CVS Specialty Pharmacy Distribution Drug List - January 2021
January 2021Updated QuarterlyCVS Specialty Pharmacy Distribution Drug ListProviding one of the broadest offerings of specialty pharmaceuticals in the industryThe CVS Specialty Pharmacy Distribution Drug List is a guide of medications available and distributed through CVSSpecialty. Our goal is to help make your life better. With more than 40 years of experience, CVS Specialty provides qualitycare and service. Our network of pharmacies includes certifications and accreditations from the Joint Commission,Utilization Review Accreditation Commission (URAC), the National Association of Boards of Pharmacy (NABP) and theAccreditation Commission for Health Care (ACHC). These nationally recognized symbols reflect an organization’scommitment to meet highest standards of quality, compliance and safety. This list is updated quarterly, and the most recentedition is January 2021. Below brand-name products are in CAPS, and generic products are shown in lowercase italics.Prospective Patients: Ready to get started? Enroll to get your medications from CVS Specialty.Health Care Providers: Visit the CVS Specialty website to download enrollment forms or call 1-800-237-2767 (TTY: 711).Therapy ClassAcromegalyAlcohol/Opioid DependencyAllergen ImmunotherapyAlpha-1 Antitrypsin DeficiencyAmyloidosisAnemiaAsthmaAtopic DermatitisBotulinum ToxinsCardiac DisordersBrand NameBYNFEZIA PENSANDOSTATINSANDOSTATIN LARSOMATULINE DEPOTSOMAVERTPROBUPHINE IMPLANT KITSUBLOCADEVIVITROLORALAIRPALFORZIAARALAST Generic Nameoctreotide acetate (SANDOSTATIN)dofetilide (TIKOSYN)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 1 of 17
January 2021Updated QuarterlyTherapy ClassBrand pyrin-Associated PeriodicARCALYSTSyndromesILARISCystic FibrosisBETHKISCAYSTONKITABIS PAKPULMOZYMETOBITOBI PODHALERElectrolyte DisordersSAMSCAGastrointestinal Disorders - OtherGATTEXMYTESIOCALIVASOLESTAGoutKRYSTEXXAGrowth Hormone & Related Disorders EGRIFTAEGRIFTA TROPIN eticsMOZOBILHemophilia, Von Willebrand DiseaseADVATE& Related Bleeding DisordersADYNOVATEAFSTYLAALPHANATEALPHANINE PEROCTFEIBAFIBRYGAHELIXATE FSGeneric NameCoagulation DisordersContraceptivestobramycin (BETHKIS)tobramycin nebulizer (TOBI)tolvaptan (SAMSCA)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 2 of 17
January 2021Updated QuarterlyTherapy ClassHemophilia, Von Willebrand Disease& Related Bleeding Disorders(cont.)HepatitisBrand NameHEMLIBRAHEMOFIL MHUMATE-PIDELVIONIXINITYJIVIKOATEKOATE-DVIKOGENATE FSKOVALTRYMONONINENOVOEIGHTNOVOSEVEN RTNUWIQOBIZURPROFILNINEPROFILNINE TRETTENVONVENDIWILATEXYNTHABARACLUDEEPCLUSAEPIVIR HBVHARVONIHEPSERAINTRON RONREBETOLREBETOL SOLUTIONRIBASPHERE RIBAPAKSOFOSBUVIR/VELPATASVIRSOVALDIVEMLIDYVIEKIRA PAKVIREADVOSEVIZEPATIERGeneric Nameadefovir dipivoxil (HEPSERA)entecavir (BARACLUDE)lamivudine hbv (EPIVIR HBV)ribasphereribavirin caps (ribasphere, REBETOL)ribavirin tabs (ribasphere, MODERIBA)tenofovir disoproxil fumarate (VIREAD)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 3 of 17
January 2021Updated QuarterlyTherapy ClassHereditary AngioedemaHormonal TherapiesHuman Immunodeficiency VirusBrand TAKHZYROAVEEDELIGARDFIRMAGONLUPANETA PACKLUPRONLUPRON DEPOTNATPARASUPPRELIN CEINVIRASEISENTRESSJULUCAKALETRAKALETRA CRIPTORRETROVIRRETROVIR INJECTABLEGeneric Nameicatibant acetate (FIRAZYR)leuprolide acetate (LUPRON)abacavir tab (ZIAGEN)abacavir-lamivudine (EPZICOM)abacavir sulfate-lamivudine-zidovudine(TRIZIVIR)atazanavir sulfate (REYATAZ)didanosine (VIDEX, VIDEX EC)efavirenz (SUSTIVA)efavirenz-emtricitabine-tenofovir df(ATRIPLA)efavirenz-lamivudine-tenofovir df(SYMFI, SYMFI LO)emtricitabine (EMTRIVA)emtricitabine-tenofovir df(TRUVADA)fosamprenavir (LEXIVA)lamivudine (EPIVIR)lamivudine-zidovudine (COMBIVIR)lopinavir-ritonavir sol (KALETRA SOL)nevirapine (VIRAMUNE, VIRAMUNE XR)ritonavir (NORVIR)stavudine (ZERIT)tenofovir disoproxil fumarate (VIREAD)zidovudine (RETROVIR)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 4 of 17
January 2021Updated QuarterlyTherapy ClassHuman Immunodeficiency Virus(cont.)Immune Deficiencies & RelatedDisordersBrand NameGeneric FI ADATYBOSTVIDEXVIDEX ECVIDEX SOLVIRACEPTVIRAMUNEVIRAMUNE TOGAMGAMASTANGAMASTAN S/DGAMMAGARD LIQUIDGAMMAGARD S/DGAMMAKEDGAMMAPLEXGAMUNEX CHEPAGAM BHIZENTRAHYPERHEP B S/DHYPERRHO GAMRHOPHYLACSpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 5 of 17
January 2021Updated QuarterlyTherapy ClassImmune Deficiencies & RelatedDisorders (cont.)Infectious Disease - OtherInfertilityInflammatory Bowel DiseaseIron OverloadLysosomal Storage DisordersMental Health ConditionsMigraineMiscellaneousBrand NameVARIZIGWINRHO SDFXEMBIFYACTIMMUNEALFERON NNUZYRAXENLETACETROTIDECHORIONIC GONADOTROPINFOLLISTIM AQGANIRELIX MZIAENTYVIOHUMIRAINFLECTRAREMICADERENFLEXISSIMPONI ARIASTELARA IGAJOVYEMGALITYGeneric Namedeferasirox (EXJADE, JADENU)deferoxamine (DESFERAL)miglustatnitisinoneSpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 6 of 17
January 2021Updated QuarterlyTherapy ClassMovement DisordersMultiple SclerosisNeutropeniaOcular DisordersBrand UDYNEGeneric Nametetrabenazine (XENAZINE)dalfampridine ER (AMPYRA)dimethyl fumarate (TECFIDERA)glatiramer acetate (COPAXONE,glatopa)mitoxantrone hclSpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 7 of 17
January 2021Updated QuarterlyTherapy ClassOncology – InjectableBrand BELRAPZOBENDAMUSTINE DARZALEXDARZALEX NFUSILEVGAZYVAHALAVENHERCEPTINHERCEPTIN HYLECTAHERZUMAIMFINZIINTRON UZANTOPDIVOPADCEVPERJETAPHESGOPOLIVYGeneric Nameazacitidine (VIDAZA)decitabine (DACOGEN)levoleucovorin calciummitoxantrone hcltemsirolimus (TORISEL)valrubicin (VALSTAR)zoledronic acidSpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 8 of 17
January 2021Updated QuarterlyTherapy ClassOncology – Injectable(cont.)Oncology – Oral/TopicalBrand NamePORTRAZZAPOTELIGEOPROLEUKINRITUXANRITUXAN VIINREBICIRESSAJAKAFIGeneric Nameabiraterone acetate (ZYTIGA)bexarotene (TARGRETIN)capecitabine (XELODA)erlotinib hydrochlorideeverolimus (AFINITOR)imatinib mesylate (GLEEVEC)lapatinib ditosylate (TYKERB)temozolomide (TEMODAR)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 9 of 17
January 2021Updated QuarterlyTherapy ClassOncology – Oral/Topical (cont.)Brand NameGeneric NameKISQALIKISQALI FZOLINZAZYDELIGZYKADIAZYTIGASpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 10 of 17
January 2021Updated QuarterlyTherapy ClassOsteoarthritisOsteoporosisParoxysmal NocturnalHemoglobinuriaPhenylketonuriaPre-Term BirthPsoriasisPulmonary Arterial HypertensionBrand NameDUROLANEEUFLEXXAGEL-ONEGELSYN-3GENVISC 850HYALGANHYMOVISMONOVISCORTHOVISCSODIUM HYALURONATESUPARTZSYNVISCSYNVISC RISOPSUMITORENITRAMGeneric Namezoledronic acid (RECLAST)sapropterin dihydrochloride (KUVAN)hydroxyprogesterone capro (MAKENA)ambrisentan (LETAIRIS)bosentan (TRACLEER)epoprostenol sodium (FLOLAN,VELETRI)sildenafil citrate (REVATIO)tadalafil (ADCIRCA, alyq)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 11 of 17
January 2021Updated QuarterlyTherapy ClassPulmonary Arterial Hypertension(cont.)Pulmonary Disorders - OtherRare Disorders - OtherRenal DiseaseRespiratory Syncytial VirusRheumatoid ArthritisSeizure DisordersSickle Cell DiseaseSleep DisordersSystemic Lupus ErythematosusThrombocytopeniaBrand CADERENFLEXISRINVOQRITUXANSIMPONISIMPONI ARIAXELJANZACTHAREPIDIOLEXSABRIL PWDSABRIL ATEPROMACTAGeneric Nametreprostinil sodium (REMODULIN)cinacalcet hydrochloride (SENSIPAR)vigabatrin pwd (SABRIL PWD)vigabatrin tabs (SABRIL TABS)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 12 of 17
January 2021Updated QuarterlyTherapy ClassTransplantUrea Cycle DisordersBrand NameASTAGRAF XLCELLCEPTCELLCEPT INJENVARSUS XRMYFORTICNEORALNULOJIXPROGRAFPROGRAF IGeneric Namecyclosporine (gengraf, NEORAL,SANDIMMUNE)everolimus (ZORTRESS)mycophenolate mofetil (CELLCEPT,CELLCEPT INJECTABLE)mycophenolic acid dr (MYFORTIC)sirolimus (RAPAMUNE)tacrolimus (PROGRAF)sodium phenylbutyrate (BUPHENYL)Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 13 of 17
January 2021Updated QuarterlyAlphabetical IndexCVS Specialty Pharmacy Distribution Drug ListABabacavir tababacavir-lamivudineabacavir sulfatelamivudinezidovudineabiraterone VIGAJOVYALDURAZYMEALECENSAALFERON NALPHANATEALPHANINE USARALAST NPARANESPARCALYSTARZERRAASCENIVASPARLASASTAGRAF XLatazanavir osentanBOSULIFBOTOXBUPHENYLBYNFEZIA 9.20.21.22.DACOGENdalfampridine ERDARZALEXDARZALEX STRIGODESCOVYDESFERALdidanosinedimethyl virenzemtricitabinetenofovir df4. efavirenz-lamivudinetenofovir df5. EGRIFTA6. EGRIFTA SV7. ELAPRASE8. ELELYSO9. ELIGARD10. ELOCTATE11. EMGALITY12. EMPLICITI13. ricitabinetenofovir RSUS XREPCLUSAEPIDIOLEXEPIVIREPIVIR HBVEPOGENepoprostenol AFIBRYGAFIRAZYRFIRMAGONFLOLANFOLLISTIM pecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 14 of 17
January 2021Updated 7.18.19.20.21.22.23.24.GAMASTANGAMASTAN S/DGAMIFANTGAMMAGARDLIQUIDGAMMAGARD S/DGAMMAKEDGAMMAPLEXGAMUNEX CGANIRELIX NGENVISC 850GENVOYAGILENYAGLASSIAglatiramer HALAVENHARVONIHELIXATE FSHEMLIBRAHEMOFIL MHEPAGAM eronecaproHYMOVISHYPERHEP B S/DHYPERRHO S/DHYQVIAI1.2.IBRANCEicatibant b CINTELENCEINTRON BITORKALETRAKALETRA SQALIKISQALI FEMARAKITABIS PAKKOATEKOATE-DVIKOGENATE 0.11.12.13.14.15.16.17.18.19.20.21.lapatinib RISLEUKINEleuprolide pinavir-ritonavir solLORBRENALUCENTISLUMIZYMELUMOXITILUPANETA PACKLUPRONLUPRON glustatMIRENAmitoxantrone ASImycophenolatemofetilmycophenolic acid elamivudine GHTNOVOSEVEN RTNPLATENUBEQANUCALANULOJIXNUPLAZIDNUTROPIN LIVAOCREVUSOCTAGAMoctreotide OZURDEXP1.2.3.PADCEVPALFORZIAPALYNZIQSpecialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, maychange from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of theirappearance on this document. Call CVS Specialty at 1-800-237-2767 (TTY: 711). for specific medications available through CVS Specialty. This documentcontains confidential and proprietary information of CVS Specialty and may not be reproduced, distributed or printed without written permission fromCVS Specialty. Listing is subject to change. This document contains references to brand-name prescription drugs that are trademarks or registeredtrademarks of pharmaceutical manufacturers not affiliated with CVS Specialty. Fax: 1-800-323-2445; e-Prescribe: CVS Specialty Pharmacy. 2021 CVS Specialty. All rights reserved. 75-CTC14953E January 2021 v12152020 CVS Specialty Pharmacy Distribution Drug ListPage 15 of 17
January 2021Updated XPREZISTAPRIVIGENPROBUPHINEIMPLANT KITPROCRITPROFILNINEPROFILNINE SUVORAVICTIREBETOLREBETOL SOL
Specialty and non-specialty products distributed by CVS Specialty, as well as products covered by a member’s prescription or medical benefit plan, may change from time to time. In addition, a member’s specific benefit plan design may not cover certain products or categories, regardless of their appearance on this document.
allied paper, inc./portage creek/ kalamazoo river superfund site area 1 supplemental remedial investigation report . cvs-10 cvs-09 cvs-08 cvs-07 cvs-04 cvs-06 cvs-05 ff-27 mos el av nue cvs-03 cvs-02 cvs-01 ff-26 ff-22 6 9 6 8 . 5 70 ff-21 6 9. 5 . parchment m-89 u s-1 3 1 g u l l r
Oct 14, 2009 · MM. CVS/pharmacy #9838 – Sun Valley NN. CVS/pharmacy #9840 – Reno OO. CVS/pharmacy #9841 – Reno PP. CVS/pharmacy #9842 – Carson City QQ. CVS/pharmacy #9843 – Fallon . Advanced Care Rx Pharmacy – Las Vegas CC. Prime Pharmacy – Henderson DD. Spring Valley Surgery Center
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Thank you for purchasing a Central Vac brand built-in vacuum system. Please take the time to read this operation manual. This product is designed for household use only. For commercial applications, please contact your nearest Central Vac dealer. This manual covers the following power units. CVS-07 CVS-11 CVS-16 CVS-19 CVS-07DP CVS-11DP CVS .
Pearland, TX 77581 (281) 997-4400 CVS PHARMACY #07120 * 11600 Shadow Creek Pearland, TX 77584 (713) 436-8250 CVS PHARMACY #10461 * 12806 Broadway St Pearland, TX 77584 (713) 436-1298 CVS PHARMACY #10908 * 7110 Magnolia Rd Pearland, TX 77584 (281) 412-4713 CVS PHARMACY #16791 * 3045 Silverlake Village Dr Pearland, TX 77584 (713) 436-2516 FAMILY PHARMACY CARE *
CVS PHARMACY #01869 * 1080 Falmouth Rd Hyannis, MA 02601 (508) 778-4064 CVS PHARMACY #02322 * 176 North St Hyannis, MA 02601 (508) 775-8346 CVS PHARMACY #10852 * 411 Barnstable Rd Hyannis, MA 02601 (508) 771-4753 CVS PHARMACY #17771 * 793 Iyannough Rd Hyannis, MA 02601 (508) 827-3147 * This pharmacy qualifies for dispensing up to a 90-day supply.
CVS PHARMACY #09250 885 A Island Dr Alameda, CA 94502 (510) 865-2155 CVS PHARMACY #09255 931 Marina Village Pkwy Alameda, CA 94501 (510) 523-3504 CVS PHARMACY #17657 2700 5Th St Alameda, CA 94501 (510) 214-0932 SAFEWAY PHARMACY #0951 Berkeley, CA 94704 867 Island Dr Alameda, CA 94502 (510) 747-1647 SAFEWAY PHARMACY #2708
pharmacy, at an out-of-network** local pharmacy or through the CVS Caremark Mail Service Pharmacy) 3 Your prescription benefit plan through CVS Caremark CVS Caremark manages your prescription benefits just like your health insurance company manages your medical benefits. You have choices when it comes to having your prescriptions filled.