ignature + RxBoost Formulary Drug List

Table of Contents

Signature PlanRxBalance Formulary pg. 2-12

RxBoost Formulary pg. 13-18

Formulary Drug ListSignature + RxBoost

1 Pointe Dr Suite 120, Brea, CA 92821 phone: 1.800.262.7726 online: pram.comcalifornia license #. 0812797

© PRAM INSURANCE SERVICES, INC.


© PRAM INSURANCE SERVICES, INC.PG 1 OF 11

2021 RxBALANCE “SIGNATURE” FORMULARYThe following list contains both brand and generic drugs that are available to members

of the RxBalance Prescription Plan. The BRAND name drugs (listed in all CAPS) and generic drugs (listed in lower case) are available at a copay up to the monthly maximum benefit of

the plan. All drugs not contained on this list are not eligible for the copay benefit, however, are eligible at PRAM’s discounted rate. Please refer to your benefit materials for Limitations and

Exclusions; Quantity Limits per copay may apply to certain medications. This list is continually evaluated and changes can occur at any time. Please contact PRAM to confirm the most current drug

list. We encourage you to share this list with your physician at the time of your treatment.

*ONLY THOSE BRAND NAME DRUGS SHOWN IN ALL CAPS ARE COVERED UNDER THIS FORMULARY, ALL OTHER BRAND NAMES ARE PROVIDED STRICTLY FOR CROSS REFERENCE TO THE APPLICABLE COVERED GENERIC.

Category Covered Generic Name Brand Name*Anti-Infective Antibiotics Cephalosporins cefaclor Ceclor

cefadroxil Duricefcefdinir Omnicefcefpodoxime Vantincefprozil Cefzilcephalexin Keflex

Erythromycins & Other Macrolides

azithromycin Zithromax / Z-PAKclarithromycin Biaxin, Biaxin XLerythromycin base Ery-Tab, E-Mycinerythromycin ethylsuccinate EES, EryPed

Penicilins amoxicillin Amoxilamoxicillin / pot. Clav Augmentindicloxacillin Dicloxacillinpenicillin VK Pen-Vee K

Quinolones ciprofloxacin Ciprolevofloxacin Levaquinmoxifloxacin Aveloxofloxacin Floxin

Tetracyclines doxycycline Vibramycinminocycline Minocin

Antifungals clotrimazole Mycelexclotrimazole / betamethasone Lotrisoneeconazole Spectazolefluconazole Diflucangriseofulvin Gris-PEG / Grifulvinketoconazole Nizoralmetronidazole Flagylnystatin oral Mycostatinterbinafine Lamisiltolnaftate

Antifungals - (Vaginal) clotrimazole Mycelex-7fluconazole Diflucanmiconazole Monistat

Antihelminics mebendazole VermoxAnti-Infective SpecializedIndications

chloroquine phosphate Aralenethambutol HCI Myambutolhydroxychloroquine Plaquenilmebendazole Vermoxneomycinpyrazinamidethiabendazole Mintezol



Category Covered Generic Name Brand Name*Anti-Infective(cont.)

Antineoplastic/Immunosuppresants

azathioprine Imuranflutamide Eulexinhydroxyurea Hydrealeucovorin Wellcovorinmegestrol Megacemethotrexatetamoxifen Nolvadex

Anti-Tubercular ethambutol MyambutolAntivirals acyclovir Zovirax

amantadine Symmetrelnevirapine Viramumerimantadine Flumadinezidovudine Retrovir

OtherAnti-Infectives

clindamycin HCI Cleocinisoniazid Nydrazidmethenamine Urexmethanamine/ sod bis/ phenyl salicyl/ methylene blue / hyos

Urimax

nitrofurantoin Macrodantin/ Macrobidrifampin Rifadinsulfadiazinetrimethoprim Trimpex

Topical Antibacterial silver sulfadiazine SilvadeneTopical Antifungals ciclopirox Loprox

ketoconazole Nizoralnystatin / triaminolone Mycolog

Autonomicand CentralNervousSystem

Analgesics, Antimigrainal

pentazocine / naloxone Talacen / Talwin NXsumatriptan Imitrextramadol Ultram

Analgesics, Narcotics APAP / codeine Tylenol w/ CodeineAPAP / hydrocodone Vicodin / NorcoASA / codeine Empirin w/ Codeinebuprenorphine HCL/ Naloxone HCL Suboxonebuprenorphine HCI Subutexbutalbital/ acetaminophen Phrenlin, Sedapapbutalbital/ acetaminophen/ caffeine Floricetbutorphanol Stadol NScodeine sulfatehydrocodone/ ibuprofen Vicoprofenlevorphanolmeperidine Demerolmepiridine/ promethazine Meperganmorphine sulfate MSIR, MSContinoxycodone OxyIRoxycodone/ APAP Percocetoxycodone/ ASA Percodan

*ONLY THOSE BRAND NAME DRUGS SHOWN IN ALL CAPS ARE COVERED UNDER THIS FORMULARY, ALL OTHER BRAND NAMES ARE PROVIDED STRICTLY FOR CROSS REFERENCE TO THE APPLICABLE

COVERED GENERIC.

2021 RxBALANCE “SIGNATURE” FORMULARY



Category Covered Generic Name Brand Name*Autonomicand CentralNervousSystem (cont.)

Analgesics, Non-SteroidalAnti-Inflammatory

diclofenac potassium Cataflamdiclofenac sodium Voltaren XRdiflunisal Dolobidetodolac Lodineibuprofen Motrinindomethacin Indocinketorolac Toradolmeloxicam Mobicnabumetone Relafennaproxen Naprosynoxaprozin Daypropiroxicam Feldenetolmetin Tolectin/ DS

Anticonvulsants PEGANONEcarbamezepine Tegretolclorazepate Tranxenedivalproex NA Depakote Sprinkle/ Depakote ERethosuximide Zarontingabapentin Neurontinlithium carbonatephenobarbitalphenytoin/ pheyntoin extended Dilantinprimidone Mysoline

topiramate Topamaxvolproic acid/ valproate sodium Depakene/ Depakote

Antiparkinsons amantadine Symmetrelbenzatropine mesylate Cogentinbromocriptine Parlodelcarbidopa/ levodopa Sinemet/ Sinemet CRropinirole HCI Requipselegiline Eldepryltrihexyphenidyl Artane

Antipsychotics chlorpromazine Thorazineclozapine Clozarilfluphenazine Prolixinhaloperidol Haldolloxapine Loxitaneolanzapine Zyprexaperphenazinepimozide Orapquetiapine fumarate Seroquelrisperidone Risperdaltiagabine HCL Gabitrilthioridazine Mellarilthiothixene Navanetrifluoperazine Stelazinezonisamide Zonegran


COVERED GENERIC.





COVERED GENERIC.

Category Covered Generic Name Brand Name*Autonomicand CentralNervousSystem(cont.)

Antivertigo/ Antiemetics hydroxyzine Ataraxmeclizine HCI Antivertondansetron Zofranprochlorperazine Compazinepromethazine HCI Phenergan

promethazine HCI suppository, rectal

Phenergan

trimethobenzamide TiganAnxiolytics, Sedatives and Hypnotics

alprazolam Xanaxbuspirone Busparchloral hydrate Noctecchlordiazepoxide HCI Libriumclonazepam Klonopindiazepam Valiumestazolam Prosomfluzapam Dalmanelorazepam Ativanoxazepam Seraxtemapzepam Restoriltriazolam Halcionzolpidem tartrate Ambien

CNS Stimulants amphetamine / dextroamphetamine

Adderall

destroamphetamine Dexedrine / Destrostatmethylphenidate Ritalin / Methylinmemantine Namenda

Drugs to Prevent and Treat Gout allopurinol Zyloprimprobenecidsulfinpyrazone Anturane

Muscle Relaxants/ Antispasmodics baclofen Lioresalcarisoprodol Somacarisoprodol and aspirin Soma Compoundcarisoprodol, aspirin, codeine Soma Compound with Codeinechlorazoxazone Parafon Forte DSCcyclobenzaprine Flexerildantrolene Dantriummetaxalone Skelaxinmethocarbamol Robaxinorphenadrine / aspirin / caffeine Norgesictizanidine Zanaflex

Psychotherapeutics Antidepressants amitriphtyline Elavilamitriptyline / chlordiazepoxide Limbitrolamitriptyline / perphenazine Triavilamoxapine Asendinbupropion Wellbutrin & Wellbutrin SR, Wellbutrin XLcitalopram Celexaclomipramine Anafrildesirpramine Norpramin




Category Covered Generic Name Brand Name*Autonomicand CentralNervousSystem(cont.)

Psychotherapeutics(cont.)

Antidepressants(cont.)

doxepin Sinequanduloxetine Cymbalta

fluoxetine Prozacfluvoxamine Luvoximipramine Tofranilmaprotiline Ludiomilmirtazapine Remeronnefazodone Serzonenortriptyline Pamelorparoxetine Paxilsertraline Zolofttranylcypromine Parnatetrazodone Desyrelvenlafaxine HCI Effexor XR

Cardiovascular ACE Inhibitors benazepril Lotensincaptopril Capotenenalapril Vasotecfosinopril Monoprillisinopril Zestrilmoexipril Univascramipril Altacequinapril Accupril

Alpha Blockers doxazosin Carduraprazosin Minipressterazosin Hytrin

AngiotensinReceptor Blockers

irbesartan Avaprolosartan Cozaarolmesartan medoxomil Benicarvalsartan Diovan

Antiarrhythmics amiodarone Cordaronedisopyramide Norpacemexiletine Mexitilnitroglycerinprocainamide Procainamidepropafenone Rythmolquinidine

Beta-Adrenergic Antagonists

acebutolol Sectralatenolol Tenorminbetaxolol Kerlonebisoprolol Zebetacarvedilol Coreglabetolol Normodynemetoprolol Lopressormetoprolol succinate Toprol XLnadolol Corgardpindolol Viskenpropranolol Inderal


COVERED GENERIC.




Category Covered Generic Name Brand Name*Cardiovascular(cont.)

Beta-Adrenergic Antagonists (cont.) sotalol Betapacetimolol Blocadren

Calcium Channel Blockers amlopidine Norvascdiltiazem Cardizem/ SR / Dilacor XRfelodipine Plendilisradipine Dynacircnicardipine Cardenenifedipine Procardia XLverapamil Calan SR / Isoptin SR

Cardiac Glycosides digoxin LanoxinCholesterol - Lowering atorvastatin Lipitor

cholestyramineezetimibe Zetiagemfibrozil Lopidlovastatin Mevacorniacinpravastatin Pravacholrosuvastatin Crestorsimvastatin Zocor

Diuretics amiloride / HCTZ Modureticbumetanide Bumexchlorthalidone Hygrotonfurosemide Lasixhydrochlorothiazideindapamide Lozolmethazolamidemetolazone Zaroxolynspironolactone Aldactonetorsemide Demadex

Diuretic Combinations atenolol / chlorthalidone Tenoreticbenazepril / hydrochlorthiazide Lotensin HCTbisoprolol / hydrochlorthiazide Ziaccaptopril / hydrochlorthiazide Capozidechlorothiazide Diurilenalapril / hydrochlorthiazide Vasoreticfosinopril / hydrochlorthiazide Monopril HCTlisinopril / hydrochlorthiazide Zestoreticmethyldopa / hydrochlorthiazide Aldorilmetoprolol / hydrochlorthiazide Lopress HCTpropranolol / hydrochlorthiazide Inderidequinapril / hydrochlorthiazide Accureticspironolactone / hydrochlorthiazide Aldactazidetriamterene / hydrochlorthiazide Dyazide

Other Antihypertensives clonidine Catapresguanfacine Tenexhydralazine Apresoline


COVERED GENERIC.




Category Covered Generic Name Brand Name*Cardiovascular(cont.)

Other Antihypertensives(cont.)

methyldopa Aldometmidodrine ProAmatineminoxidil Lonitenquinine sulfate Qualaquinreserpine

Other Cardiovascular Drugs pentoxifylline TrentalVasodilating isosorbide dinitrate Isordil

isosorbide mononitrate Imdurisoxsuprine Vasodilan

Dermatologicals Anti-Acne benzoyl peroxide Triazclindamycin Celocin-T / Clindets Pledgetssulfacetamide Novacet / Sulfacet-R

Antipsoriasis selenium sulfide Exsel / SelsunOther Dermatological aluminum chloride Drysol

permethrin ElimiteTopical Corticosteroids alclometasone Aclovate

amcinonide Cyclocortaugmented betamethasone diproprionate

Diprosone, Maxivate

betamethasone valerate Valisoneclobetasol propionate Temovate/ Edesonide DesOwendesoximetasone Topicortdiflorasone diacetate CR Florone/ Efluocinaide Lidex-Efluocinolone acetonide Synalar / Derma SmootheFSfluticasone Cutivatehalobetsaol Ultravatemometasone furoate Eloconprednicarbate Dermatoptriamcinolone Aristocort

Ear, Nose & ThroatMedications

Drugs Affecting the Ear acetic acid VoSolacetic acid / aluminum acetate Domeboro Oticantipyrine / benzocaine Auralgan/ AB Otic Solutionhydrocortisone / acetic acid Acetasol HCneomycin / polymyxin / hc Cortisporinofloxacin Floxin Otic

Drugs Affecting the Throat and Mouth

chlorhexidine Peridexlidocaine HCI viscous solution Xylocaine Viscous Gel

EndocrineMedications

Adrenal Corticosteroid dexamethasone Hexadrolfludricortisone Florinefhydrocortisone Cortefmethylprednisolone Medrol / Medrol Pakprednisolone Orapred / Pediapredprednisone Deltasone

Antidiabetic Agents ACCU-CHEK STRIPSHUMALOGLANTUS VIAL


COVERED GENERIC.




Category Covered Generic Name Brand Name*Endocrine Medications (cont.)

Antidiabetic Agents (cont.) NOVOLIN VIALNOVOLOG VIALONE-TOUCH STRIPS

TOUJEO SOLOSTARTOUJEO MAX

acarbose Precoseglimepiride Amarylglipizide Glucotrolglyburide Diabeta/ Glynaseglyburide / metformin Glucovancemetformin Glucophagemiglitol Glysetrepaglinide Prandinnateglinide Starlixpioglitazone Actos

Drugs to Treat Osteoporosis

alendronate sodium Fosamaxrisedronate sodium Actonel

Thyroid and Anti-Thyroid levothyroxine Synthroid / Levoxylliothyronine sodium Cytomelmethimazolepropylthiouracilthyroid

Gastrointestinal Antispasmodics diphenoxylate / atropine Lomotil

clidinium / chlordiazepoxide Libraxdicyclomine Bentylhyoscyamine Levsinmetoclopramide Reglan

Other Gastrointestinal ASACOLCREON/KU-ZYME/PANCRON/ VIOKASE/ PANCREASE-MTSUPREP

hydrocortisone suppositories Anusol HCgavilyte-N Nulytelymagnesium oxide Mag-Oxmisoprostol Cytotecpancrelipase / ECPEG 3350 / electrolytes solution Colytepramoxine / hydrocortisone / chloroxylenol

Cortane B

sulfasalizine AzulfidineProton Pump Inhibitors omeprazole Prilosec

lasoprazole Prevacidpantoprazole Protonix

Nutrition,BloodModifiers and Electrolytes

Drugs and VitaminsAffecting Coagulation

clopidogrel Plavixdipyridamole Persantineticlopidine Ticlidwarfarin Coumadin


COVERED GENERIC.




Category Covered Generic Name Brand Name*Nutrition, Blood Modifiers and Electrolytes

Potassium Supplements potassium chloride K-DUR/ Micro-KVitamins / Minerals B-complex w/ c & folic acid

ergocalciferol Calciferolfolic acid Folateiron polysaccharide multivitaminsmultivitamins w/ mineralspyridoxinezinc sulfate

Ophthalmic Glaucoma TRAVATAN / TRAVATAN Zacetazolamide Diamoxapraclonidine Lopidinebetaxolol Betoptic / Sbrimonidine tartrate Alphagancarbachol Carbachol/ Carbastatcarteolol Ocupressdipivefrin AKProdorzolamide Trusoptlatanoprost Xalatanlevobunolol Betaganmetipranolol Optipranololpilocarpine Pilocartimolol Timoptic/ XE

Ophthalmic Topical Antibacterial

CILOXAN OINTMENTbacitracin Ak-Tracinciprofloxacin Ciloxan ofloxacin Ocufloxsulfacetamide Bleph-10tobramycin Tobrex

Ophthalmic Antihistamines azelastine HCL Optivar

Ophthalmic Anti-Infectives/ Corticosteroids

POLY-PREDgentamicin Garamycin

neomycin / bacitracin / polymyxin Neosporinneomycin / bacitracin / polysporin / hydrocortisone

Cortisporin

neomycin / dexamethasone / polymyxin Dexacidin/ Maxitrolpolymyxin B / trimethoprim Polytrimsulfacetamide / prednisolone Blephamidesulfacetamide / prednisone Vasocidin

Ophthalmic Corticosteroids ALREXLOTEMAX

dexamethasone Decadronfluroromethalone FML Liquifilmprednisolone Econopred Plus / Pred Forteprednisolone Forte

Ophthalmic Topical Antivirals trifluridine ViropticOther Ophthalmic atropine sulfate Isopto Atropine

cromolyn sodium


COVERED GENERIC.




Category Covered Generic Name Brand Name*Ophthalmic (cont.)

Other Ophthalmic (cont.) cyclopentolate Cyclogylflurbiprofen Ocufennaphazoline AK Con/ Liquifilmphenylepinephrine Neo-Synephrinetetracainetetrahydrozoline

Obstetrical and Gynecological

AndrogensContraceptives

danazol DanocrineNUVARING

drosprienone/ehtinyl estradiol Yaz, Yazminethinyl estradiol and desogestrel Ortho-Cept/ Desogenethinyl estradiol and ethynodiol diacetate Zoviaethinyl estradiol and levonorgesterel Triphasil/ Levlennorethindrone NorQD/ Ortho Micronornorethindrone / estradiol / fe fumarate Loestrin-fenorethindrone / ethinyl estradiol Mircettenorethindrone / ethinyl estradiol Modiconnorethindrone / mestranol Ortho-Novumnorgestrimate / ethinyl estradiol Ortho Cyclennorgestrimate / ethinyl estradiol Ortho Tri-Cyclen

Estrogen Patches estradiol Vivelle/DotEstrogen/ ProgestinCombinations

METHERGINEPREMPHASEPREMPRO

Oral Estrogens PREMARINestradiol Estraceestropipate Ortho-Est/ Ogen

Prenatal Vitamins All vitamins are preferred on formularyProgestins medroxyprogesterone Provera

norethindrone Aygestinprogesterone Prometrium

Respiratory, Allergy, Coughand Cold

Antihistamines/ Anti-Allergenics

cyproheptadine Cyproheptaddexchlorpheniramine tablet SA Polaramine Repetabfexofenadine Allegrahydroxyzine pamoate Vistarilmontelukast sodium Singulair

Anti-Tussive Combinations guaifenesin / codeine Robitussin A-Cguaifenesin / PSE / hydrocodone Deconamine CXguaifenesin / hydrocodone Codiclearhydrocodone / homatropine Hydromethydrocodone / potassium guiaco CoTuss

phenylephrine / clorpheniramine / dextromethorphan

PE/GG LA

phenylephrine / hydrocodone / GG Levall 5.0pheylephrine / pyrilamine / DM PolyHist DMphenylephrine / pyrilamine / hydrocodone

Codimal DH

phenylephrine / chlorphen / hydrocodone

HC Tussive & Histinex HC

promethazine / codeine


COVERED GENERIC.




Category Covered Generic Name Brand Name*Respiratory, Allergy, Coughand Cold (cont.)

Anti-Tussive Combinations (cont.) promethazine / DMpseudoephedrine / brompheniramine / dextromethorphan

Bromdec DM

pseudoephedrine / brompheniramine / hydrocodone

Brovex HC

pseudoephedrine w/ codeine / GG Codafedpseudoephedrine-chlor / codeinepseudoephedrine-CPM / hydrocodone Genecof-HCpseudoephedrine / hydrocodone Pancofpseudoephedrine / hydro / GG Hydrotussin

Beta AgonistInhalers

PROAIR HFAVENTOLIN HFA

metaproterenol AlupentInhaled CorticosteroidsIntranasal Steroids

QVARflunisolide Nasalide

Inhaled CorticosteroidsIntranasal Steroids (cont.)

fluticasone Flonasemometasone furoate Nasonex

Beta Agonist Oral VOSPIRE ER

albuterol Proventilalbuterol, multiphasic release Proventilmetaproterenol sulfate

Decongestants/ Antihistamines benzonatate Tessalon Perlechlorpheniramine / methylscopolamine Estendrylchlorpheniramine / phenylephrine R Tanna/ Phenabidcyproheptadine Periactinpseudoephedrine / chlorpheniramine tab / syrup / cap SA

Deconamine SR/ Deconamine

pseudoephedrine / methscopolamine Allerx-DExpectorant CombinationsLeukotriene ModifiersMiscellaneous Pulmonary Agents

guaifenesin / dextromethorphan Guaibidguaifenesin / PSE / hydrocodone Guaifed/ Deconsal/ Entex PSEmontelkast sodium Singulairacetylcysteine Mucomystcromolyn sodium ampul Intalipratropium Atrovent Inhaler/ Nasal Spray

Pulmonary Agents Xanthines aminophyllinedyphyllinetheophylline Theo-Dur/ Slo-Phyllin/ Theolair-SRtheophylline-guaifenesin Elixophyl GG

UrologicalMedications

Anticholinergics/ Antispasmodics flavoxate UrispasBenign Prostatic Hypertrophy tamsulosin HCL FlomaxMiscellaneous Urologicals oxybutynin Ditropan

phenazopyridine Pyridiumtamsulosin HCL Flomaxterazosin Hytrin

Other Genitourinary Products citric acid / potassium citrate Cytra-Kpotassium citrate Urocit-Kpotassium phosphate K-Phos


COVERED GENERIC.


DRUG NAME DRUG NAME DRUG NAMEAbilify Aristada Breo ElliptaAbilify M Armour Thyroid Breo ElliptaAbrilada (Biosimilar Remicade) Arnuity Ellipta Breo Ellipta 200Absorica Arranon Breo Ellipta 100Accutane (isotretinoin) Arzerra Breo Ellipta 200achtar Asacol BrilintaActemra SC Asacol 800mg Brineuraactimmune Asmanex Twisthaler BrukinsaAcuvail Asmanex/Asmanex HFA BydureonAdakevo Asragraf XL BydureonAdcentris Atripla Bydureon 2/0.85 mlAdcirca Atrovent HFA BystolicAdhansia XR Aubagio Bystolic 10AdvairHFA /Advair Diskus auryxia Bystolic 5Advate Austedo CabometyxAdynovate Avandia CalquenceAerochamber Plus Avastin CanasaAfinitor Avonex CapecitabineAimovig Avsola (remicaid biosim) CapecitabineAiromir Avycaz CaplytaAjovy Azopt CarbagluAkynzeo Bagsimi CaystonAldurazyme Balversa Cerdelga Aliqopa Baraclude CerezymeAlphagan P barhemsys CetrotideAlprolix Basaglar KwikPen (5 x 3ml) ChantixAlunbrig Basalgar CholbamAmitiza Bebulin VH CialisAmlodipine Benefix Cialis 10mgAmpyra Benicar/Olmetec Cialis 20mgAmzeeq Benlysta Cialis 5mgAnjeso Beovu CimduoAnnovera Betaseron-Betaplus CimziaAnoro Ellipta Bethkis CimziaApidra Biorphen CiprodexApligraf Bktarvy CoagadexAptivus Blincyto CoartemAralast Bosulif ColchicineAranesp Botox CombiganArikayce Braftovi Combivent Respimat

2021 Rx BoostFormulary

PRAM Insurance Services, Inc. 2021 Rx Boost Formulary

DRUG NAME DRUG NAME DRUG NAMECometriq Dysport FarydakComplera Edarbi FasenraConcerta Edarbi/Edarbychlor FeibaCopaxone 40mg (shared solution) Edurant FerrinproxCopiktra Effexor XR FetrojaCopiktra Effient FetzimaCorifact Egrifta Fiasp VialCortef Elaprase Flovent HFACosentyx Elelyso Focalin XRCotellic Eliquis FollistimCozaar Elmiron FolotynCozaar 25mg Eloctate Forteo Cozaar 50mg Elreada GablofenCreon Elzonrus GamunexCrestor Emflaza Ganirellix Crinone Emgality GattexCryvista Emtriva GelniqueCuprimine Enbrel GenosylCuprimine Enbrel Genotropin Cuprimine Endometrin GenvoyaCyclophosamide 50mg Enhertu Gilenya Cymbalta Enstilar GilotrifCystadane Enstilar GivlaariDaklinza Entresto Glatopa (20 or 40mg/ml)Dalvance Entyvio GleevecDarzolex Envarasus XR Glucagon InjectionDaurasmo Epclusa Glucagon InjectionDaurismo Epidiolex GluconormDDAVP Rhinyle EpiPen Auto-Injector GlumetzaDelzicol Epivir GlyxambiDemser Epogen Gonal- FDescovy Epzicom GvokeDexilant Erivedge Haldol D InjDificid Erleada Haldol InjDovato Esbriet HarvoniDuaklir Pressair Esperoct HepseraDuexis Estrace Cr HerceptinDulera Evenity HerzumaDulera/Zenhale 100 Evista HetliozDulera/Zenhale200 evotaz HizentraDuobrii Exjade Humalog Duopa Extavia Humalog KwikpenDupixent Eylea Humalog KwikPen (5 x 3ml)Duragesic Fabrazyme Humalog U-200 ONLYDurizol Farseton HumatropeDurysta Farxiga Humira


DRUG NAME DRUG NAME DRUG NAMEHumulin 30/70 Kitabis PK Mesalamine 800mgHumulin R U-500 ONLY Kogenate FS Mesalamine SuppositoriesHymactin Korlym ModeribaIbrance Koselugo MonoviscIclusig Krystexxa MonuralIdelvion Kuvan MotegreityIdhifa Kynamro MugardIlaris Lamictal MulpletaIlevro Lamictal MultaqIlumya Lamictal 200 MydayisImatinib (Gleevec) Lamictal 100 MyforticImbruvica Lamictal 200 MyobolocInbrija Lantus MyrbetriqIncruse Ellipta Lantus Solostar MyxredinInfed Latuda NaglazymeInlyta Lemtrada Namenda/Namenda XRInrebic Lenvima NamzaricIntelence Letaris NayzilamInvega Sustina Levemir FlexTouch (5 x 3mL) NeoralInvega T lexiva NerlynxInvega Trinza Libtayo NeulastaInvokana Linzess NeupogenInvokana 100mg Lipitor NexavarInvokana 300 Lipitor 10mg NexletolIressa Lipitor 80mg Ninlaroisentress Lixiana NorditropinIvokamet/XR Lokelma NortheraIxinity Lonsurf NorvascJadenu Lorbrena NorvirJanumet/Janumet XR Lotemax NouressJanuvia Lotemax NourianzJardiance Lucemyra NovoeightJatenzo Lumigan NovologJelmyto Lumizyme NovologJentadueto Lumoxiti Novolog FlextouchJuluca Lupaneta Pack Novolog Penfills (5 x 3mL)Juxtapid Lupron NoxafilJynarque Lupron Depot NplateJynneso Lupron Depot Ped NubeqaKaletra Lynparza Nucala Kalydeco Lyrica NuplazidKaterzia Mavelclad NurtecKeveyis Mekinist Nurtec ODTKevzara Mektovi Nutropin Keytruda Mesalamine OcalivaKisqali, XL Mesalamine 1.2 OCREVUS


DRUG NAME DRUG NAME DRUG NAMEOdefsey Prograf Rosuvastatin 40Odomzo Prolia RozlytrekOfev Promacta RubracaOlmetec Prozac RuxienceOlumiant Pulmicort RuzurgiOmegaven Pulmicort flexhaler RybelsusOmnitrope Pulmozyme RydaptOnpattro Purixan SaizenOpsumit Pylera SamscaOrencia Qutenza SancusoOrfadin Qvar Easi-Breathe Inhaler SandimmuneOrkambi Ranexa SandostatinOrilissa Rapaflo Sandostatin LAROrthovisc Syringe Rasilez/Tekturna Santyl OintOtezla Rasuvo SaphrisOthovisc Ravciti SarclisaOvidrel Reblozyl SaxendaOxbryta Reclast Saxenda (5 Pens)Oxtrexup Rectiv ScarlisaOzempic Regranex SceneesePadcev Relistor ScenessePalynzig Relvar/Breo Ellipta selzentryPataday Remicade SensiparPazeo 0.7% Reopro SevenfactPemazyre Repatha SigniforPemfexy rescriptor SildenafilPentasa Restasis Eye Drop Sildenafil 100mgPiqray Retisert SiliqPlegridy retrovir SimbrinzaPlenity Revatio SimponiPomolyst Revcovi Simponi AriaPoteligeo Revlimid SingulairPradaxa Rexulti Singulair 10Praluent Rexulti 2mg SkyriziPrandin Rexulti 3mg SlyndPred Forte Reyataz Somatuline Depot Premarin tabs Reyvow SomavertPremarin Vaginal Cr (ONLY - not Tabs) Rhopressa Soolantra Cream 1%Prevymis Ribasphere Ribapak SovaldiPrezcoxib Ribavirin Spiriva Prezista Rinvoq SporanoxPrialt Rinvoq SpravatoPristiq Risperdal Consta SprycelProair Rituxan StelaraProcrit Rocklatan StendraProcysbi Rosuvastatin Stiolto Respimat


DRUG NAME DRUG NAME DRUG NAMEStrattera Tobi ViagraStribild Tobi Podhaler Viagra 100mgStriverdi Respimat Torgarzo ViberziSunosi Tosmyra Victozasustiva Toujeo VigamoxSutent Toviaz ViibyrdSymbicort Inhaler Tracleer VimpatSymdeko Trajenta ViokaseSymfi Lo Travatan Z viraceptSymlin Trelegy Ellipta Viramune XRSymtuza Tremfya VireadSynagis Tresiba Flextouch Pens VistogardSynjardy/XR Tretten VitektaSynthroid Trikafta VitrakviSynvisc One Trilepta VivitrolSyprine Trimeq VizimproTaclonex Trintellix Voltaren EmulgelTadalafil TRIUMEQ VoseviTadalafil 10 trizivir VotrientTagrisso Trodelvy VprivTakhzyro Trokendi VraylarTalfinar Trulicity VumerityTalicia Truvada VyeptiTaltz Tudorza Genuair VyeptiTalzenna Turalio WakixTarceva Tybost WelcholTargretin Tykerb Wixela Inhub (Geq Advair)Targrisso Tymlos XalkoriTasigna Tysabri XareltoTavalisse Tyvaso XeljanzTazverik Ubrelvy Xeljanz XRTecentriq Ubrelvy XelodaTecfidera Uceris XenazineTeflaro Uloric XenletaTegretol Uloric XeominTegsedi Ultomeris XeravaTekturna Uptravi XermeloTestosterone Gel, Valchlor XgevaThalomid Varubi XiaflexThiola EC Vemlidy XidraThyroid Hormone Venclexta XifaxinThyroid Hormone Ventavis XolairThyroid Hormone 60mg Ventolin HFA XolairTibsovo Verzenio XospataTikosyn Vesicare XuridenTivicay Vesicare Xyntha


DRUG NAMEXyremYervoyYondeusYonsaYuperliZarxioZejulaZelborafZemairaZemdriZenpepZepatierZeposiziagenZiextenzoZirabev (Biosim - Avastin)ZolinzazortressZulressoZydeligZykadiaZyprexaZyprexa RelZyprexa ZydisZytiga


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