Additions and Deletions to the Drug Product List

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Prescription and Over-the-Counter Drug Product List 37TH EDITION Cumulative Supplement Number 11 : November 2017 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

ABACAVIR SULFATE TABLET;ORAL ABACAVIR SULFATE >A> AB CIPLA LTD EQ 300MG BASE A 078119 001 Nov 21, 2017 Nov NEWA

ACALABRUTINIB CAPSULE;ORAL CALQUENCE >D> +! ACERTA PHARMA BV 100MG N 210259 001 Oct 31, 2017 Nov CAHN >A> +! ASTRAZENECA 100MG N 210259 001 Oct 31, 2017 Nov CAHN

ACETAMINOPHEN; BUTALBITAL; CAFFEINE; CODEINE PHOSPHATE CAPSULE;ORAL BUTALBITAL, ACETAMINOPHEN, CAFFEINE AND CODEINE PHOSPHATE >D> AB HIKMA INTL PHARMS 325MG;50MG;40MG;30MG A 075618 001 Mar 23, 2001 Nov DISC >A> @ 325MG;50MG;40MG;30MG A 075618 001 Mar 23, 2001 Nov DISC

ACETAMINOPHEN; CODEINE PHOSPHATE TABLET;ORAL ACETAMINOPHEN AND CODEINE PHOSPHATE >A> @ ANDA REPOSITORY 300MG;15MG A 089673 002 Feb 10, 1988 Nov CMS1 >A> @ 300MG;30MG A 089673 003 Feb 10, 1988 Nov CMS1

ACETAMINOPHEN; HYDROCODONE BITARTRATE SOLUTION;ORAL >D> ZYFREL >D> AA CYPRESS PHARM INC 325MG/15ML;7.5MG/15ML A 090468 001 Apr 14, 2016 Nov DISC >A> @ 325MG/15ML;7.5MG/15ML A 090468 001 Apr 14, 2016 Nov DISC

ACETAMINOPHEN; OXYCODONE HYDROCHLORIDE TABLET;ORAL OXYCODONE AND ACETAMINOPHEN >D> AA CEROVENE INC 325MG;5MG A 207574 001 Dec 13, 2016 Nov CAHN >A> AA CHEMO RESEARCH SL 325MG;5MG A 207574 001 Dec 13, 2016 Nov CAHN

ACETAMINOPHEN; TRAMADOL HYDROCHLORIDE TABLET;ORAL TRAMADOL HYDROCHLORIDE AND ACETAMINOPHEN >A> AB ALKEM LABS LTD 325MG;37.5MG A 202076 001 Mar 30, 2012 Nov CAHN >D> AB APOGEE PHARMA 325MG;37.5MG A 202076 001 Mar 30, 2012 Nov CAHN

ACETAZOLAMIDE TABLET;ORAL ACETAZOLAMIDE >A> AB STRIDES PHARMA 125MG A 209734 001 Nov 20, 2017 Nov NEWA >A> AB 250MG A 209734 002 Nov 20, 2017 Nov NEWA

ADENOSINE SOLUTION;IV (INFUSION) ADENOSINE >A> AP FRESENIUS KABI USA 60MG/20ML (3MG/ML) A 077897 001 Nov 27, 2017 Nov NEWA >A> AP 90MG/30ML (3MG/ML) A 077897 002 Nov 27, 2017 Nov NEWA

ALBUTEROL SULFATE; IPRATROPIUM BROMIDE SOLUTION;INHALATION ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE >A> AN SUN PHARMA GLOBAL EQ 0.083% BASE;0.017% A 207875 001 Aug 07, 2017 Nov CMS1 >D> AN EQ 0.083% BASE;0.17% A 207875 001 Aug 07, 2017 Nov CMS1

ALISKIREN HEMIFUMARATE >A> CAPSULE, PELLET;ORAL >A> TEKTURNA >A> +! NODEN PHARMA EQ 37.5MG BASE N 210709 001 Nov 14, 2017 Nov NEWA

Page 1 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

ALLOPURINOL TABLET;ORAL ALLOPURINOL >A> AB SUN PHARM INDUSTRIES 100MG A 071450 002 Jan 09, 1987 Nov CMS1

ALPRAZOLAM TABLET, EXTENDED RELEASE;ORAL ALPRAZOLAM >D> AB MYLAN 0.5MG A 077391 002 Jan 26, 2006 Nov DISC >A> @ 0.5MG A 077391 002 Jan 26, 2006 Nov DISC >D> AB 1MG A 077391 003 Jan 26, 2006 Nov DISC >A> @ 1MG A 077391 003 Jan 26, 2006 Nov DISC >D> AB 2MG A 077391 004 Jan 26, 2006 Nov DISC >A> @ 2MG A 077391 004 Jan 26, 2006 Nov DISC >D> AB 3MG A 077391 001 Jan 26, 2006 Nov DISC >A> @ 3MG A 077391 001 Jan 26, 2006 Nov DISC TABLET;ORAL ALPRAZOLAM >D> AB MYLAN PHARMS INC 0.25MG A 074046 001 Oct 19, 1993 Nov DISC >A> @ 0.25MG A 074046 001 Oct 19, 1993 Nov DISC >D> AB 0.5MG A 074046 002 Oct 19, 1993 Nov DISC >A> @ 0.5MG A 074046 002 Oct 19, 1993 Nov DISC >D> AB 1MG A 074046 003 Oct 19, 1993 Nov DISC >A> @ 1MG A 074046 003 Oct 19, 1993 Nov DISC >D> AB 2MG A 074046 004 May 07, 1997 Nov DISC >A> @ 2MG A 074046 004 May 07, 1997 Nov DISC

AMOXICILLIN; CLAVULANATE POTASSIUM FOR SUSPENSION;ORAL AUGMENTIN '125' >D> AB + DR REDDYS LABS INC 125MG/5ML;EQ 31.25MG BASE/5ML N 050575 001 Aug 06, 1984 Nov CTEC >A> + 125MG/5ML;EQ 31.25MG BASE/5ML N 050575 001 Aug 06, 1984 Nov CTEC

AMPHOTERICIN B INJECTABLE, LIPID COMPLEX;INJECTION ABELCET >A> +! LEADIANT BIOSCI INC 5MG/ML N 050724 001 Nov 20, 1995 Nov CAHN >D> +! SIGMA TAU 5MG/ML N 050724 001 Nov 20, 1995 Nov CAHN

APREPITANT >A> EMULSION;IV (INFUSION) >A> CINVANTI >A> +! HERON THERAPS INC 130MG/18ML (7.2MG/ML) N 209296 001 Nov 09, 2017 Nov NEWA

ARIPIPRAZOLE TABLET, ORALLY DISINTEGRATING;ORAL ARIPIPRAZOLE >D> ! ALEMBIC PHARMS LTD 10MG A 202102 001 Apr 28, 2015 Nov CTEC >A> AB ! 10MG A 202102 001 Apr 28, 2015 Nov CTEC >D> 15MG A 202102 002 Apr 28, 2015 Nov CTEC >A> AB 15MG A 202102 002 Apr 28, 2015 Nov CTEC >A> AB ORCHID HLTHCARE 10MG A 202547 001 Dec 11, 2017 Nov NEWA >A> AB 15MG A 202547 002 Dec 11, 2017 Nov NEWA >A> TABLET;ORAL >A> ABILIFY MYCITE KIT >A> + OTSUKA PHARM CO LTD 2MG N 207202 001 Nov 13, 2017 Nov NEWA >A> +! 5MG N 207202 002 Nov 13, 2017 Nov NEWA >A> + 10MG N 207202 003 Nov 13, 2017 Nov NEWA >A> + 15MG N 207202 004 Nov 13, 2017 Nov NEWA >A> + 20MG N 207202 005 Nov 13, 2017 Nov NEWA >A> + 30MG N 207202 006 Nov 13, 2017 Nov NEWA ARIPIPRAZOLE >A> AB PRINSTON INC 2MG A 205363 001 Dec 04, 2017 Nov NEWA >A> AB 5MG A 205363 002 Dec 04, 2017 Nov NEWA >A> AB 10MG A 205363 003 Dec 04, 2017 Nov NEWA >A> AB 15MG A 205363 004 Dec 04, 2017 Nov NEWA >A> AB 20MG A 205363 005 Dec 04, 2017 Nov NEWA >A> AB 30MG A 205363 006 Dec 04, 2017 Nov NEWA

Page 2 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN 5'-PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E INJECTABLE;INJECTION >D> M.V.I.-12 (WITHOUT VITAMIN K) >D> + @ HOSPIRA 20MG/ML;0.006MG/ML;0.05MCG/ML;1 N 008809 006 Sep 09, 2004 Nov CTNA .5MG/ML;0.0005MG/ML;0.06MG/ML;4 MG/ML;0.6MG/ML;0.36MG/ML;0.6MG/ ML;0.1MG/ML;1MG/ML >A> M.V.I.-12 ADULT >A> @ HOSPIRA 10MG/ML;0.006MG/ML;0.5MCG/ML;1. N 008809 004 Aug 08, 1985 Nov CTNA 5MG/ML;20 IU/ML;0.04MG/ML;4MG/ML;0.4MG/ML ;0.36MG/ML;0.3MG/ML;330 >A> + @ 20MG/ML;0.006MG/ML;0.05MCG/ML;1 N 008809 006 Sep 09, 2004 Nov CTNA .5MG/ML;0.0005MG/ML;0.06MG/ML;4 MG/ML;0.6MG/ML;0.36MG/ML;0.6MG/ ML;0.1MG/ML;1MG/ML

ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN PHOSPHATE SODIUM; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E INJECTABLE;INJECTION >D> M.V.I.-12 >D> @ HOSPIRA 10MG/ML;0.006MG/ML;0.5UGM/ML;1. N 008809 004 Aug 08, 1985 Nov CTNA 5MG/ML;20 IU/ML;0.04MG/ML;4MG/ML;0.4MG/ML ;0.36MG/ML;0.3MG/ML;330

ASCORBIC ACID; BIOTIN; CYANOCOBALAMIN; DEXPANTHENOL; ERGOCALCIFEROL; FOLIC ACID; NIACINAMIDE; PYRIDOXINE HYDROCHLORIDE; RIBOFLAVIN; THIAMINE HYDROCHLORIDE; VITAMIN A; VITAMIN E INJECTABLE;INJECTION >D> M.V.I.-12 >D> @ HOSPIRA 20MG/ML;0.006MG/ML;0.5UGM/ML;1. N 008809 005 Apr 22, 2004 Nov CTNA 5MG/ML;20 IU/ML;0.6MG/ML;4MG/ML;0.4MG/ML; 0.36MG/ML;0.6MG/ML;330 >A> M.V.I.-12 ADULT >A> @ HOSPIRA 20MG/ML;0.006MG/ML;0.5MCG/ML;1. N 008809 005 Apr 22, 2004 Nov CTNA 5MG/ML;20 IU/ML;0.6MG/ML;4MG/ML;0.4MG/ML; 0.36MG/ML;0.6MG/ML;330

ATENOLOL; CHLORTHALIDONE TABLET;ORAL ATENOLOL AND CHLORTHALIDONE >A> AB SUN PHARM INDUSTRIES 50MG;25MG A 073582 002 Apr 29, 1993 Nov CMS1

ATROPINE SULFATE; DIPHENOXYLATE HYDROCHLORIDE SOLUTION;ORAL DIPHENOXYLATE HYDROCHLORIDE AND ATROPINE SULFATE >D> AA ! WEST-WARD PHARMS INT 0.025MG/5ML;2.5MG/5ML A 087708 001 May 03, 1982 Nov CTEC >A> ! 0.025MG/5ML;2.5MG/5ML A 087708 001 May 03, 1982 Nov CTEC

>D> ATROPINE SULFATE; EDROPHONIUM CHLORIDE >D> INJECTABLE;INJECTION >D> ENLON-PLUS >D> +! MYLAN INSTITUTIONAL 0.14MG/ML;10MG/ML N 019678 001 Nov 06, 1991 Nov DISC >A> + @ 0.14MG/ML;10MG/ML N 019678 001 Nov 06, 1991 Nov DISC

BACITRACIN ZINC; NEOMYCIN SULFATE; POLYMYXIN B SULFATE OINTMENT;OPHTHALMIC NEOMYCIN AND POLYMYXIN B SULFATES AND BACITRACIN ZINC >D> AT PERRIGO CO TENNESSEE 400 UNITS/GM;EQ 3.5MG A 060764 002 Jan 22, 1981 Nov CPOT BASE;10,000 UNITS/GM >A> AT 400 UNITS/GM;EQ 3.5MG A 060764 002 Jan 22, 1981 Nov CPOT BASE/GM;10,000 UNITS/GM

BACLOFEN TABLET;ORAL BACLOFEN >A> RUBICON RES PVT LTD 5MG A 209102 001 Nov 28, 2017 Nov NEWA >A> AB 10MG A 209102 002 Nov 28, 2017 Nov NEWA >A> AB 20MG A 209102 003 Nov 28, 2017 Nov NEWA >A> AB SUN PHARM INDS INC 10MG A 077862 001 Aug 14, 2006 Nov CMS1

Page 3 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

BARIUM SULFATE FOR SUSPENSION;ORAL >D> E-Z-CAT DRY >D> +! BRACCO 40% (9GM/POUCH) N 208036 003 Jan 03, 2017 Nov DISC >A> + @ 40% (9GM/POUCH) N 208036 003 Jan 03, 2017 Nov DISC SUSPENSION;ORAL READI-CAT 2 SMOOTHIES >D> + BRACCO 2% (9GM/450ML) N 208143 002 Jan 15, 2016 Nov CHRS >A> +! 2% (9GM/450ML) N 208143 002 Jan 15, 2016 Nov CHRS

BENDROFLUMETHIAZIDE; NADOLOL TABLET;ORAL NADOLOL AND BENDROFLUMETHIAZIDE >D> AB MYLAN 5MG;40MG A 078688 001 Feb 15, 2008 Nov DISC >A> @ 5MG;40MG A 078688 001 Feb 15, 2008 Nov DISC >D> AB 5MG;80MG A 078688 002 Feb 15, 2008 Nov DISC >A> @ 5MG;80MG A 078688 002 Feb 15, 2008 Nov DISC

BIVALIRUDIN INJECTABLE;INTRAVENOUS BIVALIRUDIN >A> AP ACCORD HLTHCARE 250MG/VIAL A 206551 001 Nov 22, 2017 Nov NEWA

BORTEZOMIB POWDER;INTRAVENOUS >A> BORTEZOMIB >A> FRESENIUS KABI USA 3.5MG/VIAL N 205004 001 Nov 06, 2017 Nov NEWA

BUPRENORPHINE >A> SOLUTION, EXTENDED RELEASE;SUBCUTANEOUS >A> SUBLOCADE >A> + INDIVIOR INC 100MG/0.5ML (100MG/0.5ML) N 209819 001 Nov 29, 2017 Nov NEWA >A> +! 300MG/1.5ML (200MG/ML) N 209819 002 Nov 29, 2017 Nov NEWA

BUSULFAN INJECTABLE;INJECTION BUSULFAN >A> AP ACTAVIS LLC 6MG/ML A 205139 001 Dec 08, 2017 Nov NEWA >A> MYLERAN >A> AP ASPEN GLOBAL INC 6MG/ML A 208536 001 Nov 20, 2017 Nov NEWA

CANDESARTAN CILEXETIL; HYDROCHLOROTHIAZIDE TABLET;ORAL CANDESARTAN CILEXETIL AND HYDROCHLOROTHIAZIDE >A> AB ZYDUS PHARMS USA INC 16MG;12.5MG A 203466 001 Nov 27, 2017 Nov NEWA >A> AB 32MG;12.5MG A 203466 002 Nov 27, 2017 Nov NEWA >A> AB 32MG;25MG A 203466 003 Nov 27, 2017 Nov NEWA

CAPECITABINE TABLET;ORAL CAPECITABINE >A> AB ALKEM LABS LTD 150MG A 207652 001 Nov 24, 2017 Nov NEWA >A> AB 500MG A 207652 002 Nov 24, 2017 Nov NEWA

CAPREOMYCIN SULFATE INJECTABLE;INJECTION CAPASTAT SULFATE >D> +! AKORN EQ 1GM BASE/VIAL N 050095 001 Jun 02, 1971 Nov CFTG >A> AP +! EQ 1GM BASE/VIAL N 050095 001 Jun 02, 1971 Nov CFTG >A> CAPREOMYCIN SULFATE >A> AP MYLAN LABS LTD EQ 1GM BASE/VIAL A 202634 001 Nov 27, 2017 Nov NEWA

CEFACLOR FOR SUSPENSION;ORAL CEFACLOR >D> AB YUNG SHIN PHARM EQ 125MG BASE/5ML A 065412 001 Feb 17, 2012 Nov CTEC >A> EQ 125MG BASE/5ML A 065412 001 Feb 17, 2012 Nov CTEC >D> AB EQ 187MG BASE/5ML A 065412 002 Feb 17, 2012 Nov CTEC >A> EQ 187MG BASE/5ML A 065412 002 Feb 17, 2012 Nov CTEC >D> AB EQ 250MG BASE/5ML A 065412 003 Feb 17, 2012 Nov CTEC >A> EQ 250MG BASE/5ML A 065412 003 Feb 17, 2012 Nov CTEC

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CEFACLOR FOR SUSPENSION;ORAL CEFACLOR >D> AB ! EQ 375MG BASE/5ML A 065412 004 Feb 17, 2012 Nov CTEC >A> ! EQ 375MG BASE/5ML A 065412 004 Feb 17, 2012 Nov CTEC

CEFIXIME FOR SUSPENSION;ORAL CEFIXIME >A> AB SANDOZ INC 100MG/5ML A 206144 001 Nov 17, 2017 Nov NEWA >A> AB 200MG/5ML A 206144 002 Nov 17, 2017 Nov NEWA

CHOLINE C-11 INJECTABLE;INTRAVENOUS CHOLINE C-11 >A> AP UCSF RODIOPHARM 4-33.1mCi/ML A 208444 001 Nov 20, 2017 Nov NEWA

CIMETIDINE HYDROCHLORIDE INJECTABLE;INJECTION CIMETIDINE HYDROCHLORIDE >D> AP DAVA PHARMS INC EQ 300MG BASE/2ML A 074428 001 Apr 25, 1996 Nov CTEC >A> EQ 300MG BASE/2ML A 074428 001 Apr 25, 1996 Nov CTEC

>A> CISATRACURIUM BESYLATE >A> INJECTABLE;INJECTION >A> CISATRACURIUM BESYLATE PRESERVATIVE FREE >A> AP JIANGSU HENGRUI MED EQ 10MG BASE/ML A 204960 002 Sep 19, 2017 Nov CAIN

>D> CISATRACURIUM BESYLATE PRESERVATIVE FREE >D> INJECTABLE;INJECTION >D> CISATRACURIUM BESYLATE PRESERVATIVE FREE >D> AP JIANGSU HENGRUI MED EQ 10MG BASE/ML A 204960 002 Sep 19, 2017 Nov CAIN

CITRIC ACID; MAGNESIUM OXIDE; SODIUM PICOSULFATE SOLUTION;ORAL >A> CLENPIQ >A> +! FERRING PHARMS INC 12GM/160ML;3.5GM/160ML;10MG/160 N 209589 001 Nov 28, 2017 Nov NEWA ML

CLOBETASOL PROPIONATE CREAM;TOPICAL >A> IMPOYZ >A> +! PROMIUS PHARMA LLC 0.025% N 209483 001 Nov 28, 2017 Nov NEWA OINTMENT;TOPICAL CLOBETASOL PROPIONATE >D> AB1 MYLAN PHARMS INC 0.05% A 075057 001 Aug 12, 1998 Nov CTEC >A> AB 0.05% A 075057 001 Aug 12, 1998 Nov CTEC

CLOFARABINE INJECTABLE;IV (INFUSION) CLOFARABINE >A> AP MSN LABS PVT LTD 20MG/20ML (1MG/ML) A 209775 001 Dec 06, 2017 Nov NEWA

CLONIDINE HYDROCHLORIDE TABLET, EXTENDED RELEASE;ORAL CLONIDINE HYDROCHLORIDE >A> AB1 AJANTA PHARMA LTD 0.1MG A 209686 001 Nov 20, 2017 Nov NEWA >A> AB1 AMNEAL PHARMS NY 0.1MG A 210052 001 Nov 20, 2017 Nov NEWA >A> AB1 XIAMEN LP PHARM CO 0.1MG A 209757 001 Nov 20, 2017 Nov NEWA

CLOZAPINE TABLET;ORAL CLOZAPINE >A> AB ZYDUS PHARMS USA INC 25MG A 209480 001 Dec 06, 2017 Nov NEWA >A> AB 50MG A 209480 002 Dec 06, 2017 Nov NEWA >A> AB 100MG A 209480 003 Dec 06, 2017 Nov NEWA >A> AB 200MG A 209480 004 Dec 06, 2017 Nov NEWA

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COLESTIPOL HYDROCHLORIDE GRANULE;ORAL COLESTID >D> AB + PHARMACIA AND UPJOHN 5GM/SCOOPFUL N 017563 003 Sep 22, 1995 Nov CAHN >D> AB +! 5GM/PACKET N 017563 004 Sep 22, 1995 Nov CAHN >A> AB + PHARMACIA UPJOHN 5GM/SCOOPFUL N 017563 003 Sep 22, 1995 Nov CAHN >A> AB +! 5GM/PACKET N 017563 004 Sep 22, 1995 Nov CAHN FLAVORED COLESTID >D> + PHARMACIA AND UPJOHN 5GM/PACKET N 017563 001 Apr 04, 1977 Nov CAHN >D> + 5GM/SCOOPFUL N 017563 002 Apr 04, 1977 Nov CAHN >A> + PHARMACIA UPJOHN 5GM/PACKET N 017563 001 Apr 04, 1977 Nov CAHN >A> + 5GM/SCOOPFUL N 017563 002 Apr 04, 1977 Nov CAHN TABLET;ORAL COLESTID >D> AB +! PHARMACIA AND UPJOHN 1GM N 020222 001 Jul 19, 1994 Nov CAHN >A> AB +! PHARMACIA UPJOHN 1GM N 020222 001 Jul 19, 1994 Nov CAHN

COPPER INTRAUTERINE DEVICE;INTRAUTERINE PARAGARD T 380A >A> +! COOPERSURGICAL 309MG/COPPER N 018680 001 Nov 15, 1984 Nov CAHN >D> +! TEVA WOMENS 309MG/COPPER N 018680 001 Nov 15, 1984 Nov CAHN

CYTARABINE INJECTABLE;INJECTION CYTARABINE >A> AP HONG KONG 20MG/ML A 206190 001 Nov 09, 2017 Nov CAHN >D> AP SAGENT PHARMS 20MG/ML A 206190 001 Nov 09, 2017 Nov CAHN

CYTARABINE; DAUNORUBICIN >D> POWDER;INTRAVENOUS >D> VYXEOS >D> +! CELATOR PHARMS 100MG;44MG N 209401 001 Aug 03, 2017 Nov CDFR >A> POWDER;IV (INFUSION) >A> VYXEOS >A> +! CELATOR PHARMS 100MG;44MG N 209401 001 Aug 03, 2017 Nov CDFR

DACARBAZINE INJECTABLE;INJECTION DACARBAZINE >D> AP ! FRESENIUS KABI USA 100MG/VIAL A 075371 001 Aug 27, 1999 Nov CTEC >A> ! 100MG/VIAL A 075371 001 Aug 27, 1999 Nov CTEC

DAPTOMYCIN >D> POWDER;INTRAVENOUS >D> DAPTOMYCIN >D> +! SAGENT PHARMS 350MG/VIAL N 208385 001 Sep 12, 2017 Nov CDFR >A> POWDER;IV (INFUSION) >A> DAPTOMYCIN >A> +! SAGENT PHARMS 350MG/VIAL N 208385 001 Sep 12, 2017 Nov CDFR

DARIFENACIN HYDROBROMIDE TABLET, EXTENDED RELEASE;ORAL DARIFENACIN HYDROBROMIDE >A> AB ALEMBIC PHARMS LTD EQ 7.5MG BASE A 207681 001 Dec 08, 2017 Nov NEWA >A> AB EQ 15MG BASE A 207681 002 Dec 08, 2017 Nov NEWA

DARUNAVIR ETHANOLATE TABLET;ORAL >A> DARUNAVIR ETHANOLATE >A> AB TEVA PHARMS USA EQ 600MG BASE A 202118 001 Nov 21, 2017 Nov NEWA PREZISTA >D> + JANSSEN PRODS EQ 600MG BASE N 021976 002 Feb 25, 2008 Nov CFTG >A> AB + EQ 600MG BASE N 021976 002 Feb 25, 2008 Nov CFTG

DECITABINE INJECTABLE;INTRAVENOUS DECITABINE >A> AP CIPLA LTD 50MG/VIAL A 208601 001 Nov 16, 2017 Nov NEWA

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DELAFLOXACIN MEGLUMINE POWDER;IV (INFUSION) BAXDELA >A> +! MELINTA EQ 300MG BASE/VIAL N 208611 001 Jun 19, 2017 Nov CAHN >D> +! MELINTA THERAPS INC EQ 300MG BASE/VIAL N 208611 001 Jun 19, 2017 Nov CAHN TABLET;ORAL BAXDELA >A> +! MELINTA EQ 450MG BASE N 208610 001 Jun 19, 2017 Nov CAHN >D> +! MELINTA THERAPS INC EQ 450MG BASE N 208610 001 Jun 19, 2017 Nov CAHN

DESOGESTREL; ETHINYL ESTRADIOL TABLET;ORAL-28 ISIBLOOM >A> AB LABS LEON FARMA 0.15MG;0.03MG A 202789 001 Aug 12, 2015 Nov CAHN >D> AB SANDOZ INC 0.15MG;0.03MG A 202789 001 Aug 12, 2015 Nov CAHN VOLNEA >A> AB LABS LEON FARMA 0.15MG,N/A;0.02MG,0.01MG A 202689 001 Sep 09, 2016 Nov CAHN >D> AB SANDOZ INC 0.15MG,N/A;0.02MG,0.01MG A 202689 001 Sep 09, 2016 Nov CAHN

DEXMEDETOMIDINE HYDROCHLORIDE INJECTABLE;INJECTION DEXMEDETOMIDINE HYDROCHLORIDE >A> AP TEVA PHARMS USA EQ 200MCG BASE/2ML (EQ 100MCG A 205272 001 Nov 28, 2017 Nov NEWA BASE/ML)

DEXMETHYLPHENIDATE HYDROCHLORIDE TABLET;ORAL DEXMETHYLPHENIDATE HYDROCHLORIDE >A> AB RHODES PHARMS 2.5MG A 208756 001 Nov 20, 2017 Nov NEWA >A> AB 5MG A 208756 002 Nov 20, 2017 Nov NEWA >A> AB 10MG A 208756 003 Nov 20, 2017 Nov NEWA

DEXTROSE INJECTABLE;INJECTION DEXTROSE 60% IN PLASTIC CONTAINER >D> AP +! BAXTER HLTHCARE 60GM/100ML N 017521 005 Mar 26, 1982 Nov CTEC >A> +! 60GM/100ML N 017521 005 Mar 26, 1982 Nov CTEC

DEXTROSE; SODIUM CHLORIDE INJECTABLE;INJECTION DEXTROSE 10% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER >D> AP BAXTER HLTHCARE 10GM/100ML;900MG/100ML N 016696 001 Mar 22, 1971 Nov DISC >A> @ 10GM/100ML;900MG/100ML N 016696 001 Mar 22, 1971 Nov DISC

DISOPYRAMIDE PHOSPHATE CAPSULE, EXTENDED RELEASE;ORAL NORPACE CR >D> AB +! GD SEARLE LLC EQ 150MG BASE N 018655 002 Jul 20, 1982 Nov CTEC >A> +! EQ 150MG BASE N 018655 002 Jul 20, 1982 Nov CTEC

>A> DOLUTEGRAVIR SODIUM; RILPIVIRINE HYDROCHLORIDE >A> TABLET;ORAL >A> JULUCA >A> +! VIIV HLTHCARE EQ 50MG BASE;EQ 25MG BASE N 210192 001 Nov 21, 2017 Nov NEWA

DOPAMINE HYDROCHLORIDE INJECTABLE;INJECTION DOPAMINE HYDROCHLORIDE >D> AP ! LUITPOLD 160MG/ML A 070826 001 Feb 11, 1987 Nov CTEC >A> ! 160MG/ML A 070826 001 Feb 11, 1987 Nov CTEC

DORZOLAMIDE HYDROCHLORIDE SOLUTION/DROPS;OPHTHALMIC DORZOLAMIDE HYDROCHLORIDE >D> AT ZAMBON SPA EQ 2% BASE A 091034 001 Dec 04, 2013 Nov DISC >A> @ EQ 2% BASE A 091034 001 Dec 04, 2013 Nov DISC

Page 7 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

DOXEPIN HYDROCHLORIDE TABLET;ORAL DOXEPIN HYDROCHLORIDE >D> AB MYLAN PHARMS INC EQ 3MG BASE A 202337 001 Jan 20, 2016 Nov DISC >A> @ EQ 3MG BASE A 202337 001 Jan 20, 2016 Nov DISC >D> AB EQ 6MG BASE A 202337 002 Jan 20, 2016 Nov DISC >A> @ EQ 6MG BASE A 202337 002 Jan 20, 2016 Nov DISC

DOXYCYCLINE HYCLATE >A> CAPSULE;ORAL >A> PERIOSTAT >A> + @ COLLAGENEX EQ 20MG BASE N 050744 001 Sep 30, 1998 Nov CDFR INJECTABLE;INJECTION DOXY 200 >D> ! FRESENIUS KABI USA EQ 200MG BASE/VIAL A 062475 002 Dec 09, 1983 Nov CTEC >A> AP ! EQ 200MG BASE/VIAL A 062475 002 Dec 09, 1983 Nov CTEC >D> TABLET;ORAL >D> PERIOSTAT >D> + @ COLLAGENEX EQ 20MG BASE N 050744 001 Sep 30, 1998 Nov CDFR

DOXYLAMINE SUCCINATE; PYRIDOXINE HYDROCHLORIDE TABLET, DELAYED RELEASE;ORAL DOXYLAMINE SUCCINATE AND PYRIDOXINE HYDROCHLORIDE >A> AB PAR PHARM INC 10MG;10MG A 208518 001 Dec 06, 2017 Nov NEWA

DROSPIRENONE; ETHINYL ESTRADIOL TABLET;ORAL LORYNA >A> AB LABS LEON FARMA 3MG;0.02MG A 079221 001 Mar 28, 2011 Nov CAHN >D> AB SANDOZ 3MG;0.02MG A 079221 001 Mar 28, 2011 Nov CAHN TABLET;ORAL-28 SYEDA >A> AB LABS LEON FARMA 3MG;0.03MG A 090114 001 Mar 28, 2011 Nov CAHN >D> AB SANDOZ 3MG;0.03MG A 090114 001 Mar 28, 2011 Nov CAHN

DROSPIRENONE; ETHINYL ESTRADIOL; LEVOMEFOLATE CALCIUM TABLET;ORAL >A> TYDEMY >A> AB LUPIN LTD 3MG,N/A;0.03MG,N/A;0.451MG,0.45 A 205948 001 Dec 12, 2017 Nov NEWA 1MG

DUTASTERIDE CAPSULE;ORAL DUTASTERIDE >A> AB HUMANWELL PURACAP 0.5MG A 209909 001 Nov 21, 2017 Nov NEWA

EPINEPHRINE >D> INJECTABLE;INTRAMUSCULAR, SUBCUTANEOUS >D> AUVI-Q >D> BX +! KALEO INC EQ 0.15MG/DELIVERY N 201739 002 Aug 10, 2012 Nov CDFR >D> BX + EQ 0.3MG/DELIVERY N 201739 001 Aug 10, 2012 Nov CDFR SOLUTION;INTRAMUSCULAR, SUBCUTANEOUS AUVI-Q >A> + KALEO INC EQ 0.1MG/DELIVERY N 201739 003 Nov 17, 2017 Nov NEWA >A> BX +! EQ 0.15MG/DELIVERY N 201739 002 Aug 10, 2012 Nov CDFR >A> BX + EQ 0.3MG/DELIVERY N 201739 001 Aug 10, 2012 Nov CDFR

EPINEPHRINE; LIDOCAINE HYDROCHLORIDE INJECTABLE;INJECTION XYLOCAINE W/ EPINEPHRINE >D> AP +! FRESENIUS KABI USA 0.005MG/ML;1% N 006488 018 Nov 13, 1986 Nov CTEC >A> +! 0.005MG/ML;1% N 006488 018 Nov 13, 1986 Nov CTEC

ERYTHROMYCIN SOLUTION;TOPICAL ERYTHROMYCIN >A> AT TELIGENT PHARMA INC 2% A 208100 001 Nov 20, 2017 Nov NEWA

Page 8 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

ESCITALOPRAM OXALATE TABLET;ORAL ESCITALOPRAM OXALATE >D> AB MYLAN PHARMS INC EQ 5MG BASE A 077550 001 May 14, 2015 Nov DISC >A> @ EQ 5MG BASE A 077550 001 May 14, 2015 Nov DISC >D> AB EQ 10MG BASE A 077550 002 May 14, 2015 Nov DISC >A> @ EQ 10MG BASE A 077550 002 May 14, 2015 Nov DISC >D> AB EQ 20MG BASE A 077550 003 May 14, 2015 Nov DISC >A> @ EQ 20MG BASE A 077550 003 May 14, 2015 Nov DISC

ETHACRYNATE SODIUM INJECTABLE;INJECTION ETHACRYNATE SODIUM >A> AP ZYDUS PHARMS USA INC EQ 50MG BASE/VIAL A 207758 001 Nov 17, 2017 Nov NEWA

ETHINYL ESTRADIOL; LEVONORGESTREL TABLET;ORAL INTROVALE >A> AB LABS LEON FARMA 0.03MG;0.15MG A 079064 001 Sep 27, 2010 Nov CAHN >D> AB SANDOZ 0.03MG;0.15MG A 079064 001 Sep 27, 2010 Nov CAHN TABLET;ORAL-28 ALTAVERA >A> AB LABS LEON FARMA 0.03MG;0.15MG A 079102 001 Aug 03, 2010 Nov CAHN >D> AB SANDOZ 0.03MG;0.15MG A 079102 001 Aug 03, 2010 Nov CAHN VIENVA >A> AB1 LABS LEON FARMA 0.02MG;0.1MG A 201088 001 May 21, 2015 Nov CAHN >D> AB1 SANDOZ INC 0.02MG;0.1MG A 201088 001 May 21, 2015 Nov CAHN

ETHINYL ESTRADIOL; NORELGESTROMIN FILM, EXTENDED RELEASE;TRANSDERMAL XULANE >D> AB ! MYLAN TECHNOLOGIES 0.035MG/24HR;0.15MG/24HR A 200910 001 Apr 16, 2014 Nov CTEC >A> ! 0.035MG/24HR;0.15MG/24HR A 200910 001 Apr 16, 2014 Nov CTEC

ETHINYL ESTRADIOL; NORETHINDRONE ACETATE TABLET;ORAL NORETHINDRONE ACETATE AND ETHINYL ESTRADIOL AND FERROUS FUMARATE >A> AB GLENMARK PHARMS LTD 0.02MG;1MG A 204847 001 Nov 17, 2017 Nov NEWA TABLET;ORAL-28 >A> HAILEY FE 1/20 >A> AB GLENMARK PHARMS LTD 0.02MG;1MG A 206597 001 Nov 21, 2017 Nov NEWA

ETHINYL ESTRADIOL; NORGESTIMATE TABLET;ORAL-28 ESTARYLLA >A> AB LABS LEON FARMA 0.035MG;0.25MG A 090794 001 Jan 30, 2013 Nov CAHN >D> AB SANDOZ 0.035MG;0.25MG A 090794 001 Jan 30, 2013 Nov CAHN TRI-ESTARYLLA >A> AB LABS LEON FARMA 0.035MG,0.035MG,0.035MG;0.18MG, A 090793 001 Jan 30, 2013 Nov CAHN 0.215MG,0.25MG >D> AB SANDOZ 0.035MG,0.035MG,0.035MG;0.18MG, A 090793 001 Jan 30, 2013 Nov CAHN 0.215MG,0.25MG TRI-LO-ESTARYLLA >A> AB LABS LEON FARMA 0.025MG,0.025MG,0.025MG;0.18MG, A 091232 001 Jun 29, 2015 Nov CAHN 0.215MG,0.25MG >D> AB SANDOZ INC 0.025MG,0.025MG,0.025MG;0.18MG, A 091232 001 Jun 29, 2015 Nov CAHN 0.215MG,0.25MG

ETOPOSIDE INJECTABLE;INJECTION ETOPOSIDE >A> AP MYLAN LABS LTD 20MG/ML A 203507 001 Nov 20, 2017 Nov NEWA

EZETIMIBE; SIMVASTATIN TABLET;ORAL EZETIMIBE AND SIMVASTATIN >A> AB AMNEAL PHARMS CO 10MG;10MG A 208831 001 Nov 21, 2017 Nov NEWA >A> AB 10MG;20MG A 208831 002 Nov 21, 2017 Nov NEWA >A> AB 10MG;40MG A 208831 003 Nov 21, 2017 Nov NEWA >A> AB 10MG;80MG A 208831 004 Nov 21, 2017 Nov NEWA

Page 9 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

FAMOTIDINE >A> FOR SUSPENSION;ORAL >A> FAMOTIDINE >A> AB NOVEL LABS INC 40MG/5ML A 201695 001 Dec 17, 2012 Nov CDFR INJECTABLE;INJECTION FAMOTIDINE PRESERVATIVE FREE IN PLASTIC CONTAINER >D> AP ! BAXTER HLTHCARE 0.4MG/ML A 075591 001 May 10, 2001 Nov CTEC >A> ! 0.4MG/ML A 075591 001 May 10, 2001 Nov CTEC >D> SUSPENSION;ORAL >D> FAMOTIDINE >D> AB NOVEL LABS INC 40MG/5ML A 201695 001 Dec 17, 2012 Nov CDFR

FENOFIBRATE CAPSULE;ORAL FENOFIBRATE (MICRONIZED) >A> AB CNTY LINE PHARMS 67MG A 207805 001 Nov 16, 2017 Nov NEWA >A> AB 134MG A 207805 002 Nov 16, 2017 Nov NEWA >A> AB 200MG A 207805 003 Nov 16, 2017 Nov NEWA

FENTANYL FILM, EXTENDED RELEASE;TRANSDERMAL FENTANYL-37 >A> AB AVEVA 37.5MCG/HR A 077449 006 Dec 06, 2017 Nov NEWA FENTANYL-62 >A> AB AVEVA 62.5MCG/HR A 077449 007 Dec 06, 2017 Nov NEWA FENTANYL-87 >A> AB AVEVA 87.5MCG/HR A 077449 008 Dec 06, 2017 Nov NEWA

FENTANYL CITRATE SPRAY, METERED;NASAL LAZANDA >D> + DEPOMED INC EQ 0.1MG BASE N 022569 001 Jun 30, 2011 Nov CAHN >D> + EQ 0.3MG BASE N 022569 003 Dec 21, 2015 Nov CAHN >D> +! EQ 0.4MG BASE N 022569 002 Jun 30, 2011 Nov CAHN >A> + ELEFSEE PHARMS INTL EQ 0.1MG BASE N 022569 001 Jun 30, 2011 Nov CAHN >A> + EQ 0.3MG BASE N 022569 003 Dec 21, 2015 Nov CAHN >A> +! EQ 0.4MG BASE N 022569 002 Jun 30, 2011 Nov CAHN TABLET;SUBLINGUAL ABSTRAL >D> + SENTYNL THERAPS INC EQ 0.1MG BASE N 022510 001 Jan 07, 2011 Nov CFTG >A> AB + EQ 0.1MG BASE N 022510 001 Jan 07, 2011 Nov CFTG >D> + EQ 0.2MG BASE N 022510 002 Jan 07, 2011 Nov CFTG >A> AB + EQ 0.2MG BASE N 022510 002 Jan 07, 2011 Nov CFTG >D> + EQ 0.3MG BASE N 022510 003 Jan 07, 2011 Nov CFTG >A> AB + EQ 0.3MG BASE N 022510 003 Jan 07, 2011 Nov CFTG >D> +! EQ 0.4MG BASE N 022510 004 Jan 07, 2011 Nov CFTG >A> AB +! EQ 0.4MG BASE N 022510 004 Jan 07, 2011 Nov CFTG >D> + EQ 0.6MG BASE N 022510 005 Jan 07, 2011 Nov CFTG >A> AB + EQ 0.6MG BASE N 022510 005 Jan 07, 2011 Nov CFTG >D> + EQ 0.8MG BASE N 022510 006 Jan 07, 2011 Nov CFTG >A> AB + EQ 0.8MG BASE N 022510 006 Jan 07, 2011 Nov CFTG >A> FENTANYL CITRATE >A> AB ACTAVIS LABS FL INC EQ 0.1MG BASE A 207338 001 Nov 17, 2017 Nov NEWA >A> AB EQ 0.2MG BASE A 207338 002 Nov 17, 2017 Nov NEWA >A> AB EQ 0.3MG BASE A 207338 003 Nov 17, 2017 Nov NEWA >A> AB EQ 0.4MG BASE A 207338 004 Nov 17, 2017 Nov NEWA >A> AB EQ 0.6MG BASE A 207338 005 Nov 17, 2017 Nov NEWA >A> AB EQ 0.8MG BASE A 207338 006 Nov 17, 2017 Nov NEWA

FLOXURIDINE INJECTABLE;INJECTION FLOXURIDINE >A> AP PHARMAFORCE 500MG/VIAL A 203008 001 Nov 22, 2017 Nov NEWA

FLUDEOXYGLUCOSE F-18 INJECTABLE;INTRAVENOUS FLUDEOXYGLUCOSE F18 >A> AP SOFIE 20-300mCi/ML A 203591 001 Aug 31, 2015 Nov CAHN >D> AP ZEVACOR PHARMA INC 20-300mCi/ML A 203591 001 Aug 31, 2015 Nov CAHN

Page 10 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

FLUOCINONIDE SOLUTION;TOPICAL FLUOCINONIDE >D> AT FOUGERA 0.05% A 072934 001 Feb 27, 1995 Nov CAHN >A> AT FOUGERA PHARMS INC 0.05% A 072934 001 Feb 27, 1995 Nov CAHN

FLUOXETINE HYDROCHLORIDE CAPSULE;ORAL FLUOXETINE HYDROCHLORIDE >D> AB1 MYLAN PHARMS INC EQ 10MG BASE A 075577 001 Jan 29, 2002 Nov DISC >A> @ EQ 10MG BASE A 075577 001 Jan 29, 2002 Nov DISC >D> AB1 EQ 20MG BASE A 075577 002 Jan 29, 2002 Nov DISC >A> @ EQ 20MG BASE A 075577 002 Jan 29, 2002 Nov DISC TABLET;ORAL FLUOXETINE HYDROCHLORIDE >A> AB INVENTIA HLTHCARE EQ 60MG BASE A 209695 001 Nov 20, 2017 Nov NEWA

GANCICLOVIR SODIUM INJECTABLE;INJECTION GANCICLOVIR >A> AP MYLAN LABS LTD EQ 500MG BASE/ViAL A 204560 001 Nov 17, 2017 Nov NEWA GANCICLOVIR SODIUM >A> AP PHARMASCIENCE INC EQ 500MG BASE/VIAL A 207645 001 Dec 08, 2017 Nov NEWA

GEMCITABINE HYDROCHLORIDE INJECTABLE;INJECTION GEMCITABINE HYDROCHLORIDE >A> AP MYLAN LABS LTD 200MG/5.26ML (38MG/ML) A 205242 001 Dec 06, 2017 Nov NEWA >A> AP 1GM/26.3ML (38MG/ML) A 205242 002 Dec 06, 2017 Nov NEWA >A> AP 2GM/52.6ML (38MG/ML) A 205242 003 Dec 06, 2017 Nov NEWA >D> AP SAGENT PHARMS EQ 200MG BASE/VIAL A 091597 001 May 07, 2013 Nov DISC >A> @ EQ 200MG BASE/VIAL A 091597 001 May 07, 2013 Nov DISC >D> AP EQ 1GM BASE/VIAL A 091597 002 May 07, 2013 Nov DISC >A> @ EQ 1GM BASE/VIAL A 091597 002 May 07, 2013 Nov DISC

GLIMEPIRIDE TABLET;ORAL GLIMEPIRIDE >D> AB MICRO LABS LTD INDIA 1MG A 091220 001 Jun 29, 2012 Nov CAHN >D> AB 2MG A 091220 002 Jun 29, 2012 Nov CAHN >D> 3MG A 091220 003 Jun 29, 2012 Nov CAHN >D> AB 4MG A 091220 004 Jun 29, 2012 Nov CAHN >D> 6MG A 091220 005 Jun 29, 2012 Nov CAHN >D> AB 8MG A 091220 006 Jun 29, 2012 Nov CAHN >A> AB VIVA HLTHCARE 1MG A 091220 001 Jun 29, 2012 Nov CAHN >A> AB 2MG A 091220 002 Jun 29, 2012 Nov CAHN >A> 3MG A 091220 003 Jun 29, 2012 Nov CAHN >A> AB 4MG A 091220 004 Jun 29, 2012 Nov CAHN >A> 6MG A 091220 005 Jun 29, 2012 Nov CAHN >A> AB 8MG A 091220 006 Jun 29, 2012 Nov CAHN

GLIPIZIDE TABLET;ORAL GLIPIZIDE >D> AB MYLAN 5MG A 074438 001 Jun 20, 1995 Nov DISC >A> @ 5MG A 074438 001 Jun 20, 1995 Nov DISC >D> AB 10MG A 074438 002 Jun 20, 1995 Nov DISC >A> @ 10MG A 074438 002 Jun 20, 1995 Nov DISC

GLYCOPYRROLATE TABLET;ORAL GLYCOPYRROLATE >D> AA NEXGEN PHARMA 1.5MG A 091522 001 Mar 12, 2012 Nov CTEC >A> 1.5MG A 091522 001 Mar 12, 2012 Nov CTEC

Page 11 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

GUANFACINE HYDROCHLORIDE TABLET, EXTENDED RELEASE;ORAL GUANFACINE HYDROCHLORIDE >A> AB SUN PHARM INDS LTD EQ 1MG BASE A 205689 001 Nov 16, 2017 Nov NEWA >A> AB EQ 2MG BASE A 205689 002 Nov 16, 2017 Nov NEWA >A> AB EQ 3MG BASE A 205689 003 Nov 16, 2017 Nov NEWA >A> AB EQ 4MG BASE A 205689 004 Nov 16, 2017 Nov NEWA

HALOBETASOL PROPIONATE OINTMENT;TOPICAL HALOBETASOL PROPIONATE >D> @ G AND W LABS INC 0.05% A 077109 001 Jun 14, 2005 Nov CMFD >A> AB 0.05% A 077109 001 Jun 14, 2005 Nov CMFD

HEPARIN SODIUM INJECTABLE;INJECTION HEPARIN SODIUM >A> AP MYLAN LABS LTD 1,000 UNITS/ML A 203851 001 Nov 30, 2017 Nov NEWA >A> AP 5,000 UNITS/ML A 203851 002 Nov 30, 2017 Nov NEWA >A> AP 10,000 UNITS/ML A 203851 003 Nov 30, 2017 Nov NEWA >A> AP 20,000 UNITS/ML A 203852 001 Nov 30, 2017 Nov NEWA

HYDRALAZINE HYDROCHLORIDE TABLET;ORAL HYDRALAZINE HYDROCHLORIDE >D> AA MYLAN 10MG A 090413 001 Dec 08, 2010 Nov DISC >A> @ 10MG A 090413 001 Dec 08, 2010 Nov DISC >D> AA 25MG A 090413 002 Dec 08, 2010 Nov DISC >A> @ 25MG A 090413 002 Dec 08, 2010 Nov DISC >D> AA 50MG A 090413 003 Dec 08, 2010 Nov DISC >A> @ 50MG A 090413 003 Dec 08, 2010 Nov DISC >D> AA 100MG A 090413 004 Dec 08, 2010 Nov DISC >A> @ 100MG A 090413 004 Dec 08, 2010 Nov DISC

HYDROCHLOROTHIAZIDE TABLET;ORAL HYDROCHLOROTHIAZIDE >D> AB MYLAN PHARMS INC 12.5MG A 040770 001 Jan 23, 2007 Nov DISC >A> @ 12.5MG A 040770 001 Jan 23, 2007 Nov DISC

HYDROCORTISONE ACETATE CREAM;TOPICAL >D> MICORT-HC >D> ! SEBELA IRELAND LTD 2% A 040398 001 Mar 29, 2002 Nov DISC >A> @ 2% A 040398 001 Mar 29, 2002 Nov DISC

HYDROCORTISONE BUTYRATE CREAM;TOPICAL HYDROCORTISONE BUTYRATE >A> AB2 ACTAVIS MID ATLANTIC 0.1% A 205134 001 Dec 08, 2017 Nov NEWA LOTION;TOPICAL HYDROCORTISONE BUTYRATE >A> AB TELIGENT PHARMA INC 0.1% A 209556 001 Nov 21, 2017 Nov NEWA LOCOID >D> +! PRECISION DERMAT 0.1% N 022076 001 May 18, 2007 Nov CFTG >A> AB +! 0.1% N 022076 001 May 18, 2007 Nov CFTG

HYDROCORTISONE SODIUM SUCCINATE INJECTABLE;INJECTION SOLU-CORTEF >D> AP +! PHARMACIA AND UPJOHN EQ 250MG BASE/VIAL N 009866 002 Oct 04, 1962 Nov CTEC >A> +! EQ 250MG BASE/VIAL N 009866 002 Oct 04, 1962 Nov CTEC >D> AP +! EQ 500MG BASE/VIAL N 009866 003 Apr 27, 1958 Nov CTEC >A> +! EQ 500MG BASE/VIAL N 009866 003 Apr 27, 1958 Nov CTEC >D> AP +! EQ 1GM BASE/VIAL N 009866 004 Apr 27, 1958 Nov CTEC >A> +! EQ 1GM BASE/VIAL N 009866 004 Apr 27, 1958 Nov CTEC

Page 12 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

>D> HYDROFLUMETHIAZIDE >D> TABLET;ORAL >D> SALURON >D> +! SHIRE LLC 50MG N 011949 001 Jul 22, 1959 Nov DISC >A> + @ 50MG N 011949 001 Jul 22, 1959 Nov DISC

HYDROXYZINE HYDROCHLORIDE TABLET;ORAL HYDROXYZINE HYDROCHLORIDE >D> AB BAYSHORE PHARMS LLC 10MG A 207120 001 Mar 29, 2017 Nov CAHN >D> AB 50MG A 207122 001 Mar 29, 2017 Nov CAHN >A> AB NUVO PHARM 10MG A 207120 001 Mar 29, 2017 Nov CAHN >A> AB 50MG A 207122 001 Mar 29, 2017 Nov CAHN

IFOSFAMIDE INJECTABLE;INJECTION IFOSFAMIDE >D> AP WEST-WARD PHARMS INT 1GM/20ML(50MG/ML) A 076619 001 Jun 29, 2011 Nov CMS1 >A> AP 1GM/20ML (50MG/ML) A 076619 001 Jun 29, 2011 Nov CMS1 >D> AP 3GM/60ML(50MG/ML) A 076619 002 Jun 29, 2011 Nov CMS1 >A> AP 3GM/60ML (50MG/ML) A 076619 002 Jun 29, 2011 Nov CMS1

INDAPAMIDE TABLET;ORAL INDAPAMIDE >D> AB MYLAN PHARMS INC 1.25MG A 075105 001 Jul 23, 1998 Nov DISC >A> @ 1.25MG A 075105 001 Jul 23, 1998 Nov DISC >D> AB 2.5MG A 075105 002 Jul 23, 1998 Nov DISC >A> @ 2.5MG A 075105 002 Jul 23, 1998 Nov DISC

ISOSORBIDE MONONITRATE TABLET;ORAL MONOKET >D> AB + KREMERS URBAN PHARMS 10MG N 020215 002 Jun 30, 1993 Nov CAHN >D> AB +! 20MG N 020215 001 Jun 30, 1993 Nov CAHN >A> AB + LANNETT CO INC 10MG N 020215 002 Jun 30, 1993 Nov CAHN >A> AB +! 20MG N 020215 001 Jun 30, 1993 Nov CAHN

ISRADIPINE >D> TABLET, EXTENDED RELEASE;ORAL >D> ISRADIPINE >D> MYLAN PHARMS INC 5MG A 201067 001 Nov 27, 2015 Nov DISC >A> @ 5MG A 201067 001 Nov 27, 2015 Nov DISC >D> 10MG A 201067 002 Nov 27, 2015 Nov DISC >A> @ 10MG A 201067 002 Nov 27, 2015 Nov DISC

>A> LATANOPROSTENE BUNOD >A> SOLUTION/DROPS;OPHTHALMIC >A> VYZULTA >A> +! BAUSCH AND LOMB 0.024% N 207795 001 Nov 02, 2017 Nov NEWA

>A> LETERMOVIR >A> SOLUTION;IV (INFUSION) >A> PREVYMIS >A> +! MERCK SHARP DOHME 240MG/12ML (20MG/ML) N 209940 001 Nov 08, 2017 Nov NEWA >A> +! 480MG/24ML (20MG/ML) N 209940 002 Nov 08, 2017 Nov NEWA >A> TABLET;ORAL >A> PREVYMIS >A> + MERCK SHARP DOHME 240MG N 209939 001 Nov 08, 2017 Nov NEWA >A> +! 480MG N 209939 002 Nov 08, 2017 Nov NEWA

LEVETIRACETAM TABLET, FOR SUSPENSION;ORAL SPRITAM >A> + APRECIA PHARMS 250MG N 207958 001 Jul 31, 2015 Nov CAHN >A> + 500MG N 207958 002 Jul 31, 2015 Nov CAHN >A> + 750MG N 207958 003 Jul 31, 2015 Nov CAHN >A> +! 1GM N 207958 004 Jul 31, 2015 Nov CAHN >D> + APRECIA PHARMS CO 250MG N 207958 001 Jul 31, 2015 Nov CAHN >D> + 500MG N 207958 002 Jul 31, 2015 Nov CAHN >D> + 750MG N 207958 003 Jul 31, 2015 Nov CAHN

Page 13 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

LEVETIRACETAM TABLET, FOR SUSPENSION;ORAL SPRITAM >D> +! 1GM N 207958 004 Jul 31, 2015 Nov CAHN

LEVOCETIRIZINE DIHYDROCHLORIDE SOLUTION;ORAL LEVOCETIRIZINE DIHYDROCHLORIDE >D> AA SILARX PHARMS INC 2.5MG/ML A 204599 001 May 15, 2017 Nov CPOT >A> AA 2.5MG/5ML A 204599 001 May 15, 2017 Nov CPOT TABLET;ORAL LEVOCETIRIZINE DIHYDROCHLORIDE >D> AB ALLIED PHARMA INC 5MG A 202046 001 Sep 17, 2013 Nov CAHN >A> AB MICRO LABS LTD INDIA 5MG A 202046 001 Sep 17, 2013 Nov CAHN

LEVOFLOXACIN INJECTABLE;INJECTION LEVOFLOXACIN IN DEXTROSE 5% IN PLASTIC CONTAINER >D> AP HIKMA FARMACEUTICA EQ 500MG/100ML (EQ5MG/ML) A 091375 002 Sep 16, 2011 Nov CMS1 >A> AP EQ 500MG/100ML (EQ 5MG/ML) A 091375 002 Sep 16, 2011 Nov CMS1 SOLUTION/DROPS;OPHTHALMIC LEVOFLOXACIN >A> AT MYLAN LABS LTD 0.5% A 204899 001 Dec 08, 2017 Nov NEWA

LEVONORGESTREL TABLET;ORAL LEVONORGESTREL >A> @ FDN CONSUMER 0.75MG A 078665 001 Aug 28, 2009 Nov CAHN >D> @ WATSON LABS 0.75MG A 078665 001 Aug 28, 2009 Nov CAHN PLAN B >A> + @ FDN CONSUMER 0.75MG N 021045 001 Jul 28, 1999 Nov CAHN >A> + @ 0.75MG N 021045 002 Aug 24, 2006 Nov CAHN >D> + @ TEVA BRANDED PHARM 0.75MG N 021045 001 Jul 28, 1999 Nov CAHN >D> + @ 0.75MG N 021045 002 Aug 24, 2006 Nov CAHN

LIDOCAINE HYDROCHLORIDE INJECTABLE;INJECTION LIDOCAINE HYDROCHLORIDE >D> AP MYLAN LABS LTD 0.5% A 091056 001 Dec 08, 2010 Nov DISC >A> @ 0.5% A 091056 001 Dec 08, 2010 Nov DISC >D> AP 0.5% A 091058 001 Sep 30, 2010 Nov DISC >A> @ 0.5% A 091058 001 Sep 30, 2010 Nov DISC >D> AP 1% A 091056 002 Dec 08, 2010 Nov DISC >A> @ 1% A 091056 002 Dec 08, 2010 Nov DISC >D> AP 1% A 091058 002 Sep 30, 2010 Nov DISC >A> @ 1% A 091058 002 Sep 30, 2010 Nov DISC >D> AP 2% A 202242 001 Apr 11, 2014 Nov DISC >A> @ 2% A 202242 001 Apr 11, 2014 Nov DISC LIDOCAINE HYDROCHLORIDE PRESERVATIVE FREE >D> AP MYLAN LABS LTD 2% A 090665 001 Sep 27, 2010 Nov DISC >A> @ 2% A 090665 001 Sep 27, 2010 Nov DISC

LINEZOLID SOLUTION;IV (INFUSION) LINEZOLID >A> AP MYLAN LABS LTD 200MG/100ML (2MG/ML) A 205154 001 Dec 06, 2017 Nov NEWA >A> AP 600MG/300ML (2MG/ML) A 205154 002 Dec 06, 2017 Nov NEWA

LORAZEPAM TABLET;ORAL LORAZEPAM >D> AB MYLAN 2MG A 071591 001 Oct 13, 1987 Nov DISC >A> @ 2MG A 071591 001 Oct 13, 1987 Nov DISC >D> AB SANDOZ 0.5 A 071141 002 Apr 21, 1987 Nov CMS1 >A> AB 0.5MG A 071141 002 Apr 21, 1987 Nov CMS1

Page 14 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

MAGNESIUM SULFATE INJECTABLE;INJECTION MAGNESIUM SULFATE IN PLASTIC CONTAINER >D> AP + HOSPIRA 40GM/1000ML(40MG/ML) N 020309 005 Jan 18, 1995 Nov CMS1 >A> AP + 40GM/1000ML (40MG/ML) N 020309 005 Jan 18, 1995 Nov CMS1 >A> AP HQ SPCLT PHARMA 2GM/50ML (40MG/ML) A 207350 001 Dec 06, 2017 Nov NEWA >A> AP 4GM/100ML (40MG/ML) A 207350 002 Dec 06, 2017 Nov NEWA >A> AP 4GM/50ML (80MG/ML) A 207350 003 Dec 06, 2017 Nov NEWA >A> AP 20GM/500ML (40MG/ML) A 207350 004 Dec 06, 2017 Nov NEWA >A> AP 40GM/1000ML (40MG/ML) A 207350 005 Dec 06, 2017 Nov NEWA

MANGAFODIPIR TRISODIUM INJECTABLE;INJECTION TESLASCAN >D> @ GE HEALTHCARE 37.9MG/ML N 020652 001 Nov 26, 1997 Nov CAHN >A> @ IC TARGETS 37.9MG/ML N 020652 001 Nov 26, 1997 Nov CAHN

MEDROXYPROGESTERONE ACETATE INJECTABLE;INJECTION MEDROXYPROGESTERONE ACETATE >A> AB AMPHASTAR PHARMS INC 150MG/ML A 077235 001 Nov 28, 2017 Nov NEWA >A> AB 150MG/ML A 077334 001 Nov 28, 2017 Nov NEWA

MEGESTROL ACETATE SUSPENSION;ORAL MEGESTROL ACETATE >A> AB BRECKENRIDGE PHARM 125MG/ML A 204688 001 Dec 01, 2017 Nov NEWA

MELOXICAM TABLET;ORAL MELOXICAM >D> @ COREPHARMA 7.5MG A 077930 001 Jul 19, 2006 Nov CAHN >D> @ 15MG A 077930 002 Jul 19, 2006 Nov CAHN >A> @ IMPAX LABS INC 7.5MG A 077930 001 Jul 19, 2006 Nov CAHN >A> @ 15MG A 077930 002 Jul 19, 2006 Nov CAHN

MELPHALAN HYDROCHLORIDE INJECTABLE;INJECTION MELPHALAN HYDROCHLORIDE >A> AP + DR REDDYS LABS LTD EQ 50MG BASE/VIAL A 203655 001 Dec 08, 2017 Nov NEWA

METFORMIN HYDROCHLORIDE TABLET, EXTENDED RELEASE;ORAL METFORMIN HYDROCHLORIDE >D> AB1 MYLAN 500MG A 076650 001 Sep 13, 2005 Nov DISC >A> @ 500MG A 076650 001 Sep 13, 2005 Nov DISC

METHOCARBAMOL SOLUTION;IM-IV METHOCARBAMOL >A> AP NAVINTA LLC 1GM/10ML (100MG/ML) A 206071 001 Nov 24, 2017 Nov NEWA

METHOTREXATE SOLUTION;SUBCUTANEOUS >D> OTREXUP PFS >D> + ANTARES PHARMA INC 10MG/0.4ML (10MG/0.4ML) N 204824 009 May 31, 2017 Nov DISC >A> + @ 10MG/0.4ML (10MG/0.4ML) N 204824 009 May 31, 2017 Nov DISC >D> + 15MG/0.6ML (15MG/0.6ML) N 204824 010 May 31, 2017 Nov DISC >A> + @ 15MG/0.6ML (15MG/0.6ML) N 204824 010 May 31, 2017 Nov DISC >D> + 17.5MG/0.7ML (17.5MG/0.7ML) N 204824 011 May 31, 2017 Nov DISC >A> + @ 17.5MG/0.7ML (17.5MG/0.7ML) N 204824 011 May 31, 2017 Nov DISC >D> + 20MG/0.8ML (20MG/0.8ML) N 204824 012 May 31, 2017 Nov DISC >A> + @ 20MG/0.8ML (20MG/0.8ML) N 204824 012 May 31, 2017 Nov DISC >D> + 22.5MG/0.9ML (22.5MG/0.9ML) N 204824 013 May 31, 2017 Nov DISC >A> + @ 22.5MG/0.9ML (22.5MG/0.9ML) N 204824 013 May 31, 2017 Nov DISC >D> + 25MG/ML (25MG/ML) N 204824 014 May 31, 2017 Nov DISC >A> + @ 25MG/ML (25MG/ML) N 204824 014 May 31, 2017 Nov DISC

Page 15 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

METHYLPREDNISOLONE TABLET;ORAL MEDROL >D> AB + PHARMACIA AND UPJOHN 2MG N 011153 002 Mar 03, 1958 Nov CTEC >A> + 2MG N 011153 002 Mar 03, 1958 Nov CTEC

METRONIDAZOLE TABLET;ORAL METRONIDAZOLE >A> AB CADILA PHARMS LTD 250MG A 209794 001 Dec 12, 2017 Nov NEWA >A> AB 500MG A 209794 002 Dec 12, 2017 Nov NEWA

MINOCYCLINE HYDROCHLORIDE CAPSULE;ORAL MINOCIN >D> AB PRECISION DERMAT EQ 50MG BASE N 050649 001 May 31, 1990 Nov CRLD >A> AB + EQ 50MG BASE N 050649 001 May 31, 1990 Nov CRLD >D> AB EQ 100MG BASE N 050649 002 May 31, 1990 Nov CRLD >A> AB + EQ 100MG BASE N 050649 002 May 31, 1990 Nov CRLD

MIRTAZAPINE TABLET;ORAL MIRTAZAPINE >D> AB MYLAN PHARMS INC 15MG A 076176 001 Jun 19, 2003 Nov DISC >A> @ 15MG A 076176 001 Jun 19, 2003 Nov DISC >D> AB 30MG A 076176 002 Jun 19, 2003 Nov DISC >A> @ 30MG A 076176 002 Jun 19, 2003 Nov DISC >D> AB 45MG A 076176 003 Jun 19, 2003 Nov DISC >A> @ 45MG A 076176 003 Jun 19, 2003 Nov DISC

MYCOPHENOLATE MOFETIL TABLET;ORAL MYCOPHENOLATE MOFETIL >A> AB ZHEJIANG HISUN PHARM 500MG A 204076 001 Nov 16, 2017 Nov NEWA

NADOLOL TABLET;ORAL NADOLOL >A> AB AUROBINDO PHARMA LTD 40MG A 201893 001 Sep 16, 2015 Nov CAHN >A> AB 80MG A 201893 002 Sep 16, 2015 Nov CAHN >D> AB ORION CORP ORION 40MG A 201893 001 Sep 16, 2015 Nov CAHN >D> AB 80MG A 201893 002 Sep 16, 2015 Nov CAHN

NALMEFENE HYDROCHLORIDE INJECTABLE;INJECTION REVEX >D> @ EUROHLTH INTL SARL EQ 0.1MG BASE/ML N 020459 001 Apr 17, 1995 Nov CRLD >A> + @ EQ 0.1MG BASE/ML N 020459 001 Apr 17, 1995 Nov CRLD >D> @ EQ 1MG BASE/ML N 020459 002 Apr 17, 1995 Nov CRLD >A> + @ EQ 1MG BASE/ML N 020459 002 Apr 17, 1995 Nov CRLD

NALOXONE HYDROCHLORIDE INJECTABLE;INJECTION NALOXONE HYDROCHLORIDE >D> AP ! INTL MEDICATION 1MG/ML A 072076 001 Mar 24, 1988 Nov CTEC >A> ! 1MG/ML A 072076 001 Mar 24, 1988 Nov CTEC

NEFAZODONE HYDROCHLORIDE TABLET;ORAL NEFAZODONE HYDROCHLORIDE >D> BX DR REDDYS LABS INC 50MG A 076309 001 Sep 16, 2003 Nov DISC >A> @ 50MG A 076309 001 Sep 16, 2003 Nov DISC >D> BX 100MG A 076309 002 Sep 16, 2003 Nov DISC >A> @ 100MG A 076309 002 Sep 16, 2003 Nov DISC >D> BX 150MG A 076309 003 Sep 16, 2003 Nov DISC >A> @ 150MG A 076309 003 Sep 16, 2003 Nov DISC >D> BX 200MG A 076309 004 Sep 16, 2003 Nov DISC >A> @ 200MG A 076309 004 Sep 16, 2003 Nov DISC >D> BX 250MG A 076309 005 Sep 16, 2003 Nov DISC >A> @ 250MG A 076309 005 Sep 16, 2003 Nov DISC

Page 16 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

NEFAZODONE HYDROCHLORIDE TABLET;ORAL NEFAZODONE HYDROCHLORIDE >D> AB TEVA 50MG A 076037 001 Sep 16, 2003 Nov CTEC >A> 50MG A 076037 001 Sep 16, 2003 Nov CTEC >D> AB 100MG A 076037 002 Sep 16, 2003 Nov CTEC >A> 100MG A 076037 002 Sep 16, 2003 Nov CTEC >D> AB 150MG A 076037 003 Sep 16, 2003 Nov CTEC >A> 150MG A 076037 003 Sep 16, 2003 Nov CTEC >D> AB 200MG A 076037 004 Sep 16, 2003 Nov CTEC >A> 200MG A 076037 004 Sep 16, 2003 Nov CTEC >D> AB ! 250MG A 076037 005 Sep 16, 2003 Nov CTEC >A> ! 250MG A 076037 005 Sep 16, 2003 Nov CTEC

NITROFURANTOIN, MACROCRYSTALLINE CAPSULE;ORAL NITROFURANTOIN >A> AB ZYDUS PHARMS USA INC 50MG A 205005 001 Dec 12, 2017 Nov NEWA >A> AB 100MG A 205005 002 Dec 12, 2017 Nov NEWA

OLOPATADINE HYDROCHLORIDE SOLUTION/DROPS;OPHTHALMIC OLOPATADINE HYDROCHLORIDE >A> AT AKORN EQ 0.2% BASE A 204723 001 Dec 05, 2017 Nov NEWA >A> AT APOTEX INC EQ 0.2% BASE A 090918 001 Dec 05, 2017 Nov NEWA >A> AT CIPLA LTD EQ 0.2% BASE A 206087 001 Dec 05, 2017 Nov NEWA

ONDANSETRON HYDROCHLORIDE INJECTABLE;INJECTION ONDANSETRON HYDROCHLORIDE >D> AP MYLAN LABS LTD EQ 2MG BASE/ML A 078257 001 Apr 23, 2008 Nov DISC >A> @ EQ 2MG BASE/ML A 078257 001 Apr 23, 2008 Nov DISC ONDANSETRON HYDROCHLORIDE PRESERVATIVE FREE >D> AP MYLAN LABS LTD EQ 2MG BASE/ML A 078244 001 Apr 23, 2008 Nov DISC >A> @ EQ 2MG BASE/ML A 078244 001 Apr 23, 2008 Nov DISC

OXACILLIN SODIUM INJECTABLE;INJECTION OXACILLIN SODIUM >A> AP WOCKHARDT BIO AG EQ 10GM BASE/VIAL A 207148 001 Nov 24, 2017 Nov NEWA

PALONOSETRON HYDROCHLORIDE SOLUTION;INTRAVENOUS >A> PALONOSETRON HYDROCHLORIDE >A> + FRESENIUS KABI USA EQ 0.25MG BASE/5ML (EQ 0.05MG N 208109 001 Nov 21, 2017 Nov NEWA BASE/ML)

PAMIDRONATE DISODIUM INJECTABLE;INJECTION PAMIDRONATE DISODIUM >D> AP AREVA PHARMS 60MG/VIAL A 077433 002 Nov 26, 2008 Nov CTEC >A> 60MG/VIAL A 077433 002 Nov 26, 2008 Nov CTEC

PANCURONIUM BROMIDE INJECTABLE;INJECTION PANCURONIUM BROMIDE >D> AP ! TEVA PHARMS USA 2MG/ML A 072760 001 Jul 31, 1990 Nov CTEC >A> ! 2MG/ML A 072760 001 Jul 31, 1990 Nov CTEC

PENTOBARBITAL SODIUM INJECTABLE;INJECTION PENTOBARBITAL SODIUM >A> AP RENAISSANCE SSA LLC 50MG/ML A 206677 001 Nov 27, 2017 Nov NEWA

PHENTERMINE HYDROCHLORIDE TABLET;ORAL LOMAIRA >D> ! AVANTHI INC 8MG A 203495 001 Sep 12, 2016 Nov CTEC >A> AA ! 8MG A 203495 001 Sep 12, 2016 Nov CTEC

Page 17 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

PHENYTOIN SODIUM CAPSULE;ORAL DILANTIN >D> AB ! PARKE-DAVIS 30MG EXTENDED A 084349 001 Aug 27, 1976 Nov CTEC >A> ! 30MG EXTENDED A 084349 001 Aug 27, 1976 Nov CTEC

POTASSIUM CHLORIDE CAPSULE, EXTENDED RELEASE;ORAL MICRO-K >D> AB NESHER PHARMS 8MEQ N 018238 001 Oct 17, 1980 Nov CRLD >A> AB + 8MEQ N 018238 001 Oct 17, 1980 Nov CRLD MICRO-K 10 >D> AB NESHER PHARMS 10MEQ N 018238 002 May 14, 1984 Nov CRLD >A> AB + 10MEQ N 018238 002 May 14, 1984 Nov CRLD

PRAMIPEXOLE DIHYDROCHLORIDE TABLET, EXTENDED RELEASE;ORAL PRAMIPEXOLE DIHYDROCHLORIDE >A> AB ZYDUS PHARMS USA INC 0.375MG A 202891 001 Dec 12, 2017 Nov NEWA >A> AB 0.75MG A 202891 002 Dec 12, 2017 Nov NEWA >A> AB 1.5MG A 202891 003 Dec 12, 2017 Nov NEWA >A> AB 2.25MG A 202891 004 Dec 12, 2017 Nov NEWA >A> AB 3MG A 202891 005 Dec 12, 2017 Nov NEWA >A> AB 3.75MG A 202891 006 Dec 12, 2017 Nov NEWA >A> AB 4.5MG A 202891 007 Dec 12, 2017 Nov NEWA

PRAZIQUANTEL TABLET;ORAL BILTRICIDE >D> +! BAYER HLTHCARE 600MG N 018714 001 Dec 29, 1982 Nov CFTG >A> AB +! 600MG N 018714 001 Dec 29, 1982 Nov CFTG >A> PRAZIQUANTEL >A> AB PAR PHARM INC 600MG A 208820 001 Nov 27, 2017 Nov NEWA

PROMETHAZINE HYDROCHLORIDE TABLET;ORAL PROMETHAZINE HYDROCHLORIDE >D> AB MYLAN 12.5MG A 091054 001 Aug 30, 2011 Nov DISC >A> @ 12.5MG A 091054 001 Aug 30, 2011 Nov DISC >D> AB 25MG A 091054 002 Aug 30, 2011 Nov DISC >A> @ 25MG A 091054 002 Aug 30, 2011 Nov DISC >D> AB 50MG A 091054 003 Aug 30, 2011 Nov DISC >A> @ 50MG A 091054 003 Aug 30, 2011 Nov DISC

PROPAFENONE HYDROCHLORIDE TABLET;ORAL PROPAFENONE HYDROCHLORIDE >A> AB AUROBINDO PHARMA LTD 150MG A 202445 001 May 11, 2016 Nov CAHN >A> AB 225MG A 202445 002 May 11, 2016 Nov CAHN >A> AB 300MG A 202445 003 May 11, 2016 Nov CAHN >D> AB ORION CORP ORION 150MG A 202445 001 May 11, 2016 Nov CAHN >D> AB 225MG A 202445 002 May 11, 2016 Nov CAHN >D> AB 300MG A 202445 003 May 11, 2016 Nov CAHN

QUETIAPINE FUMARATE TABLET, EXTENDED RELEASE;ORAL QUETIAPINE FUMARATE >A> AB ACCORD HLTHCARE EQ 50MG BASE A 206252 001 Nov 29, 2017 Nov NEWA >A> AB ANCHEN PHARMS EQ 150MG BASE A 090757 001 Dec 01, 2017 Nov NEWA >A> AB EQ 200MG BASE A 090757 002 Dec 01, 2017 Nov NEWA >A> AB EQ 300MG BASE A 090757 003 Dec 01, 2017 Nov NEWA >A> AB EQ 400MG BASE A 090757 004 Dec 01, 2017 Nov NEWA >A> AB AUROBINDO PHARMA LTD EQ 50MG BASE A 207655 001 Nov 29, 2017 Nov NEWA >A> AB EQ 150MG BASE A 207655 002 Nov 29, 2017 Nov NEWA >A> AB EQ 200MG BASE A 207655 003 Nov 29, 2017 Nov NEWA >A> AB EQ 300MG BASE A 207655 004 Nov 29, 2017 Nov NEWA >A> AB EQ 400MG BASE A 207655 005 Nov 29, 2017 Nov NEWA >A> AB MACLEODS PHARMS LTD EQ 150MG BASE A 204253 001 Nov 29, 2017 Nov NEWA >A> AB EQ 200MG BASE A 204253 002 Nov 29, 2017 Nov NEWA >A> AB EQ 300MG BASE A 204253 003 Nov 29, 2017 Nov NEWA

Page 18 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

QUETIAPINE FUMARATE TABLET, EXTENDED RELEASE;ORAL QUETIAPINE FUMARATE >A> AB EQ 400MG BASE A 204253 004 Nov 29, 2017 Nov NEWA >A> AB NOVAST LABS LTD EQ 50MG BASE A 208947 001 Nov 29, 2017 Nov NEWA >A> AB EQ 150MG BASE A 208947 002 Nov 29, 2017 Nov NEWA >A> AB EQ 200MG BASE A 208947 003 Nov 29, 2017 Nov NEWA >A> AB EQ 300MG BASE A 208947 004 Nov 29, 2017 Nov NEWA >A> AB EQ 400MG BASE A 208947 005 Nov 29, 2017 Nov NEWA >A> AB SCIEGEN PHARMS INC EQ 150MG BASE A 209635 001 Nov 29, 2017 Nov NEWA >A> AB EQ 200MG BASE A 209635 002 Nov 29, 2017 Nov NEWA >A> AB EQ 300MG BASE A 209635 003 Nov 29, 2017 Nov NEWA >A> AB EQ 400MG BASE A 209635 004 Nov 29, 2017 Nov NEWA

QUINIDINE GLUCONATE >D> INJECTABLE;INJECTION >D> QUINIDINE GLUCONATE >D> +! LILLY 80MG/ML N 007529 002 Feb 10, 1989 Nov DISC >A> + @ 80MG/ML N 007529 002 Feb 10, 1989 Nov DISC

RANITIDINE HYDROCHLORIDE TABLET;ORAL RANITIDINE HYDROCHLORIDE >A> AB ACIC PHARMS EQ 150MG BASE A 203694 001 Nov 30, 2017 Nov NEWA >A> AB EQ 300MG BASE A 203694 002 Nov 30, 2017 Nov NEWA

ROSUVASTATIN CALCIUM TABLET;ORAL ROSUVASTATIN CALCIUM >A> AB MSN LABS PVT LTD 5MG A 208898 001 Nov 22, 2017 Nov NEWA >A> AB 10MG A 208898 002 Nov 22, 2017 Nov NEWA >A> AB 20MG A 208898 003 Nov 22, 2017 Nov NEWA >A> AB 40MG A 208898 004 Nov 22, 2017 Nov NEWA

SEVELAMER CARBONATE TABLET;ORAL SEVELAMER CARBONATE >A> AB AMNEAL PHARMS CO 800MG A 207288 001 Nov 28, 2017 Nov NEWA

SILDENAFIL CITRATE TABLET;ORAL SILDENAFIL CITRATE >D> @ TEVA EQ 25MG BASE A 077342 001 Mar 09, 2016 Nov CMFD >A> AB EQ 25MG BASE A 077342 001 Mar 09, 2016 Nov CMFD >D> @ EQ 50MG BASE A 077342 002 Mar 09, 2016 Nov CMFD >A> AB EQ 50MG BASE A 077342 002 Mar 09, 2016 Nov CMFD >D> @ EQ 100MG BASE A 077342 003 Mar 09, 2016 Nov CMFD >A> AB EQ 100MG BASE A 077342 003 Mar 09, 2016 Nov CMFD VIAGRA >D> + PFIZER INC EQ 25MG BASE N 020895 001 Mar 27, 1998 Nov CTEC >A> AB + EQ 25MG BASE N 020895 001 Mar 27, 1998 Nov CTEC >D> + EQ 50MG BASE N 020895 002 Mar 27, 1998 Nov CTEC >A> AB + EQ 50MG BASE N 020895 002 Mar 27, 1998 Nov CTEC >D> +! EQ 100MG BASE N 020895 003 Mar 27, 1998 Nov CTEC >A> AB +! EQ 100MG BASE N 020895 003 Mar 27, 1998 Nov CTEC

SODIUM ACETATE INJECTABLE;INJECTION >A> SODIUM ACETATE >A> +! HOSPIRA 2MEQ/ML N 018893 001 May 04, 1983 Nov CTNA

SODIUM ACETATE ANHYDROUS INJECTABLE;INJECTION >D> SODIUM ACETATE IN PLASTIC CONTAINER >D> +! HOSPIRA 2MEQ/ML N 018893 001 May 04, 1983 Nov CTNA

Page 19 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

SODIUM NITROPRUSSIDE INJECTABLE;INJECTION SODIUM NITROPRUSSIDE >A> AP MICRO LABS 25MG/ML A 209352 001 Dec 08, 2017 Nov NEWA

SOMATROPIN RECOMBINANT INJECTABLE;INJECTION SEROSTIM >D> BX EMD SERONO 4MG/VIAL N 020604 003 Jul 25, 1997 Nov CTEC >A> 4MG/VIAL N 020604 003 Jul 25, 1997 Nov CTEC ZOMACTON >D> BX + FERRING 10MG/VIAL N 019774 003 Mar 07, 2012 Nov CTEC >A> + 10MG/VIAL N 019774 003 Mar 07, 2012 Nov CTEC

SPIRONOLACTONE TABLET;ORAL SPIRONOLACTONE >A> AB AUROBINDO PHARMA LTD 25MG A 202187 001 Mar 06, 2014 Nov CAHN >A> AB 50MG A 202187 002 Mar 06, 2014 Nov CAHN >A> AB 100MG A 202187 003 Mar 06, 2014 Nov CAHN >D> AB ORION CORP ORION 25MG A 202187 001 Mar 06, 2014 Nov CAHN >D> AB 50MG A 202187 002 Mar 06, 2014 Nov CAHN >D> AB 100MG A 202187 003 Mar 06, 2014 Nov CAHN

STERILE WATER FOR INJECTION LIQUID;N/A STERILE WATER FOR INJECTION >A> AP FRESENIUS KABI USA 100% A 209689 001 Nov 24, 2017 Nov NEWA

SUMATRIPTAN SUCCINATE INJECTABLE;SUBCUTANEOUS SUMATRIPTAN SUCCINATE >A> AP SAGENT AGILA LLC EQ 6MG BASE/0.5ML (EQ 12MG A 090314 001 Jun 10, 2010 Nov CAHN BASE/ML) >D> AP SAGENT STRIDES EQ 6MG BASE/0.5ML (EQ 12MG A 090314 001 Jun 10, 2010 Nov CAHN BASE/ML)

TACROLIMUS CAPSULE;ORAL TACROLIMUS >A> AB BELCHER PHARMS LLC EQ 0.5MG BASE A 206651 001 Nov 30, 2017 Nov NEWA >A> AB EQ 1MG BASE A 206651 002 Nov 30, 2017 Nov NEWA >A> AB EQ 5MG BASE A 206651 003 Nov 30, 2017 Nov NEWA

TECHNETIUM TC-99M ALBUMIN AGGREGATED KIT INJECTABLE;INJECTION PULMOLITE >D> BS JUBILANT DRAXIMAGE N/A N 017776 001 Nov 16, 1976 Nov CRLD >A> BS +! N/A N 017776 001 Nov 16, 1976 Nov CRLD TECHNETIUM TC 99M ALBUMIN AGGREGATED KIT >D> BS DRAXIMAGE N/A N 017881 001 Dec 30, 1987 Nov CRLD >A> BS +! N/A N 017881 001 Dec 30, 1987 Nov CRLD

TECHNETIUM TC-99M BICISATE KIT INJECTABLE;INJECTION NEUROLITE >D> LANTHEUS MEDCL N/A N 020256 001 Nov 23, 1994 Nov CRLD >A> +! N/A N 020256 001 Nov 23, 1994 Nov CRLD

TECHNETIUM TC-99M PENTETATE KIT INJECTABLE;INJECTION DTPA >D> DRAXIMAGE N/A N 018511 001 Dec 29, 1989 Nov CRLD >A> +! N/A N 018511 001 Dec 29, 1989 Nov CRLD

TECHNETIUM TC-99M RED BLOOD CELL KIT INJECTABLE;INJECTION ULTRATAG >D> MALLINKRODT NUCLEAR N/A N 019981 001 Jun 10, 1991 Nov CRLD >A> +! N/A N 019981 001 Jun 10, 1991 Nov CRLD

Page 20 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

THEOPHYLLINE INJECTABLE;INJECTION THEOPHYLLINE 0.08% AND DEXTROSE 5% IN PLASTIC CONTAINER >D> AP +! B BRAUN 80MG/100ML N 019826 002 Aug 14, 1992 Nov CTEC >A> +! 80MG/100ML N 019826 002 Aug 14, 1992 Nov CTEC THEOPHYLLINE IN DEXTROSE 5% IN PLASTIC CONTAINER >D> AP +! HOSPIRA INC 4MG/ML N 019211 007 Dec 14, 1984 Nov CTEC >A> +! 4MG/ML N 019211 007 Dec 14, 1984 Nov CTEC

THIAMINE HYDROCHLORIDE INJECTABLE;INJECTION THIAMINE HYDROCHLORIDE >A> AP SAGENT PHARMS 100MG/ML A 206106 001 Dec 01, 2017 Nov NEWA

TIAGABINE HYDROCHLORIDE TABLET;ORAL TIAGABINE HYDROCHLORIDE >A> AB AMNEAL PHARMS CO 2MG A 208181 001 Dec 08, 2017 Nov NEWA >A> AB 4MG A 208181 002 Dec 08, 2017 Nov NEWA >A> AB 12MG A 208181 003 Dec 08, 2017 Nov NEWA >A> AB 16MG A 208181 004 Dec 08, 2017 Nov NEWA

TIZANIDINE HYDROCHLORIDE CAPSULE;ORAL ZANAFLEX >D> AB + ACORDA EQ 2MG BASE N 021447 001 Aug 29, 2002 Nov CAHN >D> AB + EQ 4MG BASE N 021447 002 Aug 29, 2002 Nov CAHN >D> AB +! EQ 6MG BASE N 021447 003 Aug 29, 2002 Nov CAHN >A> AB + COVIS PHARMA BV EQ 2MG BASE N 021447 001 Aug 29, 2002 Nov CAHN >A> AB + EQ 4MG BASE N 021447 002 Aug 29, 2002 Nov CAHN >A> AB +! EQ 6MG BASE N 021447 003 Aug 29, 2002 Nov CAHN TABLET;ORAL ZANAFLEX >D> + @ ACORDA EQ 2MG BASE N 020397 002 Feb 04, 2000 Nov CAHN >D> AB +! EQ 4MG BASE N 020397 001 Nov 27, 1996 Nov CAHN >A> + @ COVIS PHARMA BV EQ 2MG BASE N 020397 002 Feb 04, 2000 Nov CAHN >A> AB +! EQ 4MG BASE N 020397 001 Nov 27, 1996 Nov CAHN

TOLMETIN SODIUM TABLET;ORAL TOLMETIN SODIUM >D> AB ! MYLAN EQ 600MG BASE A 074473 001 Aug 30, 1994 Nov CTEC >A> ! EQ 600MG BASE A 074473 001 Aug 30, 1994 Nov CTEC

TOLTERODINE TARTRATE CAPSULE, EXTENDED RELEASE;ORAL TOLTERODINE TARTRATE >A> AB HETERO LABS LTD III 2MG A 206419 001 Dec 12, 2017 Nov NEWA >A> AB 4MG A 206419 002 Dec 12, 2017 Nov NEWA

TOPIRAMATE CAPSULE, EXTENDED RELEASE;ORAL >A> TOPIRAMATE >A> AB ZYDUS PHARMS USA INC 25MG A 207382 001 Nov 24, 2017 Nov NEWA >A> AB 50MG A 207382 002 Nov 24, 2017 Nov NEWA >A> AB 100MG A 207382 003 Nov 24, 2017 Nov NEWA TROKENDI XR >D> + SUPERNUS PHARMS 25MG N 201635 001 Aug 16, 2013 Nov CFTG >A> AB + 25MG N 201635 001 Aug 16, 2013 Nov CFTG >D> + 50MG N 201635 002 Aug 16, 2013 Nov CFTG >A> AB + 50MG N 201635 002 Aug 16, 2013 Nov CFTG >D> + 100MG N 201635 003 Aug 16, 2013 Nov CFTG >A> AB + 100MG N 201635 003 Aug 16, 2013 Nov CFTG CAPSULE;ORAL TOPIRAMATE >D> AB MYLAN 15MG A 078418 001 Oct 14, 2009 Nov DISC >A> @ 15MG A 078418 001 Oct 14, 2009 Nov DISC >D> AB 25MG A 078418 002 Oct 14, 2009 Nov DISC >A> @ 25MG A 078418 002 Oct 14, 2009 Nov DISC

Page 21 of 23 ADDITIONS/DELETIONS FOR PRESCRIPTION DRUG PRODUCT LIST

TOPOTECAN HYDROCHLORIDE SOLUTION;INTRAVENOUS TOPOTECAN HYDROCHLORIDE >D> AP ACCORD HLTHCARE EQ 1MG BASE/ML (EQ 1MG BASE/ML) A 204406 001 Jul 06, 2017 Nov CTEC >A> EQ 1MG BASE/ML (EQ 1MG BASE/ML) A 204406 001 Jul 06, 2017 Nov CTEC >A> AP MYLAN LABS LTD EQ 4MG BASE/4ML (EQ 1MG A 206074 001 Nov 24, 2017 Nov NEWA BASE/ML)

TRAMADOL HYDROCHLORIDE TABLET;ORAL TRAMADOL HYDROCHLORIDE >D> AB MYLAN PHARMS INC 50MG A 075980 001 Nov 21, 2002 Nov DISC >A> @ 50MG A 075980 001 Nov 21, 2002 Nov DISC

TRANEXAMIC ACID TABLET;ORAL LYSTEDA >D> AB +! FERRING PHARMS AS 650MG N 022430 001 Nov 13, 2009 Nov CAHN >A> AB +! FERRING PHARMS INC 650MG N 022430 001 Nov 13, 2009 Nov CAHN

TREPROSTINIL INJECTABLE;IV (INFUSION), SUBCUTANEOUS REMODULIN >D> + UNITED THERAP 1MG/ML N 021272 001 May 21, 2002 Nov CFTG >A> AP +! 1MG/ML N 021272 001 May 21, 2002 Nov CFTG >D> + 2.5MG/ML N 021272 002 May 21, 2002 Nov CFTG >A> AP +! 2.5MG/ML N 021272 002 May 21, 2002 Nov CFTG >D> + 5MG/ML N 021272 003 May 21, 2002 Nov CFTG >A> AP +! 5MG/ML N 021272 003 May 21, 2002 Nov CFTG >D> +! 10MG/ML N 021272 004 May 21, 2002 Nov CFTG >A> AP +! 10MG/ML N 021272 004 May 21, 2002 Nov CFTG >A> TREPROSTINIL >A> AP SANDOZ INC 1MG/ML A 203649 001 Nov 30, 2017 Nov NEWA >A> AP 2.5MG/ML A 203649 002 Nov 30, 2017 Nov NEWA >A> AP 5MG/ML A 203649 003 Nov 30, 2017 Nov NEWA >A> AP 10MG/ML A 203649 004 Nov 30, 2017 Nov NEWA

TRIAMCINOLONE ACETONIDE INJECTABLE;INJECTION KENALOG-40 >D> +! APOTHECON 40MG/ML N 014901 001 Sep 30, 1964 Nov CTEC >A> AP +! 40MG/ML N 014901 001 Sep 30, 1964 Nov CTEC TRIAMCINOLONE ACETONIDE >A> AP AMNEAL PHARMS CO 40MG/ML A 207550 001 Dec 11, 2017 Nov NEWA

VALGANCICLOVIR HYDROCHLORIDE TABLET;ORAL VALGANCICLOVIR HYDROCHLORIDE >A> AB DR REDDYS LABS LTD EQ 450MG BASE A 206876 001 Dec 12, 2017 Nov NEWA

VARDENAFIL HYDROCHLORIDE TABLET;ORAL LEVITRA >D> AB + BAYER HLTHCARE 2.5MG N 021400 003 Aug 19, 2003 Nov CTEC >A> + 2.5MG N 021400 003 Aug 19, 2003 Nov CTEC >D> AB + 5MG N 021400 001 Aug 19, 2003 Nov CTEC >A> + 5MG N 021400 001 Aug 19, 2003 Nov CTEC >D> AB + 10MG N 021400 002 Aug 19, 2003 Nov CTEC >A> + 10MG N 021400 002 Aug 19, 2003 Nov CTEC >D> AB +! 20MG N 021400 004 Aug 19, 2003 Nov CTEC >A> +! 20MG N 021400 004 Aug 19, 2003 Nov CTEC

ZOLEDRONIC ACID INJECTABLE;IV (INFUSION) ZOLEDRONIC ACID >A> AP AUROBINDO PHARMA LTD EQ 5MG BASE/100ML A 209125 001 Dec 08, 2017 Nov NEWA

Page 22 of 23 ADDITIONS/DELETIONS FOR OTC DRUG PRODUCT LIST

IBUPROFEN; PSEUDOEPHEDRINE HYDROCHLORIDE CAPSULE;ORAL IBUPROFEN AND PSEUDOEPHEDRINE HYDROCHLORIDE >A> AUROBINDO PHARMA LTD EQ 200MG FREE ACID AND A 209235 001 Dec 01, 2017 Nov NEWA POTASSIUM SALT;30MG

LEVONORGESTREL TABLET;ORAL LEVONORGESTREL >A> @ FDN CONSUMER 0.75MG A 078665 001 Aug 28, 2009 Nov CAHN >A> 1.5MG A 200670 001 Jul 12, 2012 Nov CAHN >D> WATSON LABS INC 1.5MG A 200670 001 Jul 12, 2012 Nov CAHN PLAN B >A> + @ FDN CONSUMER 0.75MG N 021045 002 Aug 24, 2006 Nov CAHN PLAN B ONE-STEP >A> +! FDN CONSUMER 1.5MG N 021998 001 Jul 10, 2009 Nov CAHN >D> +! TEVA BRANDED PHARM 1.5MG N 021998 001 Jul 10, 2009 Nov CAHN

NICOTINE POLACRILEX GUM, CHEWING;BUCCAL NICORETTE >D> +! GLAXOSMITHKLINE EQ 2MG BASE N 018612 002 Feb 09, 1996 Nov CHRS >A> + EQ 2MG BASE N 018612 002 Feb 09, 1996 Nov CHRS

RANITIDINE HYDROCHLORIDE TABLET;ORAL ZANTAC 75 >D> SANOFI US EQ 75MG BASE N 020520 001 Dec 19, 1995 Nov CRLD >A> + EQ 75MG BASE N 020520 001 Dec 19, 1995 Nov CRLD

CURRENT MONTH ADDS/DELETES LIST NOTE:

The List is sorted by Ingredient(s) and, within each grouping, by the Dosage Form; Route and then by trade name.

The individual product record contains the Therapeutic Equivalence Code, Reference Listed Drug symbol, Reference Standard Drug symbol, applicant holder, strength(s), New Drug Application number, product number, and approval date. The last two columns describe the action. The Action Month is the CS month the action occurred. The OB Action is the type of change that has occurred.

New ingredient(s), new dosage form; route(s), new trade names, and new product additions are preceded by >A> during the action month. The change month is the current CS month; the change code for new approvals is NEWA.

Changes to currently listed products will list two records. The deleted product record will be proceeded by >D>. The product record change addition being made will be preceded by >A>.

The change code description:

NEWA New drug product approval usually in the supplement month. CAHN** Applicant holder firm name has changed. CAIN Change. There has been a change in the Ingredient(s) name. All products will be deleted under the old name and all products will be added under the changed ingredient(s) name. CDFR Change. Dosage Form; Route of Administration. CFTG Change. A first time generic for the innovator product. A TE Code is added. CMFD Change. The product is moved from the Discontinued Section due to a change in marketing status. CMS1 Change. Miscellaneous addition to list. CMS2 Change. Miscellaneous deletion from list. CPOT Change. Potency amount/unit. CRLD Change. Reference Listed Drug. CHRS Change. Reference Standard. CTEC Change. Therapeutic Equivalence Code. CTNA Change. Trade Name. DISC Discontinued. The Rx or OTC listed product is not being marketed and will be moved to the discontinued section in the next edition.

**Note: The Cumulative Supplement (CS) currently displays a condensed 20 character collapsed applicant holder firm name and the Electronic Orange Book(EOB)query may display up to a 240 character full applicant holder firm name. An applicant holder firm name change usually changes both the collapsed name and long name. On accasion, only the long name is changed resulting in the CS displaying only the collapsed name for the >D> and >A> action. The new firm long name will display in the EOB query.

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