ALABAMA MEDICAID AGENCY Maximum Quantity Listing

Transcription

1 Alabama Medicaid provides reimbursement for most covered outpatient pharmacy drugs based on a day supply. Some maintenance classes are required to be billed as a three month supply; however, this listing is based on a day supply. Maximum units are based according to Food and Drug Administration (FDA) approved indications. If a patient needs a quantity greater than the current maximum unit quantity, an override request including appropriate medical justification must be submitted. The list is subject to change. For additional PDL and coverage information, visit our drug look-up site at ACARBOSE ORAL 00 MG 02 ACARBOSE ORAL 25 MG 02 ACARBOSE ORAL 50 MG 02 ACEBUTOLOL HCL ORAL 200 MG 36 ACEBUTOLOL HCL ORAL 400 MG ACETAMINOPHEN WITH CODEINE ORAL 20-2MG/5 ORAL SUSP 480 ACETAMINOPHEN WITH CODEINE ORAL 20-2MG/5 SOLUTION 480 ACETAMINOPHEN WITH CODEINE ORAL 0MG/2.5 SOLUTION 480 ACETAMINOPHEN WITH CODEINE ORAL 0MG-5MG ACETAMINOPHEN WITH CODEINE ORAL 0MG-MG ACETAMINOPHEN WITH CODEINE ORAL 0MG-60MG ACETAMINOPHEN/PHENYLTOLX CIT ORAL MG ACETAMINOPHEN/PHENYLTOLX CIT ORAL 650MG- 50MG ACETIC ACID/OXYQUINOLINE VAGINAL % JELLY/APPL 50 ACITRETIN ORAL 0 MG ACITRETIN ORAL 7.5 MG ACITRETIN ORAL 25 MG ACLIDINIUM BROMIDE INHALATION 400 MCG AER POW BA ACYCLOVIR BUCCAL 50 MG MA BUC TAB ACYCLOVIR TOPICAL 5 % CREAM (G) ACYCLOVIR TOPICAL 5 % OINT. (G) ACYCLOVIR/HYDROCORTISONE TOPICAL 5 %- % CREAM (G) 5 ADEFOVIR DIPIVOXIL ORAL 0 MG AFATINIB DIMALEATE ORAL 20 MG AFATINIB DIMALEATE ORAL MG AFATINIB DIMALEATE ORAL 40 MG AFLIBERCEPT INTRAOCULR 2MG/0.05ML 0.05 AGALSIDASE BETA INTRAVEN 35 MG 5 ALBIGLUTIDE SUB-Q MG/ML PEN INJCTR 4 ALBIGLUTIDE SUB-Q 50MG/ML PEN INJCTR 4 ALBUTEROL SULFATE INHALATION 0.63MG/3ML - NEB 62 ALBUTEROL SULFATE INHALATION.25MG/3ML - NEB 62 ALBUTEROL SULFATE INHALATION 2.5 MG/ -NEB 80 ALBUTEROL SULFATE INHALATION 2.5 MG/3ML - NEB 62 ALBUTEROL SULFATE INHALATION 5 MG/ML SOLUTION 80 ALBUTEROL SULFATE INHALATION 90 MCG HFA AER AD 36 ALBUTEROL SULFATE ORAL 2 MG 272 ALBUTEROL SULFATE ORAL 2 MG/5 ML SYRUP, ALBUTEROL SULFATE ORAL 4 MG TAB ER 2H 272 ALBUTEROL SULFATE ORAL 4 MG 272 ALBUTEROL SULFATE ORAL 8 MG TAB ER 2H 36 ALCAFTADINE OPHTHALMIC 0.25 % DROPS 3 ALCLOMETASONE DIPROPIONATE TOPICAL 0.05 % CREAM (G) 80 ALCLOMETASONE DIPROPIONATE TOPICAL 0.05 % OINT. (G) 80 ALENDRONATE SODIUM ORAL 0 MG ALENDRONATE SODIUM ORAL 35 MG 4 ALENDRONATE SODIUM ORAL 5 MG ALENDRONATE SODIUM ORAL 70 MG 4 ALENDRONATE SODIUM ORAL 70 MG EFF 4 ALENDRONATE SODIUM ORAL 70 MG/75ML SOLUTION 0 ALENDRONATE SODIUM/VITAMIN D3 ORAL 70 MG ALENDRONATE SODIUM/VITAMIN D3 ORAL 70 MG ALFENTANIL HCL INJECTION 500 MCG/ML AMPUL 20 ALISKIREN HEMIFUMARATE ORAL 50 MG ALISKIREN HEMIFUMARATE ORAL 0 MG ALISKIREN/AMLODIPIN/HCTHIAZIDE ORAL ALISKIREN/AMLODIPIN/HCTHIAZIDE ORAL ALISKIREN/AMLODIPIN/HCTHIAZIDE ORAL ALISKIREN/AMLODIPIN/HCTHIAZIDE ORAL MG ALISKIREN/AMLODIPIN/HCTHIAZIDE ORAL 0MG- 0MG ALISKIREN/AMLODIPINE BESYLATE ORAL 50 MG-5MG ALISKIREN/AMLODIPINE BESYLATE ORAL 50MG-0MG ALISKIREN/AMLODIPINE BESYLATE ORAL 0MG-0MG ALISKIREN/AMLODIPINE BESYLATE ORAL 0MG-5MG ALISKIREN/HYDROCHLOROTHIAZIDE ORAL MG ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 50MG- 25MG ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 0-2.5MG ALISKIREN/HYDROCHLOROTHIAZIDE ORAL 0MG- 25MG Effective 0//204

2 ALITRETINOIN TOPICAL 0. % GEL (GRAM) 80 ALMOTRIPTAN MALATE ORAL 2.5 MG 0 ALMOTRIPTAN MALATE ORAL 6.25 MG 0 ALOGLIPTIN BENZ/METFORMIN HCL ORAL ALOGLIPTIN BENZ/METFORMIN HCL ORAL MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 2.5- MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 25 MG-5MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 25 MG-MG ALOGLIPTIN BENZ/PIOGLITAZONE ORAL 25 MG-45MG ALOGLIPTIN BENZOATE ORAL 2.5 MG ALOGLIPTIN BENZOATE ORAL 25 MG ALOGLIPTIN BENZOATE ORAL 6.25 MG ALPRAZOLAM ORAL 0.25 MG TAB RAPDIS 36 ALPRAZOLAM ORAL 0.25 MG 36 ALPRAZOLAM ORAL MG TAB ER 24H ALPRAZOLAM ORAL MG TAB RAPDIS 36 ALPRAZOLAM ORAL MG 36 ALPRAZOLAM ORAL MG TAB ER 24H ALPRAZOLAM ORAL MG TAB RAPDIS 36 ALPRAZOLAM ORAL MG 36 ALPRAZOLAM ORAL MG/ML ORAL CONC 20 ALPRAZOLAM ORAL 2 MG TAB ER 24H ALPRAZOLAM ORAL 2 MG TAB RAPDIS 02 ALPRAZOLAM ORAL 2 MG 02 ALPRAZOLAM ORAL 3 MG TAB ER 24H ALTEPLASE INTRAVEN 00 MG ALTEPLASE INTRAVEN 50 MG 2 ALUMINUM CHLORIDE TOPICAL 20 % SOLUTION 80 ALUMINUM CHLORIDE TOPICAL 6.25% SOLUTION 80 AMBRISENTAN ORAL 0 MG AMBRISENTAN ORAL 5 MG AMCINONIDE TOPICAL 0. % CREAM (G) 80 AMCINONIDE TOPICAL 0. % LOTION 80 AMCINONIDE TOPICAL 0. % OINT. (G) 80 AMILORIDE HCL ORAL 5 MG 36 AMILORIDE/HYDROCHLOROTHIAZIDE ORAL 5MG-50MG 36 AMINOPHYLLINE INTRAVEN 250MG/0ML AMPUL 40 AMINOPHYLLINE INTRAVEN 250MG/0ML 40 AMINOPHYLLINE INTRAVEN 500MG/20ML 40 AMIODARONE HCL INTRAVEN 50 MG/3ML 60 AMIODARONE HCL INTRAVEN 50 MG/ML AMPUL 40 AMIODARONE HCL INTRAVEN 50 MG/ML 40 AMIODARONE HCL ORAL 00 MG 544 AMIODARONE HCL ORAL 200 MG 272 AMIODARONE HCL ORAL 400 MG 36 AMITRIP HCL/CHLORDIAZEPOXIDE ORAL 2.5MG-5MG 36 AMITRIP HCL/CHLORDIAZEPOXIDE ORAL 25 MG-0MG 36 AMITRIPTYLINE HCL ORAL 0 MG 02 AMITRIPTYLINE HCL ORAL 00 MG 02 AMITRIPTYLINE HCL ORAL 50 MG AMITRIPTYLINE HCL ORAL 25 MG 02 AMITRIPTYLINE HCL ORAL 50 MG 02 AMITRIPTYLINE HCL ORAL 75 MG 02 AMLODIPINE BES/OLMESARTAN MED ORAL 0 MG- 20MG AMLODIPINE BES/OLMESARTAN MED ORAL 0 MG- 40MG AMLODIPINE BES/OLMESARTAN MED ORAL 5 MG-20 MG AMLODIPINE BES/OLMESARTAN MED ORAL 5 MG-40 MG AMLODIPINE BESYLATE ORAL 0 MG AMLODIPINE BESYLATE ORAL 2.5 MG 272 AMLODIPINE BESYLATE ORAL 5 MG 36 AMLODIPINE BESYLATE/BENAZEPRIL ORAL 0 MG- 20MG AMLODIPINE BESYLATE/BENAZEPRIL ORAL 0 MG- 40MG AMLODIPINE BESYLATE/BENAZEPRIL ORAL 2.5MG- 0MG AMLODIPINE BESYLATE/BENAZEPRIL ORAL 5 MG-0 MG AMLODIPINE BESYLATE/BENAZEPRIL ORAL 5 MG-20 MG AMLODIPINE BESYLATE/BENAZEPRIL ORAL 5 MG-40 MG AMLODIPINE/ATORVASTATIN ORAL 0 MG-0MG AMLODIPINE/ATORVASTATIN ORAL 0 MG-20MG AMLODIPINE/ATORVASTATIN ORAL 0 MG-40MG AMLODIPINE/ATORVASTATIN ORAL 0 MG-80MG AMLODIPINE/ATORVASTATIN ORAL 2.5MG-0MG AMLODIPINE/ATORVASTATIN ORAL 2.5MG-20MG AMLODIPINE/ATORVASTATIN ORAL 2.5MG-40MG AMLODIPINE/ATORVASTATIN ORAL 5 MG-0 MG AMLODIPINE/ATORVASTATIN ORAL 5 MG-20 MG AMLODIPINE/ATORVASTATIN ORAL 5 MG-40 MG AMLODIPINE/ATORVASTATIN ORAL 5 MG-80 MG AMLODIPINE/VALSARTAN ORAL 0MG-60MG 2 Effective 0//204

3 AMLODIPINE/VALSARTAN ORAL 0MG-320MG AMLODIPINE/VALSARTAN ORAL 5MG-60MG AMLODIPINE/VALSARTAN ORAL 5MG-320MG AMLODIPINE/VALSARTAN/HCTHIAZID ORAL AMLODIPINE/VALSARTAN/HCTHIAZID ORAL AMLODIPINE/VALSARTAN/HCTHIAZID ORAL 0MG- 60MG AMLODIPINE/VALSARTAN/HCTHIAZID ORAL AMLODIPINE/VALSARTAN/HCTHIAZID ORAL MG AMMONIUM LACTATE TOPICAL 2 % CREAM (G) 385 AMMONIUM LACTATE TOPICAL 2 % LOTION 500 AMOBARBITAL SODIUM INJECTION 500 MG 0 AMOXAPINE ORAL 00 MG 02 AMOXAPINE ORAL 50 MG 02 AMOXAPINE ORAL 25 MG 02 AMOXAPINE ORAL 50 MG 02 ANAGRELIDE HCL ORAL MG 36 ANAGRELIDE HCL ORAL MG APIXABAN ORAL 2.5 MG APIXABAN ORAL 5 MG APREMILAST ORAL MG APREPITANT ORAL 25 MG APREPITANT ORAL 25MG-80MG CAP DS PK 3 APREPITANT ORAL 40 MG 2 APREPITANT ORAL 80 MG 2 ARFORMOTEROL TARTRATE INHALATION 5MCG/2ML -NEB 20 ARIPIPRAZOLE INTRAMUSC 9.75MG/.3 39 ARIPIPRAZOLE INTRAMUSC 0 MG SUSER ARIPIPRAZOLE INTRAMUSC 400 MG SUSER ARIPIPRAZOLE ORAL MG/ML SOLUTION 0 ARIPIPRAZOLE ORAL 0 MG TAB RAPDIS ARIPIPRAZOLE ORAL 0 MG ARIPIPRAZOLE ORAL 5 MG TAB RAPDIS ARIPIPRAZOLE ORAL 5 MG ARIPIPRAZOLE ORAL 2 MG ARIPIPRAZOLE ORAL 20 MG ARIPIPRAZOLE ORAL MG ARIPIPRAZOLE ORAL 5 MG ARMODAFINIL ORAL 50 MG ARMODAFINIL ORAL 200 MG ARMODAFINIL ORAL 250 MG ARMODAFINIL ORAL 50 MG ARTEMETHER/LUMEFANTRINE ORAL 20MG-20MG 24 ASENAPINE MALEATE SUBLINGUAL 0 MG TAB SUBL ASENAPINE MALEATE SUBLINGUAL 5 MG TAB SUBL ASPIRIN ORAL 8 MG DR 36 ASPIRIN/DIPYRIDAMOLE ORAL 25MG-200MG CPMP 2HR ATENOLOL ORAL 00 MG ATENOLOL ORAL 25 MG 272 ATENOLOL ORAL 50 MG 36 ATENOLOL/CHLORTHALIDONE ORAL 00MG-25MG ATENOLOL/CHLORTHALIDONE ORAL 50 MG-25MG ATOMOXETINE HCL ORAL 0 MG ATOMOXETINE HCL ORAL 00 MG ATOMOXETINE HCL ORAL 8 MG ATOMOXETINE HCL ORAL 25 MG ATOMOXETINE HCL ORAL 40 MG ATOMOXETINE HCL ORAL 60 MG ATOMOXETINE HCL ORAL 80 MG ATORVASTATIN CALCIUM ORAL 0 MG ATORVASTATIN CALCIUM ORAL 20 MG ATORVASTATIN CALCIUM ORAL 40 MG ATORVASTATIN CALCIUM ORAL 80 MG ATOVAQUONE ORAL 750 MG/5ML ORAL SUSP 420 ATRACURIUM BESYLATE INTRAVEN 0 MG/ML 0 AXITINIB ORAL MG 36 AXITINIB ORAL 5 MG AZELASTINE HCL NASAL 37 MCG SPRAY/PUMP 60 AZELASTINE HCL NASAL 205.5MCG SPRAY/PUMP 60 AZELASTINE HCL OPHTHALMIC 0.05 % DROPS 6 AZELASTINE/FLUTICASONE NASAL MCG SPRAY/PUMP 23 AZILSARTAN MED/CHLORTHALIDONE ORAL 40 MG- 25MG AZILSARTAN MED/CHLORTHALIDONE ORAL MG AZILSARTAN MEDOXOMIL ORAL 40 MG AZILSARTAN MEDOXOMIL ORAL 80 MG AZITHROMYCIN INTRAVEN 500 MG 0 AZITHROMYCIN OPHTHALMIC % DROPS 5 AZITHROMYCIN ORAL G PACKET 2 AZITHROMYCIN ORAL 00 MG/5ML SUSP RECON 45 AZITHROMYCIN ORAL 2 G/60 ML SUS ER REC AZITHROMYCIN ORAL 200 MG/5ML SUSP RECON 60 AZITHROMYCIN ORAL 250 MG 2 AZITHROMYCIN ORAL 500 MG 0 AZITHROMYCIN ORAL 600 MG AZTREONAM LYSINE INHALATION 75 MG/ML -NEB 84 BACITRACIN OPHTHALMIC 500 UNIT/G OINT. (G) 3.5 BACITRACIN/POLYMYXIN B SULFATE OPHTHALMIC 500-0K/G OINT. (G) 3.5 BACLOFEN INTRATHEC 0000/20ML 80 BACLOFEN INTRATHEC 2000MCG/ML AMPUL 80 BACLOFEN INTRATHEC 40000/20ML 80 BACLOFEN INTRATHEC 50 MCG/ML AMPUL 2 BACLOFEN INTRATHEC 0000/20ML 80 BACLOFEN INTRATHEC 20K MCG/ Effective 0//204

4 BACLOFEN INTRATHEC 40000/20ML 80 BACLOFEN INTRATHEC 50 MCG/ML 2 BACLOFEN INTRATHEC 500 MCG/ML AMPUL 80 BACLOFEN ORAL 0 MG 36 BACLOFEN ORAL 20 MG 36 BALSALAZIDE DISODIUM ORAL. G 80 BASILIXIMAB INTRAVEN 0 MG 4 BASILIXIMAB INTRAVEN 20 MG 2 BECAPLERMIN TOPICAL 0.0 % GEL (GRAM) 20 BECLOMETHASONE DIPROPIONATE INHALATION 40 MCG AER W/ADAP 7.4 BECLOMETHASONE DIPROPIONATE INHALATION 80 MCG AER W/ADAP 7.4 BECLOMETHASONE DIPROPIONATE NASAL 42MCG SPRAY 50 BECLOMETHASONE DIPROPIONATE NASAL 80 MCG HFA AER AD 8.7 BEDAQUILINE FUMARATE ORAL 00 MG BELATACEPT INTRAVEN 250 MG 24 BELIMUMAB INTRAVEN 20 MG BELIMUMAB INTRAVEN 400 MG BENAZEPRIL HCL ORAL 0 MG 36 BENAZEPRIL HCL ORAL 20 MG BENAZEPRIL HCL ORAL 40 MG BENAZEPRIL HCL ORAL 5 MG 272 BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 0-2.5MG 36 BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL MG BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL 20-25MG BENAZEPRIL/HYDROCHLOROTHIAZIDE ORAL MG 70 BENZOIC ACID/SALICYLIC ACID TOPICAL 6%-3% OINT. (G) 80 BENZYL ALCOHOL TOPICAL 5 % LOTION 227 BEPOTASTINE BESILATE OPHTHALMIC.5 % DROPS 0 BESIFLOXACIN HCL OPHTHALMIC 0.6 % DROPS SUSP 5 BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % CREAM (G) 80 BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % GEL (GRAM) 80 BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % LOTION 80 BETAMETHASONE DIPROPIONATE TOPICAL 0.05 % OINT. (G) 80 BETAMETHASONE VALERATE TOPICAL 0. % CREAM (G) 80 BETAMETHASONE VALERATE TOPICAL 0. % LOTION 80 BETAMETHASONE VALERATE TOPICAL 0. % OINT. (G) 80 BETAMETHASONE VALERATE TOPICAL 0.2 % FOAM 200 BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % CREAM (G) 80 BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % LOTION 80 BETAMETHASONE/PROPYLENE GLYC TOPICAL 0.05 % OINT. (G) 80 BETAXOLOL HCL ORAL 0 MG BETAXOLOL HCL ORAL 20 MG BEXAROTENE TOPICAL % GEL (GRAM) 80 BIMATOPROST OPHTHALMIC 0.0 % DROPS 2.5 BISMUTH SAL/METRONID/TETRACYC ORAL MG COMBO. PKG 224 BISMUTH/METRONID/TETRACYCLINE ORAL MG 20 BISOPROLOL FUMARATE ORAL 0 MG BISOPROLOL FUMARATE ORAL 5 MG BISOPROLOL FUMARATE/HCTZ ORAL MG BISOPROLOL FUMARATE/HCTZ ORAL MG 36 BISOPROLOL FUMARATE/HCTZ ORAL MG BIVALIRUDIN INTRAVEN 250 MG BOCEPREVIR ORAL 200 MG 408 BORTEZOMIB INJECTION 3.5 MG 5 BOSENTAN ORAL 25 MG BOSENTAN ORAL 62.5 MG BOSUTINIB ORAL 00 MG BOSUTINIB ORAL 500 MG BROMFENAC SODIUM OPHTHALMIC 0.07 % DROPS 3.2 BROMFENAC SODIUM OPHTHALMIC 0.09% DROPS 5 BROMPHENIRAMINE MALEATE ORAL MG/ML DROPS BUDESONIDE INHALATION 0.25MG/2ML AMPUL-NEB 36 BUDESONIDE INHALATION MG/2ML AMPUL-NEB 36 BUDESONIDE INHALATION MG/2 ML AMPUL-NEB 36 BUDESONIDE INHALATION 80 MCG AER POW BA 2 BUDESONIDE INHALATION 90 MCG AER POW BA 2 BUDESONIDE NASAL 32MCG SPRAY/PUMP 7.2 BUDESONIDE/FORMOTEROL FUMARATE INHALATION MCG HFA AER AD 2 BUDESONIDE/FORMOTEROL FUMARATE INHALATION MCG HFA AER AD 3.8 BUMETANIDE INJECTION 0.25 MG/ML 40 BUMETANIDE ORAL MG 0 BUMETANIDE ORAL MG 0 BUMETANIDE ORAL 2 MG 70 BUPRENORPHINE HCL INJECTION 0.3 MG/ML AMPUL 40 BUPRENORPHINE HCL INJECTION 0.3 MG/ML 40 BUPRENORPHINE HCL INJECTION 0.3 MG/ML 40 BUPRENORPHINE HCL SUBLINGUAL 2 MG TAB SUBL BUPRENORPHINE HCL SUBLINGUAL 8 MG TAB SUBL BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL MG TAB SUBL BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 2 MG-3 MG FILM BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 2 MG-MG FILM BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 2 MG-MG TAB SUBL BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 4MG-MG FILM 4 Effective 0//204

5 BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL MG TAB SUBL BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 8 MG-2 MG FILM BUPRENORPHINE HCL/NALOXONE HCL SUBLINGUAL 8 MG-2 MG TAB SUBL BUPRENORPHINE TRANSDERM 0 MCG/HR PATCH TDWK 5 BUPRENORPHINE TRANSDERM 20 MCG/HR PATCH TDWK 5 BUPRENORPHINE TRANSDERM 5 MCG/HR PATCH TDWK 5 BUPRENORPHINE TRANSDERM 5 MCG/HR PATCH TDWK 5 BUPROPION HBR ORAL 74MG TAB ER 24H BUPROPION HBR ORAL 8MG TAB ER 24H BUPROPION HBR ORAL 522MG TAB ER 24H BUPROPION HCL ORAL 00 MG 02 BUPROPION HCL ORAL 00 MG ER BUPROPION HCL ORAL 50 MG TAB ER 24H BUPROPION HCL ORAL 50 MG ER BUPROPION HCL ORAL 200 MG ER BUPROPION HCL ORAL 0 MG TAB ER 24H BUPROPION HCL ORAL 450 MG TAB ER 24H BUPROPION HCL ORAL 75 MG 02 BUSPIRONE HCL ORAL 0 MG 02 BUSPIRONE HCL ORAL 5 MG 02 BUSPIRONE HCL ORAL MG BUSPIRONE HCL ORAL 5 MG 02 BUSPIRONE HCL ORAL 7.5 MG 02 BUTABARBITAL SODIUM ORAL MG 02 BUTABARBITAL SODIUM ORAL MG/5 ML ELIXIR 540 BUTABARBITAL SODIUM ORAL 50 MG BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALB/ACETAMINOPHEN/CAFFEINE ORAL /5 SOLUTION 240 BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALB/ACETAMINOPHEN/CAFFEINE ORAL BUTALBIT/ACETAMIN/CAFF/CODEINE ORAL BUTALBIT/ACETAMIN/CAFF/CODEINE ORAL BUTALBITAL/ACETAMINOPHEN ORAL 50MG-0MG BUTALBITAL/ACETAMINOPHEN ORAL 50MG-325MG BUTALBITAL/ACETAMINOPHEN ORAL 50MG-650MG BUTALBITAL/ACETAMINOPHEN ORAL 50MG-650MG BUTALBITAL/ASPIRIN/CAFFEINE ORAL BUTALBITAL/ASPIRIN/CAFFEINE ORAL BUTENAFINE HCL TOPICAL % CREAM (G) 80 BUTORPHANOL TARTRATE INJECTION MG/ML 40 BUTORPHANOL TARTRATE INJECTION 2 MG/ML 40 BUTORPHANOL TARTRATE NASAL 0 MG/ML SPRAY 5 CABOZANTINIB S-MALATE ORAL 00 MG/DAY 56 CABOZANTINIB S-MALATE ORAL 40 MG/DAY 2 CABOZANTINIB S-MALATE ORAL 60 MG/DAY 84 CAFFEINE CITRATED INTRAVEN 60 MG/3 ML 36 CAFFEINE CITRATED ORAL 60 MG/3 ML SOLUTION 36 CALCIPOTRIENE TOPICAL % CREAM (G) 80 CALCIPOTRIENE TOPICAL % FOAM 20 CALCIPOTRIENE TOPICAL % OINT. (G) 80 CALCIPOTRIENE TOPICAL % SOLUTION 80 CALCIPOTRIENE/BETAMETHASONE TOPICAL OINT. (G) 80 CALCIPOTRIENE/BETAMETHASONE TOPICAL SUSPENSION 80 CALCITONIN,SALMON,SYNTHETIC INJECTION 200/ML CALCITONIN,SALMON,SYNTHETIC NASAL 200/SPRAY SPRAY/PUMP 4 CALCITRIOL TOPICAL 3 MCG/G OINT. (G) 200 CANAGLIFLOZIN ORAL 00 MG CANAGLIFLOZIN ORAL 0 MG CANAGLIFLOZIN/METFORMIN HCL CANAKINUMAB/PF SUB-Q 80 MG/.2 CANDESARTAN CILEXETIL ORAL 6 MG CANDESARTAN CILEXETIL ORAL 32 MG CANDESARTAN CILEXETIL ORAL 4 MG 272 CANDESARTAN CILEXETIL ORAL 8 MG 36 CANDESARTAN/HYDROCHLOROTHIAZID ORAL 6-2.5MG CANDESARTAN/HYDROCHLOROTHIAZID ORAL MG CANDESARTAN/HYDROCHLOROTHIAZID ORAL 32MG- 25MG CAPSAICIN/SKIN CLEANSER TOPICAL 8 % KIT 4 CAPTOPRIL ORAL 00 MG 02 CAPTOPRIL ORAL 2.5 MG 86 CAPTOPRIL ORAL 25 MG 408 CAPTOPRIL ORAL 50 MG 204 CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL 25 MG- 25MG 204 CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL 50 MG- 5MG 204 CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL 50 MG- 25MG 204 CAPTOPRIL/HYDROCHLOROTHIAZIDE ORAL 25 MG- 5MG Effective 0//204

6 CARBINOXAMINE MALEATE ORAL 4 MG 36 CARBINOXAMINE MALEATE ORAL 4 MG/5 ML LIQUID 0 CARBINOXAMINE MALEATE ORAL 4 MG/5 ML SUS ER 2H 0 CARISOPRODOL ORAL 250 MG 40 CARISOPRODOL ORAL 350 MG 40 CARISOPRODOL/ASPIRIN ORAL MG 40 CARVEDILOL ORAL 2.5 MG 36 CARVEDILOL ORAL 25 MG CARVEDILOL ORAL 3.25 MG 544 CARVEDILOL ORAL 6.25 MG 272 CARVEDILOL PHOSPHATE ORAL 0 MG CPMP 24HR CARVEDILOL PHOSPHATE ORAL 20 MG CPMP 24HR CARVEDILOL PHOSPHATE ORAL 40 MG CPMP 24HR CARVEDILOL PHOSPHATE ORAL 80 MG CPMP 24HR CEFDINIR ORAL 25 MG/5ML SUSP RECON 500 CEFDINIR ORAL 250 MG/5ML SUSP RECON 0 CEFDINIR ORAL 0 MG 40 CEFEPIME HCL INJECTION G 80 CEFEPIME HCL INJECTION 2 G 40 CEFEPIME HCL INTRAVEN G PORT 80 CEFEPIME HCL INTRAVEN 2 G PORT 40 CEFTAROLINE FOSAMIL ACETATE INTRAVEN 400 MG CEFTAROLINE FOSAMIL ACETATE INTRAVEN 600 MG CELECOXIB ORAL 00 MG CELECOXIB ORAL 200 MG CELECOXIB ORAL 400 MG CELECOXIB ORAL 50 MG CENTRUROIDES(SCORPN) ANTIVENOM INTRAVEN 20 MG CETIRIZINE HCL ORAL MG/ML SOLUTION 360 CETIRIZINE HCL ORAL 0 MG TAB CHEW CETIRIZINE HCL ORAL 0 MG CETIRIZINE HCL ORAL 5 MG TAB CHEW CETIRIZINE HCL ORAL 5 MG CHLORDIAZEPOXIDE HCL ORAL 0 MG 36 CHLORDIAZEPOXIDE HCL ORAL 25 MG 36 CHLORDIAZEPOXIDE HCL ORAL 5 MG 36 CHLOROTHIAZIDE ORAL 250 MG 272 CHLOROTHIAZIDE ORAL 250 MG/5ML ORAL SUSP, CHLOROTHIAZIDE ORAL 500 MG 36 CHLOROTHIAZIDE SODIUM INTRAVEN 500 MG CHLORPROMAZINE HCL ORAL 0 MG 02 CHLORPROMAZINE HCL ORAL 00 MG 02 CHLORPROMAZINE HCL ORAL 200 MG 02 CHLORPROMAZINE HCL ORAL 25 MG 02 CHLORPROMAZINE HCL ORAL 50 MG 02 CHLORPROPAMIDE ORAL 00 MG 70 CHLORPROPAMIDE ORAL 250 MG CHLORTHALIDONE ORAL 25 MG 36 CHLORTHALIDONE ORAL 50 MG CHLORZOXAZONE ORAL 375 MG 40 CHLORZOXAZONE ORAL 500 MG 40 CHLORZOXAZONE ORAL 750 MG 40 CHOLESTYRAMINE (WITH SUGAR) ORAL 4 G POWD PACK 204 CHOLESTYRAMINE (WITH SUGAR) ORAL 4 G POWDER 378 CHOLESTYRAMINE/ASPARTAME ORAL 4 G POWD PACK 204 CHOLINE SAL/MAG SALICYLATE ORAL 500 MG/5ML LIQUID 0 CICLESONIDE INHALATION 60 MCG HFA AER AD 2.2 CICLESONIDE INHALATION 80 MCG HFA AER AD 2.2 CICLESONIDE NASAL 37 MCG HFA AER AD 6. CICLESONIDE NASAL 50 MCG SPRAY/PUMP 2.5 CICLOPIROX OLAMINE TOPICAL 0.77 % CREAM (G) 80 CICLOPIROX OLAMINE TOPICAL 0.77 % SUSPENSION 80 CICLOPIROX TOPICAL 0.77 % GEL (GRAM) 80 CICLOPIROX TOPICAL % SHAMPOO 20 CICLOPIROX TOPICAL 8 % SOLUTION 6.6 CIDOFOVIR INTRAVEN 75 MG/ML 40 CILOSTAZOL ORAL 00 MG CILOSTAZOL ORAL 50 MG CIMETIDINE HCL ORAL 0 MG/5ML SOLUTION 240 CIMETIDINE ORAL 200 MG 36 CIMETIDINE ORAL 0 MG 36 CIMETIDINE ORAL 400 MG 36 CIMETIDINE ORAL 800 MG CIPROFLOXACIN HCL OPHTHALMIC 0.3 % DROPS 0 CIPROFLOXACIN HCL OPHTHALMIC 0.3 % OINT. (G) 3.5 CIPROFLOXACIN HCL ORAL 00 MG 0 CIPROFLOXACIN HCL ORAL 250 MG 36 CIPROFLOXACIN HCL ORAL 500 MG CIPROFLOXACIN HCL ORAL 750 MG CIPROFLOXACIN HCL OTIC 0.2 % DROPERETTE 4 CIPROFLOXACIN HCL/DEXAMETH OTIC 0.3 %-0.% DROPS SUSP 7.5 CIPROFLOXACIN LACTATE INTRAVEN 200MG/20ML,20.00 CIPROFLOXACIN LACTATE INTRAVEN 400MG/40ML 4, CIPROFLOXACIN LACTATE/D5W INTRAVEN 200MG/0.L PIGGYBACK 5, CIPROFLOXACIN LACTATE/D5W INTRAVEN 400MG/0.2L PIGGYBACK 20, CIPROFLOXACIN ORAL 250 MG/5ML SUS MC REC 700 CIPROFLOXACIN ORAL 500 MG/5ML SUS MC REC 400 CIPROFLOXACIN/CIPROFLOXA HCL ORAL 000 MG TBMP 24HR CIPROFLOXACIN/CIPROFLOXA HCL ORAL 500 MG TBMP 24HR 56 CIPROFLOXACIN/HYDROCORTISONE OTIC 0.2 %- % DROPS SUSP 0 CISATRACURIUM BESYLATE INTRAVEN 0 MG/ML 20 CISATRACURIUM BESYLATE INTRAVEN 2 MG/ML 0 CITALOPRAM HYDROBROMIDE ORAL 0 MG 6 Effective 0//204

7 CITALOPRAM HYDROBROMIDE ORAL 0 MG/5 ML SOLUTION 0 CITALOPRAM HYDROBROMIDE ORAL 20 MG CITALOPRAM HYDROBROMIDE ORAL 40 MG CLARITHROMYCIN ORAL 25 MG/5ML SUSP RECON 400 CLARITHROMYCIN ORAL 250 MG CLARITHROMYCIN ORAL 250 MG/5ML SUSP RECON 400 CLARITHROMYCIN ORAL 500 MG TAB ER 24H CLARITHROMYCIN ORAL 500 MG CLEMASTINE FUMARATE ORAL 0.67MG/5ML SYRUP 2, CLEMASTINE FUMARATE ORAL 2. MG 02 CLEVIDIPINE BUTYRATE INTRAVEN 25 MG/50ML, CLEVIDIPINE BUTYRATE INTRAVEN 50MG/00ML, CLINDAMYCIN PHOSPHATE VAGINAL 00 MG SUPP.VAG 3 CLINDAMYCIN PHOSPHATE VAGINAL 2 % CREAM/APPL 40 CLINDAMYCIN PHOSPHATE VAGINAL 2 % CRM ER (G) 40 CLOBETASOL PROPIONATE TOPICAL 0.05 % CREAM (G) 80 CLOBETASOL PROPIONATE TOPICAL 0.05 % FOAM 200 CLOBETASOL PROPIONATE TOPICAL 0.05 % GEL (GRAM) 90 CLOBETASOL PROPIONATE TOPICAL 0.05 % LOTION 80 CLOBETASOL PROPIONATE TOPICAL 0.05 % OINT. (G) 80 CLOBETASOL PROPIONATE TOPICAL 0.05 % SHAMPOO 8 CLOBETASOL PROPIONATE TOPICAL 0.05 % SOLUTION 00 CLOBETASOL PROPIONATE TOPICAL 0.05 % SPRAY 236 CLOBETASOL PROPIONATE/EMOLL TOPICAL 0.05 % CREAM (G) 80 CLOBETASOL PROPIONATE/EMOLL TOPICAL 0.05 % FOAM 200 CLOCORTOLONE PIVALATE TOPICAL 0. % CREAM (G) 80 CLOMIPRAMINE HCL ORAL 25 MG 02 CLOMIPRAMINE HCL ORAL 50 MG 70 CLOMIPRAMINE HCL ORAL 75 MG 02 CLONAZEPAM ORAL 0.25 MG TAB RAPDIS 0 CLONAZEPAM ORAL 0.25 MG TAB RAPDIS 0 CLONAZEPAM ORAL MG TAB RAPDIS 0 CLONAZEPAM ORAL MG 0 CLONAZEPAM ORAL MG TAB RAPDIS 0 CLONAZEPAM ORAL MG 0 CLONAZEPAM ORAL 2 MG TAB RAPDIS 0 CLONAZEPAM ORAL 2 MG 0 CLONIDINE HCL ORAL 0. MG TAB ER 2H CLONIDINE HCL ORAL 0. MG 86 CLONIDINE HCL ORAL MG TB ER DSPK CLONIDINE HCL ORAL 0.2 MG 408 CLONIDINE HCL ORAL 0.3 MG 204 CLONIDINE TRANSDERM 0.MG/24HR PATCH TDWK 4 CLONIDINE TRANSDERM 0.2MG/24HR PATCH TDWK 8 CLONIDINE TRANSDERM 0.3MG/24HR PATCH TDWK 8 CLOPIDOGREL BISULFATE ORAL 0 MG CLOPIDOGREL BISULFATE ORAL 75 MG CLORAZEPATE DIPOTASSIUM ORAL 5 MG 36 CLORAZEPATE DIPOTASSIUM ORAL 3.75 MG 36 CLORAZEPATE DIPOTASSIUM ORAL 7.5 MG 36 CLOTRIMAZOLE MUCOUS MEM 0 MG TROCHE 70 CLOTRIMAZOLE TOPICAL % CREAM (G) 80 CLOTRIMAZOLE TOPICAL % SOLUTION 80 CLOTRIMAZOLE/BETAMETHASONE DIP TOPICAL % % CREAM (G) 80 CLOTRIMAZOLE/BETAMETHASONE DIP TOPICAL % % LOTION 80 CLOZAPINE ORAL 00 MG TAB RAPDIS 6 CLOZAPINE ORAL 00 MG 6 CLOZAPINE ORAL 2.5 MG TAB RAPDIS 204 CLOZAPINE ORAL 50 MG TAB RAPDIS 204 CLOZAPINE ORAL 200 MG TAB RAPDIS 36 CLOZAPINE ORAL 200 MG 36 CLOZAPINE ORAL 25 MG TAB RAPDIS 204 CLOZAPINE ORAL 25 MG 204 CLOZAPINE ORAL 50 MG 204 CODEINE SULFATE ORAL 5 MG CODEINE SULFATE ORAL MG CODEINE SULFATE ORAL MG/5 ML SOLUTION 500 CODEINE SULFATE ORAL 60 MG CODEINE/BUTALBITAL/ASA/CAFFEIN ORAL CODEINE/CARISOPRODOL/ASPIRIN ORAL COLESEVELAM HCL ORAL 3.75 G POWD PACK COLESEVELAM HCL ORAL 625 MG 238 COLESTIPOL HCL ORAL G 544 COLESTIPOL HCL ORAL 5 G GRANULES 500 COLESTIPOL HCL ORAL 5 G PACKET 204 COLESTIPOL HCL ORAL 7.5G PACKET 36 COLISTIN (COLISTIMETHATE NA) INJECTION 50 MG 7 COLLAGENASE CLOSTRIDIUM HIST. INJECTION 0.9 MG COLLAGENASE CLOSTRIDIUM HIST. TOPICAL 250 UNIT/G OINT. (G) 80 COMPOUND VEHICLE SUSP SF NO. ORAL ORAL SUSP, COMPOUNDING VEHICLE NO.8 ORAL LIQUID, COMPOUNDING VEHICLE SF NO.9 ORAL LIQUID, COMPOUNDING VEHICLE SUSP NO.2 ORAL ORAL SUSP, COMPOUNDING VEHICLE SUSP NO.7 ORAL ORAL SUSP, CRIZOTINIB ORAL 200 MG CRIZOTINIB ORAL 250 MG CROFELEMER ORAL 25 MG DR CROMOLYN SODIUM INHALATION 20 MG/2 ML AMPUL- NEB 272 CROMOLYN SODIUM OPHTHALMIC 4 % DROPS 40 CROTAMITON TOPICAL 0 % CREAM (G) 80 CROTAMITON TOPICAL 0 % LOTION 80 CYANOCOBALAMIN (VITAMIN B-2) NASAL 500 MCG SPRAY 2.3 CYANOCOBALAMIN (VITAMIN B-2) NASAL 500MCG/SPR SPRAY 4 7 Effective 0//204

8 CYCLOBENZAPRINE HCL ORAL 0 MG CYCLOBENZAPRINE HCL ORAL 5 MG CAP ER 24H 0 CYCLOBENZAPRINE HCL ORAL MG CAP ER 24H 0 CYCLOBENZAPRINE HCL ORAL 5 MG CYCLOBENZAPRINE HCL ORAL 7.5 MG CYCLOSPORINE OPHTHALMIC 0.05 % DROPERETTE 60 CYSTEAMINE HCL OPHTHALMIC 0.44 % DROPS 60 DABIGATRAN ETEXILATE MESYLATE ORAL 50 MG DABIGATRAN ETEXILATE MESYLATE ORAL 75 MG DABRAFENIB MESYLATE ORAL 50 MG 36 DABRAFENIB MESYLATE ORAL 75 MG 36 DALFAMPRIDINE ORAL 0 MG TAB ER 2H DANTROLENE SODIUM INTRAVEN 20 MG DANTROLENE SODIUM ORAL 00 MG 36 DANTROLENE SODIUM ORAL 25 MG 36 DANTROLENE SODIUM ORAL 50 MG 36 DAPAGLIFLOZIN PROPANEDIOL ORAL 0 MG DAPAGLIFLOZIN PROPANEDIOL ORAL 5 MG DAPTOMYCIN INTRAVEN 500 MG DARBEPOETIN ALFA IN POLYSORBAT INJECTION 00 MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 50MCG/.75 3 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 200 MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 25 MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 60MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 00MCG/ 2 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 50MCG/0.3.2 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 200MCG/0.4.6 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 25MCG/0.42. DARBEPOETIN ALFA IN POLYSORBAT INJECTION 0 MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 0MCG/ DARBEPOETIN ALFA IN POLYSORBAT INJECTION 40 MCG/0.4.6 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 40 MCG/ML 4 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 500 MCG/ML 2 DARBEPOETIN ALFA IN POLYSORBAT INJECTION 60MCG/0.3.2 DARIFENACIN HYDROBROMIDE ORAL 5 MG TAB ER 24H DARIFENACIN HYDROBROMIDE ORAL 7.5 MG TAB ER 24H DEMECLOCYCLINE HCL ORAL 50 MG 80 DEMECLOCYCLINE HCL ORAL 0 MG 40 DENOSUMAB SUB-Q 20 MG/.7.7 DENOSUMAB SUB-Q 60 MG/ML DESIPRAMINE HCL ORAL 0 MG 02 DESIPRAMINE HCL ORAL 00 MG 02 DESIPRAMINE HCL ORAL 50 MG DESIPRAMINE HCL ORAL 25 MG 02 DESIPRAMINE HCL ORAL 50 MG 02 DESIPRAMINE HCL ORAL 75 MG 02 DESIRUDIN SUB-Q 5 MG 24 DESLORATADINE ORAL 2.5 MG TAB RAPDIS DESLORATADINE ORAL 2.5 MG/5ML SYRUP 360 DESLORATADINE ORAL 5 MG TAB RAPDIS DESLORATADINE ORAL 5 MG DESLORATADINE/PSEUDOEPHEDRINE ORAL MG TBMP 2HR DESOG-E.ESTRADIOL/E.ESTRADIOL ORAL 2-5 DESOGESTREL-ETHINYL ESTRADIOL ORAL DESOGESTREL-ETHINYL ESTRADIOL ORAL 7 DAYS X 3 DESONIDE TOPICAL 0.05 % CREAM (G) 80 DESONIDE TOPICAL 0.05 % FOAM 200 DESONIDE TOPICAL 0.05 % GEL (GRAM) 80 DESONIDE TOPICAL 0.05 % LOTION 80 DESONIDE TOPICAL 0.05 % OINT. (G) 80 DESOXIMETASONE TOPICAL 0.05 % CREAM (G) 80 DESOXIMETASONE TOPICAL 0.05 % GEL (GRAM) 80 DESOXIMETASONE TOPICAL 0.05 % OINT. (G) 80 DESOXIMETASONE TOPICAL 0.25 % CREAM (G) 80 DESOXIMETASONE TOPICAL 0.25 % OINT. (G) 80 DESOXIMETASONE TOPICAL 0.25 % SPRAY 00 DESVENLAFAXINE FUMARATE ORAL 00 MG TAB ER 24 DESVENLAFAXINE FUMARATE ORAL 50 MG TAB ER 24 DESVENLAFAXINE ORAL 00 MG TAB ER 24 DESVENLAFAXINE ORAL 00 MG TAB ER 24H DESVENLAFAXINE ORAL 50 MG TAB ER 24 DESVENLAFAXINE ORAL 50 MG TAB ER 24H DESVENLAFAXINE SUCCINATE ORAL 00 MG TAB ER 24H DESVENLAFAXINE SUCCINATE ORAL 50 MG TAB ER 24H DEXLANSOPRAZOLE ORAL MG CAP DR BP DEXLANSOPRAZOLE ORAL 60 MG CAP DR BP DEXMEDETOMIDINE HCL INTRAVEN 200MCG/2ML 8 DEXMETHYLPHENIDATE HCL ORAL 0 MG CPBP DEXMETHYLPHENIDATE HCL ORAL 0 MG DEXMETHYLPHENIDATE HCL ORAL 5 MG CPBP DEXMETHYLPHENIDATE HCL ORAL 2.5 MG DEXMETHYLPHENIDATE HCL ORAL 20 MG CPBP DEXMETHYLPHENIDATE HCL ORAL 25 MG CPBP DEXMETHYLPHENIDATE HCL ORAL MG CPBP DEXMETHYLPHENIDATE HCL ORAL 35 MG CPBP DEXMETHYLPHENIDATE HCL ORAL 40 MG CPBP DEXMETHYLPHENIDATE HCL ORAL 5 MG CPBP Effective 0//204

9 DEXMETHYLPHENIDATE HCL ORAL 5 MG DEXTROAMPHETAMINE SULFATE ORAL 0 MG ER 02 DEXTROAMPHETAMINE SULFATE ORAL 0 MG 02 DEXTROAMPHETAMINE SULFATE ORAL 5 MG ER 02 DEXTROAMPHETAMINE SULFATE ORAL 5 MG DEXTROAMPHETAMINE SULFATE ORAL 2.5 MG 02 DEXTROAMPHETAMINE SULFATE ORAL 20 MG DEXTROAMPHETAMINE SULFATE ORAL MG DEXTROAMPHETAMINE SULFATE ORAL 5 MG ER 02 DEXTROAMPHETAMINE SULFATE ORAL 5 MG 02 DEXTROAMPHETAMINE SULFATE ORAL 5 MG/5 ML SOLUTION, DEXTROAMPHETAMINE SULFATE ORAL 7.5 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 0 MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL 0 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 2.5 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 5 MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL 5 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 20 MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL 20 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 25 MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL MG DEXTROAMPHETAMINE/AMPHETAMINE ORAL 5 MG CAP ER 24H DEXTROAMPHETAMINE/AMPHETAMINE ORAL 5 MG 02 DEXTROAMPHETAMINE/AMPHETAMINE ORAL 7.5 MG 02 DEXTROMETHORPHAN HBR/QUINIDINE ORAL 20 MG- 0MG DHCODEINE BT/ACETAMINOPHN/CAFF ORAL DIAZEPAM INJECTION 5 MG/ML 8 DIAZEPAM INJECTION 5 MG/ML 8 DIAZEPAM ORAL 0 MG 36 DIAZEPAM ORAL 2 MG 36 DIAZEPAM ORAL 5 MG 36 DIAZEPAM ORAL 5 MG/5 ML SOLUTION 500 DIAZEPAM ORAL 5 MG/ML ORAL CONC 240 DIAZEPAM RECTAL KIT 5 DIAZEPAM RECTAL 2.5 MG KIT 5 DIAZEPAM RECTAL MG KIT 5 DIAZOXIDE ORAL 50 MG/ML ORAL SUSP 90 DICLOFENAC EPOLAMINE TRANSDERM.3 % PATCH TD2 DICLOFENAC POTASSIUM ORAL 25 MG 36 DICLOFENAC POTASSIUM ORAL 50 MG POWD PACK 9 DICLOFENAC POTASSIUM ORAL 50 MG 02 DICLOFENAC SODIUM OPHTHALMIC 0. % DROPS 0 DICLOFENAC SODIUM ORAL 00 MG TAB ER 24H DICLOFENAC SODIUM ORAL 25 MG DR 02 DICLOFENAC SODIUM ORAL 50 MG DR 02 DICLOFENAC SODIUM ORAL 75 MG DR 02 DICLOFENAC SODIUM TOPICAL % GEL (GRAM),00.00 DICLOFENAC SODIUM TOPICAL.5 % DROPS 600 DICLOFENAC SODIUM TOPICAL 20MG/G(2%) SOL MD PMP 2 DICLOFENAC SODIUM TOPICAL 3 % GEL (GRAM) 80 DICLOFENAC SODIUM/MISOPROSTOL ORAL 50 MG-200 TAB IR DR 02 DICLOFENAC SODIUM/MISOPROSTOL ORAL 75 MG-200 TAB IR DR 02 DICLOFENAC SUBMICRONIZED ORAL 8 MG 02 DICLOFENAC SUBMICRONIZED ORAL 35 MG 02 DICYCLOMINE HCL INTRAMUSC 0 MG/ML AMPUL DICYCLOMINE HCL ORAL 0 MG 36 DICYCLOMINE HCL ORAL 20 MG 36 DIFLORASONE DIACETATE TOPICAL 0.05 % CREAM (G) 80 DIFLORASONE DIACETATE TOPICAL 0.05 % OINT. (G) 80 DIFLORASONE DIACETATE/EMOLL TOPICAL 0.05 % CREAM (G) 80 DIFLUNISAL ORAL 500 MG 02 DIFLUPREDNATE OPHTHALMIC 0.05 % DROPS 0 DIGOXIN INJECTION 00 MCG/ML AMPUL 0 DIGOXIN INJECTION 250 MCG/ML AMPUL 36 DIGOXIN INJECTION 250 MCG/ML DIGOXIN ORAL 25 MCG 36 DIGOXIN ORAL 87.5 MCG DIGOXIN ORAL 250 MCG DIGOXIN ORAL 50 MCG/ML SOLUTION 360 DIGOXIN ORAL 62.5 MCG DIHYDROCODEINE/ASPIRIN/CAFFEIN ORAL DIHYDROERGOTAMINE MESYLATE NASAL MG/SPRY SPRAY/PUMP 8 DILTIAZEM HCL INTRAVEN 00 MG PORT 40 DILTIAZEM HCL INTRAVEN 5 MG/ML 40 DILTIAZEM HCL ORAL 20 MG CAP ER 2H 36 DILTIAZEM HCL ORAL 20 MG CAP ER 24H 36 DILTIAZEM HCL ORAL 20 MG CAP ER DEG 36 DILTIAZEM HCL ORAL 20 MG ER 36 DILTIAZEM HCL ORAL 20 MG TAB ER 24H 36 DILTIAZEM HCL ORAL 20 MG 36 DILTIAZEM HCL ORAL 80 MG CAP ER 24H 02 DILTIAZEM HCL ORAL 80 MG CAP ER DEG 02 DILTIAZEM HCL ORAL 80 MG ER 02 9 Effective 0//204

10 DILTIAZEM HCL ORAL 80 MG TAB ER 24H 36 DILTIAZEM HCL ORAL 240 MG CAP ER 24H DILTIAZEM HCL ORAL 240 MG CAP ER DEG DILTIAZEM HCL ORAL 240 MG ER DILTIAZEM HCL ORAL 240 MG TAB ER 24H DILTIAZEM HCL ORAL MG 62 DILTIAZEM HCL ORAL 0 MG CAP ER 24H DILTIAZEM HCL ORAL 0 MG ER DILTIAZEM HCL ORAL 0 MG TAB ER 24H DILTIAZEM HCL ORAL 360 MG CAP ER 24H DILTIAZEM HCL ORAL 360 MG ER DILTIAZEM HCL ORAL 360 MG TAB ER 24H DILTIAZEM HCL ORAL 420MG ER DILTIAZEM HCL ORAL 420MG TAB ER 24H DILTIAZEM HCL ORAL 60 MG CAP ER 2H 6 DILTIAZEM HCL ORAL 60 MG 6 DILTIAZEM HCL ORAL 90 MG CAP ER 2H 204 DILTIAZEM HCL ORAL 90 MG 204 DIMENHYDRINATE INJECTION 50 MG/ML 36 DIMETHYL FUMARATE ORAL 20 MG DR 4 DIMETHYL FUMARATE ORAL MG DR 60 DIMETHYL FUMARATE ORAL 240 MG DR DIPH,PERTUSS(ACELL),TET VAC/PF INTRAMUSC /.5 DIPH,PERTUSS(ACELL),TET VAC/PF INTRAMUSC /.5 DIPHENHYDRAMINE HCL ORAL 2.5MG/5ML ELIXIR 720 DIPYRIDAMOLE INTRAVEN 5 MG/ML 2 DIPYRIDAMOLE ORAL 25 MG 544 DIPYRIDAMOLE ORAL 50 MG 272 DIPYRIDAMOLE ORAL 75 MG 36 DISOPYRAMIDE PHOSPHATE ORAL 00 MG 544 DISOPYRAMIDE PHOSPHATE ORAL 00 MG ER 36 DISOPYRAMIDE PHOSPHATE ORAL 50 MG 0 DISOPYRAMIDE PHOSPHATE ORAL 50 MG ER 36 DOFETILIDE ORAL 25 MCG 36 DOFETILIDE ORAL 250 MCG 36 DOFETILIDE ORAL 500 MCG DOLASETRON MESYLATE INTRAVEN 20 MG/ML 25 DOLASETRON MESYLATE ORAL 00 MG 4 DOLASETRON MESYLATE ORAL 50 MG 4 DONEPEZIL HCL ORAL 0 MG TAB RAPDIS DONEPEZIL HCL ORAL 0 MG DONEPEZIL HCL ORAL 23 MG DONEPEZIL HCL ORAL 5 MG TAB RAPDIS DONEPEZIL HCL ORAL 5 MG DOXAZOSIN MESYLATE ORAL MG 02 DOXAZOSIN MESYLATE ORAL 2 MG DOXAZOSIN MESYLATE ORAL 4 MG TAB ER 24 DOXAZOSIN MESYLATE ORAL 4 MG DOXAZOSIN MESYLATE ORAL 8 MG TAB ER 24 DOXAZOSIN MESYLATE ORAL 8 MG DOXEPIN HCL ORAL 0 MG 36 DOXEPIN HCL ORAL 0 MG/ML ORAL CONC 240 DOXEPIN HCL ORAL 00 MG 02 DOXEPIN HCL ORAL 50 MG DOXEPIN HCL ORAL 25 MG 02 DOXEPIN HCL ORAL 3 MG DOXEPIN HCL ORAL 50 MG 02 DOXEPIN HCL ORAL 6 MG DOXEPIN HCL ORAL 75 MG 02 DOXEPIN HCL TOPICAL 5 % CREAM (G) 80 DOXYCYCLINE HYCLATE ORAL 20 MG DOXYLAMINE SUCCINATE ORAL 5 MG TAB CHEW 408 DOXYLAMINE/PYRIDOXINE HCL ORAL 0 MG-0MG DR 36 DRONABINOL ORAL 0 MG 60 DRONABINOL ORAL 2.5 MG 90 DRONABINOL ORAL 5 MG 90 DRONEDARONE HCL ORAL 400 MG DROPERIDOL INJECTION 2.5 MG/ML AMPUL 6 DROPERIDOL INJECTION 2.5 MG/ML 6 DROSPIR/ETH ESTRA/LEVOMEFOL CA ORAL (24) DROSPIR/ETH ESTRA/LEVOMEFOL CA ORAL (2) DROSPIRENONE/ESTRADIOL ORAL 0.25-MG DROSPIRENONE/ESTRADIOL ORAL MG-MG DROXIDOPA 02 DULOXETINE HCL ORAL 20 MG DR DULOXETINE HCL ORAL MG DR DULOXETINE HCL ORAL 60 MG DR DUTASTERIDE ORAL MG DYPHYLLINE ORAL 200 MG 20 DYPHYLLINE ORAL 400 MG 02 ECALLANTIDE SUB-Q 0MG/ML() 6 ECONAZOLE NITRATE TOPICAL % CREAM (G) 80 EFINACONAZOLE TOPICAL 0 % SOL W/APPL 4 ELETRIPTAN HBR ORAL 20 MG 0 ELETRIPTAN HBR ORAL 40 MG 0 ELTROMBOPAG OLAMINE ORAL 2.5 MG ELTROMBOPAG OLAMINE ORAL 25 MG ELTROMBOPAG OLAMINE ORAL 50 MG ELTROMBOPAG OLAMINE ORAL 75 MG ELVITEGR/COBICIST/EMTRIC/TENOF ORAL MG EMEDASTINE DIFUMARATE OPHTHALMIC 0.05 % DROPS 5 EMPAGLIFLOZIN EMTRICITAB/RILPIVIRINE/TENOFOV ORAL ENALAPRIL MALEATE ORAL 0 MG 36 ENALAPRIL MALEATE ORAL 2.5 MG 544 ENALAPRIL MALEATE ORAL 20 MG ENALAPRIL MALEATE ORAL 5 MG 272 ENALAPRIL/HYDROCHLOROTHIAZIDE ORAL 5MG Effective 0//204

11 2.5MG ENALAPRIL/HYDROCHLOROTHIAZIDE ORAL 0 MG- 25MG 02 ENALAPRILAT DIHYDRATE INTRAVEN.25 MG/ML 40 ENOXAPARIN SODIUM SUB-Q 00 MG/ML ENOXAPARIN SODIUM SUB-Q 20MG/.8ML 22.4 ENOXAPARIN SODIUM SUB-Q 50 MG/ML ENOXAPARIN SODIUM SUB-Q 0MG/3ML ENOXAPARIN SODIUM SUB-Q MG/0.3ML 8.4 ENOXAPARIN SODIUM SUB-Q 40MG/0.4ML.2 ENOXAPARIN SODIUM SUB-Q 60MG/0.6ML 6.8 ENOXAPARIN SODIUM SUB-Q 80MG/0.8ML 22.4 ENTECAVIR ORAL 0.05MG/ML SOLUTION 0 ENTECAVIR ORAL MG ENTECAVIR ORAL MG ENZALUTAMIDE ORAL 40 MG 36 EPINASTINE HCL OPHTHALMIC 0.05 % DROPS 0 EPINEPHRINE HCL NASAL :000 SOLUTION EPINEPHRINE INJECTION MG/ML EPINEPHRINE INJECTION 0. MG/ML EPINEPHRINE INJECTION / AUTO INJCT 6 EPINEPHRINE INJECTION MG/0.3 AUTO INJCT EPINEPHRINE INJECTION 0.3MG/0.3 AUTO INJCT 6 EPINEPHRINE INJECTION MG/ML() AMPUL EPINEPHRINE/PF INJECTION MG/ML() AMPUL EPLERENONE ORAL 25 MG 36 EPLERENONE ORAL 50 MG EPOETIN ALFA INJECTION 0000/ML EPOETIN ALFA INJECTION 2000/ML EPOETIN ALFA INJECTION 20000/2ML EPOETIN ALFA INJECTION 20000/ML EPOETIN ALFA INJECTION 00/ML EPOETIN ALFA INJECTION 4000/ML EPOETIN ALFA INJECTION 40000/ML 4 EPROSARTAN MESYLATE ORAL 600 MG EPROSARTAN/HYDROCHLOROTHIAZIDE ORAL MG EPROSARTAN/HYDROCHLOROTHIAZIDE ORAL MG ERY E-SUCC/SULFISOXAZOLE ORAL /5 SUSP RECON 400 ERYTHROMYCIN BASE OPHTHALMIC 5 MG/G OINT. (G) 3.5 ERYTHROMYCIN BASE ORAL 250 MG DR 84 ERYTHROMYCIN BASE ORAL 250 MG 84 ERYTHROMYCIN BASE ORAL 250 MG DR 84 ERYTHROMYCIN BASE ORAL 333 MG TAB PART 84 ERYTHROMYCIN BASE ORAL 333 MG DR 84 ERYTHROMYCIN BASE ORAL 500 MG TAB PART 84 ERYTHROMYCIN BASE ORAL 500 MG 84 ERYTHROMYCIN BASE ORAL 500 MG DR 84 ERYTHROMYCIN ETHYLSUCCINATE ORAL 200 MG/5ML SUSP RECON 400 ERYTHROMYCIN ETHYLSUCCINATE ORAL 400 MG 84 ERYTHROMYCIN ETHYLSUCCINATE ORAL 400 MG/5ML SUSP RECON 400 ERYTHROMYCIN LACTOBIONATE INTRAVEN 500 MG 56 ERYTHROMYCIN LACTOBIONATE INTRAVEN 500 MG PORT 56 ERYTHROMYCIN STEARATE ORAL 250 MG 84 ESCITALOPRAM OXALATE ORAL 0 MG ESCITALOPRAM OXALATE ORAL 20 MG ESCITALOPRAM OXALATE ORAL 5 MG ESCITALOPRAM OXALATE ORAL 5 MG/5 ML SOLUTION 0 ESOMEPRAZOLE MAGNESIUM ORAL 0 MG SUSPDR PKT ESOMEPRAZOLE MAGNESIUM ORAL 2.5 MG SUSPDR PKT ESOMEPRAZOLE MAGNESIUM ORAL 20 MG DR ESOMEPRAZOLE MAGNESIUM ORAL 20 MG SUSPDR PKT ESOMEPRAZOLE MAGNESIUM ORAL 40 MG DR ESOMEPRAZOLE MAGNESIUM ORAL 40 MG SUSPDR PKT ESOMEPRAZOLE MAGNESIUM ORAL 5 MG SUSPDR PKT ESOMEPRAZOLE SODIUM INTRAVEN 20 MG 0 ESOMEPRAZOLE SODIUM INTRAVEN 40 MG 0 ESOMEPRAZOLE STRONTIUM ORAL 49.3 MG DR ESTRADIOL ACETATE VAGINAL 0.05MG/24H VAG RING ESTRADIOL ACETATE VAGINAL 0.MG/24HR VAG RING ESTRADIOL CYPIONATE INTRAMUSC 5 MG/ML 0 ESTRADIOL HEMIHYDRT,MICRONIZED MISCELL 00 % POWDER ESTRADIOL MICRONIZED MISCELL 00 % POWDER ESTRADIOL ORAL MG ESTRADIOL ORAL MG ESTRADIOL ORAL 2 MG ESTRADIOL TRANSDERM.025MG/24H PATCH TDSW 8 ESTRADIOL TRANSDERM.025MG/24H PATCH TDWK 4 ESTRADIOL TRANSDERM.0375MG/24 PATCH TDSW 8 ESTRADIOL TRANSDERM.0375MG/24 PATCH TDWK 4 ESTRADIOL TRANSDERM.075MG/24H PATCH TDSW 8 ESTRADIOL TRANSDERM.075MG/24H PATCH TDWK 4 ESTRADIOL TRANSDERM 0.05MG/24H PATCH TDSW 8 ESTRADIOL TRANSDERM 0.05MG/24H PATCH TDWK 4 ESTRADIOL TRANSDERM 0.06MG/24H PATCH TDWK 4 ESTRADIOL TRANSDERM 0.MG/24HR PATCH TDSW 8 ESTRADIOL TRANSDERM 0.MG/24HR PATCH TDWK 4 ESTRADIOL TRANSDERM 0.25(0.%) GEL PACKET ESTRADIOL TRANSDERM MG(0.) GEL PACKET ESTRADIOL TRANSDERM 4MCG/24HR PATCH TDWK 4 ESTRADIOL TRANSDERM MG(0.%) GEL PACKET ESTRADIOL VAGINAL 0.0 % CREAM/APPL 43 ESTRADIOL VAGINAL 0 MCG 8 ESTRADIOL VAGINAL 7.5MCG/24H VAG RING ESTRADIOL VALERATE INTRAMUSC 0 MG/ML 0 ESTRADIOL VALERATE INTRAMUSC 20 MG/ML 0 Effective 0//204

12 ESTRADIOL VALERATE INTRAMUSC 40 MG/ML 0 ESTRADIOL VALERATE/DIENOGEST ORAL 3-2-() ESTRADIOL/LEVONORGESTREL TRANSDERM 45-5/24H PATCH TDWK 4 ESTRADIOL/NORETHINDRONE ACET ORAL -0.MG ESTRADIOL/NORETHINDRONE ACET ORAL MG-MG ESTRADIOL/NORETHINDRONE ACET TRANSDERM.05-.4/24 PATCH TDSW 8 ESTRADIOL/NORETHINDRONE ACET TRANSDERM /24 PATCH TDSW 8 ESTRADIOL/NORGESTIMATE ORAL MG ESTROGEN,CON/M-PROGEST ACET ORAL MG ESTROGEN,CON/M-PROGEST ACET ORAL MG ESTROGEN,CON/M-PROGEST ACET ORAL (4) ESTROGEN,CON/M-PROGEST ACET ORAL ESTROGEN,CON/M-PROGEST ACET ORAL MG ESTROGENS, CONJUGATED INJECTION 25 MG ESTROGENS, CONJUGATED ORAL 0.3 MG ESTROGENS, CONJUGATED ORAL 0.45MG ESTROGENS, CONJUGATED ORAL MG ESTROGENS, CONJUGATED ORAL 0.9 MG ESTROGENS, CONJUGATED ORAL.25 MG ESTROGENS, CONJUGATED VAGINAL MG/G CREAM/APPL 43 ESTROGENS,CONJ.,SYNTHETIC A ORAL 0.3 MG ESTROGENS,CONJ.,SYNTHETIC A ORAL 0.45MG ESTROGENS,CONJ.,SYNTHETIC A ORAL MG ESTROGENS,CONJ.,SYNTHETIC A ORAL 0.9 MG ESTROGENS,CONJ.,SYNTHETIC A ORAL.25 MG ESTROGENS,CONJ.,SYNTHETIC B ORAL 0.3 MG ESTROGENS,CONJ.,SYNTHETIC B ORAL 0.45MG ESTROGENS,CONJ.,SYNTHETIC B ORAL MG ESTROGENS,CONJ.,SYNTHETIC B ORAL 0.9 MG ESTROGENS,CONJ.,SYNTHETIC B ORAL.25 MG ESTROGENS,CONJ/BAZEDOXIFENE ORAL MG ESTROGENS,ESTERIFIED ORAL 0.3 MG ESTROGENS,ESTERIFIED ORAL MG ESTROGENS,ESTERIFIED ORAL.25 MG ESTROGENS,ESTERIFIED ORAL 2.5 MG ESTROPIPATE ORAL 0.75 MG ESTROPIPATE ORAL.5 MG ESTROPIPATE ORAL 3 MG ESZOPICLONE ORAL MG ESZOPICLONE ORAL 2 MG ESZOPICLONE ORAL 3 MG ETHACRYNATE SODIUM INTRAVEN 50 MG ETHACRYNIC ACID ORAL 25 MG 272 ETHINYL ESTRADIOL/DROSPIRENONE ORAL (24) ETHINYL ESTRADIOL/DROSPIRENONE ORAL MG ETHYL CHLORIDE TOPICAL 00 % SPRAY 200 ETHYNODIOL D-ETHINYL ESTRADIOL ORAL MG-35MCG ETHYNODIOL D-ETHINYL ESTRADIOL ORAL MG-50MCG ETIDRONATE DISODIUM ORAL 200 MG ETIDRONATE DISODIUM ORAL 400 MG ETODOLAC ORAL 200 MG 02 ETODOLAC ORAL 0 MG 02 ETODOLAC ORAL 400 MG TAB ER 24H ETODOLAC ORAL 400 MG ETODOLAC ORAL 500 MG TAB ER 24H ETODOLAC ORAL 500 MG ETODOLAC ORAL 600 MG TAB ER 24H ETONOGESTREL/ETHINYL ESTRADIOL VAGINAL VAG RING EXENATIDE MICROSPHERES SUB-Q 2 MG 4 EXENATIDE MICROSPHERES SUB-Q 2MG/0.65ML PEN INJCTR 4 EXENATIDE SUB-Q 0MCG/0.04 PEN INJCTR 2.4 EXENATIDE SUB-Q 5MCG/0.02 PEN INJCTR.2 EZETIMIBE ORAL 0 MG EZETIMIBE/ATORVASTATIN CALCIUM ORAL 0 MG- 0MG EZETIMIBE/ATORVASTATIN CALCIUM ORAL 0 MG- 20MG EZETIMIBE/ATORVASTATIN CALCIUM ORAL 0 MG- 40MG EZETIMIBE/ATORVASTATIN CALCIUM ORAL 0 MG- 80MG EZETIMIBE/SIMVASTATIN ORAL 0 MG-0MG EZETIMIBE/SIMVASTATIN ORAL 0 MG-20MG EZETIMIBE/SIMVASTATIN ORAL 0 MG-40MG EZETIMIBE/SIMVASTATIN ORAL 0 MG-80MG EZOGABINE ORAL 200 MG 02 EZOGABINE ORAL 0 MG 02 EZOGABINE ORAL 400 MG 02 EZOGABINE ORAL 50 MG 6 FAMCICLOVIR ORAL 25 MG 84 FAMCICLOVIR ORAL 250 MG 42 FAMCICLOVIR ORAL 500 MG 2 FAMOTIDINE INTRAVEN 0 MG/ML 0 FAMOTIDINE ORAL 20 MG FAMOTIDINE ORAL 40 MG FAMOTIDINE ORAL 40MG/5ML ORAL SUSP 20 FAMOTIDINE/PF INTRAVEN 20 MG/2 ML 0 FEBUXOSTAT ORAL 40 MG FEBUXOSTAT ORAL 80 MG FELODIPINE ORAL 0 MG TAB ER 24H 2 Effective 0//204

13 FELODIPINE ORAL 2.5 MG TAB ER 24H 36 FELODIPINE ORAL 5 MG TAB ER 24H FENOFIBRATE NANOCRYSTALLIZED ORAL 45MG FENOFIBRATE NANOCRYSTALLIZED ORAL 48 MG 02 FENOFIBRATE ORAL 50 MG FENOFIBRATE ORAL 60 MG FENOFIBRATE ORAL 50 MG 02 FENOFIBRATE ORAL 54 MG 02 FENOFIBRATE,MICRONIZED ORAL MG FENOFIBRATE,MICRONIZED ORAL MG FENOFIBRATE,MICRONIZED ORAL 200 MG FENOFIBRATE,MICRONIZED ORAL MG FENOFIBRATE,MICRONIZED ORAL 43 MG 02 FENOFIBRATE,MICRONIZED ORAL 67 MG 02 FENOFIBRATE,MICRONIZED ORAL 90 MG FENOFIBRIC ACID (CHOLINE) ORAL 35 MG DR FENOFIBRIC ACID (CHOLINE) ORAL 45 MG DR FENOFIBRIC ACID ORAL 05 MG FENOFIBRIC ACID ORAL 35 MG FENOPROFEN CALCIUM ORAL 400 MG 36 FENOPROFEN CALCIUM ORAL 600 MG 36 FENTANYL CITRATE BUCCAL 00 MCG EFF 36 FENTANYL CITRATE BUCCAL 200 MCG FILM 36 FENTANYL CITRATE BUCCAL 200 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 600 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 200 MCG FILM 36 FENTANYL CITRATE BUCCAL 200 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 200 MCG EFF 36 FENTANYL CITRATE BUCCAL 400 MCG FILM 36 FENTANYL CITRATE BUCCAL 400 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 400 MCG EFF 36 FENTANYL CITRATE BUCCAL 600 MCG FILM 36 FENTANYL CITRATE BUCCAL 600 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 600 MCG EFF 36 FENTANYL CITRATE BUCCAL 800 MCG FILM 36 FENTANYL CITRATE BUCCAL 800 MCG LOZENGE HD 36 FENTANYL CITRATE BUCCAL 800 MCG EFF 36 FENTANYL CITRATE NASAL 00 MCG SPRAY/PUMP 0 FENTANYL CITRATE NASAL 400 MCG SPRAY/PUMP 0 FENTANYL CITRATE SUBLINGUAL 00 MCG TAB SUBL 36 FENTANYL CITRATE SUBLINGUAL 200 MCG TAB SUBL 36 FENTANYL CITRATE SUBLINGUAL 0 MCG TAB SUBL 36 FENTANYL CITRATE SUBLINGUAL 400 MCG TAB SUBL 36 FENTANYL CITRATE SUBLINGUAL 600 MCG TAB SUBL 36 FENTANYL CITRATE SUBLINGUAL 800 MCG TAB SUBL 36 FENTANYL CITRATE/PF INJECTION 50 MCG/ML AMPUL 2 FENTANYL CITRATE/PF INJECTION 50 MCG/ML 2 FENTANYL SUBLINGUAL 00 MCG SPRAY 36 FENTANYL SUBLINGUAL 200 MCG SPRAY 36 FENTANYL SUBLINGUAL 600 MCG SPRAY 36 FENTANYL SUBLINGUAL 200 MCG SPRAY 36 FENTANYL SUBLINGUAL 400 MCG SPRAY 36 FENTANYL SUBLINGUAL 600 MCG SPRAY 36 FENTANYL SUBLINGUAL 800 MCG SPRAY 36 FENTANYL TRANSDERM 25MCG/HR PATCH TD72 FENTANYL TRANSDERM 50MCG/HR PATCH TD72 FENTANYL TRANSDERM 75MCG/HR PATCH TD72 FENTANYL TRANSDERM 00 MCG/HR PATCH TD72 FENTANYL TRANSDERM 2 MCG/HR PATCH TD72 FESOTERODINE FUMARATE ORAL 4 MG TAB ER 24H FESOTERODINE FUMARATE ORAL 8 MG TAB ER 24H FEXOFENADINE HCL ORAL 80 MG FEXOFENADINE HCL ORAL MG/5 ML ORAL SUSP 0 FEXOFENADINE HCL ORAL 60 MG FIBRINOGEN/THROMBIN (HUM PLAS) TOPICAL 4.8X4.8 CM ADH. PATCH FIBRINOGEN/THROMBIN (HUM PLAS) TOPICAL 9.5X4.8 CM ADH. PATCH FIDAXOMICIN ORAL 200 MG 20 FINGOLIMOD HCL ORAL MG FLAVOXATE HCL ORAL 00 MG 02 FLECAINIDE ACETATE ORAL 00 MG 36 FLECAINIDE ACETATE ORAL 50 MG 02 FLECAINIDE ACETATE ORAL 50 MG 272 FLU VAC TV 204(8-49YR)RCM/PF INTRAMUSC 35MCG/ FLU VACC QS 204-5(36MOS+)/PF INTRAMUSC 60MCG/.5ML FLU VACC QS 204-5(36MOS+)/PF INTRAMUSC 60MCG/.5ML FLU VACC QV LIVE 204(2-49YRS) NASAL 0E NAS SP SYR FLU VACC TS 4-5 (8+)CELL/PF INTRAMUSC 45MCG/.5ML FLU VACC TS 204 (8-64YRS)/PF INTRADERM 27MCG/.ML 0. FLU VACC TS (65YR+)/PF INTRAMUSC 80MCG/ FLU VACC TS 204-5(36MOS+)/PF INTRAMUSC 45MCG/.5ML FLU VACCINE QS 204-5(36MOS+) INTRAMUSC 60MCG/.5ML FLU VACCINE QS 204-5(6MOS+) INTRAMUSC 60MCG/.5ML FLU VACCINE TS (4 YR+) INTRAMUSC 45MCG/.5ML FLU VACCINE TS 204-5(36MOS+) INTRAMUSC 45MCG/.5ML FLU VACCINE TS 204-5(6 MOS+) INTRAMUSC 45MCG/.5ML FLU VACCINE TS204-5(4YR+)/PF INTRAMUSC 45MCG/.5ML FLUCONAZOLE IN DEXTROSE,ISO-OS INTRAVEN 200MG/0.L PIGGYBACK 6, FLUCONAZOLE IN DEXTROSE,ISO-OS INTRAVEN 400MG/0.2L PIGGYBACK 6, Effective 0//204

14 FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 200MG/0.L PGGYBK BTL 6, FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 200MG/0.L PIGGYBACK 6, FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 400MG/0.2L PGGYBK BTL 6, FLUCONAZOLE IN NACL,ISO-OSM INTRAVEN 400MG/0.2L PIGGYBACK 6, FLUCONAZOLE ORAL 0 MG/ML SUSP RECON, FLUCONAZOLE ORAL 00 MG 36 FLUCONAZOLE ORAL 50 MG FLUCONAZOLE ORAL 200 MG FLUCONAZOLE ORAL 40 MG/ML SUSP RECON 350 FLUCONAZOLE ORAL 50 MG 272 FLUDARABINE PHOSPHATE INTRAVEN 50 MG/2 ML 2 FLUNISOLIDE NASAL 25 MCG SPRAY 75 FLUOCINOLONE ACETONIDE OIL OTIC 0.0 % DROPS 20 FLUOCINOLONE ACETONIDE TOPICAL 0.0 % CREAM (G) 80 FLUOCINOLONE ACETONIDE TOPICAL 0.0 % OIL FLUOCINOLONE ACETONIDE TOPICAL 0.0 % SHAMPOO 80 FLUOCINOLONE ACETONIDE TOPICAL 0.0 % SOLUTION 80 FLUOCINOLONE ACETONIDE TOPICAL % CREAM (G) 80 FLUOCINOLONE ACETONIDE TOPICAL % OINT. (G) 80 FLUOCINOLONE/SHOWER CAP TOPICAL 0.0 % OIL 8. FLUOCINONIDE TOPICAL 0.05 % CREAM (G) 80 FLUOCINONIDE TOPICAL 0.05 % GEL (GRAM) 80 FLUOCINONIDE TOPICAL 0.05 % OINT. (G) 80 FLUOCINONIDE TOPICAL 0.05 % SOLUTION 80 FLUOCINONIDE TOPICAL 0. % CREAM (G) 80 FLUOCINONIDE/EMOLLIENT BASE TOPICAL 0.05 % CREAM (G) 80 FLUOROMETHOLONE OPHTHALMIC 0. % OINT. (G) 3.5 FLUOROURACIL TOPICAL % CREAM (G) 80 FLUOROURACIL TOPICAL 2 % SOLUTION FLUOROURACIL TOPICAL 5 % CREAM (G) 00 FLUOROURACIL TOPICAL 5 % SOLUTION FLUOXETINE HCL ORAL 0 MG FLUOXETINE HCL ORAL 0 MG FLUOXETINE HCL ORAL 20 MG FLUOXETINE HCL ORAL 20 MG FLUOXETINE HCL ORAL 20 MG/5 ML SOLUTION 0 FLUOXETINE HCL ORAL 40 MG FLUOXETINE HCL ORAL 60 MG FLUOXETINE HCL ORAL 90 MG DR 4 FLUPHENAZINE DECANOATE INJECTION 25 MG/ML 0 FLUPHENAZINE HCL INJECTION 2.5 MG/ML 0 FLUPHENAZINE HCL ORAL MG 02 FLUPHENAZINE HCL ORAL 0 MG FLUPHENAZINE HCL ORAL 2.5 MG 02 FLUPHENAZINE HCL ORAL 2.5 MG/5ML ELIXIR 600 FLUPHENAZINE HCL ORAL 5 MG FLUPHENAZINE HCL ORAL 5 MG/ML ORAL CONC 480 FLURANDRENOLIDE TOPICAL 4MCG/SQ CM MED. TAPE 200 FLURAZEPAM HCL ORAL 5 MG 5 FLURAZEPAM HCL ORAL MG 5 FLURBIPROFEN ORAL 00 MG 36 FLURBIPROFEN ORAL 50 MG 36 FLURBIPROFEN SODIUM OPHTHALMIC 0.03 % DROPS 2.5 FLUTICASONE FUROATE NASAL 27.5 MCG SPRAY SUSP 0 FLUTICASONE PROPIONATE INHALATION 00 MCG BLST W/DEV 240 FLUTICASONE PROPIONATE INHALATION 0 MCG AER W/ADAP 24 FLUTICASONE PROPIONATE INHALATION 220 MCG AER W/ADAP 26 FLUTICASONE PROPIONATE INHALATION 250 MCG BLST W/DEV 20 FLUTICASONE PROPIONATE INHALATION 44 MCG AER W/ADAP 2.2 FLUTICASONE PROPIONATE INHALATION 50 MCG BLST W/DEV 240 FLUTICASONE PROPIONATE NASAL 50 MCG SPRAY SUSP 6 FLUTICASONE PROPIONATE TOPICAL % OINT. (G) 80 FLUTICASONE PROPIONATE TOPICAL 0.05 % CREAM (G) 80 FLUTICASONE PROPIONATE TOPICAL 0.05 % LOTION 80 FLUTICASONE/SALMETEROL INHALATION MCG BLST W/DEV 60 FLUTICASONE/SALMETEROL INHALATION 5-2MCG HFA AER AD 6 FLUTICASONE/SALMETEROL INHALATION 2-2MCG HFA AER AD 6 FLUTICASONE/SALMETEROL INHALATION MCG BLST W/DEV 60 FLUTICASONE/SALMETEROL INHALATION 45-2MCG HFA AER AD 6 FLUTICASONE/SALMETEROL INHALATION MCG BLST W/DEV 60 FLUTICASONE/VILANTEROL INHALATION 00-25MCG BLST W/DEV 60 FLUVASTATIN SODIUM ORAL 20 MG 02 FLUVASTATIN SODIUM ORAL 40 MG FLUVASTATIN SODIUM ORAL 80 MG TAB ER 24H FLUVOXAMINE MALEATE ORAL 00 MG CAP ER 24H 02 FLUVOXAMINE MALEATE ORAL 00 MG 02 FLUVOXAMINE MALEATE ORAL 50 MG CAP ER 24H FLUVOXAMINE MALEATE ORAL 25 MG FLUVOXAMINE MALEATE ORAL 50 MG FONDAPARINUX SODIUM SUB-Q 0MG/0.8ML 20.8 FONDAPARINUX SODIUM SUB-Q 2.5 MG/ 6 FONDAPARINUX SODIUM SUB-Q 5MG/0.4ML 0.4 FONDAPARINUX SODIUM SUB-Q 7.5MG/ FORMOTEROL FUMARATE INHALATION 2 MCG CAP W/DEV FORMOTEROL FUMARATE INHALATION 20 MCG/2ML -NEB 36 FOSAPREPITANT DIMEGLUMINE INTRAVEN 50 MG FOSINOPRIL SODIUM ORAL 0 MG 36 4 Effective 0//204

15 FOSINOPRIL SODIUM ORAL 20 MG FOSINOPRIL SODIUM ORAL 40 MG FOSINOPRIL/HYDROCHLOROTHIAZIDE ORAL 0-2.5MG 36 FOSINOPRIL/HYDROCHLOROTHIAZIDE ORAL MG FROVATRIPTAN SUCCINATE ORAL 2.5 MG 0 FUROSEMIDE INJECTION 0 MG/ML 40 FUROSEMIDE INJECTION 0 MG/ML 40 FUROSEMIDE ORAL 0 MG/ML SOLUTION 480 FUROSEMIDE ORAL 20 MG, FUROSEMIDE ORAL 40 MG 50 FUROSEMIDE ORAL 40MG/5ML SOLUTION 500 FUROSEMIDE ORAL 80 MG 238 GABAPENTIN ENACARBIL ORAL 0 MG ER GABAPENTIN ENACARBIL ORAL 600 MG ER GABAPENTIN ORAL 0 MG TAB ER 24H 02 GABAPENTIN ORAL MG TAB ER 24H 78 GABAPENTIN ORAL 600 MG TAB ER 24H 02 GALANTAMINE HBR ORAL 2 MG GALANTAMINE HBR ORAL 6 MG CAP24H PEL GALANTAMINE HBR ORAL 24 MG CAP24H PEL GALANTAMINE HBR ORAL 4 MG GALANTAMINE HBR ORAL 4 MG/ML SOLUTION 204 GALANTAMINE HBR ORAL 8 MG CAP24H PEL GALANTAMINE HBR ORAL 8 MG GANCICLOVIR OPHTHALMIC % GEL (GRAM) 0 GATIFLOXACIN OPHTHALMIC % DROPS 5 GEMFIBROZIL ORAL 600 MG GENTAMICIN SULFATE INJECTION 40 MG/ML 80 GENTAMICIN SULFATE INJECTION 20 MG/2 ML 80 GENTAMICIN SULFATE OPHTHALMIC 0.3 % DROPS 5 GENTAMICIN SULFATE OPHTHALMIC 0.3 % OINT. (G) 3.5 GENTAMICIN SULFATE TOPICAL 0. % CREAM (G) 60 GENTAMICIN SULFATE TOPICAL 0. % OINT. (G) 60 GENTAMICIN SULFATE/PF INJECTION 20 MG/2 ML 80 GENTAMICIN/PREDNISOL AC OPHTHALMIC 0.3%-% DROPS SUSP 0 GENTAMICIN/PREDNISOL AC OPHTHALMIC % OINT. (G) 3.5 GLATIRAMER ACETATE SUB-Q 20 MG/ML KIT GLIMEPIRIDE ORAL MG GLIMEPIRIDE ORAL 2 MG GLIMEPIRIDE ORAL 4 MG GLIPIZIDE ORAL 0 MG TAB ER 24 GLIPIZIDE ORAL 0 MG 36 GLIPIZIDE ORAL 2.5 MG TAB ER GLIPIZIDE ORAL 5 MG TAB ER GLIPIZIDE ORAL 5 MG 36 GLIPIZIDE/METFORMIN HCL ORAL MG 36 GLIPIZIDE/METFORMIN HCL ORAL MG GLIPIZIDE/METFORMIN HCL ORAL 5 MG-500MG GLYBURIDE ORAL.25 MG 36 GLYBURIDE ORAL 2.5 MG 36 GLYBURIDE ORAL 5 MG 36 GLYBURIDE,MICRONIZED ORAL.5 MG 36 GLYBURIDE,MICRONIZED ORAL 3 MG 36 GLYBURIDE,MICRONIZED ORAL 6 MG 36 GLYBURIDE/METFORMIN HCL ORAL MG 36 GLYBURIDE/METFORMIN HCL ORAL MG 70 GLYBURIDE/METFORMIN HCL ORAL 5 MG-500MG 70 GLYCOPYRROLATE ORAL MG 02 GLYCOPYRROLATE ORAL 2 MG 02 GOLIMUMAB INTRAVEN 50 MG/4 ML 24 GOLIMUMAB SUB-Q 00 MG/ML PEN INJCTR 3 GOLIMUMAB SUB-Q 00 MG/ML 3 GOLIMUMAB SUB-Q 50MG/ML PEN INJCTR GOLIMUMAB SUB-Q 50MG/ML GOSERELIN ACETATE SUB-Q 0.8MG IMPLANT GOSERELIN ACETATE SUB-Q 3.6 MG IMPLANT GRANISETRON HCL INTRAVEN MG/ML 4 GRANISETRON HCL INTRAVEN MG/ML() 4 GRANISETRON HCL ORAL MG 8 GRANISETRON HCL/PF INTRAVEN MG/ML() 4 GRANISETRON HCL/PF INTRAVEN 00 MCG/ML 4 GRANISETRON TRANSDERM 3.MG/24HR PATCH TDWK 5 GRASS POLLEN-TIMOTHY, STD SUBLINGUAL 00 BAU TAB SUBL GUANFACINE HCL ORAL MG TAB ER 24H GUANFACINE HCL ORAL MG GUANFACINE HCL ORAL 2 MG TAB ER 24H GUANFACINE HCL ORAL 2 MG GUANFACINE HCL ORAL 3 MG TAB ER 24H GUANFACINE HCL ORAL 4 MG TAB ER 24H HALCINONIDE TOPICAL 0. % CREAM (G) 80 HALCINONIDE TOPICAL 0. % OINT. (G) 80 HALOBETASOL PROPIONATE TOPICAL 0.05 % CREAM (G) 80 HALOBETASOL PROPIONATE TOPICAL 0.05 % OINT. (G) 80 HALOBETASOL/AMMONIUM LACTATE TOPICAL 0.05%- 2% CMB ONT FM 63.4 HALOBETASOL/AMMONIUM LACTATE TOPICAL 0.05%- 2% CMB ONT LT 275 HALOBETASOL/LACTIC ACID TOPICAL 0.05%-0% CMB ONT CR 275 HALOBETASOL/LACTIC ACID TOPICAL 0.05%-0% COMBO. PKG 275 HALOPERIDOL DECANOATE INTRAMUSC 00 MG/ML AMPUL 5 HALOPERIDOL DECANOATE INTRAMUSC 00 MG/ML 5 HALOPERIDOL DECANOATE INTRAMUSC 50 MG/ML AMPUL 5 HALOPERIDOL DECANOATE INTRAMUSC 50 MG/ML 0 5 Effective 0//204