Quantity Limits Paramount Medicare Formulary 2012 Formulary ID 12112, Version 22. CMS Approved 10-23-2012. ABILIFY Abilify TABS ABILIFY DISCMELT Abilify Discmelt ACTONEL Actonel TABS 150MG Actonel TABS 30MG, 5MG Actonel TABS 35MG Quantity Limit: 1 EA Per 34 Days Quantity Limit: 5 EA Per 35 Days ACTOPLUS MET Actoplus Met Quantity Limit: 102 EA Per 34 Days ACTOPLUS MET XR Actoplus Met Xr TB24 1000MG; 15MG Actoplus Met Xr TB24 1000MG; 30MG ACTOS Actos ADCIRCA Adcirca ADVAIR DISKUS Advair Diskus Quantity Limit: 120 EA Per 30 Days ADVAIR HFA Advair Hfa Quantity Limit: 24 GM Per 34 Days
ADVICOR Advicor TB24 20MG; 1000MG, 20MG; 750MG, 40MG; 1000MG Advicor TB24 20MG; 500MG ALENDRONATE SODIUM Alendronate Sodium TABS 10MG, 40MG, 5MG Alendronate Sodium TABS 35MG, 70MG Quantity Limit: 5 EA Per 35 Days APLENZIN Aplenzin ASTEPRO Astepro Quantity Limit: 60 ML Per 34 Days ATORVASTATIN CALCIUM Atorvastatin Calcium ATROVENT Atrovent SOLN 0.03% Atrovent SOLN 0.06% Quantity Limit: 60 ML Per 34 Days Quantity Limit: 30 ML Per 34 Days ATROVENT HFA Atrovent Hfa Quantity Limit: 26 GM Per 34 Days AVONEX Avonex Quantity Limit: 4 EA Per 28 Days AXERT Axert TABS 12.5MG Axert TABS 6.25MG Quantity Limit: 24 EA Per 28 Days Quantity Limit: 18 EA Per 28 Days 2
AZELASTINE HCL Azelastine Hcl NASAL SOLN 137MCG/SPRAY Quantity Limit: 60 ML Per 34 Days AZITHROMYCIN Azithromycin SUSR 100MG/5ML Azithromycin SUSR 200MG/5ML Azithromycin TABS 250MG Azithromycin TABS 500MG Quantity Limit: 30 ML Per 5 Days Quantity Limit: 90 ML Per 5 Days Quantity Limit: 8 EA Per 7 Days Quantity Limit: 4 EA Per 4 Days BETASERON Betaseron Quantity Limit: 15 EA Per 30 Days BUDEPRION SR Budeprion Sr BUDEPRION XL Budeprion XL BUPROPION HCL SR Bupropion Hcl Sr BUTORPHANOL TARTRATE Butorphanol Tartrate NASAL SOLN Quantity Limit: 5 ML Per 3 Days BYETTA Byetta INJ 10MCG/0.04ML Byetta INJ 5MCG/0.02ML Quantity Limit: 5 ML Per 34 Days Quantity Limit: 2 ML Per 34 Days CABERGOLINE Cabergoline Quantity Limit: 20 EA Per 34 Days 3
CADUET Caduet CAYSTON Cayston Quantity Limit: 84 ML Per 28 Days CESAMET Cesamet Quantity Limit: 30 EA Per 5 Days CHORIONIC GONADOTROPIN Chorionic Gonadotropin Quantity Limit: 3 EA Per 34 Days CITALOPRAM HYDROBROMIDE Citalopram Hydrobromide TABS CLIMARA PRO Climara Pro Quantity Limit: 5 EA Per 35 Days CLONIDINE HCL Clonidine Hcl PTWK Quantity Limit: 5 EA Per 35 Days COMBIVENT Combivent Quantity Limit: 44 GM Per 34 Days COPAXONE Copaxone Quantity Limit: 30 EA Per 30 Days CORDRAN TAPE Cordran Tape Quantity Limit: 900 EA Per 34 Days CRESTOR 4
Crestor CYMBALTA Cymbalta CPEP 20MG, 60MG Cymbalta CPEP 30MG DEPO-SUBQ PROVERA 104 Depo-subq Provera 104 Quantity Limit: 1 ML Per 90 Days DEXILANT Dexilant CPDR 30MG DIVIGEL Divigel GEL 1MG/GM Quantity Limit: 34 GM Per 34 Days DOXAZOSIN MESYLATE Doxazosin Mesylate TABS 1MG, 2MG, 4MG Doxazosin Mesylate TABS 8MG DUETACT Duetact ELESTRIN Elestrin Quantity Limit: 144 GM Per 34 Days EMBEDA Embeda Quantity Limit: 90 EA Per 30 Days EMEND Emend CAPS 0 Emend CAPS 125MG, 40MG Quantity Limit: 3 EA Per 3 Days Quantity Limit: 1 EA Per 1 Days 5
Emend CAPS 80MG Quantity Limit: 2 EA Per 2 Days ENBREL Enbrel INJ 25MG Enbrel INJ 25MG/0.5ML, 50MG/ML Quantity Limit: 10 EA Per 35 Days Quantity Limit: 10 ML Per 35 Days EPIPEN 2-PAK Epipen 2-pak Quantity Limit: 4 EA Per 2 Days EPIPEN-JR 2-PAK Epipen-jr 2-pak Quantity Limit: 4 EA Per 2 Days ESCITALOPRAM OXALATE Escitalopram Oxalate TABS ESTRADIOL Estradiol PTWK Quantity Limit: 5 EA Per 35 Days EXTAVIA Extavia Quantity Limit: 15 EA Per 30 Days FACTIVE Factive Quantity Limit: 7 EA Per 7 Days FAMCICLOVIR Famciclovir TABS 125MG Famciclovir TABS 250MG Famciclovir TABS 500MG Quantity Limit: 21 EA Per 10 Days Quantity Limit: 21 EA Per 7 Days FANAPT Fanapt 6
FANAPT TITRATION PACK Fanapt Titration Pack Quantity Limit: 1 EA Per 34 Days FENTANYL CITRATE ORAL TRANSMUCOSAL Fentanyl Citrate Oral Transmucosal Quantity Limit: 120 EA Per 30 Days FENTORA Fentora Quantity Limit: 112 EA Per 28 Days FLECTOR Flector Quantity Limit: 60 EA Per 30 Days FLOVENT DISKUS Flovent Diskus AEPB 100MCG/BLIST, 50MCG/BLIST Flovent Diskus AEPB 250MCG/BLIST Quantity Limit: 120 EA Per 30 Days Quantity Limit: 300 EA Per 30 Days FLOVENT HFA Flovent Hfa AERO 110MCG/ACT Flovent Hfa AERO 220MCG/ACT Flovent Hfa AERO 44MCG/ACT Quantity Limit: 12 GM Per 34 Days Quantity Limit: 36 GM Per 34 Days Quantity Limit: 21 GM Per 34 Days FLUCONAZOLE Fluconazole TABS 150MG Quantity Limit: 2 EA Per 7 Days FLUNISOLIDE Flunisolide Quantity Limit: 75 ML Per 34 Days FLUOXETINE DR Fluoxetine Dr Quantity Limit: 5 EA Per 34 Days 7
FLUOXETINE HCL Fluoxetine Hcl CAPS 10MG Fluoxetine Hcl CAPS 40MG Fluoxetine Hcl TABS 10MG FLUTICASONE PROPIONATE Fluticasone Propionate SUSP Quantity Limit: 32 GM Per 34 Days FLUVASTATIN Fluvastatin CAPS 20MG Fluvastatin CAPS 40MG FLUVOXAMINE MALEATE Fluvoxamine Maleate TABS 100MG Fluvoxamine Maleate TABS 25MG Fluvoxamine Maleate TABS 50MG Quantity Limit: 102 EA Per 34 Days FORTEO Forteo Quantity Limit: 2.40 ML Per 28 Days FOSAMAX Fosamax SOLN Quantity Limit: 375 ML Per 35 Days FROVA Frova Quantity Limit: 27 EA Per 28 Days GEODON Geodon CAPS GRANISETRON HCL 8
Granisetron Hcl TABS Quantity Limit: 2 EA Per 1 Days HUMIRA Humira Quantity Limit: 5 EA Per 35 Days HUMIRA PEN-CROHNS DISEASESTARTER Humira Pen-crohns Diseasestarter Quantity Limit: 6 EA Per 180 Days IBANDRONATE SODIUM Ibandronate Sodium Quantity Limit: 1 EA Per 30 Days INVEGA Invega TB24 1.5MG, 3MG, 9MG Invega TB24 6MG IPRATROPIUM BROMIDE Ipratropium Bromide SOLN 0.03% Ipratropium Bromide SOLN 0.06% Quantity Limit: 60 ML Per 34 Days Quantity Limit: 30 ML Per 34 Days JANUMET Janumet JANUMET XR Janumet Xr TB24 1000MG; 100MG, 500MG; 50MG Janumet Xr TB24 1000MG; 50MG JANUVIA Januvia JUVISYNC 9
Juvisync KETOROLAC TROMETHAMINE Ketorolac Tromethamine TABS Quantity Limit: 20 EA Per 5 Days KOMBIGLYZE XR Kombiglyze Xr TB24 1000MG; 2.5MG Kombiglyze Xr TB24 1000MG; 5MG, 500MG; 5MG LANSOPRAZOLE Lansoprazole CPDR 15MG LANSOPRAZOLE ODT Lansoprazole Odt TBDP 15MG LATUDA Latuda TABS 20MG, 40MG, 80MG LEFLUNOMIDE Leflunomide LEVOCETIRIZINE DIHYDROCHLORIDE Levocetirizine Dihydrochloride TABS LEXAPRO Lexapro TABS LIPITOR Lipitor LOVASTATIN 10
Lovastatin TABS 10MG Lovastatin TABS 20MG, 40MG LUNESTA Lunesta LUVOX CR Luvox Cr MAXAIR AUTOHALER Maxair Autohaler Quantity Limit: 28 GM Per 34 Days MAXALT Maxalt Quantity Limit: 36 EA Per 28 Days MAXALT-MLT Maxalt-mlt Quantity Limit: 36 EA Per 28 Days MEDROXYPROGESTERONE ACETATE Medroxyprogesterone Acetate INJ Quantity Limit: 1 ML Per 90 Days MELOXICAM Meloxicam TABS 7.5MG MICONAZOLE 3 Miconazole 3 Quantity Limit: 3 EA Per 3 Days MIGRANAL Migranal Quantity Limit: 8 ML Per 28 Days MORPHINE SULFATE ER 11
Morphine Sulfate Er CP24 Morphine Sulfate Er TB12 Quantity Limit: 90 EA Per 30 Days Quantity Limit: 120 EA Per 30 Days NARATRIPTAN HCL Naratriptan Hcl Quantity Limit: 18 EA Per 28 Days NASONEX Nasonex Quantity Limit: 51 GM Per 34 Days NEULASTA Neulasta Quantity Limit: 2 ML Per 30 Days NEUMEGA Neumega Quantity Limit: 21 EA Per 21 Days NUCYNTA Nucynta Quantity Limit: 205 EA Per 34 Days OLANZAPINE Olanzapine TABS OLANZAPINE ODT Olanzapine Odt OMEPRAZOLE Omeprazole CPDR 10MG, 20MG OMEPRAZOLE/SODIUM BICARBONATE Omeprazole/sodium Bicarbonate CAPS 20MG; 1100MG ONDANSETRON HCL 12
Ondansetron Hcl ORAL SOLN Ondansetron Hcl TABS 24MG Ondansetron Hcl TABS 4MG, 8MG Quantity Limit: 150 ML Per 5 Days Quantity Limit: 1 EA Per 1 Days Quantity Limit: 12 EA Per 5 Days ONDANSETRON ODT Ondansetron Odt Quantity Limit: 12 EA Per 5 Days ONGLYZA Onglyza ONSOLIS Onsolis Quantity Limit: 120 EA Per 30 Days OPANA ER (CRUSH RESISTANT) Opana Er (crush Resistant) Quantity Limit: 90 EA Per 30 Days OXYBUTYNIN CHLORIDE ER Oxybutynin Chloride Er TB24 5MG OXYCONTIN Oxycontin Quantity Limit: 90 EA Per 30 Days OXYMORPHONE HYDROCHLORIDE ER Oxymorphone Hydrochloride Er Quantity Limit: 90 EA Per 30 Days PANTOPRAZOLE SODIUM Pantoprazole Sodium TBEC 20MG PAROXETINE HCL Paroxetine Hcl TABS 10MG, 40MG Paroxetine Hcl TABS 20MG, 30MG 13
PAROXETINE HCL ER Paroxetine Hcl Er PATANASE Patanase Quantity Limit: 61 GM Per 34 Days PEGASYS Pegasys INJ 180MCG/0.5ML Pegasys INJ 180MCG/ML Quantity Limit: 4 EA Per 28 Days Quantity Limit: 4 ML Per 28 Days PEG-INTRON Peg-intron Quantity Limit: 5 EA Per 34 Days PEG-INTRON REDIPEN Peg-intron Redipen Quantity Limit: 5 EA Per 34 Days PEG-INTRON REDIPEN PAK 4 Peg-intron Redipen Pak 4 Quantity Limit: 5 EA Per 34 Days PIOGLITAZONE HCL/METFORMIN HCL Pioglitazone Hcl/metformin Hcl Quantity Limit: 102 EA Per 34 Days PRANDIMET Prandimet Quantity Limit: 170 EA Per 34 Days PRAVASTATIN SODIUM Pravastatin Sodium PREVPAC Prevpac Quantity Limit: 14 EA Per 14 Days 14
PRISTIQ Pristiq PROAIR HFA Proair Hfa Quantity Limit: 26 GM Per 34 Days PROVENTIL HFA Proventil Hfa Quantity Limit: 20 GM Per 34 Days PULMICORT FLEXHALER Pulmicort Flexhaler AEPB 180MCG/ACT Pulmicort Flexhaler AEPB 90MCG/ACT Quantity Limit: 3 EA Per 34 Days Quantity Limit: 2 EA Per 34 Days QUETIAPINE FUMARATE Quetiapine Fumarate TABS 100MG, 200MG, 25MG, 50MG Quetiapine Fumarate TABS 300MG, 400MG Quantity Limit: 102 EA Per 34 Days REBIF Rebif Quantity Limit: 8 ML Per 35 Days REBIF TITRATION PACK Rebif Titration Pack Quantity Limit: 12 ML Per 28 Days REGRANEX Regranex Quantity Limit: 30 GM Per 34 Days RELENZA DISKHALER Relenza Diskhaler Quantity Limit: 60 EA Per 180 Days RELPAX Relpax Quantity Limit: 18 EA Per 28 Days 15
RESTASIS Restasis Quantity Limit: 60 EA Per 30 Days REVATIO Revatio TABS Quantity Limit: 102 EA Per 34 Days RISPERIDONE Risperidone SOLN Risperidone TABS Quantity Limit: 544 ML Per 34 Days RISPERIDONE ODT Risperidone Odt ROZEREM Rozerem SAMSCA Samsca SANDOSTATIN LAR DEPOT Sandostatin Lar Depot INJ 10MG, 30MG Sandostatin Lar Depot INJ 20MG Quantity Limit: 1 EA Per 28 Days Quantity Limit: 2 EA Per 28 Days SAPHRIS Saphris SARAFEM Sarafem TABS 10MG Sarafem TABS 20MG Quantity Limit: 35 EA Per 14 Days Quantity Limit: 140 EA Per 14 Days SAVELLA 16
Savella SAVELLA TITRATION PACK Savella Titration Pack Quantity Limit: 1 EA Per 34 Days SELFEMRA Selfemra CAPS 10MG Selfemra CAPS 20MG Quantity Limit: 35 EA Per 14 Days Quantity Limit: 140 EA Per 14 Days SEREVENT DISKUS Serevent Diskus Quantity Limit: 120 EA Per 34 Days SEROQUEL Seroquel TABS 100MG, 200MG, 25MG, 50MG Seroquel TABS 300MG, 400MG Quantity Limit: 102 EA Per 34 Days SEROQUEL XR Seroquel Xr TB24 150MG, 200MG Seroquel Xr TB24 300MG, 400MG, 50MG SERTRALINE HCL Sertraline Hcl TABS 100MG, 50MG Sertraline Hcl TABS 25MG SIMCOR Simcor TB24 1000MG; 40MG, 500MG; 20MG, 500MG; 40MG Simcor TB24 750MG; 20MG SIMVASTATIN Simvastatin 17
SPIRIVA HANDIHALER Spiriva Handihaler Quantity Limit: 60 EA Per 34 Days SUBOXONE Suboxone Quantity Limit: 102 EA Per 34 Days SUMATRIPTAN SUCCINATE Sumatriptan Succinate INJ Sumatriptan Succinate TABS Quantity Limit: 16 ML Per 28 Days Quantity Limit: 18 EA Per 28 Days SYMBICORT Symbicort Quantity Limit: 20 GM Per 34 Days SYMLIN Symlin Quantity Limit: 35 ML Per 34 Days SYMLINPEN 120 Symlinpen 120 Quantity Limit: 22 ML Per 34 Days SYMLINPEN 60 Symlinpen 60 Quantity Limit: 12 ML Per 34 Days TAMIFLU Tamiflu CAPS 30MG Tamiflu CAPS 45MG, 75MG Tamiflu SUSR 12MG/ML Tamiflu SUSR 6MG/ML Quantity Limit: 84 EA Per 180 Days Quantity Limit: 42 EA Per 180 Days Quantity Limit: 900 ML Per 180 Days Quantity Limit: 600 ML Per 180 Days TERAZOSIN HCL Terazosin Hcl CAPS 10MG 18
Terazosin Hcl CAPS 1MG, 2MG, 5MG TERCONAZOLE Terconazole CREA 0.4% Terconazole CREA 0.8% Terconazole SUPP Quantity Limit: 45 GM Per 7 Days Quantity Limit: 20 GM Per 3 Days Quantity Limit: 3 EA Per 3 Days TOBI Tobi Quantity Limit: 56 ML Per 28 Days TRAMADOL HCL Tramadol Hcl Quantity Limit: 272 EA Per 34 Days TRAMADOL HCL ER Tramadol Hcl Er TB24 TRAMADOL HYDROCHLORIDE/ACETAMINOPHEN Tramadol Hydrochloride/acetaminophen Quantity Limit: 272 EA Per 34 Days TRIAMCINOLONE ACETONIDE Triamcinolone Acetonide INHA Quantity Limit: 33 GM Per 34 Days TUDORZA PRESSAIR Tudorza Pressair Quantity Limit: 2 EA Per 34 Days TWINJECT Twinject Quantity Limit: 4 EA Per 2 Days VALACYCLOVIR HCL Valacyclovir Hcl VENLAFAXINE HCL 19
Venlafaxine Hcl Quantity Limit: 102 EA Per 34 Days VENLAFAXINE HCL ER Venlafaxine Hcl Er CP24 150MG, 37.5MG Venlafaxine Hcl Er CP24 75MG Venlafaxine Hcl Er TB24 Quantity Limit: 102 EA Per 34 Days VENTOLIN HFA Ventolin Hfa Quantity Limit: 54 GM Per 34 Days VICTOZA Victoza Quantity Limit: 3 ML Per 30 Days VIIBRYD Viibryd KIT Viibryd TABS Quantity Limit: 30 EA Per 30 Days VIVELLE-DOT Vivelle-dot Quantity Limit: 10 EA Per 35 Days VYTORIN Vytorin XOLAIR Xolair Quantity Limit: 6 EA Per 28 Days XOPENEX HFA Xopenex Hfa Quantity Limit: 45 GM Per 34 Days ZALEPLON Zaleplon CAPS 10MG 20
Zaleplon CAPS 5MG ZAZOLE Zazole CREA 0.4% Zazole CREA 0.8% Quantity Limit: 45 GM Per 7 Days Quantity Limit: 20 GM Per 3 Days ZIPRASIDONE HCL Ziprasidone Hcl ZMAX Zmax Quantity Limit: 60 EA Per 1 Days ZOLPIDEM TARTRATE Zolpidem Tartrate ZOLPIDEM TARTRATE ER Zolpidem Tartrate Er ZOMIG Zomig Quantity Limit: 18 EA Per 28 Days ZOMIG ZMT Zomig Zmt Quantity Limit: 18 EA Per 28 Days ZYPREXA Zyprexa TABS ZYPREXA ZYDIS Zyprexa Zydis 21
INDEX A ABILIFY... 1 ABILIFY DISCMELT... 1 ACTONEL... 1 ACTOPLUS MET... 1 ACTOPLUS MET XR... 1 ACTOS... 1 ADCIRCA... 1 ADVAIR DISKUS... 1 ADVAIR HFA... 1 ADVICOR... 2 ALENDRONATE SODIUM... 2 APLENZIN... 2 ASTEPRO... 2 ATORVASTATIN CALCIUM... 2 ATROVENT... 2 ATROVENT HFA... 2 AVONEX... 2 AXERT... 2 AZELASTINE HCL... 3 AZITHROMYCIN... 3 B BETASERON... 3 BUDEPRION SR... 3 BUDEPRION XL... 3 BUPROPION HCL SR... 3 BUTORPHANOL TARTRATE... 3 BYETTA... 3 C CABERGOLINE... 3 CADUET... 4 CAYSTON... 4 CESAMET... 4 CHORIONIC GONADOTROPIN... 4 CITALOPRAM HYDROBROMIDE... 4 CLIMARA PRO... 4 CLONIDINE HCL... 4 COMBIVENT... 4 COPAXONE... 4 CORDRAN TAPE... 4 CRESTOR... 4, 5 CYMBALTA... 5 D DEPO-SUBQ PROVERA 104... 5 DEXILANT... 5 DIVIGEL... 5 DOXAZOSIN MESYLATE... 5 DUETACT... 5 E ELESTRIN... 5 EMBEDA... 5 EMEND... 5, 6 ENBREL... 6 EPIPEN 2-PAK... 6 EPIPEN-JR 2-PAK... 6 ESCITALOPRAM OXALATE... 6 ESTRADIOL... 6 EXTAVIA... 6 F FACTIVE... 6 FAMCICLOVIR... 6 FANAPT... 6 FANAPT TITRATION PACK... 7 FENTANYL CITRATE ORAL TRANSMUCOSAL... 7 FENTORA... 7 FLECTOR... 7 FLOVENT DISKUS... 7 FLOVENT HFA... 7 FLUCONAZOLE... 7 FLUNISOLIDE... 7 FLUOXETINE DR... 7 22
FLUOXETINE HCL... 8 FLUTICASONE PROPIONATE... 8 FLUVASTATIN... 8 FLUVOXAMINE MALEATE... 8 FORTEO... 8 FOSAMAX... 8 FROVA... 8 G GEODON... 8 GRANISETRON HCL... 8, 9 H HUMIRA... 9 HUMIRA PEN-CROHNS DISEASESTARTER... 9 I IBANDRONATE SODIUM... 9 INVEGA... 9 IPRATROPIUM BROMIDE... 9 J JANUMET... 9 JANUMET XR... 9 JANUVIA... 9 JUVISYNC... 9, 10 K KETOROLAC TROMETHAMINE... 10 KOMBIGLYZE XR... 10 L LANSOPRAZOLE... 10 LANSOPRAZOLE ODT... 10 LATUDA... 10 LEFLUNOMIDE... 10 LEVOCETIRIZINE DIHYDROCHLORIDE... 10 LEXAPRO... 10 LIPITOR... 10 LOVASTATIN... 10, 11 LUNESTA... 11 LUVOX CR... 11 M MAXAIR AUTOHALER... 11 MAXALT... 11 MAXALT-MLT... 11 MEDROXYPROGESTERONE ACETATE... 11 MELOXICAM... 11 MICONAZOLE 3... 11 MIGRANAL... 11 MORPHINE SULFATE ER... 11, 12 N NARATRIPTAN HCL... 12 NASONEX... 12 NEULASTA... 12 NEUMEGA... 12 NUCYNTA... 12 O OLANZAPINE... 12 OLANZAPINE ODT... 12 OMEPRAZOLE... 12 OMEPRAZOLE/SODIUM BICARBONATE... 12 ONDANSETRON HCL... 12, 13 ONDANSETRON ODT... 13 ONGLYZA... 13 ONSOLIS... 13 OPANA ER (CRUSH RESISTANT)... 13 OXYBUTYNIN CHLORIDE ER... 13 OXYCONTIN... 13 OXYMORPHONE HYDROCHLORIDE ER... 13 P PANTOPRAZOLE SODIUM... 13 PAROXETINE HCL... 13 PAROXETINE HCL ER... 14 PATANASE... 14 PEGASYS... 14 PEG-INTRON... 14 PEG-INTRON REDIPEN... 14 PEG-INTRON REDIPEN PAK 4... 14 PIOGLITAZONE HCL/METFORMIN HCL... 14 PRANDIMET... 14 23
PRAVASTATIN SODIUM... 14 PREVPAC... 14 PRISTIQ... 15 PROAIR HFA... 15 PROVENTIL HFA... 15 PULMICORT FLEXHALER... 15 Q QUETIAPINE FUMARATE... 15 R REBIF... 15 REBIF TITRATION PACK... 15 REGRANEX... 15 RELENZA DISKHALER... 15 RELPAX... 15, 16 RESTASIS... 16 REVATIO... 16 RISPERIDONE... 16 RISPERIDONE ODT... 16 ROZEREM... 16 S SAMSCA... 16 SANDOSTATIN LAR DEPOT... 16 SAPHRIS... 16 SARAFEM... 16 SAVELLA... 17 SAVELLA TITRATION PACK... 17 SELFEMRA... 17 SEREVENT DISKUS... 17 SEROQUEL... 17 SEROQUEL XR... 17 SERTRALINE HCL... 17 SIMCOR... 17 SIMVASTATIN... 18 SPIRIVA HANDIHALER... 18 SUBOXONE... 18 SUMATRIPTAN SUCCINATE... 18 SYMBICORT... 18 SYMLIN... 18 SYMLINPEN 120... 18 SYMLINPEN 60... 18 T TAMIFLU... 18 TERAZOSIN HCL... 19 TERCONAZOLE... 19 TOBI... 19 TRAMADOL HCL... 19 TRAMADOL HCL ER... 19 TRAMADOL HYDROCHLORIDE/ACETAMINOPHEN... 19 TRIAMCINOLONE ACETONIDE... 19 TUDORZA PRESSAIR... 19 TWINJECT... 19 V VALACYCLOVIR HCL... 19, 20 VENLAFAXINE HCL... 20 VENLAFAXINE HCL ER... 20 VENTOLIN HFA... 20 VICTOZA... 20 VIIBRYD... 20 VIVELLE-DOT... 20 VYTORIN... 20 X XOLAIR... 20 XOPENEX HFA... 20 Z ZALEPLON... 21 ZAZOLE... 21 ZIPRASIDONE HCL... 21 ZMAX... 21 ZOLPIDEM TARTRATE... 21 ZOLPIDEM TARTRATE ER... 21 ZOMIG... 21 ZOMIG ZMT... 21 ZYPREXA... 21 ZYPREXA ZYDIS... 21, 22 24