ACTEMRA IV (USSC can dispense 162 mg PFS) ACTHAR HP ACTIMMUNE ADAGEN ADCETRIS CVS Specialty 1-800-237-2767 1-800-237-2767 ADEMPAS ADVATE ALDURAZYME ALECENSA ALIQOPA ALUNBRIG AMPYRA APOKYN ARALAST NP ARCALYST ARZERRA ATRYN Limited to Hospital www.atryn.com/orderatryn.php Pharmacies AVEED BAVENCIO Biologics 1-800-850-4306 BELEODAQ BENDEKA BENLYSTA BERINERT BETHKIS BIVIGAM BLINCYTO BOSULIF BRINEURA Provider must obtain 1-866-906-6100 WDRx Updated on July 1, 2018 1
CABOMETYX CALQUENCE CAMPATH Shipped directly from manufacturer; physician must call 1-877-422-6728 CAPRELSA CVS Specialty 1-800-237-2767 Biologics 1-800-850-4306 CARBAGLU Foundation Care 1-877-291-1122 IV Solutions & Maxor CAYSTON Pharmacies 1-806-355-5029 Mckesson Plasma and Biologics 1-877-625-2566 CEPROTIN CERDELGA CEREZYME CHENODAL CHOLBAM CINRYZE COMETRIQ CORIFACT COTELLIC CUVITRU Option Care 1-866-827-8203 BriovaRx 1-888-293-9309 CYRAMZA CRYSVITA WDRx Updated on July 1, 2018 2
Orsini Pharmacy 1-800-240-7614 1-877-793-4897 PANTHERx 1-855-726-8479 1-855-246-3986 CYSTADANE AnovoRx 1-844-288-5007 CYSTAGON CYSTARAN DACOGEN DARAPRIM DARZALEX DOPELET Kroger Specialty 1-855-733-3126 1-888-315-3270 PANTHERx 1-855-726-8479 1-855-246-3986 DUOPA DYSPORT Provider must obtain 1-908-275-6300 EGRIFTA ELAPRASE ELELYSO (USSC may be able to order this medication) EMFLAZA US Bioservices 1-888-518-7246 1-888-418-7246 EMPLICITI ENDARI US Bioservices 1-888-518-7246 1-888-418-7246 EPOPROSTENOL SODIUM ERIVEDGE ERLEADA BriovaRx 1-855-427-4682 ERWINAZE BriovaRx Infusion 1-877-306-4036 Option Care 1-844-672-4842 WDRx Updated on July 1, 2018 3
ESBRIET (USSC will fill for all mandatory USSC plans) EVOMELA EXJADE Orsini Pharmacy 1-800-356-5034 EXONDYS 51 Option Care-I only have their fax # 1-855-647-2884 EYLEA FABRAZYME Acaria Health 1-877-541-1503 BriovaRx 1-855-427-4682 Cigna Specialty 1-800-351-3606 FASENRA Humana 1-800-486-2668 Special Care Pharmacy (Located in Puerto 1-888-727-7127 Rico) FERRIPROX FIRAZYR FLOLAN GAMMAPLEX GATTEX GAZYVA GILOTRIF GLASSIA HAEGARDA Option Care 1-855-275-9647 Orsini Pharmacy 1-800-410-8575 HEMLIBRA BioPlus Specialty Pharmacy 1-866-514-8082 WDRx Updated on July 1, 2018 4
HETLIOZ Advance Care Scripts 1-866-944-9511 Vanda-Manufacturer of product 1-844-438-5469 Call Pharmacy Solutions for 1-888-857-0668 Available Pharmacies HUMIRA PEDIATRIC CROHN'S (20 MG) ACS Pharmacy 1-877-985-6337 HYQVIA IBRANCE CuraScript 1-866-474-8326 ICLUSIG PASS program 1-855-447-7277 Biologics 1-800-850-4306 IDHIFA ILARIS ILUVIEN IMBRUVICA IMFINZI IMPLANON INCRELEX INGREZZA PANTHERx 1-855-726-8479 1-855-246-3986 INLYTA INTRON A IRESSA ISTODAX WDRx Updated on July 1, 2018 5
JAKAFI JETREA JUXTAPID 1-888-608-9010 1-888-302-1028 JYNARQUE PANTHERx 1-855-726-8479 1-855-246-3986 KADCYLA KALBITOR KALYDECO BriovaRx 1-855-427-4682 Kroger Specialty 1-855-733-3126 1-888-315-3270 KANUMA KEVEYIS PANTHERx 1-855-726-8479 1-855-246-3986 KINERET RxCrossroads 1-866-547-0644 KITABIS PAK KORLYM KUVAN KYLEENA KYMRIAH Available at select treatment centers KYMRIAH-hcp.com KYNAMRO KYPROLIS LARTRUVO LEMTRADA LENVIMA Biologics 1-800-850-4306 1-800-823-4506 LETAIRIS LILETTA LONSURF WDRx Updated on July 1, 2018 6
LUCENTIS LUMIZYME LUXTURNA CuraScript 1-866-474-8326 LYNPARZA Biologics 1-800-856-1984 MACUGEN MAKENA MATULANE MEPSEVII MIRENA MYALEPT MYLOTARG Biologics Specialty Pharmacy 1-800-850-4306 NAGLAZYME NATPARA NERLYNX NEXAVAR NEXPLANON NITYR NORTHERA NOVOEIGHT NPLATE NUCALA NUPLAZID OBIZUR OCALIVA ONCASPAR Provider must obtain www.oncaspar.com OCREVUS ODOMZO WDRx Updated on July 1, 2018 7
OFEV ONIVYDE US Bioservices 1-888-518-7246 OPSUMIT ORALAIR ORENITRAM ORFADIN 1-866-849-4481 1-877-473-3172 ORKAMBI BriovaRx 1-855-427-4682 OZURDEX PALYNZIQ PERJETA PHOTREXA Provider must obtain www.livingwithkeratoconus. com PLEGRIDY POMALYST Biologics, Inc. 1-800-850-4306 PORTRAZZA PROBUPHINE IMPLANT KIT Braeburn Access Plan 1-844-859-6341 PROCYSBI PROLASTIN-C PROVENGE Available only through approved cancer treatment centers (go to website to enter zip code for to find a www.provenge.com Provenge Treatment Center) QUTENZA WDRx Updated on July 1, 2018 8
RADICAVA RAVICTI REBINYN REMODULIN RETISERT REVLIMID RIASTAP RUBRACA RUCONEST SABRIL SAMSCA SEROSTIM SILIQ SIRTURO Aetna Specialty 1-866-782-2779 SKYLA SOLESTA SOLIRIS SOMAVERT SPINRAZA STIVARGA STRENSIQ PANTHERx 1-855-726-8479 1-855-246-3986 SUBLOCADE SUCRAID US Bioservices 1-888-518-7246 1-888-418-7246 SUTENT SYLVANT SYMDEKO BriovaRx 1-855-427-4682 WDRx Updated on July 1, 2018 9
SYNAGIS TAGRISSO TARCEVA TAVALISSE US Bioservices 1-888-518-7246 1-888-418-7246 TECENTRIQ TECFIDERA TESTOPEL THALOMID THIOLA TOBI (Generic formulation is NOT LD and can be filled through USSC) TOBI PODHALER TRACLEER TRETTEN TRIPTODUR PANTHERx 1-855-726-8479 1-855-246-3986 TROGARZO CuraScript SD 1-877-599-7748 Option Care 1-866-827-8203 TYSABRI TYVASO UPTRAVI VALCHLOR VELETRI VENTAVIS VERZENIO VIMIZIM VISTOGARD Biologics 1-800-850-4306 1-800-823-4506 VISUDYNE WDRx Updated on July 1, 2018 10
VIVAGLOBIN BioRx 1-866-442-4679 VONVENDI VPRIV XALKORI XENAZINE (Generic formulation is NOT LD and can be filled through USSC) XERMELO Biologics 1-800-856-1984 XIAFLEX US Bioservices 1-888-518-7246 1-888-418-7246 XOFIGO XOLAIR (USSC will fill for all mandatory USSC plans) Provider must order through manufacturer 1-855-696-3446; XofigoAccessOnline.com XTANDI XURIDEN Cardinal Health Specialty Pharmacy 1-888-662-6779 XYREM Xyrem Central Pharmacy 1-866-997-3688 YESCARTA Cancer Centers Mayo Clinic YONDELIS ZALTRAP ZAVESCA ZEJULA US Bioservices 1-888-518-7246 1-888-418-7246 ZELBORAF ZEMAIRA ZEVALIN Y-90 Cell Therapeutics, Inc - Limited to Radiopharmacies 1-866-298-8433 ZINBRYTA ZYDELIG WDRx Updated on July 1, 2018 11