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PA Drug Name Generic Name PA Summary Name
Epaned enalapril ACE Inhibitors and Combinations
Perindopril perindopril ACE Inhibitors and Combinations
Prestalia perindopril/amlodipine ACE Inhibitors and Combinations
Qbrelis lisinopril ACE Inhibitors and Combinations
Trandolapril/Verapamil ER by Greenstone trandolapril/verapamil ER ACE Inhibitors and Combinations
Absorica/LD, Amnesteem, Claravis,
Isotretinoin, Myorisan, Zenataneisotretinoin Acne Agents, Oral
Acanya clindamycin/benzoyl peroxide Acne and Rosacea Agents, Topical
Aczone dapsone Acne and Rosacea Agents, Topical
Aklief trifarotene Acne and Rosacea Agents, Topical
Altreno, Avita, Tretinoin, Retin-A Micro tretinoin Acne and Rosacea Agents, Topical
Amzeeq, Zilxi minocycline Acne and Rosacea Agents, Topical
Arazlo, Fabior, Tazorac tazarotene Acne and Rosacea Agents, Topical
Azelex, Finacea azelaic acid Acne and Rosacea Agents, Topical
Clindamycin, Clindacin, Evoclin clindamycin Acne and Rosacea Agents, Topical
Clindamycin 1%/Benzoyl Peroxide 5%,
Neuac, Onextonclindamycin/benzoyl peroxide Acne and Rosacea Agents, Topical
Differin, Adapalene adapalene Acne and Rosacea Agents, Topical
Adapalene/Benzoyl Peroxide, Epiduo Forte adapalene/benzoyl peroxide Acne and Rosacea Agents, Topical
Ery Pad, erythromycin pad erythromycin Acne and Rosacea Agents, Topical
Erythromycin/Benzoyl Peroxide erythromycin/benzoyl peroxide Acne and Rosacea Agents, Topical
Metronidazole, Noritate, Rosadan metronidazole Acne and Rosacea Agents, Topical
Soolantra ivermectin Acne and Rosacea Agents, Topical
Ziana tretinoin/clindamycin Acne and Rosacea Agents, Topical
BP 10-1%, Sulfacetamide Sodium/Sulfur,
Sumaxinsodium sulfacetamide/sulfur Acne and Rosacea Agents, Topical
Sulfacetamide sodium sulfacetamide sodium Acne and Rosacea Agents, Topical
Tekturna aliskiren Aliskiren and Combinations
Tekturna HCT aliskiren/HCTZ Aliskiren and Combinations
Donepezil 23 mg donepezil Alzheimer's Agents
Memantine oral solution memantine Alzheimer's Agents
Prior Authorization Drug Criteria Cross Reference
Memantine ER, Namenda XR Titration Pak memantine extended-release Alzheimer's Agents
Namzaric, Titration Pak memantine/donepezil Alzheimer's Agents
Exservan, Tiglutik riluzole Amyotrophic Lateral Sclerosis Agents
Arymo ER, Kadian, Morphabond ER,
Morphine ER capsulesmorphine ER Analgesics, Narcotics Long
Belbuca buprenorphine Analgesics, Narcotics Long
Fentanyl Patch 37.5, 62.5, 87.5 mcg/hour fentanyl Analgesics, Narcotics Long
Hydromorphone ER hydromorphone ER Analgesics, Narcotics Long
Hysingla ER, Zohydro ER hydrocodone ER Analgesics, Narcotics Long
Levorphanol levorphanol Analgesics, Narcotics Long
Nucynta ER tapentadol ER Analgesics, Narcotics Long
OxyContin, Xtampza ER oxycodone ER Analgesics, Narcotics Long
Oxymorphone ER oxymorphone ER Analgesics, Narcotics Long
Acetaminophen/Caffeine/Dihydrocodeine acetaminophen/caffeine/dihydrocodeine Analgesics, Narcotics Short
Benzhydrocodone/Acetaminophen benzhydrocodone/acetaminophen Analgesics, Narcotics Short
Butalbital/Acetaminophen/Caffeine/Codeine butalbital/acetaminophen/caffeine/codeine Analgesics, Narcotics Short
Butalbital/Aspirin/Caffeine/Codeine butalbital/aspirin/caffeine/codeine Analgesics, Narcotics Short
Butorphanol Nasal Spray QLL butorphanol Analgesics, Narcotics Short
Codeine codeine Analgesics, Narcotics Short
Dilaudid Oral Liquid, Hydromorphone Rectal
Suppositoryhydromorphone Analgesics, Narcotics Short
Hydrocodone/Ibuprofen, Ibudone hydrocodone/ibuprofen Analgesics, Narcotics Short
Meperidine meperidine Analgesics, Narcotics Short
Morphine Rectal Suppository morphine Analgesics, Narcotics Short
Nalocet, Primlev, Prolate oxycodone/acetaminophen Analgesics, Narcotics Short
Nucynta tapentadol Analgesics, Narcotics Short
Oxaydo, Oxycodone QLL, Oxycodone
Concentrate Oral Solutionoxycodone Analgesics, Narcotics Short
Oxycodone/Aspirin oxycodone/aspirin Analgesics, Narcotics Short
Oxycodone/Ibuprofen oxycodone/ibuprofen Analgesics, Narcotics Short
Oxymorphone oxymorphone Analgesics, Narcotics Short
Qdolo tramadol Analgesics, Narcotics Short
Diflunisal diflunisal Analgesics, Salicylates
Salsalate salsalate Analgesics, Salicylates
Testosterone Injection testosterone cypionate Androgenic Agents, Injectable
Testosterone Injection, Xyosted testosterone enanthate Androgenic Agents, Injectable
Anadrol-50 oxymetholone Androgenic Agents, Oral
Danazol danazol Androgenic Agents, Oral
Jatenzo testosterone undecanoate Androgenic Agents, Oral
Methitest, Methyltestosterone methyltestosterone Androgenic Agents, Oral
Oxandrolone oxandrolone Androgenic Agents, Oral
Androderm, Androgel, Striant, Testosterone
Trandermaltestosterone Androgenic Agents, Topical
Candesartan candesartan Angiotensin Receptor Blockers and Combinations
Edarbi azilsartan Angiotensin Receptor Blockers and Combinations
Eprosartan eprosartan Angiotensin Receptor Blockers and Combinations
Micardis, Telmisartan telmisartan Angiotensin Receptor Blockers and Combinations
Amlodipine/Valsartan amlodipine/valsartan Angiotensin Receptor Blockers and Combinations
Amlodipine/Valsartan/HCTZ amlodipine/valsartan/HCTZ Angiotensin Receptor Blockers and Combinations
Amlodipine/olmesartan amlodipine/olmesartan Angiotensin Receptor Blockers and Combinations
Entresto sacubitril/valsartan Angiotensin Receptor Blockers and Combinations
Tribenzor olmesartan/amlodipine/HCTZ Angiotensin Receptor Blockers and Combinations
Candesartan/HCTZ candesartan/HCTZ Angiotensin Receptor Blockers and Combinations
Edarbyclor azilsartan/HCTZ Angiotensin Receptor Blockers and Combinations
Micardis, Telmisartan/HCTZ telmisartan/HCTZ Angiotensin Receptor Blockers and Combinations
Telmisartan/Amlodipine, Twynsta telmisartan/amlodipine Angiotensin Receptor Blockers and Combinations
Albendazole albendazole Anthelmintics
Emverm mebendazole Anthelmintics
Stromectol ivermectin Anthelmintics
Oralair mixed grass pollen allergen extract Antiallergens, Oral
Palforziapeanut [Arachis hypogaea] allergen powder-
dnfpAntiallergens, Oral
Multaq dronedarone Antiarrhythmics, Oral
Dificid fidaxomicin Antibiotics, GI
Paromomycin paromomycin Antibiotics, GI
Xifaxan rifamixin Antibiotics, GI
Arikayce amikacin liposome inhalation suspension Antibiotics, Inhaled
Cayston aztreonam inhalation solution Antibiotics, Inhaled
Tobi Podhaler, Tobramycin Nebulized tobramycin Antibiotics, Inhaled
Mupirocin Cream mupirocin Antibiotics, Topical
Neo-Synalar neomycin/fluocinolone Antibiotics, Topical
Neo-Synalar Kit neomycin/fluocinolone/emollient cream Antibiotics, Topical
Xepi ozenoxacin Antibiotics, Topical
Cleocin Ovules, Clindamycin Vaginal Cream
(7-day)clindamycin Antibiotics, Vaginal
Solosec secnidazole Antibiotics, Vaginal
Chlordiazepoxide/Clidinium chlordiazepoxide/clidinium Anticholinergics-Antispasmodics
Cuvposa, Glycate, Glycopyrrolate Injection glycopyrrolate Anticholinergics-Antispasmodics
Methscopolamine methscopolamine Anticholinergics-Antispasmodics
Proprantheline proprantheline Anticholinergics-Antispasmodics
Savaysa edoxaban Anticoagulants
Fondaparinux fondaparinux Anticoagulants
Fragmin Syringes dalteparin Anticoagulants
Diacomit stiripentol Anticonvulsants
Valtoco Nasal Spray diazepam Anticonvulsants
Epidiolex cannabidiol Anticonvulsants
Vimpat Injection lacosamide Anticonvulsants
Aptiom eslicarbazepine Anticonvulsants
Banzel rufinamide Anticonvulsants
Briviact brivaracetam Anticonvulsants
Clobazam oral suspension, Sympazan clobazam Anticonvulsants
Equetro carbamazepine extended-release Anticonvulsants
Felbamate felbamate Anticonvulsants
Fintepla fenfluramine Anticonvulsants
Fycompa perampanel Anticonvulsants
Gabitril, Tiagabine tiagabine Anticonvulsants
Lamictal Kits/ODT, Lamotrigine ER/ODT/kits lamotrigine Anticonvulsants
Elepsia XR, Levetiracetam ER levetiracetam extended-release Anticonvulsants
Lyrica CR pregabalin extended-release Anticonvulsants
Nayzilam midazolam Anticonvulsants
Oxtellar XR oxcarbazepine Anticonvulsants
Qudexy XR, Topiramate ER, Trokendi XR topiramate extended-release Anticonvulsants
Sabril vigabatrin Anticonvulsants
Stavzor, Valproic Acid Capsules valproic acid Anticonvulsants
Xcopri cenobamate Anticonvulsants
Brisdelle, Paxil Suspension, Pexeva paroxetine Antidepressants
Escitalopram Oral Solution escitalopram Antidepressants
Fluoxetine 10 mg, 20 mg Tablets fluoxetine Antidepressants
Fluoxetine 90 mg Delayed-Release fluoxetine DR Antidepressants
Fluoxetine [PMDD], Sarafem fluoxetine [PMDD] Antidepressants
Fluvoxamine ER fluvoxamine extended-release Antidepressants
Paroxetine ER paroxetine extended-release Antidepressants
Desvenlafaxine ER desvenlafaxine extended-release Antidepressants
Drizalma, Duloxetine 40 mg duloxetine Antidepressants
Fetzima levomilnacipran Antidepressants
Savella milnacipran Antidepressants
Trintellix (previously Brintellix) vortioxetine Antidepressants
Venlafaxine ER Tablets venlafaxine extended-release Antidepressants
Nefazodone nefazodone Antidepressants
Trazodone 300 mg trazodone Antidepressants
Viibryd viladazone Antidepressants
Emsam selegiline Antidepressants
Marplan isocarboxazid Antidepressants
Phenylzine phenylzine Antidepressants
Tranylcypromine tranylcypromine Antidepressants
Imipramine Capsules imipramine pamoate Antidepressants
Protriptyline protriptyline Antidepressants
Trimipramine trimipramine Antidepressants
Aplenzin, Forfivo XL bupropion extended-release Antidepressants
Maprotiline maprotiline Antidepressants
Spravato esketamine Antidepressants
Alogliptin, Nesina alogliptin Antidiabetic Agents
Alogliptin/Metformin alogliptin/metformin Antidiabetic Agents
Alogliptin/Pioglitazone alogliptin/pioglitazone Antidiabetic Agents
Janumet XR sitagliptin/metformin ER Antidiabetic Agents
Jentadueto XR linagliptin/metformin ER Antidiabetic Agents
Fortamet, Metformin ER (generic Fortamet),
Riomet ERmetformin ER Antidiabetic Agents
Glyxambi empagliflozin/linagliptin Antidiabetic Agents
Invokamet XR canagliflozin/metformin ER Antidiabetic Agents
Qtern dapagliflozin/saxagliptin Antidiabetic Agents
Segluromet ertugliflozin/metformin Antidiabetic Agents
Steglatro ertugliflozin Antidiabetic Agents
Steglujan ertugliflozin/sitagliptin Antidiabetic Agents
Synjardy, Synjardy XR empaglifozin/metformin, ER Antidiabetic Agents
Trijardy XR empagliflozin/linagliptin/metformin ER Antidiabetic Agents
Tolbutamide tolbutamide Antidiabetic Agents
Avandia rosiglitazone Antidiabetic Agents
Pioglitazone/Glimepride pioglitazone/glimepiride Antidiabetic Agents
Pioglitazone/Metformin pioglitazone/metformin Antidiabetic Agents
Symlin Pen pramlintide acetate Antidiabetic Agents
Adlyxin lixisenatide Antidiabetic Agents
Bydureon BCise exenatide ER Antidiabetic Agents
Cycloset bromocriptine Antidiabetic Agents
Ozempic, Rybelsus semaglutide Antidiabetic Agents
Soliqua insulin glargine/lixisenatide Antidiabetic Agents
Trulicity dulaglutide Antidiabetic Agents
Xultophy insulin degludec/liraglutide Antidiabetic Agents
Alosetron alosetron Antidiarrheals
Motofen difenoxin/atropine Antidiarrheals
Mytesi crofelemer Antidiarrheals
Opium Tincture opium tincture Antidiarrheals
Viberzi eluxadoline Antidiarrheals
Akynzeo netupitant/palonosetron Antiemetic/Antivertigo Agents
Anzemet dolasetron Antiemetic/Antivertigo Agents
Compro prochlorperazine Antiemetic/Antivertigo Agents
Dimenhydrinate Injection dimenhydrinate Antiemetic/Antivertigo Agents
Dronabinol, Syndros dronabinol Antiemetic/Antivertigo Agents
Emend Suspension aprepitant Antiemetic/Antivertigo Agents
Gimoti metoclopramide nasal spray Antiemetic/Antivertigo Agents
Granisetron, Sancuso granisetron Antiemetic/Antivertigo Agents
Metoclopramide ODT metoclopramide Antiemetic/Antivertigo Agents
Ondansetron Injection, Zuplenz ondansetron Antiemetic/Antivertigo Agents
Promethazine 50 mg Suppository promethazine Antiemetic/Antivertigo Agents
Trimethobenzamide trimethobenzamide Antiemetic/Antivertigo Agents
Varubi rolapitant Antiemetic/Antivertigo Agents
Tranexamic Acid tranexamic acid Antifibrinolytic Agents
Fluconazole Injection fluconazole Antifungals, Injectable
Ambisome amphotericin B liposome Antifungals, Injectable
Cancidas caspofungin Antifungals, Injectable
Voriconazole Injection voriconazole Antifungals, Injectable
Cresemba isavuconazonium Antifungals, Oral
Flucytosine flucytosine Antifungals, Oral
Griseofulvin griseofulvin Antifungals, Oral
Lamisil Granules terbinafine Antifungals, Oral
Noxafil posaconazole Antifungals, Oral
Itraconazole, Omnel, Sporanox Solution Itraconazole Antifungals, Oral
Oravig miconazole Antifungals, Oral
Vfend Suspension voriconazole Antifungals, Oral
Bensal HP salicylic acid Antifungals, Topical
Ciclopirox, Ciclodan Kit, Loprox Kit ciclopirox Antifungals, Topical
Clotrimazole/Betamethasone Lotion clotrimazole/betamethasone Antifungals, Topical
Extina, Ketoconazole Foam , Ketodan Kit ketoconazole Antifungals, Topical
Jublia efinaconazole Antifungals, Topical
Kerydin tavaborole Antifungals, Topical
Luzu luliconazole Antifungals, Topical
Naftifine Cream, Naftin Gel naftifine Antifungals, Topical
Nystatin/Triamcinolone Cream nystatin/triamcinolone Antifungals, Topical
Vusion miconazole/zinc oxide/petrolatum Antifungals, Topical
Clarinex-D desloratadine/pseudoephedrine Antihistamines
Clarinex Syrup, Desloratadine desloratadine Antihistamines
Karbinal ER, Ryvent carbinoxamine ER Antihistamines
Levocetirizine Solution levocetirizine Antihistamines
Ryvent carbinoxamine Antihistamines
Xenical orlistat Antihyperlipidemics, Other
Saxenda liraglutide Antihyperlipidemics, Other
Clonidine TTS clonidine TTS Antihypertensives, Sympatholytics
Colchicine QLL, Colchicine Tablets, Gloperba colchicine Antihyperuricemics
Febuxostat febuxostat Antihyperuricemics
Krintafel tafenoquine Antimalarials
Atovaquone/Proguanil, Malarone atovaquone/proguanil Antimalarials
Coartem artemether/lumefantrine Antimalarials
Quinine Sulfate quinine sulfate Antimalarials
Aimovig erenumab-aooe Antimigraine Agents, Other
Ajovy fremanezumab-vfrm Antimigraine Agents, Other
Nurtec ODT rimegepant Antimigraine Agents, Other
Emgality galcanezumab-gnlm Antimigraine Agents, Other
Reyvow lasmiditan Antimigraine Agents, Other
Ubrelvy ubrogepant Antimigraine Agents, Other
Almotriptan almotriptan Antimigraine Agents, Triptans
Dihydroergotamine, Migranal dihydroergotamine mesylate Antimigraine Agents, Triptans
Eletriptan eletriptan Antimigraine Agents, Triptans
Ergomar ergotamine Antimigraine Agents, Triptans
Frova frovatriptan Antimigraine Agents, Triptans
Migergot ergotamine/caffeine Antimigraine Agents, Triptans
Nazatriptan nazatriptan Antimigraine Agents, Triptans
Onzetra Xsail, Sumatriptan Injection,
Tosymra, Zembrace sumatriptan Antimigraine Agents, Triptans
Treximet sumatriptan/naproxen Antimigraine Agents, Triptans
Zolmitriptan, Zomig, Zomig ZMT zolmitriptan Antimigraine Agents, Triptans
Pretomanid pretomanid Antimycobacterium Agents
Sirturo bedaquiline Antimycobacterium Agents
Eurax crotamiton Antiparasitics, Topical
Ivermectin ivermectin Antiparasitics, Topical
Lindane lindane Antiparasitics, Topical
Malathion, Ovide malathion Antiparasitics, Topical
Natroba, Spinosad spinosad Antiparasitics, Topical
Apokyn, Kynmobi apomorphine Antiparkinson Agents
Carbidopa/Levodopa ODT, Rytary carbidopa/levodopa Antiparkinson Agents
Gocovri amantadine extended-release Antiparkinson Agents
Inbrija levodopa Antiparkinson Agents
Mirapex ER, Pramipexole ER pramipexole Antiparkinson Agents
Neupro rotigotine Antiparkinson Agents
Nourianz istradefylline Antiparkinson Agents
Ropinirole ER ropinirole Antiparkinson Agents
Tolcapone tolcapone Antiparkinson Agents
Xadago safinamide Antiparkinson Agents
Zelapar selegiline Antiparkinson Agents
Zontivity vorapaxar Antiplatelet Drugs
Benznidazole benznidazole Antiprotozoals
Daraprim pyrimethamine Antiprotozoals
Lampit nifurtimox Antiprotozoals
Flagyl 375 mg, Metronidazole 375 mg metronidazole Antiprotozoals
Nitazoxanide Nitazoxanide Antiprotozoals
Doxepin Cream, Prudoxin, Zonalon doxepin Antipruritics, Topical
Calcipotriene ointment, Sorilux calcipotriene Antipsoriatic Agents
Calcipotriene/betamethasone, Enstilar,
Taclonexcalcipotriene/betamethasone Antipsoriatic Agents
Calcitriol, Vectical calcitriol Antipsoriatic Agents
Methoxsalen methoxsalen Antipsoriatic Agents
Cytovene Injection, Ganciclovir Injection ganciclovir Antivirals, General
Prevymis letermovir Antivirals, General
Valcyte Powder, Valganciclovir Powder valganciclovir Antivirals, General
Valacyclovir QLL valacyclovir Antivirals, Oral
Sitavig acyclovir Antivirals, Oral
Xofluza baloxivir Antivirals, Oral
Acyclovir Ointment acyclovir Antivirals, Topical
Denavir penciclovir Antivirals, Topical
Xerese acyclovir/hydrocortisone Antivirals, Topical
Meprobamate meprobamate Anxiolytics Benzodiazepines and Barbiturates
Alprazolam ER, ODT, Concentrate alprazolam Anxiolytics Benzodiazepines and Barbiturates
Clonazepam ODT clonazepam Anxiolytics Benzodiazepines and Barbiturates
Clorazepate clorazepate Anxiolytics Benzodiazepines and Barbiturates
Oxazepam oxazepam Anxiolytics Benzodiazepines and Barbiturates
Midazolam midazolam Anxiolytics Benzodiazepines and Barbiturates
Temazepam 7.5 mg, 22.5 mg temazepam Anxiolytics Benzodiazepines and Barbiturates
Triazolam triazolam Anxiolytics Benzodiazepines and Barbiturates
Amytal amobarbital Anxiolytics Benzodiazepines and Barbiturates
Seconal secobarbital Anxiolytics Benzodiazepines and Barbiturates
Bevespi Aerosphere glycopyrrolate/formoterol Asthma and COPD Agents
Duaklir Pressair aclidinium/formotoerol Asthma and COPD Agents
Incruse Ellipta umeclidinium Asthma and COPD Agents
Lonhala Magnair glycopyrrolate Asthma and COPD Agents
Spiriva Respimat tiotropium Asthma and COPD Agents
Tudorza Pressair aclidinium Asthma and COPD Agents
Yupelri revefenacin Asthma and COPD Agents
Albuterol Inhalation 0.021%, 0.042% albuterol Asthma and COPD Agents
Albuterol Tablets albuterol Asthma and COPD Agents
Brovana aformoterol Asthma and COPD Agents
Levalbuterol, Xopenex HFA levalbuterol Asthma and COPD Agents
Metaproterenol metaproterenol Asthma and COPD Agents
Perforomist formoterol Asthma and COPD Agents
ProAir Digihaler and Respiclick albuterol Asthma and COPD Agents
Striverdi Respimat oladaterol Asthma and COPD Agents
Terbutaline terbutaline Asthma and COPD Agents
Alvesco ciclesonide Asthma and COPD Agents
Armonair Digihaler fluticasone propionate Asthma and COPD Agents
Arnuity Ellipta fluticasone furoate Asthma and COPD Agents
Asmanex Twisthaler/HFA mometasone Asthma and COPD Agents
Qvar Redihaler beclomethasone Asthma and COPD Agents
AirDuo, Fluticasone/Salmeterol fluticasone/salmeterol Asthma and COPD Agents
Breo Ellipta fluticasone/vilanterol Asthma and COPD Agents
Breztri Aerosphere budesonide/glycopyrrolate/formoterol Asthma and COPD Agents
Trelegy Ellipta fluticasone/umeclidinium/vilanterol Asthma and COPD Agents
Daliresp roflumilast Asthma and COPD Agents
Abilify Maintena, Aripiprazole,
Aristada/Aristada Initioaripiprazole Atypical Antipsychotics
Caplyta lumateperone Atypical Antipsychotics
Clozapine, Clozapine ODT, Versacloz clozapine Atypical Antipsychotics
Fanapt iloperidone Atypical Antipsychotics
Invega Sustenna, Invega Trinza, Paliperidone paliperidone Atypical Antipsychotics
Latuda lurasidone Atypical Antipsychotics
Nuplazid pimavanserin Atypical Antipsychotics
Olanzapine, Zyprexa Relprevv olanzapine Atypical Antipsychotics
Olanzapine/Fluoxetine olanzapine/fluoxetine Atypical Antipsychotics
Quetiapine IR and ER quetiapine Atypical Antipsychotics
Rexulti brexpiprazole Atypical Antipsychotics
Risperdal Consta, Risperidone risperidone Atypical Antipsychotics
Secuado, Asenapine asenapine Atypical Antipsychotics
Vraylar cariprazine Atypical Antipsychotics
Ziprasidone ziprasidone Atypical Antipsychotics
Amoxicillin/Clavulanate chewable tablets,
250/125 mg tabletsamoxicillin/clavulanate Augmentin Products
Amoxicillin/Clavulanate ER amoxicillin/clavulanate extended-release Augmentin Products
Amoxicillin/clavulanate 250-62.5 mg/5 ml,
Augmentin 125-31.25 mg/5 mLamoxicillin/clavulanate Augmentin Products
Aztreonam injection, Azactam Injection aztreonam Aztreonam
Bystolic nebivolol Beta Blockers
Coreg CR carvedilol extended-release Beta Blockers
Corzide nadolol/bendroflurmethiazide Beta Blockers
Innopran XL propranolol extended-release Beta Blockers
Metoprolol/Hydrochlorothiazide metoprolol/hydrochlorothiazide Beta Blockers
Sotylize sotalol Beta Blockers
Timolol timolol Beta Blockers
Cholestyramine, cholestyramine lite,
Prevalite powder packetscholestyramine Bile Acid Sequestrants
Colestid and colestipol granules and packets colestipol Bile Acid Sequestrants
Welchol colesevelam Bile Acid Sequestrants
Chenodal chenodiol Bile Salts
Cholbam cholic acid Bile Salts
Ocaliva obeticholic acid Bile Salts
Reltone ursodiol Bile Salts
Arcalyst rilonacept Biologic Immunomodulators
Benlysta Subcutaneous belimumab Biologic Immunomodulators
Enbrel etanercept Biologic Immunomodulators
Humira adalimumab Biologic Immunomodulators
Ilaris canakinumab Biologic Immunomodulators
Xeljanz tofacitinib Biologic Immunomodulators
Xeljanz XR tofacitinib extended-release Biologic Immunomodulators
Actemra Subcutaneous tocilizumab Biologic Immunomodulators
Cimzia certolizumab Biologic Immunomodulators
Cosentyx secukinumab Biologic Immunomodulators
Dupixent dupilumab Biologic Immunomodulators
Enspryng satralizumab-mwge Biologic Immunomodulators
Fasenra Pen benralizumab Biologic Immunomodulators
Kevzara sarilumab Biologic Immunomodulators
Kineret anakinra Biologic Immunomodulators
Nucala Pen mepolizumab Biologic Immunomodulators
Olumiant baricitinib Biologic Immunomodulators
Orencia Subcutaneous abatacept Biologic Immunomodulators
Otezla apremilast Biologic Immunomodulators
Rinvoq upadacitinib Biologic Immunomodulators
Siliq brodalumab Biologic Immunomodulators
Simponi golimumab Biologic Immunomodulators
Skyrizi risankizumab Biologic Immunomodulators
Stelara ustekinumab Biologic Immunomodulators
Taltz ixekizumab Biologic Immunomodulators
Tremfya guselkumab Biologic Immunomodulators
Vesicare LS solifenacin Bladder Relaxant Preparations
Darifenacin darifenacin Bladder Relaxant Preparations
Flavoxate flavoxate Bladder Relaxant Preparations
Gelnique oxybutunin Bladder Relaxant Preparations
Myrbetriq mirabegron Bladder Relaxant Preparations
Tolterodine IR, Tolterodine ER tolterodine Bladder Relaxant Preparations
Trospium IR, Trospium ER trospium Bladder Relaxant Preparations
Actonel 5 mg and 30 mg, Atelvia,
Risedronaterisedronate Bone Resorption Suppression and Related Agents
Alendronate Oral Solution alendronate Bone Resorption Suppression and Related Agents
Forteo teriparatide Bone Resorption Suppression and Related Agents
Fosamax Plus D alendronate with vitamin D Bone Resorption Suppression and Related Agents
Ibandronate ibandronate Bone Resorption Suppression and Related Agents
Miacalcin Injection calcitonin-salmon Bone Resorption Suppression and Related Agents
Risedronate Delayed-Release risedronate DR Bone Resorption Suppression and Related Agents
Tymlos abaloparatide Bone Resorption Suppression and Related Agents
Cardura XL doxazosin BPH Agents
Cialis 2.5 mg, 5 mg tadalafil BPH Agents
Dutasteride/Tamsulosin dutasteride/tamsulosin BPH Agents
Rapaflo silodosin BPH Agents
Nymalize nimodipine Calcium Channel Blockers
Isradipine isradipine Calcium Channel Blockers
Katerzia amlodipine Calcium Channel Blockers
Nisoldipine ER nisoldipine ER Calcium Channel Blockers
Diltiazem CD 360 mg, Matzim LA diltiazem ER Calcium Channel Blockers
Verapamil ER PM verapamil ER Calcium Channel Blockers
Capecitabine capecitabine Capecitabine
Carbaglu carglumic acid Carbaglu
Doribax doripenem Carbapenems
Meropenem meropenem Carbapenems
Meropenem/Sodium Chloride meropenem/sodium chloride Carbapenems
Primaxin, Imipenem/Cilastin imipenem/cilastin Carbapenems
Celestone Soluspan betamethasone Celestone Soluspan
Cefadroxil Tablets cefadroxil Cephalosporins and Related Antibiotics
Cephalexin 750 mg and Tablets cephalexin Cephalosporins and Related Antibiotics
Cefaclor ER, Suspension cefaclor Cephalosporins and Related Antibiotics
Cefixime, Suprax cefixime Cephalosporins and Related Antibiotics
Cefpodoxime cefpodoxime Cephalosporins and Related Antibiotics
Avycaz ceftazidime/avibactam Cephalosporins, Injectable
Teflaro ceftaroline Cephalosporins, Injectable
Zerbaxa ceftolozane/tazobactam Cephalosporins, Injectable
Depen Titratabs penicillamine Chelating Agents
Deferasirox Granules deferasirox Chelating Agents
Ferriprox deferiprone Chelating Agents
Fulphila, Neulasta, Nyvepria, Udenyca,
Ziextenzo pegfilgrastim Colony Stimulating Factors
Granix tbo filgrastrim Colony Stimulating Factors
Leukine sargramostim Colony Stimulating Factors
Neupogen, Nivestym, Zarxio filgrastim Colony Stimulating Factors
Amethia, Amethia Lo, Amethyst, Camrese,
Camrese Lo, Quartette, Twirla, Tyblume,
generics
levonorgestrel/ethinyl estradiol Contraceptives
Annovera segesterone acetate/ethinyl estradiol Contraceptives
Aranelle, Leena, generics norethindrone /ethinyl estradiol Contraceptives
Balcoltralevonorgestrel/ethinyl estradiol/ferrous
biglycinateContraceptives
Generics, Safyraldrospirenone/ ethinyl estradiol/
levomefolate calciumContraceptives
Gianvi, Ocella, Zarah, generics drospirenone/ethinyl estradiol/ Contraceptives
Layolis FE, Wymza FE, genericsnorethindrone acetate/ethinyl
estradiol/ferrous fumarateContraceptives
Lo Loestrin FE, Minastrin 24 FEnorethindrone acetate/ethinyl
estradiol/ferrous fumarateContraceptives
Natazia estradiol valerate/dienogest Contraceptives
Nextstellis drospirenone/estetrol Contraceptives
Phexxi lactic acid/citric acid/potassium bitartrate Contraceptives
Slynd drospirenone Contraceptives
Tri-Lo Estaryll, Tri-Lo Marzia, Tri-Lo Sprintec,
genericsnorgestimate/ethinyl estradiol Contraceptives
Xulane, generics norelgestromin/ethinyl estradiol Contraceptives
Zovia 1/50E, generics ethinyl estradiol/ethynodiol Contraceptives
Corlanor ivabradine Corlanor
Analpram-HC Cream,
Hydrocortisone/Pramoxine, Procorthydrocortisone acetate/pramoxine Corticosteroid Combinations
Alkindi Sprinkle hydrocortisone Corticosteroids, Oral
Emflaza deflazacort Corticosteroids, Oral
Hemady, Taperdex dexamethasone Corticosteroids, Oral
Millipred, Prednisolone ODT, 10mg/5mL,
20mg/5mLprednisolone Corticosteroids, Oral
Ortikos budesonide extended-release Corticosteroids, Oral
Rayos prednisone delayed-release Corticosteroids, Oral
Augmented Betamethasone augmented betamethasone Corticosteroids, Topical
Clobetasol, Clobex Shampoo, Clodan Kit,
Olux-Eclobetasol Corticosteroids, Topical
Ultravate X Kit halobetasol/lactic acid Corticosteroids, Topical
Bryhali, Halobetasol Aerosol and Ointment,
Ultravate Lotionhalobetasol Corticosteroids, Topical
Apexicon E, Diflorasone Diacetate diflorasone diacetate Corticosteroids, Topical
Alclometasone Dipropionate alclometasone dipropionate Corticosteroids, Topical
Cloderm, Clocortolone Pivalate clocortolone pivalate Corticosteroids, Topical
Prednicarbate prednicarbate Corticosteroids, Topical
Fluticasone fluticasone Corticosteroids, Topical
Halog halcinonide Corticosteroids, Topical
Mometasone Furoate mometasone furoate Corticosteroids, Topical
Hydrocortisone Butyrate hydrocortisone butyrate Corticosteroids, Topical
Betamethasone Dipropionate betamethasone dipropionate Corticosteroids, Topical
Luxiq, Betamethasone Valerate betamethasone valerate Corticosteroids, Topical
Pandel hydrocortisone probutate Corticosteroids, Topical
Capex, Synalar/Kit, Fluocinolone Acetonide fluocinolone acetonide Corticosteroids, Topical
Texacort hydrocortisone Corticosteroids, Topical
Amcinonide amcinonide Corticosteroids, Topical
Topicort, Desoximetasone desoximetasone Corticosteroids, Topical
Trianex augmented triamcinolone Corticosteroids, Topical
Fluocinonide fluocinonide Corticosteroids, Topical
Desonide, Desonate desonide Corticosteroids, Topical
Cordran Tape, Flurandrenolide flurandrenolide Corticosteroids, Topical
Beser Kit fluticasone propionate/emollient cream Corticosteroids, Topical
Kenalog, Triamcinolone Acetonide triamcinolone acetonide Corticosteroids, Topical
Crinone progesterone Crinone
Bronchitol mannitol Cystic Fibrosis, Oral
Kalydeco ivacaftor Cystic Fibrosis, Oral
Orkambi lumacaftor/ivacaftor Cystic Fibrosis, Oral
Symdeko tezacaftor/ivacaftor and ivacaftor Cystic Fibrosis, Oral
Triktaftaelexacaftor/tezacaftor/ivacaftor and
ivacaftor) Cystic Fibrosis, Oral
Cystadrops, Cystaran, Procysbi cysteamine Cystine Depleting Agents
Abbott Test Strips blood glucose test strips Diabetic Supplies Insulin Pens
Humalog Pens insulin lispro Diabetic Supplies Insulin Pens
Humulin Pens, Novolin Pens insulin Diabetic Supplies Insulin Pens
Insulin Aspart Pens insulin aspart Diabetic Supplies Insulin Pens
Insulin Aspart/Aspart Protamine Pens insulin aspart/aspart protamine Diabetic Supplies Insulin Pens
Insulin Lispro Pens insulin lispro Diabetic Supplies Insulin Pens
Insulin Lispro/Lispro Protamine Pens insulin lispro/lispro protamine Diabetic Supplies Insulin Pens
Insulin Syringes insulin syringes Diabetic Supplies Insulin Pens
Lancet Device and Lancets lancets Diabetic Supplies Insulin Pens
Novolog Pens insulin aspart Diabetic Supplies Insulin Pens
Pen Needles pen needles Diabetic Supplies Insulin Pens
Precision Ketone Test Strips ketone test strips Diabetic Supplies Insulin Pens
Apidra Pens insulin glulisine Diabetic Supplies Insulin Pens
Baqsimi, Gvoke glucagon Diabetic Supplies Insulin Pens
Basaglar, Semglee, Toujeo Pens insulin glargine Diabetic Supplies Insulin Pens
Fiasp Pens insulin aspart with niacinamide Diabetic Supplies Insulin Pens
Lyumjev Pens insulin lispro-aabc Diabetic Supplies Insulin Pens
Tresiba Pens insulin degludec Diabetic Supplies Insulin Pens
Zegalogue dasiglucagon Diabetic Supplies Insulin Pens
Carospir spirinolactone suspension Diuretics
Eplerenone eplerenone Diuretics
Ethacrynic Acid ethacryinic acid Diuretics
Triamterene triamterene Diuretics
Egrifta tesamorelin Egrifta
Elaprase idursulfase Elaprase
Aralast-NP alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic
Glassia alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic
Prolastin-C alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic
Zemaira alpha-1 proteinase inhibitor Enzyme Inhibitors, Systemic
Zokinvy lonafarnib Enzyme Inhibitors, Systemic
Cerdelga eliglustat Enzyme Replacement, Gauchers Disease
Cerezyme imiglucerase Enzyme Replacement, Gauchers Disease
Elelyso taliglucerase Enzyme Replacement, Gauchers Disease
VPRIV velaglucerase Enzyme Replacement, Gauchers Disease
Epinephrine injection generics EXCEPT by
Mylan, EpiPen, Symjepiepinephrine Epinephrine Injection
Epogen, Procrit, Retacrit epoetin alfa Erythropoiesis Stimulating Proteins
Aranesp darbepoetin alfa Erythropoiesis Stimulating Proteins
Mircera methoxy polyethylene glycol-epoetin beta Erythropoiesis Stimulating Proteins
Bijuva estradiol/progesterone Estrogen Agents, Oral - Transdermal
Norethindrone/ethinyl estradiol norethindrone/ethinyl estradiol Estrogen Agents, Oral - Transdermal
Divigel, Elestrin estradiol topical gel Estrogen Agents, Oral - Transdermal
Estradiol Patch, Minivelle estradiol transdermal patch Estrogen Agents, Oral - Transdermal
Duavee conjugated estrogen/bazedoxifene Estrogen Agents, Oral - Transdermal
Osphena ospemifene Estrogen Agents, Oral - Transdermal
Etoposide, Etopophos, Toposar etoposide Etoposide
Galafold migalastat Fabry Disease Agents
Antara, Fenofibrate, Fenoglide, Triglide fenofibrate Fibric Acid Derivatives
Fenofibric Acid fenofibric acid Fibric Acid Derivatives
Fenofibric Acid DR fenofibric acid delayed-release Fibric Acid Derivatives
Firmagon degarelix Firmagon
Baxdela delafloxacin Fluoroquinolones
Levofloxacin oral solution, injection levofloxacin Fluoroquinolones
Gattex teduglitide Gattex
Amitiza lubiprostone GI Motility, Chronic
Kristalose lactulose GI Motility, Chronic
Linzess linaclotide GI Motility, Chronic
Motegrity prucalopride GI Motility, Chronic
Movantik naloxegol GI Motility, Chronic
Relistor methylnaltrexone GI Motility, Chronic
Symproic naldemedine GI Motility, Chronic
Trulance plecanatide GI Motility, Chronic
Dalvance dalbavancin Glycopeptides
Firvanq vancomycin Glycopeptides
Vibativ telavancin Glycopeptides
Genotropin, Humatrope, Norditropin,
Nutropin AQ, Omnitrope, Saizen, Zomacton,
Zorbtive
somatotropin (recombinant) Growth Hormone
Pylerabismuth subcitrate/metronidazole/
tetracyclineH Pylori Treatment
Amoxicillin/Clarithromycin/Lansoprazole amoxicillin/clarithromycin/ lansoprazole H Pylori Treatment
Omeclamox amoxicillin/clarithromycin/omeprazole H Pylori Treatment
Talicia omeprazole/amoxicillin/rifabutin H Pylori Treatment
Famotidine Oral Suspenion famotidine H2 Antagonists
Nizatidine Capsules, Oral Solution nizatidine H2 Antagonists
Orladeyo berotralstat HAE Treatments
Cinryze, Ruconest C1 esterase inhibitor HAE Treatments
Takhzyro lanadelumab HAE Treatments
Adynovate, Eloctate, Esperoct, Jivi, Kovaltry,
Recombinatefactor VIII recombinant Hemophilia Treatment
Alprolix, Idelvion, Ixinity, Rebinyn, Rixubis factor IX recombinant Hemophilia Treatment
Humate-P von Willebrand factor complex human Hemophilia Treatment
Vonvedi von Willebrand factor recombinant Hemophilia Treatment
FEIBA antiinhibitor factor complex Hemophilia Treatment
Hemlibra emicizumab Hemophilia Treatment
Novoseven RT, Sevenfact factor VIIa recombinant Hemophilia Treatment
Tretten factor VIII A-subunit recombinant Hemophilia Treatment
Adefovir adefovir Hepatitis B Agents
Vemlidy tenofovir alafenamide Hepatitis B Agents
Mavyret glecaprevir/pibrentasvir Hepatitis C Agents
Sofosbuvir/Velpatasvir sofosbuvir/velpatasvir Hepatitis C Agents
Vosevi sofosbuvir/velpatasvir/voxilaprevir Hepatitis C Agents
Harvoni, Ledipasvir/Sofosbuvir ledipasvir/sofosbuvir Hepatitis C Agents
Sovaldi sofosbuvir Hepatitis C Agents
Zepatier elbasvir/grazoprevir Hepatitis C Agents
Ribapak ribavirin Hepatitis C Agents
Tegsedi inotersen Hereditary Transthyretin Amloidosis Agents
Edurant rilpivirine HIV-AIDS
Evotaz atazanavir/cobicistat HIV-AIDS
Isentress/Isentress HD raltegravir HIV-AIDS
Odefseyemtricitabine/rilpivirine/tenofovir
alafenamideHIV-AIDS
Prezcobix darunavir/cobicistat HIV-AIDS
Prezista darunavir HIV-AIDS
Tivicay PD dolutegravir HIV-AIDS
Tybost cobicistat HIV-AIDS
Abacivir/Lamivudine/Zidovudine abacivir/lamivudine/zidovudine HIV-AIDS
Aptivus tipranavir HIV-AIDS
Complera emtricitabine/rilpivirine/tenofovir HIV-AIDS
Crixivan indinavir HIV-AIDS
Delstrigodoravirine/lamivudine/tenofovir disoproxil
fumurateHIV-AIDS
Dovato dolutegravir/lamivudine HIV-AIDS
Fuzeon enfuvirtide HIV-AIDS
Intelence etavirine HIV-AIDS
Invirase saquinavir HIV-AIDS
Lexiva fosamprenavir HIV-AIDS
Nevirapine ER nevirapine extended-release HIV-AIDS
Norvir Powder and Solution ritonavir HIV-AIDS
Pifeltro doravirine HIV-AIDS
Reyataz Powder atazanavir HIV-AIDS
Rukobia fostemsavir HIV-AIDS
Selzentry maraviroc HIV-AIDS
Stribildelvitegravir/cobicistat/emtricitabine/tenofovi
r disoproxil fumarateHIV-AIDS
Symfi/Symfi Loefavirenz/lamivudine/tenofovir disoproxil
fumarateHIV-AIDS
Temixyslamivudine/tenofovir disoproxil fumarate
HIV-AIDS
Vitekta elvitegravir HIV-AIDS
HP Acthar Gel respiratory corticotropin injection HP Acthar Gel
Amphadase bovine hyaluronidase Hyaluronidase
Hylenex recombinant hyaluronidase Hyaluronidase
Vitrase ovine hyaluronidase Hyaluronidase
Qbrexza glycopyrronium Hyperhidrosis Agents
Lokelma sodium zirconium cyclosilicate Hyperkalemia Agents
Veltassa patiromer Hyperkalemia Agents
Natpara parathyroid hormone Hyperparathyroid Agents
Afrezza insulin inhaled Hypoglycemics, Insulin and Related Agents
Apidra vials insulin glulisine Hypoglycemics, Insulin and Related Agents
Fiasp vials insulin aspart with niacinamide Hypoglycemics, Insulin and Related Agents
Lyumjev vials insulin lispro-aabc Hypoglycemics, Insulin and Related Agents
Novolin vials insulin regular/isophane Hypoglycemics, Insulin and Related Agents
Semglee vials insulin glargine Hypoglycemics, Insulin and Related Agents
Tresiba vials insulin degludec Hypoglycemics, Insulin and Related Agents
Crysvita burosumab-twza Hypophosphatemia Treatments
Imcivree setmelanotide Imcrivree
CytoGam cytomegalovirus immune globulin Immune Globulins
Bivigam, Carimune, Cutaquig, Cuvitru,
Flebogamma, Gamastan, Gammagard,
Gammaked, Gammaplex, Gamunex,
Hizentra, Hyqvia, Octagam, Panzyga, Privigin,
Xembify
immune globulin Immune Globulins
HepaGam B hepatitis B immune globulin Immune Globulins
Sylatron peginterferon alfa-2b Immunomodulators, Antineoplastic
Lupkynis voclosporin Immunomodulators, Lupus
Cellcept suspension, mycophenolic mofetil
suspensionmycophenolic mofetil Immunosuppressives, Oral
Astagraf XL, Envarsus XR tacrolimus ER Immunosuppressives, Oral
Prograf Granules tacrolimus for oral suspension Immunosuppressives, Oral
Zortress everolimus Immunosuppressives, Oral
Increlex mecasermin Increlex
Invanz ertapenem Invanz
Feriva 21-7 and FA iron vitamin Iron, Oral
Infed iron dextran Iron, Parenteral
Venofer iron sucrose Iron, Parenteral
Feraheme ferumoxytol Iron, Parenteral
Injectafer ferric carboxymaltose Iron, Parenteral
Monoferric ferric derisomal Iron, Parenteral
Sodium Ferric Gluconate Complex sodium ferric gluconate complex Iron, Parenteral
Salex, Salicylic Acid Foam/Gel salicylic acid Keratolytics
Uream Cream urea Keratolytics
Keveyis dichlorphenamide Keveyis
Firdase, Ruzurgi amifampridine Lambert-Eaton Myasthenic Syndrome Agents
Lanoxin 0.0625mg, 0.1875mg digoxin Lanoxin
Clenpiq, Prepopik sodium picosulfate, magnesium, citric acid Laxatives and Cathartics
Gavilyte-H polyethylene glycol, electrolytes, bisacodyl Laxatives and Cathartics
Plenvupolyethylene glycol, sodium, ascorbic acid,
potassiumLaxatives and Cathartics
Suprep sodium, potassium, magnesium Laxatives and Cathartics
Montelukast Granules montelukast Leukotriene Modifiers
Zafirlukast zafirlukast Leukotriene Modifiers
Zileuton ER zileuton extended-release Leukotriene Modifiers
Zyflo zileuton Leukotriene Modifiers
Cubicin, Daptomycin 350 mg daptomycin Lipopeptides
Juxtapid lomitapide Lipotropics, Other
Nexletol bempedoic acid Lipotropics, Other
Nexlizet bempedoic acid and ezetimibe Lipotropics, Other
Praluent alirocumab Lipotropics, Other
Repatha evolocumab Lipotropics, Other
Vascepa icosapent ethyl Lipotropics, Other
Ezetimibe/Simvasting 10/80 mg ezetimibe/simvastatin Lipotropics, Statins
Simvastatin 80mg simvastatin Lipotropics, Statins
Altoprev lovastatin Lipotropics, Statins
Amlodipine/Atorvastatin amlodipine/atorvastatin Lipotropics, Statins
Ezallor rosuvastatin Lipotropics, Statins
Fluvastatin fluvastatin Lipotropics, Statins
Livalo, Zypitamag pitavastatin Lipotropics, Statins
Erythromycin Oral erythromycin Macrolides-Ketolides
Makena hydroxyprogesterone caproate Makena
Megace ES, Megestrol ES megestrol acetate Megace ES
Otrexup, Rasuvo, Reditrex, Xatmep methotrexate Methotrexate
Milrinone milrinone Milrinone
Bupap, Butalbital/Acetaminophen 50-300 mg butalbital/acetaminophen Miscellaneous Analgesics
Butalbital/Acetaminophen/Caffeine
Capsules, Zebutal butalbital/acetaminophen/caffeine Miscellaneous Analgesics
Conzip, Tramadol ER tramadol ER Miscellaneous Analgesics
Austedo deutetrabenazine Movement Disorder Agents
Ingrezza valbenazine Movement Disorder Agents
Tetrabenazine tetrabenazine Movement Disorder Agents
Mozobil plerixafor Mozobil
Dalfampridine dalfampridine Multiple Sclerosis Agents
Aubagio teriflunamide Multiple Sclerosis Agents
Bafiertam monomethyl fumarate Multiple Sclerosis Agents
Betaseron, Extavia interferon beta-1b Multiple Sclerosis Agents
Copaxone 40mg, Glatiramer 20mg glatiramer Multiple Sclerosis Agents
Gilenya fingolimod Multiple Sclerosis Agents
Kesimpta ofatumumab Multiple Sclerosis Agents
Mavenclad cladribine Multiple Sclerosis Agents
Mayzent siponimod Multiple Sclerosis Agents
Plegridy peginterferon beta-1a Multiple Sclerosis Agents
Rebif interferon beta-1a Multiple Sclerosis Agents
Vumerity diroximel fumarate Multiple Sclerosis Agents
Zeposia ozanimod Multiple Sclerosis Agents
Myalept metreleptin Myalept
Narcotic Fill Limit n/a Narcotic Fill Limit
Xyrem sodium oxybate Narcolepsy Agents
Xywavcalcium/magnesium/potassium/sodium
oxybatesNarcolepsy Agents
Azelastine 0.15% azelastine Nasal Antihistamines
Dymista azelastine/fluticasone Nasal Antihistamines
Olopatadine 0.6% olopatadine Nasal Antihistamines
Beconase AQ, Qnasl beclomethasone Nasal Steroids
Budesonide budesonide Nasal Steroids
Flunisolide flunisolide Nasal Steroids
Mometasone Furoate mometasone furoate Nasal Steroids
Omnaris, Zetonna ciclesonide Nasal Steroids
Veramyst fluticasone furoate Nasal Steroids
Xhance fluticasone propionate Nasal Steroids
Droxidopa droxidopa Neurogenic Orthostatic Hypotension Agents
Gralise, Horizant gabapentin Neuropathic Pain
Lidoderm, Lidocaine Patch, Lidocaine
Ointment lidocaine Neuropathic Pain
Cambia, Zipsor diclofenac potassium NSAIDs and COX II
Celecoxib celecoxib NSAIDs and COX II
Diclofenac/Misoprostol diclofenac/misoprostol NSAIDs and COX II
Diclofenac ER, Zorvolex diclofenac NSAIDs and COX II
Duexis ibuprofen/famotidine NSAIDs and COX II
Etodolac ER etodolac NSAIDs and COX II
Fenoprofen, Nalfon fenoprofen NSAIDs and COX II
Indomethacin ER indomethacin NSAIDs and COX II
Ketoprofen IR, ER ketoprofen NSAIDs and COX II
Meclofenamate meclofenamate NSAIDs and COX II
Mefenamic Acid mefenamic acid NSAIDs and COX II
Naprelan, Naproxen CR, DR, Oral Suspension naproxen NSAIDs and COX II
Oxaprozin oxaprozin NSAIDs and COX II
Relafen DS nabumetone NSAIDs and COX II
Sprix ketorolac NSAIDs and COX II
Tolmetin tolmetin NSAIDs and COX II
Vimovo naproxen/esomeprazole NSAIDs and COX II
Vivlodex meloxicam NSAIDs and COX II
Diclofenac Patch, Diclofenac Solution, Licart,
Pennsaid 2%diclofenac NSAIDs, Topical
Nuedexta dextromethorphan/quinidine Nuedexta
Dojolvi triheptanoin Nutritionals, Triglycerides
Bynfezia, Mycapssa, Octreotide octreotide Octreotide and Related Agents
Isturisa osilodrostat Octreotide and Related Agents
Korlym mifepristone Octreotide and Related Agents
Sandostatin LAR octreotide ER Octreotide and Related Agents
Xermelo telotristat Octreotide and Related Agents
Signifor pasireotide Octreotide and Related Agents
Signifor LAR pasireotide ER Octreotide and Related Agents
Somatuline Depot lanreotide ER Octreotide and Related Agents
Somavert pegvisomant Octreotide and Related Agents
Ibrance Capsules palbociclib Oncology, Oral - Breast
Kisqali riociclib Oncology, Oral - Breast
Kisqali Femara riociclib/letrozole Oncology, Oral - Breast
Nerlynx neratinib Oncology, Oral - Breast
Phesgo pertuzumab/trastuzumab/hyaluronidase Oncology, Oral - Breast
Pigray alpelisib Oncology, Oral - Breast
Talzenna talazoparib Oncology, Oral - Breast
Tukysa tucatinib Oncology, Oral - Breast
Verzenio abemaciclib Oncology, Oral - Breast
Bosulif bosutinib Oncology, Oral - Hematologic
Brukinsa zanubrutinib Oncology, Oral - Hematologic
Calquence acalabrutinib Oncology, Oral - Hematologic
Copiktra duvelisib Oncology, Oral - Hematologic
Daurismo glasdegib Oncology, Oral - Hematologic
Farydak panobinostat Oncology, Oral - Hematologic
Iclusig ponatinib Oncology, Oral - Hematologic
Idhifa enasidenib Oncology, Oral - Hematologic
Imbruvica ibrutinib Oncology, Oral - Hematologic
Inqovi decitabine/cedazuridine Oncology, Oral - Hematologic
Inrebic fedratinib Oncology, Oral - Hematologic
Ninlaro ixazomib Oncology, Oral - Hematologic
Onureg azacitidine Oncology, Oral - Hematologic
Pomalyst pomalidomide Oncology, Oral - Hematologic
Purixan mercaptopurine Oncology, Oral - Hematologic
Rydapt midostaurin Oncology, Oral - Hematologic
Sprycel dasatinib Oncology, Oral - Hematologic
Tasigna nilotinib Oncology, Oral - Hematologic
Tibsovo ivosidenib Oncology, Oral - Hematologic
Ukoniq umbralisib Oncology, Oral - Hematologic
Venclexta venetoclax Oncology, Oral - Hematologic
Xpovio selinexor Oncology, Oral - Hematologic
Zolinza vorinostat Oncology, Oral - Hematologic
Zydelig idelalisib Oncology, Oral - Hematologic
Alecensa alectinib Oncology, Oral - Lung
Alunbrig brigatinib Oncology, Oral - Lung
Erlotinib erlotinib Oncology, Oral - Lung
Gavreto pralsetinib Oncology, Oral - Lung
Gilotrif afatinib Oncology, Oral - Lung
Iressa gefitinib Oncology, Oral - Lung
Lobrena lorlatinib Oncology, Oral - Lung
Lumakras sotorasib Oncology, Oral - Lung
Retevmo selpercatinib Oncology, Oral - Lung
Rozlytrek entrectinib Oncology, Oral - Lung
Tabrecta capmatinib Oncology, Oral - Lung
Tagrisso osimertinib Oncology, Oral - Lung
Tepmetko tepotinib Oncology, Oral - Lung
Vizimpro dacomitinib Oncology, Oral - Lung
Xalkori crizotinib Oncology, Oral - Lung
Zykadia ceritinib Oncology, Oral - Lung
Ayvakit avapritinib Oncology, Oral - Other
Balversa larotrectinib Oncology, Oral - Other
Cometriq cabozantinib Oncology, Oral - Other
Koselugo selumetinib Oncology, Oral - Other
Lonsurf trifluridine/tipiracil Oncology, Oral - Other
Nexavar sorafenib Oncology, Oral - Other
Pemazyre pemigatinib Oncology, Oral - Other
Qinlock ripretinib Oncology, Oral - Other
Stivarga regorafenib Oncology, Oral - Other
Tazverik tazemetostat Oncology, Oral - Other
Temozolomide temozolomide Oncology, Oral - Other
Truseltiq infigratinib Oncology, Oral - Other
Turalio pexidartinib Oncology, Oral - Other
Vitrakvi larotrectinib Oncology, Oral - Other
Caprelsa vandetanib Oncology, Oral - Other
Lynparza olaparib Oncology, Oral - Ovarian
Rubraca rucaparib Oncology, Oral - Ovarian
Zejula niraparib Oncology, Oral - Ovarian
Abiraterone, Yonsa, Zytiga abiraterone Oncology, Oral - Prostate
Erleada apalutamide Oncology, Oral - Prostate
Nubeqa darolutamide Oncology, Oral - Prostate
Orgovyx relugolix Oncology, Oral - Prostate
Xtandi capsules enzalutamide Oncology, Oral - Prostate
Afinitor, Afinitor Disperz everolimus Oncology, Oral - Renal
Cabometyx cabozantinib Oncology, Oral - Renal
Fotivda tivozanib Oncology, Oral - Renal
Inlyta axitinib Oncology, Oral - Renal
Lenvima levatinib Oncology, Oral - Renal
Sutent sunitinib Oncology, Oral - Renal
Votrient pazopanib Oncology, Oral - Renal
Braftovi encorafenib Oncology, Oral - Skin
Cotellic cobimetinib Oncology, Oral - Skin
Erivedge vismodegib Oncology, Oral - Skin
Mekinist trametinib Oncology, Oral - Skin
Mektovi binimetinib Oncology, Oral - Skin
Odomzo sonidegib Oncology, Oral - Skin
Tafinlar dabrafenib Oncology, Oral - Skin
Zelboraf vemurafenib Oncology, Oral - Skin
AzaSite azithromycin Ophthalmic Antibiotics
Bacitracin bacitracin Ophthalmic Antibiotics
Besivance besifloxacin Ophthalmic Antibiotics
Gatifloxacin Ophthalmic gatifloxacin Ophthalmic Antibiotics
Levofloxacin Ophthalmic levofloxacin Ophthalmic Antibiotics
Moxeza moxifloxacin Ophthalmic Antibiotics
Natacyn natamycin Ophthalmic Antibiotics
Neomycin/Polymyxin B/Gramicidin neomycin/polymyxin B/gramicidin Ophthalmic Antibiotics
Lotemax Gel, Lotemax SM Gel loteprednol Ophthlamics, Antiinflammatories
Acuvail ketorolac Ophthlamics, Antiinflammatories
Bromfenac, Bromsite, Prolensa bromfenac Ophthlamics, Antiinflammatories
Nevanac nepafanac Ophthlamics, Antiinflammatories
Cequa, Restatis Multidose cyclosporine Ophthalmics, Antiinflammatory Immunomodulators
Eysuvis loteprednol Ophthalmics, Antiinflammatory Immunomodulators
Zirgan ganciclovir Ophthalmic Antivirals
Apraclonidine 0.5% apraclonidine Ophthalmics, Glaucoma Agents
Brimonidine P 0.15% brimonidine Ophthalmics, Glaucoma Agents
Simbrinza brinzolamide/brimonidine Ophthalmics, Glaucoma Agents
Istalol, Timoptic Ocudose timolol Ophthalmics, Glaucoma Agents
Combigan 10mL timolol/brimonidine Ophthalmics, Glaucoma Agents
Cosopt PF timolol/dorzolamide Ophthalmics, Glaucoma Agents
Azopt brinzolamide Ophthalmics, Glaucoma Agents
Pilocarpine pilocarpine Ophthalmics, Glaucoma Agents
Bimatoprost 0.03% bimatoprost Ophthalmics, Glaucoma Agents
Vyzulta latanoprostene bunod Ophthalmics, Glaucoma Agents
Xelpros latanoprost emulsion Ophthalmics, Glaucoma Agents
Zioptan tafluprost Ophthalmics, Glaucoma Agents
Rhopressa netarsudil Ophthalmics, Glaucoma Agents
Rocklatan netarsudil/latanoprost Ophthalmics, Glaucoma Agents
Blephamide SOP sulfacetamide/prednisolone ointment Ophthalmic Steroid-Antibiotic Combinations
Neomycin/Polymyxin
B/Bacitracin/Hydrocortisone
neomycin/polymyxin
B/bacitracin/hydrocortisoneOphthalmic Steroid-Antibiotic Combinations
Neomycin/Polymyxin B/Hydrocortisone neomycin/polymyxin B/hydrocortisone Ophthalmic Steroid-Antibiotic Combinations
TobraDex ST, Tobramycin/Dexamethasone tobramycin/dexamethasone Ophthalmic Steroid-Antibiotic Combinations
Alocril nedocromil sodium Ophthalmics for Allergic Conjuctivitis
Alomide lodoxamide tromethamine Ophthalmics for Allergic Conjuctivitis
Azelastine azelastine Ophthalmics for Allergic Conjuctivitis
Epinastine epinastine Ophthalmics for Allergic Conjuctivitis
Lastacaft alcaftadine Ophthalmics for Allergic Conjuctivitis
Olopatadine, Pataday olopatadine Ophthalmics for Allergic Conjuctivitis
Zerviate cetirizine Ophthalmics for Allergic Conjuctivitis
Oxervate cenegermin-bkbj Ophthalmics for Neurotrophic Keratitis
Narcan Nasal Spray naloxone Opiate Dependence Agents
Lucemyra lofexidine Opiate Dependence Agents
Zubsolv buprenorphine/naloxone Opiate Dependence Agents
Orfadin Suspension nitisinone Orfadin
Ciprofloxacin Otic ofloxacin Otic Antibiotics
Otovel ciprofloxacin/fluocinolone Otic Antibiotics
Linezolid, Zyvox linezolid Oxazolidinones
Sivextro tedizolid Oxazolidinones
Palynziq pegvaliase-pqpz Palyzniq
Pancreaze, Pertzye, Viokace pancrelipase Pancreatic Enzymes
Panretin alitretinoin PanretinKabiven, Perikabiven amino acid/electrolytes/dextrose/lipid Parenteral Nutrition Products
Clinolipid, Intralipid, Omegaven, Smoflipid lipid emulsion Parenteral Nutrition Products
Metyrosine metyrosine Pheochromocytoma Agents
Phenoxybenzamine phenoxybenzamine Pheochromocytoma Agents
Auryxia ferric citrate Phosphate Binders
Calcium Acetate Tablets, Phoslyra calcium acetate Phosphate BindersFosrenol Powder, Lanthanum Carbonate lanthanum carbonate Phosphate BindersRenvela Tablets, Sevelamer Carbonate
Powdersevelamer carbonate Phosphate Binders
Sevelamer Hydrochloride 400 mg sevelamer hydrochloride Phosphate Binders
Velphoro sucroferric oxyhyroxide Phosphate Binders
Oriahnn elagolix/estradiol/norethindrone Pituitary Suppressive Agents, LHRH
Orilissa elagolix Pituitary Suppressive Agents, LHRH
Fensolvi, Lupron Depot, Lupron Depot-Ped leuprolide Pituitary Suppressive Agents, LHRH
Xenleta lefamulin Pleuromutilin Antibiotics
Oxlumo lumasiran Primary Hyperoxaluria Agents
Aciphex Sprinkles, Raberprazole rabeprazole Proton Pump Inhibitors
Dexilant dexlansoprazole Proton Pump Inhibitors
Esomeprazole Rx esomeprazole Proton Pump Inhibitors
Lansoprazole Rx, Prevacid Rx Solutab lansoprazole Proton Pump Inhibitors
Prilosec Rx Powder for Oral Suspension omeprazole Proton Pump Inhibitors
Omeprazole/Sodium Bicarbonate Rx, Zegerid
Rx Powderomeprazole/sodium bicarbonate Proton Pump Inhibitors
Protonix Pak pantoprazole Proton Pump Inhibitors
Adempas riociguat Pulmonary Arterial Hypertension Agents
Epoprostenol, Flolan epoprostenol Pulmonary Arterial Hypertension Agents
Opsumit macitentan Pulmonary Arterial Hypertension Agents
Orenitram, Remodulin, Tyvaso trepostinil Pulmonary Arterial Hypertension Agents
Revatio Suspension, Sildenafil 20 mg sildenafil Pulmonary Arterial Hypertension Agents
Tadalafil 20 mg tadalafil Pulmonary Arterial Hypertension Agents
Tracleer for Oral Suspension bosentan Pulmonary Arterial Hypertension Agents
Uptravi selexipag Pulmonary Arterial Hypertension Agents
Ventavis iloprost Pulmonary Arterial Hypertension Agents
Esbriet pirfenidone Pulmonary Fibrosis Agents
Ofev nintedinab Pulmonary Fibrosis Agents
Pyridostigmine pyridostigmine Pyridostigmine
Pyridostigmine Extended-Release pyridostigmine extended-release Pyridostigmine
Ranolazine ranolazine Ranolazine
Ravicti glycerol phenylbutyrate Ravicti
Sodium Phenylbutyrate Powder sodium phenylbutyrate Ravicti
Rectiv nitroglycerin Rectiv
Regranex becaplermin Regranex
Santyl collagenase Santyl
Belsomra suvorexant Sedative Hypnotics
Dayvigo lemborexant Sedative Hypnotics
Edular, Zolpidem Sublingual zolpidem Sedative Hypnotics
Rozerem ramelteon Sedative Hypnotics
Hetlioz and Hetlioz LQ tasimelteon Sedative Hypnotics
Serostim somatotropin(recombinant) Serostim
Endari l-glutamine Sickle Cell Agents
Oxbryta voxelotor Sickle Cell Agents
Sicklos hydroxyurea tablets Sickle Cell Agents
Amrix cyclobenzaprine ER Skeletal Muscle Relaxants
Carisoprodol 250 mg carisoprodol Skeletal Muscle Relaxants
Carisoprodol/Aspirin/Codeine carisoprodol/aspirin/codeine Skeletal Muscle Relaxants
Cyclobenzaprine 7.5 mg cyclobenzaprine Skeletal Muscle Relaxants
Norgesic Forte orphenadrine/aspirin/caffeine Skeletal Muscle Relaxants
Ozobax baclofen Skeletal Muscle Relaxants
Tizanidine capsules, Zanaflex Capsules tizanidine Skeletal Muscle Relaxants
Evrysdi risdiplam Spinal Muscular Atrophy
Adzenys XR, Amphetamine ER oral
suspension, Dyanavel XR, Evekeoamphetamine Stimulants and Related Agents
Adderall XR,
Amphetamine/Dextroamphetamine IR,
Mydayis
amphetamine/dextroamphetamine IR/ER Stimulants and Related Agents
Dextroamphetamine IR/ER, Zenzedi dextroamphetamine IR/ER Stimulants and Related Agents
Adhansia XR, Aptensio XR, Concerta,
Cotempla XR, Daytrana, Jornay PM,
Methylin, Methylphenidate IR/ER, Quillichew
ER, Quillivant XR, Ritalin LA 10 mg
methylphenidate IR/ER Stimulants and Related Agents
Armodafinil armodafinil Stimulants and Related Agents
Atomoxetine atomoxetine Stimulants and Related Agents
Clonidine ER clonidine ER Stimulants and Related Agents
Desoxyn, Methamphetamine methamphetamine Stimulants and Related Agents
Dexmethylphenidate IR/ER, Focalin XR dexmethylphenidate IR/ER Stimulants and Related Agents
Guanfacine ER guanfacine ER Stimulants and Related Agents
Modafinil modafinil Stimulants and Related Agents
Sunosi solriamfetol Stimulants and Related Agents
Vyvanse lisdexamfetamine Stimulants and Related Agents
Wakix pitolisant Stimulants and Related Agents
Strensiq asfotase alfa Strensiq
Sulfadiazine sulfadiazine Sulfonamides
Synagis palivizumab Synagis
Synribo omacetaxine Synribo
Demeclocycline demeclocycline Tetracyclines
Doryx, Doryx MCP, Doxycycline Hyclate DR doxycycline hyclate delayed-release Tetracyclines
Doxycycline Hyclate IR 75, 150 mg tablets doxycycline hyclate immediate-release Tetracyclines
Doxycycline Monohydrate 75 mg and 150 mg
capsulesdoxycycline monohydrate Tetracyclines
Doxycycline [rosacea] DR, Oracea doxycycline [rosacea] delayed-release Tetracyclines
Minocycline IR tablets, Minocycline ER,
Minolira, Solodynminocycline Tetracyclines
Morgidox Kit doxycycline and cleanser Tetracyclines
Nuzyra omadacycline Tetracyclines
Thiola EC tiopronin delayed-release Thiola
Doptelet avatrombopag Thrombopoiesis Stimulating Proteins
Mulpleta lusutrombopag Thrombopoiesis Stimulating Proteins
Promacta eltrombopag Thrombopoiesis Stimulating Proteins
Tavalisse fostamatinib Thrombopoiesis Stimulating Proteins
Nplate romisplostim Thrombopoiesis Stimulating Proteins
Levothyroxine Injection, Thyquidity, Tirosint levothyroxine Thyroid Hormones
Liothyronine Injection liothyronine Thyroid Hormones
Bupropion [smoking deterrent] bupropion SR Tobacco Cessation
Nicotrol Inhaler, Nicotrol Nasal Spray nicotine Tobacco Cessation
Valchlor mechlorethamine Topical Antineoplastic and Genital Warts Therapy
Diclofenac 3% Gel diclofenac Topical Antineoplastic and Genital Warts Therapy
Picato ingenol mebutate Topical Antineoplastic and Genital Warts Therapy
Podofilox Solution podofilox Topical Antineoplastic and Genital Warts Therapy
Veregen sinecatechins Topical Antineoplastic and Genital Warts Therapy
Zyclara imiquimod Topical Antineoplastic and Genital Warts Therapy
Tacrolimus Ointment tacrolimus Topical Immunomodulators
Actiq, Fentanyl Oral Lozenges fentanyl oral lozenges Transmucosal Fentanyl
Fentora fentanyl buccal tablets Transmucosal Fentanyl
Lazanda fentanyl nasal spray Transmucosal Fentanyl
Subsys fentanyl sublingual spray Transmucosal Fentanyl
Trelstar Depot, Trelstar LA triptorelin pamoate Trelstar
Tygacil tigecycline Tygacil
Mesalamine DR mesalamine delayed-release Ulcerative Colitis Agents
Mesalamine Rectal Enema, SFRowasa mesalamine Ulcerative Colitis Agents
Giazo balsalazide Ulcerative Colitis Agents
Uceris budesonide Ulcerative Colitis Agents
Methenamine hippurate methenamine hippurate Urinary Antiinfectives
Nitrofurantoin Suspension nitrofurantoin Urinary Antiinfectives
Urimar-T, Urogesic Blue hyoscamine combination Urinary Antiinfectives
Potassium Citrate ER, Urocit-K potassium citrate Urocit-K
Femring QLL, Imvexxy estradiol Vaginal Estrogen Preparations
Intrarosa prasterone Vaginal Estrogen Preparations
BiDil isosorbide dinitrate/hydralazine HCl Vasodilators, Coronary
GoNitro, Nitroglycerin Spray nitroglycerin Vasodilators, Coronary
Verquvo vericiguat Vasodilators, Coronary
Jynarque tolvaptan Vasopressor Receptor Antagonists
Vecamyl mecamylamine Vecamyl
Vimizim elosulfase alfa Vimizim
Doxercalciferol doxercalciferol Vitamin D and ESRD Products
Paricalcitol 4 mcg paricalcitol Vitamin D and ESRD Products
Rayaldee calcifediol Vitamin D and ESRD Products
Sensipar cinacalet Vitamin D and ESRD Products
Aluminum Hydroxide aluminum hydroxide Vitamin D and ESRD Products
Calcium Carbonate calcium carbonate Vitamin D and ESRD Products
Calcium Lactate calcium lactate Vitamin D and ESRD Products
Docusate Calcium docusate calcium Vitamin D and ESRD Products
Docusate Sodium docusate sodium Vitamin D and ESRD Products
Magnebind calcium carbonate/magnesium carbonate Vitamin D and ESRD Products
Magnesium Carbonate magnesium carbonate Vitamin D and ESRD Products
Niacin niacin Vitamin D and ESRD Products
Pyridoxine pyridoxine Vitamin D and ESRD Products
Sodium Bicarbonate sodium bicarbonate Vitamin D and ESRD Products
Thiamine Hydrochloride thiamine hydrochloride Vitamin D and ESRD Products
Dialyvite, Nephplex Rx, Nephron FA, Renal,
Reno Caps, Triphrocaps, Virt-Caps, Virt-Vite
Plus, Vital-D Rx, VP-Vite Rx
vitamin B complex/folic acid and/or zinc Vitamin D and ESRD Products
Vyndaqel, Vyndamax tafamidis Vyndaqel-Vyndamax
Xospata gilteritinib Xospata