High Deductible Health Plan Preventive Medication List

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High Deductible Health Plan Preventive Medication ListThis benefit may be offered to high deductible health plans (HDHPs) designed for use with a healthsavings account (HSA). It applies only for specific large groups that have elected this benefit.If you are not certain whether your group has this benefit option, please contact BCBSAZ. The list issubject to change at any time, without prior notice. Some medications are available at a retail copay butwill still require specialty distribution limited to a maximum of a 30-day supply.HSA-compatible HDHPs generally require members to satisfy a deductible before the plan begins to payfor any benefits. The only permitted exception to that rule is for preventive care. The plan can pay forcovered preventive care benefits before the member has met the high deductible.The medications noted as HDHP have been identified as those most likely to qualify as preventive, basedon U.S. Treasury Department guidance. This list does not include every medication that might possiblybe considered preventive or every condition for which a preventive medication may be prescribed.Neither BCBSAZ nor your plan sponsor can guarantee that the U.S. Treasury Department will agree thatall of these medications qualify as preventative, particularly when applied to a member’s specificmedical circumstances. You or your provider may be asked to demonstrate that you are taking a specificmedication for purposes regarded as preventive under Treasury Department guidance.If your plan covers BCBSAZ designated prevention medications as a preventive benefit and you haveyour prescription filled at an in-network pharmacy, your plan will treat these designated medications aspreventive. This means you will pay only your applicable copay or coinsurance amount, regardless ofwhether you have met your deductible. The BCBSAZ prevention medication benefit applies only at innetwork pharmacies. If you obtain BCBSAZ designated preventative medications from an out-of-networkpharmacy, your standard prescription benefits, with applicable deductible, coinsurance and copays, willapply. Your cost share payments for preventive medications will count towards your deductible.If you want any of these listed medications to process under your standard pharmacy benefit instead ofyour preventive care benefit, please click here. If your medications process under your standardprescription benefit, your costs for applicable coverage will apply.Questions?Log in to MyBlueSM to find participating retail pharmacies, review your specific benefit information, andcompare medication pricing and options. If you have questions, please call us.Member ServicesPhone NumberStandard Hours of OperationPharmacy Benefits1 (866) 325-179424/7/365BCBSAZCall the number on your ID card8:30 a.m. to 4:30 p.m.Monday - Friday

HSA Preventive Drug ListTable of Contents*Antiasthmatic And Bronchodilator Agents*. 3*Anticoagulants*. 4*Antidepressants*.5*Antidiabetics*. 5*Antihyperlipidemics*. 8*Antihypertensives*. 9*Beta Blockers*. 12*Calcium Channel Blockers*. 12*Diuretics*. 14*Endocrine And Metabolic Agents - Misc.*.14*Hematological Agents - Misc.*. 15*Multivitamins*.15*Nasal Agents - Systemic And Topical*. 21*Vasopressors*. 212

CURRENT AS OF 9/1/2020DrugNotes*Antiasthmatic And Bronchodilator Agents**5-Lipoxygenase Inhibitors***ZYFLOPA; HDHP*Adrenergic Combinations***ADVAIR DISKUS INHALATION AEROSOL POWDER BREATHACTIVATED 100-50 MCG/DOSE, 250-50 MCG/DOSEHDHPADVAIR HFA INHALATION AEROSOL 115-21 MCG/ACT, 230-21MCG/ACTHDHPANORO ELLIPTAHDHPBREO ELLIPTAHDHPBREZTRI AEROSPHEREPA; HDHPbudesonide-formoterol fumarateHDHPCOMBIVENT RESPIMATHDHPDUAKLIR PRESSAIRPA; HDHPDULERA INHALATION AEROSOL 200-5 MCG/ACT, 50-5 MCG/ACTPA; HDHPfluticasone-salmeterol inhalation aerosol powder breath activated 100-50mcg/dose, 250-50 mcg/doseHDHPfluticasone-salmeterol inhalation aerosol powder breath activated 113-14mcg/act, 55-14 mcg/actPA; HDHP; AL (Min 12 Y ELLIPTAHDHPUTIBRON NEOHALERPA; HDHPWIXELA INHUB INHALATION AEROSOL POWDER BREATH ACTIVATEDHDHP100-50 MCG/DOSE, 250-50 MCG/DOSE*Anti-Inflammatory Agents***cromolyn sodium inhalationHDHP*Beta Adrenergics***albuterol sulfate er oral tablet extended release 12 hour 4 mgHDHPalbuterol sulfate hfa inhalation aerosol solution 108 (90 base) mcg/actHDHPalbuterol sulfate inhalation nebulization solution (2.5 mg/3ml) 0.083%, (5mg/ml) 0.5%, 2.5 mg/0.5mlHDHPalbuterol sulfate inhalation nebulization solution 0.63 mg/3ml, 1.25 mg/3mlHDHP; AL (Max 13 Years)albuterol sulfate oralHDHPARCAPTA NEOHALERHDHParformoterol tartrateHDHPformoterol fumarate inhalationHDHPlevalbuterol hcl inhalation nebulization solution 0.31 mg/3ml, 0.63 mg/3ml,1.25 mg/0.5ml, 1.25 mg/3mlHDHPmetaproterenol sulfate oralHDHPPROAIR DIGIHALER INHALATION AEROSOL POWDER BREATHACTIVATED 108 MCG/ACTHDHPLast revision date:03/17/2022 To search for a drug use control f3

DrugNotesPROAIR HFAHDHPPROAIR RESPICLICKHDHPPROVENTIL HFAHDHPSTRIVERDI RESPIMATPA; HDHPterbutaline sulfate injectionHDHPterbutaline sulfate oralHDHPVENTOLIN HFAHDHPXOPENEXHDHPXOPENEX CONCENTRATEHDHP*Bronchodilators - Anticholinergics***INCRUSE ELLIPTAHDHPipratropium bromide inhalationHDHPLONHALA MAGNAIR REFILL KITPA; HDHP; AL (Min 18 Years)LONHALA MAGNAIR STARTER KITPA; HDHP; AL (Min 18 Years)SEEBRI NEOHALERHDHPSPIRIVA RESPIMAT INHALATION AEROSOL SOLUTION 1.25 MCG/ACTHDHPTUDORZA PRESSAIR INHALATION AEROSOL POWDER BREATHACTIVATED 400 MCG/ACTHDHPYUPELRIPA; HDHP*Leukotriene Receptor Antagonists***ACCOLATEHDHPmontelukast sodium oral tablet chewableHDHPSINGULAIR ORAL TABLET CHEWABLEHDHPzafirlukastHDHP*Steroid Inhalants***ARMONAIR RESPICLICK 113HDHPARMONAIR RESPICLICK 232HDHPARMONAIR RESPICLICK 55HDHPARNUITY ELLIPTAHDHPASMANEX HFAHDHPFLOVENT DISKUSHDHPFLOVENT HFAHDHPPULMICORT FLEXHALERHDHPQVAR DHPtheophyllineHDHPtheophylline erHDHP*Anticoagulants**Coumarin Anticoagulants***COUMADIN ORALLast revision date:03/17/2022 To search for a drug use control f4HDHP

DrugNotesJANTOVENHDHPwarfarin sodium oralHDHP*Antidepressants**Selective Serotonin Reuptake Inhibitors (Ssris)***CELEXA ORAL TABLETHDHPcitalopram hydrobromide oral solutionHDHPcitalopram hydrobromide oral tabletHDHPescitalopram oxalate oralHDHPfluoxetine hcl oral capsuleHDHPfluoxetine hcl oral solutionHDHPfluoxetine hcl oral tablet 10 mg, 20 mgHDHPfluvoxamine maleateHDHPfluvoxamine maleate erHDHPLEXAPRO ORAL TABLETHDHPparoxetine hcl er oral tablet extended release 24 hour 25 mg, 37.5 mgHDHPparoxetine hcl oral suspensionHDHPparoxetine hcl oral tablet 10 mg, 40 mgHDHPPAXIL CR ORAL TABLET EXTENDED RELEASE 24 HOUR 25 MG, 37.5MGHDHPPAXIL ORAL SUSPENSIONHDHPPAXIL ORAL TABLET 10 MG, 40 MGHDHPPROZAC ORAL CAPSULEHDHPsertraline hcl oral concentrateHDHPsertraline hcl oral ase Inhibitors***acarbose es***GLUCOPHAGEHDHPmetformin hcl oralHDHPRIOMETHDHP*Diabetic Other***diazoxide oralHDHPGLUCAGEN HYPOKITHDHPglucagon emergency injection solution reconstitutedHDHPPROGLYCEMHDHPZEGALOGUEHDHPLast revision date:03/17/2022 To search for a drug use control f5

DrugNotes*Dipeptidyl Peptidase-4 (Dpp-4) Inhibitors***alogliptin benzoatePA; HDHPJANUVIA ORAL TABLET 25 MG, 50 MGHDHP; AL (Min 18 Years)NESINAPA; HDHPONGLYZAHDHP; AL (Min 16 Years)TRADJENTAHDHP*Dipeptidyl Peptidase-4 Inhibitor-Biguanide Combinations***alogliptin-metformin hclHDHPJANUMETHDHP; AL (Min 18 Years)JANUMET XR ORAL TABLET EXTENDED RELEASE 24 HOUR 50-1000MG, 50-500 MGHDHP; AL (Min 18 Years)JENTADUETOHDHPJENTADUETO XRHDHP; AL (Min 18 Years)KAZANOHDHPKOMBIGLYZE XRHDHP*Dopamine Receptor Agonists - Ergot Derivatives***CYCLOSETHDHP*Dpp-4 Inhibitor-Thiazolidinedione P*Human Insulin***AFREZZA INHALATION POWDER 12 UNIT, 4 & 8 & 12 UNIT, 4 UNIT, 8UNIT, 90 X 4 UNIT & 90X8 UNIT, 90 X 8 UNIT & 90X12 UNITPA; HDHP; AL (Min 18 Years)FIASP FLEXTOUCHPA; HDHPFIASP PENFILLPA; HDHPHUMALOG KWIKPEN SUBCUTANEOUS SOLUTION PEN-INJECTOR 200HDHPUNIT/MLHUMALOG MIX 50/50HDHPHUMALOG MIX 50/50 KWIKPEN SUBCUTANEOUS SUSPENSION PENINJECTORHDHPHUMALOG MIX 75/25HDHPHUMALOG SUBCUTANEOUS SOLUTION CARTRIDGEHDHPHUMULIN 70/30 KWIKPEN SUBCUTANEOUS SUSPENSION PENINJECTORHDHPHUMULIN RHDHPHUMULIN R U-500 KWIKPEN SUBCUTANEOUS SOLUTION PENINJECTORHDHPinsulin asp prot & asp flexpenPA; HDHPinsulin aspart prot & aspartPA; HDHPinsulin glargine-yfgn subcutaneous solutionPA; HDHPinsulin glargine-yfgn subcutaneous solution pen-injectorHDHPLEVEMIR FLEXTOUCHPA; HDHPNOVOLIN 70/30 FLEXPENPA; HDHPLast revision date:03/17/2022 To search for a drug use control f6

DrugNotesNOVOLIN 70/30 FLEXPEN RELIONPA; HDHPNOVOLIN RPA; HDHPNOVOLIN R FLEXPENPA; HDHPNOVOLIN R FLEXPEN RELIONPA; HDHPNOVOLIN R RELIONPA; HDHPNOVOLOG MIX 70/30PA; HDHPNOVOLOG MIX 70/30 FLEXPEN SUBCUTANEOUS SUSPENSION PENINJECTORPA; HDHPSEMGLEE (YFGN) SUBCUTANEOUS SOLUTIONPA; HDHPSEMGLEE (YFGN) SUBCUTANEOUS SOLUTION PEN-INJECTORHDHPTOUJEO MAX SOLOSTARHDHPTOUJEO SOLOSTARHDHPTRESIBA FLEXTOUCHPA; HDHP; AL (Min 1 Years)*Incretin Mimetic Agents (Glp-1 Receptor Agonists)***BYDUREON SUBCUTANEOUS SUSPENSION RECONSTITUTED ERHDHP; AL (Min 16 Years)OZEMPIC (0.25 OR 0.5 MG/DOSE)HDHPOZEMPIC (1 MG/DOSE)HDHPRYBELSUSHDHP*Meglitinide Analogues***nateglinideHDHPPRANDIN ORAL TABLET 1 MG, 2 MGHDHPrepaglinideHDHPSTARLIXHDHP*Sglt2 Inhibitor - Dpp-4 Inhibitor - Biguanide Comb***TRIJARDY XR ORAL TABLET EXTENDED RELEASE 24 HOUR 10-5-1000HDHPMG, 12.5-2.5-1000 MG, 5-2.5-1000 MG*Sglt2 Inhibitor - Dpp-4 Inhibitor Combinations***QTERNPA; HDHPSTEGLUJANPA; HDHP*Sodium-Glucose Co-Transporter 2 (Sglt2) Inhibitors***FARXIGAHDHPINVOKANAPA; HDHPSTEGLATROPA; HDHP*Sodium-Glucose Co-Transporter 2 Inhibitor-Biguanide Comb***INVOKAMETPA; HDHPINVOKAMET XRPA; HDHPSEGLUROMETPA; HDHPSYNJARDYHDHPSYNJARDY XRHDHPXIGDUO XRHDHP*Sulfonylurea-Biguanide Combinations***glipizide-metformin hcl oral tablet 2.5-500 mg, 5-500 mgHDHPLast revision date:03/17/2022 To search for a drug use control f7

DrugNotesGLUCOVANCE ORAL TABLET 5-500 MGHDHPglyburide-metformin oral tablet 2.5-500 mg, 5-500 mgHDHP*Sulfonylureas***chlorpropamideHDHPglipizide erHDHPglipizide oralHDHPglipizide xlHDHPGLUCOTROLHDHPGLUCOTROL XLHDHPglyburide micronizedHDHPglyburide hiazolidinedione-Biguanide Combinations***ACTOPLUS METHDHP; AL (Min 16 Years)ACTOPLUS MET XRHDHPpioglitazone hcl-metformin hclHDHP; AL (Min 16 Years)*Thiazolidinediones***AVANDIA ORAL TABLET 2 MG, 4 MGHDHP*Antihyperlipidemics**Acl Inhib-Intestinal Cholesterol Absorption Inhib Comb***NEXLIZETHDHP*Adenosine Triphosphate-Citrate Lyase (Acl) Inhibitors***NEXLETOLHDHP*Antihyperlipidemics - Misc.***VASCEPA ORAL CAPSULE 0.5 GMPA; HDHP*Bile Acid Sequestrants***cholestyramine lightHDHPcholestyramine oralHDHPCOLESTIDHDHPCOLESTID FLAVOREDHDHPcolestipol hclHDHPPREVALITEHDHPQUESTRANHDHPQUESTRAN LIGHT ORAL POWDERHDHP*Fibric Acid Derivatives***fenofibric acid oral capsule delayed releaseHDHP; AL (Min 18 Years)gemfibrozil oralHDHPLOPIDHDHPTRILIPIXHDHP; AL (Min 18 Years)Last revision date:03/17/2022 To search for a drug use control f8

DrugNotes*Hmg Coa Reductase Inhibitors***ALTOPREVHDHPCRESTOR ORAL TABLET 10 MG, 20 MG, 5 MGHDHPEZALLOR SPRINKLE ORAL CAPSULE SPRINKLE 10 MG, 20 MG, 5 MGHDHPLIVALOPA; HDHPlovastatin oral tablet 10 mg, 20 mgHDHPPRAVACHOL ORAL TABLET 20 MGHDHPpravastatin sodium oral tablet 10 mg, 20 mgHDHProsuvastatin calcium oral tablet 10 mg, 20 mg, 5 mgHDHPsimvastatin oral tablet 10 mg, 20 mg, 5 mgHDHPZOCOR ORAL TABLET 10 MG, 20 MG, 5 MGHDHPZYPITAMAGPA; HDHP*Intest Cholest Absorp Inhib-Hmg Coa Reductase Inhib atin oral tablet 10-10 mg, 10-20 mgHDHPROSZETHDHPVYTORIN ORAL TABLET 10-10 MG, 10-20 MGHDHP*Nicotinic Acid Derivatives***niacin es**Ace Inhibitor & Calcium Channel Blocker Combinations***amlodipine besy-benazepril hclHDHPLOTREL ORAL CAPSULE 10-20 MG, 10-40 MG, 5-10 MG, 5-20 MGHDHPTARKA ORAL TABLET EXTENDED RELEASE 2-180 MG, 2-240 MG, 4-240HDHPMGtrandolapril-verapamil hcl erHDHP*Ace Inhibitors & eHDHPenalapril-hydrochlorothiazideHDHPfosinopril OTENSIN HCT ORAL TABLET 10-12.5 MG, 20-12.5 MG, 20-25 Ace Inhibitors***ACCUPRILHDHPALTACE ORAL CAPSULEHDHPLast revision date:03/17/2022 To search for a drug use control f9

DrugNotesbenazepril hcl oralHDHPcaptopril oralHDHPenalapril maleate oralHDHPEPANED ORAL SOLUTIONHDHPfosinopril sodiumHDHPlisinopril oralHDHPLOTENSIN ORAL TABLET 10 MG, 20 MG, 40 MGHDHPmoexipril hclHDHPperindopril erbumineHDHPPRINIVILHDHPQBRELISHDHPquinapril RILHDHP*Adrenolytics-Central & Thiazide/Thiazide-Like sin Ii Receptor Antag & Ca Channel Blocker tensin Ii Receptor Antag & Thiazide/Thiazide-Like***ATACAND HCTHDHPcandesartan cilexetil-hctzHDHPDIOVAN HCT ORAL TABLET 160-12.5 MG, 320-12.5 MG, 320-25 MG, 8012.5 MGHDHPEDARBYCLORHDHPHYZAARHDHPlosartan potassium-hctzHDHPMICARDIS HCT ORAL TABLET 40-12.5 MG, 80-12.5 MGHDHPtelmisartan-hctz oral tablet 40-12.5 mg, 80-12.5 mgHDHPvalsartan-hydrochlorothiazide oral tablet 160-12.5 mg, 320-12.5 mg, 320-25mg, 80-12.5 mgHDHP*Angiotensin Ii Receptor Antagonists***ATACANDHDHPAVAPRO ORAL TABLET 150 MG, 75 MGHDHPcandesartan cilexetilHDHPCOZAARHDHPDIOVAN ORAL TABLET 40 MG, 80 MGHDHPEDARBIHDHP; AL (Min 18 Years)irbesartan oral tablet 150 mg, 75 mgHDHPlosartan potassium oralHDHPLast revision date:03/17/2022 To search for a drug use control f10

DrugNotesMICARDISHDHPtelmisartanHDHPvalsartan oral tablet 40 mg, 80 mgHDHP*Angiotensin Ii Receptor Ant-Ca Channel Blocker-Thiazides***amlodipine-valsartan-hctz oral tablet 10-160-12.5 mg, 10-160-25 mg, 5-16012.5 mg, 5-160-25 mgHDHPEXFORGE HCT ORAL TABLET 10-160-12.5 MG, 10-160-25 MG, 5-160-12.5HDHPMG, 5-160-25 adrenergics - Centrally S-2HDHPCATAPRES-TTS-3HDHPclonidineHDHPclonidine hcl oralHDHPguanfacine hcl oralHDHPmethyldopa oralHDHP*Antiadrenergics - Peripherally Acting***CARDURAHDHPdoxazosin mesylate oralHDHPMINIPRESSHDHPprazosin hcl oralHDHPterazosin hcl oralHDHP*Antihypertensives - Misc.***VECAMYLHDHP*Beta Blocker & Diuretic ol-hydrochlorothiazideHDHPCORZIDEHDHPLOPRESSOR HCT ORAL TABLET 50-25 ndroflumethiazide oral tablet 40-5 mgHDHPpropranolol-hctzHDHPTENORETIC 100HDHPTENORETIC 50HDHPZIACHDHP*Direct Renin Inhibitors & Thiazide/Thiazide-Like Comb***TEKTURNA HCT ORAL TABLET 150-12.5 MG, 150-25 MG, 300-12.5 MGHDHP*Direct Renin Inhibitors***aliskiren fumarateHDHP; AL (Min 18 Years)Last revision date:03/17/2022 To search for a drug use control f11

DrugNotesTEKTURNAHDHP; AL (Min 18 Years)*Vasodilators***hydralazine hcl oralHDHPminoxidil oralHDHP*Beta Blockers**Alpha-Beta Blockers***carvedilolHDHPcarvedilol phosphate erHDHPCOREGHDHPCOREG CRHDHPlabetalol hcl oralHDHP*Beta Blockers Cardio-Selective***acebutolol hcl oralHDHPatenolol oralHDHPbisoprolol fumarate oralHDHPBYSTOLICHDHPKAPSPARGO SPRINKLEHDHPLOPRESSOR ORALHDHPmetoprolol succinate erHDHPmetoprolol tartrate oralHDHPnebivolol hclHDHPTENORMINHDHPTOPROL XLHDHP*Beta Blockers Non-Selective***BETAPACE AFHDHPBETAPACE ORAL TABLET 120 MG, 160 MG, 80 MGHDHPCORGARDHDHPHEMANGEOLHDHPnadolol oral tablet 20 mg, 40 mg, 80 mgHDHPpindololHDHPpropranolol hcl erHDHPpropranolol hcl oralHDHPSORINEHDHPsotalol hcl (af)HDHPsotalol hcl oralHDHPSOTYLIZEHDHPtimolol maleate oralHDHP*Calcium Channel Blockers**Calcium Channel Blockers***ADALAT CCHDHPAFEDITAB CRHDHPAMLODIPINE BES SYRSPEND SFHDHPLast revision date:03/17/2022 To search for a drug use control f12

DrugNotesamlodipine besylate oralHDHPCALAN ORAL TABLET 120 MG, 80 MGHDHPCALAN SRHDHPCARDIZEM CDHDHPCARDIZEM LA ORAL TABLET EXTENDED RELEASE 24 HOUR 120 MG,180 MG, 300 MG, 360 MGHDHPCARDIZEM ORAL TABLET 120 MG, 30 MG, 60 MGHDHPCARTIA XTHDHPdiltiazem cdHDHPdiltiazem hcl er beadsHDHPdiltiazem hcl er coated beads oral capsule extended release 24 hourHDHPdiltiazem hcl er coated beads oral tablet extended release 24 hour 180 mg,300 mg, 360 mgHDHPdiltiazem hcl er oral capsule extended release 12 hourHDHPdiltiazem hcl er oral capsule extended release 24 hour 120 mg, 180 mg, 240mgHDHPdiltiazem hcl oralHDHPdilt-xrHDHPfelodipine erHDHPisradipineHDHPMATZIM LA ORAL TABLET EXTENDED RELEASE 24 HOUR 180 MG, 300HDHPMG, 360 MGnicardipine hcl oralHDHPnifedipine erHDHPnifedipine er osmotic releaseHDHPnifedipine oralHDHPnimodipine oralHDHPnisoldipine er oral tablet extended release 24 hour 17 mg, 20 mg, 30 mg, 34mg, 8.5 A XLHDHPSULAR ORAL TABLET EXTENDED RELEASE 24 HOUR 17 MG, 34 MG,8.5 MGHDHPTAZTIA XTHDHPTIADYLT ERHDHPTIAZACHDHPverapamil hcl er oral capsule extended release 24 hourHDHPverapamil hcl er oral tablet extended release 120 mg, 180 mg, 240 mgHDHPverapamil hcl oralHDHPVERELANHDHPVERELAN PMHDHPLast revision date:03/17/2022 To search for a drug use control f13

DrugNotes*Diuretics**Diuretic -hctz oral capsule 37.5-25 mgHDHPtriamterene-hctz oral tabletHDHP*Loop Diuretics***bumetanide oralHDHPBUMEXHDHPDEMADEX ORAL TABLET 10 MG, 20 MGHDHPEDECRINHDHPethacrynic acid oralHDHPfurosemide injection solution 10 mg/mlHDHPfurosemide oral solution 10 mg/ml, 8 mg/mlHDHPfurosemide oral tabletHDHPLASIXHDHPtorsemide oralHDHP*Potassium Sparing Diuretics***ALDACTONEHDHPspironolactone oralHDHP*Thiazides And Thiazide-Like Diuretics***chlorothiazide oralHDHPchlorthalidone oral tablet 25 mg, 50 mgHDHPDIURILHDHPhydrochlorothiazide oralHDHPindapamide oralHDHPmethyclothiazide ndocrine And Metabolic Agents - Misc.**Bisphosphonates***ACTONEL ORAL TABLET 30 MG, 5 MGHDHPalendronate sodium oral tablet 10 mg, 40 mg, 70 mgHDHPetidronate disodiumHDHPFOSAMAX ORAL TABLET 70 MGHDHPrisedronate sodium oral tablet 30 mg, 5 mgHDHP*Calcitonins***calcitonin (salmon)Last revision date:03/17/2022 To search for a drug use control f14HDHP

DrugNotes*Selective Estrogen Receptor Modulators (Serms)***OSPHENAPA; HDHP*Hematological Agents - Misc.**Direct-Acting P2y12 Inhibitors***BRILINTAHDHP*Hematorheologic Agents***pentoxifylline erHDHP*Platelet Aggregation Inhibitor Combinations***AGGRENOXHDHPaspirin-dipyridamole erHDHP*Platelet Aggregation Inhibitors***dipyridamole oralHDHPDURLAZAHDHP*Quinazoline Agents***AGRYLINHDHPanagrelide hclHDHP*Thienopyridine Derivatives***EFFIENTHDHP; AL (Min 16 Years)prasugrel hclHDHP; AL (Min 16 Years)*Multivitamins**Prenatal Mv & Min W/Fe-Fa & Coenzyme Q10***THERANATAL OVAVITEHDHP; F*Prenatal Mv & Min W/Fe-Fa***ATABEX ECHDHP; FATABEX OBHDHP; FATABEX ORAL TABLET CHEWABLEHDHP; FBAL-CARE DHAHDHP; FCITRANATAL B-CALMHDHP; FCITRANATAL BLOOMHDHP; FCITRANATAL RXHDHP; Fclassic prenatalHDHP; FCLINICAL NUTRIENTS PRENATALHDHP; Fc-nate dhaHDHP; FcompletenateHDHP; FCO-NATAL FAHDHP; FCONCEPT DHAHDHP; FCONCEPT OBHDHP; Fcvs prenatalHDHP; Fdothelle dhaHDHP; FDUET DHA 400HDHP; FDUET DHA BALANCED ORAL 25-1 & 267 MGHDHP; FELITE-OBHDHP; FLast revision date:03/17/2022 To search for a drug use control f15

DrugNotesENBRACE HRHDHP; Feql prenatal formulaHDHP; Fezfe forteHDHP; FFOLIVANE-OB ORAL CAPSULE 130-92.4-1 MGHDHP; Fgnp daily prenatalHDHP; Fgnp prenatalHDHP; Fgoodsense prenatal vitaminsHDHP; FHEALTHY MAMA BE WELL ROUNDEDHDHP; Fhemenatal obHDHP; Fhemenatal ob dhaHDHP; Fhm one daily prenatalHDHP; Fhm prenatalHDHP; FINATAL GTHDHP; Fkosher prenatal plus ironHDHP; Fkp prenatal multivitaminsHDHP; Fkpn prenatalHDHP; FMARNATAL-FHDHP; FMTERYTIHDHP; FMTERYTI FOLIC 5HDHP; Fmulti prenatalHDHP; FMYNATALHDHP; FMYNATAL ADVANCEHDHP; Fmynatal plusHDHP; Fmynatal-zHDHP; Fmynate 90 plusHDHP; FNATACHEW ORAL TABLET CHEWABLE 28-1 MGHDHP; FNATALVITHDHP; FNATELLE ONE ORAL CAPSULE 28-1-250 MGHDHP; FNEEVO DHA ORAL CAPSULE 27-1.13 MGHDHP; FNEONATAL VITAMINHDHP; FNESTABSHDHP; FNESTABS DHAHDHP; FOB COMPLETE ONEHDHP; FOB COMPLETE ORAL TABLETHDHP; FOB COMPLETE PETITEHDHP; FOB COMPLETE PREMIERHDHP; FOB COMPLETE/DHAHDHP; FOBSTETRIX DHAHDHP; FOBSTETRIX ECHDHP; FOBTREXHDHP; FOBTREX DHAHDHP; FO-CAL PRENATALHDHP; FLast revision date:03/17/2022 To search for a drug use control f16

DrugNotesone vite womensHDHP; FONE-A-DAY WOMENS PRENATALHDHP; FONE-A-DAY WOMENS PRENATAL 1HDHP; Fpa prenatal formulaHDHP; FPERRY PRENATALHDHP; Fpnv prenatal plus multivit dhaHDHP; Fpnv prenatal plus multivitaminHDHPpnv tabs 20-1HDHPpnv tabs 29-1HDHP; Fpnv-omegaHDHP; Fpnv-selectHDHP; FPREFERA OB ORAL TABLET 34-1 MGHDHP; Fprena1 pearlHDHP; FPRENATAHDHP; Fprenatabs fa oral tablet 29-1 mgHDHP; FPRENATABS RXHDHP; Fprenatal 19HDHP; Fprenatal completeHDHP; Fpre-natal formulaHDHP; Fprenatal formula a-freeHDHP; Fprenatal formula oral capsuleHDHP; Fprenatal forteHDHP; Fprenatal low iron oral tablet 27-0.8 mgHDHP; Fprenatal multi dha oral capsule 27-0.8-228 mgHDHP; Fprenatal one dailyHDHP; Fprenatal oral tablet 27-0.8 mg, 28-0.8 mg, 6.75-0.2 mgHDHP; Fprenatal plus ironHDHP; Fprenatal vitaminHDHP; Fprenatal vitamin and mineralHDHP; Fprenatal vitamins oral tablet 28-0.8 mgHDHP; Fprenatal/ironHDHP; Fprenatal/omega-3/fa/ironHDHP; FPRENATAL-UHDHP; FPRENATE ELITE ORAL TABLET 20-0.6-0.4 MGHDHP; Fprenatvite completeHDHP; Fprenatvite plusHDHP; Fprenatvite rxHDHP; FpreplusHDHP; FpretabHDHP; FPRIMACARE ORAL CAPSULEHDHP; FPROVIDA OBHDHP; Fpurefe ob plusHDHP; FLast revision date:03/17/2022 To search for a drug use control f17

DrugNotespx prenatal multivitaminsHDHP; Fqc prenatalHDHP; Fra one dailyHDHP; Fra prenatalHDHP; Fra prenatal formulaHDHP; Frelnate dhaHDHP; FRIGHT STEP PRENATALHDHP; FSELECT-OBHDHP; Fse-natal 19HDHP; Fsm one daily prenatalHDHP; Fsm prenatal vitaminsHDHP; FTARON-BCHDHP; FTARON-C DHA ORAL CAPSULE 53.5-38-1 MGHDHP; FTHERANATAL CORE NUTRITIONHDHP; Fthrivite rxHDHP; Ftl folateHDHP; Ftl-care dhaHDHP; FTRICAREHDHP; FTRICARE PRENATAL DHA ONEHDHP; Ftrinatal rx 1HDHP; FTRINATEHDHP; Ftri-tabs dhaHDHP; Fultimatecare oneHDHP; Fvena-bal dhaHDHP; Fvil-rxHDHP; FVINATE CAREHDHP; FVINATE DHA RFHDHP; FVINATE IIHDHP; FVINATE MHDHP; FVINATE ONEHDHP; Fvirt-c dhaHDHP; Fvirt-nate dhaHDHP; Fvirt-pnHDHP; Fvirt-pn plusHDHP; FVITAFOL GUMMIESHDHP; FVITAFOL-NANOHDHP; FVITAFOL-OBHDHP; FVITAPEARLHDHP; FVITATHELY WITH GINGERHDHP; FVIVA DHAHDHP; Fvol-nateHDHP; Fvol-plusHDHP; FLast revision date:03/17/2022 To search for a drug use control f18

DrugNotesvol-tab rxHDHP; Fvp-heme ob dhaHDHP; Fvp-pnv-dhaHDHP; FYOUR LIFE MULTI PRENATALHDHP; FZATEAN-PN PLUSHDHP; F*Prenatal Mv & Min W/Fe-Fa-Ca-Omega 3 Fish Oil***complete natal dha oral 29-1-200 & 250 mgHDHP; FNESTABS ABCHDHP; FPR NATAL 400HDHP; FPR NATAL 400 ECHDHP; FPR NATAL 430HDHP; FPR NATAL 430 ECHDHP; Fprenatal complete multi oral therapy pack 18-0.8 & 290 mgHDHP; FTRIVEEN-DUO DHA ORAL 29-1-200 & 400 MGHDHP; F*Prenatal Mv & Min W/Fe-Fa-Dha***BRAINSTRONG PRENATALHDHP; Fcadeau dhaHDHP; FCENTRUM SPECIALIST PRENATALHDHP; FCITRANATAL 90 DHA ORAL 90-1 & 300 MGHDHP; FCITRANATAL ASSURE ORAL 35-1 & 300 MGHDHP; FCITRANATAL BLOOM DHAHDHP; FCITRANATAL DHAHDHP; FCITRANATAL ESSENCEHDHP; FCITRANATAL HARMONY ORAL CAPSULE 27-1-260 MGHDHP; FCITRANATAL MEDLEYHDHP; Fcvs prenatal multi dhaHDHP; Fcvs womens prenatal dhaHDHP; FENFAMIL EXPECTAHDHP; FFOLET DHAHDHP; FFOLET ONEHDHP; FNESTABS ONEHDHP; FNEXA PLUSHDHP; FOBSTETRIX ONEHDHP; Fpnv ob dhaHDHP; Fpnv-dhaHDHP; Fpnv-dha docusateHDHP; FPREFERAOB DHAHDHP; FPREFERAOB ONEHDHP; Fprena 1 trueHDHP; FprenaissanceHDHP; Fprenaissance plusHDHP; FPRENATAL DHAHDHP; FLast revision date:03/17/2022 To search for a drug use control f19

DrugNotesprenatal multi dha oral capsule 27-0.8-200 mg, 27-0.8-250 mgHDHP; FPRENATAL MULTIVITAMIN DHAHDHP; Fprenatal multivitamin plus dhaHDHP; Fprenatal dha oral 28-0.975 & 200 mgHDHP; FPRENATE DHA ORAL CAPSULE 18-0.6-0.4-300 MGHDHP; FPRENATE ENHANCEHDHP; FPRENATE ESSENTIAL ORAL CAPSULE 18-0.6-0.4-300 MGHDHP; FPRENATE MINI ORAL CAPSULE 18-0.6-0.4-350 MGHDHP; FPRENATE PIXIEHDHP; FPRENATE RESTOREHDHP; FPROVIDA DHAHDHP; FR-NATAL OBHDHP; FSELECT-OB DHAHDHP; FSIMILAC PRENATAL EARLY SHIELDHDHP; FSTUART ONEHDHP; FTARON-PREXHDHP; FTHERANATAL COMPLETEHDHP; FTHERANATAL ONEHDHP; Ftl-selectHDHP; Ftristart dhaHDHP; FTRISTART ONEHDHP; Fultra prenatal dhaHDHP; Fvirt-pn dhaHDHP; FVITAFOL FE HDHP; FVITAFOL ULTRAHDHP; FVITAFOL-OB DHAHDHP; FVITAFOL-ONEHDHP; FVITAMEDMD ONE RX/QUATREFOLICHDHP; FVITATRUEHDHP; Fwegmans complete prenatal dhaHDHP; FZATEAN-PN DHAHDHP; F*Prenatal Mv & Minerals W/ Fa Without Iron***cvs prenatal gummy oral tablet chewable 0.4 mgHDHP; F*Prenatal Mv & Minerals W/ Fa-Omega Fatty Acids W/O Iron***cvs prenatal gummy oral tablet chewable 0.4-113.5 mgHDHP; F*Prenatal Mv & Minerals W/Fa Without Iron***ALIVE PRENATALHDHP; Fcvs prenatal gummy oral tablet chewable 0.4-25 mgHDHP; FONE A DAY PRENATALHDHP; Fprenatal complete multi oral therapy pack 0.267 & 373 mgHDHP; Fprenatal adult gummy/dha/faHDHP; Fprenatal gummies/dha & faHDHP; FLast revision date:03/17/2022 To search for a drug use control f20

DrugNotesPRENATEHDHP; F*Prenatal Vitamins***calnaHDHP; FPREMESISRXHDHP; Fprena1HDHP; FPRENATE AMHDHP; FVITAFOL STRIPSHDHP; FVITAMEDMD REDICHEW RX ORAL TABLET CHEWABLE 1.4 MGHDHP; F*Nasal Agents - Systemic And Topical**Topical Decongestants***ADRENALIN NASALHDHPepinephrine hcl (nasal)HDHP*Vasopressors**Anaphylaxis Therapy Agents***ADRENALIN INJECTIONHDHPepinephrine injection solution auto-injector 0.15 e injection solution 30 mg/30mlHDHPepinephrine injection solution prefilled syringe 1 mg/10mlHDHPepinephrine pf injection solutionHDHPepinephrine solution 30 mg/30ml injectionHDHPLast revision date:03/17/2022 To search for a drug use control f21

Indexacarbose. 5ACCOLATE. 4ACCUPRIL. 9ACCURETIC.9acebutolol hcl. 12ACTONEL.14ACTOPLUS MET.8ACTOPLUS MET XR.8ADALAT CC. 12ADRENALIN.21ADVAIR DISKUS.3ADVAIR HFA.3AFEDITAB CR.12AFREZZA. 6AGGRENOX. 15AGRYLIN.15albuterol sulfate.3albuterol sulfate er. 3albuterol sulfate hfa.3ALDACTAZIDE. 14ALDACTONE. 14alendronate sodium. 14aliskiren fumarate.11ALIVE PRENATAL.20alogliptin benzoate. 6alogliptin-metformin hcl. 6alogliptin-pioglitazone. 6ALTACE. 9ALTOPREV. 9AMLODIPINE BES SYRSPENDSF. 12amlodipine besy-benazepril hcl.9amlodipine besylate. 13amlodipine-va

LEXAPRO ORAL TABLET: HDHP. paroxetine hcl er oral tablet extended release 24 hour 25 mg, 37.5 mg: HDHP. paroxetine hcl oral tablet 10 mg, 40 mg: HDHP. PAXIL CR ORAL TABLET EXTENDED RELEASE 24 HOUR 25 MG, 37.5 MG: HDHP. PAXIL ORAL SUSPENSION: HDHP. PAXIL ORAL TABLET 10 MG, 40 MG: HDHP. PROZAC ORAL CAPSULE: HDHP. sertraline

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