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Unity Point Health Group #32116 Specialty Network List

Specialty medicines are usually prescribed by doctors who treat chronic and complex disease. These usually require a higher degree of management, have a high price and are not generally stocked at retail . Professionally- administered are generally billed on the medical benefit. Self-administered drugs are generally billed on the pharmacy benefit. Many specialty drugs require approval prior to use.

All medications listed on this list must be filled at Unity Point at Home Pharmacy. Please ask your provider to send prescriptions for specialty drugs to your pharmacy. • UnityPoint at Home Pharmacy: 515-557-3100 or 1-888-584-6311

If your specialty is not listed here, then find the disease state and you can choose from the below pharmacies:

Infertility Alliance RX/Walgreens Prime Specialty Pharmacy (mail order) Phone: 1-800-424-9002 Fax: 1-800-874-9179

Clomid isn’t restricted to the specialty network. You can pick it up at any retail pharmacy. Cystic Fibrosis Fairview Specialty Pharmacy (mail order) Phone: 1-800-595-7140 Pulmonary Accredo Specialty Pharmacy (mail order) Hypertension Phone: 1-866-344-4874

Sildenafil and oral tablets aren’t restricted to the specialty network. You can pick it up at any retail pharmacy. Hemophilia and other CVS Caremark Specialty Pharmacy (mail order or CVS retail pick up) clotting disorders Phone: 1-800-368-1624

All other drugs CVS Caremark Specialty Pharmacy (mail order or CVS retail pick up) Phone: 1-800-368-1624

To learn more about your Specialty, Growth Hormone, Infertility network or benefits, see your Summary of Benefits and Coverage (SBC) or call the member services phone number on the back of your card.

Last update: July 1, 2021 Note: In limited instances CVS Caremark Specialty will have to supply a specialty medication due to manufacturer limitations restricting the sale of medications to pharmacies. This list applies to the pharmacy benefit, can change and doesn’t apply to Medicare Part D benefit plans. Please see healthpartners.com for full coverage criteria. DRUG NOTES ANTI-INFLAMMATORY AGENTS (RESPIRATORY) INTERLEUKIN ANTAGONISTS DUPIXENT 200 MG/1.14 ML SYRING UnityPoint At Home FASENRA 30 MG/ML UnityPoint At Home FASENRA PEN 30 MG/ML UnityPoint At Home NUCALA (100 MG/ML AUTO-INJECTOR, 100 MG/ML VIAL, 100 UnityPoint At Home MG/ML SYRINGE)

ANTIBACTERIALS AMINOGLYCOSIDE ANTIBIOTICS BETHKIS 300 MG/4 ML AMPULE UnityPoint At Home KITABIS PAK 300 MG/5 ML UnityPoint At Home TOBI 300 MG/5 ML UnityPoint At Home tobramycin 300 mg/4ml ampul-neb UnityPoint At Home tobramycin in 0.225% sod chlor 300 mg/5ml ampul-neb UnityPoint At Home tobramycin/ 300 mg/5ml ampul-neb UnityPoint At Home

ANTICOAGULANTS , MISCELLANEOUS THROMBATE III 500 UNIT VIAL UnityPoint At Home

ANTICONVULSANTS ANTICONVULSANTS, MISCELLANEOUS VIGADRONE 500 MG POWDER PACKET UnityPoint At Home

ANTIHEMORRHAGIC AGENTS HEMOSTATICS ADVATE (200-400 UNIT VIAL, 401-800 UNIT VIAL, 801-1,200 UNIT VIAL, 1,801- UnityPoint At Home 2,400 UNIT VIAL, 3,601-4,800 UNIT VIAL) ADVATE 2,401-3,600 UNIT VIAL UnityPoint At Home

Last Updated: July 1, 2021 2 DRUG NOTES ADYNOVATE (200-400 UNIT VIAL, 401-800 UNIT VIAL, 750 UNIT VIAL, 1,251- UnityPoint At Home 2,500 UNIT VL, 1,500 UNIT VIAL) ADYNOVATE (801-1,250 UNIT VIAL, 3,000 UNIT VIAL) UnityPoint At Home AFSTYLA (250 UNIT VIAL, 500 UNIT VIAL, 1,000 UNIT VIAL, 1,500 UNIT RANGE UnityPoint At Home VIAL, 2,000 UNIT VIAL, 2,500 UNIT RANGE VIAL, 3,000 UNIT VIAL) ALPHANATE (250-100 UNIT VIAL, 500-200 UNIT VIAL, 1,000-400 UNIT VIAL, UnityPoint At Home 1,500-600 UNIT VIAL, 2,000-800 UNIT VIAL) ALPHANINE SD (SD 500 UNIT VIAL, SD 1,000 UNITS VIAL, SD 1,500 UNIT VIAL) UnityPoint At Home ALPHANINE SD 1,000 UNIT VIAL UnityPoint At Home ALPROLIX (250 UNIT, 1,000 UNIT) UnityPoint At Home ALPROLIX (500 UNIT, 2,000 UNIT, 3,000 UNIT) UnityPoint At Home BENEFIX (1,000 UNIT, 2,000 UNIT, 3,000 UNIT) UnityPoint At Home BENEFIX (250 UNIT, 500 UNIT) UnityPoint At Home CORIFACT KIT UnityPoint At Home ELOCTATE (250 UNIT, 500 UNIT, 750 UNIT, 1,000 UNIT, 1,500 UNIT, 2,000 UnityPoint At Home UNIT, 3,000 UNIT, 5,000 UNIT, 6,000 UNIT) ESPEROCT (500 UNIT VIAL, 1,000 UNIT VIAL, 1,500 UNIT VIAL, 2,000 UNIT UnityPoint At Home VIAL, 3,000 UNIT VIAL) FEIBA NF (1,000 UNIT, 2,500 UNIT) UnityPoint At Home HELIXATE FS (500 UNIT VIAL, 1,000 UNIT VIAL, 3,000 UNITS VIAL) UnityPoint At Home HEMOFIL M (250 UNIT, 500 UNIT, 1,000 UNIT, 1,700 UNIT) UnityPoint At Home HUMATE-P (600 UNIT, 1,200 UNIT, 2,400 UNIT) UnityPoint At Home IDELVION (250 UNIT VIAL, 500 UNIT VIAL, 1,000 UNIT VIAL, 2,000 UNIT VIAL, UnityPoint At Home 3,500 UNIT VIAL) IXINITY (250 UNIT, 2,000 UNIT, 3,000 UNIT) UnityPoint At Home JIVI (500 UNIT VIAL, 1,000 UNIT VIAL, 2,000 UNIT VIAL, 3,000 UNIT VIAL) UnityPoint At Home KOATE (250 UNIT VIAL, 500 UNIT VIAL) UnityPoint At Home KOGENATE FS (250 UNIT VIAL, 500 UNIT VIAL, 1,000 UNITS VIAL, 2,000 UNIT UnityPoint At Home VIAL, 3,000 UNITS VIAL)

Last Updated: July 1, 2021 3 DRUG NOTES KOVALTRY (250 UNIT KIT, 250 UNIT VIAL, 500 UNIT KIT, 1,000 UNIT KIT, 1,000 UnityPoint At Home UNIT VIAL, 2,000 UNIT KIT, 2,000 UNIT VIAL, 3,000 UNIT KIT, 3,000 UNIT VIAL) KOVALTRY 500 UNIT VIAL UnityPoint At Home NOVOEIGHT (500 UNIT VIAL, 1,000 UNIT VIAL, 1,500 UNIT VIAL, 2,000 UNIT UnityPoint At Home VIAL, 3,000 UNIT VIAL) NOVOEIGHT 250 UNIT VIAL UnityPoint At Home NOVOSEVEN RT (1 MG VIAL, 2 MG VIAL, 5 MG VIAL, 8 MG VIAL) UnityPoint At Home NUWIQ (250 UNIT VIAL, 250 UNIT VIAL PACK, 500 UNIT VIAL, 500 UNIT VIAL UnityPoint At Home PACK, 1,000 UNIT VIAL, 1,000 UNIT VIAL PACK, 2,000 UNIT VIAL, 2,000 UNIT VIAL PACK, 2,500 UNIT VIAL, 2,500 UNIT VIAL PACK, 3,000 UNIT VIAL, 3,000 UNIT VIAL PACK, 4,000 UNIT VIAL PACK) NUWIQ 4,000 UNIT VIAL UnityPoint At Home OBIZUR (500 UNIT VIAL, 500 UNIT VIAL - 5 VIALS, 500 UNIT VIAL -10 VIALS) UnityPoint At Home PROFILNINE (1,000 UNIT VIAL, 1,500 UNIT VIAL) UnityPoint At Home PROFILNINE 500 UNIT VIAL UnityPoint At Home REBINYN (500 UNIT VIAL, 1,000 UNIT VIAL, 2,000 UNIT VIAL) UnityPoint At Home RECOMBINATE (220-400 UNIT VIAL, 401-800 UNIT VIAL, 801-1,240 UNIT VL, UnityPoint At Home 1,241-1,800 UNIT V, 1,801-2,400 UNIT V) RIXUBIS (250 UNIT, 500 UNIT, 1,000 UNIT, 2,000 UNIT, 3,000 UNIT) UnityPoint At Home SEVENFACT 1 MG VIAL UnityPoint At Home SEVENFACT 5 MG VIAL UnityPoint At Home TRETTEN 2,500 UNIT VIAL UnityPoint At Home WILATE (450-450 UNIT VIAL, 900-900 UNIT VIAL) UnityPoint At Home XYNTHA (250 UNIT KIT, 500 UNIT KIT, 1,000 UNIT KIT) UnityPoint At Home XYNTHA SOLOFUSE (1,000 UNIT KIT, 1,000 UNIT SYR, 3,000 UNIT KIT, 3,000 UnityPoint At Home UNIT SYR)

ANTIMIGRAINE AGENTS CALCITONIN GENE-RELATED PEPTIDE ANTAG. AIMOVIG (70 MG/ML, 140 MG/ML) UnityPoint At Home

Last Updated: July 1, 2021 4 DRUG NOTES AJOVY 225 MG/1.5 ML AUTOINJECT UnityPoint At Home AJOVY 225 MG/1.5 ML SYRINGE UnityPoint At Home EMGALITY 120 MG/ML PEN UnityPoint At Home EMGALITY 120 MG/ML SYRINGE UnityPoint At Home

ANTINEOPLASTIC AGENTS ANTINEOPLASTIC AGENTS 250 mg tablet UnityPoint At Home abiraterone acetate 500 mg tablet UnityPoint At Home AFINITOR (2.5 MG TABLET, 7.5 MG TABLET, 10 MG TABLET) UnityPoint At Home AFINITOR 5 MG TABLET UnityPoint At Home AFINITOR DISPERZ (2 MG TABLET, 3 MG TABLET, 5 MG TABLET) UnityPoint At Home BALVERSA (3 MG TABLET, 4 MG TABLET, 5 MG TABLET) UnityPoint At Home bexarotene 75 mg UnityPoint At Home BOSULIF (100 MG TABLET, 400 MG TABLET, 500 MG TABLET) UnityPoint At Home CABOMETYX (20 MG TABLET, 60 MG TABLET) UnityPoint At Home CABOMETYX 40 MG TABLET UnityPoint At Home CALQUENCE 100 MG CAPSULE UnityPoint At Home capecitabine 150 mg tablet UnityPoint At Home capecitabine 500 mg tablet UnityPoint At Home COMETRIQ (60 MG PACK, 100 MG PK, 140 MG PK) UnityPoint At Home DAURISMO (25 MG TABLET, 100 MG TABLET) UnityPoint At Home ERLEADA 60 MG TABLET UnityPoint At Home hcl (100 mg tablet, 150 mg tablet) UnityPoint At Home erlotinib hcl 25 mg tablet UnityPoint At Home everolimus (2.5 mg tablet, 7.5 mg tablet) UnityPoint At Home everolimus 5 mg tablet UnityPoint At Home

Last Updated: July 1, 2021 5 DRUG NOTES FARYDAK (10 MG CAPSULE, 15 MG CAPSULE, 20 MG CAPSULE) UnityPoint At Home GLEEVEC (100 MG TABLET, 400 MG TABLET) UnityPoint At Home HYCAMTIN (0.25 MG CAPSULE, 1 MG CAPSULE, 4 MG VIAL) UnityPoint At Home IBRANCE (75 MG CAPSULE, 75 MG TABLET, 100 MG CAPSULE, 125 MG UnityPoint At Home CAPSULE, 125 MG TABLET) IBRANCE 100 MG TABLET UnityPoint At Home imatinib mesylate (100 mg tablet, 400 mg tablet) UnityPoint At Home INLYTA (1 MG TABLET, 5 MG TABLET) UnityPoint At Home INREBIC 100 MG CAPSULE UnityPoint At Home IRESSA 250 MG TABLET UnityPoint At Home KISQALI (200 MG DAILY, 400 MG DAILY, 600 MG DAILY) UnityPoint At Home KISQALI FEMARA 400 MG CO-PACK UnityPoint At Home KISQALI FEMARA CO-PACK (200 MG, 600 MG) UnityPoint At Home ditosylate 250 mg tablet UnityPoint At Home LORBRENA (25 MG TABLET, 100 MG TABLET) UnityPoint At Home LYNPARZA 100 MG TABLET UnityPoint At Home LYNPARZA 150 MG TABLET UnityPoint At Home MEKINIST (0.5 MG TABLET, 2 MG TABLET) UnityPoint At Home NEXAVAR 200 MG TABLET UnityPoint At Home NINLARO (3 MG CAPSULE, 4 MG CAPSULE) UnityPoint At Home NINLARO 2.3 MG CAPSULE UnityPoint At Home NUBEQA 300 MG TABLET UnityPoint At Home ODOMZO 200 MG CAPSULE UnityPoint At Home ONUREG (200 MG TABLET, 300 MG TABLET) UnityPoint At Home OPDIVO (40 MG/4 ML VIAL, 100 MG/10 ML VIAL) UnityPoint At Home OPDIVO 240 MG/24 ML VIAL UnityPoint At Home

Last Updated: July 1, 2021 6 DRUG NOTES PIQRAY (200 MG DAILY, 300 MG DAILY) UnityPoint At Home PIQRAY 250 MG DAILY DOSE UnityPoint At Home PURIXAN 20 MG/ML ORAL SUSP UnityPoint At Home REVLIMID 2.5 MG CAPSULE UnityPoint At Home RYDAPT 25 MG CAPSULE UnityPoint At Home SPRYCEL (20 MG TABLET, 50 MG TABLET, 70 MG TABLET, 100 MG TABLET, 140 UnityPoint At Home MG TABLET) SPRYCEL 80 MG TABLET UnityPoint At Home STIVARGA 40 MG TABLET UnityPoint At Home SUTENT (12.5 MG CAPSULE, 25 MG CAPSULE, 37.5 MG CAPSULE, 50 MG UnityPoint At Home CAPSULE) TAFINLAR (50 MG CAPSULE, 75 MG CAPSULE) UnityPoint At Home TAGRISSO (40 MG TABLET, 80 MG TABLET) UnityPoint At Home TALZENNA (0.25 MG CAPSULE, 1 MG CAPSULE) UnityPoint At Home TARCEVA (25 MG TABLET, 100 MG TABLET, 150 MG TABLET) UnityPoint At Home TARGRETIN (1% , 75 MG CAPSULE) UnityPoint At Home TASIGNA (50 MG CAPSULE, 150 MG CAPSULE, 200 MG CAPSULE) UnityPoint At Home TEMODAR (5 MG CAPSULE, 20 MG CAPSULE, 100 MG CAPSULE, 140 MG UnityPoint At Home CAPSULE, 180 MG CAPSULE, 250 MG CAPSULE) temozolomide (5 mg capsule, 20 mg capsule, 100 mg capsule, 140 mg UnityPoint At Home capsule, 180 mg capsule, 250 mg capsule) topotecan hcl 4 mg vial UnityPoint At Home tretinoin 10 mg capsule UnityPoint At Home TUKYSA (50 MG TABLET, 150 MG TABLET) UnityPoint At Home TYKERB 250 MG TABLET UnityPoint At Home VERZENIO (50 MG TABLET, 100 MG TABLET, 150 MG TABLET, 200 MG TABLET) UnityPoint At Home VOTRIENT 200 MG TABLET UnityPoint At Home XALKORI (200 MG CAPSULE, 250 MG CAPSULE) UnityPoint At Home

Last Updated: July 1, 2021 7 DRUG NOTES XELODA (150 MG TABLET, 500 MG TABLET) UnityPoint At Home XOSPATA 40 MG TABLET UnityPoint At Home XPOVIO (40 MG ONCE, 40 MG TWICE, 60 MG ONCE, 60 MG TWICE, 80 MG UnityPoint At Home ONCE, 80 MG TWICE) XPOVIO 100 MG ONCE WEEKLY DOSE UnityPoint At Home XTANDI (40 MG TABLET, 80 MG TABLET) UnityPoint At Home YONSA 125 MG TABLET UnityPoint At Home ZEJULA 100 MG CAPSULE UnityPoint At Home ZOLINZA 100 MG CAPSULE UnityPoint At Home ZYKADIA (150 MG CAPSULE, 150 MG TABLET) UnityPoint At Home ZYTIGA 250 MG TABLET UnityPoint At Home ZYTIGA 500 MG TABLET UnityPoint At Home

ANTITOXINS,IMMUNE GLOB,TOXOIDS,VACCINES ANTITOXINS AND IMMUNE GLOBULINS PRIVIGEN 10% VIAL UnityPoint At Home

ANTIVIRALS (SYSTEMIC) INTERFERON ANTIVIRALS INTRON A (10 MILLION UNITS VIL, 18 MILLION UNIT/3 ML, 18 MILLION UNITS UnityPoint At Home VIL, 25 MILLION UNIT/2.5ML, 50 MILLION UNITS VIL) PEGASYS (180 MCG/0.5 ML SYRINGE, 180 MCG/ML VIAL) UnityPoint At Home PEGASYS PROCLICK 180 MCG/0.5 UnityPoint At Home SYLATRON (200 MCG KIT, 300 MCG KIT, 600 MCG KIT) UnityPoint At Home

NUCLEOSIDE AND NUCLEOTIDE ANTIVIRALS REBETOL 40 MG/ML SOLUTION UnityPoint At Home RIBASPHERE (200 MG CAPSULE, 600 MG TABLET) UnityPoint At Home RIBASPHERE RIBAPAK 600-400 MG UnityPoint At Home

Last Updated: July 1, 2021 8 DRUG NOTES RIBASPHERE RIBAPAK 600-600 MG UnityPoint At Home ribavirin 200 mg capsule UnityPoint At Home ribavirin 200 mg tablet UnityPoint At Home VIRAZOLE 6 GM VIAL UnityPoint At Home

BLOOD FORMATION, COAGULATION, THROMBOSIS HEMATOPOIETIC AGENTS ARANESP (10 MCG/0.4 ML SYRINGE, 25 MCG/0.42 ML SYRING, 25 MCG/ML UnityPoint At Home VIAL, 40 MCG/0.4 ML SYRINGE, 60 MCG/0.3 ML SYRINGE, 60 MCG/ML VIAL, 100 MCG/0.5 ML SYRINGE, 100 MCG/ML VIAL, 150 MCG/0.3 ML SYRINGE, 150 MCG/0.75 ML VIAL, 200 MCG/0.4 ML SYRINGE, 200 MCG/ML VIAL, 300 MCG/0.6 ML SYRINGE, 300 MCG/ML VIAL) ARANESP (40 MCG/ML VIAL, 500 MCG/1 ML SYRINGE) UnityPoint At Home DOPTELET ((10 TAB 20 MG TAB, (15 TAB 20 MG TAB, (30 TAB 20 MG TAB) UnityPoint At Home EPOGEN (2,000 UNITS/ML VIAL, 3,000 UNITS/ML VIAL, 4,000 UNITS/ML VIAL, UnityPoint At Home 10,000 UNITS/ML VIAL, 20,000 UNITS/2 ML VIAL) EPOGEN 20,000 UNITS/ML VIAL UnityPoint At Home GRANIX (300 MCG/0.5 ML SAFE SYR, 300 MCG/0.5 ML SYRINGE, 300 MCG/ML UnityPoint At Home VIAL, 480 MCG/0.8 ML SAFE SYR, 480 MCG/1.6 ML VIAL) GRANIX 480 MCG/0.8 ML SYRINGE UnityPoint At Home LEUKINE 250 MCG VIAL UnityPoint At Home MULPLETA 3 MG TABLET UnityPoint At Home NEULASTA 6 MG/0.6 ML SYRINGE UnityPoint At Home NEULASTA ONPRO 6 MG/0.6 ML KIT UnityPoint At Home NEUPOGEN (300 MCG/0.5 ML SYR, 300 MCG/ML VIAL, 480 MCG/0.8 ML SYR) UnityPoint At Home NIVESTYM (300 MCG/0.5 ML SYRING, 300 MCG/ML VIAL, 480 MCG/0.8 ML UnityPoint At Home SYRING, 480 MCG/1.6 ML VIAL) PROCRIT (2,000 UNITS/ML VIAL, 3,000 UNITS/ML VIAL, 4,000 UNITS/ML VIAL, UnityPoint At Home 10,000 UNITS/ML VIAL, 40,000 UNITS/ML VIAL) PROCRIT 20,000 UNITS/ML VIAL UnityPoint At Home PROMACTA (12.5 MG TABLET, 25 MG PCKT, 25 MG TABLET, 50 UnityPoint At Home MG TABLET, 75 MG TABLET)

Last Updated: July 1, 2021 9 DRUG NOTES PROMACTA 12.5 MG SUSPEN PACKET UnityPoint At Home RETACRIT (2,000 UNIT/ML VIAL, 3,000 UNIT/ML VIAL, 10,000 UNIT/ML VIAL, UnityPoint At Home 20,000 UNIT/ML VIAL, 40,000 UNIT/ML VIAL) RETACRIT (4,000 UNIT/ML VIAL, 20,000 UNIT/2 ML VIAL) UnityPoint At Home ZARXIO (300 MCG/0.5 ML SYRINGE, 480 MCG/0.8 ML SYRINGE) UnityPoint At Home

CENTRAL NERVOUS SYSTEM AGENTS VESICULAR MONOAMINE TRANSPORT2 INHIBITOR AUSTEDO (6 MG TABLET, 12 MG TABLET) UnityPoint At Home AUSTEDO 9 MG TABLET UnityPoint At Home (12.5 mg tablet, 25 mg tablet) UnityPoint At Home XENAZINE (12.5 MG TABLET, 25 MG TABLET) UnityPoint At Home

DIAGNOSTIC AGENTS PITUITARY FUNCTION MACRILEN 60 MG/120 ML SOLUTION UnityPoint At Home

DIURETICS VASOPRESSIN ANTAGONISTS SAMSCA 15 MG TABLET UnityPoint At Home SAMSCA 30 MG TABLET UnityPoint At Home tolvaptan 15 mg tablet UnityPoint At Home tolvaptan 30 mg tablet UnityPoint At Home

GASTROINTESTINAL DRUGS GI DRUGS, MISCELLANEOUS HUMIRA(CF) PEDI CROHN 80-40 MG UnityPoint At Home

GONADOTROPINS AND ANTIGONADOTROPINS ANTIGONADTROPINS ORGOVYX 120 MG TABLET UnityPoint At Home

Last Updated: July 1, 2021 10 DRUG NOTES HCV ANTIVIRALS HCV POLYMERASE INHIBITOR ANTIVIRALS EPCLUSA (200 MG-50 MG TABLET, 400 MG-100 MG TABLET) UnityPoint At Home HARVONI (33.75-150 MG PELLET PK, 45-200 MG PELLET PACKT, 90-400 MG UnityPoint At Home TABLET) ledipasvir/sofosbuvir 90mg-400mg tablet UnityPoint At Home sofosbuvir/velpatasvir 400-100 mg tablet UnityPoint At Home SOVALDI (150 MG PELLET PACKET, 200 MG TABLET, 400 MG TABLET) UnityPoint At Home SOVALDI 200 MG PELLET PACKET UnityPoint At Home VOSEVI 400-100-100 MG TABLET UnityPoint At Home

HCV PROTEASE INHIBITOR ANTIVIRALS MAVYRET 100-40 MG TABLET UnityPoint At Home

HCV REPLICATION COMPLEX INHIBITORS VIEKIRA PAK UnityPoint At Home ZEPATIER 50-100 MG TABLET UnityPoint At Home

HEAVY METAL ANTAGONISTS HEAVY METAL ANTAGONISTS deferasirox (90 mg gran pack, 250 mg tab disper, 360 mg gran pack, 360 mg UnityPoint At Home tablet) deferasirox (90 mg tablet, 125 mg tab disper, 180 mg gran pack, 180 mg UnityPoint At Home tablet, 500 mg tab disper) DEPEN 250 MG TITRATAB UnityPoint At Home EXJADE (125 MG TABLET, 250 MG TABLET, 500 MG TABLET) UnityPoint At Home JADENU (90 MG TABLET, 180 MG TABLET, 360 MG TABLET) UnityPoint At Home JADENU SPRINKLE (90 MG GRANULE, 180 MG GRANULE) UnityPoint At Home JADENU SPRINKLE 360 MG GRANULE UnityPoint At Home penicillamine 250 mg tablet UnityPoint At Home

Last Updated: July 1, 2021 11 DRUG NOTES SYPRINE 250 MG CAPSULE UnityPoint At Home trientine hcl 250 mg capsule UnityPoint At Home

HORMONES AND SYNTHETIC SUBSTITUTES PITUITARY GENOTROPIN (MINIQUICK 0.2 MG, MINIQUICK 0.4 MG, MINIQUICK 0.8 MG, UnityPoint At Home MINIQUICK 1 MG, MINIQUICK 1.2 MG, MINIQUICK 1.4 MG, MINIQUICK 1.6 MG, MINIQUICK 1.8 MG, MINIQUICK 2 MG, 5 MG CARTRIDGE, 12 MG CARTRIDGE) GENOTROPIN MINIQUICK 0.6 MG UnityPoint At Home HUMATROPE (5 MG VIAL, 6 MG CARTRIDGE, 12 MG CARTRIDGE, 24 MG UnityPoint At Home CARTRIDGE) NORDITROPIN FLEXPRO (5 MG/1.5, 10 MG/1.5, 15 MG/1.5, 30 MG/3 ML) UnityPoint At Home OMNITROPE (5 MG/1.5 ML CRTG, 5.8 MG VIAL, 10 MG/1.5 ML CRTG) UnityPoint At Home SAIZEN (5 MG VIAL, 8.8 MG VIAL) UnityPoint At Home SAIZEN 8.8 MG SAIZENPREP CART UnityPoint At Home SEROSTIM (4 MG VIAL, 6 MG VIAL) UnityPoint At Home SEROSTIM 5 MG VIAL UnityPoint At Home ZORBTIVE 8.8 MG VIAL UnityPoint At Home

PROGESTINS hydroxyprogesterone caproat/pf 250 mg/ml vial UnityPoint At Home MAKENA 250 MG/ML VIAL UnityPoint At Home

MISCELLANEOUS THERAPEUTIC AGENTS COMPLEMENT INHIBITORS FIRAZYR 30 MG/3 ML SYRINGE UnityPoint At Home icatibant acetate 30 mg/3 ml syringe UnityPoint At Home KALBITOR 10 MG/ML VIAL UnityPoint At Home

DISEASE-MODIFYING ANTIRHEUMATIC AGENTS ACTEMRA 162 MG/0.9 ML SYRINGE UnityPoint At Home

Last Updated: July 1, 2021 12 DRUG NOTES ACTEMRA ACTPEN 162 MG/0.9 ML UnityPoint At Home CIMZIA (MG/ML SYRINGE KIT, MG/ML(X3)START KT) UnityPoint At Home ENBREL (25 MG KIT, 25 MG/0.5 ML SYRINGE) UnityPoint At Home ENBREL (25 MG/0.5 ML VIAL, 50 MG/ML SYRINGE) UnityPoint At Home ENBREL 50 MG/ML MINI CARTRIDGE UnityPoint At Home HUMIRA (10 MG/0.2 ML SYRINGE, 20 MG/0.4 ML SYRINGE) UnityPoint At Home HUMIRA 40 MG/0.8 ML SYRINGE UnityPoint At Home HUMIRA PEN 40 MG/0.8 ML UnityPoint At Home HUMIRA PEN CROHN-UC-HS 40 MG UnityPoint At Home HUMIRA PEN PS-UV-ADOL HS 40 MG UnityPoint At Home HUMIRA(CF) (10 MG/0.1 ML SYRING, 20 MG/0.2 ML SYRING, 40 MG/0.4 ML UnityPoint At Home SYRING) HUMIRA(CF) PEDI CROHN 80MG/0.8 UnityPoint At Home HUMIRA(CF) PEN 40 MG/0.4 ML UnityPoint At Home HUMIRA(CF) PEN 80 MG/0.8 ML UnityPoint At Home HUMIRA(CF) PEN CRHN-UC-HS 80MG UnityPoint At Home HUMIRA(CF) PEN PEDI UC 80 MG UnityPoint At Home HUMIRA(CF) PEN PS-UV-AHS 80-40 UnityPoint At Home KEVZARA (150 MG/1.14 ML PEN INJ, 200 MG/1.14 ML PEN INJ, 200 MG/1.14 UnityPoint At Home ML SYRINGE) KEVZARA 150 MG/1.14 ML SYRINGE UnityPoint At Home KINERET 100 MG/0.67 ML SYRINGE UnityPoint At Home OLUMIANT 2 MG TABLET UnityPoint At Home ORENCIA (50 MG/0.4 ML SYRINGE, 87.5 MG/0.7 ML SYRINGE, 125 MG/ML UnityPoint At Home SYRINGE) ORENCIA CLICKJECT 125 MG/ML UnityPoint At Home OTEZLA (28 DAY STARTER PACK, 30 MG TABLET, STARTER PACK) UnityPoint At Home

Last Updated: July 1, 2021 13 DRUG NOTES RINVOQ ER 15 MG TABLET UnityPoint At Home SIMPONI (50 MG/0.5 ML PEN INJEC, 50 MG/0.5 ML SYRINGE, 100 MG/ML UnityPoint At Home SYRINGE) SIMPONI 100 MG/ML PEN INJECTOR UnityPoint At Home SIMPONI ARIA 50 MG/4 ML VIAL UnityPoint At Home XELJANZ (1 MG/ML SOLUTION, 5 MG TABLET, 10 MG TABLET) UnityPoint At Home XELJANZ XR (11 MG TABLET, 22 MG TABLET) UnityPoint At Home

IMMUNOMODULATORY AGENTS ACTIMMUNE 100 MCG/0.5 ML VIAL UnityPoint At Home AUBAGIO (7 MG TABLET, 14 MG TABLET) UnityPoint At Home AVONEX (30 MCG VIAL KIT, PREFILLED SYR 30 MCG KT) UnityPoint At Home AVONEX PEN 30 MCG/0.5 ML KIT UnityPoint At Home BAFIERTAM DR 95 MG CAPSULE UnityPoint At Home BETASERON 0.3 MG KIT UnityPoint At Home COPAXONE (20 MG/ML SYRINGE, 40 MG/ML SYRINGE) UnityPoint At Home dimethyl fumarate (120-240 mg capsule dr, 240 mg capsule dr) UnityPoint At Home dimethyl fumarate 120 mg capsule dr UnityPoint At Home EXTAVIA (0.3 MG KIT, 0.3 MG VIAL) UnityPoint At Home GILENYA 0.25 MG CAPSULE UnityPoint At Home GILENYA 0.5 MG CAPSULE UnityPoint At Home glatiramer acetate (20 mg/ml syringe, 40 mg/ml syringe) UnityPoint At Home GLATOPA (20 MG/ML SYRINGE, 40 MG/ML SYRINGE) UnityPoint At Home KESIMPTA 20 MG/0.4 ML PEN UnityPoint At Home PLEGRIDY 125 MCG/0.5 ML SYRING UnityPoint At Home PONVORY (14-DAY STARTER PACK, 20 MG TABLET) UnityPoint At Home REBIF (22 MCG/0.5 ML SYRINGE, 44 MCG/0.5 ML SYRINGE, TITRATION PACK) UnityPoint At Home

Last Updated: July 1, 2021 14 DRUG NOTES REBIF REBIDOSE (22 MCG/0.5 ML, TITRATION PACK) UnityPoint At Home REBIF REBIDOSE 44 MCG/0.5 ML UnityPoint At Home TECFIDERA (DR 120 MG CAPSULE, DR 240 MG CAPSULE, STARTER PACK) UnityPoint At Home

IMMUNOSUPPRESSIVE AGENTS BENLYSTA (200 MG/ML AUTOINJECT, 200 MG/ML SYRINGE) UnityPoint At Home

OTHER MISCELLANEOUS THERAPEUTIC AGENTS AMPYRA ER 10 MG TABLET UnityPoint At Home dalfampridine 10 mg tab er 12h UnityPoint At Home ILARIS 150 MG/ML VIAL UnityPoint At Home KUVAN (100 MG POWDER PACKET, 100 MG TABLET) UnityPoint At Home KUVAN 500 MG POWDER PACKET UnityPoint At Home miglustat 100 mg capsule UnityPoint At Home sapropterin dihydrochloride (100 mg powd pack, 100 mg tablet sol) UnityPoint At Home sapropterin dihydrochloride 500 mg powd pack UnityPoint At Home

PARATHYROID AND ANTIPARATHYROID AGENTS PARATHYROID AGENTS FORTEO 620 MCG/2.48 ML PEN INJ UnityPoint At Home teriparatide 20mcg/dose pen injctr UnityPoint At Home TYMLOS 80 MCG DOSE PEN INJECTR UnityPoint At Home

RESPIRATORY TRACT AGENTS MUCOLYTIC AGENTS PULMOZYME 1 MG/ML AMPUL UnityPoint At Home

RESPIRATORY TRACT AGENTS, MISCELLANEOUS GLASSIA 1 GM/50 ML VIAL UnityPoint At Home

Last Updated: July 1, 2021 15 DRUG NOTES SKIN AND MUCOUS MEMBRANE AGENTS SKIN AND MUCOUS MEMBRANE AGENTS, MISC. COSENTYX 150 MG/ML PEN INJECT UnityPoint At Home COSENTYX 300 MG DOSE-2 PENS UnityPoint At Home COSENTYX 300 MG DOSE-2 SYRINGE UnityPoint At Home COSENTYX SYRINGE (75 MG/0.5 ML SYRINGE, 150 MG/ML SYRINGE) UnityPoint At Home DUPIXENT 300 MG/2 ML PEN UnityPoint At Home DUPIXENT 300 MG/2 ML SYRINGE UnityPoint At Home SKYRIZI (75 MG/0.83 ML SYRINGE, 150 MG/ML SYRINGE) UnityPoint At Home SKYRIZI 150 MG DOSE KIT-2 SYRN UnityPoint At Home SKYRIZI 150 MG/ML PEN UnityPoint At Home STELARA (45 MG/0.5 ML SYRINGE, 90 MG/ML SYRINGE, 130 MG/26 ML VIAL) UnityPoint At Home STELARA 45 MG/0.5 ML VIAL UnityPoint At Home TALTZ 80 MG/ML AUTOINJ (2-PK) UnityPoint At Home TALTZ 80 MG/ML AUTOINJ (3-PK) UnityPoint At Home TALTZ 80 MG/ML AUTOINJECTOR UnityPoint At Home TALTZ 80 MG/ML SYRINGE UnityPoint At Home TREMFYA 100 MG/ML INJECTOR UnityPoint At Home TREMFYA 100 MG/ML SYRINGE UnityPoint At Home

SOMATOSTATIN AGONISTS AND ANTAGONISTS SOMATOSTATIN AGONISTS BYNFEZIA 2,500 MCG/ML PEN UnityPoint At Home MYCAPSSA DR 20 MG CAPSULE UnityPoint At Home octreotide acetate (100 mcg/ml ampul, 500 mcg/ml vial) UnityPoint At Home octreotide acetate (50 mcg/ml ampul, 50 mcg/ml syringe, 50 mcg/ml vial, 100 UnityPoint At Home mcg/ml syringe, 100 mcg/ml vial, 200 mcg/ml vial, 500 mcg/ml ampul, 500 mcg/ml syringe, 1000mcg/ml vial)

Last Updated: July 1, 2021 16 DRUG NOTES SANDOSTATIN (0.05 MG/ML AMPUL, 0.1 MG/ML AMPUL, 0.5 MG/ML UnityPoint At Home AMPUL) SANDOSTATIN LAR DEPOT (10 MG KT, 10 MG VL, 20 MG KT, 30 MG KT, 30 MG UnityPoint At Home VL) SANDOSTATIN LAR DEPOT 20 MG VL UnityPoint At Home SIGNIFOR (0.6 MG/ML, 0.9 MG/ML) UnityPoint At Home SIGNIFOR 0.3 MG/ML AMPULE UnityPoint At Home SIGNIFOR LAR (10 MG KIT, 10 MG VIAL, 20 MG KIT, 20 MG VIAL, 30 MG KIT, 30 UnityPoint At Home MG VIAL, 40 MG VIAL, 60 MG KIT, 60 MG VIAL) SIGNIFOR LAR 40 MG KIT UnityPoint At Home SOMATULINE DEPOT (60 MG/0.2 ML, 120 MG/0.5 ML) UnityPoint At Home SOMATULINE DEPOT 90 MG/0.3 ML UnityPoint At Home

SYMPATHOMIMETIC (ADRENERGIC) AGENTS ALPHA- AND BETA-ADRENERGIC AGONISTS droxidopa (100 mg capsule, 300 mg capsule) UnityPoint At Home droxidopa 200 mg capsule UnityPoint At Home NORTHERA (100 MG CAPSULE, 300 MG CAPSULE) UnityPoint At Home NORTHERA 200 MG CAPSULE UnityPoint At Home

VASODILATING AGENTS PHOSPHODIESTERASE TYPE 5 INHIBITORS ADCIRCA 20 MG TABLET UnityPoint At Home ALYQ 20 MG TABLET UnityPoint At Home REVATIO 10 MG/ML ORAL SUSP UnityPoint At Home citrate 10 mg/ml susp recon UnityPoint At Home tadalafil 20 mg tablet UnityPoint At Home

Last Updated: July 1, 2021 17