Medical Assistance Handbook Prior Authorization of...

Effective 0 5/01/18 Alphabetical by Brand Na me (when a pplicable)

Medical Assistance Handbook Prior Authorization of Pharmaceutical Services

Quantity Limits & Daily Dose Limits

Therapy Class Brand Name Generic Name

Maximum

Daily Dose

Limit

Antipsychotics, Atypical ABILIFY 1 MG/ML SOLUTION ARIPIPRAZOLE 25 Antipsychotics, Atypical ABILIFY 10 MG DISCMELT ARIPIPRAZOLE 2 Antipsychotics, Atypical ABILIFY 10 MG TABLET ARIPIPRAZOLE 1 Antipsychotics, Atypical ABILIFY 15 MG DISCMELT ARIPIPRAZOLE 2 Antipsychotics, Atypical ABILIFY 15 MG TABLET ARIPIPRAZOLE 1 Antipsychotics, Atypical ABILIFY 2 MG TABLET ARIPIPRAZOLE 2 Antipsychotics, Atypical ABILIFY 20 MG TABLET ARIPIPRAZOLE 1 Antipsychotics, Atypical ABILIFY 30 MG TABLET ARIPIPRAZOLE 1 Antipsychotics, Atypical ABILIFY 5 MG TABLET ARIPIPRAZOLE 1.5 Antipsychotics, Atypical ABILIFY 9.75 MG/1.3 ML INJECTION VIAL ARIPIPRAZOLE 3.9 Antipsychotics, Atypical ABILIFY MAINTENA ER 300 MG SYRINGE ARIPIPRAZOLE 0.04 Antipsychotics, Atypical ABILIFY MAINTENA ER 300 MG VIAL ARIPIPRAZOLE 0.04 Antipsychotics, Atypical ABILIFY MAINTENA ER 400 MG SYRINGE ARIPIPRAZOLE 0.04 Antipsychotics, Atypical ABILIFY MAINTENA ER 400 MG VIAL ARIPIPRAZOLE 0.04 Antivirals, Topical ABREVA 10% CREAM DOCASONAL 1 Analgesics, Opioids Short-Acting ABSTRAL 100 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Analgesics, Opioids Short-Acting ABSTRAL 200 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Analgesics, Opioids Short-Acting ABSTRAL 300 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Analgesics, Opioids Short-Acting ABSTRAL 400 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Analgesics, Opioids Short-Acting ABSTRAL 600 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Analgesics, Opioids Short-Acting ABSTRAL 800 MCG SUBLINGUAL TABLET FENTANYL CITRATE SUBLINGUAL 4 Leukotriene Modifiers ACCOLATE 10 MG TABLET ZAFIRLUKAST 2 Leukotriene Modifiers ACCOLATE 20 MG TABLET ZAFIRLUKAST 2 Diabetic Strips ACCU-CHECK ACTIVE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters ACCU-CHECK ACTIVE CARE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters ACCU-CHECK ADVANTAGE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters ACCU-CHECK AVIVA PLUS BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips ACCU-CHECK AVIVA PLUS BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips ACCU-CHECK COMFORT CURVE BLOOD GLUCOSE STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips ACCU-CHECK COMPACT BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters ACCU-CHECK COMPACT PLUS BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Supplies, Miscellaneous ACCU-CHECK FASTCLIX LANCET KIT BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Supplies, Miscellaneous ACCU-CHECK MULTICLIX LANCET KIT BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Meters ACCU-CHECK NANO SMARTVIEW BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips ACCU-CHECK SMARTVIEW BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Supplies, Miscellaneous ACCU-CHECK SOFTCLIX LANCING KIT BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Meters ACCU-CHECK VOICEMATE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Effective 05/01/18 Alphabetical by Brand Name (when applicable)

Angiotensin Modulators ACCUPRIL 10 MG TABLET QUINAPRIL 2 Angiotensin Modulators ACCUPRIL 20 MG TABLET QUINAPRIL 2 Angiotensin Modulators ACCUPRIL 40 MG TABLET QUINAPRIL 2 Angiotensin Modulators ACCUPRIL 5 MG TABLET QUINAPRIL 2 Angiotensin Modulators ACCURETIC 10 MG/12.5 MG TABLET QUINAPRIL/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators ACCURETIC 20 MG/12.5 MG TABLET QUINAPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators ACCURETIC 20 MG/25 MG TABLET QUINAPRIL/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators ACEON 2 MG TABLET PERINDOPRIL 2 Angiotensin Modulators ACEON 4 MG TABLET PERINDOPRIL 2 Angiotensin Modulators ACEON 8 MG TABLET PERINDOPRIL 2 Analgesics, Opioids Short-Acting ACETAMIN/CAFF/DIHYDROCODEINE 320.5 MG/30 MG/16 MG ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE 10 Analgesics, Non-Salicylates ACETAMINOPHEN 100 MG/ML LIQUID (INFANTS SILAPAP) ACETAMINOPHEN 8 Analgesics, Non-Salicylates ACETAMINOPHEN 120 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 20 Analgesics, Non-Salicylates ACETAMINOPHEN 160 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 20 Analgesics, Non-Salicylates ACETAMINOPHEN 160 MG/5 ML LIQUID ACETAMINOPHEN 75 Analgesics, Non-Salicylates ACETAMINOPHEN 320 MG/10 ML LIQUID ACETAMINOPHEN 100 Analgesics, Non-Salicylates ACETAMINOPHEN 325 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 10 Analgesics, Non-Salicylates ACETAMINOPHEN 325 MG/10.15 ML LIQUID ACETAMINOPHEN 100 Analgesics, Non-Salicylates ACETAMINOPHEN 500 MG CAP/TAB/SUPPOSITORY ACETAMINOPHEN 6 Analgesics, Non-Salicylates ACETAMINOPHEN 500 MG/15 ML LIQUID ACETAMINOPHEN 90 Analgesics, Non-Salicylates ACETAMINOPHEN 500 MG/5 ML LIQUID ACETAMINOPHEN 30 Analgesics, Non-Salicylates ACETAMINOPHEN 640 MG/20 ML LIQUID ACETAMINOPHEN 125 Analgesics, Non-Salicylates ACETAMINOPHEN 650 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 6 Analgesics, Non-Salicylates ACETAMINOPHEN 650 MG/20.3 ML ACETAMINOPHEN 100 Analgesics, Non-Salicylates ACETAMINOPHEN 80 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 30 Analgesics, Non-Salicylates ACETAMINOPHEN 80 MG/0.8 ML LIQUID ACETAMINOPHEN 8 Analgesics, Non-Salicylates ACETAMINOPHEN 80 MG/2.5 ML LIQUID ACETAMINOPHEN 75 Analgesics, Opioids Short-Acting ACETAMINOPHEN/CAFF/DIHYDROCOD 325-30-16 MG ACETAMINOPHEN/CAFF/DIHYDROCODONE 10 Proton Pump Inhibitors ACIPHEX 10 MG SPRINKLE DR CAPSULE RABEPRAZOLE 2 Proton Pump Inhibitors ACIPHEX 20 MG TABLET EC RABEPRAZOLE 2 Proton Pump Inhibitors ACIPHEX 5 MG SPRINKLE DR CAPSULE RABEPRAZOLE 1 Acne Agents, Topical ACNEFREE SEVERE ACNE CLEARING SYSTEM BENZOYL PEROXIDE WASH/EMOLLIENT 1 Cytokine & CAM Antagonists ACTEMRA 162 MG/0.9 ML SYRINGE TOCILIZUMAB 0.13 Cytokine & CAM Antagonists ACTEMRA 200 MG/10 ML VIAL TOCILIZUMAB 1.5 Cytokine & CAM Antagonists ACTEMRA 400 MG/20 ML VIAL TOCILIZUMAB 1.5 Cytokine & CAM Antagonists ACTEMRA 80 MG/4 ML VIAL TOCILIZUMAB 1.5 Bile Salts ACTIGALL 300 MG CAPSULE URSODIOL 4 Analgesics, Opioids Short-Acting ACTIQ 1200 MCG LOZENGE FENTANYL CITRATE 4 Analgesics, Opioids Short-Acting ACTIQ 1600 MCG LOZENGE FENTANYL CITRATE 4 Analgesics, Opioids Short-Acting ACTIQ 200 MCG LOZENGE FENTANYL CITRATE 4 Analgesics, Opioids Short-Acting ACTIQ 400 MCG LOZENGE FENTANYL CITRATE 4 Analgesics, Opioids Short-Acting ACTIQ 600 MCG LOZENGE FENTANYL CITRATE 4 Analgesics, Opioids Short-Acting ACTIQ 800 MCG LOZENGE FENTANYL CITRATE 4


Bone Resorption Suppression & Related Agents ACTONEL 150 MG TABLET RISEDRONATE 0.04 Bone Resorption Suppression & Related Agents ACTONEL 30 MG TABLET RISEDRONATE 1 Bone Resorption Suppression & Related Agents ACTONEL 35 MG TABLET RISEDRONATE 0.14 Bone Resorption Suppression & Related Agents ACTONEL 5 MG TABLET RISEDRONATE 1 Hypoglycemics, TZD ACTOPLUS MET 15 MG/500 MG TABLET PIOGLITAZONE/METFORMIN 3 Hypoglycemics, TZD ACTOPLUS MET 15 MG/850 MG TABLET PIOGLITAZONE/METFORMIN 3 Hypoglycemics, TZD ACTOPLUS MET XR 15 MG/1000 MG TABLET PIOGLITAZONE/METFORMIN ER 2 Hypoglycemics, TZD ACTOPLUS MET XR 30 MG/1000 MG TABLET PIOGLITAZONE/METFORMIN ER 1 Hypoglycemics, TZD ACTOS 15 MG TABLET PIOGLITAZONE 1 Hypoglycemics, TZD ACTOS 30 MG TABLET PIOGLITAZONE 1 Hypoglycemics, TZD ACTOS 45 MG TABLET PIOGLITAZONE 1 Vaccines ADACEL TDAP VACCINE SYRINGE DIPHTHERIA, PERTUSSIS (ACELL), TETANTUS VACCINE 0.5 Vaccines ADACEL TDAP VACCINE VIAL DIPHTHERIA, PERTUSSIS (ACELL), TETANTUS VACCINE 0.5 Calcium Channel Blockers ADALAT CC 30 MG TABLET NIFEDIPINE 1 Calcium Channel Blockers ADALAT CC 60 MG TABLET NIFEDIPINE 2 Calcium Channel Blockers ADALAT CC 90 MG TABLET NIFEDIPINE 1 Antipsychotics ADASUVE 10 MG INHALATION POWDER LOXAPINE 0.2 PAH Agents, Oral & Inhaled ADCIRCA 20 MG TABLET TADALAFIL 2 Stimulants & Related Agents ADDERALL 10 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL 12.5 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL 15 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL 20 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL 30 MG TABLET AMPHETAMINE MIXED SALTS 2 Stimulants & Related Agents ADDERALL 5 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL 7.5 MG TABLET AMPHETAMINE MIXED SALTS 3 Stimulants & Related Agents ADDERALL XR 10 MG CAPSULE AMPHETAMINE MIXED SALTS 1 Stimulants & Related Agents ADDERALL XR 15 MG CAPSULE AMPHETAMINE MIXED SALTS 1 Stimulants & Related Agents ADDERALL XR 20 MG CAPSULE AMPHETAMINE MIXED SALTS 2 Stimulants & Related Agents ADDERALL XR 25 MG CAPSULE AMPHETAMINE MIXED SALTS 2 Stimulants & Related Agents ADDERALL XR 30 MG CAPSULE AMPHETAMINE MIXED SALTS 2 Stimulants & Related Agents ADDERALL XR 5 MG CAPSULE AMPHETAMINE MIXED SALTS 1 PAH Agents, Oral & Inhaled ADEMPAS 0.5 MG TABLET RIOCIGUAT 3 PAH Agents, Oral & Inhaled ADEMPAS 1 MG TABLET RIOCIGUAT 3 PAH Agents, Oral & Inhaled ADEMPAS 1.5 MG TABLET RIOCIGUAT 3 PAH Agents, Oral & Inhaled ADEMPAS 2 MG TABLET RIOCIGUAT 3 PAH Agents, Oral & Inhaled ADEMPAS 2.5 MG TABLET RIOCIGUAT 3 Hypoglycemics, Incretin Mimetics/Enhancers ADLYXIN 10-20 MCG STARTER PACK LIXISENATIDE 0.11 Hypoglycemics, Incretin Mimetics/Enhancers ADLYXIN 20 MCG MAINTENANCE PACK LIXISENATIDE 0.11 Glucocorticoids, Inhaled ADVAIR 100/50 DISKUS FLUTICASONE/SALMETEROL 2 Glucocorticoids, Inhaled ADVAIR 250/50 DISKUS FLUTICASONE/SALMETEROL 2 Glucocorticoids, Inhaled ADVAIR 500/50 DISKUS FLUTICASONE/SALMETEROL 2 Glucocorticoids, Inhaled ADVAIR HFA 115/21 INHALATION AEROSOL FLUTICASONE/SALMETEROL 0.4 Glucocorticoids, Inhaled ADVAIR HFA 230/21 INHALATION AEROSOL FLUTICASONE/SALMETEROL 0.4


Glucocorticoids, Inhaled ADVAIR HFA 45/21 INHALATION AEROSOL FLUTICASONE/SALMETEROL 0.4 Diabetic Meters ADVOCATE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips ADVOCATE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips ADVOCATE REDI-CODE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Stimulants & Related Agents ADZENYS ER 1.25 MG/ML SUSPENSION AMPHETAMINE EXTENDED-RELEASE 15 Stimulants & Related Agents ADZENYS XR-ODT 12.5 MG TABLET AMPHETAMINE 1 Stimulants & Related Agents ADZENYS XR-ODT 15.7 MG TABLET AMPHETAMINE 1 Stimulants & Related Agents ADZENYS XR-ODT 18.8 MG TABLET AMPHETAMINE 1 Stimulants & Related Agents ADZENYS XR-ODT 3.1 MG TABLET AMPHETAMINE 1 Stimulants & Related Agents ADZENYS XR-ODT 6.3 MG TABLET AMPHETAMINE 1 Stimulants & Related Agents ADZENYS XR-ODT 9.4 MG TABLET AMPHETAMINE 1 Glucocorticoids, Inhaled AEROSPAN INHALER #120 FLUNISOLIDE 0.6 Oncology, Oral AFINITOR 10 MG TABLET EVEROLIMUS 1 Oncology, Oral AFINITOR 2.5 MG TABLET EVEROLIMUS 1 Oncology, Oral AFINITOR 5 MG TABLET EVEROLIMUS 1 Oncology, Oral AFINITOR 7.5 MG TABLET EVEROLIMUS 1 Platelet Aggregation Inhibitors AGGRENOX 25-200 MG CAPSULE ASPIRIN/DIPYRIDAMOLE 2 Glucocorticoids, Inhaled AIRDUO RESPICLICK 113-14 MCG FLUTICASONE/SALMETEROL 0.04 Glucocorticoids, Inhaled AIRDUO RESPICLICK 232-14 MCG FLUTICASONE/SALMETEROL 0.04 Glucocorticoids, Inhaled AIRDUO RESPICLICK 55-14 MCG FLUTICASONE/SALMETEROL 0.04 Antiemetics/Antivertigo Agents AKYNZEO 300/0.5 MG CAPSULE NETUPITANT/PALONOSETRON 1 Antihistamines, Minimally Sedating ALAVERT 10 MG TABLET LORATADINE 1 Antihistamines, Minimally Sedating ALAVERT CHILDREN'S SYRUP LORATADINE 10 Antihistamines, Minimally Sedating ALAVERT-D 12 HR PSEUDOEPHEDRINE/LORATADINE 2 Antihelmintics ALBENZA 200 MG TABLET ALBENDAZOLE 4 Oncology, Oral ALECENSA 150 MG CAPSULE ALECTINIB HCL 8 Antibiotics, Gastrointestinal ALINIA 100 MG/5 ML SUSPENSION NITAZOXANIDE 60 Antibiotics, Gastrointestinal ALINIA 500 MG TABLET NITAZOXANIDE 2 Antihistamines, Minimally Sedating ALLEGRA 180 MG TABLET FEXOFENADINE 1 Antihistamines, Minimally Sedating ALLEGRA 30 MG (ODT) TABLET FEXOFENADINE ORALLY DISINTEGRATING 2 Antihistamines, Minimally Sedating ALLEGRA 30 MG/5 ML SUSPENSION FEXOFENADINE ORAL 10 Antihistamines, Minimally Sedating ALLEGRA 60 MG TABLET/CAPSULE FEXOFENADINE 2 Antihistamines, Minimally Sedating ALLEGRA-D 12 HR TABLET PSEUDOEPHEDRINE/FEXOFENADINE 2 Antihistamines, Minimally Sedating ALLEGRA-D 24 HR TABLET PSEUDOEPHEDRINE/FEXOFENADINE 1 Analgesics, Non-Narcotic Barbiturate Combos ALLZITAL 25 MG/325 MG TABLET BUTALBITAL/ACETAMINOPHEN 0.6 Anxiolytics ALPRAZOLAM INTENSOL 1 MG/ML CONCENTRATE ALPRAZOLAM 6 Angiotensin Modulators ALTACE 1.25 MG CAPSULE RAMIPRIL 1 Angiotensin Modulators ALTACE 10 MG CAPSULE RAMIPRIL 2 Angiotensin Modulators ALTACE 2.5 MG CAPSULE RAMIPRIL 4 Angiotensin Modulators ALTACE 5 MG CAPSULE RAMIPRIL 4 Lipotropics, Statins ALTOPREV 10 MG TABLET LOVASTATIN ER 1 Lipotropics, Statins ALTOPREV 20 MG TABLET LOVASTATIN ER 1 Lipotropics, Statins ALTOPREV 40 MG TABLET LOVASTATIN ER 1


Lipotropics, Statins ALTOPREV 60 MG TABLET LOVASTATIN ER 1 Oncology, Oral ALUNBRIG 180 MG TABLET BRIGATINIB 1 Oncology, Oral ALUNBRIG 30 MG TABLET BRIGATINIB 4 Oncology, Oral ALUNBRIG 90 MG TABLET BRIGATINIB 1 Oncology, Oral ALUNBRIG 90-180 MG TAB PACK BRIGATINIB 1 Glucocorticoids, Inhaled ALVESCO INHALER 160 MCG/INHALATION CICLESONIDE 0.41 Glucocorticoids, Inhaled ALVESCO INHALER 80 MCG/INHALATION CICLESONIDE 0.21 Hypoglycemics, Sulfonylureas AMARYL 1 MG TABLET GLIMEPIRIDE 2 Hypoglycemics, Sulfonylureas AMARYL 2 MG TABLET GLIMEPIRIDE 2 Hypoglycemics, Sulfonylureas AMARYL 4 MG TABLET GLIMEPIRIDE 2 Sedative Hypnotics AMBIEN 10 MG TABLET ZOLPIDEM 1-See footnote3

Sedative Hypnotics AMBIEN 5 MG TABLET ZOLPIDEM 1 Sedative Hypnotics AMBIEN CR 12.5 MG ZOLPIDEM ER 1-See footnote3

Sedative Hypnotics AMBIEN CR 6.25 MG ZOLPIDEM ER 1 Antimigraine Agents, Triptans AMERGE 1 MG TABLET NARATRIPTAN 0.3 Antimigraine Agents, Triptans AMERGE 2.5 MG TABLET NARATRIPTAN 0.3 Insect Repellent NOT for Skin Application AMERISOURCE LICE BEDING SPRAY PERMETHRIN 0.5% 29 GI Motility, Chronic AMITIZA 24 MCG CAPSULE LUBIPROSTONE 2 GI Motility, Chronic AMITIZA 8 MCG CAPSULE LUBIPROSTONE 4 Multiple Sclerosis Agents AMPYRA ER 10 MG TABLET DALFAMPRIDINE 2 Skeletal Muscle Relaxants AMRIX 15 MG ER CAPSULE CYCLOBENZAPRINE ER 1 Skeletal Muscle Relaxants AMRIX 30 MG ER CAPSULE CYCLOBENZAPRINE ER 1 NSAIDs ANAPROX 275 MG TABLET NAPROXEN 3 NSAIDs ANAPROX DS 550 MG TABLET NAPROXEN 3 Androgenic Agents ANDRODERM 2 MG/24 HR PATCH TESTOSTERONE 1 Androgenic Agents ANDRODERM 4 MG/24 HR PATCH TESTOSTERONE 1 Androgenic Agents ANDROGEL 1% (2.5 GM) GEL PACKET TESTOSTERONE 7.5 Androgenic Agents ANDROGEL 1% (5 GM) GEL PACKET TESTOSTERONE 10 Androgenic Agents ANDROGEL 1% GEL PUMP TESTOSTERONE 7.5 Androgenic Agents ANDROGEL 1.62% (1.25 GM) GEL PACKET TESTOSTERONE 1.25 Androgenic Agents ANDROGEL 1.62% (2.5 GM) GEL PACKET TESTOSTERONE 5 Androgenic Agents ANDROGEL 1.62% GEL PUMP TESTOSTERONE 5 Androgenic Agents ANDROID 10 MG CAPSULE METHYLTESTOSTERONE 5 Androgenic Agents ANDROXY 10 MG TABLET FLUOXYMESTERONE 4 COPD Agents ANORO ELLIPTA #30 UMECLIDINIUM/VILANTEROL 2 COPD Agents ANORO ELLIPTA #7 UMECLIDINIUM/VILANTEROL 2 Lipotropics, Other ANTARA 130 MG CAPSULE FENOFIBRATE MICRONIZED 1 Lipotropics, Other ANTARA 30 MG CAPSULE FENOFIBRATE MICRONIZED 2 Lipotropics, Other ANTARA 43 MG CAPSULE FENOFIBRATE MICRONIZED 2 Lipotropics, Other ANTARA 90 MG CAPSULE FENOFIBRATE MICRONIZED 1 Antiemetics/Antivertigo Agents ANZEMET 100 MG TABLET DOLASETRON 1 Antiemetics/Antivertigo Agents ANZEMET 50 MG TABLET DOLASETRON 2 Antidepressants, Other APLENZIN ER 174 MG TABLET BUPROPION HYDROBROMIDE 1


Antidepressants, Other APLENZIN ER 348 MG TABLET BUPROPION HYDROBROMIDE 1 Antidepressants, Other APLENZIN ER 522 MG TABLET BUPROPION HYDROBROMIDE 1 Antigenic Skin Tests APLISOL 5 TUBERCULIN UNITS/0.1 ML VIAL TUBERCULIN PPD INTRADERMAL 0.1 Ulcerative Colitis Agents APRISO 0.375 GRAM ER CAPSULE MESALAMINE 4 Stimulants & Related Agents APTENSIO XR 10 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 15 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 20 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 30 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 40 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 50 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents APTENSIO XR 60 MG CAPSULE METHYLPHENIDATE 1 Anticonvulsants APTIOM 200 MG TABLET ESLICARBAZEPINE 1 Anticonvulsants APTIOM 400 MG TABLET ESLICARBAZEPINE 1 Anticonvulsants APTIOM 600 MG TABLET ESLICARBAZEPINE 2 Anticonvulsants APTIOM 800 MG TABLET ESLICARBAZEPINE 2 HIV/AIDS Agents APTIVUS 100 MG/ML ORAL SOLUTION TIPRANAVIR 10 HIV/AIDS Agents APTIVUS 250 MG CAPSULE TIPRANAVIR 4 Cytokine & CAM Antagonists ARCALYST 220 MG INJECTION RILONACEPT 0.18 Bronchodilators, Beta Agonist ARCAPTA NEOHALER 75 MCG CAPSULE INDACATEROL 1 Alzheimers Agents ARICEPT 10 MG ODT DONEPEZIL 1 Alzheimers Agents ARICEPT 10 MG TABLET DONEPEZIL 1 Alzheimers Agents ARICEPT 23 MG TABLET DONEPEZIL 1 Alzheimers Agents ARICEPT 5 MG ODT DONEPEZIL 1 Alzheimers Agents ARICEPT 5 MG TABLET DONEPEZIL 1 Oncology Agents, Breast Cancer ARIMIDEX 1 MG TABLET ANASTROZOLE 1 Antipsychotics, Atypical ARISTADA ER 1064 MG/3.9 ML ARIPIPRAZOLE LAUROXIL 0.07 Antipsychotics, Atypical ARISTADA ER 441 MG/1.6 ML SYRINGE ARIPIPRAZOLE LAUROXIL 0.06 Antipsychotics, Atypical ARISTADA ER 662 MG/2.4 ML SYRINGE ARIPIPRAZOLE LAUROXIL 0.08 Antipsychotics, Atypical ARISTADA ER 882 MG/3.2 ML SYRINGE ARIPIPRAZOLE LAUROXIL 0.11 Anticoagulants, Injectable ARIXTRA 10 MG/0.8 ML INJECTION SYRINGE FONDAPARINUX See footnote1

Anticoagulants, Injectable ARIXTRA 2.5 MG/0.5 ML INJECTION SYRINGE FONDAPARINUX See footnote1

Anticoagulants, Injectable ARIXTRA 5 MG/0.4 ML INJECTION SYRINGE FONDAPARINUX See footnote1

Anticoagulants, Injectable ARIXTRA 7.5 MG/0.6 ML INJECTION SYRINGE FONDAPARINUX See footnote1

Glucocorticoids, Inhaled ARMONAIR RESPICLICK 113 MCG FLUTICASONE PROPIONATE 0.04 Glucocorticoids, Inhaled ARMONAIR RESPICLICK 232 MCG FLUTICASONE PROPIONATE 0.04 Glucocorticoids, Inhaled ARMONAIR RESPICLICK 55 MCG FLUTICASONE PROPIONATE 0.04 Glucocorticoids, Inhaled ARNUITY ELLIPTA 100 MCG INHALER FLUTICASONE FUROATE 1 Glucocorticoids, Inhaled ARNUITY ELLIPTA 200 MCG INHALER FLUTICASONE FUROATE 1 Oncology Agents, Breast Cancer AROMASIN 25 MG TABLET EXEMESTANE 2 Antiparkinson's Agents ARTANE 2 MG TABLET TRIHEXYPHENIDYL 6 Antiparkinson's Agents ARTANE 2 MG/5 ML ELIXIR TRIHEXYPHENIDYL 40 Antiparkinson's Agents ARTANE 5 MG TABLET TRIHEXYPHENIDYL 3 NSAIDs ARTHROTEC EC 50 MG/200 MCG DICLOFENAC SODIUM/MISOPROSTOL 4


NSAIDs ARTHROTEC EC 75 MG/200 MCG DICLOFENAC SODIUM/MISOPROSTOL 3 Analgesics, Opioids Long-Acting ARYMO ER 15 MG TABLET MORPHINE SULFATE 3 Analgesics, Opioids Long-Acting ARYMO ER 30 MG TABLET MORPHINE SULFATE 2 Analgesics, Opioids Long-Acting ARYMO ER 60 MG TABLET MORPHINE SULFATE 2 Ulcerative Colitis Agents ASACOL 400 MG EC TABLET MESALAMINE 6 Ulcerative Colitis Agents ASACOL HD 800 MG TABLET MESALAMINE 6 Analgesics, Opioids Short-Acting ASCOMP WITH CODEINE CAPSULE BUTALBITAL/ASA/CAFFEINE/CODEINE 0.6 Glucocorticoids, Inhaled ASMANEX HFA 100 MCG INHALER MOMETASONE FUROATE 0.44 Glucocorticoids, Inhaled ASMANEX HFA 200 MCG INHALER MOMETASONE FUROATE 0.44 Glucocorticoids, Inhaled ASMANEX TWISTHALER 110 MCG #30 MOMETASONE FUROATE 0.04 Glucocorticoids, Inhaled ASMANEX TWISTHALER 220 MCG #120 MOMETASONE FUROATE 0.04 Glucocorticoids, Inhaled ASMANEX TWISTHALER 220 MCG #30 MOMETASONE FUROATE 0.04 Glucocorticoids, Inhaled ASMANEX TWISTHALER 220 MCG #60 MOMETASONE FUROATE 0.04 Analgesics, Salicylates ASPIRIN 300 MG SUPPOSITORY ASPIRIN 6 Analgesics, Salicylates ASPIRIN 325 MG TAB/CAP ASPIRIN 12 Analgesics, Salicylates ASPIRIN 600 MG SUPPOSITORY ASPIRIN 6 Analgesics, Salicylates ASPIRIN 81 MG TAB/CAP ASPIRIN 12 Diabetic Strips ASSURE 4 BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Intranasal Rhinitis Agents ASTELIN 0.1% NASAL SPRAY AZELASTINE 1.2 Intranasal Rhinitis Agents ASTEPRO 0.1% NASAL SPRAY AZELASTINE 1.2 Intranasal Rhinitis Agents ASTEPRO 0.15% NASAL SPRAY AZELASTINE 1.2 Angiotensin Modulators ATACAND 16 MG TABLET CANDESARTAN 2 Angiotensin Modulators ATACAND 32 MG TABLET CANDESARTAN 1 Angiotensin Modulators ATACAND 4 MG TABLET CANDESARTAN 2 Angiotensin Modulators ATACAND 8 MG TABLET CANDESARTAN 2 Angiotensin Modulators ATACAND HCT 16/12.5 MG TAB CANDESARTAN/HCTZ 2 Angiotensin Modulators ATACAND HCT 32/12.5 MG TAB CANDESARTAN/HCTZ 1 Angiotensin Modulators ATACAND HCT 32/25 MG TAB CANDESARTAN/HCTZ 1 Bone Resorption Suppression & Related Agents ATELVIA 35 MG DR TABLET RISEDRONATE 0.14 Bone Resorption Suppression & Related Agents ATELVIA 35 MG DR TABLET RISEDRONATE 0.14 Anxiolytics ATIVAN 0.5 MG TABLET LORAZEPAM 6 Anxiolytics ATIVAN 1 MG TABLET LORAZEPAM 6 Anxiolytics ATIVAN 2 MG TABLET LORAZEPAM 3 HIV/AIDS Agents ATRIPLA 600 MG/200 MG/300 MG TABLET EFAVIRENZ/EMTRICITABINE/TENOFOVIR DF 1 Intranasal Rhinitis Agents ATROVENT 0.03% NASAL SPRAY IPRATROPIUM 1.05 Intranasal Rhinitis Agents ATROVENT 0.06% NASAL SPRAY IPRATROPIUM 1.5 COPD Agents ATROVENT HFA INHALER IPRATROPIUM 0.86 Multiple Sclerosis Agents AUBAGIO 14 MG TABLET TERIFLUNOMIDE 1 Multiple Sclerosis Agents AUBAGIO 7 MG TABLET TERIFLUNOMIDE 1 Phosphate Binders AURYXIA 210 MG TABLET FERRIC CITRATE 12 Movement Disorders AUSTEDO 12 MG TABLET DEUTETRABENAZINE 4 Movement Disorders AUSTEDO 6 MG TABLET DEUTETRABENAZINE 2 Movement Disorders AUSTEDO 9 MG TABLET DEUTETRABENAZINE 4


Diabetic Supplies, Miscellaneous AUTOLET IMPRESS LANCING DEVICE BLOOD GLUCOSE LANCING DEVICE 1 Angiotensin Modulators AVALIDE 150-12.5 MG TABLET IRBESARTAN/HCTZ 2 Angiotensin Modulators AVALIDE 300-12.5 MG TABLET IRBESARTAN/HCTZ 1 Hypoglycemics, TZD AVANDAMET 2 MG/1,000 MG TABLET ROSIGLITAZONE/METFORMIN 2 Hypoglycemics, TZD AVANDAMET 2 MG/500 MG TABLET ROSIGLITAZONE/METFORMIN 2 Hypoglycemics, TZD AVANDAMET 4 MG/1,000 MG TABLET ROSIGLITAZONE/METFORMIN 2 Hypoglycemics, TZD AVANDAMET 4 MG/500 MG TABLET ROSIGLITAZONE/METFORMIN 2 Hypoglycemics, TZD AVANDARYL 4 MG/ 1 MG TABLET ROSIGLITAZONE/GLIMEPIRIDE 2 Hypoglycemics, TZD AVANDARYL 4 MG/ 2 MG TABLET ROSIGLITAZONE/GLIMEPIRIDE 2 Hypoglycemics, TZD AVANDARYL 4 MG/ 4 MG TABLET ROSIGLITAZONE/GLIMEPIRIDE 2 Hypoglycemics, TZD AVANDARYL 8 MG/ 2 MG TABLET ROSIGLITAZONE/GLIMEPIRIDE 1 Hypoglycemics, TZD AVANDARYL 8 MG/ 4 MG TABLET ROSIGLITAZONE/GLIMEPIRIDE 1 Hypoglycemics, TZD AVANDIA 2 MG TABLET ROSIGLITAZONE 2 Hypoglycemics, TZD AVANDIA 4 MG TABLET ROSIGLITAZONE 2 Hypoglycemics, TZD AVANDIA 8 MG TABLET ROSIGLITAZONE 1 Angiotensin Modulators AVAPRO 150 MG TABLET IRBESARTAN 1 Angiotensin Modulators AVAPRO 300 MG TABLET IRBESARTAN 1 Angiotensin Modulators AVAPRO 75 MG TABLET IRBESARTAN 1 Oncology, Other AVASTIN 100 MG/4 ML VIAL BEVACIZUMAB 6.5 Oncology, Other AVASTIN 400 MG/16 ML VIAL BEVACIZUMAB 6.5 Androgenic Agents AVEED 750 MG/3 ML VIAL TESTOSTERONE UNDECANOATE 0.04 Analgesics, Opioids Long-Acting AVINZA 120 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting AVINZA 30 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting AVINZA 45 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting AVINZA 60 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting AVINZA 75 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting AVINZA 90 MG CAPSULE MORPHINE SULFATE ER 1 BPH Treatments AVODART 0.5 MG SOFTGEL DUTASTERIDE 1 Multiple Sclerosis Agents AVONEX ADMIN PACK 30 MCG VIAL INTERFERON BETA-1A 0.15 Multiple Sclerosis Agents AVONEX PEN 30 MCG/0.5 ML AUTOINJECTOR KIT INTERFERON BETA-1A 0.04 Multiple Sclerosis Agents AVONEX PREFILLED SYRINGE 30 MCG KIT INTERFERON BETA-1A 0.04 Antimigraine Agents, Triptans AXERT 12.5 MG TABLET ALMOTRIPTAN 0.3 Antimigraine Agents, Triptans AXERT 6.25 MG TABLET ALMOTRIPTAN 0.2 Androgenic Agents AXIRON 30 MG/ACTUATION SOLUTION TESTOSTERONE 6 Progestational Agents AYGESTIN 5 MG TABLET NORETHINDRONE ACETATE 3 Antibiotics, Injectable AZACTAM 1 GM INJECTION VIAL AZTREONAM 3 Antibiotics, Injectable AZACTAM 2 GM INJECTION VIAL AZTREONAM 4 Antiparkinson's Agents AZILECT 0.5 MG TABLET RASAGILINE 1 Antiparkinson's Agents AZILECT 1 MG TABLET RASAGILINE 1 Angiotensin Modulator Combinations AZOR 10/20 MG TABLET AMLODIPINE/OLMESARTAN 1 Angiotensin Modulator Combinations AZOR 10/40 MG TABLET AMLODIPINE/OLMESARTAN 1 Angiotensin Modulator Combinations AZOR 5/20 MG TABLET AMLODIPINE/OLMESARTAN 1 Angiotensin Modulator Combinations AZOR 5/40 MG TABLET AMLODIPINE/OLMESARTAN 1


Ulcerative Colitis Agents AZULFIDINE 500 MG TABLET SULFASALAZINE 12 Ulcerative Colitis Agents AZULFIDINE EN-TAB 500 MG TABLET SULFASALAZINE 12 Anticonvulsants BANZEL 200 MG TABLET RUFINAMIDE 4 Anticonvulsants BANZEL 40 MG/ML SUSPENSION RUFINAMIDE 80 Anticonvulsants BANZEL 400 MG TABLET RUFINAMIDE 8 Hepatitis B Agents BARACLUDE 0.05 MG/ML SOLUTION ENTECAVIR 20 Hepatitis B Agents BARACLUDE 0.5 MG TABLET ENTECAVIR 1 Hepatitis B Agents BARACLUDE 1 MG TABLET ENTECAVIR 1 Analgesics, Salicylates BC ARTHRITIS POWDER PACKET 1000 MG/65 MG ASPIRIN/CAFFEINE 4 Vaccines BCG VACCINE (TICE STRAIN) VIAL BCG VACCINE 1 Diabetic Strips BD BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Intranasal Rhinitis Agents BECONASE AQ 0.042% NASAL SPRAY BECLOMETHASONE 1.12 Analgesics, Opioids Long-Acting BELBUCA 150 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 300 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 450 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 600 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 75 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 750 MCG FILM BUPRENORPHINE 2 Analgesics, Opioids Long-Acting BELBUCA 900 MCG FILM BUPRENORPHINE 2 Sedative Hypnotics BELSOMRA 10 MG TABLET SUVOREXANT 1 Sedative Hypnotics BELSOMRA 15 MG TABLET SUVOREXANT 1 Sedative Hypnotics BELSOMRA 20 MG TABLET SUVOREXANT 1 Sedative Hypnotics BELSOMRA 5 MG TABLET SUVOREXANT 1 Angiotensin Modulators BENICAR 20 MG TABLET OLMESARTAN 1 Angiotensin Modulators BENICAR 40 MG TABLET OLMESARTAN 1 Angiotensin Modulators BENICAR 5 MG TABLET OLMESARTAN 1 Angiotensin Modulators BENICAR HCT 20-12.5 MG TAB OLMESARTN/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators BENICAR HCT 40-12.5 MG TABLET OLMESARTN/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators BENICAR HCT 40-25 MG TABLET OLMESARTN/HYDROCHLOROTHIAZIDE 1 Antibiotics, Inhaled BETHKIS 300 MG/4 ML INHALATION SOLUTION VIAL TOBRAMYCIN 8 COPD Agents BEVESPI AEROSPHERE FORMOTEROL FUMARATE DIHYDRATE/GLYCOPYRROLATE 0.36 Vaccines BEXSERO VACCINE SYRINGE MENINGOCOCCAL B VACCINE 4-COMP 0.5 Antibiotics, Injectable BICILLIN L-A 1,200,000 UNITS/2 ML PENICILLIN G BENZATHINE 0.07 Antibiotics, Injectable BICILLIN L-A 2,400,000 UNITS/4 ML PENICILLIN G BENZATHINE 0.59 Antibiotics, Injectable BICILLIN L-A 600,000 UNITS/ML PENICILLIN G BENZATHINE 0.08 HIV/AIDS Agents BIKTARVY 50-200-25 MG TABLET BICTEGRAVIR/EMTRICITABINE/TENOFOVIR ALAFENAMIDE 1 Bone Resorption Suppression & Related Agents BINOSTO 70 MG EFFERVESCENT TABLET ALENDRONATE 0.14 Bone Resorption Suppression & Related Agents BONIVA 150 MG TABLET IBANDRONATE 0.04 Bone Resorption Suppression & Related Agents BONIVA 3 MG/3 ML SYRINGE IBANDRONATE 0.04 Antiemetics/Antivertigo Agents BONJESTA ER 20-20 MG TABLET DOXYLAMINE AND PYRIDOXINE EXTENDED-RELEASE 2 Vaccines BOOSTRIX TDAP VACCINE SYRINGE DIPHTHERIA, PERTUSSIS (ACELL), TETANTUS VACCINE 0.5 Vaccines BOOSTRIX TDAP VACCINE VIAL DIPHTHERIA, PERTUSSIS (ACELL), TETANTUS VACCINE 0.5 Oncology, Oral BOSULIF 100 MG TABLET BOSUTINIB 3


Oncology, Oral BOSULIF 400 MG TABLET BOSUTINIB 1 Oncology, Oral BOSULIF 500 MG TABLET BOSUTINIB 1 Botulinum Toxins BOTOX 100 UNITS INJECTION VIAL ONABOTULINUMTOXIN A 0.1 Botulinum Toxins BOTOX 200 UNITS INJECTION VIAL ONABOTULINUMTOXIN A 0.07 Acne Agents, Topical BPO 4% CREAMY WASH KIT BENZOYL PEROXIDE 1 Acne Agents, Topical BPO 8% CREAMY WASH KIT BENZOYL PEROXIDE 1 Diabetic Meters BREEZE 2 BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips BREEZE 2 BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Glucocorticoids, Inhaled BREO ELLIPTA 100 MCG/25 MCG FLUTICASONE/VILANTEROL 2 Glucocorticoids, Inhaled BREO ELLIPTA 200 MCG/25 MCG FLUTICASONE/VILANTEROL 2 Platelet Aggregation Inhibitors BRILINTA 60 MG TABLET TICAGRELOR 2 Platelet Aggregation Inhibitors BRILINTA 90 MG TABLET TICAGRELOR 2 Antidepressants, SSRIs BRISDELLE 7.5 MG CAPSULE PAROXETINE MESYLATE 1 Anticonvulsants BRIVIACT 10 MG TABLET BRIVARACETAM 4 Anticonvulsants BRIVIACT 10 MG/ML ORAL SOLUTION BRIVARACETAM 20 Anticonvulsants BRIVIACT 100 MG TABLET BRIVARACETAM 2 Anticonvulsants BRIVIACT 25 MG TABLET BRIVARACETAM 4 Anticonvulsants BRIVIACT 50 MG TABLET BRIVARACETAM 4 Anticonvulsants BRIVIACT 50 MG/5 ML VIAL BRIVARACETAM 20 Anticonvulsants BRIVIACT 75 MG TABLET BRIVARACETAM 2 Bronchodilators, Beta Agonist BROVANA 15 MCG/2 ML SOLUTION ARFORMOTEROL 4 Opiate Dependence Treatments BUNAVAIL 2.1/0.3 MG BUCCAL FILM BUPRENORPHINE/NALOXONE 25

Opiate Dependence Treatments BUNAVAIL 4.2/0.7 MG BUCCAL FILM BUPRENORPHINE/NALOXONE 25

Opiate Dependence Treatments BUNAVAIL 6.3/1 MG BUCCAL FILM BUPRENORPHINE/NALOXONE 15

Analgesics, Non-Narcotic Barbiturate Combos BUPAP 50 MG/300 MG TABLET BUTALBITAL/ACETAMINOPHEN 0.6 Sedative Hypnotics BUTISOL SODIUM 30 MG TABLET BUTABARBITAL SODIUM 3.5 Analgesics, Opioids Long-Acting BUTRANS 10 MCG/HR TRANSDERMAL SYSTEM BUPRENORPHINE TRANSDERMAL 0.15 Analgesics, Opioids Long-Acting BUTRANS 15 MCG/HR TRANSDERMAL SYSTEM BUPRENORPHINE TRANSDERMAL 0.15 Analgesics, Opioids Long-Acting BUTRANS 20 MCG/HR TRANSDERMAL SYSTEM BUPRENORPHINE TRANSDERMAL 0.15 Analgesics, Opioids Long-Acting BUTRANS 5 MCG/HR TRANSDERMAL SYSTEM BUPRENORPHINE TRANSDERMAL 0.15 Analgesics, Opioids Long-Acting BUTRANS 7.5 MCG/HR TRANSDERMAL SYSTEM BUPRENORPHINE TRANSDERMAL 0.15 Hypoglycemics, Incretin Mimetics/Enhancers BYDUREON 2 MG PEN INJECT EXENATIDE EXTENDED-RELEASE 0.15 Hypoglycemics, Incretin Mimetics/Enhancers BYDUREON 2 MG VIAL EXENATIDE MICROSPHERES 0.15 Hypoglycemics, Incretin Mimetics/Enhancers BYDUREON BCISE 2MG AUTOINJECT EXENATIDE EXTENDED-RELEASE 0.13 Hypoglycemics, Incretin Mimetics/Enhancers BYETTA 10 MCG/DOSE PREFILLED PEN EXENATIDE 0.08 Hypoglycemics, Incretin Mimetics/Enhancers BYETTA 5 MCG/DOSE PREFILLED PEN EXENATIDE 0.04 Beta-Blockers BYSTOLIC 10 MG TABLET NEBIVOLOL 1.5 Beta-Blockers BYSTOLIC 2.5 MG TABLET NEBIVOLOL 1 Beta-Blockers BYSTOLIC 20 MG TABLET NEBIVOLOL 2 Beta-Blockers BYSTOLIC 5 MG TABLET NEBIVOLOL 1.5 Angiotensin Modulator Combinations BYVALSON 5/80 MG TABLET NEBIVOLOL/VALSARTAN 1 Oncology, Oral CABOMETYX 20 MG TABLET CABOZANTINIB 1 Oncology, Oral CABOMETYX 40 MG TABLET CABOZANTINIB 1


Oncology, Oral CABOMETYX 60 MG TABLET CABOZANTINIB 1 Lipotropics, Statins CADUET 10 MG/10 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 10 MG/20 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 10 MG/40 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 10 MG/80 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 5 MG/10 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 5 MG/20 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 5 MG/40 MG TABLET AMLODIPINE/ATORVASTATIN 1 Lipotropics, Statins CADUET 5 MG/80 MG TABLET AMLODIPINE/ATORVASTATIN 1 Antimigraine Agents, Other CAFERGOT TABLET ERGOTAMINE/CAFFEINE 1.43 Calcium Channel Blockers CALAN SR 120 MG CAPLET SA VERAPAMIL 2 Calcium Channel Blockers CALAN SR 180 MG CAPLET SA VERAPAMIL 2 Calcium Channel Blockers CALAN SR 240 MG CAPLET SA VERAPAMIL 2 Oncology, Oral CALQUENCE 100 MG CAPSULE ACALABRUTINIB 2 NSAIDs CAMBIA 50 MG POWDER PACKET DICLOFENAC POTASSIUM POWDER 0.3 Ulcerative Colitis Agents CANASA 1000 MG SUPPOSITORY MESALAMINE 1 Antifungals, Injectable CANCIDAS IV 50 MG VIAL CASPOFUNGIN 1 Antifungals, Injectable CANCIDAS IV 70 MG VIAL CASPOFUNGIN 1 Analgesics, Non-Narcotic Barbiturate Combos CAPACET 50 MG/325 MG/40 MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Analgesics, Opioids Short-Acting CAPITAL WITH CODEINE 120 MG-12 MG/5 ML SUSPENSION ACETAMINOPHEN/CODEINE 90 Angiotensin Modulators CAPOTEN 100 MG TABLET CAPTOPRIL 3 Angiotensin Modulators CAPOTEN 12.5 MG TABLET CAPTOPRIL 3 Angiotensin Modulators CAPOTEN 25 MG TABLET CAPTOPRIL 3 Angiotensin Modulators CAPOTEN 50 MG TABLET CAPTOPRIL 3 Angiotensin Modulators CAPOZIDE 25 MG/15 MG TABLET CAPTOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators CAPOZIDE 25 MG/25 MG TABLET CAPTOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators CAPOZIDE 50 MG/15 MG TABLET CAPTOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators CAPOZIDE 50 MG/25 MG TABLET CAPTOPRIL/HYDROCHLOROTHIAZIDE 2 Oncology, Oral CAPRELSA 100 MG TABLET VANDETANIB 2 Oncology, Oral CAPRELSA 300 MG TABLET VANDETANIB 1 Anticonvulsants CARBATROL ER 100 MG CAPSULE CARBAMAZEPINE ER 6 Anticonvulsants CARBATROL ER 200 MG CAPSULE CARBAMAZEPINE ER 8 Anticonvulsants CARBATROL ER 300 MG CAPSULE CARBAMAZEPINE ER 5 Calcium Channel Blockers CARDENE 20 MG CAPSULE NICARDIPINE 6 Calcium Channel Blockers CARDENE 30 MG CAPSULE NICARDIPINE 3 Calcium Channel Blockers CARDIZEM 120 MG TABLET DILTIAZEM 3 Calcium Channel Blockers CARDIZEM 30 MG TABLET DILTIAZEM 4 Calcium Channel Blockers CARDIZEM 60 MG TABLET DILTIAZEM 4 Calcium Channel Blockers CARDIZEM 90 MG TABLET DILTIAZEM 4 Calcium Channel Blockers CARDIZEM CD 120 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers CARDIZEM CD 180 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers CARDIZEM CD 240 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers CARDIZEM CD 300 MG CAPSULE DILTIAZEM 1


Calcium Channel Blockers CARDIZEM CD 360 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers CARDIZEM LA 120 MG TABLET DILTIAZEM 1 Calcium Channel Blockers CARDIZEM LA 180 MG TABLET DILTIAZEM 1 Calcium Channel Blockers CARDIZEM LA 240 MG TABLET DILTIAZEM 2 Calcium Channel Blockers CARDIZEM LA 300 MG TABLET DILTIAZEM 1 Calcium Channel Blockers CARDIZEM LA 360 MG TABLET DILTIAZEM 1 Calcium Channel Blockers CARDIZEM LA 420 MG TABLET DILTIAZEM 1 BPH Treatments CARDURA 1 MG TABLET DOXAZOSIN 1 BPH Treatments CARDURA 2 MG TABLET DOXAZOSIN 1 BPH Treatments CARDURA 4 MG TABLET DOXAZOSIN 1 BPH Treatments CARDURA 8 MG TABLET DOXAZOSIN 2 BPH Treatments CARDURA XL 4 MG TABLET DOXAZOSIN 1 BPH Treatments CARDURA XL 8 MG TABLET DOXAZOSIN 1 Calcium Channel Blockers CARTIA XT 120 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers CARTIA XT 180 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers CARTIA XT 240 MG CAPSULE SA DILTIAZEM 2 Calcium Channel Blockers CARTIA XT 300 MG CAPSULE SA DILTIAZEM 1 NSAIDs CATAFLAM 50 MG TABLET DICLOFENAC POTASSIUM 4 Antihypertensive, Sympatholytics CATAPRES-TTS 1 PATCH CLONIDINE 0.14 Antihypertensive, Sympatholytics CATAPRES-TTS 2 PATCH CLONIDINE 0.14 Antihypertensive, Sympatholytics CATAPRES-TTS 3 PATCH CLONIDINE 0.14 Antibiotics, Inhaled CAYSTON 75 MG/ML INHALATION SOLUTION VIAL AZTREONAM LYSINE 3 NSAIDs CELEBREX 100 MG CAPSULE CELECOXIB 2 NSAIDs CELEBREX 200 MG CAPSULE CELECOXIB 2 NSAIDs CELEBREX 400 MG CAPSULE CELECOXIB 1 NSAIDs CELEBREX 50 MG CAPSULE CELECOXIB 2 Antidepressants, SSRIs CELEXA 10 MG TABLET CITALOPRAM 1.5 Antidepressants, SSRIs CELEXA 10 MG/5 ML SOLUTION CITALOPRAM 20 Antidepressants, SSRIs CELEXA 20 MG TABLET CITALOPRAM 1.5 Antidepressants, SSRIs CELEXA 40 MG TABLET CITALOPRAM 1 Anticonvulsants CELONTIN 300 MG CAPSULE METHOSUXIMIDE 4 Enzyme Replacement Agents CERDELGA 84 MG CAPSULE ELIGLUSTAT 2 Vaccines CERVARIX VACCINE SYRINGE HUMAN PAPILLOMAVIRUS VACCINE 0.5 Antiemetics/Antivertigo Agents CESAMET 1 MG CAPSULE NABILONE 6 Smoking Cessation CHANTIX 0.5 MG TABLET VARENICLINE 2 Smoking Cessation CHANTIX 1 MG CONTINUING MONTH PAK VARENICLINE 2 Smoking Cessation CHANTIX 1 MG TABLET VARENICLINE 2 Bile Salts CHENODAL 250 MG TABLET CHENODIOL 6 Sedative Hypnotics CHLORAL HYDRATE 500 MG/5 ML SOLN CHLORAL HYDRATE 10 Hypoglycemics, Sulfonylureas CHLORPROPAMIDE 100 MG TABLET CHLORPROPAMIDE 3 Hypoglycemics, Sulfonylureas CHLORPROPAMIDE 250 MG TABLET CHLORPROPAMIDE 2 Analgesics, Salicylates CHOLINE/MAG TRISAL 1000 MG TABLET CHOLINE/MAGNESIUM TRISALICYLATE 4 Analgesics, Salicylates CHOLINE/MAG TRISAL 500 MG TABLET CHOLINE/MAGNESIUM TRISALICYLATE 6


Analgesics, Salicylates CHOLINE/MAG TRISAL 500 MG/5 ML LIQUID CHOLINE/MAGNESIUM TRISALICYLATE 45 Analgesics, Salicylates CHOLINE/MAG TRISAL 750 MG TABLET CHOLINE/MAGNESIUM TRISALICYLATE 6 BPH Treatments CIALIS 10 MG TABLET TADALAFIL 1 BPH Treatments CIALIS 2.5 MG TABLET TADALAFIL 1 BPH Treatments CIALIS 20 MG TABLET TADALAFIL 1 BPH Treatments CIALIS 5 MG TABLET TADALAFIL 1 HIV/AIDS Agents CIMDUO 300-300 MG TABLET LAMIVUDINE AND TENOFOVIR DF 1 Cytokine & CAM Antagonists CIMZIA 200 MG VIAL KIT CERTOLIZUMAB PEGOL 0.11 Cytokine & CAM Antagonists CIMZIA 200 MG/ML STARTER KIT CERTOLIZUMAB PEGOL 0.11 Cytokine & CAM Antagonists CIMZIA 200 MG/ML SYRINGE KIT CERTOLIZUMAB PEGOL 0.11 Hereditary Angioedema Treatments CINRYZE 500 UNIT VIAL C1 ESTERASE INHIBITOR 0.67 Antihistamines, Minimally Sedating CLARINEX - D 12 HOUR TABLET PSEUDOEPHEDRINE/DESLORATADINE 2 Antihistamines, Minimally Sedating CLARINEX - D 24 HOUR TABLET PSEUDOEPHEDRINE/DESLORATADINE 1 Antihistamines, Minimally Sedating CLARINEX 0.5 MG/ML SYRUP DESLORATADINE 10 Antihistamines, Minimally Sedating CLARINEX 2.5 MG REDITABS DESLORATADINE 1 Antihistamines, Minimally Sedating CLARINEX 5 MG REDITABS DESLORATADINE 1 Antihistamines, Minimally Sedating CLARINEX 5 MG TABLET DESLORATADINE 1 Antihistamines, Minimally Sedating CLARITIN 10 MG REDITABS LORATADINE 1 Antihistamines, Minimally Sedating CLARITIN 10 MG TABLETS LORATADINE 1 Antihistamines, Minimally Sedating CLARITIN 5 MG/5 ML SYRUP LORATADINE 10 Antihistamines, Minimally Sedating CLARITIN CHEWABLE 5 MG TABLET LORATADINE 2 Antihistamines, Minimally Sedating CLARITIN-D 12 HOUR TAB SA PSEUDOEPHEDRINE/LORATADINE 2 Antihistamines, Minimally Sedating CLARITIN-D 24 HOUR TAB ER PSEUDOEPHEDRINE/LORATADINE 1 Diabetic Meters CLEVER CHEK BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips CLEVER CHOICE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips CLEVER CHOICE VOICE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 NSAIDs CLINORIL 150 MG TABLET SULINDAC 2 NSAIDs CLINORIL 200 MG TABLET SULINDAC 2 Antipsychotics, Atypical CLOZARIL 100 MG TABLET CLOZAPINE 9 Antipsychotics, Atypical CLOZARIL 200 MG TABLET CLOZAPINE 4 Antipsychotics, Atypical CLOZARIL 25 MG TABLET CLOZAPINE 3 Antipsychotics, Atypical CLOZARIL 50 MG TABLET CLOZAPINE 3 Analgesics, Opioids Short-Acting CODEINE SULFATE 15 MG TABLET CODEINE 6 Analgesics, Opioids Short-Acting CODEINE SULFATE 30 MG TABLET CODEINE 6 Analgesics, Opioids Short-Acting CODEINE SULFATE 60 MG TABLET CODEINE 5 Antiparkinson's Agents COGENTIN 0.5 MG TABLET BENZTROPINE 2 Antiparkinson's Agents COGENTIN 1 MG TABLET BENZTROPINE 4 Antiparkinson's Agents COGENTIN 2 MG TABLET BENZTROPINE 3 Ulcerative Colitis Agents COLAZAL 750 MG CAPSULE BALSALAZIDE 9 Antihyperuricemics COLCRYS 0.6 MG TABLET COLCHICINE 3 Lipotropics, Other COLESTID 1 GRAM TABLET COLESTIPOL 16 COPD Agents COMBIVENT RESPIMAT INHALATION SPRAY IPRATROPIUM/ALBUTEROL 0.27 HIV/AIDS Agents COMBIVIR 50 MG/300 MG TABLET LAMIVUDINE/ZIDOVUDINE 2


Analgesics, Opioids Short-Acting COMBUNOX 5 MG/400 MG TABLET OXYCODONE/IBUPROFEN 4 Oncology, Oral COMETRIQ 100 MG DAILY DOSE PACK CABOZANTINIB 2 Oncology, Oral COMETRIQ 140 MG DAILY DOSE PACK CABOZANTINIB 4 Oncology, Oral COMETRIQ 60 MG DAILY DOSE PACK CABOZANTINIB 3 Smoking Cessation COMMIT 2 MG LOZENGE NICOTINE POLACRILEX 20 Smoking Cessation COMMIT 4 MG LOZENGE NICOTINE POLACRILEX 20 HIV/AIDS Agents COMPLERA 200 MG/25 MG/300 MG TABLET EMTRICITABINE/RILPIVIRINE/TENOFOVIR DF 1 Antiparkinson's Agents COMTAN 200 MG ENTACAPONE 8 Stimulants & Related Agents CONCERTA 18 MG TABLET METHYLPHENIDATE 1 Stimulants & Related Agents CONCERTA 27 MG TABLET METHYLPHENIDATE 1 Stimulants & Related Agents CONCERTA 36 MG TABLET METHYLPHENIDATE 2 Stimulants & Related Agents CONCERTA 54 MG TABLET METHYLPHENIDATE 1 Diabetic Meters CONTOUR BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips CONTOUR BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters CONTOUR LINK BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips CONTOUR NEXT BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters CONTOUR NEXT EZ BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters CONTOUR NEXT LINK BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters CONTOUR PLUS BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote3

Diabetic Meters CONTOUR PLUS BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters CONTOUR USB BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Analgesics, Opioid Short-Acting CONZIP 100 MG CAPSULE TRAMADOL 1 Analgesics, Opioid Short-Acting CONZIP 200 MG CAPSULE TRAMADOL 1 Analgesics, Opioid Short-Acting CONZIP 300 MG CAPSULE TRAMADOL 1 Multiple Sclerosis Agents COPAXONE 20 MG/ML SYRINGE GLATIRAMER ACETATE 1 Multiple Sclerosis Agents COPAXONE 40 MG/ML SYRINGE GLATIRAMER ACETATE 0.43 Beta-Blockers COREG 12.5 MG TABLET CARVEDILOL 2 Beta-Blockers COREG 25 MG TABLET CARVEDILOL 4 Beta-Blockers COREG 3.125 MG TABLET CARVEDILOL 2 Beta-Blockers COREG 6.25 MG TABLET CARVEDILOL 2 Beta-Blockers COREG CR 10 MG CAPSULE CARVEDILOL 1 Beta-Blockers COREG CR 20 MG CAPSULE CARVEDILOL 1 Beta-Blockers COREG CR 40 MG CAPSULE CARVEDILOL 1 Beta-Blockers COREG CR 80 MG CAPSULE CARVEDILOL 1 Cardiovascular Agents CORLANOR 5 MG TABLETS IVABRADINE 2 Cardiovascular Agents CORLANOR 7.5 MG TABLETS IVABRADINE 2 Cytokine & CAM Antagonists COSENTYX 300 MG DOSE 2 PENS SECUKINUMAB 0.29 Cytokine & CAM Antagonists COSENTYX 300 MG DOSE 2 SYRINGES SECUKINUMAB 0.29 Oncology, Oral COTELLIC 20 MG TABLET COBIMETINIB FUMARATE 3 Stimulants & Related Agents COTEMPLA XR-ODT 17.3 MG TABLET METHYLPHENIDATE 2 Stimulants & Related Agents COTEMPLA XR-ODT 25.9 MG TABLET METHYLPHENIDATE 2 Stimulants & Related Agents COTEMPLA XR-ODT 8.6 MG TABLET METHYLPHENIDATE 1 Calcium Channel Blockers COVERA-HS 180 MG TABLET SA VERAPAMIL 2


Calcium Channel Blockers COVERA-HS 240 MG TABLET SA VERAPAMIL 2 Angiotensin Modulators COZAAR 100 MG TABLET LOSARTAN 1 Angiotensin Modulators COZAAR 25 MG TABLET LOSARTAN 2 Angiotensin Modulators COZAAR 50 MG TABLET LOSARTAN 2 Antifungals, Oral CRESEMBA 186 MG CAPSULE ISAVUCONAZONIUM SULFATE 3.15 Lipotropics, Statins CRESTOR 10 MG TABLET ROSUVASTATIN 1.5 Lipotropics, Statins CRESTOR 20 MG TABLET ROSUVASTATIN 1.5 Lipotropics, Statins CRESTOR 40 MG TABLET ROSUVASTATIN 1 Lipotropics, Statins CRESTOR 5 MG TABLET ROSUVASTATIN 1.5 HIV/AIDS Agents CRIXIVAN 200 MG CAPSULE INDINAVIR 3 HIV/AIDS Agents CRIXIVAN 400 MG CAPSULE INDINAVIR 6 Insect Repellent for Skin Application CUTTER BACKWOODS DRY INSECT REPELLENT 25% AERO. DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application CUTTER BACKWOODS INSECT REPELLENT 25% AEROSOL DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application CUTTER BACKWOODS INSECT REPELLENT 25% AEROSOL DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application CUTTER BACKWOODS INSECT REPELLENT 25% PUMP DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application CUTTER LEMON EUCALYPTUS INSECT REPELLENT PUMP OIL OF LEMON EUCALYPTUS 30 Insect Repellent for Skin Application CUTTER SKINSATIONS INSECT REPELLENT1 7% PUMP DIETHYLTOLUAMIDE 30 Insect Repellent NOT for Skin Application CVS LICE BEDDING SPRAY PERMETHRIN 0.5% 29 Insect Repellent for Skin Application CVS TOTAL HOME INSECT 30% SPRAY DIETHYLTOLUAMIDE 30 Antidepressants, Other CYMBALTA 20 MG CAPSULE DULOXETINE 2 Antidepressants, Other CYMBALTA 30 MG CAPSULE DULOXETINE 2 Antidepressants, Other CYMBALTA 60 MG CAPSULE DULOXETINE 2 Thyroid Hormones CYTOMEL 25 MCG TABLET LIOTHYRONINE 1 Thyroid Hormones CYTOMEL 5 MCG TABLET LIOTHYRONINE 4 Thyroid Hormones CYTOMEL 50 MCG TABLET LIOTHYRONINE 2 Hepatitis C Agents DAKLINZA 30 MG TABLET DACLATASVIR 1 Hepatitis C Agents DAKLINZA 60 MG TABLET DACLATASVIR 1 Hepatitis C Agents DAKLINZA 90 MG TABLET DACLATASVIR 1 COPD Agents DALIRESP 250 MCG TABLET ROFLUMILAST 1 COPD Agents DALIRESP 500 MCG TABLET ROFLUMILAST 1 Sedative Hypnotics DALMANE 15 MG CAPSULE FLURAZEPAM 1 Sedative Hypnotics DALMANE 30 MG CAPSULE FLURAZEPAM 1 Skeletal Muscle Relaxants DANTRIUM 100 MG CAPSULE DANTROLENE 4 Skeletal Muscle Relaxants DANTRIUM 25 MG CAPSULE DANTROLENE 4 Skeletal Muscle Relaxants DANTRIUM 50 MG CAPSULE DANTROLENE 4 Antimalarial Agents DARAPRIM 25 MG TABLET PYRIMETHAMINE 3 NSAIDs DAYPRO 600 MG TABLET OXAPROZIN 3 Stimulants & Related Agents DAYTRANA TRANSDERMAL 10 MG PATCH METHYLPHENIDATE 1 Stimulants & Related Agents DAYTRANA TRANSDERMAL 15 MG PATCH METHYLPHENIDATE 1 Stimulants & Related Agents DAYTRANA TRANSDERMAL 20 MG PATCH METHYLPHENIDATE 2 Stimulants & Related Agents DAYTRANA TRANSDERMAL 30 MG PATCH METHYLPHENIDATE 2 Antidiuretic Hormones DDAVP 0.01% NASAL SPRAY PUMP DESMOPRESSIN ACETATE SOLUTION 0.4 Antidiuretic Hormones DDAVP 0.01% NASAL SPRAY PUMP (NON-REFRIGERATED) DESMOPRESSIN ACETATE SOLUTION 0.4


Androgenic Agents DELATESTRYL 200 MG/ML VIAL TESTOSTERONE ENANTHATE 0.15 Ulcerative Colitis Agents DELZICOL 400 MG DR CAPSULE MESALAMINE 6 Analgesics, Opioids Short-Acting DEMEROL 100 MG TABLET MEPERIDINE 5 Analgesics, Opioids Short-Acting DEMEROL 50 MG TABLET MEPERIDINE 10 Analgesics, Opioids Short-Acting DEMEROL 50 MG/5 ML SOLUTION MEPERIDINE 50 Antihypertensives, Miscellaneous DEMSER 250 MG CAPSULE METYROSINE 16 Antivirals, Topical DENAVIR 1% CREAM PENCICLOVIR 1.25 Contraceptives, Other DEPO-PROVERA 150 MG/ML VIAL/SYRINGE MEDROXYPROGESTERONE ACETATE 0.01 Progestational Agents DEPO-PROVERA 400 MG/ML VIAL/SYRINGE (2.5 ML) MEDROXYPROGESTERONE ACETATE 0.09 Contraceptives, Other DEPO-SUBQ PROVERA 104 SYRINGE MEDROXYPROGESTERONE ACETATE 0.01 Androgenic Agents DEPO-TESTOSTERONE 100 MG/ML VIAL TESTOSTERONE CYPIONATE 0.29 Androgenic Agents DEPO-TESTOSTERONE 200 MG/ML VIAL TESTOSTERONE CYPIONATE 0.15 Anesthetics, Topical DERMACINRX PRIZOPAK KIT LIDOCAINE/PRILOCAINE 1 Anesthetics, Topical DERMACINRX ZRM PAK KIT LIDOCAINE/DIMETHICONE 1 HIV/AIDS Agents DESCOVY 200/25 MG TABLET EMTRICITABINE/TENOFOVIR ALAFENAMIDE 1 Stimulants & Related Agents DESOXYN 5 MG TABLET METHAMPHETAMINE 5 Antidepressants, Other DESVENLAFAXINE ER 100 MG TABLET DESVENLAFAXINE 1 Antidepressants, Other DESVENLAFAXINE ER 50 MG TABLET DESVENLAFAXINE 1 Antidepressants, Other DESVENLAFAXINE FUMARATE ER 100 MG TABLET DESVENLAFAXINE FUMARATE 1 Antidepressants, Other DESVENLAFAXINE FUMARATE ER 50 MG TABLET DESVENLAFAXINE FUMARATE 1 Bladder Relaxant Preparations DETROL 1 MG TABLET TOLTERODINE 2 Bladder Relaxant Preparations DETROL 2 MG TABLET TOLTERODINE 2 Bladder Relaxant Preparations DETROL LA 2 MG CAPSULE TOLTERODINE 1 Bladder Relaxant Preparations DETROL LA 4 MG CAPSULE TOLTERODINE 1 Stimulants & Related Agents DEXEDRINE SPANSULE 10 MG DEXTROAMPHETAMINE SR 4 Stimulants & Related Agents DEXEDRINE SPANSULE 15 MG DEXTROAMPHETAMINE SR 4 Stimulants & Related Agents DEXEDRINE SPANSULE 5 MG DEXTROAMPHETAMINE SR 2 Proton Pump Inhibitors DEXILANT DR 30 MG CAPSULE DEXLANSOPRAZOLE 1 Proton Pump Inhibitors DEXILANT DR 60 MG CAPSULE DEXLANSOPRAZOLE 1 Stimulants & Related Agents DEXTROSTAT 10 MG TABLET DEXTROAMPHETAMINE 6 Stimulants & Related Agents DEXTROSTAT 5 MG TABLET DEXTROAMPHETAMINE 6 Hypoglycemics, Sulfonylureas DIABETA 1.25 MG TABLET GLYBURIDE 2 Hypoglycemics, Sulfonylureas DIABETA 2.5 MG TABLET GLYBURIDE 2 Hypoglycemics, Sulfonylureas DIABETA 5 MG TABLET GLYBURIDE 4 Anxiolytics DIAZEPAM 5 MG/5ML SOLN DIAZEPAM 40 Anxiolytics DIAZEPAM INTENSOL 5 MG/ML CONCENTRATE DIAZEPAM 8 Antiemetics/Antivertigo Agents DICLEGIS DR 10 MG/10 MG TABLET DOXYLAMINE/PYRIDOXINE 4 Antibiotics, Gastrointestinal DIFICID 200 MG TABLET FIDAXOMICIN 2 Antifungals, Oral DIFLUCAN 10 MG/ML SUSPENSION FLUCONAZOLE 10 Antifungals, Oral DIFLUCAN 100 MG TABLET FLUCONAZOLE 2 Antifungals, Oral DIFLUCAN 150 MG TABLET FLUCONAZOLE 1 Antifungals, Oral DIFLUCAN 200 MG TABLET FLUCONAZOLE 2 Antifungals, Oral DIFLUCAN 40 MG/ML SUSPENSION FLUCONAZOLE 10


Antifungals, Oral DIFLUCAN 50 MG TABLET FLUCONAZOLE 2 Analgesics, Salicylates DIFLUNISAL 500 MG TABLET DIFLUNISAL 3 Calcium Channel Blockers DILACOR XR 120 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers DILACOR XR 180 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers DILACOR XR 240 MG CAPSULE SA DILTIAZEM 2 Anticonvulsants DILANTIN 100 MG CAPSULE PHENYTOIN 6 Anticonvulsants DILANTIN 125 MG/5 ML (100 MG/4 ML) LIQUID PHENYTOIN 24 Anticonvulsants DILANTIN 30 MG CAPSULE PHENYTOIN 6 Anticonvulsants DILANTIN 50 MG CHEWABLE INFATAB PHENYTOIN 6 Analgesics, Opioids Short-Acting DILAUDID 1 MG/ML LIQUID HYDROMORPHONE 80 Analgesics, Opioids Short-Acting DILAUDID 2 MG TABLET HYDROMORPHONE 6 Analgesics, Opioids Short-Acting DILAUDID 3 MG SUPPOSITORY HYDROMORPHONE 4 Analgesics, Opioids Short-Acting DILAUDID 4 MG TABLET HYDROMORPHONE 4 Analgesics, Opioids Short-Acting DILAUDID 8 MG TABLET HYDROMORPHONE 4 Calcium Channel Blockers DILT-CD 120 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILT-CD 180 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILT-CD 240 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers DILT-CD ER 300 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILTIA XT 120 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers DILTIA XT 180 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers DILTIA XT 240 MG CAPSULE SA DILTIAZEM 2 Calcium Channel Blockers DILTIAZEM ER 60 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers DILTIAZEM ER 90 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers DILT-XR 120 MG CAP SA DILTIAZEM 1 Calcium Channel Blockers DILT-XR 180 MG CAP SA DILTIAZEM 1 Calcium Channel Blockers DILT-XR 240 MG CAP SA DILTIAZEM 2 Calcium Channel Blockers DILTZAC ER 120 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILTZAC ER 180 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILTZAC ER 240 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers DILTZAC ER 300 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers DILTZAC ER 360 MG CAPSULE DILTIAZEM 1 Angiotensin Modulators DIOVAN 160 MG VALSARTAN 2 Angiotensin Modulators DIOVAN 320 MG VALSARTAN 1 Angiotensin Modulators DIOVAN 40 MG VALSARTAN 2 Angiotensin Modulators DIOVAN 80 MG VALSARTAN 2 Angiotensin Modulators DIOVAN HCT 160/12.5 MG TAB VALSARTAN/HCTZ 1 Angiotensin Modulators DIOVAN HCT 160/25 MG TABLET VALSARTAN/HCTZ 1 Angiotensin Modulators DIOVAN HCT 320/12.5 MG TABLET VALSARTAN/HCTZ 1 Angiotensin Modulators DIOVAN HCT 320/25 MG TABLET VALSARTAN/HCTZ 1 Angiotensin Modulators DIOVAN HCT 80/12.5 MG TABLET VALSARTAN/HCTZ 1 Ulcerative Colitis Agents DIPENTUM 250 MG CAPSULE OLSALAZINE 4 Bladder Relaxant Preparations DITROPAN 5 MG TABLET OXYBUTYNIN 4 Bladder Relaxant Preparations DITROPAN 5 MG/5 ML SYRUP OXYBUTYNIN 20


Bladder Relaxant Preparations DITROPAN XL 10 MG TABLET OXYBUTYNIN 2 Bladder Relaxant Preparations DITROPAN XL 15 MG TABLET OXYBUTYNIN 2 Bladder Relaxant Preparations DITROPAN XL 5 MG TABLET OXYBUTYNIN 1 Analgesics, Opioids Long-Acting DOLOPHINE 10 MG TABLET METHADONE 2 Analgesics, Opioids Long-Acting DOLOPHINE 5 MG TABLET METHADONE 2 Sedative Hypnotics DORAL 15 MG TABLET QUAZEPAM 1 Tetracyclines DORYX DR 100 MG TABLET DOXYCYCLINE HYCLATE 1 Tetracyclines DORYX DR 150 MG TABLET DOXYCYCLINE HYCLATE 1 Tetracyclines DORYX DR 200 MG TABLET DOXYCYCLINE HYCLATE 1 Tetracyclines DORYX DR 50 MG TABLET DOXYCYCLINE HYCLATE 1 Tetracyclines DORYX DR 75 MG TABLET DOXYCYCLINE HYCLATE 1 Tetracyclines DORYX MPC DR 120 mg tablet DOXYCYCLINE HYCLATE DELAYED-RELEASE 2 Hypoglycemics, TZD DUETACT 30/2 MG TABLET PIOGLITAZONE/ GLIMEPIRIDE 1 Hypoglycemics, TZD DUETACT 30/4 MG TABLET PIOGLITAZONE/ GLIMEPIRIDE 1 NSAIDs DUEXIS 800 MG/26.6 MG TABLET IBUPROFEN/FAMOTIDINE 3 Glucocorticoids, Inhaled DULERA 100/5 DISKUS MOMETASONE/FORMOTEROL 0.44 Glucocorticoids, Inhaled DULERA 200/5 DISKUS MOMETASONE/FORMOTEROL 0.44 COPD Agents DUONEB 0.5 MG-3 MG/3 ML INHALATION SOLUTION IPRATROPIUM/ALBUTEROL 18 Cytokine & CAM Antagonists DUPIXENT 300 MG/2 ML DUPILUMAB 0.29 Analgesics, Opioids Long-Acting DURAGESIC 100 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting DURAGESIC 12 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting DURAGESIC 25 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting DURAGESIC 50 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting DURAGESIC 75 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Antihyperuricemics DUZALLO 200-200 MG TABLET LESINURAD/ALLOPURINOL 1 Antihyperuricemics DUZALLO 200-300 MG TABLET LESINURAD/ALLOPURINOL 1 Stimulants & Related Agents DYANAVEL XR 2.5 MG/ML SUSPENSION DEXTROAMPHETAMINE/AMPHETAMINE 8 Intranasal Rhinitis Agents DYMISTA NASAL SPRAY AZELASTINE/FLUTICASONE 0.77 Calcium Channel Blockers DYNACIRC 2.5 MG CAPSULE ISRADIPINE 2 Calcium Channel Blockers DYNACIRC 5 MG CAPSULE ISRADIPINE 2 Calcium Channel Blockers DYNACIRC CR 10 MG TABLET SA ISRADIPINE 2 Calcium Channel Blockers DYNACIRC CR 5 MG TABLET SA ISRADIPINE 1 Botulinum Toxins DYSPORT 300 UNIT INJECTION VIAL ABOBOTULINUMTOXIN A 0.04 Botulinum Toxins DYSPORT 500 UNIT INJECTION VIAL ABOBOTULINUMTOXIN A 0.04 Diabetic Strips EASYGLUCO BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 NSAIDs EC-NAPROSYN 375 MG TABLET NAPROXEN 3 NSAIDs EC-NAPROSYN 500 MG TABLET NAPROXEN 3 Angiotensin Modulators EDARBI 40 MG TABLET AZILSARTAN 1 Angiotensin Modulators EDARBI 80 MG TABLET AZILSARTAN 1 Angiotensin Modulators EDARBYCLOR 40 MG/12.5 MG TABLET AZILSARTAN/CHLORTHALIDONE 1 Angiotensin Modulators EDARBYCLOR 40 MG/25 MG TABLET AZILSARTAN/CHLORTHALIDONE 1 Sedative Hypnotics EDLUAR 10 MG SL TABLET ZOLPIDEM 1-See footnote3

Sedative Hypnotics EDLUAR 5 MG SL TABLET ZOLPIDEM 1


HIV/AIDS Agents EDURANT 25 MG TABLET RILPIVIRINE 1 Antidepressants, Other EFFEXOR 100 MG TABLET VENLAFAXINE 3 Antidepressants, Other EFFEXOR 25 MG TABLET VENLAFAXINE 3 Antidepressants, Other EFFEXOR 37.5 MG TABLET VENLAFAXINE 3 Antidepressants, Other EFFEXOR 50 MG TABLET VENLAFAXINE 3 Antidepressants, Other EFFEXOR 75 MG TABLET VENLAFAXINE 3 Antidepressants, Other EFFEXOR XR 150 MG CAPSULE SA VENLAFAXINE 2 Antidepressants, Other EFFEXOR XR 37.5 MG CAPSULE SA VENLAFAXINE 1 Antidepressants, Other EFFEXOR XR 75 MG CAPSULE SA VENLAFAXINE 3 Platelet Aggregation Inhibitors EFFIENT 10 MG TABLET PRASUGREL 1 Platelet Aggregation Inhibitors EFFIENT 5 MG TABLET PRASUGREL 1 Antiparkinson's Agents ELDEPRYL 5 MG CAPSULE/TABLET SELEGILINE 2 Pituitary Suppressive Agents, LHRH ELIGARD 22.5 MG SYRINGE KIT (3-MONTH) LEUPROLIDE ACETATE 0.2 Pituitary Suppressive Agents, LHRH ELIGARD 30 MG SYRINGE KIT (4-MONTH) LEUPROLIDE ACETATE 0.01 Pituitary Suppressive Agents, LHRH ELIGARD 45 MG SYRINGE KIT (6-MONTH) LEUPROLIDE ACETATE 0.01 Pituitary Suppressive Agents, LHRH ELIGARD 7.5 MG SYRINGE KIT (1-MONTH) LEUPROLIDE ACETATE 0.4 Phosphate Binders ELIPHOS 667 MG TABLET CALCIUM ACETATE 12 Anticoagulants, Oral ELIQUIS 2.5 MG TABLET APIXABAN 2 Anticoagulants, Oral ELIQUIS 5 MG STARTER PACK APIXABAN 2.47 Anticoagulants, Oral ELIQUIS 5 MG TABLET APIXABAN 2 Analgesics, Urinary ELMIRON 100 MG CAPSULE PENTOSAN POLYSULFATE SODIUM 3 Analgesics, Opioids Long-Acting EMBEDA ER 100-4 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Analgesics, Opioids Long-Acting EMBEDA ER 20-0.8 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Analgesics, Opioids Long-Acting EMBEDA ER 30-1.2 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Analgesics, Opioids Long-Acting EMBEDA ER 50-2 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Analgesics, Opioids Long-Acting EMBEDA ER 60-2.4 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Analgesics, Opioids Long-Acting EMBEDA ER 80-3.2 MG CAPSULE MORPHINE SULFATE/NALTREXONE HCL ER 1 Diabetic Meters EMBRACE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips EMBRACE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Antiemetics/Antivertigo Agents EMEND 115 MG INJECTION VIAL FOSAPREPITANT 0.08 Antiemetics/Antivertigo Agents EMEND 125 MG CAPSULE APREPITANT 0.34 Antiemetics/Antivertigo Agents EMEND 125 MG POWDER PACKET APREPITANT 1 Antiemetics/Antivertigo Agents EMEND 150 MG INJECTION VIAL FOSAPREPITANT 0.08 Antiemetics/Antivertigo Agents EMEND 40 MG CAPSULE APREPITANT 1 Antiemetics/Antivertigo Agents EMEND 80 MG CAPSULE APREPITANT 1 Antiemetics/Antivertigo Agents EMEND BIFOLD PACK APREPITANT 1 Antiemetics/Antivertigo Agents EMEND TRIFOLD PACK APREPITANT 1 Glucocorticoids, Oral EMFLAZA 18 MG TABLET DEFLAZACORT 1 Glucocorticoids, Oral EMFLAZA 22.75 MG/ML ORAL SUSPENSION DEFLAZACORT 1.86 Glucocorticoids, Oral EMFLAZA 30 MG TABLET DEFLAZACORT 1 Glucocorticoids, Oral EMFLAZA 36 MG TABLET DEFLAZACORT 1 Glucocorticoids, Oral EMFLAZA 6 MG TABLET DEFLAZACORT 2 Antidepressants, Other EMSAM 12 MG/24 HR TRANSDERMAL PATCH SELEGILINE 1


Antidepressants, Other EMSAM 6 MG/24 HR TRANSDERMAL PATCH SELEGILINE 1 Antidepressants, Other EMSAM 9 MG/24 HR TRANSDERMAL PATCH SELEGILINE 1 HIV/AIDS Agents EMTRIVA 10 MG/ML ORAL SOLUTION EMTRICITABINE 24 HIV/AIDS Agents EMTRIVA 200 MG CAPSULE EMTRICITABINE 1 Antiparasitics EMVERM 100 MG CHEWABLE TABLET MEBENDAZOLE 2 Bladder Relaxant Preparations ENABLEX 15 MG ER TABLET DARIFENACIN 1 Bladder Relaxant Preparations ENABLEX 7.5 MG ER TABLET DARIFENACIN 1 Cytokine & CAM Antagonists ENBREL 25 MG VIAL KIT ETANERCEPT 0.29 Cytokine & CAM Antagonists ENBREL 25 MG/0.5 ML SYRINGE ETANERCEPT 0.3 Cytokine & CAM Antagonists ENBREL 50 MG/ML MINI CARTRIDGE ETANERCEPT 0.28 Cytokine & CAM Antagonists ENBREL 50 MG/ML SURECLICK SYRINGE ETANERCEPT 0.28 Cytokine & CAM Antagonists ENBREL 50 MG/ML SYRINGE ETANERCEPT 0.28 Analgesics, Opioids Short-Acting ENDOCET 10-325 MG TABLET OXYCODONE/ACETAMINOPHEN 4 Analgesics, Opioids Short-Acting ENDOCET 5-325 MG TABLET OXYCODONE/ACETAMINOPHEN 6 Analgesics, Opioids Short-Acting ENDOCET 7.5-325 MG TABLET OXYCODONE/ACETAMINOPHEN 4 Analgesics, Opioids Short-Acting ENDODAN 4.83-325 MG TABLET OXYCODONE/ASPIRIN 6 Vaccines ENGERIX-B 10 MCG/0.5 ML PEDIATRIC SYRINGE HEPATITIS B VIRUS VACCINE 0.5 Vaccines ENGERIX-B 10 MCG/0.5 ML PEDIATRIC VIAL HEPATITIS B VIRUS VACCINE 0.5 Vaccines ENGERIX-B 20 MCG/ML SYRINGE HEPATITIS B VIRUS VACCINE 1 Vaccines ENGERIX-B 20 MCG/ML VIAL HEPATITIS B VIRUS VACCINE 1 Glucocorticoids, Oral ENTOCORT EC 3 MG CAPSULE BUDESONIDE 3 Angiotensin Modulators ENTRESTO 24 MG/26 MG TABLET SACUBITRIL/VALSARTAN 2 Angiotensin Modulators ENTRESTO 49 MG/51 MG TABLET SACUBITRIL/VALSARTAN 2 Angiotensin Modulators ENTRESTO 97 MG/103 MG TABLET SACUBITRIL/VALSARTAN 2 Cytokine & CAM Antagonists ENTYVIO 300 MG/20 ML VIAL VEDOLIZUMAB 0.08 Hepatitis C Agents EPCLUSA 400 MG/100 MG TABLET SOFOSBUVIR/VELPATASVIR 1 Anticonvulsants EPITOL 200 MG TABLET CARBAMAZEPINE 8 HIV/AIDS Agents EPIVIR 10 MG/ML ORAL SOLUTION LAMIVUDINE 30 HIV/AIDS Agents EPIVIR 150 MG TABLET LAMIVUDINE 2 HIV/AIDS Agents EPIVIR 300 MG TABLET LAMIVUDINE 1 Hepatitis B Agents EPIVIR HBV 100 MG TABLET LAMIVUDINE 1 Hepatitis B Agents EPIVIR HBV 25 MG/5 ML SOLUTION LAMIVUDINE 20 HIV/AIDS Agents EPZICOM 600 MG/300 MG TABLET ABACAVIR/LAMIVUDINE 1 Anticonvulsants EQUETRO 100 MG CAPSULE CARBAMAZEPINE ER 6 Anticonvulsants EQUETRO 200 MG CAPSULE CARBAMAZEPINE ER 8 Anticonvulsants EQUETRO 300 MG CAPSULE CARBAMAZEPINE ER 5 Antimigraine Agents, Other ERGOMAR 2 MG TABLET SL ERGOTAMINE TARTRATE 0.72 Oncology, Oral ERIVEDGE 150 MG CAPSULE VISMODEGIB 1 Oncology, Oral ERLEADA 60 MG TABLET APALUTAMIDE 4 Idiopathic Pulmonary Fibrosis Agents ESBRIET 267 MG CAPSULE PERFENIDONE 6.9 Idiopathic Pulmonary Fibrosis Agents ESBRIET 267 MG TABLET PERFENIDONE 6.9 Idiopathic Pulmonary Fibrosis Agents ESBRIET 801 MG TABLET PERFENIDONE 3 Analgesics, Non-Narcotic Barbiturate Combos ESGIC 50 MG/325 MG/40 MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6


Analgesics, Non-Narcotic Barbiturate Combos ESGIC 50 MG/325 MG/40 MG TABLET BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Proton Pump Inhibitors ESOMEPRAZOLE STRONTIUM 49.3 MG DR CAPSULE ESOMEPRAZOLE STRONTIUM 1 Intra-Articular Hyaluronic Acids EUFLEXXA 20 MG/2 ML SYRINGE HYALURONIC ACID 0.72 Oncology, Oral EULIXIN 125 MG CAPSULE FLUTAMIDE 6 Stimulants & Related Agents EVEKEO 10 MG TABLET AMPHETAMINE SULFATE 6 Stimulants & Related Agents EVEKEO 5 MG TABLET AMPHETAMINE SULFATE 2 Bone Resorption Suppression & Related Agents EVISTA 60 MG TABLET RALOXIFENE 1 HIV/AIDS Agents EVOTAZ 300 MG/150 MG TABLET ATAZANAVIR/COBICISTAT 1 Analgesics, Opioids Long-Acting EXALGO 12 MG ER TABLET HYDROMORPHONE ER 1 Analgesics, Opioids Long-Acting EXALGO 16 MG ER TABLET HYDROMORPHONE ER 1 Analgesics, Opioids Long-Acting EXALGO 32 MG ER TABLET HYDROMORPHONE ER 1 Analgesics, Opioids Long-Acting EXALGO 8 MG ER TABLET HYDROMORPHONE ER 1 Analgesics, Salicylates EXCEDRIN EXTRA STRENGTH 250 MG/250 MG/65 MG ASPIRIN/ACETAMINOPHEN/CAFFEINE 13 Analgesics, Non-Salicylates EXCEDRIN TENSION HEADACHE 500 MG/65 MG ACETAMINOPHEN/CAFFEINE 6 Alzheimers Agents EXELON 1.5 MG CAPSULE RIVASTIGMINE 2 Alzheimers Agents EXELON 13.3 MG/24 HR PATCH RIVASTIGMINE 1 Alzheimers Agents EXELON 2 MG/ML ORAL SOLUTION RIVASTIGMINE 6 Alzheimers Agents EXELON 3 MG CAPSULE RIVASTIGMINE 2 Alzheimers Agents EXELON 4.5 MG CAPSULE RIVASTIGMINE 2 Alzheimers Agents EXELON 4.6 MG/24 HR PATCH RIVASTIGMINE 1 Alzheimers Agents EXELON 6 MG CAPSULE RIVASTIGMINE 2 Alzheimers Agents EXELON 9.5 MG/24 HR PATCH RIVASTIGMINE 1 Angiotensin Modulator Combinations EXFORGE 10/160 MG TABLET AMLODIPINE/VALSARTAN 1 Angiotensin Modulator Combinations EXFORGE 10/320 MG TABLET AMLODIPINE/VALSARTAN 1 Angiotensin Modulator Combinations EXFORGE 5/160 MG TABLET AMLODIPINE/VALSARTAN 1 Angiotensin Modulator Combinations EXFORGE 5/320 MG TABLET AMLODIPINE/VALSARTAN 1 Angiotensin Modulator Combinations EXFORGE HCT 10/160/12.5 MG TABLET AMLODIPINE/VALSARTAN/HCTZ 1 Angiotensin Modulator Combinations EXFORGE HCT 10/320/25 MG TABLET AMLODIPINE/VALSARTAN/HCTZ 1 Angiotensin Modulator Combinations EXFORGE HCT 5/160/12.5 MG TABLET AMLODIPINE/VALSARTAN/HCTZ 1 Angiotensin Modulator Combinations EXFORGE HCT 5/160/25 MG TABLET AMLODIPINE/VALSARTAN/HCTZ 1 Angiotensin Modulator Combinations EXFORGE HCT10/160/25 MG TABLET AMLODIPINE/VALSARTAN/HCTZ 1 Macular Degeneration Agents EYLEA 2 MG/0.05 INTRAVITREAL INJECTION VIAL AFLIBERCEPT 0.01 Diabetic Strips EZ SMART BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Antivirals, Oral FAMVIR 125 MG TABLET FAMCICLOVIR 6 Antivirals, Oral FAMVIR 250 MG TABLET FAMCICLOVIR 6 Antivirals, Oral FAMVIR 500 MG TABLET FAMCICLOVIR 4 Antipsychotics, Atypical FANAPT 1 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 10 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 12 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 2 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 4 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 6 MG TABLET ILOPERIDONE 2 Antipsychotics, Atypical FANAPT 8 MG TABLET ILOPERIDONE 2


Antipsychotics, Atypical FANAPT TITRATION PACK ILOPERIDONE 2 Oncology Agents, Breast Cancer FARESTON 60 MG TABLET TOREMIFENE 1 Hypoglycemics, SGLT2 FARXIGA 10 MG TABLET DAPAGLIFLOZIN 1 Hypoglycemics, SGLT2 FARXIGA 5 MG TABLET DAPAGLIFLOZIN 1 Oncology, Oral FARYDAK 10 MG CAPSULE PANOBINOSTAT 0.5 Oncology, Oral FARYDAK 15 MG CAPSULE PANOBINOSTAT 0.5 Oncology, Oral FARYDAK 20 MG CAPSULE PANOBINOSTAT 0.5 Antipsychotics, Atypical FAZACLO 100 MG ODT CLOZAPINE 9 Antipsychotics, Atypical FAZACLO 12.5 MG ODT CLOZAPINE 2 Antipsychotics, Atypical FAZACLO 150 MG ODT CLOZAPINE 6 Antipsychotics, Atypical FAZACLO 200 MG ODT CLOZAPINE 4 Antipsychotics, Atypical FAZACLO 25 MG ODT CLOZAPINE 3 NSAIDs FELDENE 10 MG CAPSULE PIROXICAM 1 NSAIDs FELDENE 20 MG CAPSULE PIROXICAM 1 Oncology Agents, Breast Cancer FEMARA 2.5 MG TABLET LETROZOLE 1 Lipotropics, Other FENOGLIDE 120 MG TABLET FENOFIBRATE 1 Lipotropics, Other FENOGLIDE 40 MG TABLET FENOFIBRATE 2 Analgesics, Opioids Long-Acting FENTANYL 37.5 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting FENTANYL 62.5 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Long-Acting FENTANYL 87.5 MCG/HR PATCH FENTANYL TRANSDERMAL 0.34 Analgesics, Opioids Short-Acting FENTORA 100 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Analgesics, Opioids Short-Acting FENTORA 200 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Analgesics, Opioids Short-Acting FENTORA 300 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Analgesics, Opioids Short-Acting FENTORA 400 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Analgesics, Opioids Short-Acting FENTORA 600 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Analgesics, Opioids Short-Acting FENTORA 800 MCG BUCCAL TABLET FENTANYL CITRATE BUCCAL 4 Iron Replacement Agents FERAHEME 510 MG/17 ML VIAL FERUMOXYTOL 17 Antidepressants, Other FETZIMA ER 120 MG CAPSULE LEVOMILNACIPRIN 1 Antidepressants, Other FETZIMA ER 20 MG CAPSULE LEVOMILNACIPRIN 1 Antidepressants, Other FETZIMA ER 40 MG CAPSULE LEVOMILNACIPRIN 1 Antidepressants, Other FETZIMA ER 80 MG CAPSULE LEVOMILNACIPRIN 1 Skeletal Muscle Relaxants FEXMID 7.5 MG TABLET CYCLOBENZAPRINE 3 Lipotropics, Other FIBRICOR 105 MG TABLET FENOFIBRIC ACID 1 Lipotropics, Other FIBRICOR 35 MG TABLET FENOFIBRIC ACID 2 Analgesics, Non-Narcotic Barbiturate Combos FIORICET 50 MG/300 MG/40 MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Analgesics, Non-Narcotic Barbiturate Combos FIORICET 50 MG/325 MG/40 MG TABLET BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Analgesics, Opioids Short-Acting FIORICET W/ CODEINE 50MG/300 MG/40MG/30MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEINE 0.6 Analgesics, Opioids Short-Acting FIORICET W/ CODEINE 50MG/325 MG/40MG/30MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE/CODEINE 0.6 Analgesics, Non-Narcotic Barbiturate Combos FIORINAL 50 MG/325 MG/40 MG CAPSULE BUTALBITAL/ASA/CAFFEINE 0.6 Analgesics, Opioids Short-Acting FIORINAL W/ CODEINE 50 MG/325 MG/40 MG/30 MG CAPSULE BUTALBITAL/ASA/CAFFEINE/CODEINE 0.6 Hereditary Angioedema Treatments FIRAZYR 30 MG/3 ML SYRINGE ICATIBANT ACETATE 9 Antibiotics, Gastrointestinal FLAGYL ER 750 MG TABLET METRONIDAZOLE 1 NSAIDs FLECTOR 180 MG PATCH DICLOFENAC EPOLAMINE TRANSDERMAL 2


Skeletal Muscle Relaxants FLEXERIL 10 MG TABLET CYCLOBENZAPRINE 3 Skeletal Muscle Relaxants FLEXERIL 5 MG TABLET CYCLOBENZAPRINE 3 BPH Treatments FLOMAX 0.4 MG CAPSULE TAMSULOSIN 2 Intranasal Rhinitis Agents FLONASE ALLERGY RELIEF OTC NASAL SPRAY FLUTICASONE 0.66 Intranasal Rhinitis Agents FLONASE NASAL SPRAY (RX) FLUTICASONE 0.54 Intranasal Rhinitis Agents FLONASE SENSIMIST 27.5 MCG SPRAY FLUTICASONE FUROATE 0.66 Glucocorticoids, Inhaled FLOVENT 100 MCG DISKUS #28 FLUTICASONE 2 Glucocorticoids, Inhaled FLOVENT 100 MCG DISKUS #60 FLUTICASONE 2 Glucocorticoids, Inhaled FLOVENT 250 MCG DISKUS #28 FLUTICASONE 8 Glucocorticoids, Inhaled FLOVENT 250 MCG DISKUS #60 FLUTICASONE 8 Glucocorticoids, Inhaled FLOVENT 50 MCG DISKUS #60 FLUTICASONE 2 Glucocorticoids, Inhaled FLOVENT HFA 110 MCG INHALER FLUTICASONE 0.4 Glucocorticoids, Inhaled FLOVENT HFA 220 MCG INHALER FLUTICASONE 0.8 Glucocorticoids, Inhaled FLOVENT HFA 44 MCG INHALER FLUTICASONE 0.36 Vaccine FLU VACCINE INTRADERMAL SYRINGE INFLUENZA VIRUS VACCINE 0.1 Vaccine FLU VACCINE PEDIATRIC SYRINGE INFLUENZA VIRUS VACCINE 0.25 Vaccine FLU VACCINE SYRINGE INFLUENZA VIRUS VACCINE 0.5 Vaccine FLU VACCINE VIAL INFLUENZA VIRUS VACCINE 0.5 Vaccine FLUMIST NASAL SPRAY INFLUENZA VIRUS VACCINE 1 Antidepressants, SSRIs FLUOXETINE 60 MG TABLET FLUOXETINE 60 MG TABLET 1 NSAIDs FLURBIPROFEN 100 MG TABLET FLURBIPROFEN 3 NSAIDs FLURBIPROFEN 50 MG TABLET FLURBIPROFEN 4 Stimulants & Related Agents FOCALIN 10 MG TABLET DEXMETHYLPHENIDATE 2 Stimulants & Related Agents FOCALIN 2.5 MG TABLET DEXMETHYLPHENIDATE 2 Stimulants & Related Agents FOCALIN 5 MG TABLET DEXMETHYLPHENIDATE 2 Stimulants & Related Agents FOCALIN XR 10 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 15 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 20 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 25 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 30 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 35 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 40 MG CAPSULE DEXMETHYLPHENIDATE 1 Stimulants & Related Agents FOCALIN XR 5 MG CAPSULE DEXMETHYLPHENIDATE 1 Bronchodilators, Beta Agonist FORADIL AEROLIZER 12 MCG CAP FORMOTEROL 2 Antidepressants, Other FORFIVO XL 450 MG TABLET BUPROPION 1 Hypoglycemics, Metformins FORTAMET ER 1,000 MG TABLET METFORMIN ER 2 Hypoglycemics, Metformins FORTAMET ER 500 MG TABLET METFORMIN ER 3 Antibiotics, Injectable FORTAZ 1 GM TWISTVIAL CEFTAZIDIME 3 Antibiotics, Injectable FORTAZ 1 GM VIAL CEFTAZIDIME 3 Antibiotics, Injectable FORTAZ 2 GM TWISTVIAL CEFTAZIDIME 3 Antibiotics, Injectable FORTAZ 2 GM VIAL CEFTAZIDIME 3 Antibiotics, Injectable FORTAZ 500 MG VIAL CEFTAZIDIME 3 Antibiotics, Injectable FORTAZ 6 GM VIAL CEFTAZIDIME 1


Antibiotics, Injectable FORTAZ-ISO-OSMOT 1 GM/50 ML CEFTAZIDIME 150 Antibiotics, Injectable FORTAZ-ISO-OSMOT 2 GM/50 ML CEFTAZIDIME 150 Bone Resorption Suppression & Related Agents FORTEO 600 MCG/2.4 ML PEN INJ TERIPARATIDE 0.09 Androgenic Agents FORTESTA 10 MG GEL PUMP TESTOSTERONE 3.51 Bone Resorption Suppression & Related Agents FORTICAL 200 UNITS NASAL SPRAY CALCITONIN-SALMON 0.13 Bone Resorption Suppression & Related Agents FOSAMAX 10 MG TABLET ALENDRONATE 1 Bone Resorption Suppression & Related Agents FOSAMAX 35 MG TABLET ALENDRONATE 0.14 Bone Resorption Suppression & Related Agents FOSAMAX 40 MG TABLET ALENDRONATE 1 Bone Resorption Suppression & Related Agents FOSAMAX 5 MG TABLET ALENDRONATE 1 Bone Resorption Suppression & Related Agents FOSAMAX 70 MG TABLET ALENDRONATE 0.14 Bone Resorption Suppression & Related Agents FOSAMAX 70 MG/75 ML ORAL SOLUTION ALENDRONATE 10.71 Bone Resorption Suppression & Related Agents FOSAMAX PLUS D 70 MG-2800 IU TABLET ALENDRONATE/CHOLECALCIFEROL 0.14 Bone Resorption Suppression & Related Agents FOSAMAX PLUS D 70 MG-5600 IU TABLET ALENDRONATE/CHOLECALCIFEROL 0.14 Phosphate Binders FOSRENOL 1000 MG CHEWABLE TABLET LANTHANUM CARBONATE 3 Phosphate Binders FOSRENOL 1000 MG POWDER PACKET LANTHANUM CARBONATE 3 Phosphate Binders FOSRENOL 500 MG CHEWABLE TABLET LANTHANUM CARBONATE 3 Phosphate Binders FOSRENOL 750 MG CHEWABLE TABLET LANTHANUM CARBONATE 3 Phosphate Binders FOSRENOL 750 MG POWDER PACKET LANTHANUM CARBONATE 3 Anticoagulants, Injectable FRAGMIN 10,000 UNITS/ML INJECTION SYRINGE DALTEPARIN See footnote1

Anticoagulants, Injectable FRAGMIN 12,500 UNITS/0.5 ML INJECTION SYRINGE DALTEPARIN See footnote1



Anticoagulants, Injectable FRAGMIN 25,000 UNITS/ML INJECTION VIAL DALTEPARIN See footnote1

Anticoagulants, Injectable FRAGMIN 2500 UNITS/0.2 ML INJECTION SYRINGE DALTEPARIN See footnote1



Diabetic Meters FREESTYLE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips FREESTYLE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters FREESTYLE FLASH BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters FREESTYLE FREEDOM LITE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters FREESTYLE INSULINX BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips FREESTYLE INSULINX BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Supplies, Miscellaneous FREESTYLE LANCING DEVICE BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Meters FREESTYLE LITE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips FREESTYLE LITE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters FREESTYLE PRECISION NEO BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips FREESTYLE PRECISION NEO BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Antimigraine Agents, Triptans FROVA 2.5 MG TABLET FROVATRIPTAN 0.3 Anti-Diarrheals FULYZAQ DR 125 MG TABLET CROFELEMER 2 Nitrofuran Dervatives FURADANTIN 25 MG/5 ML SUSPENSION NITROFURANTOIN 80 HIV/AIDS Agents FUZEON INJECTION 90 MG CONVENIENCE KIT ENFUVIRTIDE 0.04 HIV/AIDS Agents FUZEON INJECTION 90 MG VIAL ENFUVIRTIDE 2 Anticonvulsants FYCOMPA 0.5 MG/ML SUSPENSION PERAMPANEL 24


Anticonvulsants FYCOMPA 10 MG TABLET PERAMPANEL 1 Anticonvulsants FYCOMPA 12 MG TABLET PERAMPANEL 1 Anticonvulsants FYCOMPA 2 MG TABLET PERAMPANEL 2 Anticonvulsants FYCOMPA 4 MG TABLET PERAMPANEL 1 Anticonvulsants FYCOMPA 6 MG TABLET PERAMPANEL 1 Anticonvulsants FYCOMPA 8 MG TABLET PERAMPANEL 1 Vaccines GARDASIL 9 VACCINE SYRINGE HUMAN PAPILLOMAVIRUS VACCINE 9-VALENT 0.5 Vaccines GARDASIL 9 VACCINE VIAL HUMAN PAPILLOMAVIRUS VACCINE 9-VALENT 0.5 Vaccine GARDASIL VACCINE PREFILLED SYR HPV RECOMBINANT VACCINE 0.5 Vaccine GARDASIL VACCINE SINGLE DOSE VIAL HPV RECOMBINANT VACCINE 0.5 Vaccines GARDASIL VACCINE SYRINGE HUMAN PAPILLOMAVIRUS VACCINE QUADVALENT 0.5 Vaccines GARDASIL VACCINE VIAL HUMAN PAPILLOMAVIRUS VACCINE QUADVALENT 0.5 Bladder Relaxant Preparations GELNIQUE 10% GEL PUMP OXYBUTYNIN 1 Bladder Relaxant Preparations GELNIQUE 10% GEL SACHET OXYBUTYNIN 1 Bladder Relaxant Preparations GELNIQUE 3% TOPICAL GEL PUMP OXYBUTYNIN 3.1 Intra-Articular Hyaluronic Acids GEL-ONE 30 MG/3 ML SYRINGE HYALURONATE SODIUM, CROSS-LINKED 0.2 Intra-Articular Hyaluronic Acids GELSYN-3 16.8 MG/2 ML SYRINGE HYALURONATE SODIUM 0.58 Intra-Articular Hyaluronic Acids GENVISC 850 25 MG/2.5 ML SYRINGE HYALURONATE SODIUM 0.72 HIV/AIDS Agents GENVOYA TABLET ELVITEGRAVIR/COBI/EMTRICITABINE/TENOFOVIR AF 1 Antipsychotics, Atypical GEODON 20 MG CAPSULE ZIPRASIDONE 2 Antipsychotics, Atypical GEODON 20 MG INJECTION VIAL ZIPRASIDONE 2 Antipsychotics, Atypical GEODON 40 MG CAPSULE ZIPRASIDONE 2 Antipsychotics, Atypical GEODON 60 MG CAPSULE ZIPRASIDONE 2 Antipsychotics, Atypical GEODON 80 MG CAPSULE ZIPRASIDONE 2 Ulcerative Colitis Agents GIAZO 1.1 GRAM TABLET BALSALAZIDE 6 Multiple Sclerosis Agents GILENYA 0.5 MG CAPSULE FINGOLIMOD 1 Oncology, Oral GILOTRIF 20 MG TABLET AFATINIB DIMALEATE 1 Oncology, Oral GILOTRIF 30 MG TABLET AFATINIB DIMALEATE 1 Oncology, Oral GILOTRIF 40 MG TABET AFATINIB DIMALEATE 1 Oncology, Oral GLEEVEC 100 MG TABLET IMATINIB MESYLATE 6 Oncology, Oral GLEEVEC 400 MG TABLET IMATINIB MESYLATE 2 Hypoglycemics, Metformins GLUCOPHAGE 1,000 MG TABLET METFORMIN HCL 1,000 MG TABLET 2.5 Hypoglycemics, Metformins GLUCOPHAGE 500 MG TABLET METFORMIN HCL 500 MG TABLET 5 Hypoglycemics, Metformins GLUCOPHAGE 850 MG TABLET METFORMIN HCL 850 MG TABLET 3 Hypoglycemics, Metformins GLUCOPHAGE XR 500 MG TABLET METFORMIN HCL ER 500 MG TABLET 5 Hypoglycemics, Metformins GLUCOPHAGE XR 750 MG TABLET METFORMIN HCL ER 750 MG TABLET 3 Hypoglycemics, Sulfonylureas GLUCOTROL 10 MG TABLET GLIPIZIDE 4 Hypoglycemics, Sulfonylureas GLUCOTROL 5 MG TABLET GLIPIZIDE 4 Hypoglycemics, Sulfonylureas GLUCOTROL XL 10 MG TABLET GLIPIZIDE ER 2 Hypoglycemics, Sulfonylureas GLUCOTROL XL 2.5 MG TABLET GLIPIZIDE ER 1 Hypoglycemics, Sulfonylureas GLUCOTROL XL 5 MG TABLET GLIPIZIDE ER 1 Hypoglycemics, Metformins GLUCOVANCE 1.25 MG/250 MG TABLET GLYBURIDE/METFORMIN 4 Hypoglycemics, Metformins GLUCOVANCE 2.5 MG/500 MG TABLET GLYBURIDE/METFORMIN 4

65 MG


Hypoglycemics, Metformins GLUCOVANCE 5 MG/500 MG TABLET GLYBURIDE/METFORMIN 4 Hypoglycemics, Metformins GLUMETZA ER 1000 MG TABLET METFORMIN ER 2 Hypoglycemics, Metformins GLUMETZA ER 500 MG TABLET METFORMIN ER 3 Hypoglycemics, Sulfonylureas GLYNASE 1.5 MG TABLET GLYBURIDE MICRONIZED 4 Hypoglycemics, Sulfonylureas GLYNASE 3 MG TABLET GLYBURIDE MICRONIZED 4 Hypoglycemics, Sulfonylureas GLYNASE 6 MG TABLET GLYBURIDE MICRONIZED 2 Hypoglycemics, Alpha-Glucosidase Inhibitors GLYSET 100 MG TABLET MIGLITOL 3 Hypoglycemics, Alpha-Glucosidase Inhibitors GLYSET 25 MG TABLET MIGLITOL 3 Hypoglycemics, Alpha-Glucosidase Inhibitors GLYSET 50 MG TABLET MIGLITOL 3 Hypoglycemics, Incretin Mimetics/Enhancers GLYXAMBI 10 MG/5 MG TABLET EMPAGLIFLOZIN/LINAGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers GLYXAMBI 25 MG/5 MG TABLET EMPAGLIFLOZIN/LINAGLIPTIN 1 Insect Repellent NOT for Skin Application GOOD NEIGHBOR LICE BEDDING SPRAY PERMETHRIN 0.5% 29 Analgesics, Salicylates GOODY'S EX-STR POWDER PACKET 500 MG/325 MG/CAFFEINE ASPIRIN/ACETAMINOPHEN/CAFFEINE 8 Neuropathic Pain Agents GRALISE 300 MG TABLETS GABAPENTIN 1 Neuropathic Pain Agents GRALISE 600 MG TABLETS GABAPENTIN 3 Antiemetics/Antivertigo Agents GRANISOL 2 MG/10 ML SOLUTION GRANISETRON 10 Hereditary Angioedema Treatments HAEGARDA 2000 UNIT VIAL C1 ESTERASE INHIBITOR 0.58 Hereditary Angioedema Treatments HAEGARDA 3000 UNIT VIAL C1 ESTERASE INHIBITOR 1.15 Sedative Hypnotics HALCION 0.125 MG TABLET TRIAZOLAM 1 Sedative Hypnotics HALCION 0.25 MG TABLET TRIAZOLAM 2 Hepatitis C Agents HARVONI 90 MG/400 MG TABLET LEDIPASVIR/SOFOSBUVIR 1 Vaccines HAVRIX 1440 UNITS/ML SYRINGE HEPATITIS A VIRUS VACCINE 1 Vaccines HAVRIX 1440 UNITS/ML VIAL HEPATITIS A VIRUS VACCINE 1 Vaccines HAVRIX 720 UNITS/0.5 ML SYRINGE HEPATITIS A VIRUS VACCINE 0.5 Vaccines HAVRIX 720 UNITS/0.5 ML VIAL HEPATITIS A VIRUS VACCINE 0.5 Hepatitis B Agents HEPSERA 10 MG TABLET ADEFOVIR DIPIVOXIL 1 Sedative Hypnotics HETLIOZ 20 MG CAPSULE TASIMELTEON 1 Neuropathic Pain Agents HORIZANT ER 300 MG TABLET GABAPENTIN ENACARBIL 2 Neuropathic Pain Agents HORIZANT ER 600 MG TABLET GABAPENTIN ENACARBIL 2 Cytokine & CAM Antagonists HUMIRA 10 MG/0.2 ML SYRINGE KIT ADALIMUMAB 0.08 Cytokine & CAM Antagonists HUMIRA 20 MG/0.4 ML SYRINGE KIT ADALIMUMAB 0.08 Cytokine & CAM Antagonists HUMIRA 40 MG/0.8 ML PEN KIT ADALIMUMAB 0.22 Cytokine & CAM Antagonists HUMIRA 40 MG/0.8 ML SYRINGE KIT ADALIMUMAB 0.22 Cytokine & CAM Antagonists HUMIRA PEDIATRIC CROHN'S 3-SYRINGE STARTER KIT ADALIMUMAB (< 88 LBS) 0.22 Cytokine & CAM Antagonists HUMIRA PEDIATRIC CROHN'S 6-SYRINGE STARTER KIT ADALIMUMAB (≥ 88 LBS) 0.22 Cytokine & CAM Antagonists HUMIRA PEN CROHN'S-US-HS STARTER KIT ADALIMUMAB 0.22 Cytokine & CAM Antagonists HUMIRA PEN PSORIASIS STARTER PACK ADALIMUMAB 0.22 Intra-Articular Hyaluronic Acids HYALGAN 10 MG/ML SYRINGE HYALURONATE SODIUM 0.72 Intra-Articular Hyaluronic Acids HYALGAN 20 MG/2 ML SYRINGE HYALURONATE SODIUM 0.72 Intra-Articular Hyaluronic Acids HYALGAN 20 MG/2 ML VIAL HYALURONATE SODIUM 0.72 Analgesics, Opioids Short-Acting HYCET SOLUTION 7.5 MG-325 MG/15 ML HYDROCODONE/ACETAMINOPHEN 100 Ergotamine Derivatives HYDERGINE 1 MG TABLET ERGOLOID MESYLATES 3 Analgesics, Opioids Short-Acting HYDROCODONE/APAP 2.5-167 MG/5 ML ORAL SOLUTION HYDROCODONE/ACETAMINOPHEN 60


Analgesics, Opioids Short-Acting HYDROCODONE/APAP 2.5-325 MG TABLET HYDROCODONE/ACETAMINOPHEN 8 Analgesics, Opioids Short-Acting HYDROCODONE/APAP 5-217 MG/10 ML ORAL SOLUTION HYDROCODONE/ACETAMINOPHEN 100 Progestational Agents HYDROXYPROGESTERONE CAPROATE 1.25 GM/5 ML MDV HYDROXYPROGESTERONE CAPROATE 0.15 Intra-Articular Hyaluronic Acids HYMOVIS 24 MG/3 ML SYRINGE HYALURONATE, NON-CROSSLINKED 0.86 Analgesics, Opioids Long-Acting HYSINGLA ER 100 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 120 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 20 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 30 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 40 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 60 MG TABLET HYDROCODONE ER 1 Analgesics, Opioids Long-Acting HYSINGLA ER 80 MG TABLET HYDROCODONE ER 1 BPH Treatments HYTRIN 1 MG CAPSULE TERAZOSIN 1 BPH Treatments HYTRIN 10 MG CAPSULE TERAZOSIN 2 BPH Treatments HYTRIN 2 MG CAPSULE TERAZOSIN 1 BPH Treatments HYTRIN 5 MG CAPSULE TERAZOSIN 1 Angiotensin Modulators HYZAAR 100-12.5 TABLET LOSARTAN/HCTZ 1 Angiotensin Modulators HYZAAR 100-25 TABLET LOSARTAN/HCTZ 1 Angiotensin Modulators HYZAAR 50-12.5 TABLET LOSARTAN/HCTZ 2 Oncology, Oral IBRANCE 100 MG CAPSULE PALBOCICLIB 1 Oncology, Oral IBRANCE 125 MG CAPSULE PALBOCICLIB 1 Oncology, Oral IBRANCE 75 MG CAPSULE PALBOCICLIB 1 Analgesics, Opioids Short-Acting IBUDONE 10-200 MG TABLET HYDROCODONE/IBUPROFEN 5 Analgesics, Opioids Short-Acting IBUDONE 5-200 MG TABLET HYDROCODONE/IBUPROFEN 5 NSAIDs IBUPROFEN 100 MG TABLET/CAPLET IBUPROFEN 4 NSAIDs IBUPROFEN 100 MG/5 ML LIQUID IBUPROFEN 60 NSAIDs IBUPROFEN 200 MG TABLET/CAPLET IBUPROFEN 4 NSAIDs IBUPROFEN 400 MG TABLET/CAPLET IBUPROFEN 4 NSAIDs IBUPROFEN 50 MG/1.25 ML LIQUID IBUPROFEN 8 NSAIDs IBUPROFEN 600 MG TABLET/CAPLET IBUPROFEN 4 NSAIDs IBUPROFEN 800 MG TABLET/CAPLET IBUPROFEN 4 Oncology, Oral ICLUSIG 15 MG TABLET PONATINIB 2 Oncology, Oral ICLUSIG 45 MG TABLET PONATINIB 1 Oncology, Oral IDHIFA 1000 MG TABLET ENASIDENIB 1 Oncology, Oral IDHIFA 50 MG TABLET ENASIDENIB 1 Cytokine & CAM Antagonists ILARIS 150 MG/ML VIAL CANAKINUMAB 0.08 Cytokine & CAM Antagonists ILARIS 180 MG VIAL CANAKINUMAB 0.08 Ophthalmics, Anti-Inflammatories ILUVIEN 0.19 MG INTRAOCULAR IMPLANT FLUOCINOLONE INTRAOCULAR 0.04 Oncology, Oral IMBRUVICA 140 MG CAPSULE IBRUTINIB 1 Oncology, Oral IMBRUVICA 140 MG TABLET IBRUTINIB 1 Oncology, Oral IMBRUVICA 280 MG TABLET IBRUTINIB 1 Oncology, Oral IMBRUVICA 420 MG TABLET IBRUTINIB 1 Oncology, Oral IMBRUVICA 560 MG TABLET IBRUTINIB 1 Oncology, Oral IMBRUVICA 70 MG CAPSULE IBRUTINIB 1


Antimigraine Agents, Triptans IMITREX 100 MG TABLET SUMATRIPTAN 0.3 Antimigraine Agents, Triptans IMITREX 20 MG NASAL SPRAY SUMATRIPTAN 0.3 Antimigraine Agents, Triptans IMITREX 25 MG TABLET SUMATRIPTAN 0.3 Antimigraine Agents, Triptans IMITREX 4 MG/0.5 ML KIT REFILL SUMATRIPTAN 0.14 Antimigraine Agents, Triptans IMITREX 4 MG/0.5 ML SYRNG KIT SUMATRIPTAN 0.14 Antimigraine Agents, Triptans IMITREX 5 MG NASAL SPRAY SUMATRIPTAN 1 Antimigraine Agents, Triptans IMITREX 50 MG TABLET SUMATRIPTAN 0.3 Antimigraine Agents, Triptans IMITREX 6 MG/0.5 ML KIT REFLL SUMATRIPTAN 0.14 Antimigraine Agents, Triptans IMITREX 6 MG/0.5 ML SYRNG KIT SUMATRIPTAN 0.14 Antimigraine Agents, Triptans IMITREX 6 MG/0.5 ML VIAL SUMATRIPTAN 0.14 Anti-Diarrheals IMODIUM 2 MG CAPSULE LOPERAMIDE 8 Anti-Diarrheals IMODIUM A-D 1 MG/5 ML SOLUTION LOPERAMIDE 80 Anti-Diarrheals IMODIUM A-D 1 MG/7.5 ML (2 MG/15 ML) SUSPENSION LOPERAMIDE 120 Antiprotozoals IMPAVIDO 50 MG CAPSULE MILTEFOSINE 3 Contraceptives, Other IMPLANON 68 MG IMPLANT ETONOGESTREL IMPLANT see footnote4

COPD Agents INCRUSE ELLIPTA UMECLIDINIUM 1 Beta-Blockers INDERAL XL 120 MG CAPSULE PROPRANOLOL 1 Beta-Blockers INDERAL XL 80 MG CAPSULE PROPRANOLOL 1 NSAIDs INDOCIN 25 MG CAPSULE INDOMETHACIN 4 NSAIDs INDOCIN 25 MG/5 ML LIQUID INDOMETHACIN 40 NSAIDs INDOCIN 50 MG CAPSULE INDOMETHACIN 4 NSAIDs INDOCIN 50 MG SUPPOSITORY INDOMETHACIN 4 NSAIDs INDOCIN ER 75 MG CAPSULE INDOMETHACIN 2 Movement Disorders INGREZZA 40 MG CAPSULE VALBENAZINE TOSYLATE 1 Movement Disorders INGREZZA 80 MG CAPSULE VALBENAZINE TOSYLATE 1 Oncology, Oral INLYTA 1 MG TABLET AXITINIB 6 Oncology, Oral INLYTA 5 MG TABLET AXITINIB 4 Beta-Blockers INNOPRAN XL 120 MG CAPSULE PROPRANOLOL 1 Beta-Blockers INNOPRAN XL 80 MG CAPSULE PROPRANOLOL 1 Diuretics INSPRA 25 MG TABLET EPLERENONE 4 Diuretics INSPRA 50 MG TABLET EPLERENONE 2 HIV/AIDS Agents INTELENCE 100 MG TABLET ETRAVIRINE 4 HIV/AIDS Agents INTELENCE 200 MG TABLET ETRAVIRINE 2 HIV/AIDS Agents INTELENCE 25 MG TABLET ETRAVIRINE 4 Sedative Hypnotics INTERMEZZO SL TABLET 1.75 MG ZOLPIDEM 1 Sedative Hypnotics INTERMEZZO SL TABLET 3.5 MG ZOLPIDEM 1 Stimulants & Related Agents INTUNIV ER 1 MG TABLET GUANFACINE ER 1 Stimulants & Related Agents INTUNIV ER 2 MG TABLET GUANFACINE ER 1 Stimulants & Related Agents INTUNIV ER 3 MG TABLET GUANFACINE ER 1 Stimulants & Related Agents INTUNIV ER 4 MG TABLET GUANFACINE ER 1 Antibiotics, Injectable INVANZ 1 GM ADD-VANTAGE VIAL ERTAPENEM 1 Antibiotics, Injectable INVANZ 1 GM VIAL ERTAPENEM 1 Antipsychotics, Atypical INVEGA ER 1.5 MG TABLET PALIPERIDONE ER 1


Antipsychotics, Atypical INVEGA ER 3 MG TABLET PALIPERIDONE ER 1 Antipsychotics, Atypical INVEGA ER 6 MG TABLET PALIPERIDONE ER 2 Antipsychotics, Atypical INVEGA ER 9 MG TABLET PALIPERIDONE ER 1 Antipsychotics, Atypical INVEGA SUSTENNA 117 MG/0.75 ML SYRINGE PALIPERIDONE ER 0.03 Antipsychotics, Atypical INVEGA SUSTENNA 156 MG/ML SYRINGE PALIPERIDONE ER 0.05 Antipsychotics, Atypical INVEGA SUSTENNA 234 MG/1.5 ML SYRINGE PALIPERIDONE ER 0.08 Antipsychotics, Atypical INVEGA SUSTENNA 39 MG/0.25 ML SYRINGE PALIPERIDONE ER 0.01 Antipsychotics, Atypical INVEGA SUSTENNA 78 MG/0.5 ML SYRINGE PALIPERIDONE ER 0.02 HIV/AIDS Agents INVIRASE 200 MG CAPSULE SAQUINAVIR 10 HIV/AIDS Agents INVIRASE 500 MG TABLET SAQUINAVIR 4 Hypoglycemics, SGLT2 INVOKAMET 150/1000 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET 150/500 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET 50/1000 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET 50/500 MG TABLET CANAGLIFLOZIN/METFORMIN 3 Hypoglycemics, SGLT2 INVOKAMET XR 150/1000 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET XR 150/500 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET XR 50/1000 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKAMET XR 50/500 MG TABLET CANAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 INVOKANA 100 MG TABLET CANAGLIFLOZIN 2 Hypoglycemics, SGLT2 INVOKANA 300 MG TABLET CANAGLIFLOZIN 1 Neuropathic Pain Agents IRENKA DR 40 MG CAPSULE DULOXETINE 3 Oncology, Oral IRESSA 250 MG TABLET GEFITINIB 2 HIV/AIDS Agents ISENTRESS 100 MG CHEWABLE TABLET RALTEGRAVIR 6 HIV/AIDS Agents ISENTRESS 100 MG POWDER PACKETS RALTEGRAVIR POWDER 2 HIV/AIDS Agents ISENTRESS 25 MG CHEWABLE TABLET RALTEGRAVIR 6 HIV/AIDS Agents ISENTRESS 400 MG TABLET RALTEGRAVIR 2 HIV/AIDS Agents ISENTRESS HD 600 MG TABLET RALTEGRAVIR 2 Calcium Channel Blockers ISOPTIN S.R. 120 MG TAB SA VERAPAMIL 2 Calcium Channel Blockers ISOPTIN S.R. 180 MG TAB SA VERAPAMIL 2 Calcium Channel Blockers ISOPTIN S.R. 240 MG TAB SA VERAPAMIL 2 Oncology, Oral JAKAFI 10 MG TABLET RUXOLITINIB 2 Oncology, Oral JAKAFI 15 MG TABLET RUXOLITINIB 2 Oncology, Oral JAKAFI 20 MG TABLET RUXOLITINIB 2 Oncology, Oral JAKAFI 25 MG TABLET RUXOLITINIB 2 Oncology, Oral JAKAFI 5 MG TABLET RUXOLITINIB 2 BPH Treatments JALYN 0.5 MG/0.4 MG CAPSULE DUTASTERIDE/TAMSULOSIN 1 Hypoglycemics, Incretin Mimetics/Enhancers JANUMET 50 MG/1000 MG TABLET SITAGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JANUMET 50 MG/500 MG TABLET SITAGLIPTIN/ METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JANUMET XR 100 MG/1000 MG TABLET SITAGLIPTIN/METFORMIN 1 Hypoglycemics, Incretin Mimetics/Enhancers JANUMET XR 50 MG/1000 MG TABLET SITAGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JANUMET XR 50 MG/500 MG TABLET SITAGLIPTIN/METFORMIN 1 Hypoglycemics, Incretin Mimetics/Enhancers JANUVIA 100 MG TABLET SITAGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers JANUVIA 25 MG TABLET SITAGLIPTIN 1


Hypoglycemics, Incretin Mimetics/Enhancers JANUVIA 50 MG TABLET SITAGLIPTIN 1 Hypoglycemics, SGLT2 JARDIANCE 10 MG TABLET EMPAGLIFLOZIN 1 Hypoglycemics, SGLT2 JARDIANCE 25 MG TABLET EMPAGLIFLOZIN 1 Hypoglycemics, Incretin Mimetics/Enhancers JENTADUETO 2.5 MG/1000 MG TABLET LINAGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JENTADUETO 2.5 MG/500 MG TABLET LINAGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JENTADUETO 2.5 MG/850 MG TABLET LINAGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers JENTADUETO XR 2.5 MG/1000 MG TABLET LINAGLIPTIN/METFORMIN ER 2 Hypoglycemics, Incretin Mimetics/Enhancers JENTADUETO XR 5 MG/1000 MG TABLET LINAGLIPTIN/METFORMIN ER 1 Ophthalmic Proteolytic Enzyme JETREA 0.5 MG/0.2 ML INTRAOCULAR SOLUTION OCRIPLASMIN 0.06 Ophthalmic Proteolytic Enzyme JETREA 1.25 MG/ML VIAL OCRIPLASMIN 0.08 HIV/AIDS Agents JULUCA 50-25 MG TABLET DOLUTEGRAVIR AND RILPIVIRINE 1 Lipotropics, Other JUXTAPID 10 MG CAPSULE LOMITAPIDE 1 Lipotropics, Other JUXTAPID 20 MG CAPSULE LOMITAPIDE 1 Lipotropics, Other JUXTAPID 30 MG CAPSULE LOMITAPIDE 1 Lipotropics, Other JUXTAPID 40 MG CAPSULE LOMITAPIDE 1 Lipotropics, Other JUXTAPID 5 MG CAPSULE LOMITAPIDE 1 Lipotropics, Other JUXTAPID 60 MG CAPSULE LOMITAPIDE 1 Analgesics, Opioids Long-Acting KADIAN ER 10 MG CAPSULE MORPHINE SULFATE ER 2 Analgesics, Opioids Long-Acting KADIAN ER 100 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 20 MG CAPSULE MORPHINE SULFATE ER 2 Analgesics, Opioids Long-Acting KADIAN ER 200 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 30 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 40 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 50 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 60 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 70 MG CAPSULE MORPHINE SULFATE ER 1 Analgesics, Opioids Long-Acting KADIAN ER 80 MG CAPSULE MORPHINE SULFATE ER 1 Hereditary Angioedema Treatments KALBITOR 10 MG/ML VIAL ECALLANTIDE 6 HIV/AIDS Agents KALETRA 100 MG/25 MG TABLET LOPINAVIR/RITONAVIR 10 HIV/AIDS Agents KALETRA 200 MG/50 MG TABLET LOPINAVIR/RITONAVIR 4 HIV/AIDS Agents KALETRA 80 MG/20 MG PER ML ORAL SOLUTION LOPINAVIR/RITONAVIR 16 Cystic Fibrosis Agents KALYDECO 150 MG TABLET IVACAFTOR 2 Cystic Fibrosis Agents KALYDECO 50 MG GRANULES PACKET IVACAFTOR 2 Cystic Fibrosis Agents KALYDECO 75 MG GRANULES PACKET IVACAFTOR 2 Stimulants & Related Agents KAPVAY 0.1 MG ER TABLET CLONIDINE ER 4 Hypoglycemics, Incretin Mimetics/Enhancers KAZANO 12.5 MG/1000 MG TABLET ALOGLIPTIN/METFORMIN 2 Hypoglycemics, Incretin Mimetics/Enhancers KAZANO 12.5 MG/500 MG TABLET ALOGLIPTIN/METFORMIN 2 Steroids, Topical KENALOG IN ORABASE DENTAL PASTE TRIAMCINOLONE 0.72 Anticonvulsants KEPPRA 100 MG/ML ORAL SOLN LEVETIRACETAM 40 Anticonvulsants KEPPRA 1000 MG TABLET LEVETIRACETAM 3 Anticonvulsants KEPPRA 250 MG TABLET LEVETIRACETAM 6 Anticonvulsants KEPPRA 500 MG TABLET LEVETIRACETAM 6 Anticonvulsants KEPPRA 500 MG/5 ML INJECTION VIAL LEVETIRACETAM 30


Anticonvulsants KEPPRA 750 MG TABLET LEVETIRACETAM 4 Anticonvulsants KEPPRA XR 500 MG TABLET LEVETIRACETAM 6 Anticonvulsants KEPPRA XR 750 MG TABLET LEVETIRACETAM 4 NSAIDs KETOPROFEN 50 MG CAPSULE KETOPROFEN 6 NSAIDs KETOPROFEN 75 MG CAPSULE KETOPROFEN 4 NSAIDs KETOPROFEN ER 200 MG CAPSULE KETOPROFEN 1 Cytokine & CAM Antagonists KEVZARA 150 MG/1.14 ML SYRINGE SARILUMAB 0.09 Cytokine & CAM Antagonists KEVZARA 200 MG/1.14 ML SYRINGE SARILUMAB 0.09 Antidepressants, Other KHEDEZLA ER 100 MG TABLET DESVENLAFAXINE 1 Antidepressants, Other KHEDEZLA ER 50 MG TABLET DESVENLAFAXINE 1 Diabetic Strips KINRAY BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Oncology, Oral KISQALI 200 MG DAILY DOSE (21 X 200 MG TABLETS) RIBOCICLIB SUCCINATE 0.75 Oncology, Oral KISQALI 400 MG DAILY DOSE (42 X 200 MG TABLETS) RIBOCICLIB SUCCINATE 1.5 Oncology, Oral KISQALI 600 MG DAILY DOSE (63 X 200 MG TABLETS) RIBOCICLIB SUCCINATE 2.25 Oncology, Oral KISQALI FEMARA 200 MG CO-PACK RIBOCICLIB SUCCINATE/LETROZOLE 1.75 Oncology, Oral KISQALI FEMARA 400 MG CO-PACK RIBOCICLIB SUCCINATE/LETROZOLE 2.5 Oncology, Oral KISQALI FEMARA 600 MG CO-PACK RIBOCICLIB SUCCINATE/LETROZOLE 3.25 Antibiotics, Inhaled KITABIS PAK 300 MG/5 ML NEBULIZER KIT TOBRAMYCIN 10 Anticonvulsants KLONOPIN 0.5 MG TABLET CLONAZEPAM 6 Anticonvulsants KLONOPIN 1 MG TABLET CLONAZEPAM 4 Anticonvulsants KLONOPIN 2 MG TABLET CLONAZEPAM 3 Anticonvulsants KLONOPIN WAFERS 0.125 MG ODT CLONAZEPAM ODT 6 Anticonvulsants KLONOPIN WAFERS 0.25 MG ODT CLONAZEPAM ODT 6 Anticonvulsants KLONOPIN WAFERS 0.5 MG ODT CLONAZEPAM ODT 6 Anticonvulsants KLONOPIN WAFERS 1 MG ODT CLONAZEPAM ODT 4 Anticonvulsants KLONOPIN WAFERS 2 MG ODT CLONAZEPAM ODT 3 Hypoglycemics, Incretin Mimetics/Enhancers KOMBIGLYZE XR 2.5 MG/1000 MG TABLET SAXAGLIPTIN/METFORMIN ER 2 Hypoglycemics, Incretin Mimetics/Enhancers KOMBIGLYZE XR 5 MG/1000 MG TABLET SAXAGLIPTIN/METFORMIN ER 1 Hypoglycemics, Incretin Mimetics/Enhancers KOMBIGLYZE XR 5 MG/500 MG TABLET SAXAGLIPTIN/METFORMIN ER 1 Antihyperglycemics, Miscellaneous KORLYM 300 MG TABLET MIFEPRISTONE 4 Antihyperuricemics KRYSTEXXA 8 MG/ML VIAL PEGLOTICASE 0.08 Contraceptives, Other KYLEENA 19.5 MG INTRAUTERINE SYSTEM LEVONORGESTRAL 1 Contraceptives, Other KYLEENA 19.5 MG INTRAUTERINE SYSTEM LEVONORGESTREL INTRAUTERINE see footnote4

Lipotropics, Other KYNAMRO 200 MG/ML SYRINGE MIPOMERSEN 0.08 Antiemetics/Antivertigo Agents KYTRIL 1 MG GRANISETRON 2 Antifungals, Oral LAMISIL 125 MG GRANULES PACKET TERBINAFINE 2 Antifungals, Oral LAMISIL 187.5 MG GRANULES PACKET TERBINAFINE 1 Antifungals, Oral LAMISIL 250 MG TABLET TERBINAFINE 1 Antipsychotics, Atypical LATUDA 120 MG TABLET LURASIDONE 1 Antipsychotics, Atypical LATUDA 20 MG TABLET LURASIDONE 1 Antipsychotics, Atypical LATUDA 40 MG TABLET LURASIDONE 1 Antipsychotics, Atypical LATUDA 60 MG TABLET LURASIDONE 1 Antipsychotics, Atypical LATUDA 80 MG TABLET LURASIDONE 2


Analgesics, Opioids Short-Acting LAZANDA 100 MCG NASAL SPRAY FENTANYL CITRATE NASAL 1 Analgesics, Opioids Short-Acting LAZANDA 300 MCG NASAL SPRAY FENTANYL CITRATE 1 Analgesics, Opioids Short-Acting LAZANDA 400 MCG NASAL SPRAY FENTANYL CITRATE NASAL 1 Insect Repellent NOT for Skin Application LEADER BEDDING 0.5% SPRAY PERMETHRIN 0.5% 29 Multiple Sclerosis Agents LEMTRADA 12 MG/1.2 ML VIAL ALEMTUZUMAB 0.02 Oncology, Oral LENVIMA 10 MG DAILY DOSE LENVATINIB MESYLATE 1 Oncology, Oral LENVIMA 14 MG DAILY DOSE LENVATINIB MESYLATE 2 Oncology, Oral LENVIMA 18 MG DAILY DOSE LENVATINIB MESYLATE 3 Oncology, Oral LENVIMA 20 MG DAILY DOSE LENVATINIB MESYLATE 2 Oncology, Oral LENVIMA 24 MG DAILY DOSE LENVATINIB MESYLATE 3 Oncology, Oral LENVIMA 8 MG DAILY DOSE LENVATINIB MESYLATE 2 Lipotropics, Statins LESCOL 20 MG CAPSULE FLUVASTATIN 2 Lipotropics, Statins LESCOL 40 MG CAPSULE FLUVASTATIN 2 Lipotropics, Statins LESCOL XL 80 MG TABLET SA FLUVASTATIN 1 PAH Agents, Oral & Inhaled LETAIRIS 10 MG TABLET AMBRISENTAN 1 PAH Agents, Oral & Inhaled LETAIRIS 5 MG TABLET AMBRISENTAN 1 Analgesics, Opioids Short-Acting LEVO-DROMORAN 2 MG TABLET LEVORPHANOL 4 Antidepressants, SSRIs LEXAPRO 10 MG TABLET ESCITALOPRAM 1.5 Antidepressants, SSRIs LEXAPRO 20 MG TABLET ESCITALOPRAM 1 Antidepressants, SSRIs LEXAPRO 5 MG TABLET ESCITALOPRAM 1 Antidepressants, SSRIs LEXAPRO 5 MG/5 ML SOLUTION ESCITALOPRAM 20 HIV/AIDS Agents LEXIVA 50 MG/ML ORAL SUSPENSION FOSAMPRENAVIR 56 HIV/AIDS Agents LEXIVA 700 MG TABLET FOSAMPRENAVIR 4 Ulcerative Colitis Agents LIALDA DR 1.2 GRAM TABLET MESALAMINE 4 Diabetic Meters LIBERTY BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips LIBERTY BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Benzodiazepines LIBRAX 2.5 MG/5 MG CAPSULE CLIDINIUM/CHLORDIAZEPOXIDE 8 Anxiolytics LIBRIUM 10 MG CAPSULE CHLORDIAZEPOXIDE 8 Anxiolytics LIBRIUM 25 MG CAPSULE CHLORDIAZEPOXIDE 4 Anxiolytics LIBRIUM 5 MG CAPSULE CHLORDIAZEPOXIDE 4 Neuropathic Pain Agents LIDODERM 5% PATCH LIDOCAINE 3 Contraceptives, Other LILETTA 52 MG SYSTEM (IUD) LEVONORGESTREL INTRAUTERINE see footnote4

Benzodiazepines LIMBITROL 12.5/5 MG TABLET AMITRIPTYLINE/CHLORDIAZEPOXIDE 6 Benzodiazepines LIMBITROL DS 25/10 MG TABLET AMITRIPTYLINE/CHLORDIAZEPOXIDE 6 GI Motility, Chronic LINZESS 145 MCG CAPSULE LINACLOTIDE 1 GI Motility, Chronic LINZESS 290 MCG CAPSULE LINACLOTIDE 1 GI Motility, Chronic LINZESS 72 MCG CAPSULE LINACLOTIDE 1 Skeletal Muscle Relaxants LIORESAL 10 MG TABLET BACLOFEN 5 Skeletal Muscle Relaxants LIORESAL 20 MG TABLET BACLOFEN 4 Lipotropics, Statins LIPITOR 10 MG TABLET ATORVASTATIN 1 Lipotropics, Statins LIPITOR 20 MG TABLET ATORVASTATIN 1 Lipotropics, Statins LIPITOR 40 MG TABLET ATORVASTATIN 1 Lipotropics, Statins LIPITOR 80 MG TABLET ATORVASTATIN 1


Lipotropics, Other LIPOFEN 150 MG CAPSULE FENOFIBRATE 1 Lipotropics, Other LIPOFEN 50 MG CAPSULE FENOFIBRATE 2 Lipotropics, Statins LIVALO 1 MG TABLET PITAVASTATIN 1 Lipotropics, Statins LIVALO 2 MG TABLET PITAVASTATIN 1 Lipotropics, Statins LIVALO 4 MG TABLET PITAVASTATIN 1 NSAIDs LODINE 200 MG CAPSULE ETODOLAC 4 NSAIDs LODINE 300 MG CAPSULE ETODOLAC 3 NSAIDs LODINE 400 MG TABLET ETODOLAC 2 NSAIDs LODINE 500 MG TABLET ETODOLAC 2 NSAIDs LODINE XL 400 MG TABLET ETODOLAC ER 2 NSAIDs LODINE XL 500 MG TABLET ETODOLAC ER 2 NSAIDs LODINE XL 600 MG TABLET ETODOLAC ER 1 Antiparkinson's Agents LODOSYN 25 MG TABLET CARBIDOPA 8 Lipotropics, Other LOFIBRA 134 MG CAPSULE FENOFIBRATE MICRONIZED 1 Lipotropics, Other LOFIBRA 160 MG TABLET FENOFIBRATE MICRONIZED 1 Lipotropics, Other LOFIBRA 200 MG CAPSULE FENOFIBRATE MICRONIZED 1 Lipotropics, Other LOFIBRA 54 MG TABLET FENOFIBRATE MICRONIZED 1 Lipotropics, Other LOFIBRA 67 MG CAPSULE FENOFIBRATE MICRONIZED 1 COPD Agents LONHALA MAGNAIR 25 MCG REFILL GLYCOPYRROLATE 2 COPD Agents LONHALA MAGNAIR 25 MCG STARTER GLYCOPYRROLATE 2 Oncology, Oral LONSURF 15 MG/6.14 MG TABLET TRIFLURIDINE/TIPIRACIL 2.15 Oncology, Oral LONSURF 20 MG/8.19 MG TABLET TRIFLURIDINE/TIPIRACIL 2.86 Lipotropics, Other LOPID 600 MG TABLET GEMFIBROZIL 2 Anxiolytics LORAZEPAM INTENSOL 2 MG/ML CONCENTRATE LORAZEPAM 5 Analgesics, Opioids Short-Acting LORTAB 10 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 5 Analgesics, Opioids Short-Acting LORTAB 5 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 10 Analgesics, Opioids Short-Acting LORTAB 7.5 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 6 Analgesics, Opioids Short-Acting LORTAB ELIXIR 10 MG-300 MG/15 ML HYDROCODONE/ACETAMINOPHEN 75 Skeletal Muscle Relaxants LORZONE 375 MG TABLET CHLORZOXAZONE 4 Skeletal Muscle Relaxants LORZONE 750 MG TABLET CHLORZOXAZONE 4 Angiotensin Modulators LOTENSIN 10 MG TABLET BENAZEPRIL 2 Angiotensin Modulators LOTENSIN 20 MG TABLET BENAZEPRIL 2 Angiotensin Modulators LOTENSIN 40 MG TABLET BENAZEPRIL 2 Angiotensin Modulators LOTENSIN HCT 10 MG/12.5 MG TABLET BENAZEPRIL/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators LOTENSIN HCT 20 MG/12.5 MG TABLET BENAZEPRIL/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulators LOTENSIN HCT 20 MG/25 MG TABLET BENAZEPRIL/HYDROCHLOROTHIAZIDE 1 Angiotensin Modulator Combinations LOTREL 10/20 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 Angiotensin Modulator Combinations LOTREL 10/40 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 Angiotensin Modulator Combinations LOTREL 2.5/10 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 Angiotensin Modulator Combinations LOTREL 5/10 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 Angiotensin Modulator Combinations LOTREL 5/20 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 Angiotensin Modulator Combinations LOTREL 5/40 MG CAPSULE AMLODIPINE/BENAZEPRIL 1 GI Motility, Chronic LOTRONEX 0.5 MG TABLET ALOSETRON 2


GI Motility, Chronic LOTRONEX 1 MG TABLET ALOSETRON 2 Lipotropics, Other LOVAZA 1 GRAM CAPSULE OMEGA-3-ACID ETHYL ESTERS 4 Anticoagulants, Injectable LOVENOX 100 MG/ML INJECTION SYRINGE ENOXAPARIN See footnote1

Anticoagulants, Injectable LOVENOX 100 MG/ML INJECTION VIAL ENOXAPARIN See footnote1

Anticoagulants, Injectable LOVENOX 120 MG/0.8 ML INJECTION SYRINGE ENOXAPARIN See footnote1

Anticoagulants, Injectable LOVENOX 150 MG/ML INJECTION SYRINGE ENOXAPARIN See footnote1





Macular Degeneration Agents LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL INJECTION SYRINGE RANIBIZUMAB 0.01 Macular Degeneration Agents LUCENTIS 0.3 MG/0.05 ML INTRAVITREAL INJECTION VIAL RANIBIZUMAB 0.01 Macular Degeneration Agents LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL INJECTION SYRINGE RANIBIZUMAB 0.01 Macular Degeneration Agents LUCENTIS 0.5 MG/0.05 ML INTRAVITREAL INJECTION VIAL RANIBIZUMAB 0.01 Sedative Hypnotics LUNESTA 1 MG ESZOPICLONE 1 Sedative Hypnotics LUNESTA 2 MG ESZOPICLONE 1 Sedative Hypnotics LUNESTA 3 MG ESZOPICLONE 1 Pituitary Suppressive Agents, LHRH LUPANETA PACK 11.25/5 MG 3-MONTH KIT LEUPROLIDE ACETATE/NORETHINDRONE ACETATE 0.2 Pituitary Suppressive Agents, LHRH LUPANETA PACK 3.75/5 MG 1-MONTH KIT LEUPROLIDE ACETATE/NORETHINDRONE ACETATE 0.4 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 11.25 MG 3-MONTH KIT LEUPROLIDE ACETATE 0.2 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 22.5 MG 3-MONTH KIT LEUPROLIDE ACETATE 0.2 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 3.75 MG KIT LEUPROLIDE ACETATE 0.4 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 30 MG 4-MONTH KIT LEUPROLIDE ACETATE 0.01 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 45 MG 6-MONTH KIT LEUPROLIDE ACETATE 0.01 Pituitary Suppressive Agents, LHRH LUPRON DEPOT 7.5 MG KIT LEUPROLIDE ACETATE 0.4 Pituitary Suppressive Agents, LHRH LUPRON DEPOT-PED 11.25 MG 3-MONTH KIT LEUPROLIDE ACETATE 0.2 Pituitary Suppressive Agents, LHRH LUPRON DEPOT-PED 11.25 MG KIT LEUPROLIDE ACETATE 0.4 Pituitary Suppressive Agents, LHRH LUPRON DEPOT-PED 30 MG 3-MONTH KIT LEUPROLIDE ACETATE 0.2 Pituitary Suppressive Agents, LHRH LUPRON DEPOT-PED 7.5 MG KIT LEUPROLIDE ACETATE 0.4 Antidepressants, SSRIs LUVOX 100 MG TABLET FLUVOXAMINE MALEATE 3 Antidepressants, SSRIs LUVOX 25 MG TABLET FLUVOXAMINE MALEATE 1 Antidepressants, SSRIs LUVOX 50 MG TABLET FLUVOXAMINE MALEATE 1.5 Antidepressants, SSRIs LUVOX CR 100 MG CAPSULE FLUVOXAMINE MALEATE 2 Antidepressants, SSRIs LUVOX CR 150 MG CAPSULE FLUVOXAMINE MALEATE 2 Oncology, Oral LYNPARZA 100 MG TABLET OLAPARIB 4 Oncology, Oral LYNPARZA 150 MG TABLET OLAPARIB 4 Oncology, Oral LYNPARZA 50 MG CAPSULE OLAPARIB 16 Neuropathic Pain Agents LYRICA 100 MG PREGABALIN 3 Neuropathic Pain Agents LYRICA 150 MG PREGABALIN 3 Neuropathic Pain Agents LYRICA 20 MG/ML SOLUTION PREGABALIN 30 Neuropathic Pain Agents LYRICA 200 MG PREGABALIN 3 Neuropathic Pain Agents LYRICA 225 MG PREGABALIN 2 Neuropathic Pain Agents LYRICA 25 MG PREGABALIN 3


Neuropathic Pain Agents LYRICA 300 MG PREGABALIN 2 Neuropathic Pain Agents LYRICA 50 MG PREGABALIN 3 Neuropathic Pain Agents LYRICA 75 MG PREGABALIN 3 Neuropathic Pain LYRICA CR 165 MG TABLET PREGABALIN EXTENDED-RELEASE 3 Neuropathic Pain LYRICA CR 330 MG TABLET PREGABALIN EXTENDED-RELEASE 2 Neuropathic Pain LYRICA CR 82.5 MG TABLET PREGABALIN EXTENDED-RELEASE 3 Antifibrinolytics LYSTEDA 650 MG TABLET TRANEXAMIC ACID 6 Nitrofuran Dervatives MACROBID 100 MG CAPSULE NITROFURANTOIN MONOHYD-MACRO 2 Nitrofuran Dervatives MACRODANTIN 100 MG CAPSULE NITROFURANTOIN MACROCRYSTAL 4 Nitrofuran Dervatives MACRODANTIN 25 MG CAPSULE NITROFURANTOIN MACROCRYSTAL 1 Nitrofuran Dervatives MACRODANTIN 50 MG CAPSULE NITROFURANTOIN MACROCRYSTAL 4 Macular Degeneration Agents MACUGEN 0.3 MG/0.09 ML INTRAVITREAL INJ. SYRINGE PEGAPTANIB SODIUM 0.01 Progestational Agents MAKENA 1250 MG/5 ML MULTI-DOSE VIAL HYDROXYPROGESTERONE CAPROATE 0.15 Progestational Agents MAKENA 250 MG/ML SINGLE-DOSE VIAL HYDROXYPROGESTERONE CAPROATE 0.15 Progestational Agents MAKENA 275 MG/1.1 ML AUTOINJECTOR HYDROXYPROGESTERONE CAPROATE 0.16 Antimalarial Agents MALARONE 250 MG/100 MG TABLET ATOVAQUONE/PROGUANIL 4 Antimalarial Agents MALARONE 62.5 MG/25 MG PEDIATRIC TABLET ATOVAQUONE/PROGUANIL 3 Analgesics, Non-Narcotic Barbiturate Combos MARGESIC 50 MG/325 MG/40 MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Antiemetics/Antivertigo Agents MARINOL 10 MG CAPSULE DRONABINOL 3 Antiemetics/Antivertigo Agents MARINOL 2.5 MG CAPSULE DRONABINOL 6 Antiemetics/Antivertigo Agents MARINOL 5 MG CAPSULE DRONABINOL 6 Angiotensin Modulators MAVIK 1 MG TABLET TRANDOLAPRIL 1 Angiotensin Modulators MAVIK 2 MG TABLET TRANDOLAPRIL 1 Angiotensin Modulators MAVIK 4 MG TABLET TRANDOLAPRIL 2 Hepatitis C Agents MAVYRET 100-40 MG TABLET GLECAPREVIR/PIBRENTASVIR 3 Antimigraine Agents, Triptans MAXALT 10 MG TABLET/MLT RIZATRIPTAN 0.4 Antimigraine Agents, Triptans MAXALT 5 MG TABLET/MLT RIZATRIPTAN 0.4 NSAIDs MECLOFENAMATE 100 MG CAPSULE MECLOFENAMATE 4 NSAIDs MECLOFENAMATE 50 MG CAPSULE MECLOFENAMATE 6 Oncology, Oral MEKINIST 0.5 MG TABLET TRAMETINIB 3 Oncology, Oral MEKINIST 2 MG TABLET TRAMETINIB 1 Vaccines MENACTRA VACCINE VIAL MENINGOCOCCAL A, C, Y, W-135 VACCINE 0.5 Vaccines MENOMUNE-A/C/Y/W-135 VIAL VACCINE WITH DILUENT MENINGOCOCCAL A, C, Y, W-135 VACCINE 1 Vaccines MENVEO A/C/Y/W-135 DIP VACCINE VIAL KIT MENINGOCOCCAL A, C, Y, W-135 VACCINE 1 Antiprotozoal Agents MEPRON 750 MG/5 ML SUSPENSION ATOVAQUONE 20 Stimulants & Related Agents METADATE CD 10 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE CD 20 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE CD 30 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE CD 40 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE CD 50 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE CD 60 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents METADATE ER 10 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METADATE ER 20 MG TABLET METHYLPHENIDATE 3


Hypoglycemics, Metformins METAGLIP 2.5 MG/250 MG TABLET GLIPIZIDE/METFORMIN 4 Hypoglycemics, Metformins METAGLIP 2.5 MG/500 MG TABLET GLIPIZIDE/METFORMIN 4 Hypoglycemics, Metformins METAGLIP 5 MG/500 MG TABLET GLIPIZIDE/METFORMIN 4 Analgesics, Opioids Long-Acting METHADONE 10MG/5ML SOLN METHADONE 10 Analgesics, Opioids Long-Acting METHADONE 5MG/5ML SOLN METHADONE 10 Analgesics, Opioids Long-Acting METHADOSE 10MG/ML ORAL CONCENTRATE METHADONE 2 Androgenic Agents METHITEST 10 MG TABLET METHYLTESTOSTERONE 5 Stimulants & Related Agents METHYLIN 10 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN 20 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN 5 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN CHEWABLE 10 MG METHYLPHENIDATE 6 Stimulants & Related Agents METHYLIN CHEWABLE 2.5 MG METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN CHEWABLE 5 MG METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN ER 10 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN ER 20 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents METHYLIN ORAL SOLUTION 10 MG/ 5 ML METHYLPHENIDATE 30 Stimulants & Related Agents METHYLIN ORAL SOLUTION 5 MG/5 ML METHYLPHENIDATE 15 Stimulants & Related Agents METHYLPHENIDATE ER 72 MG TABLET METHYLPHENIDATE ER 1 Lipotropics, Statins MEVACOR 10 MG TABLET LOVASTATIN 1.5 Lipotropics, Statins MEVACOR 20 MG TABLET LOVASTATIN 1.5 Lipotropics, Statins MEVACOR 40 MG TABLET LOVASTATIN 2 Bone Resorption Suppression & Related Agents MIACALCIN 200 UNIT NASAL SPRAY CALCITONIN-SALMON 0.13 Bone Resorption Suppression & Related Agents MIACALCIN 200 UNIT/ML VIAL CALCITONIN-SALMON 0.5 Angiotensin Modulators MICARDIS 20 MG TABLET TELMISARTAN 1 Angiotensin Modulators MICARDIS 40 MG TABLET TELMISARTAN 1 Angiotensin Modulators MICARDIS 80 MG TABLET TELMISARTAN 1 Angiotensin Modulators MICARDIS HCT 40/12.5 MG TAB TELMISARTAN/HCTZ 1 Angiotensin Modulators MICARDIS HCT 80/12.5 MG TAB TELMISARTAN/HCTZ 2 Angiotensin Modulators MICARDIS HCT 80/25 MG TABLET TELMISARTAN/HCTZ 1 Diabetic Supplies, Miscellaneous MICROLET 2 LANCING DEVICE BLOOD GLUCOSE LANCING DEVICE 1 Benzodiazepines MIDAZOLAM 2 MG/ML SYRUP MIDAZOLAM 10 Antimigraine Agents, Other MIGERGOT SUPPOSITORY ERGOTAMINE TARTRATE/CAFFEINE 0.72 Antimigraine Agents, Other MIGRANAL 4 MG/ML NASAL SPRAY DIHYDROERGOTAMINE 0.3 Anxiolytics MILTOWN 200 MG TABLET MEPROBAMATE 4 Anxiolytics MILTOWN 400 MG TABLET MEPROBAMATE 4 Antiparkinson's Agents MIRAPEX 0.125 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX 0.25 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX 0.5 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX 0.75 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX 1 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX 1.5 MG TABLET PRAMIPEXOLE 3 Antiparkinson's Agents MIRAPEX ER 0.375 MG TABLET PRAMIPEXOLE ER 1 Antiparkinson's Agents MIRAPEX ER 0.75 MG TABLET PRAMIPEXOLE ER 1


Antiparkinson's Agents MIRAPEX ER 1.5 MG TABLET PRAMIPEXOLE ER 1 Antiparkinson's Agents MIRAPEX ER 3 MG TABLET PRAMIPEXOLE ER 1 Antiparkinson's Agents MIRAPEX ER 4.5 MG TABLET PRAMIPEXOLE ER 1 Contraceptives, Other MIRENA INTRAUTERINE SYSTEM LEVONORGESTREL see footnote4

Antihyperuricemics MITIGARE 0.6 MG CAPSULE COLCHICINE 3 Vaccines M-M-R II VACCINE VIAL WITH DILUENT MEASLES, MUMPS, RUBELLA VACCINE 1 Antipsychotics MOBAN 10 MG TABLET MOLINDONE 4 Antipsychotics MOBAN 25 MG TABLET MOLINDONE 9 Antipsychotics MOBAN 5 MG TABLET MOLINDONE 4 NSAIDs MOBIC 15 MG TABLET MELOXICAM 1 NSAIDs MOBIC 7.5 MG TABLET MELOXICAM 2 NSAIDs MOBIC 7.5 MG/5 ML LIQUID MELOXICAM 10 Angiotensin Modulators MONOPRIL 10 MG TABLET FOSINOPRIL 2 Angiotensin Modulators MONOPRIL 20 MG TABLET FOSINOPRIL 2 Angiotensin Modulators MONOPRIL 40 MG TABLET FOSINOPRIL 1 Angiotensin Modulators MONOPRIL-HCT 10 MG/12.5 MG TABLET FOSINOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators MONOPRIL-HCT 20 MG/12.5 MG TABLET FOSINOPRIL/HYDROCHLOROTHIAZIDE 2 Intra-Articular Hyaluronic Acids MONOVISC 88 MG/4 ML SYRINGE HYALURONATE SODIUM, STABILIZED 0.27 Tetracyclines MORGIDOX 1 X 50 MG KIT DOXYCYCLINE/SKIN CLEANSER 0.04 Tetracyclines MORGIDOX 1X100 MG KIT DOXYCYCLINE/SKIN CLEANSER 0.04 Tetracyclines MORGIDOX 2X100 MG KIT DOXYCYCLINE/SKIN CLEANSER 0.04 Analgesics, Opioids Long-Acting MORPHABOND ER 100 MG TABLET MORPHINE SULFATE 2 Analgesics, Opioids Long-Acting MORPHABOND ER 15 MG TABLET MORPHINE SULFATE 2 Analgesics, Opioids Long-Acting MORPHABOND ER 30 MG TABLET MORPHINE SULFATE 2 Analgesics, Opioids Long-Acting MORPHABOND ER 60 MG TABLET MORPHINE SULFATE 2 Analgesics, Opioids Short-Acting MORPHINE 100 MG/5 ML CONCENTRATE (INTENSOL) MORPHINE SULFATE 9 Analgesics, Opioids Short-Acting MORPHINE 20 MG/ML CONCENTRATE (INTENSOL) MORPHINE SULFATE 9 GI Motility, Chronic MOVANTIK 12.5 MG TABLET NALOXEGOL 1 GI Motility, Chronic MOVANTIK 25 MG TABLET NALOXEGOL 1 Hemantics & Blood Cell Stimulators MOZOBIL 24 MG/1.2 ML VIAL PLERIXAFOR 2.4 Analgesics, Opioids Long-Acting MS CONTIN 100 MG TABLET MORPHINE SULFATE ER 2 Analgesics, Opioids Long-Acting MS CONTIN 15 MG TABLET MORPHINE SULFATE ER 3 Analgesics, Opioids Long-Acting MS CONTIN 200 MG TABLET MORPHINE SULFATE ER 2 Analgesics, Opioids Long-Acting MS CONTIN 30 MG TABLET MORPHINE SULFATE ER 2 Analgesics, Opioids Long-Acting MS CONTIN 60 MG TABLET MORPHINE SULFATE ER 2 Analgesics, Opioids Short-Acting MSIR 10 MG/5 ML SOLN MORPHINE SULFATE IR 30 Analgesics, Opioids Short-Acting MSIR 15 MG TABLET MORPHINE SULFATE IR 6 Analgesics, Opioids Short-Acting MSIR 20 MG/5 ML SOLN MORPHINE SULFATE IR 15 Analgesics, Opioids Short-Acting MSIR 30 MG TABLET MORPHINE SULFATE IR 6 Antiarrhythmics MULTAQ 400 MG TABLET DRONEDARONE 2 Leptin Hormone Analogs MYALEPT 11.3 MG (5 MG/ML) VIAL METRELEPTIN 1 Antifungals, Injectable MYCAMINE 100 MG VIAL MICAFUNGIN 1 Antifungals, Injectable MYCAMINE 50 MG VIAL MICAFUNGIN 3


Antifungals, Oral MYCELEX 10 MG TROCHE CLOTRIMAZOLE 5 Stimulants & Related Agents MYDAYIS ER 12.5 MG AMPHETAMINE MIXED SALTS 1 Stimulants & Related Agents MYDAYIS ER 25 MG AMPHETAMINE MIXED SALTS 1 Stimulants & Related Agents MYDAYIS ER 37.5 MG AMPHETAMINE MIXED SALTS 1 Stimulants & Related Agents MYDAYIS ER 50 MG AMPHETAMINE MIXED SALTS 1 Botulinum Toxins MYOBLOC 10000 UNITS INJECTION VIAL RIMABOTULINUMTOXIN B 0.07 Botulinum Toxins MYOBLOC 2500 UNITS INJECTION VIAL RIMABOTULINUMTOXIN B 0.02 Botulinum Toxins MYOBLOC 5000 UNITS INJECTION VIAL RIMABOTULINUMTOXIN B 0.04 Bladder Relaxant Preparations MYRBETRIQ ER 25 MG TABLET MIRABEGRON 1 Bladder Relaxant Preparations MYRBETRIQ ER 50 MG TABLET MIRABEGRON 1 Anticonvulsants MYSOLINE 250 MG TABLET PRIMIDONE 8 Anticonvulsants MYSOLINE 50 MG TABLET PRIMIDONE 8 NSAIDs NALFON 200 MG PULVULE FENOPROFEN 12 NSAIDs NALFON 400 MG CAPSULE FENOPROFEN 4 Alzheimers Agents NAMENDA 10 MG TABLET MEMANTINE 2 Alzheimers Agents NAMENDA 10 MG/5 ML ORAL SOLUTION MEMANTINE 10 Alzheimers Agents NAMENDA 5 MG TABLET MEMANTINE 2 Alzheimers Agents NAMENDA XR 14 MG CAPSULE MEMANTINE HCL EXTENDED-RELEASE 1 Alzheimers Agents NAMENDA XR 21 MG CAPSULE MEMANTINE HCL EXTENDED-RELEASE 1 Alzheimers Agents NAMENDA XR 28 MG CAPSULE MEMANTINE HCL EXTENDED-RELEASE 1 Alzheimers Agents NAMENDA XR 7 MG CAPSULE MEMANTINE HCL EXTENDED-RELEASE 1 Alzheimers Agents NAMENDA XR TITRATION PACK MEMANTINE HCL EXTENDED-RELEASE 1 Alzheimers Agents NAMZARIC 10 MG/14 MG ER CAPSULE MEMANTINE/DONEPEZIL 1 Alzheimers Agents NAMZARIC 10 MG/28 MG ER CAPSULES MEMANTINE/DONEPEZIL 1 Alzheimers Agents NAMZARIC 21/10 MG CAPSULE MEMANTINE/DONEPEZIL 1 Alzheimers Agents NAMZARIC 7/10 MG CAPSULE MEMANTINE/DONEPEZIL 1 Alzheimers Agents NAMZARIC TITRATION PACK MEMANTINE/DONEPEZIL 1 NSAIDs NAPRELAN CR 375 MG TABLET NAPROXEN 3 NSAIDs NAPRELAN CR 500 MG TABLET NAPROXEN 3 NSAIDs NAPRELAN CR 750 MG TABLET NAPROXEN 2 NSAIDs NAPRELAN CR DOSECARD 500 MG/750 MG NAPROXEN 2 NSAIDs NAPROSYN 250 MG TABLET/CAPLET NAPROXEN 4 NSAIDs NAPROSYN 375 MG TABLET/CAPLET NAPROXEN 3 NSAIDs NAPROSYN 500 MG TABLET/CAPLET NAPROXEN 3 NSAIDs NAPROXEN 125 MG/5 ML LIQUID NAPROXEN 60 NSAIDs NAPROXEN 220 MG TABLET/CAPLET NAPROXEN 4 Intranasal Rhinitis Agents NASACORT AQ 55 MCG TRIAMCINOLONE 0.55 Intranasal Rhinitis Agents NASALIDE 0.025% NASAL SPRAY FLUNISOLIDE 1.51 Intranasal Rhinitis Agents NASAREL 0.025% NASAL SPRAY FLUNISOLIDE 1.51 Intranasal Rhinitis Agents NASONEX NASAL SPRAY MOMETASONE 0.57 Androgenic Agents NATESTO NASAL 5.5 MG/0.122 GM TESTOSTERONE 0.74 Parathyroid Hormones NATPARA 100 MCG DOSE CARTRIDGE PARATHYROID HORMONE 0.08 Parathyroid Hormones NATPARA 25 MCG DOSE CARTRIDGE PARATHYROID HORMONE 0.08


Parathyroid Hormones NATPARA 50 MCG DOSE CARTRIDGE PARATHYROID HORMONE 0.08 Parathyroid Hormones NATPARA 75 MCG DOSE CARTRIDGE PARATHYROID HORMONE 0.08 Insect Repellent for Skin Application NATRAPEL 20% CONTINUOUS SPRAY PICARIDIN 30 Irrigants NEOSPORIN GU IRRIGATION 40 MG/ML AMP NEOMYCIN/POLYMIXIN B IRRIG. 2 Irrigants NEOSPORIN GU IRRIGATION 40 MG/ML VIAL NEOMYCIN/POLYMIXIN B IRRIG. 2 Oncology, Oral NERLYNX 40 MG TABLET NERATINIB 6 Hypoglycemics, Incretin Mimetics/Enhancers NESINA 12.5 MG TABLET ALOGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers NESINA 25 MG TABLET ALOGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers NESINA 6.25 MG TABLET ALOGLIPTIN 1 Colony Stimulating Factors NEULASTA 6 MG/0.6 ML ONPRO DELIVERY KIT PEGFILGRASTIM 0.05 Colony Stimulating Factors NEULASTA 6 MG/0.6 ML SYRINGE PEGFILGRASTIM 0.15 Antiparkinson's Agents NEUPRO 1 MG/24 HR PATCH ROTIGOTINE 1 Antiparkinson's Agents NEUPRO 2 MG/24 HR PATCH ROTIGOTINE 1 Antiparkinson's Agents NEUPRO 3 MG/24 HR PATCH ROTIGOTINE 1 Antiparkinson's Agents NEUPRO 4 MG/24 HR PATCH ROTIGOTINE 1 Antiparkinson's Agents NEUPRO 6 MG/24 HR PATCH ROTIGOTINE 1 Antiparkinson's Agents NEUPRO 8 MG/24 HR PATCH ROTIGOTINE 1 Neuropathic Pain Agents NEURONTIN 100 MG CAPSULE GABAPENTIN 6 Neuropathic Pain Agents NEURONTIN 250 MG/5 ML SOLN GABAPENTIN 72 Neuropathic Pain Agents NEURONTIN 300 MG CAPSULE GABAPENTIN 12 Neuropathic Pain Agents NEURONTIN 400 MG CAPSULE GABAPENTIN 9 Neuropathic Pain Agents NEURONTIN 600 MG TABLET GABAPENTIN 6 Neuropathic Pain Agents NEURONTIN 800 MG TABLET GABAPENTIN 4 Oncology, Oral NEXAVAR 200 MG TABLET SORAFENIB 4 Proton Pump Inhibitors NEXIUM 20 MG CAPSULE ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM 40 MG CAPSULE ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM ORAL SUSPENSION 10 MG PACKET ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM ORAL SUSPENSION 2.5 MG PACKET ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM ORAL SUSPENSION 20 MG PACKET ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM ORAL SUSPENSION 40 MG PACKET ESOMEPRAZOLE 1 Proton Pump Inhibitors NEXIUM ORAL SUSPENSION 5 MG PACKET ESOMEPRAZOLE 1 Contraceptives, Other NEXPLANON 68 MG IMPLANT ETONOGESTREL IMPLANT see footnote4

Smoking Cessation NICODERM CQ 14 MG/24 HOURS TRANSDERMAL PATCH NICOTINE 1 Smoking Cessation NICODERM CQ 21 MG/24 HOURS TRANSDERMAL PATCH NICOTINE 1 Smoking Cessation NICODERM CQ 7 MG/24 HOURS TRANSDERMAL PATCH NICOTINE 1 Smoking Cessation NICORETTE 2 MG GUM NICOTINE POLACRILEX 24 Smoking Cessation NICORETTE 2 MG LOZENGE NICOTINE POLACRILEX 20 Smoking Cessation NICORETTE 4 MG GUM NICOTINE POLACRILEX 24 Smoking Cessation NICORETTE 4 MG LOZENGE NICOTINE POLACRILEX 20 Smoking Cessation NICOTROL NS 10 MG/ML NASAL SPRAY NICOTINE 4 Smoking Cessation NICOTROL ORAL INHALATION CARTRIDGE NICOTINE 16 Calcium Channel Blockers NIFEDIAC CC 30 MG TABLET NIFEDIPINE 1 Calcium Channel Blockers NIFEDIAC CC 60 MG TABLET NIFEDIPINE 2


Calcium Channel Blockers NIFEDIAC CC 90 MG TABLET NIFEDIPINE 1 Calcium Channel Blockers NIFEDICAL XL 30 MG TABLET NIFEDIPINE 1 Calcium Channel Blockers NIFEDICAL XL 60 MG TABLET NIFEDIPINE 2 Oncology, Oral NILANDRON 150 MG TABLET NILUTAMIDE 2 Oncology, Oral NINLARO 2.3 MG CAPSULE IXAZOMIB 0.2 Oncology, Oral NINLARO 3 MG CAPSULE IXAZOMIB 0.2 Oncology, Oral NINLARO 4 MG CAPSULE IXAZOMIB 0.2 Anxiolytics NIRAVAM 0.25 MG TABLET ALPRAZOLAM ODT 6 Anxiolytics NIRAVAM 0.5 MG TABLET ALPRAZOLAM ODT 6 Anxiolytics NIRAVAM 1 MG TABLET ALPRAZOLAM ODT 4 Anxiolytics NIRAVAM 2 MG TABLET ALPRAZOLAM ODT 2 Calcium Channel Blockers NISOLDIPINE ER 20 MG TABLET NISOLDIPINE 1 Calcium Channel Blockers NISOLDIPINE ER 30 MG TABLET NISOLDIPINE 2 Calcium Channel Blockers NISOLDIPINE ER 40 MG TABLET NISOLDIPINE 1 Antifungals, Oral NIZORAL 200 MG TABLET KETOCONAZOLE 1 Antimigraine Agents, Other NODOLOR CAPSULE ISOMETHEPTENE/DICHLORALPHENAZONE/APAP 8 Oncology Agents, Breast Cancer NOLVADEX 10 MG TABLET TAMOXIFEN 2 Oncology Agents, Breast Cancer NOLVADEX 20 MG TABLET TAMOXIFEN 2 Analgesics, Opioids Short-Acting NORCO 10 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 5 Analgesics, Opioids Short-Acting NORCO 5 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 10 Analgesics, Opioids Short-Acting NORCO 7.5 MG/325 MG TABLET HYDROCODONE/ACETAMINOPHEN 6 Skeletal Muscle Relaxants NORFLEX ER 100 MG SR TABLET ORPHENADRINE SR 2 Vasopressors NORTHERA 100 MG CAPSULE DROXIDOPA 3 Vasopressors NORTHERA 200 MG CAPSULE DROXIDOPA 3 Vasopressors NORTHERA 300 MG CAPSULE DROXIDOPA 6 Calcium Channel Blockers NORVASC 10 MG TABLET AMLODIPINE 1 Calcium Channel Blockers NORVASC 2.5 MG TABLET AMLODIPINE 4 Calcium Channel Blockers NORVASC 5 MG TABLET AMLODIPINE 2 HIV/AIDS Agents NORVIR 100 MG CAPSULE/TABLET RITONAVIR 12 HIV/AIDS Agents NORVIR 80 MG/ML ORAL SOLUTION RITONAVIR 16 Diabetic Strips NOVA MAX BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Antifungals, Injectable NOXAFIL 300 MG/16.7 ML VIAL POSACONAZOLE 25.1 Antifungals, Oral NOXAFIL 40 MG/ML SUSPENSION POSACONAZOLE 20 Antifungals, Oral NOXAFIL DR 100 MG TABLET POSACONAZOLE 3.22 Monoclonal Antibodies to IL-5 NUCALA 100 MG VIAL MEPOLIZUMAB 0.11 Analgesics, Opioids Short-Acting NUCYNTA 100 MG TABLET TAPENTADOL 4 Analgesics, Opioids Short-Acting NUCYNTA 50 MG TABLET TAPENTADOL 4 Analgesics, Opioids Short-Acting NUCYNTA 75 MG TABLET TAPENTADOL 4 Analgesics, Opioids Long-Acting NUCYNTA ER 100 MG TABLET TAPENTADOL HCL ER 2 Analgesics, Opioids Long-Acting NUCYNTA ER 150 MG TABLET TAPENTADOL HCL ER 2 Analgesics, Opioids Long-Acting NUCYNTA ER 200 MG TABLET TAPENTADOL HCL ER 2 Analgesics, Opioids Long-Acting NUCYNTA ER 250 MG TABLET TAPENTADOL HCL ER 2 Analgesics, Opioids Long-Acting NUCYNTA ER 50 MG TABLET TAPENTADOL HCL ER 2


NMDA Antagonists NUEDEXTA 20-10 MG CAPSULE DEXTROMETHORPHAN/QUINIDINE 2 Antipsychotics NUPLAZID 17 MG TABLET PIMAVANSERIN 2 Contraceptives, Other NUVARING VAGINAL RING ETONOGESTREL/ETHINYL ESTRADIOL 0.05 Stimulants & Related Agents NUVIGIL 150 MG TABLET ARMODAFINIL 1 Stimulants & Related Agents NUVIGIL 200MG TABLET ARMODAFINIL 1 Stimulants & Related Agents NUVIGIL 250 MG TABLET ARMODAFINIL 1 Stimulants & Related Agents NUVIGIL 50 MG TABLET ARMODAFINIL 2 Bile Salts OCALIVA 10 MG TABLET OBETICHOLIC ACID 1 Bile Salts OCALIVA 5 MG TABLET OBETICHOLIC ACID 1 Multiple Sclerosis Agents OCREVUS 300 MG/10 MLVIAL OCRELIZUMAB 0.72 HIV/AIDS Agents ODEFSEY 200 MG/25 MG/25 MG TABLET EMTRICITABINE/RILPIVIRINE/TENOFOVIR ALAFENAMIDE 1 Oncology, Oral ODOMZO 200 MG CAPSULE SONIDEGIB 1 Idiopathic Pulmonary Fibrosis Agents OFEV 100 MG CAPSULE NINTEDANIB ESYLATE 2 Idiopathic Pulmonary Fibrosis Agents OFEV 150 MG CAPSULE NINTEDANIB ESYLATE 2 Insect Repellent for Skin Application OFF! ACTIVE INSECT REPELLENT I 15% AEROSOL DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application OFF! DEEP WOODS INSECT REPELLENT V 25% AEROSOL DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application OFF! DEEP WOODS INSECT REPELLENT VII PUMP DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application OFF! DEEP WOODS INSECT REPELLENT VIII DRY 25% AERO. DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application OFF! FAMILYCARE INSECT REPELLENT I SMOOTH & DRY 15% DIETHYLTOLUAMIDE 36 Hepatitis C Agents OLYSIO 150 MG CAPSULE SIMEPREVIR 1 Intranasal Rhinitis Agents OMNARIS NASAL SPRAY CICLESONIDE AQUEOUS 0.42 Diabetic Supplies, Miscellaneous ONE TOUCH DELICA LANCING DEVICE BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Supplies, Miscellaneous ONE TOUCH PENLET PLUS BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Meters ONE TOUCH ULTRA 2 BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips ONE TOUCH ULTRA BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters ONE TOUCH ULTRA LINK BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters ONE TOUCH ULTRA MINI BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters ONE TOUCH ULTRA SMART BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters ONE TOUCH ULTRA SYSTEM BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips ONE TOUCH VERIO BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters ONE TOUCH VERIO IQ BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Anticonvulsants ONFI 10 MG TABLET CLOBAZAM 2 Anticonvulsants ONFI 2.5 MG/ML SUSPENSION CLOBAZAM 16 Anticonvulsants ONFI 20 MG TABLET CLOBAZAM 2 Anticonvulsants ONFI 5 MG TABLET CLOBAZAM 2 Hypoglycemics, Incretin Mimetics/Enhancers ONGLYZA 2.5 MG TABLET SAXAGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers ONGLYZA 5 MG TABLET SAXAGLIPTIN 1 Antifungals, Oral ONMEL 200 MG TABLET ITRACONAZOLE 1 Antimigraine Agents, Triptans ONZETRA XSAIL 11 MG NASAL SUMATRIPTAN 0.54 Analgesics, Opioids Long-Acting OPANA ER 10 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Long-Acting OPANA ER 15 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Long-Acting OPANA ER 20 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Long-Acting OPANA ER 30 MG TABLET OXYMORPHONE HCL ER 2


Analgesics, Opioids Long-Acting OPANA ER 40 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Long-Acting OPANA ER 5 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Long-Acting OPANA ER 7.5 MG TABLET OXYMORPHONE HCL ER 2 Analgesics, Opioids Short-Acting OPANA IR 10 MG TABLET OXYMORPHONE HCL 4 Analgesics, Opioids Short-Acting OPANA IR 5 MG TABLET OXYMORPHONE HCL 4 Analgesics, Opioids OPIUM TINCTURE 10 MG/ML OPIUM 5 PAH Agents, Oral & Inhaled OPSUMIT 10 MG TABLET MACITENTAN 1 Diabetic Strips OPTIUM BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Tetracyclines ORACEA 40 MG CAPSULE DOXYCYCLINE MONOHYDRATE 1 Analgesics, Opioids Long-Acting ORAMORPH SR 100 MG TABLET MORPHINE SULFATE SR 2 Analgesics, Opioids Long-Acting ORAMORPH SR 15 MG TABLET MORPHINE SULFATE SR 3 Analgesics, Opioids Long-Acting ORAMORPH SR 30 MG TABLET MORPHINE SULFATE SR 2 Analgesics, Opioids Long-Acting ORAMORPH SR 60 MG TABLET MORPHINE SULFATE SR 2 Antifungals, Oral ORAVIG 50 MG BUCCAL TABLET MICONAZOLE 1 Cytokine & CAM Antagonists ORENCIA 125 MG INJECTION SYRINGE ABATACEPT 0.15 Cytokine & CAM Antagonists ORENCIA 125 MG/ML CLICKJET ABATACEPT 0.15 Cytokine & CAM Antagonists ORENCIA 250 MG INJECTION VIAL ABATACEPT 0.43 Cytokine & CAM Antagonists ORENCIA 50 MG/0.4ML SYRINGE ABATACEPT 0.06 Cytokine & CAM Antagonists ORENCIA 87.5 MG/0.7 ML SYRINGE ABATACEPT 0.1 Cystic Fibrosis Agents ORKAMBI 100 MG/125 MG TABLET LUMACAFTOR/IVACAFTOR 4 Cystic Fibrosis Agents ORKAMBI 200 MG/125 MG TABLET LUMACAFTOR/IVACAFTOR 4 Contraceptives, Other ORTHO EVRA TRANSDERMAL PATCH NORELGESTROMIN/ETHINYL ESTRADIOL 0.14 Intra-Articular Hyaluronic Acids ORTHOVISC 15 MG/ML SYRINGE HYALURONATE SODIUM 0.58 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 12.5 MG/15 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 12.5 MG/30 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 12.5 MG/45 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 25 MG/15 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 25 MG/30 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Hypoglycemics, Incretin Mimetics/Enhancers OSENI 25 MG/45 MG TABLET ALOGLIPTIN/PIOGLITAZONE 1 Cytokine & CAM Antagonists OTEZLA 30 MG TABLET APREMILAST 2 Cytokine & CAM Antagonists OTEZLA STARTER PACK (28 DAY, 55 TABLETS) APREMILAST 1.97 Methotrexates OTREXUP 10 MG/0.4 ML AUTO-INJECTOR METHOTREXATE 0.06 Methotrexates OTREXUP 15 MG/0.4 ML AUTO-INJECTOR METHOTREXATE 0.06 Methotrexates OTREXUP 20 MG/0.4 ML AUTO-INJECTOR METHOTREXATE 0.06 Methotrexates OTREXUP 25 MG/0.4 ML AUTO-INJECTOR METHOTREXATE 0.06 Androgenic Agents OXANDRIN 10 MG TABLET OXANDROLONE 2 Androgenic Agents OXANDRIN 2.5 MG TABLET OXANDROLONE 8 Analgesics, Opioids Short-Acting OXAYDO 5 MG TABLET OXYCODONE HCL 6 Analgesics, Opioids Short-Acting OXAYDO 7.5 MG TABLET OXYCODONE HCL 4 Anticonvulsants OXTELLAR XR 150 MG TABLET OXCARBAZEPINE 3 Anticonvulsants OXTELLAR XR 300 MG TABLET OXCARBAZEPINE 3 Anticonvulsants OXTELLAR XR 600 MG TABLET OXCARBAZEPINE 4 Analgesics, Opioids Short-Acting OXY IR 5MG CAPSULE OXYCODONE 6


Analgesics, Opioids Short-Acting OXYCODONE 10 MG/0.5 ML ORAL SYRINGE OXYCODONE HCL 9 Analgesics, Opioids Short-Acting OXYCODONE 20 MG/ML SOLN OXYCODONE 9 Analgesics, Opioids Short-Acting OXYCODONE 5 MG/5 ML SOLN OXYCODONE 30 Analgesics, Opioids Long-Acting OXYCONTIN 10 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 15 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 20 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 30 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 40 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 60 MG CR TABLET OXYCODONE CR 2 Analgesics, Opioids Long-Acting OXYCONTIN 80 MG CR TABLET OXYCODONE CR 2 Bladder Relaxant Preparations OXYTROL 3.9 MG/DAY TD PATCH OXYBUTYNIN 0.34 Bladder Relaxant Preparations OXYTROL FOR WOMEN 3.9 MG/DAY TD PATCH OXYBUTYNIN 0.34 Hypoglycemics, Incretin Mimetics/Enhancers OZEMPIC 0.25-0.5 MG DOSE PEN SEMAGLUTIDE 0.06 Hypoglycemics, Incretin Mimetics/Enhancers OZEMPIC 1 MG DOSE PEN SEMAGLUTIDE 0.11 Analgesics, Opioids Short-Acting PANLOR 325-30-16 MG TABLET ACETAMINOPHEN/CAFFEINE/DIHYDROCODEINE 10 Skeletal Muscle Relaxants PARAFON FORTE DSC 500 MG TABLET CHLORZOXAZONE 6 Contraceptives, Other PARAGARD T 380-A IUD COPPER INTRAUTERINE DEVICE see footnote4

Antiparkinson's Agents PARCOPA 10/100 MG ODT CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents PARCOPA 25/100 MG ODT CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents PARCOPA 25/250 MG ODT CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents PARLODEL 2.5 MG TABLET BROMOCRIPTINE 20 Antiparkinson's Agents PARLODEL 5 MG CAPSULE BROMOCRIPTINE 10 Intranasal Rhinitis Agents PATANASE 0.6% NASAL SPRAY OLOPATADINE 1.02 Antidepressants, SSRIs PAXIL 10 MG TABLET PAROXETINE 3 Antidepressants, SSRIs PAXIL 10 MG/5 ML SUSPENSION PAROXETINE 30 Antidepressants, SSRIs PAXIL 20 MG TABLET PAROXETINE 3 Antidepressants, SSRIs PAXIL 30 MG TABLET PAROXETINE 2 Antidepressants, SSRIs PAXIL 40 MG TABLET PAROXETINE 1.5 Antidepressants, SSRIs PAXIL CR 12.5 MG TABLET PAROXETINE 1 Antidepressants, SSRIs PAXIL CR 25 MG TABLET PAROXETINE 2 Antidepressants, SSRIs PAXIL CR 37.5 MG TABLET PAROXETINE 2 Anticonvulsants PEGANONE 250 MG TABLET ETHOTOIN 12 Hepatitis C Agents PEGASYS 180 MCG/0.5 ML MONTHLY CONVENIENCE PAK PEGINTERFERON ALFA-2A 0.04 Hepatitis C Agents PEGASYS 180 MCG/ML SINGE USE VIAL PEGINTERFERON ALFA-2A 0.14 Antiemetics/Antivertigo Agents PENERGAN 25 MG SUPPOSITORY PROMETHAZINE 6 NSAIDs PENNSAID 1.5% SOLUTION DICLOFENAC SODIUM 10 NSAIDs PENNSAID 2% PUMP DICLOFENAC SODIUM 8 Ulcerative Colitis Agents PENTASA 250 MG ER CAPSULE MESALAMINE 16 Ulcerative Colitis Agents PENTASA 500 MG ER CAPSULE MESALAMINE 8 Histamine II Receptor Blockers PEPCID 10 MG TABLET FAMOTIDINE 2 Histamine II Receptor Blockers PEPCID 20 MG TABLET FAMOTIDINE 2 Histamine II Receptor Blockers PEPCID 40 MG TABLET FAMOTIDINE 1 Analgesics, Opioids Short-Acting PERCOCET 10 MG/325 MG TABLET OXYCODONE/APAP 4


Analgesics, Opioids Short-Acting PERCOCET 2.5 MG/325 MG TABLET OXYCODONE/APAP 10 Analgesics, Opioids Short-Acting PERCOCET 5 MG/325 MG TABLET OXYCODONE/APAP 6 Analgesics, Opioids Short-Acting PERCOCET 7.5 MG/325 MG TABLET OXYCODONE/APAP 4 Analgesics, Opioids Short-Acting PERCODAN TABLET OXYCODONE/ASA 6 Bronchodilators, Beta Agonist PERFOROMIST 20 MCG/2 ML SOLN FORMOTEROL 4 Insect Repellent NOT for Skin Application PERRIGO LICE BEDDING SPRAY PERMETHRIN 0.5% 29 Platelet Aggregation Inhibitors PERSANTINE 25 MG TABLET DIPYRIDAMOLE 4 Platelet Aggregation Inhibitors PERSANTINE 50 MG TABLET DIPYRIDAMOLE 8 Platelet Aggregation Inhibitors PERSANTINE 75 MG TABLET DIPYRIDAMOLE 4 Antidepressants, SSRIs PEXEVA 10 MG TABLET PAROXETINE MESYLATE 1 Antidepressants, SSRIs PEXEVA 20 MG TABLET PAROXETINE MESYLATE 1 Antidepressants, SSRIs PEXEVA 30 MG TABLET PAROXETINE MESYLATE 2 Antidepressants, SSRIs PEXEVA 40 MG TABLET PAROXETINE MESYLATE 1 Antiemetics/Antivertigo Agents PHENERGAN 12.5 MG SUPPOSITORY PROMETHAZINE 6 Antiemetics/Antivertigo Agents PHENERGAN 12.5 MG TABLET PROMETHAZINE 6 Antiemetics/Antivertigo Agents PHENERGAN 25 MG TABLET PROMETHAZINE 6 Antiemetics/Antivertigo Agents PHENERGAN 50 MG SUPPOSITORY PROMETHAZINE 3 Antiemetics/Antivertigo Agents PHENERGAN 50 MG TABLET PROMETHAZINE 3 Anticonvulsants PHENYTEK 200 MG CAPSULE PHENYTOIN 3 Anticonvulsants PHENYTEK 300 MG CAPSULE PHENYTOIN 2 Phosphate Binders PHOSLO 667 MG CAPSULE/TABLET CALCIUM ACETATE 12 Phosphate Binders PHOSLYRA 667 MG/5 ML ORAL SOLUTION CALCIUM ACETATE 60 Analgesics, Non-Narcotic Barbiturate Combos PHRENILIN 50 MG/325 MG TABLET BUTALBITAL/ACETAMINOPHEN 0.6 Platelet Aggregation Inhibitors PLAVIX 300 MG TABLET CLOPIDOGREL 1 Platelet Aggregation Inhibitors PLAVIX 75 MG TABLET CLOPIDOGREL 1 Multiple Sclerosis Agents PLEGRIDY 125 MCG/0.5 ML PEN PEGINTERFERON BETA-1A 0.04 Multiple Sclerosis Agents PLEGRIDY 125 MCG/0.5 ML SYRINGE PEGINTERFERON BETA-1A 0.04 Multiple Sclerosis Agents PLEGRIDY PEN INJECTION STARTER PACK PEGINTERFERON BETA-1A 0.04 Multiple Sclerosis Agents PLEGRIDY SYRINGE STARTER PACK PEGINTERFERON BETA-1A 0.04 Calcium Channel Blockers PLENDIL 10 MG TABLET SA FELODIPINE 1 Calcium Channel Blockers PLENDIL 2.5 MG TABLET SA FELODIPINE 1 Calcium Channel Blockers PLENDIL 5 MG TABLET SA FELODIPINE 1 Platelet Aggregation Inhibitors PLETAL 100 MG TABLET CILOSTAZOL 2 Platelet Aggregation Inhibitors PLETAL 50 MG TABLET CILOSTAZOL 2 Vaccine PNEUMOVAX 23 SYRINGE/VIAL PNEUMOCOCCAL VACCINE 0.5 Thalidomides & Derivatives POMALYST 1 MG CAPSULE POMALIDOMIDE 1 Thalidomides & Derivatives POMALYST 2 MG CAPSULE POMALIDOMIDE 1 Thalidomides & Derivatives POMALYST 3 MG CAPSULE POMALIDOMIDE 1 Thalidomides & Derivatives POMALYST 4 MG CAPSULE POMALIDOMIDE 1 NSAIDs PONSTEL 250 MG CAPSULE MEFENAMIC ACID 6 Anticonvulsants POTIGA 200 MG TABLET EZOGABINE 3 Anticonvulsants POTIGA 300 MG TABLET EZOGABINE 3 Anticonvulsants POTIGA 400 MG TABLET EZOGABINE 3


Anticonvulsants POTIGA 50 MG TABLET EZOGABINE 9 Anticoagulants, Oral PRADAXA 110 MG CAPSULE DABIGATRAN 2 Anticoagulants, Oral PRADAXA 150 MG CAPSULE DABIGATRAN 2 Anticoagulants, Oral PRADAXA 75 MG CAPSULE DABIGATRAN 2 Lipotropics, Other PRALUENT 150 MG/ML INJECTION PEN ALIROCUMAB 0.08 Lipotropics, Other PRALUENT 150 MG/ML INJECTION SYRINGE ALIROCUMAB 0.08 Lipotropics, Other PRALUENT 75 MG/ML INJECTION PEN ALIROCUMAB 0.08 Lipotropics, Other PRALUENT 75 MG/ML INJECTION SYRINGE ALIROCUMAB 0.08 Hypoglycemics, Meglitinides PRANDIMET 1 MG/500 MG TABLET REPAGLINIDE/METFORMIN 5 Hypoglycemics, Meglitinides PRANDIMET 2 MG/500 MG TABLET REPAGLINIDE/METFORMIN 5 Hypoglycemics, Meglitinides PRANDIN 0.5 MG TABLET REPAGLINIDE 4 Hypoglycemics, Meglitinides PRANDIN 1 MG TABLET REPAGLINIDE 4 Hypoglycemics, Meglitinides PRANDIN 2 MG TABLET REPAGLINIDE 8 Lipotropics, Statins PRAVACHOL 10 MG TABLET PRAVASTATIN 1.5 Lipotropics, Statins PRAVACHOL 20 MG TABLET PRAVASTATIN 1.5 Lipotropics, Statins PRAVACHOL 40 MG TABLET PRAVASTATIN 1.5 Lipotropics, Statins PRAVACHOL 80 MG TABLET PRAVASTATIN 1 Diabetic Strips PRECISION PCX BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips PRECISION Q-I-D BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters PRECISION XTRA BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips PRECISION XTRA BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Hypoglycemics, Alpha-Glucosidase Inhibitors PRECOSE 100 MG TABLET ACARBOSE 3 Hypoglycemics, Alpha-Glucosidase Inhibitors PRECOSE 25 MG TABLET ACARBOSE 3 Hypoglycemics, Alpha-Glucosidase Inhibitors PRECOSE 50 MG TABLET ACARBOSE 3 Estrogens PREMARIN 25 MG VIAL CONJUGATED ESTROGENS 2 Angiotensin Modulator Combinations PRESTALIA 14 MG/10 MG TABLET PERINDOPRIL ARGININE/AMLODIPINE BESYLATE 1 Angiotensin Modulator Combinations PRESTALIA 3.5 MG/2.5 MG TABLET PERINDOPRIL ARGININE/AMLODIPINE BESYLATE 2 Angiotensin Modulator Combinations PRESTALIA 7 MG/5 MG TABLET PERINDOPRIL ARGININE/AMLODIPINE BESYLATE 2 Diabetic Meters PRESTIGE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips PRESTIGE BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips PRESTIGE SMART BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Proton Pump Inhibitors PREVACID 15 MG CAPSULE/SOLUTAB LANSOPRAZOLE 1 Proton Pump Inhibitors PREVACID 24 HR (OTC) 15 MG CAPSULE LANSOPRAZOLE 1 Proton Pump Inhibitors PREVACID 30 MG CAPSULE/SOLUTAB LANSOPRAZOLE 1 Vaccines PREVNAR 13 VACCINE SYRINGE PNEUMOCOCCAL 13-VALENT CONJUGATED VACCINE 0.5 H. Pylori Treatment PREVPAC PATIENT PACK LANSOPRAZOLE/AMOXICILLIN/CLARITHR 8 Antivirals, General PREVYMIS 240 MG TABLET LETERMOVIR 1 Antivirals, General PREVYMIS 240 MG/ 12 ML VIAL LETERMOVIR 12 Antivirals, General PREVYMIS 480 MG TABLET LETERMOVIR 1 Antivirals, General PREVYMIS 480 MG/ 24 ML VIAL LETERMOVIR 24 HIV/AIDS Agents PREZCOBIX 800 MG/150 MG TABLET DARUNAVIR/COBICISTAT 1 HIV/AIDS Agents PREZISTA 100 MG/ML SUSPENSION DARUNAVIR 8 HIV/AIDS Agents PREZISTA 150 MG TABLET DARUNAVIR 6


HIV/AIDS Agents PREZISTA 400 MG TABLET DARUNAVIR 2 HIV/AIDS Agents PREZISTA 600 MG TABLET DARUNAVIR 2 HIV/AIDS Agents PREZISTA 75 MG TABLET DARUNAVIR 2 HIV/AIDS Agents PREZISTA 800 MG TABLET DARUNAVIR 1 Proton Pump Inhibitors PRILOSEC 10 MG CAPSULE DR OMEPRAZOLE 2 Proton Pump Inhibitors PRILOSEC 10 MG SUSPENSION PACKET OMEPRAZOLE 2 Proton Pump Inhibitors PRILOSEC 2.5 MG SUSPENSION PACKET OMEPRAZOLE 2 Proton Pump Inhibitors PRILOSEC 20 MG CAPSULE DR OMEPRAZOLE 2 Proton Pump Inhibitors PRILOSEC 40 MG CAPSULE DR OMEPRAZOLE 2 Proton Pump Inhibitors PRILOSEC OTC 20 MG TABLET OMEPRAZOLE 2 Antibiotics, Injectable PRIMAXIN 250 MG VIAL IMIPENEM/CILASTATIN 8 Antibiotics, Injectable PRIMAXIN 500 MG VIAL IMIPENEM/CILASTATIN 8 Analgesics, Opioids Short-Acting PRIMLEV 10 MG/300 MG TABLET OXYCODONE/ACETAMINOPHEN 4 Analgesics, Opioids Short-Acting PRIMLEV 5 MG/300 MG TABLET OXYCODONE/ACETAMINOPHEN 6 Analgesics, Opioids Short-Acting PRIMLEV 7.5 MG/300 MG TABLET OXYCODONE/ACETAMINOPHEN 4 Angiotensin Modulators PRINIVIL 10 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINIVIL 2.5 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINIVIL 20 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINIVIL 30 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINIVIL 40 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINIVIL 5 MG TABLET LISINOPRIL 2 Angiotensin Modulators PRINZIDE 10 MG/12.5 MG TABLET LISINOPRIL/HYDROCHLOROTHIAZIDE 4 Angiotensin Modulators PRINZIDE 20 MG/12.5 MG TABLET LISINOPRIL/HYDROCHLOROTHIAZIDE 2 Antidepressants, Other PRISTIQ 100 MG TABLET DESVENLAFAXINE SUCCINATE MONOHYDRATE 1 Antidepressants, Other PRISTIQ 50 MG TABLET DESVENLAFAXINE SUCCINATE MONOHYDRATE 1 Bronchodilators, Beta Agonist PROAIR HFA 90 MCG INHALER ALBUTEROL 1.2 Bronchodilators, Beta Agonist PROAIR RESPICLICK INHALATION POWDER ALBUTEROL 0.07 Opiate Dependence Treatments PROBUPHINE 74.2 MG IMPLANT BUPRENORPHINE HCL 0.03 Calcium Channel Blockers PROCARDIA XL 30 MG TABLET NIFEDIPINE 1 Calcium Channel Blockers PROCARDIA XL 60 MG TABLET NIFEDIPINE 2 Calcium Channel Blockers PROCARDIA XL 90 MG TABLET NIFEDIPINE 1 Stimulants & Related Agents PROCENTRA 5 MG/5 ML ORAL SOLUTION DEXTROAMPHETAMINE 60 Diabetic Meters PRODIGY AUTOCODE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips PRODIGY NO CODING BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters PRODIGY VOICE BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Bone Resorption Suppression & Related Agents PROLIA 60 MG/ML INJECTION SYRINGE DENOSUMAB 0.04 Thrombopoietin Receptor Antagonists PROMACTA 12.5 MG TABLET ELTROMBOPAG 4 Thrombopoietin Receptor Antagonists PROMACTA 25 MG TABLET ELTROMBOPAG 3 Thrombopoietin Receptor Antagonists PROMACTA 50 MG TABLET ELTROMBOPAG 2 Thrombopoietin Receptor Antagonists PROMACTA 75 MG TABLET ELTROMBOPAG 2 Progestational Agents PROMETRIUM 100 MG CAPSULE PROGESTERONE 1 Progestational Agents PROMETRIUM 200 MG CAPSULE PROGESTERONE 2 BPH Treatments PROSCAR 5 MG TABLET FINASTERIDE 1


Sedative Hypnotics PROSOM 1 MG TABLET ESTAZOLAM 1 Sedative Hypnotics PROSOM 2 MG TABLET ESTAZOLAM 1 Proton Pump Inhibitors PROTONIX 20 MG TABLET EC PANTOPRAZOLE 2 Proton Pump Inhibitors PROTONIX 40 MG SUSPENSION PACKET PANTOPRAZOLE 2 Proton Pump Inhibitors PROTONIX 40 MG TABLET EC PANTOPRAZOLE 2 Oncology, Other PROVENGE INFUSION BAG SIPULEUCEL-T 27 Bronchodilators, Beta Agonist PROVENTIL HFA 90 MCG INHALER ALBUTEROL 1.2 Progestational Agents PROVERA 10 MG TABLET MEDROXYPROGESTERONE ACETATE 1 Progestational Agents PROVERA 2.5 MG TABLET MEDROXYPROGESTERONE ACETATE 1 Progestational Agents PROVERA 5 MG TABLET MEDROXYPROGESTERONE ACETATE 1 Stimulants & Related Agents PROVIGIL 100 MG TABLET MODAFINIL 1 Stimulants & Related Agents PROVIGIL 200 MG TABLET MODAFINIL 2 Antidepressants, SSRIs PROZAC 10 MG PULVULE/CAPSULE/TABLET FLUOXETINE 6 Antidepressants, SSRIs PROZAC 20 MG PULVULE/CAPSULE/TABLET FLUOXETINE 4 Antidepressants, SSRIs PROZAC 20 MG/5 ML SOLUTION FLUOXETINE 20 Antidepressants, SSRIs PROZAC 40 MG PULVULE/CAPSULE FLUOXETINE 2 Antidepressants, SSRIs PROZAC WEEKLY 90 MG CAPSULE FLUOXETINE 0.14 Diabetic Strips PSS BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Glucocorticoids, Inhaled PULMICORT 0.25 MG/2 ML RESPULE BUDESONIDE 4 Glucocorticoids, Inhaled PULMICORT 0.5 MG/2 ML RESPULE BUDESONIDE 4 Glucocorticoids, Inhaled PULMICORT 1 MG/2 ML RESPULE BUDESONIDE 2 Glucocorticoids, Inhaled PULMICORT 180 MCG FLEXHALER BUDESONIDE 0.07 Glucocorticoids, Inhaled PULMICORT 90 MCG FLEXHALER BUDESONIDE 0.04 Mucolytics PULMOZYME 1 MG/ML AMPULE (2.5 ML/AMPULE) DORNASE ALFA 2.50 Angiotensin Modulators QBRELIS 1 MG/ML SOLUTION LISINOPRIL 40 Intranasal Rhinitis Agents QNASL 80 MCG NASAL SPRAY BECLOMETHASONE 0.29 Intranasal Rhinitis Agents QNASL CHILDREN'S 40 MCG NASAL SPRAY BECLOMETHASONE 0.17 Hypoglycemics, Incretin Mimetics/Enhancers QTERN 10 MG-5 MG TABLET DAPAGLIFLOZIN AND SAXAGLIPTIN 1 Anticonvulsants QUDEXY XR 100 MG SPRINKLE CAPSULE TOPIRAMATE ER 2 Anticonvulsants QUDEXY XR 150 MG SPRINKLE CAPSULE TOPIRAMATE ER 2 Anticonvulsants QUDEXY XR 200 MG SPRINKLE CAPSULE TOPIRAMATE ER 2 Anticonvulsants QUDEXY XR 25 MG SPRINKLE CAPSULE TOPIRAMATE ER 4 Anticonvulsants QUDEXY XR 50 MG SPRINKLE CAPSULE TOPIRAMATE ER 4 Stimulants & Related Agents QUILLICHEW ER 20 MG TABLET METHYLPHENIDATE 1.5 Stimulants & Related Agents QUILLICHEW ER 30 MG TABLET METHYLPHENIDATE 2 Stimulants & Related Agents QUILLICHEW ER 40 MG TABLET METHYLPHENIDATE 1.5 Stimulants & Related Agents QUILLIVANT XR 25 MG/5 ML SUSPENSION METHYLPHENIDATE 12 Neuropathic Pain Agents QUTENZA 8% KIT CAPSAICIN 0.05 Glucocorticoids, Inhaled QVAR 40 MCG INHALER BECLOMETHASONE 0.29 Glucocorticoids, Inhaled QVAR 80 MCG INHALER BECLOMETHASONE 0.58 Glucocorticoids, Inhaled QVAR REDIHALER 40 MCG BECLOMETHASONE 0.36 Glucocorticoids, Inhaled QVAR REDIHALER 80 MCG BECLOMETHASONE 0.71 Anti-Anginal & Anti-Ischemic RANEXA 1000 MG TABLET RANOLAZINE 2


Anti-Anginal & Anti-Ischemic RANEXA 500 MG TABLET RANOLAZINE 2 BPH Treatments RAPAFLO 4 MG CAPSULE SILODOSIN 1 BPH Treatments RAPAFLO 8 MG CAPSULE SILODOSIN 1 Methotrexates RASUVO 10 MG/0.2 ML AUTOINJECTOR METHOTREXATE 0.03 Methotrexates RASUVO 12.5 MG/0.25 ML AUTOINJECTOR METHOTREXATE 0.04 Methotrexates RASUVO 15 MG/0.3 ML AUTOINJECTOR METHOTREXATE 0.05 Methotrexates RASUVO 17.5 MG/0.35 ML AUTOINJECTOR METHOTREXATE 0.05 Methotrexates RASUVO 20 MG/0.4 ML AUTOINJECTOR METHOTREXATE 0.06 Methotrexates RASUVO 22.5 MG/0.45 ML AUTOINJECTOR METHOTREXATE 0.07 Methotrexates RASUVO 25 MG/0.5 ML AUTOINJECTOR METHOTREXATE 0.08 Methotrexates RASUVO 27.5 MG/0.55 ML AUTOINJECTOR METHOTREXATE 0.08 Methotrexates RASUVO 30 MG/0.6 ML AUTOINJECTOR METHOTREXATE 0.09 Methotrexates RASUVO 7.5 MG/0.15 ML AUTOINJECTOR METHOTREXATE 0.03 Ammonia Inhibitors RAVICTI 1.1 GRAM/ML LIQUID GLYCEROL PHENYLBUTYRATE 18 Vitamin D Analogs RAYALDEE ER 30 MCG CAPSULE CALCIFEDIOL 2 Alzheimers Agents RAZADYNE 12 MG TABLET GALANTAMINE 2 Alzheimers Agents RAZADYNE 4 MG TABLET GALANTAMINE 2 Alzheimers Agents RAZADYNE 4 MG/ML ORAL SOLUTION GALANTAMINE 6 Alzheimers Agents RAZADYNE 8 MG TABLET GALANTAMINE 2 Alzheimers Agents RAZADYNE ER 16 MG CAPSULE GALANTAMINE ER 1 Alzheimers Agents RAZADYNE ER 24 MG CAPSULE GALANTAMINE ER 1 Alzheimers Agents RAZADYNE ER 8 MG CAPSULE GALANTAMINE ER 1 Multiple Sclerosis Agents REBIF 22 MCG/0.5 ML SYRINGE INTERFERON BETA-1A 0.22 Multiple Sclerosis Agents REBIF 44 MCG/0.5 ML SYRINGE INTERFERON BETA-1A 0.22 Bone Resorption Suppression & Related Agents RECLAST 5 ML/100 ML IV INJECTION ZOLEDRONIC ACID 3.4 Vaccines RECOMBIVAX HB 10 MCG/ML SYRINGE HEPATITIS B VIRUS VACCINE 1 Vaccines RECOMBIVAX HB 10 MCG/ML VIAL HEPATITIS B VIRUS VACCINE 1 Vaccines RECOMBIVAX HB 40 MCG/ML VIAL HEPATITIS B VIRUS VACCINE 1 Vaccines RECOMBIVAX HB 5 MCG/0.5 ML SYRINGE HEPATITIS B VIRUS VACCINE 0.5 Vaccines RECOMBIVAX HB 5 MCG/0.5 ML VIAL HEPATITIS B VIRUS VACCINE 0.5 Anorectal Nitrate Preparations RECTIV 0.4% OINTMENT NITROGLYCERIN RECTAL 1.2 NSAIDs RELAFEN 500 MG TABLET NABUMETONE 4 NSAIDs RELAFEN 750 MG TABLET NABUMETONE 2 Antivirals, Oral RELENZA 5 MG DISKHALER ZANAMAVIR 4 Diabetic Supplies, Miscellaneous RELION LANCING DEVICE BLOOD GLUCOSE LANCING DEVICE 1 Diabetic Strips RELION ULTIMA BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Bronchodilators, Beta Agonist RELION VENTOLIN HFA 90 MCG INHALER (8 GRAMS) ALBUTEROL 1.2 GI Motility Agents, Chronic RELISTOR 12 MG/0.6 ML SYRINGE METHYLNALTREXONE BROMIDE 0.6 GI Motility Agents, Chronic RELISTOR 150 MG TABLET METHYLNALTREXONE BROMIDE 3 GI Motility Agents, Chronic RELISTOR 8 MG/0.4 ML SYRINGE METHYLNALTREXONE BROMIDE 0.4 Antimigraine Agents, Triptans RELPAX 20 MG TABLET ELETRIPTAN 0.2 Antimigraine Agents, Triptans RELPAX 40 MG TABLET ELETRIPTAN 0.2 Antidepressants, Other REMERON 15 MG SOLTAB MIRTAZAPINE 1


Antidepressants, Other REMERON 15 MG TABLET MIRTAZAPINE 1 Antidepressants, Other REMERON 30 MG SOLTAB MIRTAZAPINE 1 Antidepressants, Other REMERON 30 MG TABLET MIRTAZAPINE 1 Antidepressants, Other REMERON 45 MG SOLTAB MIRTAZAPINE 1 Antidepressants, Other REMERON 45 MG TABLET MIRTAZAPINE 1 Antidepressants, Other REMERON 7.5 MG TABLET MIRTAZAPINE 1 Phosphate Binders RENAGEL 400 MG TABLET SEVELAMER HCL 33 Phosphate Binders RENAGEL 800 MG TABLET SEVELAMER HCL 17 Phosphate Binders RENVELA 0.8 GM POWDER PACKET SEVELAMER CARBONATE 6 Phosphate Binders RENVELA 2.4 GM POWDER PACKET SEVELAMER CARBONATE 6 Phosphate Binders RENVELA 800 MG TABLET SEVELAMER CARBONATE 18 Lipotropics, Other REPATHA 140 MG/ML INJECTION SURECLICK AUTOINJECTOR EVOLOCUMAB 0.1 Lipotropics, Other REPATHA 140 MG/ML INJECTION SYRINGE EVOLOCUMAB 0.1 Lipotropics, Other REPATHA 420 MG/3.5 ML PUSHTRONEX SYSTEM EVOLOCUMAB 0.12 Insect Repellent for Skin Application REPEL FAMILY 10% INSECT REPELLENT DRY AEROSOL DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application REPEL FAMILY 15% INSECT REPELLENT SPRAY DIETHYLTOLUAMIDE 36 Insect Repellent for Skin Application REPEL SPORTSMEN 25% SPRAY DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application REPEL SPORTSMEN MAX 40% LOTION DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application REPEL SPORTSMEN MAX 40% PEN-SIZE PUMP SPRAY DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application REPEL SPORTSMEN MAX 40% PUMP SPRAY DIETHYLTOLUAMIDE 31 Insect Repellent for Skin Application REPEL SPORTSMEN MAX 40% PUMP SPRAY DIETHYLTOLUAMIDE 30 Insect Repellent for Skin Application REPEL TICK DEFENSE 15% AEROSOL PICARIDIN 31 Analgesics, Opioids Short-Acting REPREXAIN 10-200 MG TABLET HYDROCODONE/IBUPROFEN 5 Analgesics, Opioids Short-Acting REPREXAIN 2.5-200 MG TABLET HYDROCODONE/IBUPROFEN 5 Analgesics, Opioids Short-Acting REPREXAIN 5-200 MG TABLET HYDROCODONE/IBUPROFEN 5 Analgesics, Opioids Short-Acting REPREXAIN 7.5-200 MG TABLET HYDROCODONE/IBUPROFEN 5 Antiparkinson's Agents REQUIP 0.25 MG TABLET ROPINIROLE 4 Antiparkinson's Agents REQUIP 0.5 MG TABLET ROPINIROLE 4 Antiparkinson's Agents REQUIP 1 MG TABLET ROPINIROLE 3 Antiparkinson's Agents REQUIP 2 MG TBALET ROPINIROLE 3 Antiparkinson's Agents REQUIP 3 MG TABLET ROPINIROLE 6 Antiparkinson's Agents REQUIP 4 MG TABLET ROPINIROLE 6 Antiparkinson's Agents REQUIP 5 MG TABLET ROPINIROLE 4 Antiparkinson's Agents REQUIP XL 12 MG TABLET ROPINIROLE 2 Antiparkinson's Agents REQUIP XL 2 MG TABLET ROPINIROLE 1 Antiparkinson's Agents REQUIP XL 4 MG TABLET ROPINIROLE 1 Antiparkinson's Agents REQUIP XL 6 MG TABLET ROPINIROLE 1 Antiparkinson's Agents REQUIP XL 8 MG TABLET ROPINIROLE 2 HIV/AIDS Agents RESCRIPTOR 100 MG TABLET DELAVIRDINE 12 HIV/AIDS Agents RESCRIPTOR 200 MG TABLET DELAVIRDINE 6 Ophthalmics, Immunomodulators RESTASIS 0.05% EYE DROPS CYCLOSPORINE 2 Ophthalmics, Immunomodulators RESTASIS MULTIDOSE 0.05% EYE DROP CYCLOSPORINE 0.22 Sedative Hypnotics RESTORIL 15 MG CAPSULE TEMAZEPAM 1


Sedative Hypnotics RESTORIL 22.5 MG CAPSULE TEMAZEPAM 1 Sedative Hypnotics RESTORIL 30 MG CAPSULE TEMAZEPAM 1 Sedative Hypnotics RESTORIL 7.5 MG CAPSULE TEMAZEPAM 1 Ophthalmics, Anti-Inflammatories RETISERT 0.59 MG INTRAOCULAR IMPLANT FLUOCINOLONE INTRAOCULAR 0.04 HIV/AIDS Agents RETROVIR 10 MG/ML ORAL SOLUTION ZIDOVUDINE 60 HIV/AIDS Agents RETROVIR 100 MG CAPSULE ZIDOVUDINE 6 HIV/AIDS Agents RETROVIR 300 MG TABLET ZIDOVUDINE 2 PAH Agents, Oral & Inhaled REVATIO 10 MG/ML SUSPENSION SILDENAFIL 6 PAH Agents, Oral & Inhaled REVATIO 20 MG SILDENAFIL 3 Thalidomides & Derivatives REVLIMID 10 MG TABLET LENALIDOMIDE 1 Thalidomides & Derivatives REVLIMID 15 MG TABLET LENALIDOMIDE 1 Thalidomides & Derivatives REVLIMID 2.5 MG TABLET LENALIDOMIDE 1 Thalidomides & Derivatives REVLIMID 20 MG TABLET LENALIDOMIDE 1 Thalidomides & Derivatives REVLIMID 25 MG TABLET LENALIDOMIDE 1 Thalidomides & Derivatives REVLIMID 5 MG TABLET LENALIDOMIDE 1 Antipsychotics, Atypical REXULTI 0.25 MG TABLET BREXPIPRAZOLE 2 Antipsychotics, Atypical REXULTI 0.5 MG TABLET BREXPIPRAZOLE 2 Antipsychotics, Atypical REXULTI 1 MG TABLET BREXPIPRAZOLE 2 Antipsychotics, Atypical REXULTI 2 MG TABLET BREXPIPRAZOLE 1 Antipsychotics, Atypical REXULTI 3 MG TABLET BREXPIPRAZOLE 1 Antipsychotics, Atypical REXULTI 4 MG TABLET BREXPIPRAZOLE 1 HIV/AIDS Agents REYATAZ 100 MG CAPSULE ATAZANAVIR 1 HIV/AIDS Agents REYATAZ 150 MG CAPSULE ATAZANAVIR 1 HIV/AIDS Agents REYATAZ 200 MG CAPSULE ATAZANAVIR 2 HIV/AIDS Agents REYATAZ 300 MG CAPSULE ATAZANAVIR 1 HIV/AIDS Agents REYATAZ 50 MG POWDER PACKET ATAZANAVIR 6 Intranasal Rhinitis Agents RHINOCORT AQUA 32 MCG NASAL SPRAY (RX) BUDESONIDE 0.58 Insect Repellent NOT for Skin Application RID HOME LICE CONTROL SPRAY PERMETHRIN 0.5% 29 ALS Agents RILUTEK 50 MG TABLET RILUZOLE 2 Interstitial Cystitis Agents RIMSO-50 SOLUTION DIMETHYL SULFOXIDE 7.15 Hypoglycemics, Metformins RIOMET 500 MG/5 ML SOLUTION METFORMIN 25 Antipsychotics, Atypical RISPERDAL 0.25 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL 0.5 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL 1 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL 1 MG/ML SOLUTION RISPERIDONE 8 Antipsychotics, Atypical RISPERDAL 2 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL 3 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL 4 MG TABLET RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL CONSTA 12.5 MG SYRINGE RISPERIDONE 0.07 Antipsychotics, Atypical RISPERDAL CONSTA 25 MG SYRINGE RISPERIDONE 0.07 Antipsychotics, Atypical RISPERDAL CONSTA 37.5 MG SYRINGE RISPERIDONE 0.07 Antipsychotics, Atypical RISPERDAL CONSTA 50 MG SYRINGE RISPERIDONE 0.07 Antipsychotics, Atypical RISPERDAL M-TAB 0.5 MG ODT RISPERIDONE 2


Antipsychotics, Atypical RISPERDAL M-TAB 1 MG ODT RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL M-TAB 2 MG ODT RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL M-TAB 3 MG ODT RISPERIDONE 2 Antipsychotics, Atypical RISPERDAL M-TAB 4 MG ODT RISPERIDONE 2 Stimulants & Related Agents RITALIN 10 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents RITALIN 20 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents RITALIN 5 MG TABLET METHYLPHENIDATE 3 Stimulants & Related Agents RITALIN LA 10 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents RITALIN LA 20 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents RITALIN LA 30 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents RITALIN LA 40 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents RITALIN LA 60 MG CAPSULE METHYLPHENIDATE 1 Stimulants & Related Agents RITALIN SR 20 MG TABLET METHYLPHENIDATE 3 Insect Repellent NOT for Skin Application RITE AID LICE BEDDING SPRAY PERMETHRIN 0.5% 29 Analgesics, Opioids Short-Acting RMS 10 MG SUPPOSITORY MORPHINE SULFATE 6 Analgesics, Opioids Short-Acting RMS 20 MG SUPPOSITORY MORPHINE SULFATE 6 Analgesics, Opioids Short-Acting RMS 30 MG SUPPOSITORY MORPHINE SULFATE 4 Analgesics, Opioids Short-Acting RMS 5 MG SUPPOSITORY MORPHINE SULFATE 10 Skeletal Muscle Relaxants ROBAXIN 500 MG TABLET METHOCARBAMOL 16 Skeletal Muscle Relaxants ROBAXIN-750 TABLET METHOCARBAMOL 10 Antibiotics, Injectable ROCEPHIN 1 GM PIGGYBACK CEFTRIAXONE 200 Antibiotics, Injectable ROCEPHIN 1 GM VIAL CEFTRIAXONE 2 Antibiotics, Injectable ROCEPHIN 10 GM VIAL CEFTRIAXONE 0.4 Antibiotics, Injectable ROCEPHIN 2 GM PIGGYBACK CEFTRIAXONE 100 Antibiotics, Injectable ROCEPHIN 2 GM VIAL CEFTRIAXONE 2 Antibiotics, Injectable ROCEPHIN 250 MG VIAL CEFTRIAXONE 1 Antibiotics, Injectable ROCEPHIN 500 MG VIAL CEFTRIAXONE 2 Analgesics, Opioids Short-Acting ROXICET 5 MG/325 MG TABLET OXYCODONE/ACETAMINOPHEN 6 Analgesics, Opioids Short-Acting ROXICET 5 MG-325 MG/5 ML ORAL SOLUTION OXYCODONE/ACETAMINOPHEN 30 Analgesics, Opioids Short-Acting ROXICODONE 10 MG TABLET OXYCODONE 4 Analgesics, Opioids Short-Acting ROXICODONE 15 MG TABLET OXYCODONE 4 Analgesics, Opioids Short-Acting ROXICODONE 20 MG TABLET OXYCODONE 4 Analgesics, Opioids Short-Acting ROXICODONE 30 MG TABLET OXYCODONE 4 Analgesics, Opioids Short-Acting ROXICODONE 5 MG TABLET OXYCODONE 6 Sedative Hypnotics ROZEREM 8 MG TABLET RAMELTEON 1 Oncology, Oral RUBRACA 200 MG TABLET RUCAPARIB CAMSYLATE 4 Oncology, Oral RUBRACA 250 MG RUCAPARIB 4 Oncology, Oral RUBRACA 300 MG TABLET RUCAPARIB CAMSYLATE 4 Hereditary Angioedema Treatments RUCONEST 2100 UNIT VIAL C1 ESTERASE INHIBITOR 4 Analgesics, Opioids Short-Acting RYBIX 50 MG ODT TRAMADOL 8 Oncology, Oral RYDAPT 25 MG CAPSULE MIDOSTAURIN 8 Antiparkinson's Agents RYTARY 23.75/95 MG ER CAPSULE CARBIDOPA/LEVODOPA 12 Antiparkinson's Agents RYTARY 36.25/145 MG ER CAPSULE CARBIDOPA/LEVODOPA 9


Antiparkinson's Agents RYTARY 48.75/195 MG ER CAPSULE CARBIDOPA/LEVODOPA 12 Antiparkinson's Agents RYTARY 61.25/245 MG ER CAPSULE CARBIDOPA/LEVODOPA 10 Analgesics, Opioids Long-Acting RYZOLT ER 100 MG TABLET TRAMADOL ER 1 Analgesics, Opioids Long-Acting RYZOLT ER 200 MG TABLET TRAMADOL ER 1 Analgesics, Opioids Long-Acting RYZOLT ER 300 MG TABLET TRAMADOL ER 1 Anticonvulsants SABRIL 500 MG POWDER PACKET VIGABATRIN 6 Anticonvulsants SABRIL 500 MG TABLET VIGABATRIN 6 Analgesics, Salicylates SALSALATE 500 MG TABLET SALSALATE 4 Analgesics, Salicylates SALSALATE 750 MG TABLET SALSALATE 4 Diuretics, Vasopressin Receptor Antagonists SAMSCA 15 MG TABLET TOLVAPTAN 1 Diuretics, Vasopressin Receptor Antagonists SAMSCA 30 MG TABLET TOLVAPTAN 2 Bladder Relaxant Preparations SANCTURA 20 MG TABLET TROSPIUM 2 Bladder Relaxant Preparations SANCTURA XR 60MG CAPSULE TROSPIUM 1 Antiemetics/Antivertigo Agents SANCUSO 3.1 MG/24 HR PATCH GRANISETRON 0.14 Gastrointestinal Agents SANDOSTATIN LAR 10 MG KIT OCTREOTIDE INTRAMUSCULAR 0.04 Somatostatic Agents SANDOSTATIN LAR 10MG DEPOT KIT OCTREOTIDE ACETATE 0.04 Somatostatic Agents SANDOSTATIN LAR 20MG DEPOT KIT OCTREOTIDE ACETATE 0.08 Somatostatic Agents SANDOSTATIN LAR 30MG DEPOT KIT OCTREOTIDE ACETATE 0.04 Antipsychotics, Atypical SAPHRIS 10 MG SUBLINGUAL TABLET ASENAPINE 2 Antipsychotics, Atypical SAPHRIS 5 MG SUBLINGUAL TABLET ASENAPINE 2 Antidepressants, SSRIs SARAFEM 10 MG PULVULE FLUOXETINE 3 Antidepressants, SSRIs SARAFEM 20 MG PULVULE FLUOXETINE 4 Anticoagulants, Oral SAVAYSA 15 MG TABLET EDOXABAN 1 Anticoagulants, Oral SAVAYSA 30 MG TABLET EDOXABAN 1 Anticoagulants, Oral SAVAYSA 60 MG TABLET EDOXABAN 1 Neuropathic Pain Agents SAVELLA 100 MG TABLET MILNACIPRAN 2 Neuropathic Pain Agents SAVELLA 12.5 MG TABLET MILNACIPRAN 2 Neuropathic Pain Agents SAVELLA 25 MG TABLET MILNACIPRAN 2 Neuropathic Pain Agents SAVELLA 50 MG TABLET MILNACIPRAN 2 Insect Repellent for Skin Application SAWYER PREMIUM INSECT REPELLENT 20% PUMP SPRAY PICARIDIN 30 COPD Agents SEEBRI NEOHALER 15.6 MCG INHAL GLYCOPYRROLATE 2 Hypoglycemics, SGLT2 SEGLUROMET 2.5-1000 MG TABLET ERTUGLIFLOZIN AND METFORMIN 2 Hypoglycemics, SGLT2 SEGLUROMET 2.5-500 MG TABLET ERTUGLIFLOZIN AND METFORMIN 2 Hypoglycemics, SGLT2 SEGLUROMET 7.5-1000 MG TABLET ERTUGLIFLOZIN AND METFORMIN 2 Hypoglycemics, SGLT2 SEGLUROMET 7.5-500 MG TABLET ERTUGLIFLOZIN AND METFORMIN 2 Antidepressants, SSRIs SELFEMRA 10 MG CAPSULE FLUOXETINE 3 Antidepressants, SSRIs SELFEMRA 20 MG CAPSULE FLUOXETINE 4 HIV/AIDS Agents SELZENTRY 150 MG TABLET MARAVIROC 2 HIV/AIDS Agents SELZENTRY 20 MG/ML SOLUTION MARAVIROC 60 HIV/AIDS Agents SELZENTRY 25 MG TABLET MARAVIROC 4 HIV/AIDS Agents SELZENTRY 300 MG TABLET MARAVIROC 4 HIV/AIDS Agents SELZENTRY 75 MG TABLET MARAVIROC 2 Antihistamines, Minimally Sedating SEMPREX-D CAPSULE ACRIVASTINE/PSEUDOEPHEDRINE 4


Calcimimetics SENSIPAR 30 MG TABLET CINACALCET 4 Calcimimetics SENSIPAR 60 MG TABLET CINACALCET 4 Calcimimetics SENSIPAR 90 MG TABLET CINACALCET 4 Anxiolytics SERAX 10 MG CAPSULE OXAZEPAM 8 Anxiolytics SERAX 15 MG CAPSULE OXAZEPAM 4 Anxiolytics SERAX 30 MG CAPSULE OXAZEPAM 4 Bronchodilators, Beta Agonist SEREVENT DISKUS 50 MCG SALMETEROL 2 Antipsychotics, Atypical SEROQUEL 100 MG TABLET QUETIAPINE 3 Antipsychotics, Atypical SEROQUEL 200 MG TABLET QUETIAPINE 4 Antipsychotics, Atypical SEROQUEL 25 MG TABLET QUETIAPINE 6 Antipsychotics, Atypical SEROQUEL 300 MG TABLET QUETIAPINE 2 Antipsychotics, Atypical SEROQUEL 400 MG TABLET QUETIAPINE 2 Antipsychotics, Atypical SEROQUEL 50 MG TABLET QUETIAPINE 3 Antipsychotics, Atypical SEROQUEL XR 150 MG TABLET QUETIAPINE 1 Antipsychotics, Atypical SEROQUEL XR 200 MG TABLET QUETIAPINE 1 Antipsychotics, Atypical SEROQUEL XR 300 MG TABLET QUETIAPINE 2 Antipsychotics, Atypical SEROQUEL XR 400 MG TABLET QUETIAPINE 2 Antipsychotics, Atypical SEROQUEL XR 50 MG TABLET QUETIAPINE 2 Growth Hormones SEROSTIM 6 MG VIAL SOMATROPIN 2 Ulcerative Colitis Agents SF ROWASA 4 GRAM/60 ML ENEMA MESALAMINE 60 Vaccines SHINGRIX VIAL KIT ZOSTER VACCINE RECOMBINANT, ADJUVANTED 1 Somatostatic Agents SIGNIFOR 0.3 MG/ML AMPULE PASIREOTIDE DIASPARTATE 2 Somatostatic Agents SIGNIFOR 0.6 MG/ML AMPULE PASIREOTIDE DIASPARTATE 2 Somatostatic Agents SIGNIFOR 0.9 MG/ML AMPULE PASIREOTIDE DIASPARTATE 2 Somatostatic Agents SIGNIFOR LAR 20 MG KIT PASIREOTIDE PAMOATE 0.04 Somatostatic Agents SIGNIFOR LAR 20 MG VIAL PASIREOTIDE PAMOATE 0.04 Somatostatic Agents SIGNIFOR LAR 40 MG KIT PASIREOTIDE PAMOATE 0.04 Somatostatic Agents SIGNIFOR LAR 40 MG VIAL PASIREOTIDE PAMOATE 0.04 Somatostatic Agents SIGNIFOR LAR 60 MG KIT PASIREOTIDE PAMOATE 0.04 Somatostatic Agents SIGNIFOR LAR 60 MG VIAL PASIREOTIDE PAMOATE 0.04 Sedative Hypnotics SILENOR 3 MG TABLET DOXEPIN 1 Sedative Hypnotics SILENOR 6 MG TABLET DOXEPIN 1 Cytokine & CAM Antagonists SILIQ 210 MG/1.5 ML SYRINGE BRODALUMAB 0.15 Cytokine & CAM Antagonists SIMPONI 100 MG/ML PEN INJECTOR GOLIMUMAB 0.18 Cytokine & CAM Antagonists SIMPONI 100 MG/ML SYRINGE GOLIMUMAB 0.18 Cytokine & CAM Antagonists SIMPONI 50 MG/0.5 ML PEN INJECTOR GOLIMUMAB 0.02 Cytokine & CAM Antagonists SIMPONI 50 MG/0.5 ML SYRINGE GOLIMUMAB 0.02 Immunosuppresives SIMULECT 10 MG VIAL BASILIXIMAB 1 Immunosuppresives SIMULECT 20 MG VIAL BASILIXIMAB 1 Antiparkinson's Agents SINEMET 10/100 MG TABLET CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents SINEMET 25/100 MG TABLET CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents SINEMET 25/250 MG TABLET CARBIDOPA/LEVODOPA 8 Antiparkinson's Agents SINEMET CR 25/100 MG TABLET CARBIDOPA/LEVODOPA 8


Antiparkinson's Agents SINEMET CR 50/200 MG TABLET CARBIDOPA/LEVODOPA 8 Leukotriene Modifiers SINGULAIR 10 MG TABLET MONTELUKAST 1 Leukotriene Modifiers SINGULAIR 4 MG GRANULES MONTELUKAST 1 Leukotriene Modifiers SINGULAIR 4 MG TABLET CHEW MONTELUKAST 1 Leukotriene Modifiers SINGULAIR 5 MG TABLET CHEW MONTELUKAST 1 Antibiotics, Other SIRTURO 100 MG TABLET BEDAQUILINE 4 Antivirals, Oral SITAVIG 50 MG BUCCAL TABLET ACYCLOVIR DR 1 Antibiotics, Other SIVEXTRO 200 MG TABLET TEDIZOLID PHOSPHATE 1 Antibiotics, Injectable SIVEXTRO 200 MG VIAL TEDIZOLID PHOSPHATE 1 Skeletal Muscle Relaxants SKELAXIN 400 MG TABLET METAXOLONE 8 Skeletal Muscle Relaxants SKELAXIN 800 MG TABLET METAXALONE 4 Contraceptives, Other SKYLA INTRAUTERINE SYSTEM LEVONORGESTREL INTRAUTERINE see footnote4

Hypoglycemics, Insulin and Related Agents SOLIQUA 100 UNIT-33 MCG/ML PEN INSULIN GLARGINE/LIXISENATIDE 0.6 Complement Inhibitor SOLIRIS 300 MG/30 ML VIAL ECULIZUMAB 12.42 Tetracyclines SOLODYN ER 105 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 115 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 135 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 45 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 55 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 65 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 80 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines SOLODYN ER 90 MG TABLET MINOCYCLINE HYDROCHLORIDE 1 Oncology Agents, Breast Cancer SOLTAMOX 10 MG/5 ML SOLUTION TAMOXIFEN 20 Skeletal Muscle Relaxants SOMA 250 MG TABLET CARISOPRODOL 4 Skeletal Muscle Relaxants SOMA 350 MG TABLET CARISOPRODOL 4 Skeletal Muscle Relaxants SOMA COMPOUND CARISOPRODOL/ASPIRIN 4 Analgesics, Opioids SOMA COMPOUND WITH CODEINE CARISOPRODOL/ASPIRIN/CODEINE 4 Somatostatic Agents SOMATULINE DEPOT 120 MG/0.5 ML LANREOTIDE 0.08 Somatostatic Agents SOMATULINE DEPOT 60 MG/0.2 ML INJECTION LANREOTIDE 0.01 Somatostatic Agents SOMATULINE DEPOT 90 MG/0.3 ML INJECTION LANREOTIDE 0.02 Growth Hormone Receptor Antagonists SOMAVERT 10 MG VIAL PEGVISOMANT 1 Growth Hormone Receptor Antagonists SOMAVERT 15 MG VIAL PEGVISOMANT 1 Growth Hormone Receptor Antagonists SOMAVERT 20 MG VIAL PEGVISOMANT 2 Growth Hormone Receptor Antagonists SOMAVERT 25 MG VIAL PEGVISOMANT 1 Growth Hormone Receptor Antagonists SOMAVERT 30 MG VIAL PEGVISOMANT 1 Sedative Hypnotics SOMNOTE 500 MG SOFTGEL CHLORAL HYDRATE 2 Sedative Hypnotics SONATA 10 MG CAPSULE ZALEPLON 2 Sedative Hypnotics SONATA 5 MG CAPSULE ZALEPLON 1 Antipsoriatics, Oral SORIATANE 10 MG CAPSULE ACITRETIN 4 Antipsoriatics, Oral SORIATANE 17.5 MG CAPSULE ACITRETIN 2 Antipsoriatics, Oral SORIATANE 25 MG CAPSULE ACITRETIN 2 Hepatitis C Agents SOVALDI 400 MG TABLET SOFOSBUVIR 1 COPD Agents SPIRIVA 1.25 MCG RESPIMAT #60 TIOTROPIUM 0.14


COPD Agents SPIRIVA 18 MCG HANDIHALER #30 TIOTROPIUM 1 COPD Agents SPIRIVA 18 MCG HANDIHALER #5 TIOTROPIUM 1 COPD Agents SPIRIVA 18 MCG HANDIHALER #90 TIOTROPIUM 1 COPD Agents SPIRIVA 2.5 MCG RESPIMAT #60 TIOTROPIUM 0.14 Antifungals, Oral SPORANOX 10 MG/ML SOLUTION ITRACONAZOLE 20 Antifungals, Oral SPORANOX 100 MG CAPSULE ITRACONAZOLE 4 Anticonvulsants SPRITAM 1000 MG TABLET LEVETIRACETAM FOR SUSPENSION 3 Anticonvulsants SPRITAM 1000 MG TABLET LEVETIRACETAM 2 Anticonvulsants SPRITAM 250 MG TABLET LEVETIRACETAM FOR SUSPENSION 4 Anticonvulsants SPRITAM 250 MG TABLET LEVETIRACETAM 6 Anticonvulsants SPRITAM 500 MG TABLET LEVETIRACETAM FOR SUSPENSION 4 Anticonvulsants SPRITAM 500 MG TABLET LEVETIRACETAM 6 Anticonvulsants SPRITAM 750 MG TABLET LEVETIRACETAM FOR SUSPENSION 4 Anticonvulsants SPRITAM 750 MG TABLET LEVETIRACETAM 4 NSAIDs SPRIX 15.75 MG NASAL SPRAY KETOROLAC TROMETHAMINE 1 Oncology, Oral SPRYCEL 100 MG TABLET DASATINIB 1 Oncology, Oral SPRYCEL 140 MG TABLET DASATINIB 1 Oncology, Oral SPRYCEL 20 MG TABLET DASATINIB 1 Oncology, Oral SPRYCEL 50 MG TABLET DASATINIB 1 Oncology, Oral SPRYCEL 70 MG TABLET DASATINIB 1 Oncology, Oral SPRYCEL 80 MG TABLET DASATINIB 1 Analgesics, Opioids Short-Acting STADOL NS 10 MG/ML SPRAY BUTORPHANOL TARTRATE 0.17 Antiparkinson's Agents STALEVO 100 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 8 Antiparkinson's Agents STALEVO 125 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 8 Antiparkinson's Agents STALEVO 150 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 8 Antiparkinson's Agents STALEVO 200 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 6 Antiparkinson's Agents STALEVO 50 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 8 Antiparkinson's Agents STALEVO 75 MG TABLET CARBIDOPA/LEVODOPA/ENTACAPONE 8 Vaccines STAMARIL VIAL YELLOW FEVER VACCINE 1 Hypoglycemics, Meglitinides STARLIX 120 MG TABLET NATEGLINIDE 3 Hypoglycemics, Meglitinides STARLIX 60 MG TABLET NATEGLINIDE 3 Anticonvulsants STAVZOR DR 125 MG CAPSULE VALPROIC ACID DR 8 Anticonvulsants STAVZOR DR 250 MG CAPSULE VALPROIC ACID DR 8 Anticonvulsants STAVZOR DR 500 MG CAPSULE VALPROIC ACID DR 9 Hypoglycemics, SGLT2 STEGLATRO 15 MG TABLET ERTUGLIFLOZIN 1 Hypoglycemics, SGLT2 STEGLATRO 5 MG TABLET ERTUGLIFLOZIN 1 Hypoglycemics, Incretin Mimetics/Enhancers STEGLUJAN 15-100 MG TABLET ERTUGLIFLOZIN AND SITAGLIPTIN 1 Hypoglycemics, Incretin Mimetics/Enhancers STEGLUJAN 5-100 MG TABLET ERTUGLIFLOZIN AND SITAGLIPTIN 1 Cytokine & CAM Antagonists STELARA 130 MG/26 ML VIAL USTEKINUMAB 1.86 Cytokine & CAM Antagonists STELARA 45 MG/0.5 ML INJECTION SYRINGE USTEKINUMAB 0.02 Cytokine & CAM Antagonists STELARA 90 MG/ML INJECTION SYRINGE USTEKINUMAB 0.04 COPD Agents STIOLTO RESPIMAT TIOTROPIUM/OLODATEROL 0.14 Oncology, Oral STIVARGA 40 MG TABLET REGORAFENIB 4


Stimulants & Related Agents STRATTERA 10 MG CAPSULE ATOMOXETINE 2 Stimulants & Related Agents STRATTERA 100 MG CAPSULE ATOMOXETINE 1 Stimulants & Related Agents STRATTERA 18 MG CAPSULE ATOMOXETINE 4 Stimulants & Related Agents STRATTERA 25 MG CAPSULE ATOMOXETINE 2 Stimulants & Related Agents STRATTERA 40 MG CAPSULE ATOMOXETINE 2 Stimulants & Related Agents STRATTERA 60 MG CAPSULE ATOMOXETINE 1 Stimulants & Related Agents STRATTERA 80 MG CAPSULE ATOMOXETINE 1 Androgenic Agents STRIANT 30 MG MUCOADHESIVE TESTOSTERONE 2 HIV/AIDS Agents STRIBILD TABLET ELVITEGRAVIR/COBI/EMTRICITAPINE/TENOFOVIR DF 1 Bronchodilators, Beta Agonist STRIVERDI RESPIMAT #60 OLODATEROL 0.14 Opiate Dependence Treatments SUBLOCADE 100 MG/0.5 ML BUPRENORPHINE EXTENDED-RELEASE 0.02 Opiate Dependence Treatments SUBLOCADE 300 MG/1.5 ML BUPRENORPHINE EXTENDED-RELEASE 0.06 Opiate Dependence Treatments SUBOXONE 12 MG/3 MG SL FILM BUPRENORPHINE/NALOXONE 15

Opiate Dependence Treatments SUBOXONE 2 MG/0.5 MG SL FILM BUPRENORPHINE/NALOXONE 35

Opiate Dependence Treatments SUBOXONE 2 MG/0.5 MG SL TABLET BUPRENORPHINE/NALOXONE 35

Opiate Dependence Treatments SUBOXONE 4 MG/1 MG SL FILM BUPRENORPHINE/NALOXONE 25

Opiate Dependence Treatments SUBOXONE 8 MG/2 MG SL FILM BUPRENORPHINE/NALOXONE 25

Opiate Dependence Treatments SUBOXONE 8 MG/2 MG SL TABLET BUPRENORPHINE/NALOXONE 25

Analgesics, Opioids Short-Acting SUBSYS 100 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 1200 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 1600 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 200 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 400 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 600 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Analgesics, Opioids Short-Acting SUBSYS 800 MCG SUBLINGUAL SPRAY FENTANYL SUBLINQUAL 4 Opiate Dependence Treatments SUBUTEX 2 MG SL TABLET BUPRENORPHINE 35

Opiate Dependence Treatments SUBUTEX 8 MG SL TABLET BUPRENORPHINE 25

Calcium Channel Blockers SULAR 17 MG TABLET NISOLDIPINE 1 Calcium Channel Blockers SULAR 25.5 MG TABLET NISOLDIPINE 1 Calcium Channel Blockers SULAR 34 MG TABLET NISOLDIPINE 1 Calcium Channel Blockers SULAR 8.5 MG TABLET NISOLDIPINE 1 Ulcerative Colitis Agents SULFAZINE 500 MG TABLET SULFASALAZINE 12 Ulcerative Colitis Agents SULFAZINE EC 500 MG TABLET SULFASALAZINE 12 Acne Agents, Topical SUMADAN KIT SULFACETAMIDE/SULFUR/CLEANSER COMBO 1 Antimigraine Agents, Triptans SUMATRIPTAN 6 MG/0.5 ML SYRINGE (GSN 33592) SUMATRIPTAN 0.14 Antimigraine Agents, Triptans SUMAVEL DOSEPRO SUMATRIPTAN 0.14 Acne Agents, Topical SUMAXIN CP KIT SULFACETAMIDE/SULFUR/CLEANSER COMBO 1 Insect Repellent NOT for Skin Application SUNMARK LICE BEDDING SPRAY PERMETHRIN 0.5% 29 Intra-Articular Hyaluronic Acids SUPARTZ 25 MG/2.5 ML SYRINGE HYALURONATE SODIUM 0.72 Intra-Articular Hyaluronic Acids SUPARTZ FX 25 MG/2.5 ML SYRINGE HYALURONATE SODIUM 0.72 Pituitary Suppressive Agents, LHRH SUPPRELIN LA 50 MG IMPLANT KIT HISTRELIN AC IMPLANT 0.04 Diabetic Strips SURESTEP PRO BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 HIV/AIDS Agents SUSTIVA 200 MG CAPSULE EFAVIRENZ 2


HIV/AIDS Agents SUSTIVA 50 MG CAPSULE EFAVIRENZ 3 HIV/AIDS Agents SUSTIVA 600 MG TABLET EFAVIRENZ 1 Antiemetics/Antivertigo Agents SUSTOL 10 MG/0.4 ML SYRINGE GRANISETRON 0.06 Oncology, Oral SUTENT 12.5 MG CAPSULE SUNITINIB 1 Oncology, Oral SUTENT 25 MG CAPSULE SUNITINIB 1 Oncology, Oral SUTENT 37.5 MG CAPSULE SUNITINIB 1 Oncology, Oral SUTENT 50 MG CAPSULE SUNITINIB 1 Glucocorticoids, Inhaled SYMBICORT INHALER 160/4.5 MCG BUDESONIDE/FORMOTEROL 0.34 Glucocorticoids, Inhaled SYMBICORT INHALER 80/4.5 MCG BUDESONIDE/FORMOTEROL 0.34 Antipsychotics, Atypical SYMBYAX 12-25 MG CAPSULE OLANZAPINE/FLUOXETINE 1 Antipsychotics, Atypical SYMBYAX 12-50 MG CAPSULE OLANZAPINE/FLUOXETINE 1 Antipsychotics, Atypical SYMBYAX 3-25 MG CAPSULE OLANZAPINE/FLUOXETINE 1 Antipsychotics, Atypical SYMBYAX 6-25 MG CAPSULE OLANZAPINE/FLUOXETINE 1 Antipsychotics, Atypical SYMBYAX 6-50 MG CAPSULE OLANZAPINE/FLUOXETINE 1 HIV/AIDS Agents SYMFI 600-300-300 MG TABLET EFAVIRENZ/LAMIVUDINE/TENOFOVIR DF 1 HIV/AIDS Agents SYMFI LO 400-300-300 MG TABLET EFAVIRENZ/LAMIVUDINE/TENOFOVIR DF 1 Hypoglycemics, Incretin Mimetics/Enhancers SYMLIN 0.6 MG/ML VIAL PRAMLINTIDE 0.6 Hypoglycemics, Incretin Mimetics/Enhancers SYMLINPEN 120 PEN INJECTOR PRAMLINTIDE 0.36 Hypoglycemics, Incretin Mimetics/Enhancers SYMLINPEN 60 PEN INJECTOR PRAMLINTIDE 0.18 GI Motility, Chronic SYMPROIC 0.2 MG TABLET NALDEMEDINE 1 Analgesics, Opioids Short-Acting SYNALGOS-DC CAPSULE DIHYDROCODEINE/ASPIRIN/CAFFEINE 10 Pituitary Suppressive Agents, LHRH SYNAREL 2 MG/ML NASAL SPRAY NAFARELIN ACETATE 1.1 Hypoglycemics, SGLT2 SYNJARDY 12.5 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 SYNJARDY 12.5 MG/500 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 SYNJARDY 5 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 SYNJARDY 5 MG/500 MG TABLET EMPAGLIFLOZIN/METFORMIN 4 Hypoglycemics, SGLT2 Inhibitors SYNJARDY XR 10 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 Inhibitors SYNJARDY XR 12.5 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 Inhibitors SYNJARDY XR 25 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 1 Hypoglycemics, SGLT2 Inhibitors SYNJARDY XR 5 MG/1000 MG TABLET EMPAGLIFLOZIN/METFORMIN 2 Intra-Articular Hyaluronic Acids SYNVISC SYRINGE HYLAN G-F POLYMERS 0.58 Intra-Articular Hyaluronic Acids SYNVISC-ONE SYRINGE HYLAN G-F POLYMERS 0.4 Oncology, Oral TAFINLAR 50 MG CAPSULE DABRAFENIB 4 Oncology, Oral TAFINLAR 75 MG CAPSULE DABRAFENIB 4 Oncology, Oral TAGRISSO 40 MG TABLET OSIMERTINIB 1 Oncology, Oral TAGRISSO 80 MG TABLET OSIMERTINIB 1 Cytokine & CAM Antagonists TALTZ 80 MG/ML AUTOINJECTOR IXEKIZUMAB 0.15 Cytokine & CAM Antagonists TALTZ 80 MG/ML SYRINGE IXEKIZUMAB 0.15 Analgesics, Opioids Short-Acting TALWIN NX 50MG/0.5MG TABLET PENTAZOCINE/NALOXONE 3 Antivirals, Oral TAMIFLU 30 MG CAPSULE OSELTAMIVIR PHOSPHATE 46

Antivirals, Oral TAMIFLU 45 MG CAPSULE OSELTAMIVIR PHOSPHATE 26

Antivirals, Oral TAMIFLU 6 MG/ML SUSPENSION OSELTAMIVIR PHOSPHATE 366

Antivirals, Oral TAMIFLU 75 MG CAPSULE OSELTAMIVIR PHOSPHATE 26


Hypoglycemics, Incretin Mimetics/Enhancers TANZEUM 30MG/0.5ML INJECTION #1 SYRINGE ALBIGLUTIDE 0.15 Hypoglycemics, Incretin Mimetics/Enhancers TANZEUM 30MG/0.5ML INJECTION #4 SYRINGES ALBIGLUTIDE 0.15 Hypoglycemics, Incretin Mimetics/Enhancers TANZEUM 50MG/0.5ML INJECTION #1 SYRINGE ALBIGLUTIDE 0.15 Hypoglycemics, Incretin Mimetics/Enhancers TANZEUM 50MG/0.5ML INJECTION #4 SYRINGES ALBIGLUTIDE 0.15 Oncology, Oral TARCEVA 100 MG TABLET ERLOTINIB HYDROCHLORIDE 1 Oncology, Oral TARCEVA 150 MG TABLET ERLOTINIB HYDROCHLORIDE 2 Oncology, Oral TARCEVA 25 MG TABLET ERLOTINIB HYDROCHLORIDE 2 Angiotensin Modulator Combinations TARKA 1/240 MG TABLET SA TRANDOLAPRIL/VERAPAMIL 1 Angiotensin Modulator Combinations TARKA 2/180 MG TABLET SA TRANDOLAPRIL/VERAPAMIL 1 Angiotensin Modulator Combinations TARKA 2/240 MG TABLET SA TRANDOLAPRIL/VERAPAMIL 1 Angiotensin Modulator Combinations TARKA 4/240 MG TABLET SA TRANDOLAPRIL/VERAPAMIL 1 Oncology, Oral TASIGNA 150 MG CAPSULE NILOTINIB 4 Oncology, Oral TASIGNA 200 MG CAPSULE NILOTINIB 4 Oncology, Oral TASIGNA 50 MG CAPSULE NILOTINIB 4 Antiparkinson's Agents TASMAR 100 MG TABLET TOLCAPONE 6 Calcium Channel Blockers TAZTIA XT 120 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers TAZTIA XT 180 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers TAZTIA XT 240 MG CAPSULE DILTIAZEM 2 Calcium Channel Blockers TAZTIA XT 300 MG CAPSULE DILTIAZEM 1 Calcium Channel Blockers TAZTIA XT 360 MG CAPSULE DILTIAZEM 1 Multiple Sclerosis Agents TECFIDERA 120 MG DR CAPSULE DIMETHYL FUMARATE 2 Multiple Sclerosis Agents TECFIDERA 240 MG DR CAPSULE DIMETHYL FUMARATE 2 Multiple Sclerosis Agents TECFIDERA 30-DAY STARTER PACK DIMETHYL FUMARATE 2 Hepatitis C Agents TECHNIVIE DOSE PACK OMBITASVIR/PARITAPREVIR/RITONAVIR 2 Anticonvulsants TEGRETOL 100 MG CHEWABLE TABLET CARBAMAZEPINE 6 Anticonvulsants TEGRETOL 100 MG/5 ML SUSPENSION CARBAMAZEPINE 80 Anticonvulsants TEGRETOL 200 MG TABLET CARBAMAZEPINE 8 Anticonvulsants TEGRETOL XR 100 MG TABLET CARBAMAZEPINE ER 6 Anticonvulsants TEGRETOL XR 200 MG TABLET CARBAMAZEPINE ER 8 Anticonvulsants TEGRETOL XR 400 MG TABLET CARBAMAZEPINE ER 4 Angiotensin Modulators TEKTURNA 150 MG TABLET ALISKIREN 1 Angiotensin Modulators TEKTURNA 300 MG TABLET ALISKIREN 1 Angiotensin Modulators TEKTURNA HCT 150-12.5 MG TAB ALISKIREN/HCTZ 1 Angiotensin Modulators TEKTURNA HCT 150-25 MG TABLET ALISKIREN/HCTZ 1 Angiotensin Modulators TEKTURNA HCT 300-12.5 MG TAB ALISKIREN/HCTZ 1 Angiotensin Modulators TEKTURNA HCT 300-25 MG TABLET ALISKIREN/HCTZ 1 Antihypertensive, Sympatholytics TENEX 1 MG TABLET GUANFACINE IMMEDIATE-RELEASE 3 Antihypertensive, Sympatholytics TENEX 2 MG TABLET GUANFACINE IMMEDIATE-RELEASE 2 Vaccines TENIVAC VACCINE SYRINGE TETANUS & DIPHTHERIA VACCINE 0.5 Vaccines TENIVAC VACCINE VIAL TETANUS & DIPHTHERIA VACCINE 0.5 Androgenic Agents TESTIM 1% (50 MG) GEL TUBES TESTOSTERONE 10 Androgenic Agents TESTOPEL 75 MG PELLETS TESTOSTERONE IMPLANT 0.2 Androgenic Agents TESTRED 10 MG CAPSULE METHYLTESTOSTERONE 5


Angiotensin Modulators TEVETEN 400 MG TABLET EPROSARTAN 2 Angiotensin Modulators TEVETEN 600 MG TABLET EPROSARTAN 1 Angiotensin Modulators TEVETEN HCT 600-12.5 MG TAB EPROSARTAN/HCTZ 1 Angiotensin Modulators TEVETEN HCT 600-25 MG TAB EPROSARTAN/HCTZ 1 Thalidomides & Derivatives THALOMID 100 MG CAPSULE THALIDOMIDE 1 Thalidomides & Derivatives THALOMID 150 MG CAPSULE THALIDOMIDE 2 Thalidomides & Derivatives THALOMID 200 MG CAPSULE THALIDOMIDE 2 Thalidomides & Derivatives THALOMID 50 MG CAPSULE THALIDOMIDE 1 Vaccines THERACYS 81 MG VIAL BCG VACCINE LIVE INTRAVESICAL 0.15 Calcium Channel Blockers TIAZAC 120 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers TIAZAC 180 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers TIAZAC 240 MG CAPSULE SA DILTIAZEM 2 Calcium Channel Blockers TIAZAC 300 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers TIAZAC 360 MG CAPSULE SA DILTIAZEM 1 Calcium Channel Blockers TIAZAC 420 MG CAPSULE SA DILTIAZEM 1 Intranasal Rhinitis Agents TICANASE KIT NASAL SPRAY FLUTICASONE/SALINE 0.04 Platelet Aggregation Inhibitors TICLID 250 MG TABLET TICLOPIDINE 2 Antiemetics/Antivertigo Agents TIGAN 100 MG/ML MULTI-DOSE 20 ML VIAL TRIMETHOBENZAMIDE 8 Antiemetics/Antivertigo Agents TIGAN 100 MG/ML SINGLE-DOSE 2 ML VIAL TRIMETHOBENZAMIDE 8 Antiemetics/Antivertigo Agents TIGAN 300 MG CAPSULE TRIMETHOBENZAMIDE 4 Antiarrhythmics TIKOSYN 125 MCG CAPSULE DOFETILIDE 2 Antiarrhythmics TIKOSYN 250 MCG CAPSULE DOFETILIDE 2 Antiarrhythmics TIKOSYN 500 MCG CAPSULE DOFETILIDE 2 Antibiotics, Gastrointestinal TINDAMAX 250 MG TABLET TINIDAZOLE 8 Antibiotics, Gastrointestinal TINDAMAX 500 MG TABLET TINIDAZOLE 4 HIV/AIDS Agents TIVICAY 10 MG TABLET DOLUTEGRAVIR 1 HIV/AIDS Agents TIVICAY 25 MG TABLET DOLUTEGRAVIR 1 HIV/AIDS Agents TIVICAY 50 MG TABLET DOLUTEGRAVIR 2 NSAIDs TIVORBEX 20 MG CAPSULE INDOMETHACIN SUBMICRONIZED 3 NSAIDs TIVORBEX 40 MG CAPSULE INDOMETHACIN SUBMICRONIZED 3 Antibiotics, Inhaled TOBI 300 MG/5 ML INHALATION SOLUTION VIAL TOBRAMYCIN 10 Antibiotics, Inhaled TOBI PODHALER 28 MG CAPSULES TOBRAMYCIN 8 Hypoglycemics, Sulfonylureas TOLAZAMIDE 250 MG TABLET TOLAZAMIDE 1 Hypoglycemics, Sulfonylureas TOLAZAMIDE 500 MG TABLET TOLAZAMIDE 2 Hypoglycemics, Sulfonylureas TOLBUTAMIDE 500 MG TABLET TOLBUTAMIDE 6 NSAIDs TOLECTIN 200 MG TABLET TOLMETIN 3 NSAIDs TOLECTIN 400 MG CAPSULE TOLMETIN 3 NSAIDs TOLECTIN 600 MG TABLET TOLMETIN 3 Anticonvulsants TOPAMAX 100 MG TABLET TOPIRAMATE 3 Anticonvulsants TOPAMAX 15 MG SPRINKLE CAPSULE TOPIRAMATE 6 Anticonvulsants TOPAMAX 200 MG TABLET TOPIRAMATE 2 Anticonvulsants TOPAMAX 25 MG SPRINKLE CAPSULE TOPIRAMATE 6 Anticonvulsants TOPAMAX 25 MG TABLET TOPIRAMATE 6


Anticonvulsants TOPAMAX 50 MG TABLET TOPIRAMATE 4 NSAIDs TORADOL 10 MG TABLET KETOROLAC 4 Bladder Relaxant Preparations TOVIAZ 4 MG ER TABLET FESOTERODINE 1 Bladder Relaxant Preparations TOVIAZ 8 MG ER TABLET FESOTERODINE 1 PAH Agents, Oral & Inhaled TRACLEER 125 MG TABLET BOSENTAN 2 PAH Agents, Oral & Inhaled TRACLEER 32 MG TABLET FOR SUSP BOSENTAN 4 PAH Agents, Oral & Inhaled TRACLEER 62.5 MG TABLET BOSENTAN 2 Hypoglycemics, Incretin Mimetics/Enhancers TRADJENTA 5 MG TABLET LINAGLIPTIN 1 Antiemetics/Antivertigo Agents TRANSDERM-SCOP PATCH SCOPOLAMINE 0.4 Anxiolytics TRANXENE T-TAB 15 MG CLORAZEPATE 4 Anxiolytics TRANXENE T-TAB 3.75 MG CLORAZEPATE 4 Anxiolytics TRANXENE T-TAB 7.5 MG CLORAZEPATE 4 COPD Agents TRELEGY ELLIPTA 100-62.5-25 FLUTICASONE/UMECLIDINIUM/VILANTEROL 2 Pituitary Suppressive Agents, LHRH TRELSTAR 11.25 MG SYRINGE TRIPTORELIN PAMOATE 0.04 Pituitary Suppressive Agents, LHRH TRELSTAR 22.5 MG SYRINGE TRIPTORELIN PAMOATE 0.04 Pituitary Suppressive Agents, LHRH TRELSTAR 3.75 MG SYRINGE TRIPTORELIN PAMOATE 0.04 Cytokine & CAM Antagonists TREMFYA 100 MG/ML SYRINGE GUSELKUMAB 0.04 Antimigraine Agents, Triptans TREXIMET 10 MG/60 MG TABLET SUMATRIPTAN/NAPROXEN SODIUM 0.3 Antimigraine Agents, Triptans TREXIMET 85 MG/500 MG TABLET SUMATRIPTAN/NAPROXEN 0.3 Angiotensin Modulator Combinations TRIBENZOR 20 MG/5 MG/12.5 MG TABLET AMLODIPINE/OLMESARTAN/HCTZ 1 Angiotensin Modulator Combinations TRIBENZOR 40 MG/10 MG/12.5 MG TABLET AMLODIPINE/OLMESARTAN/HCTZ 1 Angiotensin Modulator Combinations TRIBENZOR 40 MG/10 MG/25 MG TABLET AMLODIPINE/OLMESARTAN/HCTZ 1 Angiotensin Modulator Combinations TRIBENZOR 40 MG/5 MG/12.5 MG TABLET AMLODIPINE/OLMESARTAN/HCTZ 1 Angiotensin Modulator Combinations TRIBENZOR 40 MG/5 MG/25 MG TABLET AMLODIPINE/OLMESARTAN/HCTZ 1 Lipotropics, Other TRICOR 145 MG TABLET FENOFIBRATE NANOCRYSTALLIZED 1 Lipotropics, Other TRICOR 48 MG TABLET FENOFIBRATE NANOCRYSTALLIZED 2 Ophthalmics, Anti-Inflammatories TRIESENCE 40 MG/ML INTRAOCULAR INJ VIAL TRIAMCINOLONE INTRAOCULAR 0.07 Lipotropics, Other TRIGLIDE 160 MG TABLET FENOFIBRATE NANOCRYSTALLIZED 1 Lipotropics, Other TRIGLIDE 50 MG TABLET FENOFIBRATE NANOCRYSTALLIZED 3 Anticonvulsants TRILEPTAL 150 MG TABLET OXCARBAZEPINE 6 Anticonvulsants TRILEPTAL 300 MG TABLET OXCARBAZEPINE 7 Anticonvulsants TRILEPTAL 300 MG/5 ML LIQUID OXCARBAZEPINE 40 Anticonvulsants TRILEPTAL 600 MG TABLET OXCARBAZEPINE 4 Lipotropics, Other TRILIPIX 135 MG DR CAPSULE FENOFIBRIC ACID (CHOLINE) 1 Lipotropics, Other TRILIPIX 45 MG DR CAPSULE FENOFIBRIC ACID (CHOLINE) 2 Antidepressants, Other TRINTELLIX 10 MG TABLET VORTIOXETINE 2 Antidepressants, Other TRINTELLIX 20 MG TABLET VORTIOXETINE 1 Antidepressants, Other TRINTELLIX 5 MG TABLET VORTIOXETINE 2 Pituitary Suppressive Agents, LHRH TRIPTODUR 22.5 MG KIT TRIPTORELIN 0.01 HIV/AIDS Agents TRIUMEQ 600/50/300 MG TABLET ABACAVIR/DOLUTEGRAVIR/LAMIVUDINE 1 HIV/AIDS Agents TRIZIVIR 300 MG/150 MG/300 MG TABLET ABACAVIR/LAMIVUDINE/ZIDOVUDINE 2 Anticonvulsants TROKENDI XR 100 MG CAPSULE TOPIRAMATE ER 3 Anticonvulsants TROKENDI XR 200 MG CAPSULE TOPIRAMATE ER 2


Anticonvulsants TROKENDI XR 25 MG CAPSULE TOPIRAMATE ER 4 Anticonvulsants TROKENDI XR 50 MG CAPSULE TOPIRAMATE ER 4 Diabetic Meters TRUE2GO BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Meters TRUERESULT BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

Diabetic Strips TRUETEST BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Strips TRUETRACK BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Diabetic Meters TRUETRACK SMART BLOOD GLUCOSE METER BLOOD GLUCOSE METER See footnote2

GI Motility, Chronic TRULANCE 3 MG TABLET PLECANATIDE 1 Hypoglycemics, Incretin Mimetics/Enhancers TRULICITY 0.75 MG/0.5 ML PEN DULAGLUTIDE 0.08 Hypoglycemics, Incretin Mimetics/Enhancers TRULICITY 1.5 MG/0.5 ML PEN DULAGLUTIDE 0.08 Vaccines TRUMENBA 120 MCG/0.5 ML VACCINE VIAL MENINGOCOCCAL B VACCINE LIP FHBP 0.5 HIV/AIDS Agents TRUVADA 100 MG/150 MG TABLET EMTRICITABINE/TENOFOVIR DF 1 HIV/AIDS Agents TRUVADA 133 MG/200 MG TABLET EMTRICITABINE/TENOFOVIR DF 1 HIV/AIDS Agents TRUVADA 167 MG/250 MG TABLET EMTRICITABINE/TENOFOVIR DF 1 HIV/AIDS Agents TRUVADA 200 MG/300 MG TABLET EMTRICITABINE/TENOFOVIR DF 1 COPD Agents TUDORZA 400 MCG PRESSAIR INHALER ACLIDINIUM 0.04 Vaccines TWINRIX VACCINE SYRINGE HEPATITIS A & B VACCINE 1 Vaccines TWINRIX VACCINE VIAL HEPATITIS A & B VACCINE 1 Angiotensin Modulator Combinations TWYNSTA 40/10 MG TABLET AMLODIPINE/TELMISARTAN 1 Angiotensin Modulator Combinations TWYNSTA 40/5 MG TABLET AMLODIPINE/TELMISARTAN 1 Angiotensin Modulator Combinations TWYNSTA 80/10 MG TABLET AMLODIPINE/TELMISARTAN 1 Angiotensin Modulator Combinations TWYNSTA 80/5 MG TABLET AMLODIPINE/TELMISARTAN 1 HIV/AIDS Agents TYBOST 150 MG TABLET COBICISTAT 1 Oncology, Oral TYKERB 250 MG TABLET LAPATINIB 6 Analgesics, Non-Salicylates TYLENOL 100 MG/ML LIQUID (INFANTS SILAPAP) ACETAMINOPHEN 8 Analgesics, Non-Salicylates TYLENOL 120 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 20 Analgesics, Non-Salicylates TYLENOL 160 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 20 Analgesics, Non-Salicylates TYLENOL 160 MG/5 ML LIQUID ACETAMINOPHEN 75 Analgesics, Non-Salicylates TYLENOL 320 MG/10 ML LIQUID ACETAMINOPHEN 100 Analgesics, Non-Salicylates TYLENOL 325 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 10 Analgesics, Non-Salicylates TYLENOL 325 MG/10.15 ML LIQUID ACETAMINOPHEN 100 Analgesics, Non-Salicylates TYLENOL 500 MG CAP/TAB/SUPPOSITORY ACETAMINOPHEN 6 Analgesics, Non-Salicylates TYLENOL 500 MG/15 ML LIQUID ACETAMINOPHEN 90 Analgesics, Non-Salicylates TYLENOL 500 MG/5 ML LIQUID ACETAMINOPHEN 30 Analgesics, Non-Salicylates TYLENOL 640 MG/20 ML LIQUID ACETAMINOPHEN 125 Analgesics, Non-Salicylates TYLENOL 650 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 6 Analgesics, Non-Salicylates TYLENOL 650 MG/20.3 ML ACETAMINOPHEN 100 Analgesics, Non-Salicylates TYLENOL 80 MG TAB/CAP/SUPPOSITORY ACETAMINOPHEN 30 Analgesics, Non-Salicylates TYLENOL 80 MG/0.8 ML LIQUID ACETAMINOPHEN 8 Analgesics, Non-Salicylates TYLENOL 80 MG/2.5 ML LIQUID ACETAMINOPHEN 75 Analgesics, Opioids Short-Acting TYLENOL WITH CODEINE #2 ACETAMINOPHEN/CODEINE 10 Analgesics, Opioids Short-Acting TYLENOL WITH CODEINE #3 ACETAMINOPHEN/CODEINE 10 Analgesics, Opioids Short-Acting TYLENOL WITH CODEINE #4 ACETAMINOPHEN/CODEINE 5


Analgesics, Opioids Short-Acting TYLENOL WITH CODEINE 120 MG-12 MG/5 ML ELIXIR ACETAMINOPHEN/CODEINE 90 Bone Resorption Suppression & Related Agents TYMLOS 80 MCG DOSE PEN INJECTOR ABALOPARATIDE 0.06 Vaccines TYPHIM VI 25 MCG/0.5 ML SYRINGE TYPHOID VACCINE 0.5 Vaccines TYPHIM VI 25 MCG/0.5 ML VIAL TYPHOID VACCINE 0.5 Multiple Sclerosis Agents TYSABRI 300 MG/15 ML INJECTION VIAL NATALIZUMAB 0.54 PAH Agents, Oral & Inhaled TYVASO 4-PACK CARTON TREPROSTINIL 2.9 PAH Agents, Oral & Inhaled TYVASO INHALATION SYSTEM REFILL KIT TREPROSTINIL 2.9 PAH Agents, Oral & Inhaled TYVASO INHALATION SYSTEM STARTER KIT TREPROSTINIL 2.9 Hepatitis B Agents TYZEKA 600 MG TABLET TELBIDVUDINE 1 Ulcerative Colitis Agents UCERIS 9 MG ER TABLET BUDESONIDE 1 Ulcerative Colitis Agents UCERIS RECTAL FOAM BUDESONIDE 4.78 Antihyperuricemics ULORIC 40 MG TABLET FEBUXOSTAT 1 Antihyperuricemics ULORIC 80 MG TABLET FEBUXOSTAT 1.5 Analgesics, Opioids Short-Acting ULTRACET 37.5 MG/325 MG TABLET TRAMADOL/ACETAMINOPHEN 8 Analgesics, Opioids Short-Acting ULTRAM 50 MG TABLET TRAMADOL 8 Analgesics, Opioids Long-Acting ULTRAM ER 100 MG TABLET TRAMADOL ER 1 Analgesics, Opioids Long-Acting ULTRAM ER 200 MG TABLET TRAMADOL ER 1 Analgesics, Opioids Long-Acting ULTRAM ER 300 MG TABLET TRAMADOL ER 1 Angiotensin Modulators UNIRETIC 15 MG/12.5 MG TABLET MOEXIPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators UNIRETIC 15 MG/25 MG TABLET MOEXIPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators UNIRETIC 7.5 MG/12.5 MG TABLET MOEXIPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators UNIVASC 15 MG TABLET MOEXIPRIL 2 Angiotensin Modulators UNIVASC 7.5 MG TABLET MOEXIPRIL 2 PAH Agents, Oral & Inhaled UPTRAVI 1000 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 1200 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 1400 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 1600 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 200 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 200 MCG-800 MCG TITRATION PACK SELEXIPAG 4.55 PAH Agents, Oral & Inhaled UPTRAVI 400 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 600 MCG TABLET SELEXIPAG 2 PAH Agents, Oral & Inhaled UPTRAVI 800 MCG TABLET SELEXIPAG 2 BPH Treatments UROXATRAL 10 MG TABLET ALFUZOSIN 1 Bile Salts URSO 250 MG TABLET URSODIOL 3 Bile Salts URSO FORTE 500 MG TABLET URSODIOL 3 COPD Agents UTIBRON NEOHALER INDACATEROL/GLYCOPYRROLATE 2 Anxiolytics VALIUM 10 MG TABLET DIAZEPAM 4 Anxiolytics VALIUM 2 MG TABLET DIAZEPAM 8 Anxiolytics VALIUM 5 MG TABLET DIAZEPAM 6 Antivirals, Oral VALTREX 1000 MG TABLET VALACYCLOVIR 4 Antivirals, Oral VALTREX 500 MG TABLET VALACYCLOVIR 2 Angiotensin Modulator Combinations VALTURNA 150 MG/160 MG TABLET ALISKIREN/VALSARTAN 1 Angiotensin Modulator Combinations VALTURNA 300 MG/320 MG TABLET ALISKIREN/VALSARTAN 1


Analgesics, Non-Narcotic Barbiturate Combos VANATOL LQ 50 MG-325 MG-40 MG/15 ML ORAL SOLUTION BUTALBITAL/ACETAMINOPHEN/CAFFEINE 9 Pituitary Suppressive Agents, LHRH VANTAS 50 MG KIT HISTRELIN IMPLANT 0.04 Vaccines VAQTA 25 UNITS/0.5 ML VIAL HEPATITIS A VIRUS VACCINE 0.5 Vaccines VAQTA 50 UNITS/ML VIAL HEPATITIS A VIRUS VACCINE 1 Vaccines VARIVAX VACCINE VIAL VARICELLA VACCINE 1 Antiemetics/Antivertigo Agents VARUBI 90 MG TABLET ROLAPITANT 2 Lipotropics, Other VASCEPA 0.5 GM CAPSULE ICOSAPENT ETHYL 8 Lipotropics, Other VASCEPA 1 GM CAPSULE ICOSAPENT ETHYL 4 Lipotropics, Other VASCEPA 1 GRAM CAPSULE ICOSAPENT ETHYL 4 Angiotensin Modulators VASERETIC 10 MG/25 MG TABLET ENALAPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators VASERETIC 5 MG/12.5 MG TABLET ENALAPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators VASOTEC 10 MG TABLET ENALAPRIL 2 Angiotensin Modulators VASOTEC 2.5 MG TABLET ENALAPRIL 2 Angiotensin Modulators VASOTEC 20 MG TABLET ENALAPRIL 2 Angiotensin Modulators VASOTEC 5 MG TABLET ENALAPRIL 2 Antihypertensives, Miscellaneous VECAMYL 2.5 MG TABLET MECAMYLAMINE 10 Phosphate Binders VELPHORO 500 MG CHEWABLE TABLET SUCROFERRIC OXYHYDROXIDE 6 Electrolyte Depleters VELTASSA 16.8 GM POWDER PACKET PATIROMER SORBITEX CALCIUM 1 Electrolyte Depleters VELTASSA 25.2 GM POWDER PACKET PATIROMER SORBITEX CALCIUM 1 Electrolyte Depleters VELTASSA 8.4 GM POWDER PACKET PATIROMER SORBITEX CALCIUM 1 Hepatitis B Agents VEMLIDY 25 MG TABLET TENOFOVIR ALAFENAMIDE FUMARATE 1 Oncology, Oral VENCLEXTA 10 MG TABLET VENETOCLAX 2 Oncology, Oral VENCLEXTA 100 MG TABLET VENETOCLAX 4 Oncology, Oral VENCLEXTA 50 MG TABLET VENETOCLAX 1 Antidepressants, Other VENLAFAXINE ER 150 MG TABLET VENLAFAXINE 1 Antidepressants, Other VENLAFAXINE ER 225 MG TABLET VENLAFAXINE 1 Antidepressants, Other VENLAFAXINE ER 37.5 MG TABLET VENLAFAXINE 1 Antidepressants, Other VENLAFAXINE ER 75 MG TABLET VENLAFAXINE 1 Iron Replacement Agents VENOFER 100 MG/5 ML VIAL IRON SUCROSE COMPLEX 20 Iron Replacement Agents VENOFER 200 MG/10 ML VIAL IRON SUCROSE COMPLEX 20 Iron Replacement Agents VENOFER 50 MG/2.5 ML VIAL IRON SUCROSE COMPLEX 5 Bronchodilators, Beta Agonist VENTOLIN HFA 90 MCG INHALER (18 GRAMS) ALBUTEROL 1.2 Bronchodilators, Beta Agonist VENTOLIN HFA 90 MCG INHALER (8 GRAMS) ALBUTEROL 1.2 Intranasal Rhinitis Agents VERAMYST 27.5 MCG NASAL SPRAY FLUTICASONE 0.34 Calcium Channel Blockers VERELAN 120 MG CAPSULE PELLET VERAPAMIL 1 Calcium Channel Blockers VERELAN 180 MG CAPSULE PELLET VERAPAMIL 1 Calcium Channel Blockers VERELAN 240 MG CAPSULE PELLET VERAPAMIL 2 Calcium Channel Blockers VERELAN 360 MG CAPSULE PELLET VERAPAMIL 1 Calcium Channel Blockers VERELAN PM 100 MG CAP VERAPAMIL 1 Calcium Channel Blockers VERELAN PM 200 MG CAP VERAPAMIL 2 Calcium Channel Blockers VERELAN PM 300 MG CAP VERAPAMIL 1 Oncology, Oral VERZENIO 100 MG TABLET ABEMACICLIB 2 Oncology, Oral VERZENIO 150 MG TABLET ABEMACICLIB 2


Oncology, Oral VERZENIO 200 MG TABLET ABEMACICLIB 2 Oncology, Oral VERZENIO 50 MG TABLET ABEMACICLIB 2 Bladder Relaxant Preparations VESICARE 10 MG TABLET SOLIFENACIN 1 Bladder Relaxant Preparations VESICARE 5 MG TABLET SOLIFENACIN 1 GI Motility, Chronic VIBERZI 100 MG TABLET ELUXADOLINE 2 GI Motility, Chronic VIBERZI 75 MG TABLET ELUXADOLINE 2 Analgesics, Opioids Short-Acting VICODIN 5 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 10 Analgesics, Opioids Short-Acting VICODIN ES 7.5 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 6 Analgesics, Opioids Short-Acting VICODIN HP 10 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 5 Analgesics, Opioids Short-Acting VICOPROFEN 7.5 MG/200 MG HYDROCODONE/IBUPROFEN 5 Hypoglycemics, Incretin Mimetics/Enhancers VICTOZA 2-PAK 18 MG/3 ML PEN LIRAGLUTIDE 0.3 Hypoglycemics, Incretin Mimetics/Enhancers VICTOZA 3-PAK 18 MG/3 ML PEN LIRAGLUTIDE 0.3 HIV/AIDS Agents VIDEX 10 MG/ML POWDER FOR ORAL SOLUTION DIDANOSINE 40 HIV/AIDS Agents VIDEX EC 125 MG CAPSULE DIDANOSINE 2 HIV/AIDS Agents VIDEX EC 200 MG CAPSULE DIDANOSINE 2 HIV/AIDS Agents VIDEX EC 250 MG CAPSULE DIDANOSINE 1 HIV/AIDS Agents VIDEX EC 400 MG CAPSULE DIDANOSINE 1 Hepatitis C Agents VIEKIRA PAK OMBITASVIR/PARITAPREVIR/RITONAVIR/DASABUVIR 4 Hepatitis C Agents VIEKIRA XR TABLET DASABUVIR/OMBITASVIR/PARITAPREVIR/RITONAVIR ER 3 Antidepressants, Other VIIBRYD 10 MG TABLET VILAZODONE 1 Antidepressants, Other VIIBRYD 20 MG TABLET VILAZODONE 1 Antidepressants, Other VIIBRYD 40 MG TABLET VILAZODONE 1 NSAIDs VIMOVO 375 MG/20 MG TABLET NAPROXEN/ESOMEPRAZOLE 2 NSAIDs VIMOVO 500 MG/20 MG TABLET NAPROXEN/ESOMEPRAZOLE 2 Anticonvulsants VIMPAT 10 MG/ML SOLUTION LACOSAMIDE 40 Anticonvulsants VIMPAT 100 MG TABLET LACOSAMIDE 2 Anticonvulsants VIMPAT 150 MG TABLET LACOSAMIDE 2 Anticonvulsants VIMPAT 200 MG TABLET LACOSAMIDE 2 Anticonvulsants VIMPAT 50 MG TABLET LACOSAMIDE 4 HIV/AIDS Agents VIRACEPT 250 MG TABLET NELFINAVIR 9 HIV/AIDS Agents VIRACEPT 625 MG TABLET NELFINAVIR 4 HIV/AIDS Agents VIRAMUNE 200 MG TABLET NEVIRAPINE 2 HIV/AIDS Agents VIRAMUNE 50 MG/5 ML ORAL SUSPENSION NEVIRAPINE 40 HIV/AIDS Agents VIRAMUNE XR 100 MG TABLET NEVIRAPINE 3 HIV/AIDS Agents VIRAMUNE XR 400 MG TABLET NEVIRAPINE 1 HIV/AIDS Agents VIREAD 150 MG TABLET TENOFOVIR DISOPROXIL FUMARATE (TDF) 2 HIV/AIDS Agents VIREAD 200 MG TABLET TENOFOVIR DISOPROXIL FUMARATE (TDF) 1.5 HIV/AIDS Agents VIREAD 250 MG TABLET TENOFOVIR DISOPROXIL FUMARATE (TDF) 1 HIV/AIDS Agents VIREAD 300 MG TABLET TENOFOVIR DISOPROXIL FUMARATE (TDF) 1 HIV/AIDS Agents VIREAD 40 MG/SCOOP POWDER TENOFOVIR DISOPROXIL FUMARATE (TDF) 7.5 HIV/AIDS Agents VITEKTA 150 MG TABLET ELVITEGRAVIR 1 HIV/AIDS Agents VITEKTA 85 MG TABLET ELVITEGRAVIR 1 Opiate Dependence Treatments VIVITROL INJECTABLE SUSPENSION KIT NALTREXONE 1


NSAIDs VIVLODEX 10 MG CAPSULE MELOXICAM 1 NSAIDs VIVLODEX 5 MG CAPSULE MELOXICAM 1 Vaccines VIVOTIF BERNA EC CAPSULE TYPHOID VACCINE 0.58 NSAIDs VOLTAREN 1% GEL DICLOFENAC SODIUM 32 NSAIDs VOLTAREN EC 50 MG TABLET DICLOFENAC SODIUM DR 4 NSAIDs VOLTAREN EC 75 MG TABLET DICLOFENAC SODIUM DR 3 NSAIDs VOLTAREN XR 100 MG TABLET DICLOFENAC SODIUM ER 2 Hepatitis C Agents VOSEVI 400-100-100 MG TABLET SOFOSBUVIR/VELPATAS/VOXILAPREV 1 Oncology, Oral VOTRIENT 200 MG TABLET PAZOPANIB HYDROCHLORIDE 4 Diabetic Strips V-R BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Antipsychotics, Atypical VRAYLAR 1.5 MG CAPSULE CARIPRAZINE 1 Antipsychotics, Atypical VRAYLAR 1.5 MG/3 MG PACK CARIPRAZINE 1 Antipsychotics, Atypical VRAYLAR 3 MG CAPSULE CARIPRAZINE 1 Antipsychotics, Atypical VRAYLAR 4.5 MG CAPSULE CARIPRAZINE 1 Antipsychotics, Atypical VRAYLAR 6 MG CAPSULE CARIPRAZINE 1 Lipotropics, Statins VYTORIN 10/10 TABLET EZETIMIBE/SIMVASTATIN 1 Lipotropics, Statins VYTORIN 10/20 TABLET EZETIMIBE/SIMVASTATIN 1 Lipotropics, Statins VYTORIN 10/40 TABLET EZETIMIBE/SIMVASTATIN 1 Lipotropics, Statins VYTORIN 10/80 TABLET EZETIMIBE/SIMVASTATIN 1 Stimulants & Related Agents VYVANSE 10 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 10 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 20 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 20 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 30 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 30 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 40 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 40 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 50 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 50 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 60 MG CAPSULE LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 60 MG CHEWABLE TABLET LISDEXAMFETAMINE 1 Stimulants & Related Agents VYVANSE 70 MG CAPSULE LISDEXAMFETAMINE 1 Insect Repellent NOT for Skin Application WALGREENS STOP LICE IN-HOME SPRAY PERMETHRIN 0.5% 29 Diabetic Strips WAVESENSE PRESTO BLOOD GLUCOSE TEST STRIPS BLOOD GLUCOSE TEST STRIPS 5 Lipotropics, Other WELCHOL 3.75 GRAM POWDER PACKET COLESEVELAM 1 Lipotropics, Other WELCHOL 625 MG TABLET COLESEVELAM 6 Antidepressants, Other WELLBUTRIN SR 100 MG TABLET BUPROPION 2 Antidepressants, Other WELLBUTRIN SR 150 MG TABLET BUPROPION 2 Antidepressants, Other WELLBUTRIN SR 200 MG TABLET BUPROPION 2 Antidepressants, Other WELLBUTRIN XL 150 MG TABLET BUPROPION 1 Antidepressants, Other WELLBUTRIN XL 300 MG TABLET BUPROPION 1 Antiparkinson's Agents XADAGO 100 MG TABLET SAFINAMIDE MESYLATE 1 Antiparkinson's Agents XADAGO 50 MG TABLET SAFINAMIDE MESYLATE 1


Oncology, Oral XALKORI 200 MG CAPSULE CRIZOTINIB 2 Oncology, Oral XALKORI 250 MG CAPSULE CRIZOTINIB 2 Anxiolytics XANAX 0.25 MG TABLET ALPRAZOLAM 6 Anxiolytics XANAX 0.5 MG TABLET ALPRAZOLAM 6 Anxiolytics XANAX 1 MG TABLET ALPRAZOLAM 4 Anxiolytics XANAX 2 MG TABLET ALPRAZOLAM 3 Anxiolytics XANAX XR 0.5 MG TABLET ALPRAZOLAM ER 2 Anxiolytics XANAX XR 1 MG TABLET ALPRAZOLAM ER 2 Anxiolytics XANAX XR 2 MG TABLET ALPRAZOLAM ER 2 Anxiolytics XANAX XR 3 MG TABLET ALPRAZOLAM ER 2 Anticoagulants, Oral XARELTO 10 MG TABLET RIVAROXOBAN 1 Anticoagulants, Oral XARELTO 15 MG TABLET RIVAROXOBAN 2 Anticoagulants, Oral XARELTO 20 MG TABLET RIVAROXOBAN 1 Anticoagulants, Oral XARELTO STARTER PACK RIVAROXOBAN 1.7 Analgesics, Opioids Long-Acting XARTEMIS XR 7.5 MG/325 MG ER TABLET OXYCODONE/ACETAMINOPHEN 4 Cytokine & CAM Antagonists XELJANZ 5 MG TABLET TOFACITINIB 2 Cytokine & CAM Antagonists XELJANZ XR 11 MG TABLET TOFACITINIB 1 Huntington’s Chorea Agents XENAZINE 12.5 MG TABLET TETRABENAZINE 4 Huntington’s Chorea Agents XENAZINE 25 MG TABLET TETRABENAZINE 4 Botulinum Toxins XEOMIN 100 UNIT INJECTION VIAL INCOBOTULINUMTOXIN A 0.14 Botulinum Toxins XEOMIN 200 UNIT INJECTION VIAL INCOBOTULINUMTOXIN A 0.07 Botulinum Toxins XEOMIN 50 UNIT INJECTION VIAL INCOBOTULINUMTOXIN A 0.14 Antivirals, Topical XERESE 5%/1% CREAM ACYCLOVIR/HYDROCORTISONE 1 Antidiarrheals XERMELO 250 MG TABLET TELOTRISTAT ETHYL 3 Bone Resorption Suppression & Related Agents XGEVA 120 MG/1.7 ML VIAL DENOSUMAB 0.19 Enzymes XIAFLEX 0.9 MG VIAL COLLAGENASE CLOSTRIDIUM HISTOLYTICUM 0.15 Antibiotics, Gastrointestinal XIFAXAN 200 MG TABLET RIVAMIXIN 2 Antibiotics, Gastrointestinal XIFAXAN 550 MG TABLET RIFAXIMIN 3 Hypoglycemics, SGLT2 XIGDUO XR 10/1000 MG TABLET DAPAGLIFLOZIN/METFORMIN 1 Hypoglycemics, SGLT2 XIGDUO XR 10/500 MG TABLET DAPAGLIFLOZIN/METFORMIN 1 Hypoglycemics, SGLT2 XIGDUO XR 2.5-1000 MG TABLET DAPAGLIFLOZIN AND METFORMIN ER 2 Hypoglycemics, SGLT2 XIGDUO XR 5/1000 MG TABLET DAPAGLIFLOZIN/METFORMIN 2 Hypoglycemics, SGLT2 XIGDUO XR 5/500 MG TABLET DAPAGLIFLOZIN/METFORMIN 2 Ophthalmics, Immunomodulators XIIDRA 5% EYE DROPS LEFITEGRAST 2 Tetracyclines XIMINO ER 135 MG CAPSULE MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines XIMINO ER 45 MG CAPSULE MINOCYCLINE HYDROCHLORIDE 1 Tetracyclines XIMINO ER 90 MG CAPSULE MINOCYCLINE HYDROCHLORIDE 1 Analgesics, Opioids Short-Acting XODOL 10 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 5 Analgesics, Opioids Short-Acting XODOL 5 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 10 Analgesics, Opioids Short-Acting XODOL 7.5 MG/300 MG TABLET HYDROCODONE/ACETAMINOPHEN 6 Monoclonal Antibodies to IgE XOLAIR 150 MG/5 ML INJECTION VIAL OMALIZUMAB 0.22 Bronchodilators, Beta Agonist XOPENEX 0.31 MG/3 ML SOLUTION LEVALBUTEROL NEBULIZER VIAL 9 Bronchodilators, Beta Agonist XOPENEX 0.63 MG/3 ML SOLUTION LEVALBUTEROL NEBULIZER VIAL 9


Bronchodilators, Beta Agonist XOPENEX 1.25 MG/3 ML SOLUTION LEVALBUTEROL NEBULIZER VIAL 9 Bronchodilators, Beta Agonist XOPENEX CONCENTRATE 1.25 MG/0.5 ML SOLUTION LEVALBUTEROL CONCENTRATE SOLUTION 3 Bronchodilators, Beta Agonist XOPENEX HFA 45 MCG INHALER LEVALBUTEROL 1 Analgesics, Opioids Long-Acting XTAMPZA 36 MG CAPSULE OXYCODONE MYRISTATE 2 Analgesics, Opioids Long-Acting XTAMPZA 9 MG CAPSULE OXYCODONE MYRISTATE 2 Analgesics, Opioids Long-Acting XTAMPZA ER 13.5 MG CAPSULE OXYCODONE MYRISTATE 2 Analgesics, Opioids Long-Acting XTAMPZA ER 18 MG CAPSULE OXYCODONE MYRISTATE 2 Analgesics, Opioids Long-Acting XTAMPZA ER 27 MG CAPSULE OXYCODONE MYRISTATE 2 Oncology, Oral XTANDI 40 MG CAPSULE ENZALUTAMIDE 4 Hypoglycemics, Insulin and Related Agents XULTOPHY 100 UNIT-3.6 MG/ML PEN INSULIN DEGLUDEC/LIRAGLUTIDE 0.5 Analgesics, Opioids Short-Acting XYLON 10/200 MG TABLET HYDROCODONE/IBUPROFEN 5 Sedative, Non-Barbituate XYREM 500 MG/ML ORAL SOLUTION SODIUM OXYBATE 18 Antihistamines, Minimally Sedating XYZAL 0.5 MG/ML SOLUTION LEVOCETIRIZINE 10 Antihistamines, Minimally Sedating XYZAL 5 MG TABLET LEVOCETIRIZINE 1 Platelet Aggregation Inhibitors YOSPRALA DR 325 MG/40 MG TABLET ASPIRIN/OMEPRAZOLE 1 Platelet Aggregation Inhibitors YOSPRALA DR 81 MG/40 MG TABLET ASPIRIN/OMEPRAZOLE 1 Analgesics, Opioids Short-Acting ZAMICET 10 MG-325 MG/15 ML SOLUTION HYDROCODONE/ACETAMINOPHEN 75 Skeletal Muscle Relaxants ZANAFLEX 2 MG CAPSULE TIZANIDINE 3 Skeletal Muscle Relaxants ZANAFLEX 2 MG TABLET TIZANIDINE 3 Skeletal Muscle Relaxants ZANAFLEX 4 MG CAPSULE TIZANIDINE 8 Skeletal Muscle Relaxants ZANAFLEX 4 MG TABLET TIZANIDINE 8 Skeletal Muscle Relaxants ZANAFLEX 6 MG CAPSULE TIZANIDINE 6 Histamine II Receptor Blockers ZANTAC 1000 MG/40 ML VIAL RANITIDINE 16 Histamine II Receptor Blockers ZANTAC 150 MG CAPSULE/TABLET RANITIDINE 2 Histamine II Receptor Blockers ZANTAC 150 MG/6 ML VIAL RANITIDINE 16 Histamine II Receptor Blockers ZANTAC 300 MG CAPSULE/TABLET RANITIDINE 1 Histamine II Receptor Blockers ZANTAC 50 MG/2 ML VIAL RANITIDINE 16 Histamine II Receptor Blockers ZANTAC 75 MG TABLET RANITIDINE 2 Anticonvulsants ZARONTIN 250 MG CAPSULE ETHOSUXIMIDE 6 Anticonvulsants ZARONTIN 250 MG/5 ML SOLUTION ETHOSUXIMIDE 30 Analgesics, Non-Narcotic Barbiturate Combos ZEBUTAL 50 MG/325 MG/40 MG CAPSULE BUTALBITAL/ACETAMINOPHEN/CAFFEINE 0.6 Antimigraine Agents, Triptans ZECUITY 6.5 MG/4 HOUR PATCH SUMATRIPTAN 0.27 Proton Pump Inhibitors ZEGERID 40/1100 MG CAPSULE OMEPRAZOLE/SODIUM BICARBONATE 1 Proton Pump Inhibitors ZEGERID OTC 20/1100 MG CAPSULE OMEPRAZOLE/SODIUM BICARBONATE 1 Oncology, Oral ZEJULA 100 MG CAPSULE NIRAPARIB TOSYLATE 3 Antiparkinson's Agents ZELAPAR 1.25 MG ODT SELEGILINE 2 Oncology, Oral ZELBORAF 240 MG TABLET VEMURAFENIB 8 Antimigraine Agents, Triptans ZEMBRACE SYMTOUCH 3 MG/0.5 ML PEN SUMATRIPTAN 0.27 Stimulants & Related Agents ZENZEDI 10 MG TABLET DEXTROAMPHETAMINE 3 Stimulants & Related Agents ZENZEDI 15 MG TABLET DEXTROAMPHETAMINE 3 Stimulants & Related Agents ZENZEDI 2.5 MG TABLET DEXTROAMPHETAMINE 3 Stimulants & Related Agents ZENZEDI 20 MG TABLET DEXTROAMPHETAMINE 3 Stimulants & Related Agents ZENZEDI 30 MG TABLET DEXTROAMPHETAMINE 2


Stimulants & Related Agents ZENZEDI 5 MG TABLET DEXTROAMPHETAMINE 3 Stimulants & Related Agents ZENZEDI 7.5 MG TABLET DEXTROAMPHETAMINE 3 Hepatitis C Agents ZEPATIER 50 MG/100 MG TABLET ELBASVIR/GRAZOPREVIR 1 HIV/AIDS Agents ZERIT 1 MG/ML POWDER FOR ORAL SOLUTION STAVUDINE 80 HIV/AIDS Agents ZERIT 15 MG CAPSULE STAVUDINE 2 HIV/AIDS Agents ZERIT 20 MG CAPSULE STAVUDINE 2 HIV/AIDS Agents ZERIT 30 MG CAPSULE STAVUDINE 2 HIV/AIDS Agents ZERIT 40 MG CAPSULE STAVUDINE 2 Angiotensin Modulators ZESTORETIC 10 MG/12.5 MG TABLET LISINOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators ZESTORETIC 20 MG/12.5 MG TABLET LISINOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators ZESTORETIC 20 MG/25 MG TABLET LISINOPRIL/HYDROCHLOROTHIAZIDE 2 Angiotensin Modulators ZESTRIL 10 MG TABLET LISINOPRIL 1 Angiotensin Modulators ZESTRIL 2.5 MG TABLET LISINOPRIL 1 Angiotensin Modulators ZESTRIL 20 MG TABLET LISINOPRIL 1 Angiotensin Modulators ZESTRIL 30 MG TABLET LISINOPRIL 1 Angiotensin Modulators ZESTRIL 40 MG TABLET LISINOPRIL 2 Angiotensin Modulators ZESTRIL 5 MG TABLET LISINOPRIL 1 Lipotropics, Other ZETIA 10 MG TABLET EZETIMIBE 1 Intranasal Rhinitis Agents ZETONNA NASAL SPRAY CICLESONIDE 0.21 HIV/AIDS Agents ZIAGEN 20 MG/ML ORAL SOLUTION ABACAVIR 30 HIV/AIDS Agents ZIAGEN 300 MG TABLET ABACAVIR 2 Multiple Sclerosis Agents ZINBRYTA 150 MG/ML SYRINGE DACLIZUMAB 0.04 Antibiotic, GI and Related Agents ZINPLAVA 1,000 MG/40 ML VIAL BEZLOTOXUMAB 807

NSAIDs ZIPSOR 25 MG CAPSULE DICLOFENAC POTASSIUM 4 Antibiotics, Injectable ZITHROMAX I.V. 500 MG VIAL AZITHROMYCIN 1 Lipotropics, Statins ZOCOR 10 MG TABLET SIMVASTATIN 1.5 Lipotropics, Statins ZOCOR 20 MG TABLET SIMVASTATIN 1.5 Lipotropics, Statins ZOCOR 40 MG TABLET SIMVASTATIN 1 Lipotropics, Statins ZOCOR 5 MG TABLET SIMVASTATIN 1.5 Lipotropics, Statins ZOCOR 80 MG TABLET SIMVASTATIN 1 Antiemetics/Antivertigo Agents ZOFRAN 2 MG/ML VIAL ONDANSETRON 24 Antiemetics/Antivertigo Agents ZOFRAN 24 MG TABLET ONDANSETRON 1 Antiemetics/Antivertigo Agents ZOFRAN 4 MG TABLET ONDANSETRON 4 Antiemetics/Antivertigo Agents ZOFRAN 4 MG/5 ML ORAL SOLUTION ONDANSETRON 20 Antiemetics/Antivertigo Agents ZOFRAN 8 MG TABLET ONDANSETRON 3 Antiemetics/Antivertigo Agents ZOFRAN ODT 4 MG TABLET ONDANSETRON 3 Antiemetics/Antivertigo Agents ZOFRAN ODT 8 MG TABLET ONDANSETRON 3 Analgesics, Opioids Long-Acting ZOHYDRO ER 10 MG CAPSULE HYDROCODONE ER 2 Analgesics, Opioids Long-Acting ZOHYDRO ER 15 MG CAPSULE HYDROCODONE ER 2 Analgesics, Opioids Long-Acting ZOHYDRO ER 20 MG CAPSULE HYDROCODONE ER 2 Analgesics, Opioids Long-Acting ZOHYDRO ER 30 MG CAPSULE HYDROCODONE ER 2 Analgesics, Opioids Long-Acting ZOHYDRO ER 40 MG CAPSULE HYDROCODONE ER 2 Analgesics, Opioids Long-Acting ZOHYDRO ER 50 MG CAPSULE HYDROCODONE ER 2


Oncology, Other ZOLADEX 10.8 MG IMPLANT SYRINGE GOSERELIN 0.04 Oncology, Other ZOLADEX 3.6 MG IMPLANT SYRINGE GOSERELIN 0.15 Oncology, Oral ZOLINZA 100 MG TABLET VORINOSTAT 4 Antidepressants, SSRIs ZOLOFT 100 MG TABLET SERTRALINE 2 Antidepressants, SSRIs ZOLOFT 20 MG/ML ORAL CONCENTRATE SERTRALINE 10 Antidepressants, SSRIs ZOLOFT 25 MG TABLET SERTRALINE 3 Antidepressants, SSRIs ZOLOFT 50 MG TABLET SERTRALINE 3 Sedative Hypnotics ZOLPIMIST 5 MG ORAL SPRAY ZOLPIDEM 0.26-See footnote3

Bone Resorption Suppression & Related Agents ZOMETA 4 MG/100 ML INJECTION VIAL ZOLEDRONIC ACID 14.29 Bone Resorption Suppression & Related Agents ZOMETA 4 MG/5 ML VIAL ZOLEDRONIC ACID 0.72 Antimigraine Agents, Triptans ZOMIG 2.5 MG TABLET ZOLMITRIPTAN 0.2 Antimigraine Agents, Triptans ZOMIG 5 MG NASAL SPRAY ZOLMITRIPTAN 0.2 Antimigraine Agents, Triptans ZOMIG 5 MG TABLET ZOLMITRIPTAN 0.2 Antimigraine Agents, Triptans ZOMIG-ZMT 2.5 MG ODT ZOLMITRIPTAN 0.2 Antimigraine Agents, Triptans ZOMIG-ZMT 5 MG ODT ZOLMITRIPTAN 0.2


Anticonvulsants ZONEGRAN 100 MG CAPSULE ZONISAMIDE 6 Anticonvulsants ZONEGRAN 25 MG CAPSULE ZONISAMIDE 6 Anticonvulsants ZONEGRAN 50 MG CAPSULE ZONISAMIDE 6 Platelet Aggregation Inhibitors ZONTIVITY 2.08 MG TABLET VORAPAXAR 1 NSAIDs ZORVOLEX 18 MG CAPSULE DICLOFENAC 3 NSAIDs ZORVOLEX 35 MG CAPSULE DICLOFENAC 3 Vaccines ZOSTAVAX VACCINE VIAL ZOSTER VACCINE 1 Antivirals, Topical ZOVIRAX 5% CREAM ACYCLOVIR 1.25 Antivirals, Topical ZOVIRAX 5% OINTMENT ACYCLOVIR 4.29 Opiate Dependence Treatments ZUBSOLV 0.7 MG/0.18 MG SL TABLET BUPRENORPHINE/NALOXONE 35

Opiate Dependence Treatments ZUBSOLV 1.4 MG/0.36 MG SL TABLET BUPRENORPHINE/NALOXONE 35





Antiemetics/Antivertigo Agents ZUPLENZ 4 MG SOLUBLE FILM ONDANSETRON 3 Antiemetics/Antivertigo Agents ZUPLENZ 8 MG SOLUBLE FILM ONDANSETRON 3 Antihyperuricemics ZURAMPIC 200 MG TABLET LESINURAD 1 Antihyperuricemics ZURAMPIC 200 MG TABLET LESINURAD 1 Smoking Cessation ZYBAN SR 150 MG TABLET BUPROPION 2 Oncology, Oral ZYDELIG 100 MG TABLET IDELALISIB 2 Oncology, Oral ZYDELIG 150 MG TABLET IDELALISIB 2 Leukotriene Modifiers ZYFLO CR 600 MG TABLET ZILEUTON 4 Oncology, Oral ZYKADIA 150 MG CAPSULE CERITINIB 5 Antipsychotics, Atypical ZYPREXA 10 MG INJECTION VIAL OLANZAPINE 3 Antipsychotics, Atypical ZYPREXA 10 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA 15 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA 2.5 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA 20 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA 5 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA 7.5 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA RELPREVV 210 MG INJECTION VIAL OLANZAPINE 0.07 Antipsychotics, Atypical ZYPREXA RELPREVV 300 MG INJECTION VIAL OLANZAPINE 0.07 Antipsychotics, Atypical ZYPREXA RELPREVV 405 MG INJECTION VIAL OLANZAPINE 0.04 Antipsychotics, Atypical ZYPREXA ZYDIS 10 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA ZYDIS 15 MG TAB OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA ZYDIS 20 MG TABLET OLANZAPINE 1 Antipsychotics, Atypical ZYPREXA ZYDIS 5 MG TABLET OLANZAPINE 1 Antihistamines, Minimally Sedating ZYRTEC 10 MG TABLET/CHEW TAB CETIRIZINE 1 Antihistamines, Minimally Sedating ZYRTEC 5 MG TABLET/CHEW TAB CETIRIZINE 1 Antihistamines, Minimally Sedating ZYRTEC-D TABLET PSEUDOEPHEDRINE/CETIRIZINE 2 Oncology, Oral ZYTIGA 250 MG TABLET ABIRATERONE 4 Oncology, Oral ZYTIGA 500 MG TABLET ABIRATERONE 2

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