORT PEN NEEDLE pramipexole...... 108 CARB)...... 171 ...... 230, 237 PRAMOSONE...... 148 PRENATAL PLUS DHA...... 171 PROAIR HFA...... 263 PRANDIN...... 178 PRENATAL VITAMIN PLUS LOW PROAIR RESPICLICK...... 263 prasugrel...... 215 IRON...... 171 probenecid...... 206 PRAVACHOL...... 82 PRENATAL-U...... 171 probenecid-colchicine...... 206 pravastatin...... 82 PRENATE AM...... 171 PROBUPHINE...... 125 PRAXBIND...... 21 PRENATE CHEWABLE...... 171 procainamide...... 79 praziquantel...... 25 PRENATE DHA...... 171 PROCAINAMIDE...... 79 prazosin...... 93 PRENATE DHA (FERR ASP PROCALAMINE 3%...... 166, 167 PRECEDEX...... 124 GLYCIN)...... 171 PROCARDIA...... 87 PRECEDEX IN 0.9 % SODIUM PRENATE ELITE...... 171 PROCARDIA XL...... 87 CHLOR...... 124 PRENATE ELITE (IRON ASP Procentra...... 117 PRECOSE...... 178 GLYC)...... 171 prochlorperazine...... 194 PRED FORTE...... 250 PRENATE ENHANCE...... 171 prochlorperazine edisylate...... 194 290 prochlorperazine maleate...... 110, 194 PRUCLAIR...... 144 RECEDO...... 150 PROCRIT...... 208 PRUDOXIN...... 153 RECLAST...... 181 PROCTOCORT...... 21, 147 PRUMYX...... 144 Reclipsen (28)...... 131 PROCTOFOAM HC...... 21 PRUTECT...... 144 RECOMBINATE...... 209 Procto-Med Hc...... 21, 147 PSORCON...... 147 RECOMBIVAX HB (PF)...... 68 Procto-Pak...... 21, 147 PULMICORT...... 260 RECOTHROM...... 211 Proctosol Hc...... 21, 147 pulmosal...... 126 RECOTHROM SPRAY KIT...... 210 Proctozone-Hc...... 21, 147 PULMOZYME...... 265 RECTIV...... 21 PROCYSBI...... 202 PUREFE OB PLUS...... 171 refissa...... 151 PRODIGY INSULIN SYRINGE PURIXAN...... 48 REGENECARE...... 153 ...... 230, 237 PUSH BUTTON SAFETY REGENECARE WITH ALOE...... 153 PRODIGY LANCETS...... 224, 237 LANCETS...... 225, 237 REGLAN...... 197 PRODIGY TWIST TOP LANCET PYLERA...... 201 REGONOL...... 218 ...... 225, 237 pyrazinamide...... 32 REGRANEX...... 155 PROFILNINE...... 208 pyridostigmine bromide...... 218 RELENZA DISKHALER...... 38 progesterone...... 190 PYRIDOSTIGMINE BROMIDE..... 218 Relexxii...... 112 progesterone micronized...... 190 pyridoxine (vitamin b6)...... 175 RELIAMED LANCET...... 225, 237 PROGLYCEM...... 176 QBRELIS...... 75 RELIAMED SAFETY SEAL PROGRAF...... 217 QBREXZA...... 138 LANCETS...... 225, 237 PROLASTIN-C...... 265 Q-CARE RX Q2...... 222 RELION NEEDLES...... 230, 237 PROLENSA...... 250 Q-CARE RX Q4...... 222 RELION PEN NEEDLES...... 230, 237 PROLEUKIN...... 51 QSYMIA...... 157 RELION THIN LANCETS...... 225, 237 PROLIA...... 191 QUADRACEL (PF)...... 71 RELION ULTRA THIN PLUS PROMACTA...... 216 QUADRAMET...... 56 LANCETS...... 225, 237 promethazine...... 194, 258, 259 QUALAQUIN...... 28 RELISTOR...... 23 promethazine-codeine...... 266 QUARTETTE...... 133 RELPAX...... 120 promethazine-dm...... 266 QUAZEPAM...... 114, 123 REMERON...... 102 promethazine-phenyleph-codeine...... 267 QUDEXY XR...... 100 REMERON SOLTAB...... 102 promethazine-phenylephrine...... 258 QUELICIN...... 219 REMICADE...... 12, 200 Promethegan...... 194, 258, 259 Questran...... 81 remifentanil...... 18 PROMETRIUM...... 190 QUESTRAN LIGHT...... 81 REMODULIN...... 94 PROMISEB...... 142, 144 quetiapine...... 110, 116 RENACIDIN...... 202 propafenone...... 79 QUILLICHEW ER...... 112 RENAGEL...... 203 propantheline...... 197 QUILLIVANT XR...... 112 RENOVA...... 151 proparacaine...... 252 quinapril...... 75 RENVELA...... 203 PROPECIA...... 153 quinapril-hydrochlorothiazide...... 74 REOPRO...... 214 propofol...... 18 quinidine gluconate...... 79 repaglinide...... 178 propranolol...... 84, 85 quinidine sulfate...... 79 repaglinide-metformin...... 178 propranolol-hydrochlorothiazid...... 93 quinine sulfate...... 28 REPATHA PUSHTRONEX...... 83 propylthiouracil...... 180 QVAR REDIHALER...... 260 REPATHA SURECLICK...... 83 PROQUAD (PF)...... 70, 73, 74 RABAVERT (PF)...... 73 REPATHA SYRINGE...... 83 PRO-RED AC (W/ RADIOGARDASE...... 22 REQUIP...... 108 DEXCHLORPHENIR)...... 267 RAGWITEK...... 65 REQUIP XL...... 108 PROSCAR...... 203 Rajani...... 131 RESCRIPTOR...... 30 PROSOL 20 %...... 167 raloxifene...... 191 RESECTISOL...... 202 PROSTIN E2...... 175 ramelteon...... 118 RESPA-AR...... 258 PROSTIN VR PEDIATRIC...... 93 ramipril...... 75 RESTASIS...... 250 protamine...... 24 RANEXA...... 78 RESTASIS MULTIDOSE...... 250 PROTHELIAL...... 245 ranitidine hcl...... 196 RESTORIL...... 114, 123 PROTONIX...... 196 ranolazine...... 78 RETACRIT...... 208 PROTOPAM CHLORIDE...... 22 RAPAFLO...... 203 RETAVASE...... 216 PROTOPIC...... 142 RAPAMUNE...... 217 RETIN-A...... 136, 137 protriptyline...... 106 RAPIVAB (PF)...... 38 RETIN-A MICRO...... 136 PROTYL AG...... 155 rasagiline...... 107 RETIN-A MICRO PUMP...... 136 PROVAYBLUE...... 22 RASUVO (PF)...... 13 RETISERT...... 250 PROVENGE...... 51 RAVICTI...... 243 RETROVIR...... 30 PROVENTIL HFA...... 263 RAYALDEE...... 242 REVATIO...... 95 PROVERA...... 190 RAZADYNE...... 127 REVCOVI...... 242 PROVIDA DHA...... 171 RAZADYNE ER...... 127 REVLIMID...... 57 PROVIDA OB...... 171 READYLANCE SAFETY Revonto...... 221 PROVIGIL...... 122 LANCETS...... 225, 237 REXULTI...... 111 PROVISC...... 253 REBETOL...... 38 REYATAZ...... 42 PROZAC...... 103 REBINYN...... 208 RHOFADE...... 152 291 RHOGAM ULTRA-FILTERED Roweepra...... 101 SE-NATAL 19 (WITH DOCUSATE) PLUS...... 69 Roweepra Xr...... 101 ...... 172 RHOPHYLAC...... 69 ROXICODONE...... 7 SENSIPAR...... 181 RHOPRESSA...... 255 ROXYBOND...... 7 SENSORCAINE...... 20 RIASTAP...... 210 ROZEREM...... 118 Sensorcaine...... 20 Ribasphere...... 38 RUBRACA...... 54, 55 Sensorcaine/Epinephrine...... 20 ribasphere...... 38 RUCONEST...... 207 SENSORCAINE-MPF...... 20 ribasphere ribapak...... 38 RUZURGI...... 246 Sensorcaine-Mpf Spinal...... 20 ribavirin...... 38, 43 RYANODEX...... 221 SENSORCAINE- RIDAURA...... 13 RYCLORA...... 258, 259 MPF/EPINEPHRINE...... 20 rifabutin...... 32, 43 RYDAPT...... 56 SENSURA CLICK OSTOMY RIFADIN...... 32, 43 RYDEX...... 267 POUCH...... 231, 238 RIFAMATE...... 32 RYTARY...... 106 SENSURA OSTOMY BASE PLATE rifampin...... 32, 43 RYTHMOL SR...... 79 ...... 231, 238 RIFATER...... 32 RYVENT...... 258, 259 SEREVENT DISKUS...... 262 RIGHTEST GL300 LANCETS 225, 238 SABRIL...... 99 serophene...... 183 RILUTEK...... 218 SACCHARIN...... 159 SEROQUEL...... 110, 116 riluzole...... 218 SAF-CLENS AF DERMAL SEROQUEL XR...... 110, 116 rimantadine...... 39 WOUND...... 152 SEROSTIM...... 186 RIMSO-50...... 202 SAFESNAP INSULIN SYRINGE sertraline...... 103 ringer's...... 160, 173 ...... 230, 238 Setlakin...... 131 RIOMET...... 188 SAFETY LANCETS...... 225, 238 sevelamer carbonate...... 203 risedronate...... 181 SAFETY PEN NEEDLE...... 230, 238 sevelamer hcl...... 203 RISPERDAL...... 108, 116 SAFETY SEAL LANCETS...... 225, 238 sevoflurane...... 17 RISPERDAL CONSTA...... 108 SAFETY-LET LANCETS...... 225, 238 sf...... 244 risperidone...... 108, 116 SAFYRAL...... 131 SFROWASA...... 199 RITALIN...... 113, 122 SALAGEN (PILOCARPINE)...... 245 Sharobel...... 132 RITALIN LA...... 113 salicylic acid...... 149 SHINGRIX (PF)...... 73 ritonavir...... 42 SALIVAMAX...... 245 SHOHL'S MODIFIED...... 204 RITUXAN...... 13, 50 SALKERA...... 149 SIGNIFOR...... 191 RITUXAN HYCELA...... 49 SALVAX...... 149 SIGNIFOR LAR...... 191 rivastigmine...... 127 SALVAX DUO PLUS...... 149 SIKLOS...... 215 rivastigmine tartrate...... 127 SAMSCA...... 92, 192, 203 sildenafil...... 157 rivelsa...... 133 SANCUSO...... 194 sildenafil (antihypertensive)...... 95 RIXUBIS...... 208 SANDIMMUNE...... 13, 217 SILENOR...... 124 rizatriptan...... 120 SANDOSTATIN...... 191, 201 SILIPAC...... 151 R-NATAL OB...... 172 SANDOSTATIN LAR DEPOT.191, 201 SILIQ...... 137 robafen ac...... 268 SANTYL...... 144 silodosin...... 203 ROBAXIN...... 221 SAPHRIS...... 108, 116 SILVADENE...... 142 ROBAXIN-750...... 221 SARAFEM...... 103 SILVER NITRATE...... 138 ROCALTROL...... 175, 242 SAVAYSA...... 207 silver sulfadiazine...... 142 ROCKLATAN...... 253 SAVELLA...... 104, 118 SILVRSTAT...... 138 rocuronium...... 220 SAXENDA...... 158 SIMBRINZA...... 247 ROCURONIUM...... 220 scalacort...... 147 Simliya (28)...... 128 ROMIDEPSIN...... 51 SCARCIN GEL...... 150 Simpesse...... 128 ropinirole...... 108 SCARCIN ROLL-ON...... 151 SIMPONI...... 12, 200 ropivacaine (pf)...... 20 SCARSILK GEL...... 151 SIMPONI ARIA...... 12 ROPIVACAINE (PF)...... 20 SCLEROSOL INTRAPLEURAL.....268 SIMULECT...... 217 ROPIVACAINE (PF) IN 0.9 % scopolamine base...... 193 simvastatin...... 82 NACL...... 19, 20 SEASONIQUE...... 128 SINEMET...... 106 ROPIVACAINE (PF)-NACL,ISO- SEBUDERM...... 144 SINEMET CR...... 106 OSM...... 20 SECONAL SODIUM...... 123 SINGLE-LET...... 225, 238 ROPIVACAINE-CLONIDIN- SEEBRI NEOHALER...... 262 SINGULAIR...... 261 KETOROLAC...... 21 SELECT-OB...... 172 SINUVA...... 264, 266 ROPIVACAINE-EPI-CLONID- SELECT-OB (FOLIC ACID)...... 172 sirolimus...... 217 KETOROL...... 21 SELECT-OB + DHA...... 172 SIRTURO...... 32 ROPIVACAINE-KETOROLAC- selegiline hcl...... 107 SIVEXTRO...... 41 KETAMINE...... 21 SELENIOUS ACID...... 164 SKELAXIN...... 221 Rosadan...... 135, 152 selenium...... 165 SKLICE...... 154 rosuvastatin...... 82 selenium sulfide...... 142 SKYLA...... 128 ROTARIX...... 70, 73 SELZENTRY...... 29 SLYND...... 132 ROTATEQ VACCINE...... 70, 73 SEMPREX-D...... 258 SMART SENSE LANCETS...... 225, 238 ROWASA...... 199 SE-NATAL 19...... 172 SMARTEST LANCET...... 225, 238 292 SMOFLIPID...... 167 SOTALOL...... 80, 85 SUCCINYLCHOLINE-SOD SODIUM ACETATE...... 160 sotalol...... 80, 85 CL,ISO(PF)...... 219 sodium acetate...... 160 Sotalol Af...... 80, 85 SUCRAID...... 195 sodium benzoate-sod phenylacet...... 243 SOTRADECOL...... 95 sucralfate...... 201 sodium bicarbonate...... 160 SOTYLIZE...... 80, 85 SUFENTANIL CITRATE...... 18 SODIUM BICARBONATE IN D5W160 SOVALDI...... 37 SULAR...... 87 sodium chlor 0.9% bacteriostat....159, 173 SP ANTIPRURITIC...... 153, 155 SULFACETAMIDE SODIUM...... 142 sodium chloride...... 126, 160, 174 SP SCAR MANAGEMENT...... 144, 231 sulfacetamide sodium...... 142, 255 sodium chloride 0.45 %...... 174 SPECTRACEF...... 34 sulfacetamide sodium (acne)...... 135 sodium chloride 0.9 %...... 159, 173, 174 SPHERUSOL...... 155 sulfacetamide sodium-sulfur.135, 136, 138 sodium chloride 0.9 % (flush) spinosad...... 154 SULFACETAMIDE SODIUM- ...... 159, 173, 174 SPIRIVA RESPIMAT...... 262 SULFUR...... 136 SODIUM CHLORIDE 0.9 % SPIRIVA WITH HANDIHALER.....262 SULFACETAMIDE SOD-SULFUR- (FLUSH)...... 159, 173, 174 spironolactone...... 75, 90 UREA...... 136, 152 sodium chloride 3 %...... 174 spironolacton-hydrochlorothiaz...... 92 sulfacetamide-prednisolone...... 248 sodium chloride 5 %...... 174 SPORANOX...... 27 sulfacetamide-sulfur-cleansr23...... 136 SODIUM CITRATE...... 206 SPORANOX PULSEPAK...... 27 SULFADIAZINE...... 43 SODIUM CITRATE IN 0.9 % SPRAVATO...... 102 sulfamethoxazole-trimethoprim...... 25, 26 NACL...... 206 SPRAY AND STRETCH...... 150 SULFAMYLON...... 142 SODIUM EDECRIN...... 91 Sprintec (28)...... 131 sulfasalazine...... 14, 199 sodium ferric gluconat-sucrose...... 162 SPRITAM...... 101 sulfatrim...... 26 SODIUM HYALURONATE SPRYCEL...... 56 sulindac...... 15 (VISCOSUP)...... 219 sps (with sorbitol)...... 160 sumatriptan...... 120 SODIUM LACTATE...... 161 Sronyx...... 132 sumatriptan succinate...... 120 SODIUM NITRITE...... 22 ssd...... 142 sumatriptan-naproxen...... 121 sodium nitroprusside...... 90 SSKI...... 161 SUMAVEL DOSEPRO...... 120 sodium phenylbutyrate...... 243 sss 10-5...... 135, 138 SUNOSI...... 121 sodium phosphate...... 163 STALEVO 100...... 106 SUPARTZ FX...... 219 SODIUM PHOSPHATE IN 0.9 % STALEVO 125...... 106 SUPER THIN LANCETS...... 225, 238 NACL...... 163 STALEVO 150...... 106 SUPPRELIN LA...... 189 SODIUM PHOSPHATE IN D5W.....163 STALEVO 200...... 106 SUPRANE...... 17 sodium polystyrene sulfonate...... 160 STALEVO 50...... 106 SUPRAX...... 34 SODIUM POLYSTYRENE STALEVO 75...... 106 SUPREP BOWEL PREP KIT...... 201 SULFONATE...... 160 STAMARIL (PF)...... 70, 74 SURE COMFORT INS. SYR. U-100 SODIUM SUCCINATE...... 126 STARLIX...... 178 ...... 230, 238 sodium thiosulfate...... 22 stavudine...... 30 SURE COMFORT INSULIN SOFOSBUVIR-VELPATASVIR...... 37 STD GRASS POLLEN-SWEET SYRINGE...... 230, 238 SOFT TOUCH LANCETS...... 225, 238 VERNAL...... 62 SURE COMFORT LANCETS..225, 238 SOLARAZE...... 141 STELARA...... 137, 198 SURE COMFORT PEN NEEDLE solifenacin...... 205 STERILANCE TL...... 225, 238 ...... 230, 238 SOLIQUA 100/33...... 180 STERILE TALC...... 268 SURE-FINE PEN NEEDLES....230, 238 SOLIRIS...... 213 Sterile Water For Injection...... 160 SUREFLEX DEVICE WITH SOLOSEC...... 29 STERITALC...... 268 LANCETS...... 225, 238 SOLOX GEL...... 138 STIMATE...... 177 SURE-JECT INSULIN SYRINGE Soloxide...... 44 STIOLTO RESPIMAT...... 263 ...... 230, 238 SOLTAMOX...... 56 STIVARGA...... 53 SURE-LANCE...... 225, 238 SOLU-CORTEF...... 185 STRATTERA...... 113 SURE-LANCE ULTRA THIN..225, 238 SOLU-CORTEF (PF)...... 185 STRAVIX...... 154 SURE-TOUCH LANCET...... 225, 238 SOLU-MEDROL...... 185 STRENSIQ...... 241 SURFAXIN...... 265 SOLU-MEDROL (PF)...... 185 STREPTOMYCIN...... 24 SURGIFOAM...... 211 SOLUS V2 LANCETS...... 225, 238 STRIANT...... 177 SURGISEAL STYLUS...... 152 SOLUS V2 LANCING DEVICE STRIBILD...... 31 SURGISEAL TEARDROP ...... 225, 238 STRIVERDI RESPIMAT...... 262 APPLICATOR...... 152 SOMA...... 221 STROMECTOL...... 25 SURGISEAL TWIST...... 152 SOMATULINE DEPOT...... 191 STRONG IODINE...... 61 SURVANTA...... 265 SOMAVERT...... 186 SUBLOCADE...... 125 SUSTIVA...... 30 SONAFINE...... 144 SUBOXONE...... 125 SUSTOL...... 194 SOOLANTRA...... 152 Subvenite...... 101 SUTENT...... 56 SORBITOL...... 126, 200, 202 Subvenite Starter (Blue) Kit...... 101, 115 SWABFLUSH...... 160, 173, 174 SORBITOL-MANNITOL...... 202 Subvenite Starter (Green) Kit...... 101, 115 Syeda...... 132 SORIATANE...... 141 Subvenite Starter (Orange) Kit.....101, 115 SYLATRON...... 51 SORILUX...... 141 succinylcholine chloride...... 219 SYLVANT...... 51 Sorine...... 80, 85 SUCCINYLCHOLINE CHLORIDE219 symax fastabs...... 197, 205 293 SYMBICORT...... 264 TAXOTERE...... 57 THEO-24...... 261 SYMBYAX...... 105, 110, 116 TAYTULLA...... 132 Theochron...... 261 SYMDEKO...... 265 tazarotene...... 141, 151 theophylline...... 261 SYMFI...... 32 Tazicef...... 34 theophylline in dextrose 5 %...... 261 SYMFI LO...... 31 tazicef...... 34 THEOPHYLLINE IN DEXTROSE SYMJEPI...... 88 TAZORAC...... 141 5 %...... 261 SYMLINPEN 120...... 179 Taztia Xt...... 86 THERAPEVO...... 151 SYMLINPEN 60...... 179 TDVAX...... 71 thiamine hcl (vitamin b1)...... 174 SYMPAZAN...... 97, 114 TECENTRIQ...... 58 THIN LANCETS...... 225, 239 SYMPROIC...... 23 TECFIDERA...... 246 thinpro insulin syringe...... 230, 239 SYMTUZA...... 31 TECHLITE INSULIN SYR HALF THINPRO INSULIN SYRINGE SYNAGIS...... 67 UNIT...... 230, 238 ...... 230, 239 SYNALAR...... 147 TECHLITE INSULIN SYRINGE THIOLA...... 202 SYNALAR CREAM KIT...... 148 ...... 230, 238 THIOLA EC...... 202 SYNALAR OINTMENT KIT...... 148 TECHLITE LANCETS...... 225, 238 thioridazine...... 110 SYNAREL...... 189 TECHLITE PEN NEEDLE...... 230, 238 thiotepa...... 45 SYNDROS...... 117, 158, 193 TEFLARO...... 35 thiothixene...... 110 SYNERA...... 153 TEGRETOL...... 100, 115 THRIVITE RX...... 172 SYNERCID...... 43 TEGRETOL XR...... 100, 115 THROMBATE III...... 214 SYNJARDY...... 178 TEGSEDI...... 176 THROMBI-GEL...... 211 SYNJARDY XR...... 178 TEKTURNA...... 95 THROMBIN-JMI...... 211 SYNRIBO...... 58 TEKTURNA HCT...... 95 THROMBI-PAD...... 211 SYNTHAMIN 17 WITHOUT TELCARE LANCETS...... 225, 239 THYMOGLOBULIN...... 69 ELYTE...... 167 telmisartan...... 78 THYROGEN...... 155 SYNTHROID...... 192 telmisartan-amlodipine...... 75, 76 thyroid (pork)...... 191 SYNVISC...... 219 telmisartan-hydrochlorothiazid...... 77 THYROLAR-1...... 191 SYNVISC-ONE...... 219 temazepam...... 114, 123 THYROLAR-1/2...... 191 SYPRINE...... 23 TEMODAR...... 46 THYROLAR-1/4...... 191 SYRINGE AVITENE...... 211 TEMOVATE...... 147 THYROLAR-2...... 191 TABLOID...... 48 temozolomide...... 46 THYROLAR-3...... 191 TACHOSIL...... 211 temsirolimus...... 53 tiagabine...... 99 TACLONEX...... 137 Tencon...... 11 TIAZAC...... 86 tacrolimus...... 142, 217 TENIPOSIDE...... 50 TIBSOVO...... 53 tadalafil...... 95, 157, 203 TENIVAC (PF)...... 71 TICE BCG...... 54, 70 tadalafil (antihypertensive)...... 95 tenofovir disoproxil fumarate...... 31 TIGAN...... 193 TAFINLAR...... 49 TENORETIC 100...... 88 TIGECYCLINE...... 37, 44 TAGRISSO...... 45 TENORETIC 50...... 88 TIGLUTIK...... 218 TAKHZYRO...... 94 TENORMIN...... 84 TIKOSYN...... 80 TALTZ AUTOINJECTOR...... 137 TEPADINA...... 45 tilia fe...... 133 TALTZ AUTOINJECTOR (2 terazosin...... 93 timolol maleate...... 85, 251 PACK)...... 137 terbinafine hcl...... 26 TIMOPTIC...... 252 TALTZ AUTOINJECTOR (3 terbutaline...... 263 TIMOPTIC OCUDOSE (PF)...... 252 PACK)...... 137 terconazole...... 269 TIMOPTIC-XE...... 252 TALTZ SYRINGE...... 137 Terrell...... 17 tinidazole...... 29 TALWIN...... 10 TERUMO INSULIN SYRINGE TIROSINT...... 192 TALZENNA...... 55 ...... 230, 239 TIROSINT-SOL...... 192 TAMIFLU...... 38 TESSALON PERLES...... 260 TISSEEL VHSD (APROTININ, tamoxifen...... 56 TESTOPEL...... 177 SYN)...... 152 tamsulosin...... 203 testosterone...... 177 tis-u-sol pentalyte...... 160 TAPAZOLE...... 180 testosterone cypionate...... 177 TIVICAY...... 29 TAPERDEX...... 185 TESTOSTERONE CYPIONATE.....177 tizanidine...... 221 TARCEVA...... 44 TESTOSTERONE ENANTHATE... 177 TNKASE...... 216 TARGADOX...... 44 TESTRED...... 177 TOBI...... 264 TARGRETIN...... 56, 141 TETANUS,DIPHTHERIA TOX TOBI PODHALER...... 264 Tarina 24 Fe...... 132 PED(PF)...... 71 TOBRADEX...... 248 Tarina Fe 1/20 (28)...... 132 tetcaine...... 252 TOBRADEX ST...... 248 Tarina Fe 1-20 Eq (28)...... 132 tetrabenazine...... 121 tobramycin...... 254 TARKA...... 74 TETRACAINE HCL (PF)...... 252 tobramycin in 0.225 % nacl...... 264 TARON-C DHA...... 172 tetracycline...... 44 tobramycin in 0.9 % nacl...... 24 TARON-PREX PRENATAL-DHA.. 172 TETRIX...... 151 tobramycin sulfate...... 24 TASIGNA...... 56 TEXACORT...... 148 TOBRAMYCIN WITH TASMAR...... 106 THALOMID...... 28, 57 NEBULIZER...... 264 TAVALISSE...... 207 THAM...... 161 tobramycin-dexamethasone...... 248 294 TOBREX...... 254 TRETIN-X...... 137 Trivora (28)...... 133 TOFRANIL...... 106 TRETTEN...... 209 Tri-Vylibra...... 133 TOLAK...... 140 TREXALL...... 13, 47 Tri-Vylibra Lo...... 133 tolazamide...... 179 TREXIMET...... 121 TRIZIVIR...... 31 tolbutamide...... 179 TREZIX...... 8 TROGARZO...... 29 tolcapone...... 106 Tri Femynor...... 133 TROKENDI XR...... 100 tolmetin...... 15 TRIACETIN...... 140 TROPHAMINE 10 %...... 167 TOLSURA...... 27 TRIAMCINOL AC (PF) IN TROPHAMINE 6%...... 167 tolterodine...... 205 0.9%NACL...... 185 tropicamide...... 249 TOPAMAX...... 100 TRIAMCINOL ACE-BUPIV-0.9% trospium...... 205 TOPCARE CLICKFINE...... 230, 239 NACL...... 184 TRUE COMFORT INSULIN TOPCARE ULTRA COMFORT TRIAMCINOLONE ACETON- SYRINGE...... 230, 239 ...... 230, 239 0.9% NACL...... 185 TRUE COMFORT LANCET... 225, 239 TOPCARE UNIVERSAL1 LANCET triamcinolone acetonide...... 148, 186, 245 TRUE COMFORT PEN NEEDLE ...... 225, 239 TRIAMCINOLONE DIA(PF)- ...... 230, 239 TOPICORT...... 148 0.9%NACL...... 186 TRUEPLUS INSULIN...... 230, 239 topiramate...... 100 TRIAMCINOLONE DIACET-0.9% TRUEPLUS LANCETS...... 225, 239 TOPIRAMATE...... 100 NACL...... 186 TRUEPLUS PEN NEEDLE...... 230, 239 Toposar...... 50 triamterene-hydrochlorothiazid...... 92 TRULICITY...... 179 topotecan...... 57 Trianex...... 148 TRUMENBA...... 71 TOPOTECAN...... 57 triazolam...... 114, 123 TRUSKIN...... 154 TOPROL XL...... 84 TRIBENZOR...... 76 TRUSOPT...... 251 toremifene...... 56 TRICARE...... 172 trust natal dha...... 172 TORISEL...... 53 TRICARE PRENATAL DHA ONE.172 TRUVADA...... 30 torsemide...... 91 TRICHLOROACETIC ACID...... 149 TUBERSOL...... 155 TOTECT...... 60 TRICITRASOL...... 206 TUDORZA PRESSAIR...... 262 TOUJEO MAX U-300 SOLOSTAR.188 TRICOR...... 81 Tulana...... 132 TOUJEO SOLOSTAR U-300 Triderm...... 148 TUSNEL PEDIATRIC...... 266 INSULIN...... 188 trientine...... 23 TUSSICAPS...... 266 TOVIAZ...... 205 TRIESENCE (PF)...... 250 TUXARIN ER...... 266 TPN ELECTROLYTES...... 163 Tri-Estarylla...... 133 TUZISTRA XR...... 266 TPN ELECTROLYTES II...... 163 TRIFERIC...... 162 TWINRIX (PF)...... 67 TRACE ELEMENTS 4/PEDIATRIC trifluoperazine...... 110 TWIST LANCETS...... 225, 239 ...... 164 trifluridine...... 255 TWYNSTA...... 76 TRACLEER...... 95 trihexyphenidyl...... 107 TYBOST...... 243 TRADJENTA...... 178 tri-legest fe...... 133 Tydemy...... 132 TRAMADOL...... 7 TRILEPTAL...... 100 TYGACIL...... 37, 44 tramadol...... 7 Tri-Linyah...... 133 TYKERB...... 44 tramadol-acetaminophen...... 10 TRILIPIX...... 81 TYLENOL-CODEINE #3...... 7 trandolapril...... 75 Tri-Lo-Estarylla...... 133 TYLENOL-CODEINE #4...... 8 trandolapril-verapamil...... 74 Tri-Lo-Marzia...... 133 TYMLOS...... 180 tranexamic acid...... 210 Tri-Lo-Mili...... 133 TYPHIM VI...... 71 TRANSDERM-SCOP...... 193 Tri-Lo-Sprintec...... 133 TYSABRI...... 246 TRANXENE T-TAB...... 96, 114 TRI-LUMA...... 142 TYVASO...... 94 tranylcypromine...... 102 Trilyte With Flavor Packets...... 201 TYVASO INSTITUTIONAL TRAVASOL 10 %...... 167 trimethobenzamide...... 193 START KIT...... 94 TRAVATAN Z...... 255 trimethoprim...... 26 TYVASO REFILL KIT...... 94 trazodone...... 103 Tri-Mili...... 133 TYVASO STARTER KIT...... 94 TREANDA...... 46 trimipramine...... 106 TYZINE...... 266 TRECATOR...... 32 TRIMPEX...... 26 UCERIS...... 199 TREE POLLEN-ARIZONA TRINATAL RX 1...... 172 UDENYCA...... 209 CYPRESS...... 66 trinate...... 172 ULESFIA...... 154 TREE POLLEN-BALD CYPRESS....66 TRINTELLIX...... 105 ULORIC...... 206 TREE POLLEN-BLACK WILLOW. 66 TRIOSTAT...... 192 ULTANE...... 17 TREE POLLEN-PRIVET...... 66 TRIPLE DYE...... 140 ULTICARE...... 231, 239 TREE POLLEN-SWEET GUM...... 66 Tri-Previfem (28)...... 133 ULTICARE INSULIN SYR HALF TRELEGY ELLIPTA...... 264 TRIPTODUR...... 189 UNIT...... 231, 239 TRELSTAR...... 52 TRISENOX...... 49 ULTICARE INSULIN SYRINGE treprostinil sodium...... 94 Tri-Sprintec (28)...... 133 ...... 231, 239 tretinoin...... 137 TRISTART DHA...... 172 ULTICARE PEN NEEDLE...... 231, 239 tretinoin (chemotherapy)...... 56 TRIUMEQ...... 31 ULTI-LANCE...... 225, 239 tretinoin (emollient)...... 151 TRIVEEN-DUO DHA...... 172 ULTILET BASIC LANCETS... 225, 239 tretinoin microspheres...... 137 TRIVISC...... 219 295 ULTILET CLASSIC LANCETS UNISTIK 3 COMFORT LANCET VANIQA...... 150 ...... 225, 239 ...... 226, 240 VANISHPOINT SYRINGE...... 231, 241 ULTILET INSULIN SYRINGE231, 239 UNISTIK 3 EXTRA LANCET. 226, 240 VANOS...... 148 ULTILET LANCETS...... 225, 239 UNISTIK 3 GENTLE...... 226, 240 VANTAS...... 52 ULTILET PEN NEEDLE...... 231, 239 UNISTIK 3 LANCETS...... 226, 240 VAPRISOL IN 5 % DEXTROSE...... 90 ULTILET SAFETY LANCETS225, 239 UNISTIK 3 NEONATAL...... 226, 240 VAQTA (PF)...... 67 ULTIVA...... 18 UNISTIK 3 NEONATAL DEVICE vardenafil...... 157 ULTOMIRIS...... 213 ...... 226, 240 VARITHENA...... 95 ULTRA CMFT INS SYR HALF UNISTIK 3 NORMAL LANCET VARIVAX (PF)...... 70, 73 UNIT...... 231, 239 ...... 226, 240 VARIZIG...... 69 ULTRA COMFORT INSULIN UNISTIK CZT LANCET...... 226, 240 VARUBI...... 195 SYRINGE...... 231, 239 UNISTIK PRO LANCET...... 226, 240 VASELINE WHITE PETROLEUM 151 ULTRA THIN II LANCETS.....225, 239 UNISTIK SAFETY...... 226, 240 VASERETIC...... 74 ULTRA THIN LANCETS...... 225, 239 UNISTIK TOUCH LANCETS..226, 240 VASHE WOUND THERAPY...... 155 ULTRA THIN PLUS LANCETS unithroid...... 192 VASOPRESSIN IN 0.9 % SOD ...... 226, 240 UNITUXIN...... 47 CHLOR...... 177 ULTRA TLC LANCETS...... 226, 240 UNIVERSAL 1 LANCETS...... 226, 240 VASOPRESSIN IN DEXTROSE 5 ULTRABAG/DIANEAL PD-2/1.5% UPTRAVI...... 93 %...... 177 DEX...... 257 ur n-c...... 40, 204 VASOSTRICT...... 177 ULTRABAG/DIANEAL PD-2/2.5% urea...... 144, 149 VASOTEC...... 75 DEX...... 257 UREA...... 149 VAXCHORA VACCINE...... 70, 72 ULTRABAG/DIANEAL PD- UREA NAIL STICK...... 149 VAZCULEP...... 89 2/4.25%DEX...... 257 URECHOLINE...... 205 VECAMYL...... 92 ULTRABAG/DIANEAL/2.5% uretron d-s...... 40, 205 VECTIBIX...... 59 DEXTROSE...... 257 UROCIT-K 10...... 204 VECTICAL...... 141 ULTRACARE INSULIN SYRINGE UROCIT-K 15...... 204 vecuronium bromide...... 220 ...... 231, 240 UROCIT-K 5...... 204 VECURONIUM IN STERILE ULTRA-CARE LANCETS...... 226, 240 UROQID-ACID NO.2...... 40, 204 WATER...... 220 ULTRACARE PEN NEEDLE.. 231, 240 UROXATRAL...... 203 VELCADE...... 55 ULTRACET...... 10 URSO 250...... 195 veletri...... 94 ULTRAFOAM...... 211 URSO FORTE...... 195 velivet triphasic regimen (28)...... 133 ULTRALANCE LANCETS...... 226, 240 ursodiol...... 195, 196 VELPHORO...... 203 ULTRAM...... 7 uryl...... 40, 205 VELTASSA...... 160 ULTRA-THIN II (SHORT) INS ustell...... 40, 205 VELTIN...... 136 SYR...... 231, 240 UTIBRON NEOHALER...... 263 VEMLIDY...... 37 ULTRA-THIN II (SHORT) PEN UVADEX...... 54 VENCLEXTA...... 49 NDL...... 231, 240 VABOMERE...... 33 VENCLEXTA STARTING PACK.....49 ULTRA-THIN II INS PEN VAGIFEM...... 269 venlafaxine...... 104 NEEDLES...... 231, 240 valacyclovir...... 38 VENOFER...... 162 ULTRA-THIN II INSULIN VALCHLOR...... 140 VENTAVIS...... 94 SYRINGE...... 231, 240 VALCYTE...... 35 VENTOLIN HFA...... 263 ULTRA-THIN II LANCETS.... 226, 240 valganciclovir...... 35 verapamil...... 80, 87 ULTRAVATE...... 141, 148 VALIUM...... 96, 114 VEREGEN...... 148 UNASYN...... 25 valproate sodium...... 98 VERELAN...... 87, 88 UNIFINE PENTIPS...... 231, 240 valproic acid...... 98, 115 VERELAN PM...... 88 UNIFINE PENTIPS PLUS...... 231, 240 valproic acid (as sodium salt)...... 98, 115 VERIPRED 20...... 186 UNILET COMFORTOUCH valrubicin...... 58 VERSACLOZ...... 109 LANCET...... 226, 240 valsartan...... 78 VERZENIO...... 50 UNILET EXCELITE II LANCET valsartan-hydrochlorothiazide...... 77 VESICARE...... 205 ...... 226, 240 VALSTAR...... 58 VFEND...... 27 UNILET EXCELITE LANCET226, 240 VALTREX...... 38 VFEND IV...... 27 UNILET GP LANCET...... 226, 240 VANATOL LQ...... 11 VIAGRA...... 157 UNILET LANCET...... 226, 240 VANATOL S...... 11 VIBATIV...... 39 UNILET LANCETS...... 226, 240 VANCOCIN...... 36 VIBERZI...... 198, 200 UNILET SUPER THIN LANCETS VANCOMYCIN...... 36 VIBRAMYCIN...... 44 ...... 226, 240 vancomycin...... 36, 37 Vicodin...... 8, 9 UNISTIK 2 DEVICE...... 226, 240 VANCOMYCIN IN 0.9 % SODIUM Vicodin Es...... 8, 9 UNISTIK 2 NORMAL CHL...... 36 Vicodin Hp...... 8, 9 LANCET,DEVICE...... 226, 240 VANCOMYCIN IN DEXTROSE 5 VICTOZA 2-PAK...... 179 UNISTIK 3...... 226, 240 %...... 36 VICTOZA 3-PAK...... 179 UNISTIK 3 COMFORT DEVICE VANCOMYCIN-WATER INJECT VIDAZA...... 48 ...... 226, 240 (PEG)...... 37 VIDEX 2 GRAM PEDIATRIC...... 30 vandazole...... 269 VIDEX EC...... 30 296 VIEKIRA PAK...... 38 VOLUVEN 6 %...... 213 XEOMIN...... 219 Vienva...... 132 VONVENDI...... 210 XEPI...... 138 vigabatrin...... 99 VORAXAZE...... 60 XERAVA...... 35, 44 Vigadrone...... 99 voriconazole...... 27 XERESE...... 142 VIGAMOX...... 254 VOSEVI...... 37 XERMELO...... 193 VIIBRYD...... 104, 105 VOTRIENT...... 56 XEROSTOMIA RELIEF...... 245 VIMIZIM...... 241 VP-CH PLUS...... 173 XGEVA...... 191 VIMPAT...... 98 VP-CH-PNV...... 173 XHANCE...... 266 VINATE CARE...... 172 VP-PNV-DHA...... 173 XIAFLEX...... 219 VINATE DHA RF...... 172 VPRIV...... 241 XIFAXAN...... 43 VINATE II...... 172 VRAYLAR...... 111, 116 XIIDRA...... 250 VINATE M...... 172 VUSION...... 140 XOFIGO...... 56 VINATE ONE...... 172 vyfemla (28)...... 132 XOFLUZA...... 39 vinblastine...... 57 Vylibra...... 132 XOLAIR...... 261 vincristine...... 57 VYNDAQEL...... 176 XOLEGEL...... 140 vinorelbine...... 57 VYTORIN 10-10...... 83 XOPENEX...... 263 VIOKACE...... 195 VYTORIN 10-20...... 83 XOPENEX CONCENTRATE...... 263 Viorele (28)...... 128 VYTORIN 10-40...... 83 XOPENEX HFA...... 263 VIRACEPT...... 42 VYTORIN 10-80...... 83 XOSPATA...... 51 VIRAMUNE...... 30 VYVANSE...... 113 XPOVIO...... 50, 56 VIRAMUNE XR...... 30 VYXEOS...... 47 XTANDI...... 47 VIRAZOLE...... 43 VYZULTA...... 255, 256 xulane...... 133, 134 VIREAD...... 31 warfarin...... 207 XULTOPHY 100/3.6...... 180 VIRT-ADVANCE...... 172 water for inject, bacteriostat...... 160 XURIDEN...... 243 VIRT-C DHA...... 172 water for injection, sterile...... 160, 174 XYLOCAINE...... 20 VIRT-NATE DHA...... 172 water for irrigation, sterile...... 160 XYLOCAINE (CARDIAC) (PF)...... 79 VIRT-PN DHA...... 172 WEED POLLEN-SHORT Xylocaine Dental-Epinephrine...... 20, 244 VIRT-PN PLUS...... 172 RAGWEED...... 65 XYLOCAINE WITH VIRTPREX...... 172 WEED POLLEN-TRUE MARSH EPINEPHRINE...... 21 VIRT-SELECT...... 172 ELDER...... 65 XYLOCAINE-MPF...... 20 virtussin ac...... 268 WELCHOL...... 81 XYLOCAINE-MPF/EPINEPHRINE.21 virtussin dac...... 267 WELLBUTRIN SR...... 105 XYNTHA...... 209 VIRT-VITE GT...... 172 WELLBUTRIN XL...... 105 XYNTHA SOLOFUSE...... 209 VISCO-3...... 219 wera (28)...... 132 XYOSTED...... 177 VISCOAT...... 253 WESTHROID...... 191 XYREM...... 121 VISIONBLUE...... 253 WIDE-SEAL DIAPHRAGM 60222, 241 YASMIN (28)...... 132 VISTARIL...... 96 WIDE-SEAL DIAPHRAGM 65222, 241 YAZ (28)...... 132 VISTOGARD...... 60 WIDE-SEAL DIAPHRAGM 70222, 241 YELLOW JACKET VENOM...... 63 VISUDYNE...... 252 WIDE-SEAL DIAPHRAGM 75222, 241 YERVOY...... 50 VITAFOL FE+ (WITH WIDE-SEAL DIAPHRAGM 80222, 241 YF-VAX (PF)...... 70, 74 DOCUSATE)...... 172 WIDE-SEAL DIAPHRAGM 85222, 241 YONDELIS...... 46 VITAFOL GUMMIES...... 172 WIDE-SEAL DIAPHRAGM 90222, 241 YONSA...... 44, 47 VITAFOL NANO...... 172 WIDE-SEAL DIAPHRAGM 95222, 241 YOSPRALA...... 215 VITAFOL ULTRA...... 173 WILATE...... 209 YUPELRI...... 262 VITAFOL-OB...... 173 WINRHO SDF...... 69 YUTIQ...... 250 VITAFOL-OB+DHA...... 173 WINTERGREEN OIL...... 153 yuvafem...... 269 VITAFOL-ONE...... 173 Wixela Inhub...... 264 zafirlukast...... 261 VITAMED MD ONE RX...... 173 WP THYROID...... 191 zaleplon...... 124 VITAMEDMD REDICHEW RX...... 173 wymzya fe...... 132 ZALTRAP...... 59 Vitamin D2...... 175 XADAGO...... 107 ZANAFLEX...... 221 vitamin k...... 175 XALATAN...... 255 ZANOSAR...... 58 Vitamin K1...... 175 XALKORI...... 46 ZANTAC...... 196 VITAPEARL...... 173 XANAX...... 96, 114 Zarah...... 132 VITATRUE...... 173 XANAX XR...... 96, 114 ZARONTIN...... 101 VITRAKVI...... 57 XARELTO...... 207 ZARXIO...... 209 VITRASE...... 192 XATMEP...... 13, 47 ZATEAN-PN DHA...... 173 VIVAGUARD LANCET...... 226, 241 XCLAIR...... 144 ZATEAN-PN PLUS...... 173 VIVELLE-DOT...... 183 XELJANZ...... 14, 199 ZAVESCA...... 242 VIVITROL...... 125 XELJANZ XR...... 14 zebutal...... 11 VIVOTIF...... 70, 71 XELODA...... 48 ZEJULA...... 55 VIZIMPRO...... 45 XELPROS...... 255 ZELAPAR...... 107 VOLTAREN...... 150 XENAZINE...... 121 ZELBORAF...... 49 VOLTAREN-XR...... 16 XENICAL...... 158 ZEMAIRA...... 265 297 ZEMBRACE SYMTOUCH...... 120 ZOLEDRONIC AC-MANNITOL- ZEMDRI...... 24, 204 0.9NACL...... 181 ZEMPLAR...... 242 ZOLINZA...... 51 Zenatane...... 134 zolmitriptan...... 120 zenchent (28)...... 132 ZOLOFT...... 103 ZENPEP...... 195 zolpidem...... 124 Zenzedi...... 113, 117, 122 ZOLPIMIST...... 124 ZENZEDI...... 113, 117, 122 ZOMIG...... 120 ZEPATIER...... 37 ZOMIG ZMT...... 121 ZERBAXA...... 33 ZONALON...... 153 ZESTORETIC...... 74 ZONEGRAN...... 101 ZESTRIL...... 75 zonisamide...... 101 ZETIA...... 83 ZONTIVITY...... 215 ZETONNA...... 266 ZORBTIVE...... 186, 201 ZEVALIN (Y-90)...... 53 ZORTRESS...... 217 ZIAC...... 88 ZOSTAVAX (PF)...... 70, 73 ZIAGEN...... 30 ZOSYN...... 42 ZIANA...... 136 ZOSYN IN DEXTROSE (ISO-OSM).42 zidovudine...... 30 Zovia 1/35E (28)...... 132 ZILACAINE PATCH...... 153, 231 ZOVIRAX...... 38, 142 zileuton...... 260 ZTLIDO...... 153 ZILRETTA...... 186 Z-TUSS AC...... 266 zinc chloride...... 165 ZUBSOLV...... 125 zinc oxide...... 151 ZULRESSO...... 102 ZINC OXIDE...... 151 Zumandimine (28)...... 132 zinc sulfate...... 165 ZUPLENZ...... 194 ZINECARD (AS HCL)...... 59 ZYCLARA...... 148 zingiber...... 173 ZYDELIG...... 54 ZINGO...... 20 ZYFLO...... 260 ZINPLAVA...... 67 ZYKADIA...... 46 ZIOPTAN (PF)...... 255 ZYLET...... 248 ziprasidone hcl...... 108, 116 ZYLOPRIM...... 206 ZIRGAN...... 255 ZYMAXID...... 254 ZITHROMAX...... 40 ZYPITAMAG...... 82 ZITHROMAX TRI-PAK...... 40 ZYPREXA...... 110, 116 ZITHROMAX Z-PAK...... 40 ZYPREXA RELPREVV...... 110 ZOCOR...... 82 ZYPREXA ZYDIS...... 110, 116 ZODRYL AC 25...... 266 ZYTIGA...... 44, 47 ZODRYL AC 30...... 266 ZYVOX...... 41 ZODRYL AC 35...... 266 ZODRYL AC 40...... 266 ZODRYL AC 50...... 266 ZODRYL AC 60...... 266 ZODRYL AC 80...... 266 ZODRYL DAC 25...... 267 ZODRYL DAC 30...... 267 ZODRYL DAC 35...... 267 ZODRYL DAC 40...... 267 ZODRYL DAC 50...... 267 ZODRYL DAC 60...... 267 ZODRYL DAC 80...... 267 ZODRYL DEC 25...... 267 ZODRYL DEC 30...... 267 ZODRYL DEC 35...... 267 ZODRYL DEC 40...... 267 ZODRYL DEC 50...... 267 ZODRYL DEC 60...... 267 ZODRYL DEC 80...... 267 ZOFRAN...... 194 ZOLADEX...... 52 zoledronic acid...... 181 zoledronic acid-mannitol-water...... 181

298 Most plans include our home delivery program at no extra cost to you. Find out more by going online to anthem.com/ca or call 866-297-1013.

For information about your pharmacy benefit, log in at

anthem.com/ca.

You’ll find the most up-to-date drug list and details about your benefits. If you still have questions, we’re here. Just call the Member Services number on your ID card.

Speech and hearing impaired (TDD/TTY) users Call 1-800-221-6915, Monday through Friday, 8:30 a.m. to 5 p.m.ET.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Express Scripts, Inc. is a separate company that manages the pharmacy benefit services for members of our health plans. Rev. 11/18