UUHP Exchange Formulary

UUHP Exchange Formulary Table of Contents Analgesic, Anti-Inflammatory Or Antipyretic... Anesthetics...7 Anorectal Preparations...7 Antidotes And Other Reversal Agents... 7 Anti-Infective Agents... 8 Antineoplastics... 4 Biologicals... 6 Cardiovascular Therapy Agents... 7 Central Nervous System Agents... Chemical Dependency, Agents To Treat... Chemicals-Pharmaceutical Adjuvants... Cognitive Disorder Therapy... Contraceptives... Dermatological... 5 Diagnostic Agents...4 Eating Disorder Therapy...4 Electrolyte Balance-Nutritional Products...4 Endocrine...4 Gastrointestinal Therapy Agents... 49 Genitourinary Therapy...5 Gout And Hyperuricemia Therapy... 5 Hematological Agents... 5 Immunosuppressive Agents...55 Locomotor System...55 Medical Supplies And Durable Medical Equipment (Dme)...56 Medical Supply, Fdb Superset...56 Metabolic Modifiers... 57 Mouth-Throat-Dental - Preparations... 57 Multiple Sclerosis Agents...58 Ophthalmic Agents... 58 Otic... 6 Respiratory Therapy Agents...6 Vaginal Products...64

UUHP Exchange Formulary lowercase italics = Generic drugs UPPERCASE BOLD = Brand name drugs Tier = Zero Cost Share Preventive Drugs = Preferred Generic = Non-Preferred Generic, Preferred Brand = Non-Preferred Brand 4 = Specialty Drugs Notes Drug Tier Notes Analgesic, Anti-Inflammatory Or Antipyretic ABSTRAL SUBLINGUAL TABLET MCG, MCG, MCG, 4 MCG, 6 MCG, 8 MCG ; QL acetaminophen-codeine oral tablet - mg, -6 mg QL ACTEMRA SUBCUTANEOUS SYRINGE 6 MG/.9 ML aspirin oral tablet 5 mg QL aspirin oral tablet,delayed release (dr/ec) 8 mg AZASAN ORAL TABLET MG, 75 MG PA azathioprine oral tablet 5 mg buprenorphine hcl injection syringe. mg/ml BUTALBITAL COMPOUND W/CODEINE ORAL CAPSULE -5-5-4 MG BUTALBITAL COMPOUND-CODEINE ORAL CAPSULE -5-5-4 MG butalbital-acetaminop-caf-cod oral capsule 5--4- mg, 5-5-4- mg butalbital-acetaminophen-caff oral tablet 5-5-4 mg butalbital-aspirin-caffeine oral tablet 5-5-4 mg butorphanol tartrate nasal spray,non-aerosol mg/ml QL BUTRANS TRANSDERMAL PATCH WEEKLY MCG/HOUR, 5 MCG/HOUR, MCG/HOUR, 5 MCG/HOUR, 7.5 MCG/HOUR CELEBREX ORAL CAPSULE MG, MG, 4 MG, 5 MG celecoxib oral capsule mg, mg, 4 mg, 5 mg CIMZIA POWDER FOR RECONST SUBCUTANEOUS KIT 4 MG ( MG X VIALS) CIMZIA STARTER KIT SUBCUTANEOUS SYRINGE KIT 4 MG/ ML ( MG/ML X ) CIMZIA SUBCUTANEOUS SYRINGE KIT 4 MG/ ML ( MG/ML X ) codeine sulfate oral tablet 5 mg, mg, 6 mg COMFORT PAC-IBUPROFEN KIT 8 MG COMFORT PAC-MELOXICAM KIT 5 MG COMFORT PAC-NAPROXEN KIT 5 MG QL PA; QL CUPRIMINE ORAL CAPSULE 5 MG cyclophosphamide oral capsule 5 mg, 5 mg cyclosporine modified oral capsule mg, 5 mg, 5 mg cyclosporine modified oral solution mg/ml

cyclosporine oral capsule mg cyclosporine oral capsule 5 mg diclofenac potassium oral tablet 5 mg diclofenac sodium oral tablet extended release 4 hr mg diclofenac sodium oral tablet,delayed release (dr/ec) 5 mg, 5 mg, 75 mg diflunisal oral tablet 5 mg EMBEDA ORAL CAPSULE,ORAL ONLY,EXT.REL PELL -4 MG, -.8 MG, -. MG, 5- MG, 6-.4 MG, 8-. MG ENBREL SUBCUTANEOUS RECON SOLN 5 MG ( ML) ENBREL SUBCUTANEOUS SYRINGE 5 MG/.5ML (.5), 5 MG/ML (.98 ML) ENBREL SURECLICK SUBCUTANEOUS PEN INJECTOR 5 MG/ML (.98 ML) PA ENDOCET ORAL TABLET.5-5 MG QL ENTERIC COATED ASPIRIN ORAL TABLET,DELAYED RELEASE (DR/EC) 8 MG etodolac oral capsule mg, mg etodolac oral tablet 4 mg, 5 mg etodolac oral tablet extended release 4 hr 4 mg, 5 mg, 6 mg FELDENE ORAL CAPSULE MG fenoprofen oral capsule 4 mg fenoprofen oral tablet 6 mg fentanyl citrate buccal lozenge on a handle, mcg,,6 mcg, mcg fentanyl citrate buccal lozenge on a handle 4 mcg, 6 mcg, 8 mcg ; QL fentanyl transdermal patch 7 hour mcg/hr, mcg/hr PA; QL fentanyl transdermal patch 7 hour 5 mcg/hr, 7.5 mcg/hour, 5 mcg/hr, 6.5 mcg/hour, 75 mcg/hr, 87.5 mcg/hour FENTORA BUCCAL TABLET, EFFERVESCENT MCG FENTORA BUCCAL TABLET, EFFERVESCENT MCG, 4 MCG, 6 MCG, 8 MCG flurbiprofen oral tablet mg, 5 mg GENGRAF ORAL CAPSULE MG, 5 MG, 5 MG GENGRAF ORAL SOLUTION MG/ML HUMIRA PEDIATRIC CROHN'S START SUBCUTANEOUS SYRINGE KIT 4 MG/.8 ML HUMIRA PEN CROHN'S-UC-HS START SUBCUTANEOUS PEN INJECTOR KIT 4 MG/.8 ML PA ; QL 4

HUMIRA PEN SUBCUTANEOUS PEN INJECTOR KIT 4 MG/.8 ML HUMIRA SUBCUTANEOUS SYRINGE KIT MG/. ML, MG/.4 ML, 4 MG/.8 ML hydrocodone-acetaminophen oral solution 7.5-5 mg/5 ml hydrocodone-acetaminophen oral tablet -5 mg, 5-5 mg, 7.5-5 mg hydrocodone-ibuprofen oral tablet 7.5- mg hydromorphone oral liquid mg/ml hydromorphone oral tablet mg, 4 mg, 8 mg hydromorphone oral tablet extended release 4 hr mg, 6 mg, mg, 8 mg hydroxychloroquine oral tablet mg HYSINGLA ER ORAL TABLET,ORAL ONLY,EXT.REL.4 HR MG, MG, MG, MG, 4 MG, 6 MG, 8 MG ibuprofen oral tablet 4 mg, 6 mg, 8 mg PA PA ibuprofen-oxycodone oral tablet 4-5 mg QL INDOCIN ORAL SUSPENSION 5 MG/5 ML indomethacin oral capsule 5 mg, 5 mg indomethacin oral capsule, extended release 75 mg ketoprofen oral capsule 5 mg, 75 mg ketorolac oral tablet mg QL LAZANDA NASAL SPRAY,NON-AEROSOL MCG/SPRAY, MCG/SPRAY, 4 MCG/SPRAY ; QL leflunomide oral tablet mg QL leflunomide oral tablet mg LORCET (HYDROCODONE) ORAL TABLET 5-5 MG QL LORCET HD ORAL TABLET -5 MG QL LORCET PLUS ORAL TABLET 7.5-5 MG QL LORTAB ELIXIR ORAL SOLUTION - MG/5 ML meclofenamate oral capsule mg, 5 mg mefenamic acid oral capsule 5 mg meloxicam oral tablet 5 mg, 7.5 mg QL methadone oral concentrate mg/ml PA; QL methadone oral solution mg/5 ml, 5 mg/5 ml PA; QL methadone oral tablet mg, 5 mg PA; QL methotrexate sodium oral tablet.5 mg minocycline oral capsule mg, 5 mg, 75 mg minocycline oral tablet mg, 5 mg, 75 mg MOBIC ORAL TABLET 5 MG morphine concentrate oral solution mg/5 ml ( mg/ml) QL morphine oral capsule, er multiphase 4 hr mg, mg PA; QL 5

morphine oral capsule, er multiphase 4 hr 45 mg, 6 mg, 75 mg, 9 mg morphine oral capsule,extend.release pellets mg, mg, mg morphine oral capsule,extend.release pellets mg, 5 mg, 6 mg, 8 mg morphine oral solution mg/5 ml PA PA; QL PA morphine oral solution mg/5 ml (4 mg/ml) QL morphine oral tablet 5 mg, mg QL morphine oral tablet extended release mg, 5 mg, mg PA; QL morphine oral tablet extended release mg, 6 mg PA mycophenolate mofetil oral capsule 5 mg mycophenolate mofetil oral tablet 5 mg nabumetone oral tablet 5 mg, 75 mg NALFON ORAL CAPSULE 4 MG naproxen oral suspension 5 mg/5 ml naproxen oral tablet 5 mg, 75 mg, 5 mg naproxen oral tablet,delayed release (dr/ec) 75 mg, 5 mg naproxen sodium oral tablet 75 mg, 55 mg NEORAL ORAL CAPSULE MG, 5 MG NEORAL ORAL SOLUTION MG/ML NUCYNTA ORAL TABLET MG, 5 MG, 75 MG PA; QL ORENCIA CLICKJECT SUBCUTANEOUS AUTO- INJECTOR 5 MG/ML ORENCIA SUBCUTANEOUS SYRINGE 5 MG/ML oxaprozin oral tablet 6 mg oxycodone oral tablet mg, 5 mg, mg, mg, 5 mg QL oxycodone-acetaminophen oral solution 5-5 mg/5 ml QL oxycodone-acetaminophen oral tablet -5 mg, 5-5 mg, 7.5-5 mg OXYCONTIN ORAL TABLET,ORAL ONLY,EXT.REL. HR MG OXYCONTIN ORAL TABLET,ORAL ONLY,EXT.REL. HR 5 MG, MG, MG, 4 MG, 6 MG, 8 MG oxymorphone oral tablet mg QL PA; QL PA oxymorphone oral tablet 5 mg QL oxymorphone oral tablet extended release hr mg, 5 mg, mg, mg, 4 mg, 5 mg, 7.5 mg piroxicam oral capsule mg, mg PA; QL RIDAURA ORAL CAPSULE MG ROXICODONE ORAL TABLET 5 MG, MG, 5 MG SUBSYS SUBLINGUAL SPRAY,NON-AEROSOL MCG/SPRAY, MCG/SPRAY, 4 MCG/SPRAY, 6 MCG/SPRAY, 8 MCG/SPRAY 6

sulfasalazine oral tablet 5 mg sulfasalazine oral tablet,delayed release (dr/ec) 5 mg sulindac oral tablet 5 mg, mg tolmetin oral capsule 4 mg tolmetin oral tablet mg, 6 mg tramadol oral capsule,er biphase 4 hr 5-75 5 mg PA tramadol oral tablet 5 mg QL tramadol oral tablet extended release 4 hr mg, mg, mg tramadol oral tablet, er multiphase 4 hr mg, mg, mg tramadol-acetaminophen oral tablet 7.5-5 mg TREXALL ORAL TABLET MG, 5 MG, 5 MG, 7.5 MG PA PA XELJANZ ORAL TABLET 5 MG ; QL XELJANZ XR ORAL TABLET EXTENDED RELEASE 4 HR MG ZEBUTAL ORAL CAPSULE 5-5-4 MG ZIPSOR ORAL CAPSULE 5 MG Anesthetics lidocaine hcl laryngotracheal solution 4 % lidocaine topical ointment 5 % Anorectal Preparations ANUCORT-HC RECTAL SUPPOSITORY 5 MG QL hydrocortisone topical cream with perineal applicator.5 % PROCTOSOL HC TOPICAL CREAM WITH PERINEAL APPLICATOR.5 % PROCTOZONE-HC TOPICAL CREAM WITH PERINEAL APPLICATOR.5 % RECTIV RECTAL OINTMENT.4 % (W/W) Antidotes And Other Reversal Agents acetylcysteine solution mg/ml ( %), mg/ml ( %) CHEMET ORAL CAPSULE MG PA CUPRIMINE ORAL CAPSULE 5 MG FERRIPROX ORAL TABLET 5 MG JADENU ORAL TABLET 8 MG, 6 MG, 9 MG MOVANTIK ORAL TABLET 5 MG naltrexone oral tablet 5 mg NARCAN NASAL SPRAY,NON-AEROSOL 4 MG/ACTUATION RADIOGARDASE ORAL CAPSULE.5 GRAM PA SYPRINE ORAL CAPSULE 5 MG 7

Anti-Infective Agents abacavir oral tablet mg 4 abacavir-lamivudine-zidovudine oral tablet -5- mg acyclovir oral capsule mg acyclovir oral suspension mg/5 ml, mg/5 ml (5 ml) acyclovir oral tablet 4 mg, 8 mg ALINIA ORAL SUSPENSION FOR RECONSTITUTION MG/5 ML 4 PA ALINIA ORAL TABLET 5 MG PA amoxicillin oral capsule 5 mg, 5 mg amoxicillin oral suspension for reconstitution 5 mg/5 ml, mg/5 ml, 5 mg/5 ml, 4 mg/5 ml amoxicillin oral tablet 5 mg, 875 mg amoxicillin oral tablet,chewable 5 mg, 5 mg, 4 mg amoxicillin-pot clavulanate oral suspension for reconstitution -8.5 mg/5 ml, 5-6.5 mg/5 ml, 4-57 mg/5 ml, 6-4.9 mg/5 ml amoxicillin-pot clavulanate oral tablet 5-5 mg, 5-5 mg, 875-5 mg amoxicillin-pot clavulanate oral tablet extended release hr,-6.5 mg amoxicillin-pot clavulanate oral tablet,chewable -8.5 mg, 4-57 mg ampicillin oral capsule 5 mg, 5 mg APTIVUS ORAL CAPSULE 5 MG 4 APTIVUS ORAL SOLUTION MG/ML 4 atovaquone oral suspension 75 mg/5 ml atovaquone-proguanil oral tablet 5- mg, 6.5-5 mg ATRIPLA ORAL TABLET 6-- MG 4 AVIDOXY ORAL TABLET MG azithromycin oral packet gram azithromycin oral suspension for reconstitution mg/5 ml, mg/5 ml azithromycin oral tablet 5 mg, 5 mg, 6 mg BILTRICIDE ORAL TABLET 6 MG CEDAX ORAL CAPSULE 4 MG cefaclor oral capsule 5 mg, 5 mg cefaclor oral suspension for reconstitution 5 mg/5 ml, 5 mg/5 ml, 75 mg/5 ml cefaclor oral tablet extended release hr 5 mg cefadroxil oral capsule 5 mg cefadroxil oral suspension for reconstitution 5 mg/5 ml, 5 mg/5 ml cefadroxil oral tablet gram cefdinir oral capsule mg 8

cefdinir oral suspension for reconstitution 5 mg/5 ml, 5 mg/5 ml cefditoren pivoxil oral tablet mg, 4 mg cefixime oral suspension for reconstitution mg/5 ml, mg/5 ml cefpodoxime oral suspension for reconstitution mg/5 ml, 5 mg/5 ml cefpodoxime oral tablet mg, mg cefprozil oral suspension for reconstitution 5 mg/5 ml, 5 mg/5 ml cefprozil oral tablet 5 mg, 5 mg cefuroxime axetil oral suspension for reconstitution 5 mg/5 ml cefuroxime axetil oral tablet 5 mg, 5 mg cephalexin oral capsule 5 mg cephalexin oral capsule 5 mg cephalexin oral suspension for reconstitution 5 mg/5 ml cephalexin oral suspension for reconstitution 5 mg/5 ml cephalexin oral tablet 5 mg cephalexin oral tablet 5 mg chloroquine phosphate oral tablet 5 mg, 5 mg ciprofloxacin hcl oral tablet mg, 5 mg, 5 mg, 75 mg ciprofloxacin oral suspension,microcapsule recon 5 mg/5 ml, 5 mg/5 ml clarithromycin oral suspension for reconstitution 5 mg/5 ml, 5 mg/5 ml clarithromycin oral tablet 5 mg clarithromycin oral tablet 5 mg clarithromycin oral tablet extended release 4 hr 5 mg clindamycin hcl oral capsule 5 mg, mg, 75 mg clindamycin palmitate hcl oral recon soln 75 mg/5 ml CLINDAMYCIN PEDIATRIC ORAL RECON SOLN 75 MG/5 ML COARTEM ORAL TABLET - MG COMPLERA ORAL TABLET -5- MG 4 CRIXIVAN ORAL CAPSULE MG, 4 MG 4 cycloserine oral capsule 5 mg dapsone oral tablet mg, 5 mg DARAPRIM ORAL TABLET 5 MG demeclocycline oral tablet 5 mg, mg DESCOVY ORAL TABLET -5 MG 4 dicloxacillin oral capsule 5 mg, 5 mg didanosine oral capsule,delayed release(dr/ec) 5 mg, mg, 5 mg, 4 mg DIFICID ORAL TABLET MG ; QL 4 9

doxycycline hyclate oral capsule mg, 5 mg doxycycline hyclate oral tablet mg doxycycline hyclate oral tablet,delayed release (dr/ec) mg, 5 mg, 75 mg doxycycline monohydrate oral capsule mg, 5 mg, 75 mg doxycycline monohydrate oral capsule 5 mg doxycycline monohydrate oral capsule,ir - delay rel,biphase 4 mg doxycycline monohydrate oral suspension for reconstitution 5 mg/5 ml doxycycline monohydrate oral tablet mg, 5 mg, 75 mg E.E.S. 4 ORAL TABLET 4 MG E.E.S. GRANULES ORAL SUSPENSION FOR RECONSTITUTION MG/5 ML EDURANT ORAL TABLET 5 MG 4 EMTRIVA ORAL CAPSULE MG 4 EMTRIVA ORAL SOLUTION MG/ML 4 entecavir oral tablet.5 mg 4 QL entecavir oral tablet mg 4 EPCLUSA ORAL TABLET 4- MG EPZICOM ORAL TABLET 6- MG ERYPED ORAL SUSPENSION FOR RECONSTITUTION MG/5 ML ERYPED 4 ORAL SUSPENSION FOR RECONSTITUTION 4 MG/5 ML ERY-TAB ORAL TABLET,DELAYED RELEASE (DR/EC) 5 MG, MG, 5 MG ERYTHROCIN (AS STEARATE) ORAL TABLET 5 MG erythromycin ethylsuccinate oral suspension for reconstitution mg/5 ml erythromycin ethylsuccinate oral tablet 4 mg erythromycin oral tablet 5 mg, 5 mg erythromycin stearate oral tablet 5 mg ethambutol oral tablet mg, 4 mg EVOTAZ ORAL TABLET -5 MG 4 FACTIVE ORAL TABLET MG famciclovir oral tablet 5 mg, 5 mg, 5 mg QL fluconazole oral suspension for reconstitution mg/ml, 4 mg/ml fluconazole oral tablet mg, 5 mg, mg, 5 mg flucytosine oral capsule 5 mg, 5 mg FUZEON SUBCUTANEOUS RECON SOLN 9 MG GENVOYA ORAL TABLET 5-5-- MG 4 griseofulvin microsize oral suspension 5 mg/5 ml

griseofulvin microsize oral tablet 5 mg griseofulvin ultramicrosize oral tablet 5 mg, 5 mg HEPSERA ORAL TABLET MG hydroxychloroquine oral tablet mg INVIRASE ORAL CAPSULE MG 4 INVIRASE ORAL TABLET 5 MG 4 ISENTRESS ORAL POWDER IN PACKET MG 4 ISENTRESS ORAL TABLET 4 MG 4 ISENTRESS ORAL TABLET,CHEWABLE MG, 5 MG isoniazid oral solution 5 mg/5 ml isoniazid oral tablet mg, mg itraconazole oral capsule mg PA ketoconazole oral tablet mg lamivudine oral tablet mg, 5 mg, mg 4 lamivudine-zidovudine oral tablet 5- mg 4 levofloxacin oral solution 5 mg/ ml levofloxacin oral tablet 5 mg, 5 mg, 75 mg LEXIVA ORAL SUSPENSION 5 MG/ML 4 LEXIVA ORAL TABLET 7 MG 4 linezolid oral tablet 6 mg lopinavir-ritonavir oral solution 4- mg/5 ml 4 MAVYRET ORAL TABLET -4 MG mefloquine oral tablet 5 mg metronidazole oral capsule 75 mg metronidazole oral tablet 5 mg, 5 mg minocycline oral capsule mg, 5 mg, 75 mg minocycline oral tablet mg, 5 mg, 75 mg minocycline oral tablet extended release 4 hr 5 mg, 45 mg, 9 mg MONDOXYNE NL ORAL CAPSULE MG, 75 MG MONDOXYNE NL ORAL CAPSULE 5 MG MORGIDOX X KIT MG MORGIDOX X KIT MG MORGIDOX ORAL CAPSULE MG moxifloxacin oral tablet 4 mg NEBUPENT INHALATION RECON SOLN MG neomycin oral tablet 5 mg nevirapine oral suspension 5 mg/5 ml 4 nevirapine oral tablet mg 4 nevirapine oral tablet extended release 4 hr 4 mg 4 NORVIR ORAL CAPSULE MG 4 NORVIR ORAL SOLUTION 8 MG/ML 4 NORVIR ORAL TABLET MG 4 4

nystatin oral tablet 5, unit ODEFSEY ORAL TABLET -5-5 MG 4 ofloxacin oral tablet mg, 4 mg ORAVIG BUCCAL MUCO-ADHESIVE BUCCAL TABLET 5 MG oseltamivir oral capsule 75 mg PEGASYS PROCLICK SUBCUTANEOUS PEN INJECTOR 5 MCG/.5 ML, 8 MCG/.5 ML PEGASYS SUBCUTANEOUS SYRINGE 8 MCG/.5 ML PA ; QL ; QL PEGINTRON SUBCUTANEOUS KIT 5 MCG/.5 ML ; QL penicillin v potassium oral recon soln 5 mg/5 ml, 5 mg/5 ml penicillin v potassium oral tablet 5 mg, 5 mg PREZISTA ORAL SUSPENSION MG/ML 4 PREZISTA ORAL TABLET 5 MG, 6 MG, 75 MG, 8 MG PRIFTIN ORAL TABLET 5 MG primaquine oral tablet 6. mg PRIMSOL ORAL SOLUTION 5 MG/5 ML pyrazinamide oral tablet 5 mg quinine sulfate oral capsule 4 mg RELENZA DISKHALER INHALATION BLISTER WITH DEVICE 5 MG/ACTUATION RESCRIPTOR ORAL TABLET MG 4 RESCRIPTOR ORAL TABLET, DISPERSIBLE MG REYATAZ ORAL CAPSULE 5 MG, MG, MG REYATAZ ORAL POWDER IN PACKET 5 MG 4 4 QL RIBASPHERE ORAL CAPSULE MG RIBASPHERE ORAL TABLET MG, 4 MG, 6 MG RIBASPHERE RIBAPAK ORAL TABLETS,DOSE PACK 4 MG (7)- 4 MG (7), 4-4 MG (8)-MG (8), 6 MG (7)- 4 MG (7), 6 MG (7)- 6 MG (7), 6-4 MG (8)-MG (8), 6-6 MG (8)-MG (8) 4 4 ribavirin oral capsule mg ribavirin oral tablet mg rifabutin oral capsule 5 mg rifampin oral capsule 5 mg, mg RIFATER ORAL TABLET 5-- MG rimantadine oral tablet mg SELZENTRY ORAL TABLET 5 MG, MG SIRTURO ORAL TABLET MG SIVEXTRO ORAL TABLET MG SOVALDI ORAL TABLET 4 MG

stavudine oral capsule 5 mg, mg, mg, 4 mg 4 stavudine oral recon soln mg/ml 4 STRIBILD ORAL TABLET 5-5-- MG 4 STROMECTOL ORAL TABLET MG sulfadiazine oral tablet 5 mg sulfamethoxazole-trimethoprim oral suspension -4 mg/5 ml sulfamethoxazole-trimethoprim oral tablet 4-8 mg, 8-6 mg SULFATRIM ORAL SUSPENSION -4 MG/5 ML SUPRAX ORAL SUSPENSION FOR RECONSTITUTION MG/5 ML TAMIFLU ORAL CAPSULE MG, 45 MG, 75 MG QL TAMIFLU ORAL SUSPENSION FOR RECONSTITUTION 6 MG/ML QL TECHNIVIE ORAL TABLET.5-75-5 MG terbinafine hcl oral tablet 5 mg tetracycline oral capsule 5 mg PA tetracycline oral capsule 5 mg THALOMID ORAL CAPSULE MG, 5 MG, MG, 5 MG TIVICAY ORAL TABLET MG, 5 MG, 5 MG 4 TRECATOR ORAL TABLET 5 MG trimethoprim oral tablet mg TRIUMEQ ORAL TABLET 6-5- MG 4 TRUVADA ORAL TABLET -5 MG, - MG, 67-5 MG, - MG valacyclovir oral tablet gram, 5 mg ; QL 4 QL VALCYTE ORAL TABLET 45 MG valganciclovir oral tablet 45 mg vancomycin oral capsule 5 mg, 5 mg PA; QL VIBRAMYCIN ORAL CAPSULE MG VIEKIRA PAK ORAL TABLETS,DOSE PACK.5 MG-75 MG -5 MG/5 MG VIEKIRA XR ORAL TABLET, IR - ER, BIPHASIC 4HR 8. MG-5 MG-. MG- MG VIREAD ORAL POWDER 4 MG/SCOOP (4 MG/GRAM) VIREAD ORAL TABLET 5 MG, MG, 5 MG, MG voriconazole oral tablet mg, 5 mg PA XIFAXAN ORAL TABLET MG, 55 MG PA ZEPATIER ORAL TABLET 5- MG ; QL zidovudine oral capsule mg 4 zidovudine oral syrup mg/ml 4 zidovudine oral tablet mg 4 4 4

ZITHROMAX ORAL PACKET GRAM ZITHROMAX ORAL TABLET 5 MG ZMAX ORAL SUSPENSION,EXTENDED REL RECON GRAM/6 ML ZYVOX ORAL SUSPENSION FOR RECONSTITUTION MG/5 ML PA ZYVOX ORAL TABLET 6 MG PA Antineoplastics AFINITOR DISPERZ ORAL TABLET FOR SUSPENSION MG, MG, 5 MG AFINITOR ORAL TABLET MG,.5 MG, 5 MG, 7.5 MG ; QL ALECENSA ORAL CAPSULE 5 MG anastrozole oral tablet mg QL bexarotene oral capsule 75 mg bicalutamide oral tablet 5 mg CABOMETYX ORAL TABLET MG, 4 MG, 6 MG capecitabine oral tablet 5 mg, 5 mg COTELLIC ORAL TABLET MG cromolyn oral concentrate mg/5 ml cyclophosphamide oral capsule 5 mg, 5 mg EMCYT ORAL CAPSULE 4 MG ERIVEDGE ORAL CAPSULE 5 MG ; QL exemestane oral tablet 5 mg FARESTON ORAL TABLET 6 MG PA FARYDAK ORAL CAPSULE MG, 5 MG, MG flutamide oral capsule 5 mg GLEEVEC ORAL TABLET MG, 4 MG ; QL GLEOSTINE ORAL CAPSULE MG, MG, 4 MG HEXALEN ORAL CAPSULE 5 MG hydroxyurea oral capsule 5 mg IBRANCE ORAL CAPSULE MG, 5 MG, 75 MG ICLUSIG ORAL TABLET 5 MG, 45 MG imatinib oral tablet mg, 4 mg IMBRUVICA ORAL CAPSULE 4 MG INTRON A INJECTION RECON SOLN MILLION UNIT ( ML), 8 MILLION UNIT ( ML), 5 MILLION UNIT ( ML) INTRON A INJECTION SOLUTION MILLION UNIT/ML, 6 MILLION UNIT/ML JAKAFI ORAL TABLET MG, 5 MG, MG, 5 MG, 5 MG ; QL 4

LENVIMA ORAL CAPSULE MG/DAY ( MG X /DAY), 4 MG/DAY( MG X -4 MG X ), MG/DAY ( MG X ), 4 MG/DAY( MG X -4 MG X ) letrozole oral tablet.5 mg leucovorin calcium oral tablet mg, 5 mg, 5 mg, 5 mg LEUKERAN ORAL TABLET MG leuprolide subcutaneous kit mg/. ml leuprolide subcutaneous solution mg/. ml LONSURF ORAL TABLET 5-6.4 MG, -8.9 MG LUPRON DEPOT ( MONTH) INTRAMUSCULAR SYRINGE KIT.5 MG LUPRON DEPOT (4 MONTH) INTRAMUSCULAR SYRINGE KIT MG LUPRON DEPOT (6 MONTH) INTRAMUSCULAR SYRINGE KIT 45 MG LUPRON DEPOT INTRAMUSCULAR SYRINGE KIT 7.5 MG LYNPARZA ORAL CAPSULE 5 MG LYSODREN ORAL TABLET 5 MG MATULANE ORAL CAPSULE 5 MG megestrol oral tablet mg, 4 mg MEKINIST ORAL TABLET.5 MG, MG mercaptopurine oral tablet 5 mg methotrexate sodium (pf) injection recon soln gram methotrexate sodium (pf) injection solution 5 mg/ml methotrexate sodium injection solution 5 mg/ml methotrexate sodium oral tablet.5 mg NEXAVAR ORAL TABLET MG ; QL NILANDRON ORAL TABLET 5 MG PA NINLARO ORAL CAPSULE. MG, MG, 4 MG ODOMZO ORAL CAPSULE MG PURIXAN ORAL SUSPENSION MG/ML REVLIMID ORAL CAPSULE MG, 5 MG,.5 MG, MG, 5 MG, 5 MG SPRYCEL ORAL TABLET MG, 4 MG, MG, 5 MG, 7 MG, 8 MG ; QL ; QL STIVARGA ORAL TABLET 4 MG SUTENT ORAL CAPSULE.5 MG, 5 MG, 7.5 MG, 5 MG ; QL TABLOID ORAL TABLET 4 MG TAFINLAR ORAL CAPSULE 5 MG, 75 MG TAGRISSO ORAL TABLET 4 MG, 8 MG tamoxifen oral tablet mg, mg QL TARCEVA ORAL TABLET MG, 5 MG, 5 MG ; QL TARGRETIN ORAL CAPSULE 75 MG 5

TASIGNA ORAL CAPSULE 5 MG, MG ; QL THALOMID ORAL CAPSULE MG, 5 MG, MG, 5 MG ; QL tretinoin (chemotherapy) oral capsule mg TREXALL ORAL TABLET MG, 5 MG, 5 MG, 7.5 MG TYKERB ORAL TABLET 5 MG ; QL VENCLEXTA ORAL TABLET MG, MG, 5 MG VOTRIENT ORAL TABLET MG ; QL XALKORI ORAL CAPSULE MG ; QL XALKORI ORAL CAPSULE 5 MG ZOLINZA ORAL CAPSULE MG ; QL ZYKADIA ORAL CAPSULE 5 MG ZYTIGA ORAL TABLET 5 MG Biologicals AFLURIA 7-8 (PF) INTRAMUSCULAR SYRINGE 45 MCG (5 MCG X )/.5 ML AFLURIA 7-8 INTRAMUSCULAR SUSPENSION 45 MCG (5 MCG X )/.5 ML AFLURIA QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 6 MCG/.5 ML AFLURIA QUAD 7-8 INTRAMUSCULAR SUSPENSION 6 MCG/.5 ML FLUAD 7-8 (65 YR UP)(PF) INTRAMUSCULAR SYRINGE 45 MCG (5 MCG X )/.5 ML FLUARIX QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 6 MCG (5 MCG X 4)/.5 ML FLUBLOK 7-8 (PF) INTRAMUSCULAR SOLUTION 5 MCG (45 MCG X )/.5 ML FLUBLOK QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 8 MCG (45 MCG X 4)/.5 ML FLUCELVAX QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 6 MCG (5 MCG X 4)/.5 ML FLUCELVAX QUAD 7-8 INTRAMUSCULAR SUSPENSION 6 MCG (5 MCG X 4)/.5 ML FLULAVAL QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 6 MCG (5 MCG X 4)/.5 ML FLULAVAL QUAD 7-8 INTRAMUSCULAR SUSPENSION 6 MCG (5 MCG X 4)/.5 ML FLUMIST QUAD 7-8 NASAL NASAL SPRAY SYRINGE EXP6.5-7.5 FF UNIT/. ML FLUVIRIN 7-8 (PF) INTRAMUSCULAR SYRINGE 45 MCG (5 MCG X )/.5 ML FLUVIRIN 7-8 INTRAMUSCULAR SUSPENSION 45 MCG (5 MCG X )/.5 ML 6

FLUZONE HIGH-DOSE 7-8 (PF) INTRAMUSCULAR SYRINGE 8 MCG/.5 ML FLUZONE INTRADERM QUAD 7-8 INTRADERMAL SYRINGE 6 MCG/. ML FLUZONE QUAD 7-8 (PF) INTRAMUSCULAR SUSPENSION 6 MCG (5 MCG X 4)/.5 ML FLUZONE QUAD 7-8 (PF) INTRAMUSCULAR SYRINGE 6 MCG (5 MCG X 4)/.5 ML FLUZONE QUAD 7-8 INTRAMUSCULAR SUSPENSION 6 MCG (5 MCG X 4)/.5 ML FLUZONE QUAD PEDI 7-8 (PF) INTRAMUSCULAR SYRINGE MCG (7.5 MCG X 4)/.5 ML HYQVIA SUBCUTANEOUS SOLUTION GRAM / ML ( %),.5 GRAM /5 ML ( %), GRAM / ML ( %), GRAM / ML ( %), 5 GRAM /5 ML ( %) Cardiovascular Therapy Agents acebutolol oral capsule mg, 4 mg ADCIRCA ORAL TABLET MG ; QL AFEDITAB CR ORAL TABLET EXTENDED RELEASE MG, 6 MG amiloride oral tablet 5 mg amiloride-hydrochlorothiazide oral tablet 5-5 mg amiodarone oral tablet mg, mg, 4 mg amlodipine oral tablet mg,.5 mg, 5 mg amlodipine-benazepril oral capsule - mg, -4 mg, 5- mg, 5- mg amlodipine-valsartan oral tablet 5-6 mg atenolol oral tablet mg, 5 mg, 5 mg atenolol-chlorthalidone oral tablet -5 mg atorvastatin oral tablet mg, mg, 4 mg, 8 mg QL benazepril oral tablet mg, mg, 4 mg, 5 mg benazepril-hydrochlorothiazide oral tablet -5 mg betaxolol oral tablet mg, mg bisoprolol fumarate oral tablet mg, 5 mg bisoprolol-hydrochlorothiazide oral tablet -6.5 mg,.5-6.5 mg, 5-6.5 mg bumetanide oral tablet.5 mg, mg, mg BYSTOLIC ORAL TABLET MG,.5 MG, MG, 5 MG QL candesartan oral tablet 6 mg, mg QL candesartan oral tablet 4 mg, 8 mg candesartan-hydrochlorothiazid oral tablet -5 mg QL captopril oral tablet mg,.5 mg, 5 mg, 5 mg CARTIA XT ORAL CAPSULE,EXTENDED RELEASE 4HR MG, 8 MG, 4 MG, MG 7

carvedilol oral tablet.5 mg,.5 mg, 6.5 mg carvedilol oral tablet 5 mg chlorothiazide oral tablet 5 mg, 5 mg chlorthalidone oral tablet 5 mg, 5 mg cholestyramine (with sugar) oral powder 4 gram cholestyramine (with sugar) oral powder in packet 4 gram clonidine hcl oral tablet. mg,. mg,. mg clonidine transdermal patch weekly. mg/4 hr,. mg/4 hr,. mg/4 hr colestipol oral granules 5 gram colestipol oral packet 5 gram colestipol oral tablet gram COREG CR ORAL CAPSULE, ER MULTIPHASE 4 HR MG CRESTOR ORAL TABLET MG, MG, 4 MG, 5 MG QL PA; QL DIBENZYLINE ORAL CAPSULE MG DIGOX ORAL TABLET 5 MCG, 5 MCG digoxin oral solution.5 mg/5 ml (5 ml), 5 mcg/ml digoxin oral tablet 5 mcg, 5 mcg DILATRATE-SR ORAL CAPSULE, EXTENDED RELEASE 4 MG diltiazem hcl oral capsule,ext.rel 4h degradable mg, 8 mg, 4 mg diltiazem hcl oral capsule,extended release hr mg, 6 mg, 9 mg diltiazem hcl oral capsule,extended release 4 hr mg, 8 mg, 4 mg, mg, 6 mg, 4 mg diltiazem hcl oral capsule,extended release 4hr mg, 8 mg, 4 mg, mg, 6 mg diltiazem hcl oral tablet mg, mg, 6 mg, 9 mg diltiazem hcl oral tablet extended release 4 hr 8 mg, 4 mg, mg, 6 mg, 4 mg DILT-XR ORAL CAPSULE,EXT.REL 4H DEGRADABLE MG, 8 MG, 4 MG disopyramide phosphate oral capsule mg DIURIL ORAL SUSPENSION 5 MG/5 ML doxazosin oral tablet mg, mg, 4 mg, 8 mg DYRENIUM ORAL CAPSULE MG, 5 MG EDARBI ORAL TABLET 4 MG, 8 MG QL EDECRIN ORAL TABLET 5 MG PA enalapril maleate oral tablet mg,.5 mg, mg, 5 mg enalapril-hydrochlorothiazide oral tablet -5 mg epinephrine injection auto-injector. mg/. ml QL eplerenone oral tablet 5 mg, 5 mg eprosartan oral tablet 6 mg QL 8

ezetimibe oral tablet mg felodipine oral tablet extended release 4 hr mg,.5 mg, 5 mg fenofibrate micronized oral capsule mg, 4 mg, mg, 4 mg, 67 mg fenofibrate nanocrystallized oral tablet 45 mg, 48 mg fenofibrate oral capsule 5 mg, 5 mg fenofibrate oral tablet 6 mg, 54 mg fenofibric acid oral tablet 5 mg fenofibric acid oral tablet 5 mg FIRAZYR SUBCUTANEOUS SYRINGE MG/ ML flecainide oral tablet mg, 5 mg, 5 mg fluvastatin oral capsule mg, 4 mg QL fluvastatin oral tablet extended release 4 hr 8 mg QL fosinopril oral tablet mg, mg, 4 mg furosemide oral solution mg/ml, 4 mg/4 ml furosemide oral tablet mg, 4 mg, 8 mg gemfibrozil oral tablet 6 mg guanfacine oral tablet mg, mg QL hydralazine oral tablet mg, mg, 5 mg, 5 mg hydrochlorothiazide oral capsule.5 mg hydrochlorothiazide oral tablet.5 mg, 5 mg hydrochlorothiazide oral tablet 5 mg indapamide oral tablet.5 mg,.5 mg INDERAL LA ORAL CAPSULE,EXTENDED RELEASE 4 HR MG, 8 MG INDERAL XL ORAL CAPSULE,EXTENDED RELEASE 4HR MG, 8 MG irbesartan oral tablet 5 mg, mg, 75 mg QL irbesartan-hydrochlorothiazide oral tablet -.5 mg QL ISOCHRON ORAL TABLET EXTENDED RELEASE 4 MG ISORDIL ORAL TABLET 4 MG isosorbide dinitrate oral tablet mg, mg, mg, 5 mg isosorbide dinitrate oral tablet extended release 4 mg isosorbide mononitrate oral tablet mg, mg isosorbide mononitrate oral tablet extended release 4 hr mg, mg, 6 mg isradipine oral capsule.5 mg, 5 mg labetalol oral tablet mg, mg, mg LANOXIN ORAL TABLET 5 MCG, 5 MCG LANOXIN ORAL TABLET 87.5 MCG, 6.5 MCG LASIX ORAL TABLET 4 MG LETAIRIS ORAL TABLET MG, 5 MG LEVATOL ORAL TABLET MG 9

lisinopril oral tablet mg,.5 mg, mg, mg, 4 mg, 5 mg lisinopril-hydrochlorothiazide oral tablet -.5 mg, -.5 mg, -5 mg LIVALO ORAL TABLET MG, MG PA; QL LIVALO ORAL TABLET 4 MG QL losartan oral tablet mg losartan oral tablet 5 mg, 5 mg QL losartan-hydrochlorothiazide oral tablet -.5 mg, - 5 mg, 5-.5 mg lovastatin oral tablet mg, mg, 4 mg QL MATZIM LA ORAL TABLET EXTENDED RELEASE 4 HR 8 MG, 4 MG, MG, 6 MG, 4 MG methazolamide oral tablet 5 mg, 5 mg methyclothiazide oral tablet 5 mg methyldopa oral tablet 5 mg, 5 mg metolazone oral tablet mg,.5 mg, 5 mg metoprolol succinate oral tablet extended release 4 hr mg, mg, 5 mg, 5 mg metoprolol ta-hydrochlorothiaz oral tablet 5-5 mg metoprolol tartrate oral tablet mg, 5 mg, 5 mg mexiletine oral capsule 5 mg, mg, 5 mg midodrine oral tablet mg,.5 mg, 5 mg MINITRAN TRANSDERMAL PATCH 4 HOUR. MG/HR,. MG/HR,.4 MG/HR,.6 MG/HR minoxidil oral tablet mg,.5 mg moexipril oral tablet 5 mg, 7.5 mg MULTAQ ORAL TABLET 4 MG QL nadolol oral tablet mg, 4 mg, 8 mg NIACOR ORAL TABLET 5 MG nicardipine oral capsule mg, mg nifedipine oral capsule mg, mg nifedipine oral tablet extended release 4hr mg, 6 mg, 9 mg nifedipine oral tablet extended release mg, 6 mg, 9 mg nimodipine oral capsule mg nisoldipine oral tablet extended release 4 hr 7 mg, mg, 5.5 mg, mg, 4 mg, 4 mg, 8.5 mg NITRO-BID TRANSDERMAL OINTMENT % nitroglycerin sublingual tablet.4 mg nitroglycerin transdermal patch 4 hour. mg/hr,. mg/hr,.4 mg/hr,.6 mg/hr nitroglycerin translingual aerosol,spray 4 mcg/spray nitroglycerin translingual spray,non-aerosol 4 mcg/spray NITROLINGUAL TRANSLINGUAL SPRAY,NON- AEROSOL 4 MCG/SPRAY

NITROMIST TRANSLINGUAL AEROSOL,SPRAY 4 MCG/SPRAY NITROSTAT SUBLINGUAL TABLET. MG,.4 MG,.6 MG NORPACE CR ORAL CAPSULE, EXTENDED RELEASE MG, 5 MG ST olmesartan oral tablet mg, 4 mg, 5 mg QL omega- acid ethyl esters oral capsule gram OPSUMIT ORAL TABLET MG PACERONE ORAL TABLET MG, MG, 4 MG perindopril erbumine oral tablet mg, 4 mg, 8 mg phenoxybenzamine oral capsule mg pindolol oral tablet mg, 5 mg PRAVACHOL ORAL TABLET 4 MG QL pravastatin oral tablet mg, mg, 4 mg, 8 mg QL prazosin oral capsule mg, mg, 5 mg PREVALITE ORAL POWDER 4 GRAM PREVALITE ORAL POWDER IN PACKET 4 GRAM propafenone oral capsule,extended release hr 5 mg, 5 mg, 45 mg propafenone oral tablet 5 mg, 5 mg, mg propranolol oral capsule,extended release 4 hr mg, 6 mg, 6 mg, 8 mg propranolol oral solution mg/5 ml (4 mg/ml), 4 mg/5 ml (8 mg/ml) propranolol oral tablet mg, mg, 4 mg, 6 mg, 8 mg QUESTRAN ORAL POWDER 4 GRAM QUESTRAN ORAL POWDER IN PACKET 4 GRAM quinapril oral tablet mg, mg, 4 mg, 5 mg quinapril-hydrochlorothiazide oral tablet -5 mg quinidine gluconate oral tablet extended release 4 mg quinidine sulfate oral tablet mg, mg ramipril oral capsule.5 mg, mg,.5 mg, 5 mg RANEXA ORAL TABLET EXTENDED RELEASE HR, MG, 5 MG rosuvastatin oral tablet mg, mg, 4 mg, 5 mg SAMSCA ORAL TABLET 5 MG, MG sildenafil (antihypertensive) oral tablet mg ; QL simvastatin oral tablet mg, mg, 4 mg, 5 mg, 8 mg QL SORINE ORAL TABLET MG, 6 MG, 4 MG, 8 MG sotalol oral tablet mg, 6 mg, 4 mg, 8 mg spironolactone oral tablet mg, 5 mg, 5 mg spironolacton-hydrochlorothiaz oral tablet 5-5 mg

TAZTIA XT ORAL CAPSULE,EXTENDED RELEASE 4 HR MG, 8 MG, 4 MG, MG, 6 MG TEKTURNA ORAL TABLET 5 MG, MG QL telmisartan oral tablet mg, 4 mg, 8 mg QL terazosin oral capsule mg, mg, mg, 5 mg TIKOSYN ORAL CAPSULE 5 MCG, 5 MCG, 5 MCG timolol maleate oral tablet mg, mg, 5 mg TOPROL XL ORAL TABLET EXTENDED RELEASE 4 HR MG, MG, 5 MG, 5 MG torsemide oral tablet mg, mg, mg, 5 mg PA TRACLEER ORAL TABLET 5 MG, 6.5 MG trandolapril oral tablet mg, mg, 4 mg triamterene-hydrochlorothiazid oral capsule 7.5-5 mg triamterene-hydrochlorothiazid oral tablet 7.5-5 mg, 75-5 mg TRICOR ORAL TABLET 48 MG valsartan oral tablet 6 mg, mg, 8 mg valsartan oral tablet 4 mg QL valsartan-hydrochlorothiazide oral tablet 6-.5 mg, 6-5 mg, -5 mg, 8-.5 mg VASCEPA ORAL CAPSULE GRAM QL VENTAVIS INHALATION SOLUTION FOR NEBULIZATION MCG/ML, MCG/ML verapamil oral capsule, 4 hr er pellet ct mg, mg, mg verapamil oral capsule,ext rel. pellets 4 hr mg, 8 mg, 4 mg, 6 mg verapamil oral tablet mg, 4 mg, 8 mg verapamil oral tablet extended release mg, 8 mg, 4 mg ZETIA ORAL TABLET MG PA; QL Central Nervous System Agents ADDERALL ORAL TABLET MG,.5 MG, 5 MG, MG, MG, 5 MG ADZENYS XR-ODT ORAL TABLET,DISINTEG ER BIPHASE 4H.5 MG, 5.7 MG, 8.8 MG,. MG, 6. MG, 9.4 MG almotriptan malate oral tablet.5 mg, 6.5 mg ALPRAZOLAM INTENSOL ORAL CONCENTRATE MG/ML alprazolam oral tablet.5 mg,.5 mg, mg, mg alprazolam oral tablet extended release 4 hr.5 mg, mg, mg, mg alprazolam oral tablet,disintegrating.5 mg,.5 mg, mg, mg PA; QL amantadine hcl oral capsule mg

amantadine hcl oral solution 5 mg/5 ml amantadine hcl oral tablet mg amitriptyline oral tablet mg, mg, 5 mg, 5 mg, 75 mg amitriptyline oral tablet 5 mg amoxapine oral tablet mg, 5 mg, 5 mg, 5 mg APLENZIN ORAL TABLET EXTENDED RELEASE 4 HR 74 MG, 48 MG, 5 MG aripiprazole oral solution mg/ml aripiprazole oral tablet mg, 5 mg, mg, mg, mg, 5 mg aripiprazole oral tablet 5 mg, mg, mg, 5 mg aripiprazole oral tablet mg ST QL armodafinil oral tablet 5 mg, mg, 5 mg, 5 mg QL AXERT ORAL TABLET.5 MG, 6.5 MG PA; QL BANZEL ORAL SUSPENSION 4 MG/ML PA BANZEL ORAL TABLET MG, 4 MG PA BELSOMRA ORAL TABLET MG, 5 MG, MG, 5 MG benztropine oral tablet.5 mg, mg, mg ST BRIVIACT ORAL SOLUTION MG/ML PA BRIVIACT ORAL TABLET MG, MG, 5 MG, 5 MG, 75 MG bromocriptine oral capsule 5 mg bromocriptine oral tablet.5 mg bupropion hcl oral tablet mg, 75 mg bupropion hcl oral tablet extended release hr mg, 5 mg, mg bupropion hcl oral tablet extended release 4 hr 5 mg, mg buspirone oral tablet mg, 5 mg, mg, 5 mg, 7.5 mg carbamazepine oral capsule, er multiphase hr mg, mg, mg carbamazepine oral suspension mg/5 ml, mg/5 ml (5 ml), mg/ ml carbamazepine oral tablet mg carbamazepine oral tablet extended release hr mg, mg, 4 mg carbamazepine oral tablet,chewable mg carbidopa-levodopa oral tablet - mg, 5- mg, 5-5 mg carbidopa-levodopa oral tablet extended release 5- mg, 5- mg carbidopa-levodopa oral tablet,disintegrating - mg, 5- mg, 5-5 mg CELEXA ORAL TABLET 4 MG CELONTIN ORAL CAPSULE MG PA

chlorpromazine oral tablet mg, mg, mg, 5 mg chlorpromazine oral tablet 5 mg citalopram oral solution mg/5 ml citalopram oral tablet mg, mg, 4 mg clomipramine oral capsule 5 mg, 5 mg, 75 mg clonazepam oral tablet.5 mg, mg, mg clorazepate dipotassium oral tablet.75 mg clozapine oral tablet mg, mg, 5 mg, 5 mg clozapine oral tablet,disintegrating mg,.5 mg, 5 mg desipramine oral tablet mg, mg, 5 mg, 5 mg, 5 mg, 75 mg desvenlafaxine succinate oral tablet extended release 4 hr 5 mg dexmethylphenidate oral capsule,er biphasic 5-5 5 mg QL dexmethylphenidate oral capsule,er biphasic 5-5 mg, 4 mg dexmethylphenidate oral tablet mg,.5 mg, 5 mg QL dextroamphetamine oral capsule, extended release mg, 5 mg, 5 mg dextroamphetamine oral tablet mg QL dextroamphetamine oral tablet 5 mg QL dextroamphetamine-amphetamine oral capsule,extended release 4hr mg, 5 mg, mg, 5 mg, mg, 5 mg dextroamphetamine-amphetamine oral tablet mg,.5 mg, 5 mg, mg, mg, 5 mg diazepam injection solution 5 mg/ml DIAZEPAM INTENSOL ORAL CONCENTRATE 5 MG/ML diazepam oral concentrate 5 mg/ml diazepam oral solution 5 mg/5 ml ( mg/ml), 5 mg/5 ml ( mg/ml, 5 ml) diazepam oral tablet mg, mg, 5 mg QL QL dihydroergotamine injection solution mg/ml PA dihydroergotamine nasal spray,non-aerosol.5 mg/pump act. (4 mg/ml) DILANTIN EXTENDED ORAL CAPSULE MG DILANTIN KAPSEAL ORAL CAPSULE MG DILANTIN KAPSEAL ORAL CAPSULE MG DILANTIN ORAL CAPSULE MG divalproex oral capsule, delayed rel sprinkle 5 mg divalproex oral tablet extended release 4 hr 5 mg, 5 mg divalproex oral tablet,delayed release (dr/ec) 5 mg, 5 mg, 5 mg doxepin oral capsule mg, mg, 5 mg, 5 mg, 5 mg, 75 mg PA doxepin oral concentrate mg/ml 4

duloxetine oral capsule,delayed release(dr/ec) mg, mg, 4 mg, 6 mg EFFEXOR XR ORAL CAPSULE,EXTENDED RELEASE 4HR 7.5 MG ST eletriptan hbr oral tablet mg, 4 mg QL EMSAM TRANSDERMAL PATCH 4 HOUR MG/4 HR, 6 MG/4 HR, 9 MG/4 HR entacapone oral tablet mg EPITOL ORAL TABLET MG EQUETRO ORAL CAPSULE, ER MULTIPHASE HR MG, MG, MG escitalopram oxalate oral solution 5 mg/5 ml escitalopram oxalate oral tablet mg, mg, 5 mg QL eszopiclone oral tablet mg, mg, mg QL ethosuximide oral capsule 5 mg FANAPT ORAL TABLET MG, MG, MG, MG, 4 MG, 6 MG, 8 MG FANAPT ORAL TABLETS,DOSE PACK MG()- MG()- 4MG()-6MG() felbamate oral suspension 6 mg/5 ml felbamate oral tablet 4 mg, 6 mg FETZIMA ORAL CAPSULE,EXTENDED RELEASE 4 HR MG, MG, 4 MG, 8 MG fluoxetine oral capsule mg, 4 mg fluoxetine oral capsule mg fluoxetine oral capsule,delayed release(dr/ec) 9 mg fluoxetine oral solution mg/5 ml (4 mg/ml) fluoxetine oral tablet mg, mg fluoxetine oral tablet 6 mg fluphenazine hcl oral concentrate 5 mg/ml fluphenazine hcl oral elixir.5 mg/5 ml fluphenazine hcl oral tablet mg, mg,.5 mg, 5 mg fluvoxamine oral tablet mg, 5 mg, 5 mg FORFIVO XL ORAL TABLET EXTENDED RELEASE 4 HR 45 MG PA; QL PA; QL PA ST frovatriptan oral tablet.5 mg QL gabapentin oral capsule mg, mg, 4 mg gabapentin oral solution 5 mg/5 ml, 5 mg/5 ml (5 ml), mg/6 ml (6 ml) gabapentin oral tablet 6 mg, 8 mg guanfacine oral tablet extended release 4 hr mg, mg, mg, 4 mg haloperidol lactate oral concentrate mg/ml haloperidol oral tablet.5 mg, mg, mg, mg, mg, 5 mg QL HORIZANT ORAL TABLET EXTENDED RELEASE MG 5

hydroxyzine hcl oral solution mg/5 ml, mg/5 ml (5 ml) hydroxyzine hcl oral tablet mg, 5 mg, 5 mg hydroxyzine pamoate oral capsule mg, 5 mg, 5 mg imipramine hcl oral tablet mg, 5 mg, 5 mg imipramine pamoate oral capsule mg, 5 mg, 5 mg, 75 mg INVEGA ORAL TABLET EXTENDED RELEASE 4HR.5 MG, MG, 6 MG, 9 MG lamotrigine oral tablet mg, 5 mg, mg, 5 mg lamotrigine oral tablet extended release 4hr 5 mg lamotrigine oral tablet, chewable dispersible 5 mg, 5 mg lamotrigine oral tablets,dose pack 5 mg (5), 5 mg (84) - mg (4) LATUDA ORAL TABLET MG, MG, 4 MG, 6 MG, 8 MG levetiracetam oral solution mg/ml, 5 mg/5 ml (5 ml) levetiracetam oral tablet, mg, 5 mg, 5 mg, 75 mg levetiracetam oral tablet extended release 4 hr 5 mg, 75 mg lithium carbonate oral capsule 5 mg, mg lithium carbonate oral capsule 6 mg lithium carbonate oral tablet mg lithium carbonate oral tablet extended release mg, 45 mg lithium citrate oral solution 8 meq/5 ml, 8 meq/5 ml (5 ml) PA; QL PA; QL LODOSYN ORAL TABLET 5 MG PA LORAZEPAM INTENSOL ORAL CONCENTRATE MG/ML lorazepam oral concentrate mg/ml lorazepam oral tablet.5 mg, mg, mg loxapine succinate oral capsule mg, 5 mg, 5 mg, 5 mg LYRICA ORAL CAPSULE MG, 5 MG, MG, 5 MG, 5 MG, MG, 5 MG, 75 MG LYRICA ORAL SOLUTION MG/ML maprotiline oral tablet 5 mg, 5 mg, 75 mg MARPLAN ORAL TABLET MG meprobamate oral tablet mg, 4 mg METADATE ER ORAL TABLET EXTENDED RELEASE MG methamphetamine oral tablet 5 mg QL methylphenidate hcl oral capsule, er biphasic -7 mg, mg, mg, 4 mg, 5 mg, 6 mg methylphenidate hcl oral capsule,er biphasic 5-5 mg, mg, 4 mg QL QL methylphenidate hcl oral solution mg/5 ml, 5 mg/5 ml QL methylphenidate hcl oral tablet mg, mg, 5 mg QL 6

methylphenidate hcl oral tablet extended release mg, mg methylphenidate hcl oral tablet extended release 4hr 8 mg, 7 mg, 6 mg, 54 mg methylphenidate hcl oral tablet,chewable mg,.5 mg, 5 mg MIGRANAL NASAL SPRAY,NON-AEROSOL.5 MG/PUMP ACT. (4 MG/ML) mirtazapine oral tablet 5 mg, mg, 45 mg, 7.5 mg mirtazapine oral tablet,disintegrating 5 mg, mg, 45 mg QL QL QL QL modafinil oral tablet mg, mg QL naratriptan oral tablet mg,.5 mg QL nefazodone oral tablet mg, 5 mg, mg, 5 mg, 5 mg nortriptyline oral capsule mg, 5 mg, 5 mg, 75 mg nortriptyline oral solution mg/5 ml NUPLAZID ORAL TABLET 7 MG olanzapine oral tablet mg, 5 mg,.5 mg, mg, 5 mg, 7.5 mg olanzapine oral tablet,disintegrating mg QL olanzapine oral tablet,disintegrating 5 mg, 5 mg QL ORAP ORAL TABLET MG, MG PA oxcarbazepine oral suspension mg/5 ml (6 mg/ml) oxcarbazepine oral tablet 5 mg, mg, 6 mg paliperidone oral tablet extended release 4hr.5 mg, mg, 6 mg, 9 mg paroxetine hcl oral tablet mg, mg, mg, 4 mg paroxetine hcl oral tablet extended release 4 hr.5 mg, 5 mg, 7.5 mg PEGANONE ORAL TABLET 5 MG perphenazine oral tablet 6 mg, mg, 4 mg, 8 mg phenelzine oral tablet 5 mg phenobarbital oral tablet 5 mg, mg phenobarbital oral tablet 64.8 mg PHENYTEK ORAL CAPSULE MG phenytoin oral suspension mg/4 ml, 5 mg/5 ml phenytoin oral tablet,chewable 5 mg phenytoin sodium extended oral capsule mg, mg, mg pimozide oral tablet mg, mg pramipexole oral tablet.5 mg,.5 mg,.5 mg,.75 mg, mg,.5 mg pramipexole oral tablet extended release 4 hr.75 mg,.75 mg,.5 mg,.5 mg, mg,.75 mg, 4.5 mg primidone oral tablet 5 mg, 5 mg PA PRISTIQ ORAL TABLET EXTENDED RELEASE 4 PA; QL HR MG, 5 MG 7

protriptyline oral tablet mg, 5 mg quetiapine oral tablet mg, mg, 5 mg, mg, 4 mg, 5 mg QL quetiapine oral tablet extended release 4 hr 5 mg QL QUILLICHEW ER ORAL TABLET,CHEW,IR- ER.BIPHASIC4HR MG, MG, 4 MG QUILLIVANT XR ORAL SUSPENSION,EXT REL 4HR,RECON 5 MG/ML (5 MG/5 ML) rasagiline oral tablet mg QL QL RELPAX ORAL TABLET MG, 4 MG QL REXULTI ORAL TABLET.5 MG,.5 MG, MG, MG, MG, 4 MG PA; QL risperidone oral solution mg/ml QL risperidone oral tablet.5 mg,.5 mg, mg, mg, mg, 4 mg risperidone oral tablet,disintegrating.5 mg,.5 mg, mg, mg, mg, 4 mg QL QL rizatriptan oral tablet mg, 5 mg QL rizatriptan oral tablet,disintegrating mg QL ropinirole oral tablet.5 mg,.5 mg, mg, mg, mg, 4 mg, 5 mg ropinirole oral tablet extended release 4 hr mg, mg, 4 mg, 6 mg, 8 mg ROZEREM ORAL TABLET 8 MG ST; QL SABRIL ORAL POWDER IN PACKET 5 MG SABRIL ORAL TABLET 5 MG SAPHRIS (BLACK CHERRY) SUBLINGUAL TABLET MG,.5 MG, 5 MG SAVELLA ORAL TABLET MG,.5 MG, 5 MG, 5 MG selegiline hcl oral capsule 5 mg selegiline hcl oral tablet 5 mg SEROQUEL XR ORAL TABLET EXTENDED RELEASE 4 HR MG, 5 MG sertraline oral concentrate mg/ml sertraline oral tablet mg, 5 mg, 5 mg STRATTERA ORAL CAPSULE MG, MG, 5 MG, 4 MG, 6 MG, 8 MG PA; QL QL ST; QL STRATTERA ORAL CAPSULE 8 MG ST; QL sumatriptan nasal spray,non-aerosol mg/actuation, 5 mg/actuation QL sumatriptan succinate oral tablet mg, 5 mg, 5 mg QL sumatriptan succinate subcutaneous cartridge 4 mg/.5 ml, 6 mg/.5 ml sumatriptan succinate subcutaneous pen injector 6 mg/.5 ml QL QL sumatriptan succinate subcutaneous solution 6 mg/.5 ml QL 8

sumatriptan succinate subcutaneous syringe 6 mg/.5 ml SUMAVEL DOSEPRO SUBCUTANEOUS NEEDLE- FREE INJECTOR 4 MG/.5 ML, 6 MG/.5 ML PA TASMAR ORAL TABLET MG temazepam oral capsule 5 mg,.5 mg, mg, 7.5 mg tetrabenazine oral tablet.5 mg, 5 mg thioridazine oral tablet mg, mg, 5 mg, 5 mg thiothixene oral capsule mg, mg, mg, 5 mg tiagabine oral tablet mg, 4 mg tolcapone oral tablet mg topiramate oral capsule,sprinkle,er 4hr mg, 5 mg, mg, 5 mg, 5 mg topiramate oral tablet mg, mg, 5 mg, 5 mg tranylcypromine oral tablet mg trazodone oral tablet mg, 5 mg, mg, 5 mg triazolam oral tablet.5 mg trifluoperazine oral tablet mg, mg, mg, 5 mg trihexyphenidyl oral elixir.4 mg/ml trihexyphenidyl oral tablet mg, 5 mg trimipramine oral capsule mg, 5 mg, 5 mg TRINTELLIX ORAL TABLET MG, MG, 5 MG PA valproic acid (as sodium salt) oral solution 5 mg/5 ml, 5 mg/5 ml (5 ml), 5 mg/ ml ( ml) valproic acid oral capsule 5 mg venlafaxine oral capsule,extended release 4hr 5 mg, 7.5 mg, 75 mg venlafaxine oral tablet mg, 5 mg, 7.5 mg, 75 mg venlafaxine oral tablet extended release 4hr 5 mg, 7.5 mg, 75 mg venlafaxine oral tablet extended release 4hr 5 mg ST VIIBRYD ORAL TABLET MG, MG, 4 MG ST VIIBRYD ORAL TABLETS,DOSE PACK MG (7)- MG () ST VIMPAT ORAL SOLUTION MG/ML PA VIMPAT ORAL TABLET MG, 5 MG, MG, 5 MG VRAYLAR ORAL CAPSULE.5 MG, MG, 4.5 MG, 6 MG VYVANSE ORAL CAPSULE MG, MG, 4 MG, 5 MG, 6 MG, 7 MG PA ST VYVANSE ORAL CAPSULE MG QL WELLBUTRIN SR ORAL TABLET EXTENDED RELEASE HR MG, 5 MG XENAZINE ORAL TABLET.5 MG, 5 MG zaleplon oral capsule mg, 5 mg QL 9

ZELAPAR ORAL TABLET,DISINTEGRATING.5 MG ZENZEDI ORAL TABLET MG, 5 MG PA ziprasidone hcl oral capsule mg, 4 mg, 6 mg, 8 mg QL zolmitriptan oral tablet.5 mg, 5 mg zolmitriptan oral tablet,disintegrating.5 mg, 5 mg ZOLOFT ORAL TABLET MG zolpidem oral tablet mg, 5 mg QL zolpidem oral tablet,ext release multiphase.5 mg, 6.5 mg QL ZOMIG ORAL TABLET.5 MG, 5 MG PA; QL ZOMIG ZMT ORAL TABLET,DISINTEGRATING.5 MG ZOMIG ZMT ORAL TABLET,DISINTEGRATING 5 MG zonisamide oral capsule mg, 5 mg, 5 mg Chemical Dependency, Agents To Treat PA; QL PA buprenorphine hcl sublingual tablet mg, 8 mg QL buprenorphine-naloxone sublingual tablet -.5 mg, 8- mg QL bupropion hcl (smoking deter) oral tablet extended release hr 5 mg bupropion hcl oral tablet extended release hr 5 mg CHANTIX CONTINUING MONTH BOX ORAL TABLET MG QL QL CHANTIX ORAL TABLET.5 MG, MG QL CHANTIX STARTING MONTH BOX ORAL TABLETS,DOSE PACK.5 MG ()- MG (4) disulfiram oral tablet 5 mg, 5 mg nicotine transdermal patch 4 hour 4 mg/4 hr, mg/4 hr QL NICOTROL INHALATION CARTRIDGE MG QL NICOTROL NS NASAL SPRAY,NON-AEROSOL MG/ML QL SUBOXONE SUBLINGUAL FILM 8- MG PA Chemicals-Pharmaceutical Adjuvants benzoin compound (bulk) tincture isopropyl alcohol solution 7 % polyethylene glycol 5(bulk) powder Cognitive Disorder Therapy donepezil oral tablet mg, 5 mg donepezil oral tablet,disintegrating mg, 5 mg ergoloid oral tablet mg galantamine oral capsule,ext rel. pellets 4 hr 6 mg, 4 mg, 8 mg galantamine oral solution 4 mg/ml galantamine oral tablet mg, 4 mg, 8 mg

memantine oral tablet mg NAMENDA XR ORAL CAPSULE,SPRINKLE,ER 4HR 4 MG, MG, 8 MG, 7 MG rivastigmine tartrate oral capsule.5 mg, mg, 4.5 mg, 6 mg Contraceptives AFTERA ORAL TABLET.5 MG AMETHIA LO ORAL TABLETS,DOSE PACK, MONTH. MG- MCG (84)/ MCG (7) AMETHIA ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG (84)/ MCG (7) AMETHYST ORAL TABLET 9- MCG APRI ORAL TABLET.5-. MG ASHLYNA ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG (84)/ MCG (7) AVIANE ORAL TABLET.- MG-MCG AZURETTE (8) ORAL TABLET.5-. MGX /. MG X 5 BALZIVA (8) ORAL TABLET.4-5 MG-MCG BEKYREE (8) ORAL TABLET.5-. MGX /. MG X 5 BLISOVI 4 FE ORAL TABLET MG- MCG (4)/75 MG (4) BLISOVI FE.5/ (8) ORAL TABLET.5 MG- MCG ()/75 MG (7) BLISOVI FE / (8) ORAL TABLET MG- MCG ()/75 MG (7) CAMILA ORAL TABLET.5 MG CAMRESE ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG (84)/ MCG (7) CAZIANT (8) ORAL TABLET./.5/.5-5 MG- MCG CRYSELLE (8) ORAL TABLET.- MG-MCG CYCLAFEM /5 (8) ORAL TABLET -5 MG-MCG CYCLAFEM 7/7/7 (8) ORAL TABLET.5/.75/ MG- 5 MCG CYRED ORAL TABLET.5-. MG DASETTA /5 (8) ORAL TABLET -5 MG-MCG DASETTA 7/7/7 (8) ORAL TABLET.5/.75/ MG- 5 MCG DEBLITANE ORAL TABLET.5 MG DELYLA (8) ORAL TABLET.- MG-MCG desog-e.estradiol/e.estradiol oral tablet.5-. mgx /. mg x 5 desogestrel-ethinyl estradiol oral tablet.5-. mg drospirenone-ethinyl estradiol oral tablet -. mg, -. mg ST ECONTRA EZ ORAL TABLET.5 MG

ELINEST ORAL TABLET.- MG-MCG ELLA ORAL TABLET MG EMOQUETTE ORAL TABLET.5-. MG ENSKYCE ORAL TABLET.5-. MG ERRIN ORAL TABLET.5 MG ESTARYLLA ORAL TABLET.5-5 MG-MCG FALMINA (8) ORAL TABLET.- MG-MCG GIANVI (8) ORAL TABLET -. MG GILDAGIA ORAL TABLET.4-5 MG-MCG HEATHER ORAL TABLET.5 MG JENCYCLA ORAL TABLET.5 MG JOLESSA ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG JOLIVETTE ORAL TABLET.5 MG JULEBER ORAL TABLET.5-. MG JUNEL.5/ () ORAL TABLET.5- MG-MCG JUNEL / () ORAL TABLET - MG-MCG JUNEL FE.5/ (8) ORAL TABLET.5 MG- MCG ()/75 MG (7) JUNEL FE / (8) ORAL TABLET MG- MCG ()/75 MG (7) JUNEL FE 4 ORAL TABLET MG- MCG (4)/75 MG (4) KAITLIB FE ORAL TABLET,CHEWABLE.8MG- 5MCG(4) AND 75 MG (4) KARIVA (8) ORAL TABLET.5-. MGX /. MG X 5 KELNOR /5 (8) ORAL TABLET -5 MG-MCG KIMIDESS (8) ORAL TABLET.5-. MGX /. MG X 5 KURVELO ORAL TABLET.5-. MG LARIN.5/ () ORAL TABLET.5- MG-MCG LARIN / () ORAL TABLET - MG-MCG LARIN 4 FE ORAL TABLET MG- MCG (4)/75 MG (4) LARIN FE.5/ (8) ORAL TABLET.5 MG- MCG ()/75 MG (7) LARIN FE / (8) ORAL TABLET MG- MCG ()/75 MG (7) LARISSIA ORAL TABLET.- MG-MCG LAYOLIS FE ORAL TABLET,CHEWABLE.8MG- 5MCG(4) AND 75 MG (4) LESSINA ORAL TABLET.- MG-MCG LEVONEST (8) ORAL TABLET 5- (6)/75-4 (5)/5-() levonorgestrel-ethinyl estrad oral tablet.- mg-mcg,.5-. mg

levonorgestrel-ethinyl estrad oral tablets,dose pack, month.5 mg- mcg LEVORA.5/ (8) ORAL TABLET.5-. MG LEVORA-8 ORAL TABLET.5-. MG LO LOESTRIN FE ORAL TABLET MG- MCG (4)/ MCG () LOMEDIA 4 FE ORAL TABLET MG- MCG (4)/75 MG (4) LORYNA (8) ORAL TABLET -. MG LOW-OGESTREL (8) ORAL TABLET.- MG- MCG LUTERA (8) ORAL TABLET.- MG-MCG LYZA ORAL TABLET.5 MG MARLISSA ORAL TABLET.5-. MG medroxyprogesterone intramuscular suspension 5 mg/ml medroxyprogesterone intramuscular syringe 5 mg/ml MICROGESTIN.5/ () ORAL TABLET.5- MG-MCG MICROGESTIN / () ORAL TABLET - MG- MCG MICROGESTIN 4 FE ORAL TABLET MG- MCG (4)/75 MG (4) MICROGESTIN FE.5/ (8) ORAL TABLET.5 MG- MCG ()/75 MG (7) MICROGESTIN FE / (8) ORAL TABLET MG- MCG ()/75 MG (7) MIRENA INTRAUTERINE INTRAUTERINE DEVICE MCG/4 HR (5 YEARS) MONO-LINYAH ORAL TABLET.5-5 MG-MCG MONONESSA (8) ORAL TABLET.5-5 MG-MCG MYZILRA ORAL TABLET 5- (6)/75-4 (5)/5- () NECON.5/5 (8) ORAL TABLET.5-5 MG-MCG NECON /5 (8) ORAL TABLET -5 MG-MCG NECON 7/7/7 (8) ORAL TABLET.5/.75/ MG- 5 MCG NIKKI (8) ORAL TABLET -. MG NORA-BE ORAL TABLET.5 MG noreth-ethinyl estradiol-iron oral tablet,chewable.8mg- 5mcg(4) and 75 mg (4) norethindrone (contraceptive) oral tablet.5 mg norethindrone ac-eth estradiol oral tablet - mg-mcg norethindrone-e.estradiol-iron oral tablet mg- mcg ()/75 mg (7) norgestimate-ethinyl estradiol oral tablet.8/.5/.5 mg-5 mcg (8) NORLYROC ORAL TABLET.5 MG

NORTREL /5 (8) ORAL TABLET -5 MG-MCG NUVARING VAGINAL RING.-.5 MG/4 HR OCELLA ORAL TABLET -. MG OPCICON ONE-STEP ORAL TABLET.5 MG ORSYTHIA ORAL TABLET.- MG-MCG ORTHO TRI-CYCLEN LO (8) ORAL TABLET.8/.5/.5 MG-5 MCG PIMTREA (8) ORAL TABLET.5-. MGX /. MG X 5 PIRMELLA ORAL TABLET.5/.75/ MG- 5 MCG, -5 MG-MCG PORTIA ORAL TABLET.5-. MG PREVIFEM ORAL TABLET.5-5 MG-MCG QUASENSE ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG RECLIPSEN (8) ORAL TABLET.5-. MG SETLAKIN ORAL TABLETS,DOSE PACK, MONTH.5 MG- MCG SHAROBEL ORAL TABLET.5 MG SPRINTEC (8) ORAL TABLET.5-5 MG-MCG SRONYX ORAL TABLET.- MG-MCG TAKE ACTION ORAL TABLET.5 MG TARINA FE / (8) ORAL TABLET MG- MCG ()/75 MG (7) TAYTULLA ORAL CAPSULE MG- MCG (4)/75 MG (4) TRI-ESTARYLLA ORAL TABLET.8/.5/.5 MG-5 MCG (8) TRI-LINYAH ORAL TABLET.8/.5/.5 MG-5 MCG (8) TRI-LO-ESTARYLLA ORAL TABLET.8/.5/.5 MG-5 MCG TRI-LO-MARZIA ORAL TABLET.8/.5/.5 MG-5 MCG TRI-LO-SPRINTEC ORAL TABLET.8/.5/.5 MG-5 MCG TRINESSA (8) ORAL TABLET.8/.5/.5 MG- 5 MCG (8) TRINESSA LO ORAL TABLET.8/.5/.5 MG-5 MCG TRI-PREVIFEM (8) ORAL TABLET.8/.5/.5 MG-5 MCG (8) TRI-SPRINTEC (8) ORAL TABLET.8/.5/.5 MG-5 MCG (8) VELIVET TRIPHASIC REGIMEN (8) ORAL TABLET./.5/.5-5 MG-MCG VESTURA (8) ORAL TABLET -. MG VIENVA ORAL TABLET.- MG-MCG 4

VIORELE (8) ORAL TABLET.5-. MGX /. MG X 5 VYFEMLA (8) ORAL TABLET.4-5 MG-MCG WERA (8) ORAL TABLET.5-5 MG-MCG WYMZYA FE ORAL TABLET,CHEWABLE.4MG- 5MCG() AND 75 MG (7) XULANE TRANSDERMAL PATCH WEEKLY 5-5 MCG/4 HR ZARAH ORAL TABLET -. MG Dermatological ACANYA TOPICAL GEL WITH PUMP.-.5 % ST acitretin oral capsule mg, 7.5 mg, 5 mg PA acyclovir topical ointment 5 % QL adapalene topical cream. % adapalene topical gel. %,. % adapalene topical gel with pump. % AGONEAZE TOPICAL KIT.5-.5 % alclometasone topical cream.5 % alclometasone topical ointment.5 % ALTABAX TOPICAL OINTMENT % amcinonide topical cream. % amcinonide topical lotion. % amcinonide topical ointment. % ammonium lactate topical cream % ANODYNE LPT TOPICAL KIT.5-.5 % AVITA TOPICAL CREAM.5 % AVITA TOPICAL GEL.5 % AZELEX TOPICAL CREAM % ST bacitracin topical ointment 5 unit/gram bacitracin topical packet 5 unit/gram benzoin compound (bulk) tincture benzoin compound topical tincture BENZOIN COMPOUND TOPICAL TINCTURE -- 8-4 % betamethasone dipropionate topical cream.5 % betamethasone dipropionate topical lotion.5 % betamethasone dipropionate topical ointment.5 % betamethasone valerate topical cream. % betamethasone valerate topical lotion. % betamethasone valerate topical ointment. % betamethasone, augmented topical cream.5 % betamethasone, augmented topical gel.5 % betamethasone, augmented topical lotion.5 % betamethasone, augmented topical ointment.5 % 5

calcipotriene scalp solution.5 % calcipotriene topical cream.5 % calcitriol topical ointment mcg/gram camphor topical spirit CICLODAN KIT TOPICAL COMBO PACK.77 % CICLODAN KIT TOPICAL SOLUTION 8 % CICLODAN TOPICAL CREAM.77 % CICLODAN TOPICAL SOLUTION 8 % ciclopirox topical cream.77 % ciclopirox topical gel.77 % ciclopirox topical shampoo % ciclopirox topical solution 8 % ciclopirox topical suspension.77 % ciclopirox-ure-camph-menth-euc topical solution 8 % CLARAVIS ORAL CAPSULE MG, MG, MG, 4 MG CLINDACIN ETZ TOPICAL KIT % CLINDACIN ETZ TOPICAL SWAB % CLINDACIN P TOPICAL SWAB % CLINDACIN PAC TOPICAL KIT % CLINDAGEL TOPICAL GEL % clindamycin phosphate topical foam % clindamycin phosphate topical gel % clindamycin phosphate topical lotion % clindamycin phosphate topical solution % clindamycin phosphate topical swab % clindamycin-benzoyl peroxide topical gel -5 % clindamycin-benzoyl peroxide topical gel with pump -5 % clobetasol scalp solution.5 % clobetasol topical cream.5 % clobetasol topical foam.5 % clobetasol topical gel.5 % clobetasol topical lotion.5 % clobetasol topical ointment.5 % clobetasol topical shampoo.5 % clobetasol topical spray,non-aerosol.5 % clobetasol-emollient topical cream.5 % clobetasol-emollient topical foam.5 % clocortolone pivalate topical cream. % CLODAN KIT TOPICAL KIT,SHAMPOO AND CLEANSER.5 % CLODAN TOPICAL SHAMPOO.5 % clotrimazole-betamethasone topical cream -.5 % QL CORDRAN TOPICAL LOTION.5 % PA 6