formulary for ndpers dakota plan members · 7/15/2020 · tencon oral tablet 50-325 mg: tramadol...

Formulary for NDPERS Dakota Plan Members

For the most current list of covered medications or if you have questions: Call Pharmacy Management Team at (877) 658-9194

Visit sanfordhealthplan.com/members and link to the OptumRx website to:• Locate a participating retail pharmacy by ZIP code• Look up possible lower-cost medication alternatives• Compare medication pricing and options

HP-2175 07-15-2020

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What is a formulary?

A formulary is a list of prescribed medications chosen by health care providers on Sanford Health Plan’s Pharmacy and Therapeutics Committee. Selection criteria includes clinical efficacy, safety, and cost. Medications on this list are approved by the U.S. Food and Drug Administration for use in the United States.

How do I use my formulary?

You and your provider can consult the formulary to help you select the most cost-effective prescription medications. This guide tells you if a medication is generic or brand, and if special rules apply. If your medication is not listed here, please visit sanfordhealthplan.com, log in to your Member Portal at sanfordhealthplan.com/memberlogin or call the toll-free member phone number on your ID card.

About this formularyWhere differences exist between this formulary and your benefit plan documents, the benefit plan documents rule. This may not be a complete list of medications, and not all medications listed may be covered by your plan. Please look at the benefit plan documents provided by your employer or plan sponsor for full details.

Understanding your formulary

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The formulary gives you choices so you and your provider can decide your best course of treatment. In this formulary, brand-name medications are shown in UPPERCASE (for example, CLOBEX) and generic medications in lowercase (for example, clobetasol).

Drug Category Information

The drug category determines the cost levels you pay for a medication. This is how much you will pay when you fill a prescription. Using generic or formulary brand medications can help you pay your lowest out-of-pocket cost. Consult your Summary of Benefits and Coverage (SBC) to determine your cost for each of the drug categories listed below.

Drug Category

Includes Helpful Tips

Generic $ Lower-cost generic medications

Use generic drugs for the lowest out-of-pocket costs.

Formulary Brand

$$ Mid-range cost preferred brand-name

Use Formulary Brand drugs if a generic alternative is not available.

Non-Formulary Brand

$$$ Higher-cost non-preferred

Non-Formulary Brand drugs are not listed and have lower-cost options in Generic or Formulary Brand categories. Ask your provider if they could work for you.

Reading your formulary

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Drug list information

In this drug list, some medications are noted with letters next to them to help you see which ones may have coverage requirements or limits. Your benefit plan determines how these medications may be covered for you.

PA

Prior Authorization – You or your provider must get pre-approval for the medicine with Sanford Health Plan before you can get the prescription filled. NOTE: The Member is ultimately responsible for obtaining pre-approval from the Plan, but your provider may also request approval.

QL Quantity Limit / Amount Allowed – Medication may be limited to a certain quantity.

SP

Specialty Medication – Medication is designated as specialty. Specialty medications are typically used to treat complex medical conditions. These medications may require frequent dosing adjustments, close monitoring, special training, or compliance assistance. In addition, specialty medications may need special handling and/or administration, and may have limited or exclusive product availability and distribution.

STStep Therapy – Trial of a lower-cost medication(s) is required before a higher-cost medication can be covered.

Table of Contents

Analgesics - Drugs for Pain......................................................................................................................7Analgesics - Drugs for Pain and Inflammation......................................................................................... 9Anesthetics.............................................................................................................................................10Anti-Addiction / Substance Abuse Treatment Agents............................................................................ 10Antibacterials..........................................................................................................................................11Anticoagulants........................................................................................................................................13Anticonvulsants - Drugs for Seizures..................................................................................................... 14Antidementia Agents - Drugs for Alzheimer's Disease and Dementia................................................... 15Antidepressants......................................................................................................................................16Antiemetics - Drugs for Nausea and Vomiting........................................................................................17Antifungals..............................................................................................................................................18Antigout Agents...................................................................................................................................... 19Anti-inflammatory Agents....................................................................................................................... 19Antimigraine Agents............................................................................................................................... 19Antimyasthenic Agents...........................................................................................................................20Antimycobacterials................................................................................................................................. 20Antineoplastics - Drugs for Cancer.........................................................................................................20Antiparasitics.......................................................................................................................................... 21Antiparkinson Agents............................................................................................................................. 22Antiplatelets............................................................................................................................................22Antipsychotics - Drugs for Mood Disorders............................................................................................ 23Antivirals.................................................................................................................................................23Anxiolytics - Drugs for Anxiety................................................................................................................26Bipolar Agents - Drugs for Mood Disorders............................................................................................27Blood Products / Modifiers / Volume Expanders - Drugs for Bleeding Disorders...................................27Cardiovascular Agents - Drugs for Heart and Circulation Conditions.....................................................27Central Nervous System Agents - Drugs for Attention Deficit Disorder.................................................33Central Nervous System Agents - Drugs for Multiple Sclerosis............................................................. 33Central Nervous System Agents - Miscellaneous.................................................................................. 34Dental and Oral Agents - Drugs for Mouth and Throat Conditions.........................................................35Dermatological Agents - Drugs for Skin Conditions............................................................................... 36Diabetes - Antidiabetic Agents............................................................................................................... 40Diabetes - Glucose Monitoring............................................................................................................... 42Diabetes - Glycemic Agents................................................................................................................... 42Diabetes - Insulins..................................................................................................................................42Electrolytes / Minerals / Metals / Vitamins..............................................................................................43Gastrointestinal Agents - Drugs for Acid Reflux and Ulcer.....................................................................46Gastrointestinal Agents - Drugs for Bowel, Intestine and Stomach Conditions......................................46Genetic or Enzyme Disorder - Drugs for Replacement, Modification, Treatment...................................48Genitourinary Agents - Drugs for Bladder, Genital and Kidney Conditions............................................49Genitourinary Agents - Drugs for Prostate Conditions........................................................................... 50Hormonal Agents - Adrenal.................................................................................................................... 50Hormonal Agents - Men's Health............................................................................................................51Hormonal Agents - Osteoporosis........................................................................................................... 51Hormonal Agents - Pituitary................................................................................................................... 51Hormonal Agents - Prostaglandins.........................................................................................................52Hormonal Agents - Sex Hormones and Birth Control.............................................................................52

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Hormonal Agents - Thyroid.................................................................................................................... 54Immunological Agents - Drugs for Immune System Stimulation or Suppression................................... 54Inflammatory Bowel Disease Agents......................................................................................................57Metabolic Bone Disease Agents - Drugs for Osteoporosis.................................................................... 57Metabolic Bone Disease Agents - Other................................................................................................ 57Miscellaneous Therapeutic Agents........................................................................................................ 58Ophthalmic Agents - Drugs for Eye Allergy, Infection and Inflammation................................................59Ophthalmic Agents - Drugs for Glaucoma..............................................................................................60Ophthalmic Agents - Drugs for Miscellaneous Eye Conditions.............................................................. 61Otic Agents - Drugs for Ear Conditions.................................................................................................. 62Respiratory Tract / Pulmonary Agents - Drugs for Allergies, Cough, Cold.............................................63Respiratory Tract / Pulmonary Agents - Drugs for Asthma and Other Lung Conditions........................ 64Respiratory Tract / Pulmonary Agents - Drugs for Cystic Fibrosis......................................................... 66Respiratory Tract / Pulmonary Agents - Drugs for Pulmonary Hypertension......................................... 67Skeletal Muscle Relaxants - Drugs for Muscle Pain and Spasm............................................................67Sleep Disorder Agents........................................................................................................................... 68

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Drug Name Limits/ Required

Analgesics - Drugs for Pain

ABSTRAL SUBLINGUAL TABLET SUBLINGUAL 400 MCG, 600 MCG, 800 MCG

acetaminophen-codeine QL

acetaminophen-codeine #2 QL



apap-caff-dihydrocodeine oral tablet 325-30-16 mg QL

ascomp-codeine

BELBUCA QL

buprenorphine transdermal QL

butalbital-acetaminophen oral tablet 25-325 mg, 50-325 mg

butalbital-apap-caff-cod

butalbital-apap-caffeine oral capsule

butalbital-apap-caffeine oral tablet 50-325-40 mg

butalbital-asa-caff-codeine

butalbital-aspirin-caffeine

butorphanol tartrate nasal QL

carisoprodol-aspirin-codeine

codeine sulfate oral tablet QL

duraxin

endocet oral tablet 10-325 mg, 2.5-325 mg, 5-325 mg, 7.5-325 mg

QL

fentanyl QL

fentanyl citrate buccal lozenge on a handle

FENTANYL CITRATE BUCCAL TABLET

FENTORA BUCCAL TABLET 100 MCG, 200 MCG, 400 MCG, 600 MCG, 800 MCG

hydrocodone bitartrate er QL

hydrocodone-acetaminophen oral solution 10-325 mg/15ml, 2.5-108 mg/5ml, 5-217 mg/10ml, 7.5-325 mg/15ml

QL

hydrocodone-acetaminophen oral tablet 10-300 mg, 10-325 mg, 5-300 mg, 5-325 mg, 7.5-300 mg, 7.5-325 mg

QL

hydrocodone-ibuprofen oral tablet 10-200 mg, 5-200 mg, 7.5-200 mg

QL

For more information regarding the tiers and designations in this drug list, please see the Reading your formulary section of this booklet.

Created on 7/15/20207


hydromorphone hcl er QL

hydromorphone hcl oral QL

HYSINGLA ER QL

levorphanol tartrate oral tablet 2 mg QL

levorphanol tartrate oral tablet 3 mg

lorcet QL

lorcet hd QL

lorcet plus oral tablet 7.5-325 mg QL

LORTAB ORAL ELIXIR 10-300 MG/15ML QL

meperidine hcl oral QL

methadone hcl intensol

methadone hcl oral

methadose oral concentrate 10 mg/ml

methadose oral tablet soluble

methadose sugar-free

morphine sulfate (concentrate) oral solution 100 mg/5ml, 20 mg/ml

QL

morphine sulfate er beads QL

morphine sulfate er oral capsule extended release 24 hour QL

morphine sulfate er oral tablet extended release QL

morphine sulfate oral QL

NUCYNTA QL

oxycodone hcl oral capsule QL

oxycodone hcl oral concentrate 100 mg/5ml QL

oxycodone hcl oral solution QL

oxycodone hcl oral tablet QL

oxycodone-acetaminophen oral tablet 10-325 mg, 2.5-300 mg, 2.5-325 mg, 5-325 mg, 7.5-325 mg

QL

oxycodone-aspirin oral tablet 4.8355-325 mg QL

OXYCONTIN ORAL TABLET ER 12 HOUR ABUSE-DETERRENT

QL

oxymorphone hcl QL

oxymorphone hcl er QL

pentazocine-naloxone hcl QL

SUBSYS




tencon oral tablet 50-325 mg

tramadol hcl er (biphasic) oral tablet extended release 24 hour 100 mg, 200 mg, 300 mg

tramadol hcl er oral tablet extended release 24 hour

tramadol hcl oral tablet 100 mg

tramadol hcl oral tablet 50 mg QL

tramadol-acetaminophen QL

VTOL LQ PA

Analgesics - Drugs for Pain and Inflammation

celecoxib oral

DICLOFENAC EPOLAMINE QL

diclofenac potassium

diclofenac sodium er

diclofenac sodium oral

diclofenac sodium transdermal gel 1 % QL

diclofenac sodium transdermal solution

diclofenac-misoprostol oral tablet delayed release

diflunisal oral

ec-naproxen

etodolac er

etodolac oral

FLECTOR QL

flurbiprofen oral

ibu

ibuprofen oral suspension

ibuprofen oral tablet 400 mg, 600 mg, 800 mg

INDOCIN ORAL

indomethacin er

indomethacin oral capsule 25 mg, 50 mg

ketoprofen er

ketoprofen oral

ketorolac tromethamine injection solution 15 mg/ml, 30 mg/ml

ketorolac tromethamine intramuscular solution 60 mg/2ml

ketorolac tromethamine oral QL




meclofenamate sodium oral

mefenamic acid oral

meloxicam oral tablet

nabumetone oral

naproxen dr

naproxen oral

naproxen sodium er

naproxen sodium oral tablet 275 mg, 550 mg

naproxen-esomeprazole

oxaprozin

piroxicam oral

sulindac oral

tolmetin sodium oral capsule

tolmetin sodium oral tablet 600 mg

Anesthetics

ethyl chloride

GEBAUERS PAIN EASE

GEBAUERS SPRAY AND STRETCH

glydo external prefilled syringe

lidocaine external patch 5 %

lidocaine hcl external solution

lidocaine hcl urethral/mucosal

lidocaine ointment 5 % external

lidocaine-prilocaine external cream

Anti-Addiction / Substance Abuse Treatment Agents

acamprosate calcium

BUNAVAIL QL

buprenorphine hcl sublingual QL

buprenorphine hcl-naloxone hcl QL

disulfiram oral

LUCEMYRA QL

NALOXONE HCL INJECTION SOLUTION AUTO-INJECTOR

naltrexone hcl oral

NARCAN QL




ZUBSOLV QL

Antibacterials

amoxicillin oral capsule

amoxicillin oral suspension reconstituted

amoxicillin oral tablet

amoxicillin oral tablet chewable 125 mg, 250 mg

amoxicillin-potassium clavulanate er

amoxicillin-potassium clavulanate oral

ampicillin oral capsule 500 mg

AUGMENTIN ORAL SUSPENSION RECONSTITUTED 125-31.25 MG/5ML

avidoxy

azithromycin oral packet

azithromycin oral suspension reconstituted

azithromycin oral tablet 250 mg, 500 mg, 600 mg

BAXDELA ORAL PA

benzalkonium chloride external solution , 50 %

cefaclor

cefaclor er

cefadroxil

cefdinir

cefditoren pivoxil

cefixime

cefpodoxime proxetil

cefprozil

cefuroxime axetil oral tablet

cephalexin

ciprofloxacin hcl oral

clarithromycin er

clarithromycin oral

CLEOCIN VAGINAL SUPPOSITORY

clindamycin hcl oral

clindamycin palmitate hcl

clindamycin phosphate vaginal




CLINDESSE

demeclocycline hcl oral

dicloxacillin sodium

DIFICID

doxycycline hyclate oral capsule

doxycycline hyclate oral tablet 100 mg, 150 mg, 20 mg, 50 mg, 75 mg

doxycycline hyclate oral tablet delayed release 100 mg, 150 mg, 200 mg, 50 mg, 75 mg

doxycycline monohydrate oral capsule 100 mg, 50 mg

doxycycline monohydrate oral suspension reconstituted

doxycycline monohydrate oral tablet

E.E.S. 400 ORAL TABLET

ERYTHROCIN STEARATE ORAL TABLET 250 MG

erythromycin base oral

erythromycin ethylsuccinate oral

erythromycin oral

FIRVANQ

gentamicin sulfate external

hydrogen peroxide solution 30 %

levofloxacin oral

linezolid oral PA

mafenide acetate external

methenamine hippurate

metronidazole oral

metronidazole vaginal

minocycline hcl oral

mondoxyne nl oral capsule 100 mg

MONUROL

morgidox oral capsule 100 mg

moxifloxacin hcl oral

mupirocin external

neomycin sulfate oral

nitrofurantoin macrocrystal oral




nitrofurantoin monohydrate macrocrystals

nitrofurantoin oral suspension

ofloxacin oral tablet 300 mg, 400 mg

paromomycin sulfate oral

penicillin v potassium

silver sulfadiazine external

ssd

sulfadiazine oral

sulfamethoxazole-trimethoprim oral suspension 200-40 mg/5ml

sulfamethoxazole-trimethoprim oral tablet

sulfatrim pediatric

SUPRAX ORAL SUSPENSION RECONSTITUTED 500 MG/5ML

SUPRAX ORAL TABLET CHEWABLE

tetracycline hcl oral

tinidazole oral

trimethoprim oral

vancomycin hcl oral

vandazole

VIBRAMYCIN ORAL SYRUP

XENLETA ORAL

XEPI

XIFAXAN ORAL TABLET 550 MG

Anticoagulants

BEVYXXA QL

ELIQUIS

ELIQUIS DVT/PE STARTER PACK

enoxaparin sodium

fondaparinux sodium

FRAGMIN SUBCUTANEOUS SOLUTION 10000 UNIT/ML, 12500 UNIT/0.5ML, 15000 UNIT/0.6ML, 18000 UNT/0.72ML, 2500 UNIT/0.2ML, 5000 UNIT/0.2ML, 7500 UNIT/0.3ML, 95000 UNIT/3.8ML

heparin sodium (porcine) injection solution 1000 unit/ml, 10000 unit/ml, 20000 unit/ml, 5000 unit/ml

heparin sodium (porcine) pf injection solution 5000 unit/0.5ml




jantoven

warfarin sodium oral

XARELTO

XARELTO STARTER PACK

Anticonvulsants - Drugs for Seizures

BANZEL

BRIVIACT ORAL

carbamazepine er

carbamazepine oral

CELONTIN

clobazam

DIACOMIT PA; SP

diazepam rectal QL

DILANTIN ORAL CAPSULE 30 MG

divalproex sodium er oral tablet extended release 24 hour

divalproex sodium oral capsule delayed release sprinkle

divalproex sodium oral tablet delayed release

EPIDIOLEX PA; SP

epitol

ethosuximide oral

felbamate

FYCOMPA

gabapentin oral

LAMICTAL XR ORAL KIT

lamotrigine er

lamotrigine oral tablet

lamotrigine oral tablet chewable

lamotrigine oral tablet dispersible

lamotrigine starter kit-blue

lamotrigine starter kit-green

lamotrigine starter kit-orange

levetiracetam er

levetiracetam oral

NAYZILAM QL




oxcarbazepine

OXTELLAR XR

PEGANONE

phenobarbital oral

phenytoin infatabs

phenytoin oral suspension 125 mg/5ml

phenytoin oral tablet chewable

phenytoin sodium extended

primidone oral

roweepra

roweepra xr

subvenite

subvenite starter kit-blue

subvenite starter kit-green

subvenite starter kit-orange

tiagabine hcl

topiramate er

topiramate oral

TROKENDI XR

valproic acid oral capsule

valproic acid oral solution

VALTOCO 10 MG DOSE QL




vigabatrin SP

vigadrone SP

VIMPAT ORAL

zonisamide oral

Antidementia Agents - Drugs for Alzheimer's Disease and Dementia

donepezil hcl

galantamine hydrobromide

galantamine hydrobromide er




memantine hcl er

memantine hcl oral

NAMENDA XR TITRATION PACK

NAMZARIC

rivastigmine

rivastigmine tartrate

Antidepressants

amitriptyline hcl oral

amoxapine

bupropion hcl er (sr)

bupropion hcl er (xl) oral tablet extended release 24 hour 150 mg, 300 mg

bupropion hcl oral

chlordiazepoxide-amitriptyline

citalopram hydrobromide QL

clomipramine hcl oral

desipramine hcl oral

desvenlafaxine succinate er

doxepin hcl oral capsule

doxepin hcl oral concentrate

duloxetine hcl oral

escitalopram oxalate

fluoxetine hcl (pmdd) oral tablet

fluoxetine hcl oral

fluvoxamine maleate

fluvoxamine maleate er

imipramine hcl oral

imipramine pamoate

maprotiline hcl

MARPLAN

mirtazapine oral

nefazodone hcl

nortriptyline hcl oral

olanzapine-fluoxetine hcl




paroxetine hcl er QL

paroxetine hcl oral tablet QL

paroxetine mesylate QL

perphenazine-amitriptyline

phenelzine sulfate oral

protriptyline hcl

sertraline hcl oral

tranylcypromine sulfate

trazodone hcl oral

trimipramine maleate oral

TRINTELLIX ST; QL

venlafaxine hcl

venlafaxine hcl er oral capsule extended release 24 hour

venlafaxine hcl er oral tablet extended release 24 hour 225 mg

Antiemetics - Drugs for Nausea and Vomiting

AKYNZEO ORAL QL

ANZEMET ORAL QL

aprepitant QL

compro

dronabinol

EMEND ORAL SUSPENSION RECONSTITUTED QL

granisetron hcl oral QL

meclizine hcl oral tablet

metoclopramide hcl oral solution 10 mg/10ml, 5 mg/5ml

metoclopramide hcl oral tablet

metoclopramide hcl oral tablet dispersible

ondansetron hcl oral

ondansetron odt

perphenazine oral

prochlorperazine

prochlorperazine maleate oral

scopolamine

trimethobenzamide hcl oral




Antifungals

BIO-STATIN ORAL CAPSULE

ciclodan external solution

ciclopirox

CICLOPIROX OLAMINE

ciclopirox olamine external

clotrimazole cream 1 % external (rx)

clotrimazole mouth/throat

CLOTRIMAZOLE POWDER

clotrimazole solution 1 % external (rx)

clotrimazole-betamethasone

CRESEMBA ORAL

econazole nitrate external

exoderm external lotion

fluconazole oral

flucytosine oral

griseofulvin microsize oral

griseofulvin ultramicrosize

GYNAZOLE-1

itraconazole oral QL

ketoconazole external cream

ketoconazole external foam

ketoconazole external shampoo 2 %

ketoconazole oral

ketodan external foam

miconazole 3 vaginal suppository

naftifine hcl

NAFTIN EXTERNAL GEL 2 %

NOXAFIL ORAL SUSPENSION

nyamyc

nystatin external

nystatin mouth/throat

nystatin oral tablet

nystatin-triamcinolone




nystop

oxiconazole nitrate

posaconazole

terbinafine hcl oral

terconazole QL

TOLNAFTATE

voriconazole oral

Antigout Agents

allopurinol oral

COLCHICINE ORAL CAPSULE ST

colchicine tablet 0.6 mg oral

COLCHICINE TABLET 0.6 MG ORAL ST

colchicine-probenecid

COLCRYS

febuxostat ST

MITIGARE ST

probenecid oral

Anti-inflammatory Agents

EMFLAZA PA; SP

Antimigraine Agents

AIMOVIG ST; QL

almotriptan malate QL

dihydroergotamine mesylate injection QL

dihydroergotamine mesylate nasal QL

eletriptan hydrobromide QL

EMGALITY ST; QL

EMGALITY (300 MG DOSE) ST; QL

ERGOMAR

ergotamine-caffeine

frovatriptan succinate QL

MIGERGOT

naratriptan hcl QL

ONZETRA XSAIL

REYVOW ST; QL




rizatriptan benzoate QL

sumatriptan nasal QL

sumatriptan succinate oral QL

sumatriptan succinate refill subcutaneous solution cartridge QL

sumatriptan succinate subcutaneous solution 6 mg/0.5ml QL

sumatriptan succinate subcutaneous solution auto-injector 4 mg/0.5ml, 6 mg/0.5ml

QL

sumatriptan succinate subcutaneous solution prefilled syringe 6 mg/0.5ml

QL

UBRELVY PA; QL

zolmitriptan oral QL

ZOMIG NASAL QL

Antimyasthenic Agents

pyridostigmine bromide er

pyridostigmine bromide oral solution

pyridostigmine bromide oral tablet

Antimycobacterials

cycloserine oral

dapsone oral

ethambutol hcl oral

isoniazid oral

PASER

PRETOMANID

PRIFTIN

pyrazinamide oral

rifabutin QL

RIFAMATE

rifampin oral

RIFATER

SIRTURO

TRECATOR

Antineoplastics - Drugs for Cancer

anastrozole oral

DROXIA




exemestane

hydroxyurea oral

letrozole oral

leucovorin calcium oral

mercaptopurine oral

MESNEX ORAL

PANRETIN

PURIXAN

SOLTAMOX

tamoxifen citrate oral

TARGRETIN EXTERNAL SP

Antiparasitics

albendazole oral

ALINIA

atovaquone oral

atovaquone-proguanil hcl

BENZNIDAZOLE QL

chloroquine phosphate oral

COARTEM

crotan

EMVERM

hydroxychloroquine sulfate oral

IMPAVIDO

ivermectin oral

KRINTAFEL QL

lindane external shampoo

malathion external

mefloquine hcl

pentamidine isethionate inhalation

permethrin external cream

praziquantel oral

primaquine phosphate oral

pyrimethamine oral PA; SP

quinine sulfate oral




SKLICE

spinosad

sulfurated lime

Antiparkinson Agents

amantadine hcl oral

APOKYN SUBCUTANEOUS SOLUTION CARTRIDGE SP

benztropine mesylate oral

bromocriptine mesylate oral

carbidopa oral

carbidopa-levodopa

carbidopa-levodopa er oral tablet extended release 25-100 mg, 50-200 mg

carbidopa-levodopa-entacapone

entacapone

NEUPRO

pramipexole dihydrochloride

pramipexole dihydrochloride er

rasagiline mesylate oral

ropinirole hcl

ropinirole hcl er

RYTARY ST

selegiline hcl oral

tolcapone

trihexyphenidyl hcl

ZELAPAR

Antiplatelets

aspirin-dipyridamole er

BRILINTA

CABLIVI PA; SP; QL

cilostazol

clopidogrel bisulfate oral

dipyridamole oral

prasugrel hcl

ZONTIVITY




Antipsychotics - Drugs for Mood Disorders

ADASUVE

aripiprazole oral solution

aripiprazole oral tablet QL

aripiprazole oral tablet dispersible QL

chlorpromazine hcl oral

clozapine

fluphenazine hcl oral

haloperidol lactate oral

haloperidol oral

LATUDA ST; QL

loxapine succinate oral

molindone hcl

NUPLAZID ORAL CAPSULE ST; QL

NUPLAZID ORAL TABLET 10 MG ST; QL

olanzapine oral

paliperidone er

pimozide

quetiapine fumarate QL

quetiapine fumarate er QL

risperidone

thioridazine hcl oral

thiothixene oral

trifluoperazine hcl oral

VERSACLOZ

ziprasidone hcl

Antivirals

abacavir sulfate

abacavir sulfate-lamivudine

abacavir-lamivudine-zidovudine

acyclovir external

acyclovir oral

adefovir dipivoxil

APTIVUS




atazanavir sulfate

ATRIPLA

BARACLUDE ORAL SOLUTION

BIKTARVY

CIMDUO

COMPLERA

CRIXIVAN ORAL CAPSULE 200 MG, 400 MG

DELSTRIGO

DESCOVY

didanosine oral capsule delayed release 200 mg, 250 mg, 400 mg

DOVATO

EDURANT

efavirenz

EMTRIVA

entecavir

EPCLUSA PA; SP; QL

EPIVIR HBV ORAL SOLUTION

EVOTAZ

famciclovir oral QL

fosamprenavir calcium

GENVOYA

HARVONI ORAL TABLET PA; SP; QL

INTELENCE

INVIRASE ORAL TABLET

ISENTRESS

ISENTRESS HD

JULUCA

KALETRA ORAL TABLET

lamivudine oral solution

lamivudine oral tablet 100 mg, 300 mg

lamivudine oral tablet 150 mg QL

lamivudine-zidovudine

LEDIPASVIR-SOFOSBUVIR PA; SP; QL




LEXIVA ORAL SUSPENSION

lopinavir-ritonavir

MAVYRET PA; SP; QL

nevirapine

nevirapine er

NORVIR ORAL PACKET

NORVIR ORAL SOLUTION

ODEFSEY

oseltamivir phosphate oral QL

PEGASYS PROCLICK SUBCUTANEOUS SOLUTION 180 MCG/0.5ML

SP

PEGASYS SUBCUTANEOUS SOLUTION SP

PEGINTRON SUBCUTANEOUS KIT 50 MCG/0.5ML SP

PIFELTRO

PREVYMIS ORAL SP; QL

PREZCOBIX

PREZISTA ORAL SUSPENSION

PREZISTA ORAL TABLET 150 MG, 600 MG, 75 MG, 800 MG

RELENZA DISKHALER QL

REYATAZ ORAL PACKET

ribavirin inhalation

ribavirin oral capsule

ribavirin oral tablet 200 mg

rimantadine hcl

ritonavir

SELZENTRY

SITAVIG

SOFOSBUVIR-VELPATASVIR PA; SP; QL

stavudine oral capsule

STRIBILD

SYMFI

SYMFI LO

SYMTUZA

TEMIXYS




tenofovir disoproxil fumarate

TIVICAY

TRIUMEQ

TRUVADA

TYBOST

valacyclovir hcl oral

valganciclovir hcl

VEMLIDY

VIRACEPT ORAL TABLET

VIREAD ORAL POWDER

VIREAD ORAL TABLET 150 MG, 200 MG, 250 MG

VOSEVI PA; SP; QL

XOFLUZA (40 MG DOSE) QL

XOFLUZA (80 MG DOSE) QL

zidovudine

Anxiolytics - Drugs for Anxiety

alprazolam er

alprazolam intensol

alprazolam oral tablet

alprazolam xr

buspirone hcl oral

chlordiazepoxide hcl

clonazepam oral

clorazepate dipotassium

diazepam intensol

diazepam oral concentrate

diazepam oral solution 5 mg/5ml

diazepam oral tablet

estazolam

hydroxyzine hcl oral syrup

hydroxyzine hcl oral tablet

hydroxyzine pamoate oral

lorazepam intensol

lorazepam oral concentrate 2 mg/ml




lorazepam oral tablet

meprobamate

midazolam hcl oral

oxazepam

triazolam

Bipolar Agents - Drugs for Mood Disorders

EQUETRO

lithium

lithium carbonate er

lithium carbonate oral

Blood Products / Modifiers / Volume Expanders - Drugs for Bleeding Disorders

aminocaproic acid oral solution

aminocaproic acid oral tablet

anagrelide hcl

MULPLETA PA; SP; QL

PROMACTA PA; SP; QL

TAVALISSE PA; SP; QL

tranexamic acid oral QL

Cardiovascular Agents - Drugs for Heart and Circulation Conditions

acebutolol hcl oral

ALDACTAZIDE ORAL TABLET 50-50 MG

aliskiren fumarate

amiloride hcl oral

amiloride-hydrochlorothiazide

amiodarone hcl oral

amlodipine besylate oral

amlodipine besylate-benazepril hcl

amlodipine besylate-valsartan

amlodipine-atorvastatin QL

amlodipine-olmesartan

amlodipine-valsartan-hctz

atenolol oral




atenolol-chlorthalidone

atorvastatin calcium oral QL

benazepril hcl oral

benazepril-hydrochlorothiazide

betaxolol hcl oral

BIDIL

bisoprolol fumarate

bisoprolol-hydrochlorothiazide

bumetanide oral

BYSTOLIC

candesartan cilexetil

candesartan cilexetil-hctz

captopril oral

captopril-hydrochlorothiazide

CARDIZEM LA ORAL TABLET EXTENDED RELEASE 24 HOUR 120 MG

cartia xt

carvedilol

carvedilol phosphate er

chlorothiazide oral

chlorthalidone oral tablet 25 mg, 50 mg

cholestyramine light QL

cholestyramine oral QL

clonidine

clonidine hcl oral

colesevelam hcl

colestipol hcl

CORLANOR

DEMSER

digitek

digox

digoxin oral

DILATRATE-SR

diltiazem hcl er beads




diltiazem hcl er coated beads

diltiazem hcl er oral capsule extended release 12 hour

diltiazem hcl oral

dilt-xr

disopyramide phosphate oral

DIURIL

dofetilide

doxazosin mesylate oral QL

enalapril maleate oral

enalapril-hydrochlorothiazide

ENTRESTO

eplerenone

ethacrynic acid oral

ezetimibe QL

ezetimibe-simvastatin QL

felodipine er

fenofibrate micronized

fenofibrate oral capsule 134 mg, 200 mg, 67 mg

fenofibrate oral tablet 145 mg, 160 mg, 48 mg, 54 mg

fenofibric acid oral capsule delayed release

fenofibric acid oral tablet 105 mg

flecainide acetate

fluvastatin sodium QL

fluvastatin sodium er QL

fosinopril sodium

fosinopril sodium-hctz

furosemide oral solution 10 mg/ml, 8 mg/ml

furosemide oral tablet

gemfibrozil oral

GONITRO

guanfacine hcl oral

HEMANGEOL SP

hydralazine hcl oral

hydrochlorothiazide oral




indapamide oral

irbesartan

irbesartan-hydrochlorothiazide

isosorbide dinitrate oral

isosorbide mononitrate

isosorbide mononitrate er

isradipine

KATERZIA

labetalol hcl oral

LANOXIN ORAL TABLET 62.5 MCG

lisinopril oral

lisinopril-hydrochlorothiazide

losartan potassium oral

losartan potassium-hctz

lovastatin QL

matzim la

methyldopa oral

methyldopa-hydrochlorothiazide

metolazone

metoprolol succinate er

metoprolol tartrate oral

metoprolol-hydrochlorothiazide

mexiletine hcl oral

midodrine hcl

minoxidil oral

moexipril hcl

MULTAQ

nadolol oral tablet 20 mg, 40 mg, 80 mg

niacin (antihyperlipidemic)

niacin er (antihyperlipidemic)

niacor

nicardipine hcl oral

nifedipine er

nifedipine er osmotic release




nifedipine oral

nimodipine oral

nisoldipine er

NITRO-BID

NITRO-DUR TRANSDERMAL PATCH 24 HOUR 0.3 MG/HR, 0.8 MG/HR

nitroglycerin sublingual

nitroglycerin transdermal patch 24 hour

nitroglycerin translingual solution

NORPACE CR

NORTHERA SP

olmesartan medoxomil oral

olmesartan medoxomil-hctz

olmesartan-amlodipine-hctz

omega-3-acid ethyl esters

pacerone oral tablet 200 mg

pentoxifylline er

perindopril erbumine

phenoxybenzamine hcl oral

pindolol

PRALUENT SUBCUTANEOUS SOLUTION AUTO-INJECTOR PA; QL

pravastatin sodium QL

prazosin hcl oral

PRESTALIA

prevalite QL

propafenone hcl

propafenone hcl er

propranolol hcl er

propranolol hcl oral

propranolol-hctz

quinapril hcl

quinapril-hydrochlorothiazide

quinidine gluconate er

quinidine sulfate oral




ramipril

ranolazine er

RECTIV

REPATHA PA; QL

REPATHA PUSHTRONEX SYSTEM PA; QL

REPATHA SURECLICK PA; QL

rosuvastatin calcium QL

simvastatin oral tablet QL

sorine

sotalol hcl (af)

sotalol hcl oral

SOTYLIZE

spironolactone oral

spironolactone-hctz

taztia xt

TEKTURNA HCT

telmisartan

telmisartan-amlodipine

telmisartan-hctz

tiadylt er

timolol maleate oral

torsemide oral

trandolapril

trandolapril-verapamil hcl er

triamterene oral

triamterene-hctz oral capsule 37.5-25 mg

triamterene-hctz oral tablet

valsartan

valsartan-hydrochlorothiazide

VASCEPA

VECAMYL

verapamil hcl er oral capsule extended release 24 hour

verapamil hcl er oral tablet extended release 120 mg, 180 mg, 240 mg




verapamil hcl oral

VYNDAMAX PA; SP; QL

VYNDAQEL PA; SP; QL

Central Nervous System Agents - Drugs for Attention Deficit Disorder

ADZENYS ER

ADZENYS XR-ODT

AMPHETAMINE ER

amphetamine sulfate

amphetamine-dextroamphetamine

amphetamine-dextroamphetamine er

atomoxetine hcl QL

clonidine hcl er

DAYTRANA

dexmethylphenidate hcl

dexmethylphenidate hcl er

dextroamphetamine sulfate er

dextroamphetamine sulfate oral

guanfacine hcl er

metadate er oral tablet extended release 20 mg

methamphetamine hcl

methylphenidate hcl er (cd)

methylphenidate hcl er (la)

methylphenidate hcl er oral tablet extended release 10 mg, 18 mg, 20 mg, 27 mg, 36 mg, 54 mg

methylphenidate hcl er oral tablet extended release 24 hour

methylphenidate hcl oral

QUILLIVANT XR ORAL SUSPENSION RECONSTITUTED ER

VYVANSE

ZENZEDI ORAL TABLET 15 MG, 2.5 MG, 20 MG, 30 MG, 7.5 MG

Central Nervous System Agents - Drugs for Multiple Sclerosis

AUBAGIO PA; SP; QL

AVONEX PEN INTRAMUSCULAR AUTO-INJECTOR KIT PA; SP; QL




AVONEX PREFILLED INTRAMUSCULAR PREFILLED SYRINGE KIT

PA; SP; QL

AVONEX VIAL INTRAMUSCULAR KIT PA; SP; QL

COPAXONE SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

dalfampridine er PA; SP; QL

EXTAVIA SUBCUTANEOUS KIT PA; SP; QL

GILENYA ORAL CAPSULE 0.25 MG PA; SP

GILENYA ORAL CAPSULE 0.5 MG PA; SP; QL

MAVENCLAD (10 TABS) PA; SP; QL







MAYZENT PA; SP; QL

MAYZENT STARTER PACK PA; SP; QL

PLEGRIDY PA; SP; QL

PLEGRIDY STARTER PACK PA; SP; QL

REBIF REBIDOSE SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP; QL

REBIF REBIDOSE TITRATION PACK SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP; QL

REBIF SUBCUTANEOUS SOLUTION PREFILLED SYRINGE PA; SP; QL

REBIF TITRATION PACK SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

TECFIDERA PA; SP; QL

Central Nervous System Agents - Miscellaneous

benzphetamine hcl PA

caffeine citrate oral

diethylpropion hcl er PA

diethylpropion hcl oral PA

GRALISE

GRALISE STARTER




HORIZANT ORAL TABLET EXTENDED RELEASE

LOMAIRA PA

NUEDEXTA QL

phendimetrazine tartrate PA

phendimetrazine tartrate er PA

phentermine hcl oral PA

pregabalin oral QL

riluzole

SAVELLA ST; QL

SAVELLA TITRATION PACK ST; QL

TEGSEDI PA; SP; QL

tetrabenazine PA; SP

Dental and Oral Agents - Drugs for Mouth and Throat Conditions

cavarest

cevimeline hcl

chlorhexidine gluconate mouth/throat

clinpro 5000 paste 1.1 % dental

DEBACTEROL SOLUTION 30-50 % MOUTH/THROAT

denta 5000 plus

dentagel

fluoridex

fluoridex enhanced whitening dental paste

fluoridex sensitivity relief dental paste

lidocaine hcl mouth/throat

lidocaine viscous hcl

MI PASTE

MI PASTE PLUS

NAFRINSE DAILY ACIDULATED

NAFRINSE DAILY/NEUTRAL

NAFRINSE WEEKLY

neutral sodium fluoride

oralone

paroex




periogard

pilocarpine hcl oral

PREVIDENT 5000 BOOSTER PLUS

PREVIDENT 5000 DRY MOUTH DENTAL GEL

PREVIDENT 5000 ENAMEL PROTECT

PREVIDENT 5000 ORTHO DEFENSE

PREVIDENT 5000 PLUS

PREVIDENT 5000 SENSITIVE

PREVIDENT DENTAL

prevident mouth/throat

REMESENSE

sf

sf 5000 plus

sodium fluoride 5000 plus

sodium fluoride 5000 ppm

sodium fluoride 5000 sensitive

sodium fluoride dental cream

sodium fluoride dental gel 1.1 %

TOPEX TOPICAL ANESTHETIC MOUTH/THROAT AEROSOL

triamcinolone acetonide mouth/throat

Dermatological Agents - Drugs for Skin Conditions

acitretin

ACZONE EXTERNAL GEL 7.5 %

adapalene external cream

adapalene external gel

ADAPALENE EXTERNAL SOLUTION

adapalene-benzoyl peroxide

ala-cort external cream

alclometasone dipropionate

ALTRENO

ALUMINUM CHLORIDE ANHYDROUS

ALUMINUM CHLORIDE HEXAHYDRATE POWDER

amcinonide external lotion

ammonium lactate cream 12 % external (rx)




ammonium lactate lotion 12 % external (rx)

amnesteem

avita external cream

azelaic acid external

AZELEX

balsam peru-castor oil

benzoyl peroxide-erythromycin

beser external lotion

betamethasone dipropionate aug

betamethasone dipropionate external

betamethasone valerate external

BPCO

CALAMINE

calcipotriene external cream

calcipotriene external ointment

calcipotriene external solution

calcipotriene-betameth diprop external ointment QL

calcipotriene-betameth diprop suspension 0.005-0.064 % external

QL

CALCIPOTRIENE-BETAMETH DIPROP SUSPENSION 0.005-0.064 % EXTERNAL

QL

calcitriol external

CARAC

claravis

clindacin etz external swab

clindacin-p

clindamycin phos-benzoyl perox external gel 1-5 %, 1.2-2.5 %, 1.2-5 %

clindamycin phosphate external foam

clindamycin phosphate external lotion

clindamycin phosphate external solution

clindamycin phosphate external swab

clindamycin phosphate gel 1 % external

clindamycin-tretinoin

clobetasol prop emollient base




clobetasol propionate e

clobetasol propionate emulsion

clobetasol propionate external

clocortolone pivalate

clodan external shampoo

coal tar external solution

CONDYLOX EXTERNAL GEL

CORDRAN EXTERNAL TAPE

CORTISPORIN EXTERNAL

dapsone external gel 5 %

dapsone gel 7.5 % external

DAPSONE GEL 7.5 % EXTERNAL

DERMULCERA

desonide external

desoximetasone external cream 0.25 %

desoximetasone external gel

desoximetasone external liquid

desoximetasone external ointment 0.25 %

diclofenac sodium gel 3 % transdermal

diflorasone diacetate external

doxepin hcl external

DRYSOL

DUPIXENT SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

EPIDUO FORTE

EPIFOAM

ery

erythromycin external gel

erythromycin external solution

EUCRISA PA; QL

FINACEA EXTERNAL FOAM

fluocinolone acetonide body

fluocinolone acetonide external

fluocinolone acetonide scalp




fluocinonide emulsified base

fluocinonide external

FLUOROPLEX

FLUOROURACIL EXTERNAL CREAM 0.5 %

fluorouracil external cream 5 %

fluorouracil external solution

flurandrenolide

fluticasone propionate external

halobetasol propionate external cream

halobetasol propionate external ointment

hydrocortisone butyr lipo base

hydrocortisone butyrate external lotion

hydrocortisone butyrate external ointment

hydrocortisone butyrate external solution

hydrocortisone cream 1 % external (rx)

hydrocortisone external cream 2.5 %

hydrocortisone external lotion 2.5 %

hydrocortisone external ointment 2.5 %

hydrocortisone ointment 1 % external (rx)

hydrocortisone valerate

imiquimod external QL

isotretinoin oral

lactic acid e

lactic acid external lotion

LEVULAN KERASTICK

methoxsalen rapid

metronidazole external

mometasone furoate external

myorisan

NEO-SYNALAR EXTERNAL CREAM

neuac external gel

nolix

ONEXTON

PICATO




pimecrolimus

podofilox external

prednicarbate

PYROGALLIC ACID

QBREXZA ST; QL

REGRANEX QL

rosadan external cream

rosadan external gel

SANTYL

selenium sulfide external lotion

SOOLANTRA

sulfacetamide sodium (acne)

sulfacetamide sodium-sulfur emulsion 10-5 % external

sulfacetamide sodium-sulfur liquid 9.8-4.8 % external

TACLONEX EXTERNAL SUSPENSION QL

tacrolimus external ointment

tazarotene external

TEXACORT

TOLAK

tovet external foam

tretinoin external

tretinoin microsphere

tretinoin microsphere pump

triamcinolone acetonide external

trianex

triderm external cream

VENELEX

zenatane

Diabetes - Antidiabetic Agents

acarbose oral

AVANDIA ORAL TABLET 2 MG, 4 MG

BYDUREON BCISE AUTOINJECTOR ST; QL

BYDUREON PEN ST; QL

BYDUREON VIAL ST; QL




BYETTA 10 MCG PEN ST; QL

BYETTA 5 MCG PEN ST; QL

CYCLOSET

FARXIGA QL

glimepiride

glipizide er

glipizide ir

glipizide xl

glipizide-metformin hcl

glyburide micronized

glyburide oral

glyburide-metformin

GLYXAMBI QL

JANUMET QL

JANUMET XR QL

JANUVIA QL

JARDIANCE QL

KOMBIGLYZE XR QL

metformin hcl er

metformin hcl ir

miglitol

nateglinide

ONGLYZA QL

OZEMPIC ST; QL

pioglitazone hcl QL

pioglitazone hcl-glimepiride

pioglitazone hcl-metformin hcl

QTERN QL

repaglinide

RIOMET ER

RYBELSUS ST; QL

SOLIQUA ST; QL

SYMLINPEN 120 PA

SYMLINPEN 60 PA




SYNJARDY QL

SYNJARDY XR QL

tolbutamide

TRIJARDY XR QL

TRULICITY ST; QL

VICTOZA ST; QL

XIGDUO XR QL

XULTOPHY ST; QL

Diabetes - Glucose Monitoring

ONETOUCH ULTRA BLUE TEST STRIPS QL

ONETOUCH VERIO TEST STRIPS QL

Diabetes - Glycemic Agents

BAQSIMI ONE PACK QL

BAQSIMI TWO PACK QL

diazoxide oral

GLUCAGON EMERGENCY KIT QL

GVOKE PFS QL

Diabetes - Insulins

AFREZZA INHALATION POWDER 12 UNIT, 4 & 8 & 12 UNIT, 4 UNIT, 8 UNIT, 90 X 4 UNIT & 90X8 UNIT

FIASP

FIASP FLEXTOUCH

FIASP PENFILL

HUMULIN R U-500 KWIKPEN

HUMULIN R U-500 VIAL (CONCENTRATED)

LANTUS U-100 SOLOSTAR

LANTUS U-100 VIAL

LEVEMIR U-100 FLEXTOUCH

LEVEMIR U-100 VIAL

NOVOLIN 70/30 FLEXPEN

NOVOLIN 70/30 FLEXPEN RELION

NOVOLIN 70/30 RELION

NOVOLIN 70/30 VIAL

NOVOLIN N FLEXPEN




NOVOLIN N FLEXPEN RELION

NOVOLIN N RELION

NOVOLIN N VIAL

NOVOLIN R FLEXPEN

NOVOLIN R FLEXPEN RELION

NOVOLIN R RELION

NOVOLIN R VIAL

NOVOLOG U-100 FLEXPEN

NOVOLOG MIX 70/30 FLEXPEN

NOVOLOG MIX 70/30 VIAL

NOVOLOG U-100 PENFILL

NOVOLOG U-100 VIAL

TOUJEO MAX SOLOSTAR

TOUJEO SOLOSTAR

TRESIBA

TRESIBA FLEXTOUCH

Electrolytes / Minerals / Metals / Vitamins

ALANINE

CALCIFOL

CALCIUM CHLORIDE DIHYDRATE POWDER

CALCIUM GLUCONATE

CALCIUM GLUCONATE ANHYDROUS

CALCIUM GLUCONATE MONOHYDRATE

CALCIUM LACTATE PENTAHYDRATE

CALCIUM PHOSPHATE DIBASIC

CALCIUM PHOSPHATE TRIBASIC

CARBAGLU SP

CHEMET

CHOLINE BITARTRATE POWDER

clovique SP

cyanocobalamin injection solution 1000 mcg/ml

deferasirox SP

DL-ALANINE

DL-LEUCINE




DL-METHIONINE POWDER (RX)

DL-PHENYLALANINE

effer-k oral tablet effervescent 25 meq

FERRIPROX SP

GALZIN

iodine strong oral

JADENU SPRINKLE SP

JYNARQUE PA; SP; QL

kionex oral suspension

klor-con 10

klor-con m10

KLOR-CON M15

klor-con m20

klor-con oral packet 20 meq

klor-con oral tablet extended release

klor-con sprinkle

klor-con/ef tablet effervescent 25 meq oral

K-PHOS TABLET 500 MG ORAL

k-prime

L-ALANINE

L-ARGININE

L-CYSTINE

levocarnitine oral solution

levocarnitine oral tablet

levocarnitine sf

L-GLUTAMIC ACID

L-HISTIDINE MONOHYDROCHLORIDE POWDER

L-ISOLEUCINE POWDER (RX)

L-LEUCINE

L-METHIONINE POWDER (RX)

LOKELMA QL

L-PHENYLALANINE

L-PROLINE

L-TYROSINE




L-VALINE POWDER

MAGNEBIND 400

MAGNESIUM CARBONATE HEAVY

MAGNESIUM CARBONATE POWDER

METHIONINE POWDER (RX)

M-NATAL PLUS

NEONATAL PLUS

NESTABS

ONE VITE WOMENS PLUS

ORACIT SOLUTION 490-640 MG/5ML ORAL

phosphorous

phytonadione oral

pnv prenatal plus multivit+dha

pot bicarb-pot chloride

potassium chloride crys er

potassium chloride er

potassium chloride oral packet

potassium chloride oral solution 20 meq/15ml (10%), 40 meq/15ml (20%)

potassium citrate er

prenatal oral tablet 27-1 mg

prenatal plus iron

RELNATE DHA

SAMSCA ORAL TABLET 15 MG SP

sod citrate-citric acid solution 500-334 mg/5ml oral

SODIUM ASCORBATE POWDER

sodium polystyrene sulfonate oral

sodium polystyrene sulfonate rectal

sps

TAURINE POWDER

THREONINE

tolvaptan SP

trientine hcl SP

trinate




VALINE

VELTASSA

virt-phos 250 neutral

vp-pnv-dha

Gastrointestinal Agents - Drugs for Acid Reflux and Ulcer

cimetidine hcl oral

cimetidine oral

esomeprazole magnesium capsule delayed release 20 mg oral (rx)

QL

esomeprazole magnesium oral capsule delayed release 40 mg QL

esomeprazole magnesium oral packet QL

famotidine oral suspension reconstituted

famotidine oral tablet 40 mg

famotidine tablet 20 mg oral (rx)

lansoprazole oral capsule delayed release QL

misoprostol oral

NEXIUM ORAL PACKET 2.5 MG, 5 MG QL

nizatidine

omeprazole oral capsule delayed release QL

omeprazole-sodium bicarbonate QL

pantoprazole sodium oral QL

PRILOSEC ORAL PACKET

rabeprazole sodium oral tablet delayed release QL

sucralfate oral

Gastrointestinal Agents - Drugs for Bowel, Intestine and Stomach Conditions

alosetron hcl

AMITIZA QL

amoxicill-clarithro-lansopraz QL

BISACODYL

cascara sagrada oral fluid extract

CHENODAL PA; SP

chlordiazepoxide-clidinium capsule 5-2.5 mg oral

CLENPIQ




constulose

cromolyn sodium oral

CUVPOSA

dicyclomine hcl oral

diphenoxylate-atropine

ed-spaz

ENTEREG

enulose

GATTEX PA; SP

gavilyte-c

gavilyte-g

gavilyte-h

gavilyte-n with flavor pack

generlac

glycopyrrolate oral tablet 1 mg, 2 mg

GOLYTELY ORAL SOLUTION RECONSTITUTED 227.1 GM

hyoscyamine sulfate oral elixir

hyoscyamine sulfate oral solution

hyoscyamine sulfate sl

hyoscyamine sulfate tablet 0.125 mg oral

hyoscyamine sulfate tablet dispersible 0.125 mg oral

hyoscyamine sulfate tablet sublingual 0.125 mg sublingual

lactulose encephalopathy

lactulose oral solution

LINZESS QL

loperamide hcl oral capsule

methscopolamine bromide oral

mineral oil heavy oral

MOTEGRITY ST; QL

MOVANTIK QL

MOVIPREP

MYTESI

nulev

oscimin oral tablet




oscimin sublingual

OSMOPREP

peg 3350-kcl-na bicarb-nacl

peg-3350/electrolytes

peg-prep

phenobarbital-belladonna alk elixir 16.2 mg/5ml oral

PLENVU

PREPOPIK

propantheline bromide oral

RESTORA RX

sodium bicarbonate oral powder

SUPREP BOWEL PREP KIT

SYMPROIC QL

trilyte

ursodiol oral

VIBERZI

XERMELO PA; SP; QL

Genetic or Enzyme Disorder - Drugs for Replacement, Modification, Treatment

CERDELGA PA; SP

CHOLBAM PA; SP

CREON

CYSTADANE POWDER ORAL SP

CYSTAGON SP

GALAFOLD PA; SP; QL

KUVAN PA; SP

L-GLUTAMIC ACID HCL

miglustat PA; SP

MYALEPT PA; SP

nitisinone SP

NITYR SP

ORFADIN ORAL CAPSULE 20 MG SP

ORFADIN ORAL SUSPENSION SP

PALYNZIQ PA; SP; QL




PANCREAZE

PERTZYE

RAVICTI PA; SP

sodium phenylbutyrate oral powder 3 gm/tsp SP

sodium phenylbutyrate oral tablet SP

STRENSIQ PA; SP

SUCRAID PA; SP

VIOKACE

XURIDEN SP

ZENPEP ORAL CAPSULE DELAYED RELEASE PARTICLES 10000-32000 UNIT, 15000-47000 UNIT, 20000-63000 UNIT, 25000-79000 UNIT, 3000-14000 UNIT, 40000-126000 UNIT, 5000-24000 UNIT

Genitourinary Agents - Drugs for Bladder, Genital and Kidney Conditions

AURYXIA

bethanechol chloride oral

calcium acetate (phos binder)

calcium acetate oral tablet 667 mg

darifenacin hydrobromide er

ELMIRON

flavoxate hcl

FOSRENOL ORAL PACKET

INTRAROSA QL

lanthanum carbonate

LITHOSTAT

MYRBETRIQ ST

oxybutynin chloride er

oxybutynin chloride oral

penicillamine oral capsule

penicillamine oral tablet SP

phenazo oral tablet 200 mg

phenazopyridine hcl oral tablet 100 mg, 200 mg

PHOSLYRA

sevelamer carbonate




sevelamer hcl

sildenafil citrate oral tablet 100 mg, 25 mg, 50 mg QL

solifenacin succinate

tadalafil oral tablet 10 mg, 2.5 mg, 20 mg QL

THIOLA SP

THIOLA EC SP

tolterodine tartrate

tolterodine tartrate er

TOVIAZ ST

trospium chloride

trospium chloride er

uretron d/s

urin ds

utrona-c

vardenafil hcl oral QL

VELPHORO

Genitourinary Agents - Drugs for Prostate Conditions

alfuzosin hcl er

dutasteride oral

dutasteride-tamsulosin hcl

finasteride oral tablet 5 mg

silodosin

tamsulosin hcl

terazosin hcl oral

Hormonal Agents - Adrenal

cortisone acetate oral

dexamethasone intensol

dexamethasone oral

fludrocortisone acetate oral

hydrocortisone oral

MEDROL ORAL TABLET 2 MG

methylprednisolone oral

MILLIPRED DP 12-DAY ORAL TABLET THERAPY PACK

MILLIPRED DP ORAL TABLET THERAPY PACK




MILLIPRED ORAL TABLET

prednisolone oral solution

prednisolone sodium phosphate oral solution 10 mg/5ml, 15 mg/5ml, 20 mg/5ml, 25 mg/5ml, 6.7 (5 base) mg/5ml

prednisolone sodium phosphate oral tablet dispersible

prednisone intensol

prednisone oral

Hormonal Agents - Men's Health

ANADROL-50

ANDRODERM TRANSDERMAL PATCH 24 HOUR PA

danazol oral

FORTESTA PA

METHITEST

METHYLTESTOSTERONE

methyltestosterone oral

oxandrolone oral

testosterone cypionate intramuscular solution 100 mg/ml, 200 mg/ml

PA

testosterone enanthate intramuscular solution PA

testosterone gel 50 mg/5gm (1%) transdermal PA

testosterone transdermal gel 1.62 %, 10 mg/act (2%), 12.5 mg/act (1%), 20.25 mg/1.25gm (1.62%), 20.25 mg/act (1.62%), 25 mg/2.5gm (1%), 40.5 mg/2.5gm (1.62%)

PA

testosterone transdermal solution PA

Hormonal Agents - Osteoporosis

OSPHENA

raloxifene hcl

Hormonal Agents - Pituitary

ACTHAR PA; SP

cabergoline QL

CETROTIDE SUBCUTANEOUS KIT 0.25 MG

chorionic gonadotropin intramuscular QL

clomiphene citrate oral

DDAVP RHINAL TUBE

desmopressin ace spray refrig




desmopressin acetate oral

desmopressin acetate spray

FOLLISTIM AQ SUBCUTANEOUS

ganirelix acetate subcutaneous solution prefilled syringe

GONAL-F

GONAL-F RFF

GONAL-F RFF REDIJECT

HUMATROPE PA; SP

INCRELEX PA; SP

leuprolide acetate injection SP

MENOPUR

novarel intramuscular solution reconstituted 10000 unit QL

NOVAREL INTRAMUSCULAR SOLUTION RECONSTITUTED 5000 UNIT

QL

NUTROPIN AQ NUSPIN 10 PA; SP



octreotide acetate injection solution 100 mcg/ml, 1000 mcg/ml, 200 mcg/ml, 50 mcg/ml, 500 mcg/ml

SP

ORILISSA PA; QL

OVIDREL

pregnyl QL

SIGNIFOR SP

STIMATE SP

SYNAREL

Hormonal Agents - Prostaglandins

KORLYM PA; SP

Hormonal Agents - Sex Hormones and Birth Control

amabelz

COMBIPATCH QL

CRINONE

DELESTROGEN INTRAMUSCULAR OIL 10 MG/ML

DEPO-ESTRADIOL

DEPO-PROVERA INTRAMUSCULAR SUSPENSION 400 MG/ML




DIVIGEL

dotti QL

DUAVEE

ELESTRIN

ENDOMETRIN

estradiol oral

estradiol transdermal QL

estradiol vaginal

estradiol valerate intramuscular oil 20 mg/ml, 40 mg/ml

estradiol-norethindrone acet

ESTRING QL

ESTROGEL

EVAMIST

FEMRING QL

fyavolv

hydroxyprogesterone caproate intramuscular

IMVEXXY MAINTENANCE PACK

IMVEXXY STARTER PACK

jinteli

lopreeza oral tablet 1-0.5 mg

medroxyprogesterone acetate oral

megestrol acetate oral suspension 40 mg/ml, 400 mg/10ml, 625 mg/5ml

megestrol acetate oral tablet

mimvey

norethindrone acetate oral

norethindrone-eth estradiol

PREFEST

PREMARIN ORAL

PREMARIN VAGINAL

PREMPHASE

PREMPRO

progesterone intramuscular

progesterone micronized oral




yuvafem

Hormonal Agents - Thyroid

ARMOUR THYROID

euthyrox

levo-t

levothyroxine sodium oral

levoxyl

liothyronine sodium oral

methimazole oral

NATURE-THROID

np thyroid

propylthiouracil oral

SYNTHROID

TIROSINT

TIROSINT-SOL

unithroid

WESTHROID ORAL TABLET 130 MG, 195 MG, 32.5 MG, 65 MG, 97.5 MG

WP THYROID ORAL TABLET 113.75 MG, 130 MG, 32.5 MG, 48.75 MG, 65 MG, 81.25 MG, 97.5 MG

Immunological Agents - Drugs for Immune System Stimulation or Suppression

ACTEMRA ACTPEN PA; SP; QL

ACTEMRA SUBCUTANEOUS PA; SP; QL

ACTIMMUNE PA; SP

ARCALYST PA; SP

ASTAGRAF XL

AZASAN

azathioprine oral

BENLYSTA SUBCUTANEOUS PA; SP; QL

CIMZIA PREFILLED KIT PA; SP; QL

CIMZIA STARTER KIT PA; SP; QL

COSENTYX (300 MG DOSE) PA; SP; QL

COSENTYX 150 MG/ML PA; SP; QL

COSENTYX SENSOREADY (300 MG) PA; SP; QL




COSENTYX SENSOREADY PEN SUBCUTANEOUS SOLUTION AUTO-INJECTOR 150 MG/ML

PA; SP; QL

cyclosporine modified

cyclosporine oral capsule

ENBREL MINI PA; SP; QL

ENBREL SUBCUTANEOUS SOLUTION PREFILLED SYRINGE PA; SP; QL

ENBREL SUBCUTANEOUS SOLUTION RECONSTITUTED PA; SP; QL

ENBREL SURECLICK SUBCUTANEOUS SOLUTION AUTO-INJECTOR

PA; SP; QL

ENVARSUS XR

everolimus oral tablet 0.25 mg, 0.5 mg, 0.75 mg

gengraf oral capsule 100 mg, 25 mg

gengraf oral solution

HAEGARDA PA; SP

HUMIRA PEDIATRIC CROHNS START SUBCUTANEOUS PREFILLED SYRINGE KIT 40 MG/0.8ML, 80 MG/0.8ML, 80 MG/0.8ML & 40MG/0.4ML

PA; SP; QL

HUMIRA PEN PEN-INJECTOR KIT 40 MG/0.4ML SUBCUTANEOUS

PA; SP

HUMIRA PEN PEN-INJECTOR KIT 40 MG/0.4ML SUBCUTANEOUS

PA; SP; QL

HUMIRA PEN SUBCUTANEOUS PEN-INJECTOR KIT 40 MG/0.8ML

PA; SP; QL

HUMIRA PEN-CD/UC/HS STARTER PEN-INJECTOR KIT 80 MG/0.8ML SUBCUTANEOUS

PA; SP

HUMIRA PEN-CD/UC/HS STARTER PEN-INJECTOR KIT 80 MG/0.8ML SUBCUTANEOUS

PA; SP; QL

HUMIRA PEN-CD/UC/HS STARTER SUBCUTANEOUS PEN-INJECTOR KIT 40 MG/0.8ML

PA; SP; QL

HUMIRA PEN-PS/UV/ADOL HS START PA; SP; QL

HUMIRA SUBCUTANEOUS PREFILLED SYRINGE KIT PA; SP; QL

icatibant acetate PA; SP

KEVZARA PA; SP; QL

KINERET SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

leflunomide oral QL




methotrexate oral

methotrexate sodium (pf) injection solution 1 gm/40ml, 250 mg/10ml, 50 mg/2ml

methotrexate sodium injection solution 250 mg/10ml, 50 mg/2ml

methotrexate sodium injection solution reconstituted

methotrexate sodium oral

mycophenolate mofetil

mycophenolate sodium

OLUMIANT PA; SP; QL

ORENCIA CLICKJECT PA; SP; QL

ORENCIA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

OTEZLA ORAL TABLET PA; SP; QL

OTEZLA ORAL TABLET THERAPY PACK PA; SP; QL

PROGRAF ORAL PACKET

RIDAURA SP

RINVOQ PA; SP; QL

SANDIMMUNE ORAL SOLUTION

SILIQ PA; SP; QL

SIMPONI SUBCUTANEOUS SOLUTION AUTO-INJECTOR PA; SP; QL

SIMPONI SUBCUTANEOUS SOLUTION PREFILLED SYRINGE PA; SP; QL

sirolimus oral

SKYRIZI (150 MG DOSE) PA; SP; QL

STELARA SUBCUTANEOUS SOLUTION 45 MG/0.5ML PA; SP; QL

STELARA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE

PA; SP; QL

tacrolimus oral

TAKHZYRO PA; SP; QL

TALTZ PA; SP; QL

TREMFYA PA; SP; QL

TREXALL

VARIZIG INTRAMUSCULAR SOLUTION

XELJANZ PA; SP; QL

XELJANZ XR PA; SP; QL

ZORTRESS ORAL TABLET 1 MG




Inflammatory Bowel Disease Agents

balsalazide disodium

budesonide er oral tablet extended release 24 hour QL

budesonide oral QL

colocort

CORTIFOAM EXTERNAL

hydrocortisone (perianal)

hydrocortisone rectal enema

mesalamine er

mesalamine oral

mesalamine rectal

mesalamine-cleanser

PENTASA

PROCTOFOAM HC EXTERNAL

procto-med hc external

procto-pak external

proctosol hc external

proctozone-hc external

sulfasalazine oral

UCERIS RECTAL

Metabolic Bone Disease Agents - Drugs for Osteoporosis

alendronate sodium oral solution

alendronate sodium oral tablet 10 mg, 35 mg, 5 mg, 70 mg

calcitonin (salmon)

ibandronate sodium oral

MIACALCIN INJECTION

RAYALDEE

risedronate sodium oral tablet 150 mg, 30 mg, 35 mg, 5 mg

risedronate sodium oral tablet delayed release

TYMLOS PA; SP; QL

Metabolic Bone Disease Agents - Other

calcitriol oral

cinacalcet hcl

doxercalciferol oral




NATPARA PA; SP

paricalcitol oral

Miscellaneous Therapeutic Agents

ASPARTAME

aspartame (nutrasweet)

BREATHE EASE LARGE

BREATHE EASE MEDIUM

BREATHE EASE SMALL

BREATHERITE

BROMELAIN

CETYLCIDE-G

CHARCOAL ACTIVATED

COMPACT SPACE CHAMBER/LG MASK

COMPACT SPACE CHAMBER/MED MASK

COMPACT SPACE CHAMBER/SM MASK

EASIVENT

ENDARI

ergoloid mesylates oral

formaldehyde solution 37 % external (rx)

glutaraldehyde external

GRASTEK

methergine oral

methylergonovine maleate oral

MICROCHAMBER DEVICE

ODACTRA QL

ORALAIR

ORALAIR ADULT SAMPLE KIT

ORALAIR ADULT STARTER PACK

ORALAIR CHILDRENS STARTER PACK

PALFORZIA (12 MG DAILY DOSE) SP










PALFORZIA (300 MG MAINTENANCE) SP

PALFORZIA (300 MG TITRATION) SP




PALFORZIA INITIAL ESCALATION SP

pocket spacer

RADIOGARDASE

RAGWITEK

RUZURGI PA; SP; QL

SACCHARIN

sodium saccharin powder

VISTOGARD SP

Ophthalmic Agents - Drugs for Eye Allergy, Infection and Inflammation

AZASITE

azelastine hcl ophthalmic

bacitracin ophthalmic

BETADINE OPHTHALMIC PREP

bromfenac sodium (once-daily)

CILOXAN OPHTHALMIC OINTMENT

ciprofloxacin hcl ophthalmic

cromolyn sodium ophthalmic

dexamethasone sodium phosphate ophthalmic

diclofenac sodium ophthalmic

epinastine hcl

erythromycin ophthalmic

FLAREX

fluorometholone ophthalmic

flurbiprofen sodium

FML

FML FORTE ST




gatifloxacin ophthalmic

gentak ophthalmic ointment

gentamicin sulfate ophthalmic solution

ILEVRO

INVELTYS

ketorolac tromethamine ophthalmic

levofloxacin ophthalmic

LOTEMAX SM

MAXIDEX

MITOSOL

moxifloxacin hcl (2x day)

moxifloxacin hcl ophthalmic

NATACYN

ofloxacin ophthalmic

olopatadine hcl ophthalmic

POVIDONE-IODINE OPHTHALMIC

PRED MILD ST

prednisolone acetate ophthalmic

prednisolone sodium phosphate ophthalmic

sulfacetamide sodium ophthalmic

tobramycin ophthalmic

TOBREX OPHTHALMIC OINTMENT

trifluridine ophthalmic

ZIRGAN

Ophthalmic Agents - Drugs for Glaucoma

acetazolamide er

acetazolamide oral

ALPHAGAN P OPHTHALMIC SOLUTION 0.1 %

apraclonidine hcl

AZOPT

betaxolol hcl ophthalmic

BETIMOL

BETOPTIC-S

bimatoprost ophthalmic




brimonidine tartrate ophthalmic

carteolol hcl

COMBIGAN

dorzolamide hcl solution 2 % ophthalmic

dorzolamide hcl-timolol mal

dorzolamide hcl-timolol mal pf

IOPIDINE OPHTHALMIC SOLUTION 1 %

KEVEYIS SP

latanoprost ophthalmic

levobunolol hcl ophthalmic solution 0.5 %

LUMIGAN OPHTHALMIC SOLUTION 0.01 % ST

methazolamide oral

PHOSPHOLINE IODIDE

pilocarpine hcl ophthalmic solution 1 %, 2 %, 4 %

RHOPRESSA

ROCKLATAN ST

SIMBRINZA

timolol maleate ophthalmic

TIMOPTIC OCUDOSE

travoprost (bak free)

XELPROS

Ophthalmic Agents - Drugs for Miscellaneous Eye Conditions

ak-poly-bac

altafrin ophthalmic solution 10 %, 2.5 %

atropine sulfate ophthalmic ointment

atropine sulfate ophthalmic solution 1 %

bacitracin-polymyxin b ophthalmic ointment 500-10000 unit/gm

bacitra-neomycin-polymyxin-hc

BLEPHAMIDE

BLEPHAMIDE S.O.P.

CEQUA QL

cyclopentolate hcl ophthalmic

CYSTARAN SP




homatropaire

ISOPTO ATROPINE

LACRISERT

neomycin-bacitracin zn-polymyx

neomycin-polymyxin-dexameth ophthalmic ointment

neomycin-polymyxin-dexameth ophthalmic suspension 3.5-10000-0.1

neomycin-polymyxin-gramicidin ophthalmic solution 1.75-10000-.025

neomycin-polymyxin-hc ophthalmic suspension 3.5-10000-1

neo-polycin

neo-polycin hc

OXERVATE PA; SP; QL

phenylephrine hcl ophthalmic solution 10 %, 2.5 %

polycin

polymyxin b-trimethoprim

PRED-G

PRED-G S.O.P.

proparacaine hcl ophthalmic

RESTASIS QL

RESTASIS MULTIDOSE EMULSION 0.05 % OPHTHALMIC QL

RESTASIS MULTIDOSE EMULSION 0.05 % OPHTHALMIC

sulfacetamide-prednisolone ophthalmic solution

TOBRADEX OPHTHALMIC OINTMENT

TOBRADEX ST

tobramycin-dexamethasone

XIIDRA QL

ZYLET

Otic Agents - Drugs for Ear Conditions

acetic acid otic

CIPRODEX

ciprofloxacin hcl otic

flac

fluocinolone acetonide otic




hydrocortisone-acetic acid

neomycin-polymyxin-hc otic

ofloxacin otic

PRAMOTIC

Respiratory Tract / Pulmonary Agents - Drugs for Allergies, Cough, Cold

azelastine hcl nasal

benzonatate

bromfed dm

brompheniramine tannate oral tablet chewable

carbinoxamine maleate oral solution

carbinoxamine maleate oral tablet

cetirizine hcl oral solution

clemastine fumarate oral tablet 2.68 mg

cyproheptadine hcl oral

desloratadine

diphen oral elixir

diphenhydramine hcl oral elixir

FASENRA PEN PA; SP; QL

flunisolide nasal solution 25 mcg/act (0.025%)

fluticasone propionate suspension 50 mcg/act nasal (rx) QL

guaiatussin ac QL

guaifenesin ac QL

hydrocodone polst-cpm polst er oral suspension extended release

QL

hydrocodone-homatropine QL

hydromet QL

HYPERSAL INHALATION NEBULIZATION SOLUTION 3.5 %

ipratropium bromide nasal

levocetirizine dihydrochloride oral solution

levocetirizine dihydrochloride tablet 5 mg oral (rx)

maxi-tuss ac QL

mometasone furoate nasal QL

nebusal inhalation nebulization solution 3 %




NEBUSAL INHALATION NEBULIZATION SOLUTION 6 %

NUCALA SUBCUTANEOUS SOLUTION AUTO-INJECTOR PA; SP; QL

NUCALA SUBCUTANEOUS SOLUTION PREFILLED SYRINGE PA; SP; QL

olopatadine hcl nasal

promethazine hcl oral

promethazine hcl rectal suppository 12.5 mg, 25 mg

promethazine-codeine QL

promethazine-dm oral syrup

promethazine-phenyleph-codeine QL

promethazine-phenylephrine

promethegan

pseudoephedrine-bromphen-dm oral syrup 30-2-10 mg/5ml

pulmosal

sodium chloride inhalation nebulization solution 0.9 %, 10 %, 3 %, 7 %

virtussin ac w/alc QL

Respiratory Tract / Pulmonary Agents - Drugs for Asthma and Other Lung Conditions

acetylcysteine inhalation

ADVAIR DISKUS QL

ADVAIR HFA QL

albuterol sulfate er

albuterol sulfate hfa aerosol solution 108 (90 base) mcg/act inhalation

albuterol sulfate hfa aerosol solution 108 (90 base) mcg/act inhalation

QL

ALBUTEROL SULFATE HFA AEROSOL SOLUTION 108 (90 BASE) MCG/ACT INHALATION

QL

albuterol sulfate inhalation

albuterol sulfate oral

ANORO ELLIPTA QL

ARCAPTA NEOHALER QL

ARNUITY ELLIPTA QL

ASMANEX (120 METERED DOSES) QL








ASMANEX HFA QL

ATROVENT HFA QL

BEVESPI AEROSPHERE QL

BREO ELLIPTA QL

budesonide inhalation QL

COMBIVENT RESPIMAT QL

cromolyn sodium inhalation

DALIRESP

difil-g forte

ELIXOPHYLLIN

epinephrine injection solution auto-injector QL

ESBRIET PA; SP; QL

FLOVENT DISKUS QL

FLOVENT HFA QL

fluticasone-salmeterol inhalation aerosol powder breath activated 100-50 mcg/dose, 250-50 mcg/dose, 500-50 mcg/dose

FLUTICASONE-SALMETEROL INHALATION AEROSOL POWDER BREATH ACTIVATED 113-14 MCG/ACT, 232-14 MCG/ACT, 55-14 MCG/ACT

QL

INCRUSE ELLIPTA QL

ipratropium bromide inhalation

ipratropium-albuterol

levalbuterol hcl inhalation nebulization solution 0.31 mg/3ml, 0.63 mg/3ml, 1.25 mg/0.5ml, 1.25 mg/3ml

LEVALBUTEROL HFA INHALATION AEROSOL 45 MCG/ACT QL

LONHALA MAGNAIR REFILL KIT ST; QL

LONHALA MAGNAIR STARTER KIT ST; QL

metaproterenol sulfate oral syrup

montelukast sodium oral

OFEV PA; SP; QL

PERFOROMIST QL

PROAIR HFA QL




PROAIR RESPICLICK QL

PROVENTIL HFA QL

PULMICORT FLEXHALER QL

QVAR REDIHALER QL

SEEBRI NEOHALER

SEREVENT DISKUS QL

SPIRIVA HANDIHALER QL

SPIRIVA RESPIMAT INHALATION AEROSOL SOLUTION 1.25 MCG/ACT, 2.5 MCG/ACT

QL

STIOLTO RESPIMAT INHALATION AEROSOL SOLUTION 2.5-2.5 MCG/ACT

QL

STRIVERDI RESPIMAT QL

SYMBICORT QL

SYMJEPI INJECTION SOLUTION PREFILLED SYRINGE 0.3 MG/0.3ML

QL

terbutaline sulfate oral

THEO-24

theophylline

theophylline er oral tablet extended release 12 hour 300 mg, 450 mg

theophylline er oral tablet extended release 24 hour

TRELEGY ELLIPTA QL

TUDORZA PRESSAIR INHALATION AEROSOL POWDER BREATH ACTIVATED 400 MCG/ACT

QL

UTIBRON NEOHALER QL

VENTOLIN HFA QL

wixela inhub

XOPENEX HFA QL

YUPELRI ST; QL

zafirlukast

zileuton er

Respiratory Tract / Pulmonary Agents - Drugs for Cystic Fibrosis

BETHKIS SP; QL

CAYSTON SP




KALYDECO PA; SP; QL

KITABIS PAK SP; QL

ORKAMBI PA; SP; QL

PULMOZYME SP

SYMDEKO PA; SP; QL

TOBI PODHALER SP; QL

tobramycin nebulization solution 300 mg/5ml inhalation SP; QL

TOBRAMYCIN NEBULIZATION SOLUTION 300 MG/5ML INHALATION

SP; QL

TRIKAFTA PA; SP; QL

Respiratory Tract / Pulmonary Agents - Drugs for Pulmonary Hypertension

ADEMPAS PA; SP; QL

alyq PA; SP; QL

ambrisentan PA; SP; QL

bosentan PA; SP; QL

OPSUMIT PA; SP; QL

ORENITRAM PA; SP

sildenafil citrate oral suspension reconstituted PA; QL

sildenafil citrate oral tablet 20 mg PA; QL

tadalafil (pah) PA; SP; QL

TRACLEER 32 MG PA; SP; QL

TYVASO PA; SP

TYVASO REFILL PA; SP

TYVASO STARTER PA; SP

UPTRAVI PA; SP; QL

VENTAVIS PA; SP; QL

Skeletal Muscle Relaxants - Drugs for Muscle Pain and Spasm

baclofen oral

carisoprodol oral

carisoprodol-aspirin

chlorzoxazone oral tablet 250 mg, 500 mg

cyclobenzaprine hcl oral tablet 5 mg, 7.5 mg

cyclobenzaprine hcl tablet 10 mg oral




dantrolene sodium oral

metaxalone

methocarbamol oral

orphenadrine citrate er

orphenadrine-asa-caffeine

ORPHENGESIC FORTE ORAL TABLET 770-60-50 MG PA

tizanidine hcl oral

Sleep Disorder Agents

armodafinil QL

doxepin hcl oral tablet QL

eszopiclone QL

flurazepam hcl

modafinil QL

ramelteon

SECONAL

temazepam

XYREM PA; SP; QL

zaleplon QL

zolpidem tartrate QL

zolpidem tartrate er QL



Index of Drugs

abacavir sulfate..................... 23abacavir sulfate-lamivudine... 23abacavir-lamivudine-zidovudine............................. 23ABSTRAL................................ 7acamprosate calcium.............10acarbose................................40acebutolol hcl.........................27acetaminophen-codeine.......... 7acetaminophen-codeine #2..... 7acetaminophen-codeine #3..... 7acetaminophen-codeine #4..... 7acetazolamide....................... 60acetazolamide er................... 60acetic acid..............................62acetylcysteine........................ 64acitretin.................................. 36ACTEMRA............................. 54ACTEMRA ACTPEN............. 54ACTHAR................................51ACTIMMUNE.........................54acyclovir.................................23ACZONE................................36adapalene..............................36ADAPALENE......................... 36adapalene-benzoyl peroxide. 36ADASUVE............................. 23adefovir dipivoxil.................... 23ADEMPAS............................. 67ADVAIR DISKUS...................64ADVAIR HFA......................... 64ADZENYS ER........................33ADZENYS XR-ODT...............33AFREZZA.............................. 42AIMOVIG............................... 19ak-poly-bac............................ 61AKYNZEO............................. 17ala-cort...................................36ALANINE............................... 43albendazole........................... 21albuterol sulfate..................... 64albuterol sulfate er................. 64albuterol sulfate hfa............... 64ALBUTEROL SULFATE HFA....................................... 64alclometasone dipropionate...36ALDACTAZIDE......................27alendronate sodium............... 57alfuzosin hcl er.......................50

ALINIA................................... 21aliskiren fumarate.................. 27allopurinol.............................. 19almotriptan malate................. 19alosetron hcl.......................... 46ALPHAGAN P........................60alprazolam............................. 26alprazolam er.........................26alprazolam intensol................26alprazolam xr......................... 26altafrin....................................61ALTRENO..............................36ALUMINUM CHLORIDE ANHYDROUS........................36ALUMINUM CHLORIDE HEXAHYDRATE....................36alyq........................................ 67amabelz................................. 52amantadine hcl...................... 22ambrisentan...........................67amcinonide............................ 36amiloride hcl.......................... 27amiloride-hydrochlorothiazide............... 27aminocaproic acid..................27amiodarone hcl...................... 27AMITIZA................................ 46amitriptyline hcl......................16amlodipine besylate...............27amlodipine besylate-benazepril hcl........................ 27amlodipine besylate-valsartan................................ 27amlodipine-atorvastatin......... 27amlodipine-olmesartan.......... 27amlodipine-valsartan-hctz......27ammonium lactate........... 36, 37amnesteem............................37amoxapine............................. 16amoxicill-clarithro-lansopraz.. 46amoxicillin.............................. 11amoxicillin-potassium clavulanate............................ 11amoxicillin-potassium clavulanate er........................ 11AMPHETAMINE ER.............. 33amphetamine sulfate............. 33amphetamine-dextroamphetamine...............33

amphetamine-dextroamphetamine er...........33ampicillin................................11ANADROL-50........................ 51anagrelide hcl........................ 27anastrozole............................ 20ANDRODERM....................... 51ANORO ELLIPTA.................. 64ANZEMET............................. 17apap-caff-dihydrocodeine........ 7APOKYN................................22apraclonidine hcl....................60aprepitant...............................17APTIVUS............................... 23ARCALYST............................54ARCAPTA NEOHALER.........64aripiprazole............................ 23armodafinil ............................. 68ARMOUR THYROID............. 54ARNUITY ELLIPTA............... 64ascomp-codeine...................... 7ASMANEX (120 METERED DOSES).................................64ASMANEX (14 METERED DOSES).................................64ASMANEX (30 METERED DOSES).................................65ASMANEX (60 METERED DOSES).................................65ASMANEX (7 METERED DOSES).................................65ASMANEX HFA.....................65ASPARTAME........................ 58aspartame (nutrasweet).........58aspirin-dipyridamole er.......... 22ASTAGRAF XL......................54atazanavir sulfate.................. 24atenolol.................................. 27atenolol-chlorthalidone.......... 28atomoxetine hcl..................... 33atorvastatin calcium...............28atovaquone............................21atovaquone-proguanil hcl...... 21ATRIPLA................................24atropine sulfate...................... 61ATROVENT HFA...................65AUBAGIO.............................. 33AUGMENTIN......................... 11AURYXIA...............................49

69

AVANDIA...............................40avidoxy.................................. 11avita....................................... 37AVONEX PEN....................... 33AVONEX PREFILLED........... 34AVONEX VIAL INTRAMUSCULAR KIT........ 34AZASAN................................ 54AZASITE................................59azathioprine........................... 54azelaic acid............................37azelastine hcl...................59, 63AZELEX.................................37azithromycin.......................... 11AZOPT...................................60bacitracin............................... 59bacitracin-polymyxin b........... 61bacitra-neomycin-polymyxin-hc...........................................61baclofen................................. 67balsalazide disodium............. 57balsam peru-castor oil........... 37BANZEL.................................14BAQSIMI ONE PACK............ 42BAQSIMI TWO PACK........... 42BARACLUDE.........................24BAXDELA.............................. 11BELBUCA................................7benazepril hcl........................ 28benazepril-hydrochlorothiazide............... 28BENLYSTA............................54benzalkonium chloride...........11BENZNIDAZOLE................... 21benzonatate...........................63benzoyl peroxide-erythromycin.......................... 37benzphetamine hcl................ 34benztropine mesylate............ 22beser......................................37BETADINE OPHTHALMIC PREP.....................................59betamethasone dipropionate.37betamethasone dipropionate aug.........................................37betamethasone valerate........ 37betaxolol hcl.....................28, 60bethanechol chloride............. 49BETHKIS............................... 66BETIMOL...............................60

BETOPTIC-S......................... 60BEVESPI AEROSPHERE..... 65BEVYXXA..............................13BIDIL......................................28BIKTARVY.............................24bimatoprost............................60BIO-STATIN.......................... 18BISACODYL.......................... 46bisoprolol fumarate................ 28bisoprolol-hydrochlorothiazide............... 28BLEPHAMIDE....................... 61BLEPHAMIDE S.O.P.............61bosentan................................67BPCO.................................... 37BREATHE EASE LARGE......58BREATHE EASE MEDIUM... 58BREATHE EASE SMALL...... 58BREATHERITE..................... 58BREO ELLIPTA..................... 65BRILINTA.............................. 22brimonidine tartrate................61BRIVIACT.............................. 14BROMELAIN......................... 58bromfed dm........................... 63bromfenac sodium (once-daily)...................................... 59bromocriptine mesylate......... 22brompheniramine tannate......63budesonide...................... 57, 65budesonide er........................57bumetanide............................28BUNAVAIL.............................10buprenorphine......................... 7buprenorphine hcl..................10buprenorphine hcl-naloxone hcl.......................................... 10bupropion hcl......................... 16bupropion hcl er (sr).............. 16bupropion hcl er (xl)...............16buspirone hcl......................... 26butalbital-acetaminophen........ 7butalbital-apap-caff-cod........... 7butalbital-apap-caffeine........... 7butalbital-asa-caff-codeine...... 7butalbital-aspirin-caffeine.........7butorphanol tartrate................. 7BYDUREON.......................... 40BYDUREON BCISE AUTOINJECTOR...................40

BYETTA 10 MCG PEN..........41BYETTA 5 MCG PEN............41BYSTOLIC.............................28cabergoline............................ 51CABLIVI.................................22caffeine citrate....................... 34CALAMINE............................ 37CALCIFOL............................. 43calcipotriene.......................... 37calcipotriene-betameth diprop.....................................37CALCIPOTRIENE-BETAMETH DIPROP............ 37calcitonin (salmon).................57calcitriol............................37, 57calcium acetate......................49calcium acetate (phos binder)................................... 49CALCIUM CHLORIDE DIHYDRATE..........................43CALCIUM GLUCONATE....... 43CALCIUM GLUCONATE ANHYDROUS........................43CALCIUM GLUCONATE MONOHYDRATE.................. 43CALCIUM LACTATE PENTAHYDRATE................. 43CALCIUM PHOSPHATE DIBASIC................................ 43CALCIUM PHOSPHATE TRIBASIC.............................. 43candesartan cilexetil .............. 28candesartan cilexetil-hctz...... 28captopril ................................. 28captopril-hydrochlorothiazide.28CARAC.................................. 37CARBAGLU...........................43carbamazepine...................... 14carbamazepine er..................14carbidopa...............................22carbidopa-levodopa............... 22carbidopa-levodopa er...........22carbidopa-levodopa-entacapone............................22carbinoxamine maleate......... 63CARDIZEM LA...................... 28carisoprodol........................... 67carisoprodol-aspirin............... 67carisoprodol-aspirin-codeine... 7carteolol hcl........................... 61

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cartia xt.................................. 28carvedilol............................... 28carvedilol phosphate er......... 28cascara sagrada.................... 46cavarest................................. 35CAYSTON............................. 66cefaclor.................................. 11cefaclor er..............................11cefadroxil............................... 11cefdinir................................... 11cefditoren pivoxil....................11cefixime................................. 11cefpodoxime proxetil ..............11cefprozil................................. 11cefuroxime axetil ....................11celecoxib..................................9CELONTIN............................ 14cephalexin............................. 11CEQUA..................................61CERDELGA...........................48cetirizine hcl...........................63CETROTIDE..........................51CETYLCIDE-G...................... 58cevimeline hcl........................ 35CHARCOAL ACTIVATED..... 58CHEMET............................... 43CHENODAL...........................46chlordiazepoxide hcl.............. 26chlordiazepoxide-amitriptyline........................... 16chlordiazepoxide-clidinium.... 46chlorhexidine gluconate.........35chloroquine phosphate.......... 21chlorothiazide........................ 28chlorpromazine hcl................ 23chlorthalidone........................ 28chlorzoxazone....................... 67CHOLBAM.............................48cholestyramine...................... 28cholestyramine light...............28CHOLINE BITARTRATE....... 43chorionic gonadotropin.......... 51ciclodan................................. 18ciclopirox................................18CICLOPIROX OLAMINE....... 18ciclopirox olamine.................. 18cilostazol................................22CILOXAN...............................59CIMDUO................................ 24cimetidine.............................. 46

cimetidine hcl.........................46CIMZIA PREFILLED KIT....... 54CIMZIA STARTER KIT.......... 54cinacalcet hcl......................... 57CIPRODEX............................62ciprofloxacin hcl......... 11, 59, 62citalopram hydrobromide....... 16claravis.................................. 37clarithromycin........................ 11clarithromycin er.................... 11clemastine fumarate.............. 63CLENPIQ...............................46CLEOCIN...............................11clindacin etz...........................37clindacin-p............................. 37clindamycin hcl...................... 11clindamycin palmitate hcl.......11clindamycin phosphate.... 11, 37clindamycin phosphate-benzoyl peroxide................... 37clindamycin-tretinoin..............37CLINDESSE.......................... 12clinpro 5000........................... 35clobazam............................... 14clobetasol prop emollient base.......................................37clobetasol propionate............ 38clobetasol propionate e......... 38clobetasol propionate emulsion................................ 38clocortolone pivalate..............38clodan.................................... 38clomiphene citrate................. 51clomipramine hcl....................16clonazepam........................... 26clonidine................................ 28clonidine hcl...........................28clonidine hcl er.......................33clopidogrel bisulfate...............22clorazepate dipotassium........26clotrimazole........................... 18CLOTRIMAZOLE...................18clotrimazole-betamethasone. 18clovique................................. 43clozapine............................... 23coal tar...................................38COARTEM.............................21codeine sulfate........................ 7COLCHICINE........................ 19colchicine...............................19

colchicine-probenecid............19COLCRYS............................. 19colesevelam hcl..................... 28colestipol hcl.......................... 28colocort.................................. 57COMBIGAN........................... 61COMBIPATCH.......................52COMBIVENT RESPIMAT......65COMPACT SPACE CHAMBER/LG MASK............58COMPACT SPACE CHAMBER/MED MASK........ 58COMPACT SPACE CHAMBER/SM MASK........... 58COMPLERA.......................... 24compro...................................17CONDYLOX.......................... 38constulose............................. 47COPAXONE.......................... 34CORDRAN............................ 38CORLANOR.......................... 28CORTIFOAM......................... 57cortisone acetate................... 50CORTISPORIN......................38COSENTYX (300 MG DOSE)................................... 54COSENTYX 150 MG/ML....... 54COSENTYX SENSOREADY (300 MG)............................... 54COSENTYX SENSOREADY PEN....................................... 55CREON..................................48CRESEMBA.......................... 18CRINONE.............................. 52CRIXIVAN..............................24cromolyn sodium....... 47, 59, 65crotan.....................................21CUVPOSA............................. 47cyanocobalamin.....................43cyclobenzaprine hcl............... 67cyclopentolate hcl.................. 61cycloserine.............................20CYCLOSET........................... 41cyclosporine...........................55cyclosporine modified............ 55cyproheptadine hcl................ 63CYSTADANE.........................48CYSTAGON.......................... 48CYSTARAN........................... 61dalfampridine er.....................34

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DALIRESP.............................65danazol.................................. 51dantrolene sodium................. 68dapsone...........................20, 38DAPSONE............................. 38darifenacin hydrobromide er..49DAYTRANA........................... 33DDAVP RHINAL TUBE......... 51DEBACTEROL...................... 35deferasirox.............................43DELESTROGEN................... 52DELSTRIGO..........................24demeclocycline hcl................ 12DEMSER............................... 28denta 5000 plus..................... 35dentagel.................................35DEPO-ESTRADIOL...............52DEPO-PROVERA..................52DERMULCERA..................... 38DESCOVY............................. 24desipramine hcl..................... 16desloratadine......................... 63desmopressin ace spray refrig...................................... 51desmopressin acetate........... 52desmopressin acetate spray..52desonide................................ 38desoximetasone.................... 38desvenlafaxine succinate er.. 16dexamethasone..................... 50dexamethasone intensol........50dexamethasone sodium phosphate..............................59dexmethylphenidate hcl.........33dexmethylphenidate hcl er.....33dextroamphetamine sulfate... 33dextroamphetamine sulfate er........................................... 33DIACOMIT............................. 14diazepam......................... 14, 26diazepam intensol..................26diazoxide............................... 42DICLOFENAC EPOLAMINE... 9diclofenac potassium............... 9diclofenac sodium........9, 38, 59diclofenac sodium er................9diclofenac-misoprostol.............9dicloxacillin sodium................12dicyclomine hcl...................... 47didanosine............................. 24

diethylpropion hcl...................34diethylpropion hcl er.............. 34DIFICID..................................12difil-g forte..............................65diflorasone diacetate............. 38diflunisal...................................9digitek.................................... 28digox...................................... 28digoxin................................... 28dihydroergotamine mesylate. 19DILANTIN.............................. 14DILATRATE-SR.....................28diltiazem hcl...........................29diltiazem hcl er.......................29diltiazem hcl er beads............28diltiazem hcl er coated beads.....................................29dilt-xr......................................29diphen....................................63diphenhydramine hcl............. 63diphenoxylate-atropine.......... 47dipyridamole.......................... 22disopyramide phosphate....... 29disulfiram............................... 10DIURIL...................................29divalproex sodium..................14divalproex sodium er............. 14DIVIGEL................................ 53DL-ALANINE......................... 43DL-LEUCINE......................... 43DL-METHIONINE.................. 44DL-PHENYLALANINE........... 44dofetilide................................ 29donepezil hcl..........................15dorzolamide hcl..................... 61dorzolamide hcl-timolol mal... 61dorzolamide hcl-timolol mal pf............................................61dotti........................................53DOVATO............................... 24doxazosin mesylate............... 29doxepin hcl................ 16, 38, 68doxercalciferol....................... 57doxycycline hyclate................12doxycycline monohydrate...... 12dronabinol..............................17DROXIA.................................20DRYSOL................................38DUAVEE................................53duloxetine hcl.........................16

DUPIXENT............................ 38duraxin.....................................7dutasteride.............................50dutasteride-tamsulosin hcl.....50E.E.S. 400............................. 12EASIVENT.............................58ec-naproxen.............................9econazole nitrate................... 18ed-spaz..................................47EDURANT............................. 24efavirenz................................ 24effer-k.................................... 44ELESTRIN............................. 53eletriptan hydrobromide.........19ELIQUIS................................ 13ELIQUIS DVT/PE STARTER PACK.....................................13ELIXOPHYLLIN..................... 65ELMIRON.............................. 49EMEND..................................17EMFLAZA.............................. 19EMGALITY............................ 19EMGALITY (300 MG DOSE).19EMTRIVA...............................24EMVERM...............................21enalapril maleate................... 29enalapril-hydrochlorothiazide.29ENBREL................................ 55ENBREL MINI........................55ENBREL SURECLICK...........55ENDARI................................. 58endocet....................................7ENDOMETRIN...................... 53enoxaparin sodium................ 13entacapone............................22entecavir................................ 24ENTEREG............................. 47ENTRESTO........................... 29enulose.................................. 47ENVARSUS XR.....................55EPCLUSA..............................24EPIDIOLEX............................14EPIDUO FORTE....................38EPIFOAM.............................. 38epinastine hcl.........................59epinephrine............................65epitol...................................... 14EPIVIR HBV.......................... 24eplerenone.............................29EQUETRO.............................27

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ergoloid mesylates.................58ERGOMAR............................ 19ergotamine-caffeine...............19ery..........................................38ERYTHROCIN STEARATE...12erythromycin.............. 12, 38, 59erythromycin base................. 12erythromycin ethylsuccinate.. 12ESBRIET............................... 65escitalopram oxalate..............16esomeprazole magnesium.... 46estazolam.............................. 26estradiol................................. 53estradiol valerate................... 53estradiol-norethindrone acet..53ESTRING...............................53ESTROGEL........................... 53eszopiclone............................68ethacrynic acid.......................29ethambutol hcl....................... 20ethosuximide......................... 14ethyl chloride......................... 10etodolac................................... 9etodolac er...............................9EUCRISA...............................38euthyrox.................................54EVAMIST...............................53everolimus............................. 55EVOTAZ................................ 24exemestane........................... 21exoderm.................................18EXTAVIA............................... 34ezetimibe............................... 29ezetimibe-simvastatin............ 29famciclovir..............................24famotidine.............................. 46FARXIGA...............................41FASENRA PEN..................... 63febuxostat.............................. 19felbamate...............................14felodipine er........................... 29FEMRING.............................. 53fenofibrate..............................29fenofibrate micronized........... 29fenofibric acid........................ 29fentanyl.................................... 7fentanyl citrate......................... 7FENTANYL CITRATE............. 7FENTORA............................... 7FERRIPROX..........................44

FIASP.................................... 42FIASP FLEXTOUCH............. 42FIASP PENFILL.....................42FINACEA............................... 38finasteride.............................. 50FIRVANQ...............................12flac......................................... 62FLAREX.................................59flavoxate hcl...........................49flecainide acetate...................29FLECTOR................................9FLOVENT DISKUS................65FLOVENT HFA......................65fluconazole............................ 18flucytosine..............................18fludrocortisone acetate.......... 50flunisolide...............................63fluocinolone acetonide.....38, 62fluocinolone acetonide body..38fluocinolone acetonide scalp. 38fluocinonide........................... 39fluocinonide emulsified base. 39fluoridex................................. 35fluoridex enhanced whitening............................... 35fluoridex sensitivity relief........35fluorometholone.....................59FLUOROPLEX...................... 39FLUOROURACIL.................. 39fluorouracil............................. 39fluoxetine hcl..........................16fluoxetine hcl (pmdd)............. 16fluphenazine hcl.....................23flurandrenolide.......................39flurazepam hcl....................... 68flurbiprofen...............................9flurbiprofen sodium................ 59fluticasone propionate..... 39, 63fluticasone-salmeterol............65FLUTICASONE-SALMETEROL...................... 65fluvastatin sodium..................29fluvastatin sodium er..............29fluvoxamine maleate..............16fluvoxamine maleate er......... 16FML....................................... 59FML FORTE.......................... 59FOLLISTIM AQ......................52fondaparinux sodium............. 13formaldehyde.........................58

FORTESTA........................... 51fosamprenavir calcium...........24fosinopril sodium....................29fosinopril sodium-hctz............29FOSRENOL...........................49FRAGMIN.............................. 13frovatriptan succinate............ 19furosemide.............................29fyavolv................................... 53FYCOMPA.............................14gabapentin.............................14GALAFOLD........................... 48galantamine hydrobromide.... 15galantamine hydrobromide er........................................... 15GALZIN..................................44ganirelix acetate.................... 52gatifloxacin.............................60GATTEX................................ 47gavilyte-c............................... 47gavilyte-g............................... 47gavilyte-h............................... 47gavilyte-n with flavor pack..... 47GEBAUERS PAIN EASE.......10GEBAUERS SPRAY AND STRETCH..............................10gemfibrozil............................. 29generlac.................................47gengraf.................................. 55gentak....................................60gentamicin sulfate............12, 60GENVOYA.............................24GILENYA............................... 34glimepiride............................. 41glipizide er............................. 41glipizide ir...............................41glipizide xl.............................. 41glipizide-metformin hcl...........41GLUCAGON EMERGENCY KIT......................................... 42glutaraldehyde....................... 58glyburide................................ 41glyburide micronized..............41glyburide-metformin...............41glycopyrrolate........................ 47glydo...................................... 10GLYXAMBI............................ 41GOLYTELY............................47GONAL-F...............................52GONAL-F RFF.......................52

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GONAL-F RFF REDIJECT.... 52GONITRO..............................29GRALISE............................... 34GRALISE STARTER............. 34granisetron hcl....................... 17GRASTEK............................. 58griseofulvin microsize............ 18griseofulvin ultramicrosize..... 18guaiatussin ac........................63guaifenesin ac....................... 63guanfacine hcl....................... 29guanfacine hcl er................... 33GVOKE PFS..........................42GYNAZOLE-1........................18HAEGARDA.......................... 55halobetasol propionate.......... 39haloperidol............................. 23haloperidol lactate................. 23HARVONI.............................. 24HEMANGEOL........................29heparin sodium (porcine).......13heparin sodium (porcine) pf...13homatropaire......................... 62HORIZANT............................ 35HUMATROPE........................52HUMIRA................................ 55HUMIRA PEDIATRIC CROHNS START.................. 55HUMIRA PEN........................ 55HUMIRA PEN-CD/UC/HS STARTER..............................55HUMIRA PEN-PS/UV/ADOL HS START.............................55HUMULIN R U-500 KWIKPEN.............................. 42HUMULIN R U-500 VIAL (CONCENTRATED).............. 42hydralazine hcl.......................29hydrochlorothiazide............... 29hydrocodone bitartrate er........ 7hydrocodone polst-cpm polst er........................................... 63hydrocodone-acetaminophen........................ 7hydrocodone-homatropine.....63hydrocodone-ibuprofen............7hydrocortisone........... 39, 50, 57hydrocortisone (perianal).......57hydrocortisone butyr lipo base.......................................39

hydrocortisone butyrate......... 39hydrocortisone valerate......... 39hydrocortisone-acetic acid.....63hydrogen peroxide.................12hydromet................................63hydromorphone hcl..................8hydromorphone hcl er..............8hydroxychloroquine sulfate....21hydroxyprogesterone caproate.................................53hydroxyurea...........................21hydroxyzine hcl......................26hydroxyzine pamoate............ 26hyoscyamine sulfate.............. 47hyoscyamine sulfate sl.......... 47HYPERSAL........................... 63HYSINGLA ER........................ 8ibandronate sodium............... 57ibu............................................9ibuprofen..................................9icatibant acetate.................... 55ILEVRO................................. 60imipramine hcl....................... 16imipramine pamoate.............. 16imiquimod.............................. 39IMPAVIDO............................. 21IMVEXXY MAINTENANCE PACK.....................................53IMVEXXY STARTER PACK..53INCRELEX.............................52INCRUSE ELLIPTA............... 65indapamide............................ 30INDOCIN................................. 9indomethacin........................... 9indomethacin er....................... 9INTELENCE.......................... 24INTRAROSA..........................49INVELTYS............................. 60INVIRASE..............................24iodine strong.......................... 44IOPIDINE...............................61ipratropium bromide.........63, 65ipratropium-albuterol..............65irbesartan...............................30irbesartan-hydrochlorothiazide............... 30ISENTRESS.......................... 24ISENTRESS HD.................... 24isoniazid.................................20ISOPTO ATROPINE..............62

isosorbide dinitrate................ 30isosorbide mononitrate.......... 30isosorbide mononitrate er...... 30isotretinoin............................. 39isradipine............................... 30itraconazole........................... 18ivermectin.............................. 21JADENU SPRINKLE............. 44jantoven................................. 14JANUMET..............................41JANUMET XR........................41JANUVIA............................... 41JARDIANCE.......................... 41jinteli ...................................... 53JULUCA.................................24JYNARQUE........................... 44KALETRA.............................. 24KALYDECO........................... 67KATERZIA............................. 30ketoconazole......................... 18ketodan..................................18ketoprofen................................9ketoprofen er........................... 9ketorolac tromethamine..... 9, 60KEVEYIS............................... 61KEVZARA..............................55KINERET............................... 55kionex.................................... 44KITABIS PAK.........................67klor-con..................................44klor-con 10.............................44klor-con m10..........................44KLOR-CON M15....................44klor-con m20..........................44klor-con sprinkle.................... 44klor-con/ef..............................44KOMBIGLYZE XR................. 41KORLYM............................... 52K-PHOS.................................44k-prime...................................44KRINTAFEL...........................21KUVAN.................................. 48labetalol hcl............................30LACRISERT.......................... 62lactic acid...............................39lactic acid e............................39lactulose................................ 47lactulose encephalopathy...... 47L-ALANINE............................ 44LAMICTAL XR....................... 14

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lamivudine............................. 24lamivudine-zidovudine........... 24lamotrigine............................. 14lamotrigine er.........................14lamotrigine starter kit-blue..... 14lamotrigine starter kit-green...14lamotrigine starter kit-orange.14LANOXIN...............................30lansoprazole.......................... 46lanthanum carbonate.............49LANTUS SOLOSTAR............42LANTUS U-100 VIAL.............42L-ARGININE.......................... 44latanoprost.............................61LATUDA................................ 23L-CYSTINE............................44LEDIPASVIR-SOFOSBUVIR.24leflunomide............................ 55letrozole................................. 21leucovorin calcium................. 21leuprolide acetate.................. 52levalbuterol hcl.......................65LEVALBUTEROL HFA.......... 65LEVEMIR U-100 FLEXTOUCH.........................42LEVEMIR U-100 VIAL........... 42levetiracetam......................... 14levetiracetam er..................... 14levobunolol hcl.......................61levocarnitine.......................... 44levocarnitine sf.......................44levocetirizine dihydrochloride 63levofloxacin......................12, 60levorphanol tartrate..................8levo-t......................................54levothyroxine sodium.............54levoxyl....................................54LEVULAN KERASTICK.........39LEXIVA.................................. 25L-GLUTAMIC ACID............... 44L-GLUTAMIC ACID HCL....... 48L-HISTIDINE MONOHYDROCHLORIDE....44lidocaine................................ 10lidocaine hcl.....................10, 35lidocaine hcl urethral/mucosal.................... 10lidocaine viscous hcl..............35lidocaine-prilocaine................10lindane................................... 21

linezolid..................................12LINZESS................................47liothyronine sodium................54lisinopril ..................................30lisinopril-hydrochlorothiazide. 30L-ISOLEUCINE......................44lithium.................................... 27lithium carbonate................... 27lithium carbonate er............... 27LITHOSTAT...........................49L-LEUCINE............................44L-METHIONINE.....................44LOKELMA..............................44LOMAIRA.............................. 35LONHALA MAGNAIR REFILL KIT............................65LONHALA MAGNAIR STARTER KIT....................... 65loperamide hcl....................... 47lopinavir-ritonavir................... 25lopreeza.................................53lorazepam........................26, 27lorazepam intensol................ 26lorcet........................................8lorcet hd...................................8lorcet plus................................ 8LORTAB.................................. 8losartan potassium................ 30losartan potassium-hctz.........30LOTEMAX SM....................... 60lovastatin............................... 30loxapine succinate................. 23L-PHENYLALANINE..............44L-PROLINE............................44L-TYROSINE......................... 44LUCEMYRA...........................10LUMIGAN.............................. 61L-VALINE...............................45mafenide acetate................... 12MAGNEBIND 400..................45MAGNESIUM CARBONATE.45MAGNESIUM CARBONATE HEAVY.................................. 45malathion............................... 21maprotiline hcl....................... 16MARPLAN............................. 16matzim la............................... 30MAVENCLAD (10 TABS)...... 34MAVENCLAD (4 TABS)........ 34MAVENCLAD (5 TABS)........ 34

MAVENCLAD (6 TABS)........ 34MAVENCLAD (7 TABS)........ 34MAVENCLAD (8 TABS)........ 34MAVENCLAD (9 TABS)........ 34MAVYRET............................. 25MAXIDEX.............................. 60maxi-tuss ac.......................... 63MAYZENT............................. 34MAYZENT STARTER PACK.34meclizine hcl.......................... 17meclofenamate sodium......... 10MEDROL............................... 50medroxyprogesterone acetate...................................53mefenamic acid..................... 10mefloquine hcl....................... 21megestrol acetate.................. 53meloxicam............................. 10memantine hcl....................... 16memantine hcl er................... 16MENOPUR............................ 52meperidine hcl......................... 8meprobamate........................ 27mercaptopurine......................21mesalamine........................... 57mesalamine er....................... 57mesalamine-cleanser............ 57MESNEX............................... 21metadate er........................... 33metaproterenol sulfate...........65metaxalone............................ 68metformin hcl er.....................41metformin hcl ir...................... 41methadone hcl......................... 8methadone hcl intensol............8methadose...............................8methadose sugar-free............. 8methamphetamine hcl........... 33methazolamide...................... 61methenamine hippurate.........12methergine.............................58methimazole.......................... 54METHIONINE........................ 45METHITEST.......................... 51methocarbamol......................68methotrexate..........................56methotrexate sodium............. 56methotrexate sodium (pf).......56methoxsalen rapid................. 39methscopolamine bromide.... 47

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methyldopa............................ 30methyldopa-hydrochlorothiazide............... 30methylergonovine maleate.... 58methylphenidate hcl...............33methylphenidate hcl er.......... 33methylphenidate hcl er (cd)... 33methylphenidate hcl er (la).... 33methylprednisolone............... 50METHYLTESTOSTERONE...51methyltestosterone................ 51metoclopramide hcl............... 17metolazone............................ 30metoprolol succinate er......... 30metoprolol tartrate................. 30metoprolol-hydrochlorothiazide............... 30metronidazole.................. 12, 39mexiletine hcl.........................30MI PASTE..............................35MI PASTE PLUS................... 35MIACALCIN........................... 57miconazole 3......................... 18MICROCHAMBER.................58midazolam hcl........................27midodrine hcl......................... 30MIGERGOT........................... 19miglitol................................... 41miglustat................................ 48MILLIPRED............................51MILLIPRED DP......................50MILLIPRED DP 12-DAY........ 50mimvey.................................. 53mineral oil heavy....................47minocycline hcl...................... 12minoxidil.................................30mirtazapine............................ 16misoprostol............................ 46MITIGARE............................. 19MITOSOL.............................. 60M-NATAL PLUS.................... 45modafinil ................................ 68moexipril hcl...........................30molindone hcl........................ 23mometasone furoate........39, 63mondoxyne nl........................ 12montelukast sodium...............65MONUROL............................ 12morgidox................................12morphine sulfate...................... 8

morphine sulfate (concentrate)........................... 8morphine sulfate er..................8morphine sulfate er beads....... 8MOTEGRITY......................... 47MOVANTIK............................47MOVIPREP............................47moxifloxacin hcl............... 12, 60moxifloxacin hcl (2x day)....... 60MULPLETA............................27MULTAQ................................30mupirocin............................... 12MYALEPT..............................48mycophenolate mofetil ...........56mycophenolate sodium..........56myorisan................................ 39MYRBETRIQ......................... 49MYTESI................................. 47nabumetone...........................10nadolol................................... 30NAFRINSE DAILY ACIDULATED........................35NAFRINSE DAILY/NEUTRAL.................. 35NAFRINSE WEEKLY............ 35naftifine hcl............................ 18NAFTIN..................................18NALOXONE HCL.................. 10naltrexone hcl........................ 10NAMENDA XR TITRATION PACK.....................................16NAMZARIC............................16naproxen................................10naproxen dr........................... 10naproxen sodium................... 10naproxen sodium er...............10naproxen-esomeprazole........10naratriptan hcl........................19NARCAN............................... 10NATACYN............................. 60nateglinide............................. 41NATPARA..............................58NATURE-THROID.................54NAYZILAM.............................14nebusal.................................. 63NEBUSAL..............................64nefazodone hcl...................... 16neomycin sulfate....................12neomycin-bacitracin zn-polymyx................................. 62

neomycin-polymyxin-dexameth...............................62neomycin-polymyxin-gramicidin.............................. 62neomycin-polymyxin-hc... 62, 63NEONATAL PLUS.................45neo-polycin............................ 62neo-polycin hc....................... 62NEO-SYNALAR.....................39NESTABS..............................45neuac.....................................39NEUPRO............................... 22neutral sodium fluoride.......... 35nevirapine.............................. 25nevirapine er..........................25NEXIUM.................................46niacin (antihyperlipidemic)..... 30niacin er (antihyperlipidemic).30niacor.....................................30nicardipine hcl........................30nifedipine............................... 31nifedipine er........................... 30nifedipine er osmotic release.30nimodipine............................. 31nisoldipine er......................... 31nitisinone............................... 48NITRO-BID............................ 31NITRO-DUR.......................... 31nitrofurantoin..........................13nitrofurantoin macrocrystal.... 12nitrofurantoin monohydrate macrocrystals........................ 13nitroglycerin........................... 31NITYR....................................48nizatidine............................... 46nolix....................................... 39norethindrone acetate............53norethindrone-eth estradiol....53NORPACE CR.......................31NORTHERA.......................... 31nortriptyline hcl...................... 16NORVIR.................................25novarel...................................52NOVAREL............................. 52NOVOLIN 70/30 FLEXPEN...42NOVOLIN 70/30 FLEXPEN RELION................................. 42NOVOLIN 70/30 RELION...... 42NOVOLIN 70/30 VIAL............42NOVOLIN N FLEXPEN......... 42

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NOVOLIN N FLEXPEN RELION................................. 43NOVOLIN N RELION............ 43NOVOLIN N VIAL.................. 43NOVOLIN R FLEXPEN......... 43NOVOLIN R FLEXPEN RELION................................. 43NOVOLIN R RELION............ 43NOVOLIN R VIAL.................. 43NOVOLOG FLEXPEN........... 43NOVOLOG MIX 70/30 FLEXPEN.............................. 43NOVOLOG MIX 70/30 VIAL.. 43NOVOLOG PENFILL.............43NOVOLOG U-100 VIAL.........43NOXAFIL............................... 18np thyroid...............................54NUCALA................................ 64NUCYNTA............................... 8NUEDEXTA........................... 35nulev...................................... 47NUPLAZID.............................23NUTROPIN AQ NUSPIN 10.. 52NUTROPIN AQ NUSPIN 20.. 52NUTROPIN AQ NUSPIN 5.... 52nyamyc.................................. 18nystatin.................................. 18nystatin-triamcinolone............18nystop.................................... 19octreotide acetate.................. 52ODACTRA............................. 58ODEFSEY............................. 25OFEV.....................................65ofloxacin.................... 13, 60, 63olanzapine............................. 23olanzapine-fluoxetine hcl....... 16olmesartan medoxomil.......... 31olmesartan medoxomil-hctz...31olmesartan-amlodipine-hctz.. 31olopatadine hcl................ 60, 64OLUMIANT............................ 56omega-3-acid ethyl esters..... 31omeprazole............................46omeprazole-sodium bicarbonate............................46ondansetron hcl..................... 17ondansetron odt.....................17ONE VITE WOMENS PLUS..45ONETOUCH ULTRA BLUE TEST STRIPS....................... 42

ONETOUCH VERIO KIT W/DEVICE.............................42ONEXTON.............................39ONGLYZA............................. 41ONZETRA XSAIL.................. 19OPSUMIT.............................. 67ORACIT................................. 45ORALAIR...............................58ORALAIR ADULT SAMPLE KIT......................................... 58ORALAIR ADULT STARTER PACK................... 58ORALAIR CHILDRENS STARTER PACK................... 58oralone...................................35ORENCIA.............................. 56ORENCIA CLICKJECT..........56ORENITRAM......................... 67ORFADIN.............................. 48ORILISSA.............................. 52ORKAMBI.............................. 67orphenadrine citrate er.......... 68orphenadrine-asa-caffeine.....68ORPHENGESIC FORTE.......68oscimin............................ 47, 48oseltamivir phosphate............25OSMOPREP..........................48OSPHENA............................. 51OTEZLA.................................56OVIDREL...............................52oxandrolone...........................51oxaprozin............................... 10oxazepam.............................. 27oxcarbazepine....................... 15OXERVATE........................... 62oxiconazole nitrate.................19OXTELLAR XR......................15oxybutynin chloride................49oxybutynin chloride er............49oxycodone hcl..........................8oxycodone-acetaminophen..... 8oxycodone-aspirin................... 8OXYCONTIN........................... 8oxymorphone hcl..................... 8oxymorphone hcl er................. 8OZEMPIC.............................. 41pacerone................................31PALFORZIA (12 MG DAILY DOSE)................................... 58

PALFORZIA (120 MG DAILY DOSE)........................58PALFORZIA (160 MG DAILY DOSE)........................58PALFORZIA (20 MG DAILY DOSE)................................... 58PALFORZIA (200 MG DAILY DOSE)........................58PALFORZIA (240 MG DAILY DOSE)........................59PALFORZIA (3 MG DAILY DOSE)................................... 59PALFORZIA (300 MG MAINTENANCE)................... 59PALFORZIA (300 MG TITRATION).......................... 59PALFORZIA (40 MG DAILY DOSE)................................... 59PALFORZIA (6 MG DAILY DOSE)................................... 59PALFORZIA (80 MG DAILY DOSE)................................... 59PALFORZIA INITIAL ESCALATION........................59paliperidone er.......................23PALYNZIQ.............................48PANCREAZE.........................49PANRETIN............................ 21pantoprazole sodium............. 46paricalcitol..............................58paroex....................................35paromomycin sulfate............. 13paroxetine hcl........................ 17paroxetine hcl er.................... 17paroxetine mesylate.............. 17PASER.................................. 20peg 3350-kcl-na bicarb-nacl.. 48peg-3350/electrolytes............ 48PEGANONE.......................... 15PEGASYS............................. 25PEGASYS PROCLICK.......... 25PEGINTRON......................... 25peg-prep................................ 48penicillamine..........................49penicillin v potassium.............13pentamidine isethionate.........21PENTASA..............................57pentazocine-naloxone hcl........8pentoxifylline er......................31PERFOROMIST.................... 65

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perindopril erbumine..............31periogard............................... 36permethrin............................. 21perphenazine.........................17perphenazine-amitriptyline.... 17PERTZYE.............................. 49phenazo.................................49phenazopyridine hcl...............49phendimetrazine tartrate........35phendimetrazine tartrate er... 35phenelzine sulfate..................17phenobarbital.........................15phenobarbital-belladonna alk 48phenoxybenzamine hcl..........31phentermine hcl..................... 35phenylephrine hcl.................. 62phenytoin............................... 15phenytoin infatabs................. 15phenytoin sodium extended...15PHOSLYRA........................... 49PHOSPHOLINE IODIDE....... 61phosphorous..........................45phytonadione......................... 45PICATO................................. 39PIFELTRO............................. 25pilocarpine hcl..................36, 61pimecrolimus......................... 40pimozide................................ 23pindolol.................................. 31pioglitazone hcl......................41pioglitazone hcl-glimepiride... 41pioglitazone hcl-metformin hcl.......................................... 41piroxicam............................... 10PLEGRIDY............................ 34PLEGRIDY STARTER PACK.....................................34PLENVU................................ 48pnv prenatal plus multivit+dha........................... 45pocket spacer........................ 59podofilox................................ 40polycin................................... 62polymyxin b-trimethoprim...... 62posaconazole........................ 19pot bicarb-pot chloride........... 45potassium chloride.................45potassium chloride crys er.....45potassium chloride er............ 45potassium citrate er............... 45

POVIDONE-IODINE.............. 60PRALUENT........................... 31pramipexole dihydrochloride..22pramipexole dihydrochloride er........................................... 22PRAMOTIC............................63prasugrel hcl.......................... 22pravastatin sodium................ 31praziquantel........................... 21prazosin hcl........................... 31PRED MILD........................... 60PRED-G.................................62PRED-G S.O.P...................... 62prednicarbate.........................40prednisolone.......................... 51prednisolone acetate............. 60prednisolone sodium phosphate........................51, 60prednisone.............................51prednisone intensol............... 51PREFEST.............................. 53pregabalin..............................35pregnyl...................................52PREMARIN............................53PREMPHASE........................ 53PREMPRO............................ 53prenatal..................................45prenatal plus iron................... 45PREPOPIK............................ 48PRESTALIA...........................31PRETOMANID.......................20prevalite................................. 31PREVIDENT.......................... 36prevident................................36PREVIDENT 5000 BOOSTER PLUS...................36PREVIDENT 5000 DRY MOUTH................................. 36PREVIDENT 5000 ENAMEL PROTECT............................. 36PREVIDENT 5000 ORTHO DEFENSE..............................36PREVIDENT 5000 PLUS.......36PREVIDENT 5000 SENSITIVE............................36PREVYMIS............................ 25PREZCOBIX..........................25PREZISTA............................. 25PRIFTIN.................................20PRILOSEC............................ 46

primaquine phosphate........... 21primidone...............................15PROAIR HFA.........................65PROAIR RESPICLICK.......... 66probenecid.............................19prochlorperazine....................17prochlorperazine maleate...... 17PROCTOFOAM HC...............57procto-med hc........................57procto-pak..............................57proctosol hc........................... 57proctozone-hc........................57progesterone......................... 53progesterone micronized....... 53PROGRAF.............................56PROMACTA.......................... 27promethazine hcl................... 64promethazine-codeine........... 64promethazine-dm...................64promethazine-phenyleph-codeine.................................. 64promethazine-phenylephrine.64promethegan......................... 64propafenone hcl.....................31propafenone hcl er.................31propantheline bromide...........48proparacaine hcl.................... 62propranolol hcl....................... 31propranolol hcl er...................31propranolol-hctz.....................31propylthiouracil...................... 54protriptyline hcl...................... 17PROVENTIL HFA.................. 66pseudoephedrine-bromphen-dm........................ 64PULMICORT FLEXHALER... 66pulmosal................................ 64PULMOZYME........................67PURIXAN...............................21pyrazinamide......................... 20pyridostigmine bromide......... 20pyridostigmine bromide er..... 20pyrimethamine....................... 21PYROGALLIC ACID.............. 40QBREXZA............................. 40QTERN.................................. 41quetiapine fumarate...............23quetiapine fumarate er...........23QUILLIVANT XR....................33quinapril hcl........................... 31

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quinapril-hydrochlorothiazide.31quinidine gluconate er........... 31quinidine sulfate.....................31quinine sulfate....................... 21QVAR REDIHALER...............66rabeprazole sodium............... 46RADIOGARDASE..................59RAGWITEK........................... 59raloxifene hcl......................... 51ramelteon...............................68ramipril ...................................32ranolazine er..........................32rasagiline mesylate................22RAVICTI................................ 49RAYALDEE........................... 57REBIF.................................... 34REBIF REBIDOSE................ 34REBIF REBIDOSE TITRATION PACK.................34REBIF TITRATION PACK..... 34RECTIV................................. 32REGRANEX.......................... 40RELENZA DISKHALER.........25RELNATE DHA..................... 45REMESENSE........................ 36repaglinide............................. 41REPATHA..............................32REPATHA PUSHTRONEX SYSTEM................................32REPATHA SURECLICK........ 32RESTASIS.............................62RESTASIS MULTIDOSE.......62RESTORA RX....................... 48REYATAZ.............................. 25REYVOW...............................19RHOPRESSA........................ 61ribavirin.................................. 25RIDAURA.............................. 56rifabutin..................................20RIFAMATE............................ 20rifampin..................................20RIFATER............................... 20riluzole................................... 35rimantadine hcl...................... 25RINVOQ................................ 56RIOMET ER...........................41risedronate sodium................ 57risperidone.............................23ritonavir..................................25rivastigmine........................... 16

rivastigmine tartrate............... 16rizatriptan benzoate............... 20ROCKLATAN.........................61ropinirole hcl.......................... 22ropinirole hcl er...................... 22rosadan..................................40rosuvastatin calcium.............. 32roweepra................................15roweepra xr............................15RUZURGI.............................. 59RYBELSUS........................... 41RYTARY................................ 22SACCHARIN......................... 59SAMSCA............................... 45SANDIMMUNE...................... 56SANTYL.................................40SAVELLA...............................35SAVELLA TITRATION PACK.....................................35scopolamine.......................... 17SECONAL............................. 68SEEBRI NEOHALER.............66selegiline hcl.......................... 22selenium sulfide.....................40SELZENTRY......................... 25SEREVENT DISKUS.............66sertraline hcl.......................... 17sevelamer carbonate............. 49sevelamer hcl........................ 50sf............................................36sf 5000 plus........................... 36SIGNIFOR............................. 52sildenafil citrate................50, 67SILIQ..................................... 56silodosin.................................50silver sulfadiazine.................. 13SIMBRINZA........................... 61SIMPONI............................... 56simvastatin.............................32sirolimus................................ 56SIRTURO.............................. 20SITAVIG................................ 25SKLICE..................................22SKYRIZI (150 MG DOSE)..... 56sod citrate-citric acid..............45SODIUM ASCORBATE......... 45sodium bicarbonate............... 48sodium chloride..................... 64sodium fluoride...................... 36sodium fluoride 5000 plus......36

sodium fluoride 5000 ppm..... 36sodium fluoride 5000 sensitive.................................36sodium phenylbutyrate.......... 49sodium polystyrene sulfonate................................ 45sodium saccharin...................59SOFOSBUVIR-VELPATASVIR...................... 25solifenacin succinate............. 50SOLIQUA...............................41SOLTAMOX...........................21SOOLANTRA........................ 40sorine.....................................32sotalol hcl...............................32sotalol hcl (af)........................ 32SOTYLIZE............................. 32spinosad................................ 22SPIRIVA HANDIHALER........ 66SPIRIVA RESPIMAT............. 66spironolactone....................... 32spironolactone-hctz............... 32sps......................................... 45ssd......................................... 13stavudine............................... 25STELARA.............................. 56STIMATE............................... 52STIOLTO RESPIMAT............66STRENSIQ............................ 49STRIBILD.............................. 25STRIVERDI RESPIMAT........ 66SUBSYS.................................. 8subvenite............................... 15subvenite starter kit-blue....... 15subvenite starter kit-green..... 15subvenite starter kit-orange... 15SUCRAID.............................. 49sucralfate............................... 46sulfacetamide sodium............60sulfacetamide sodium (acne).40sulfacetamide sodium-sulfur..40sulfacetamide-prednisolone...62sulfadiazine............................13sulfamethoxazole-trimethoprim...........................13sulfasalazine..........................57sulfatrim pediatric.................. 13sulfurated lime....................... 22sulindac................................. 10sumatriptan............................20

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sumatriptan succinate............20sumatriptan succinate refill .... 20SUPRAX................................13SUPREP BOWEL PREP KIT 48SYMBICORT......................... 66SYMDEKO.............................67SYMFI....................................25SYMFI LO..............................25SYMJEPI............................... 66SYMLINPEN 120...................41SYMLINPEN 60.....................41SYMPROIC........................... 48SYMTUZA............................. 25SYNAREL..............................52SYNJARDY........................... 42SYNJARDY XR..................... 42SYNTHROID......................... 54TACLONEX........................... 40tacrolimus........................ 40, 56tadalafil .................................. 50tadalafil (pah).........................67TAKHZYRO........................... 56TALTZ....................................56tamoxifen citrate.................... 21tamsulosin hcl........................50TARGRETIN..........................21TAURINE...............................45TAVALISSE........................... 27tazarotene..............................40taztia xt.................................. 32TECFIDERA.......................... 34TEGSEDI...............................35TEKTURNA HCT...................32telmisartan............................. 32telmisartan-amlodipine.......... 32telmisartan-hctz..................... 32temazepam............................68TEMIXYS...............................25tencon......................................9tenofovir disoproxil fumarate. 26terazosin hcl.......................... 50terbinafine hcl........................ 19terbutaline sulfate.................. 66terconazole............................ 19testosterone...........................51testosterone cypionate.......... 51testosterone enanthate..........51tetrabenazine.........................35tetracycline hcl.......................13TEXACORT........................... 40

THEO-24............................... 66theophylline........................... 66theophylline er....................... 66THIOLA..................................50THIOLA EC............................50thioridazine hcl.......................23thiothixene............................. 23THREONINE......................... 45tiadylt er................................. 32tiagabine hcl.......................... 15timolol maleate................ 32, 61TIMOPTIC OCUDOSE.......... 61tinidazole............................... 13TIROSINT..............................54TIROSINT-SOL..................... 54TIVICAY.................................26tizanidine hcl..........................68TOBI PODHALER................. 67TOBRADEX...........................62TOBRADEX ST..................... 62tobramycin....................... 60, 67TOBRAMYCIN.......................67tobramycin-dexamethasone.. 62TOBREX................................60TOLAK...................................40tolbutamide............................ 42tolcapone............................... 22tolmetin sodium..................... 10TOLNAFTATE....................... 19tolterodine tartrate................. 50tolterodine tartrate er............. 50tolvaptan................................ 45TOPEX TOPICAL ANESTHETIC........................36topiramate..............................15topiramate er......................... 15torsemide...............................32TOUJEO MAX SOLOSTAR...43TOUJEO SOLOSTAR........... 43tovet.......................................40TOVIAZ..................................50TRACLEER........................... 67tramadol hcl er.........................9tramadol hcl er (biphasic)........ 9tramadol hcl ir.......................... 9tramadol-acetaminophen.........9trandolapril .............................32trandolapril-verapamil hcl er.. 32tranexamic acid..................... 27tranylcypromine sulfate..........17

travoprost (bak free).............. 61trazodone hcl......................... 17TRECATOR...........................20TRELEGY ELLIPTA.............. 66TREMFYA............................. 56TRESIBA............................... 43TRESIBA FLEXTOUCH........ 43tretinoin..................................40tretinoin microsphere............. 40tretinoin microsphere pump... 40TREXALL...............................56triamcinolone acetonide...36, 40triamterene............................ 32triamterene-hctz.....................32trianex....................................40triazolam................................ 27triderm................................... 40trientine hcl............................ 45trifluoperazine hcl.................. 23trifluridine............................... 60trihexyphenidyl hcl................. 22TRIJARDY XR....................... 42TRIKAFTA............................. 67trilyte...................................... 48trimethobenzamide hcl.......... 17trimethoprim...........................13trimipramine maleate............. 17trinate.....................................45TRINTELLIX.......................... 17TRIUMEQ.............................. 26TROKENDI XR...................... 15trospium chloride................... 50trospium chloride er............... 50TRULICITY............................ 42TRUVADA............................. 26TUDORZA PRESSAIR.......... 66TYBOST................................ 26TYMLOS................................57TYVASO................................ 67TYVASO REFILL...................67TYVASO STARTER.............. 67UBRELVY..............................20UCERIS................................. 57unithroid.................................54UPTRAVI............................... 67uretron d/s............................. 50urin ds....................................50ursodiol.................................. 48UTIBRON NEOHALER..........66utrona-c................................. 50

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valacyclovir hcl...................... 26valganciclovir hcl................... 26VALINE..................................46valproic acid...........................15valsartan................................ 32valsartan-hydrochlorothiazide............... 32VALTOCO 10 MG DOSE...... 15VALTOCO 15 MG DOSE...... 15VALTOCO 20 MG DOSE...... 15VALTOCO 5 MG DOSE........ 15vancomycin hcl...................... 13vandazole.............................. 13vardenafil hcl......................... 50VARIZIG................................ 56VASCEPA..............................32VECAMYL............................. 32VELPHORO...........................50VELTASSA............................ 46VEMLIDY...............................26VENELEX.............................. 40venlafaxine hcl.......................17venlafaxine hcl er...................17VENTAVIS.............................67VENTOLIN HFA.................... 66verapamil hcl......................... 33verapamil hcl er..................... 32VERSACLOZ.........................23VIBERZI.................................48VIBRAMYCIN........................ 13VICTOZA............................... 42vigabatrin............................... 15vigadrone...............................15VIMPAT................................. 15VIOKACE...............................49VIRACEPT.............................26VIREAD................................. 26virt-phos 250 neutral..............46virtussin ac w/alc................... 64VISTOGARD......................... 59voriconazole.......................... 19VOSEVI................................. 26vp-pnv-dha.............................46VTOL LQ................................. 9VYNDAMAX.......................... 33VYNDAQEL........................... 33VYVANSE..............................33warfarin sodium..................... 14WESTHROID.........................54wixela inhub...........................66

WP THYROID........................54XARELTO..............................14XARELTO STARTER PACK. 14XELJANZ...............................56XELJANZ XR.........................56XELPROS..............................61XENLETA.............................. 13XEPI...................................... 13XERMELO............................. 48XIFAXAN............................... 13XIGDUO XR.......................... 42XIIDRA...................................62XOFLUZA (40 MG DOSE).....26XOFLUZA (80 MG DOSE).....26XOPENEX HFA..................... 66XULTOPHY........................... 42XURIDEN.............................. 49XYREM..................................68YUPELRI............................... 66yuvafem................................. 54zafirlukast.............................. 66zaleplon................................. 68ZELAPAR.............................. 22zenatane................................40ZENPEP................................ 49ZENZEDI............................... 33zidovudine............................. 26zileuton er.............................. 66ziprasidone hcl.......................23ZIRGAN................................. 60zolmitriptan............................ 20zolpidem tartrate....................68zolpidem tartrate er................68ZOMIG...................................20zonisamide............................ 15ZONTIVITY............................22ZORTRESS........................... 56ZUBSOLV..............................11ZYLET................................... 62

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Non-discrimination notice

Sanford Health Plan does not discriminate against any future, current, or past Member on the basis of race; ethnicity; color; national origin; disability; sex; gender; sexual orientation; gender identity; religion; spiritual beliefs; medical condition, including a current or past history of mental health and substance use disorders; sources of payment for care; or age, in its coverage, treatment, or benefit decisions.

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Provides free aids and services to people with disabilities to communicate effectively with us, such as:

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Provides free language services to people whose primary language is not English, such as: o Qualified interpreters o Information written in other languages

If you need these services, contact our Civil Rights Coordinator, 300 Cherapa Place #201, Sioux Falls, SD 57103, (800) 752-5863, TTY/TDD (877) 652-1844, fax (605) 328-6812, [email protected].

If you believe that Sanford Health Plan has failed to provide these services or discriminated in any way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with our Civil Rights Coordinator (contact information listed above.) You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Civil Rights Coordinator is available to help you.

You can also file a civil rights complaint with the US Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at: US Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, (800) 368-1019, TTY/TDD (800) 537-7697. Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

For help in a language other than English, please call toll-free (800) 892-0675. Free oral and written translation services are available in at least 150 languages. If you have any questions, for example, about your benefits, this document, or how Sanford Health Plan pays for your care, please call us.

ế ạ ế ệ ị ụ ỗ ợ ữ ễ ạ

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This Notice has Important Information. This notice

has important information about your application or

coverage through Sanford Health Plan. Look for key

dates in this notice. You may need to take action by certain

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You have the right to get this information and help in your

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Este Aviso contiene información importante. Este

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Hmong

Tsab ntawv tshaj xo no muaj cov ntshiab lus tseem

ceeb. Tsab ntawv tshaj xo no muaj cov ntsiab lus tseem

ceeb txog koj daim ntawv thov kev pab los yog koj qhov

kev pab cuam los ntawm Sanford Health Plan. Saib cov

caij nyoog los yog tej hnub tseem ceeb uas sau rau hauv

daim ntawv no kom zoo. Tej zaum koj kuj yuav tau ua

qee yam uas peb kom koj ua tsis pub dhau cov caij

nyoog uas teev tseg rau hauv daim ntawv no mas koj

thiaj yuav tau txais kev pab cuam kho mob los yog kev

pab them tej nqi kho mob ntawd. Koj muaj cai kom

lawv muab cov ntshiab lus no uas tau muab sau ua koj

hom lus pub dawb rau koj. Hu rau 1-800-892-

0675.

Cushite

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barbaachisaa qaba. Beeksisti kun

sagantaa yookan karaa Sanford Health

Plan tiin tajaajila keessan ilaalchisee

odeeffannoo barbaachisaa qaba.

Guyyaawwan murteessaa ta’an

beeksisa kana keessatti ilaalaa. Tarii

kaffaltiidhaan deeggaramuuf yookan

tajaajila fayyaa keessaniif guyyaa

dhumaa irratti wanti raawwattan

jiraachuu danda’a. Kaffaltii irraa bilisa

haala ta’een afaan keessaniin

ВНИМАНИЕ Если вы говорите на русском языке то вам доступны бесплатные услуги

перевода Звоните телетайп

ໂປດຊາບ ຖ້າວ່າ ທ່ານເວ ້ າພາສາ ລາວ ການບໍ ລິ ການຊ່ວຍເຫ ຼື ອດ້ານພາສາ ໂດຍບໍ່ ເສັຽຄ່າແມ່ນມີ ພ້ອມໃຫ້ທ່ານ ໂທຣ

رقم ملحوظة إذا كنت تتحدث اذكر ،اللغة فإن خدمات المساعدة اللغویة تتوافر لك بالمجان اتصل برقم

ھاتف الصم والبكم

ማስታወሻ የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር

ይደውሉ መስማት ለተሳናቸው

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