1         ANTI-INFECTIVES                                                       
2         ANTHELMINTICS                                                         
41                          MEBENDAZOLE                                         
42                          100MG TABLET                                        
6                           00556734    VERMOX                    JAN 0104950 F 
41                          PRAZIQUANTEL                                        
42                          600MG TABLET                                        
6                           02230897    BILTRICIDE                BAY 0062900 F 
42                         ?600MG TABLET (FOREIGN LABELLED)                     
6                           90108977    BILTRICIDE AFRICA-LABEL   BAY 0062900 F 
6                           90109394    BILTRICIDE US-LABEL       BAY 0062900 F 
41                          PYRANTEL PAMOATE                                    
42                          125MG TABLET                                        
6                           01944363    COMBANTRIN                KNV 0014350 F 
2         AMINOGLYCOSIDES                                                       
41                          GENTAMICIN SO4                                      
42                          40MG/ML INJECTION SOLUTION (2ML)                    
6                           02242652    GENTAMICIN                SDZ 0178900 F 
41                          TOBRAMYCIN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *60MG/ML INHALATION SOLUTION (5ML)                   
61                          02389622    TEVA-TOBRAMYCIN (EDS)     TEV 0410985 E 
61                          02239630    TOBI (EDS)                BGP 0618445 E 
42                          28MG INHALATION CAPSULE                             
61                          02365154    TOBI PODHALER (EDS)       BGP 0140613 E 
2         ANTIFUNGALS                                                           
41                          FLUCONAZOLE                                         
42                         *150MG CAPSULE                                       
6                           02241895    APO-FLUCONAZOLE           APX 0039400 F 
6                           02428792    MAR-FLUCONAZOLE-150       MPI 0039400 F 
6                           02432471    JAMP-FLUCONAZOLE          JPC 0039400 F 
6                           02433702    PRIVA-FLUCONAZOLE         STR 0039400 F 
6                           02521229    FLUCONAZOLE-150           SAN 0039400 F 
6                           02547864    JAMP FLUCONAZOLE          JPC 0039400 F 
42                         *50MG TABLET                                         
6                           02237370    APO-FLUCONAZOLE           APX 0012904 F 
6                           02245292    MYLAN-FLUCONAZOLE         MYL 0012904 F 
6                           02245643    PMS-FLUCONAZOLE           PMS 0012904 F 
6                           02281260    ACT FLUCONAZOLE           TEV 0012904 F 
6                           02517396    FLUCONAZOLE               SAN 0012904 F 
6                           02534886    FLUCONAZOLE               SIV 0012904 F 
42                         *100MG TABLET                                        
6                           02237371    APO-FLUCONAZOLE           APX 0022891 F 
6                           02245293    MYLAN-FLUCONAZOLE         MYL 0022891 F 
6                           02245644    PMS-FLUCONAZOLE           PMS 0022891 F 
6                           02281279    ACT FLUCONAZOLE           TEV 0022891 F 
6                           02517418    FLUCONAZOLE               SAN 0022891 F 
6                           02534894    FLUCONAZOLE               SIV 0022891 F 
42                          10MG/ML POWDER FOR ORAL SUSPENSION                  
6                           02024152    DIFLUCAN P.O.S.           PFI 0012649 F 
41                          ISAVUCONAZOLE                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG CAPSULE                                       
61                          02483971    CRESEMBA (EDS)            AVR 0788300 E 
41                          ITRACONAZOLE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG CAPSULE                                       
61                          02462559    MINT-ITRACONAZOLE (EDS)   MNT 0042075 E 
42                         *10MG/ML ORAL SOLUTION                               
61                          02484315    JAMP ITRACONAZOLE (EDS)   JPC 0004111 E 
61                          02495988    ODAN-ITRACONAZOLE (EDS)   ODN 0004111 E 
41                          KETOCONAZOLE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *200MG TABLET                                        
61                          02231061    TEVA-KETOCONAZOLE (EDS)   TEV 0009393 E 
61                          02237235    APO-KETOCONAZOLE (EDS)    APX 0009393 E 
41                          NYSTATIN                                            
42                         *100,000U/ML ORAL SUSPENSION                         
6                           02194201    RATIO-NYSTATIN            RPH 0000521 F 
6                           00792667    PMS-NYSTATIN              PMS 0000518 F 
6                           02433443    JAMP-NYSTATIN ORAL SUSP   JPC 0000518 F 
41                          TERBINAFINE HCL                                     
42                         *250MG TABLET                                        
6                           02239893    APO-TERBINAFINE           APX 0007714 F 
6                           02254727    ACT TERBINAFINE           TEV 0007714 F 
6                           02294273    PMS-TERBINAFINE           PMS 0007714 F 
6                           02320134    AURO-TERBINAFINE          API 0007714 F 
6                           02353121    TERBINAFINE               SAN 0007714 F 
6                           02385279    TERBINAFINE               SIV 0007714 F 
41                          VORICONAZOLE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *50MG TABLET                                         
61                          02399245    SANDOZ VORICONAZOLE (EDS) SDZ 0067818 E 
61                          02525771    JAMP VORICONAZOLE (EDS)   JPC 0067818 E 
61                          02256460    VFEND (EDS)               PFI 0134310 E 
42                         *200MG TABLET                                        
61                          02399253    SANDOZ VORICONAZOLE (EDS) SDZ 0264807 E 
61                          02525798    JAMP VORICONAZOLE (EDS)   JPC 0264807 E 
61                          02256479    VFEND (EDS)               PFI 0537017 E 
2         CEPHALOSPORINS                                                        
41                          CEFADROXIL                                          
42                         *500MG CAPSULE                                       
6                           02235134    TEVA-CEFADROXIL           TEV 0005895 F 
6                           02240774    APO-CEFADROXIL            APX 0005895 F 
6                           02544792    JAMP CEFADROXIL           JPC 0005895 F 
41                          CEFIXIME                                            
42                         *400MG TABLET                                        
6                           02432773    AURO-CEFIXIME             API 0030796 F 
6                           00868981    SUPRAX                    ODN 0030800 F 
42                         *20MG/ML ORAL SUSPENSION                             
6                           02468689    AURO-CEFIXIME             API 0003899 F 
6                           00868965    SUPRAX                    ODN 0003900 F 
41                          CEFPROZIL                                           
42                          250MG TABLET                                        
6                           02293528    TARO-CEFPROZIL            SUN 0017374 F 
42                         *500MG TABLET                                        
6                           02293536    TARO-CEFPROZIL            SUN 0020038 F 
6                           02347253    AURO-CEFPROZIL            API 0020038 F 
42                         *25MG/ML ORAL SUSPENSION                             
6                           02329204    TARO-CEFPROZIL            SUN 0000970 F 
6                           02347261    AURO-CEFPROZIL            API 0000970 F 
42                         *50MG/ML ORAL SUSPENSION                             
6                           02293579    TARO-CEFPROZIL            SUN 0001938 F 
6                           02347288    AURO-CEFPROZIL            API 0001938 F 
41                          CEFUROXIME AXETIL                                   
42                         *250MG TABLET                                        
6                           02244393    APO-CEFUROXIME            APX 0004194 F 
6                           02344823    AURO-CEFUROXIME           API 0004194 F 
6                           02547198    JAMP CEFUROXIME           JPC 0004194 F 
42                         *500MG TABLET                                        
6                           02244394    APO-CEFUROXIME            APX 0008308 F 
6                           02344831    AURO-CEFUROXIME           API 0008308 F 
6                           02547201    JAMP CEFUROXIME           JPC 0008308 F 
42                          25MG/ML ORAL SUSPENSION                             
6                           02212307    CEFTIN                    SDZ 0001792 F 
41                          CEPHALEXIN MONOHYDRATE                              
42                          250MG CAPSULE                                       
6                           00342084    TEVA-CEPHALEXIN           TEV 0004642 F 
42                          500MG CAPSULE                                       
6                           00342114    TEVA-CEPHALEXIN           TEV 0008779 F 
42                         *250MG TABLET                                        
6                           00583413    TEVA-CEPHALEXIN           TEV 0000866 F 
6                           00768723    APO-CEPHALEX              APX 0000866 F 
6                           02470578    AURO-CEPHALEXIN           API 0000866 F 
6                           02471140    LUPIN-CEPHALEXIN          LUP 0000866 F 
6                           02494698    JAMP CEPHALEXIN           JPC 0000866 F 
6                           02521253    CEPHALEXIN                SAN 0000866 F 
42                         *500MG TABLET                                        
6                           00583421    TEVA-CEPHALEXIN           TEV 0001731 F 
6                           00768715    APO-CEPHALEX              APX 0001731 F 
6                           02470586    AURO-CEPHALEXIN           API 0001731 F 
6                           02471159    LUPIN-CEPHALEXIN          LUP 0001731 F 
6                           02494701    JAMP CEPHALEXIN           JPC 0001731 F 
6                           02495651    CEPHALEXIN                SIV 0001731 F 
6                           02521261    CEPHALEXIN                SAN 0001731 F 
42                         *25MG/ML ORAL SUSPENSION                             
6                           00342106    TEVA-LEXIN                TEV 0001535 F 
6                           02469170    LUPIN-CEPHALEXIN          LUP 0001535 F 
6                           02497743    AURO-CEPHALEXIN           API 0001535 F 
6                           02528436    JAMP CEPHALEXIN           JPC 0001535 F 
42                         *50MG/ML ORAL SUSPENSION                             
6                           00342092    TEVA-LEXIN                TEV 0002573 F 
6                           02469189    LUPIN-CEPHALEXIN          LUP 0002573 F 
6                           02497751    AURO-CEPHALEXIN           API 0002573 F 
6                           02528444    JAMP CEPHALEXIN           JPC 0002573 F 
2         MACROLIDES                                                            
41                          AZITHROMYCIN                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *250MG TABLET                                        
6                           02261634    PMS-AZITHROMYCIN          PMS 0009410 F 
6                           02265826    SANDOZ AZITHROMYCIN       SDZ 0009410 F 
6                           02267845    NOVO-AZITHROMYCIN         TEV 0009410 F 
6                           02275309    RIVA-AZITHROMYCIN         RIV 0009410 F 
6                           02330881    AZITHROMYCIN              SAN 0009410 F 
6                           02415542    APO-AZITHROMYCIN Z        APX 0009410 F 
6                           02442434    AZITHROMYCIN              SIV 0009410 F 
6                           02452308    JAMP-AZITHROMYCIN         JPC 0009410 F 
6                           02452324    MAR-AZITHROMYCIN          MPI 0009410 F 
6                           02479680    NRA-AZITHROMYCIN          NRA 0009410 F 
6                           02480700    AG-AZITHROMYCIN           ANG 0009410 F 
6                           02502038    M-AZITHROMYCIN            MNP 0009410 F 
42                          600MG TABLET                                        
61                          02261642    PMS-AZITHROMYCIN (EDS)    PMS 0106652 E 
42                         *20MG/ML ORAL SUSPENSION                             
6                           02332388    SANDOZ AZITHROMYCIN       SDZ 0005881 F 
6                           02482363    AURO-AZITHROMYCIN         API 0005881 F 
42                         *40MG/ML ORAL SUSPENSION                             
6                           02332396    SANDOZ AZITHROMYCIN       SDZ 0008330 F 
6                           02482371    AURO-AZITHROMYCIN         API 0008330 F 
41                          CLARITHROMYCIN                                      
42                         *250MG TABLET                                        
6                           02247573    PMS-CLARITHROMYCIN        PMS 0004122 F 
6                           02248804    TEVA-CLARITHROMYCIN       TEV 0004122 F 
6                           02266539    SANDOZ CLARITHROMYCIN     SDZ 0004122 F 
6                           02274744    APO-CLARITHROMYCIN        APX 0004122 F 
6                           02361426    RAN-CLARITHROMYCIN        RAN 0004122 F 
6                           02442469    CLARITHROMYCIN            SIV 0004122 F 
6                           02466120    CLARITHROMYCIN            SAN 0004122 F 
6                           02471388    M-CLARITHROMYCIN          MNP 0004122 F 
6                           01984853    BIAXIN BID                BGP 0019453 F 
42                         *500MG TABLET                                        
6                           02247574    PMS-CLARITHROMCYIN        PMS 0008318 F 
6                           02248805    TEVA-CLARITHROMYCIN       TEV 0008318 F 
6                           02266547    SANDOZ CLARITHROMYCIN     SDZ 0008318 F 
6                           02274752    APO-CLARITHROMYCIN        APX 0008318 F 
6                           02361434    RAN-CLARITHROMYCIN        RAN 0008318 F 
6                           02442485    CLARITHROMYCIN            SIV 0008318 F 
6                           02466139    CLARITHROMYCIN            SAN 0008318 F 
6                           02471396    M-CLARITHROMYCIN          MNP 0008318 F 
6                           02126710    BIAXIN BID                BGP 0038430 F 
42                         *500MG EXTENDED-RELEASE TABLET                       
6                           02403196    ACT CLARITHROMYCIN XL     TEV 0012572 F 
6                           02413345    APO-CLARITHROMYCIN XL     APX 0012572 F 
42                         *25MG/ML ORAL SUSPENSION                             
6                           02390442    TARO-CLARITHROMYCIN       TAR 0002388 F 
6                           02146908    BIAXIN                    BGP 0003500 F 
42                         *50MG/ML ORAL SUSPENSION                             
6                           02390450    TARO-CLARITHROMYCIN       TAR 0004685 F 
6                           02244641    BIAXIN                    BGP 0006866 F 
2         PENICILLINS                                                           
41                          AMOXICILLIN (AMOXYCILLIN)                           
42                         *250MG CAPSULE                                       
6                           00406724    NOVAMOXIN                 TEV 0000672 F 
6                           00628115    APO-AMOXI                 APX 0000672 F 
6                           02352710    AMOXICILLIN               SAN 0000672 F 
6                           02388073    AURO-AMOXICILLIN          API 0000672 F 
6                           02433060    JAMP-AMOXICILLIN          JPC 0000672 F 
6                           02525348    AMOXICILLIN CAPSULES BP   SAN 0000672 F 
6                           02532042    PRZ-AMOXICILLIN           PRZ 0000672 F 
42                         *500MG CAPSULE                                       
6                           00406716    NOVAMOXIN                 TEV 0001308 F 
6                           00628123    APO-AMOXI                 APX 0001308 F 
6                           02352729    AMOXICILLIN               SAN 0001308 F 
6                           02388081    AURO-AMOXICILLIN          API 0001308 F 
6                           02401509    AMOXICILLIN               SIV 0001308 F 
6                           02433079    JAMP-AMOXICILLIN          JPC 0001308 F 
6                           02477726    AG-AMOXICILLIN            ANG 0001308 F 
6                           02525356    AMOXICILLIN CAPSULES BP   SAN 0001308 F 
6                           02532050    PRZ-AMOXICILLIN           PRZ 0001308 F 
6                           02561417    NRA-AMOXICILLIN           NRA 0001308 F 
42                          125MG CHEWABLE TABLET                               
6                           02036347    NOVAMOXIN                 TEV 0005099 F 
42                          250MG CHEWABLE TABLET                               
6                           02036355    NOVAMOXIN                 TEV 0008659 F 
42                         *25MG/ML ORAL SUSPENSION                             
6                           00628131    APO-AMOXI                 APX 0000247 F 
6                           02458586    AMOXICILLIN               API 0000247 F 
6                           02535793    JAMP-AMOXICILLIN          JPC 0000247 F 
42                         *50MG/ML ORAL SUSPENSION                             
6                           00452130    NOVAMOXIN                 TEV 0000540 F 
6                           00628158    APO-AMOXI                 APX 0000540 F 
6                           01934163    NOVAMOXIN (SUGAR REDUCED) TEV 0000540 F 
6                           02230880    APO-AMOXI SUGAR FREE      APX 0000540 F 
6                           02352753    AMOXICILLIN               SAN 0000540 F 
6                           02352788    AMOXICILLIN LS            SAN 0000540 F 
6                           02401541    AMOXICILLIN               SIV 0000540 F 
6                           02458594    AURO-AMOXICILLIN          API 0000540 F 
6                           02495864    SANDOZ AMOXICILLIN        SDZ 0000540 F 
6                           02535815    JAMP-AMOXICILLIN          JPC 0000540 F 
41                          AMOXICILLIN TRIHYDRATE/POTASSIUM CLAVULANATE        
42                         *250MG/125MG TABLET                                  
6                           02243350    APO-AMOXI CLAV            APX 0002467 F 
6                           02471671    AURO-AMOXICLAV            API 0002467 F 
6                           02508249    JAMP AMOXI CLAV           JPC 0002467 F 
42                         *500MG/125MG TABLET                                  
6                           02243351    APO-AMOXI CLAV            APX 0003778 F 
6                           02471698    AURO-AMOXICLAV            API 0003778 F 
6                           02482576    SANDOZ AMOXI-CLAV TABLET  SDZ 0003778 F 
6                           02508257    JAMP AMOXI CLAV           JPC 0003778 F 
6                           02536021    AMOXICILLIN-CLAV          SAN 0003778 F 
42                         *875MG/125MG TABLET                                  
6                           02245623    APO-AMOXI CLAV            APX 0005551 F 
6                           02471701    AURO-AMOXICLAV            API 0005551 F 
6                           02482584    SANDOZ AMOXI-CLAV TABLET  SDZ 0005551 F 
6                           02508265    JAMP AMOXI CLAV           JPC 0005551 F 
6                           02536048    AMOXICILLIN-CLAV          SAN 0005551 F 
42                          25MG/6.25MG/ML ORAL SUSPENSION                      
6                           01916882    CLAVULIN-125F             GSK 0001194 F 
42                         *40MG/5.7MG/ML ORAL SUSPENSION                       
6                           02539411    JAMP AMOXI CLAV SUSP      JPC 0001007 F 
6                           02238831    CLAVULIN-200              GSK 0001723 F 
42                         *50MG/12.5MG/ML ORAL SUSPENSION                      
6                           02539438    JAMP AMOXI CLAV SUSP      JPC 0001216 F 
6                           02542226    M-AMOXI CLAV              MNP 0001216 F 
6                           01916874    CLAVULIN-250F             GSK 0002600 F 
42                         *80MG/11.4MG/ML ORAL SUSPENSION                      
6                           02530694    M-AMOXI CLAV              MNP 0001591 F 
6                           02539446    JAMP AMOXI CLAV SUSP      JPC 0001591 F 
6                           02238830    CLAVULIN-400              GSK 0003346 F 
41                          AMPICILLIN                                          
42                          250MG CAPSULE                                       
6                           00020877    TEVA-AMPICILLIN           TEV 0004754 F 
42                          500MG CAPSULE                                       
6                           00020885    TEVA-AMPICILLIN           TEV 0009012 F 
41                          CLOXACILLIN                                         
42                         *250MG CAPSULE                                       
6                           00337765    TEVA-CLOXACILLIN          TEV 0002141 F 
6                           02510731    JAMP CLOXACILLIN          JPC 0002141 F 
42                         *500MG CAPSULE                                       
6                           00337773    TEVA-CLOXACILLIN          TEV 0004045 F 
6                           02510758    JAMP CLOXACILLIN          JPC 0004045 F 
42                          25MG/ML ORAL LIQUID                                 
6                           00337757    TEVA-CLOXACILLIN          TEV 0002419 F 
41                          PENICILLIN G (BENZATHINE)                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1,200,000IU/2ML SUSPENSION FOR INJECTION            
61                          02291924    BICILLIN L-A (EDS)        PFI 0550430 E 
42                          1,200,000IU/4ML SUSPENSION FOR INJECTION            
43                          (PORTUGUESE-LABELLED)                               
61                          66128607    LENTOCILIN-PT LABEL(EDS)  SPT 1760900 E 
41                          PENICILLIN V (POTASSIUM)                            
42                          300MG TABLET                                        
6                           00642215    PEN-VK                    AAP 0002452 F 
2         TETRACYCLINES                                                         
41                          DOXYCYCLINE                                         
42                         *100MG CAPSULE                                       
6                           00725250    TEVA-DOXYCYCLINE          TEV 0004651 F 
6                           00740713    APO-DOXY                  APX 0004651 F 
6                           02351234    DOXYCYCLINE               SAN 0004651 F 
6                           02528940    JAMP DOXYCYCLINE CAPSULES JPC 0004651 F 
42                         *100MG TABLET                                        
6                           00874256    APO-DOXY                  APX 0004560 F 
6                           02158574    TEVA-DOXYLIN              TEV 0004560 F 
6                           02351242    DOXYCYLINE                SAN 0004560 F 
6                           02536250    PRZ-DOXYCYCLINE           PRZ 0004560 F 
6                           02543478    M-DOXYCYCLINE             MNP 0004560 F 
6                           02554372    JAMP DOXYCYCLINE TABLETS  JPC 0004560 F 
6                           02558505    NRA-DOXYCYCLINE           NRA 0004560 F 
41                          MINOCYCLINE HCL                                     
42                          50MG CAPSULE                                        
6                           02084090    MINOCYCLINE               AAP 0005616 F 
42                          100MG CAPSULE                                       
6                           02084104    MINOCYCLINE               AAP 0010836 F 
41                          TETRACYCLINE                                        
42                          250MG CAPSULE                                       
6                           00580929    TETRACYCLINE              AAP 0000877 F 
2         MISCELLANEOUS ANTIBIOTICS                                             
41                          AZTREONAM                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          75MG VIAL INHALATION POWDER FOR SOLUTION            
61                          02329840    CAYSTON (EDS)             GSI 0423989 E 
41                          CLINDAMYCIN HCL                                     
42                         *150MG CAPSULE                                       
6                           02241709    TEVA-CLINDAMYCIN          TEV 0002217 F 
6                           02245232    APO-CLINDAMYCIN           APX 0002217 F 
6                           02400529    CLINDAMYCIN               SAN 0002217 F 
6                           02436906    AURO-CLINDAMYCIN          API 0002217 F 
6                           02462656    MED-CLINDAMYCIN           GMP 0002217 F 
6                           02468476    RIVA-CLINDAMYCIN          RIV 0002217 F 
6                           02479923    M-CLINDAMYCIN             MNP 0002217 F 
6                           02483734    JAMP-CLINDAMYCIN          JPC 0002217 F 
6                           02493748    NRA-CLINDAMYCIN           NRA 0002217 F 
6                           02557878    JAMP CLINDAMYCIN CAPSULES JPC 0002217 F 
42                         *300MG CAPSULE                                       
6                           02241710    TEVA-CLINDAMYCIN          TEV 0004434 F 
6                           02245233    APO-CLINDAMYCIN           APX 0004434 F 
6                           02400537    CLINDAMYCIN               SAN 0004434 F 
6                           02436914    AURO-CLINDAMYCIN          API 0004434 F 
6                           02462664    MED-CLINDAMYCIN           GMP 0004434 F 
6                           02468484    RIVA-CLINDAMYCIN          RIV 0004434 F 
6                           02479931    M-CLINDAMYCIN             MNP 0004434 F 
6                           02483742    JAMP-CLINDAMYCIN          JPC 0004434 F 
6                           02493756    NRA-CLINDAMYCIN           NRA 0004434 F 
6                           02557886    JAMP CLINDAMYCIN CAPSULES JPC 0004434 F 
41                          CLINDAMYCIN PALMITATE HCL                           
42                          15MG/ML ORAL SOLUTION                               
6                           00225851    DALACIN C                 PFI 0003211 F 
41                          LINEZOLID                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *600MG TABLET                                        
61                          02422689    SANDOZ LINEZOLID (EDS)    SDZ 0193041 E 
61                          02426552    APO-LINEZOLID (EDS)       APX 0193041 E 
61                          02520354    JAMP LINEZOLID (EDS)      JPC 0193041 E 
42                          100MG/5ML ORAL SUSPENSION                           
61                          02243686    ZYVOXAM (EDS)             PFI 0027639 E 
41                          RIFAXIMIN                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          550MG TABLET                                        
61                          02410702    ZAXINE (EDS)              LUP 0087985 E 
41                          VANCOMYCIN HCL                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *125MG CAPSULE                                       
61                          00800430    VANCOCIN (EDS)            SLP 0051800 E 
61                          02407744    JAMP-VANCOMYCIN (EDS)     JPC 0051800 E 
42                         *250MG CAPSULE                                       
61                          00788716    VANCOCIN (EDS)            SLP 0103600 E 
61                          02377489    VANCOMYCIN HCL CAPS (EDS) PPC 0103600 E 
61                          02407752    JAMP-VANCOMYCIN (EDS)     JPC 0103600 E 
42                         *500MG INJECTION                                     
61                          02342855    VANCOMYCIN HCL INJ (EDS)  STE 0098669 E 
61                          02394626    VANCOMYCIN HCL (EDS)      SDZ 0098669 E 
61                          02406535    VANCOMYCIN HCL (EDS)      MPI 0098669 E 
61                          02502593    VANCOMYCIN HCL INJ (EDS)  JPC 0098669 E 
61                          02543974    VANCOMYCIN HCL INJ (EDS)  HIK 0098669 E 
42                         *1GM INJECTION                                       
61                          02342863    VANCOMYCIN HCL INJ (EDS)  STE 0187810 E 
61                          02394634    VANCOMYCIN HCL (EDS)      SDZ 0187810 E 
61                          02406543    VANCOMYCIN HCL (EDS)      MPI 0187810 E 
61                          02420309    JAMP-VANCOMYCIN (EDS)     JPC 0187810 E 
61                          02502607    VANCOMYCIN HCL INJ (EDS)  JPC 0187810 E 
61                          02543982    VANCOMYCIN HCL INJ (EDS)  HIK 0187810 E 
2         ADAMANTANES                                                           
41                          AMANTADINE                                          
42                          100MG CAPSULE                                       
6                           01990403    PDP-AMANTADINE HCL        PED 0007564 F 
42                         *10MG/ML SYRUP                                       
6                           02022826    PDP-AMANTADINE HCL SYRUP  PED 0000988 F 
6                           02538601    ODAN-AMANTADINE SYRUP     ODN 0000988 F 
2         FUSION INHIBITORS                                                     
41                          ENFUVIRTIDE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          108MG/VIAL POWDER FOR SOLUTION                      
61                          02247725    FUZEON (EDS)              HLR 0423230 E 
41                          MARAVIROC                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *150MG TABLET                                        
61                          02561921    WAYMADE-MARAVIROC (EDS)   WAY 0118914 E 
61                          02299844    CELSENTRI (EDS)           VII 0209577 E 
42                         *300MG TABLET                                        
61                          02561948    WAYMADE-MARAVIROC (EDS)   WAY 0118914 E 
61                          02299852    CELSENTRI (EDS)           VII 0209577 E 
2         NONNUCLEOSIDE REVERSE TRANSCRIPTASE INHIBITOR                         
41                          EFAVIRENZ                                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *600MG TABLET                                        
61                          02381524    MYLAN-EFAVIRENZ (EDS)     MYL 0038031 E 
61                          02389762    TEVA-EFAVIRENZ (EDS)      TEV 0038031 E 
61                          02418428    AURO-EFAVIRENZ (EDS)      API 0038031 E 
61                          02458233    JAMP-EFAVIRENZ (EDS)      JPC 0038031 E 
41                          ETRAVIRINE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG TABLET                                        
61                          02306778    INTELENCE (EDS)           JAN 0065710 E 
42                          200MG TABLET                                        
61                          02375931    INTELENCE (EDS)           JAN 0126195 E 
41                          NEVIRAPINE                                          
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *200MG TABLET                                        
61                          02318601    AURO-NEVIRAPINE (EDS)     API 0012346 E 
61                          02352893    TEVA-NEVIRAPINE (EDS)     TEV 0012346 E 
61                          02387727    MYLAN-NEVIRAPINE (EDS)    MYL 0012346 E 
61                          02405776    JAMP-NEVIRAPINE (EDS)     JPC 0012346 E 
42                          400MG EXTENDED-RELEASE TABLET                       
61                          02427931    APO-NEVIRAPINE XR (EDS)   APX 0018519 E 
2         NUCLEOSIDE/NUCLEOTIDE REV. TRANSCRIPT. INHIB.                         
41                          ABACAVIR SO4                                        
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *300MG TABLET                                        
61                          02396769    APO-ABACAVIR (EDS)        APX 0034828 E 
61                          02480956    MINT-ABACAVIR (EDS)       MNT 0034828 E 
42                          20MG/ML ORAL SOLUTION                               
61                          02240358    ZIAGEN (EDS)              VII 0005877 E 
41                          ABACAVIR SO4/DOLUTEGRAVIR/LAMIVUDINE                
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          600MG/50MG/300MG TABLET                             
61                          02430932    TRIUMEQ (EDS)             VII 0524280 E 
41                          ABACAVIR SO4/LAMIVUDINE                             
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *600MG/300MG TABLET                                  
61                          02399539    APO-ABACAVIR-LAMIV (EDS)  APX 0059875 E 
61                          02416662    TEVA-ABACAVIR/LAMIV (EDS) TEV 0059875 E 
61                          02450682    MYLAN-ABACAVIR/LAMIV (EDS MYL 0059875 E 
61                          02454513    AURO-ABACAVIR/LAMIV (EDS) API 0059875 E 
61                          02458381    PMS-ABACAVIR-LAMIVU (EDS) PMS 0059875 E 
61                          02497654    JAMP ABACAVIR/LAMIV (EDS) JPC 0059875 E 
41                          ABACAVIR SO4/LAMIVUDINE/ZIDOVUDINE                  
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          300MG/150MG/300MG TABLET                            
61                          02416255    APO-ABAC/LAMIV/ZIDOV (EDS APX 0136425 E 
41                          BICTEGRAVIR/EMTRICITABINE/TENOFOVIR                 
41                          ALAFENAMIDE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG/200MG/25MG TABLET                              
61                          02478579    BIKTARVY (EDS)            GSI 0401640 E 
41                          DOLUTEGRAVIR/LAMIVUDINE                             
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          50MG/300MG TABLET                                   
61                          02491753    DOVATO (EDS)              VII 0350473 E 
41                          DOLUTEGRAVIR/RILPIVIRINE                            
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          50MG/25MG TABLET                                    
61                          02475774    JULUCA (EDS)              VII 0417120 E 
41                          EFAVIRENZ/EMTRICITABINE/TENOFOVIR DISOPROXIL        
41                          FUMARATE                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *600MG/200MG/300MG TABLET                            
61                          02393549    TEVA-EFAVIR/EMTR/TENO(EDS TEV 0113300 E 
61                          02461412    MYLAN-EFAV/EMTRI/TENO(EDS MYL 0113300 E 
61                          02468247    APO-EFAVIR-EMTR-TENO(EDS) APX 0113300 E 
61                          02478404    AURO-EFAVIR-EMTR-TENO(EDS API 0113300 E 
61                          02484676    SANDOZ EFAV/EMTR/TENO(EDS SDZ 0113300 E 
61                          02487284    PMS-EFAVIR/EMTR/TENO (EDS PMS 0113300 E 
61                          02519461    JAMP EFAVI/EMTR/TENO (EDS JPC 0113300 E 
41                          ELVITEGRAVIR/COBICISTAT/EMTRICITABINE               
41                          /TENOFOVIR DISOPROXIL FUMARATE                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG/150MG/200MG/300MG TABLET                      
61                          02397137    STRIBILD (EDS)            GSI 0455200 E 
41                          ELVITEGRAVIR/COBICISTAT/EMTRICITABINE/              
41                          TENOFOVIR ALAFENAMIDE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG/150MG/200MG/10MG TABLET                       
61                          02449498    GENVOYA (EDS)             GSI 0462273 E 
41                          EMTRICITABINE/RILPIVIRINE/TENOFOVIR                 
41                          ALAFENAMIDE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/25MG/25MG TABLET                              
61                          02461463    ODEFSEY (EDS)             GSI 0433837 E 
41                          EMTRICITABINE/RILPIVIRINE/TENOFOVIR/                
41                          DISOPROXIL FUMARATE                                 
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          200MG/25MG/300MG TABLET                             
61                          02374129    COMPLERA (EDS)            GSI 0419140 E 
41                          EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE         
42                         *200MG/300MG TABLET                                  
6                           02399059    TEVA-EMTRICI/TENOFOVIR    TEV 0073035 F 
6                           02443902    MYLAN-EMTRICI/TENOFOVIR   MYL 0073035 F 
6                           02452006    APO-EMTRICI/TENOFOVIR     APX 0073035 F 
6                           02461110    PMS-EMTRICITABINE-TENOFOV PMS 0073035 F 
6                           02487012    JAMP EMTRIC/TENOFOVIR     JPC 0073035 F 
6                           02490684    AURO-EMTRICITAB-TENOFOVIR API 0073035 F 
6                           02496356    AG-EMTRICI/TENOFOVIR      ANG 0073035 F 
6                           02521547    MINT-EMTRICI/TENOFOVIR    MNT 0073035 F 
6                           02274906    TRUVADA                   GSI 0277030 F 
41                          LAMIVUDINE                                          
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *100MG TABLET                                        
61                          02393239    APO-LAMIVUDINE HBV (EDS)  APX 0026154 E 
61                          02512467    JAMP LAMIVUDINE HBV (EDS) JPC 0026154 E 
42                         *150MG TABLET                                        
61                          02369052    APO-LAMIVUDINE (EDS)      APX 0027323 E 
61                          02507110    JAMP LAMIVUDINE (EDS)     JPC 0027323 E 
61                          02192683    3TC (EDS)                 VII 0062980 E 
42                         *300MG TABLET                                        
61                          02369060    APO-LAMIVUDINE (EDS)      APX 0054857 E 
61                          02507129    JAMP LAMIVUDINE (EDS)     JPC 0054857 E 
61                          02247825    3TC (EDS)                 VII 0126440 E 
42                          10MG/ML ORAL SOLUTION                               
61                          02192691    3TC (EDS)                 VII 0004067 E 
41                          LAMIVUDINE/ZIDOVUDINE                               
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *150MG/300MG TABLET                                  
61                          02375540    APO-LAMIVUDINE/ZIDOV (EDS APX 0026103 E 
61                          02414414    AURO-LAMIVUDINE/ZIDOV(EDS API 0026103 E 
61                          02502801    JAMP LAMIVUDINE/ZID (EDS) JPC 0026103 E 
41                          RILPIVIRINE                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          25MG TABLET                                         
61                          02370603    EDURANT (EDS)             JAN 0177500 E 
41                          TENOFOVIR ALAFENAMIDE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25MG TABLET                                         
61                          02464241    VEMLIDY (EDS)             GSI 0195537 E 
41                          TENOFOVIR DISOPROXIL FUMARATE                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *300MG TABLET                                        
61                          02403889    TEVA-TENOFOVIR (EDS)      TEV 0048884 E 
61                          02451980    APO-TENOFOVIR (EDS)       APX 0048884 E 
61                          02452634    MYLAN-TENOFOVIR (EDS)     MYL 0048884 E 
61                          02453940    PMS-TENOFOVIR (EDS)       PMS 0048884 E 
61                          02460173    AURO-TENOFOVIR (EDS)      API 0048884 E 
61                          02472511    NAT-TENOFOVIR (EDS)       NPI 0048884 E 
61                          02479087    JAMP-TENOFOVIR (EDS)      JPC 0048884 E 
61                          02512327    TENOFOVIR (EDS)           SAN 0048884 E 
61                          02512939    MINT-TENOFOVIR (EDS)      MNT 0048884 E 
61                          02523922    TENOFOVIR (EDS)           SIV 0048884 E 
61                          02247128    VIREAD (EDS)              GSI 0187680 E 
41                          ZIDOVUDINE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG CAPSULE                                       
61                          01946323    APO-ZIDOVUDINE (EDS)      APX 0013977 E 
42                          10MG/ML SOLUTION                                    
61                          01902652    RETROVIR (EDS)            VII 0002525 E 
42                          10MG/ML INJECTION SOLUTION                          
61                          01902644    RETROVIR (EDS)            VII 0212280 E 
2         INTEGRASE STRAND TRANSFER INHIBITORS                                  
41                          CABOTEGRAVIR                                        
42                          30MG TABLET                                         
61                          02497204    VOCABRIA (EDS)            VII 0305297 E 
42                          30MG  TABLET                                        
6                           02547465    APRETUDE                  VII 0305297 F 
42                          200MG/ML INJECTION SUSPENSION (3ML VIAL)(MG)        
6                           02547473    APRETUDE                  VII 0029042 F 
41                          CABOTEGRAVIR & RILPIVIRINE                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/ML & 300MG/ML EXTENDED RELEASE                
43                          INJECTABLE SUSPENSION 2ML&2ML,4ML KIT (ML)          
61                          02497220    CABENUVA (EDS)            VII 3350425 E 
42                          200MG/ML & 300MG/ML EXTENDED RELEASE                
43                          INJECTABLE SUSPENSION 3ML&3ML,6ML KIT (ML)          
61                          02497247    CABENUVA (EDS)            VII 4362533 E 
41                          DOLUTEGRAVIR                                        
42                         *50MG TABLET                                         
6                           02556782    PMS-DOLUTEGRAVIR          PMS 0129452 F 
6                           02414945    TIVICAY                   VII 0233570 F 
41                          RALTEGRAVIR                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400MG TABLET                                        
61                          02301881    ISENTRESS (EDS)           MRK 0140302 E 
2         PROTEASE INHIBITORS                                                   
41                          ATAZANAVIR SO4                                      
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *150MG CAPSULE                                       
61                          02443791    TEVA-ATAZANAVIR (EDS)     TEV 0028386 E 
61                          02456877    MYLAN-ATAZANAVIR (EDS)    MYL 0028386 E 
61                          02513102    JAMP ATAZANAVIR (EDS)     JPC 0028386 E 
42                         *200MG CAPSULE                                       
61                          02443813    TEVA-ATAZANAVIR (EDS)     TEV 0028552 E 
61                          02456885    MYLAN-ATAZANAVIR (EDS)    MYL 0028552 E 
61                          02513110    JAMP ATAZANAVIR (EDS)     JPC 0028552 E 
61                          02248611    REYATAZ (EDS)             BMY 0118200 E 
42                         *300MG CAPSULE                                       
61                          02443821    TEVA-ATAZANAVIR (EDS)     TEV 0056083 E 
61                          02456893    MYLAN-ATAZANAVIR (EDS)    MYL 0056083 E 
61                          02513129    JAMP ATAZANAVIR (EDS)     JPC 0056083 E 
61                          02294176    REYATAZ (EDS)             BMY 0231034 E 
41                          DARUNAVIR                                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *600MG TABLET                                        
61                          02486121    AURO-DARUNAVIR (EDS)      API 0042970 E 
61                          02487241    APO-DARUNAVIR (EDS)       APX 0042970 E 
61                          02521342    DARUNAVIR (EDS)           JPC 0042970 E 
42                         *800MG TABLET                                        
61                          02486148    AURO-DARUNAVIR (EDS)      API 0058295 E 
61                          02487268    APO-DARUNAVIR (EDS)       APX 0058295 E 
61                          02521350    DARUNAVIR (EDS)           JPC 0058295 E 
41                          DARUNAVIR/COBICISTAT                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          800MG/150MG TABLET                                  
61                          02426501    PREZCOBIX (EDS)           JAN 0251870 E 
41                          DORAVIRINE                                          
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          100MG TABLET                                        
61                          02481545    PIFELTRO (EDS)            MRK 0166500 E 
41                          DORAVIRINE/LAMIVUDINE/TENOFOVIR DISOPROXIL          
41                          FUMARATE                                            
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          100MG/300MG/300MG TABLET                            
61                          02482592    DELSTRIGO (EDS)           MRK 0287900 E 
41                          FOSAMPRENAVIR CALCIUM                               
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          50MG/ML ORAL SUSPENSION                             
61                          02261553    TELZIR (EDS)              VII 0006536 E 
41                          LOPINAVIR/RITONAVIR                                 
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          100MG/25MG TABLET                                   
61                          02312301    KALETRA (EDS)             ABV 0029932 E 
42                          200MG/50MG TABLET                                   
61                          02285533    KALETRA (EDS)             ABV 0059865 E 
42                          80MG/20MG (ML) ORAL SOLUTION                        
61                          02243644    KALETRA (EDS)             ABV 0023955 E 
41                          RITONAVIR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *100MG TABLET                                        
61                          02523620    AURO-RITONAVIR (EDS)      API 0011745 E 
61                          02357593    NORVIR (EDS)              ABV 0015507 E 
2         INTERFERONS                                                           
41                          PEGINTERFERON ALFA-2A                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          180UG/0.5ML PRE-FILLED SYRINGE                      
61                          02248077    PEGASYS (EDS)             ALR 4679000 E 
2         NEURAMINIDASE INHIBITORS                                              
41                          OSELTAMIVIR                                         
42                         *30MG CAPSULE                                        
6                           02472635    NAT-OSELTAMIVIR           NPI 0005243 F 
6                           02497409    JAMP OSELTAMIVIR          JPC 0005243 F 
6                           02497441    MINT-OSELTAMIVIR          MNT 0005243 F 
6                           02504006    SANDOZ OSELTAMIVIR        SDZ 0005243 F 
6                           02304848    TAMIFLU                   HLR 0021150 F 
42                         *45MG CAPSULE                                        
6                           02472643    NAT-OSELTAMIVIR           NPI 0016135 F 
6                           02504014    SANDOZ OSELTAMIVIR        SDZ 0016135 F 
6                           02304856    TAMIFLU                   HLR 0032540 F 
42                         *75MG CAPSULE                                        
6                           02457989    NAT-OSELTAMIVIR           NPI 0010393 F 
6                           02497425    JAMP OSELTAMIVIR          JPC 0010393 F 
6                           02497476    MINT-OSELTAMIVIR          MNT 0010393 F 
6                           02504022    SANDOZ OSELTAMIVIR        SDZ 0010393 F 
6                           02241472    TAMIFLU                   HLR 0041940 F 
42                         *6MG/ML ORAL SUSPENSION                              
6                           02499894    NAT-OSELTAMIVIR           NPI 0002811 F 
6                           02381842    TAMIFLU                   HLR 0003307 F 
41                          ZANAMIVIR                                           
42                          5MG/BLISTER POWDER DISK                             
6                           02240863    RELENZA                   GSK 0097100 F 
2         NUCLEOSIDES AND NUCLEOTIDES                                           
41                          ACYCLOVIR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *200MG TABLET                                        
6                           02207621    APO-ACYCLOVIR             APX 0003511 F 
6                           02242784    MYLAN-ACYCLOVIR           MYL 0003511 F 
6                           02285959    TEVA-ACYCLOVIR            TEV 0003511 F 
6                           02524708    MINT-ACYCLOVIR            MNT 0003511 F 
42                         *400MG TABLET                                        
6                           02207648    APO-ACYCLOVIR             APX 0008890 F 
6                           02242463    MYLAN-ACYCLOVIR           MYL 0008890 F 
6                           02285967    TEVA-ACYCLOVIR            TEV 0008890 F 
6                           02524716    MINT-ACYCLOVIR            MNT 0008890 F 
42                         *800MG TABLET                                        
6                           02207656    APO-ACYCLOVIR             APX 0012673 F 
6                           02242464    MYLAN-ACYCLOVIR           MYL 0012673 F 
6                           02285975    TEVA-ACYCLOVIR            TEV 0012673 F 
6                           02524724    MINT-ACYCLOVIR            MNT 0012673 F 
41                          ADEFOVIR DIPIVOXIL                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02420333    AA-ADEFOVIR (EDS)         AAP 0182518 E 
41                          ENTECAVIR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.5MG TABLET                                        
61                          02396955    APO-ENTECAVIR (EDS)       APX 0055000 E 
61                          02430576    PMS-ENTECAVIR (EDS)       PMS 0055000 E 
61                          02448777    AURO-ENTECAVIR (EDS)      API 0055000 E 
61                          02453797    ENTECAVIR TABLETS (EDS)   STR 0055000 E 
61                          02467232    JAMP-ENTECAVIR (EDS)      JPC 0055000 E 
61                          02479907    ACCEL-ENTECAVIR (EDS)     ACC 0055000 E 
61                          02485907    MINT-ENTECAVIR (EDS)      MNT 0055000 E 
61                          02527154    ENTECAVIR (EDS)           SAN 0055000 E 
61                          02282224    BARACLUDE (EDS)           BMY 0226600 E 
41                          FAMCICLOVIR                                         
42                         *125MG TABLET                                        
6                           02292025    APO-FAMCICLOVIR           APX 0026605 F 
6                           02229110    FAMVIR                    ATN 0031300 F 
42                         *250MG TABLET                                        
6                           02292041    APO-FAMCICLOVIR           APX 0036091 F 
6                           02229129    FAMVIR                    ATN 0042460 F 
42                         *500MG TABLET                                        
6                           02292068    APO-FAMCICLOVIR           APX 0042591 F 
6                           02177102    FAMVIR                    ATN 0075639 F 
41                          GLECAPREVIR/PIBRENTASVIR                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG/20MG GRANULES (SACHET)                         
61                          02522470    MAVIRET (EDS)             ABV 1190500 E 
42                          100MG/40MG TABLET                                   
61                          02467550    MAVIRET (EDS)             ABV 2380952 E 
41                          LEDIPASVIR/SOFOSBUVIR                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          90MG/400MG TABLET                                   
61                          02432226    HARVONI (EDS)             GSI 7976189 E 
41                          REMDESIVIR                                          
51                          SEE APPENDIX A FOR CRITERIA                         
42                          100MG/VIAL POWDER FOR SOLUTION                      
61                          02502143    VEKLURY (EDS)             GSI 6605300 E 
41                          SOFOSBUVIR                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400MG TABLET                                        
61                          02418355    SOVALDI (EDS)             GSI 6547618 E 
41                          SOFOSBUVIR/VELPATASVIR                              
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400MG/100MG TABLET                                  
61                          02456370    EPCLUSA (EDS)             GSI 7142857 E 
41                          SOFOSBUVIR/VELPATASVIR/VOXILAPREVIR                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400MG/100MG/100MG TABLET                            
61                          02467542    VOSEVI (EDS)              GSI 7142857 E 
41                          VALACYCLOVIR                                        
42                         *500MG TABLET                                        
6                           02295822    APO-VALACYCLOVIR          APX 0006198 F 
6                           02298457    PMS-VALACYCLOVIR          PMS 0006198 F 
6                           02316447    RIVA-VALACYCLOVIR         RIV 0006198 F 
6                           02347091    SANDOZ VALACYCLOVIR       SDZ 0006198 F 
6                           02351579    MYLAN-VALACYCLOVIR        MYL 0006198 F 
6                           02357534    TEVA-VALACYCLOVIR         TEV 0006198 F 
6                           02405040    AURO-VALACYCLOVIR         API 0006198 F 
6                           02440598    JAMP VALACYCLOVIR         JPC 0006198 F 
6                           02441454    JAMP-VALACYCLOVIR         JPC 0006198 F 
6                           02442000    VALACYCLOVIR              SIV 0006198 F 
6                           02454645    VALACYCLOVIR              SAN 0006198 F 
6                           02219492    VALTREX                   GSK 0040573 F 
41                          VALGANCICLOVIR HCL                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *450MG TABLET                                        
61                          02413825    TEVA-VALGANCICLOVIR (EDS) TEV 0058553 E 
61                          02435179    AURO-VALGANCICLOVIR (EDS) API 0058553 E 
61                          02495457    MINT-VALGANCICLOVIR (EDS) MNT 0058553 E 
61                          02245777    VALCYTE (EDS)             XED 0289633 E 
42                         *50MG/ML POWDER FOR ORAL SOLUTION (ML)               
61                          02535483    AURO-VALGANCICLOVIR (EDS) API 0015099 E 
61                          02306085    VALCYTE (EDS)             XED 0028309 E 
2         MISCELLANEOUS ANTIVIRALS                                              
41                          LETERMOVIR                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *240MG TABLET                                        
61                          02559323    LUPIN-LETERMOVIR (EDS)    LUP 1790370 E 
61                          02469375    PREVYMIS (EDS)            MRK 2387160 E 
42                         *480MG TABLET                                        
61                          02559331    LUPIN-LETERMOVIR (EDS)    LUP 1790370 E 
61                          02469383    PREVYMIS (EDS)            MRK 2387160 E 
41                          MARIBAVIR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG TABLET                                        
61                          02530740    LIVTENCITY (EDS)          TAK 2767857 E 
41                          NIRMATRELVIR & RITONAVIR                            
42                          4X150MG & 2X100MG TABLET (BLISTER CARD)             
61                          02524031    PAXLOVID (EDS)            PFI 2577760 E 
42                          2X150MG & 2X100MG TABLET (BLISTER CARD)             
61                          02527804    PAXLOVID RENAL (EDS)      PFI 1160000 E 
2         ANTIMALARIALS                                                         
41                          HYDROXYCHLOROQUINE SO4                              
42                         *200MG TABLET                                        
6                           02246691    APO-HYDROXYQUINE          APX 0001576 F 
6                           02424991    MINT-HYDROXYCHLOROQU      MNT 0001576 F 
6                           02491427    JAMP-HYDROXYCHLOROQU      JPC 0001576 F 
6                           02511886    NRA-HYDROXYCHLOROQUINE    NRA 0001576 F 
6                           02519348    HYDROXYCHLOROQUINE        SAN 0001576 F 
6                           02017709    PLAQUENIL                 AVT 0006653 F 
41                          QUININE SO4                                         
42                         *200MG CAPSULE                                       
6                           00021008    TEVA-QUININE              TEV 0002390 F 
6                           00695440    QUININE-ODAN              ODN 0002390 F 
6                           02254514    APO-QUININE               APX 0002390 F 
6                           02445190    JAMP-QUININE              JPC 0002390 F 
42                         *300MG CAPSULE                                       
6                           00021016    TEVA-QUININE              TEV 0003750 F 
6                           00695459    QUININE-ODAN              ODN 0003750 F 
6                           02254522    APO-QUININE               APX 0003750 F 
6                           02445204    JAMP-QUININE              JPC 0003750 F 
42                          300MG TABLET                                        
6                           00695432    QUININE-ODAN              ODN 0003750 F 
2         QUINOLONES                                                            
41                          CIPROFLOXACIN                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *250MG TABLET                                        
61                          02247339    ACT CIPROFLOXACIN (EDS)   TEV 0004454 E 
61                          02248437    PMS-CIPROFLOXACIN (EDS)   PMS 0004454 E 
61                          02248756    SANDOZ CIPROFLOXACIN (EDS SDZ 0004454 E 
61                          02303728    RAN-CIPROFLOX (EDS)       RAN 0004454 E 
61                          02353318    CIPROFLOXACIN (EDS)       SAN 0004454 E 
61                          02379686    MAR-CIPROFLOXACIN (EDS)   MPI 0004454 E 
61                          02380358    JAMP-CIPROFLOXACIN (EDS)  JPC 0004454 E 
61                          02381907    AURO-CIPROFLOXACIN (EDS)  API 0004454 E 
61                          02386119    CIPROFLOXACIN (EDS)       SIV 0004454 E 
61                          02423553    MINT-CIPROFLOX (EDS)      MNT 0004454 E 
42                         *500MG TABLET                                        
61                          02247340    ACT CIPROFLOXACIN (EDS)   TEV 0005025 E 
61                          02248438    PMS-CIPROFLOXACIN (EDS)   PMS 0005025 E 
61                          02248757    SANDOZ CIPROFLOXACIN (EDS SDZ 0005025 E 
61                          02303736    RAN-CIPROFLOX (EDS)       RAN 0005025 E 
61                          02353326    CIPROFLOXACIN (EDS)       SAN 0005025 E 
61                          02379694    MAR-CIPROFLOXACIN (EDS)   MPI 0005025 E 
61                          02380366    JAMP-CIPROFLOXACIN (EDS)  JPC 0005025 E 
61                          02381923    AURO-CIPROFLOXACIN (EDS)  API 0005025 E 
61                          02386127    CIPROFLOXACIN (EDS)       SIV 0005025 E 
61                          02492008    NRA-CIPROFLOXACIN (EDS)   NRA 0005025 E 
42                         *750MG TABLET                                        
61                          02247341    ACT CIPROFLOXACIN (EDS)   TEV 0009201 E 
61                          02248439    PMS-CIPROFLOXACIN (EDS)   PMS 0009201 E 
61                          02248758    SANDOZ CIPROFLOXACIN (EDS SDZ 0009201 E 
61                          02303744    RAN-CIPROFLOX (EDS)       RAN 0009201 E 
61                          02379708    MAR-CIPROFLOXACIN (EDS)   MPI 0009201 E 
61                          02380374    JAMP-CIPROFLOXACIN (EDS)  JPC 0009201 E 
61                          02423588    MINT-CIPROFLOX (EDS)      MNT 0009201 E 
42                          500MG EXTENDED RELEASE TABLET                       
61                          02416433    PMS-CIPROFLOXACIN XL(EDS) PMS 0023110 E 
42                          100MG/ML ORAL SUSPENSION                            
61                          02237514    CIPRO (EDS)               BAY 0005756 E 
41                          LEVOFLOXACIN                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *250MG TABLET                                        
61                          02248262    TEVA-LEVOFLOXACIN (EDS)   TEV 0015032 E 
61                          02284707    APO-LEVOFLOXACIN (EDS)    APX 0015032 E 
61                          02298635    SANDOZ LEVOFLOXACIN (EDS) SDZ 0015032 E 
61                          02315424    ACT LEVOFLOXACIN (EDS)    TEV 0015032 E 
61                          02505797    MINT-LEVOFLOXACIN (EDS)   MNT 0015032 E 
61                          02508443    JAMP LEVOFLOXACIN (EDS)   JPC 0015032 E 
42                         *500MG TABLET                                        
61                          02248263    TEVA-LEVOFLOXACIN (EDS)   TEV 0017130 E 
61                          02284715    APO-LEVOFLOXACIN (EDS)    APX 0017130 E 
61                          02298643    SANDOZ LEVOFLOXACIN (EDS) SDZ 0017130 E 
61                          02315432    ACT LEVOFLOXACIN (EDS)    TEV 0017130 E 
61                          02505819    MINT-LEVOFLOXACIN (EDS)   MNT 0017130 E 
61                          02508451    JAMP LEVOFLOXACIN (EDS)   JPC 0017130 E 
42                         *750MG TABLET                                        
61                          02285649    TEVA-LEVOFLOXACIN (EDS)   TEV 0026604 E 
61                          02298651    SANDOZ LEVOFLOXACIN (EDS) SDZ 0026604 E 
61                          02315440    ACT LEVOFLOXACIN (EDS)    TEV 0026604 E 
61                          02325942    APO-LEVOFLOXACIN (EDS)    APX 0026604 E 
61                          02505800    MINT-LEVOFLOXACIN (EDS)   MNT 0026604 E 
61                          02508478    JAMP LEVOFLOXACIN (EDS)   JPC 0026604 E 
42                          240MG/2.4ML SOL FOR INHALATION (AMPOULES)           
61                          02442302    QUINSAIR (EDS)            AMG 0644887 E 
41                          MOXIFLOXACIN HCL                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *400MG TABLET                                        
61                          02375702    TEVA-MOXIFLOXACIN (EDS)   TEV 0015230 E 
61                          02383381    SANDOZ MOXIFLOXACIN (EDS) SDZ 0015230 E 
61                          02404923    APO-MOXIFLOXACIN (EDS)    APX 0015230 E 
61                          02432242    AURO-MOXIFLOXACIN (EDS)   API 0015230 E 
61                          02443929    JAMP-MOXIFLOXACIN (EDS)   JPC 0015230 E 
61                          02447053    MAR-MOXIFLOXACIN (EDS)    MPI 0015230 E 
61                          02447061    JAMP-MOXIFLOXACIN TAB(EDS JPC 0015230 E 
61                          02457814    MED-MOXIFLOXACIN (EDS)    GMP 0015230 E 
61                          02472791    M-MOXIFLOXACIN (EDS)      MNP 0015230 E 
61                          02478137    AG-MOXIFLOXACIN (EDS)     ANG 0015230 E 
61                          02520710    MOXIFLOXACIN (EDS)        SAN 0015230 E 
41                          NORFLOXACIN                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400MG TABLET                                        
61                          02229524    NORFLOXACIN (EDS)         AAP 0018586 E 
2         SULFONES                                                              
41                          DAPSONE                                             
42                         *100MG TABLET                                        
6                           02481227    MAR-DAPSONE               MPI 0011952 F 
6                           02041510    DAPSONE                   JAC 0014061 F 
2         URINARY TRACT ANTI-INFECTIVES                                         
41                          FOSFOMYCIN TROMETHAMINE                             
42                         *3G ORAL POWDER (SACHET)                             
6                           02473801    JAMP-FOSFOMYCIN           JPC 0140250 F 
6                           02240335    MONUROL                   KTI 0201900 F 
41                          NITROFURANTOIN                                      
42                         *50MG CAPSULE (MACROCRYSTALS)                        
6                           02231015    TEVA-NITROFURANTOIN       TEV 0002927 F 
6                           02495503    JAMP NITROFURANTOIN       JPC 0002927 F 
42                          50MG TABLET                                         
6                           00319511    NITROFURANTOIN            AAP 0002230 F 
42                          100MG TABLET                                        
6                           00312738    NITROFURANTOIN            AAP 0002974 F 
41                          NITROFURANTOIN MONOHYDRATE                          
42                         *100MG CAPSULE (MACROCRYSTALS)                       
6                           02455676    PMS-NITROFURANTOIN        PMS 0003067 F 
6                           02466392    AURO-NITROFURANTOIN BID   API 0003067 F 
6                           02544954    JAMP NITROFURANTOIN BID   JPC 0003067 F 
41                          TRIMETHOPRIM                                        
42                          100MG TABLET                                        
6                           02243116    TRIMETHOPRIM              AAP 0003426 F 
42                          200MG TABLET                                        
6                           02243117    TRIMETHOPRIM              AAP 0007042 F 
2         MISCELLANEOUS ANTI-INFECTIVES                                         
41                          ATOVAQUONE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *150MG/ML SUSPENSION                                 
61                          02528495    GLN-ATOVAQUONE (EDS)      GLN 0015857 E 
61                          02556618    AURO-ATOVAQUONE (EDS)     API 0015857 E 
61                          02217422    MEPRON (EDS)              GSK 0033008 E 
41                          ETHAMBUTOL                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG TABLET                                        
61                          00247960    ETIBI (EDS)               BAU 0002670 E 
42                          400MG TABLET                                        
61                          00247979    ETIBI (EDS)               BAU 0008011 E 
41                          FIDAXOMICIN                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG FILM-COATED TABLET                            
61                          02387174    DIFICID (EDS)             MRK 0946000 E 
41                          ISONIAZID                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG TABLET                                        
61                          00577790    PDP-ISONIAZID (EDS)       PED 0011120 E 
42                          300MG TABLET                                        
61                          00577804    PDP-ISONIAZID (EDS)       PED 0010413 E 
42                          10MG/ML ORAL SOLUTION (ML)                          
61                          00577812    PDP-ISONIAZID (EDS)       PED 0003383 E 
41                          METRONIDAZOLE                                       
42                         *250MG TABLET                                        
6                           00545066    APO-METRONIDAZOLE         APX 0000572 F 
6                           02535807    MINT-METRONIDAZOLE        MNT 0000572 F 
42                         *500MG CAPSULE                                       
6                           00783137    PMS-METRONIDAZOLE         PMS 0002739 F 
6                           02248562    APO-METRONIDAZOLE         APX 0002739 F 
6                           02470284    AURO-METRONIDAZOLE        API 0002739 F 
6                           02518767    METRONIDAZOLE             JPC 0002739 F 
6                           02519755    M-MOTRONIDAZOLE           MNP 0002739 F 
6                           02534592    METRONIDAZOLE             SAN 0002739 F 
41                          RIFAMPIN                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG CAPSULE                                       
61                          00393444    ROFACT (EDS)              BAU 0008684 E 
42                          300MG CAPSULE                                       
61                          00343617    ROFACT (EDS)              BAU 0013671 E 
41                          SULFAMETHOXAZOLE/TRIMETHOPRIM                       
41                          (CO-TRIMOXAZOLE)                                    
42                          400MG/80MG TABLET                                   
6                           00445274    SULFATRIM                 AAP 0002184 F 
42                          800MG/160MG TABLET                                  
6                           00445282    SULFATRIM DS              AAP 0002074 F 
42                          100MG/20MG PEDIATRIC TABLET                         
6                           00445266    SULFATRIM PEDIATRIC       AAP 0001128 F 
42                          40MG/8MG PER ML ORAL SUSPENSION                     
6                           00726540    TEVA-TRIMEL               TEV 0002100 F 
1         ANTINEOPLASTICS                                                       
2         ANTINEOPLASTICS                                                       
41                          CYCLOPHOSPHAMIDE                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG TABLET                                         
61                          02241796    PROCYTOX (EDS)            BAX 0005668 E 
41                          CYPROTERONE ACETATE                                 
42                         *50MG TABLET                                         
6                           00704431    ANDROCUR                  MET 0014085 F 
6                           02390760    MED-CYPROTERONE           GMP 0014085 F 
6                           02245898    CYPROTERONE               AAP 0014395 F 
41                          FLUOROURACIL/SALICYLIC ACID                         
42                          0.5%/10% TOPICAL SOLUTION (ML)                      
6                           02428946    ACTIKERALL                CPI 0020272 F 
41                          HYDROXYUREA                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *500MG CAPSULE                                       
61                          02242920    MYLAN-HYDROXYUREA (EDS)   MYL 0010203 E 
61                          02247937    APO-HYDROXYUREA (EDS)     APX 0010203 E 
61                          00465283    HYDREA (EDS)              XED 0012012 E 
41                          LEUPROLIDE ACETATE                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          45MG PREFILLED SYRINGE (MG)                         
61                          02268892    ELIGARD (EDS)             TOL 0368867 E 
41                          MEGESTROL                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          40MG TABLET                                         
61                          02195917    MEGESTROL (EDS)           AAP 0016701 E 
42                          160MG TABLET                                        
61                          02195925    MEGESTROL (EDS)           AAP 0072803 E 
41                          MERCAPTOPURINE                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *50MG TABLET                                         
61                          00004723    PURINETHOL (EDS)          TEV 0028610 E 
61                          02415275    MERCAPTOPURINE TABLETS(ED STE 0028610 E 
41                          METHOTREXATE                                        
42                         *2.5MG TABLET                                        
6                           02170698    PMS-METHOTREXATE          PMS 0002513 F 
6                           02182963    APO-METHOTREXATE          APX 0002513 F 
6                           02509067    ACH-METHOTREXATE          AHI 0002513 F 
6                           02524023    AURO-METHOTREXATE         API 0002513 F 
6                           02534916    M-METHOTREXATE            MNP 0002513 F 
42                         *10MG TABLET                                         
6                           02553740    JAMP-METHOTREXATE         JPC 0013994 F 
6                           02561956    PMS-METHOTREXATE TABLETS  PMS 0013994 F 
6                           02182750    METHOTREXATE              PFI 0027983 F 
42                         *10MG/0.2ML PRE-FILLED SYRINGE                       
6                           02491281    METHOTREXATE SUBCUTANEOUS AHI 0148200 F 
6                           02539608    PMS-METHOTREXATE INJ      PMS 0148200 F 
6                           02454831    METOJECT SUBCUTANEOUS     MDX 0163020 F 
42                         *12.5MG/0.25ML PRE-FILLED SYRINGE                    
6                           02491303    METHOTREXATE SUBCUTANEOUS AHI 0156000 F 
6                           02539616    PMS-METHOTREXATE INJ      PMS 0156000 F 
6                           02454750    METOJECT SUBCUTANEOUS     MDX 0171600 F 
42                         *15MG/0.3ML PRE-FILLED SYRINGE                       
6                           02454858    METOJECT SUBCUTANEOUS     MDX 0163800 F 
6                           02491311    METHOTREXATE SUBCUTANEOUS AHI 0163800 F 
6                           02539624    PMS-METHOTREXATE INJ      PMS 0163800 F 
42                         *17.5MG/0.35ML PRE-FILLED SYRINGE                    
6                           02454769    METOJECT SUBCUTANEOUS     MDX 0160000 F 
6                           02491338    METHOTREXATE SUBCUTANEOUS AHI 0160000 F 
6                           02539632    PMS-METHOTREXATE INJ      PMS 0160000 F 
42                         *20MG/0.4ML PRE-FILLED SYRINGE                       
6                           02454866    METOJECT SUBCUTANEOUS     MDX 0175000 F 
6                           02491346    METHOTREXATE SUBCUTANEOUS AHI 0175000 F 
6                           02539640    PMS-METHOTREXATE INJ      PMS 0175000 F 
42                         *22.5MG/0.45ML PRE-FILLED SYRINGE                    
6                           02454777    METOJECT SUBCUTANEOUS     MDX 0175000 F 
6                           02491354    METHOTREXATE SUBCUTANEOUS AHI 0175000 F 
6                           02539659    PMS-METHOTREXATE INJ      PMS 0175000 F 
42                         *25MG/0.5ML PRE-FILLED SYRINGE                       
6                           02454874    METOJECT SUBCUTANEOUS     MDX 0195000 F 
6                           02491362    METHOTREXATE SUBCUTANEOUS AHI 0195000 F 
6                           02539667    PMS-METHOTREXATE INJ      PMS 0195000 F 
41                          RUXOLITINIB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG TABLET                                          
61                          02388006    JAKAVI (EDS)              NVR 0850400 E 
42                          10MG TABLET                                         
61                          02434814    JAKAVI (EDS)              NVR 0965209 E 
41                          SELUMETINIB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG CAPSULE                                        
61                          02530139    KOSELUGO (EDS)            AXN 1226000 E 
42                          25MG CAPSULE                                        
61                          02530147    KOSELUGO (EDS)            AXN 3065000 E 
1         AUTONOMIC AGENTS                                                      
2         CHOLINERGICS                                                          
41                          BETHANECHOL CHLORIDE                                
42                          10MG TABLET                                         
6                           01947958    DUVOID                    KTI 0003851 F 
42                          25MG TABLET                                         
6                           01947931    DUVOID                    KTI 0006240 F 
42                          50MG TABLET                                         
6                           01947923    DUVOID                    KTI 0007637 F 
41                          DONEPEZIL HCL                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02322331    PMS-DONEPEZIL (EDS)       PMS 0004586 E 
61                          02328666    SANDOZ DONEPEZIL (EDS)    SDZ 0004586 E 
61                          02340607    TEVA-DONEPEZIL (EDS)      TEV 0004586 E 
61                          02362260    APO-DONEPEZIL (EDS)       APX 0004586 E 
61                          02381508    TARO-DONEPEZIL (EDS)      SUN 0004586 E 
61                          02400561    AURO-DONEPEZIL (EDS)      API 0004586 E 
61                          02402092    MAR-DONEPEZIL (EDS)       MPI 0004586 E 
61                          02402645    DONEPEZIL HCL (EDS)       AHI 0004586 E 
61                          02408600    MINT-DONEPEZIL (EDS)      MNT 0004586 E 
61                          02416948    JAMP-DONEPEZIL TABS (EDS) JPC 0004586 E 
61                          02420597    DONEPEZIL (EDS)           SIV 0004586 E 
61                          02426846    DONEPEZIL (EDS)           SAN 0004586 E 
61                          02432684    AG-DONEPEZIL (EDS)        ANG 0004586 E 
61                          02467453    M-DONEPEZIL (EDS)         MNP 0004586 E 
61                          02475278    DONEPEZIL (EDS)           RIV 0004586 E 
61                          02232043    ARICEPT (EDS)             PFI 0050780 E 
42                         *10MG TABLET                                         
61                          02322358    PMS-DONEPEZIL (EDS)       PMS 0004586 E 
61                          02328682    SANDOZ DONEPEZIL (EDS)    SDZ 0004586 E 
61                          02340615    TEVA-DONEPEZIL (EDS)      TEV 0004586 E 
61                          02362279    APO-DONEPEZIL (EDS)       APX 0004586 E 
61                          02381516    TARO-DONEPEZIL (EDS)      SUN 0004586 E 
61                          02400588    AURO-DONEPEZIL (EDS)      API 0004586 E 
61                          02402106    MAR-DONEPEZIL (EDS)       MPI 0004586 E 
61                          02402653    DONEPEZIL HCL (EDS)       AHI 0004586 E 
61                          02408619    MINT-DONEPEZIL (EDS)      MNT 0004586 E 
61                          02416956    JAMP-DONEPEZIL TABS (EDS) JPC 0004586 E 
61                          02420600    DONEPEZIL (EDS)           SIV 0004586 E 
61                          02426854    DONEPEZIL (EDS)           SAN 0004586 E 
61                          02432692    AG-DONEPEZIL (EDS)        ANG 0004586 E 
61                          02467461    M-DONEPEZIL (EDS)         MNP 0004586 E 
61                          02475286    DONEPEZIL (EDS)           RIV 0004586 E 
61                          02232044    ARICEPT (EDS)             PFI 0050780 E 
41                          GALANTAMINE HYDROBROMIDE                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *8MG EXTENDED-RELEASE CAPSULE                        
61                          02316943    PAT-GALANTAMINE ER (EDS)  PAT 0012865 E 
61                          02339439    MYLAN-GALANTAMINE ER(EDS) MYL 0012865 E 
61                          02425157    AURO-GALANTAMINE (EDS)    API 0012865 E 
61                          02443015    GALANTAMINE ER (EDS)      SAN 0012865 E 
61                          02562154    GALANTAMINE ER (EDS)      SIV 0012865 E 
42                         *16MG EXTENDED-RELEASE CAPSULE                       
61                          02316951    PAT-GALANTAMINE ER (EDS)  PAT 0012865 E 
61                          02339447    MYLAN-GALANTAMINE ER(EDS) MYL 0012865 E 
61                          02425165    AURO-GALANTAMINE (EDS)    API 0012865 E 
61                          02443023    GALANTAMINE ER (EDS)      SAN 0012865 E 
61                          02562162    GALANTAMINE ER (EDS)      SIV 0012865 E 
42                         *24MG EXTENDED-RELEASE CAPSULE                       
61                          02316978    PAT-GALANTAMINE ER (EDS)  PAT 0012865 E 
61                          02339455    MYLAN-GALANTAMINE ER(EDS) MYL 0012865 E 
61                          02425173    AURO-GALANTAMINE (EDS)    API 0012865 E 
61                          02443031    GALANTAMINE ER (EDS)      SAN 0012865 E 
61                          02562170    GALANTAMINE ER (EDS)      SIV 0012865 E 
41                          PILOCARPINE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02216345    SALAGEN (EDS)             MET 0007321 E 
61                          02496119    M-PILOCARPINE (EDS)       MNP 0007321 E 
61                          02509571    JAMP PILOCARPINE (EDS)    JPC 0007321 E 
41                          PYRIDOSTIGMINE BROMIDE                              
42                         *60MG TABLET                                         
6                           02495643    RIVA-PYRIDOSTIGMINE       RIV 0002673 F 
6                           02508362    JAMP PYRIDOSTIGMINE       JPC 0002673 F 
6                           00869961    MESTINON                  BAU 0005747 F 
42                          180MG LONG ACTING TABLET                            
6                           00869953    MESTINON                  BAU 0012750 F 
41                          RIVASTIGMINE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *1.5MG CAPSULE                                       
61                          02324563    SANDOZ RIVASTIGMINE (EDS) SDZ 0006515 E 
61                          02336715    APO-RIVASTIGMINE (EDS)    APX 0006515 E 
61                          02401614    MED-RIVASTIGMINE (EDS)    GMP 0006515 E 
61                          02406985    MINT-RIVASTIGMINE (EDS)   MNT 0006515 E 
61                          02485362    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02552256    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02242115    EXELON (EDS)              KTI 0032289 E 
42                         *3MG CAPSULE                                         
61                          02324571    SANDOZ RIVASTIGMINE (EDS) SDZ 0006515 E 
61                          02336723    APO-RIVASTIGMINE (EDS)    APX 0006515 E 
61                          02401622    MED-RIVASTIGMINE (EDS)    GMP 0006515 E 
61                          02406993    MINT-RIVASTIGMINE (EDS)   MNT 0006515 E 
61                          02485370    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02552264    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02242116    EXELON (EDS)              KTI 0032289 E 
42                         *4.5MG CAPSULE                                       
61                          02324598    SANDOZ RIVISTIGMINE (EDS) SDZ 0006515 E 
61                          02336731    APO-RIVASTIGMINE (EDS)    APX 0006515 E 
61                          02401630    MED-RIVASTIGMINE (EDS)    GMP 0006515 E 
61                          02407000    MINT-RIVASTIGMINE (EDS)   MNT 0006515 E 
61                          02485389    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02552272    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02242117    EXELON (EDS)              KTI 0032289 E 
42                         *6MG CAPSULE                                         
61                          02324601    SANDOZ RIVASTIGMINE (EDS) SDZ 0006515 E 
61                          02336758    APO-RIVASTIGMINE (EDS)    APX 0006515 E 
61                          02401649    MED-RIVASTIGMINE (EDS)    GMP 0006515 E 
61                          02407019    MINT-RIVASTIGMINE (EDS)   MNT 0006515 E 
61                          02485397    JAMP-RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02552280    JAMP RIVASTIGMINE (EDS)   JPC 0006515 E 
61                          02242118    EXELON (EDS)              KTI 0032289 E 
42                          2MG/ML ORAL SOLUTION                                
61                          02245240    EXELON (EDS)              KTI 0016975 E 
2         ANTIPARKINSON DRUGS                                                   
41                          BENZTROPINE MESYLATE                                
42                          1MG TABLET                                          
6                           00706531    PDP-BENZTROPINE           PED 0000642 F 
42                          2MG TABLET                                          
6                           00426857    PDP-BENZTROPINE           PED 0000608 F 
42                          1MG/ML INJECTION SOLUTION (2ML)                     
6                           02238903    BENZTROPINE OMEGA         OMG 0129450 F 
41                          ETHOPROPAZINE                                       
42                          50MG TABLET                                         
6                           01927744    PARSITAN                  SLP 0003258 F 
41                          TRIHEXYPHENIDYL HCL                                 
42                          2MG TABLET                                          
6                           00545058    TRIHEXYPHENIDYL           AAP 0000493 F 
42                          5MG TABLET                                          
6                           00545074    TRIHEXYPHENIDYL           AAP 0000890 F 
2         ANTIMUSCARINICS                                                       
41                          ACLIDINIUM BROMIDE                                  
42                          400UG POWDER FOR INHALATION                         
6                           02409720    TUDORZA GENUAIR           AZR 0573500 F 
41                          ACLIDINIUM BROMIDE/FORMOTEROL FUMARATE              
41                          DIHYDRATE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          400UG/12UG INHALATION POWDER                        
61                          02439530    DUAKLIR GENUAIR (EDS)     AZR 0655100 E 
41                          BUDESONIDE/GLYCOPYRRONIUM/FORMOTEROL FUMARATE       
41                          DIHYDRATE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          160UG/7.2UG/5UG METERED DOSE INHALER (PKG)          
61                          02518058    BREZTRI AEROSPHERE (EDS)  AST 1270000 E 
41                          DICYCLOMINE HCL                                     
42                          10MG TABLET                                         
6                           02391619    JAMP-DICYCLOMINE          JPC 0004220 F 
42                          20MG TABLET                                         
6                           02366088    JAMP-DICYCLOMINE HCL      JPC 0006990 F 
41                          FLUTICASONE FUROATE/UMECLIDINIUM/VILANTEROL         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MCG/62.5MCG/25MCG INHALATION POWDER              
61                          02474522    TRELEGY ELLIPTA (EDS)     GSK 1376700 E 
41                          GLYCOPYRRONIUM BROMIDE                              
42                          50UG/DOSE INHALATION POWDER CAPSULE                 
6                           02394936    SEEBRI BREEZHALER         NVR 0017700 F 
41                          HYOSCINE BUTYLBROMIDE                               
42                         *10MG TABLET                                         
6                           02512335    ACCEL-HYOSCINE            ACC 0002711 F 
6                           00363812    BUSCOPAN                  OPL 0003465 F 
41                          INDACATEROL/GLYCOPYRRONIUM                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          110UG/50UG INHALATION POWDER CAPSULE                
61                          02418282    ULTIBRO BREEZHALER (EDS)  NVR 0025830 E 
41                          IPRATROPIUM BROMIDE                                 
42                         *20UG INHALER AEROSOL (PACKAGE)                      
6                           02542587    JAMP IPRATROPIUM HFA      JPC 0112600 F 
6                           02247686    ATROVENT HFA              BOE 0204200 F 
42                          0.0125% INHALATION SOLUTION (2ML)                   
6                           02231135    PMS-IPRATROPIUM           PMS 0011505 F 
42                         *0.025% INHALATION SOLUTION                          
6                           02126222    APO-IPRAVENT              APX 0003157 F 
6                           02231136    PMS-IPRATROPIUM           PMS 0003157 F 
42                         *0.025% INHALATION SOLUTION (2ML)                    
6                           02216221    TEVA-IPRATROPIUM          TEV 0013180 F 
6                           02231245    PMS-IPRATROPIUM           PMS 0013180 F 
41                          IPRATROPIUM BROMIDE/SALBUTAMOL SO4                  
51                          NOTE:  SALBUTAMOL STRENGTHS ARE EXPRESSED IN        
52                          TERMS OF SALBUTAMOL BASE EQUIVALENT.                
42                          20UG/100UG INHALER AEROSOL (PACKAGE)                
6                           02419106    COMBIVENT RESPIMAT        BOE 0309800 F 
42                         *0.5MG/2.5MG INHALATION SOLUTION (2.5ML)             
6                           02272695    TEVA-COMBO STERINEBS      TEV 0008066 F 
6                           02483394    IPRATROPIUM/SALBUTAMOL    MIC 0008066 F 
41                          TIOTROPIUM BROMIDE MONOHYDRATE                      
42                          2.5UG SOLUTION FOR INHALATION                       
6                           02435381    SPIRIVA RESPIMAT          BOE 0558200 F 
42                         *18UG/DOSE INHALATION POWDER CAPSULE                 
6                           02246793    SPIRIVA                   BOE 0009143 F 
6                           02537850    LUPIN TIOTROPIUM          LUP 0009143 F 
6                           02550865    APO-TIOTROPIUM            APX 0009143 F 
41                          TIOTROPIUM BROMIDE/OLODATEROL HCL                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2.5UG/2.5UG SOLUTION FOR INHALATION                 
61                          02441888    INSPIOLTO RESPIMAT (EDS)  BOE 0655000 E 
41                          UMECLIDINIUM BROMIDE                                
42                          62.5UG POWDER FOR INHALATION                        
6                           02423596    INCRUSE ELLIPTA           GSK 0500000 F 
41                          UMECLIDINIUM BROMIDE/VILANTEROL TRIFENATATE         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          62.5UG/25UG POWDER FOR INHALATION                   
61                          02418401    ANORO ELLIPTA (EDS)       GSK 0029503 E 
2         SYMPATHOMIMETICS                                                      
41                          EPINEPHRINE                                         
42                          0.15MG/DOSE INJECTION SOLUTION (PACKAGE)            
6                           00578657    EPIPEN JR.                BGP 0905100 F 
42                          0.3MG/DOSE INJECTION SOLUTION (PACKAGE)             
6                           00509558    EPIPEN                    BGP 0905100 F 
41                          EPINEPHRINE HCL                                     
42                          1MG/ML INJECTION SOLUTION (1ML)                     
6                           00721891    EPINEPHRINE               PFI 0033500 F 
41                          FORMOTEROL FUMARATE                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          6UG/DOSE POWDER FOR INHALATION (PACKAGE)            
61                          02237225    OXEZE TURBUHALER (EDS)    AST 0390700 E 
42                          12UG/DOSE POWDER FOR INHALATION (PACKAGE)           
61                          02237224    OXEZE TURBUHALER (EDS)    AST 0519900 E 
41                          FORMOTEROL FUMARATE DIHYDRATE/BUDESONIDE            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          6UG/100UG POWDER FOR INHALATION (PACKAGE)           
61                          02245385    SYMBICORT TURBUHALER (EDS AST 0798500 E 
42                          6UG/200UG POWDER FOR INHALATION (PACKAGE)           
61                          02245386    SYMBICORT TURBUHALER (EDS AST 1037500 E 
41                          INDACATEROL/GLYCOPYRRONIUM/MOMETASONE FUROATE       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150UG/50UG/160UG INHALATION POWDER CAPSULE          
61                          02501244    ENERZAIR BREEZHALER (EDS) VAL 0034277 E 
41                          INDACATEROL/MOMETASONE FUROATE                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150UG/80UG INHALATION POWDER CAPSULE                
61                          02498685    ATECTURA BREEZHALER (EDS) VAL 0010731 E 
42                          150UG/160UG INHALATION POWDER CAPSULE               
61                          02498707    ATECTURA BREEZHALER (EDS) VAL 0013419 E 
42                          150UG/320UG INHALATION POWDER CAPSULE               
61                          02498693    ATECTURA BREEZHALER (EDS) VAL 0018473 E 
41                          MIDODRINE HCL                                       
42                         *2.5MG TABLET                                        
6                           02278677    APO-MIDODRINE             APX 0001153 F 
6                           02473984    MAR-MIDODRINE             MPI 0001153 F 
6                           02517701    JAMP MIDODRINE            JPC 0001153 F 
6                           02533200    MIDODRINE                 SAN 0001153 F 
42                         *5MG TABLET                                          
6                           02278685    APO-MIDODRINE             APX 0001921 F 
6                           02473992    MAR-MIDODRINE             MPI 0001921 F 
6                           02517728    JAMP MIDODRINE            JPC 0001921 F 
6                           02533219    MIDODRINE                 SAN 0001921 F 
41                          MOMETASONE FUROATE/FORMOTEROL FUMARATE              
41                          DIHYDRATE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100UG/5UG METERED DOSE INHALER                      
61                          02361752    ZENHALE (EDS)             ORG 1170480 E 
42                          200UG/5UG METERED DOSE INHALER                      
61                          02361760    ZENHALE (EDS)             ORG 1418280 E 
41                          ORCIPRENALINE SO4                                   
42                          2MG/ML SYRUP                                        
6                           02236783    ORCIPRENALINE             AAP 0000621 F 
41                          SALBUTAMOL SO4                                      
51                          NOTE:  PRODUCT STRENGTHS ARE EXPRESSED IN           
52                          TERMS OF SALBUTAMOL BASE EQUIVALENT.                
42                         *100MCG/DOSE METERED DOSE INHALER (PACKAGE)          
43                          (CFC-FREE)                                          
6                           02245669    APO-SALVENT CFC FREE      APX 0060000 F 
6                           02326450    TEVA-SALBUTAMOL HFA       TEV 0060000 F 
6                           02419858    SALBUTAMOL HFA            SAN 0060000 F 
6                           02241497    VENTOLIN HFA              GSK 0068300 F 
42                          0.5MG/ML INHALATION SOLUTION PRESERVATIVE           
43                          FREE (2.5ML)                                        
6                           02208245    PMS-SALBUTAMOL            PMS 0003730 F 
42                         *1MG/ML INHALATION SOLUTION PRESERVATIVE FREE        
43                          (2.5ML)                                             
6                           01926934    TEVA-SALBUTAMOL STERINEBS TEV 0003618 F 
6                           01986864    RATIO-SALBUTAMOL          RPH 0003618 F 
6                           02208229    PMS-SALBUTAMOL            PMS 0003618 F 
42                         *2MG/ML INHALATION SOLUTION PRESERVATIVE FREE        
43                          (2.5ML)                                             
6                           02208237    PMS-SALBUTAMOL            PMS 0006750 F 
6                           02173360    TEVA-SALBUTAMOL STERINEBS TEV 0006870 F 
6                           02239366    RATIO-SALBUTAMOL P.F.     RPH 0006870 F 
42                          5MG/ML INHALATION SOLUTION                          
6                           02213486    VENTOLIN RESPIRATOR SOL.  GSK 0002744 F 
41                          SALMETEROL XINAFOATE                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50UG/DOSE POWDER FOR INHALATION (PACKAGE)           
61                          02231129    SEREVENT DISKUS (EDS)     GSK 0697300 E 
41                          SALMETEROL XINAFOATE/FLUTICASONE PROPIONATE         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25UG/125UG INHALER AEROSOL (PACKAGE)                
61                          02245126    ADVAIR (EDS)              GSK 1183800 E 
42                          25UG/250UG INHALER AEROSOL (PACKAGE)                
61                          02245127    ADVAIR (EDS)              GSK 1680500 E 
42                         *50UG/100UG POWDER FOR INHALATION (PACKAGE)          
61                          02494507    PMS-FLUTIC/SALMETER (EDS) PMS 0424050 E 
61                          02495597    WIXELA INHUB (EDS)        MYL 0424050 E 
61                          02240835    ADVAIR DISKUS (EDS)       GSK 0988800 E 
42                         *50UG/250UG POWDER FOR INHALATION (PACKAGE)          
61                          02494515    PMS-FLUTIC/SALMETER (EDS) PMS 0507600 E 
61                          02495600    WIXELA INHUB (EDS)        MYL 0507600 E 
61                          02240836    ADVAIR DISKUS (EDS)       GSK 1183800 E 
42                         *50UG/500UG POWDER FOR INHALATION (PACKAGE)          
61                          02494523    PMS-FLUTIC/SALMETER (EDS) PMS 0720600 E 
61                          02495619    WIXELA INHUB (EDS)        MYL 0720600 E 
61                          02240837    ADVAIR DISKUS (EDS)       GSK 1680500 E 
41                          TERBUTALINE SO4                                     
42                          0.5MG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           00786616    BRICANYL TURBUHALER       AST 0115400 F 
41                          VILANTEROL/FLUTICASONE FUROATE                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25UG/100UG POWDER FOR INHALATION (PKG)              
61                          02408872    BREO ELLIPTA (EDS)        GSK 0982500 E 
42                          25UG/200UG POWDER FOR INHALATION (PKG)              
61                          02444186    BREO ELLIPTA (EDS)        GSK 1538800 E 
2         SYMPATHOLYTIC DRUGS                                                   
41                          ALMOTRIPTAN MALATE                                  
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 6 DOSES         
53                          PER 30 DAYS WITHIN A 60 DAY PERIOD.                 
54                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          6.25MG TABLET                                       
61                          02398435    MYLAN-ALMOTRIPTAN (EDS)   MYL 0070434 E 
42                         *12.5MG TABLET                                       
61                          02398443    MYLAN-ALMOTRIPTAN (EDS)   MYL 0023478 E 
61                          02405334    SANDOZ ALMOTRIPTAN (EDS)  SDZ 0023478 E 
61                          02434849    TEVA-ALMOTRIPTAN (EDS)    TEV 0023478 E 
61                          02466821    ALMOTRIPTAN (EDS)         SAN 0023478 E 
41                          DIHYDROERGOTAMINE MESYLATE                          
42                          1MG/ML INJECTION SOLUTION (1ML)                     
6                           00027243    DIHYDROERGOTAMINE         STE 0165000 F 
42                          4MG/ML NASAL SPRAY                                  
6                           02228947    MIGRANAL                  STE 0190000 F 
41                          FLUNARIZINE HCL                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG CAPSULE                                         
61                          02246082    FLUNARIZINE (EDS)         AAP 0009619 E 
41                          NARATRIPTAN HCL                                     
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 6 DOSES         
53                          PER 30 DAYS WITHIN A 60 DAY PERIOD.                 
54                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG TABLET                                          
61                          02314290    TEVA-NARATRIPTAN (EDS)    TEV 0137210 E 
42                         *2.5MG TABLET                                        
61                          02314304    TEVA-NARATRIPTAN (EDS)    TEV 0061436 E 
61                          02322323    SANDOZ NARATRIPTAN (EDS)  SDZ 0061436 E 
41                          PIZOTYLINE HYDROGEN MALATE                          
42                          1MG TABLET                                          
6                           00511552    SANDOMIGRAN DS            KTI 0008301 F 
41                          RIZATRIPTAN BENZOATE                                
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 6 DOSES         
53                          PER 30 DAYS WITHIN A 60 DAY PERIOD.                 
54                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02393468    APO-RIZATRIPTAN (EDS)     APX 0074100 E 
61                          02429233    JAMP-RIZATRIPTAN IR (EDS) JPC 0074100 E 
42                         *10MG TABLET                                         
61                          02379678    MAR-RIZATRIPTAN (EDS)     MPI 0037050 E 
61                          02380463    JAMP-RIZATRIPTAN (EDS)    JPC 0037050 E 
61                          02381702    ACT RIZATRIPTAN (EDS)     TEV 0037050 E 
61                          02393476    APO-RIZATRIPTAN (EDS)     APX 0037050 E 
61                          02428520    VAN-RIZATRIPTAN (EDS)     VAN 0037050 E 
61                          02429241    JAMP-RIZATRIPTAN IR (EDS) JPC 0037050 E 
61                          02441144    AURO-RIZATRIPTAN (EDS)    API 0037050 E 
61                          02516756    RIZATRIPTAN (EDS)         SAN 0037050 E 
61                          02240521    MAXALT (EDS)              ORG 0213437 E 
42                         *5MG ORALLY DISINTEGRATING TABLET                    
61                          02351870    SANDOZ RIZATRIPTAN ODT(ED SDZ 0037050 E 
61                          02379198    MYLAN-RIZATRIPTAN ODT(EDS MYL 0037050 E 
61                          02393360    PMS-RIZATRIPTAN RDT(EDS)  PMS 0037050 E 
61                          02396661    TEVA-RIZATRIPTAN ODT (EDS TEV 0037050 E 
61                          02436604    NAT-RIZATRIPTAN ODT (EDS) NPI 0037050 E 
61                          02439573    MINT-RIZATRIPTAN ODT (EDS MNT 0037050 E 
61                          02442906    RIZATRIPTAN ODT (EDS)     SAN 0037050 E 
61                          02446111    RIZATRIPTAN ODT (EDS)     SIV 0037050 E 
61                          02458764    CCP-RIZATRIPTAN (EDS)     CCP 0037050 E 
61                          02462788    MAR-RIZATRIPTAN ODT (EDS) MPI 0037050 E 
61                          02465086    JAMP-RIZATRIPTAN ODT (EDS JPC 0037050 E 
61                          02483270    ACCEL-RIZATRIPTAN ODT(EDS ACC 0037050 E 
61                          02240518    MAXALT RPD (EDS)          ORG 0213437 E 
42                         *10MG ORALLY DISINTEGRATING TABLET                   
61                          02351889    SANDOZ RIZATRIPTAN ODT(ED SDZ 0037050 E 
61                          02379201    MYLAN-RIZATRIPTAN ODT(EDS MYL 0037050 E 
61                          02393379    PMS-RIZATRIPTAN RDT(EDS)  PMS 0037050 E 
61                          02396688    TEVA-RIZATRIPTAN ODT (EDS TEV 0037050 E 
61                          02436612    NAT-RIZATRIPTAN ODT (EDS) NPI 0037050 E 
61                          02439581    MINT-RIZATRIPTAN ODT (EDS MNT 0037050 E 
61                          02442914    RIZATRIPTAN ODT (EDS)     SAN 0037050 E 
61                          02446138    RIZATRIPTAN ODT (EDS)     SIV 0037050 E 
61                          02448505    VAN-RIZATRIPTAN ODT (EDS) VAN 0037050 E 
61                          02458772    CCP-RIZATRIPTAN (EDS)     CCP 0037050 E 
61                          02462796    MAR-RIZATRIPTAN ODT (EDS) MPI 0037050 E 
61                          02465094    JAMP-RIZATRIPTAN ODT (EDS JPC 0037050 E 
61                          02483289    ACCEL-RIZATRIPTAN ODT(EDS ACC 0037050 E 
61                          02489384    NRA-RIZATRIPTAN ODT (EDS) NRA 0037050 E 
61                          02492490    AG-RIZATRIPTAN ODT (EDS)  ANG 0037050 E 
61                          02240519    MAXALT RPD (EDS)          ORG 0213437 E 
41                          SUMATRIPTAN                                         
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 6 DOSES         
53                          PER 30 DAYS WITHIN A 60 DAY PERIOD.                 
54                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *25MG TABLET                                         
61                          02256428    PMS-SUMATRIPTAN (EDS)     PMS 0062930 E 
61                          02268906    MYLAN-SUMATRIPTAN (EDS)   MYL 0062930 E 
61                          02286815    TEVA-SUMATRIPTAN DF (EDS) TEV 0062930 E 
61                          02545292    JAMP SUMATRIPTAN DF (EDS) JPC 0062930 E 
61                          02545349    JAMP SUMATRIPTAN (EDS)    JPC 0062930 E 
42                         *50MG TABLET                                         
61                          02256436    PMS-SUMATRIPTAN (EDS)     PMS 0027732 E 
61                          02268388    APO-SUMATRIPTAN (EDS)     APX 0027732 E 
61                          02268914    MYLAN-SUMATRIPTAN (EDS)   MYL 0027732 E 
61                          02286521    SUMATRIPTAN (EDS)         SAN 0027732 E 
61                          02286823    TEVA-SUMATRIPTAN DF (EDS) TEV 0027732 E 
61                          02385570    SUMATRIPTAN DF (EDS)      SIV 0027732 E 
61                          02545306    JAMP SUMATRIPTAN DF (EDS) JPC 0027732 E 
61                          02545357    JAMP SUMATRIPTAN (EDS)    JPC 0027732 E 
61                          02546035    SUMATRIPTAN (EDS)         SIV 0027732 E 
42                         *100MG TABLET                                        
61                          02239367    TEVA-SUMATRIPTAN (EDS)    TEV 0030549 E 
61                          02256444    PMS-SUMATRIPTAN (EDS)     PMS 0030549 E 
61                          02268396    APO-SUMATRIPTAN (EDS)     APX 0030549 E 
61                          02268922    MYLAN-SUMATRIPTAN (EDS)   MYL 0030549 E 
61                          02286548    SUMATRIPTAN (EDS)         SAN 0030549 E 
61                          02286831    TEVA-SUMATRIPTAN DF (EDS) TEV 0030549 E 
61                          02385589    SUMATRIPTAN DF (EDS)      SIV 0030549 E 
61                          02545314    JAMP SUMATRIPTAN DF (EDS) JPC 0030549 E 
61                          02545365    JAMP SUMATRIPTAN (EDS)    JPC 0030549 E 
61                          02546043    SUMATRIPTAN (EDS)         SIV 0030549 E 
61                          02212161    IMITREX DF (EDS)          GSK 0202867 E 
42                         *6MG/0.5ML INJECTION SOLUTION                        
61                          02361698    SUMATRIPTAN SUN INJ (EDS) TAR 0405834 E 
61                          02212188    IMITREX (EDS)             GSK 0548000 E 
42                          5MG NASAL SPRAY                                     
61                          02230418    IMITREX (EDS)             GSK 0181500 E 
42                          20MG NASAL SPRAY                                    
61                          02230420    IMITREX (EDS)             GSK 0186750 E 
41                          ZOLMITRIPTAN                                        
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 6 DOSES         
53                          PER 30 DAYS WITHIN A 60 DAY PERIOD.                 
54                          SEE APPENDIX A FOR EDS CRITERIA.                    
42                         *2.5MG TABLET                                        
61                          02313960    TEVA-ZOLMITRIPTAN (EDS)   TEV 0035375 E 
61                          02362988    SANDOZ ZOLMITRIPTAN (EDS) SDZ 0035375 E 
61                          02380951    APO-ZOLMITRIPTAN (EDS)    APX 0035375 E 
61                          02399458    MAR-ZOLMITRIPTAN (EDS)    MPI 0035375 E 
61                          02419521    MINT-ZOLMITRIPTAN (EDS)   MNT 0035375 E 
61                          02421534    NAT-ZOLMITRIPTAN (EDS)    NPI 0035375 E 
61                          02421623    JAMP-ZOLMITRIPTAN (EDS)   JPC 0035375 E 
61                          02442655    ZOLMITRIPTAN (EDS)        SAN 0035375 E 
61                          02458780    CCP-ZOLMITRIPTAN (EDS)    CCP 0035375 E 
61                          02477106    JAMP ZOLMITRIPTAN (EDS)   JPC 0035375 E 
61                          02481030    AURO-ZOLMITRIPTAN (EDS)   API 0035375 E 
61                          02489392    NRA-ZOLMITRIPTAN (EDS)    NRA 0035375 E 
61                          02238660    ZOMIG (EDS)               XED 0177367 E 
42                         *2.5MG ORALLY DISPERSIBLE TABLET                     
61                          02342545    TEVA-ZOLMITRIPTAN OD(EDS) TEV 0035375 E 
61                          02362996    SDZ ZOLMITRIPTAN ODT (EDS SDZ 0035375 E 
61                          02419513    MINT-ZOLMITRIPTAN ODT(EDS MNT 0035375 E 
61                          02428237    JAMP-ZOLMITRIPTAN ODT (ED JPC 0035375 E 
61                          02442671    ZOLMITRIPTAN ODT (EDS)    SAN 0035375 E 
61                          02243045    ZOMIG RAPIMELT (EDS)      XED 0177367 E 
42                          5MG NASAL SPRAY                                     
61                          02248993    ZOMIG (EDS)               XED 0177367 E 
2         SKELETAL MUSCLE RELAXANTS                                             
41                          BACLOFEN                                            
42                         *10MG TABLET                                         
6                           02063735    PMS-BACLOFEN              PMS 0001595 F 
6                           02088398    MYLAN-BACLOFEN            MYL 0001595 F 
6                           02139332    APO-BACLOFEN              APX 0001595 F 
6                           02287021    BACLOFEN                  SAN 0001595 F 
6                           02544482    JAMP BACLOFEN             JPC 0001595 F 
6                           02544660    BACLOFEN                  SIV 0001595 F 
42                         *20MG TABLET                                         
6                           02063743    PMS-BACLOFEN              PMS 0003104 F 
6                           02088401    MYLAN-BACLOFEN            MYL 0003104 F 
6                           02139391    APO-BACLOFEN              APX 0003104 F 
6                           02287048    BACLOFEN                  SAN 0003104 F 
6                           02544490    JAMP BACLOFEN             JPC 0003104 F 
6                           02544679    BACLOFEN                  SIV 0003104 F 
42                         *0.05MG/ML INJECTION (1ML)                           
61                          02413620    BACLOFEN INJECTION (EDS)  STE 0075160 E 
61                          02457059    BACLOFEN INJECTION (EDS)  TEL 0075160 E 
42                         *0.5MG/ML INJECTION (20ML)                           
61                          02413639    BACLOFEN INJECTION (EDS)  STE 0788580 E 
61                          02457067    BACLOFEN INJECTION (EDS)  TEL 0788580 E 
61                          02485508    BACLOFEN INTRATHECAL(EDS) AVR 0788580 E 
42                         *2MG/ML INJECTION (5ML)                              
61                          02413647    BACLOFEN INJECTION (EDS)  STE 0788670 E 
61                          02457075    BACLOFEN INJECTION (EDS)  TEL 0788670 E 
61                          02485516    BACLOFEN INTRATHECAL (EDS AVR 0788670 E 
61                          02553341    BACLOFEN INJECTION (EDS)  JPC 0788670 E 
41                          CYCLOBENZAPRINE HCL                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG TABLET                                         
61                          02080052    TEVA-CYCLOBENZAPRINE(EDS) TEV 0001022 E 
61                          02177145    APO-CYCLOBENZAPRINE (EDS) APX 0001022 E 
61                          02212048    PMS-CYCLOBENZAPRINE (EDS) PMS 0001022 E 
61                          02287064    CYCLOBENZAPRINE (EDS)     SAN 0001022 E 
61                          02348853    AURO-CYCLOBENZAPRINE (EDS API 0001022 E 
61                          02357127    JAMP-CYCLOBENZAPRINE(EDS) JPC 0001022 E 
61                          02424584    CYCLOBENZAPRINE (EDS)     SIV 0001022 E 
61                          02485419    AG-CYCLOBENZAPRINE (EDS)  ANG 0001022 E 
61                          02495422    FLEXERIL (EDS)            ORI 0001022 E 
41                          DANTROLENE SODIUM                                   
42                          25MG CAPSULE                                        
6                           01997602    DANTRIUM                  KTI 0005011 F 
41                          TIZANIDINE HCL                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *4MG TABLET                                          
61                          02259893    APO-TIZANIDINE (EDS)      APX 0003931 E 
61                          02536765    MINT-TIZANIDINE (EDS)     MNT 0003931 E 
2         MISCELLANEOUS AUTONOMIC DRUGS                                         
41                          VARENICLINE TARTRATE                                
51                          THE MAXIMUM QUANTITY THAT CAN BE CLAIMED            
52                          THROUGH THE DRUG PLAN IS LIMITED TO 12 WEEKS/       
53                          PATIENT/365 DAYS.                                   
42                         *0.5MG/1.0MG TABLET                                  
6                           02435675    APO-VARENICLINE KIT       APX 0004601 F 
6                           02542986    NRA-VARENICLINE           NRA 0004601 F 
6                           02546965    MINT-VARENICLINE          MNT 0004601 F 
42                         *0.5MG TABLET                                        
6                           02419882    APO-VARENICLINE           APX 0004618 F 
6                           02426226    TEVA-VARENICLINE          TEV 0004618 F 
6                           02542951    NRA-VARENICLINE           NRA 0004618 F 
6                           02546949    MINT-VARENICLINE          MNT 0004618 F 
6                           02554445    AURO-VARENICLINE          API 0004618 F 
6                           02559897    ZDS-VARENICLINE           ZDS 0004618 F 
42                         *1.0MG TABLET                                        
6                           02419890    APO-VARENICLINE           APX 0004618 F 
6                           02426234    TEVA-VARENICLINE          TEV 0004618 F 
6                           02542978    NRA-VARENICLINE           NRA 0004618 F 
6                           02546957    MINT-VARENICLINE          MNT 0004618 F 
6                           02554453    AURO-VARENICLINE          API 0004618 F 
6                           02559900    ZDS-VARENICLINE           ZDS 0004618 F 
1         HEMOPOIESIS AND COAGULATION                                           
2         IRON PREPARATIONS                                                     
41                          IRON FERRIC DERISOMALTOSE                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          100MG/ML ELEMENTAL IRON INJECTION (ML)              
61                          02477777    MONOFERRIC (EDS)          PFI 0450000 E 
41                          IRON SODIUM FERRIC GLUCONATE                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          12.5MG/ML INJECTION SOLUTION                        
61                          02243333    FERRLECIT (EDS)           AVT 0288940 E 
41                          IRON SUCROSE                                        
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *20MG/ML INJECTION (ML)                              
61                          02243716    VENOFER (EDS)             ARI 0055000 E 
61                          02502917    PMS-IRON SUCROSE (EDS)    PMS 0055000 E 
2         ANTICOAGULANTS                                                        
41                          APIXABAN                                            
42                         *2.5MG TABLET                                        
6                           02484994    TEVA-APIXABAN             TEV 0004084 F 
6                           02486806    AURO-APIXABAN             API 0004084 F 
6                           02487381    APO-APIXABAN              APX 0004084 F 
6                           02487519    SANDOZ APIXABAN TABLET    SDZ 0004084 F 
6                           02487713    ACH-APIXABAN              AHI 0004084 F 
6                           02489228    SANDOZ APIXABAN SDZ       SDZ 0004084 F 
6                           02492369    MAR-APIXABAN              MPI 0004084 F 
6                           02492814    NAT-APIXABAN              NPI 0004084 F 
6                           02495430    MINT-APIXABAN             MNT 0004084 F 
6                           02510464    TARO-APIXABAN             SUN 0004084 F 
6                           02528924    JAMP APIXABAN             JPC 0004084 F 
6                           02529009    M-APIXABAN                MNP 0004084 F 
6                           02530708    APIXABAN                  SIV 0004084 F 
6                           02546884    NRA-APIXABAN              NRA 0004084 F 
6                           02548879    APIXABAN                  SAN 0004084 F 
6                           02377233    ELIQUIS                   BMY 0016337 F 
42                         *5MG TABLET                                          
6                           02485001    TEVA-APIXABAN             TEV 0004084 F 
6                           02486814    AURO-APIXABAN             API 0004084 F 
6                           02487403    APO-APIXABAN              APX 0004084 F 
6                           02487527    SANDOZ APIXABAN TABLET    SDZ 0004084 F 
6                           02487721    ACH-APIXABAN              AHI 0004084 F 
6                           02489236    SANDOZ APIXABAN SDZ       SDZ 0004084 F 
6                           02492377    MAR-APIXABAN              MPI 0004084 F 
6                           02492822    NAT-APIXABAN              NPI 0004084 F 
6                           02495449    MINT-APIXABAN             MNT 0004084 F 
6                           02510472    TARO-APIXABAN             SUN 0004084 F 
6                           02528932    JAMP APIXABAN             JPC 0004084 F 
6                           02529017    M-APIXABAN                MNP 0004084 F 
6                           02530716    APIXABAN                  SIV 0004084 F 
6                           02546892    NRA-APIXABAN              NRA 0004084 F 
6                           02548887    APIXABAN                  SAN 0004084 F 
6                           02397714    ELIQUIS                   BMY 0016337 F 
41                          DABIGATRAN                                          
42                          110MG TABLET                                        
6                           02312441    PRADAXA                   BOE 0017258 F 
42                          150MG TABLET                                        
6                           02358808    PRADAXA                   BOE 0017258 F 
41                          DALTEPARIN SODIUM                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2,500IU PF SYRINGE (0.2ML)                          
61                          02132621    FRAGMIN (EDS)             PFI 0058480 E 
42                          3,500IU PF SYRINGE (0.28ML)                         
61                          02430789    FRAGMIN (EDS)             PFI 0081850 E 
42                          5,000IU PF SYRINGE(0.2ML)                           
61                          02132648    FRAGMIN (EDS)             PFI 0116950 E 
42                          7,500IU PF SYRINGE (0.3ML)                          
61                          02352648    FRAGMIN (EDS)             PFI 0175400 E 
42                          10,000IU PF SYRINGE (0.4ML)                         
61                          02352656    FRAGMIN (EDS)             PFI 0233900 E 
42                          12,500IU PF SYRINGE (0.5ML)                         
61                          02352664    FRAGMIN (EDS)             PFI 0292380 E 
42                          15,000IU PF SYRINGE (0.6ML)                         
61                          02352672    FRAGMIN (EDS)             PFI 0350860 E 
42                          16,500IU PF SYRINGE (0.66ML)                        
61                          02494582    FRAGMIN (EDS)             PFI 0385940 E 
42                          18,000IU PF SYRINGE (0.72ML)                        
61                          02352680    FRAGMIN (EDS)             PFI 0421020 E 
42                          25,000IU INJECTION SOLUTION (3.8ML)                 
61                          02231171    FRAGMIN (EDS)             PFI 1754300 E 
41                          EDOXABAN                                            
42                         *15MG TABLET                                         
6                           02553414    SANDOZ EDOXABAN           SDZ 0014697 F 
6                           02554208    TEVA-EDOXABAN             TEV 0014697 F 
6                           02458640    LIXIANA                   SEV 0029394 F 
42                         *30MG TABLET                                         
6                           02553422    SANDOZ EDOXABAN           SDZ 0007348 F 
6                           02554216    TEVA-EDOXABAN             TEV 0007348 F 
6                           02557282    JAMP EDOXABAN             JPC 0007348 F 
6                           02458659    LIXIANA                   SEV 0029394 F 
42                         *60MG TABLET                                         
6                           02553430    SANDOZ EDOXABAN           SDZ 0007348 F 
6                           02554224    TEVA-EDOXABAN             TEV 0007348 F 
6                           02557290    JAMP EDOXABAN             JPC 0007348 F 
6                           02458667    LIXIANA                   SEV 0029394 F 
41                          ENOXAPARIN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          20MG/0.2ML PRE-FILLED-SYRINGE                       
61                          02506440    NOROMBY (EDS)             JNO 0035280 E 
42                          100MG/ML VIAL (3ML)                                 
61                          02509121    REDESCA (EDS)             VAL 0496200 E 
42                         ?30MG/0.3ML PRE-FILLED SYRINGE                       
61                          02506459    NOROMBY (EDS)             JNO 0049124 E 
61                          02532247    ELONOX (EDS)              FCL 0049124 E 
61                          02539977    AXBERI (EDS)              BAX 0049124 E 
61                          02507501    INCLUNOX (EDS)            SDZ 0049620 E 
61                          02509075    REDESCA (EDS)             VAL 0049620 E 
42                         ?40MG/0.4ML PRE-FILLED SYRINGE                       
61                          02506467    NOROMBY (EDS)             JNO 0065498 E 
61                          02532255    ELONOX (EDS)              FCL 0065498 E 
61                          02539985    AXBERI (EDS)              BAX 0065498 E 
61                          02507528    INCLUNOX (EDS)            SDZ 0066160 E 
61                          02509083    REDESCA (EDS)             VAL 0066160 E 
42                         ?60MG/0.6ML PRE-FILLED SYRINGE                       
61                          02506475    NOROMBY (EDS)             JNO 0098248 E 
61                          02532263    ELONOX (EDS)              FCL 0098248 E 
61                          02540002    AXBERI (EDS)              BAX 0098248 E 
61                          02507536    INCLUNOX (EDS)            SDZ 0099240 E 
61                          02509091    REDESCA (EDS)             VAL 0099240 E 
42                         ?80MG/0.8ML PRE-FILLED SYRINGE                       
61                          02506483    NOROMBY (EDS)             JNO 0130997 E 
61                          02532271    ELONOX (EDS)              FCL 0130997 E 
61                          02540010    AXBERI (EDS)              BAX 0130997 E 
61                          02507544    INCLUNOX (EDS)            SDZ 0132320 E 
61                          02509105    REDESCA (EDS)             VAL 0132320 E 
42                         ?100MG/1.0ML PRE-FILLED SYRINGE                      
61                          02506491    NOROMBY (EDS)             JNO 0163746 E 
61                          02532298    ELONOX (EDS)              FCL 0163746 E 
61                          02540045    AXBERI (EDS)              BAX 0163746 E 
61                          02507552    INCLUNOX (EDS)            SDZ 0165400 E 
61                          02509113    REDESCA (EDS)             VAL 0165400 E 
42                         ?120MG/0.8ML PRE-FILLED-SYRINGE                      
61                          02506505    NOROMBY HP (EDS)          JNO 0196495 E 
61                          02532301    ELONOX (EDS)              FCL 0196495 E 
61                          02540029    AXBERI HP (EDS)           BAX 0196495 E 
61                          02507560    INCLUNOX HP (EDS)         SDZ 0198480 E 
61                          02509148    REDESCA HP (EDS)          VAL 0198480 E 
42                         ?150MG/ML PRE-FILLED-SYRINGE                         
61                          02506513    NOROMBY HP (EDS)          JNO 0245619 E 
61                          02532328    ELONOX (EDS)              FCL 0245619 E 
61                          02540037    AXBERI HP (EDS)           BAX 0245619 E 
61                          02507579    INCLUNOX HP (EDS)         SDZ 0248100 E 
61                          02509156    REDESCA HP (EDS)          VAL 0248100 E 
41                          HEPARIN                                             
42                          10,000 USP U/ML INJECTION SOLUTION (ML)             
6                           02382326    HEPARIN SODIUM INJECTION  PFI 0053476 F 
41                          NADROPARIN CALCIUM                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          9,500IU/ML SYRINGE 0.3ML                            
61                          02236913    FRAXIPARINE (EDS)         ASC 0054200 E 
42                          9,500IU/ML SYRINGE 0.4ML                            
61                          02450623    FRAXIPARINE (EDS)         ASC 0068400 E 
42                          9,500IU/ML SYRINGE 0.6ML                            
61                          02450631    FRAXIPARINE (EDS)         ASC 0090600 E 
42                          9,500IU/ML SYRINGE 1ML                              
61                          02450658    FRAXIPARINE (EDS)         ASC 0090600 E 
42                          19,000IU/ML SYRINGE 0.6ML                           
61                          02450674    FRAXIPARINE FORTE (EDS)   ASC 0181200 E 
42                          19,000IU/ML SYRINGE 0.8ML                           
61                          02450666    FRAXIPARINE FORTE (EDS)   ASC 0181200 E 
42                          19,000IU/ML SYRINGE 1ML                             
61                          02240114    FRAXIPARINE FORTE (EDS)   ASC 0181200 E 
41                          RIVAROXABAN                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *2.5MG TABLET                                        
61                          02480808    XARELTO (EDS)             BAY 0003550 E 
61                          02524503    REDDY-RIVAROXABAN (EDS)   DLC 0003550 E 
61                          02526786    TARO-RIVAROXABAN (EDS)    TAR 0003550 E 
61                          02527537    PMS-RIVAROXABAN (EDS)     PMS 0003550 E 
61                          02537877    SANDOZ-RIVAROXABAN (EDS)  SDZ 0003550 E 
61                          02541467    RIVAROXABAN (EDS)         SIV 0003550 E 
61                          02541734    APO-RIVAROXABAN (EDS)     APX 0003550 E 
61                          02547295    TEVA-RIVAROXABAN (EDS)    TEV 0003550 E 
61                          02547899    RIVAROXABAN (EDS)         SAN 0003550 E 
61                          02551608    M-RIVAROXABAN (EDS)       MNP 0003550 E 
61                          02553368    JAMP-RIVAROXABAN (EDS)    JPC 0003550 E 
42                         *10MG TABLET                                         
61                          02470497    APO-RIVAROXABAN (EDS)     APX 0007175 E 
61                          02472414    REDDY-RIVAROXABAN (EDS)   DLC 0007175 E 
61                          02482223    SANDOZ RIVAROXABAN (EDS)  SDZ 0007175 E 
61                          02483807    TARO-RIVAROXABAN (EDS)    TAR 0007175 E 
61                          02507196    TEVA-RIVAROXABAN (EDS)    TEV 0007175 E 
61                          02512041    PMS-RIVAROXABAN (EDS)     PMS 0007175 E 
61                          02516292    JAMP RIVAROXABAN (EDS)    JPC 0007175 E 
61                          02541475    RIVAROXABAN (EDS)         SIV 0007175 E 
61                          02547902    RIVAROXABAN (EDS)         SAN 0007175 E 
61                          02551616    M-RIVAROXABAN (EDS)       MNP 0007175 E 
61                          02560356    AURO-RIVAROXABAN (EDS)    API 0007125 E 
61                          02316986    XARELTO (EDS)             BAY 0007175 E 
42                         *15MG TABLET                                         
6                           02378604    XARELTO                   BAY 0007175 F 
6                           02470500    APO-RIVAROXABAN           APX 0007175 F 
6                           02472430    REDDY-RIVAROXABAN         DLC 0007175 F 
6                           02482231    SANDOZ RIVAROXABAN        SDZ 0007175 F 
6                           02483815    TARO-RIVAROXABAN          TAR 0007175 F 
6                           02507218    TEVA-RIVAROXABAN          TEV 0007175 F 
6                           02512068    PMS-RIVAROXABAN           PMS 0007175 F 
6                           02516306    JAMP RIVAROXABAN          JPC 0007175 F 
6                           02541483    RIVAROXABAN               SIV 0007175 F 
6                           02547910    RIVAROXABAN               SAN 0007175 F 
6                           02551624    M-RIVAROXABAN             MNP 0007175 F 
6                           02560364    AURO-RIVAROXABAN          API 0007175 F 
42                         *20MG TABLET                                         
6                           02378612    XARELTO                   BAY 0007175 F 
6                           02470519    APO-RIVAROXABAN           APX 0007175 F 
6                           02472422    REDDY-RIVAROXABAN         DLC 0007175 F 
6                           02482258    SANDOZ RIVAROXABAN        SDZ 0007175 F 
6                           02483823    TARO-RIVAROXABAN          TAR 0007175 F 
6                           02507226    TEVA-RIVAROXABAN          TEV 0007175 F 
6                           02512076    PMS-RIVAROXABAN           PMS 0007175 F 
6                           02516314    JAMP RIVAROXABAN          JPC 0007175 F 
6                           02541491    RIVAROXABAN               SIV 0007175 F 
6                           02547929    RIVAROXABAN               SAN 0007175 F 
6                           02551632    M-RIVAROXABAN             MNP 0007175 F 
42                          51.7MG GRANULES FOR SUSPENSION                      
61                          02510162    XARELTO (EDS)             BAY 0073400 E 
42                          103.4MG GRANULES FOR SUSPENSION                     
61                          02510170    XARELTO (EDS)             BAY 0146800 E 
41                          TINZAPARIN SODIUM                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10,000IU/ML INJECTION SOLUTION (2ML)                
61                          02167840    INNOHEP (EDS)             LEO 0531190 E 
42                          10,000IU/ML SYRINGE (0.25ML)                        
61                          02229755    INNOHEP (EDS)             LEO 0070370 E 
42                          10,000IU/ML SYRINGE (0.35ML)                        
61                          02358158    INNOHEP (EDS)             LEO 0098390 E 
42                          10,000IU/ML SYRINGE (0.45ML)                        
61                          02358166    INNOHEP (EDS)             LEO 0126550 E 
42                          20,000IU/ML INJECTION SOLUTION (2ML)                
61                          02229515    INNOHEP (EDS)             LEO 1133010 E 
42                          20,000IU/ML SYRINGE (0.4ML)                         
61                          02429462    INNOHEP (EDS)             LEO 0218860 E 
42                          20,000IU/ML SYRINGE (0.5ML)                         
61                          02231478    INNOHEP (EDS)             LEO 0286980 E 
42                          20,000IU/ML SYRINGE (0.6ML)                         
61                          02429470    INNOHEP (EDS)             LEO 0344700 E 
42                          20,000IU/ML SYRINGE (0.7ML)                         
61                          02358174    INNOHEP (EDS)             LEO 0402160 E 
42                          20,000IU/ML SYRINGE (0.8ML)                         
61                          02429489    INNOHEP (EDS)             LEO 0459610 E 
42                          20,000IU/ML SYRINGE (0.9ML)                         
61                          02358182    INNOHEP (EDS)             LEO 0517000 E 
41                          WARFARIN                                            
42                         *1MG TABLET                                          
6                           02242680    TARO-WARFARIN             TAR 0000781 F 
6                           02242924    APO-WARFARIN              APX 0000781 F 
42                         *2MG TABLET                                          
6                           02242681    TARO-WARFARIN             TAR 0000841 F 
6                           02242925    APO-WARFARIN              APX 0000841 F 
42                         *2.5MG TABLET                                        
6                           02242682    TARO-WARFARIN             TAR 0000674 F 
6                           02242926    APO-WARFARIN              APX 0000674 F 
42                         *3MG TABLET                                          
6                           02242683    TARO-WARFARIN             TAR 0001043 F 
6                           02245618    APO-WARFARIN              APX 0001043 F 
42                         *4MG TABLET                                          
6                           02242684    TARO-WARFARIN             TAR 0001043 F 
6                           02242927    APO-WARFARIN              APX 0001043 F 
42                         *5MG TABLET                                          
6                           02242685    TARO-WARFARIN             TAR 0000675 F 
6                           02242928    APO-WARFARIN              APX 0000675 F 
42                         *10MG TABLET                                         
6                           02242687    TARO-WARFARIN             TAR 0001211 F 
6                           02242929    APO-WARFARIN              APX 0001211 F 
2         HEMATOPOIETIC DRUGS                                                   
41                          DARBEPOETIN ALFA                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MCG/0.4ML PRE-FILLED SYRINGE                      
61                          02392313    ARANESP (EDS)             AMG 0305500 E 
42                          20MCG/0.5ML PRE-FILLED SYRINGE                      
61                          02392321    ARANESP (EDS)             AMG 0611000 E 
42                          30MCG/0.3ML PRE-FILLED SYRINGE                      
61                          02392348    ARANESP (EDS)             AMG 0916600 E 
42                          40MCG/0.4ML PRE-FILLED SYRINGE                      
61                          02391740    ARANESP (EDS)             AMG 1222100 E 
42                          50MCG/0.5ML PRE-FILLED SYRINGE                      
61                          02391759    ARANESP (EDS)             AMG 1527600 E 
42                          60MCG/0.3ML PRE-FILLED SYRINGE                      
61                          02392356    ARANESP (EDS)             AMG 1833200 E 
42                          80MCG/0.4ML PRE-FILLED SYRINGE                      
61                          02391767    ARANESP (EDS)             AMG 2444300 E 
42                          100MCG/0.5ML PRE-FILLED SYRINGE                     
61                          02391775    ARANESP (EDS)             AMG 3055400 E 
42                          130MCG/0.65ML PRE-FILLED SYRINGE                    
61                          02391783    ARANESP (EDS)             AMG 3972000 E 
42                          150MCG/0.3ML PRE-FILLED SYRINGE                     
61                          02391791    ARANESP (EDS)             AMG 4560400 E 
42                          200MCG/0.4ML PRE-FILLED SYRINGE                     
61                          02391805    ARANESP (EDS)             AMG 6875900 E 
41                          ELTROMBOPAG OLAMINE                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *25MG TABLET                                         
61                          02506742    APO-ELTROMBOPAG (EDS)     APX 0487500 E 
61                          02361825    REVOLADE (EDS)            NVR 0650000 E 
42                         *50MG TABLET                                         
61                          02506769    APO-ELTROMBOPAG (EDS)     APX 0975000 E 
61                          02361833    REVOLADE (EDS)            NVR 1300000 E 
41                          EPOETIN ALFA                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1000IU/0.5ML PRE-FILLED SYRINGE                     
61                          02231583    EPREX (EDS)               JAN 0142500 E 
42                          2000IU/0.5ML PRE-FILLED SYRINGE                     
61                          02231584    EPREX (EDS)               JAN 0285000 E 
42                          3000IU/0.3ML PRE-FILLED SYRINGE                     
61                          02231585    EPREX (EDS)               JAN 0427500 E 
42                          4000IU/0.4ML PRE-FILLED SYRINGE                     
61                          02231586    EPREX (EDS)               JAN 0570000 E 
42                          5000IU/0.5ML PRE-FILLED SYRINGE                     
61                          02243400    EPREX (EDS)               JAN 0712500 E 
42                          6000IU/0.6ML PRE-FILLED SYRINGE                     
61                          02243401    EPREX (EDS)               JAN 0855000 E 
42                          8000IU/0.8ML PRE-FILLED SYRINGE                     
61                          02243403    EPREX (EDS)               JAN 1140000 E 
42                          10000IU/ML PRE-FILLED SYRINGE                       
61                          02231587    EPREX (EDS)               JAN 1425000 E 
42                          20000IU/0.5ML PRE-FILLED SYRINGE                    
61                          02243239    EPREX (EDS)               JAN 3250900 E 
42                          30000IU/0.75ML PRE-FILLED SYRINGE                   
61                          02288680    EPREX (EDS)               JAN 3608300 E 
42                          40000IU/ML PRE-FILLED SYRINGE                       
61                          02240722    EPREX (EDS)               JAN 4867900 E 
41                          FILGRASTIM                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?300UG/0.5ML PRE-FILLED SYRINGE                      
61                          02441489    GRASTOFIL (EDS)           ABO 1056798 E 
61                          02485575    NIVESTYM (EDS)            PFI 1056798 E 
61                          02520990    NYPOZI (EDS)              TVX 1056798 E 
42                          300UG/1ML VIAL                                      
61                          02485591    NIVESTYM (EDS)            PFI 1056798 E 
42                         ?480UG/0.8ML PRE-FILLED SYRINGE                      
61                          02454548    GRASTOFIL (EDS)           ABO 1690872 E 
61                          02485583    NIVESTYM (EDS)            PFI 1690872 E 
61                          02521008    NYPOZI (EDS)              TVX 1690872 E 
42                          480UG/1.6ML VIAL                                    
61                          02485656    NIVESTYM (EDS)            PFI 1690872 E 
41                          LUSPATERCEPT                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25MG/VIAL POWDER FOR SOLUTION (MG)                  
61                          02505541    REBLOZYL (EDS)            BMY 0875600 E 
42                          75MG/VIAL POWDER FOR SOLUTION (MG)                  
61                          02505568    REBLOZYL (EDS)            BMY 0875600 E 
41                          ROMIPLOSTIM                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MICROGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          250UG/0.5ML SOLUTION FOR INJECTION                  
61                          02322854    NPLATE (EDS)              AMG 0041400 E 
42                          500UG/ML SOLUTION FOR INJECTION                     
61                          02322862    NPLATE (EDS)              AMG 0041400 E 
2         HEMORRHEOLOGIC DRUGS                                                  
41                          CLOPIDOGREL BISULFATE                               
42                         *75MG TABLET                                         
6                           02252767    APO-CLOPIDOGREL           APX 0002631 F 
6                           02293161    TEVA-CLOPIDOGREL          TEV 0002631 F 
6                           02348004    PMS-CLOPIDOGREL           PMS 0002631 F 
6                           02379813    RAN-CLOPIDOGREL           RAN 0002631 F 
6                           02385813    CLOPIDOGREL               SIV 0002631 F 
6                           02400553    CLOPIDOGREL               SAN 0002631 F 
6                           02408910    MINT-CLOPIDOGREL          MNT 0002631 F 
6                           02415550    JAMP-CLOPIDOGREL          JPC 0002631 F 
6                           02416387    AURO-CLOPIDOGREL          API 0002631 F 
6                           02422255    MAR-CLOPIDOGREL           MPI 0002631 F 
6                           02482037    NRA-CLOPIDOGREL           NRA 0002631 F 
6                           02502283    M-CLOPIDOGREL             MNP 0002631 F 
6                           02238682    PLAVIX                    AVT 0028771 F 
41                          PENTOXIFYLLINE                                      
42                         *400MG SUSTAINED RELEASE TABLET                      
6                           02230090    APO-PENTOXIFYLLINE SR     APX 0007238 F 
6                           02543087    JAMP PENTOXIFYLLINE       JPC 0007238 F 
41                          TICAGRELOR                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *60MG TABLET                                         
61                          02482622    APO-TICAGRELOR (EDS)      APX 0003778 E 
61                          02492571    TARO-TICAGRELOR (EDS)     TAR 0003778 E 
61                          02529750    M-TICAGRELOR (EDS)        MNP 0003778 E 
61                          02531798    JAMP TICAGRELOR (EDS)     JPC 0003778 E 
61                          02455005    BRILINTA (EDS)            AST 0017348 E 
42                         *90MG TABLET                                         
61                          02482630    APO-TICAGRELOR (EDS)      APX 0003960 E 
61                          02492598    TARO-TICAGRELOR (EDS)     TAR 0003960 E 
61                          02529769    M-TICAGRELOR (EDS)        MNP 0003960 E 
61                          02531801    JAMP TICAGRELOR (EDS)     JPC 0003960 E 
61                          02368544    BRILINTA (EDS)            AST 0018187 E 
41                          TICLOPIDINE HCL                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          250MG TABLET                                        
61                          02237701    TICLOPIDINE (EDS)         AAP 0010679 E 
2         HEMOSTATIC DRUGS                                                      
41                          TRANEXAMIC ACID                                     
42                         *500MG TABLET                                        
6                           02401231    TRANEXAMIC ACID TABLETS   STE 0002967 F 
6                           02409097    GD-TRANEXAMIC ACID        GDI 0002967 F 
6                           02496232    MAR-TRANEXAMIC ACID       MPI 0002967 F 
6                           02519194    TRANEXAMIC ACID           JPC 0002967 F 
6                           02064405    CYKLOKAPRON               PFI 0014296 F 
1         CARDIOVASCULAR SYSTEM DRUGS                                           
2         CARDIAC DRUGS                                                         
41                          ACEBUTOLOL HCL                                      
42                         *100MG TABLET                                        
6                           02147602    APO-ACEBUTOLOL            APX 0001871 F 
6                           02204517    TEVA-ACEBUTOLOL           TEV 0001871 F 
42                         *200MG TABLET                                        
6                           02147610    APO-ACEBUTOLOL            APX 0002808 F 
6                           02204525    TEVA-ACEBUTOLOL           TEV 0002808 F 
42                         *400MG TABLET                                        
6                           02147629    APO-ACEBUTOLOL            APX 0005348 F 
6                           02204533    TEVA-ACEBUTOLOL           TEV 0005348 F 
41                          AMIODARONE                                          
42                          100MG TABLET                                        
6                           02292173    PMS-AMIODARONE            PMS 0008593 F 
42                         *200MG TABLET                                        
6                           02239835    TEVA-AMIODARONE           TEV 0003706 F 
6                           02242472    PMS-AMIODARONE            PMS 0003706 F 
6                           02243836    SANDOZ AMIODARONE         SDZ 0003706 F 
6                           02246194    APO-AMIODARONE            APX 0003706 F 
6                           02364336    AMIODARONE                SAN 0003706 F 
6                           02385465    AMIODARONE                SIV 0003706 F 
6                           02531844    JAMP AMIODARONE           JPC 0003706 F 
41                          AMLODIPINE BESYLATE                                 
42                          1MG/ML ORAL SOLUTION (ML)                           
6                           02484706    PDP-AMLODIPINE            PED 0012807 F 
42                         *5MG TABLET                                          
6                           02272113    MYLAN-AMLODIPINE          MYL 0001343 F 
6                           02273373    APO-AMLODIPINE            APX 0001343 F 
6                           02284065    PMS-AMLODIPINE            PMS 0001343 F 
6                           02284383    SANDOZ AMLODIPINE         SDZ 0001343 F 
6                           02297485    ACT AMLODIPINE            TEV 0001343 F 
6                           02321858    RAN-AMLODIPINE            RAN 0001343 F 
6                           02331284    AMLODIPINE                SAN 0001343 F 
6                           02357194    JAMP-AMLODIPINE           JPC 0001343 F 
6                           02357712    SEPTA-AMLODIPINE          SPT 0001343 F 
6                           02362651    MINT-AMLODIPINE           MNT 0001343 F 
6                           02371715    MAR-AMLODIPINE            MPI 0001343 F 
6                           02385791    AMLODIPINE                SIV 0001343 F 
6                           02397072    AURO-AMLODIPINE           API 0001343 F 
6                           02419564    AMLODIPINE BESYLATE TABS  AHI 0001343 F 
6                           02429217    AMLODIPINE                JPC 0001343 F 
6                           02468026    M-AMLODIPINE              MNP 0001343 F 
6                           02476460    NRA-AMLODIPINE            NRA 0001343 F 
6                           02522519    PRZ-AMLODIPINE            PRZ 0001343 F 
6                           00878928    NORVASC                   BGP 0016790 F 
42                         *10MG TABLET                                         
6                           02272121    MYLAN-AMLODIPINE          MYL 0001993 F 
6                           02273381    APO-AMLODIPINE            APX 0001993 F 
6                           02284073    PMS-AMLODIPINE            PMS 0001993 F 
6                           02284391    SANDOZ AMLODIPINE         SDZ 0001993 F 
6                           02297493    ACT AMLODIPINE            TEV 0001993 F 
6                           02321866    RAN-AMLODIPINE            RAN 0001993 F 
6                           02331292    AMLODIPINE                SAN 0001993 F 
6                           02357208    JAMP-AMLODIPINE           JPC 0001993 F 
6                           02362678    MINT-AMLODIPINE           MNT 0001993 F 
6                           02371723    MAR-AMLODIPINE            MPI 0001993 F 
6                           02385805    AMLODIPINE                SIV 0001993 F 
6                           02397080    AURO-AMLODIPINE           API 0001993 F 
6                           02419572    AMLODIPINE BESYLATE TABS  AHI 0001993 F 
6                           02429225    AMLODIPINE                JPC 0001993 F 
6                           02468034    M-AMLODIPINE              MNP 0001993 F 
6                           02476479    NRA-AMLODIPINE            NRA 0001993 F 
6                           02522527    PRZ-AMLODIPINE            PRZ 0001993 F 
6                           00878936    NORVASC                   BGP 0024508 F 
41                          AMLODIPINE BESYLATE/ATORVASTATIN CALCIUM            
42                         *5MG/10MG TABLET                                     
6                           02362759    GD-AMLODIPINE/ATORVASTATI UJC 0011603 F 
6                           02411253    APO-AMLODIPINE-ATORVASTAT APX 0011603 F 
6                           02273233    CADUET                    BGP 0028536 F 
42                         *5MG/20MG TABLET                                     
6                           02362767    GD-AMLODIPINE/ATORVASTATI UJC 0013683 F 
6                           02411261    APO-AMLODIPINE-ATORVASTAT APX 0013683 F 
6                           02273241    CADUET                    BGP 0033651 F 
42                         *5MG/40MG TABLET                                     
6                           02362775    GD-AMLODIPINE/ATORVASTATI UJC 0007232 F 
6                           02411288    APO-AMLODIPINE-ATORVASTAT APX 0007232 F 
6                           02273268    CADUET                    BGP 0035570 F 
42                         *5MG/80MG TABLET                                     
6                           02362783    GD-AMLODIPINE/ATORVASTATI UJC 0007232 F 
6                           02411296    APO-AMLODIPINE-ATORVASTAT APX 0007232 F 
6                           02273276    CADUET                    BGP 0035570 F 
42                         *10MG/10MG TABLET                                    
6                           02362791    GD-AMLODIPINE/ATORVASTATI UJC 0012250 F 
6                           02411318    APO-AMLODIPINE-ATORVASTAT APX 0012250 F 
6                           02273284    CADUET                    BGP 0030128 F 
42                         *10MG/20MG TABLET                                    
6                           02362805    GD-AMLODIPINE/ATORVASTATI UJC 0015272 F 
6                           02411326    APO-AMLODIPINE-ATORVASTAT APX 0015272 F 
6                           02273292    CADUET                    BGP 0037560 F 
42                         *10MG/40MG TABLET                                    
6                           02362813    GD-AMLODIPINE/ATORVASTATI UJC 0008000 F 
6                           02411334    APO-AMLODIPINE-ATORVASTAT APX 0008000 F 
6                           02273306    CADUET                    BGP 0039351 F 
42                         *10MG/80MG TABLET                                    
6                           02362821    GD-AMLODIPINE/ATORVASTATI UJC 0008000 F 
6                           02411342    APO-AMLODIPINE-ATORVASTAT APX 0008000 F 
6                           02273314    CADUET                    BGP 0039351 F 
41                          ATENOLOL                                            
42                         *25MG TABLET                                         
6                           02246581    PMS-ATENOLOL              PMS 0000441 F 
6                           02266660    TEVA-ATENOLOL             TEV 0000441 F 
6                           02367556    JAMP-ATENOLOL             JPC 0000441 F 
6                           02368013    MINT-ATENOL               MNT 0000441 F 
6                           02369176    AG-ATENOLOL               ANG 0000441 F 
6                           02371979    MAR-ATENOLOL              MPI 0000441 F 
6                           02373963    RAN-ATENOLOL              RAN 0000441 F 
6                           02541564    ATENOLOL                  SIV 0000441 F 
42                         *50MG TABLET                                         
6                           00773689    APO-ATENOL                APX 0000938 F 
6                           02171791    TEVA-ATENOLOL             TEV 0000938 F 
6                           02237600    PMS-ATENOLOL              PMS 0000938 F 
6                           02238316    ATENOLOL                  SIV 0000938 F 
6                           02267985    RAN-ATENOLOL              RAN 0000938 F 
6                           02367564    JAMP-ATENOLOL             JPC 0000938 F 
6                           02368021    MINT-ATENOL               MNT 0000938 F 
6                           02369184    AG-ATENOLOL               ANG 0000938 F 
6                           02371987    MAR-ATENOLOL              MPI 0000938 F 
6                           02466465    ATENOLOL                  SAN 0000938 F 
6                           02039532    TENORMIN                  SLP 0006150 F 
42                         *100MG TABLET                                        
6                           00773697    APO-ATENOL                APX 0001543 F 
6                           02171805    TEVA-ATENOLOL             TEV 0001543 F 
6                           02237601    PMS-ATENOLOL              PMS 0001543 F 
6                           02238318    ATENOLOL                  SIV 0001543 F 
6                           02267993    RAN-ATENOLOL              RAN 0001543 F 
6                           02367572    JAMP-ATENOLOL             JPC 0001543 F 
6                           02368048    MINT-ATENOL               MNT 0001543 F 
6                           02369192    AG-ATENOLOL               ANG 0001543 F 
6                           02371995    MAR-ATENOLOL              MPI 0001543 F 
6                           02466473    ATENOLOL                  SAN 0001543 F 
6                           02039540    TENORMIN                  SLP 0010117 F 
41                          BISOPROLOL FUMARATE                                 
42                          1.25MG TABLET                                       
6                           02544245    SANDOZ BISOPROLOL         SDZ 0000152 F 
42                          2.5MG TABLET                                        
6                           02544253    SANDOZ BISOPROLOL         SDZ 0000303 F 
42                         *5MG TABLET                                          
6                           02247439    SANDOZ BISOPROLOL         SDZ 0000606 F 
6                           02256134    APO-BISOPROLOL            APX 0000606 F 
6                           02267470    TEVA-BISOPROLOL           TEV 0000606 F 
6                           02383055    BISOPROLOL                SIV 0000606 F 
6                           02391589    BISOPROLOL                SAN 0000606 F 
6                           02465612    MINT-BISOPROLOL           MNT 0000606 F 
6                           02494035    SANDOZ BISOPROLOL TABLETS SDZ 0000606 F 
6                           02495562    BISOPROLOL TABLETS        SIV 0000606 F 
6                           02518805    JAMP BISOPROLOL           JPC 0000606 F 
6                           02541394    PRZ-BISOPROLOL            PRZ 0000606 F 
42                         *10MG TABLET                                         
6                           02247440    SANDOZ BISOPROLOL         SDZ 0000885 F 
6                           02256177    APO-BISOPROLOL            APX 0000885 F 
6                           02267489    TEVA-BISOPROLOL           TEV 0000885 F 
6                           02383063    BISOPROLOL                SIV 0000885 F 
6                           02391597    BISOPROLOL                SAN 0000885 F 
6                           02465620    MINT-BISOPROLOL           MNT 0000885 F 
6                           02494043    SANDOZ BISOPROLOL TABLETS SDZ 0000885 F 
6                           02495570    BISOPROLOL TABLETS        SIV 0000885 F 
6                           02518791    JAMP BISOPROLOL           JPC 0000885 F 
6                           02541408    PRZ-BISOPROLOL            PRZ 0000885 F 
41                          CARVEDILOL                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *3.125MG TABLET                                      
6                           02245914    PMS-CARVEDILOL            PMS 0002060 F 
6                           02247933    APO-CARVEDILOL            APX 0002060 F 
6                           02248752    CARVEDILOL                SIV 0002060 F 
6                           02252309    TEVA-CARVEDILOL           TEV 0002060 F 
6                           02364913    CARVEDILOL                SAN 0002060 F 
6                           02368897    JAMP-CARVEDILOL           JPC 0002060 F 
6                           02418495    AURO-CARVEDILOL           API 0002060 F 
42                         *6.25MG TABLET                                       
6                           02245915    PMS-CARVEDILOL            PMS 0002060 F 
6                           02247934    APO-CARVEDILOL            APX 0002060 F 
6                           02248753    CARVEDILOL                SIV 0002060 F 
6                           02252317    TEVA-CARVEDILOL           TEV 0002060 F 
6                           02364921    CARVEDILOL                SAN 0002060 F 
6                           02368900    JAMP-CARVEDILOL           JPC 0002060 F 
6                           02418509    AURO-CARVEDILOL           API 0002060 F 
42                         *12.5MG TABLET                                       
6                           02245916    PMS-CARVEDILOL            PMS 0002060 F 
6                           02247935    APO-CARVEDILOL            APX 0002060 F 
6                           02248754    CARVEDILOL                SIV 0002060 F 
6                           02252325    TEVA-CARVEDILOL           TEV 0002060 F 
6                           02364948    CARVEDILOL                SAN 0002060 F 
6                           02368919    JAMP-CARVEDILOL           JPC 0002060 F 
6                           02418517    AURO-CARVEDILOL           API 0002060 F 
42                         *25MG TABLET                                         
6                           02245917    PMS-CARVEDILOL            PMS 0002060 F 
6                           02247936    APO-CARVEDILOL            APX 0002060 F 
6                           02248755    CARVEDILOL                SIV 0002060 F 
6                           02252333    TEVA-CARVEDILOL           TEV 0002060 F 
6                           02364956    CARVEDILOL                SAN 0002060 F 
6                           02368927    JAMP-CARVEDILOL           JPC 0002060 F 
6                           02418525    AURO-CARVEDILOL           API 0002060 F 
41                          DIGOXIN                                             
42                         *0.0625MG TABLET                                     
6                           02335700    PMS-DIGOXIN               PMS 0001089 F 
6                           02498502    JAMP DIGOXIN              JPC 0001089 F 
6                           02554399    AURO-DIGOXIN              API 0001089 F 
42                         *0.125MG TABLET                                      
6                           02335719    PMS-DIGOXIN               PMS 0001030 F 
6                           02498510    JAMP DIGOXIN              JPC 0001030 F 
6                           02554402    AURO-DIGOXIN              API 0001030 F 
42                          0.05MG/ML ELIXIR                                    
6                           02242320    PMS-DIGOXIN               PMS 0017433 F 
41                          DILTIAZEM HCL                                       
42                          30MG TABLET                                         
6                           00771376    AA-DILTIAZ                AAP 0002168 F 
42                          60MG TABLET                                         
6                           00771384    AAP-DILTIAZ               AAP 0003802 F 
42                         *120MG CONTROLLED DELIVERY CAPSULE                   
6                           02230997    APO-DILTIAZ CD            APX 0003634 F 
6                           02242538    TEVA-DILTIAZEM CD         TEV 0003634 F 
6                           02243338    SANDOZ DILTIAZEM CD       SDZ 0003634 F 
6                           02370611    ACT DILTIAZEM CD          TEV 0003634 F 
6                           02400421    DILTIAZEM CD              SAN 0003634 F 
6                           02445999    DILTIAZEM CD              SIV 0003634 F 
6                           02484064    MAR-DILTIAZEM CD          MPI 0003634 F 
6                           02528037    JAMP DILTIAZEM CD         JPC 0003634 F 
6                           02546086    M-DILTIAZEM CD            MNP 0003634 F 
42                         *120MG EXTENDED RELEASE CAPSULE                      
6                           02245918    SANDOZ DILTIAZEM T        SDZ 0002133 F 
6                           02271605    TEVA-DILTIAZEM HCL ER     TEV 0002133 F 
6                           02370441    TEVA-DILTIAZEM T          TEV 0002133 F 
6                           02465353    MAR-DILTIAZEM T           MPI 0002133 F 
6                           02495376    JAMP-DILTIAZEM T          JPC 0002133 F 
6                           02516101    DILTIAZEM T               SAN 0002133 F 
6                           02546434    M-DILTIAZEM T             MNP 0002133 F 
6                           02231150    TIAZAC                    BAU 0010934 F 
42                          120MG EXTENDED RELEASE TABLET                       
6                           02256738    TIAZAC XC                 BAU 0010269 F 
42                         *180MG CONTROLLED DELIVERY CAPSULE                   
6                           02230998    APO-DILTIAZ CD            APX 0004824 F 
6                           02242539    TEVA-DILTIAZEM CD         TEV 0004824 F 
6                           02243339    SANDOZ DILTIAZEM CD       SDZ 0004824 F 
6                           02370638    ACT DILTIAZEM CD          TEV 0004824 F 
6                           02400448    DILTIAZEM CD              SAN 0004824 F 
6                           02446006    DILTIAZEM CD              SIV 0004824 F 
6                           02484072    MAR-DILTIAZEM CD          MPI 0004824 F 
6                           02528045    JAMP DILTIAZEM CD         JPC 0004824 F 
6                           02546094    M-DILTIAZEM CD            MNP 0004824 F 
42                         *180MG EXTENDED RELEASE CAPSULE                      
6                           02245919    SANDOZ DILTIAZEM T        SDZ 0002889 F 
6                           02271613    TEVA-DILTIAZEM HCL ER     TEV 0002889 F 
6                           02370492    TEVA-DILTIAZEM T          TEV 0002889 F 
6                           02465361    MAR-DILTIAZEM T           MPI 0002889 F 
6                           02495384    JAMP-DILTIAZEM T          JPC 0002889 F 
6                           02516128    DILTIAZEM T               SAN 0002889 F 
6                           02546442    M-DILTIAZEM T             MNP 0002889 F 
6                           02231151    TIAZAC                    BAU 0014607 F 
42                         *180MG EXTENDED RELEASE TABLET                       
6                           02429322    TEVA-DILTIAZEM XC         TEV 0009195 F 
6                           02256746    TIAZAC XC                 BAU 0013644 F 
42                         *240MG CONTROLLED DELIVERY CAPSULE                   
6                           02230999    APO-DILTIAZ CD            APX 0006399 F 
6                           02242540    TEVA-DILTIAZEM CD         TEV 0006399 F 
6                           02243340    SANDOZ DILTIAZEM CD       SDZ 0006399 F 
6                           02370646    ACT DILTIAZEM CD          TEV 0006399 F 
6                           02400456    DILTIAZEM CD              SAN 0006399 F 
6                           02446014    DILTIAZEM CD              SIV 0006399 F 
6                           02484080    MAR-DILTIAZEM CD          MPI 0006399 F 
6                           02528053    JAMP DILTIAZEM CD         JPC 0006399 F 
6                           02546108    M-DILTIAZEM CD            MNP 0006399 F 
42                         *240MG EXTENDED RELEASE CAPSULE                      
6                           02245920    SANDOZ DILTIAZEM T        SDZ 0003832 F 
6                           02271621    TEVA-DILTIAZEM HCL ER     TEV 0003832 F 
6                           02370506    TEVA-DILTIAZEM T          TEV 0003832 F 
6                           02465388    MAR-DILTIAZEM T           MPI 0003832 F 
6                           02495392    JAMP-DILTIAZEM T          JPC 0003832 F 
6                           02516136    DILTIAZEM T               SAN 0003832 F 
6                           02546450    M-DILTIAZEM T             MNP 0003832 F 
6                           02231152    TIAZAC                    BAU 0019376 F 
42                         *240MG EXTENDED RELEASE TABLET                       
6                           02429330    TEVA-DILTIAZEM XC         TEV 0012212 F 
6                           02256754    TIAZAC XC                 BAU 0018136 F 
42                         *300MG CONTROLLED DELIVERY CAPSULE                   
6                           02229526    APO-DILTIAZ CD            APX 0007999 F 
6                           02242541    TEVA-DILTIAZEM CD         TEV 0007999 F 
6                           02243341    SANDOZ DILTIAZEM CD       SDZ 0007999 F 
6                           02370654    ACT DILTIAZEM CD          TEV 0007999 F 
6                           02400464    DILTIAZEM CD              SAN 0007999 F 
6                           02446022    DILTIAZEM CD              SIV 0007999 F 
6                           02484099    MAR-DILTIAZEM CD          MPI 0007999 F 
6                           02528061    JAMP DILTIAZEM CD         JPC 0007999 F 
6                           02546116    M-DILTIAZEM CD            MNP 0007999 F 
42                         *300MG EXTENDED RELEASE CAPSULE                      
6                           02245921    SANDOZ DILTIAZEM T        SDZ 0004720 F 
6                           02271648    TEVA-DILTIAZEM HCL ER     TEV 0004720 F 
6                           02370514    TEVA-DILTIAZEM T          TEV 0004720 F 
6                           02465396    MAR-DILTIAZEM T           MPI 0004720 F 
6                           02495406    JAMP-DILTIAZEM T          JPC 0004720 F 
6                           02516144    DILTIAZEM T               SAN 0004720 F 
6                           02546469    M-DILTIAZEM T             MNP 0004720 F 
42                         *300MG EXTENDED RELEASE TABLET                       
6                           02429349    TEVA-DILTIAZEM XC         TEV 0012175 F 
6                           02256762    TIAZAC XC                 BAU 0018099 F 
42                         *360MG EXTENDED RELEASE CAPSULE                      
6                           02245922    SANDOZ DILTIAZEM T        SDZ 0005778 F 
6                           02271656    TEVA-DILTIAZEM HCL ER     TEV 0005778 F 
6                           02370522    TEVA-DILTIAZEM T          TEV 0005778 F 
6                           02465418    MAR-DILTIAZEM T           MPI 0005778 F 
6                           02495414    JAMP-DILTIAZEM T          JPC 0005778 F 
6                           02516152    DILTIAZEM T               SAN 0005778 F 
6                           02546477    M-DILTIAZEM T             MNP 0005778 F 
6                           02231155    TIAZAC                    BAU 0029216 F 
42                         *360MG EXTENDED RELEASE TABLET                       
6                           02429357    TEVA-DILTIAZEM XC         TEV 0012211 F 
6                           02256770    TIAZAC XC                 BAU 0018108 F 
41                          DISOPYRAMIDE                                        
42                          100MG CAPSULE                                       
6                           02224801    RYTHMODAN                 XED 0003448 F 
42                          100MG CAPSULE US LABELLED                           
6                           09858365    DISOPYRAMIDE US-LABELLED  DLC 0014000 F 
41                          FLECAINIDE ACETATE                                  
42                         *50MG TABLET                                         
6                           02275538    APO-FLECAINIDE            APX 0001389 F 
6                           02459957    AURO-FLECAINIDE           API 0001389 F 
6                           02476177    MAR-FLECAINIDE            MPI 0001389 F 
6                           02493705    JAMP FLECAINIDE           JPC 0001389 F 
6                           02534800    FLECAINIDE                SAN 0001389 F 
42                         *100MG TABLET                                        
6                           02275546    APO-FLECAINIDE            APX 0002779 F 
6                           02459965    AURO-FLECAINIDE           API 0002779 F 
6                           02476185    MAR-FLECAINIDE            MPI 0002779 F 
6                           02493713    JAMP FLECAINIDE           JPC 0002779 F 
6                           02534819    FLECAINIDE                SAN 0002779 F 
41                          IVABRADINE HCL                                      
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          5MG TABLET                                          
61                          02459973    LANCORA (EDS)             SEV 0009314 E 
42                          7.5MG TABLET                                        
61                          02459981    LANCORA (EDS)             SEV 0017032 E 
41                          MAVACAMTEN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2.5MG CAPSULE                                       
61                          02532549    CAMZYOS (EDS)             BMY 0616000 E 
42                          5MG CAPSULE                                         
61                          02532557    CAMZYOS (EDS)             BMY 0616000 E 
42                          10MG CAPSULE                                        
61                          02532565    CAMZYOS (EDS)             BMY 0616000 E 
42                          15MG CAPSULE                                        
61                          02532573    CAMZYOS (EDS)             BMY 0616000 E 
41                          METOPROLOL TARTRATE                                 
42                         *25MG TABLET                                         
6                           02246010    APO-METOPROLOL            APX 0000643 F 
6                           02248855    PMS-METOPROLOL-L          PMS 0000643 F 
6                           02261898    TEVA-METOPROLOL           TEV 0000643 F 
6                           02356813    JAMP-METOPROLOL-L         JPC 0000643 F 
42                         *50MG TABLET                                         
6                           00618632    APO-METOPROLOL            APX 0000624 F 
6                           00648035    TEVA-METOPROLOL           TEV 0000624 F 
6                           00749354    APO-METOPROLOL-TYPE L     APX 0000624 F 
6                           00842648    TEVA-METOPROLOL           TEV 0000624 F 
6                           02230803    PMS-METOPROLOL-L          PMS 0000624 F 
6                           02350394    METOPROLOL                SAN 0000624 F 
6                           02354187    SANDOZ-METOPROLOL(TYPE L) SDZ 0000624 F 
6                           02356821    JAMP-METOPROLOL-L         JPC 0000624 F 
6                           02442124    METOPROLOL-L              SIV 0000624 F 
6                           02481316    AG-METOPROLOL-L           ANG 0000624 F 
42                         *100MG TABLET                                        
6                           00618640    APO-METOPROLOL            APX 0001361 F 
6                           00648043    TEVA-METOPROLOL           TEV 0001361 F 
6                           00751170    APO-METOPROLOL-TYPE L     APX 0001361 F 
6                           00842656    TEVA-METOPROLOL           TEV 0001361 F 
6                           02230804    PMS-METOPROLOL-L          PMS 0001361 F 
6                           02350408    METOPROLOL                SAN 0001361 F 
6                           02354195    SANDOZ-METOPROLOL(TYPE L) SDZ 0001361 F 
6                           02356848    JAMP-METOPROLOL-L         JPC 0001361 F 
6                           02442132    METOPROLOL-L              SIV 0001361 F 
6                           02481324    AG-METOPROLOL-L           ANG 0001361 F 
42                          100MG SUSTAINED RELEASE TABLET                      
6                           02285169    AA-METOPROLOL SR          AAP 0002058 F 
42                         *200MG SUSTAINED RELEASE TABLET                      
6                           02285177    AA-METOPROLOL SR          AAP 0003234 F 
6                           02303418    SANDOZ METOPROLOL SR      SDZ 0003234 F 
41                          MEXILETINE HCL                                      
42                         *100MG CAPSULE                                       
6                           02230359    TEVA-MEXILETINE           TEV 0007346 F 
6                           02536846    MINT-MEXILETINE           MNT 0007346 F 
42                         *200MG CAPSULE                                       
6                           02230360    TEVA-MEXILETINE           TEV 0009837 F 
6                           02536854    MINT-MEXILETINE           MNT 0009837 F 
41                          NADOLOL                                             
42                         *40MG TABLET                                         
6                           00782505    APO-NADOLOL               APX 0002375 F 
6                           02496380    MINT-NADOLOL              MNT 0002375 F 
42                         *80MG TABLET                                         
6                           00782467    APO-NADOLOL               APX 0003410 F 
6                           02496399    MINT-NADOLOL              MNT 0003410 F 
42                          160MG TABLET                                        
6                           00782475    APO-NADOLOL               APX 0013035 F 
41                          NIFEDIPINE                                          
42                          5MG CAPSULE                                         
6                           00725110    NIFEDIPINE                AAP 0004814 F 
42                          10MG CAPSULE                                        
6                           00755907    NIFEDIPINE                AAP 0006382 F 
42                         *30MG EXTENDED-RELEASE TABLET                        
6                           02349167    MYLAN-NIFEDIPINE          MYL 0006171 F 
6                           02155907    ADALAT XL                 BAY 0006172 F 
42                          60MG EXTENDED-RELEASE TABLET                        
6                           02321149    MYLAN-NIFEDIPINE XL       MYL 0009374 F 
41                          PINDOLOL                                            
42                          5MG TABLET                                          
6                           00869007    TEVA-PINDOLOL             TEV 0004068 F 
42                          10MG TABLET                                         
6                           00869015    TEVA-PINDOLOL             TEV 0006947 F 
42                          15MG TABLET                                         
6                           00869023    TEVA-PINDOLOL             TEV 0009783 F 
41                          PROPAFENONE HCL                                     
42                         *150MG TABLET                                        
6                           02243324    APO-PROPAFENONE           APX 0006306 F 
6                           02457172    MYLAN-PROPAFENONE         MYL 0006306 F 
6                           00603708    RYTHMOL                   BGP 0015269 F 
42                         *300MG TABLET                                        
6                           02243325    APO-PROPAFENONE           APX 0011116 F 
6                           02457164    MYLAN-PROPAFENONE         MYL 0011116 F 
6                           00603716    RYTHMOL                   BGP 0026915 F 
41                          PROPRANOLOL                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
6                           00496480    TEVA-PROPRANOLOL          TEV 0000850 F 
42                         *20MG TABLET                                         
6                           00740675    TEVA-PROPRANOLOL          TEV 0001119 F 
6                           02550814    PRZ-PROPRANOLOL           PRZ 0001119 F 
42                         *40MG TABLET                                         
6                           00496499    TEVA-PROPRANOLOL          TEV 0001239 F 
6                           02550822    PRZ-PROPRANOLOL           PRZ 0001239 F 
42                         *80MG TABLET                                         
6                           00496502    TEVA-PROPRANOLOL          TEV 0002057 F 
6                           02550830    PRZ-PROPRANOLOL           PRZ 0002057 F 
42                          3.75MG/ML ORAL SOLUTION                             
61                          02457857    HEMANGIOL (EDS)           PDC 0022809 E 
41                          SOTALOL HCL                                         
42                         *80MG TABLET                                         
6                           02210428    APO-SOTALOL               APX 0002198 F 
6                           02238326    PMS-SOTALOL               PMS 0002198 F 
6                           02368617    JAMP-SOTALOL              JPC 0002198 F 
6                           02565404    AMB-SOTALOL               AMB 0002198 F 
42                         *160MG TABLET                                        
6                           02084236    RATIO-SOTALOL             RPH 0001623 F 
6                           02167794    APO-SOTALOL               APX 0001623 F 
6                           02238327    PMS-SOTALOL               PMS 0001623 F 
6                           02368625    JAMP-SOTALOL              JPC 0001623 F 
6                           02385996    SOTALOL                   SIV 0001623 F 
6                           02565412    AMB-SOTALOL               AMB 0001623 F 
41                          TAFAMIDIS                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          61MG CAPSULE                                        
61                          02517841    VYNDAMAX (EDS)            PFI 5342800 E 
41                          TAFAMIDIS MEGLUMINE                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          20MG CAPSULE                                        
61                          02495732    VYNDAQEL (EDS)            PFI 1335700 E 
41                          TIMOLOL MALEATE                                     
42                          5MG TABLET                                          
6                           00755842    TIMOLOL                   AAP 0002662 F 
42                          10MG TABLET                                         
6                           00755850    TIMOLOL                   AAP 0004152 F 
42                          20MG TABLET                                         
6                           00755869    TIMOLOL                   AAP 0008082 F 
2         LIPID-LOWERING DRUGS                                                  
41                          ALIROCUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          75MG/ML SOL FOR INJ PRE-FILLED PEN                  
61                          02453819    PRALUENT (EDS)            AVT 2734500 E 
42                          150MG/ML SOL FOR INJ PRE-FILLED PEN                 
61                          02453835    PRALUENT (EDS)            AVT 2734500 E 
42                          300MG/2ML SOL FOR INJ PRE-FILLED PEN                
61                          02547732    PRALUENT (EDS)            AVT 5469000 E 
41                          ATORVASTATIN CALCIUM                                
42                         *10MG TABLET                                         
6                           02295261    APO-ATORVASTATIN          APX 0001743 F 
6                           02310899    TEVA-ATORVASTATIN         TEV 0001743 F 
6                           02313707    TARO-ATORVASTATIN         SUN 0001743 F 
6                           02324946    SANDOZ ATORVASTATIN       SDZ 0001743 F 
6                           02348705    ATORVASTATIN              SAN 0001743 F 
6                           02391058    JAMP-ATORVASTATIN         JPC 0001743 F 
6                           02392933    MYLAN-ATORVASTATIN        MYL 0001743 F 
6                           02407256    AURO-ATORVASTATIN         API 0001743 F 
6                           02411350    ATORVASTATIN-10           SIV 0001743 F 
6                           02417936    REDDY-ATORVASTATIN        DLC 0001743 F 
6                           02454017    MAR-ATORVASTATIN          MPI 0001743 F 
6                           02457741    ACH-ATORVASTATIN CALCIUM  AHI 0001743 F 
6                           02471167    M-ATORVASTATIN            MNP 0001743 F 
6                           02475022    ATORVASTATIN              RIV 0001743 F 
6                           02476517    NRA-ATORVASTATIN          NRA 0001743 F 
6                           02477149    PMS-ATORVASTATIN          PMS 0001743 F 
6                           02478145    AG-ATORVASTATIN           ANG 0001743 F 
6                           02479508    MINT-ATORVASTATIN         MNT 0001743 F 
6                           02504197    JAMP ATORVASTATIN CALCIUM JPC 0001743 F 
6                           02507234    PMSC-ATORVASTATIN         PMS 0001743 F 
6                           02521555    PRZ-ATORVASTATIN          PRZ 0001743 F 
6                           02545462    ATORVASTATIN              TEV 0001743 F 
6                           02230711    LIPITOR                   BGP 0021757 F 
42                         *20MG TABLET                                         
6                           02295288    APO-ATORVASTATIN          APX 0002179 F 
6                           02310902    TEVA-ATORVASTATIN         TEV 0002179 F 
6                           02313715    TARO-ATORVASTATIN         SUN 0002179 F 
6                           02324954    SANDOZ ATORVASTATIN       SDZ 0002179 F 
6                           02348713    ATORVASTATIN              SAN 0002179 F 
6                           02391066    JAMP-ATORVASTATIN         JPC 0002179 F 
6                           02392941    MYLAN-ATORVASTATIN        MYL 0002179 F 
6                           02407264    AURO-ATORVASTATIN         API 0002179 F 
6                           02411369    ATORVASTATIN-20           SIV 0002179 F 
6                           02417944    REDDY-ATORVASTATIN        DLC 0002179 F 
6                           02454025    MAR-ATORVASTATIN          MPI 0002179 F 
6                           02457768    ACH-ATORVASTATIN CALCIUM  AHI 0002179 F 
6                           02471175    M-ATORVASTATIN            MNP 0002179 F 
6                           02475030    ATORVASTATIN              RIV 0002179 F 
6                           02476525    NRA-ATORVASTATIN          NRA 0002179 F 
6                           02477157    PMS-ATORVASTATIN          PMS 0002179 F 
6                           02478153    AG-ATORVASTATIN           ANG 0002179 F 
6                           02479516    MINT-ATORVASTATIN         MNT 0002179 F 
6                           02504200    JAMP ATORVASTATIN CALCIUM JPC 0002179 F 
6                           02507242    PMSC-ATORVASTATIN         PMS 0002179 F 
6                           02521563    PRZ-ATORVASTATIN          PRZ 0002179 F 
6                           02545470    ATORVASTATIN              TEV 0002179 F 
6                           02230713    LIPITOR                   BGP 0027196 F 
42                         *40MG TABLET                                         
6                           02295296    APO-ATORVASTATIN          APX 0002342 F 
6                           02310910    TEVA-ATORVASTATIN         TEV 0002342 F 
6                           02313723    TARO-ATORVASTATIN         SUN 0002342 F 
6                           02324962    SANDOZ ATORVASTATIN       SDZ 0002342 F 
6                           02348721    ATORVASTATIN              SAN 0002342 F 
6                           02391074    JAMP-ATORVASTATIN         JPC 0002342 F 
6                           02392968    MYLAN-ATORVASTATIN        MYL 0002342 F 
6                           02407272    AURO-ATORVASTATIN         API 0002342 F 
6                           02411377    ATORVASTATIN-40           SIV 0002342 F 
6                           02417952    REDDY-ATORVASTATIN        DLC 0002342 F 
6                           02454033    MAR-ATORVASTATIN          MPI 0002342 F 
6                           02457776    ACH-ATORVASTATIN CALCIUM  AHI 0002342 F 
6                           02471183    M-ATORVASTATIN            MNP 0002342 F 
6                           02475049    ATORVASTATIN              RIV 0002342 F 
6                           02476533    NRA-ATORVASTATIN          NRA 0002342 F 
6                           02477165    PMS-ATORVASTATIN          PMS 0002342 F 
6                           02478161    AG-ATORVASTATIN           ANG 0002342 F 
6                           02479524    MINT-ATORVASTATIN         MNT 0002342 F 
6                           02504219    JAMP ATORVASTATIN CALCIUM JPC 0002342 F 
6                           02507250    PMSC-ATORVASTATIN         PMS 0002342 F 
6                           02521571    PRZ-ATORVASTATIN          PRZ 0002342 F 
6                           02545489    ATORVASTATIN              TEV 0002342 F 
6                           02230714    LIPITOR                   BGP 0029230 F 
42                         *80MG TABLET                                         
6                           02295318    APO-ATORVASTATIN          APX 0002342 F 
6                           02310929    TEVA-ATORVASTATIN         TEV 0002342 F 
6                           02313758    TARO-ATORVASTATIN         SUN 0002342 F 
6                           02324970    SANDOZ ATORVASTATIN       SDZ 0002342 F 
6                           02348748    ATORVASTATIN              SAN 0002342 F 
6                           02391082    JAMP-ATORVASTATIN         JPC 0002342 F 
6                           02392976    MYLAN-ATORVASTATIN        MYL 0002342 F 
6                           02407280    AURO-ATORVASTATIN         API 0002342 F 
6                           02411385    ATORVASTATIN-80           SIV 0002342 F 
6                           02417960    REDDY-ATORVASTATIN        DLC 0002342 F 
6                           02454041    MAR-ATORVASTATIN          MPI 0002342 F 
6                           02457784    ACH-ATORVASTATIN CALCIUM  AHI 0002342 F 
6                           02471191    M-ATORVASTATIN            MNP 0002342 F 
6                           02475057    ATORVASTATIN              RIV 0002342 F 
6                           02476541    NRA-ATORVASTATIN          NRA 0002342 F 
6                           02477173    PMS-ATORVASTATIN          PMS 0002342 F 
6                           02478188    AG-ATORVASTATIN           ANG 0002342 F 
6                           02479532    MINT-ATORVASTATIN         MNT 0002342 F 
6                           02504235    JAMP ATORVASTATIN CALCIUM JPC 0002342 F 
6                           02507269    PMSC-ATORVASTATIN         PMS 0002342 F 
6                           02521598    PRZ-ATORVASTATIN          PRZ 0002342 F 
6                           02545497    ATORVASTATIN              TEV 0002342 F 
6                           02243097    LIPITOR                   BGP 0029233 F 
41                          BEZAFIBRATE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *400MG SUSTAINED RELEASE TABLET                      
61                          02453312    JAMP-BEZAFIBRATE (EDS)    JPC 0017460 E 
61                          02083523    BEZALIP SR (EDS)          APH 0028577 E 
41                          CHOLESTYRAMINE RESIN                                
42                          444MG/G ORAL POWDER                                 
6                           02210320    OLESTYR                   PMS 0009217 F 
42                         *800MG/G ORAL POWDER                                 
6                           02455609    ODAN-CHOLESTYRAMINE       ODN 0009217 F 
6                           02478595    JAMP-CHOLESTYRAMINE       JPC 0009217 F 
41                          COLESEVELAM HCL                                     
42                          625MG TABLET                                        
6                           02373955    LODALIS                   BAU 0013663 F 
41                          COLESTIPOL HCL RESIN                                
42                          1G TABLET                                           
6                           02132680    COLESTID                  PFI 0003775 F 
41                          EVINACUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA.                    
42                          150MG/ML SOLUTION FOR INFUSION (2.3ML VIAL)         
43                          (MG)                                                
61                          02541769    EVKEEZA (EDS)             UPI 0294600 E 
41                          EVOLOCUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          140MG/ML SOLUTION FOR INJECTION                     
61                          02446057    REPATHA (EDS)             AMG 2916650 E 
41                          EZETIMIBE                                           
42                         *10MG TABLET                                         
6                           02354101    TEVA-EZETIMIBE            TEV 0001811 F 
6                           02416409    PMS-EZETIMIBE             PMS 0001811 F 
6                           02416778    SANDOZ EZETIMIBE          SDZ 0001811 F 
6                           02419548    RAN-EZETIMIBE             RAN 0001811 F 
6                           02422662    MAR-EZETIMIBE             MPI 0001811 F 
6                           02423235    JAMP-EZETIMIBE            JPC 0001811 F 
6                           02423243    MINT-EZETIMIBE            MNT 0001811 F 
6                           02425610    ACH-EZETIMIBE             AHI 0001811 F 
6                           02427826    APO-EZETIMIBE             APX 0001811 F 
6                           02429659    EZETIMIBE                 SIV 0001811 F 
6                           02431300    EZETIMIBE                 SAN 0001811 F 
6                           02460750    GLN-EZETIMIBE             GLN 0001811 F 
6                           02467437    M-EZETIMIBE               MNP 0001811 F 
6                           02469286    AURO-EZETIMIBE            API 0001811 F 
6                           02475898    AG-EZETIMIBE              ANG 0001811 F 
6                           02481669    NRA-EZETIMIBE             NRA 0001811 F 
6                           02247521    EZETROL                   ORG 0021888 F 
41                          FENOFIBRATE                                         
42                          200MG CAPSULE                                       
6                           02239864    AAP-FENO-MICRO            AAP 0009257 F 
42                         *48MG TABLET                                         
6                           02390698    SANDOZ FENOFIBRATE E      SDZ 0003670 F 
6                           02269074    LIPIDIL EZ                BGP 0005097 F 
42                         *145MG TABLET                                        
6                           02390701    SANDOZ FENOFIBRATE E      SDZ 0005489 F 
6                           02454696    TARO-FENOFIBRATE E        TAR 0005489 F 
6                           02269082    LIPIDIL EZ                BGP 0013050 F 
41                          FLUVASTATIN SODIUM                                  
42                          20MG CAPSULE                                        
6                           02299224    TEVA-FLUVASTATIN          TEV 0006882 F 
42                          40MG CAPSULE                                        
6                           02299232    TEVA-FLUVASTATIN          TEV 0009671 F 
41                          GEMFIBROZIL                                         
42                          300MG CAPSULE                                       
6                           02241704    TEVA-GEMFIBROZIL          TEV 0003260 F 
42                          600MG TABLET                                        
6                           02142074    TEVA-GEMFIBROZIL          TEV 0009321 F 
41                          ICOSAPENT ETHYL                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1G CAPSULE                                          
61                          02495244    VASCEPA (EDS)             HLS 0024500 E 
41                          INCLISIRAN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          284MG/1.5ML SOL FOR SC INJECTION PRE-FILLED         
43                          SYRINGE (MG)                                        
61                          02518376    LEQVIO (EDS)              NVR 0102074 E 
41                          LOVASTATIN                                          
42                          20MG TABLET                                         
6                           02220172    LOVASTATIN                AAP 0011931 F 
42                          40MG TABLET                                         
6                           02220180    LOVASTATIN                AAP 0021793 F 
41                          PRAVASTATIN                                         
42                         *10MG TABLET                                         
6                           02243506    APO-PRAVASTATIN           APX 0002916 F 
6                           02247008    TEVA-PRAVASTATIN          TEV 0002916 F 
6                           02247655    PMS-PRAVASTATIN           PMS 0002916 F 
6                           02284421    RAN-PRAVASTATIN           RAN 0002916 F 
6                           02317451    MINT-PRAVASTATIN          MNT 0002916 F 
6                           02330954    JAMP-PRAVASTATIN          JPC 0002916 F 
6                           02356546    PRAVASTATIN               SAN 0002916 F 
6                           02389703    PRAVASTATIN               SIV 0002916 F 
6                           02432048    MAR-PRAVASTATIN           MPI 0002916 F 
6                           02440644    ACH-PRAVASTATIN           AHI 0002916 F 
6                           02458977    AURO-PRAVASTATIN          API 0002916 F 
6                           02468700    SANDOZ PRAVASTATIN TABLET SDZ 0002916 F 
6                           02476142    AG-PRAVASTATIN            ANG 0002916 F 
6                           02476274    M-PRAVASTATIN             MNP 0002916 F 
6                           02535653    NRA-PRAVASTATIN           NRA 0002916 F 
6                           02558084    JAMP PRAVASTATIN          JPC 0002916 F 
42                         *20MG TABLET                                         
6                           02243507    APO-PRAVASTATIN           APX 0003440 F 
6                           02247009    TEVA-PRAVASTATIN          TEV 0003440 F 
6                           02247656    PMS-PRAVASTATIN           PMS 0003440 F 
6                           02284448    RAN-PRAVASTATIN           RAN 0003440 F 
6                           02317478    MINT-PRAVASTATIN          MNT 0003440 F 
6                           02330962    JAMP-PRAVASTATIN          JPC 0003440 F 
6                           02356554    PRAVASTATIN               SAN 0003440 F 
6                           02389738    PRAVASTATIN               SIV 0003440 F 
6                           02432056    MAR-PRAVASTATIN           MPI 0003440 F 
6                           02440652    ACH-PRAVASTATIN           AHI 0003440 F 
6                           02458985    AURO-PRAVASTATIN          API 0003440 F 
6                           02468719    SANDOZ PRAVASTATIN TABLET SDZ 0003440 F 
6                           02476150    AG-PRAVASTATIN            ANG 0003440 F 
6                           02476282    M-PRAVASTATIN             MNP 0003440 F 
6                           02535661    NRA-PRAVASTATIN           NRA 0003440 F 
6                           02558092    JAMP PRAVASTATIN          JPC 0003440 F 
42                         *40MG TABLET                                         
6                           02243508    APO-PRAVASTATIN           APX 0004143 F 
6                           02247010    TEVA-PRAVASTATIN          TEV 0004143 F 
6                           02247657    PMS-PRAVASTATIN           PMS 0004143 F 
6                           02284456    RAN-PRAVASTATIN           RAN 0004143 F 
6                           02317486    MINT-PRAVASTATIN          MNT 0004143 F 
6                           02330970    JAMP-PRAVASTATIN          JPC 0004143 F 
6                           02356562    PRAVASTATIN               SAN 0004143 F 
6                           02389746    PRAVASTATIN               SIV 0004143 F 
6                           02432064    MAR-PRAVASTATIN           MPI 0004143 F 
6                           02440660    ACH-PRAVASTATIN           AHI 0004143 F 
6                           02458993    AURO-PRAVASTATIN          API 0004143 F 
6                           02468727    SANDOZ PRAVASTATIN TABLET SDZ 0004143 F 
6                           02476169    AG-PRAVASTATIN            ANG 0004143 F 
6                           02476290    M-PRAVASTATIN             MNP 0004143 F 
6                           02535688    NRA-PRAVASTATIN           NRA 0004143 F 
6                           02558106    JAMP PRAVASTATIN          JPC 0004143 F 
41                          ROSUVASTATIN CALCIUM                                
42                         *5MG TABLET                                          
6                           02337975    APO-ROSUVASTATIN          APX 0001284 F 
6                           02338726    SANDOZ ROSUVASTATIN       SDZ 0001284 F 
6                           02354608    TEVA-ROSUVASTATIN         TEV 0001284 F 
6                           02378523    PMS-ROSUVASTATIN          PMS 0001284 F 
6                           02382644    TARO-ROSUVASTATIN         SUN 0001284 F 
6                           02391252    JAMP-ROSUVASTATIN         JPC 0001284 F 
6                           02397781    MINT-ROSUVASTATIN         MNT 0001284 F 
6                           02405628    ROSUVASTATIN              SAN 0001284 F 
6                           02411628    ROSUVASTATIN-5            SIV 0001284 F 
6                           02413051    MAR-ROSUVASTATIN          MPI 0001284 F 
6                           02438917    ACH-ROSUVASTATIN          AHI 0001284 F 
6                           02442574    AURO-ROSUVASTATIN         API 0001284 F 
6                           02477483    NRA-ROSUVASTATIN          NRA 0001284 F 
6                           02496534    M-ROSUVASTATIN            MNP 0001284 F 
6                           02498332    JAMP ROSUVASTATIN CALCIUM JPC 0001284 F 
6                           02505576    PRZ-ROSUVASTATIN          PRZ 0001284 F 
6                           02536595    NRA-ROSUVASTATIN          NRA 0001284 F 
6                           02265540    CRESTOR                   AST 0015177 F 
42                         *10MG TABLET                                         
6                           02337983    APO-ROSUVASTATIN          APX 0001354 F 
6                           02338734    SANDOZ ROSUVASTATIN       SDZ 0001354 F 
6                           02354616    TEVA-ROSUVASTATIN         TEV 0001354 F 
6                           02378531    PMS-ROSUVASTATIN          PMS 0001354 F 
6                           02382652    TARO-ROSUVASTATIN         SUN 0001354 F 
6                           02391260    JAMP-ROSUVASTATIN         JPC 0001354 F 
6                           02397803    MINT-ROSUVASTATIN         MNT 0001354 F 
6                           02405636    ROSUVASTATIN              SAN 0001354 F 
6                           02411636    ROSUVASTATIN-10           SIV 0001354 F 
6                           02413078    MAR-ROSUVASTATIN          MPI 0001354 F 
6                           02438925    ACH-ROSUVASTATIN          AHI 0001354 F 
6                           02442582    AURO-ROSUVASTATIN         API 0001354 F 
6                           02477491    NRA-ROSUVASTATIN          NRA 0001354 F 
6                           02496542    M-ROSUVASTATIN            MNP 0001354 F 
6                           02498340    JAMP ROSUVASTATIN CALCIUM JPC 0001354 F 
6                           02505584    PRZ-ROSUVASTATIN          PRZ 0001354 F 
6                           02536609    NRA-ROSUVASTATIN          NRA 0001354 F 
6                           02247162    CRESTOR                   AST 0016117 F 
42                         *20MG TABLET                                         
6                           02337991    APO-ROSUVASTATIN          APX 0001692 F 
6                           02338742    SANDOZ ROSUVASTATIN       SDZ 0001692 F 
6                           02354624    TEVA-ROSUVASTATIN         TEV 0001692 F 
6                           02378558    PMS-ROSUVASTATIN          PMS 0001692 F 
6                           02382660    TARO-ROSUVASTATIN         SUN 0001692 F 
6                           02391279    JAMP-ROSUVASTATIN         JPC 0001692 F 
6                           02397811    MINT-ROSUVASTATIN         MNT 0001692 F 
6                           02405644    ROSUVASTATIN              SAN 0001692 F 
6                           02411644    ROSUVASTATIN-20           SIV 0001692 F 
6                           02413086    MAR-ROSUVASTATIN          MPI 0001692 F 
6                           02438933    ACH-ROSUVASTATIN          AHI 0001692 F 
6                           02442590    AURO-ROSUVASTATIN         API 0001692 F 
6                           02477505    NRA-ROSUVASTATIN          NRA 0001692 F 
6                           02496550    M-ROSUVASTATIN            MNP 0001692 F 
6                           02498359    JAMP ROSUVASTATIN CALCIUM JPC 0001692 F 
6                           02505592    PRZ-ROSUVASTATIN          PRZ 0001692 F 
6                           02536625    NRA-ROSUVASTATIN          NRA 0001692 F 
6                           02247163    CRESTOR                   AST 0020057 F 
42                         *40MG TABLET                                         
6                           02338009    APO-ROSUVASTATIN          APX 0001990 F 
6                           02338750    SANDOZ ROSUVASTATIN       SDZ 0001990 F 
6                           02354632    TEVA-ROSUVASTATIN         TEV 0001990 F 
6                           02378566    PMS-ROSUVASTATIN          PMS 0001990 F 
6                           02382679    TARO-ROSUVASTATIN         SUN 0001990 F 
6                           02391287    JAMP-ROSUVASTATIN         JPC 0001990 F 
6                           02397838    MINT-ROSUVASTATIN         MNT 0001990 F 
6                           02405652    ROSUVASTATIN              SAN 0001990 F 
6                           02411652    ROSUVASTATIN-40           SIV 0001990 F 
6                           02413108    MAR-ROSUVASTATIN          MPI 0001990 F 
6                           02438941    ACH-ROSUVASTATIN          AHI 0001990 F 
6                           02442604    AURO-ROSUVASTATIN         API 0001990 F 
6                           02477513    NRA-ROSUVASTATIN          NRA 0001990 F 
6                           02496569    M-ROSUVASTATIN            MNP 0001990 F 
6                           02498367    JAMP ROSUVASTATIN CALCIUM JPC 0001990 F 
6                           02505606    PRZ-ROSUVASTATIN          PRZ 0001990 F 
6                           02536633    NRA-ROSUVASTATIN          NRA 0001990 F 
6                           02247164    CRESTOR                   AST 0023543 F 
41                          SIMVASTATIN                                         
42                         *5MG TABLET                                          
6                           02247011    APO-SIMVASTATIN           APX 0001023 F 
6                           02250144    TEVA-SIMVASTATIN          TEV 0001023 F 
6                           02284723    SIMVASTATIN               SAN 0001023 F 
6                           02329131    RAN-SIMVASTATIN           RAN 0001023 F 
6                           02372932    MINT-SIMVASTATIN          MNT 0001023 F 
6                           02375591    JAMP-SIMVASTATIN          JPC 0001023 F 
6                           02386291    SIMVASTATIN               SIV 0001023 F 
6                           02405148    AURO-SIMVASTATIN          API 0001023 F 
6                           02469979    PHARMA-SIMVASTATIN        PMS 0001023 F 
6                           02480050    AG-SIMVASTATIN            ANG 0001023 F 
6                           02549638    PMSC-SIMVASTATIN          PMS 0001023 F 
42                         *10MG TABLET                                         
6                           02247012    APO-SIMVASTATIN           APX 0002023 F 
6                           02250152    TEVA-SIMVASTATIN          TEV 0002023 F 
6                           02284731    SIMVASTATIN               SAN 0002023 F 
6                           02329158    RAN-SIMVASTATIN           RAN 0002023 F 
6                           02372940    MINT-SIMVASTATIN          MNT 0002023 F 
6                           02375044    MAR-SIMVASTATIN           MPI 0002023 F 
6                           02375605    JAMP-SIMVASTATIN          JPC 0002023 F 
6                           02386305    SIMVASTATIN               SIV 0002023 F 
6                           02405156    AURO-SIMVASTATIN          API 0002023 F 
6                           02469987    PHARMA-SIMVASTATIN        PMS 0002023 F 
6                           02480069    AG-SIMVASTATIN            ANG 0002023 F 
6                           02549646    PMSC-SIMVASTATIN          PMS 0002023 F 
6                           00884332    ZOCOR                     ORG 0026121 F 
42                         *20MG TABLET                                         
6                           02247013    APO-SIMVASTATIN           APX 0002501 F 
6                           02250160    TEVA-SIMVASTATIN          TEV 0002501 F 
6                           02284758    SIMVASTATIN               SAN 0002501 F 
6                           02329166    RAN-SIMVASTATIN           RAN 0002501 F 
6                           02372959    MINT-SIMVASTATIN          MNT 0002501 F 
6                           02375052    MAR-SIMVASTATIN           MPI 0002501 F 
6                           02375613    JAMP-SIMVASTATIN          JPC 0002501 F 
6                           02386313    SIMVASTATIN               SIV 0002501 F 
6                           02405164    AURO-SIMVASTATIN          API 0002501 F 
6                           02469995    PHARMA-SIMVASTATIN        PMS 0002501 F 
6                           02480077    AG-SIMVASTATIN            ANG 0002501 F 
6                           02549654    PMSC-SIMVASTATIN          PMS 0002501 F 
6                           00884340    ZOCOR                     ORG 0032286 F 
42                         *40MG TABLET                                         
6                           02247014    APO-SIMVASTATIN           APX 0002501 F 
6                           02250179    TEVA-SIMVASTATIN          TEV 0002501 F 
6                           02284766    SIMVASTATIN               SAN 0002501 F 
6                           02329174    RAN-SIMVASTATIN           RAN 0002501 F 
6                           02372967    MINT-SIMVASTATIN          MNT 0002501 F 
6                           02375060    MAR-SIMVASTATIN           MPI 0002501 F 
6                           02375621    JAMP-SIMVASTATIN          JPC 0002501 F 
6                           02386321    SIMVASTATIN               SIV 0002501 F 
6                           02405172    AURO-SIMVASTATIN          API 0002501 F 
6                           02470004    PHARMA-SIMVASTATIN        PMS 0002501 F 
6                           02480085    AG-SIMVASTATIN            ANG 0002501 F 
6                           02549662    PMSC-SIMVASTATIN          PMS 0002501 F 
6                           00884359    ZOCOR                     ORG 0032286 F 
42                         *80MG TABLET                                         
6                           02247015    APO-SIMVASTATIN           APX 0002501 F 
6                           02250187    TEVA-SIMVASTATIN          TEV 0002501 F 
6                           02284774    SIMVASTATIN               SAN 0002501 F 
6                           02329182    RAN-SIMVASTATIN           RAN 0002501 F 
6                           02372975    MINT-SIMVASTATIN          MNT 0002501 F 
6                           02375648    JAMP-SIMVASTATIN          JPC 0002501 F 
6                           02386348    SIMVASTATIN               SIV 0002501 F 
6                           02405180    AURO-SIMVASTATIN          API 0002501 F 
6                           02470012    PHARMA-SIMVASTATIN        PMS 0002501 F 
6                           02480093    AG-SIMVASTATIN            ANG 0002501 F 
6                           02549670    PMSC-SIMVASTATIN          PMS 0002501 F 
2         HYPOTENSIVE DRUGS                                                     
41                          AMILORIDE HCL/HYDROCHLOROTHIAZIDE                   
42                         *5MG/50MG TABLET                                     
6                           01937219    NOVAMILOR                 TEV 0000838 F 
6                           00784400    AA-AMILZIDE               AAP 0000969 F 
41                          ATENOLOL/CHLORTHALIDONE                             
42                          50MG/25MG TABLET                                    
6                           02248763    AA-ATENIDONE              AAP 0005342 F 
42                          100MG/25MG TABLET                                   
6                           02248764    AA-ATENIDONE              AAP 0008755 F 
41                          BENAZEPRIL HCL                                      
42                          5MG TABLET                                          
6                           02290332    BENAZEPRIL                AAP 0010433 F 
42                          10MG TABLET                                         
6                           02290340    BENAZEPRIL                AAP 0012356 F 
42                          20MG TABLET                                         
6                           02273918    BENAZEPRIL                AAP 0014162 F 
41                          CANDESARTAN CILEXETIL                               
42                         *4MG TABLET                                          
6                           02326957    SANDOZ-CANDESARTAN        SDZ 0001700 F 
6                           02365340    APO-CANDESARTAN           APX 0001700 F 
6                           02379260    CANDESARTAN CILEXETIL     AHI 0001700 F 
6                           02380684    RAN-CANDESARTAN           RAN 0001700 F 
6                           02388901    CANDESARTAN               SAN 0001700 F 
6                           02391171    PMS-CANDESARTAN           PMS 0001700 F 
6                           02445786    AURO-CANDESARTAN          API 0001700 F 
6                           02476908    MINT-CANDESARTAN          MNT 0001700 F 
6                           02527006    NRA-CANDESARTAN           NRA 0001700 F 
6                           02528258    CANDESARTAN               SIV 0001700 F 
6                           02541289    APO-CANDESARTAN TABLETS   APX 0001700 F 
6                           02239090    ATACAND                   XED 0009717 F 
42                         *8MG TABLET                                          
6                           02326965    SANDOZ-CANDESARTAN        SDZ 0002281 F 
6                           02365359    APO-CANDESARTAN           APX 0002281 F 
6                           02366312    TEVA-CANDESARTAN          TEV 0002281 F 
6                           02379279    CANDESARTEN CILEXETIL     AHI 0002281 F 
6                           02380692    RAN-CANDESARTAN           RAN 0002281 F 
6                           02386518    JAMP-CANDESARTAN          JPC 0002281 F 
6                           02388707    CANDESARTAN               SIV 0002281 F 
6                           02388928    CANDESARTAN               SAN 0002281 F 
6                           02391198    PMS-CANDESARTAN           PMS 0002281 F 
6                           02445794    AURO-CANDESARTAN          API 0002281 F 
6                           02476916    MINT-CANDESARTAN          MNT 0002281 F 
6                           02527014    NRA-CANDESARTAN           NRA 0002281 F 
6                           02541297    APO-CANDESARTAN TABLETS   APX 0002281 F 
6                           02239091    ATACAND                   XED 0016160 F 
42                         *16MG TABLET                                         
6                           02326973    SANDOZ-CANDESARTAN        SDZ 0002281 F 
6                           02365367    APO-CANDESARTAN           APX 0002281 F 
6                           02366320    TEVA-CANDESARTAN          TEV 0002281 F 
6                           02379287    CANDESARTAN CILEXETIL     AHI 0002281 F 
6                           02380706    RAN-CANDESARTAN           RAN 0002281 F 
6                           02386526    JAMP-CANDESARTAN          JPC 0002281 F 
6                           02388715    CANDESARTAN               SIV 0002281 F 
6                           02388936    CANDESARTAN               SAN 0002281 F 
6                           02391201    PMS-CANDESARTAN           PMS 0002281 F 
6                           02445808    AURO-CANDESARTAN          API 0002281 F 
6                           02476924    MINT-CANDESARTAN          MNT 0002281 F 
6                           02527022    NRA-CANDESARTAN           NRA 0002281 F 
6                           02541300    APO-CANDESARTAN TABLETS   APX 0002281 F 
6                           02239092    ATACAND                   XED 0016160 F 
42                         *32MG TABLET                                         
6                           02366339    TEVA-CANDESARTAN          TEV 0002281 F 
6                           02379295    CANDESARTAN CILEXETIL     AHI 0002281 F 
6                           02380714    RAN-CANDESARTAN           RAN 0002281 F 
6                           02386534    JAMP-CANDESARTAN          JPC 0002281 F 
6                           02391228    PMS-CANDESARTAN           PMS 0002281 F 
6                           02399105    APO-CANDESARTAN           APX 0002281 F 
6                           02417340    SANDOZ CANDESARTAN        SDZ 0002281 F 
6                           02435845    CANDESARTAN               SAN 0002281 F 
6                           02445816    AURO-CANDESARTAN          API 0002281 F 
6                           02476932    MINT-CANDESARTAN          MNT 0002281 F 
6                           02527030    NRA-CANDESARTAN           NRA 0002281 F 
6                           02528266    CANDESARTAN               SIV 0002281 F 
6                           02541319    APO-CANDESARTAN TABLETS   APX 0002281 F 
6                           02311658    ATACAND                   XED 0016160 F 
41                          CANDESARTAN CILEXETIL/HYDROCHLOROTHIAZIDE           
42                         *16MG/12.5MG TABLET                                  
6                           02327902    SANDOZ-CANDESARTAN PLUS   SDZ 0002156 F 
6                           02391295    PMS-CANDESARTAN-HCTZ      PMS 0002156 F 
6                           02394804    CANDESARTAN/HCTZ          SAN 0002156 F 
6                           02394812    CANDESARTAN HCT           SIV 0002156 F 
6                           02395541    TEVA-CANDESARTAN/HCTZ     TEV 0002156 F 
6                           02421038    AURO-CANDESARTAN HCT      API 0002156 F 
6                           02473240    JAMP-CANDESARTAN HCT      JPC 0002156 F 
6                           02531240    NRA-CANDESARTAN HCTZ      NRA 0002156 F 
6                           02244021    ATACAND PLUS              XED 0016160 F 
42                         *32MG/12.5MG TABLET                                  
6                           02395568    TEVA-CANDESARTAN/HCTZ     TEV 0002156 F 
6                           02420732    SANDOZ CANDESARTAN PLUS   SDZ 0002156 F 
6                           02421046    AURO-CANDESARTAN HCT      API 0002156 F 
6                           02473259    JAMP-CANDESARTAN HCT      JPC 0002156 F 
6                           02531259    NRA-CANDESARTAN HCTZ      NRA 0002156 F 
6                           02536064    CANDESARTAN/HCTZ          SAN 0002156 F 
6                           02332922    ATACAND PLUS              XED 0016160 F 
42                         *32MG/25MG TABLET                                    
6                           02395134    APO-CANDESARTAN/HCTZ      APX 0003008 F 
6                           02420740    SANDOZ CANDESARTAN PLUS   SDZ 0003008 F 
6                           02421054    AURO-CANDESARTAN HCT      API 0003008 F 
6                           02473267    JAMP-CANDESARTAN HCT      JPC 0003008 F 
6                           02531267    NRA-CANDESARTAN HCTZ      NRA 0003008 F 
6                           02332957    ATACAND PLUS              XED 0016160 F 
41                          CAPTOPRIL                                           
42                          6.25MG TABLET                                       
6                           01999559    APO-CAPTO                 APX 0001237 F 
42                          12.5MG TABLET                                       
6                           01942964    TEVA-CAPTOPRIL            TEV 0001060 F 
42                          25MG TABLET                                         
6                           01942972    TEVA-CAPTOPRIL            TEV 0001500 F 
42                          50MG TABLET                                         
6                           01942980    TEVA-CAPTOPRIL            TEV 0002795 F 
42                          100MG TABLET                                        
6                           01942999    TEVA-CAPTOPRIL            TEV 0005198 F 
42                          1MG/ML ORAL SOLUTION (ML)                           
6                           02543907    NOYADA                    ETH 0006000 F 
42                          5MG/ML ORAL SOLUTION (ML)                           
6                           02543915    NOYADA                    ETH 0006500 F 
41                          CILAZAPRIL                                          
42                          1MG TABLET                                          
6                           02283778    MYLAN-CILAZAPRIL          MYL 0003426 F 
42                         *2.5MG TABLET                                        
6                           02283786    MYLAN-CILAZAPRIL          MYL 0004295 F 
6                           02291142    APO-CILAZAPRIL            APX 0004295 F 
42                         *5MG TABLET                                          
6                           02283794    MYLAN-CILAZAPRIL          MYL 0004989 F 
6                           02291150    APO-CILAZAPRIL            APX 0004989 F 
6                           01911481    INHIBACE                  CHP 0011698 F 
41                          CILAZAPRIL/HYDROCHLOROTHIAZIDE                      
42                         *5MG/12.5MG TABLET                                   
6                           02284987    APO-CILAZAPRIL/HCTZ       APX 0006306 F 
6                           02181479    INHIBACE PLUS             CHP 0011696 F 
41                          CLONIDINE HCL                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.025MG TABLET                                      
61                          02304163    TEVA-CLONIDINE (EDS)      TEV 0000680 E 
61                          02516217    SANDOZ CLONIDINE (EDS)    SDZ 0000680 E 
61                          02524198    MAR-CLONIDINE (EDS)       MPI 0000680 E 
61                          02528207    JAMP CLONIDINE (EDS)      JPC 0000680 E 
61                          02534738    MINT-CLONIDINE (EDS)      MNT 0000680 E 
61                          02540061    CLONIDINE (EDS)           SIV 0000680 E 
42                         *0.1MG TABLET                                        
6                           02046121    TEVA-CLONIDINE            TEV 0000679 F 
6                           02462192    MINT-CLONIDINE            MNT 0000679 F 
6                           02515784    SANDOZ CLONIDINE          SDZ 0000679 F 
6                           02538490    CLONIDINE                 SIV 0000679 F 
42                         *0.2MG TABLET                                        
6                           02046148    TEVA-CLONIDINE            TEV 0001212 F 
6                           02462206    MINT-CLONIDINE            MNT 0001212 F 
6                           02515792    SANDOZ CLONIDINE          SDZ 0001212 F 
6                           02538504    CLONIDINE                 SIV 0001212 F 
41                          DIAZOXIDE                                           
42                          100MG CAPSULE                                       
6                           00503347    PROGLYCEM                 MRK 0021299 F 
41                          DOXAZOSIN MESYLATE                                  
42                         *1MG TABLET                                          
6                           02240588    APO-DOXAZOSIN             APX 0001719 F 
6                           02242728    TEVA-DOXAZOSIN            TEV 0001719 F 
6                           02489937    JAMP-DOXAZOSIN            JPC 0001719 F 
42                         *2MG TABLET                                          
6                           02240589    APO-DOXAZOSIN             APX 0002062 F 
6                           02242729    TEVA-DOXAZOSIN            TEV 0002062 F 
6                           02489945    JAMP-DOXAZOSIN            JPC 0002062 F 
42                         *4MG TABLET                                          
6                           02240590    APO-DOXAZOSIN             APX 0002681 F 
6                           02242730    TEVA-DOXAZOSIN            TEV 0002681 F 
6                           02489953    JAMP-DOXAZOSIN            JPC 0002681 F 
41                          ENALAPRIL MALEATE                                   
42                         *2.5MG TABLET                                        
6                           02020025    APO-ENALAPRIL             APX 0001863 F 
6                           02291878    ACT ENALAPRIL             TEV 0001863 F 
6                           02299933    SANDOZ ENALAPRIL          SDZ 0001863 F 
6                           02300036    MYLAN-ENALAPRIL           MYL 0001863 F 
6                           02300680    TEVA-ENALAPRIL            TEV 0001863 F 
6                           02323478    SIG-ENALAPRIL             SLI 0001863 F 
6                           02352230    RAN-ENALAPRIL             RAN 0001863 F 
6                           02400650    ENALAPRIL                 SAN 0001863 F 
6                           02442957    ENALAPRIL                 SIV 0001863 F 
6                           02459450    MAR-ENALAPRIL             MPI 0001863 F 
6                           02474786    JAMP-ENALAPRIL            JPC 0001863 F 
6                           02565285    NRA-ENALAPRIL             NRA 0001863 F 
42                         *5MG TABLET                                          
6                           02019884    APO-ENALAPRIL             APX 0002203 F 
6                           02233005    TEVA-ENALAPRIL            TEV 0002203 F 
6                           02291886    ACT ENALAPRIL             TEV 0002203 F 
6                           02299941    SANDOZ ENALAPRIL          SDZ 0002203 F 
6                           02300044    MYLAN-ENALAPRIL           MYL 0002203 F 
6                           02323486    SIG-ENALAPRIL             SLI 0002203 F 
6                           02352249    RAN-ENALAPRIL             RAN 0002203 F 
6                           02400669    ENALAPRIL                 SAN 0002203 F 
6                           02442965    ENALAPRIL                 SIV 0002203 F 
6                           02459469    MAR-ENALAPRIL             MPI 0002203 F 
6                           02474794    JAMP-ENALAPRIL            JPC 0002203 F 
6                           02565293    NRA-ENALAPRIL             NRA 0002203 F 
6                           00708879    VASOTEC                   ORG 0011843 F 
42                         *10MG TABLET                                         
6                           02019892    APO-ENALAPRIL             APX 0002647 F 
6                           02233006    TEVA-ENALAPRIL            TEV 0002647 F 
6                           02291894    ACT ENALAPRIL             TEV 0002647 F 
6                           02299968    SANDOZ ENALAPRIL          SDZ 0002647 F 
6                           02300052    MYLAN-ENALAPRIL           MYL 0002647 F 
6                           02323494    SIG-ENALAPRIL             SLI 0002647 F 
6                           02352257    RAN-ENALAPRIL             RAN 0002647 F 
6                           02400677    ENALAPRIL                 SAN 0002647 F 
6                           02442973    ENALAPRIL                 SIV 0002647 F 
6                           02444771    MAR-ENALAPRIL             MPI 0002647 F 
6                           02474808    JAMP-ENALAPRIL            JPC 0002647 F 
6                           02565307    NRA-ENALAPRIL             NRA 0002647 F 
6                           00670901    VASOTEC                   ORG 0014229 F 
42                         *20MG TABLET                                         
6                           02019906    APO-ENALAPRIL             APX 0003195 F 
6                           02233007    TEVA-ENALAPRIL            TEV 0003195 F 
6                           02291908    ACT ENALAPRIL             TEV 0003195 F 
6                           02299976    SANDOZ ENALAPRIL          SDZ 0003195 F 
6                           02300060    MYLAN-ENALAPRIL           MYL 0003195 F 
6                           02323508    SIG-ENALAPRIL             SLI 0003195 F 
6                           02352265    RAN-ENALAPRIL             RAN 0003195 F 
6                           02400685    ENALAPRIL                 SAN 0003195 F 
6                           02442981    ENALAPRIL                 SIV 0003195 F 
6                           02444798    MAR-ENALAPRIL             MPI 0003195 F 
6                           02474816    JAMP-ENALAPRIL            JPC 0003195 F 
6                           02565315    NRA-ENALAPRIL             NRA 0003195 F 
6                           00670928    VASOTEC                   ORG 0017172 F 
41                          ENALAPRIL MALEATE/HYDROCHLOROTHIAZIDE               
42                          5MG/12.5MG TABLET                                   
6                           02352923    ENALAPRIL/HCTZ            AAP 0007492 F 
42                         *10MG/25MG TABLET                                    
6                           02352931    ENALAPRIL/HCTZ            AAP 0010893 F 
6                           00657298    VASERETIC                 ORG 0015036 F 
41                          FELODIPINE                                          
42                         *2.5MG SUSTAINED RELEASE TABLET                      
6                           02452367    APO-FELODIPINE            APX 0004050 F 
6                           02057778    PLENDIL                   GGP 0006063 F 
42                         *5MG SUSTAINED RELEASE TABLET                        
6                           02280264    SANDOZ FELODIPINE         SDZ 0003565 F 
6                           02452375    APO-FELODIPINE            APX 0003565 F 
6                           00851779    PLENDIL                   GGP 0008020 F 
42                         *10MG SUSTAINED RELEASE TABLET                       
6                           02280272    SANDOZ FELODIPINE         SDZ 0005350 F 
6                           02452383    APO-FELODIPINE            APX 0005350 F 
6                           00851787    PLENDIL                   GGP 0012027 F 
41                          FOSINOPRIL                                          
42                         *10MG TABLET                                         
6                           02247802    TEVA-FOSINOPRIL           TEV 0002178 F 
6                           02266008    APO-FOSINOPRIL            APX 0002178 F 
6                           02294524    RAN-FOSINOPRIL            RAN 0002178 F 
6                           02331004    JAMP-FOSINOPRIL           JPC 0002178 F 
6                           02459388    FOSINOPRIL                SAN 0002178 F 
42                         *20MG TABLET                                         
6                           02247803    TEVA-FOSINOPRIL           TEV 0002619 F 
6                           02266016    APO-FOSINOPRIL            APX 0002619 F 
6                           02294532    RAN-FOSINOPRIL            RAN 0002619 F 
6                           02331012    JAMP-FOSINOPRIL           JPC 0002619 F 
6                           02459396    FOSINOPRIL                SAN 0002619 F 
41                          GUANFACINE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *1MG EXTENDED RELEASE TABLET                         
61                          02523558    JAMP GUANFACINE XR (EDS)  JPC 0007688 E 
61                          02563185    SANDOZ GUANFACINE XR (EDS SDZ 0007688 E 
42                         *2MG EXTENDED RELEASE TABLET                         
61                          02523566    JAMP GUANFACINE XR (EDS)  JPC 0009353 E 
61                          02563193    SANDOZ GUANFACINE XR (EDS SDZ 0009353 E 
42                         *3MG EXTENDED RELEASE TABLET                         
61                          02523574    JAMP GUANFACINE XR (EDS)  JPC 0011019 E 
61                          02563207    SANDOZ GUANFACINE XR (EDS SDZ 0011019 E 
42                         *4MG EXTENDED RELEASE TABLET                         
61                          02523582    JAMP GUANFACINE XR (EDS)  JPC 0012685 E 
61                          02563215    SANDOZ GUANFACINE XR (EDS SDZ 0012685 E 
41                          HYDRALAZINE HCL                                     
42                         *10MG TABLET                                         
6                           00441619    APO-HYDRALAZINE           APX 0000355 F 
6                           02457865    JAMP-HYDRALAZINE          JPC 0000355 F 
6                           02468778    MINT-HYDRALAZINE          MNT 0000355 F 
6                           02539802    HYDRALAZINE               SAN 0000355 F 
42                         *25MG TABLET                                         
6                           00441627    APO-HYDRALAZINE           APX 0000609 F 
6                           02457873    JAMP-HYDRALAZINE          JPC 0000609 F 
6                           02468786    MINT-HYDRALAZINE          MNT 0000609 F 
6                           02539810    HYDRALAZINE               SAN 0000609 F 
42                         *50MG TABLET                                         
6                           00441635    APO-HYDRALAZINE           APX 0000956 F 
6                           02457881    JAMP-HYDRALAZINE          JPC 0000956 F 
6                           02468794    MINT-HYDRALAZINE          MNT 0000956 F 
6                           02539829    HYDRALAZINE               SAN 0000956 F 
41                          IRBESARTAN                                          
42                         *75MG TABLET                                         
6                           02316390    TEVA-IRBESARTAN           TEV 0002281 F 
6                           02317060    PMS-IRBESARTAN            PMS 0002281 F 
6                           02328461    SANDOZ IRBESARTAN         SDZ 0002281 F 
6                           02372347    IRBESARTAN                SAN 0002281 F 
6                           02385287    IRBESARTAN                SIV 0002281 F 
6                           02406098    AURO-IRBESARTAN           API 0002281 F 
6                           02406810    RAN-IRBESARTAN            RAN 0002281 F 
6                           02418193    JAMP-IRBESARTAN           JPC 0002281 F 
6                           02422980    MINT-IRBESARTAN           MNT 0002281 F 
6                           02524813    M-IRBESARTAN              MNP 0002281 F 
6                           02545225    JAMP IRBESARTAN           JPC 0002281 F 
42                         *150MG TABLET                                        
6                           02316404    TEVA-IRBESARTAN           TEV 0002281 F 
6                           02317079    PMS-IRBESARTAN            PMS 0002281 F 
6                           02328488    SANDOZ IRBESARTAN         SDZ 0002281 F 
6                           02372371    IRBESARTAN                SAN 0002281 F 
6                           02385295    IRBESARTAN                SIV 0002281 F 
6                           02406101    AURO-IRBESARTAN           API 0002281 F 
6                           02406829    RAN-IRBESARTAN            RAN 0002281 F 
6                           02422999    MINT-IRBESARTAN           MNT 0002281 F 
6                           02524821    M-IRBESARTAN              MNP 0002281 F 
6                           02545233    JAMP IRBESARTAN           JPC 0002281 F 
6                           02237924    AVAPRO                    AVT 0012937 F 
42                         *300MG TABLET                                        
6                           02316412    TEVA-IRBESARTAN           TEV 0002281 F 
6                           02317087    PMS-IRBESARTAN            PMS 0002281 F 
6                           02328496    SANDOZ IRBESARTAN         SDZ 0002281 F 
6                           02372398    IRBESARTAN                SAN 0002281 F 
6                           02385309    IRBESARTAN                SIV 0002281 F 
6                           02406128    AURO-IRBESARTAN           API 0002281 F 
6                           02406837    RAN-IRBESARTAN            RAN 0002281 F 
6                           02423006    MINT-IRBESARTAN           MNT 0002281 F 
6                           02524848    M-IRBESARTAN              MNP 0002281 F 
6                           02545241    JAMP IRBESARTAN           JPC 0002281 F 
6                           02237925    AVAPRO                    AVT 0012937 F 
41                          IRBESARTAN/HYDROCHLOROTHIAZIDE                      
42                         *150MG/12.5MG TABLET                                 
6                           02328518    PMS-IRBESARTAN HCTZ       PMS 0002281 F 
6                           02330512    TEVA-IRBESARTAN HCTZ      TEV 0002281 F 
6                           02337428    SANDOZ IRBESARTAN HCT     SDZ 0002281 F 
6                           02372886    IRBESARTAN/HCTZ           SAN 0002281 F 
6                           02385317    IRBESARTAN HCT            SIV 0002281 F 
6                           02447878    AURO-IRBESARTAN HCT       API 0002281 F 
6                           02241818    AVALIDE                   AVT 0013440 F 
42                         *300MG/12.5MG TABLET                                 
6                           02328526    PMS-IRBESARTAN HCTZ       PMS 0002281 F 
6                           02330520    TEVA-IRBESARTAN HCTZ      TEV 0002281 F 
6                           02337436    SANDOZ IRBESARTAN HCT     SDZ 0002281 F 
6                           02372894    IRBESARTAN/HCTZ           SAN 0002281 F 
6                           02385325    IRBESARTAN HCT            SIV 0002281 F 
6                           02418231    JAMP-IRBESARTAN AND HCTZ  JPC 0002281 F 
6                           02447886    AURO-IRBESARTAN HCT       API 0002281 F 
6                           02241819    AVALIDE                   AVT 0013440 F 
42                         *300MG/25MG TABLET                                   
6                           02328534    PMS-IRBESARTAN HCTZ       PMS 0002184 F 
6                           02330539    TEVA-IRBESARTAN HCTZ      TEV 0002184 F 
6                           02337444    SANDOZ IRBESARTAN HCT     SDZ 0002184 F 
6                           02372908    IRBESARTAN/HCTZ           SAN 0002184 F 
6                           02385333    IRBESARTAN HCT            SIV 0002184 F 
6                           02418258    JAMP-IRBESARTAN AND HCTZ  JPC 0002184 F 
6                           02447894    AURO-IRBESARTAN HCT       API 0002184 F 
41                          LABETALOL HCL                                       
42                         *100MG TABLET                                        
6                           02243538    APO-LABETALOL             APX 0001983 F 
6                           02489406    RIVA-LABETALOL            RIV 0001983 F 
6                           02106272    TRANDATE                  KTI 0003104 F 
42                         *200MG TABLET                                        
6                           02243539    APO-LABETALOL             APX 0003504 F 
6                           02489414    RIVA-LABETALOL            RIV 0003504 F 
6                           02106280    TRANDATE                  KTI 0005487 F 
41                          LISINOPRIL                                          
42                         *5MG TABLET                                          
6                           02217481    APO-LISINOPRIL            APX 0001347 F 
6                           02285061    TEVA-LISINOPRIL (TYPE P)  TEV 0001347 F 
6                           02285118    TEVA-LISINOPRIL (TYPE Z)  TEV 0001347 F 
6                           02289199    SANDOZ LISINOPRIL         SDZ 0001347 F 
6                           02294230    RAN-LISINOPRIL            RAN 0001347 F 
6                           02361531    JAMP-LISINOPRIL           JPC 0001347 F 
6                           02386232    LISINOPRIL                SIV 0001347 F 
6                           02394472    AURO-LISINOPRIL           API 0001347 F 
6                           02525186    LISINOPRIL                SAN 0001347 F 
6                           02554488    LISINOPRIL TABLETS        SIV 0001347 F 
6                           02049333    ZESTRIL                   SLP 0005770 F 
42                         *10MG TABLET                                         
6                           02217503    APO-LISINOPRIL            APX 0001619 F 
6                           02285088    TEVA-LISINOPRIL (TYPE P)  TEV 0001619 F 
6                           02285126    TEVA-LISINOPRIL (TYPE Z)  TEV 0001619 F 
6                           02289202    SANDOZ LISINOPRIL         SDZ 0001619 F 
6                           02294249    RAN-LISINOPRIL            RAN 0001619 F 
6                           02361558    JAMP-LISINOPRIL           JPC 0001619 F 
6                           02386240    LISINOPRIL                SIV 0001619 F 
6                           02394480    AURO-LISINOPRIL           API 0001619 F 
6                           02525194    LISINOPRIL                SAN 0001619 F 
6                           02554496    LISINOPRIL TABLETS        SIV 0001619 F 
6                           02049376    ZESTRIL                   SLP 0006935 F 
42                         *20MG TABLET                                         
6                           02217511    APO-LISINOPRIL            APX 0001945 F 
6                           02285096    TEVA-LISINOPRIL (TYPE P)  TEV 0001945 F 
6                           02285134    TEVA-LISINOPRIL (TYPE Z)  TEV 0001945 F 
6                           02289229    SANDOZ LISINOPRIL         SDZ 0001945 F 
6                           02294257    RAN-LISINOPRIL            RAN 0001945 F 
6                           02361566    JAMP-LISINOPRIL           JPC 0001945 F 
6                           02386259    LISINOPRIL                SIV 0001945 F 
6                           02394499    AURO-LISINOPRIL           API 0001945 F 
6                           02525208    LISINOPRIL                SAN 0001945 F 
6                           02554518    LISINOPRIL TABLETS        SIV 0001945 F 
6                           02049384    ZESTRIL                   SLP 0008330 F 
41                          LISINOPRIL/HYDROCHLOROTHIAZIDE                      
42                         *10MG/12.5MG TABLET                                  
6                           02301768    TEVA-LISINOPRIL/HCTZ (Z)  TEV 0002084 F 
6                           02302136    TEVA-LISINOPRIL/HCTZ (P)  TEV 0002084 F 
6                           02302365    SANDOZ LISINOPRIL HCT     SDZ 0002084 F 
6                           02362945    LISINOPRIL/HCTZ (Z)       SAN 0002084 F 
6                           02103729    ZESTORETIC                SLP 0009286 F 
42                         *20MG/12.5MG TABLET                                  
6                           02301776    TEVA-LISINOPRIL/HCTZ (Z)  TEV 0002504 F 
6                           02302373    SANDOZ LISINOPRIL HCT     SDZ 0002504 F 
6                           02362953    LISINOPRIL/HCTZ (Z)       SAN 0002504 F 
6                           02045737    ZESTORETIC                SLP 0011159 F 
42                         *20MG/25MG TABLET                                    
6                           02301784    TEVA-LISINOPRIL/HCTZ (Z)  TEV 0002504 F 
6                           02302381    SANDOZ LISINOPRIL HCT     SDZ 0002504 F 
6                           02362961    LISINOPRIL/HCTZ (Z)       SAN 0002504 F 
6                           02045729    ZESTORETIC                SLP 0011159 F 
41                          LOSARTAN POTASSIUM                                  
42                         *25MG TABLET                                         
6                           02309750    PMS-LOSARTAN              PMS 0003147 F 
6                           02313332    SANDOZ LOSARTAN           SDZ 0003147 F 
6                           02379058    APO-LOSARTAN              APX 0003147 F 
6                           02380838    TEVA-LOSARTAN             TEV 0003147 F 
6                           02388790    LOSARTAN                  SIV 0003147 F 
6                           02388863    LOSARTAN                  SAN 0003147 F 
6                           02398834    JAMP-LOSARTAN             JPC 0003147 F 
6                           02403323    AURO-LOSARTAN             API 0003147 F 
6                           02404451    RAN-LOSARTAN              RAN 0003147 F 
6                           02405733    MINT-LOSARTAN             MNT 0003147 F 
6                           02182815    COZAAR                    ORG 0017937 F 
42                         *50MG TABLET                                         
6                           02309769    PMS-LOSARTAN              PMS 0003147 F 
6                           02313340    SANDOZ LOSARTAN           SDZ 0003147 F 
6                           02353504    APO-LOSARTAN              APX 0003147 F 
6                           02357968    TEVA-LOSARTAN             TEV 0003147 F 
6                           02388804    LOSARTAN                  SIV 0003147 F 
6                           02388871    LOSARTAN                  SAN 0003147 F 
6                           02398842    JAMP-LOSARTAN             JPC 0003147 F 
6                           02403331    AURO-LOSARTAN             API 0003147 F 
6                           02404478    RAN-LOSARTAN              RAN 0003147 F 
6                           02405741    MINT-LOSARTAN             MNT 0003147 F 
6                           02182874    COZAAR                    ORG 0017937 F 
42                         *100MG TABLET                                        
6                           02309777    PMS-LOSARTAN              PMS 0003147 F 
6                           02313359    SANDOZ LOSARTAN           SDZ 0003147 F 
6                           02353512    APO-LOSARTAN              APX 0003147 F 
6                           02357976    TEVA-LOSARTAN             TEV 0003147 F 
6                           02388812    LOSARTAN                  SIV 0003147 F 
6                           02388898    LOSARTAN                  SAN 0003147 F 
6                           02398850    JAMP-LOSARTAN             JPC 0003147 F 
6                           02403358    AURO-LOSARTAN             API 0003147 F 
6                           02404486    RAN-LOSARTAN              RAN 0003147 F 
6                           02405768    MINT-LOSARTAN             MNT 0003147 F 
6                           02182882    COZAAR                    ORG 0017937 F 
41                          LOSARTAN POTASSIUM/HYDROCHLOROTHIAZIDE              
42                         *50MG/12.5MG TABLET                                  
6                           02313375    SANDOZ LOSARTAN HCT       SDZ 0003147 F 
6                           02358263    TEVA-LOSARTAN/HCTZ        TEV 0003147 F 
6                           02371235    APO-LOSARTAN/HCTZ         APX 0003147 F 
6                           02388960    LOSARTAN HCT              SIV 0003147 F 
6                           02389657    MINT-LOSARTAN/HCTZ        MNT 0003147 F 
6                           02392224    PMS-LOSARTAN-HCTZ         PMS 0003147 F 
6                           02408244    JAMP-LOSARTAN HCTZ        JPC 0003147 F 
6                           02423642    AURO-LOSARTAN HCT         API 0003147 F 
6                           02427648    LOSARTAN/HCTZ             SAN 0003147 F 
6                           02230047    HYZAAR                    ORG 0017937 F 
42                         *100MG/12.5MG TABLET                                 
6                           02362449    SANDOZ LOSARTAN HCT       SDZ 0003082 F 
6                           02371243    APO-LOSARTAN/HCTZ         APX 0003082 F 
6                           02377144    TEVA-LOSARTAN/HCTZ        TEV 0003082 F 
6                           02388979    LOSARTAN HCT              SIV 0003082 F 
6                           02389665    MINT-LOSARTAN/HCTZ        MNT 0003082 F 
6                           02392232    PMS-LOSARTAN-HCTZ         PMS 0003082 F 
6                           02423650    AURO-LOSARTAN HCT         API 0003082 F 
6                           02427656    LOSARTAN/HCTZ             SAN 0003082 F 
6                           02297841    HYZAAR                    ORG 0017560 F 
42                         *100MG/25MG TABLET                                   
6                           02313383    SANDOZ LOSARTAN HCT DS    SDZ 0003147 F 
6                           02371251    APO-LOSARTAN/HCTZ         APX 0003147 F 
6                           02377152    TEVA-LOSARTAN/HCTZ        TEV 0003147 F 
6                           02388987    LOSARTAN HCT              SIV 0003147 F 
6                           02389673    MINT-LOSARTAN/HCTZ        MNT 0003147 F 
6                           02392240    PMS-LOSARTAN-HCTZ         PMS 0003147 F 
6                           02408252    JAMP-LOSARTAN HCTZ        JPC 0003147 F 
6                           02423669    AURO-LOSARTAN HCT         API 0003147 F 
6                           02427664    LOSARTAN/HCTZ             SAN 0003147 F 
6                           02241007    HYZAAR DS                 ORG 0017937 F 
41                          METHYLDOPA                                          
42                          125MG TABLET                                        
6                           00360252    METHYLDOPA                AAP 0001319 F 
42                          250MG TABLET                                        
6                           00360260    METHYLDOPA                AAP 0001977 F 
42                          500MG TABLET                                        
6                           00426830    METHYLDOPA                AAP 0003387 F 
41                          MINOXIDIL                                           
42                          2.5MG TABLET                                        
6                           00514497    LONITEN                   PFI 0005387 F 
42                          10MG TABLET                                         
6                           00514500    LONITEN                   PFI 0011884 F 
41                          OLMESARTAN MEDOXOMIL                                
42                         *20MG TABLET                                         
6                           02442191    ACT OLMESARTAN            TEV 0003019 F 
6                           02443414    SANDOZ OLMESARTAN         SDZ 0003019 F 
6                           02443864    AURO-OLMESARTAN           API 0003019 F 
6                           02453452    APO-OLMESARTAN            APX 0003019 F 
6                           02456311    ACH-OLMESARTAN            AHI 0003019 F 
6                           02461307    PMS-OLMESARTAN            PMS 0003019 F 
6                           02461641    JAMP-OLMESARTAN           JPC 0003019 F 
6                           02469812    GLN-OLMESARTAN            GLN 0003019 F 
6                           02481057    OLMESARTAN                SAN 0003019 F 
6                           02499258    NRA-OLMESARTAN            NRA 0003019 F 
6                           02318660    OLMETEC                   ORG 0012974 F 
42                         *40MG TABLET                                         
6                           02442205    ACT OLMESARTAN            TEV 0003019 F 
6                           02443422    SANDOZ OLMESARTAN         SDZ 0003019 F 
6                           02443872    AURO-OLMESARTAN           API 0003019 F 
6                           02453460    APO-OLMESARTAN            APX 0003019 F 
6                           02456338    ACH-OLMESARTAN            AHI 0003019 F 
6                           02461315    PMS-OLMESARTAN            PMS 0003019 F 
6                           02461668    JAMP-OLMESARTAN           JPC 0003019 F 
6                           02469820    GLN-OLMESARTAN            GLN 0003019 F 
6                           02481065    OLMESARTAN                SAN 0003019 F 
6                           02499266    NRA-OLMESARTAN            NRA 0003019 F 
6                           02318679    OLMETEC                   ORG 0012974 F 
41                          OLMESARTAN MEDOXOMIL/HCTZ                           
42                         *20MG/12.5MG TABLET                                  
6                           02443112    ACT OLMESARTAN HCT        TEV 0003019 F 
6                           02453606    APO-OLMESARTAN/HCTZ       APX 0003019 F 
6                           02468948    ACH-OLMESARTAN HCTZ       AHI 0003019 F 
6                           02475707    GLN-OLMESARTAN HCTZ       GLN 0003019 F 
6                           02476487    AURO-OLMESARTAN HCTZ      API 0003019 F 
6                           02508273    NRA-OLMESARTAN HCTZ       NRA 0003019 F 
6                           02509601    OLMESARTAN/HCTZ           SAN 0003019 F 
6                           02526468    PRZ-OLMESARTAN/HCTZ       PRZ 0003019 F 
6                           02319616    OLMETEC PLUS              ORG 0013622 F 
42                         *40MG/12.5MG TABLET                                  
6                           02443120    ACT OLMESARTAN HCT        TEV 0003019 F 
6                           02453614    APO-OLMESARTAN/HCTZ       APX 0003019 F 
6                           02468956    ACH-OLMESARTAN HCTZ       AHI 0003019 F 
6                           02475715    GLN-OLMESARTAN HCTZ       GLN 0003019 F 
6                           02476495    AURO-OLMESARTAN HCTZ      API 0003019 F 
6                           02508281    NRA-OLMESARTAN HCTZ       NRA 0003019 F 
6                           02509636    OLMESARTAN/HCTZ           SAN 0003019 F 
6                           02526476    PRZ-OLMESARTAN/HCTZ       PRZ 0003019 F 
6                           02319624    OLMETEC PLUS              ORG 0014010 F 
42                         *40MG/25MG TABLET                                    
6                           02443139    ACT OLMESARTAN HCT        TEV 0003019 F 
6                           02453622    APO-OLMESARTAN/HCTZ       APX 0003019 F 
6                           02468964    ACH-OLMESARTAN HCTZ       AHI 0003019 F 
6                           02475723    GLN-OLMESARTAN HCTZ       GLN 0003019 F 
6                           02476509    AURO-OLMESARTAN HCTZ      API 0003019 F 
6                           02508303    NRA-OLMESARTAN HCTZ       NRA 0003019 F 
6                           02509628    OLMESARTAN/HCTZ           SAN 0003019 F 
6                           02526484    PRZ-OLMESARTAN/HCTZ       PRZ 0003019 F 
6                           02319632    OLMETEC PLUS              ORG 0013622 F 
41                          PERINDOPRIL ERBUMINE                                
42                         *2MG TABLET                                          
6                           02289261    APO-PERINDOPRIL           APX 0001632 F 
6                           02459817    AURO-PERINDOPRIL          API 0001632 F 
6                           02464985    TEVA-PERINDOPRIL          TEV 0001632 F 
6                           02470225    SANDOZ PERINDOPRIL ERBUM  SDZ 0001632 F 
6                           02470675    PMS-PERINDOPRIL           PMS 0001632 F 
6                           02474824    MAR-PERINDOPRIL           MPI 0001632 F 
6                           02476762    MINT-PERINDOPRIL          MNT 0001632 F 
6                           02477009    JAMP-PERINDOPRIL          JPC 0001632 F 
6                           02479877    PERINDOPRIL ERBUMINE      SIV 0001632 F 
6                           02481634    PERINDOPRIL ERBUMINE      SAN 0001632 F 
6                           02481677    AG-PERINDOPRIL            ANG 0001632 F 
6                           02482924    M-PERINDOPRIL ERBUMINE    MNP 0001632 F 
6                           02489015    NRA-PERINDOPRIL           NRA 0001632 F 
6                           02527200    JAMP PERINDOPRIL          JPC 0001632 F 
6                           02123274    COVERSYL                  SEV 0007943 F 
42                         *4MG TABLET                                          
6                           02289288    APO-PERINDOPRIL           APX 0002042 F 
6                           02459825    AURO-PERINDOPRIL          API 0002042 F 
6                           02464993    TEVA-PERINDOPRIL          TEV 0002042 F 
6                           02470233    SANDOZ PERINDOPRIL ERBUM  SDZ 0002042 F 
6                           02470683    PMS-PERINDOPRIL           PMS 0002042 F 
6                           02474832    MAR-PERINDOPRIL           MPI 0002042 F 
6                           02476770    MINT-PERINDOPRIL          MNT 0002042 F 
6                           02477017    JAMP-PERIDOPRIL           JPC 0002042 F 
6                           02479885    PERINDOPRIL ERBUMINE      SIV 0002042 F 
6                           02481642    PERINDOPRIL ERBUMINE      SAN 0002042 F 
6                           02481685    AG-PERINDOPRIL            ANG 0002042 F 
6                           02482932    M-PERINDOPRIL ERBUMINE    MNP 0002042 F 
6                           02489023    NRA-PERINDOPRIL           NRA 0002042 F 
6                           02527219    JAMP PERINDOPRIL          JPC 0002042 F 
6                           02123282    COVERSYL                  SEV 0009943 F 
42                         *8MG TABLET                                          
6                           02289296    APO-PERINDOPRIL           APX 0002831 F 
6                           02459833    AURO-PERINDOPRIL          API 0002831 F 
6                           02465000    TEVA-PERINDOPRIL          TEV 0002831 F 
6                           02470241    SANDOZ PERINDOPRIL ERBUM  SDZ 0002831 F 
6                           02470691    PMS-PERINDOPRIL           PMS 0002831 F 
6                           02474840    MAR-PERINDOPRIL           MPI 0002831 F 
6                           02476789    MINT-PERINDOPRIL          MNT 0002831 F 
6                           02477025    JAMP-PERINDOPRIL          JPC 0002831 F 
6                           02479893    PERINDOPRIL ERBUMINE      SIV 0002831 F 
6                           02481650    PERINDOPRIL ERBUMINE      SAN 0002831 F 
6                           02481693    AG-PERINDOPRIL            ANG 0002831 F 
6                           02482940    M-PERINDOPRIL ERBUMINE    MNP 0002831 F 
6                           02489031    NRA-PERINDOPRIL           NRA 0002831 F 
6                           02527227    JAMP PERINDOPRIL          JPC 0002831 F 
6                           02246624    COVERSYL                  SEV 0013927 F 
41                          PERINDOPRIL ERBUMINE/INDAPAMIDE                     
42                         *4MG/1.25MG TABLET                                   
6                           02297574    APO-PERINDOPRIL-INDAP     APX 0002556 F 
6                           02464020    TEVA-PERINDOPRIL/INDAP    TEV 0002556 F 
6                           02470438    SANDOZ PERINDOPRIL/INDAP  SDZ 0002556 F 
6                           02479834    PERINDOPRIL ERBUMINE/INDA SIV 0002556 F 
6                           02519720    PERINDOPRIL INDAPAMIDE    SAN 0002556 F 
6                           02538008    PMS-PERINDOPRIL INDAPAMID PMS 0002556 F 
6                           02554127    JAMP PERINDOPRIL/INDAPAMI JPC 0002556 F 
6                           02246569    COVERSYL PLUS             SEV 0011987 F 
42                         *8MG/2.5MG TABLET                                    
6                           02453061    APO-PERINDOPRIL-INDAP     APX 0002859 F 
6                           02464039    TEVA-PERINDOPRIL/INDAP    TEV 0002859 F 
6                           02470446    SANDOZ PERINDOPRIL/INDAP  SDZ 0002859 F 
6                           02479842    PERINDOPRIL ERBUMINE/INDA SIV 0002859 F 
6                           02519739    PERINDOPRIL INDAPAMIDE    SAN 0002859 F 
6                           02537982    PMS-PERINDOPRIL INDAPAMID PMS 0002859 F 
6                           02554135    JAMP PERINDOPRIL/INDAPAMI JPC 0002859 F 
6                           02321653    COVERSYL PLUS HD          SEV 0013380 F 
41                          PINDOLOL/HYDROCHLOROTHIAZIDE                        
42                          10MG/25MG TABLET                                    
6                           00568627    VISKAZIDE                 XED 0013682 F 
42                          10MG/50MG TABLET                                    
6                           00568635    VISKAZIDE                 XED 0013682 F 
41                          PRAZOSIN                                            
42                         *1MG TABLET                                          
6                           00882801    APO-PRAZO                 APX 0002634 F 
6                           01934198    TEVA-PRAZOSIN             TEV 0002634 F 
42                         *2MG TABLET                                          
6                           00882828    APO-PRAZO                 APX 0003643 F 
6                           01934201    TEVA-PRAZOSIN             TEV 0003643 F 
42                         *5MG TABLET                                          
6                           00882836    APO-PRAZO                 APX 0005009 F 
6                           01934228    TEVA-PRAZOSIN             TEV 0005009 F 
41                          QUINAPRIL HCL                                       
42                         *5MG TABLET                                          
6                           02248499    APO-QUINAPRIL             APX 0004642 F 
6                           02340550    PMS-QUINAPRIL             PMS 0004642 F 
42                         *10MG TABLET                                         
6                           02340569    PMS-QUINAPRIL             PMS 0004642 F 
6                           02517450    JAMP QUINAPRIL            JPC 0004642 F 
42                         *20MG TABLET                                         
6                           02340577    PMS-QUINAPRIL             PMS 0004642 F 
6                           02517469    JAMP QUINAPRIL            JPC 0004642 F 
42                         *40MG TABLET                                         
6                           02340585    PMS-QUINAPRIL             PMS 0004642 F 
6                           02517477    JAMP QUINAPRIL            JPC 0004642 F 
41                          QUINAPRIL HCL/HYDROCHLOROTHIAZIDE                   
42                         *10MG/12.5MG TABLET                                  
6                           02408767    APO-QUINAPRIL/HCTZ        APX 0002393 F 
6                           02473291    AURO-QUINAPRIL HCTZ       API 0002393 F 
6                           02547430    JAMP QUINAPRIL HCTZ       JPC 0002393 F 
42                         *20MG/12.5MG TABLET                                  
6                           02408775    APO-QUINAPRIL/HCTZ        APX 0004786 F 
6                           02473305    AURO-QUINAPRIL HCTZ       API 0004786 F 
42                         *20MG/25MG TABLET                                    
6                           02408783    APO-QUINAPRIL/HCTZ        APX 0002301 F 
6                           02473321    AURO-QUINAPRIL HCTZ       API 0002301 F 
6                           02547449    JAMP QUINAPRIL HCTZ       JPC 0002301 F 
41                          RAMIPRIL                                            
42                         *1.25MG CAPSULE/TABLET                               
6                           02251515    APO-RAMIPRIL              APX 0000708 F 
6                           02308363    RAMIPRIL                  SIV 0000708 F 
6                           02310503    RAN-RAMIPRIL              RAN 0000708 F 
6                           02387387    AURO-RAMIPRIL             API 0000708 F 
6                           02420457    MAR-RAMIPRIL              MPI 0000708 F 
6                           02469057    PHARMA-RAMIPRIL           PMS 0000708 F 
6                           02550202    PMSC-RAMIPRIL             PMS 0000708 F 
6                           02221829    ALTACE                    BAU 0008940 F 
42                         *2.5MG CAPSULE/TABLET                                
6                           02247945    TEVA-RAMIPRIL             TEV 0000817 F 
6                           02251531    APO-RAMIPRIL              APX 0000817 F 
6                           02287927    RAMIPRIL                  SIV 0000817 F 
6                           02310511    RAN-RAMIPRIL              RAN 0000817 F 
6                           02331128    JAMP-RAMIPRIL             JPC 0000817 F 
6                           02374846    RAMIPRIL                  SAN 0000817 F 
6                           02387395    AURO-RAMIPRIL             API 0000817 F 
6                           02420465    MAR-RAMIPRIL              MPI 0000817 F 
6                           02421305    MINT-RAMIPRIL             MNT 0000817 F 
6                           02469065    PHARMA-RAMIPRIL           PMS 0000817 F 
6                           02477572    AG-RAMIPRIL               ANG 0000817 F 
6                           02486172    NRA-RAMIPRIL              NRA 0000817 F 
6                           02550210    PMSC-RAMIPRIL             PMS 0000817 F 
6                           02221837    ALTACE                    BAU 0010057 F 
42                         *5MG CAPSULE/TABLET                                  
6                           02247946    TEVA-RAMIPRIL             TEV 0000817 F 
6                           02251574    APO-RAMIPRIL              APX 0000817 F 
6                           02287935    RAMIPRIL                  SIV 0000817 F 
6                           02310538    RAN-RAMIPRIL              RAN 0000817 F 
6                           02331136    JAMP-RAMIPRIL             JPC 0000817 F 
6                           02387409    AURO-RAMIPRIL             API 0000817 F 
6                           02420473    MAR-RAMIPRIL              MPI 0000817 F 
6                           02421313    MINT-RAMIPRIL             MNT 0000817 F 
6                           02469073    PHARMA-RAMIPRIL           PMS 0000817 F 
6                           02477580    AG-RAMIPRIL               ANG 0000817 F 
6                           02486180    NRA-RAMIPRIL              NRA 0000817 F 
6                           02550229    PMSC-RAMIPRIL             PMS 0000817 F 
6                           02221845    ALTACE                    BAU 0010320 F 
42                         *10MG CAPSULE/TABLET                                 
6                           02247947    TEVA-RAMIPRIL             TEV 0001034 F 
6                           02251582    APO-RAMIPRIL              APX 0001034 F 
6                           02287943    RAMIPRIL                  SIV 0001034 F 
6                           02310546    RAN-RAMIPRIL              RAN 0001034 F 
6                           02331144    JAMP-RAMIPRIL             JPC 0001034 F 
6                           02374862    RAMIPRIL                  SAN 0001034 F 
6                           02387417    AURO-RAMIPRIL             API 0001034 F 
6                           02420481    MAR-RAMIPRIL              MPI 0001034 F 
6                           02421321    MINT-RAMIPRIL             MNT 0001034 F 
6                           02469081    PHARMA-RAMIPRIL           PMS 0001034 F 
6                           02477599    AG-RAMIPRIL               ANG 0001034 F 
6                           02486199    NRA-RAMIPRIL              NRA 0001034 F 
6                           02550237    PMSC-RAMIPRIL             PMS 0001034 F 
6                           02221853    ALTACE                    BAU 0013255 F 
41                          RAMIPRIL/HYDROCHLOROTHIAZIDE                        
42                          2.5MG/12.5MG TABLET                                 
6                           02449439    RAN-RAMIPRIL HCTZ         RAN 0002242 F 
42                          5MG/12.5MG TABLET                                   
6                           02449447    RAN-RAMIPRIL HCTZ         RAN 0003016 F 
42                         *10MG/12.5MG TABLET                                  
6                           02342154    PMS-RAMIPRIL/HCTZ         PMS 0002634 F 
6                           02449455    RAN-RAMIPRIL HCTZ         RAN 0002634 F 
6                           02283166    ALTACE HCT                BAU 0006068 F 
42                          5MG/25MG TABLET                                     
6                           02449463    RAN-RAMIPRIL HCTZ         RAN 0002872 F 
42                         *10MG/25MG TABLET                                    
6                           02342170    PMS-RAMIPRIL/HCTZ         PMS 0002634 F 
6                           02449471    RAN-RAMIPRIL HCTZ         RAN 0002634 F 
41                          SPIRONOLACTONE/HYDROCHLOROTHIAZIDE                  
42                          25MG/25MG TABLET                                    
6                           00613231    TEVA-SPIRONOLACTONE/HCTZ  TEV 0001471 F 
42                          50MG/50MG TABLET                                    
6                           00657182    TEVA-SPIRONOLACTONE/HCTZ  TEV 0003112 F 
41                          TELMISARTAN                                         
42                         *40MG TABLET                                         
6                           02320177    TEVA-TELMISARTAN          TEV 0002161 F 
6                           02375958    SANDOZ TELMISARTAN        SDZ 0002161 F 
6                           02386755    JAMP TELMISARTAN          JPC 0002161 F 
6                           02388944    TELMISARTAN               SAN 0002161 F 
6                           02390345    TELMISARTAN               SIV 0002161 F 
6                           02407485    TELMISARTAN TABLETS       AHI 0002161 F 
6                           02453568    AURO-TELMISARTAN          API 0002161 F 
6                           02486369    MINT-TELMISARTAN          MNT 0002161 F 
6                           02499622    PMS-TELMISARTAN           PMS 0002161 F 
6                           02503794    NRA-TELMISARTAN           NRA 0002161 F 
6                           02240769    MICARDIS                  BOE 0013211 F 
42                         *80MG TABLET                                         
6                           02320185    TEVA-TELMISARTAN          TEV 0002161 F 
6                           02375966    SANDOZ TELMISARTAN        SDZ 0002161 F 
6                           02386763    JAMP TELMISARTAN          JPC 0002161 F 
6                           02388952    TELMISARTAN               SAN 0002161 F 
6                           02390353    TELMISARTAN               SIV 0002161 F 
6                           02407493    TELMISARTAN TABLETS       AHI 0002161 F 
6                           02453576    AURO-TELMISARTAN          API 0002161 F 
6                           02486377    MINT-TELMISARTAN          MNT 0002161 F 
6                           02499630    PMS-TELMISARTAN           PMS 0002161 F 
6                           02503808    NRA-TELMISARTAN           NRA 0002161 F 
6                           02240770    MICARDIS                  BOE 0013211 F 
41                          TELMISARTAN/AMLODIPINE                              
42                         *40MG/5MG TABLET                                     
6                           02559854    RIVA-TELMISARTAN AMLODIPI RIV 0004470 F 
6                           02371022    TWYNSTA                   BOE 0007668 F 
42                         *40MG/10MG TABLET                                    
6                           02559862    RIVA-TELMISARTAN AMLODIPI RIV 0004470 F 
6                           02371030    TWYNSTA                   BOE 0007668 F 
42                         *80MG/5MG TABLET                                     
6                           02559870    RIVA-TELMISARTAN AMLODIPI RIV 0003648 F 
6                           02371049    TWYNSTA                   BOE 0007668 F 
42                         *80MG/10MG TABLET                                    
6                           02559889    RIVA-TELMISARTAN AMLODIPI RIV 0003648 F 
6                           02371057    TWYNSTA                   BOE 0007668 F 
41                          TELMISARTAN/HYDROCHLOROTHIAZIDE                     
42                         *80MG/12.5MG TABLET                                  
6                           02330288    TEVA-TELMISARTAN HCTZ     TEV 0002098 F 
6                           02389940    JAMP TELMISARTAN-HCT      JPC 0002098 F 
6                           02390302    TELMISARTAN HCTZ          SIV 0002098 F 
6                           02393557    SANDOZ-TELMISARTAN HCT    SDZ 0002098 F 
6                           02395355    TELMISARTAN/HCTZ          SAN 0002098 F 
6                           02419114    ACH-TELMISARTAN HCTZ      AHI 0002098 F 
6                           02456389    AURO-TELMISARTAN HCTZ     API 0002098 F 
6                           02504146    NRA-TELMISARTAN HCTZ      NRA 0002098 F 
6                           02244344    MICARDIS PLUS             BOE 0013211 F 
42                         *80MG/25MG TABLET                                    
6                           02379252    TEVA-TELMISARTAN HCTZ     TEV 0002098 F 
6                           02389959    JAMP TELMISARTAN-HCT      JPC 0002098 F 
6                           02390310    TELMISARTAN HCTZ          SIV 0002098 F 
6                           02393565    SANDOZ-TELMISARTAN HCT    SDZ 0002098 F 
6                           02395363    TELMISARTAN/HCTZ          SAN 0002098 F 
6                           02419122    ACH-TELMISARTAN HCTZ      AHI 0002098 F 
6                           02456397    AURO-TELMISARTAN HCTZ     API 0002098 F 
6                           02504138    NRA-TELMISARTAN HCTZ      NRA 0002098 F 
6                           02318709    MICARDIS PLUS             BOE 0013211 F 
41                          TERAZOSIN HCL                                       
42                         *1MG TABLET                                          
6                           02234502    APO-TERAZOSIN             APX 0003938 F 
6                           02243518    PMS-TERAZOSIN             PMS 0003938 F 
42                         *2MG TABLET                                          
6                           02234503    APO-TERAZOSIN             APX 0005005 F 
6                           02243519    PMS-TERAZOSIN             PMS 0005005 F 
42                         *5MG TABLET                                          
6                           02234504    APO-TERAZOSIN             APX 0006797 F 
6                           02243520    PMS-TERAZOSIN             PMS 0006797 F 
42                         *10MG TABLET                                         
6                           02234505    APO-TERAZOSIN             APX 0009950 F 
6                           02243521    PMS-TERAZOSIN             PMS 0009950 F 
41                          TRANDOLAPRIL                                        
42                         *0.5MG CAPSULE                                       
6                           02325721    SANDOZ TRANDOLAPRIL       SDZ 0000698 F 
6                           02357755    PMS-TRANDOLAPRIL          PMS 0000698 F 
6                           02471868    AURO-TRANDOLAPRIL         API 0000698 F 
6                           02231457    MAVIK                     BGP 0002963 F 
42                         *1MG CAPSULE                                         
6                           02325748    SANDOZ TRANDOLAPRIL       SDZ 0001762 F 
6                           02357763    PMS-TRANDOLAPRIL          PMS 0001762 F 
6                           02471876    AURO-TRANDOLAPRIL         API 0001762 F 
6                           02525046    TRANDOLAPRIL              SAN 0001762 F 
6                           02526565    TRANDOLAPRIL              SIV 0001762 F 
6                           02231459    MAVIK                     BGP 0007482 F 
42                         *2MG CAPSULE                                         
6                           02325756    SANDOZ TRANDOLAPRIL       SDZ 0002025 F 
6                           02357771    PMS-TRANDOLAPRIL          PMS 0002025 F 
6                           02471884    AURO-TRANDOLAPRIL         API 0002025 F 
6                           02525054    TRANDOLAPRIL              SAN 0002025 F 
6                           02526573    TRANDOLAPRIL              SIV 0002025 F 
6                           02231460    MAVIK                     BGP 0008599 F 
42                         *4MG CAPSULE                                         
6                           02325764    SANDOZ TRANDOLAPRIL       SDZ 0002498 F 
6                           02357798    PMS-TRANDOLAPRIL          PMS 0002498 F 
6                           02471892    AURO-TRANDOLAPRIL         API 0002498 F 
6                           02525070    TRANDOLAPRIL              SAN 0002498 F 
6                           02526581    TRANDOLAPRIL              SIV 0002498 F 
6                           02239267    MAVIK                     BGP 0010608 F 
41                          TRIAMTERENE/HYDROCHLOROTHIAZIDE                     
42                         *50MG/25MG TABLET                                    
6                           00441775    APO-TRIAZIDE              APX 0000608 F 
6                           00532657    TEVA-TRIAMTERENE/HCTZ     TEV 0000608 F 
41                          VALSARTAN                                           
42                         *40MG TABLET                                         
6                           02356643    TEVA-VALSARTAN            TEV 0002211 F 
6                           02356740    SANDOZ VALSARTAN          SDZ 0002211 F 
6                           02363062    TARO-VALSARTAN            SUN 0002211 F 
6                           02366940    VALSARTAN                 SAN 0002211 F 
6                           02384523    VALSARTAN                 SIV 0002211 F 
6                           02414201    AURO-VALSARTAN            API 0002211 F 
6                           02524511    M-VALSARTAN               MNP 0002211 F 
6                           02270528    DIOVAN                    NVR 0014168 F 
42                         *80MG TABLET                                         
6                           02356651    TEVA-VALSARTAN            TEV 0002159 F 
6                           02356759    SANDOZ VALSARTAN          SDZ 0002159 F 
6                           02363100    TARO-VALSARTAN            SUN 0002159 F 
6                           02366959    VALSARTAN                 SAN 0002159 F 
6                           02384531    VALSARTAN                 SIV 0002159 F 
6                           02414228    AURO-VALSARTAN            API 0002159 F 
6                           02524538    M-VALSARTAN               MNP 0002159 F 
6                           02244781    DIOVAN                    NVR 0014554 F 
42                         *160MG TABLET                                        
6                           02356678    TEVA-VALSARTAN            TEV 0002159 F 
6                           02356767    SANDOZ VALSARTAN          SDZ 0002159 F 
6                           02363119    TARO-VALSARTAN            SUN 0002159 F 
6                           02366967    VALSARTAN                 SAN 0002159 F 
6                           02384558    VALSARTAN                 SIV 0002159 F 
6                           02414236    AURO-VALSARTAN            API 0002159 F 
6                           02524546    M-VALSARTAN               MNP 0002159 F 
6                           02244782    DIOVAN                    NVR 0014554 F 
42                         *320MG TABLET                                        
6                           02356686    TEVA-VALSARTAN            TEV 0002098 F 
6                           02356775    SANDOZ VALSARTAN          SDZ 0002098 F 
6                           02366975    VALSARTAN                 SAN 0002098 F 
6                           02384566    VALSARTAN                 SIV 0002098 F 
6                           02414244    AURO-VALSARTAN            API 0002098 F 
6                           02289504    DIOVAN                    NVR 0014018 F 
41                          VALSARTAN/HYDROCHLOROTHIAZIDE                       
42                         *80MG/12.5MG TABLET                                  
6                           02356694    SANDOZ VALSARTAN HCT      SDZ 0002213 F 
6                           02356996    TEVA-VALSARTAN/HCTZ       TEV 0002213 F 
6                           02367009    VALSARTAN HCT             SAN 0002213 F 
6                           02384736    VALSARTAN HCT             SIV 0002213 F 
6                           02408112    AURO-VALSARTAN HCT        API 0002213 F 
6                           02241900    DIOVAN-HCT                NVR 0014471 F 
42                         *160MG/12.5MG TABLET                                 
6                           02356708    SANDOZ VALSARTAN HCT      SDZ 0002240 F 
6                           02357003    TEVA-VALSARTAN/HCTZ       TEV 0002240 F 
6                           02367017    VALSARTAN HCT             SAN 0002240 F 
6                           02384744    VALSARTAN HCT             SIV 0002240 F 
6                           02408120    AURO-VALSARTAN HCT        API 0002240 F 
6                           02241901    DIOVAN-HCT                NVR 0014529 F 
42                         *160MG/25MG TABLET                                   
6                           02356716    SANDOZ VALSARTAN HCT      SDZ 0002238 F 
6                           02357011    TEVA-VALSARTAN/HCTZ       TEV 0002238 F 
6                           02367025    VALSARTAN HCT             SAN 0002238 F 
6                           02384752    VALSARTAN HCT             SIV 0002238 F 
6                           02408139    AURO-VALSARTAN HCT        API 0002238 F 
6                           02246955    DIOVAN-HCT                NVR 0014579 F 
42                         *320MG/12.5MG TABLET                                 
6                           02356724    SANDOZ VALSARTAN HCT      SDZ 0002235 F 
6                           02357038    TEVA-VALSARTAN/HCTZ       TEV 0002235 F 
6                           02367033    VALSARTAN HCT             SAN 0002235 F 
6                           02384760    VALSARTAN HCT             SIV 0002235 F 
6                           02408147    AURO-VALSARTAN HCT        API 0002235 F 
6                           02308908    DIOVAN-HCT                NVR 0014354 F 
42                         *320MG/25MG TABLET                                   
6                           02356732    SANDOZ VALSARTAN HCT      SDZ 0002231 F 
6                           02357046    TEVA-VALSARTAN/HCTZ       TEV 0002231 F 
6                           02367041    VALSARTAN HCT             SAN 0002231 F 
6                           02408155    AURO-VALSARTAN HCT        API 0002231 F 
6                           02308916    DIOVAN-HCT                NVR 0014354 F 
41                          VERAPAMIL HCL                                       
42                          80MG TABLET                                         
6                           00782483    AA-VERAP                  AAP 0002795 F 
42                         *120MG TABLET                                        
6                           00782491    AA-VERAP                  AAP 0004250 F 
6                           02237922    MYLAN-VERAPAMIL           MYL 0004250 F 
42                         *120MG SUSTAINED RELEASE TABLET                      
6                           02210347    MYLAN-VERAPAMIL SR        MYL 0005078 F 
6                           02246893    APO-VERAP SR              APX 0005078 F 
6                           01907123    ISOPTIN SR                BGP 0017677 F 
42                         *180MG SUSTAINED RELEASE TABLET                      
6                           02246894    APO-VERAP SR              APX 0005204 F 
6                           02450488    MYLAN-VERAPAMIL SR        MYL 0005204 F 
6                           01934317    ISOPTIN SR                BGP 0019960 F 
42                         *240MG SUSTAINED RELEASE TABLET                      
6                           02450496    MYLAN-VERAPAMIL SR        MYL 0017143 F 
6                           00742554    ISOPTIN SR                BGP 0026618 F 
41                          1MG EXTENDED RELEASE TABLET                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
2         VASODILATORS                                                          
41                          AMBRISENTAN                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02475375    APO-AMBRISENTAN (EDS)     APX 0625464 E 
61                          02521938    JAMP AMBRISENTAN (EDS)    JPC 0625464 E 
61                          02307065    VOLIBRIS (EDS)            GSK 1339247 E 
42                         *10MG TABLET                                         
61                          02475383    APO-AMBRISENTAN (EDS)     APX 0625464 E 
61                          02521946    JAMP AMBRISENTAN (EDS)    JPC 0625464 E 
61                          02307073    VOLIBRIS (EDS)            GSK 1339247 E 
41                          BETAHISTINE DIHYDROCHLORIDE                         
42                         *8MG TABLET                                          
6                           02449145    AURO-BETAHISTINE          API 0000637 F 
6                           02519682    M-BETAHISTINE             MNP 0000637 F 
6                           02538121    MINT-BETAHISTINE          MNT 0000637 F 
42                         *16MG TABLET                                         
6                           02280191    TEVA-BETAHISTINE          TEV 0001167 F 
6                           02330210    PMS-BETAHISTINE           PMS 0001167 F 
6                           02449153    AURO-BETAHISTINE          API 0001167 F 
6                           02466449    BETAHISTINE               SAN 0001167 F 
6                           02519690    M-BETAHISTINE             MNP 0001167 F 
6                           02538148    MINT-BETAHISTINE          MNT 0001167 F 
6                           02544938    NRA-BETAHISTINE           NRA 0001167 F 
6                           02243878    SERC                      BGP 0005806 F 
42                         *24MG TABLET                                         
6                           02280205    TEVA-BETAHISTINE          TEV 0001750 F 
6                           02330237    PMS-BETAHISTINE           PMS 0001750 F 
6                           02449161    AURO-BETAHISTINE          API 0001750 F 
6                           02466457    BETAHISTINE               SAN 0001750 F 
6                           02519704    M-BETAHISTINE             MNP 0001750 F 
6                           02538156    MINT-BETAHISTINE          MNT 0001750 F 
6                           02544946    NRA-BETAHISTINE           NRA 0001750 F 
6                           02247998    SERC                      BGP 0008706 F 
41                          BOSENTAN                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *62.5MG TABLET                                       
61                          02383012    PMS-BOSENTAN (EDS)        PMS 0160447 E 
61                          02467984    NAT-BOSENTAN (EDS)        NPI 0160447 E 
61                          02483130    TARO-BOSENTAN (EDS)       TAR 0160447 E 
61                          02244981    TRACLEER (EDS)            JAN 0888725 E 
42                         *125MG TABLET                                        
61                          02383020    PMS-BOSENTAN (EDS)        PMS 0160447 E 
61                          02467992    NAT-BOSENTAN (EDS)        NPI 0160447 E 
61                          02483149    TAR-BOSENTAN (EDS)        TAR 0160447 E 
61                          02244982    TRACLEER (EDS)            JAN 0888725 E 
41                          DIPYRIDAMOLE/ACETYLSALICYLIC ACID                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/25MG CAPSULE                                  
61                          02471051    TARO-DIPYRIDAMOLE/ASA(EDS TAR 0006656 E 
41                          EPOPROSTENOL                                        
51                          PLEASE CONTACT THE DRUG PLAN FOR DETAILS.           
52                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?0.5MG/VIAL INJECTION                                
61                          02397447    CARIPUL (EDS)             JAN 0207800 E 
61                          02230845    FLOLAN (EDS)              GSK 0246800 E 
42                         ?1.5MG/VIAL INJECTION                                
61                          02397455    CARIPUL (EDS)             JAN 0416800 E 
61                          02230848    FLOLAN (EDS)              GSK 0493500 E 
42                          FLOLAN DILUENT                                      
61                          02443651    FLOLAN DILUENT (EDS)      GSK 0130550 E 
42                          PER DIEM SUPPLIES                                   
61                          00951211    CARIPUL SUPP/PER DIEM(EDS JAN 0460000 E 
42                          CARIPUL DILUENT                                     
61                          00951210    CARIPUL DILUENT (EDS)     JAN 0068000 E 
41                          ISOSORBIDE DINITRATE                                
42                          10MG TABLET                                         
6                           00441686    ISDN                      AAP 0000489 F 
42                          30MG TABLET                                         
6                           00441694    ISDN                      AAP 0001143 F 
42                          5MG SUBLINGUAL TABLET                               
6                           00670944    ISDN                      AAP 0000685 F 
41                          ISOSORBIDE-5 MONONITRATE                            
42                         *60MG EXTENDED-RELEASE TABLET                        
6                           02272830    APO-ISMN                  APX 0001841 F 
6                           02301288    PMS-ISMN                  PMS 0001841 F 
6                           02562561    PRZ-ISMN                  PRZ 0001841 F 
41                          MACITENTAN                                          
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          10MG TABLET                                         
61                          02415690    OPSUMIT (EDS)             JAN 1320550 E 
41                          NIMODIPINE                                          
42                          30MG TABLET                                         
6                           02325926    NIMOTOP                   LXO 0103006 F 
41                          NITROGLYCERIN                                       
42                          0.2MG/HR. TRANSDERMAL THERAPEUTIC SYSTEM            
6                           02230732    TRINIPATCH 0.2            KTI 0007607 F 
42                         *0.2MG/HR TRANSDERMAL THERAPEUTIC SYSTEM             
6                           01911910    NITRO-DUR 0.2             DLC 0004686 F 
6                           02407442    MYLAN-NITRO PATCH 0.2     MYL 0004785 F 
42                          0.4MG/HR. TRANSDERMAL THERAPEUTIC SYSTEM            
6                           02230733    TRINIPATCH 0.4            KTI 0008580 F 
42                         *0.4MG/HR TRANSDERMAL THERAPEUTIC SYSTEM             
6                           01911902    NITRO-DUR 0.4             DLC 0005292 F 
6                           02407450    MYLAN-NITRO PATCH 0.4     MYL 0005403 F 
42                          0.6MG/HR. TRANSDERMAL THERAPEUTIC SYSTEM            
6                           02230734    TRINIPATCH 0.6            KTI 0008580 F 
42                         *0.6MG/HR TRANSDERMAL THERAPEUTIC SYSTEM             
6                           01911929    NITRO-DUR 0.6             DLC 0005292 F 
6                           02407469    MYLAN-NITRO PATCH 0.6     MYL 0005403 F 
42                         *0.8MG/HR. TRANSDERMAL THERAPEUTIC SYSTEM            
6                           02011271    NITRO-DUR 0.8             DLC 0009177 F 
6                           02407477    MYLAN-NITRO PATCH 0.8     MYL 0009371 F 
42                          0.3MG SUBLINGUAL TABLET                             
6                           00037613    NITROSTAT                 BGP 0001844 F 
42                          0.6MG SUBLINGUAL TABLET                             
6                           00037621    NITROSTAT                 BGP 0001844 F 
42                         *0.4MG/DOSE LINGUAL SPRAY (PACKAGE)                  
6                           02238998    RHO-NITRO PUMPSPRAY       SDZ 0088000 F 
6                           02231441    NITROLINGUAL PUMPSPRAY    MDX 0160000 F 
41                          SELEXIPAG                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MCG TABLET                                       
61                          02451158    UPTRAVI (EDS)             JAN 0747550 E 
42                          400MCG TABLET                                       
61                          02451166    UPTRAVI (EDS)             JAN 0747550 E 
42                          600MCG TABLET                                       
61                          02451174    UPTRAVI (EDS)             JAN 0747550 E 
42                          800MCG TABLET                                       
61                          02451182    UPTRAVI (EDS)             JAN 0747550 E 
42                          1000MCG TABLET                                      
61                          02451190    UPTRAVI (EDS)             JAN 0747550 E 
42                          1200MCG TABLET                                      
61                          02451204    UPTRAVI (EDS)             JAN 0747550 E 
42                          1400MCG TABLET                                      
61                          02451212    UPTRAVI (EDS)             JAN 0747550 E 
42                          1600MCG TABLET                                      
61                          02451220    UPTRAVI (EDS)             JAN 0747550 E 
41                          SILDENAFIL CITRATE                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *20MG TABLET                                         
61                          02319500    TEVA-SILDENAFIL R (EDS)   TEV 0029620 E 
61                          02412179    PMS-SILDENAFIL R (EDS)    PMS 0029620 E 
61                          02469669    JAMP-SILDENAFIL R (EDS)   JPC 0029620 E 
61                          02279401    REVATIO (EDS)             BGP 0134637 E 
41                          TADALAFIL                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *20MG TABLET                                         
61                          02421933    APO-TADALAFIL PAH (EDS)   APX 0101228 E 
61                          02338327    ADCIRCA (EDS)             LIL 0149763 E 
41                          TREPROSTINIL                                        
51                          PLEASE CONTACT THE DRUG PLAN FOR DETAILS.           
52                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG INJECTION SOLUTION                              
61                          02246552    REMODULIN (EDS)           UTI 0450000 E 
42                          2.5MG INJECTION SOLUTION                            
61                          02246553    REMODULIN (EDS)           UTI 1125000 E 
42                          5MG INJECTION SOLUTION                              
61                          02246554    REMODULIN (EDS)           UTI 2250000 E 
42                          10MG INJECTION SOLUTION                             
61                          02246555    REMODULIN (EDS)           UTI 4500000 E 
42                          PER DIEM SUPPLIES                                   
61                          00950963    REMODULIN SUPP/DIEM (EDS) UTI 0460000 E 
2         ANGIOTENSIN II RECEPTOR INHIBITORS                                    
41                          SACUBITRIL/VALSARTAN                                
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          24.3MG/25.7MG TABLET                                
61                          02446928    ENTRESTO (EDS)            NVR 0037060 E 
42                          48.6MG/51.4MG TABLET                                
61                          02446936    ENTRESTO (EDS)            NVR 0037060 E 
42                          97.2MG/102.8MG TABLET                               
61                          02446944    ENTRESTO (EDS)            NVR 0037060 E 
2         ALDOSTERONE RECEPTOR INHIBITORS                                       
41                          EPLERENONE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *25MG TABLET                                         
61                          02471442    MINT-EPLERENONE (EDS)     MNT 0013730 E 
61                          02543389    JAMP EPLERENONE (EDS)     JPC 0013730 E 
61                          02323052    INSPRA (EDS)              BGP 0033407 E 
42                         *50MG TABLET                                         
61                          02471450    MINT-EPLERENONE (EDS)     MNT 0013730 E 
61                          02543397    JAMP EPLERENONE (EDS)     JPC 0013730 E 
61                          02323060    INSPRA (EDS)              BGP 0033407 E 
41                          FINERENONE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02531917    KERENDIA (EDS)            BAY 0032565 E 
42                          20MG TABLET                                         
61                          02531925    KERENDIA (EDS)            BAY 0032565 E 
1         CENTRAL NERVOUS SYSTEM DRUGS                                          
2         NON-STEROIDAL ANTI-INFLAMMATORY DRUGS                                 
41                          CELECOXIB                                           
42                         *100MG CAPSULE                                       
6                           02355442    PMS-CELECOXIB             PMS 0001279 F 
6                           02412497    MINT-CELECOXIB            MNT 0001279 F 
6                           02418932    APO-CELECOXIB             APX 0001279 F 
6                           02420058    MAR-CELECOXIB             MPI 0001279 F 
6                           02424533    JAMP-CELECOXIB            JPC 0001279 F 
6                           02429675    CELECOXIB                 SIV 0001279 F 
6                           02436299    CELECOXIB                 SAN 0001279 F 
6                           02437570    AG-CELECOXIB              ANG 0001279 F 
6                           02445670    AURO-CELECOXIB            API 0001279 F 
6                           02479737    NRA-CELECOXIB             NRA 0001279 F 
6                           02495465    M-CELECOXIB               MNP 0001279 F 
6                           02517116    PMSC-CELECOXIB            PMS 0001279 F 
6                           02239941    CELEBREX                  BGP 0008398 F 
42                         *200MG CAPSULE                                       
6                           02355450    PMS-CELECOXIB             PMS 0002558 F 
6                           02412500    MINT-CELECOXIB            MNT 0002558 F 
6                           02418940    APO-CELECOXIB             APX 0002558 F 
6                           02420066    MAR-CELECOXIB             MPI 0002558 F 
6                           02424541    JAMP-CELECOXIB            JPC 0002558 F 
6                           02429683    CELECOXIB                 SIV 0002558 F 
6                           02436302    CELECOXIB                 SAN 0002558 F 
6                           02437589    AG-CELECOXIB              ANG 0002558 F 
6                           02445689    AURO-CELECOXIB            API 0002558 F 
6                           02479745    NRA-CELECOXIB             NRA 0002558 F 
6                           02495473    M-CELECOXIB               MNP 0002558 F 
6                           02517124    PMSC-CELECOXIB            PMS 0002558 F 
6                           02239942    CELEBREX                  BGP 0016799 F 
41                          DICLOFENAC SODIUM                                   
42                         *25MG ENTERIC TABLET                                 
6                           00839175    APO-DICLO                 APX 0001563 F 
6                           02302616    PMS-DICLOFENAC            PMS 0001563 F 
42                         *50MG ENTERIC TABLET                                 
6                           00808547    TEVA-DICLOFENAC EC        TEV 0002216 F 
6                           00839183    APO-DICLO                 APX 0002216 F 
6                           02261960    SANDOZ DICLOFENAC         SDZ 0002216 F 
6                           02302624    PMS-DICLOFENAC            PMS 0002216 F 
42                          75MG SUSTAINED RELEASE TABLET                       
6                           02162814    APO-DICLO SR              APX 0007699 F 
42                          100MG SUSTAINED RELEASE TABLET                      
6                           02091194    APO-DICLO SR              APX 0011053 F 
42                         *50MG SUPPOSITORY                                    
6                           02261928    SANDOZ DICLOFENAC         SDZ 0012818 F 
6                           00632724    VOLTAREN                  NVR 0016280 F 
42                         *100MG SUPPOSITORY                                   
6                           02241225    SANDOZ DICLOFENAC         SDZ 0005840 F 
6                           02261936    SANDOZ DICLOFENAC         SDZ 0005840 F 
41                          DICLOFENAC SODIUM/MISOPROSTOL                       
42                         *50MG/200UG ENTERIC TABLET                           
6                           02341689    GD-DICLOFENAC/MISOPROSTOL GDI 0003149 F 
6                           02413469    PMS-DICLOFENAC-MISOPROST  PMS 0003149 F 
6                           01917056    ARTHROTEC                 PFI 0007788 F 
42                         *75MG/200UG ENTERIC TABLET                           
6                           02341697    GD-DICLOFENAC/MISOPROSTOL GDI 0004286 F 
6                           02413477    PMS-DICLOFENAC-MISOPROST  PMS 0004286 F 
6                           02229837    ARTHROTEC 75              PFI 0010599 F 
41                          FLURBIPROFEN                                        
42                          50MG TABLET                                         
6                           01912046    FLURBIPROFEN              AAP 0004530 F 
42                          100MG TABLET                                        
6                           01912038    FLURBIPROFEN              AAP 0005930 F 
41                          IBUPROFEN                                           
42                         *300MG TABLET                                        
6                           00441651    APO-IBUPROFEN             APX 0001377 F 
6                           02242632    MOTRIN EXTRA STRENGTH IB  KNV 0001630 F 
42                         *400MG TABLET                                        
6                           02317338    IBUPROFEN                 JPC 0000468 F 
6                           02242658    MOTRIN SUPER STRENGTH IB  KNV 0002173 F 
42                          600MG TABLET                                        
6                           00585114    APO-IBUPROFEN             APX 0001313 F 
41                          INDOMETHACIN                                        
42                         *25MG CAPSULE                                        
6                           00337420    TEVA-INDOMETHACIN         TEV 0001519 F 
6                           02461811    MINT-INDOMETHACIN         MNT 0001519 F 
42                         *50MG CAPSULE                                        
6                           00337439    TEVA-INDOMETHACIN         TEV 0002469 F 
6                           02461536    MINT-INDOMETHACIN         MNT 0002469 F 
41                          KETOPROFEN                                          
42                          50MG CAPSULE                                        
6                           00790427    KETOPROFEN                AAP 0003440 F 
42                          50MG ENTERIC COATED TABLET                          
6                           00790435    KETOPROFEN-E              AAP 0004503 F 
42                          100MG ENTERIC COATED TABLET                         
6                           00842664    KETOPROFEN-E              AAP 0009111 F 
42                          200MG SUSTAINED RELEASE TABLET                      
6                           02172577    KETOPROFEN SR             AAP 0018545 F 
41                          MEFENAMIC ACID                                      
42                          250MG CAPSULE                                       
6                           02229452    MEFENAMIC                 AAP 0005499 F 
41                          MELOXICAM                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *7.5MG TABLET                                        
61                          02248267    PMS-MELOXICAM (EDS)       PMS 0002003 E 
61                          02248973    APO-MELOXICAM (EDS)       APX 0002003 E 
61                          02250012    ACT MELOXICAM (EDS)       TEV 0002003 E 
61                          02258315    TEVA-MELOXICAM (EDS)      TEV 0002003 E 
61                          02353148    MELOXICAM (EDS)           SAN 0002003 E 
61                          02390884    AURO-MELOXICAM (EDS)      API 0002003 E 
42                         *15MG TABLET                                         
61                          02248268    PMS-MELOXICAM (EDS)       PMS 0002311 E 
61                          02248974    APO-MELOXICAM (EDS)       APX 0002311 E 
61                          02250020    ACT MELOXICAM (EDS)       TEV 0002311 E 
61                          02258323    TEVA-MELOXICAM (EDS)      TEV 0002311 E 
61                          02353156    MELOXICAM (EDS)           SAN 0002311 E 
61                          02390892    AURO-MELOXICAM (EDS)      API 0002311 E 
41                          NABUMETONE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          500MG TABLET                                        
61                          02238639    NABUMETONE (EDS)          AAP 0006130 E 
41                          NAPROXEN                                            
42                          125MG TABLET                                        
6                           00522678    APO-NAPROXEN              APX 0000781 F 
42                         *250MG TABLET                                        
6                           00522651    APO-NAPROXEN              APX 0001068 F 
6                           00565350    TEVA-NAPROXEN             TEV 0001068 F 
42                         *375MG TABLET                                        
6                           00600806    APO-NAPROXEN              APX 0001458 F 
6                           00627097    TEVA-NAPROXEN             TEV 0001458 F 
42                         *500MG TABLET                                        
6                           00589861    TEVA-NAPROXEN             TEV 0004522 F 
6                           00592277    APO-NAPROXEN              APX 0004522 F 
42                          750MG SUSTAINED RELEASE TABLET                      
6                           02162466    NAPROSYN-S.R.             SLP 0014757 F 
42                          25MG/ML SUSPENSION                                  
6                           02162431    PEDIAPHARM NAPROXEN SUSP  MDX 0000950 F 
41                          PIROXICAM                                           
42                         *20MG CAPSULE                                        
6                           00695696    TEVA-PIROXICAM            TEV 0003711 F 
6                           00642894    APO-PIROXICAM             APX 0007422 F 
41                          SULINDAC                                            
42                          150MG TABLET                                        
6                           00745588    TEVA-SULINDAC             TEV 0004746 F 
42                          200MG TABLET                                        
6                           00745596    TEVA-SULINDAC             TEV 0005721 F 
41                          TIAPROFENIC ACID                                    
42                          200MG TABLET                                        
6                           02179679    TEVA-TIAPROFENIC ACID     TEV 0006140 F 
42                          300MG TABLET                                        
6                           02179687    TEVA-TIAPROFENIC ACID     TEV 0009085 F 
2         OPIOID ANALGESICS                                                     
41                          ACETAMINOPHEN/CAFFEINE/CODEINE                      
42                          300MG ACETAMINOPHEN & 15MG CODEINE/TABLET           
6                           00653241    TEVA-LENOLTEC NO.2        TEV 0000975 F 
42                          300MG ACETAMINOPHEN & 30MG CODEINE/TABLET           
6                           00653276    TEVA-LENOLTEC NO.3        TEV 0001025 F 
41                          ACETAMINOPHEN/CODEINE                               
42                          300MG/30MG TABLET                                   
6                           00608882    TEVA-EMTEC                TEV 0001300 F 
42                          300MG/60MG TABLET                                   
6                           00621463    TEVA-LENOLTEC NO.4        TEV 0001890 F 
41                          CODEINE                                             
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG CONTROLLED RELEASE TABLET                      
61                          02230302    CODEINE CONTIN (EDS)      PFR 0004138 E 
42                          100MG CONTROLLED RELEASE TABLET                     
61                          02163748    CODEINE CONTIN (EDS)      PFR 0008277 E 
42                          150MG CONTROLLED RELEASE TABLET                     
61                          02163780    CODEINE CONTIN (EDS)      PFR 0012414 E 
42                          200MG CONTROLLED RELEASE TABLET                     
61                          02163799    CODEINE CONTIN (EDS)      PFR 0016552 E 
41                          CODEINE PHOSPHATE                                   
42                          15MG TABLET                                         
6                           00593435    TEVA-CODEINE              TEV 0000972 F 
42                          30MG TABLET                                         
6                           00593451    TEVA-CODEINE              TEV 0001541 F 
42                          5MG/ML SYRUP                                        
6                           00050024    CODEINE PHOSPHATE SYRUP   ATL 0000671 F 
41                          FENTANYL                                            
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *12MCG/HR TRANSDERMAL SYSTEM                         
61                          02311925    TEVA-FENTANYL (EDS)       TEV 0033200 E 
61                          02327112    SANDOZ FENTANYL PATCH (ED SDZ 0033200 E 
42                         *25MCG/HR TRANSDERMAL SYSTEM                         
61                          02282941    TEVA-FENTANYL (EDS)       TEV 0085600 E 
61                          02327120    SANDOZ FENTANYL PATCH (ED SDZ 0085600 E 
42                          37MCG/HR TRANSDERMAL SYSTEM                         
61                          02327139    SANDOZ FENTANYL PATCH(EDS SDZ 0095180 E 
42                         *50MCG/HR TRANSDERMAL SYSTEM                         
61                          02282968    TEVA-FENTANYL (EDS)       TEV 0161100 E 
61                          02327147    SANDOZ FENTANYL PATCH (ED SDZ 0161100 E 
42                         *75MCG/HR TRANSDERMAL SYSTEM                         
61                          02282976    TEVA-FENTANYL (EDS)       TEV 0276500 E 
61                          02327155    SANDOZ FENTANYL PATCH (ED SDZ 0276500 E 
42                         *100MCG/HR TRANSDERMAL SYSTEM                        
61                          02282984    TEVA-FENTANYL (EDS)       TEV 0281950 E 
61                          02327163    SANDOZ FENTANYL PATCH (ED SDZ 0281950 E 
41                          HYDROMORPHONE HCL                                   
42                         *1MG TABLET                                          
6                           02319403    TEVA-HYDROMORPHONE        TEV 0000959 F 
6                           02364115    APO-HYDROMORPHONE         APX 0000959 F 
6                           00705438    DILAUDID                  PFR 0001053 F 
6                           00885444    PMS-HYDROMORPHONE         PMS 0000959 F 
42                         *2MG TABLET                                          
6                           00885436    PMS-HYDROMORPHONE         PMS 0001417 F 
6                           02319411    TEVA-HYDROMORPHONE        TEV 0001417 F 
6                           02364123    APO-HYDROMORPHONE         APX 0001417 F 
6                           00125083    DILAUDID                  PFR 0001556 F 
42                         *4MG TABLET                                          
6                           00885401    PMS-HYDROMORPHONE         PMS 0002240 F 
6                           02319438    TEVA-HYDROMORPHONE        TEV 0002240 F 
6                           02364131    APO-HYDROMORPHONE         APX 0002240 F 
6                           00125121    DILAUDID                  PFR 0002459 F 
42                         *8MG TABLET                                          
6                           00885428    PMS-HYDROMORPHONE         PMS 0003528 F 
6                           02319446    TEVA-HYDROMORPHONE        TEV 0003528 F 
6                           02364158    APO-HYDROMORPHONE         APX 0003528 F 
6                           00786543    DILAUDID                  PFR 0003873 F 
42                          3MG CONTROLLED-RELEASE CAPSULE                      
6                           02125323    HYDROMORPH CONTIN         PFR 0007181 F 
42                          4.5MG CONTROLLED-RELEASE CAPSULE                    
6                           02359502    HYDROMORPH CONTIN         PFR 0008673 F 
42                          6MG CONTROLLED RELEASE CAPSULE                      
6                           02125331    HYDROMORPH CONTIN         PFR 0010772 F 
42                          9MG CONTROLLED-RELEASE CAPSULE                      
6                           02359510    HYDROMORPH CONTIN         PFR 0014224 F 
42                          12MG CONTROLLED-RELEASE CAPSULE                     
6                           02125366    HYDROMORPH CONTIN         PFR 0018672 F 
42                          18MG CONTROLLED-RELEASE CAPSULE                     
6                           02243562    HYDROMORPH CONTIN         PFR 0026949 F 
42                          24MG CONTROLLED-RELEASE CAPSULE                     
6                           02125382    HYDROMORPH CONTIN         PFR 0031180 F 
42                          30MG CONTROLLED-RELEASE CAPSULE                     
6                           02125390    HYDROMORPH CONTIN         PFR 0037346 F 
42                          1MG/ML ORAL LIQUID                                  
6                           01916386    PMS-HYDROMORPHONE         PMS 0000953 F 
42                          2MG/ML INJECTION SOLUTION (1ML)                     
6                           02145901    HYDROMORPHONE HCL         SDZ 0020600 F 
42                          10MG/ML INJECTION SOLUTION (1ML)                    
6                           02145928    HYDROMORPHONE HP 10       SDZ 0043500 F 
42                          20MG/ML INJECTION SOLUTION (1ML)                    
6                           02145936    HYDROMORPHONE HP 20       SDZ 0102820 F 
42                         *50MG/ML INJECTION SOLUTION (1ML)                    
6                           02146126    HYDROMORPHONE HP 50       SDZ 0069525 F 
6                           02469413    HYDROMORPHONE HCL HP 50   STE 0069525 F 
41                          METHADONE HCL                                       
51                          TABLETS AND SUSPENSION COVERAGE RESTRICTED TO       
52                          DRUG PLAN REGISTERED PALLIATIVE CARE PATIENTS       
53                          ONLY.EDS IS NOT REQUIRED FOR THESE PATIENTS.        
42                         *1MG TABLET                                          
61                          02533642    APO-METHADONE (PC)        APX 0001026 E 
61                          02247698    METADOL (PC)              KTI 0001399 E 
42                         *5MG TABLET                                          
61                          02533650    APO-METHADONE (PC)        APX 0003417 E 
61                          02247699    METADOL (PC)              KTI 0004659 E 
42                         *10MG TABLET                                         
61                          02533669    APO-METHADONE (PC)        APX 0005466 E 
61                          02247700    METADOL (PC)              KTI 0007454 E 
42                         *25MG TABLET                                         
61                          02533677    APO-METHADONE (PC)        APX 0010157 E 
61                          02247701    METADOL (PC)              KTI 0013850 E 
42                          1MG/ML ORAL SUSPENSION                              
61                          02247694    METADOL (PC)              KTI 0001325 E 
42                          10MG/ML ORAL SUSPENSION                             
61                          02241377    METADOL (PC)              KTI 0004789 E 
42                          10MG/ML ORAL SOLUTION (CONCENTRATE)(ML)             
6                           02244290    METADOL-D                 KTI 0001639 F 
42                         *10MG/ML ORAL SOLUTION(CHERRY CONCENTRATE)(ML)       
6                           02394596    METHADOSE CHERRY          MAL 0000525 F 
6                           02495872    ODAN METHADONE (CHERRY)   ODN 0000525 F 
6                           02552736    PMS-METHADONE HCL CHERRY  PMS 0000525 F 
42                         *10MG/ML ORAL SOLUTION (UNFLAVOURED                  
43                          CONCENTRATE)(ML)                                    
6                           02394618    METHADOSE, SUGAR FREE     MAL 0000525 F 
6                           02495783    JAMP METHADONE ORAL       JPC 0000525 F 
6                           02495880    ODAN METHADONE UNFLAVORED ODN 0000525 F 
6                           02552728    PMS METHADONE UNFLAVORED  PMS 0000525 F 
41                          MORPHINE                                            
51                          ORAL FORMS CONTAIN MORPHINE HYDROCHLORIDE           
52                          OR SULFATE, INJECTABLE FORMS CONTAIN                
53                          MORPHINE SULFATE.                                   
42                         *5MG TABLET (IMMEDIATE RELEASE)                      
6                           02549794    PMS-MORPHINE SULFATE      PMS 0000709 F 
6                           02014203    MSIR                      PFR 0001150 F 
6                           00594652    STATEX                    KTI 0001251 F 
42                         *10MG TABLET (IMMEDIATE RELEASE)                     
6                           02549808    PMS-MORPHINE SULFATE      PMS 0001096 F 
6                           02014211    MSIR                      PFR 0001777 F 
6                           00594644    STATEX                    KTI 0001935 F 
42                          20MG TABLET (IMMEDIATE RELEASE)                     
6                           02014238    MSIR                      PFR 0004178 F 
42                          30MG TABLET (IMMEDIATE RELEASE)                     
6                           02014254    MSIR                      PFR 0005353 F 
42                          5MG CAPSULE (IMMEDIATE RELEASE)                     
6                           02320398    M-EDIAT                   ETH 0001045 F 
42                          10 MG CAPSULE (IMMEDIATE RELEASE)                   
6                           02320428    M-EDIAT                   ETH 0001615 F 
42                          20MG CAPSULE (IMMEDIATE RELEASE)                    
6                           02320436    M-EDIAT                   ETH 0003268 F 
42                          30MG CAPSULE (IMMEDIATE RELEASE)                    
6                           02320444    M-EDIAT                   ETH 0004190 F 
42                          10MG EXTENDED-RELEASE CAPSULE                       
6                           02019930    M-ESLON                   ETH 0003416 F 
42                          10MG SUSTAINED RELEASE CAPSULE                      
6                           02242163    KADIAN                    BGP 0004447 F 
42                          15MG EXTENDED-RELEASE CAPSULE                       
6                           02177749    M-ESLON                   ETH 0003942 F 
42                         *15MG SUSTAINED RELEASE TABLET                       
6                           02244790    SANDOZ MORPHINE SR        SDZ 0004145 F 
6                           02302764    TEVA-MORPHINE SR          TEV 0004145 F 
6                           02015439    MS CONTIN                 PFR 0008784 F 
42                          20MG SUSTAINED-RELEASE CAPSULE                      
6                           02184435    KADIAN                    BGP 0009571 F 
42                          30MG EXTENDED-RELEASE CAPSULE                       
6                           02019949    M-ESLON                   ETH 0005876 F 
42                         *30MG SUSTAINED RELEASE TABLET                       
6                           02244791    SANDOZ MORPHINE SR        SDZ 0006580 F 
6                           02302772    TEVA-MORPHINE SR          TEV 0006580 F 
6                           02014297    MS CONTIN                 PFR 0013297 F 
42                          50MG SUSTAINED-RELEASE CAPSULE                      
6                           02184443    KADIAN                    BGP 0017496 F 
42                          60MG EXTENDED-RELEASE CAPSULE                       
6                           02019957    M-ESLON                   ETH 0010458 F 
42                         *60MG SUSTAINED RELEASE TABLET                       
6                           02244792    SANDOZ MORPHINE SR        SDZ 0012180 F 
6                           02302780    TEVA-MORPHINE SR          TEV 0012180 F 
6                           02014300    MS CONTIN                 PFR 0023434 F 
42                          100MG SUSTAINED-RELEASE CAPSULE                     
6                           02184451    KADIAN                    BGP 0030706 F 
42                          100MG EXTENDED-RELEASE CAPSULE                      
6                           02019965    M-ESLON                   ETH 0022555 F 
42                         *100MG SUSTAINED RELEASE TABLET                      
6                           02302799    TEVA-MORPHINE SR          TEV 0015395 F 
6                           02478889    SANDOZ MORPHINE SR        SDZ 0015395 F 
6                           02014319    MS CONTIN                 PFR 0035709 F 
42                          200MG EXTENDED-RELEASE CAPSULE                      
6                           02177757    M-ESLON                   ETH 0045150 F 
42                         *200MG SUSTAINED RELEASE TABLET                      
6                           02302802    TEVA-MORPHINE SR          TEV 0027718 F 
6                           02478897    SANDOZ MORPHINE SR        SDZ 0027718 F 
6                           02014327    MS CONTIN                 PFR 0066428 F 
42                          1MG/ML ORAL SOLUTION                                
6                           00614491    DOLORAL 1                 ATL 0000375 F 
42                          5MG/ML ORAL SOLUTION                                
6                           00614505    DOLORAL 5                 ATL 0000705 F 
42                          10MG/ML INJECTION SOLUTION (1ML)                    
6                           00392588    MORPHINE SO4              SDZ 0027700 F 
42                          15MG/ML INJECTION SOLUTION (1ML)                    
6                           00392561    MORPHINE SO4              SDZ 0030727 F 
42                          50MG/ML INJECTION SOLUTION (1ML)                    
6                           00617288    MORPHINE HP50             SDZ 0104770 F 
41                          OXYCODONE HCL                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG IMMEDIATE RELEASE TABLET                        
6                           00789739    SUPEUDOL                  SDZ 0001510 F 
6                           02319977    PMS-OXYCODONE             PMS 0001510 F 
6                           02231934    OXY-IR                    PFR 0002993 F 
42                         *10MG IMMEDIATE RELEASE TABLET                       
6                           00443948    SUPEUDOL                  SDZ 0002346 F 
6                           02319985    PMS-OXYCODONE             PMS 0002346 F 
6                           02240131    OXY-IR                    PFR 0004410 F 
42                         *20MG IMMEDIATE RELEASE TABLET                       
6                           02262983    SUPEUDOL                  SDZ 0003704 F 
6                           02319993    PMS-OXYCODONE             PMS 0003704 F 
6                           02240132    OXY-IR                    PFR 0007675 F 
42                          10MG CONTROLLED-RELEASE TABLET                      
61                          02372525    OXYNEO (EDS)              PFR 0009825 E 
42                          15MG CONTROLLED-RELEASE TABLET                      
61                          02372533    OXYNEO (EDS)              PFR 0011855 E 
42                          20MG CONTROLLED-RELEASE TABLET                      
61                          02372797    OXYNEO (EDS)              PFR 0014740 E 
42                          30MG CONTROLLED-RELEASE TABLET                      
61                          02372541    OXYNEO (EDS)              PFR 0019470 E 
42                          40MG CONTROLLED-RELEASE TABLET                      
61                          02372568    OXYNEO (EDS)              PFR 0025410 E 
42                          60MG CONTROLLED-RELEASE TABLET                      
61                          02372576    OXYNEO (EDS)              PFR 0035260 E 
42                          80MG CONTROLLED-RELEASE TABLET                      
61                          02372584    OXYNEO (EDS)              PFR 0047190 E 
2         PARTIAL OPIOID AGONISTS                                               
41                          BUPRENORPHINE                                       
42                          100MG/0.5ML ER SUBCUTANEOUS SOLUTION                
43                          (SYRINGE)                                           
6                           02483084    SUBLOCADE                 IUL 5500000 F 
42                          300MG/1.5ML ER SUBCUTANEOUS SOLUTION                
43                          (SYRINGE)                                           
6                           02483092    SUBLOCADE                 IUL 5500000 F 
41                          BUPRENORPHINE/NALOXONE                              
42                         *2MG/0.5MG SUBLINGUAL TABLET                         
6                           02424851    PMS-BUPREN/NALOXONE       PMS 0013350 F 
6                           02453908    ACT BUPREN/NALOXONE       TEV 0013350 F 
6                           02295695    SUBOXONE                  IUL 0027261 F 
42                         *8MG/2MG SUBLINGUAL TABLET                           
6                           02424878    PMS-BUPREN/NALOXONE       PMS 0023650 F 
6                           02453916    ACT BUPREN/NALOXONE       TEV 0023650 F 
6                           02295709    SUBOXONE                  IUL 0048293 F 
42                          2MG/0.5MG SOLUBLE FILM                              
6                           02502313    SUBOXONE                  IUL 0026700 F 
42                          4MG/1MG SOLUBLE FILM                                
6                           02502321    SUBOXONE                  IUL 0036889 F 
42                          8MG/2MG SOLUBLE FILM                                
6                           02502348    SUBOXONE                  IUL 0047300 F 
42                          12MG/3MG SOLUBLE FILM                               
6                           02502356    SUBOXONE                  IUL 0070950 F 
2         BARBITURATES                                                          
41                          PHENOBARBITAL                                       
42                         *15MG TABLET                                         
6                           00178799    PHENOBARB                 PED 0000829 F 
6                           02557789    JAMP PHENOBARBITAL        JPC 0000829 F 
42                         *30MG TABLET                                         
6                           00178802    PHENOBARB                 PED 0000987 F 
6                           02557797    JAMP PHENOBARBITAL        JPC 0000987 F 
42                         *60MG TABLET                                         
6                           00178810    PHENOBARB                 PED 0001338 F 
6                           02557800    JAMP PHENOBARBITAL        JPC 0001338 F 
42                         *100MG TABLET                                        
6                           00178829    PHENOBARB                 PED 0001831 F 
6                           02557819    JAMP PHENOBARBITAL        JPC 0001831 F 
42                          5MG/ML ELIXIR                                       
6                           00645575    PHENOBARB ELIXIR          PED 0001888 F 
41                          PRIMIDONE                                           
42                          125MG TABLET                                        
6                           00399310    PRIMIDONE                 AAP 0000731 F 
42                          250MG TABLET                                        
6                           00396761    PRIMIDONE                 AAP 0001149 F 
2         BENZODIAZEPINES                                                       
41                          CLONAZEPAM                                          
42                         *0.5MG TABLET                                        
6                           02048701    PMS-CLONAZEPAM            PMS 0000418 F 
6                           02177889    APO-CLONAZEPAM            APX 0000418 F 
6                           02207818    PMS-CLONAZEPAM-R          PMS 0000418 F 
6                           00382825    RIVOTRIL                  XED 0002924 F 
42                          1MG TABLET                                          
6                           02048728    PMS-CLONAZEPAM            PMS 0001561 F 
42                         *2MG TABLET                                          
6                           02048736    PMS-CLONAZEPAM            PMS 0000721 F 
6                           02177897    APO-CLONAZEPAM            APX 0000721 F 
6                           00382841    RIVOTRIL                  XED 0005013 F 
41                          NITRAZEPAM                                          
42                          5MG TABLET                                          
6                           00511528    MOGADON                   AAP 0002036 F 
42                          10MG TABLET                                         
6                           00511536    MOGADON                   AAP 0003046 F 
2         HYDANTOINS                                                            
41                          PHENYTOIN                                           
42                          30MG CAPSULE                                        
6                           00022772    DILANTIN                  BGP 0002369 F 
42                         *100MG CAPSULE                                       
6                           02460912    PHENYTOIN SODIUM          AAP 0000665 F 
6                           00022780    DILANTIN                  BGP 0001247 F 
42                          50MG TABLET                                         
6                           00023698    DILANTIN                  BGP 0001061 F 
42                          25MG/ML ORAL SUSPENSION                             
6                           02250896    TARO-PHENYTOIN            TAR 0000517 F 
2         SUCCINIMIDES                                                          
41                          ETHOSUXIMIDE                                        
42                         *250MG CAPSULE                                       
6                           02545772    MAR-ETHOSUXIMIDE          MPI 0002628 F 
6                           02547171    ODAN ETHOSUXIMIDE         ODN 0002628 F 
6                           00022799    ZARONTIN                  SLP 0005360 F 
42                          50MG/ML ORAL SYRUP                                  
6                           00023485    ZARONTIN                  SLP 0000783 F 
2         MISCELLANEOUS ANTIEPILEPTIC/ANTISEIZURE DRUGS                         
41                          BRIVARACETAM                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG TABLET                                         
61                          02538679    APO-BRIVARACETAM (EDS)    APX 0023760 E 
61                          02452936    BRIVLERA (EDS)            UCB 0043200 E 
42                         *25MG TABLET                                         
61                          02538687    APO-BRIVARACETAM (EDS)    APX 0023760 E 
61                          02452944    BRIVLERA (EDS)            UCB 0043200 E 
42                         *50MG TABLET                                         
61                          02538695    APO-BRIVARACETAM (EDS)    APX 0021600 E 
61                          02539292    AURO-BRIVARACETAM (EDS)   API 0021600 E 
61                          02452952    BRIVLERA (EDS)            UCB 0043200 E 
42                         *75MG TABLET                                         
61                          02538709    APO-BREVARACETAM (EDS)    APX 0023760 E 
61                          02452960    BRIVLERA (EDS)            UCB 0043200 E 
42                         *100MG TABLET                                        
61                          02538717    APO-BRIVARACETAM (EDS)    APX 0021600 E 
61                          02539306    AURO-BRIVARACETAM (EDS)   API 0021600 E 
61                          02452979    BRIVLERA (EDS)            UCB 0043200 E 
41                          CANNABIDIOL                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG/ML ORAL SOLUTION (ML)                         
61                          02543079    EPIDIOLEX (EDS)           JAZ 0142454 E 
41                          CARBAMAZEPINE                                       
42                          100MG CHEWABLE TABLET                               
6                           02244403    TARO-CARBAMAZEPINE        TAR 0001702 F 
42                          200MG CHEWABLE TABLET                               
6                           02244404    TARO-CARBAMAZEPINE CHEWS  TAR 0003302 F 
42                         *200MG TABLET                                        
6                           00782718    TEVA-CARBAMAZEPINE        TEV 0002217 F 
6                           02541238    MINT-CARBAMAZEPINE        MNT 0002217 F 
6                           00010405    TEGRETOL                  NVR 0004841 F 
42                         *200MG CONTROLLED RELEASE TABLET                     
6                           02261839    SANDOZ CARBAM. CR         SDZ 0003845 F 
6                           00773611    TEGRETOL CR               NVR 0004881 F 
42                         *400MG CONTROLLED RELEASE TABLET                     
6                           02261847    SANDOZ CARBAMAZEPINE CR   SDZ 0007689 F 
6                           00755583    TEGRETOL CR               NVR 0009764 F 
42                         *20MG/ML ORAL SUSPENSION                             
6                           02367394    TARO-CARBAMAZEPINE        TAR 0000801 F 
6                           02194333    TEGRETOL                  NVR 0000937 F 
41                          CENOBAMATE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          12.5MG TABLET                                       
61                          02538652    XCOPRI (EDS)              KTI 0089580 E 
42                          25MG TABLET                                         
61                          02538660    XCOPRI (EDS)              KTI 0089580 E 
42                          50MG TABLET                                         
61                          02538725    XCOPRI (EDS)              KTI 0089580 E 
42                          100MG TABLET                                        
61                          02538733    XCOPRI (EDS)              KTI 0089580 E 
42                          150MG TABLET                                        
61                          02538741    XCOPRI (EDS)              KTI 0089580 E 
42                          200MG TABLET                                        
61                          02538768    XCOPRI (EDS)              KTI 0089580 E 
42                          12.5MG & 25MG TABLET,28-DAY STARTER (KIT)           
61                          02538776    XCOPRI (EDS)              KTI 2508200 E 
42                          50MG & 100MG TABLET,28-DAY STARTER (KIT)            
61                          02538784    XCOPRI (EDS)              KTI 2508200 E 
41                          CLOBAZAM                                            
42                         *10MG TABLET                                         
6                           02238334    TEVA-CLOBAZAM             TEV 0002197 F 
6                           02244638    APO-CLOBAZAM              APX 0002197 F 
41                          DIVALPROEX SODIUM                                   
42                         *125MG ENTERIC COATED TABLET                         
6                           02239698    APO-DIVALPROEX            APX 0001539 F 
6                           02458926    MYLAN-DIVALPROEX          MYL 0001539 F 
6                           00596418    EPIVAL                    BGP 0003828 F 
42                         *250MG ENTERIC COATED TABLET                         
6                           02239699    APO-DIVALPROEX            APX 0002767 F 
6                           02458934    MYLAN-DIVALPROEX          MYL 0002767 F 
6                           00596426    EPIVAL                    BGP 0006883 F 
42                         *500MG ENTERIC COATED TABLET                         
6                           02239700    APO-DIVALPROEX            APX 0005537 F 
6                           02459019    MYLAN-DIVALPROEX          MYL 0005537 F 
6                           00596434    EPIVAL                    BGP 0013773 F 
41                          ESLICARBAZEPINE ACETATE                             
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *200MG TABLET                                        
61                          02527421    AURO-ESLICARBAZEPINE (EDS API 0049350 E 
61                          02537931    APO-ESLICARBAZEPINE (EDS) APX 0049350 E 
61                          02426862    APTIOM (EDS)              SNV 0098700 E 
42                         *400MG TABLET                                        
61                          02527448    AURO-ESLICARBAZEPINE (EDS API 0049350 E 
61                          02537958    APO-ESLICARBAZEPINE (EDS) APX 0049350 E 
61                          02426870    APTIOM (EDS)              SNV 0098700 E 
42                         *600MG TABLET                                        
61                          02527456    AURO-ESLICARBAZEPINE (EDS API 0049350 E 
61                          02537966    APO-ESLICARBAZEPINE (EDS) APX 0049350 E 
61                          02426889    APTIOM (EDS)              SNV 0098700 E 
42                         *800MG TABLET                                        
61                          02527464    AURO-ESLICARBAZEPINE (EDS API 0049350 E 
61                          02537974    APO-ESLICARBAZEPINE (EDS) APX 0049350 E 
61                          02426897    APTIOM (EDS)              SNV 0098700 E 
41                          GABAPENTIN                                          
42                         *100MG CAPSULE                                       
6                           02243446    PMS-GABAPENTIN            PMS 0000416 F 
6                           02244304    APO-GABAPENTIN            APX 0000416 F 
6                           02244513    TEVA-GABAPENTIN           TEV 0000416 F 
6                           02246314    GABAPENTIN                SIV 0000416 F 
6                           02321203    AURO-GABAPENTIN           API 0000416 F 
6                           02353245    GABAPENTIN                SAN 0000416 F 
6                           02361469    JAMP-GABAPENTIN           JPC 0000416 F 
6                           02391473    MAR-GABAPENTIN            MPI 0000416 F 
6                           02408880    MINT-GABAPENTIN           MNT 0000416 F 
6                           02416840    GABAPENTIN CAPSULES USP   AHI 0000416 F 
6                           02477912    AG-GABAPENTIN             ANG 0000416 F 
6                           02535246    JAMP GABAPENTIN           JPC 0000416 F 
6                           02550016    NRA-GABAPENTIN            NRA 0000416 F 
6                           02084260    NEURONTIN                 BGP 0005585 F 
42                         *300MG CAPSULE                                       
6                           02243447    PMS-GABAPENTIN            PMS 0001012 F 
6                           02244305    APO-GABAPENTIN            APX 0001012 F 
6                           02244514    TEVA-GABAPENTIN           TEV 0001012 F 
6                           02246315    GABAPENTIN                SIV 0001012 F 
6                           02319063    RAN-GABAPENTIN            RAN 0001012 F 
6                           02321211    AURO-GABAPENTIN           API 0001012 F 
6                           02353253    GABAPENTIN                SAN 0001012 F 
6                           02361485    JAMP-GABAPENTIN           JPC 0001012 F 
6                           02391481    MAR-GABAPENTIN            MPI 0001012 F 
6                           02408899    MINT-GABAPENTIN           MNT 0001012 F 
6                           02477920    AG-GABAPENTIN             ANG 0001012 F 
6                           02535254    JAMP GABAPENTIN           JPC 0001012 F 
6                           02550024    NRA-GABAPENTIN            NRA 0001012 F 
6                           02084279    NEURONTIN                 BGP 0013365 F 
42                         *400MG CAPSULE                                       
6                           02243448    PMS-GABAPENTIN            PMS 0001206 F 
6                           02244306    APO-GABAPENTIN            APX 0001206 F 
6                           02244515    TEVA-GABAPENTIN           TEV 0001206 F 
6                           02246316    GABAPENTIN                SIV 0001206 F 
6                           02321238    AURO-GABAPENTIN           API 0001206 F 
6                           02353261    GABAPENTIN                SAN 0001206 F 
6                           02361493    JAMP-GABAPENTIN           JPC 0001206 F 
6                           02391503    MAR-GABAPENTIN            MPI 0001206 F 
6                           02408902    MINT-GABAPENTIN           MNT 0001206 F 
6                           02477939    AG-GABAPENTIN             ANG 0001206 F 
6                           02535262    JAMP GABAPENTIN           JPC 0001206 F 
6                           02550032    NRA-GABAPENTIN            NRA 0001206 F 
6                           02084287    NEURONTIN                 BGP 0015927 F 
42                         *600MG TABLET                                        
6                           02248457    TEVA-GABAPENTIN           TEV 0001809 F 
6                           02293358    APO-GABAPENTIN            APX 0001809 F 
6                           02388200    GABAPENTIN                SIV 0001809 F 
6                           02392526    GABAPENTIN TABLETS        AHI 0001809 F 
6                           02402289    JAMP-GABAPENTIN TABLETS   JPC 0001809 F 
6                           02410990    GLN-GABAPENTIN            GLN 0001809 F 
6                           02428334    AURO-GABAPENTIN           API 0001809 F 
6                           02431289    GABAPENTIN                SAN 0001809 F 
6                           02432072    GABAPENTIN                JPC 0001809 F 
6                           02239717    NEURONTIN                 BGP 0024295 F 
42                         *800MG TABLET                                        
6                           02247346    TEVA-GABAPENTIN           TEV 0002412 F 
6                           02293366    APO-GABAPENTIN            APX 0002412 F 
6                           02388219    GABAPENTIN                SIV 0002412 F 
6                           02392534    GABAPENTIN TABLETS        AHI 0002412 F 
6                           02402297    JAMP-GABAPENTIN TABLETS   JPC 0002412 F 
6                           02411008    GLN-GABAPENTIN            GLN 0002412 F 
6                           02428342    AURO-GABAPENTIN           API 0002412 F 
6                           02431297    GABAPENTIN                SAN 0002412 F 
6                           02432080    GABAPENTIN                JPC 0002412 F 
6                           02239718    NEURONTIN                 BGP 0032425 F 
41                          LACOSAMIDE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *50MG TABLET                                         
61                          02472902    TEVA-LACOSAMIDE (EDS)     TEV 0006313 E 
61                          02474670    SANDOZ LACOSAMIDE (EDS)   SDZ 0006313 E 
61                          02475332    AURO-LACOSAMIDE (EDS)     API 0006313 E 
61                          02478196    PHARMA-LACOSAMIDE (EDS)   PMS 0006313 E 
61                          02487802    ZDS-LACOSAMIDE (EDS)      ZDS 0006313 E 
61                          02488388    JAMP-LACOSAMIDE (EDS)     JPC 0006313 E 
61                          02489287    ACH-LACOSAMIDE (EDS)      AHI 0006313 E 
61                          02490544    MINT-LACOSAMIDE (EDS)     MNT 0006313 E 
61                          02499568    NRA-LACOSAMIDE (EDS)      NRA 0006313 E 
61                          02512874    LACOSAMIDE (EDS)          SAN 0006313 E 
61                          02357615    VIMPAT (EDS)              UCB 0024255 E 
42                         *100MG TABLET                                        
61                          02472910    TEVA-LACOSAMIDE (EDS)     TEV 0008750 E 
61                          02474689    SANDOZ LACOSAMIDE (EDS)   SDZ 0008750 E 
61                          02475340    AURO-LACOSAMIDE (EDS)     API 0008750 E 
61                          02478218    PHARMA-LACOSAMIDE (EDS)   PMS 0008750 E 
61                          02487810    ZDS-LACOSAMIDE (EDS)      ZDS 0008750 E 
61                          02488396    JAMP-LACOSAMIDE (EDS)     JPC 0008750 E 
61                          02489295    ACH-LACOSAMIDE (EDS)      AHI 0008750 E 
61                          02490552    MINT-LACOSAMIDE (EDS)     MNT 0008750 E 
61                          02499576    NRA-LACOSAMIDE (EDS)      NRA 0008750 E 
61                          02512882    LACOSAMIDE (EDS)          SAN 0008750 E 
61                          02357623    VIMPAT (EDS)              UCB 0034709 E 
42                         *150MG TABLET                                        
61                          02472929    TEVA-LACOSAMIDE (EDS)     TEV 0011763 E 
61                          02474697    SANDOZ LACOSAMIDE (EDS)   SDZ 0011763 E 
61                          02475359    AURO-LACOSAMIDE (EDS)     API 0011763 E 
61                          02478226    PHARMA-LACOSAMIDE (EDS)   PMS 0011763 E 
61                          02487829    ZDS-LACOSAMIDE (EDS)      ZDS 0011763 E 
61                          02488418    JAMP-LACOSAMIDE (EDS)     JPC 0011763 E 
61                          02489309    ACH-LACOSAMIDE (EDS)      AHI 0011763 E 
61                          02490560    MINT-LACOSAMIDE (EDS)     MNT 0011763 E 
61                          02499584    NRA-LACOSAMIDE (EDS)      NRA 0011763 E 
61                          02512890    LACOSAMIDE (EDS)          SAN 0011763 E 
61                          02357631    VIMPAT (EDS)              UCB 0045164 E 
42                         *200MG TABLET                                        
61                          02472937    TEVA-LACOSAMIDE (EDS)     TEV 0014500 E 
61                          02474700    SANDOZ LACOSAMIDE (EDS)   SDZ 0014500 E 
61                          02475367    AURO-LACOSAMIDE (EDS)     API 0014500 E 
61                          02478234    PHARMA-LACOSAMIDE (EDS)   PMS 0014500 E 
61                          02487837    ZDS-LACOSAMIDE (EDS)      ZDS 0014500 E 
61                          02488426    JAMP-LACOSAMIDE (EDS)     JPC 0014500 E 
61                          02489317    ACH-LACOSAMIDE (EDS)      AHI 0014500 E 
61                          02490579    MINT-LACOSAMIDE (EDS)     MNT 0014500 E 
61                          02499592    NRA-LACOSAMIDE (EDS)      NRA 0014500 E 
61                          02512904    LACOSAMIDE (EDS)          SAN 0014500 E 
61                          02357658    VIMPAT (EDS)              UCB 0055619 E 
41                          LAMOTRIGINE                                         
42                          5MG CHEWABLE TABLET                                 
6                           02240115    LAMICTAL                  GSK 0001977 F 
42                         *25MG TABLET                                         
6                           02245208    APO-LAMOTRIGINE           APX 0000698 F 
6                           02246897    PMS-LAMOTRIGINE           PMS 0000698 F 
6                           02265494    MYLAN-LAMOTRIGINE         MYL 0000698 F 
6                           02343010    LAMOTRIGINE               SAN 0000698 F 
6                           02381354    AURO-LAMOTRIGINE          API 0000698 F 
6                           02428202    LAMOTRIGINE               SIV 0000698 F 
6                           02542730    JAMP LAMOTRIGINE          JPC 0000698 F 
6                           02142082    LAMICTAL                  GSK 0004636 F 
42                         *100MG TABLET                                        
6                           02245209    APO-LAMOTRIGINE           APX 0002787 F 
6                           02246898    PMS-LAMOTRIGINE           PMS 0002787 F 
6                           02265508    MYLAN-LAMOTRIGINE         MYL 0002787 F 
6                           02343029    LAMOTRIGINE               SAN 0002787 F 
6                           02381362    AURO-LAMOTRIGINE          API 0002787 F 
6                           02428210    LAMOTRIGINE               SIV 0002787 F 
6                           02542749    JAMP LAMOTRIGINE          JPC 0002787 F 
6                           02142104    LAMICTAL                  GSK 0018507 F 
42                         *150MG TABLET                                        
6                           02245210    APO-LAMOTRIGINE           APX 0004107 F 
6                           02246899    PMS-LAMOTRIGINE           PMS 0004107 F 
6                           02265516    MYLAN-LAMOTRIGINE         MYL 0004107 F 
6                           02343037    LAMOTRIGINE               SAN 0004107 F 
6                           02381370    AURO-LAMOTRIGINE          API 0004107 F 
6                           02428229    LAMOTRIGINE               SIV 0004107 F 
6                           02542757    JAMP LAMOTRIGINE          JPC 0004107 F 
6                           02142112    LAMICTAL                  GSK 0027272 F 
41                          LEVETIRACETAM                                       
42                         *250MG TABLET                                        
6                           02274183    ACT LEVETIRACETAM         TEV 0003210 F 
6                           02285924    APO-LEVETIRACETAM         APX 0003210 F 
6                           02296101    PMS-LEVETIRACETAM         PMS 0003210 F 
6                           02353342    LEVETIRACETAM             SAN 0003210 F 
6                           02375249    AURO-LEVETIRACETAM        API 0003210 F 
6                           02399776    LEVETIRACETAM TABLETS     AHI 0003210 F 
6                           02403005    JAMP-LEVETIRACETAM        JPC 0003210 F 
6                           02442388    MINT-LEVETIRACETAM        MNT 0003210 F 
6                           02442531    LEVETIRACETAM             SIV 0003210 F 
6                           02461986    SANDOZ LEVETIRACETAM      SDZ 0003210 F 
6                           02482274    RIVA-LEVETIRACETAM        RIV 0003210 F 
6                           02499193    NRA-LEVETIRACETAM         NRA 0003210 F 
6                           02504553    JAMP LEVETIRACETAM TABLET JPC 0003210 F 
6                           02524562    M-LEVETIRACETAM           MNP 0003210 F 
6                           02247027    KEPPRA                    UCB 0017836 F 
42                         *500MG TABLET                                        
6                           02274191    ACT LEVETIRACETAM         TEV 0003911 F 
6                           02285932    APO-LEVETIRACETAM         APX 0003911 F 
6                           02296128    PMS-LEVETIRACETAM         PMS 0003911 F 
6                           02353350    LEVETIRACETAM             SAN 0003911 F 
6                           02375257    AURO-LEVETRICETAM         API 0003911 F 
6                           02399784    LEVETIRACETAM TABLETS     AHI 0003911 F 
6                           02403021    JAMP-LEVETIRACETAM        JPC 0003911 F 
6                           02442396    MINT-LEVETIRACETAM        MNT 0003911 F 
6                           02442558    LEVETIRACETAM             SIV 0003911 F 
6                           02461994    SANDOZ LEVETIRACETAM      SDZ 0003911 F 
6                           02482282    RIVA-LEVETIRACETAM        RIV 0003911 F 
6                           02499207    NRA-LEVETIRACETAM         NRA 0003911 F 
6                           02504561    JAMP LEVETIRACETAM TABLET JPC 0003911 F 
6                           02524570    M-LEVETIRACETAM           MNP 0003911 F 
6                           02247028    KEPPRA                    UCB 0021725 F 
42                         *750MG TABLET                                        
6                           02274205    ACT LEVETIRACETAM         TEV 0005416 F 
6                           02285940    APO-LEVETIRACETAM         APX 0005416 F 
6                           02296136    PMS-LEVETIRACETAM         PMS 0005416 F 
6                           02353369    LEVETIRACETAM             SAN 0005416 F 
6                           02375265    AURO-LEVETIRACETAM        API 0005416 F 
6                           02399792    LEVETIRACETAM TABLETS     AHI 0005416 F 
6                           02403048    JAMP-LEVETIRACETAM        JPC 0005416 F 
6                           02442418    MINT-LEVETIRACETAM        MNT 0005416 F 
6                           02442566    LEVETIRACETAM             SIV 0005416 F 
6                           02462001    SANDOZ LEVETIRACETAM      SDZ 0005416 F 
6                           02482290    RIVA-LEVETIRACETAM        RIV 0005416 F 
6                           02499215    NRA-LEVETIRACETAM         NRA 0005416 F 
6                           02504588    JAMP LEVETIRACETAM TABLET JPC 0005416 F 
6                           02524589    M-LEVETIRACETAM           MNP 0005416 F 
6                           02247029    KEPPRA                    UCB 0030089 F 
42                          1000MG TABLET                                       
6                           02462028    SANDOZ LEVETIRACETAM      SDZ 0007221 F 
42                         *100MG/ML ORAL SOLUTION (ML)                         
6                           02515318    PHARMA-LEVETIRACETAM      PMS 0004071 F 
6                           02558416    MINT-LEVETIRACETAM        MNT 0004071 F 
6                           02490447    PDP-LEVETIRACETAM         PED 0008663 F 
41                          OXCARBAZEPINE                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *150MG TABLET                                        
61                          02284294    APO-OXCARBAZEPINE (EDS)   APX 0004263 E 
61                          02560593    JAMP OXCARBAZEPINE  (EDS) JPC 0004263 E 
42                         *300MG TABLET                                        
61                          02284308    APO-OXCARBAZEPINE (EDS)   APX 0005394 E 
61                          02560607    JAMP OXCARBAZEPINE (EDS)  JPC 0005394 E 
61                          02242068    TRILEPTAL (EDS)           NVR 0010788 E 
42                         *600MG TABLET                                        
61                          02284316    APO-OXCARBAZEPINE (EDS)   APX 0010793 E 
61                          02560615    JAMP OXCARBAZEPINE (EDS)  JPC 0010793 E 
61                          02242069    TRILEPTAL (EDS)           NVR 0021586 E 
42                          60MG/ML ORAL SUSPENSION                             
61                          02244673    TRILEPTAL (EDS)           NVR 0003813 E 
41                          PERAMPANEL                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *2MG TABLET                                          
61                          02522632    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404516    FYCOMPA (EDS)             EIS 0103872 E 
42                         *4MG TABLET                                          
61                          02522640    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404524    FYCOMPA (EDS)             EIS 0103868 E 
42                         *6MG TABLET                                          
61                          02522659    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404532    FYCOMPA (EDS)             EIS 0103868 E 
42                         *8MG TABLET                                          
61                          02522667    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404540    FYCOMPA (EDS)             EIS 0103868 E 
42                         *10MG TABLET                                         
61                          02522675    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404559    FYCOMPA (EDS)             EIS 0103868 E 
42                         *12MG TABLET                                         
61                          02522683    TARO-PERAMPANEL (EDS)     TAR 0057128 E 
61                          02404567    FYCOMPA (EDS)             EIS 0103868 E 
41                          RUFINAMIDE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG TABLET                                        
61                          02369613    BANZEL (EDS)              EIS 0009703 E 
42                         *200MG TABLET                                        
61                          02545985    AURO-RUFINAMIDE (EDS)     API 0010083 E 
61                          02369621    BANZEL (EDS)              EIS 0019409 E 
42                         *400MG TABLET                                        
61                          02545993    AURO-RUFINAMIDE (EDS)     API 0021970 E 
61                          02369648    BANZEL (EDS)              EIS 0042292 E 
41                          STIRIPENTOL                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          250MG CAPSULE                                       
61                          02398958    DIACOMIT (EDS)            BCX 0064807 E 
42                          500MG CAPSULE                                       
61                          02398966    DIACOMIT (EDS)            BCX 0129408 E 
42                          250MG POWDER FOR SUSPENSION                         
61                          02398974    DIACOMIT (EDS)            BCX 0064807 E 
41                          TOPIRAMATE                                          
42                         *25MG TABLET                                         
6                           02248860    TEVA-TOPIRAMATE           TEV 0002433 F 
6                           02262991    PMS-TOPIRAMATE            PMS 0002433 F 
6                           02263351    MYLAN-TOPIRAMATE          MYL 0002433 F 
6                           02279614    APO-TOPIRAMATE            APX 0002433 F 
6                           02287765    GLN-TOPIRAMATE            GLN 0002433 F 
6                           02315645    MINT-TOPIRAMATE           MNT 0002433 F 
6                           02345250    JAMP TOPIRAMATE           JPC 0002433 F 
6                           02345803    AURO-TOPIRAMATE           API 0002433 F 
6                           02356856    TOPIRAMATE                SAN 0002433 F 
6                           02389460    TOPIRAMATE                SIV 0002433 F 
6                           02395738    TOPIRAMATE TABLETS        AHI 0002433 F 
6                           02435608    JAMP-TOPIRAMATE           JPC 0002433 F 
6                           02475936    AG-TOPIRAMATE             ANG 0002433 F 
6                           02230893    TOPAMAX                   JAN 0023561 F 
42                         *50MG TABLET                                         
6                           02312085    PMS-TOPIRAMATE            PMS 0003579 F 
6                           02544377    JAMP TOPIRAMATE           JPC 0003579 F 
42                         *100MG TABLET                                        
6                           02248861    TEVA-TOPIRAMATE           TEV 0004583 F 
6                           02263009    PMS-TOPIRAMATE            PMS 0004583 F 
6                           02263378    MYLAN-TOPIRAMATE          MYL 0004583 F 
6                           02279630    APO-TOPIRAMATE            APX 0004583 F 
6                           02287773    GLN-TOPIRAMATE            GLN 0004583 F 
6                           02315653    MINT-TOPIRAMATE           MNT 0004583 F 
6                           02345269    JAMP TOPIRAMATE           JPC 0004583 F 
6                           02345838    AURO-TOPIRAMATE           API 0004583 F 
6                           02356864    TOPIRAMATE                SAN 0004583 F 
6                           02389487    TOPIRAMATE                SIV 0004583 F 
6                           02395746    TOPIRAMATE TABLETS        AHI 0004583 F 
6                           02435616    JAMP-TOPIRAMATE           JPC 0004583 F 
6                           02475944    AG-TOPIRAMATE             ANG 0004583 F 
6                           02230894    TOPAMAX                   JAN 0044180 F 
42                         *200MG TABLET                                        
6                           02248862    TEVA-TOPIRAMATE           TEV 0006748 F 
6                           02263017    PMS-TOPIRAMATE            PMS 0006748 F 
6                           02263386    MYLAN-TOPIRAMATE          MYL 0006748 F 
6                           02279649    APO-TOPIRAMATE            APX 0006748 F 
6                           02287781    GLN-TOPIRAMATE            GLN 0006748 F 
6                           02315661    MINT-TOPIRAMATE           MNT 0006748 F 
6                           02345277    JAMP TOPIRAMATE           JPC 0006748 F 
6                           02345846    AURO-TOPIRAMATE           API 0006748 F 
6                           02356872    TOPIRAMATE                SAN 0006748 F 
6                           02395754    TOPIRAMATE TABLETS        AHI 0006748 F 
6                           02435624    JAMP-TOPIRAMATE           JPC 0006748 F 
6                           02553880    TOPIRAMATE                SIV 0006748 F 
6                           02230896    TOPAMAX                   JAN 0065235 F 
42                          15MG SPRINKLE CAPSULE                               
6                           02239907    TOPAMAX                   JAN 0022425 F 
42                          25MG SPRINKLE CAPSULE                               
6                           02239908    TOPAMAX                   JAN 0023445 F 
41                          VALPROATE SODIUM                                    
42                         *50MG/ML ORAL SYRUP                                  
6                           02236807    PMS-VALPROIC ACID         PMS 0000480 F 
6                           02238370    APO-VALPROIC              APX 0000480 F 
6                           02532441    JAMP VALPROIC ACID ORAL   JPC 0000480 F 
6                           02549190    ODAN-VALPROIC ACID        ODN 0000480 F 
6                           00443832    DEPAKENE                  BGP 0001505 F 
41                          VALPROIC ACID                                       
42                         *250MG CAPSULE                                       
6                           02230768    PMS-VALPROIC              PMS 0002905 F 
6                           02238048    APO-VALPROIC              APX 0002905 F 
42                          500MG ENTERIC COATED CAPSULE                        
6                           02229628    PMS-VALPROIC ACID E.C.    PMS 0008102 F 
41                          VIGABATRIN                                          
42                          500MG TABLET                                        
6                           02065819    SABRIL                    LDU 0009110 F 
42                          500MG SACHET                                        
6                           02068036    SABRIL                    LDU 0009110 F 
42                          500MG SACHET (US LABELLED)                          
6                           00951691    US-LABELLED VIGABATRIN    LDU 0009110 F 
2         ANTIDEPRESSANTS                                                       
41                          AMITRIPTYLINE                                       
42                         *10MG TABLET                                         
6                           00335053    ELAVIL                    AAP 0000305 F 
6                           00654523    PMS-AMITRIPTYLINE         PMS 0000305 F 
6                           02403137    APO-AMITRIPTYLINE         APX 0000305 F 
6                           02429861    MAR-AMITRIPTYLINE         MPI 0000305 F 
6                           02457679    JAMP-AMITRIPTYLINE        JPC 0000305 F 
42                         *25MG TABLET                                         
6                           00335061    ELAVIL                    AAP 0000580 F 
6                           00654515    PMS-AMITRIPTYLINE         PMS 0000580 F 
6                           02403145    APO-AMITRIPTYLINE         APX 0000580 F 
6                           02429888    MAR-AMITRIPTYLINE         MPI 0000580 F 
6                           02457695    JAMP-AMITRIPTYLINE        JPC 0000580 F 
42                         *50MG TABLET                                         
6                           00335088    ELAVIL                    AAP 0001078 F 
6                           00654507    PMS-AMITRIPTYLINE         PMS 0001078 F 
6                           02403153    APO-AMITRIPTYLINE         APX 0001078 F 
6                           02429896    MAR-AMITRIPTYLINE         MPI 0001078 F 
6                           02457687    JAMP-AMITRIPTYLINE        JPC 0001078 F 
41                          BUPROPION HCL                                       
42                          100MG SUSTAINED RELEASE TABLET                      
6                           02275074    ODAN BUPROPION SR         ODN 0005260 F 
42                          150MG SUSTAINED RELEASE TABLET                      
6                           02275082    ODAN BUPROPION SR         ODN 0009169 F 
42                          150MG SUSTAINED RELEASE TABLET (SMOKING CESS)       
6                           02238441    ZYBAN                     BAU 0012074 F 
42                         *150MG EXTENDED-RELEASE TABLET                       
6                           02439654    TEVA-BUPROPION XL         TEV 0001463 F 
6                           02475804    TARO-BUPROPION XL         SUN 0001463 F 
6                           02565838    ODAN-BUPROPION XL         ODN 0001463 F 
6                           02275090    WELLBUTRIN XL             BAU 0006452 F 
42                         *300MG EXTENDED-RELEASE TABLET                       
6                           02439662    TEVA-BUPROPION XL         TEV 0002927 F 
6                           02475812    TARO-BUPROPION XL         SUN 0002927 F 
6                           02565846    ODAN-BUPROPION XL         ODN 0002927 F 
6                           02275104    WELLBUTRIN XL             BAU 0012281 F 
41                          CITALOPRAM HYDROBROMIDE                             
42                         *20MG TABLET                                         
6                           02246056    APO-CITALOPRAM            APX 0001332 F 
6                           02248010    PMS-CITALOPRAM            PMS 0001332 F 
6                           02275562    AURO-CITALOPRAM           API 0001332 F 
6                           02293218    TEVA-CITALOPRAM           TEV 0001332 F 
6                           02313405    JAMP-CITALOPRAM           JPC 0001332 F 
6                           02353660    CITALOPRAM                SAN 0001332 F 
6                           02371898    MAR-CITALOPRAM            MPI 0001332 F 
6                           02387956    CITALOPRAM                SIV 0001332 F 
6                           02429705    MINT-CITALOPRAM           MNT 0001332 F 
6                           02430541    CITALOPRAM                JPC 0001332 F 
6                           02443880    NATCO-CITALOPRAM          NPI 0001332 F 
6                           02459914    CCP-CITALOPRAM            CCP 0001332 F 
6                           02467836    M-CITALOPRAM              MNP 0001332 F 
6                           02477645    NRA-CITALOPRAM            NRA 0001332 F 
6                           02239607    CELEXA                    LUD 0018130 F 
42                         *40MG TABLET                                         
6                           02246057    APO-CITALOPRAM            APX 0001332 F 
6                           02248011    PMS-CITALOPRAM            PMS 0001332 F 
6                           02275570    AURO-CITALOPRAM           API 0001332 F 
6                           02293226    TEVA-CITALOPRAM           TEV 0001332 F 
6                           02313413    JAMP-CITALOPRAM           JPC 0001332 F 
6                           02353679    CITALOPRAM                SAN 0001332 F 
6                           02371901    MAR-CITALOPRAM            MPI 0001332 F 
6                           02387964    CITALOPRAM                SIV 0001332 F 
6                           02429713    MINT-CITALOPRAM           MNT 0001332 F 
6                           02430568    CITALOPRAM                JPC 0001332 F 
6                           02443899    NATCO-CITALOPRAM          NPI 0001332 F 
6                           02459922    CCP-CITALOPRAM            CCP 0001332 F 
6                           02467844    M-CITALOPRAM              MNP 0001332 F 
6                           02477653    NRA-CITALOPRAM            NRA 0001332 F 
6                           02239608    CELEXA                    LUD 0018130 F 
41                          CLOMIPRAMINE HCL                                    
42                          10MG CAPSULE/TABLET                                 
6                           00330566    ANAFRANIL                 APX 0003258 F 
42                         *25MG CAPSULE/TABLET                                 
6                           02497506    TARO-CLOMIPRAMINE         TAR 0003417 F 
6                           00324019    ANAFRANIL                 APX 0003489 F 
42                         *50MG CAPSULE/TABLET                                 
6                           02497514    TARO-CLOMIPRAMINE         TAR 0006291 F 
6                           00402591    ANAFRANIL                 APX 0006423 F 
41                          DESIPRAMINE HCL                                     
42                          10MG TABLET                                         
6                           02216248    DESIPRAMINE               AAP 0005078 F 
42                          25MG TABLET                                         
6                           02216256    DESIPRAMINE               AAP 0005078 F 
42                          50MG TABLET                                         
6                           02216264    DESIPRAMINE               AAP 0008951 F 
42                          75MG TABLET                                         
6                           02216272    DESIPRAMINE               AAP 0011902 F 
42                          100MG TABLET                                        
6                           02216280    DESIPRAMINE               AAP 0011902 F 
41                          DOXEPIN HCL                                         
42                         *10MG CAPSULE                                        
6                           02049996    APO-DOXEPIN               APX 0001019 F 
6                           02559080    MAR-DOXEPIN               MPI 0001019 F 
6                           02559250    JAMP DOXEPIN              JPC 0001019 F 
6                           00024325    SINEQUAN                  AAP 0004543 F 
42                         *25MG CAPSULE                                        
6                           02050005    APO-DOXEPIN               APX 0001250 F 
6                           02559099    MAR-DOXEPIN               MPI 0001250 F 
6                           02559269    JAMP DOXEPIN              JPC 0001250 F 
6                           00024333    SINEQUAN                  AAP 0005575 F 
42                         *50MG CAPSULE                                        
6                           02050013    APO-DOXEPIN               APX 0002319 F 
6                           02559102    MAR-DOXEPIN               MPI 0002319 F 
6                           02559277    JAMP DOXEPIN              JPC 0002319 F 
6                           00024341    SINEQUAN                  AAP 0010340 F 
42                         *75MG CAPSULE                                        
6                           02050021    APO-DOXEPIN               APX 0003342 F 
6                           02559110    MAR-DOXEPIN               MAR 0003342 F 
6                           02559285    JAMP DOXEPIN              JPC 0003342 F 
6                           00400750    SINEQUAN                  AAP 0013649 F 
42                         *100MG CAPSULE                                       
6                           02050048    APO-DOXEPIN               APX 0004395 F 
6                           02559129    MAR-DOXEPIN               MAR 0004395 F 
6                           02559293    JAMP DOXEPIN              JPC 0004395 F 
6                           00326925    SINEQUAN                  AAP 0017950 F 
41                          DULOXETINE HYDROCHLORIDE                            
42                         *30MG DELAYED RELEASE CAPSULE                        
6                           02429446    PMS-DULOXETINE            PMS 0004814 F 
6                           02436647    AURO-DULOXETINE           API 0004814 F 
6                           02437082    DULOXETINE DR             TEV 0004814 F 
6                           02438259    RAN-DULOXETINE            RAN 0004814 F 
6                           02438984    MINT-DULOXETINE           MNT 0004814 F 
6                           02439948    SANDOZ DULOXETINE         SDZ 0004814 F 
6                           02440423    APO-DULOXETINE            APX 0004814 F 
6                           02446081    MAR-DULOXETINE            MPI 0004814 F 
6                           02451913    JAMP-DULOXETINE           JPC 0004814 F 
6                           02453630    DULOXETINE                SIV 0004814 F 
6                           02456753    TEVA-DULOXETINE           TEV 0004814 F 
6                           02457199    TARO-DULOXETINE           TAR 0004814 F 
6                           02473208    M-DULOXETINE              MNP 0004814 F 
6                           02475308    AG-DULOXETINE             ANG 0004814 F 
6                           02482126    NRA-DULOXETINE            NRA 0004814 F 
6                           02490889    DULOXETINE                SAN 0004814 F 
42                         *60MG DELAYED RELEASE CAPSULE                        
6                           02429454    PMS-DULOXETINE            PMS 0009769 F 
6                           02436655    AURO-DULOXETINE           API 0009769 F 
6                           02437090    DULOXETINE DR             TEV 0009769 F 
6                           02438267    RAN-DULOXETINE            RAN 0009769 F 
6                           02438992    MINT-DULOXETINE           MNT 0009769 F 
6                           02439956    SANDOZ DULOXETINE         SDZ 0009769 F 
6                           02440431    APO-DULOXETINE            APX 0009769 F 
6                           02446103    MAR-DULOXETINE            MPI 0009769 F 
6                           02451921    JAMP-DULOXETINE           JPC 0009769 F 
6                           02453649    DULOXETINE                SIV 0009769 F 
6                           02456761    TEVA-DULOXETINE           TEV 0009769 F 
6                           02457202    TARO-DULOXETINE           TAR 0009769 F 
6                           02473216    M-DULOXETINE              MNP 0009769 F 
6                           02475316    AG-DULOXETINE             ANG 0009769 F 
6                           02482134    NRA-DULOXETINE            NRA 0009769 F 
6                           02490897    DULOXETINE                SAN 0009769 F 
41                          ESCITALOPRAM                                        
42                         *10MG TABLET                                         
6                           02295016    APO-ESCITALOPRAM          APX 0003109 F 
6                           02309467    MYLAN-ESCITALOPRAM        MYL 0003109 F 
6                           02318180    TEVA-ESCITALOPRAM         TEV 0003109 F 
6                           02364077    SANDOZ ESCITALOPRAM       SDZ 0003109 F 
6                           02385481    RAN-ESCITALOPRAM          RAN 0003109 F 
6                           02397358    AURO-ESCITALOPRAM         API 0003109 F 
6                           02407418    MINT-ESCITALOPRAM         MNT 0003109 F 
6                           02423480    MAR-ESCITALOPRAM          MPI 0003109 F 
6                           02429039    ESCITALOPRAM              SIV 0003109 F 
6                           02429780    JAMP-ESCITALOPRAM         JPC 0003109 F 
6                           02430118    ESCITALOPRAM              SAN 0003109 F 
6                           02434652    ACH-ESCITALOPRAM          AHI 0003109 F 
6                           02440296    NAT-ESCITALOPRAM          NPI 0003109 F 
6                           02469243    PMS-ESCITALOPRAM          PMS 0003109 F 
6                           02471418    M-ESCITALOPRAM            MNP 0003109 F 
6                           02476851    NRA-ESCITALOPRAM          NRA 0003109 F 
6                           02508893    JAMP ESCITALOPRAM         JPC 0003109 F 
6                           02554909    NATCO-ESCITALOPRAM        NPI 0003109 F 
6                           02263238    CIPRALEX                  LUD 0023481 F 
42                          15MG TABLET                                         
6                           02512653    KYE-ESCITALOPRAM          KYE 0003210 F 
42                         *20MG TABLET                                         
6                           02295024    APO-ESCITALOPRAM          APX 0003310 F 
6                           02309475    MYLAN-ESCITALOPRAM        MYL 0003310 F 
6                           02318202    TEVA-ESCITALOPRAM         TEV 0003310 F 
6                           02364085    SANDOZ ESCITALOPRAM       SDZ 0003310 F 
6                           02385503    RAN-ESCITALOPRAM          RAN 0003310 F 
6                           02397374    AURO-ESCITALOPRAM         API 0003310 F 
6                           02407434    MINT-ESCITLOPRAM          MNT 0003310 F 
6                           02423502    MAR-ESCITALOPRAM          MPI 0003310 F 
6                           02429047    ESCITALOPRAM              SIV 0003310 F 
6                           02429799    JAMP-ESCITALOPRAM         JPC 0003310 F 
6                           02430126    ESCITALOPRAM              SAN 0003310 F 
6                           02434660    ACH-ESCITALOPRAM          AHI 0003310 F 
6                           02440318    NAT-ESCITALOPRAM          NPI 0003310 F 
6                           02469251    PMS-ESCITALOPRAM          PMS 0003310 F 
6                           02471426    M-ESCITALOPRAM            MNP 0003310 F 
6                           02476878    NRA-ESCITALOPRAM          NRA 0003310 F 
6                           02508907    JAMP ESCITALOPRAM         JPC 0003310 F 
6                           02554933    NATCO-ESCITALOPRAM        NPI 0003310 F 
6                           02263254    CIPRALEX                  LUD 0025070 F 
41                          FLUOXETINE                                          
42                         *10MG CAPSULE                                        
6                           02177579    PMS-FLUOXETINE            PMS 0003404 F 
6                           02216353    APO-FLUOXETINE            APX 0003404 F 
6                           02216582    TEVA-FLUOXETINE           TEV 0003404 F 
6                           02286068    FLUOXETINE                SAN 0003404 F 
6                           02374447    FLUOXETINE                SIV 0003404 F 
6                           02380560    MINT-FLUOXETINE           MNT 0003404 F 
6                           02385627    AURO-FLUOXETINE           API 0003404 F 
6                           02392909    MAR-FLUOXETINE            MPI 0003404 F 
6                           02393441    FLUOXETINE CAPSULES BP    AHI 0003404 F 
6                           02401894    JAMP-FLUOXETINE           JPC 0003404 F 
6                           02485052    AG-FLUOXETINE             ANG 0003404 F 
6                           02503875    NRA-FLUOXETINE            NRA 0003404 F 
6                           02529432    M-FLUOXETINE              MNP 0003404 F 
42                         *20MG CAPSULE                                        
6                           02177587    PMS-FLUOXETINE            PMS 0003311 F 
6                           02216361    APO-FLUOXETINE            APX 0003311 F 
6                           02216590    TEVA-FLUOXETINE           TEV 0003311 F 
6                           02286076    FLUOXETINE                SAN 0003311 F 
6                           02374455    FLUOXETINE                SIV 0003311 F 
6                           02380579    MINT-FLUOXETINE           MNT 0003311 F 
6                           02383241    FLUOXETINE CAPSULES BP    AHI 0003311 F 
6                           02385635    AURO-FLUOXETINE           API 0003311 F 
6                           02386402    JAMP-FLUOXETINE           JPC 0003311 F 
6                           02392917    MAR-FLUOXETINE            MPI 0003311 F 
6                           02485060    AG-FLUOXETINE             ANG 0003311 F 
6                           02503883    NRA-FLUOXETINE            NRA 0003311 F 
6                           02529440    M-FLUOXETINE              MNP 0003311 F 
42                          40MG CAPSULE                                        
6                           02464640    PMS-FLUOXETINE            PMS 0006622 F 
42                          60MG CAPSULE                                        
6                           02464659    PMS-FLUOXETINE            PMS 0009933 F 
42                         *4MG/ML ORAL SOLUTION                                
6                           02231328    FLUOXETINE                APX 0002158 F 
6                           02459361    ODAN-FLUOXETINE           ODN 0002158 F 
6                           02546752    JAMP FLUOXETINE SOLUTION  JPC 0002158 F 
41                          FLUVOXAMINE MALEATE                                 
42                         *50MG TABLET                                         
6                           02231329    APO-FLUVOXAMINE           APX 0005410 F 
6                           02255529    TEVA-FLUVOXAMINE          TEV 0005410 F 
6                           01919342    LUVOX                     BGP 0010953 F 
42                         *100MG TABLET                                        
6                           02231330    APO-FLUVOXAMINE           APX 0009728 F 
6                           02255537    TEVA-FLUVOXAMINE          TEV 0009728 F 
6                           01919369    LUVOX                     BGP 0019690 F 
41                          IMIPRAMINE                                          
42                         *10MG TABLET                                         
6                           00360201    APO-IMIPRAMINE TABLETS    APX 0001257 F 
6                           02546337    JAMP IMIPRAMINE           JPC 0001257 F 
42                         *25MG TABLET                                         
6                           00312797    APO-IMIPRAMINE TABLETS    APX 0002316 F 
6                           02546345    JAMP IMIPRAMINE           JPC 0002316 F 
42                         *50MG TABLET                                         
6                           00326852    APO-IMIPRAMINE TABLETS    APX 0004519 F 
6                           02546353    JAMP IMIPRAMINE           JPC 0004519 F 
41                          MAPROTILINE                                         
42                          25MG TABLET                                         
6                           02158612    TEVA-MAPROTILINE          TEV 0005687 F 
42                          50MG TABLET                                         
6                           02158620    TEVA-MAPROTILINE          TEV 0010769 F 
42                          75MG TABLET                                         
6                           02158639    TEVA-MAPROTILINE          TEV 0014707 F 
41                          MIRTAZAPINE                                         
42                         *15MG TABLET                                         
6                           02250594    SANDOZ MIRTAZAPINE        SDZ 0000975 F 
6                           02256096    MYLAN-MIRTAZAPINE         MYL 0000975 F 
6                           02273942    PMS-MIRTAZAPINE           PMS 0000975 F 
6                           02286610    APO-MIRTAZAPINE           APX 0000975 F 
6                           02411695    AURO-MIRTAZAPINE          API 0000975 F 
6                           02496666    MIRTAZAPINE               SIV 0000975 F 
6                           02532689    MIRTAZAPINE               SAN 0000975 F 
6                           02534924    NRA-MIRTAZAPINE           NRA 0000975 F 
6                           02541572    TEVA-MIRTAZAPINE          TEV 0000975 F 
42                         *15MG ORALLY DISINTEGRATING TABLET                   
6                           02299801    AURO-MIRTAZAPINE OD       API 0004046 F 
6                           02248542    REMERON RD                ORG 0005220 F 
42                         *30MG TABLET                                         
6                           02248762    PMS-MIRTAZAPINE           PMS 0003100 F 
6                           02250608    SANDOZ MIRTAZAPINE        SDZ 0003100 F 
6                           02256118    MYLAN-MIRTAZAPINE         MYL 0003100 F 
6                           02259354    TEVA-MIRTAZAPINE          TEV 0003100 F 
6                           02286629    APO-MIRTAZAPINE           APX 0003100 F 
6                           02370689    MIRTAZAPINE               SAN 0003100 F 
6                           02411709    AURO-MIRTAZAPINE          API 0003100 F 
6                           02496674    MIRTAZAPINE               SIV 0003100 F 
6                           02534932    NRA-MIRTAZAPINE           NRA 0003100 F 
6                           02243910    REMERON                   ORG 0017934 F 
42                         *30MG ORALLY DISINTEGRATING TABLET                   
6                           02299828    AURO-MIRTAZAPINE OD       API 0008087 F 
6                           02248543    REMERON RD                ORG 0010440 F 
42                         *45MG TABLET                                         
6                           02256126    MYLAN-MIRTAZAPINE         MYL 0002925 F 
6                           02286637    APO-MIRTAZAPINE           APX 0002925 F 
6                           02411717    AURO-MIRTAZAPINE          API 0002925 F 
6                           02496682    MIRTAZAPINE               SIV 0002925 F 
6                           02534940    NRA-MIRTAZAPINE           NRA 0002925 F 
6                           02541580    TEVA-MIRTAZAPINE          TEV 0002925 F 
42                         *45MG ORALLY DISINTEGRATING TABLET                   
6                           02299836    AURO-MIRTAZAPINE OD       API 0012132 F 
6                           02248544    REMERON RD                ORG 0015660 F 
41                          MOCLOBEMIDE                                         
42                          100MG TABLET                                        
6                           02232148    MOCLOBEMIDE               AAP 0003400 F 
42                         *150MG TABLET                                        
6                           02232150    MOCLOBEMIDE               AAP 0005295 F 
6                           00899356    MANERIX                   BAU 0008633 F 
42                         *300MG TABLET                                        
6                           02240456    MOCLOBEMIDE               AAP 0010399 F 
6                           02166747    MANERIX                   BAU 0016952 F 
41                          NORTRIPTYLINE                                       
42                          10MG CAPSULE                                        
6                           00015229    AVENTYL                   AAP 0003340 F 
42                          25MG CAPSULE                                        
6                           00015237    AVENTYL                   AAP 0006750 F 
41                          PAROXETINE HCL                                      
42                         *10MG TABLET                                         
6                           02240907    APO-PAROXETINE            APX 0003046 F 
6                           02247750    PMS-PAROXETINE            PMS 0003046 F 
6                           02248556    TEVA-PAROXETINE           TEV 0003046 F 
6                           02282844    PAROXETINE                SAN 0003046 F 
6                           02368862    JAMP-PAROXETINE           JPC 0003046 F 
6                           02383276    AURO-PAROXETINE           API 0003046 F 
6                           02388227    PAROXETINE                SIV 0003046 F 
6                           02411946    MAR-PAROXETINE            MPI 0003046 F 
6                           02421372    MINT-PAROXETINE           MNT 0003046 F 
6                           02467402    M-PAROXETINE              MNP 0003046 F 
6                           02475537    AG-PAROXETINE             ANG 0003046 F 
6                           02479753    NRA-PAROXETINE            NRA 0003046 F 
6                           02507773    JAMP PAROXETINE           JPC 0003046 F 
42                         *20MG TABLET                                         
6                           02240908    APO-PAROXETINE            APX 0003250 F 
6                           02247751    PMS-PAROXETINE            PMS 0003250 F 
6                           02248557    TEVA-PAROXETINE           TEV 0003250 F 
6                           02282852    PAROXETINE                SAN 0003250 F 
6                           02368870    JAMP-PAROXETINE           JPC 0003250 F 
6                           02383284    AURO-PAROXETINE           API 0003250 F 
6                           02388235    PAROXETINE                SIV 0003250 F 
6                           02411954    MAR-PAROXETINE            MPI 0003250 F 
6                           02421380    MINT-PAROXETINE           MNT 0003250 F 
6                           02467410    M-PAROXETINE              MNP 0003250 F 
6                           02475545    AG-PAROXETINE             ANG 0003250 F 
6                           02479761    NRA-PAROXETINE            NRA 0003250 F 
6                           02507781    JAMP PAROXETINE           JPC 0003250 F 
6                           01940481    PAXIL                     GSK 0021581 F 
42                         *30MG TABLET                                         
6                           02240909    APO-PAROXETINE            APX 0003453 F 
6                           02247752    PMS-PAROXETINE            PMS 0003453 F 
6                           02248558    TEVA-PAROXETINE           TEV 0003453 F 
6                           02282860    PAROXETINE                SAN 0003453 F 
6                           02368889    JAMP-PAROXETINE           JPC 0003453 F 
6                           02383292    AURO-PAROXETINE           API 0003453 F 
6                           02388243    PAROXETINE                SIV 0003453 F 
6                           02411962    MAR-PAROXETINE            MPI 0003453 F 
6                           02421399    MINT-PAROXETINE           MNT 0003453 F 
6                           02467429    M-PAROXETINE              MNP 0003453 F 
6                           02475553    AG-PAROXETINE             ANG 0003453 F 
6                           02479788    NRA-PAROXETINE            NRA 0003453 F 
6                           02507803    JAMP PAROXETINE           JPC 0003453 F 
6                           01940473    PAXIL                     GSK 0022927 F 
41                          PHENELZINE SO4                                      
42                         ?15MG TABLET                                         
6                           00476552    NARDIL                    SLP 0004992 F 
6                           09858123    PHENELZINE SULFATE (USA)  LUP 0005908 F 
41                          SERTRALINE HYDROCHLORIDE                            
42                         *25MG CAPSULE                                        
6                           02238280    APO-SERTRALINE            APX 0001516 F 
6                           02240485    TEVA-SERTRALINE           TEV 0001516 F 
6                           02244838    PMS-SERTRALINE            PMS 0001516 F 
6                           02353520    SERTRALINE                SAN 0001516 F 
6                           02357143    JAMP-SERTRALINE           JPC 0001516 F 
6                           02386070    SERTRALINE                SIV 0001516 F 
6                           02390906    AURO-SERTRALINE           API 0001516 F 
6                           02399415    MAR-SERTRALINE            MPI 0001516 F 
6                           02402378    MINT-SERTRALINE           MNT 0001516 F 
6                           02469626    SERTRALINE                JPC 0001516 F 
6                           02477882    ANG-SERTRALINE            ANG 0001516 F 
6                           02488434    NRA-SERTRALINE            NRA 0001516 F 
6                           02530937    M-SERTRALINE              MNP 0001516 F 
6                           02132702    ZOLOFT                    BGP 0010460 F 
42                         *50MG CAPSULE                                        
6                           02238281    APO-SERTRALINE            APX 0003032 F 
6                           02240484    TEVA-SERTRALINE           TEV 0003032 F 
6                           02244839    PMS-SERTRALINE            PMS 0003032 F 
6                           02353539    SERTRALINE                SAN 0003032 F 
6                           02357151    JAMP-SERTRALINE           JPC 0003032 F 
6                           02386089    SERTRALINE                SIV 0003032 F 
6                           02390914    AURO-SERTRALINE           API 0003032 F 
6                           02399423    MAR-SERTRALINE            MPI 0003032 F 
6                           02402394    MINT-SERTRALINE           MNT 0003032 F 
6                           02469634    SERTRALINE                JPC 0003032 F 
6                           02477890    ANG-SERTRALINE            ANG 0003032 F 
6                           02488442    NRA-SERTRALINE            NRA 0003032 F 
6                           02530945    M-SERTRALINE              MNP 0003032 F 
6                           01962817    ZOLOFT                    BGP 0020919 F 
42                         *100MG CAPSULE                                       
6                           02238282    APO-SERTRALINE            APX 0003303 F 
6                           02240481    TEVA-SERTRALINE           TEV 0003303 F 
6                           02244840    PMS-SERTRALINE            PMS 0003303 F 
6                           02353547    SERTRALINE                SAN 0003303 F 
6                           02357178    JAMP-SERTRALINE           JPC 0003303 F 
6                           02386097    SERTRALINE                SIV 0003303 F 
6                           02390922    AURO-SERTRALINE           API 0003303 F 
6                           02399431    MAR-SERTRALINE            MPI 0003303 F 
6                           02402408    MINT-SERTRALINE           MNT 0003303 F 
6                           02469642    SERTRALINE                JPC 0003303 F 
6                           02477904    ANG-SERTRALINE            ANG 0003303 F 
6                           02488450    NRA-SERTRALINE            NRA 0003303 F 
6                           02530953    M-SERTRALINE              MNP 0003303 F 
6                           01962779    ZOLOFT                    BGP 0022251 F 
41                          TRANYLCYPROMINE SO4                                 
42                          10MG TABLET                                         
6                           01919598    PARNATE                   GSK 0004637 F 
41                          TRAZODONE                                           
42                         *50MG TABLET                                         
6                           01937227    PMS-TRAZODONE             PMS 0000554 F 
6                           02144263    TEVA-TRAZODONE            TEV 0000554 F 
6                           02147637    APO-TRAZODONE             APX 0000554 F 
6                           02348772    TRAZODONE                 SAN 0000554 F 
6                           02442809    JAMP TRAZODONE            JPC 0000554 F 
42                         *100MG TABLET                                        
6                           01937235    PMS-TRAZODONE             PMS 0000989 F 
6                           02144271    TEVA-TRAZODONE            TEV 0000989 F 
6                           02147645    APO-TRAZODONE             APX 0000989 F 
6                           02348780    TRAZODONE                 SAN 0000989 F 
6                           02442817    JAMP TRAZODONE            JPC 0000989 F 
41                          TRIMIPRAMINE                                        
42                          75MG CAPSULE                                        
6                           02070987    TRIMIPRAMINE              AAP 0009556 F 
42                          12.5MG TABLET                                       
6                           00740799    TRIMIPRAMINE              AAP 0002877 F 
42                          25MG TABLET                                         
6                           00740802    TRIMIPRAMINE              AAP 0003707 F 
42                          50MG TABLET                                         
6                           00740810    TRIMIPRAMINE              AAP 0007254 F 
42                          100MG TABLET                                        
6                           00740829    TRIMIPRAMINE              AAP 0012381 F 
41                          VENLAFAXINE HCL                                     
42                         *37.5MG EXTENDED-RELEASE CAPSULE                     
6                           02275023    TEVA-VENLAFAXINE XR       TEV 0000913 F 
6                           02278545    PMS-VENLAFAXINE XR        PMS 0000913 F 
6                           02304317    ACT VENLAFAXINE XR        TEV 0000913 F 
6                           02310317    SANDOZ VENLAFAXINE XR     SDZ 0000913 F 
6                           02331683    APO-VENLAFAXINE XR        APX 0000913 F 
6                           02354713    VENLAFAXINE XR            SAN 0000913 F 
6                           02380072    TARO-VENLAFAXINE XR       SUN 0000913 F 
6                           02385929    VENLAFAXINE XR            SIV 0000913 F 
6                           02452839    AURO-VENLAFAXINE XR       API 0000913 F 
6                           02471280    M-VENLAFAXINE XR          MNP 0000913 F 
6                           02489678    VENLAFAXINE XR            RIV 0000913 F 
6                           02516535    VENLAFAXINE XR            JPC 0000913 F 
6                           02521466    PMSC-VENLAFAXINE XR       PMS 0000913 F 
6                           02522977    MINT-VENLAFAXINE XR       MNT 0000913 F 
6                           02237279    EFFEXOR XR                BGP 0011944 F 
42                         *75MG EXTENDED-RELEASE CAPSULE                       
6                           02275031    TEVA-VENLAFAXINE XR       TEV 0001825 F 
6                           02278553    PMS-VENLAFAXINE XR        PMS 0001825 F 
6                           02304325    ACT VENLAFAXINE XR        TEV 0001825 F 
6                           02310325    SANDOZ VENLAFAXINE XR     SDZ 0001825 F 
6                           02331691    APO-VENLAFAXINE XR        APX 0001825 F 
6                           02354721    VENLAFAXINE XR            SAN 0001825 F 
6                           02380080    TARO-VENLAFAXINE XR       SUN 0001825 F 
6                           02385937    VENLAFAXINE XR            SIV 0001825 F 
6                           02452847    AURO-VENLAFAXINE XR       API 0001825 F 
6                           02471299    M-VENLAFAXINE XR          MNP 0001825 F 
6                           02489686    VENLAFAXINE XR            RIV 0001825 F 
6                           02516543    VENLAFAXINE XR            JPC 0001825 F 
6                           02521482    PMSC-VENLAFAXINE XR       PMS 0001825 F 
6                           02522985    MINT-VENLAFAXINE XR       MNT 0001825 F 
6                           02237280    EFFEXOR XR                BGP 0023889 F 
42                         *150MG EXTENDED-RELEASE CAPSULE                      
6                           02275058    TEVA-VENLAFAXINE XR       TEV 0001927 F 
6                           02278561    PMS-VENLAFAXINE XR        PMS 0001927 F 
6                           02304333    ACT VENLAFAXINE XR        TEV 0001927 F 
6                           02310333    SANDOZ VENLAFAXINE XR     SDZ 0001927 F 
6                           02331705    APO-VENLAFAXINE XR        APX 0001927 F 
6                           02354748    VENLAFAXINE XR            SAN 0001927 F 
6                           02380099    TARO-VENLAFAXINE XR       SUN 0001927 F 
6                           02385945    VENLAFAXINE XR            SIV 0001927 F 
6                           02452855    AURO-VENLAFAXINE XR       API 0001927 F 
6                           02471302    M-VENLAFAXINE XR          MNP 0001927 F 
6                           02489694    VENLAFAXINE XR            RIV 0001927 F 
6                           02516551    VENLAFAXINE XR            JPC 0001927 F 
6                           02521474    PMSC-VENLAFAXINE XR       PMS 0001927 F 
6                           02522993    MINT-VENLAFAXINE XR       MNT 0001927 F 
6                           02237282    EFFEXOR XR                BGP 0025220 F 
41                          VORTIOXETINE HYDROBROMIDE                           
42                          5MG TABLET                                          
6                           02432919    TRINTELLIX                LUD 0028825 F 
42                          10MG TABLET                                         
6                           02432927    TRINTELLIX                LUD 0030193 F 
42                          20MG TABLET                                         
6                           02432943    TRINTELLIX                LUD 0032779 F 
2         ANTIPSYCHOTICS                                                        
41                          ARIPIPRAZOLE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *2MG TABLET                                          
6                           02460025    AURO-ARIPIPRAZOLE         API 0008092 F 
6                           02464144    TEVA-ARIPIPRAZOLE         TEV 0008092 F 
6                           02466635    PMS-ARIPIPRAZOLE          PMS 0008092 F 
6                           02471086    APO-ARIPIPRAZOLE          APX 0008092 F 
6                           02473658    SANDOZ ARIPIPRAZOLE       SDZ 0008092 F 
6                           02483556    MINT-ARIPIPRAZOLE         MNT 0008092 F 
6                           02506688    ARIPIPRAZOLE              SAN 0008092 F 
6                           02534320    ARIPIPRAZOLE              SIV 0008092 F 
6                           02553163    JAMP ARIPIPRAZOLE         JPC 0008092 F 
6                           02322374    ABILIFY                   OTS 0031617 F 
42                         *5MG TABLET                                          
6                           02460033    AURO-ARIPIPRAZOLE         API 0009046 F 
6                           02464152    TEVA-ARIPIPRAZOLE         TEV 0009046 F 
6                           02466643    PMS-ARIPIPRAZOLE          PMS 0009046 F 
6                           02471094    APO-ARIPIPRAZOLE          APX 0009046 F 
6                           02473666    SANDOZ ARIPIPRAZOLE       SDZ 0009046 F 
6                           02483564    MINT-ARIPIPRAZOLE         MNT 0009046 F 
6                           02506718    ARIPIPRAZOLE              SAN 0009046 F 
6                           02534339    ARIPIPRAZOLE              SIV 0009046 F 
6                           02553171    JAMP ARIPIPRAZOLE         JPC 0009046 F 
6                           02322382    ABILIFY                   OTS 0035590 F 
42                         *10MG TABLET                                         
6                           02460041    AURO-ARIPIPRAZOLE         API 0010754 F 
6                           02464160    TEVA-ARIPIPRAZOLE         TEV 0010754 F 
6                           02466651    PMS-ARIPIPRAZOLE          PMS 0010754 F 
6                           02471108    APO-ARIPIPRAZOLE          APX 0010754 F 
6                           02473674    SANDOZ ARIPIPRAZOLE       SDZ 0010754 F 
6                           02483572    MINT-ARIPIPRAZOLE         MNT 0010754 F 
6                           02506726    ARIPIPRAZOLE              SAN 0010754 F 
6                           02534347    ARIPIPRAZOLE              SIV 0010754 F 
6                           02553198    JAMP ARIPIPRAZOLE         JPC 0010754 F 
6                           02322390    ABILIFY                   OTS 0041017 F 
42                         *15MG TABLET                                         
6                           02460068    AURO-ARIPIPRAZOLE         API 0012692 F 
6                           02464179    TEVA-ARIPIPRAZOLE         TEV 0012692 F 
6                           02466678    PMS-ARIPIPRAZOLE          PMS 0012692 F 
6                           02471116    APO-ARIPIPRAZOLE          APX 0012692 F 
6                           02473682    SANDOZ ARIPIPRAZOLE       SDZ 0012692 F 
6                           02483580    MINT-ARIPIPRAZOLE         MNT 0012692 F 
6                           02506734    ARIPIPRAZOLE              SAN 0012692 F 
6                           02534355    ARIPIPRAZOLE              SIV 0012692 F 
6                           02553201    JAMP ARIPIPRAZOLE         JPC 0012692 F 
6                           02322404    ABILIFY                   OTS 0041017 F 
42                         *20MG TABLET                                         
6                           02460076    AURO-ARIPIPRAZOLE         API 0010017 F 
6                           02464187    TEVA-ARIPIPRAZOLE         TEV 0010017 F 
6                           02466686    PMS-ARIPIPRAZOLE          PMS 0010017 F 
6                           02471124    APO-ARIPIPRAZOLE          APX 0010017 F 
6                           02473690    SANDOZ ARIPIPRAZOLE       SDZ 0010017 F 
6                           02483599    MINT-ARIPIPRAZOLE         MNT 0010017 F 
6                           02506750    ARIPIPRAZOLE              SAN 0010017 F 
6                           02534363    ARIPIPRAZOLE              SIV 0010017 F 
6                           02553228    JAMP ARIPIPRAZOLE         JPC 0010017 F 
6                           02322412    ABILIFY                   OTS 0041017 F 
42                         *30MG TABLET                                         
6                           02460084    AURO-ARIPIPRAZOLE         API 0010017 F 
6                           02464195    TEVA-ARIPIPRAZOLE         TEV 0010017 F 
6                           02466694    PMS-ARIPIPRAZOLE          PMS 0010017 F 
6                           02471132    APO-ARIPIPRAZOLE          APX 0010017 F 
6                           02473704    SANDOZ ARIPIPRAZOLE       SDZ 0010017 F 
6                           02483602    MINT-ARIPIPRAZOLE         MNT 0010017 F 
6                           02506785    ARIPIPRAZOLE              SAN 0010017 F 
6                           02534371    ARIPIPRAZOLE              SIV 0010017 F 
6                           02553236    JAMP ARIPIPRAZOLE         JPC 0010017 F 
6                           02322455    ABILIFY                   OTS 0041017 F 
42                          300MG/VIAL LONG ACTING INJECTION                    
61                          02420864    ABILIFY MAINTENA (EDS)    OTS 4839244 E 
42                          400MG/VIAL LONG ACTING INJECTION                    
61                          02420872    ABILIFY MAINTENA (EDS)    OTS 4839244 E 
42                          720MG/2.4ML PRE-FILLED SYRINGE                      
61                          02554569    ABILIFY ASIMTUFII (EDS)   OTS 9123600 E 
42                          960MG/3.2ML PRE-FILLED SYRINGE                      
61                          02554577    ABILIFY ASIMTUFII (EDS)   OTS 9123600 E 
41                          ASENAPINE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG SUBLINGUAL TABLET                               
61                          02374803    SAPHRIS (EDS)             ORG 0015447 E 
42                          10MG SUBLINGUAL TABLET                              
61                          02374811    SAPHRIS (EDS)             ORG 0015447 E 
41                          BREXPIPRAZOLE                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.25MG TABLET                                       
61                          02461749    REXULTI (EDS)             OTS 0035000 E 
42                          0.5MG TABLET                                        
61                          02461757    REXULTI (EDS)             OTS 0035000 E 
42                          1MG TABLET                                          
61                          02461765    REXULTI (EDS)             OTS 0035000 E 
42                          2MG TABLET                                          
61                          02461773    REXULTI (EDS)             OTS 0035000 E 
42                          3MG TABLET                                          
61                          02461781    REXULTI (EDS)             OTS 0035000 E 
42                          4MG TABLET                                          
61                          02461803    REXULTI (EDS)             OTS 0035000 E 
41                          CARIPRAZINE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1.5MG CAPSULE                                       
61                          02526794    VRAYLAR (EDS)             ABV 0050029 E 
42                          3MG CAPSULE                                         
61                          02526808    VRAYLAR (EDS)             ABV 0050029 E 
42                          4.5MG CAPSULE                                       
61                          02526816    VRAYLAR (EDS)             ABV 0050029 E 
42                          6MG CAPSULE                                         
61                          02526824    VRAYLAR (EDS)             ABV 0050029 E 
41                          CHLORPROMAZINE                                      
42                          25MG TABLET                                         
6                           00232823    TEVA-CHLORPROMAZINE       TEV 0002829 F 
42                          50MG TABLET                                         
6                           00232807    TEVA-CHLORPROMAZINE       TEV 0003236 F 
42                          100MG TABLET                                        
6                           00232831    TEVA-CHLORPROMAZINE       TEV 0008439 F 
41                          CLOZAPINE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *25MG TABLET                                         
61                          02247243    GEN-CLOZAPINE (EDS)       MYL 0006594 E 
61                          02248034    AA-CLOZAPINE (EDS)        AAP 0006594 E 
61                          00894737    CLOZARIL (EDS)            HLS 0009420 E 
42                         *50MG TABLET                                         
61                          02305003    GEN-CLOZAPINE (EDS)       MYL 0013206 E 
61                          02458748    AA-CLOZAPINE (EDS)        AAP 0013206 E 
61                          02490668    CLOZARIL (EDS)            HLS 0018840 E 
42                         *100MG TABLET                                        
61                          02247244    GEN-CLOZAPINE (EDS)       MYL 0026446 E 
61                          02248035    AA-CLOZAPINE (EDS)        AAP 0026446 E 
61                          00894745    CLOZARIL (EDS)            HLS 0037780 E 
42                         *200MG TABLET                                        
61                          02305011    GEN-CLOZAPINE (EDS)       MYL 0052892 E 
61                          02458756    AA-CLOZAPINE (EDS)        AAP 0052892 E 
61                          02490676    CLOZARIL (EDS)            HLS 0075560 E 
41                          FLUPENTIXOL DECANOATE                               
42                          20MG/ML INJECTION SOLUTION (ML)                     
6                           02156032    FLUANXOL DEPOT            LUD 0098090 F 
42                          100MG/ML INJECTION SOLUTION (ML)                    
6                           02156040    FLUANXOL DEPOT            LUD 0490480 F 
41                          FLUPENTIXOL DIHYDROCHLORIDE                         
42                          0.5MG TABLET                                        
6                           02156008    FLUANXOL                  LUD 0003389 F 
42                          3MG TABLET                                          
6                           02156016    FLUANXOL                  LUD 0007320 F 
41                          FLUPHENAZINE DECANOATE                              
42                          25MG/ML INJECTION SOLUTION (5ML)                    
6                           02239636    FLUPHENAZINE OMEGA        OMG 0231600 F 
41                          FLUPHENAZINE HCL                                    
42                          1MG TABLET                                          
6                           00405345    FLUPHENAZINE              AAP 0002338 F 
42                          2MG TABLET                                          
6                           00410632    FLUPHENAZINE              AAP 0003006 F 
42                          5MG TABLET                                          
6                           00405361    FLUPHENAZINE              AAP 0004674 F 
41                          HALOPERIDOL                                         
42                          0.5MG TABLET                                        
6                           00363685    TEVA-HALOPERIDOL          TEV 0001570 F 
42                          1MG TABLET                                          
6                           00363677    TEVA-HALOPERIDOL          TEV 0002357 F 
42                          2MG TABLET                                          
6                           00363669    TEVA-HALOPERIDOL          TEV 0003526 F 
42                          5MG TABLET                                          
6                           00363650    TEVA-HALOPERIDOL          TEV 0005622 F 
42                          10MG TABLET                                         
6                           00713449    TEVA-HALOPERIDOL          TEV 0008179 F 
42                         *5MG/ML INJECTION SOLUTION (1ML)                     
6                           02366010    HALOPERIDOL INJECTION     OMG 0049400 F 
6                           00808652    HALOPERIDOL               SDZ 0050715 F 
41                          HALOPERIDOL DECANOATE                               
42                          100MG/ML INJECTION  SOLUTION (5ML)                  
6                           02130300    HALOPERIDOL LA            SDZ 1131300 F 
41                          LOXAPINE SUCCINATE                                  
42                          5MG TABLET                                          
6                           02230837    XYLAC                     PED 0001948 F 
42                          10MG TABLET                                         
6                           02230838    XYLAC                     PED 0004356 F 
42                          25MG TABLET                                         
6                           02230839    XYLAC                     PED 0006622 F 
42                          50MG TABLET                                         
6                           02230840    XYLAC                     PED 0006703 F 
41                          LURASIDONE HCL                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *20MG TABLET                                         
61                          02504499    TARO-LURASIDONE (EDS)     TAR 0012250 E 
61                          02505878    PMS-LURASIDONE (EDS)      PMS 0012250 E 
61                          02513986    AURO-LURASIDONE (EDS)     API 0012250 E 
61                          02516438    JAMP LURASIDONE (EDS)     JPC 0012250 E 
61                          02521075    SANDOZ LURASIDONE (EDS)   SDZ 0012250 E 
61                          02522314    NRA-LURASIDONE (EDS)      NRA 0012250 E 
61                          02548585    LURASIDONE (EDS)          SAN 0012250 E 
61                          02422050    LATUDA (EDS)              SUM 0042500 E 
42                         *40MG TABLET                                         
61                          02504502    TARO-LURASIDONE (EDS)     TAR 0012250 E 
61                          02505886    PMS-LURASIDONE (EDS)      PMS 0012250 E 
61                          02513994    AURO-LURASIDONE (EDS)     API 0012250 E 
61                          02516446    JAMP LURASIDONE (EDS)     JPC 0012250 E 
61                          02521091    SANDOZ LURASIDONE (EDS)   SDZ 0012250 E 
61                          02522322    NRA-LURASIDONE (EDS)      NRA 0012250 E 
61                          02548593    LURASIDONE (EDS)          SAN 0012250 E 
61                          02387751    LATUDA (EDS)              SUM 0042500 E 
42                         *60MG TABLET                                         
61                          02504510    TARO-LURASIDONE (EDS)     TAR 0012250 E 
61                          02505894    PMS-LURASIDONE (EDS)      PMS 0012250 E 
61                          02514001    AURO-LURASIDONE (EDS)     API 0012250 E 
61                          02516454    JAMP LURASIDONE (EDS)     JPC 0012250 E 
61                          02521105    SANDOZ LURASIDONE (EDS)   SDZ 0012250 E 
61                          02522330    NRA-LURASIDONE (EDS)      NRA 0012250 E 
61                          02548607    LURASIDONE (EDS)          SAN 0012250 E 
61                          02413361    LATUDA (EDS)              SUM 0042500 E 
42                         *80MG TABLET                                         
61                          02504529    TARO-LURASIDONE (EDS)     TAR 0012250 E 
61                          02505908    PMS-LURASIDONE (EDS)      PMS 0012250 E 
61                          02514028    AURO-LURASIDONE (EDS)     API 0012250 E 
61                          02516462    JAMP LURASIDONE (EDS)     JPC 0012250 E 
61                          02521113    SANDOZ LURASIDONE (EDS)   SDZ 0012250 E 
61                          02522349    NRA-LURASIDONE (EDS)      NRA 0012250 E 
61                          02548615    LURASIDONE (EDS)          SAN 0012250 E 
61                          02387778    LATUDA (EDS)              SUM 0042500 E 
42                         *120MG TABLET                                        
61                          02504537    TARO-LURASIDONE (EDS)     TAR 0012250 E 
61                          02505916    PMS-LURASIDONE (EDS)      PMS 0012250 E 
61                          02514036    AURO-LURASIDONE (EDS)     API 0012250 E 
61                          02516470    JAMP LURASIDONE (EDS)     JPC 0012250 E 
61                          02521121    SANDOZ LURASIDONE (EDS)   SDZ 0012250 E 
61                          02387786    LATUDA (EDS)              SUM 0042500 E 
41                          OLANZAPINE                                          
42                         *2.5MG TABLET                                        
6                           02276712    TEVA-OLANZAPINE           TEV 0001772 F 
6                           02281791    APO-OLANZAPINE            APX 0001772 F 
6                           02303116    PMS-OLANZAPINE            PMS 0001772 F 
6                           02310341    SANDOZ OLANZAPINE         SDZ 0001772 F 
6                           02372819    OLANZAPINE                SAN 0001772 F 
6                           02385864    OLANZAPINE                SIV 0001772 F 
6                           02410141    MINT-OLANZAPINE           MNT 0001772 F 
6                           02417243    JAMP-OLANZAPINE FC        JPC 0001772 F 
6                           02487608    AG-OLANZAPINE FC          ANG 0001772 F 
6                           02545586    NRA-OLANZAPINE            NRA 0001772 F 
6                           02229250    ZYPREXA                   XED 0024018 F 
42                         *5MG TABLET                                          
6                           02276720    TEVA-OLANZAPINE           TEV 0003544 F 
6                           02281805    APO-OLANZAPINE            APX 0003544 F 
6                           02303159    PMS-OLANZAPINE            PMS 0003544 F 
6                           02310368    SANDOZ OLANZAPINE         SDZ 0003544 F 
6                           02372827    OLANZAPINE                SAN 0003544 F 
6                           02385872    OLANZAPINE                SIV 0003544 F 
6                           02410168    MINT-OLANZAPINE           MNT 0003544 F 
6                           02417251    JAMP-OLANZAPINE FC        JPC 0003544 F 
6                           02487616    AG-OLANZAPINE FC          ANG 0003544 F 
6                           02545594    NRA-OLANZAPINE            NRA 0003544 F 
6                           02229269    ZYPREXA                   XED 0047243 F 
42                         *7.5MG TABLET                                        
6                           02276739    TEVA-OLANZAPINE           TEV 0005316 F 
6                           02281813    APO-OLANZAPINE            APX 0005316 F 
6                           02303167    PMS-OLANZAPINE            PMS 0005316 F 
6                           02310376    SANDOZ OLANZAPINE         SDZ 0005316 F 
6                           02372835    OLANZAPINE                SAN 0005316 F 
6                           02385880    OLANZAPINE                SIV 0005316 F 
6                           02410176    MINT-OLANZAPINE           MNT 0005316 F 
6                           02417278    JAMP-OLANZAPINE FC        JPC 0005316 F 
6                           02545608    NRA-OLANZAPINE            NRA 0005316 F 
6                           02229277    ZYPREXA                   XED 0070868 F 
42                         *10MG TABLET                                         
6                           02276747    TEVA-OLANZAPINE           TEV 0007088 F 
6                           02281821    APO-OLANZAPINE            APX 0007088 F 
6                           02303175    PMS-OLANZAPINE            PMS 0007088 F 
6                           02310384    SANDOZ OLANZAPINE         SDZ 0007088 F 
6                           02372843    OLANZAPINE                SAN 0007088 F 
6                           02385899    OLANZAPINE                SIV 0007088 F 
6                           02410184    MINT-OLANZAPINE           MNT 0007088 F 
6                           02417286    JAMP-OLANZAPINE FC        JPC 0007088 F 
6                           02487632    AG-OLANZAPINE FC          ANG 0007088 F 
6                           02545616    NRA-OLANZAPINE            NRA 0007088 F 
6                           02229285    ZYPREXA                   XED 0094493 F 
42                         *15MG TABLET                                         
6                           02276755    TEVA-OLANZAPINE           TEV 0010631 F 
6                           02281848    APO-OLANZAPINE            APX 0010631 F 
6                           02303183    PMS-OLANZAPINE            PMS 0010631 F 
6                           02310392    SANDOZ OLANZAPINE         SDZ 0010631 F 
6                           02372851    OLANZAPINE                SAN 0010631 F 
6                           02385902    OLANZAPINE                SIV 0010631 F 
6                           02410192    MINT-OLANZAPINE           MNT 0010631 F 
6                           02417294    JAMP-OLANZAPINE FC        JPC 0010631 F 
6                           02545624    NRA-OLANZAPINE            NRA 0010631 F 
6                           02238850    ZYPREXA                   XED 0144150 F 
42                         *5MG ORALLY DISINTEGRATING TABLET                    
6                           02303191    PMS-OLANZAPINE ODT        PMS 0003574 F 
6                           02327775    SANDOZ OLANZAPINE ODT     SDZ 0003574 F 
6                           02343665    OLANZAPINE ODT            SIV 0003574 F 
6                           02352974    OLANZAPINE ODT            SAN 0003574 F 
6                           02360616    APO-OLANZAPINE ODT        APX 0003574 F 
6                           02406624    JAMP-OLANZAPINE ODT       JPC 0003574 F 
6                           02436965    MINT-OLANZAPINE ODT       MNT 0003574 F 
6                           02448726    AURO-OLANZAPINE ODT       API 0003574 F 
6                           02536188    NRA-OLANZAPINE ODT        NRA 0003574 F 
6                           02243086    ZYPREXA ZYDIS             XED 0046982 F 
42                         *10MG ORALLY DISINTEGRATING TABLET                   
6                           02303205    PMS-OLANZAPINE ODT        PMS 0007143 F 
6                           02327783    SANDOZ OLANZAPINE ODT     SDZ 0007143 F 
6                           02343673    OLANZAPINE ODT            SIV 0007143 F 
6                           02352982    OLANZAPINE ODT            SAN 0007143 F 
6                           02360624    APO-OLANZAPINE ODT        APX 0007143 F 
6                           02406632    JAMP-OLANZAPINE ODT       JPC 0007143 F 
6                           02436973    MINT-OLANZAPINE ODT       MNT 0007143 F 
6                           02448734    AURO-OLANZAPINE ODT       API 0007143 F 
6                           02536196    NRA-OLANZAPINE ODT        NRA 0007143 F 
6                           02243087    ZYPREXA ZYDIS             XED 0093882 F 
42                         *15MG ORALLY DISINTEGRATING TABLET                   
6                           02303213    PMS-OLANZAPINE ODT        PMS 0010711 F 
6                           02327791    SANDOZ OLANZAPINE ODT     SDZ 0010711 F 
6                           02343681    OLANZAPINE ODT            SIV 0010711 F 
6                           02352990    OLANZAPINE ODT            SAN 0010711 F 
6                           02360632    APO-OLANZAPINE ODT        APX 0010711 F 
6                           02406640    JAMP-OLANZAPINE ODT       JPC 0010711 F 
6                           02414112    RAN-OLANZAPINE ODT        RAN 0010711 F 
6                           02436981    MINT-OLANZAPINE ODT       MNT 0010711 F 
6                           02448742    AURO-OLANZAPINE ODT       API 0010711 F 
6                           02536218    NRA-OLANZAPINE ODT        NRA 0010711 F 
6                           02243088    ZYPREXA ZYDIS             XED 0141904 F 
41                          PALIPERIDONE PALMITATE                              
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG PRE-FILLED SYRINGE                             
61                          02354217    INVEGA SUSTENNA (EDS)     JAN 3274400 E 
42                          75MG PRE-FILLED SYRINGE                             
61                          02354225    INVEGA SUSTENNA (EDS)     JAN 4912100 E 
42                          100MG PRE-FILLED SYRINGE                            
61                          02354233    INVEGA SUSTENNA (EDS)     JAN 5412300 E 
42                          150MG PRE-FILLED SYRINGE                            
61                          02354241    INVEGA SUSTENNA (EDS)     JAN 7216300 E 
42                          175MG/0.875ML PROLONGED RELEASE PF SYR (MG)         
61                          02455943    INVEGA TRINZA (EDS)       JAN 0054200 E 
42                          263MG/1.315ML PROLONGED RELEASE PF SYR (MG)         
61                          02455986    INVEGA TRINZA (EDS)       JAN 0054100 E 
42                          350MG/1.75ML PROLONGED RELEASE PF SYR (MG)          
61                          02455994    INVEGA TRINZA (EDS)       JAN 0040700 E 
42                          525MG/2.625ML PROLONGED RELEASE PF SYR (MG)         
61                          02456001    INVEGA TRINZA (EDS)       JAN 0036200 E 
41                          PERICYAZINE                                         
42                          5MG CAPSULE                                         
6                           01926780    NEULEPTIL                 SLP 0002680 F 
42                          10MG CAPSULE                                        
6                           01926772    NEULEPTIL                 SLP 0004624 F 
42                          10MG/ML ORAL DROPS                                  
6                           01926756    NEULEPTIL                 SLP 0004624 F 
41                          PERPHENAZINE                                        
42                          2MG TABLET                                          
6                           00335134    PERPHENAZINE              AAP 0000837 F 
42                          4MG TABLET                                          
6                           00335126    PERPHENAZINE              AAP 0001012 F 
42                          8MG TABLET                                          
6                           00335118    PERPHENAZINE              AAP 0001111 F 
42                          16MG TABLET                                         
6                           00335096    PERPHENAZINE              AAP 0001702 F 
41                          PIMOZIDE                                            
42                          2MG TABLET                                          
6                           02245432    PIMOZIDE                  AAP 0004128 F 
42                          4MG TABLET                                          
6                           02245433    PIMOZIDE                  AAP 0006287 F 
41                          PROCHLORPERAZINE                                    
42                          5MG TABLET                                          
6                           00886440    PROCHLORAZINE             AAP 0002191 F 
42                          10MG TABLET                                         
6                           00886432    PROCHLORAZINE             AAP 0002676 F 
42                          10MG SUPPOSITORY                                    
6                           00789720    ODAN-PROCHLORPERAZINE     ODN 0034180 F 
41                          QUETIAPINE                                          
42                         *25MG TABLET                                         
6                           02296551    PMS-QUETIAPINE            PMS 0000494 F 
6                           02313901    APO-QUETIAPINE            APX 0000494 F 
6                           02313995    SANDOZ QUETIAPINE         SDZ 0000494 F 
6                           02316080    ACT QUETIAPINE            TEV 0000494 F 
6                           02317893    QUETIAPINE                SIV 0000494 F 
6                           02330415    JAMP-QUETIAPINE           JPC 0000494 F 
6                           02353164    QUETIAPINE                SAN 0000494 F 
6                           02387794    QUETIAPINE TABLETS        AHI 0000494 F 
6                           02390140    JAMP QUETIAPINE FUMARATE  JPC 0000494 F 
6                           02390205    AURO-QUETIAPINE           API 0000494 F 
6                           02397099    RAN-QUETIAPINE            RAN 0000494 F 
6                           02399822    MAR-QUETIAPINE            MPI 0000494 F 
6                           02438003    MINT-QUETIAPINE           MNT 0000494 F 
6                           02475979    AG-QUETIAPINE             ANG 0000494 F 
6                           02486237    NRA-QUETIAPINE            NRA 0000494 F 
6                           02501635    APO-QUETIAPINE FUMARATE   APX 0000494 F 
6                           02236951    SEROQUEL                  XED 0005491 F 
42                          50MG TABLET                                         
6                           02361892    PMS-QUETIAPINE            PMS 0005778 F 
42                         *100MG TABLET                                        
6                           02296578    PMS-QUETIAPINE            PMS 0001318 F 
6                           02313928    APO-QUETIAPINE            APX 0001318 F 
6                           02316099    ACT QUETIAPINE            TEV 0001318 F 
6                           02317907    QUETIAPINE                SIV 0001318 F 
6                           02330423    JAMP-QUETIAPINE           JPC 0001318 F 
6                           02353172    QUETIAPINE                SAN 0001318 F 
6                           02387808    QUETIAPINE TABLETS        AHI 0001318 F 
6                           02390159    JAMP QUETIAPINE FUMARATE  JPC 0001318 F 
6                           02390213    AURO-QUETIAPINE           API 0001318 F 
6                           02399830    MAR-QUETIAPINE            MPI 0001318 F 
6                           02438011    MINT-QUETIAPINE           MNT 0001318 F 
6                           02501643    APO-QUETIAPINE FUMARATE   APX 0001318 F 
6                           02236952    SEROQUEL                  XED 0014649 F 
42                         *200MG TABLET                                        
6                           02296594    PMS-QUETIAPINE            PMS 0002647 F 
6                           02313936    APO-QUETIAPINE            APX 0002647 F 
6                           02314010    SANDOZ QUETIAPINE         SDZ 0002647 F 
6                           02316110    ACT QUETIAPINE            TEV 0002647 F 
6                           02317923    QUETIAPINE                SIV 0002647 F 
6                           02330458    JAMP-QUETIAPINE           JPC 0002647 F 
6                           02353199    QUETIAPINE                SAN 0002647 F 
6                           02387824    QUETIAPINE TABLETS        AHI 0002647 F 
6                           02390167    JAMP QUETIAPINE FUMARATE  JPC 0002647 F 
6                           02390248    AURO-QUETIAPINE           API 0002647 F 
6                           02399849    MAR-QUETIAPINE            MPI 0002647 F 
6                           02438046    MINT-QUETIAPINE           MNT 0002647 F 
6                           02501651    APO-QUETIAPINE FUMARATE   APX 0002647 F 
6                           02236953    SEROQUEL                  XED 0028839 F 
42                         *300MG TABLET                                        
6                           02296608    PMS-QUETIAPINE            PMS 0003863 F 
6                           02313944    APO-QUETIAPINE            APX 0003863 F 
6                           02316129    ACT QUETIAPINE            TEV 0003863 F 
6                           02317931    QUETIAPINE                SIV 0003863 F 
6                           02330466    JAMP-QUETIAPINE           JPC 0003863 F 
6                           02353202    QUETIAPINE                SAN 0003863 F 
6                           02387832    QUETIAPINE TABLETS        AHI 0003863 F 
6                           02390175    JAMP QUETIAPINE FUMARATE  JPC 0003863 F 
6                           02390256    AURO-QUETIAPINE           API 0003863 F 
6                           02399857    MAR-QUETIAPINE            MPI 0003863 F 
6                           02438054    MINT-QUETIAPINE           MNT 0003863 F 
6                           02501678    APO-QUETIAPINE FUMARATE   APX 0003863 F 
6                           02244107    SEROQUEL                  XED 0042925 F 
42                         *50MG EXTENDED RELEASE TABLET                        
6                           02395444    TEVA-QUETIAPINE XR        TEV 0002501 F 
6                           02407671    SANDOZ QUETIAPINE XRT     SDZ 0002501 F 
6                           02417359    QUETIAPINE XR             SIV 0002501 F 
6                           02450860    ACH-QUETIAPINE FUMAR XR   AHI 0002501 F 
6                           02457229    APO-QUETIAPINE XR         APX 0002501 F 
6                           02510677    NRA-QUETIAPINE XR         NRA 0002501 F 
6                           02516616    QUETIAPINE FUMARATE XR    SAN 0002501 F 
6                           02519607    QUETIAPINE XR             JPC 0002501 F 
6                           02522187    MINT-QUETIAPINE XR        MNT 0002501 F 
6                           02527928    M-QUETIAPINE FUMARATE XR  MNP 0002501 F 
6                           02300184    SEROQUEL XR               XED 0011523 F 
42                         *150MG EXTENDED RELEASE TABLET                       
6                           02395452    TEVA-QUETIAPINE XR        TEV 0004926 F 
6                           02407698    SANDOZ QUETIAPINE XRT     SDZ 0004926 F 
6                           02417367    QUETIAPINE XR             SIV 0004926 F 
6                           02450879    ACH-QUETIAPINE FUMAR XR   AHI 0004926 F 
6                           02457237    APO-QUETIAPINE XR         APX 0004926 F 
6                           02510685    NRA-QUETIAPINE XR         NRA 0004926 F 
6                           02516624    QUETIAPINE FUMARATE XR    SAN 0004926 F 
6                           02519615    QUETIAPINE XR             JPC 0004926 F 
6                           02522195    MINT-QUETIAPINE XR        MNT 0004926 F 
6                           02527936    M-QUETIAPINE FUMARATE XR  MNP 0004926 F 
6                           02321513    SEROQUEL XR               XED 0022698 F 
42                         *200MG EXTENDED RELEASE TABLET                       
6                           02395460    TEVA-QUETIAPINE XR        TEV 0006661 F 
6                           02407701    SANDOZ QUETIAPINE XRT     SDZ 0006661 F 
6                           02417375    QUETIAPINE XR             SIV 0006661 F 
6                           02450887    ACH-QUETIAPINE FUMAR XR   AHI 0006661 F 
6                           02457245    APO-QUETIAPINE XR         APX 0006661 F 
6                           02510693    NRA-QUETIAPINE XR         NRA 0006661 F 
6                           02516632    QUETIAPINE FUMARATE XR    SAN 0006661 F 
6                           02519623    QUETIAPINE XR             JPC 0006661 F 
6                           02522209    MINT-QUETIAPINE XR        MNT 0006661 F 
6                           02527944    M-QUETIAPINE FUMARATE XR  MNP 0006661 F 
6                           02300192    SEROQUEL XR               XED 0030692 F 
42                         *300MG EXTENDED RELEASE TABLET                       
6                           02395479    TEVA-QUETIAPINE XR        TEV 0009776 F 
6                           02407728    SANDOZ QUETIAPINE XRT     SDZ 0009776 F 
6                           02417383    QUETIAPINE XR             SIV 0009776 F 
6                           02450895    ACH-QUETIAPINE FUMAR XR   AHI 0009776 F 
6                           02457253    APO-QUETIAPINE XR         APX 0009776 F 
6                           02510707    NRA-QUETIAPINE XR         NRA 0009776 F 
6                           02516640    QUETIAPINE FUMARATE XR    SAN 0009776 F 
6                           02519747    QUETIAPINE XR             JPC 0009776 F 
6                           02522217    MINT-QUETIAPINE XR        MNT 0009776 F 
6                           02527952    M-QUETIAPINE FUMARATE XR  MNP 0009776 F 
6                           02300206    SEROQUEL XR               XED 0045045 F 
42                         *400MG EXTENDED RELEASE TABLET                       
6                           02395487    TEVA-QUETIAPINE XR        TEV 0013270 F 
6                           02407736    SANDOZ QUETIAPINE XRT     SDZ 0013270 F 
6                           02417391    QUETIAPINE XR             SIV 0013270 F 
6                           02450909    ACH-QUETIAPINE FUMAR XR   AHI 0013270 F 
6                           02457261    APO-QUETIAPINE XR         APX 0013270 F 
6                           02510715    NRA-QUETIAPINE XR         NRA 0013270 F 
6                           02516659    QUETIAPINE FUMARATE XR    SAN 0013270 F 
6                           02519763    QUETIAPINE XR             JPC 0013270 F 
6                           02522225    MINT-QUETIAPINE           MNT 0013270 F 
6                           02527960    M-QUETIAPINE FUMARATE XR  MNP 0013270 F 
6                           02300214    SEROQUEL XR               XED 0061148 F 
41                          RISPERIDONE                                         
42                         *0.25MG TABLET                                       
6                           02252007    PMS-RISPERIDONE           PMS 0000878 F 
6                           02282119    APO-RISPERIDONE           APX 0000878 F 
6                           02282690    TEVA-RISPERIDONE          TEV 0000878 F 
6                           02303655    SANDOZ RISPERIDONE        SDZ 0000878 F 
6                           02328305    RAN-RISPERIDONE           RAN 0000878 F 
6                           02356880    RISPERIDONE               SAN 0000878 F 
6                           02359529    JAMP-RISPERIDONE          JPC 0000878 F 
6                           02359790    MINT-RISPERIDON           MNT 0000878 F 
6                           02371766    MAR-RISPERIDONE           MPI 0000878 F 
6                           02533804    RISPERIDONE               SIV 0000878 F 
6                           02563320    JAMP RISPERIDONE          JPC 0000878 F 
42                         *0.5MG TABLET                                        
6                           02252015    PMS-RISPERIDONE           PMS 0001470 F 
6                           02264188    TEVA-RISPERIDONE          TEV 0001470 F 
6                           02282127    APO-RISPERIDONE           APX 0001470 F 
6                           02303663    SANDOZ RISPERIDONE        SDZ 0001470 F 
6                           02328313    RAN-RISPERIDONE           RAN 0001470 F 
6                           02356899    RISPERDONE                SAN 0001470 F 
6                           02359537    JAMP-RISPERIDONE          JPC 0001470 F 
6                           02359804    MINT-RISPERDON            MNT 0001470 F 
6                           02371774    MAR-RISPERIDONE           MPI 0001470 F 
6                           02533928    RISPERIDONE               SIV 0001470 F 
6                           02563339    JAMP RISPERIDONE          JPC 0001470 F 
42                          0.5MG ORALLY DISINTEGRATING TABLET                  
6                           02413485    MYLAN-RISPERIDONE ODT     MYL 0005588 F 
42                         *1MG TABLET                                          
6                           02252023    PMS-RISPERIDONE           PMS 0002031 F 
6                           02264196    TEVA-RISPERIDONE          TEV 0002031 F 
6                           02279800    SANDOZ RISPERIDONE        SDZ 0002031 F 
6                           02282135    APO-RISPERIDONE           APX 0002031 F 
6                           02328321    RAN-RISPERIDONE           RAN 0002031 F 
6                           02356902    RISPERIDONE               SAN 0002031 F 
6                           02359545    JAMP-RISPERIDONE          JPC 0002031 F 
6                           02359812    MINT-RISPERIDON           MNT 0002031 F 
6                           02371782    MAR-RISPERIDONE           MPI 0002031 F 
6                           02533936    RISPERIDONE               SIV 0002031 F 
6                           02563347    JAMP RISPERIDONE          JPC 0002031 F 
42                          1MG ORALLY DISINTEGRATING TABLET                    
6                           02413493    MYLAN-RISPERIDONE ODT     MYL 0005150 F 
42                         *2MG TABLET                                          
6                           02252031    PMS-RISPERIDONE           PMS 0004062 F 
6                           02264218    TEVA-RISPERIDONE          TEV 0004062 F 
6                           02279819    SANDOZ RISPERIDONE        SDZ 0004062 F 
6                           02282143    APO-RISPERIDONE           APX 0004062 F 
6                           02328348    RAN-RISPERIDONE           RAN 0004062 F 
6                           02356910    RISPERIDONE               SAN 0004062 F 
6                           02359553    JAMP-RISPERIDONE          JPC 0004062 F 
6                           02359820    MINT-RISPERIDON           MNT 0004062 F 
6                           02371790    MAR-RISPERIDONE           MPI 0004062 F 
6                           02533944    RISPERIDONE               SIV 0004062 F 
42                          2MG ORALLY DISINTEGRATING TABLET                    
6                           02413507    MYLAN-RISPERIDONE ODT     MYL 0010187 F 
42                         *3MG TABLET                                          
6                           02252058    PMS-RISPERIDONE           PMS 0006083 F 
6                           02264226    TEVA-RISPERIDONE          TEV 0006083 F 
6                           02279827    SANDOZ RISPERIDONE        SDZ 0006083 F 
6                           02282151    APO-RISPERIDONE           APX 0006083 F 
6                           02328364    RAN-RISPERIDONE           RAN 0006083 F 
6                           02356929    RISPERIDONE               SAN 0006083 F 
6                           02359561    JAMP-RISPERIDONE          JPC 0006083 F 
6                           02359839    MINT-RISPERIDON           MNT 0006083 F 
6                           02371804    MAR-RISPERIDONE           MPI 0006083 F 
6                           02533952    RISPERIDONE               SIV 0006083 F 
6                           02563363    JAMP RISPERIDONE          JPC 0006083 F 
42                          3MG ORALLY DISINTEGRATING TABLET                    
6                           02413515    MYLAN-RISPERIDONE ODT     MYL 0015277 F 
42                         *4MG TABLET                                          
6                           02252066    PMS-RISPERIDONE           PMS 0008111 F 
6                           02264234    TEVA-RISPERIDONE          TEV 0008111 F 
6                           02279835    SANDOZ RISPERIDONE        SDZ 0008111 F 
6                           02282178    APO-RISPERIDONE           APX 0008111 F 
6                           02328372    RAN-RISPERIDONE           RAN 0008111 F 
6                           02356937    RISPERIDONE               SAN 0008111 F 
6                           02359588    JAMP-RISPERIDONE          JPC 0008111 F 
6                           02359847    MINT-RISPERDON            MNT 0008111 F 
6                           02371812    MAR-RISPERIDONE           MPI 0008111 F 
6                           02533960    RISPERIDONE               SIV 0008111 F 
42                          4MG ORALLY DISINTEGRATING TABLET                    
6                           02413523    MYLAN-RISPERIDONE ODT     MYL 0020427 F 
42                         *1MG/ML ORAL SOLUTION                                
6                           02279266    PMS-RISPERIDONE           PMS 0007080 F 
6                           02454319    JAMP-RISPERIDONE          JPC 0007080 F 
42                          12.5MG/VIAL POWDER FOR INJECTION (VIAL)             
61                          02298465    RISPERDAL CONSTA (EDS)    JAN 1003400 E 
42                          25MG/VIAL POWDER FOR INJECTION (VIAL)               
61                          02255707    RISPERDAL CONSTA (EDS)    JAN 2083500 E 
42                          37.5MG/VIAL POWDER FOR INJECTION (VIAL)             
61                          02255723    RISPERDAL CONSTA (EDS)    JAN 3125100 E 
42                          50MG/VIAL POWDER FOR INJECTION (VIAL)               
61                          02255758    RISPERDAL CONSTA (EDS)    JAN 4166800 E 
42                          75MG/PFS POWDER FOR INJECTION (SYRINGE)             
61                          02544601    OKEDI (EDS)               BAU 2500000 E 
42                          100MG/PFS POWDER FOR INJECTION (SYRINGE)            
61                          02544628    OKEDI (EDS)               BAU 2500000 E 
41                          TRIFLUOPERAZINE                                     
42                          1MG TABLET                                          
6                           00345539    TRIFLUOPERAZINE           AAP 0001628 F 
42                          2MG TABLET                                          
6                           00312754    TRIFLUOPERAZINE           AAP 0002135 F 
42                          5MG TABLET                                          
6                           00312746    TRIFLUOPERAZINE           AAP 0002970 F 
42                          10MG TABLET                                         
6                           00326836    TRIFLUOPERAZINE           AAP 0003560 F 
41                          ZIPRASIDONE                                         
42                         *20MG CAPSULE                                        
6                           02449544    AURO-ZIPRASIDONE          API 0013784 F 
6                           02298597    ZELDOX                    BGP 0022180 F 
42                         *40MG CAPSULE                                        
6                           02449552    AURO-ZIPRASIDONE          API 0015786 F 
6                           02298600    ZELDOX                    BGP 0025408 F 
42                         *60MG CAPSULE                                        
6                           02449560    AURO-ZIPRASIDONE          API 0015786 F 
6                           02298619    ZELDOX                    BGP 0025408 F 
42                         *80MG CAPSULE                                        
6                           02449579    AURO-ZIPRASIDONE          API 0015786 F 
6                           02298627    ZELDOX                    BGP 0025408 F 
41                          ZUCLOPENTHIXOL ACETATE                              
42                          50MG/ML INJECTION (ML)                              
6                           02230405    CLOPIXOL ACUPHASE         LUD 0203580 F 
41                          ZUCLOPENTHIXOL DECANOATE                            
42                          200MG/ML INJECTION (ML)                             
6                           02230406    CLOPIXOL DEPOT            LUD 0203590 F 
41                          ZUCLOPENTHIXOL DIHYDROCHLORIDE                      
42                          10MG TABLET                                         
6                           02230402    CLOPIXOL                  LUD 0005236 F 
42                          25MG TABLET                                         
6                           02230403    CLOPIXOL                  LUD 0013089 F 
2         RESPIRATORY/CENTRAL NERVOUS SYSTEM STIMULANTS                         
41                          DEXTROAMPHETAMINE SO4                               
42                         *5MG TABLET                                          
6                           02443236    DEXTROAMPHETAMINE         AAP 0005081 F 
6                           01924516    DEXEDRINE                 KTI 0007366 F 
42                         *10MG SPANSULE CAPSULE                               
6                           02448319    TEVA-DEXTROAMPHETAMINE SR TEV 0008096 F 
6                           01924559    DEXEDRINE                 KTI 0010569 F 
42                         *15MG SPANSULE CAPSULE                               
6                           02448327    TEVA-DEXTROAMPHETAMINE SR TEV 0009898 F 
6                           01924567    DEXEDRINE                 KTI 0012921 F 
41                          LISDEXAMFETAMINE DIMESYLATE                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG CAPSULE                                        
61                          02535122    JAMP LISDEXAMFETAMIN(EDS) JPC 0005692 E 
61                          02545861    TEVA-LISDEXAMFETAM (EDS)  TEV 0005692 E 
61                          02546248    SANDOZ LISDEXAMFETAM(EDS) SDZ 0005692 E 
61                          02546647    APO-LISDEXAMFETAMINE(EDS) APX 0005692 E 
61                          02439603    VYVANSE (EDS)             TAK 0024105 E 
42                         *20MG CAPSULE                                        
61                          02535130    JAMP LISDEXAMFETAMIN(EDS) JPC 0007081 E 
61                          02545888    TEVA-LISDEXAMFETAM (EDS)  TEV 0007081 E 
61                          02546256    SANDOZ-LISDEXAMFETAM(EDS) SDZ 0007081 E 
61                          02546655    APO-LISDEXAMFETAMINE(EDS) APX 0007081 E 
61                          02347156    VYVANSE (EDS)             TAK 0029985 E 
42                         *30MG CAPSULE                                        
61                          02535149    JAMP LISDEXAMFETAMIN(EDS) JPC 0008469 E 
61                          02545896    TEVA-LISDEXAMFETAM (EDS)  TEV 0008469 E 
61                          02546264    SANDOZ LISDEXAMFETA (EDS) SDZ 0008469 E 
61                          02546663    APO-LISDEXAMFETAMINE(EDS) APX 0008469 E 
61                          02322951    VYVANSE (EDS)             TAK 0035864 E 
42                         *40MG CAPSULE                                        
61                          02535157    JAMP LISDEXAMFETAMIN(EDS) JPC 0009857 E 
61                          02545918    TEVA-LISDEXAMFETAM (EDS)  TEV 0009857 E 
61                          02546272    SANDOZ-LISDEXAMFETAM(EDS) SDZ 0009857 E 
61                          02546671    APO-LISDEXAMFETAMINE(EDS) APX 0009857 E 
61                          02347164    VYVANSE (EDS)             TAK 0041744 E 
42                         *50MG CAPSULE                                        
61                          02535165    JAMP LISDEXAMFETAMIN(EDS) JPC 0011246 E 
61                          02545926    TEVA-LISDEXAMFETAM (EDS)  TEV 0011246 E 
61                          02546280    SANDOZ-LISDEXAMFETAM(EDS) SDZ 0011246 E 
61                          02546698    APO-LISDEXAMFETAMINE(EDS) APX 0011246 E 
61                          02322978    VYVANSE (EDS)             TAK 0047623 E 
42                         *60MG CAPSULE                                        
61                          02535173    JAMP LISDEXAMFETAMIN(EDS) JPC 0012634 E 
61                          02545934    TEVA-LISDEXAMFETAM (EDS)  TEV 0012634 E 
61                          02546299    SANDOZ-LISDEXAMFETAM(EDS) SDZ 0012634 E 
61                          02546701    APO-LISDEXAMFETAMINE(EDS) APX 0012634 E 
61                          02347172    VYVANSE (EDS)             TAK 0053502 E 
42                         *10MG CHEWABLE TABLET                                
61                          02533340    TARO-LISDEXAMFETAM (EDS)  TAR 0011385 E 
61                          02534444    APO-LISDEXAMFETAMINE (EDS APX 0011385 E 
61                          02490226    VYVANSE (EDS)             TAK 0024105 E 
42                         *20MG CHEWABLE TABLET                                
61                          02533359    TARO-LISDEXAMFETAM (EDS)  TAR 0014161 E 
61                          02534452    APO-LISDEXAMFETAMINE (EDS APX 0014161 E 
61                          02490234    VYVANSE (EDS)             TAK 0029985 E 
42                         *30MG CHEWABLE TABLET                                
61                          02533367    TARO-LISDEXAMFETAM (EDS)  TAR 0016938 E 
61                          02534460    APO-LISDEXAMFETAMINE (EDS APX 0016938 E 
61                          02490242    VYVANSE (EDS)             TAK 0035864 E 
42                         *40MG CHEWABLE TABLET                                
61                          02533375    TARO-LISDEXAMFETAM (EDS)  TAR 0019715 E 
61                          02534479    APO-LISDEXAMFETAMINE (EDS APX 0019715 E 
61                          02490250    VYVANSE (EDS)             TAK 0041744 E 
42                         *50MG CHEWABLE TABLET                                
61                          02533383    TARO-LISDEXAMFETAM (EDS)  TAR 0022491 E 
61                          02534487    APO-LISDEXAMFETAMINE (EDS APX 0022491 E 
61                          02490269    VYVANSE (EDS)             TAK 0047623 E 
42                         *60MG CHEWABLE TABLET                                
61                          02533391    TARO-LISDEXAMFETAM (EDS)  TAR 0025268 E 
61                          02534495    APO-LISDEXAMFETAMINE (EDS APX 0025268 E 
61                          02490277    VYVANSE (EDS)             TAK 0053502 E 
41                          METHYLPHENIDATE HCL                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
6                           02234749    PMS-METHYLPHENIDATE       PMS 0000947 F 
6                           02273950    APO-METHYLPHENIDATE       APX 0000947 F 
42                         *10MG TABLET                                         
6                           00584991    PMS-METHYLPHENIDATE       PMS 0002216 F 
6                           02249324    APO-METHYLPHENIDATE       APX 0002216 F 
42                         *20MG TABLET                                         
6                           00585009    PMS-METHYLPHENIDATE       PMS 0003387 F 
6                           02249332    APO-METHYLPHENIDATE       APX 0003387 F 
42                         *10MG EXTENDED RELEASE CAPSULE                       
61                          02536943    PMS-METHYLPHENIDAT CR(EDS PMS 0005128 E 
61                          02277166    BIPHENTIN (EDS)           ELS 0008778 E 
42                         *15MG EXTENDED RELEASE CAPSULE                       
61                          02536951    PMS-METHYLPHENIDAT CR(EDS PMS 0007354 E 
61                          02277131    BIPHENTIN (EDS)           ELS 0012553 E 
42                          18MG EXTENDED RELEASE TABLET                        
6                           02247732    CONCERTA                  JAN 0032995 F 
42                         *20MG EXTENDED RELEASE CAPSULE                       
61                          02536978    PMS-METHYLPHENIDAT CR(EDS PMS 0009477 E 
61                          02277158    BIPHENTIN (EDS)           ELS 0016230 E 
42                          27MG EXTENDED RELEASE TABLET                        
6                           02250241    CONCERTA                  JAN 0038076 F 
42                         *30MG EXTENDED RELEASE CAPSULE                       
61                          02536986    PMS-METHYLPHENIDAT CR(EDS PMS 0013021 E 
61                          02277174    BIPHENTIN (EDS)           ELS 0022275 E 
42                          36MG EXTENDED RELEASE TABLET                        
6                           02247733    CONCERTA                  JAN 0043163 F 
42                         *40MG EXTENDED RELEASE CAPSULE                       
61                          02536994    PMS-METHYLPHENIDAT CR(EDS PMS 0016588 E 
61                          02277182    BIPHENTIN (EDS)           ELS 0028374 E 
42                         *50MG EXTENDED RELEASE CAPSULE                       
61                          02537001    PMS-METHYLPHENIDAT CR(EDS PMS 0020130 E 
61                          02277190    BIPHENTIN (EDS)           ELS 0034408 E 
42                          54MG EXTENDED RELEASE TABLET                        
6                           02247734    CONCERTA                  JAN 0053326 F 
42                         *60MG EXTENDED RELEASE CAPSULE                       
61                          02537028    PMS-METHYLPHENIDAT CR(EDS PMS 0023425 E 
61                          02277204    BIPHENTIN (EDS)           ELS 0040033 E 
42                         *80MG EXTENDED RELEASE CAPSULE                       
61                          02537036    PMS-METHYLPHENIDAT CR(EDS PMS 0030883 E 
61                          02277212    BIPHENTIN (EDS)           ELS 0052827 E 
42                          20MG SUSTAINED RELEASE TABLET                       
6                           02266687    AA-METHYLPHENIDATE SR     AAP 0006796 F 
42                          25MG CONTROLLED RELEASE CAPSULE                     
61                          02470292    FOQUEST (EDS)             ELS 0029332 E 
42                          35MG CONTROLLED RELEASE CAPSULE                     
61                          02470306    FOQUEST (EDS)             ELS 0032268 E 
42                          45MG CONTROLLED RELEASE CAPSULE                     
61                          02470314    FOQUEST (EDS)             ELS 0035056 E 
42                          55MG CONTROLLED RELEASE CAPSULE                     
61                          02470322    FOQUEST (EDS)             ELS 0037940 E 
42                          70MG CONTROLLED RELEASE CAPSULE                     
61                          02470330    FOQUEST (EDS)             ELS 0042282 E 
42                          85MG CONTROLLED RELEASE CAPSULE                     
61                          02470349    FOQUEST (EDS)             ELS 0046517 E 
42                          100MG CONTROLLED RELEASE CAPSULE                    
61                          02470357    FOQUEST (EDS)             ELS 0050708 E 
41                          MODAFINIL                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *100MG TABLET                                        
61                          02285398    APO-MODAFINIL (EDS)       APX 0003427 E 
61                          02420260    TEVA-MODAFINIL (EDS)      TEV 0003427 E 
61                          02430487    AURO-MODAFINIL (EDS)      API 0003427 E 
61                          02432560    MAR-MODAFINIL (EDS)       MPI 0003427 E 
61                          02503727    JAMP MODAFINIL (EDS)      JPC 0003427 E 
61                          02530244    MODAFINIL (EDS)           SAN 0003427 E 
61                          02239665    ALERTEC (EDS)             TVM 0017953 E 
2         MISCELLANEOUS ANOREXIGENIC DRUGS                                      
41                          SETMELANOTIDE                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML SOLUTION FOR INJECTION (MG)                 
61                          02537745    IMCIVREE (EDS)            RHY 4022905 E 
2         ANXIOLYTIC/SEDATIVE-HYPNOTIC, BENZODIAZEPINES                         
41                          ALPRAZOLAM                                          
42                         *0.25MG TABLET                                       
6                           00865397    APO-ALPRAZ                APX 0000609 F 
6                           01913484    TEVA-ALPRAZOL             TEV 0000609 F 
6                           02349191    ALPRAZOLAM                SAN 0000609 F 
6                           02400111    JAMP-ALPRAZOLAM           JPC 0000609 F 
6                           00548359    XANAX                     BGP 0003592 F 
42                         *0.5MG TABLET                                        
6                           00865400    APO-ALPRAZ                APX 0000728 F 
6                           01913492    TEVA-ALPRAZOL             TEV 0000728 F 
6                           02349205    ALPRAZOLAM                SAN 0000728 F 
6                           02400138    JAMP-ALPRAZOLAM           JPC 0000728 F 
6                           00548367    XANAX                     BGP 0004298 F 
41                          BROMAZEPAM                                          
42                          1.5MG TABLET                                        
6                           02177153    APO-BROMAZEPAM            APX 0001028 F 
42                         *3MG TABLET                                          
6                           02177161    APO-BROMAZEPAM            APX 0000897 F 
6                           02230584    TEVA-BROMAZEPAM           TEV 0000897 F 
42                         *6MG TABLET                                          
6                           02177188    APO-BROMAZEPAM            APX 0001310 F 
6                           02230585    TEVA-BROMAZEPAM           TEV 0001310 F 
41                          CHLORDIAZEPOXIDE                                    
42                          5MG CAPSULE                                         
6                           00522724    CHLORDIAZEPOXIDE          AAP 0000867 F 
42                          10MG CAPSULE                                        
6                           00522988    CHLORDIAZEPOXIDE          AAP 0001364 F 
42                          25MG CAPSULE                                        
6                           00522996    CHLORDIAZEPOXIDE          AAP 0002216 F 
41                          CLORAZEPATE DIPOTASSIUM                             
42                          3.75MG CAPSULE                                      
6                           00860689    CLORAZEPATE               AAP 0001972 F 
42                          7.5MG CAPSULE                                       
6                           00860700    CLORAZEPATE               AAP 0002570 F 
42                          15MG CAPSULE                                        
6                           00860697    CLORAZEPATE               AAP 0005148 F 
41                          DIAZEPAM                                            
42                          2MG TABLET                                          
6                           00405329    APO-DIAZEPAM              AAP 0000532 F 
42                         *5MG TABLET                                          
6                           00362158    APO-DIAZEPAM              AAP 0001662 F 
6                           00013285    VALIUM                    SLP 0001955 F 
42                          10MG TABLET                                         
6                           00405337    APO-DIAZEPAM              AAP 0012040 F 
42                          5MG/ML RECTAL GEL (DELIVERY SYSTEM)                 
6                           02238162    DIASTAT                   BAU 1017000 F 
42                          10MG/2ML RECTAL GEL (DELIVERY SYSTEM)               
6                           02519070    DIASTAT                   BAU 1017000 F 
42                          15MG/3ML RECTAL GEL (DELIVERY SYSTEM)               
6                           02519089    DIASTAT                   BAU 1017000 F 
41                          FLURAZEPAM HCL                                      
42                          15MG CAPSULE                                        
6                           00521698    FLURAZEPAM                AAP 0001526 F 
42                          30MG CAPSULE                                        
6                           00521701    FLURAZEPAM                AAP 0001786 F 
41                          LORAZEPAM                                           
42                         *0.5MG TABLET                                        
6                           00655740    APO-LORAZEPAM             APX 0000359 F 
6                           00711101    TEVA-LORAZEPAM            TEV 0000359 F 
6                           00728187    PMS-LORAZEPAM             PMS 0000359 F 
6                           02351072    LORAZEPAM                 SAN 0000359 F 
42                         *1MG TABLET                                          
6                           00637742    TEVA-LORAZEPAM            TEV 0000447 F 
6                           00655759    APO-LORAZEPAM             APX 0000447 F 
6                           00728195    PMS-LORAZEPAM             PMS 0000447 F 
42                         *2MG TABLET                                          
6                           00637750    TEVA-LORAZEPAM            TEV 0000699 F 
6                           00655767    APO-LORAZEPAM             APX 0000699 F 
6                           00728209    PMS-LORAZEPAM             PMS 0000699 F 
41                          OXAZEPAM                                            
42                          10MG TABLET                                         
6                           00402680    APO-OXAZEPAM              APX 0000350 F 
42                          15MG TABLET                                         
6                           00402745    APO-OXAZEPAM              APX 0000550 F 
42                          30MG TABLET                                         
6                           00402737    APO-OXAZEPAM              APX 0000750 F 
41                          TEMAZEPAM                                           
42                          15MG CAPSULE                                        
6                           00604453    RESTORIL                  AAP 0002744 F 
42                          30MG CAPSULE                                        
6                           00604461    RESTORIL                  AAP 0003322 F 
41                          TRIAZOLAM                                           
42                          0.25MG TABLET                                       
6                           00808571    TRIAZOLAM                 AAP 0003178 F 
2         MISCELLANEOUS ANXIOLYTICS/SEDATIVE-HYPNOTICS                          
41                          BUSPIRONE                                           
42                         *10MG TABLET                                         
6                           02211076    APO-BUSPIRONE             APX 0002713 F 
6                           02230942    PMS-BUSPIRONE             PMS 0002713 F 
6                           02231492    TEVA-BUSPIRONE            TEV 0002713 F 
6                           02447851    BUSPIRONE                 SAN 0002713 F 
6                           02500213    AURO-BUSPIRONE            API 0002713 F 
6                           02509911    JAMP BUSPIRONE            JPC 0002713 F 
6                           02519054    MINT-BUSPIRONE            MNT 0002713 F 
6                           02550555    AMB-BUSPIRONE             AMB 0002713 F 
6                           02568128    BUSPIRONE                 SAN 0002713 F 
41                          CHLORAL HYDRATE                                     
42                          100MG/ML SYRUP                                      
6                           02247621    CHLORAL HYDRATE SYRUP     ODN 0001680 F 
41                          HYDROXYZINE                                         
42                          10MG CAPSULE                                        
6                           00646059    HYDROXYZINE               AAP 0001292 F 
42                          25MG CAPSULE                                        
6                           00646024    HYDROXYZINE               AAP 0001937 F 
42                          50MG CAPSULE                                        
6                           00646016    HYDROXYZINE               AAP 0002388 F 
42                          2MG/ML ORAL SYRUP                                   
6                           00024694    ATARAX                    SLP 0000622 F 
41                          METHOTRIMEPRAZINE                                   
42                          2MG TABLET                                          
6                           02238403    METHOPRAZINE              AAP 0000915 F 
42                          5MG TABLET                                          
6                           02238404    METHOPRAZINE              AAP 0001322 F 
42                          25MG TABLET                                         
6                           02238405    METHOPRAZINE              AAP 0003402 F 
42                          50MG TABLET                                         
6                           02238406    METHOPRAZINE              AAP 0005149 F 
2         MOOD STABILIZERS                                                      
41                          LITHIUM CARBONATE                                   
42                         *150MG CAPSULE                                       
6                           02216132    PMS-LITHIUM CARBONATE     PMS 0000667 F 
6                           02242837    APO-LITHIUM CARBONATE     APX 0000667 F 
6                           00461733    CARBOLITH                 BAU 0001500 F 
42                         *300MG CAPSULE                                       
6                           02216140    PMS-LITHIUM CARBONATE     PMS 0000657 F 
6                           02242838    APO-LITHIUM CARBONATE     APX 0000657 F 
6                           00236683    CARBOLITH                 BAU 0001166 F 
42                          600MG CAPSULE                                       
6                           02011239    CARBOLITH                 BAU 0002398 F 
42                          300MG SUSTAINED RELEASE TABLET                      
6                           02266695    LITHMAX                   AAP 0002880 F 
2         CGRP INHIBITORS                                                       
41                          ATOGEPANT                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02533979    QULIPTA (EDS)             ABV 0188274 E 
42                          30MG TABLET                                         
61                          02533987    QULIPTA (EDS)             ABV 0188272 E 
42                          60MG TABLET                                         
61                          02533995    QULIPTA (EDS)             ABV 0188272 E 
41                          EPTINEZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
53                          INFORMATION                                         
42                          100MG/1ML SOLUTION IV INFUSION 1ML VIAL (MG)        
61                          02510839    VYEPTI (EDS)              LUD 0185732 E 
42                          100MG/1ML SOLUTION IV INFUSION 3ML VIAL (MG)        
61                          02542269    VYEPTI (EDS)              LUD 0061911 E 
41                          FREMANEZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          225MG/1.5ML PRE-FILLED SYRINGE (PER SYRINGE)        
61                          02497859    AJOVY (EDS)               TVM 5727600 E 
42                          225MG/1.5ML PRE-FILLED AUTOINJECTOR (PER AUTO       
43                          INJECTOR)                                           
61                          02509474    AJOVY (EDS)               TVM 5727600 E 
2         MISCELLANEOUS CENTRAL NERVOUS SYSTEM DRUGS                            
41                          ACAMPROSATE CALCIUM                                 
42                          333MG DELAYED RELEASE TABLET                        
6                           02293269    CAMPRAL                   MYL 0009663 F 
41                          AMIFAMPRIDINE                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02503034    RUZURGI (EDS)             MEC 0200000 E 
41                          AMIFAMPRIDINE PHOSPHATE                             
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02502984    FIRDAPSE (EDS)            KYE 0180000 E 
41                          EDARAVONE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          21MG/ML ORAL SUSPENSION (ML)                        
61                          02532611    RADICAVA (EDS)            SHC 1895200 E 
41                          ENTACAPONE                                          
42                         *200MG TABLET                                        
6                           02375559    TEVA-ENTACAPONE           TEV 0004209 F 
6                           02380005    SANDOZ ENTACAPONE         SDZ 0004209 F 
6                           02535939    MINT-ENTACAPONE           MNT 0004209 F 
41                          FOSLEVODOPA/FOSCARBIDOPA                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          240MG/12MG/ML (10ML VIAL)                           
61                          02537702    VYALEV (EDS)              ABV 1698100 E 
41                          LEVODOPA/BENZERAZIDE                                
42                          50MG/12.5MG CAPSULE                                 
6                           00522597    PROLOPA                   HLR 0003508 F 
42                          100MG/25MG CAPSULE                                  
6                           00386464    PROLOPA                   HLR 0005777 F 
42                          200MG/50MG CAPSULE                                  
6                           00386472    PROLOPA                   HLR 0009699 F 
41                          LEVODOPA/CARBIDOPA                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *100MG/10MG TABLET                                   
6                           02195933    APO-LEVOCARB              APX 0001479 F 
6                           02244494    TEVA-LEVOCARBIDOPA        TEV 0001479 F 
6                           02457954    MINT-LEVOCARB             MNT 0001479 F 
6                           02531593    AURO-LEVOCARB             API 0001479 F 
6                           02546396    JAMP LEVOCARB             JPC 0001479 F 
6                           02549719    PMS-LEVODOPA/CARBIDOPA    PMS 0001479 F 
42                         *100MG/25MG TABLET                                   
6                           02195941    APO-LEVOCARB              APX 0002209 F 
6                           02244495    TEVA-LEVOCARBIDOPA        TEV 0002209 F 
6                           02457962    MINT-LEVOCARB             MNT 0002209 F 
6                           02531607    AURO-LEVOCARB             API 0002209 F 
6                           02546418    JAMP LEVOCARB             JPC 0002209 F 
6                           02549727    PMS-LEVODOPA/CARBIDOPA    PMS 0002209 F 
42                         *250MG/25MG TABLET                                   
6                           02195968    APO-LEVOCARB              APX 0002466 F 
6                           02244496    TEVA-LEVOCARBIDOPA        TEV 0002466 F 
6                           02457970    MINT-LEVOCARB             MNT 0002466 F 
6                           02531615    AURO-LEVOCARB             API 0002466 F 
6                           02546426    JAMP LEVOCARB             JPC 0002466 F 
6                           02549735    PMS-LEVODOPA/CARBIDOPA    PMS 0002466 F 
42                          100MG/25MG CONTROLLED RELEASE TABLET                
6                           02272873    AA-LEVOCARB CR            AAP 0007974 F 
42                          200MG/50MG CONTROLLED RELEASE TABLET                
6                           02245211    AA-LEVOCARB CR            AAP 0014282 F 
42                          20MG/ML/5MG/ML INTRAINTESTINAL GEL                  
61                          02292165    DUODOPA (EDS)             ABV 1698100 E 
41                          LEVODOPA/CARBIDOPA/ENTACAPONE                       
42                          50MG/12.5MG/200MG TABLET                            
6                           02305933    STALEVO                   SDZ 0019534 F 
42                          75MG/18.75MG/200MG TABLET                           
6                           02337827    STALEVO                   SDZ 0019534 F 
42                          125MG/31.25MG/200MG TABLET                          
6                           02337835    STALEVO                   SDZ 0019534 F 
42                          100MG/25MG/200MG TABLET                             
6                           02305941    STALEVO                   SDZ 0019534 F 
42                          150MG/37.5MG/200MG TABLET                           
6                           02305968    STALEVO                   SDZ 0019534 F 
41                          NALTREXONE HYDROCHLORIDE                            
42                         *50MG TABLET                                         
6                           02213826    REVIA                     TEV 0028075 F 
6                           02444275    APO-NALTREXONE            APX 0028075 F 
6                           02451883    NALTREXONE HCL TAB        JPC 0028075 F 
41                          PATISIRAN                                           
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION. SUBMIT QUANTITY PER 10MCG              
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG/ML SOLUTION FOR INJECTION (10MCG)               
61                          02489252    ONPATTRO (EDS)            ALN 0105025 E 
41                          PRAMIPEXOLE DIHYDROCHLORIDE                         
42                         *0.25MG TABLET                                       
6                           02292378    APO-PRAMIPEXOLE           APX 0001950 F 
6                           02297302    ACT PRAMIPEXOLE           TEV 0001950 F 
6                           02309122    PRAMIPEXOLE               SIV 0001950 F 
6                           02315262    SANDOZ PRAMIPEXOLE        SDZ 0001950 F 
6                           02367602    PRAMIPEXOLE               SAN 0001950 F 
6                           02424061    AURO-PRAMIPEXOLE          API 0001950 F 
6                           02237145    MIRAPEX                   BOE 0012189 F 
42                         *0.5MG TABLET                                        
6                           02292386    APO-PRAMIPEXOLE           APX 0004018 F 
6                           02297310    ACT PRAMIPEXOLE           TEV 0004018 F 
6                           02309130    PRAMIPEXOLE               SIV 0004018 F 
6                           02315270    SANDOZ PRAMIPEXOLE        SDZ 0004018 F 
6                           02367610    PRAMIPEXOLE               SAN 0004018 F 
6                           02424088    AURO-PRAMIPEXOLE          API 0004018 F 
42                         *1MG TABLET                                          
6                           02292394    APO-PRAMIPEXOLE           APX 0003901 F 
6                           02297329    ACT PRAMIPEXOLE           TEV 0003901 F 
6                           02309149    PRAMIPEXOLE               SIV 0003901 F 
6                           02315289    SANDOZ PRAMIPEXOLE        SDZ 0003901 F 
6                           02367629    PRAMIPEXOLE               SAN 0003901 F 
6                           02424096    AURO-PRAMIPEXOLE          API 0003901 F 
42                         *1.5MG TABLET                                        
6                           02292408    APO-PRAMIPEXOLE           APX 0003901 F 
6                           02297337    ACT PRAMIPEXOLE           TEV 0003901 F 
6                           02309157    PRAMIPEXOLE               SIV 0003901 F 
6                           02315297    SANDOZ PRAMIPEXOLE        SDZ 0003901 F 
6                           02367645    PRAMIPEXOLE               SAN 0003901 F 
6                           02424118    AURO-PRAMIPEXOLE          API 0003901 F 
41                          RILUZOLE                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *50MG TABLET                                         
61                          02352583    APO-RILUZOLE (EDS)        APX 0034361 E 
61                          02390299    MYLAN-RILUZOLE (EDS)      MYL 0034361 E 
61                          02242763    RILUTEK (EDS)             AVT 0105500 E 
41                          ROPINIROLE HCL                                      
42                         *0.25MG TABLET                                       
6                           02314037    RAN-ROPINIROLE            RAN 0001441 F 
6                           02316846    TEVA-ROPINIROLE           TEV 0001411 F 
42                         *1MG TABLET                                          
6                           02314053    RAN-ROPINIROLE            RAN 0005762 F 
6                           02316854    TEVA-ROPINIROLE           TEV 0005762 F 
42                         *2MG TABLET                                          
6                           02314061    RAN-ROPINIROLE            RAN 0006338 F 
6                           02316862    TEVA-ROPINIROLE           TEV 0006338 F 
42                         *5MG TABLET                                          
6                           02314088    RAN-ROPINIROLE            RAN 0017450 F 
6                           02316870    TEVA-ROPINIROLE           TEV 0017450 F 
41                          ROTIGOTINE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG/24HR TRANSDERMAL SYSTEM                         
61                          02403900    NEUPRO (EDS)              UCB 0036970 E 
42                          4MG/24HR TRANSDERMAL SYSTEM                         
61                          02403927    NEUPRO (EDS)              UCB 0067890 E 
42                          6MG/24HR TRANSDERMAL SYSTEM                         
61                          02403935    NEUPRO (EDS)              UCB 0075930 E 
42                          8MG/24HR TRANSDERMAL SYSTEM                         
61                          02403943    NEUPRO (EDS)              UCB 0075930 E 
41                          SELEGILINE HCL                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG TABLET                                          
61                          02230641    SELEGILINE (EDS)          AAP 0017072 E 
1         DIAGNOSTIC AGENTS                                                     
2         FLASH GLUCOSE MONITORING SYSTEM                                       
41                          FLASH GLUCOSE MONITORING                            
42                          SENSOR KIT (14DAY)                                  
61                          97799075    FREESTYLE LIBRE 2 (EDS)   ABC 0910000 E 
42                          SENSOR KIT (15DAY)                                  
61                          97798966    FREESTYLE LIBRE 3+ (EDS)  ABC 0975000 E 
2         CONTINUOUS GLUCOSE MONITORING SYSTEM                                  
41                          CONTINUOUS GLUCOSE MONITORING                       
42                         ?DEXCOM SENSOR                                       
61                          97798972    DEXCOM G7 SENSOR (EDS)    DXC 0750000 E 
61                          97799137    DEXCOM G6 SENSOR (EDS)    DXC 0996700 E 
42                          DEXCOM TRANSMITTER                                  
61                          97799135    DEXCOM G6 TRANSMITTER(EDS DXC 0290000 E 
42                         ?MEDTRONIC SENSOR KIT                                
61                          97798971    GUARDIAN SENSOR 4 (EDS)   MOC 0798000 E 
61                          97799158    GUARDIAN SENSOR 3 (EDS)   MOC 0798000 E 
42                         ?MEDTRONIC TRANSMITTER                               
61                          97799152    GUARDIAN CONNECT (EDS     MOC 5990000 E 
61                          97798969    GUARDIAN LINK 4 780G(EDS) MOC 8000000 E 
61                          97799070    GUARDIAN LINK 3 770G(EDS) MOC 8000000 E 
61                          97799154    GUARDIAN LINK 3 670G(EDS) MOC 8000000 E 
2         DIABETES TEST STRIPS                                                  
31        NOTE:  THE IDENTIFICATION NUMBERS LISTED IN THIS SECTION              
32        HAVE BEEN GENERATED BY THE PRESCRIPTION DRUG PLAN FOR                 
33        BILLING PURPOSES ONLY.                                                
41                          BLOOD GLUCOSE TEST STRIP                            
42                         ?STRIP                                               
6                           97799394    BRAVO BLOOD GLUCOSE TEST  DEX 0003999 F 
6                           00950957    TRUETRACK SMART SYSTEM    NDI 0004180 F 
6                           00905622    SPIRIT BLOOD GLUCOSE STR  ARA 0005000 F 
6                           97799373    GE200 BLOOD GLUCOSE STRIP BNM 0005100 F 
6                           00951353    ON CALL VIVID             ALI 0005400 F 
6                           97799532    TRUETEST                  NDI 0005400 F 
6                           00951354    ALLEVIA PLUS              ESS 0005600 F 
6                           00951190    ACCU-CHEK INFORM II       ROC 0006727 F 
6                           00951369    D360 BLOOD GLUCOSE STRIP  IGP 0006750 F 
6                           97799177    ACCU-CHEK GUIDE           RDC 0006814 F 
6                           97799597    FREESTYLE LITE            ABC 0006900 F 
6                           97799582    ON-CALL PLUS              MGM 0007000 F 
6                           97799497    ACCU-CHEK MOBILE          RDC 0007125 F 
6                           00950900    ACCU-CHEK COMPACT         RDC 0007126 F 
6                           97799459    CONTOUR NEXT              ADC 0006989 F 
6                           97799355    SURETEST                  SKM 0007290 F 
6                           97799564    EZ HEALTH ORACLE          THI 0007290 F 
6                           97799596    FREESTYLE LITE            ABC 0007400 F 
6                           00950893    ONETOUCH ULTRA            LSN 0007950 F 
6                           00950894    FREESTYLE PRECISION STRIP ABC 0007950 F 
6                           97799476    ONETOUCH VERIO            LSN 0007950 F 
6                           00950949    ACCU-CHEK AVIVA           RDC 0008160 F 
6                           97799460    CONTOUR NEXT              ADC 0008396 F 
41                          HYDROXYBUTYRATE DEHYDROGENASE                       
42                          BLOOD KETONE TEST STRIP                             
6                           00950896    FREESTYLE PRECISION KETON ABC 0019500 F 
2         URINE TESTS                                                           
31        NOTE:  THE IDENTIFICATION NUMBERS LISTED IN THIS SECTION              
32        HAVE BEEN GENERATED BY THE PRESCRIPTION DRUG PLAN FOR                 
33        BILLING PURPOSES ONLY.                                                
41                          GLUCOSE OXIDASE/PEROXIDASE REAGENT                  
42                          STICK                                               
6                           00035130    DIASTIX                   ADC 0001150 F 
41                          GLUCOSE OXIDASE/PEROXIDASE/SODIUM                   
41                          NITROFERRICYANIDE/GLYCINE REAGENT                   
42                          STICK                                               
6                           00950238    CHEMSTRIP UG 5000K        ROC 0001332 F 
41                          GLUCOSE OXIDASE/PEROXIDASE/SODIUM                   
41                          NITROPRUSSIDE REAGENT                               
42                          STICK                                               
6                           00035149    KETO DIASTIX              ADC 0001377 F 
41                          SODIUM NITROPRUSSIDE REAGENT                        
42                          STICK                                               
6                           00035092    KETOSTIX                  ADC 0001280 F 
1         ELECTROLYTE, DIURETICS, AND CALORIC AGENTS                            
2         ELECTROLYTE REPLACEMENT                                               
41                          POTASSIUM CHLORIDE                                  
42                         ?600MG LONG ACTING TABLET                            
6                           80013005    JAMP K-8                  JPC 0000472 F 
6                           80035346    M-K8 L.A.                 MNP 0000472 F 
6                           80108882    PRZ-K8                    PRZ 0000472 F 
42                         ?1500MG LONG ACTING TABLET                           
6                           02242261    SANDOZ-K 20               SDZ 0001161 F 
6                           80004415    ODAN K-20                 ODN 0001161 F 
6                           80013007    JAMP K-20                 JPC 0001161 F 
6                           80025624    M-K20 L.A.                MNP 0001161 F 
6                           80107649    PRZ K20                   PRZ 0001161 F 
42                         *1.33MMOL/ML ORAL SOLUTION                           
6                           02238604    PMS-POTASSIUM CHLORIDE    PMS 0000227 F 
6                           80024835    JAMP POTASSIUM CHLORIDE   JPC 0000227 F 
6                           80046782    ODAN POTASSIUM CHLORIDE   ODN 0000227 F 
6                           80138308    EURO-POTASSIUM CHLORIDE   EUR 0000227 F 
2         RESINS AND BINDERS                                                    
41                          CALCIUM POLYSTYRENE SULFONATE                       
42                         *POWDER                                              
6                           02502631    JAMP CALCIUM POLYSTYRENE  JPC 0003397 F 
6                           02017741    RESONIUM CALCIUM          AVT 0003529 F 
41                          IRON (SUCROFERRIC OXYHYDROXIDE)                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          500MG CHEWABLE TABLET                               
61                          02471574    VELPHORO (EDS)            OTS 0042036 E 
41                          SODIUM POLYSTYRENE SULFONATE                        
42                         *250MG/ML ORAL SUSPENSION                            
6                           00769541    SOLYSTAT                  PED 0001409 F 
6                           02473968    ODAN-SODIUM POLYSTYRENE   ODN 0001409 F 
42                         *POWDER                                              
6                           00755338    SOLYSTAT                  PED 0000648 F 
6                           02473941    ODAN-SODIUM POLYSTYRENE   ODN 0000648 F 
6                           02497557    JAMP SODIUM POLYSTYRENE   JPC 0000648 F 
6                           02026961    KAYEXALATE                AVT 0001923 F 
2         CALORIC AGENTS                                                        
41                          TRIHEPTANOIN                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100% W/W ORAL LIQUID (ML)                           
61                          02512556    DOJOLVI (EDS)             UPI 0133665 E 
2         DIURETICS                                                             
41                          BUMETANIDE                                          
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          1MG TABLET                                          
61                          00728284    BURINEX (EDS)             KTI 0008253 E 
42                          5MG TABLET                                          
61                          00728276    BURINEX (EDS)             KTI 0031523 E 
41                          CHLORTHALIDONE                                      
42                         *50MG TABLET                                         
6                           00360279    APO-CHLORTHALIDONE        APX 0000894 F 
6                           02523817    JAMP CHLORTHALIDONE       JPC 0000894 F 
6                           02557142    MINT-CHLORTHALIDONE       MNT 0000894 F 
41                          ETHACRYNIC ACID                                     
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          25MG TABLET                                         
61                          02258528    EDECRIN (EDS)             BAU 0011013 E 
41                          FUROSEMIDE                                          
42                         *20MG TABLET                                         
6                           00337730    TEVA-FUROSEMIDE           TEV 0000218 F 
6                           00396788    APO-FUROSEMIDE            APX 0000218 F 
6                           02351420    FUROSEMIDE                SAN 0000218 F 
6                           02466759    MINT-FUROSEMIDE           MNT 0000218 F 
42                         *40MG TABLET                                         
6                           00337749    TEVA-FUROSEMIDE           TEV 0000327 F 
6                           00362166    APO-FUROSEMIDE            APX 0000327 F 
6                           02351439    FUROSEMIDE                SAN 0000327 F 
6                           02466767    MINT-FUROSEMIDE           MNT 0000327 F 
42                          10MG/ML ORAL SOLUTION                               
6                           02224720    LASIX                     AVT 0003538 F 
41                          HYDROCHLOROTHIAZIDE                                 
42                         *12.5 TABLET                                         
6                           02327856    APO-HYDRO                 APX 0000079 F 
6                           02425947    MINT-HYDROCHLOROTHIAZIDE  MNT 0000079 F 
42                         *25MG TABLET                                         
6                           00021474    TEVA-HYDROCHLOROTHIAZIDE  TEV 0000157 F 
6                           00326844    APO-HYDRO                 APX 0000157 F 
6                           02247386    PMS-HYDROCHLOROTHIAZIDE   PMS 0000157 F 
6                           02360594    HYDROCHLOROTHIAZIDE       SAN 0000157 F 
6                           02426196    MINT-HYDROCHLOROTHIAZIDE  MNT 0000157 F 
42                         *50MG TABLET                                         
6                           00021482    TEVA-HYDROCHLOROTHIAZIDE  TEV 0000217 F 
6                           00312800    APO-HYDRO                 APX 0000217 F 
6                           02247387    PMS-HYDROCHLOROTHIAZIDE   PMS 0000217 F 
6                           02360608    HYDROCHLOROTHIAZIDE       SAN 0000217 F 
41                          INDAPAMIDE HEMIHYDRATE                              
42                         *1.25MG TABLET                                       
6                           02240067    MYLAN-INDAPAMIDE          MYL 0001490 F 
6                           02245246    APO-INDAPAMIDE            APX 0001490 F 
42                         *2.5MG TABLET                                        
6                           02153483    MYLAN-INDAPAMIDE          MYL 0002364 F 
6                           02223678    APO-INDAPAMIDE            APX 0002364 F 
41                          METOLAZONE                                          
42                          2.5MG TABLET                                        
6                           00888400    ZAROXOLYN                 AVT 0002294 F 
2         POTASSIUM SPARING DIURETICS                                           
41                          AMILORIDE HCL                                       
42                          5MG TABLET                                          
6                           02249510    MIDAMOR                   AAP 0003626 F 
41                          SPIRONOLACTONE                                      
42                         *25MG TABLET                                         
6                           00613215    TEVA-SPIRONOLACTONE       TEV 0000405 F 
6                           02488140    MINT-SPIRONOLACTONE       MNT 0000405 F 
6                           02518821    JAMP SPIRONOLACTONE       JPC 0000405 F 
6                           00028606    ALDACTONE                 PFI 0002746 F 
42                         *100MG TABLET                                        
6                           00613223    TEVA-SPIRONOLACTONE       TEV 0000955 F 
6                           02488159    MINT-SPIRONOLACTONE       MNT 0000955 F 
6                           02518848    JAMP SPIRONOLACTONE       JPC 0000955 F 
6                           00285455    ALDACTONE                 PFI 0006410 F 
2         URICOSURICS                                                           
41                          SULFINPYRAZONE                                      
42                          200MG TABLET                                        
6                           00441767    SULFINPYRAZONE            AAP 0003121 F 
1         ENZYMES                                                               
2         ENZYMES                                                               
41                          ASFOTASE ALFA                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          18MG/0.45ML SUBCUTANEOUS SOLUTION-VIAL (MG)         
61                          02444615    STRENSIQ (EDS)            AXN 0754800 E 
42                          28MG/0.7ML SUBCUTANEOUS SOLUTION-VIAL (MG)          
61                          02444623    STRENSIQ (EDS)            AXN 0754800 E 
42                          40MG/1ML SUBCUTANEOUS SOLUTION-VIAL (MG)            
61                          02444631    STRENSIQ (EDS)            AXN 0754800 E 
42                          80MG/0.8ML SUBCUTANEOUS SOLUTION-VIAL (MG)          
61                          02444658    STRENSIQ (EDS)            AXN 0754800 E 
1         COUGH SUPPRESSANTS, EXPECTORANTS, MUCOLYTICS                          
2         CF TRANSMEMBRANE CONDUCTANCE REG. CORRECTORS                          
41                          ELEXACAFTOR/TEZACAFTOR/IVACAFTOR&IVACAFTOR          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG/25MG/37.5MG&75MG TABLET                        
61                          02526670    TRIKAFTA (EDS)            VER 2800000 E 
42                          80MG/40MG/60MG&59.5MG GRANULES                      
61                          02542285    TRIKAFTA (EDS)            VER 4200000 E 
42                          100MG/50MG/75MG&75MG GRANULES                       
61                          02542277    TRIKAFTA (EDS)            VER 4200000 E 
42                          100MG/50MG/75MG&150MG TABLET                        
61                          02517140    TRIKAFTA (EDS)            VER 2800000 E 
41                          LUMACAFTOR/IVACAFTOR                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG/125MG TABLET                                  
61                          02463040    ORKAMBI(EDS)              VER 1455357 E 
42                          200MG/125MG TABLET                                  
61                          02451379    ORKAMBI(EDS)              VER 1455357 E 
42                          100MG/125MG GRANULES                                
61                          02483831    ORKAMBI(EDS)              VER 2910714 E 
42                          150MG/188MG GRANULES                                
61                          02483858    ORKAMBI(EDS)              VER 2910714 E 
41                          VANZACAFTOR/TEZACAFTOR/DEUTIVACAFTOR                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          4MG/20MG/50MG TABLET                                
61                          02559676    ALYFTREK (EDS)            VER 2940000 E 
42                          10MG/50MG/125MG TABLET                              
61                          02559684    ALYFTREK (EDS)            VER 4410000 E 
2         CF TRANSMEMBRANE CONDUCTANCE REG. POTENTIATOR                         
41                          IVACAFTOR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG TABLET                                        
61                          02397412    KALYDECO(EDS)             VER 4200000 E 
2         MUCOLYTICS                                                            
41                          ACETYLCYSTEINE                                      
42                          20% SOLUTION (30ML)                                 
6                           02243098    ACETYLCYSTEINE SOLUTION   SDZ 0325100 F 
41                          DORNASE ALFA                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG/ML INHALATION SOLUTION (2.5ML)                  
61                          02046733    PULMOZYME (EDS)           HLR 0447097 E 
2         MISCELLANEOUS RESPIRATORY DRUGS                                       
41                          BENRALIZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          30MG/ML PREFILLED SYRINGE                           
61                          02473232    FASENRA (EDS)             AST 1371847 E 
42                          30MG/ML PREFILLED AUTOINJECTOR                      
61                          02496135    FASENRA PEN (EDS)         AST 1345600 E 
41                          LUMACAFTOR/IVACAFTOR                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
41                          OMALIZUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          75MG/0.5ML PREFILLED SYRINGE                        
61                          02553805    OMLYCLO (EDS)             CEL 1687440 E 
42                          150MG/ML PREFILLED SYRINGE                          
61                          02553813    OMLYCLO (EDS)             CEL 3849600 E 
41                          SOTATERCEPT                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          45MG/VIAL SOL FOR SC INJECTION(1VIAL KIT)(MG)       
61                          02551306    WINREVAIR (EDS)           MRK 1937145 E 
42                          45MG/VIAL SOL FOR SC INJECTION(2VIAL KIT)(MG)       
61                          00900098    WINREVAIR (EDS)           MRK 1937145 E 
42                          60MG/VIAL SOL FOR SC INJECTION(1VIAL KIT)(MG)       
61                          02551314    WINREVAIR (EDS)           MRK 1937145 E 
42                          60MG/VIAL SOL FOR SC INJECTION(2VIAL KIT)(MG)       
61                          00900099    WINREVAIR (EDS)           MRK 1937145 E 
41                          TEZEPELUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          210MG/1.91ML PRE-FILLED SYRINGE (MG)                
61                          02529548    TEZSPIRE (EDS)            AST 0098389 E 
42                          210MG/1.91ML PRE-FILLED PEN (MG)                    
61                          02529556    TEZSPIRE (EDS)            AST 0098389 E 
1         EAR, EYE, AND NOSE PREPARATIONS                                       
2         ANTIBIOTICS                                                           
41                          FUSIDIC ACID                                        
42                          1% OPHTHALMIC DROPS (G)                             
6                           02243862    FUCITHALMIC               MET 0020300 F 
41                          POLYMYXIN B SO4/NEOMYCIN SO4/GRAMICIDIN             
42                          10,000U/2.5MG/0.025MG PER ML EYE/EAR SOLUTION       
6                           00807435    OPTIMYXIN PLUS            SDZ 0007250 F 
41                          POLYMYXIN B SO4/TRIMETHOPRIM SO4                    
42                          10,000U/1MG PER ML OPHTHALMIC SOLUTION              
6                           02239234    SANDOZ POLYTRIMETHOPRIM   SDZ 0031400 F 
41                          TOBRAMYCIN                                          
42                         *0.3% OPHTHALMIC SOLUTION                            
6                           02241755    SANDOZ TOBRAMYCIN         SDZ 0013620 F 
6                           00513962    TOBREX                    NVR 0018580 F 
42                          0.3% OPHTHALMIC OINTMENT (3.5G)                     
6                           00614254    TOBREX                    NVR 0092200 F 
2         SULFONAMIDES                                                          
41                          SULFACETAMIDE (SODIUM)                              
42                          10% OPHTHALMIC SOLUTION                             
6                           00028053    SODIUM SULAMYD            SDZ 0004933 F 
2         MISC. EAR, EYE, AND NOSE ANTI-INFECTIVES                              
41                          CIPROFLOXACIN                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.3% OPHTHALMIC SOLUTION                            
61                          02387131    SANDOZ CIPROFLOXACIN (EDS SDZ 0017600 E 
61                          01945270    CILOXAN (EDS)             NVR 0021800 E 
42                          0.3% OPHTHALMIC OINTMENT (3.5G)                     
61                          02200864    CILOXAN (EDS)             NVR 0110000 E 
41                          MOXIFLOXACIN HCL                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.5% OPHTHALMIC SOLUTION                            
61                          02404656    ACT MOXIFLOXACIN (EDS)    TEV 0015435 E 
61                          02406373    APO-MOXIFLOXACIN (EDS)    APX 0015435 E 
61                          02411520    SANDOZ MOXIFLOXACIN (EDS) SDZ 0015435 E 
61                          02432218    PMS-MOXIFLOXACIN (EDS)    PMS 0015435 E 
61                          02472120    JAMP-MOXIFLOXACIN (EDS)   JPC 0015435 E 
61                          02484757    AG-MOXIFLOXACIN (EDS)     ANG 0015435 E 
61                          02529076    MOXIFLOXACIN (EDS)        SAN 0015435 E 
61                          02252260    VIGAMOX (EDS)             NVR 0051367 E 
41                          OFLOXACIN                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.3% OPHTHALMIC SOLUTION                            
61                          02143291    OCUFLOX (EDS)             ABV 0028720 E 
2         ANTI-INFLAMMATORY DRUGS                                               
41                          BECLOMETHASONE DIPROPIONATE                         
42                         *50UG/DOSE AQUEOUS NASAL SPRAY (PACKAGE)             
6                           02238796    APO-BECLOMETHASONE        APX 0122600 F 
6                           02172712    MYLAN-BECLOMETHASONE AQ   MYL 0125175 F 
41       M                  BUDESONIDE (MAC)                                    
51                          SEE APPENDIX C FOR MAC POLICY                       
42                         *64UG/DOSE NASAL SPRAY (PACKAGE)                     
6        M                  02241003    MYLAN-BUDESONIDE AQ       MYL 0103284 F 
6        M                  02231923    RHINOCORT AQUA            KNV 0110400 F 
42                          100UG/DOSE NASAL SPRAY (PACKAGE)                    
6        M                  02230648    MYLAN-BUDESONIDE AQ       MYL 0161389 F 
41       M                  CICLESONIDE (MAC)                                   
51                          SEE APPENDIX C FOR MAC POLICY                       
42                          50MCG/DOSE METERED DOSE NASAL SPRAY                 
6        M                  02303671    OMNARIS                   AZR 0314200 F 
41                          CYCLOSPORINE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA"                    
42                          0.1% OPHTHALMIC EMULSION                            
61                          02484137    VERKAZIA (EDS)            APX 0037437 E 
41                          DEXAMETHASONE                                       
42                          0.1% OPHTHALMIC SUSPENSION                          
6                           00042560    MAXIDEX                   NVR 0017200 F 
42                          0.1% OPHTHALMIC OINTMENT 3.5G                       
6                           00042579    MAXIDEX                   NVR 0093100 F 
41                          FLUOROMETHOLONE                                     
42                         *0.1% OPHTHALMIC SUSPENSION                          
6                           00432814    SANDOZ FLUOROMETHOLONE    SDZ 0019600 F 
6                           00247855    FML                       ABV 0036184 F 
41                          KETOROLAC TROMETHAMINE                              
42                          0.45% OPHTHALMIC SOLUTION                           
6                           02369362    ACUVAIL                   ABV 0002594 F 
42                         *0.5% OPHTHALMIC SOLUTION                            
6                           02245821    APO-KETOROLAC             AAP 0031875 F 
6                           01968300    ACULAR                    ABV 0036800 F 
41                          MOMETASONE FUROATE MONOHYDRATE                      
42                         *0.05% AQUEOUS NASAL SPRAY                           
6                           02403587    APO-MOMETASONE            APX 0105300 F 
6                           02449811    SANDOZ MOMETASONE         SDZ 0105300 F 
6                           02475863    TEVA-MOMETASONE           TEV 0105300 F 
6                           02519127    MOMETASONE                SAN 0105300 F 
6                           02551756    MOMETASONE                SIV 0105300 F 
6                           02238465    NASONEX                   ORG 0325500 F 
41                          PREDNISOLONE ACETATE                                
42                         *1.0% OPHTHALMIC SUSPENSION                          
6                           00700401    RATIO-PREDNISOLONE        RPH 0026500 F 
6                           01916203    SANDOZ PREDNISOLONE       SDZ 0026500 F 
6                           00301175    PRED FORTE                ABV 0052880 F 
2         ANTI-INFECTIVE/ANTI-INFLAMMATORY COMBINATIONS                         
41                          CIPROFLOXACIN HCL/DEXAMETHASONE                     
42                         *0.3%/0.1% OTIC SUSPENSION                           
6                           02481901    TARO-CIPROFLOX/DEXAMETH   TAR 0020600 F 
6                           02506882    SANDOZ CIPRO/DEXAMETH     SDZ 0020600 F 
6                           02252716    CIPRODEX                  NVR 0041853 F 
41                          FRAMYCETIN SO4/GRAMICIDIN/DEXAMETHASONE BASE        
42                          5MG/50UG/0.5MG PER ML EYE/EAR SOLUTION              
6                           02224623    SOFRACORT                 XED 0022213 F 
41                          IODOCHLORHYDROXYQUIN/FLUMETHASONE PIVALATE          
42                          1%/0.02% OTIC SOLUTION                              
6                           00074454    LOCACORTEN-VIOFORM        KTI 0019455 F 
41                          POLYMYXIN B SO4/NEOMYCIN SO4/DEXAMETHASONE          
42                          6,000U/5MG/1MG PER ML OPHTHALMIC SUSPENSION         
6                           00042676    MAXITROL                  NVR 0024060 F 
42                          6,000U/5MG/1MG PER G OPHTHALMIC OINTMENT            
43                          (3.5G)                                              
6                           00358177    MAXITROL                  NVR 0117400 F 
41                          POLYMYXIN B SO4/NEOMYCIN SO4/HYDROCORTISONE         
42                          10,000U/5MG/10MG PER ML OTIC SOLUTION               
6                           02230386    SANDOZ CORTIMYXIN         SDZ 0011400 F 
41                          TOBRAMYCIN/DEXAMETHASONE                            
42                          0.3%/0.1% OPHTHALMIC SUSPENSION                     
6                           00778907    TOBRADEX                  NVR 0021720 F 
42                          0.3%/0.1% OPHTHALMIC OINTMENT (3.5G)                
6                           00778915    TOBRADEX                  NVR 0112200 F 
2         CARBONIC ANHYDRASE INHIBITORS                                         
41                          ACETAZOLAMIDE                                       
42                          250MG TABLET                                        
6                           00545015    ACETAZOLAMIDE             AAP 0001654 F 
41                          BRINZOLAMIDE                                        
42                          1% OPHTHALMIC SUSPENSION                            
6                           02238873    AZOPT                     NVR 0035500 F 
41                          DORZOLAMIDE HCL                                     
42                         *2% OPHTHALMIC SOLUTION (ML)                         
6                           02316307    SANDOZ DORZOLAMIDE        SDZ 0014757 F 
6                           02453347    JAMP-DORZOLAMIDE          JPC 0014757 F 
6                           02457210    MED-DORZOLAMIDE           GMP 0014757 F 
6                           02522373    DORZOLAMIDE               JPC 0014757 F 
6                           02561573    DORZOLAMIDE               STM 0014757 F 
6                           02216205    TRUSOPT                   ELS 0050803 F 
41                          METHAZOLAMIDE                                       
42                          50MG TABLET                                         
6                           02245882    METHAZOLAMIDE             AAP 0006430 F 
2         OPHTHALMIC MIOTIC DRUGS                                               
41                          PILOCARPINE HCL                                     
42                          2% OPHTHALMIC SOLUTION                              
6                           00000868    ISOPTO CARPINE            NVR 0003073 F 
2         OPHTHALMIC MYDRIATIC DRUGS                                            
41                          ATROPINE SO4                                        
42                         *1% OPHTHALMIC SOLUTION                              
6                           02023695    ATROPINE                  PST 0005490 F 
6                           00035017    ALCON ATROPINE            ALC 0008900 F 
2         MISCELLANEOUS EAR, EYE, AND NOSE PREPARATIONS                         
41                          APRACLONIDINE HCL                                   
42                          0.5% OPHTHALMIC SOLUTION (5ML)                      
6                           02076306    IOPIDINE                  ESP 0270100 F 
42                          1% OPHTHALMIC SOLUTION (1 TREATMENT)                
6                           00888354    IOPIDINE                  ESP 0135900 F 
41                          BIMATOPROST                                         
42                         *0.01% OPHTHALMIC SOLUTION (ML)                      
6                           02529580    BIMATOPROST RC            JNO 0060189 F 
6                           02565773    JAMP BIMATOPROST SOL RC   JPC 0060189 F 
6                           02324997    LUMIGAN RC                ABV 0120380 F 
41                          BRIMONIDINE TARTRATE                                
42                         *0.15% OPHTHALMIC SOLUTION                           
6                           02301334    BRIMONIDINE P             AAP 0022085 F 
6                           02248151    ALPHAGAN P                ABV 0026020 F 
42                         *0.2% OPHTHALMIC SOLUTION                            
6                           02260077    APO-BRIMONIDINE           APX 0011550 F 
6                           02305429    SANDOZ BRIMONIDINE        SDZ 0011550 F 
6                           02449226    JAMP-BRIMONIDINE          JPC 0011550 F 
6                           02507811    MED-BRIMONIDINE           GMP 0011550 F 
6                           02515377    BRIMONIDINE TARTRATE      TEL 0011550 F 
6                           02562316    BRIMONIDINE               STM 0011550 F 
6                           02236876    ALPHAGAN                  ABV 0037980 F 
41                          BRIMONIDINE TARTRATE/TIMOLOL MALEATE                
42                         *0.2%/0.5% OPHTHALMIC SOLUTION                       
6                           02375311    APO-BRIMONIDINE-TIMOP     APX 0023290 F 
6                           02531704    JAMP BRIMONIDINE/TIMOLOL  JPC 0023290 F 
6                           02248347    COMBIGAN                  ABV 0046700 F 
41                          BRINZOLAMIDE/BRIMONIDINE TARTRATE                   
42                          1%/0.2% OPHTHALMIC SUSPENSION                       
6                           02435411    SIMBRINZA                 VAL 0050690 F 
41                          BRINZOLAMIDE/TIMOLOL MALEATE                        
42                          1%/0.5% OPHTHALMIC SUSPENSION                       
6                           02331624    AZARGA                    NVR 0040800 F 
41                          DICLOFENAC SODIUM                                   
42                         *0.1% OPHTHALMIC SOLUTION (ML)                       
6                           02441020    APO-DICLOFENAC OPHTHALMIC APX 0012397 F 
6                           02454807    SANDOZ DICLOFENAC OPHTHA  SDZ 0012397 F 
6                           02475065    DICLOFENAC                PST 0012397 F 
6                           02475197    MINT-DICLOFENAC           MNT 0012397 F 
6                           02534525    JAMP DICLOFENAC           JPC 0012397 F 
6                           01940414    VOLTAREN OPHTHA           NVR 0037320 F 
41                          DORZOLAMIDE HCL/TIMOLOL MALEATE                     
42                         *2%/0.5% OPHTHALMIC SOLUTION (ML)                    
6                           02299615    APO-DORZO-TIMOP           APX 0019887 F 
6                           02344351    SANDOZ DORZOLAMIDE-TIMOLO SDZ 0019887 F 
6                           02404389    ACT DORZOTIMOLOL          TEV 0019887 F 
6                           02437686    MED-DORZOLAMIDE-TIMOLOL   GMP 0019887 F 
6                           02441659    RIVA-DORZOLAMIDE/TIMOLOL  RIV 0019887 F 
6                           02457539    JAMP DORZOLOMIDE-TIMOLOL  JPC 0019887 F 
6                           02489635    DORZOLAMIDE & TIMOLOL     TEL 0019887 F 
6                           02522020    DORZOLAMIDE-TIMOLOL       JPC 0019887 F 
6                           02537796    M-DORZOLAMIDE-TIMOLOL     MNP 0019887 F 
6                           02562138    DORZOLAMIDE-TIMOLOL       STM 0019887 F 
6                           02240113    COSOPT                    ELS 0080514 F 
42                          2%/0.5% OPHTHALMIC SOLUTION PF (PKG)                
6                           02258692    COSOPT-PRESERVATIVE FREE  ELS 0381800 F 
41                          GATIFLOXACIN                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.3% OPHTHALMIC SOLUTION                            
61                          02327260    APO-GATIFLOXACIN (EDS)    APX 0013550 E 
61                          02533235    JAMP GATIFLOXACIN (EDS)   JPC 0013550 E 
61                          02257270    ZYMAR (EDS)               ABV 0023040 E 
41                          IPRATROPIUM BROMIDE                                 
42                          21UG/DOSE NASAL SPRAY (PACKAGE)                     
6                           02239627    PMS-IPRATROPIUM           PMS 0301900 F 
41                          LATANOPROST                                         
42                         *50UG/ML OPHTHALMIC SOLUTION (2.5ML)                 
6                           02254786    TEVA-LATANOPROST          TEV 0094640 F 
6                           02296527    APO-LATANOPROST           APX 0094640 F 
6                           02367335    SANDOZ LATANOPROST        SDZ 0094640 F 
6                           02373041    GD-LATANOPROST            UJC 0094640 F 
6                           02426935    MED-LATANOPROST           GMP 0094600 F 
6                           02341085    RIVA-LATANOPROST          RIV 0094640 F 
6                           02453355    JAMP-LATANOPROST          JPC 0094640 F 
6                           02513285    M-LATANOPROST             MNP 0094640 F 
6                           02231493    XALATAN                   BGP 0362700 F 
41                          LATANOPROST/TIMOLOL MALEATE                         
42                         *50UG/5MG PER ML OPHTHALMIC SOLUTION (2.5ML)         
6                           02373068    GD-LATANOPROST/TIMOLOL    UJC 0110700 F 
6                           02394685    SANDOZ LATANOPROST/TIMOL  SDZ 0110700 F 
6                           02436256    ACT LATANOPROST/TIMOLOL   TEV 0110700 F 
6                           02453770    JAMP-LATANOPROST/TIMOLOL  JPC 0110700 F 
6                           02454505    MED-LATANOPROST-TIMOLOL   GMP 0110700 F 
6                           02489368    LATANOPROST AND TIMOLOL   TEL 0110700 F 
6                           02514516    M-LATANOPROST-TIMOLOL     MNP 0110700 F 
6                           02553848    LATANOPROST/TIMOLOL       JPC 0110700 F 
6                           02246619    XALACOM                   BGP 0410600 F 
41                          LATANOPROSTENE BUNOD                                
42                          0.024% OPHTHALMIC SOLUTION                          
6                           02484218    VYZULTA                   BSH 0262500 F 
41                          LEVOBUNOLOL HCL                                     
42                          0.25% OPHTHALMIC SOLUTION                           
6                           02031159    RATIO-LEVOBUNOLOL         RPH 0009330 F 
41                          LODOXAMIDE TROMETHAMINE                             
42                          0.1% OPHTHALMIC SOLUTION                            
6                           00893560    ALOMIDE                   NVR 0013660 F 
41                          TIMOLOL MALEATE                                     
42                          0.25% OPHTHALMIC SOLUTION                           
6                           02166712    SANDOZ TIMOLOL            SDZ 0023503 F 
42                         *0.5% OPHTHALMIC SOLUTION                            
6                           00755834    APO-TIMOP                 APX 0012145 F 
6                           02166720    SANDOZ TIMOLOL            SDZ 0012145 F 
6                           02447800    JAMP-TIMOLOL              JPC 0012145 F 
6                           00451207    TIMOPTIC                  ELS 0053510 F 
42                          0.25% OPHTHALMIC GEL FORMING SOLUTION               
6                           02242275    TIMOLOL MALEATE-EX        ALC 0033768 F 
42                         *0.5% OPHTHALMIC GEL FORMING SOLUTION                
6                           02242276    TIMOLOL MALEATE-EX        ALC 0040404 F 
6                           02171899    TIMOPTIC-XE               ELS 0068340 F 
41                          TRAVOPROST                                          
42                          0.003% OPHTHALMIC SOLUTION (5ML)                    
6                           02457997    IZBA                      NVR 0197000 F 
42                         *0.004% OPHTHALMIC SOLUTION (5ML)                    
6                           02413167    SANDOZ TRAVOPROST         SDZ 0287600 F 
6                           02548089    JAMP TRAVOPROST Z         JPC 0287600 F 
6                           02318008    TRAVATAN Z                NVR 0584800 F 
41                          TRAVOPROST/TIMOLOL MALEATE                          
42                         *0.004%/0.5% OPHTHALMIC SOLUTION                     
6                           02415305    APO-TRAVOPROST-TIMOP PQ   APX 0442200 F 
6                           02278251    DUOTRAV PQ                NVR 0567000 F 
41                          VERTEPORFIN                                         
51                          SEE APPENDIX A FOR CRITERIA                         
42                          15MG/VIAL INJECTION SOLUTION (MG)                   
61                          02242367    VISUDYNE (EDS)            CHP 1331140 E 
1         GASTROINTESTINAL SYSTEM DRUGS                                         
2         ANTIDIARRHEALS                                                        
41                          DIPHENOXYLATE HCL                                   
42                          2.5MG TABLET                                        
6                           00036323    LOMOTIL                   PFI 0005837 F 
41                          LOPERAMIDE HCL                                      
42                         *2MG CAPLET                                          
6                           02132591    TEVA-LOPERAMIDE           TEV 0000952 F 
6                           02228351    PMS-LOPERAMIDE            PMS 0000952 F 
42                          0.2MG/ML ORAL SOLUTION                              
6                           02016095    PMS-LOPERAMIDE HCL        PMS 0001868 F 
2         LAXATIVE AGENTS                                                       
41                          LACTULOSE                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *667MG/ML SOLUTION                                   
61                          00703486    PMS-LACTULOSE (EDS)       PMS 0000145 E 
61                          00854409    RATIO-LACTULOSE (EDS)     RPH 0000145 E 
61                          02247383    PHARMA-LACTULOSE (EDS)    PMS 0000145 E 
61                          02295881    JAMP-LACTULOSE (EDS)      JPC 0000145 E 
61                          02412268    LACTULOSE (EDS)           SAN 0000145 E 
61                          02469391    PMS-LACTULOSE-PHARMA (EDS PMS 0000145 E 
2         BILE ACID PREPARATIONS                                                
41                          ODEVIXIBAT                                          
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION.SUBMIT QUANTITY PER 100MCG.             
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MCG ORAL CAPSULE (100MCG)                        
61                          02542641    BYLVAY (EDS)              MSN 0879624 E 
42                          400MCG ORAL CAPSULE (100MCG)                        
61                          02542676    BYLVAY (EDS)              MSN 0879624 E 
42                          600MCG ORAL CAPSULE (100MCG)                        
61                          02542684    BYLVAY (EDS)              MSN 0879624 E 
42                          1200MCG ORAL CAPSULE (100MCG)                       
61                          02542692    BYLVAY (EDS)              MSN 0879624 E 
41                          URSODIOL                                            
42                         *250MG TABLET                                        
6                           02273497    PMS-URSODIOL C            PMS 0003818 F 
6                           02426900    GLN-URSODIOL              GLN 0003818 F 
6                           02472392    JAMP-URSODIOL             JPC 0003818 F 
6                           02505363    AG-URSODIOL               ANG 0003818 F 
6                           02515520    URSODIOL C                SAN 0003818 F 
6                           02544032    NRA-URSODIOL              NRA 0003818 F 
42                         *500MG TABLET                                        
6                           02273500    PMS-URSODIOL C            PMS 0007242 F 
6                           02426919    GLN-URSODIOL              GLN 0007242 F 
6                           02472406    JAMP-URSODIOL             JPC 0007242 F 
6                           02505371    AG-URSODIOL               ANG 0007242 F 
6                           02515539    URSODIOL C                SAN 0007242 F 
6                           02544024    NRA-URSODIOL              NRA 0007242 F 
2         DIGESTIVE ENZYMES                                                     
41                          PANCRELIPASE (LIPASE/AMYLASE/PROTEASE)              
42                          4200U/17500U/10000U CAPSULE CONTAINING              
43                          ENTERIC COATED PARTICLES                            
6                           00789445    PANCREASE MT 4            VVS 0007274 F 
42                          5000U/5100U/320U GRANULES (GR)                      
6                           02445158    CREON MINIMICROSPHERES    BGP 0019120 F 
42                          10000U/40000U/35000U CAPSULE                        
6                           00263818    COTAZYM                   ORG 0002765 F 
42                          10800U/42000U/45000U CAPSULE CONTAINING             
43                          ENTERIC COATED PARTICLES                            
6                           00502790    COTAZYM ECS 8             ORG 0004995 F 
42                          10500U/43750U/25000U CAPSULE CONTAINING             
43                          ENTERIC COATED PARTICLES                            
6                           00789437    PANCREASE MT 10           VVS 0018188 F 
42                          10000U/11200U/730U CAPSULE CONTAINING               
43                          ENTERIC COATED PARTICLES                            
6                           02200104    CREON MINIMICROSPHERES 10 BGP 0002954 F 
42                          16800U/70000U/40000U CAPSULE CONTAINING             
43                          ENTERIC COATED PARTICLES                            
6                           00789429    PANCREASE MT 16           VVS 0029100 F 
42                          25000U/100000U/100000U CAPSULE CONTAINING           
43                          ENTERIC COATED PARTICLES                            
6                           00821373    COTAZYM ECS 20            ORG 0013092 F 
42                          25000U/25500U/1600U CAPSULE CONTAINING              
43                          ENTERIC COATED PARTICLES                            
6                           01985205    CREON MINIMICROSPHERES 25 BGP 0009229 F 
42                          35000U/35700U/2240U CAPSULE CONTAINING              
43                          ENTERIC COATED PARTICLES                            
6                           02494639    CREON MINIMICROSPHERES 35 BGP 0009741 F 
42                          10440U/56400U/57100U TABLET                         
6                           02230019    VIOKACE                   NEN 0003271 F 
42                          20880U/113400U/112500U TABLET                       
6                           02241933    VIOKACE                   NEN 0005124 F 
2         ANTIEMETIC DRUGS                                                      
41                          DIMENHYDRINATE                                      
42                          50MG TABLET                                         
6                           02245416    JAMP-DIMENHYDRINATE       JPC 0000560 F 
42                          3MG/ML ORAL LIQUID                                  
6                           00230197    GRAVOL                    CDC 0000836 F 
42                         ?50MG/ML INJECTION SOLUTION (ML)                     
6                           00392537    DIMENHYDRINATE INJ PF     SDZ 0014490 F 
6                           02536536    DIMENYDRINATE INJ         SDZ 0014490 F 
42                          100MG SUPPOSITORY                                   
6                           00013609    GRAVOL                    CDC 0006640 F 
41                          DOXYLAMINE SUCCINATE/PYRIDOXINE HCL                 
42                         *10MG/10MG DELAYED RELEASE TABLET                    
6                           02406187    PMS-DOXYLAMINE-PYRIDOXINE PMS 0003201 F 
6                           02413248    APO-DOXYLAMINE/B6         APX 0003201 F 
6                           02552574    ALOG-DOXYLAMINE/PYRIDOXIN ANA 0003201 F 
6                           00609129    DICLECTIN                 DUI 0012803 F 
41                          NABILONE                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.5MG CAPSULE                                       
61                          02380900    PMS-NABILONE (EDS)        PMS 0018886 E 
61                          02384884    TEVA-NABILONE (EDS)       TEV 0018886 E 
61                          02256193    CESAMET (EDS)             BAU 0040188 E 
42                         *1MG CAPSULE                                         
61                          02380919    PMS-NABILONE (EDS)        PMS 0036669 E 
61                          02384892    TEVA-NABILONE (EDS)       TEV 0036669 E 
61                          00548375    CESAMET (EDS)             BAU 0080372 E 
41                          ONDANSETRON                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *4MG ORALLY DISINTEGRATING TABLET/FILM               
61                          02389983    ONDISSOLVE (EDS)          TAK 0032720 E 
61                          02444674    VPI-ONDANSETRON ODT(EDS)  VPI 0032720 E 
61                          02481723    ONDANSETRON ODT (EDS)     SDZ 0032720 E 
61                          02487330    MINT-ONDANSETRON ODT (EDS MNT 0032720 E 
61                          02511282    AURO-ONDANSETRON ODT (EDS API 0032720 E 
61                          02514966    MAR-ONDANSETRON ODT (EDS) MPI 0032720 E 
61                          02519232    ONDANSETRON ODT (EDS)     JPC 0032720 E 
61                          02519445    PMS-ONDANSETRON ODT (EDS) PMS 0032720 E 
61                          02524279    ONDANSETRON (EDS)         SAN 0032720 E 
61                          02541351    JAMP ONDANSETRON ODF (EDS JPC 0032720 E 
42                         *8MG ORALLY DISINTEGRATING TABLET/FILM               
61                          02389991    ONDISSOLVE (EDS)          TAK 0049930 E 
61                          02444682    VPI-ONDANSETRON ODT(EDS)  VPI 0049930 E 
61                          02481731    ONDANSETRON ODT (EDS)     SDZ 0049930 E 
61                          02487349    MINT-ONDANSETRON ODT (EDS MNT 0049930 E 
61                          02511290    AURO-ONDANSETRON ODT (EDS API 0049930 E 
61                          02514974    MAR-ONDANSETRON ODT (EDS) MPI 0049930 E 
61                          02519240    ONDANSETRON ODT (EDS)     JPC 0049930 E 
61                          02519453    PMS-ONDANSETRON ODT (EDS) PMS 0049930 E 
61                          02524287    ONDANSETRON (EDS)         SAN 0049930 E 
61                          02541378    JAMP ONDANSETRON ODF (EDS JPC 0049930 E 
41                          ONDANSETRON HCL DIHYDRATE                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *4MG/5ML ORAL SOLUTION                               
61                          02490617    JAMP ONDANSETRON (EDS)    JPC 0007952 E 
61                          02524090    MINT-ONDANSETRON SOL(EDS) MNT 0007952 E 
42                         *2MG/ML SOLUTION FOR INJECTION (ML)                  
61                          02274418    ONDANSETRON HCL INJ.(EDS) SDZ 0034552 E 
61                          02279428    ONDANSETRON (PFREE) (EDS) SDZ 0034552 E 
61                          02279436    ONDANSETRON PRESERVE(EDS) SDZ 0034552 E 
2         MISCELLANEOUS GASTROINTESTINAL SYSTEM DRUGS                           
41                          BUDESONIDE                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          3MG CONTROLLED ILEAL RELEASE CAPSULE                
61                          02229293    ENTOCORT (EDS)            TIL 0021747 E 
41                          CIMETIDINE                                          
42                          300MG TABLET                                        
6                           00487872    CIMETIDINE                AAP 0003598 F 
42                          400MG TABLET                                        
6                           00600059    CIMETIDINE                AAP 0002930 F 
42                          600MG TABLET                                        
6                           00600067    CIMETIDINE                AAP 0003405 F 
41                          DOMPERIDONE MALEATE                                 
42                         *10MG TABLET                                         
6                           01912070    TEVA-DOMPERIDONE          TEV 0000428 F 
6                           02103613    APO-DOMPERIDONE           APX 0000428 F 
6                           02238341    DOMPERIDONE               SIV 0000428 F 
6                           02268078    RAN-DOMPERIDONE           RAN 0000428 F 
6                           02350440    DOMPERIDONE               SAN 0000428 F 
6                           02369206    JAMP-DOMPERIDONE          JPC 0000428 F 
6                           02403870    MAR-DOMPERIDONE           MPI 0000428 F 
6                           02462834    PRZ-DOMPERIDONE           PRZ 0000428 F 
6                           02543435    JAMP DOMPERIDONE          JPC 0000428 F 
6                           02561905    NRA-DOMPERIDONE           NRA 0000428 F 
41       M                  ESOMEPRAZOLE MAGNESIUM (MAC)                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          SEE APPENDIX C FOR MAC POLICY                       
42                         *20MG DELAYED RELEASE TABLET                         
61       M                  02339099    APO-ESOMEPRAZOLE (EDS)    APX 0005500 E 
61       M                  02383039    MYLAN-ESOMEPRAZOLE (EDS)  MYL 0005500 E 
61       M                  02423855    TEVA-ESOMEPRAZOLE (EDS)   TEV 0005500 E 
61       M                  02423979    RAN-ESOMEPRAZOLE (EDS)    RAN 0005500 E 
61       M                  02442493    ESOMEPRAZOLE (EDS)        SIV 0005500 E 
61       M                  02460920    SANDOZ ESOMEPRAZOLE (EDS) SDZ 0005500 E 
61       M                  02479419    MYL-ESOMEPRAZOLE (EDS)    MYL 0005500 E 
61       M                  02520109    M-ESOMEPRAZOLE (EDS)      MNP 0005500 E 
61       M                  02520699    ESOMEPRAZOLE (EDS)        JPC 0005500 E 
61       M                  02528479    PMSC-ESOMEPRAZOLE(EDS)    PMS 0005500 E 
61       M                  02535335    ESOMEPRAZOLE (EDS)        SAN 0005500 E 
61       M                  02244521    NEXIUM (EDS)              AST 0027604 E 
42                         *40MG DELAYED RELEASE TABLET/CAPSULE                 
61       M                  02339102    APO-ESOMEPRAZOLE (EDS)    APX 0005500 E 
61       M                  02383047    MYLAN-ESOMEPRAZOLE (EDS)  MYL 0005500 E 
61       M                  02423863    TEVA-ESOMEPRAZOLE (EDS)   TEV 0005500 E 
61       M                  02423987    RAN-ESOMEPRAZOLE (EDS)    RAN 0005500 E 
61       M                  02431173    ESOMEPRAZOLE (EDS)        SAN 0005500 E 
61       M                  02442507    ESOMEPRAZOLE (EDS)        SIV 0005500 E 
61       M                  02460939    SANDOZ ESOMEPRAZOLE (EDS) SDZ 0005500 E 
61       M                  02479427    MYL-ESOMEPRAZOLE (EDS)    MYL 0005500 E 
61       M                  02520117    M-ESOMEPRAZOLE (EDS)      MNP 0005500 E 
61       M                  02520702    ESOMEPRAZOLE (EDS)        JPC 0005500 E 
61       M                  02528487    PMSC-ESOMEPRAZOLE (EDS)   PMS 0005500 E 
61       M                  02244522    NEXIUM (EDS)              AST 0027635 E 
41                          ETRASIMOD                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG TABLET                                          
61                          02544903    VELSIPITY (EDS)           PFI 0431000 E 
41                          FAMOTIDINE                                          
42                         *20MG TABLET                                         
6                           02022133    TEVA-FAMOTIDINE           TEV 0002658 F 
6                           02351102    FAMOTIDINE                SAN 0002658 F 
6                           02507749    JAMP FAMOTIDINE           JPC 0002658 F 
6                           02538628    MINT-FAMOTIDINE           MNT 0002658 F 
6                           02549107    FAMOTIDINE                SIV 0002658 F 
42                         *40MG TABLET                                         
6                           02022141    TEVA-FAMOTIDINE           TEV 0004834 F 
6                           02351110    FAMOTIDINE                SAN 0004834 F 
6                           02507757    JAMP FAMOTIDINE           JPC 0004834 F 
6                           02538636    MINT-FAMOTIDINE           MNT 0004834 F 
6                           02549115    FAMOTIDINE                SIV 0004834 F 
41       M                  LANSOPRAZOLE (MAC)                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          SEE APPENDIX C FOR MAC POLICY                       
42                         *15MG DELAYED RELEASE CAPSULE                        
6        M                  02280515    TEVA-LANSOPRAZOLE         TEV 0005000 F 
6        M                  02293811    APO-LANSOPRAZOLE          APX 0005000 F 
6        M                  02353830    MYLAN-LANSOPRAZOLE        MYL 0005000 F 
6        M                  02357682    LANSOPRAZOLE              SAN 0005000 F 
6        M                  02385643    SANDOZ LANSOPRAZOLE       SDZ 0005000 F 
6        M                  02385767    LANSOPRAZOLE              SIV 0005000 F 
6        M                  02402610    TARO-LANSOPRAZOLE         SUN 0005000 F 
6        M                  02165503    PREVACID                  BGP 0024873 F 
42                         *30MG DELAYED RELEASE CAPSULE                        
6        M                  02280523    TEVA-LANSOPRAZOLE         TEV 0005000 F 
6        M                  02293838    APO-LANSOPRAZOLE          APX 0005000 F 
6        M                  02353849    MYLAN-LANSOPRAZOLE        MYL 0005000 F 
6        M                  02357690    LANSOPRAZOLE              SAN 0005000 F 
6        M                  02385651    SANDOZ LANSOPRAZOLE       SDZ 0005000 F 
6        M                  02402629    TARO-LANSOPRAZOLE         SUN 0005000 F 
6        M                  02410389    LANSOPRAZOLE              SIV 0005000 F 
6        M                  02165511    PREVACID                  BGP 0024873 F 
42                          15MG ORALLY DISINTEGRATING TABLET                   
61       M                  02249464    PREVACID FASTAB (EDS)     BGP 0024873 E 
42                          30MG ORALLY DISINTEGRATING TABLET                   
61       M                  02249472    PREVACID FASTAB (EDS)     BGP 0024873 E 
41                          LANSOPRAZOLE/CLARITHROMYCIN/AMOXICILLIN             
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          30MG/500MG/500MG 7-DAY PACKAGE                      
61                          02470780    AA-LANSOP-AMOX-CLAR (EDS) AAP 0679100 E 
41                          MARALIXIBAT                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MILLIGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          9.5MG/ML ORAL SOLUTION (MG)                         
61                          02539888    LIVMARLI (EDS)            MIR 1631579 E 
41                          METOCLOPRAMIDE HCL                                  
42                         *5MG TABLET                                          
6                           02230431    PMS-METOCLOPRAMIDE TABLET PMS 0000257 F 
6                           02517795    MAR-METOCLOPRAMIDE        MPI 0000257 F 
6                           02548747    PRZ-METOCLOPRAMIDE        PRZ 0000257 F 
42                          10MG TABLET                                         
6                           02548755    PRZ-METOCLOPRAMIDE        PRZ 0001513 F 
42                          1MG/ML ORAL SOLUTION                                
6                           02230433    PMS-METOCLOPRAMIDE ORAL   PMS 0000686 F 
41                          MIRIKIZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          20MG/ML VIAL SOLUTION FOR I.V. INFUSION (MG)        
61                          02539861    OMVOH (EDS)               LIL 0084538 E 
42                          100MG/ML PRE-FILLED PEN (MG)                        
61                          02539845    OMVOH (EDS)               LIL 0126807 E 
42                          100MG/ML PRE-FILLED SYRINGE (MG)                    
61                          02539853    OMVOH (EDS)               LIL 0126807 E 
42                          100MG/ML+200MG/2ML PRE-FILLED PENS (MG)             
61                          02559242    OMVOH (EDS)               LIL 0084538 E 
42                          100MG/ML+200MG/2ML PRE-FILLED SYRINGES (MG)         
61                          02559234    OMVOH (EDS)               LIL 0084538 E 
41                          MISOPROSTOL                                         
42                          100UG TABLET                                        
6                           02244022    MISOPROSTOL               AAP 0003449 F 
42                          200UG TABLET                                        
6                           02244023    MISOPROSTOL               AAP 0005746 F 
41                          NIZATIDINE                                          
42                          150MG CAPSULE                                       
6                           00778338    AXID                      PED 0015935 F 
42                          300MG CAPSULE                                       
6                           00778346    AXID                      PED 0015206 F 
41                          OBETICHOLIC ACID                                    
51                          SEE APPENDIX FOR EDS CRITERIA                       
42                          5MG TABLET                                          
61                          02463121    OCALIVA (EDS)             ADV 1044494 E 
42                          10MG TABLET                                         
61                          02463148    OCALIVA (EDS)             ADV 1044494 E 
41                          OLSALAZINE SODIUM                                   
42                          250MG CAPSULE                                       
6                           02063808    DIPENTUM                  ATN 0006066 F 
41       M                  OMEPRAZOLE (MAC)                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          SEE APPENDIX C FOR MAC POLICY                       
42                         *10MG CAPSULE/TABLET                                 
61       M                  02295407    TEVA-OMEPRAZOLE (EDS)     TEV 0009470 E 
61       M                  02296438    SANDOZ OMEPRAZOLE (EDS)   SDZ 0009470 E 
42                         *20MG CAPSULE/TABLET                                 
6        M                  02245058    APO-OMEPRAZOLE            APX 0002287 F 
6        M                  02295415    TEVA-OMEPRAZOLE           TEV 0002287 F 
6        M                  02296446    SANDOZ OMEPRAZOLE         SDZ 0002287 F 
6        M                  02348691    OMEPRAZOLE                SAN 0002287 F 
6        M                  02411857    OMEPRAZOLE-20             SIV 0002287 F 
6        M                  02416549    OMEPRAZOLE MAGNESIUM      AHI 0002287 F 
6        M                  02420198    JAMP-OMEPRAZOLE DR        JPC 0002287 F 
6        M                  02501880    NRA-OMEPRAZOLE            NRA 0002287 F 
6        M                  00846503    LOSEC (CAP)               XED 0013270 F 
41                          PANTOPRAZOLE MAGNESIUM                              
42                         *40MG ENTERIC COATED TABLET                          
6                           02408570    MYLAN-PANTOPRAZOLE T      MYL 0001875 F 
6                           02440628    TEVA-PANTOPRAZOLE MAGNES  TEV 0001875 F 
6                           02441853    PANTOPRAZOLE MAGNESIUM    AHC 0001875 F 
6                           02466147    PANTOPRAZOLE T            SAN 0001875 F 
6                           02519534    PANTOPRAZOLE T            SIV 0001875 F 
6                           02267233    TECTA                     TAK 0008260 F 
41       M                  PANTOPRAZOLE SODIUM (MAC)                           
51                          SEE APPENDIX C FOR MAC POLICY                       
42                         *20MG ENTERIC COATED TABLET                          
6        M                  02285479    TEVA-PANTOPRAZOLE         TEV 0001803 F 
6        M                  02292912    APO-PANTOPRAZOLE          APX 0001803 F 
6        M                  02301075    SANDOZ PANTOPRAZOLE       SDZ 0001803 F 
6        M                  02392615    JAMP PANTOPRAZOLE SODIUM  JPC 0001803 F 
6        M                  02428172    PANTOPRAZOLE-20           SIV 0001803 F 
6        M                  02536137    PANTOPRAZOLE              SAN 0001803 F 
42                         *40MG ENTERIC COATED TABLET                          
6        M                  02285487    TEVA-PANTOPRAZOLE         TEV 0002016 F 
6        M                  02292920    APO-PANTOPRAZOLE          APX 0002016 F 
6        M                  02301083    SANDOZ PANTOPRAZOLE       SDZ 0002016 F 
6        M                  02305046    RAN-PANTOPRAZOLE          RAN 0002016 F 
6        M                  02307871    PMS-PANTOPRAZOLE          PMS 0002016 F 
6        M                  02357054    JAMP-PANTOPRAZOLE         JPC 0002016 F 
6        M                  02370808    PANTOPRAZOLE              SAN 0002016 F 
6        M                  02392623    JAMP PANTOPRAZOLE SODIUM  JPC 0002016 F 
6        M                  02415208    AURO-PANTOPRAZOLE         API 0002016 F 
6        M                  02416565    MAR-PANTOPRAZOLE          MPI 0002016 F 
6        M                  02417448    MINT-PANTOPRAZOLE         MNT 0002016 F 
6        M                  02428180    PANTOPRAZOLE-40           SIV 0002016 F 
6        M                  02431327    PANTOPRAZOLE              RIV 0002016 F 
6        M                  02467372    M-PANTOPRAZOLE            MNP 0002016 F 
6        M                  02471825    NRA-PANTOPRAZOLE          NRA 0002016 F 
6        M                  02481588    AG-PANTOPRAZOLE           ANG 0002016 F 
6        M                  02229453    PANTOLOC                  TAK 0020803 F 
41                          RABEPRAZOLE SODIUM                                  
42                         *10MG ENTERIC COATED TABLET                          
6                           02298074    RAN-RABEPRAZOLE           RAN 0000669 F 
6                           02314177    SANDOZ RABEPRAZOLE        SDZ 0000669 F 
6                           02356511    RABEPRAZOLE EC            SAN 0000669 F 
6                           02385449    RABEPRAZOLE               SIV 0000669 F 
6                           02415283    JAMP RABEPRAZOLE          JPC 0000669 F 
6                           02243796    PARIET                    JAN 0016598 F 
42                         *20MG ENTERIC COATED TABLET                          
6                           02298082    RAN-RABEPRAZOLE           RAN 0001338 F 
6                           02314185    SANDOZ RABEPRAZOLE        SDZ 0001338 F 
6                           02356538    RABEPRAZOLE EC            SAN 0001338 F 
6                           02385457    RABEPRAZOLE               SIV 0001338 F 
6                           02415291    JAMP RABEPRAZOLE          JPC 0001338 F 
6                           02243797    PARIET                    JAN 0033196 F 
41                          RANITIDINE                                          
42                         *150MG TABLET                                        
6                           00733059    APO-RANITIDINE            APX 0001197 F 
6                           02242453    PMS-RANITIDINE            PMS 0001197 F 
6                           02353016    RANITIDINE                SAN 0001197 F 
6                           02443708    MAR-RANITIDINE            MPI 0001197 F 
6                           02463717    JAMP-RANITIDINE           JPC 0001197 F 
6                           02526379    MINT-RANITIDINE           MNT 0001197 F 
42                         *300MG TABLET                                        
6                           00733067    APO-RANITIDINE            APX 0002253 F 
6                           02242454    PMS-RANITIDINE            PMS 0002253 F 
6                           02443716    MAR-RANITIDINE            MPI 0002253 F 
6                           02463725    JAMP-RANITIDINE           JPC 0002253 F 
6                           02526387    MINT-RANITIDINE           MNT 0002253 F 
42                         *15MG/ML ORAL SOLUTION                               
6                           02242940    TEVA-RANITIDINE           TEV 0001480 F 
6                           02280833    APO-RANITIDINE            APX 0001480 F 
41                          SUCRALFATE                                          
42                         *1G TABLET                                           
6                           02045702    TEVA-SUCRALFATE           TEV 0003089 F 
6                           02125250    APO-SUCRALFATE            APX 0003089 F 
6                           02100622    SULCRATE                  ABV 0007306 F 
42                          200MG/ML ORAL SUSPENSION                            
6                           02103567    SULCRATE SUSPENSION PLUS  ABV 0001340 F 
41                          SULFASALAZINE (SALICYLAZOSULFAPYRIDINE)             
42                         *500MG TABLET                                        
6                           00598461    PMS-SULFASALAZINE         PMS 0001807 F 
6                           02544652    JAMP-SULFASALAZINE        JPC 0001807 F 
6                           02064480    SALAZOPYRIN               PFI 0003682 F 
42                         *500MG ENTERIC TABLET                                
6                           00598488    PMS-SULFASALAZINE         PMS 0004074 F 
6                           02064472    SALAZOPYRIN               PFI 0005616 F 
41                          TEDUGLUTIDE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG/VIAL POWDER FOR INJECTION                       
61                          02445727    REVESTIVE (EDS)           TAK 9250000 E 
41                          5-AMINOSALICYLIC ACID (MESALAMINE)                  
42                          400MG ENTERIC COATED TABLET                         
6                           02171929    TEVA-5-ASA                TEV 0004996 F 
42                         ?500MG DELAYED RELEASE TABLET                        
6                           02524481    MEZERA                    AVR 0006662 F 
6                           02099683    PENTASA                   FEI 0007653 F 
42                          500MG ENTERIC COATED TABLET                         
6                           02112787    SALOFALK                  ABV 0007198 F 
42                          800MG DELAYED RELEASE TABLET                        
6                           02465752    OCTASA                    PED 0011358 F 
42                          1600MG DELAYED RELEASE TABLET                       
6                           02529610    OCTASA                    PED 0023740 F 
42                          1G EXTENDED RELEASE TABLET                          
6                           02399466    PENTASA                   FEI 0014910 F 
42                          1G DELAYED RELEASE TABLET                           
6                           02545012    MEZERA                    AVR 0013011 F 
42                          1.2G DELAYED & EXTENDED RELEASE TABLET              
6                           02297558    MEZAVANT                  TAK 0019635 F 
42                          1.0G/100ML RETENTION ENEMA                          
6                           02153521    PENTASA                   FEI 0053457 F 
42                          1.0G/ACTUATION FOAM ENEMA                           
6                           02474026    MEZERA                    AVR 0073114 F 
42                          2.0G/60G RETENTION ENEMA                            
6                           02112795    SALOFALK RETENTION ENEMA  ABV 0055471 F 
42                          4.0G/60G RETENTION ENEMA                            
6                           02112809    SALOFALK RETENTION ENEMA  ABV 0094034 F 
42                          4.0G/100ML RETENTION ENEMA                          
6                           02153556    PENTASA                   FEI 0070571 F 
42                          500MG SUPPOSITORY                                   
6                           02112760    SALOFALK                  ABV 0017700 F 
42                         ?1.0G SUPPOSITORY                                    
6                           02474018    MEZERA                    AVR 0018800 F 
6                           02153564    PENTASA                   FEI 0021843 F 
42                         *1.0G-SUPPOSITORY                                    
6                           02562367    ZDS-MESALAMINE SUPPOSITOR ZDS 0014005 F 
6                           02242146    SALOFALK                  ABV 0025997 F 
1         GOLD PREPARATIONS                                                     
2         GOLD PREPARATIONS                                                     
41                          AURANOFIN                                           
42                          3MG CAPSULE                                         
6                           01916823    RIDAURA                   XED 0070510 F 
1         CHELATING AGENTS                                                      
2         CHELATING AGENTS                                                      
41                          DEFERASIROX                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *125MG TABLET FOR SUSPENSION                         
61                          02461544    APO-DEFERASIROX (EDS)     APX 0052408 E 
61                          02464454    SANDOZ DEFERASIROX (EDS)  SDZ 0052408 E 
61                          02287420    EXJADE (EDS)              NVR 0108864 E 
42                         *250MG TABLET FOR SUSPENSION                         
61                          02461552    APO-DEFERASIROX (EDS)     APX 0104820 E 
61                          02464462    SANDOZ DEFERASIROX (EDS)  SDZ 0104820 E 
61                          02287439    EXJADE (EDS)              NVR 0217735 E 
42                         *500MG TABLET FOR SUSPENSION                         
61                          02461560    APO-DEFERASIROX (EDS)     APX 0209649 E 
61                          02464470    SANDOZ DEFERASIROX (EDS)  SDZ 0209649 E 
61                          02287447    EXJADE (EDS)              NVR 0435489 E 
42                         *90MG FILM COATED TABLET                             
61                          02485265    APO-DEFERASIROX (J) (EDS) APX 0026303 E 
61                          02489899    SANDOZ DEFERASIROX(J)(EDS SDZ 0026303 E 
61                          02507315    TARO-DEFERASIROX (J) (EDS TAR 0026303 E 
61                          02527774    AURO-DEFERASIROX (J)(EDS) API 0026303 E 
61                          02528290    PMS-DEFERASIROX (J) (EDS) PMS 0026303 E 
61                          02549832    JAMP DEFERASIROX (J) (EDS JPC 0026303 E 
61                          02452219    JADENU (EDS)              NVR 0107419 E 
42                         *180MG FILM COATED TABLET                            
61                          02485273    APO-DEFERASIROX (J) (EDS) APX 0052610 E 
61                          02489902    SANDOZ DEFERASIROX(J)(EDS SDZ 0052610 E 
61                          02507323    TARO-DEFERASIROX (J) (EDS TAR 0052610 E 
61                          02527782    AURO-DEFERASIROX (J)(EDS) API 0052610 E 
61                          02528304    PMS-DEFERASIROX (J) (EDS) PMS 0052610 E 
61                          02549840    JAMP DEFERASIROX (J) (EDS JPC 0052610 E 
61                          02452227    JADENU (EDS)              NVR 0214859 E 
42                         *360MG FILM COATED TABLET                            
61                          02485281    APO-DEFERASIROX (J) (EDS) APX 0105228 E 
61                          02489910    SANDOZ DEFERASIROX(J)(EDS SDZ 0105228 E 
61                          02507331    TARO-DEFERASIROX (J) (EDS TAR 0105228 E 
61                          02527790    AURO-DEFERASIROX (J)(EDS) API 0105228 E 
61                          02528312    PMS-DEFERASIROX (J) (EDS) PMS 0105228 E 
61                          02549859    JAMP DEFERASIROX (J) (EDS JPC 0105228 E 
61                          02452235    JADENU (EDS)              NVR 0429327 E 
41                          DEFERIPRONE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *1000MG TABLET                                       
61                          02553112    TARO-DEFERIPRONE (EDS)    TAR 0184107 E 
61                          02436558    FERRIPROX (EDS)           CCC 0327452 E 
42                          1000MG MODIFIED RELEASE TABLET                      
61                          02536579    FERRIPROX MR (EDS)        CCC 0334740 E 
42                          100MG/ML ORAL SOLUTION                              
61                          02436523    FERRIPROX (EDS)           CCC 0032766 E 
41                          DEFEROXAMINE MESYLATE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *500MG/VIAL POWDER FOR SOLUTION                      
61                          02241600    DEFEROXAMINE MES (EDS)    PFI 0151700 E 
61                          01981242    DESFERAL (EDS)            NVR 0175220 E 
42                          2G/VIAL POWDER FOR SOLUTION                         
61                          02247022    DESFERRIOXAMINE MES (EDS) PFI 0303400 E 
41                          PENICILLAMINE                                       
42                          250MG CAPSULE                                       
6                           00016055    CUPRIMINE                 BAU 0043552 F 
1         HORMONES AND HORMONE SUBSTITUTES                                      
2         CORTICOSTEROIDS                                                       
41                          BECLOMETHASONE DIPROPIONATE                         
42                          50UG/INHALATION AEROSOL (PACKAGE)                   
43                          (CFC-FREE)                                          
6                           02242029    QVAR                      BAU 0385200 F 
42                          100UG/INHALATION AEROSOL (PACKAGE)                  
43                          (CFC-FREE)                                          
6                           02242030    QVAR                      BAU 0743600 F 
41                          BETAMETHASONE ACETATE/                              
41                          BETAMETHASONE SODIUM PHOSPHATE                      
42                          3MG/3MG PER ML INJECTION SUSPENSION (1ML)           
6                           00028096    CELESTONE SOLUSPAN        ORG 0139900 F 
41                          BUDESONIDE                                          
42                         *0.125MG/ML INHALATION SOLUTION (2ML)                
6                           02465949    TEVA-BUDESONIDE           TEV 0002286 F 
6                           02494264    TARO-BUDESONIDE           TAR 0002286 F 
6                           02229099    PULMICORT NEBUAMP         AST 0005555 F 
42                         *0.25MG/ML INHALATION SOLUTION (2ML)                 
6                           02494272    TARO-BUDESONIDE           TAR 0004794 F 
6                           02535416    TEVA-BUDESONIDE           TEV 0004794 F 
6                           01978918    PULMICORT NEBUAMP         AST 0011120 F 
42                         *0.5MG/ML INHALATION SOLUTION (2ML)                  
6                           02465957    TEVA-BUDESONIDE           TEV 0009122 F 
6                           02494280    TARO-BUDESONIDE           TAR 0009122 F 
6                           01978926    PULMICORT NEBUAMP         AST 0022190 F 
42                          100UG POWDER FOR INHALATION (PACKAGE)               
6                           00852074    PULMICORT TURBUHALER      AST 0390000 F 
42                          200UG POWDER FOR INHALATION (PACKAGE)               
6                           00851752    PULMICORT TURBUHALER      AST 0797600 F 
42                          400UG POWDER FOR INHALATION (PACKAGE)               
6                           00851760    PULMICORT TURBUHALER      AST 1164200 F 
41                          CICLESONIDE                                         
42                          100UG METERED DOSE INHALER                          
6                           02285606    ALVESCO                   AZR 0552300 F 
42                          200UG METERED DOSE INHALER                          
6                           02285614    ALVESCO                   AZR 0913300 F 
41                          CORTISONE ACETATE                                   
42                          25MG TABLET                                         
6                           00280437    CORTISONE                 BAU 0004162 F 
41                          DEXAMETHASONE                                       
42                         *0.5MG TABLET                                        
6                           01964976    PMS-DEXAMETHASONE         PMS 0001564 F 
6                           02261081    APO-DEXAMETHASONE         APX 0001564 F 
42                          0.75MG TABLET                                       
6                           01964968    PMS-DEXAMETHASONE         PMS 0006783 F 
42                          2MG TABLET                                          
6                           02279363    PMS-DEXAMETHASONE         PMS 0005530 F 
42                         *4MG TABLET                                          
6                           01964070    PMS-DEXAMETHASONE         PMS 0006112 F 
6                           02250055    APO-DEXAMETHASONE         APX 0006112 F 
41                          DEXAMETHASONE PHOSPHATE                             
42                         *4MG/ML INJECTION SOLUTION (5ML)                     
6                           00664227    DEXAMETHASONE SOD PHO INJ SDZ 0080300 F 
6                           01977547    DEXAMETHASONE SOD PHO INJ STE 0080300 F 
6                           02204266    DEXAMETHASONE OMEGA       OMG 0080300 F 
41                          FLUDROCORTISONE ACETATE                             
42                         *0.1MG TABLET                                        
6                           02552248    JAMP FLUDROCORTISONE      JPC 0003131 F 
6                           02086026    FLORINEF                  KTI 0003278 F 
41                          FLUTICASONE FUROATE                                 
42                          100UG POWDER FOR INHALATION                         
6                           02446561    ARNUITY ELLIPTA           GSK 0454800 F 
42                          200UG POWDER FOR INHALATION                         
6                           02446588    ARNUITY ELLIPTA           GSK 0909600 F 
41                          FLUTICASONE PROPIONATE                              
42                         *50UG/INHALATION AEROSOL (PACKAGE)                   
6                           02503115    PMS-FLUTICASONE HFA       PMS 0142100 F 
6                           02528428    APO-FLUTICASONE HFA       APX 0142100 F 
6                           02244291    FLOVENT HFA               GSK 0290600 F 
42                         *125UG/INHALATION AEROSOL (PACKAGE)                  
6                           02503123    PMS-FLUTICASONE HFA       PMS 0234100 F 
6                           02526557    APO-FLUTICASONE HFA       APX 0234100 F 
6                           02244292    FLOVENT HFA               GSK 0501200 F 
42                         *250UG/INHALATION AEROSOL (PACKAGE)                  
6                           02503131    PMS-FLUTICASONE HFA       PMS 0450200 F 
6                           02510987    APO-FLUTICASONE HFA       APX 0450200 F 
6                           02244293    FLOVENT HFA               GSK 1002700 F 
42                          55UG/DOSE POWDER FOR INHALATION (PACKAGE)           
6                           02467895    AERMONY RESPICLICK        TVM 0169600 F 
42                          100UG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           02237245    FLOVENT DISKUS            GSK 0324900 F 
42                          113UG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           02467909    AERMONY RESPICLICK        TVM 0309700 F 
42                          232UG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           02467917    AERMONY RESPICLICK        TVM 0481600 F 
42                          250UG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           02237246    FLOVENT DISKUS            GSK 0501200 F 
42                          500UG/DOSE POWDER FOR INHALATION (PACKAGE)          
6                           02237247    FLOVENT DISKUS            GSK 0767300 F 
41                          HYDROCORTISONE                                      
42                         *10MG TABLET                                         
6                           02524465    AURO-HYDROCORTISONE       API 0001639 F 
6                           00030910    CORTEF                    PFI 0002301 F 
42                         *20MG TABLET                                         
6                           02524473    AURO-HYDROCORTISONE       API 0002958 F 
6                           00030929    CORTEF                    PFI 0004155 F 
41                          HYDROCORTISONE SODIUM SUCCINATE                     
42                          100MG INJECTION POWDER                              
6                           00030600    SOLU-CORTEF               PFI 0050370 F 
42                          250MG INJECTION POWDER                              
6                           00030619    SOLU-CORTEF               PFI 0085240 F 
41                          METHYLPREDNISOLONE                                  
42                          4MG TABLET                                          
6                           00030988    MEDROL                    PFI 0005465 F 
42                          16MG TABLET                                         
6                           00036129    MEDROL                    PFI 0015757 F 
41                          METHYLPREDNISOLONE ACETATE                          
42                         ?40MG/ML INJECTION SUSPENSION (1ML)                  
6                           01934333    DEPO-MEDROL               PFI 0067960 F 
6                           00030759    DEPO-MEDROL               PFI 0068760 F 
42                         ?80MG/ML INJECTION SUSPENSION (1ML)                  
6                           01934341    DEPO-MEDROL               PFI 0101780 F 
6                           00030767    DEPO-MEDROL               PFI 0131800 F 
41                          MOMETASONE FUROATE                                  
42                          200UG POWDER FOR INHALATION                         
6                           02243595    ASMANEX TWISTHALER        ORG 0424300 F 
42                          400UG POWDER FOR INHALATION                         
6                           02243596    ASMANEX TWISTHALER        ORG 0848300 F 
41                          PREDNISOLONE SODIUM PHOSPHATE                       
42                          1MG/ML ORAL LIQUID                                  
6                           02245532    PMS-PREDNISOLONE          PMS 0001259 F 
41                          PREDNISONE                                          
42                          1MG TABLET                                          
6                           00271373    WINPRED TAB 1MG           AAP 0001403 F 
42                         *5MG TABLET                                          
6                           00021695    TEVA-PREDNISONE           TEV 0000401 F 
6                           00312770    APO-PREDNISONE            APX 0000401 F 
42                         *50MG TABLET                                         
6                           00232378    TEVA-PREDNISONE           TEV 0001735 F 
6                           00550957    APO-PREDNISONE            APX 0001735 F 
41                          TRIAMCINOLONE ACETONIDE                             
42                          10MG/ML INJECTION SUSPENSION (5ML)                  
6                           01999761    KENALOG 10                BMY 0194500 F 
42                         *40MG/ML INJECTION SUSPENSION (1ML)                  
6                           01977563    TRIAMCINOLONE ACETONIDE   STE 0077759 F 
6                           01999869    KENALOG 40                BMY 0089600 F 
2         ANDROGENS                                                             
41                          DANAZOL                                             
42                          100MG CAPSULE                                       
6                           02018152    CYCLOMEN                  AVT 0015910 F 
42                          200MG CAPSULE                                       
6                           02018160    CYCLOMEN                  AVT 0025425 F 
41                          TESTOSTERONE CYPIONATE                              
42                          100MG/ML OILY INJECTION SOLUTION (10ML)             
6                           02496003    TARO-TESTOSTERONE CYPION  TAR 0348800 F 
41                          TESTOSTERONE ENANTHATE                              
42                         *200MG/ML OILY INJECTION SOLUTION (ML)               
6                           02536315    TESTOSTERONE ENANTHATE    HIK 0071190 F 
6                           00029246    DELATESTRYL               BAU 0118680 F 
41                          TESTOSTERONE UNDECANOATE                            
42                          40MG CAPSULE                                        
6                           02421186    TARO-TESTOSTERONE         TAR 0005649 F 
2         CONTRACEPTION                                                         
41                          DROSPIRENONE                                        
42                          4MG TABLET (28 TABLET)                              
6                           02522802    SLYND                     DUI 0126600 F 
41                          ETHINYL ESTRADIOL/DESOGESTREL                       
42                         *0.03MG/0.15MG (21 TABLET)                           
6                           02317192    APRI                      TEV 0052780 F 
6                           02396491    FREYA 21                  MYL 0052780 F 
6                           02410249    MIRVALA 21                APX 0052780 F 
6                           02556553    MILEY 21                  AMB 0052780 F 
6                           02042487    MARVELON                  ORG 0208192 F 
42                         *0.03MG/0.15MG (28 TABLET)                           
6                           02317206    APRI                      TEV 0052780 F 
6                           02396610    FREYA 28                  MYL 0052780 F 
6                           02410257    MIRVALA 28                APX 0052780 F 
6                           02556561    MILEY 28                  AMB 0052780 F 
6                           02042479    MARVELON                  ORG 0208192 F 
42                          0.1MG/0.025MG/0.125MG/0.025MG/0.15MG/0.025MG        
43                          (21 TABLET)                                         
6                           02272903    LINESSA                   ASC 0202500 F 
42                          0.1MG/0.025MG/0.125MG/0.025MG/0.15MG/0.025MG        
43                          (28 TABLET)                                         
6                           02257238    LINESSA                   ASC 0202500 F 
41                          ETHINYL ESTRADIOL/DROSPIRENONE                      
42                         *0.020MG/3.0MG (28 TABLET)                           
6                           02415380    MYA                       APX 0082600 F 
6                           02462060    DROSPIRENONE/ETHINYL ESTR GLN 0082600 F 
6                           02321157    YAZ (28)                  BAY 0168200 F 
42                         *0.030MG/3.0MG (21 TABLET)                           
6                           02410788    ZAMINE 21                 APX 0062200 F 
6                           02421437    DROSPIRENONE & ETHINYL 21 GLN 0062200 F 
6                           02261723    YASMIN 21                 BAY 0126900 F 
42                         *0.030MG/3.0MG (28 TABLET)                           
6                           02410796    ZAMINE 28                 APX 0062200 F 
6                           02421445    DROSPIRENONE/ETHINYL ESTR GLN 0062200 F 
6                           02261731    YASMIN 28                 BAY 0126900 F 
41                          ETHINYL ESTRADIOL/ETONOGESTREL                      
42                         *0.120MG/0.015MG/24HR SLOW RELEASE VAGINAL           
43                          RING                                                
6                           02520028    HALOETTE                  SLP 0125400 F 
6                           02253186    NUVARING                  ORG 0197600 F 
41                          ETHINYL ESTRADIOL/L-NORGESTREL                      
42                         *0.02MG/0.1MG (21 TABLET)                            
6                           02298538    AVIANE                    TEV 0039425 F 
6                           02387875    ALYSENA 21                APX 0039425 F 
6                           02424282    LAYLAA                    LUP 0039425 F 
6                           02532174    AUDRINA 21                JPC 0039425 F 
6                           02236974    ALESSE                    PFI 0159800 F 
42                         *0.02MG/0.1MG (28 TABLET)                            
6                           02298546    AVIANE                    TEV 0039425 F 
6                           02387883    ALYSENA 28                APX 0039425 F 
6                           02424290    LAYLAA                    LUP 0039425 F 
6                           02532182    AUDRINA 28                JPC 0039425 F 
6                           02236975    ALESSE                    PFI 0159800 F 
42                          0.03MG/0.05MG(6)0.04MG/0.075MG(5)                   
43                          0.03MG/0.125MG(10) (21 TABLET)                      
6                           00707600    TRIQUILAR                 BAY 0160700 F 
42                          0.03MG/0.05MG(6)0.04MG/0.075MG(5)                   
43                          0.03MG/0.125MG(10) INERT (7) (28 TABLET)            
6                           00707503    TRIQUILAR                 BAY 0160700 F 
42                         *0.03MG/0.15MG (21 TABLET)                           
6                           02295946    PORTIA 21                 TEV 0072800 F 
6                           02387085    OVIMA 21                  APX 0072800 F 
6                           02042320    MIN-OVRAL                 PFI 0192900 F 
42                         *0.03MG/0.15MG (28 TABLET)                           
6                           02295954    PORTIA 28                 TEV 0072800 F 
6                           02387093    OVIMA 28                  APX 0072800 F 
6                           02042339    MIN-OVRAL                 PFI 0192900 F 
41                          ETHINYL ESTRADIOL/NORETHINDRONE                     
42                          0.035MG/0.5MG (21 TABLET)                           
6                           02187086    BREVICON                  PFI 0164500 F 
42                          0.035MG/0.5MG (28 TABLET)                           
6                           02187094    BREVICON                  PFI 0164500 F 
42                          0.035MG/0.5MG(7)0.035MG/1.0MG(9)                    
43                          0.035MG/0.5MG(5) (21 TABLET)                        
6                           02187108    SYNPHASIC                 PFI 0136400 F 
42                          0.035MG/0.5MG(7)0.035MG/1.0MG(9)                    
43                          0.035MG/0.5MG(5) INERT (7) (28 TABLET)              
6                           02187116    SYNPHASIC                 PFI 0136400 F 
42                         ?0.035MG/1MG (21 TABLET)                             
6                           02197502    SELECT 1/35               PFI 0117700 F 
6                           02189054    BREVICON 1/35             PFI 0164500 F 
42                         ?0.035MG/1MG (28 TABLET)                             
6                           02199297    SELECT 1/35               PFI 0115600 F 
6                           02189062    BREVICON 1/35             PFI 0164500 F 
41                          ETHINYL ESTRADIOL/NORETHINDRONE ACETATE AND         
41                          ETHINYL ESTRADIOL                                   
42                         *0.01MG/1MG (24) AND 0.01MG (2) INERT (2)            
43                          (28 TABLET)                                         
6                           02553481    ELFY                      APX 0104239 F 
6                           02417456    LOLO                      ABV 0189525 F 
41                          ETHINYL ESTRADIOL/NORGESTIMATE                      
42                          0.025MG/0.18MG (7) 0.025MG/0.215MG (7)              
43                          0.025MG/0.25MG (7) (21 TABLET)                      
6                           02401967    TRICIRA LO (21 DAY)       APX 0165500 F 
42                          0.025MG/0.18MG (7) 0.025MG/0.215MG (7)              
43                          0.025MG/0.25MG (7) INERT (7) (28 TABLET)            
6                           02401975    TRICIRA LO (28 DAY)       APX 0165500 F 
42                         *0.035MG/0.18MG (7) 0.035MG/0.215MG (7)              
43                          0.035MG/0.25MG (7) (21 TABLET)                      
6                           02486296    TRI-JORDYNA 21            GLN 0143900 F 
6                           02508087    TRI-CIRA 21               APX 0143900 F 
42                         *0.035MG/0.18MG (7) 0.035MG/0.215MG (7)              
43                          0.035MG/0.25MG (7) INERT (7) (28 TABLET)            
6                           02486318    TRI-JORDYNA 28            GLN 0143900 F 
6                           02508095    TRI-CIRA 28               APX 0143900 F 
41                          ETONOGESTREL                                        
42                          68MG EXTENDED RELEASE SUBDERMAL IMPLANT             
6                           02499509    NEXPLANON                 ORG 3208110 F 
41                          LEVONORGESTREL                                      
42                         *1.5MG TABLET                                        
6                           02425009    CONTINGENCY ONE           MYL 0043000 F 
6                           02433532    BACKUP PLAN ONESTEP       APX 0043000 F 
6                           02548461    MYSTEP                    JPC 0043000 F 
6                           02293854    PLAN B                    FCH 0172000 F 
42                          52MG EXTENDED RELEASE INTRAUTERINE INSERT           
6                           02243005    MIRENA                    BAY 3800000 F 
42                          19.5MG EXTENDED RELEASE INTRAUTERINE INSERT         
6                           02459523    KYLEENA                   BAY 3555800 F 
41                          NORETHINDRONE                                       
42                         *0.35MG (28 TABLET)                                  
6                           02410303    MOVISSE                   MYL 0109900 F 
6                           02441306    JENCYCLA                  LUP 0109900 F 
2         ESTROGENS                                                             
41                          CONJUGATED ESTROGENS                                
42                          0.3MG TABLET                                        
6                           02414678    PREMARIN                  PFI 0003964 F 
42                          0.625MG TABLET                                      
6                           02414686    PREMARIN                  PFI 0004164 F 
42                          1.25MG TABLET                                       
6                           02414694    PREMARIN                  PFI 0004339 F 
42                          0.625MG/G VAGINAL CREAM                             
6                           02043440    PREMARIN                  PFI 0009280 F 
41                          ESTRADIOL                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.5MG TABLET                                        
6                           02449048    LUPIN-ESTRADIOL           LUP 0001199 F 
6                           02225190    ESTRACE                   ACP 0001646 F 
42                         *1MG TABLET                                          
6                           02449056    LUPIN-ESTRADIOL           LUP 0002313 F 
6                           02148587    ESTRACE                   ACP 0003176 F 
42                         *2MG TABLET                                          
6                           02449064    LUPIN-ESTRADIOL           LUP 0004083 F 
6                           02148595    ESTRACE                   ACP 0005608 F 
42                          0.06% TRANSDERMAL GEL SPRAY (PACKAGE)               
6                           02238704    ESTROGEL                  ORG 0435760 F 
42                          0.1% TRANSDERMAL GEL (0.25MG PACKET)                
6                           02424924    DIVIGEL                   SLP 0274000 F 
42                          0.1% TRANSDERMAL GEL (0.5MG PACKET)                 
6                           02424835    DIVIGEL                   SLP 0274000 F 
42                          0.1% TRANSDERMAL GEL (1MG PACKET)                   
6                           02424843    DIVIGEL                   SLP 0274000 F 
42                          2MG VAGINAL RING (7.5UG/24 HOURS)                   
6                           02168898    ESTRING                   PFI 0865100 F 
42                          10UG VAGINAL TABLET                                 
6                           02325462    VAGIFEM 10                NOO 0049061 F 
42                         ?25UG TRANSDERMAL THERAPEUTIC SYSTEM (PKG)           
6                           02247499    CLIMARA 25                BAY 0210500 F 
6                           02245676    ESTRADOT                  SDZ 0261400 F 
42                          37.5UG TRANSDERMAL THERAPEUTIC SYSTEM (PKG)         
6                           02243999    ESTRADOT                  SDZ 0263000 F 
42                         *50UG TRANSDERMAL PATCH (PKG)                        
6                           02246967    SANDOZ ESTRADIOL DERM     SDZ 0245600 F 
6                           02244000    ESTRADOT                  SDZ 0280600 F 
42                          50UG TRANSDERMAL THERAPEUTIC SYSTEM (PKG)           
6                           02231509    CLIMARA 50                BAY 0224900 F 
42                         *75UG TRANSDERMAL PATCH (PKG)                        
6                           02246968    SANDOZ ESTRADIOL DERM     SDZ 0263200 F 
6                           02244001    ESTRADOT                  SDZ 0300800 F 
42                          75UG TRANSDERMAL THERAPEUTIC SYSTEM (PKG)           
6                           02247500    CLIMARA 75                BAY 0239800 F 
42                         *100UG TRANSDERMAL PATCH (PKG)                       
6                           02246969    SANDOZ ESTRADIOL DERM     SDZ 0278800 F 
6                           02244002    ESTRADOT                  SDZ 0318200 F 
42                          4UG VAGINAL INSERT                                  
6                           02503689    IMVEXXY                   KTI 0036944 F 
42                          10UG VAGINAL INSERT                                 
6                           02503697    IMVEXXY                   KTI 0036944 F 
41                          ESTRADIOL/NORETHINDRONE ACETATE                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50UG/140UG TRANSDERMAL THERAPEUTIC SYSTEM (8)       
6                           02241835    ESTALIS                   SDZ 0311200 F 
42                          50UG/250UG TRANSDERMAL THERAPEUTIC SYSTEM (8)       
6                           02241837    ESTALIS                   SDZ 0311200 F 
41                          ESTRADIOL/PROGESTERONE                              
42                          1MG/100MG CAPSULE                                   
6                           02505223    BIJUVA                    KTI 0009143 F 
41                          ESTRONE                                             
42                          0.1% VAGINAL CREAM                                  
6                           00727369    ESTRAGYN VAGINAL CREAM    SLP 0007576 F 
41                          RELUGOLIX/ESTRADIOL/NORETHINDRONE ACETATE           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          40MG/1MG/0.5MG TABLET                               
61                          02541742    MYFEMBREE (EDS)           KTI 0093150 E 
2         ESTROGEN RECEPTOR AGONIST/ANTAGONISTS                                 
41                          RALOXIFENE HCL                                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *60MG TABLET                                         
61                          02279215    APO-RALOXIFENE (EDS)      APX 0005134 E 
61                          02358840    ACT RALOXIFENE (EDS)      TEV 0005134 E 
61                          02540681    JAMP RALOXIFENE (EDS)     JPC 0005134 E 
61                          02239028    EVISTA (EDS)              LIL 0023168 E 
2         GONADOTROPIN HORMONES                                                 
41                          BUSERELIN ACETATE                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG/ML INJECTION                                    
61                          02225166    SUPREFACT (EDS)           XED 1471700 E 
41                          CHORIONIC GONADOTROPIN                              
51                          SEE APPENDIX A FOR EDS CRITERIA                     
41                          GOSERELIN ACETATE                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          3.6MG/SYRINGE                                       
61                          02049325    ZOLADEX (EDS)             TST 4226800 E 
41                          LEUPROLIDE ACETATE                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          WHEN BILLING 11.25MG INJECTION, SUBMIT AS           
53                          QUANTITY OF 3                                       
42                          3.75MG/ML INJECTION                                 
61                          00884502    LUPRON DEPOT (EDS)        ABV 3953720 E 
42                          7.5MG/ML INJECTION                                  
61                          00836273    LUPRON DEPOT (EDS)        ABV 3879700 E 
42                          11.25MG (3-MONTH SR) DEPOT INJECTION                
61                          02239834    LUPRON DEPOT (EDS)        ABV 3926933 E 
41                          NAFARELIN ACETATE                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG/ML NASAL SOLUTION                               
61                          02188783    SYNAREL (EDS)             PFI 4542500 E 
2         ALPHA-GLUCOSIDASE INHIBITORS                                          
41                          ACARBOSE                                            
42                          50MG TABLET                                         
6                           02494078    MAR-ACARBOSE              MPI 0001482 F 
42                          100MG TABLET                                        
6                           02494086    MAR-ACARBOSE              MPI 0002053 F 
2         BIGUANIDES                                                            
41                          METFORMIN                                           
42                         *500MG TABLET                                        
6                           02223562    PMS-METFORMIN             PMS 0000247 F 
6                           02246820    SANDOZ METFORMIN FC       SDZ 0000247 F 
6                           02257726    TEVA-METFORMIN            TEV 0000247 F 
6                           02353377    METFORMIN                 SAN 0000247 F 
6                           02378620    MAR-METFORMIN             MPI 0000247 F 
6                           02380196    JAMP-METFORMIN            JPC 0000247 F 
6                           02385341    METFORMIN FC              SIV 0000247 F 
6                           02388766    MINT-METFORMIN            MNT 0000247 F 
6                           02438275    AURO-METFORMIN            API 0000247 F 
6                           02520303    PMSC-METFORMIN            PMS 0000247 F 
6                           02531895    PRZ-METFORMIN             PRZ 0000247 F 
6                           02536439    NRA-METFORMIN             NRA 0000247 F 
6                           02547767    M-METFORMIN               MNP 0000247 F 
6                           02099233    GLUCOPHAGE                AVT 0002880 F 
42                         *850MG TABLET                                        
6                           02242589    PMS-METFORMIN             PMS 0000339 F 
6                           02246821    SANDOZ METFORMIN FC       SDZ 0000339 F 
6                           02257734    TEVA-METFORMIN            TEV 0000339 F 
6                           02353385    METFORMIN                 SAN 0000339 F 
6                           02378639    MAR-METFORMIN             MPI 0000339 F 
6                           02380218    JAMP-METFORMIN            JPC 0000339 F 
6                           02385368    METFORMIN FC              SIV 0000339 F 
6                           02388774    MINT-METFORMIN            MNT 0000339 F 
6                           02438283    AURO-METFORMIN            API 0000339 F 
6                           02520311    PMSC-METFORMIN            PMS 0000339 F 
6                           02531909    PRZ-METFORMIN             PRZ 0000339 F 
6                           02536447    NRA-METFORMIN             NRA 0000339 F 
6                           02547775    M-METFORMIN               MNP 0000339 F 
6                           02162849    GLUCOPHAGE                AVT 0003815 F 
2         DPP-4 INHIBITORS                                                      
41                          LINAGLIPTIN                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          5MG TABLET                                          
61                          02370921    TRAJENTA (EDS)            BOE 0027427 E 
41                          LINAGLIPTIN/METFORMIN                               
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          2.5/500MG TABLET                                    
61                          02403250    JENTADUETO (EDS)          BOE 0014345 E 
42                          2.5/850MG TABLET                                    
61                          02403269    JENTADUETO (EDS)          BOE 0014345 E 
42                          2.5/1000MG TABLET                                   
61                          02403277    JENTADUETO (EDS)          BOE 0014345 E 
41                          SAXAGLIPTIN                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *2.5MG TABLET                                        
61                          02468603    SANDOZ SAXAGLIPTIN (EDS)  SDZ 0012650 E 
61                          02507471    APO-SAXAGLIPTIN (EDS)     APX 0012650 E 
61                          02375842    ONGLYZA (EDS)             AST 0028920 E 
42                         *5MG TABLET                                          
61                          02468611    SANDOZ SAXAGLIPTIN (EDS)  SDZ 0015195 E 
61                          02507498    APO-SAXAGLIPTIN (EDS)     APX 0015195 E 
61                          02333554    ONGLYZA (EDS)             AST 0034780 E 
41                          SAXAGLIPTIN/METFORMIN HCL                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          2.5MG/500MG TABLET                                  
61                          02389169    KOMBOGLYZE (EDS)          AST 0014743 E 
42                          2.5MG/850MG TABLET                                  
61                          02389177    KOMBOGLYZE (EDS)          AST 0014743 E 
42                          2.5MG/1000MG TABLET                                 
61                          02389185    KOMBOGLYZE (EDS)          AST 0014743 E 
41                          SITAGLIPTIN                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *25MG TABLET                                         
61                          02428261    APO-SITAGLIPTIN (EDS)     APX 0008197 E 
61                          02503840    PMS-SITAGLIPTIN (EDS)     PMS 0008197 E 
61                          02504049    SANDOZ SITAGLIPTIN (EDS)  SDZ 0008197 E 
61                          02508656    APO-SITAGLIPTIN MAL (EDS) APX 0008197 E 
61                          02512475    ACH-SITAGLIPTIN (EDS)     AHI 0008197 E 
61                          02522705    TEVA-SITAGLIPTIN MAL(EDS) TEV 0008197 E 
61                          02529033    SITAGLIPTIN (EDS)         SIV 0008197 E 
61                          02529866    AURO-SITAGLIPTIN (EDS)    API 0008197 E 
61                          02531631    TARO-SITAGLIPTIN (EDS)    TAR 0008197 E 
61                          02534134    JAMP SITAGLIPTIN (EDS)    JPC 0008197 E 
61                          02534983    M-SITAGLIPTIN (EDS)       MNP 0008197 E 
61                          02548550    SITAGLIPTIN (EDS)         SAN 0008197 E 
61                          02553910    MINT-SITAGLIPTIN (EDS)    MNT 0008197 E 
61                          02558157    NAT-SITAGLIPTIN (EDS)     NPI 0008197 E 
61                          02388839    JANUVIA (EDS)             MRK 0033477 E 
42                         *50MG TABLET                                         
61                          02428288    APO-SITAGLIPTIN (EDS)     APX 0008197 E 
61                          02503859    PMS-SITAGLIPTIN (EDS)     PMS 0008197 E 
61                          02504057    SANDOZ SITAGLIPTIN (EDS)  SDZ 0008197 E 
61                          02508664    APO-SITAGLIPTIN MAL (EDS) APX 0008197 E 
61                          02512483    ACH-SITAGLIPTIN (EDS)     AHI 0008197 E 
61                          02522713    TEVA-SITAGLIPTIN MAL(EDS) TEV 0008197 E 
61                          02529041    SITAGLIPTIN (EDS)         SIV 0008197 E 
61                          02529874    AURO-SITAGLIPTIN (EDS)    API 0008197 E 
61                          02531658    TARO-SITAGLIPTIN (EDS)    TAR 0008197 E 
61                          02534142    JAMP SITAGLIPTIN (EDS)    JPC 0008197 E 
61                          02534991    M-SITAGLIPTIN (EDS)       MNP 0008197 E 
61                          02548569    SITAGLIPTIN (EDS)         SAN 0008197 E 
61                          02553929    MINT-SITAGLIPTIN (EDS)    MNT 0008197 E 
61                          02558165    NAT-SITAGLIPTIN (EDS)     NPI 0008197 E 
61                          02388847    JANUVIA (EDS)             MRK 0033477 E 
42                         *100MG TABLET                                        
61                          02428296    APO-SITAGLIPTIN (EDS)     APX 0008197 E 
61                          02503867    PMS-SITAGLIPTIN (EDS)     PMS 0008197 E 
61                          02504065    SANDOZ SITAGLIPTIN (EDS)  SDZ 0008197 E 
61                          02508672    APO-SITAGLIPTIN MAL (EDS) APO 0008197 E 
61                          02512491    ACH-SITAGLIPTIN (EDS)     AHI 0008197 E 
61                          02522721    TEVA-SITAGLIPTIN MAL(EDS) TEV 0008197 E 
61                          02529068    SITAGLIPTIN (EDS)         SIV 0008197 E 
61                          02529882    AURO-SITAGLIPTIN (EDS)    API 0008197 E 
61                          02531666    TARO-SITAGLIPTIN (EDS)    TAR 0008197 E 
61                          02534150    JAMP SITAGLIPTIN (EDS)    JPC 0008197 E 
61                          02535009    M-SITAGLIPTIN (EDS)       MNP 0008197 E 
61                          02543400    NAT-SITAGLIPTIN (EDS)     NPI 0008197 E 
61                          02548577    SITAGLIPTIN (EDS)         SAN 0008197 E 
61                          02553937    MINT-SITAGLIPTIN (EDS)    MNT 0008197 E 
61                          02303922    JANUVIA (EDS)             MRK 0033477 E 
41                          SITAGLIPTIN/METFORMIN HCL                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *50MG/500MG TABLET                                   
61                          02435772    APO-SITAGLIPTIN-MET (EDS) APX 0004446 E 
61                          02503956    SANDOZ-SITAGLIPTIN (EDS)  SDZ 0004446 E 
61                          02509415    APO-SITAGLIPTIN MAL (EDS) APX 0004446 E 
61                          02520494    TEVA-SITAGLIPTIN MAL(EDS) TEV 0004446 E 
61                          02529157    SITAGLIPTIN-MET (EDS)     SIV 0004446 E 
61                          02540118    REDDY-SITAGLIPTIN (EDS)   DLC 0004446 E 
61                          02547805    AURO SITAGLIP/METFOR(EDS) API 0004446 E 
61                          02556189    JAMP SITAGLIP/METFOR(EDS) JPC 0004446 E 
61                          02560445    SITAGLIPTIN/METFORM (EDS) SAN 0004446 E 
61                          02333856    JANUMET (EDS)             MRK 0018158 E 
42                         *50MG/850MG TABLET                                   
61                          02435780    APO-SITAGLIPTIN-MET (EDS) APX 0004446 E 
61                          02503964    SANDOZ SITAGLIPTIN (EDS)  SDZ 0004446 E 
61                          02509423    APO-SITAGLIPTIN MAL (EDS) APX 0004446 E 
61                          02520508    TEVA-SITAGLIPTIN MAL(EDS) TEV 0004446 E 
61                          02529165    SITAGLIPTIN-MET (EDS)     SIV 0004446 E 
61                          02540126    REDDY-SITAGLIPTIN (EDS)   DLC 0004446 E 
61                          02547813    AURO SITAGLIP/METFOR(EDS) API 0004446 E 
61                          02552310    PRZ-SITAGLIPTIN-MET (EDS) PRZ 0004446 E 
61                          02556197    JAMP SITAGLIP/METFOR(EDS) JPC 0004446 E 
61                          02560453    SITAGLIPTIN/METFORM (EDS) SAN 0004446 E 
42                         *50MG/1000MG TABLET                                  
61                          02435799    APO-SITAGLIPTIN-MET (EDS) APX 0004446 E 
61                          02503972    SANDOZ SITAGLIPTAN (EDS)  SDZ 0004446 E 
61                          02509431    APO-SITAGLIPTIN MAL (EDS) APX 0004446 E 
61                          02520516    TEVA-SITAGLIPTIN MAL(EDS) TEV 0004446 E 
61                          02529173    SITAGLIPTIN-MET (EDS)     SIV 0004446 E 
61                          02540134    REDDY-SITAGLIPTIN (EDS)   DLC 0004446 E 
61                          02547821    AURO SITAGLIP/METFOR(EDS) API 0004446 E 
61                          02552329    PRZ-SITAGLIPTIN-MET (EDS) PRZ 0004446 E 
61                          02556200    JAMP SITAGLIP/METFOR(EDS) JPC 0004446 E 
61                          02560461    SITAGLIPTIN/METFORM (EDS) SAN 0004446 E 
61                          02333872    JANUMET (EDS)             MRK 0018158 E 
42                         *50MG/500MG MODIFIED RELEASE TABLET                  
61                          02506270    APO-SITAGLIPTIN/MET (EDS) APX 0008893 E 
61                          02529106    SANDOZ SITAG-MET XR (EDS) SDZ 0008893 E 
61                          02416786    JANUMET XR (EDS)          MRK 0018158 E 
42                         *50MG/1000MG MODIFIED RELEASE TABLET                 
61                          02506289    APO-SITAGLIPTIN/MET (EDS) APX 0008893 E 
61                          02529114    SANDOZ SITAG-MET XR (EDS) SDZ 0008893 E 
61                          02416794    JANUMET XR (EDS)          MRK 0018158 E 
42                         *100MG/1000MG MODIFIED RELEASE TABLET                
61                          02506297    APO-SITAGLIPTIN/MET (EDS) APX 0017784 E 
61                          02529122    SANDOZ SITAG-MET XR (EDS) SDZ 0017784 E 
61                          02416808    JANUMET XR (EDS)          MRK 0036317 E 
2         INCRETIN MIMETIC DRUGS                                                
41                          INSULIN GLARGINE/LIXISENATIDE                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100IU/33MCG/ML SOLUTION FOR INJECTION               
61                          02478293    SOLIQUA (EDS)             AVT 2025300 E 
41                          SEMAGLUTIDE                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *0.68MG/ML (2MG/PEN) SOLUTION                        
61                          02568020    APO-SEMAGLUTIDE INJ (EDS) APX 0781410 E 
61                          02540258    OZEMPIC (EDS)             NOO 2279400 E 
42                         *1.34MG/ML (2MG/PEN) SOLUTION                        
61                          02567806    SEMAGLUTIDE INJ (EDS)     DLC 0781410 E 
61                          02471477    OZEMPIC (EDS)             NOO 2279400 E 
42                         *1.34MG/ML (4MG/PEN) SOLUTION                        
61                          02567814    SEMAGLUTIDE INJ (EDS)     DLC 0781410 E 
61                          02568012    APO-SEMAGLUTIDE INJ (EDS) APX 0781410 E 
61                          02471469    OZEMPIC (EDS)             NOO 2279400 E 
2         PORK INSULINS                                                         
41                          INSULIN (ISOPHANE) PORK                             
42                          100U/ML INJECTION SUSPENSION (10ML)                 
6                           02275864    HYPURIN NPH               WCK 0990000 F 
2         BIOSYNTHETIC HUMAN INSULINS                                           
41                          INSULIN (ISOPHANE) HUMAN BIOSYNTHETIC               
42                         ?100U/ML INJECTION SUSPENSION (10ML)                 
6                           02024225    NOVOLIN GE NPH            NOO 0263200 F 
6                           00587737    HUMULIN-N                 LIL 0292400 F 
42                         ?100U/ML INJECTION SUSPENSION (5X3ML)                
6                           02024268    NOVOLIN GE NPH PENFILL    NOO 0517500 F 
6                           01959239    HUMULIN-N CARTRIDGE       LIL 0585100 F 
6                           02403447    HUMULIN-N KWIKPEN         LIL 0585100 F 
41                          INSULIN (REGULAR) ASPART                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100U/ML INJECTION SOLUTION (10ML)                   
61                          02245397    NOVORAPID (EDS)           NOO 0326200 E 
42                          100U/ML-INJECTION SOLUTION (10ML)                   
6                           02529254    TRURAPI                   AVT 0226430 F 
42                         ?100U/ML-INJECTION SOLUTION (5X3ML)                  
6                           02506564    TRURAPI                   AVT 0450000 F 
6                           02506572    TRURAPI SOLOSTAR          AVT 0450000 F 
42                          100U/ML INJECTION-SOLUTION (5X3ML)                  
6                           02520974    KIRSTY                    BBL 0427200 F 
41                          INSULIN (REGULAR) HUMAN BIOSYNTHETIC                
42                         ?100U/ML INJECTION SOLUTION (10ML)                   
6                           02024233    NOVOLIN GE TORONTO        NOO 0257300 F 
6                           00586714    HUMULIN-R                 LIL 0292400 F 
42                         ?100U/ML INJECTION SOLUTION (5X3ML)                  
6                           02024284    NOVOLIN GE TORONTO PENFIL NOO 0505500 F 
6                           01959220    HUMULIN-R CARTRIDGE       LIL 0585100 F 
42                          500U/ML INJECTION SOLUTION (2X3ML)                  
6                           02466864    ENTUZITY KWIKPEN          LIL 1136200 F 
41                          INSULIN (REGULAR) LISPRO                            
42                          100U/ML INJECTION SOLUTION (10ML)                   
6                           02469901    ADMELOG                   AVT 0227000 F 
42                         ?100U/ML INJECTION SOLUTION (5X3ML)                  
6                           02469871    ADMELOG (SOLOSTAR PF PEN) AVT 0450000 F 
6                           02469898    ADMELOG (CARTRIDGE)       AVT 0450000 F 
42                          200U/ML INJECTION SOLUTION (5X3ML)                  
6                           02439611    HUMALOG KWIKPEN           LIL 1330600 F 
41                          INSULIN (REGULAR/ISOPHANE) HUMAN BIOSYNTHETIC       
42                         ?100U/ML INJECTION SUSPENSION 30%/70% (10ML)         
6                           02024217    NOVOLIN GE 30/70          NOO 0264500 F 
6                           00795879    HUMULIN 30/70             LIL 0292400 F 
42                         ?100U/ML INJECTION SUSPENSION 30%/70%                
43                          (5X3ML)                                             
6                           02025248    NOVOLIN GE 30/70 PENFILL  NOO 0500100 F 
6                           01959212    HUMULIN 30/70 CARTRIDGE   LIL 0585100 F 
41                          INSULIN DEGLUDEC                                    
42                         ?100UNIT/ML INJECTION SOLUTION                       
6                           02467860    TRESIBA U-100 PENFILL     NOO 1165600 F 
6                           02467879    TRESIBA U-100 FLEXTOUCH   NOO 1165600 F 
42                          200UNIT/ML INJECTION SOLUTION                       
6                           02467887    TRESIBA U-200 FLEXTOUCH   NOO 1398800 F 
41                          INSULIN DETEMIR                                     
42                          100U/ML INJECTION SOLUTION                          
6                           02271842    LEVEMIR PENFILL           NOO 1167600 F 
41                          INSULIN GLARGINE                                    
42                          100U/ML INJECTION SOLUTION (5X3ML)                  
61                          02251930    LANTUS (EDS)              AVT 0928500 E 
42                         ?100U/ML-INJECTION SOLUTION (5X3ML)                  
6                           02444844    BASAGLAR                  LIL 0834800 F 
6                           02461528    BASAGLAR KWIKPEN          LIL 0834800 F 
42                          100U/ML INJECTION-SOLUTION (5X3ML)                  
6                           02526441    SEMGLEE                   BBL 0638400 F 
41                          INSULIN GLULISINE                                   
42                          100U/ML INJECTION SOLUTION (10ML)                   
6                           02279460    APIDRA                    AVT 0287600 F 
42                          100U/ML INJECTION SOLUTION (5X3ML)                  
6                           02294346    APIDRA SOLOSTAR           AVT 0575400 F 
42                          100U/ML-INJECTION SOLUTION (5X3ML)                  
6                           02279479    APIDRA                    AVT 0569900 F 
2         MEGLITINIDE ANALOGUES                                                 
41                          REPAGLINIDE                                         
42                         *0.5MG TABLET                                        
6                           02321475    ACT REPAGLINIDE           TEV 0000808 F 
6                           02354926    JAMP-REPAGLINIDE          JPC 0000808 F 
6                           02357453    SANDOZ REPAGLINIDE        SDZ 0000808 F 
6                           02424258    AURO-REPAGLINIDE          API 0000808 F 
42                         *1MG TABLET                                          
6                           02321483    ACT REPAGLINIDE           TEV 0000840 F 
6                           02354934    JAMP-REPAGLINIDE          JPC 0000840 F 
6                           02357461    SANDOZ REPAGLINIDE        SDZ 0000840 F 
6                           02424266    AURO-REPAGLINIDE          API 0000840 F 
42                         *2MG TABLET                                          
6                           02321491    ACT REPAGLINIDE           TEV 0000873 F 
6                           02354942    JAMP-REPAGLINIDE          JPC 0000873 F 
6                           02357488    SANDOZ REPAGLINIDE        SDZ 0000873 F 
6                           02424274    AURO-REPAGLINIDE          API 0000873 F 
6                           02239926    GLUCONORM                 NOO 0003634 F 
2         SGLT2 INHIBITORS                                                      
41                          CANAGLIFLOZIN                                       
42                         *100MG TABLET                                        
6                           02510367    AURO-CANAGLIFLOZIN        API 0007228 F 
6                           02543486    JAMP CANAGLIFLOZIN        JPC 0007228 F 
6                           02564556    APO-CANAGLIFLOZIN         APX 0007228 F 
6                           02425483    INVOKANA                  JAN 0028910 F 
42                         *300MG TABLET                                        
6                           02510375    AURO-CANAGLIFLOZIN        API 0007515 F 
6                           02543494    JAMP CANAGLIFLOZIN        JPC 0007515 F 
6                           02564564    APO-CANAGLIFLOZIN         APX 0007515 F 
6                           02425491    INVOKANA                  JAN 0030060 F 
41                          DAPAGLIFLOZIN                                       
42                         *5MG TABLET                                          
6                           02518732    SANDOZ DAPAGLIFLOZIN      SDZ 0006825 F 
6                           02519852    GLN-DAPAGLIFLOZIN         GLN 0006825 F 
6                           02527189    APO-DAPAGLIFLOZIN         APX 0006825 F 
6                           02531364    JAMP-DAPAGLIFLOZIN        JPC 0006825 F 
6                           02531402    AURO-DAPAGLIFLOZIN        API 0006825 F 
6                           02531550    PMS-DAPAGLIFLOZIN         PMS 0006825 F 
6                           02535297    M-DAPAGLIFLOZIN           MNP 0006825 F 
6                           02538334    NRA-DAPAGLIFOZIN          NRA 0006825 F 
6                           02561328    DAPAGLIFLOZIN             SAN 0006825 F 
6                           02435462    FORXIGA                   AST 0027300 F 
42                         *10MG TABLET                                         
6                           02518740    SANDOZ DAPAGLIFLOZIN      SDZ 0006825 F 
6                           02519860    GLN-DAPAGLIFLOZIN         GLN 0006825 F 
6                           02527197    APO-DAPAGLIFLOZIN         APX 0006825 F 
6                           02531372    JAMP DAPAGLIFLOZIN        JPC 0006825 F 
6                           02531410    AURO-DAPAGLIFLOZIN        API 0006825 F 
6                           02531569    PMS-DAPAGLIFLOZIN         PMS 0006825 F 
6                           02535300    M-DAPAGLIFLOZIN           MNP 0006825 F 
6                           02538342    NRA-DAPAGLIFLOZIN         NRA 0006825 F 
6                           02561336    DAPAGLIFLOZIN             SAN 0006825 F 
6                           02435470    FORXIGA                   AST 0027300 F 
41                          DAPAGLIFLOZIN/METFORMIN HCL                         
42                         *5MG/850MG TABLET                                    
6                           02533073    AURO-DAPAGLI/METFORMIN    API 0006432 F 
6                           02536153    APO-DAPAGLIF/METFORMIN    APX 0006432 F 
6                           02449935    XIGDUO                    AST 0012863 F 
42                         *5MG/1000MG TABLET                                   
6                           02533081    AURO-DAPAGLI/METFORMIN    API 0006432 F 
6                           02536161    APO-DAPAGLIF/METFORMIN    APX 0006432 F 
6                           02449943    XIGDUO                    AST 0012863 F 
41                          EMPAGLIFLOZIN                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG TABLET                                         
61                          02443937    JARDIANCE (EDS)           BOE 0028157 E 
42                          25MG TABLET                                         
61                          02443945    JARDIANCE (EDS)           BOE 0028157 E 
41                          EMPAGLIFLOZIN/METFORMIN HCL                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG/500MG TABLET                                    
61                          02456575    SYNJARDY (EDS)            BOE 0014227 E 
42                          5MG/850MG TABLET                                    
61                          02456583    SYNJARDY (EDS)            BOE 0014227 E 
42                          5MG/1000MG TABLET                                   
61                          02456591    SYNJARDY (EDS)            BOE 0014227 E 
42                          12.5MG/500MG TABLET                                 
61                          02456605    SYNJARDY (EDS)            BOE 0014227 E 
42                          12.5MG/850MG TABLET                                 
61                          02456613    SYNJARDY (EDS)            BOE 0014227 E 
42                          12.5MG/1000MG TABLET                                
61                          02456621    SYNJARDY (EDS)            BOE 0014227 E 
2         SULFONYLUREA INSULIN SECRETAGOGUES                                    
41                          CHLORPROPAMIDE                                      
42                          100MG TABLET                                        
6                           00399302    APO-CHLORPROPAMIDE        APX 0000745 F 
42                          250MG TABLET                                        
6                           00312711    APO-CHLORPROPAMIDE        APX 0000760 F 
41                          GLICLAZIDE                                          
42                         *30MG MODIFIED RELEASE TABLET                        
6                           02297795    APO-GLICLAZIDE MR         APX 0000931 F 
6                           02423286    MINT-GLICLAZIDE MR        MNT 0000931 F 
6                           02429764    JAMP GLICLAZIDE-MR        JPC 0000931 F 
6                           02438658    MYLAN-GLICLAZIDE MR       MYL 0000931 F 
6                           02461323    SANDOZ GLICLAZIDE MR      SDZ 0000931 F 
6                           02463571    TARO-GLICLAZIDE MR        SUN 0000931 F 
6                           02524856    GLICLAZIDE MR             SAN 0000931 F 
6                           02242987    DIAMICRON MR              SEV 0001660 F 
42                         *60MG MODIFIED RELEASE TABLET                        
6                           02407124    APO-GLICLAZIDE MR         APX 0000632 F 
6                           02423294    MINT-GLICLAZIDE MR        MNT 0000632 F 
6                           02429772    JAMP GLICLAZIDE-MR        JPC 0000632 F 
6                           02439328    TARO-GLICLAZIDE MR        SUN 0000632 F 
6                           02461331    SANDOZ GLICLAZIDE MR      SDZ 0000632 F 
6                           02356422    DIAMICRON MR              SEV 0002990 F 
41                          GLYBURIDE                                           
42                         *2.5MG TABLET                                        
6                           01913654    APO-GLYBURIDE             APX 0000321 F 
6                           01913670    TEVA-GLYBURIDE            TEV 0000321 F 
42                         *5MG TABLET                                          
6                           01913662    APO-GLYBURIDE             APX 0000573 F 
6                           01913689    TEVA-GLYBURIDE            TEV 0000573 F 
6                           02350467    GLYBURIDE                 SAN 0000573 F 
2         THIAZOLIDINEDIONES                                                    
41                          PIOGLITAZONE HCL                                    
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *15MG TABLET                                         
61                          02274914    TEVA-PIOGLITAZONE (EDS)   TEV 0006225 E 
61                          02297906    SANDOZ PIOGLITAZONE (EDS) SDZ 0006225 E 
61                          02302861    TEVA-PIOGLITAZONE (EDS)   TEV 0006225 E 
61                          02302942    APO-PIOGLITAZONE (EDS)    APX 0006225 E 
61                          02326477    MINT-PIOGLITAZONE (EDS)   MNT 0006225 E 
61                          02375850    RAN-PIOGLITAZONE (EDS)    RAN 0006225 E 
61                          02391600    PIOGLITAZONE (EDS)        AHI 0006225 E 
61                          02397307    JAMP-PIOGLITAZONE (EDS)   JPC 0006225 E 
61                          02434121    VAN-PIOGLITAZONE (EDS)    VAN 0006225 E 
42                         *30MG TABLET                                         
61                          02274922    TEVA-PIOGLITAZONE (EDS)   TEV 0008721 E 
61                          02297914    SANDOZ PIOGLITAZONE (EDS) SDZ 0008721 E 
61                          02302888    TEVA-PIOGLITAZONE (EDS)   TEV 0008721 E 
61                          02302950    APO-PIOGLITAZONE (EDS)    APX 0008721 E 
61                          02326485    MINT-PIOGLITAZONE (EDS)   MNT 0008721 E 
61                          02339587    PIOGLITAZONE (EDS)        AHI 0008721 E 
61                          02365529    JAMP-PIOGLITAZONE (EDS)   JPC 0008721 E 
61                          02375869    RAN-PIOGLITAZONE (EDS)    RAN 0008721 E 
61                          02434148    VAN-PIOGLITAZONE (EDS)    VAN 0008721 E 
42                         *45MG TABLET                                         
61                          02274930    TEVA-PIOGLITAZONE (EDS)   TEV 0013113 E 
61                          02297922    SANDOZ PIOGLITAZONE (EDS) SDZ 0013113 E 
61                          02302896    TEVA-PIOGLITAZONE (EDS)   TEV 0013113 E 
61                          02302977    APO-PIOGLITAZONE (EDS)    APX 0013113 E 
61                          02326493    MINT-PIOGLITAZONE (EDS)   MNT 0013113 E 
61                          02339595    PIOGLITAZONE (EDS)        AHI 0013113 E 
61                          02365537    JAMP-PIOGLITAZONE (EDS)   JPC 0013113 E 
61                          02375877    RAN-PIOGLITAZONE (EDS)    RAN 0013113 E 
61                          02434156    VAN-PIOGLITAZONE (EDS)    VAN 0013113 E 
41                          ROSIGLITAZONE MALEATE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG TABLET                                          
61                          02403366    ROSIGLITAZONE (EDS)       AAP 0010316 E 
42                          4MG TABLET                                          
61                          02403374    ROSIGLITAZONE (EDS)       AAP 0016188 E 
42                          8MG TABLET                                          
61                          02403382    ROSIGLITAZONE (EDS)       AAP 0023150 E 
2         PARATHYROID DRUGS                                                     
41                          CALCITONIN SALMON                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200IU/ML INJECTION (2ML)                            
61                          01926691    CALCIMAR (EDS)            AVT 0654400 E 
2         PITUITARY DRUGS                                                       
41                          DESMOPRESSIN                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.1MG TABLET                                        
61                          02284030    APO-DESMOPRESSIN (EDS)    APX 0006609 E 
61                          02304368    PMS-DESMOPRESSIN (EDS)    PMS 0006609 E 
42                         *0.2MG TABLET                                        
61                          02284049    APO-DESMOPRESSIN (EDS)    APX 0013217 E 
61                          02304376    PMS-DESMOPRESSIN (EDS)    PMS 0013217 E 
42                          60UG ORALLY DISINTEGRATING TABLET                   
61                          02284995    DDAVP MELT (EDS)          FEI 0014860 E 
42                          120UG ORALLY DISINTEGRATING TABLET                  
61                          02285002    DDAVP MELT (EDS)          FEI 0029733 E 
42                         *4UG/ML INJECTION (1ML)                              
61                          02513579    BIPAZEN (EDS)             KVR 0090000 E 
61                          00873993    D.D.A.V.P. (EDS)          FEI 0115490 E 
42                          10UG/DOSE INTRANASAL SOLUTION (SPRAY PUMP)          
61                          02242465    DESMOPRESSIN (EDS)        AAP 0927654 E 
41                          SOMATROGON                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          24MG/1.2ML PRE-FILLED PEN                           
61                          02521679    NGENLA (EDS)              PFI 3524100 E 
42                          60MG/1.2ML PRE-FILLED PEN                           
61                          02521687    NGENLA (EDS)              PFI 8810200 E 
41                          SOMATROPIN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.6MG/SYRINGE                                       
61                          02401762    GENOTROPIN (EDS)          PFI 0180100 E 
42                          0.8MG/SYRINGE                                       
61                          02401770    GENOTROPIN (EDS)          PFI 0244657 E 
42                          1.0MG/SYRINGE                                       
61                          02401789    GENOTROPIN (EDS)          PFI 0305800 E 
42                          1.2MG/SYRINGE                                       
61                          02401797    GENOTROPIN (EDS)          PFI 0367043 E 
42                          1.4MG/SYRINGE                                       
61                          02401800    GENOTROPIN (EDS)          PFI 0428171 E 
42                          1.6MG/SYRINGE                                       
61                          02401819    GENOTROPIN (EDS)          PFI 0489314 E 
42                          1.8MG/SYRINGE                                       
61                          02401827    GENOTROPIN (EDS)          PFI 0550457 E 
42                          2.0MG/SYRINGE                                       
61                          02401835    GENOTROPIN (EDS)          PFI 0611600 E 
42                          5MG INJECTION (VIAL)                                
61                          02237971    SAIZEN (EDS)              SRO 2340000 E 
42                          5MG/1.5ML INJECTION (CARTRIDGE)                     
61                          02325063    OMNITROPE (EDS)           SDZ 1558000 E 
42                          5MG/1.5ML PRE-FILLED PEN (PEN)                      
61                          02529181    NORDITROPIN FLEXPRO (EDS) NOO 1987800 E 
42                          5.3MG/PEN                                           
61                          02401703    GENOTROPIN (EDS)          PFI 1620920 E 
42                          6MG INJECTION (CARTRIDGE)                           
61                          02350122    SAIZEN (EDS)              SRO 2807800 E 
42                          6MG INJECTION-(CARTRIDGE)                           
61                          02243077    HUMATROPE CARTRIDGE (EDS) LIL 3556500 E 
42                          10MG/1.5ML PRE-FILLED PEN (PEN)                     
61                          02529203    NORDITROPIN FLEXPRO (EDS) NOO 3975700 E 
42                          10MG/1.5ML INJECTION (CARTRIDGE)                    
61                          02325071    OMNITROPE (EDS)           SDZ 3116000 E 
42                          12MG INJECTION (CARTRIDGE)                          
61                          02350130    SAIZEN (EDS)              SRO 5615600 E 
42                          12MG INJECTION-(CARTRIDGE)                          
61                          02243078    HUMATROPE CARTRIDGE (EDS) LIL 7112900 E 
42                          12MG/PEN                                            
61                          02401711    GENOTROPIN (EDS)          PFI 3601400 E 
42                          15MG/1.5ML INJECTION (CARTRIDGE)                    
61                          02459647    OMNITROPE (EDS)           SDZ 4674000 E 
42                          15MG/1.5ML PRE-FILLED PEN (PEN)                     
61                          02529211    NORDITROPIN FLEXPRO (EDS) NOO 5963600 E 
42                          20MG INJECTION (CARTRIDGE)                          
61                          02350149    SAIZEN (EDS)              SRO 9359300 E 
42                          24MG INJECTION (CARTRIDGE)                          
61                          02243079    HUMATROPE (EDS)           LIL 9999900 E 
2         GROWTH HORMONE AGONISTS                                               
41                          MECASERMIN                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML (4ML VIAL) (MG)                             
61                          02509733    INCRELEX (EDS)            IPS 1479200 E 
2         PROGESTOGENS                                                          
41                          DIENOGEST                                           
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *2MG TABLET                                          
61                          02493055    ASPEN-DIENOGEST (EDS)     ASC 0005115 E 
61                          02498189    JAMP DIENOGEST (EDS)      JPC 0005115 E 
61                          02543613    M-DIENOGEST (EDS)         MNP 0005115 E 
61                          02551683    MAR-DIENOGEST (EDS)       MPI 0005115 E 
61                          02374900    VISANNE (EDS)             BAY 0022314 E 
41                          MEDROXYPROGESTERONE ACETATE                         
42                         *2.5MG TABLET                                        
6                           02244726    AA-MEDROXY                AAP 0001301 F 
6                           00708917    PROVERA                   PFI 0002567 F 
42                         *5MG TABLET                                          
6                           02244727    AA-MEDROXY                AAP 0002602 F 
6                           00030937    PROVERA                   PFI 0005274 F 
42                         *10MG TABLET                                         
6                           02277298    AA-MEDROXY                AAP 0005649 F 
6                           00729973    PROVERA                   PFI 0010271 F 
42                          150MG/ML INJECTION SUSPENSION (1ML)                 
6                           02523493    DEPO-PROVERA              PFI 0347800 F 
41                          PROGESTERONE (MICRONIZED)                           
42                         *100MG CAPSULE                                       
6                           02439913    TEVA-PROGESTERONE         TEV 0003762 F 
6                           02463113    REDDY-PROGESTERONE        DLC 0003762 F 
6                           02476576    PMS-PROGESTERONE          PMS 0003762 F 
6                           02493578    AURO-PROGESTERONE         API 0003762 F 
6                           02516187    PROGESTERONE              SAN 0003762 F 
6                           02549158    ACH-PROGESTERONE          AHI 0003762 F 
6                           02551268    M-PROGESTERONE            MNP 0003762 F 
6                           02166704    PROMETRIUM                ORG 0017533 F 
2         THYROID DRUGS                                                         
41                          LEVOTHYROXINE (SODIUM)                              
42                         *0.025MG TABLET                                      
6                           02550709    APO-LEVOTHYROXINE         APX 0000597 F 
6                           02172062    SYNTHROID                 BGP 0001102 F 
42                         *0.05MG TABLET                                       
6                           02213192    ELTROXIN                  ASC 0000373 F 
6                           02550717    APO-LEVOTHYROXINE         APX 0000373 F 
6                           02172070    SYNTHROID                 BGP 0000758 F 
42                         *0.075MG TABLET                                      
6                           02550725    APO-LEVOTHYROXINE         APX 0000646 F 
6                           02172089    SYNTHROID                 BGP 0001192 F 
42                         *0.088MG TABLET                                      
6                           02550733    APO-LEVOTHYROXINE         APX 0000646 F 
6                           02172097    SYNTHROID                 BGP 0001192 F 
42                         *0.1MG TABLET                                        
6                           02213206    ELTROXIN                  ASC 0000460 F 
6                           02534681    APO-LEVOTHYROXINE         APX 0000460 F 
6                           02172100    SYNTHROID                 BGP 0000933 F 
42                         *0.112MG TABLET                                      
6                           02550741    APO-LEVOTHYROXINE         APX 0000682 F 
6                           02171228    SYNTHROID                 BGP 0001257 F 
42                         *0.125MG TABLET                                      
6                           02550768    APO-LEVOTHYROXINE         APX 0000690 F 
6                           02172119    SYNTHROID                 BGP 0001272 F 
42                         *0.137MG TABLET                                      
6                           02550776    APO-LEVOTHYROXINE         APX 0001801 F 
6                           02233852    SYNTHROID                 BGP 0002150 F 
42                         *0.15MG TABLET                                       
6                           02213214    ELTROXIN                  ASC 0000495 F 
6                           02550784    APO-LEVOTHYROXINE         APX 0000495 F 
6                           02172127    SYNTHROID                 BGP 0001000 F 
42                         *0.175MG TABLET                                      
6                           02550792    APO-LEVOTHYROXINE         APX 0000740 F 
6                           02172135    SYNTHROID                 BGP 0001364 F 
42                         *0.2MG TABLET                                        
6                           02213222    ELTROXIN                  ASC 0000526 F 
6                           02550806    APO-LEVOTHYROXINE         APX 0000526 F 
6                           02172143    SYNTHROID                 BGP 0001066 F 
42                         *0.3MG TABLET                                        
6                           02534703    APO-LEVOTHYROXINE         APX 0000797 F 
6                           02172151    SYNTHROID                 BGP 0001471 F 
41                          THYROID                                             
42                          30MG TABLET                                         
6                           00023949    THYROID                   SLP 0003862 F 
42                          60MG TABLET                                         
6                           00023957    THYROID                   SLP 0006621 F 
42                          125MG TABLET                                        
6                           00023965    THYROID                   SLP 0011918 F 
2         ANTITHYROID DRUGS                                                     
41                          METHIMAZOLE                                         
42                         *5MG TABLET                                          
6                           02480107    MAR-METHIMAZOLE           MPI 0001531 F 
6                           02490625    JAMP METHIMAZOLE          JPC 0001531 F 
6                           00015741    TAPAZOLE                  KTI 0003074 F 
41                          PROPYLTHIOURACIL                                    
42                         ?50MG TABLET                                         
6                           02521059    HALYCIL                   HCL 0005000 F 
6                           02523019    PROPYLTHIOURACIL TABLETS  PHE 0005000 F 
2         LEPTINS                                                               
41                          METRELEPTIN                                         
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION.SUBMIT QUANTITY PER 100MCG.             
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          3MG SOL FOR SC INJECTION (VIAL) (100MCG)            
61                          02544555    MYALEPTA (EDS)            MSN 0267560 E 
42                          5.8MG SOL FOR SC INJECTION (VIAL) (100MCG)          
61                          02544563    MYALEPTA (EDS)            MSN 0276649 E 
42                          11.3MG SOL FOR SC INJECTION (VIAL) (100MCG)         
61                          02544571    MYALEPTA (EDS)            MSN 0276143 E 
1         OXYTOCIC DRUGS                                                        
2         OXYTOCIC DRUGS                                                        
41                          MIFEPRISTONE/MISOPROSTOL                            
42                         *200MG/200MCG TABLET                                 
6                           02444038    MIFEGYMISO                NOR 1650000 F 
6                           02560569    FEMYSO                    LUP 1650000 F 
1         SKIN AND MUCOUS MEMBRANE DRUGS                                        
2         ANTIBIOTICS                                                           
41                          CLINDAMYCIN PHOSPHATE                               
42                          1% TOPICAL SOLUTION                                 
6                           02266938    TARO-CLINDAMYCIN          TAR 0004311 F 
41                          CLINDAMYCIN PO4/ADAPALENE/BENZOYL PEROXIDE          
42                          1.2%/0.15%/3.1% TOPICAL GEL                         
6                           02550423    CABTREO                   BAU 0030074 F 
41                          FUSIDIC ACID                                        
42                         *2% TOPICAL CREAM                                    
6                           02528096    TARO-FUSIDIC ACID         TAR 0005676 F 
6                           00586668    FUCIDIN                   LEO 0010790 F 
41                          MUPIROCIN                                           
42                          2% OINTMENT                                         
6                           02279983    TARO-MUPIROCIN            TAR 0005623 F 
41                          SODIUM FUSIDATE                                     
42                         *2% TOPICAL OINTMENT                                 
6                           02565587    TARO-SODIUM FUSIDATE      TAR 0008402 F 
6                           00586676    FUCIDIN                   LEO 0010790 F 
2         ANTIFUNGALS                                                           
41                          CICLOPIROX OLAMINE                                  
42                          1% TOPICAL CREAM                                    
6                           02221802    LOPROX                    BAU 0003712 F 
41                          CLOTRIMAZOLE                                        
42                          1% TOPICAL CREAM                                    
6                           00812382    CLOTRIMADERM              TAR 0002977 F 
42                          1% VAGINAL CREAM                                    
6                           00812366    CLOTRIMADERM              TAR 0002275 F 
42                          2% VAGINAL CREAM                                    
6                           00812374    CLOTRIMADERM              TAR 0004642 F 
41                          KETOCONAZOLE                                        
42                          2% TOPICAL CREAM                                    
6                           02245662    KETODERM                  TPM 0004801 F 
41                          MICONAZOLE NITRATE                                  
42                          100MG VAGINAL SUPPOSITORY/2% TOPICAL CREAM          
43                          (COMBINATION PACKAGE)                               
6                           02126257    MONISTAT 7 COMBINATION    IPC 0143100 F 
42                         *2% VAGINAL CREAM                                    
6                           02231106    MICOZOLE                  TAR 0002829 F 
6                           02084309    MONISTAT-7                IPC 0003571 F 
42                          2% TOPICAL CREAM                                    
6                           02085852    MICATIN                   WEL 0003000 F 
41                          NYSTATIN                                            
42                          100,000U/G TOPICAL CREAM                            
6                           00716871    NYADERM                   TAR 0002037 F 
42                          100,000U/G TOPICAL OINTMENT                         
6                           02194228    RATIO-NYSTATIN            RPH 0001277 F 
42                          25,000U/G VAGINAL CREAM                             
6                           00716901    NYADERM                   TAR 0001541 F 
42                          100,000U/G VAGINAL CREAM                            
6                           02194163    RATIO-NYSTATIN            RPH 0003191 F 
41                          TERBINAFINE HCL                                     
42                          1% TOPICAL CREAM                                    
6                           02031094    LAMISIL                   NVR 0006217 F 
42                          1% TOPICAL SPRAY SOLUTION                           
6                           02238703    LAMISIL                   NVR 0006307 F 
41                          TERCONAZOLE                                         
42                          0.4% VAGINAL CREAM (PKG)                            
6                           02247651    TARO-TERCONAZOLE          TAR 0336620 F 
2         SCABICIDES AND PEDICULICIDES                                          
41                          ISOPROPYL MYRISTATE                                 
42                          50% TOPICAL SOLUTION                                
6                           02279592    RESULTZ                   APH 0001022 F 
41                          PERMETHRIN                                          
42                         *1% CREME RINSE                                      
6                           00771368    NIX CREME RINSE           IPC 0002163 F 
6                           02231480    KWELLADA-P CREME RINSE    MTP 0002328 F 
42                          5% TOPICAL CREAM                                    
6                           02219905    NIX DERMAL CREAM          HLN 0004977 F 
42                          5% TOPICAL LOTION                                   
6                           02231348    KWELLADA-P LOTION         MTP 0005053 F 
41                          PYRETHINS/PIPERONYL BUTOXIDE/                       
41                          PETROLEUM DISTILLATE                                
42                          0.33%/3.0%/1.2% SHAMPOO/CONDITIONER                 
6                           02125447    R&C SHAMPOO/CONDITIONER   MTP 0001538 F 
2         MISC. SKIN/MUCOUS MEMBRANE ANTI-INFECTIVES                            
41                          METRONIDAZOLE                                       
42                          1% TOPICAL GEL                                      
6                           02297809    METROGEL                  GAC 0007315 F 
42                          1% TOPICAL CREAM                                    
6                           02156091    NORITATE                  BAU 0007220 F 
42                          0.75% VAGINAL GEL                                   
6                           02125226    NIDAGEL                   BAU 0003581 F 
42                          10% VAGINAL CREAM                                   
6                           01926861    FLAGYL                    AVT 0002740 F 
2         ANTI-INFLAMMATORY DRUGS                                               
41                          AMCINONIDE                                          
42                          0.1% TOPICAL CREAM                                  
6                           02246714    TARO-AMCINONIDE           TAR 0004522 F 
42                          0.1% TOPICAL OINTMENT                               
6                           02247096    RATIO-AMCINONIDE          RPH 0003609 F 
42                          0.1% TOPICAL LOTION                                 
6                           02247097    RATIO-AMCINONIDE          RPH 0002997 F 
41                          BECLOMETHASONE DIPROPIONATE                         
42                          0.025% TOPICAL CREAM                                
6                           02089602    PROPADERM                 BAU 0005429 F 
41                          BETAMETHASONE DIPROPIONATE                          
42                         *0.05% TOPICAL CREAM                                 
6                           00804991    TEVA-TOPISONE             TEV 0002047 F 
6                           01925350    TARO-SONE                 TAR 0002047 F 
6                           00323071    DIPROSONE                 ORG 0002174 F 
42                         *0.05% TOPICAL OINTMENT                              
6                           00805009    TEVA-TOPISONE             RPH 0002187 F 
6                           00344923    DIPROSONE                 ORG 0002284 F 
42                         *0.05% TOPICAL LOTION                                
6                           00809187    TEVA-TOPISONE             TEV 0002023 F 
6                           00417246    DIPROSONE                 ORG 0002100 F 
42                          0.05% TOPICAL GLYCOL CREAM                          
6                           00849650    TEVA-TOPILENE             TEV 0005187 F 
42                         *0.05% TOPICAL GLYCOL OINTMENT                       
6                           00849669    TEVA-TOPILENE             TEV 0005187 F 
6                           00629367    DIPROLENE                 ORG 0005186 F 
42                          0.05% TOPICAL GLYCOL LOTION                         
6                           01927914    TEVA-TOPILENE             TEV 0005620 F 
41                          BETAMETHASONE DIPROPIONATE/                         
41                          SALICYLIC ACID                                      
42                          0.05%/3% TOPICAL OINTMENT                           
6                           00578436    DIPROSALIC                ORG 0012078 F 
42                          0.05%/2% TOPICAL LOTION                             
6                           02245688    RATIO-TOPISALIC           RPH 0004652 F 
41                          BETAMETHASONE VALERATE                              
42                         *0.05% TOPICAL CREAM                                 
6                           02357860    CELESTODERM V/2           BAU 0000596 F 
6                           00535427    RATIO-ECTOSONE            RPH 0000606 F 
6                           00716618    BETADERM                  TAR 0000606 F 
42                         *0.1% TOPICAL CREAM                                  
6                           00535435    RATIO-ECTOSONE            RPH 0000991 F 
6                           02357844    CELESTODERM V             BAU 0000889 F 
6                           00716626    BETADERM                  TAR 0000991 F 
42                          0.05% TOPICAL OINTMENT                              
6                           00716642    BETADERM                  TAR 0000748 F 
42                          0.1% TOPICAL OINTMENT                               
6                           00716650    BETADERM                  TAR 0001115 F 
42                          0.05% TOPICAL LOTION                                
6                           00653209    RATIO-ECTOSONE MILD       RPH 0002847 F 
42                          0.1% TOPICAL LOTION                                 
6                           00750050    RATIO-ECTOSONE            RPH 0003529 F 
42                          0.1% SCALP LOTION                                   
6                           00716634    BETADERM                  TAR 0001271 F 
41                          BUDESONIDE                                          
42                          0.02MG/ML ENEMA (100ML)                             
6                           02052431    ENTOCORT                  TIL 0118457 F 
42                          2MG PER ACTUATION RECTAL FOAM (ACT)                 
6                           02498057    UCERIS                    BAU 0071400 F 
41                          CALCIPOTRIOL/BETAMETHASONE DIPROPIONATE             
42                          50MCG/0.5MG/G TOPICAL AEROSOL FOAM                  
6                           02457393    ENSTILAR                  LEO 0016397 F 
41                          CLOBETASOL PROPIONATE                               
42                         *0.05% TOPICAL CREAM                                 
6                           01910272    TEVA-CLOBETASOL           TEV 0002623 F 
6                           02024187    MYLAN-CLOBETASOL          MYL 0002623 F 
6                           02245523    TARO-CLOBETASOL CREAM     TAR 0002623 F 
6                           02213265    DERMOVATE                 TPM 0010316 F 
42                         *0.05% TOPICAL OINTMENT                              
6                           01910280    TEVA-CLOBETASOL           TEV 0002623 F 
6                           02026767    MYLAN-CLOBETASOL          MYL 0002623 F 
6                           02245524    TARO-CLOBETASOL OINTMENT  TAR 0002623 F 
6                           02213273    DERMOVATE                 TPM 0010315 F 
42                         *0.05% SCALP APPLICATION                             
6                           02216213    MYLAN-CLOBETASOL          MYL 0003996 F 
6                           02245522    TARO-CLOBETASOL SOLUTION  TAR 0003996 F 
6                           02213281    DERMOVATE                 TPM 0008272 F 
41                          CLOBETASONE BUTYRATE                                
42                          0.05% TOPICAL CREAM                                 
6                           02214415    SPECTRO ECZEMA CARE       HLN 0003817 F 
41                          DESONIDE                                            
42                          0.05% TOPICAL CREAM                                 
6                           02229315    PDP-DESONIDE              PED 0004737 F 
42                          0.05% TOPICAL OINTMENT                              
6                           02229323    PDP-DESONIDE              PED 0004737 F 
41                          DESOXIMETASONE                                      
42                          0.05% TOPICAL CREAM                                 
6                           02221918    TOPICORT MILD             BAU 0006010 F 
42                          0.25% TOPICAL CREAM                                 
6                           02221896    TOPICORT                  BAU 0008455 F 
42                          0.05% TOPICAL GEL                                   
6                           02221926    TOPICORT                  BAU 0006575 F 
42                          0.25% TOPICAL OINTMENT                              
6                           02221934    TOPICORT                  BAU 0008478 F 
41                          FLUOCINOLONE ACETONIDE                              
42                          0.01% TOPICAL OIL                                   
6                           00873292    DERMA-SMOOTHE/FS          HDI 0002979 F 
41                          FLUOCINONIDE                                        
42                         *0.05% TOPICAL CREAM                                 
6                           02161923    LIDEX                     BAU 0002597 F 
6                           00716863    LYDERM                    TPM 0002880 F 
42                          0.05% TOPICAL GEL                                   
6                           02236997    LYDERM                    TPM 0003902 F 
42                          0.05% TOPICAL OINTMENT                              
6                           02236996    LYDERM                    TPM 0003738 F 
41                          HALOBETASOL PROPIONATE                              
42                          0.01% LOTION                                        
6                           02506262    BRYHALI                   BAU 0009816 F 
41                          HALOBETASOL PROPIONATE/TAZAROTENE                   
42                          0.01%/0.045% TOPICAL LOTION                         
6                           02499967    DUOBRII                   BAU 0019300 F 
41                          HYDROCORTISONE                                      
42                          0.5% TOPICAL CREAM                                  
6                           00716820    HYDERM                    TAR 0002248 F 
42                          1% TOPICAL CREAM                                    
6                           02412926    SANDOZ HYDROCORTISONE CR  SDZ 0000859 F 
42                          0.5% TOPICAL OINTMENT                               
6                           00716685    CORTODERM                 TAR 0002245 F 
42                          1% TOPICAL OINTMENT                                 
6                           00716693    CORTODERM                 TAR 0001487 F 
42                          1% TOPICAL LOTION                                   
6                           80057191    JAMP-HYDROCORTISONE       JPC 0001216 F 
41                          HYDROCORTISONE ACETATE                              
42                         *1% TOPICAL CREAM                                    
6                           00716839    HYDERM                    TAR 0000875 F 
6                           80057178    JAMP-HYDROCORTISONE ACETA JPC 0000875 F 
41                          HYDROCORTISONE VALERATE                             
42                          0.2% TOPICAL CREAM                                  
6                           02242984    HYDROVAL                  TPM 0001916 F 
42                          0.2% TOPICAL OINTMENT                               
6                           02242985    HYDROVAL                  TPM 0001916 F 
41                          MOMETASONE FUROATE                                  
42                         *0.1% TOPICAL CREAM                                  
6                           02367157    TARO-MOMETASONE CREAM     TAR 0006492 F 
6                           00851744    ELOCOM                    ORG 0007394 F 
42                         *0.1% TOPICAL OINTMENT                               
6                           02248130    RATIO-MOMETASONE          RPH 0006013 F 
6                           00851736    ELOCOM                    ORG 0007342 F 
42                         *0.1% TOPICAL LOTION                                 
6                           02266385    TARO-MOMETASONE LOTION    TAR 0004308 F 
6                           00871095    ELOCOM                    ORG 0005255 F 
41                          TRIAMCINOLONE ACETONIDE                             
42                         *0.1% TOPICAL CREAM                                  
6                           00716960    TRIADERM                  TAR 0001196 F 
6                           02194058    ARISTOCORT R              BAU 0001570 F 
42                          0.1% TOPICAL OINTMENT                               
6                           02194031    ARISTOCORT R              BAU 0001584 F 
42                          0.1% ORAL TOPICAL OINTMENT                          
6                           01964054    ORACORT DENTAL PASTE      TAR 0017317 F 
2         ANTI-INFECTIVE/ANTI-INFLAMMATORY COMBINATIONS                         
41                          BETAMETHASONE DIPROPIONATE/CLOTRIMAZOLE             
42                         *0.05%/1% TOPICAL CREAM                              
6                           02496410    TARO-CLOTRI/BETAMETHASONE TAR 0006964 F 
6                           00611174    LOTRIDERM                 ORG 0013008 F 
41                          FUSIDIC ACID/HYDROCORTISONE ACETATE                 
42                          2%/1% TOPICAL CREAM                                 
6                           02238578    FUCIDIN H                 LEO 0019183 F 
41                          NEOMYCIN/GRAMICIDIN/NYSTATIN/                       
41                          TRIAMCINOLONE ACETONIDE                             
42                         *2.5MG/0.25MG/100,000U/1MG PER G                     
43                          TOPICAL CREAM                                       
6                           00550507    RATIO-TRIACOMB            RPH 0004027 F 
6                           00717002    VIADERM-KC                TAR 0004142 F 
42                          2.5MG/0.25MG/100,000U/1MG PER G                     
43                          TOPICAL OINTMENT                                    
6                           00717029    VIADERM-KC                TAR 0006911 F 
2         TOPICAL PROLIFERANTS                                                  
41                          ADAPALENE                                           
42                          0.1% TOPICAL CREAM                                  
6                           02231592    DIFFERIN                  GAC 0022643 F 
42                          0.1% TOPICAL GEL                                    
6                           02148749    DIFFERIN                  GAC 0022643 F 
41                          TRETINOIN                                           
42                          0.025% TOPICAL GEL                                  
6                           00443816    RETIN A                   BAU 0005310 F 
42                          0.05% TOPICAL CREAM                                 
6                           00443794    RETIN A                   BAU 0005310 F 
2         KERATOLYTICS                                                          
41                          ADAPALENE/BENZOYL PEROXIDE                          
42                         *0.1%/2.5% TOPICAL GEL                               
6                           02456923    TARO-ADAPALENE BENZOYL PR TAR 0007482 F 
6                           02489007    SANDOZ ADAPALENE/BENZ PER SDZ 0007482 F 
6                           02365871    TACTUPUMP                 GAC 0016669 F 
42                         *0.3%/2.5% TOPICAL GEL                               
6                           02505053    TARO-ADAPALENE/BENZOYL    TAR 0012693 F 
6                           02517205    SANDOZ ADAPALENE/BENZOYL  SDZ 0012693 F 
6                           02446235    TACTUPUMP FORTE           GAC 0027179 F 
41                          BENZOYL PEROXIDE                                    
42                          10% WASH                                            
6                           01925199    BENZAC W                  GAC 0004928 F 
41                          CLINDAMYCIN PHOSPHATE/BENZOYL PEROXIDE              
42                          1%/3% TOPICAL GEL                                   
6                           02382822    CLINDOXYL ADV GEL         GSK 0008436 F 
42                         *1%/5% TOPICAL GEL                                   
6                           02440180    TARO-CLINDAMYCIN/BENZOYL  TAR 0006857 F 
6                           02243158    CLINDOXYL GEL             GSK 0007680 F 
42                         *1%/5%-TOPICAL GEL                                   
6                           02464519    TARO-BENZOYL/CLINDMYCIN   TAR 0007422 F 
6                           02248472    BENZACLIN                 BAU 0011786 F 
41                          ERYTHROMYCIN/BENZOYL PEROXIDE                       
42                          3%/5% TOPICAL GEL                                   
6                           02225271    BENZAMYCIN                BAU 0014742 F 
2         MISCELLANEOUS SKIN AND MUCOUS MEMBRANE DRUGS                          
41                          ACITRETIN                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG CAPSULE                                        
61                          02466074    TARO-ACITRETIN (EDS)      TAR 0012965 E 
61                          02468840    MINT-ACITRETIN (EDS)      MNT 0012965 E 
61                          02070847    SORIATANE (EDS)           APH 0028113 E 
42                         *25MG CAPSULE                                        
61                          02466082    TARO-ACITRETIN (EDS)      TAR 0022770 E 
61                          02468859    MINT-ACITRETIN (EDS)      MNT 0022770 E 
61                          02070863    SORIATANE (EDS)           APH 0049373 E 
41                          AZELAIC ACID                                        
42                          15% TOPICAL GEL                                     
6                           02270811    FINACEA                   LEO 0008442 F 
41                          CALCIPOTRIOL                                        
42                          50UG/G TOPICAL OINTMENT                             
6                           01976133    DOVONEX                   LEO 0011222 F 
41                          CALCIPOTRIOL/BETAMETHASONE DIPROPIONATE             
42                         *50UG/0.5MG/G TOPICAL OINTMENT                       
6                           02427419    TEVA-BETAMETH/CALCIPOTR   TEV 0012545 F 
6                           02244126    DOVOBET                   LEO 0020887 F 
42                         *50UG/0.5MG/G TOPICAL GEL                            
6                           02525178    TARO-CALCIPOTRIOL/BETAMET TAR 0013142 F 
6                           02319012    DOVOBET GEL               LEO 0020569 F 
41                          CYCLOSPORINE                                        
51                          NOTE:  THE IDENTIFICATION NUMBERS LISTED FOR        
52                          THIS PRODUCT HAVE BEEN GENERATED BY THE             
53                          PRESCRIPTION DRUG PLAN FOR BILLING PURPOSES         
54                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG CAPSULE                                        
61                          00950792    NEORAL (EDS)              NVR 0007370 E 
42                          25MG CAPSULE                                        
61                          00950793    NEORAL (EDS)              NVR 0017133 E 
42                          50MG CAPSULE                                        
61                          00950807    NEORAL (EDS)              NVR 0033420 E 
42                          100MG CAPSULE                                       
61                          00950815    NEORAL (EDS)              NVR 0066863 E 
42                          100MG/ML LIQUID                                     
61                          00950823    NEORAL (EDS)              NVR 0059456 E 
41                          FLUOROURACIL                                        
42                          5% TOPICAL CREAM                                    
6                           00330582    EFUDEX                    BAU 0010605 F 
41                          IMIQUIMOD                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5% TOPICAL CREAM (7.5G PUMP)                        
61                          02482983    TARO-IMIQUIMOD PUMP (EDS) TAR 3326040 E 
61                          02239505    ALDARA P (EDS)            BAU 4575200 E 
41                          ISOTRETINOIN                                        
42                         *10MG CAPSULE                                        
6                           02257955    CLARUS                    MYL 0009313 F 
6                           00582344    ACCUTANE                  XED 0009737 F 
42                          10 MG CAPSULE                                       
6                           02396971    EPURIS                    CPI 0014703 F 
42                          20 MG CAPSULE                                       
6                           02396998    EPURIS                    CPI 0020343 F 
42                          30 MG CAPSULE                                       
6                           02397005    EPURIS                    CPI 0025580 F 
42                         *40MG CAPSULE                                        
6                           02257963    CLARUS                    MYL 0019003 F 
6                           00582352    ACCUTANE                  XED 0019870 F 
42                          40 MG CAPSULE                                       
6                           02397013    EPURIS                    CPI 0029990 F 
41                          IXEKIZUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          80MG/ML SUBCUTANEOUS INJ PF AUTO INJ (MG)           
61                          02455102    TALTZ (EDS)               LIL 0243513 E 
42                          80MG/ML SUBCUTANEOUS INJ PF SYRINGE (MG)            
61                          02455110    TALTZ (EDS)               LIL 0243513 E 
41                          PIMECROLIMUS                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1% TOPICAL CREAM                                    
61                          02247238    ELIDEL (EDS)              BAU 0028677 E 
41                          TACROLIMUS                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.03% TOPICAL OINTMENT                              
61                          02244149    PROTOPIC (EDS)            LEO 0032358 E 
42                          0.1% TOPICAL OINTMENT                               
61                          02244148    PROTOPIC (EDS)            LEO 0034612 E 
41                          TAZAROTENE                                          
42                          0.045% TOPICAL LOTION                               
6                           02517868    ARAZLO                    BAU 0014051 F 
1         ANTISPASMODICS, SMOOTH MUSCLE RELAXANTS                               
2         SMOOTH MUSCLE RELAXANTS, GENITOURINARY SYSTEM                         
41                          DARIFENACIN                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *7.5MG EXTENDED RELEASE TABLET                       
61                          02452510    APO-DARIFENACIN (EDS)     APX 0008058 E 
61                          02491869    JAMP DARIFENACIN (EDS)    JPC 0008058 E 
61                          02273217    ENABLEX (EDS)             SLP 0016958 E 
42                         *15MG EXTENDED RELEASE TABLET                        
61                          02452529    APO-DARIFENACIN (EDS)     APX 0008058 E 
61                          02491877    JAMP DARIFENACIN (EDS)    JPC 0008058 E 
61                          02273225    ENABLEX (EDS)             SLP 0016958 E 
41                          FESOTERODINE FUMARATE                               
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *4MG EXTENDED RELEASE TABLET                         
61                          02521768    SANDOZ FESOTERODINE (EDS) SDZ 0007500 E 
61                          02535998    ACH-FESOTERODINE (EDS)    AHI 0007500 E 
61                          02380021    TOVIAZ (EDS)              PFI 0015793 E 
42                         *8MG EXTENDED RELEASE TABLET                         
61                          02521776    SANDOZ FESOTERODINE (EDS) SDZ 0007500 E 
61                          02536005    ACH-FESOTERODINE (EDS)    AHI 0007500 E 
61                          02380048    TOVIAZ (EDS)              PFI 0015793 E 
41                          MIRABEGRON                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *25MG EXTENDED RELEASE TABLET                        
61                          02564963    APO-MIRABEGRON (EDS)      APX 0008030 E 
61                          02402874    MYRBETRIQ (EDS)           APC 0014600 E 
42                         *50MG EXTENDED RELEASE TABLET                        
61                          02564971    APO-MIRABEGRON (EDS)      APX 0008030 E 
61                          02402882    MYRBETRIQ (EDS)           APC 0014600 E 
41                          OXYBUTYNIN CHLORIDE                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
6                           02163543    APO-OXYBUTYNIN            APX 0000986 F 
6                           02230394    TEVA-OXYBUTYNIN           TEV 0000986 F 
6                           02240550    PMS-OXYBUTYNIN            PMS 0000986 F 
6                           02350238    OXYBUTYNIN                SAN 0000986 F 
42                          1MG/ML SYRUP                                        
6                           02223376    PMS-OXYBUTYNIN            PMS 0002179 F 
41                          PROPIVERINE HCL                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          5MG TABLET                                          
61                          02460289    MICTORYL PEDIATRIC (EDS)  DUI 0003700 E 
41                          SOLIFENACIN SUCCINATE                               
42                         *5MG TABLET                                          
6                           02397900    TEVA-SOLIFENACIN          TEV 0003041 F 
6                           02399032    SANDOZ SOLIFENACIN        SDZ 0003041 F 
6                           02417723    PMS-SOLIFENACIN           PMS 0003041 F 
6                           02424339    JAMP-SOLIFENACIN          JPC 0003041 F 
6                           02428911    JAMP SOLIFENACIN SUCCINAT JPC 0003041 F 
6                           02437988    RAN-SOLIFENACIN           RAN 0003041 F 
6                           02439344    ACH-SOLIFENACIN SUCCINATE AHI 0003041 F 
6                           02446375    AURO-SOLIFENACIN          API 0003041 F 
6                           02458241    SOLIFENACIN               SAN 0003041 F 
6                           02493039    PRZ-SOLIFENACIN           PRZ 0003041 F 
6                           02529696    M-SOLIFENACIN SUCCINATE   MNP 0003041 F 
6                           02277263    VESICARE                  APC 0015137 F 
42                         *10MG TABLET                                         
6                           02397919    TEVA-SOLIFENACIN          TEV 0003041 F 
6                           02399040    SANDOZ SOLIFENACIN        SDZ 0003041 F 
6                           02417731    PMS-SOLIFENACIN           PMS 0003041 F 
6                           02424347    JAMP-SOLIFENACIN          JPC 0003041 F 
6                           02428938    JAMP SOLIFENACIN SUCCINAT JPC 0003041 F 
6                           02437996    RAN-SOLIFENACIN           RAN 0003041 F 
6                           02439352    ACH-SOLIFENACIN SUCCINATE AHI 0003041 F 
6                           02446383    AURO-SOLIFENACIN          API 0003041 F 
6                           02458268    SOLIFENACIN               SAN 0003041 F 
6                           02493047    PRZ-SOLIFENACIN           PRZ 0003041 F 
6                           02529718    M-SOLIFENACIN SUCCINATE   MNP 0003041 F 
6                           02277271    VESICARE                  APC 0015137 F 
41                          TOLTERODINE L-TARTRATE                              
42                         *2MG EXTENDED-RELEASE CAPSULE                        
6                           02412195    TEVA-TOLTERODINE LA       TEV 0009822 F 
6                           02413140    SANDOZ TOLTERODINE LA     SDZ 0009822 F 
6                           02244612    DETROL LA                 BGP 0023943 F 
42                         *4MG EXTENDED-RELEASE CAPSULE                        
6                           02412209    TEVA-TOLTERODINE LA       TEV 0009822 F 
6                           02413159    SANDOZ TOLTERODINE LA     SDZ 0009822 F 
6                           02244613    DETROL LA                 BGP 0023943 F 
41                          TROSPIUM CHLORIDE                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *20MG TABLET                                         
61                          02488353    MAR-TROSPIUM (EDS)        MPI 0004072 E 
61                          02506661    JAMP TROSPIUM (EDS)       JPC 0004072 E 
61                          02275066    TROSEC (EDS)              SUM 0007820 E 
2         SMOOTH MUSCLE RELAXANTS, RESPIRATORY                                  
41                          THEOPHYLLINE (ANHYDROUS)                            
42                          100MG SUSTAINED RELEASE TABLET                      
6                           00692689    AA-THEO LA                AAP 0001624 F 
42                          200MG SUSTAINED RELEASE TABLET                      
6                           00692697    AA-THEO LA                AAP 0001805 F 
42                          300MG SUSTAINED RELEASE TABLET                      
6                           00692700    AA-THEO LA                AAP 0002186 F 
42                          400MG SUSTAINED RELEASE TABLET                      
6                           02360101    THEO ER                   AAP 0003886 F 
42                          600MG SUSTAINED RELEASE TABLET                      
6                           02360128    THEO ER                   AAP 0004707 F 
1         VITAMINS                                                              
2         VITAMIN B                                                             
41                          CYANOCOBALAMIN                                      
42                         *1MG/ML INJECTION SOLUTION (10ML)                    
6                           00626112    CYANOCOBALAMIN INJECTION  OMG 0030700 F 
6                           01987003    CYANOCOBALAMIN            STE 0030700 F 
6                           02413795    CYANOCOBALAMIN INJECTION  MYL 0030700 F 
6                           02420147    JAMP-CYANOCOBALAMIN       JPC 0030700 F 
6                           02465507    CYANOCOBALAMIN            HIK 0030700 F 
6                           00521515    VITAMIN B12               SDZ 0045000 F 
41                          FOLIC ACID                                          
42                         *1MG TABLET                                          
6                           80000274    FOLIC ACID                JAM 0000247 F 
6                           00647039    FOLIC ACID                VTH 0000285 F 
6                           02236747    FOLIC ACID                WAM 0000412 F 
6                           00318973    FOLIC ACID                JAM 0000603 F 
42                         *5MG TABLET                                          
6                           00426849    FOLIC ACID                AAP 0000368 F 
6                           02366061    JAMP-FOLIC ACID           JPC 0000368 F 
41                          LEUCOVORIN CALCIUM (FOLINIC ACID)                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02493357    RIVA-LEUCOVORIN (EDS)     RIV 0018388 E 
61                          02496828    MINT-LEUCOVORIN (EDS)     MNT 0018388 E 
61                          02548208    JAMP LEUCOVORIN (EDS)     JPC 0018388 E 
61                          02170493    LEUCOVORIN (EDS)          PFI 0072467 E 
41                          NIACIN                                              
42                          500MG TABLET                                        
6                           00557412    NIACIN                    JPC 0000450 F 
41                          PYRIDOXINE HCL                                      
42                          25MG TABLET                                         
6                           80002890    JAMP-VITAMIN B6           JPC 0000192 F 
41                          THIAMINE HCL                                        
42                          50MG TABLET                                         
6                           80009633    JAMP-VITAMIN B1           JPC 0000735 F 
42                          100MG TABLET                                        
6                           80009588    JAMP-VITAMIN B1           JPC 0001318 F 
42                          100MG/ML INJECTION SOLUTION (10ML)                  
6                           02193221    THIAMIJECT                OMG 0145550 F 
2         VITAMIN D                                                             
41                          ALFACALCIDOL                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.25UG CAPSULE                                      
61                          02533316    SANDOZ ALFACALCIDOL (EDS) SDZ 0004313 E 
61                          00474517    ONE-ALPHA (EDS)           XED 0006371 E 
42                         *1.0UG CAPSULE                                       
61                          02533324    SANDOZ ALFACALCIDOL (EDS) SDZ 0012911 E 
61                          00474525    ONE-ALPHA (EDS)           XED 0018920 E 
42                          2UG/ML ORAL DROPS (ML)                              
61                          02240329    ONE-ALPHA (EDS)           XED 0072275 E 
41                          CALCIFEROL                                          
42                          8,288IU/ML ORAL SOLUTION                            
6                           80003615    ERDOL/DRISODAN            ODN 0005503 F 
41                          CALCITRIOL                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.25UG CAPSULE                                      
61                          02431637    CALCITRIOL-ODAN (EDS)     ODN 0002341 E 
61                          02485710    TARO-CALCITRIOL (EDS)     TAR 0002341 E 
61                          02495899    CALCITRIOL CAPSULES (EDS) STR 0002341 E 
61                          00481823    ROCALTROL (EDS)           SLP 0007400 E 
42                         *0.5UG CAPSULE                                       
61                          02431645    CALCITRIOL-ODAN (EDS)     ODN 0003723 E 
61                          02485729    TARO-CALCITRIOL (EDS)     TAR 0003723 E 
61                          02495902    CALCITRIOL CAPSULES (EDS) STR 0003723 E 
61                          00481815    ROCALTROL (EDS)           SLP 0011700 E 
1         MISCELLANEOUS THERAPEUTIC PRODUCTS                                    
2         MISCELLANEOUS THERAPEUTIC PRODUCTS                                    
41                          ABATACEPT                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          125MG/ML SC PRE-FILLED SYRINGE                      
61                          02402475    ORENCIA (EDS)             BMY 3737900 E 
42                          125MG/ML SC PRE-FILLED SYRINGE (US LABEL)           
61                          09858343    ORENCIA (EDS)(US LABEL)   BMY 3737900 E 
42                          125MG/ML SC PRE-FILLED SYRINGE (SAUDI LABEL)        
61                          00951670    ORENCIA (EDS)(SAUDI LABEL BMY 3737900 E 
42                          250MG POWDER FOR SOLUTION                           
61                          02282097    ORENCIA (EDS)             BMY 5003400 E 
41                          ABOBOTULINUMTOXINA                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          BILLING IS PER UNIT                                 
42                          300U/VIAL INJECTION                                 
61                          02460203    DYSPORT THERAPEUTIC (EDS) IPS 0012852 E 
42                          500U/VIAL INJECTION                                 
61                          02456117    DYSPORT THERAPEUTIC (EDS) IPS 0012852 E 
41                          ABROCITINIB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG TABLET                                         
61                          02528363    CIBINQO (EDS)             PFI 0495910 E 
42                          100MG TABLET                                        
61                          02528371    CIBINQO (EDS)             PFI 0495910 E 
42                          200MG TABLET                                        
61                          02528398    CIBINQO (EDS)             PFI 0555013 E 
41                          ADALIMUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          20MG/0.2ML PRE-FILLED SYRINGE                       
61                          02542315    HYRIMOZ (EDS)             SDZ 2356350 E 
42                         ?20MG/0.4ML PRE-FILLED SYRINGE                       
61                          02502380    HULIO (EDS)               BBL 2356350 E 
61                          02459310    AMGEVITA (EDS)            AMG 2356400 E 
61                          02505258    HYRIMOZ (EDS)             SDZ 2356350 E 
61                          02511061    ABRILADA (EDS)            PFI 2356300 E 
42                         ?40MG/0.4ML AUTO-INJECTOR                            
61                          02523957    SIMLANDI (EDS)            JPC 4712700 E 
61                          02533480    HADLIMA PUSHTOUCH (EDS)   ORG 4712700 E 
61                          02542331    HYRIMOZ (EDS)             SDZ 4712700 E 
42                          40MG/0.4ML PRE-FILLED PEN                           
61                          02523779    YUFLYMA (EDS)             CEL 4712700 E 
42                         ?40MG/0.4ML PRE-FILLED SYRINGE                       
61                          02523760    YUFLYMA (EDS)             CEL 4712700 E 
61                          02523949    SIMLANDI (EDS)            JPC 4712700 E 
61                          02533472    HADLIMA (EDS)             ORG 4712700 E 
61                          02542323    HYRIMOZ (EDS)             SDZ 4712700 E 
42                         ?40MG/0.8ML PRE-FILLED SYRINGE                       
61                          02459299    AMGEVITA (EDS)            AMG 4712700 E 
61                          02473097    HADLIMA (EDS)             ORG 4712700 E 
61                          02492164    HYRIMOZ (EDS)             SDZ 4712700 E 
61                          02502399    HULIO (EDS)               BBL 4712700 E 
61                          02502682    IDACIO (EDS)              FCL 4712700 E 
61                          02511053    ABRILADA (EDS)            PFI 4712700 E 
42                         ?40MG/0.8ML PRE-FILLED PEN                           
61                          02502402    HULIO (EDS)               BBL 4712700 E 
61                          02511045    ABRILADA (EDS)            PFI 4712700 E 
42                         ?40MG/0.8ML AUTO-INJECTOR                            
61                          02459302    AMGEVITA (EDS)            AMG 4712700 E 
61                          02473100    HADLIMA PUSHTOUCH (EDS)   ORG 4712700 E 
61                          02492156    HYRIMOZ (EDS)             SDZ 4712700 E 
61                          02502674    IDACIO (EDS)              FCL 4712700 E 
42                         ?80MG/0.8ML PRE-FILLED SYRINGE                       
61                          02523965    SIMLANDI (EDS)            JPC 9425400 E 
61                          02535076    YUFLYMA (EDS)             CEL 9425400 E 
61                          02542358    HYRIMOZ (EDS)             SDZ 9425400 E 
42                          80MG/0.8ML PRE-FILLED PEN                           
61                          02535084    YUFLYMA (EDS)             CEL 9425400 E 
42                          80MG/0.8ML AUTO-INJECTOR                            
61                          02542366    HYRIMOZ (EDS)             SDZ 9425400 E 
41                          AFLIBERCEPT                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MILLIGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          8MG/0.07ML PRE-FILLED SYRINGE (MG)                  
61                          02554798    EYLEA HD (EDS)            BAY 1562500 E 
42                          40MG/ML INJECTION (MG)                              
61                          02415992    EYLEA (EDS)               BAY 1275200 E 
41                          ALEMTUZUMAB                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MICROGRAMS.                                         
53                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          12MG/1.2ML SOLUTION FOR IV INFUSION (MCG)           
61                          02418320    LEMTRADA (EDS)            AVT 0010900 E 
41                          ALENDRONATE SODIUM                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG TABLET                                         
61                          02247373    TEVA-ALENDRONATE (EDS)    TEV 0004987 E 
61                          02248728    APO-ALENDRONATE (EDS)     APX 0004987 E 
61                          02288087    SANDOZ ALENDRONATE (EDS)  SDZ 0004987 E 
61                          02381486    ALENDRONATE SODIUM (EDS)  AHI 0004987 E 
61                          02384701    RAN-ALENDRONATE (EDS)     RAN 0004987 E 
61                          02388545    AURO-ALENDRONATE (EDS)    API 0004987 E 
42                         *70MG TABLET                                         
61                          02248730    APO-ALENDRONATE (EDS)     APX 0017804 E 
61                          02261715    TEVA-ALENDRONATE (EDS)    TEV 0017804 E 
61                          02270889    RIVA-ALENDRONATE (EDS)    RIV 0017804 E 
61                          02284006    PMS-ALENDRONATE FC (EDS)  PMS 0017804 E 
61                          02288109    SANDOZ ALENDRONATE (EDS)  SDZ 0017804 E 
61                          02299712    ALENDRONATE (EDS)         SIV 0017804 E 
61                          02352966    ALENDRONATE (EDS)         SAN 0017804 E 
61                          02381494    ALENDRONATE SODIUM (EDS)  AHI 0017804 E 
61                          02385031    JAMP-ALENDRONATE (EDS)    JPC 0017804 E 
61                          02388553    AURO-ALENDRONATE (EDS)    API 0017804 E 
61                          02394871    MINT-ALENDRONATE (EDS)    MNT 0017804 E 
61                          02485184    AG-ALENDRONATE (EDS)      ANG 0017804 E 
61                          02500175    JAMP ALENDRONATE (EDS)    JPC 0017804 E 
61                          02529394    M-ALENDRONATE (EDS)       MNP 0017804 E 
61                          02245329    FOSAMAX (EDS)             ORG 0121150 E 
41                          ALENDRONATE SODIUM/VITAMIN D3(CHOLECALCIFEROL       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *70MG/5600IU TABLET                                  
61                          02454475    APO-ALENDRONATE/VIT D3(ED APX 0024348 E 
61                          02519836    JAMP ALENDRO/VIT D3 (EDS) JPC 0024348 E 
61                          02314940    FOSAVANCE 70/5600 (EDS)   ORG 0053550 E 
41                          ALFUZOSIN                                           
42                         *10MG EXTENDED-RELEASE TABLET                        
6                           02304678    SANDOZ ALFUZOSIN          SDZ 0002601 F 
6                           02315866    APO-ALFUZOSIN             APX 0002601 F 
6                           02443201    AURO-ALFUZOSIN            API 0002601 F 
6                           02447576    ALFUZOSIN                 SIV 0002601 F 
6                           02519844    ALFUZOSIN                 SAN 0002601 F 
6                           02245565    XATRAL                    AVT 0011129 F 
41                          ALGLUCOSIDASE ALFA                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG/VIAL POWDER FOR SOLUTION                       
61                          02284863    MYOZYME (EDS)             AVT 8403100 E 
41                          ALLOPURINOL                                         
42                         *100MG TABLET                                        
6                           02396327    MAR-ALLOPURINOL           MPI 0000780 F 
6                           02402769    APO-ALLOPURINOL           APX 0000780 F 
6                           00402818    APO-ALLOPURINOL TABLETS   APX 0000820 F 
42                         *200MG TABLET                                        
6                           02396335    MAR-ALLOPURINOL           MPI 0001300 F 
6                           02402777    APO-ALLOPURINOL           APX 0001300 F 
6                           00479799    APO-ALLOPURINOL TABLETS   APX 0001366 F 
42                         *300MG TABLET                                        
6                           02396343    MAR-ALLOPURINOL           MPI 0002125 F 
6                           02402785    APO-ALLOPURINOL           APX 0002125 F 
6                           00402796    APO-ALLOPURINOL TABLETS   APX 0002233 F 
41                          ANAGRELIDE HCL                                      
42                          0.5MG CAPSULE                                       
6                           02274949    PMS-ANAGRELIDE            PMS 0046997 F 
42                          0.5MG CAPSULE (AUSTRALIAN LABELLED)                 
6                           09858363    ANAGRIDE-AUSTRALIAN LABEL SPT 0059696 F 
41                          ANAKINRA                                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG/0.67ML PRE-FILLED SYRINGE                     
61                          02245913    KINERET (EDS)             BIO 0546186 E 
41                          ANIFROLUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG/ML (2ML VIAL) (MG) I.V. INFUSION              
61                          02522845    SAPHNELO (EDS)            AST 0057421 E 
41                          ATOMOXETINE HCL                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG CAPSULE                                        
61                          02314541    TEVA-ATOMOXETINE (EDS)    TEV 0005106 E 
61                          02318024    APO-ATOMOXETINE (EDS)     APX 0005106 E 
61                          02381028    PMS-ATOMOXETINE (EDS)     PMS 0005106 E 
61                          02386410    SANDOZ ATOMOXETINE (EDS)  SDZ 0005106 E 
61                          02445883    ATOMOXETINE (EDS)         SIV 0005106 E 
61                          02467747    ATOMOXETINE (EDS)         SAN 0005106 E 
61                          02471485    AURO-ATOMOXETINE (EDS)    API 0005106 E 
61                          02506807    JAMP ATOMOXETINE (EDS)    JPC 0005106 E 
42                         *18MG CAPSULE                                        
61                          02314568    TEVA-ATOMOXETINE (EDS)    TEV 0005748 E 
61                          02318032    APO-ATOMOXETINE (EDS)     APX 0005748 E 
61                          02381036    PMS-ATOMOXETINE (EDS)     PMS 0005748 E 
61                          02386429    SANDOZ ATOMOXETINE (EDS)  SDZ 0005748 E 
61                          02445905    ATOMOXETINE (EDS)         SIV 0005748 E 
61                          02467755    ATOMOXETINE (EDS)         SAN 0005748 E 
61                          02471493    AURO-ATOMOXETINE (EDS)    API 0005748 E 
61                          02506815    JAMP ATOMOXETINE (EDS)    JPC 0005748 E 
42                         *25MG CAPSULE                                        
61                          02314576    TEVA-ATOMOXETINE (EDS)    TEV 0006420 E 
61                          02318040    APO-ATOMOXETINE (EDS)     APX 0006420 E 
61                          02381044    PMS-ATOMOXETINE (EDS)     PMS 0006420 E 
61                          02386437    SANDOZ ATOMOXETINE (EDS)  SDZ 0006420 E 
61                          02445913    ATOMOXETINE (EDS)         SIV 0006420 E 
61                          02467763    ATOMOXETINE (EDS)         SAN 0006420 E 
61                          02471507    AURO-ATOMOXETINE (EDS)    API 0006420 E 
61                          02506823    JAMP ATOMOXETINE (EDS)    JPC 0006420 E 
42                         *40MG CAPSULE                                        
61                          02314584    TEVA-ATOMOXETINE (EDS)    TEV 0007369 E 
61                          02318059    APO-ATOMOXETINE (EDS)     APX 0007369 E 
61                          02381052    PMS-ATOMOXETINE (EDS)     PMS 0007369 E 
61                          02386445    SANDOZ ATOMOXETINE (EDS)  SDZ 0007369 E 
61                          02445948    ATOMOXETINE (EDS)         SIV 0007369 E 
61                          02467771    ATOMOXETINE (EDS)         SAN 0007369 E 
61                          02471515    AURO-ATOMOXETINE (EDS)    API 0007369 E 
61                          02506831    JAMP ATOMOXETINE (EDS)    JPC 0007369 E 
42                         *60MG CAPSULE                                        
61                          02314592    TEVA-ATOMOXETINE (EDS)    TEV 0008092 E 
61                          02318067    APO-ATOMOXETINE (EDS)     APX 0008092 E 
61                          02381060    PMS-ATOMOXETINE (EDS)     PMS 0008092 E 
61                          02386453    SANDOZ ATOMOXETINE (EDS)  SDZ 0008092 E 
61                          02445956    ATOMOXETINE (EDS)         SIV 0008092 E 
61                          02467798    ATOMOXETINE (EDS)         SAN 0008092 E 
61                          02471523    AURO-ATOMOXETINE (EDS)    API 0008092 E 
61                          02506858    JAMP ATOMOXETINE (EDS)    JPC 0008092 E 
42                         *80MG CAPSULE                                        
61                          02318075    APO-ATOMOXETINE (EDS)     APX 0012193 E 
61                          02362511    TEVA-ATOMOXETINE (EDS)    TEV 0012193 E 
61                          02386461    SANDOZ ATOMOXETINE (EDS)  SDZ 0012193 E 
61                          02467801    ATOMOXETINE (EDS)         SAN 0012193 E 
61                          02471531    AURO-ATOMOXETINE (EDS)    API 0012193 E 
61                          02506866    JAMP ATOMOXETINE (EDS)    JPC 0012193 E 
42                         *100MG CAPSULE                                       
61                          02318083    APO-ATOMOXETINE (EDS)     APX 0013382 E 
61                          02386488    SANDOZ ATOMOXETINE (EDS)  SDZ 0013382 E 
61                          02467828    ATOMOXETINE (EDS)         SAN 0013382 E 
61                          02471558    AURO-ATOMOXETINE (EDS)    API 0013382 E 
61                          02506874    JAMP ATOMOXETINE (EDS)    JPC 0013382 E 
41                          AZATHIOPRINE                                        
42                         *50MG TABLET                                         
6                           02236819    TEVA-AZATHIOPRINE         TEV 0005185 F 
6                           02242907    APO-AZATHIOPRINE          APX 0005185 F 
6                           00004596    IMURAN                    ASC 0014110 F 
41                          BARICITINIB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2MG TABLET                                          
61                          02480018    OLUMIANT (EDS)            LIL 0585787 E 
42                          4MG TABLET                                          
61                          02544768    OLUMIANT (EDS)            LIL 0585787 E 
41                          BELIMUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          20MG/ML (20ML VIAL)(MG)POWDER FOR INTRAVENOUS       
61                          02370069    BENLYSTA (EDS)            GSK 0025959 E 
42                          24MG/ML (5ML VIAL)(MG) POWDER FOR INTRAVENOUS       
61                          02370050    BENLYSTA (EDS)            GSK 0025960 E 
42                          200MG/ML AUTOINJECTOR (MG)                          
61                          02470489    BENLYSTA (EDS)            GSK 0020146 E 
41                          BEROTRALSTAT HCL                                    
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG CAPSULE                                       
61                          02527693    ORLADEYO (EDS)            BCY 8500000 E 
41                          BETAINE ANHYDROUS                                   
42                          1G/SCOOP POWDER FOR ORAL SOLUTION                   
6                           02238526    CYSTADANE                 RRD 0047597 F 
41                          BIMEKIZUMAB                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MILLIGRAMS                                          
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          160MG/ML PREFILLED SYRINGE (MG)                     
61                          02525267    BIMZELX (EDS)             UCB 0101600 E 
42                          160MG/ML AUTOINJECTOR (MG)                          
61                          02525275    BIMZELX (EDS)             UCB 0101600 E 
42                          320MG/2ML PREFILLED SYRINGE (MG)                    
61                          02553619    BIMZELX (EDS)             UCB 0101600 E 
42                          320MG/2ML AUTOINJECTOR (MG)                         
61                          02553627    BIMZELX (EDS)             UCB 0101600 E 
41                          BRODALUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          210MG/1.5ML PRE-FILLED SYRINGE                      
61                          02473623    SILIQ (EDS)               BAU 6450000 E 
41                          BROLUCIZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          6MG/0.05ML SOLUTION INTRAVITREAL INJECTION-MG       
61                          02496976    BEOVU (EDS)               NVR 2316700 E 
41                          BROMOCRIPTINE MESYLATE                              
42                          5MG CAPSULE                                         
6                           02230454    BROMOCRIPTINE             AAP 0019553 F 
42                          2.5MG TABLET                                        
6                           02087324    BROMOCRIPTINE             AAP 0013062 F 
41                          BUROSUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML SOLUTION FOR INJECTION (MG)                 
61                          02483629    CRYSVITA (EDS)            KKL 4514940 E 
42                          20MG/ML SOLUTION FOR INJECTION (MG)                 
61                          02483637    CRYSVITA (EDS)            KKL 4514950 E 
42                          30MG/ML SOLUTION FOR INJECTION (MG)                 
61                          02483645    CRYSVITA (EDS)            KKL 4514947 E 
41                          CABERGOLINE                                         
51                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                         *0.5MG TABLET                                        
61                          02455897    APO-CABERGOLINE (EDS)     APX 0072907 E 
61                          02549611    JAMP CABERGOLINE (EDS)    JPC 0072907 E 
61                          02242471    DOSTINEX (EDS)            PFI 0176613 E 
41                          CERTOLIZUMAB PEGOL                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/ML SOL FOR INJECTION PRE-FILLED SYRINGE       
61                          02331675    CIMZIA (EDS)              UCB 7252950 E 
42                          200MG/ML SOL FOR INJECTION AUTOINJECTOR             
61                          02465574    CIMZIA (EDS)              UCB 7252950 E 
41                          CLADRIBINE                                          
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          10MG TABLET (MG)                                    
61                          02470179    MAVENCLAD (EDS)           SRO 3212000 E 
41                          COLCHICINE                                          
42                         *0.6MG TABLET                                        
6                           00287873    SANDOZ COLCHICINE         SDZ 0002565 F 
6                           00572349    COLCHICINE-ODAN           ODN 0002565 F 
6                           02373823    JAMP-COLCHICINE           JPC 0002565 F 
6                           02402181    PMS-COLCHICINE            PMS 0002565 F 
41                          CROVALIMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          340MG/2ML SOLUTION FOR INJECTION (MG)               
61                          02558262    PIASKY (EDS)              HLR 0470000 E 
41                          CYCLOSPORINE (TRANSPLANT)                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG CAPSULE                                        
61                          02237671    NEORAL (EDS)              NVR 0007370 E 
42                          25MG CAPSULE                                        
61                          02150689    NEORAL (EDS)              NVR 0017133 E 
42                          50MG CAPSULE                                        
61                          02150662    NEORAL (EDS)              NVR 0033420 E 
42                          100MG CAPSULE                                       
61                          02150670    NEORAL (EDS)              NVR 0066863 E 
42                          100MG/ML LIQUID                                     
61                          02150697    NEORAL (EDS)              NVR 0059456 E 
41                          CYSTEAMINE BITARTRATE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25MG DELAYED RELEASE CAPSULE                        
61                          02464705    PROCYSBI (EDS)            AMG 0059537 E 
42                          75MG DELAYED RELEASE CAPSULE                        
61                          02464713    PROCYSBI (EDS)            AMG 0178610 E 
41                          DENOSUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          60MG/ML PRE-FILLED SYRINGE                          
61                          02343541    PROLIA (EDS)              AMG 4322600 E 
42                         ?60MG/ML PREFILLED SYRINGE                           
61                          02565951    BILDYOS (EDS)             ORG 1810710 E 
61                          02545411    JUBBONTI (EDS)            SDZ 1744900 E 
61                          02560917    STOBOCLO (EDS)            CEL 1744900 E 
41                          DIMETHYL FUMARATE                                   
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                         *120MG DELAYED-RELEASE CAPSULE                       
61                          02494809    GLN-DIMETHYL FUMARA (EDS) GLN 0044266 E 
61                          02495341    ACH-DIMETHYL FUMARA (EDS) AHI 0044266 E 
61                          02497026    PMS-DIMETHYL FUMARA (EDS) PMS 0044266 E 
61                          02502690    MAR-DIMETHYL FUMARA (EDS) MPI 0044266 E 
61                          02505762    APO-DIMETHYL FUMARA (EDS) APX 0044266 E 
61                          02513781    SANDOZ-DIMETHYL FUM (EDS) SDZ 0044266 E 
61                          02516047    JAMP DIMETHYL FUMAR (EDS) JPC 0044266 E 
61                          02540746    AURO-DIMETHYL FUMAR (EDS) API 0044266 E 
61                          02404508    TECFIDERA (EDS)           BGN 0173781 E 
42                         *240MG DELAYED-RELEASE CAPSULE                       
61                          02494817    GLN-DIMETHYL FUMARA (EDS) GLN 0086888 E 
61                          02495368    ACH-DIMETHYL FUMARA (EDS) AHI 0086888 E 
61                          02497034    PMS-DIMETHYL FUMARA (EDS) PMS 0086888 E 
61                          02502704    MAR-DIMETHYL FUMARA (EDS) MPI 0086888 E 
61                          02505770    APO-DIMETHYL FUMARA (EDS) APX 0086888 E 
61                          02513803    SANDOZ-DIMETHYL FUM (EDS) SDZ 0086888 E 
61                          02516055    JAMP DIMETHYL FUMAR (EDS) JPC 0086888 E 
61                          02540754    AURO-DIMETHYL FUMAR (EDS) API 0086888 E 
61                          02420201    TECFIDERA (EDS)           BGN 0347552 E 
41                          DUPILUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/1.14ML PRE-FILLED SYRINGE (MG)                
61                          02492504    DUPIXENT (EDS)            AVT 0049963 E 
42                          200MG/1.14ML PRE-FILLED PEN (MG)                    
61                          02524252    DUPIXENT (EDS)            AVT 0049963 E 
42                          300MG/2ML PRE-FILLED SYRINGE (MG)                   
61                          02470365    DUPIXENT (EDS)            AVT 0033308 E 
42                          300MG/2ML PRE-FILLED PEN (MG)                       
61                          02510049    DUPIXENT (EDS)            AVT 0033308 E 
41                          DUTASTERIDE                                         
42                         *0.5MG CAPSULE                                       
6                           02393220    PMS-DUTASTERIDE           PMS 0002565 F 
6                           02404206    APO-DUTASTERIDE           APX 0002565 F 
6                           02408287    TEVA-DUTASTERIDE          TEV 0002565 F 
6                           02416298    MED-DUTASTERIDE           GMP 0002565 F 
6                           02424444    SANDOZ DUTASTERIDE        SDZ 0002565 F 
6                           02428873    MINT-DUTASTERIDE          MNT 0002565 F 
6                           02429012    DUTASTERIDE               SIV 0002565 F 
6                           02443058    DUTASTERIDE               SAN 0002565 F 
6                           02469308    AURO-DUTASTERIDE          API 0002565 F 
6                           02484870    JAMP DUTASTERIDE          JPC 0002565 F 
6                           02490587    PRIVA-DUTASTERIDE         STR 0002565 F 
6                           02546167    JAMP DUTASTERIDE          JPC 0002565 F 
6                           02247813    AVODART                   GSK 0019817 F 
41                          ECULIZUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML INTRAVENOUS SOLUTION (30ML VIAL)(ML)        
61                          02322285    SOLIRIS (EDS)             AXN 2225100 E 
41                          EFGARTIGIMOD ALFA                                   
51                          SEE APPENDIX A FOR CRITERIA                         
42                          400MG/20ML (20MG/ML) SOL FOR INFUSION (MG)          
61                          02541599    VYVGART (EDS)             AGX 0197500 E 
41                          EPLONTERSEN                                         
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION.SUBMIT QUANTITY PER 100MCG.             
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          45MG/0.8ML PRE-FILLED AUTOINJECTOR (100MCG)         
61                          02548909    WAINUA (EDS)              AST 1059563 E 
41                          ETANERCEPT                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25MG/0.5ML PRE-FILLED SYRINGE                       
61                          02462877    ERELZI (EDS)              SDZ 1205000 E 
42                         ?50MG/ML PRE-FILLED SYRINGE                          
61                          02455323    BRENZYS (EDS)             ORG 2361800 E 
61                          02530295    RYMTI (EDS)               LUP 2361800 E 
61                          02462869    ERELZI (EDS)              SDZ 2410000 E 
42                         ?50MG/ML AUTOINJECTOR                                
61                          02455331    BRENZYS (EDS)             ORG 2361800 E 
61                          02530309    RYMTI (EDS)               LUP 2361800 E 
61                          02462850    ERELZI (EDS)              SDZ 2410000 E 
41                          FARICIMAB                                           
51                          WHEN BILLING,SUBMIT QUANTITY IN TERMS OF            
52                          MILLIGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          6MG/0.05ML PRE-FILLED SYRINGE (MG)                  
61                          02554003    VABYSMO (EDS)             HLR 2250000 E 
41                          FEBUXOSTAT                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *80MG TABLET                                         
61                          02466198    TEVA-FEBUXOSTAT (EDS)     TEV 0003975 E 
61                          02473607    MAR-FEBUXOSTAT (EDS)      MPI 0003975 E 
61                          02490870    JAMP-FEBUXOSTAT (EDS)     JPC 0003975 E 
61                          02533243    AURO-FEBUXOSTAT (EDS)     API 0003975 E 
61                          02539837    FEBUXOSTAT (EDS)          SAN 0003975 E 
41                          FINASTERIDE                                         
42                         *5MG TABLET                                          
6                           02310112    PMS-FINASTERIDE           PMS 0003506 F 
6                           02322579    SANDOZ FINASTERIDE        SDZ 0003506 F 
6                           02348500    TEVA-FINASTERIDE          TEV 0003506 F 
6                           02355043    FINASTERIDE TABLETS USP   AHI 0003506 F 
6                           02357224    JAMP-FINASTERIDE          JPC 0003506 F 
6                           02365383    APO-FINASTERIDE           APX 0003506 F 
6                           02389878    MINT-FINASTERIDE          MNT 0003506 F 
6                           02405814    AURO-FINASTERIDE          API 0003506 F 
6                           02445077    FINASTERIDE               SAN 0003506 F 
6                           02447541    FINASTERIDE               SIV 0003506 F 
6                           02455013    RIVA-FINASTERIDE          RIV 0003506 F 
6                           02522489    M-FINASTERIDE             MNP 0003506 F 
6                           02535637    NRA-FINASTERIDE           NRA 0003506 F 
6                           02010909    PROSCAR                   ORG 0024933 F 
41                          FINGOLIMOD HYDROCHLORIDE                            
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                         *0.5MG CAPSULE                                       
61                          02469618    TARO-FINGOLIMOD (EDS)     TAR 0217381 E 
61                          02469715    MYLAN-FINGOLIMOD (EDS)    MYL 0217381 E 
61                          02469782    PMS-FINGOLIMOD (EDS)      PMS 0217381 E 
61                          02469936    APO-FINGOLIMOD (EDS)      APX 0217381 E 
61                          02474743    MAR-FINGOLIMOD (EDS)      MPI 0217381 E 
61                          02482606    SANDOZ FINGOLIMOD (EDS)   SDZ 0217381 E 
61                          02487772    JAMP FINGOLIMOD (EDS)     JPC 0217381 E 
61                          02365480    GILENYA (EDS)             NVR 0869525 E 
41                          GALCANEZUMAB                                        
51                          WHEN BILLING,SUBMIT QUANTITY IN TERMS OF            
52                          MILLIGRAMS                                          
53                          SEE APPRENDIX A FOR EDS CRITERIA                    
42                          120MG/ML PRE-FILLED SYRINGE                         
61                          02491060    EMGALITY (EDS)            ORG 6035000 E 
42                          120MG/ML PRE-FILLED PEN                             
61                          02491087    EMGALITY (EDS)            ORG 6035000 E 
41                          GARADACIMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          200MG/1.2ML PRE-FILLED PEN (MG)                     
61                          02559773    ANDEMBRY (EDS)            CSL 1742000 E 
41                          GIVOSIRAN                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          189MG/ML 1ML VIAL SUBCUTANEOUS INJECTION (MG)       
61                          02506343    GIVLAARI (EDS)            ALN 3410281 E 
41                          GLATIRAMER ACETATE                                  
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                         ?20MG/ML INJECTION (PRE-FILLED SYRINGE)              
61                          02541440    GLATIRAMER ACETATE (EDS)  MYL 0278587 E 
61                          02460661    GLATECT (EDS)             PED 0324000 E 
41                          GLUCAGON                                            
42                          1MG INJECTION POWDER                                
6                           09858279    GLUCAGON KIT(US LABELLED) AMP 2800000 F 
42                          3MG NASAL POWDER                                    
6                           02492415    BAQSIMI                   AMP 1570400 F 
41                          GLYCEROL PHENYLBUTYRATE                             
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1.1G/ML ORAL LIQUID                                 
61                          02453304    RAVICTI (EDS)             AMG 0480000 E 
41                          GOLIMUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50MG/0.5ML PRE-FILLED SYRINGE (MG)                  
61                          02324776    SIMPONI (EDS)             JAN 0311100 E 
42                          50MG/0.5ML AUTO-INJECTOR (MG)                       
61                          02324784    SIMPONI (EDS)             JAN 0311100 E 
42                          100MG/1.0ML PRE-FILLED SYRINGE (MG)                 
61                          02413175    SIMPONI (EDS)             JAN 0155600 E 
42                          100MG/1.0ML AUTO-INJECTOR (MG)                      
61                          02413183    SIMPONI (EDS)             JAN 0155600 E 
42                          50MG/4.0ML SOLUTION FOR INFUSION (MG)               
61                          02417472    SIMPONI I.V. (EDS)        JAN 0175900 E 
41                          GUSELKUMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML VIAL SOLUTION FOR I.V. INFUSION (MG)        
61                          02559153    TREMFYA I.V. (EDS)        JAN 0152987 E 
42                          100MG/ML AUTOINJECTOR (MG)                          
61                          02487314    TREMFYA (EDS)             JAN 0305974 E 
42                          100MG/ML PRE-FILLED SYRINGE (MG)                    
61                          02469758    TREMFYA (EDS)             JAN 0305974 E 
42                          100MG/ML PRE-FILLED PEN (MG)                        
61                          02566877    TREMFYA (EDS)             JAN 0305974 E 
42                          200MG/2ML PRE-FILLED PEN (MG)                       
61                          02559145    TREMFYA (EDS)             JAN 0152987 E 
41                          ICATIBANT ACETATE                                   
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG/ML SUBCUTANEOUS INJECTION (MG)                 
61                          02547562    ICATIBANT INJECTION (EDS) JPC 0495000 E 
61                          02425696    FIRAZYR (EDS)             TAK 0900000 E 
41                          INCOBOTULINUMTOXIN A                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50U/VIAL POWDER FOR SOLUTION                        
61                          02371081    XEOMIN (EDS)              MRZ 1689600 E 
42                          100U/VIAL POWDER FOR SOLUTION                       
61                          02324032    XEOMIN (EDS)              MRZ 3379200 E 
41                          INEBILIZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          10MG/ML SOLUTION FOR INFUSION VIAL (MG)             
61                          02543931    UPLIZNA (EDS)             AMG 2562300 E 
41                          INFLIXIMAB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?100MG/VIAL VIAL (MG)                                
61                          02419475    REMDANTRY VIAL (EDS)      CEL 0049300 E 
61                          02470373    RENFLEXIS VIAL (EDS)      ORG 0049300 E 
61                          02496933    AVSOLA VIAL (EDS)         AMG 0049300 E 
61                          02523191    IXIFI VIAL (EDS)          PFI 0049300 E 
42                          120MG/ML PRE-FILLED SYRINGE (SYRINGE)               
61                          02511576    REMSIMA SC (EDS)          CEL 4745100 E 
42                          120MG/ML PRE-FILLED PEN (PEN)                       
61                          02511584    REMSIMA SC (EDS)          CEL 4745100 E 
41                          INTERFERON BETA-1A                                  
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          22UG (6 MILLION IU) PRE-FILLED SYRINGE              
61                          02237319    REBIF (EDS)               SRO 1648200 E 
42                          44UG (12 MILLION IU) PRE-FILLED SYRINGE             
61                          02237320    REBIF (EDS)               SRO 2006500 E 
42                          66UG/1.5ML (3 DOSES/22UG) PF CARTRIDGE              
61                          02318253    REBIF (EDS)               SRO 4944800 E 
42                          132UG/1.5ML (3 DOSES/44UG) PF CARTRIDGE             
61                          02318261    REBIF (EDS)               SRO 6019600 E 
42                          30UG (30 MILLION IU) PF SYRINGE/PEN AUTO-INJ        
61                          02269201    AVONEX PS/PEN (EDS)       BGN 4438300 E 
41                          INTERFERON BETA-1B                                  
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          0.3MG POWDER FOR INJECTION (VIAL)                   
61                          02169649    BETASERON (EDS)           BAY 1100000 E 
41                          IVACAFTOR                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
41                          KETOTIFEN FUMARATE                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG TABLET                                          
61                          00577308    ZADITEN (EDS)             TEV 0021787 E 
41                          LANADELUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          300MG/2ML INJECTION, PRE-FILLED SYRINGE (MG)        
61                          02505614    TAKHZYRO (EDS)            TAK 0684600 E 
42                          300MG/2ML INJECTION, PRE-FILLED PEN (MG)            
61                          02564483    TAKHZYRO (EDS)            TAK 0684600 E 
42                          300MG/2ML INJECTION, VIAL (MG)                      
61                          02480948    TAKHZYRO (EDS)            TAK 0684600 E 
41                          LANREOTIDE ACETATE                                  
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MILLIGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *60MG/UNIT SYRINGE (MG)                              
61                          02555867    MYTOLAC (EDS)             ADV 0126668 E 
61                          02283395    SOMATULINE AUTOGEL (EDS)  IPS 0225192 E 
42                         *90MG/UNIT SYRINGE (MG)                              
61                          02555875    MYTOLAC (EDS)             ADV 0112645 E 
61                          02283409    SOMATULINE AUTOGEL (EDS)  IPS 0200283 E 
42                         *120MG/UNIT SYRINGE (MG)                             
61                          02555883    MYTOLAC (EDS)             ADV 0105748 E 
61                          02283417    SOMATULINE AUTOGEL (EDS)  IPS 0188095 E 
41                          LEFLUNOMIDE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *10MG TABLET                                         
61                          02256495    APO-LEFLUNOMIDE (EDS)     APX 0026433 E 
61                          02261251    TEVA-LEFLUNOMIDE (EDS)    TEV 0026433 E 
61                          02283964    SANDOZ LEFLUNOMIDE (EDS)  SDZ 0026433 E 
61                          02351668    LEFLUNOMIDE (EDS)         SAN 0026433 E 
61                          02478862    ACCEL-LEFLUNOMIDE (EDS)   ACC 0026433 E 
61                          02543575    LEFLUNOMIDE (EDS)         SIV 0026433 E 
61                          02551918    MAR-LEFLUNOMIDE (EDS)     MPI 0026433 E 
61                          02241888    ARAVA (EDS)               AVT 0114440 E 
42                         *20MG TABLET                                         
61                          02256509    APO-LEFLUNOMIDE (EDS)     APX 0026433 E 
61                          02261278    TEVA-LEFLUNOMIDE (EDS)    TEV 0026433 E 
61                          02283972    SANDOZ LEFLUNOMIDE (EDS)  SDZ 0026433 E 
61                          02351676    LEFLUNOMIDE (EDS)         SAN 0026433 E 
61                          02478870    ACCEL-LEFLUNOMIDE (EDS)   ACC 0026433 E 
61                          02543583    LEFLUNOMIDE (EDS)         SIV 0026433 E 
61                          02551926    MAR-LEFLUNOMIDE (EDS)     MPI 0026433 E 
61                          02241889    ARAVA (EDS)               AVT 0114443 E 
41                          LUMASIRAN                                           
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION.SUBMIT QUANTITY PER 100MCG.SEE          
53                          APPENDIX A FOR EDS CRITERIA                         
42                          94.5MG/0.5ML SOLUTION FOR SC INJECT (100MCG)        
61                          02525755    OXLUMO (EDS)              ALN 1024925 E 
41                          MEPOLIZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG/ML POWDER FOR INJECTION (MG)                  
61                          02449781    NUCALA (EDS)              GSK 0205864 E 
42                          100MG/ML PREFILLED AUTOINJECTOR (MG)                
61                          02492989    NUCALA (EDS)              GSK 0220664 E 
42                          100MG/ML PREFILLED SYRINGE (MG)                     
61                          02492997    NUCALA (EDS)              GSK 0220664 E 
41                          MONTELUKAST SODIUM                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *4MG CHEWABLE TABLET                                 
61                          02330385    SANDOZ MONTELUKAST (EDS)  SDZ 0002758 E 
61                          02354977    PMS-MONTELUKAST (EDS)     PMS 0002758 E 
61                          02355507    TEVA-MONTELUKAST (EDS)    TEV 0002758 E 
61                          02377608    APO-MONTELUKAST (EDS)     APX 0002758 E 
61                          02382458    MONTELUKAST (EDS)         SIV 0002758 E 
61                          02399865    MAR-MONTELUKAST (EDS)     MPI 0002758 E 
61                          02408627    MINT-MONTELUKAST (EDS)    MNT 0002758 E 
61                          02442353    JAMP-MONTELUKAST (EDS)    JPC 0002758 E 
61                          02514877    JAMP MONTELUKAST (EDS)    JPC 0002758 E 
61                          02522101    NAT-MONTELUKAST (EDS)     NPI 0002758 E 
61                          02243602    SINGULAIR (EDS)           ORG 0017989 E 
42                         *5MG CHEWABLE TABLET                                 
61                          02330393    SANDOZ MONTELUKAST (EDS)  SDZ 0003082 E 
61                          02354985    PMS-MONTELUKAST (EDS)     PMS 0003082 E 
61                          02355515    TEVA-MONTELUKAST (EDS)    TEV 0003082 E 
61                          02377616    APO-MONTELUKAST (EDS)     APX 0003082 E 
61                          02379325    MONTELUKAST (EDS)         SAN 0003082 E 
61                          02382466    MONTELUKAST (EDS)         SIV 0003082 E 
61                          02399873    MAR-MONTELUKAST (EDS)     MPI 0003082 E 
61                          02408635    MINT-MONTELUKAST (EDS)    MNT 0003082 E 
61                          02442361    JAMP-MONTELUKAST (EDS)    JPC 0003082 E 
61                          02514885    JAMP MONTELUKAST (EDS)    JPC 0003082 E 
61                          02522128    NAT-MONTELUKAST (EDS)     NPI 0003082 E 
61                          02238216    SINGULAIR (EDS)           ORG 0020526 E 
42                         *10MG TABLET                                         
61                          02328593    SANDOZ MONTELUKAST (EDS)  SDZ 0004231 E 
61                          02355523    TEVA-MONTELUKAST (EDS)    TEV 0004231 E 
61                          02373947    PMS-MONTELUKAST (EDS)     PMS 0004231 E 
61                          02374609    APO-MONTELUKAST (EDS)     APX 0004231 E 
61                          02379236    MONTELUKAST SODIUM (EDS)  AHI 0004231 E 
61                          02379333    MONTELUKAST (EDS)         SAN 0004231 E 
61                          02382474    MONTELUKAST (EDS)         SIV 0004231 E 
61                          02389517    RAN-MONTELUKAST (EDS)     RAN 0004231 E 
61                          02391422    JAMP-MONTELUKAST (EDS)    JPC 0004231 E 
61                          02399997    MAR-MONTELUKAST (EDS)     MPI 0004231 E 
61                          02401274    AURO-MONTELUKAST (EDS)    API 0004231 E 
61                          02408643    MINT-MONTELUKAST (EDS)    MNT 0004231 E 
61                          02488183    M-MONTELUKAST (EDS)       MNP 0004231 E 
61                          02489821    NRA-MONTELUKAST (EDS)     NRA 0004231 E 
61                          02522136    NAT-MONTELUKAST (EDS)     NPI 0004231 E 
61                          02238217    SINGULAIR (EDS)           ORG 0030025 E 
42                          4MG ORAL GRANULE                                    
61                          02358611    SANDOZ MONTELUKAST (EDS)  SDZ 0013139 E 
41                          MYCOPHENOLATE MOFETIL                               
51                          NOTE:SEE APPENDIX A FOR EDS CRITERIA;THE ID         
52                          NUMBERS FOR THIS PRODUCT HAVE BEEN GENERATED        
53                          BY THE DRUG PLAN FOR BILLING PURPOSES               
54                          THIS PRODUCT HAVE BEEN GENERATED BY THE             
55                          PRESCRIPTION DRUG PLAN FOR BILLING PURPOSES         
42                         *250MG CAPSULE                                       
61                          00951163    APO-MYCOPHENOLATE (EDS)   APX 0003712 E 
61                          00951167    TEVA-MYCOPHENOLATE (EDS)  TEV 0003712 E 
61                          00951169    SANDOZ MYCOPHENOLATE(EDS) SDZ 0003712 E 
61                          00951174    MYCOPHENOLATE MOFETIL(EDS AHI 0003712 E 
61                          00951175    JAMP-MYCOPHENOLATE (EDS)  JPC 0003712 E 
61                          00951359    MYCOPHENOLATE (EDS)       SAN 0003712 E 
61                          00950887    CELLCEPT (EDS)            HLR 0022833 E 
42                         *500MG TABLET                                        
61                          00951164    APO-MYCOPHENOLATE (EDS)   APX 0007423 E 
61                          00951168    TEVA-MYCOPHENOLATE (EDS)  TEV 0007423 E 
61                          00951170    SANDOZ MYCOPHENOLATE(EDS) SDZ 0007423 E 
61                          00951172    MYCOPHENOLATE MOFETIL(EDS AHI 0007423 E 
61                          00951176    JAMP-MYCOPHENOLATE (EDS)  JPC 0007423 E 
61                          00951360    MYCOPHENOLATE (EDS)       SAN 0007423 E 
61                          00950888    CELLCEPT (EDS)            HLR 0045666 E 
42                         *200MG/ML SUSPENSION                                 
61                          00951560    MAR-MYCOPHENOLATE (EDS)   MPI 0013983 E 
61                          00950937    CELLCEPT (EDS)            HLR 0020461 E 
41                          MYCOPHENOLATE MOFETIL (TRANSPLANT)                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *250MG CAPSULE                                       
61                          02320630    SANDOZ MYCOPHENOLATE(EDS) SDZ 0003712 E 
61                          02352559    APO-MYCOPHENOLATE (EDS)   APX 0003712 E 
61                          02364883    TEVA-MYCOPHENOLATE (EDS)  TEV 0003712 E 
61                          02383780    MYCOPHENOLATE MOFETIL(EDS AHI 0003712 E 
61                          02386399    JAMP-MYCOPHENOLATE (EDS)  JPC 0003712 E 
61                          02457369    MYCOPHENOLATE MOFETIL(EDS SAN 0003712 E 
61                          02192748    CELLCEPT (EDS)            HLR 0022833 E 
42                         *500MG TABLET                                        
61                          02313855    SANDOZ MYCOPHENOLATE(EDS) SDZ 0007423 E 
61                          02348675    TEVA-MYCOPHENOLATE (EDS)  TEV 0007423 E 
61                          02352567    APO-MYCOPHENOLATE (EDS)   APX 0007423 E 
61                          02378574    MYCOPHENOLATE MOFETIL(EDS AHI 0007423 E 
61                          02380382    JAMP-MYCOPHENOLATE (EDS)  JPC 0007423 E 
61                          02457377    MYCOPHENOLATE MOFETIL(EDS SAN 0007423 E 
61                          02237484    CELLCEPT (EDS)            HLR 0045666 E 
42                         *200MG/ML SUSPENSION                                 
61                          02522233    MAR-MYCOPHENOLATE (EDS)   MPI 0013983 E 
61                          02242145    CELLCEPT (EDS)            HLR 0020461 E 
41                          MYCOPHENOLATE SODIUM                                
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *180MG ENTERIC COATED TABLET                         
61                          02372738    APO-MYCOPHENOLIC ACID(EDS APX 0004994 E 
61                          02511673    MAR-MYCOPHENOLIC ACID(EDS MPI 0004994 E 
61                          02518538    JAMP MYCOPHENOLIC (EDS)   JPC 0004994 E 
61                          02264560    MYFORTIC (EDS)            NVR 0020396 E 
42                         *360MG ENTERIC COATED TABLET                         
61                          02372746    APO-MYCOPHENOLIC ACID(EDS APX 0009988 E 
61                          02511681    MAR-MYCOPHENOLIC ACID(EDS MPI 0009988 E 
61                          02518511    JAMP MYCOPHENOLIC (EDS)   JPC 0009988 E 
61                          02264579    MYFORTIC (EDS)            NVR 0040792 E 
41                          NATALIZUMAB                                         
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          20MG/ML INJECTION SOLUTION (ML)                     
61                          02286386    TYSABRI (EDS)             BGN 2243900 E 
41                          NINTEDANIB                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *100MG CAPSULE                                       
61                          02526891    AURO-NINTEDANIB (EDS)     API 0142084 E 
61                          02550849    JAMP NINTEDANIB (EDS)     JPC 0142084 E 
61                          02443066    OFEV (EDS)                BOE 0283217 E 
42                         *150MG CAPSULE                                       
61                          02526905    AURO-NINTEDANIB (EDS)     API 0284168 E 
61                          02540762    JAMP NINTEDANIB (EDS)     JPC 0284168 E 
61                          02443074    OFEV (EDS)                BOE 0555017 E 
41                          NUSINERSEN                                          
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MICROGRAMS.                                         
53                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          12MG/5ML SOLUTION FOR INTRATHECAL INJ (MCG)         
61                          02465663    SPINRAZA (EDS)            BGN 0098334 E 
41                          OCRELIZUMAB                                         
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          30MG/ML SOLUTION FOR INFUSION                       
61                          02467224    OCREVUS (EDS)             HLR 0271700 E 
41                          OCTREOTIDE                                          
51                          WHEN BILLING LAR FORM, SUBMIT QUANTITY IN           
52                          TERMS OF MILLIGRAMS.                                
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50UG INJECTION (1ML)                                
61                          00839191    SANDOSTATIN (EDS)         NVR 0051500 E 
42                         *100UG INJECTION (1ML)                               
61                          02248640    OCTREOTIDE ACETATE (EDS)  OMG 0050440 E 
61                          02560240    OCTREOTIDE INJECTION(EDS) STE 0050440 E 
42                         *200UG/ML INJECTION (5ML)                            
61                          02248642    OCTREOTIDE ACETATE (EDS)  OMG 0485150 E 
61                          02560283    OCTREOTIDE INJECTION(EDS) STE 0485150 E 
42                         *500UG INJECTION (1ML)                               
61                          02248641    OCTREOTIDE ACETATE (EDS)  OMG 0237070 E 
61                          02560291    OCTREOTIDE INJECTION(EDS) STE 0237070 E 
42                         *10MG/VIAL POWDER FOR INJECTION (MG)                 
61                          02567776    OCTREOTIDE DEPOT (EDS)    STE 0726512 E 
61                          02239323    SANDOSTATIN LAR (EDS)     NVR 1315800 E 
42                         *20MG/VIAL POWDER FOR INJECTION (MG)                 
61                          02567784    OCTREOTIDE DEPOT (EDS)    STE 0469310 E 
61                          02239324    SANDOSTATIN LAR (EDS)     NVR 0850000 E 
42                         *30MG/VIAL POWDER FOR INJECTION (MG)                 
61                          02567792    OCTREOTIDE DEPOT (EDS)    STE 0364920 E 
61                          02239325    SANDOSTATIN LAR (EDS)     NVR 0727000 E 
41                          OFATUMUMAB                                          
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          20MG/0.4ML PRE-FILLED PEN (MG)                      
61                          02511355    KESIMPTA (EDS)            NVR 1193570 E 
41                          ONABOTULINUMTOXIN A                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          50 ALLERGAN UNITS/VIAL INJ (UNITS)                  
61                          02531577    BOTOX (EDS)               ABV 0038272 E 
42                          100 ALLERGAN UNITS/VIAL INJ (UNITS)                 
61                          01981501    BOTOX (EDS)               ABV 0038272 E 
42                          200 ALLERGAN UNITS/VIAL INJ (UNITS)                 
61                          02531585    BOTOX (EDS)               ABV 0038272 E 
41                          OZANIMOD                                            
51                          SEE APPENDIX A FOR CRITERIA                         
42                          0.23MG & 0.46MG CAPSULE INITIATION KIT              
61                          02506009    ZEPOSIA (EDS)             BMY 0680643 E 
42                          0.92MG CAPSULE                                      
61                          02505991    ZEPOSIA (EDS)             BMY 0684932 E 
41                          PALOVAROTENE                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG CAPSULE (MG)                                    
61                          02524627    SOHONOS (EDS)             IPS 3242200 E 
42                          1.5MG CAPSULE (MG)                                  
61                          02524635    SOHONOS (EDS)             IPS 3242200 E 
42                          2.5MG CAPSULE (MG)                                  
61                          02524643    SOHONOS (EDS)             IPS 3242200 E 
42                          5MG CAPSULE (MG)                                    
61                          02524651    SOHONOS (EDS)             IPS 3242200 E 
42                          10MG CAPSULE (MG)                                   
61                          02524678    SOHONOS (EDS)             IPS 3242200 E 
41                          PEGCETACOPLAN                                       
51                          SEE APPENDIX A FOR CRITERIA                         
42                          54MG/ML SUBCUTANEOUS INFUSION 20ML VIAL (ML)        
61                          02533294    EMPAVELI (EDS)            BIO 2485000 E 
41                          PEGINTERFERON BETA-1A                               
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          63MCG/94MCG/0.5ML PREFILLED SYRINGE/PEN             
61                          02444402    PLEGRIDY (EDS)            BGN 9397450 E 
42                          125MCG/0.5ML PREFILLED SYRINGE/PEN                  
61                          02444399    PLEGRIDY (EDS)            BGN 9397450 E 
41                          PENTOSAN POLYSULFATE SO4                            
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG CAPSULE                                       
61                          02029448    ELMIRON (EDS)             JAN 0046905 E 
41                          PIRFENIDONE                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *267MG CAPSULE                                       
61                          02488833    SANDOZ PIRFENIDONE (EDS)  SDZ 0067120 E 
61                          02509938    JAMP PIRFENIDONE (EDS)    JPC 0067120 E 
42                         *267MG TABLET                                        
61                          02488507    SANDOZ PIRFENIDONE (EDS)  SDZ 0033560 E 
61                          02514702    JAMP PIRFENIDONE (EDS)    JPC 0033560 E 
61                          02531526    PMS-PIRFENIDONE (EDS)     PMS 0033560 E 
61                          02537753    AURO-PIRFENIDONE (EDS)    API 0033560 E 
61                          02550644    M-PIRFENIDONE (EDS)       MNP 0033560 E 
61                          02464489    ESBRIET (EDS)             HLR 0134241 E 
42                         *801MG TABLET                                        
61                          02488515    SANDOZ PIRFENIDONE (EDS)  SDZ 0100680 E 
61                          02514710    JAMP PIRFENIDONE (EDS)    JPC 0100680 E 
61                          02531534    PMS-PIRFENIDONE (EDS)     PMS 0100680 E 
61                          02537761    AURO-PIRFENIDONE (EDS)    API 0100680 E 
61                          02550652    M-PIRFENIDONE (EDS)       MNP 0100680 E 
61                          02464500    ESBRIET (EDS)             HLR 0402720 E 
41                          PREGABALIN                                          
42                         *25MG CAPSULE                                        
6                           02359596    PMS-PREGABALIN            PMS 0001481 F 
6                           02361159    TEVA-PREGABALIN           TEV 0001481 F 
6                           02390817    SANDOZ PREGABALIN         SDZ 0001481 F 
6                           02392801    RAN-PREGABALIN            RAN 0001481 F 
6                           02394235    APO-PREGABALIN            APX 0001481 F 
6                           02403692    PREGABALIN                SIV 0001481 F 
6                           02405539    PREGABALIN                SAN 0001481 F 
6                           02423804    MINT-PREGABALIN           MNT 0001481 F 
6                           02433869    AURO-PREGABALIN           API 0001481 F 
6                           02435977    JAMP-PREGABALIN           JPC 0001481 F 
6                           02449838    ACH-PREGABALIN            AHI 0001481 F 
6                           02467291    M-PREGABALIN              MNP 0001481 F 
6                           02479117    NRA-PREGABALIN            NRA 0001481 F 
6                           02480727    AG-PREGABALIN             ANG 0001481 F 
6                           02494841    NAT-PREGABALIN            NPI 0001481 F 
6                           02268418    LYRICA                    BGP 0010222 F 
42                         *50MG CAPSULE                                        
6                           02359618    PMS-PREGABALIN            PMS 0002324 F 
6                           02361175    TEVA-PREGABALIN           TEV 0002324 F 
6                           02390825    SANDOZ PREGABALIN         SDZ 0002324 F 
6                           02392828    RAN-PREGABALIN            RAN 0002324 F 
6                           02394243    APO-PREGABALIN            APX 0002324 F 
6                           02403706    PREGABALIN                SIV 0002324 F 
6                           02405547    PREGABALIN                SAN 0002324 F 
6                           02423812    MINT-PREGABALIN           MNT 0002324 F 
6                           02433877    AURO-PREGABALIN           API 0002324 F 
6                           02435985    JAMP-PREGABALIN           JPC 0002324 F 
6                           02449846    ACH-PREGABALIN            AHI 0002324 F 
6                           02467305    M-PREGABALIN              MNP 0002324 F 
6                           02479125    NRA-PREGABALIN            NRA 0002324 F 
6                           02480735    AG-PREGABALIN             ANG 0002324 F 
6                           02494868    NAT-PREGABALIN            NPI 0002324 F 
6                           02268426    LYRICA                    BGP 0016035 F 
42                         *75MG CAPSULE                                        
6                           02359626    PMS-PREGABALIN            PMS 0003007 F 
6                           02361183    TEVA-PREGABALIN           TEV 0003007 F 
6                           02390833    SANDOZ PREGABALIN         SDZ 0003007 F 
6                           02392836    RAN-PREGABALIN            RAN 0003007 F 
6                           02394251    APO-PREGABALIN            APX 0003007 F 
6                           02403714    PREGABALIN                SIV 0003007 F 
6                           02405555    PREGABALIN                SAN 0003007 F 
6                           02424185    MINT-PREGABALIN           MNT 0003007 F 
6                           02433885    AURO-PREGABALIN           API 0003007 F 
6                           02435993    JAMP-PREGABALIN           JPC 0003007 F 
6                           02449854    ACH-PREGABALIN            AHI 0003007 F 
6                           02467313    M-PREGABALIN              MNP 0003007 F 
6                           02479133    NRA-PREGABALIN            NRA 0003007 F 
6                           02480743    AG-PREGABALIN             ANG 0003007 F 
6                           02494876    NAT-PREGABALIN            NPI 0003007 F 
6                           02268434    LYRICA                    BGP 0020747 F 
42                         *150MG CAPSULE                                       
6                           02359634    PMS-PREGABALIN            PMS 0004145 F 
6                           02361205    TEVA-PREGABALIN           TEV 0004145 F 
6                           02390841    SANDOZ PREGABALIN         SDZ 0004145 F 
6                           02392844    RAN-PREGABALIN            RAN 0004145 F 
6                           02394278    APO-PREGABALIN            APX 0004145 F 
6                           02403722    PREGABALIN                SIV 0004145 F 
6                           02405563    PREGABALIN                SAN 0004145 F 
6                           02424207    MINT-PREGABALIN           MNT 0004145 F 
6                           02433907    AURO-PREGABALIN           API 0004145 F 
6                           02436000    JAMP-PREGABALIN           JPC 0004145 F 
6                           02449870    ACH-PREGABALIN            AHI 0004145 F 
6                           02467321    M-PREGABALIN              MNP 0004145 F 
6                           02479168    NRA-PREGABALIN            NRA 0004145 F 
6                           02480751    AG-PREGABALIN             ANG 0004145 F 
6                           02494884    NAT-PREGABALIN            NPI 0004145 F 
6                           02268450    LYRICA                    BGP 0028597 F 
42                         *300MG CAPSULE                                       
6                           02359642    PMS-PREGABALIN            PMS 0004145 F 
6                           02361248    TEVA-PREGABALIN           TEV 0004145 F 
6                           02390868    SANDOZ PREGABALIN         SDZ 0004145 F 
6                           02392860    RAN-PREGABALIN            RAN 0004145 F 
6                           02394294    APO-PREGABALIN            APX 0004145 F 
6                           02403730    PREGABALIN                SIV 0004145 F 
6                           02405598    PREGABALIN                SAN 0004145 F 
6                           02436019    JAMP-PREGABALIN           JPC 0004145 F 
6                           02449900    ACH-PREGABALIN            AHI 0004145 F 
6                           02479192    NRA-PREGABALIN            NRA 0004145 F 
6                           02480778    AG-PREGABALIN             ANG 0004145 F 
6                           02494906    NAT-PREGABALIN            NPI 0004145 F 
6                           02541963    M-PREGABALIN              MNP 0004145 F 
6                           02268485    LYRICA                    BGP 0028597 F 
41                          RANIBIZUMAB                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MICROGRAMS.                                         
53                          SEE APPENDIX A FOR EDS ONLINE ADJUDICATION          
42                          10MG/ML INJECTION SOLUTION (MCG)                    
61                          02296810    LUCENTIS (EDS)            NVR 0007598 E 
41                          RASAGILINE MESYLATE                                 
42                         *0.5MG TABLET                                        
6                           02404680    APO-RASAGILINE            APX 0036050 F 
6                           02418436    TEVA-RASAGILINE           TEV 0036050 F 
6                           02284642    AZILECT                   TVM 0095087 F 
42                         *1MG TABLET                                          
6                           02404699    APO-RASAGILINE            APX 0036050 F 
6                           02418444    TEVA-RASAGILINE           TEV 0036050 F 
6                           02284650    AZILECT                   TVM 0095087 F 
41                          RAVULIZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          WHEN BILLING SUBMIT QTY IN MILLIGRAMS               
42                          10MG/ML (30ML VIAL) INTRAVENOUS SOLUTION (MG)       
61                          02491559    ULTOMIRIS (EDS)           AXN 0242739 E 
42                          100MG/ML (3ML VIAL) INTRAVENOUS SOLUTION (MG)       
61                          02533448    ULTOMIRIS (EDS)           AXN 0242739 E 
42                          100MG/ML (11ML VIAL) INTRAVENOUS SOLUTION(MG)       
61                          02533456    ULTOMIRIS (EDS)           AXN 0242739 E 
41                          RIFABUTIN                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG CAPSULE                                       
61                          02063786    MYCOBUTIN (EDS)           PFI 0063342 E 
42                          150MG CAPSULE (US-LABELLED)                         
61                          09858390    RIFABUTIN US-LABEL (EDS)  STE 0230000 E 
41                          RIOCIGUAT                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *0.5MG TABLET                                        
61                          02533545    SANDOZ RIOCIGUAT (EDS)    SDZ 0240460 E 
61                          02412764    ADEMPAS (EDS)             BAY 0437200 E 
42                         *1MG TABLET                                          
61                          02533561    SANDOZ RIOCIGUAT (EDS)    SDZ 0240460 E 
61                          02412772    ADEMPAS (EDS)             BAY 0437200 E 
42                         *1.5MG TABLET                                        
61                          02533588    SANDOZ RIOCIGUAT (EDS)    SDZ 0240460 E 
61                          02412799    ADEMPAS (EDS)             BAY 0437200 E 
42                         *2MG TABLET                                          
61                          02533596    SANDOZ RIOCIGUAT (EDS)    SDZ 0240460 E 
61                          02412802    ADEMPAS (EDS)             BAY 0437200 E 
42                         *2.5MG TABLET                                        
61                          02533618    SANDOZ RIOCIGUAT (EDS)    SDZ 0240460 E 
61                          02412810    ADEMPAS (EDS)             BAY 0437200 E 
41                          RISANKIZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          60MG/ML SOLUTION FOR INFUSION (10ML VIAL)(MG)       
61                          02532107    SKYRIZI (EDS)             ABV 0076552 E 
42                          150MG/ML PRE-FILLED SYRINGE (MG)                    
61                          02519283    SKYRIZI (EDS)             ABV 0329000 E 
42                          150MG/ML PRE-FILLED PEN (MG)                        
61                          02519291    SKYRIZI (EDS)             ABV 0329000 E 
42                          180MG/1.2ML PREFILLED CARTRIDGE (MG)                
61                          02552507    SKYRIZI (EDS)             ABV 0255175 E 
42                          360MG/2.4ML PREFILLED CARTRIDGE (MG)                
61                          02532093    SKYRIZI (EDS)             ABV 0127587 E 
41                          RISDIPLAM                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.75MG/ML POWDER FOR ORAL SOLUTION (MG)             
61                          02514931    EVRYSDI (EDS)             HLR 1939725 E 
42                          5MG TABLET (MG)                                     
61                          02560747    EVRYSDI (EDS)             HLR 1939725 E 
41                          RISEDRONATE SODIUM                                  
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          30MG TABLET                                         
61                          02298384    TEVA-RISEDRONATE (EDS)    TEV 0119497 E 
42                         *35MG TABLET                                         
61                          02298392    TEVA-RISEDRONATE (EDS)    TEV 0016764 E 
61                          02302209    PMS-RISEDRONATE (EDS)     PMS 0016764 E 
61                          02327295    SANDOZ RISEDRONATE (EDS)  SDZ 0016764 E 
61                          02353687    APO-RISEDRONATE (EDS)     APX 0016764 E 
61                          02368552    JAMP-RISEDRONATE (EDS)    JPC 0016764 E 
61                          02370255    RISEDRONATE (EDS)         SAN 0016764 E 
61                          02406306    AURO-RISEDRONATE (EDS)    API 0016764 E 
61                          02411407    RISEDRONATE-35 (EDS)      SIV 0016764 E 
61                          02246896    ACTONEL (EDS)             ABV 0115600 E 
42                         *35MG DELAYED RELEASE TABLET                         
61                          02493268    AA-RISEDRONATE DR (EDS)   AAP 0047461 E 
61                          02370417    ACTONEL DR (EDS)          ABV 0135625 E 
42                         *150MG TABLET                                        
61                          02377721    APO-RISEDRONATE (EDS)     APX 0111875 E 
61                          02413809    TEVA-RISEDRONATE (EDS)    TEV 0111875 E 
61                          02424177    PMS-RISEDRONATE (EDS)     PMS 0111875 E 
61                          02442760    AURO-RISEDRONATE (EDS)    API 0111875 E 
61                          02528460    RISEDRONATE (EDS)         SAN 0111875 E 
61                          02316838    ACTONEL (EDS)             ABV 0585700 E 
41                          RITUXIMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?10MG/ML INJECTION SOLUTION (ML)                     
61                          02478382    TRUXIMA (EDS)             TVM 0297000 E 
61                          02478390    TRUXIMA (EDS)             TVM 0297000 E 
61                          02495724    RUXIENCE (EDS)            PFI 0297000 E 
61                          02498316    RIXIMYO (EDS)             SDZ 0297000 E 
41                          ROMOSOZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          105MG/1.17ML PRE-FILLED SYRINGE (SYR)               
61                          02489597    EVENITY (EDS)             AMG 3594350 E 
41                          ROZANOLIXIZUMAB                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          140MG/ML SOL FOR SC INFUSION 2ML VIAL (MG)          
61                          02556081    RYSTIGGO (EDS)            UCB 0437867 E 
41                          SAPROPTERIN DIHYDROCHLORIDE                         
51                          SEE INHERITED METABOLIC DISEASE BENEFIT LIST        
42                          100MG TABLET                                        
61                          02350580    KUVAN (EDS)               BIL 0330000 E 
42                          100MG POWDER SACHET                                 
61                          02482207    KUVAN (EDS)               BIL 0330000 E 
41                          SARILUMAB                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          150MG/1.14ML PRE-FILLED PEN                         
61                          02472961    KEVZARA (EDS)             AVT 7456900 E 
42                          200MG/1.14ML PRE-FILLED SYRINGE                     
61                          02460548    KEVZARA (EDS)             AVT 7456900 E 
42                          200MG/1.14ML PRE-FILLED PEN                         
61                          02472988    KEVZARA (EDS)             AVT 7456900 E 
41                          SATRALIZUMAB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          120MG/ML PRE-FILLED SYRINGE (MG)                    
61                          02499681    ENSPRYNG (EDS)            HLR 0787500 E 
41                          SECUKINUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          75MG/0.5ML PRE-FILLED SYRINGE (MG)                  
61                          02525569    COSENTYX (EDS)            NVR 0103000 E 
42                          150MG/1.0ML PRE-FILLED SYRINGE (MG)                 
61                          02547724    COSENTYX (EDS)            NVR 0062883 E 
42                          150MG/1.0ML PRE-FILLED PEN (MG)                     
61                          02438070    COSENTYX (EDS)            NVR 0062883 E 
42                          300MG/2.0ML PRE-FILLED SYRINGE (MG)                 
61                          02529653    COSENTYX (EDS)            NVR 0061650 E 
42                          300MG/2.0ML PRE-FILLED PEN (MG)                     
61                          02529661    COSENTYX (EDS)            NVR 0062883 E 
41                          SEVELAMER CARBONATE                                 
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *800MG TABLET                                        
61                          02461501    ACCEL-SEVELAMER (EDS)     ACC 0012635 E 
61                          02354586    RENVELA (EDS)             AVT 0013125 E 
41                          SEVELAMER HCL                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          800MG TABLET                                        
61                          02244310    RENAGEL (EDS)             AVT 0018585 E 
41                          SIPONIMOD                                           
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                          0.25MG TABLET                                       
61                          02496429    MAYZENT (EDS)             NVR 0223285 E 
42                          2MG TABLET                                          
61                          02496437    MAYZENT (EDS)             NVR 0893150 E 
41                          SIROLIMUS                                           
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          1MG/ML ORAL SOLUTION                                
61                          02243237    RAPAMUNE (EDS)            PFI 0098695 E 
42                          1MG TABLET                                          
61                          02247111    RAPAMUNE (EDS)            PFI 0098695 E 
41                          SODIUM CROMOGLYCATE                                 
42                          100MG CAPSULE                                       
6                           00500895    NALCROM                   LUP 0017766 F 
41                          SODIUM PHENYLBUTYRATE                               
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          483MG/G ORAL GRANULES                               
61                          02436663    PHEBURANE (EDS)           MEC 0092690 E 
41                          SODIUM THIOSULFATE                                  
51                          SEE APPENDIX A FOR CRITERIA                         
42                          250MG/ML SOLUTION FOR INJECTION (ML)                
61                          02386666    SEACALPHYX (EDS)          SFP 0028895 E 
41                          TACROLIMUS                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          0.5MG CAPSULE                                       
61                          02243144    PROGRAF (EDS)             APC 0019700 E 
42                          1MG CAPSULE                                         
61                          02175991    PROGRAF (EDS)             APC 0025200 E 
42                          5MG CAPSULE                                         
61                          02175983    PROGRAF (EDS)             APC 0126200 E 
42                          5MG/ML AMPOULE                                      
61                          02176009    PROGRAF (EDS)             APC 1245000 E 
42                          0.5MG EXTENDED RELEASE CAPSULE                      
61                          02296462    ADVAGRAF (EDS)            APC 0019700 E 
42                          0.75MG EXTENDED RELEASE TABLET                      
61                          02485877    ENVARSUS PA (EDS)         KTI 0020999 E 
42                          1MG EXTENDED RELEASE TABLET                         
61                          02485885    ENVARSUS PA (EDS)         KTI 0027430 E 
42                          1MG EXTENDED RELEASE CAPSULE                        
61                          02296470    ADVAGRAF (EDS)            APC 0025200 E 
42                          3MG EXTENDED RELEASE CAPSULE                        
61                          02331667    ADVAGRAF (EDS)            APC 0075600 E 
42                          4MG EXTENDED RELEASE TABLET                         
61                          02485893    ENVARSUS PA (EDS)         KTI 0109719 E 
42                          5MG EXTENDED RELEASE CAPSULE                        
61                          02296489    ADVAGRAF (EDS)            APC 0126200 E 
41                          TAMSULOSIN HCL                                      
42                         *0.4MG SUSTAINED RELEASE CAPSULE                     
6                           02319217    SANDOZ TAMSULOSIN         SDZ 0004750 F 
6                           02352419    JAMP-TAMSULOSIN           JPC 0004750 F 
42                         *0.4MG CR TABLET                                     
6                           02340208    SANDOZ TAMSULOSIN CR      SDZ 0001500 F 
6                           02362406    APO-TAMSULOSIN CR         APX 0001500 F 
6                           02368242    TEVA-TAMSULOSIN CR        TEV 0001500 F 
6                           02427117    TAMSULOSIN CR             SAN 0001500 F 
6                           02429667    TAMSULOSIN CR             SIV 0001500 F 
6                           02545179    AURO-TAMSULOSIN           API 0001500 F 
41                          TERIFLUNOMIDE                                       
51                          SEE APPENDIX D FOR EDS CRITERIA                     
42                         *14MG TABLET                                         
61                          02500310    NAT-TERIFLUNOMIDE (EDS)   NPI 0149300 E 
61                          02500434    PMS-TERIFLUNOMIDE (EDS)   PMS 0149300 E 
61                          02500469    MAR-TERIFLUNOMIDE (EDS)   MPI 0149300 E 
61                          02500639    APO-TERIFLUNOMIDE (EDS)   APX 0149300 E 
61                          02501090    TEVA-TERIFLUNOMIDE (EDS)  TEV 0149300 E 
61                          02502933    ACH-TERIFLUNOMIDE (EDS)   AHI 0149300 E 
61                          02504170    JAMP TERIFLUNOMIDE (EDS)  JPC 0149300 E 
61                          02505843    SANDOZ TERIFLUOMIDE (EDS) SDZ 0149300 E 
61                          02523833    M-TERIFLUNOMIDE (EDS)     MNP 0149300 E 
41                          TETRABENAZINE                                       
42                         *25MG TABLET                                         
6                           02402424    PMS-TETRABENAZINE         PMS 0042686 F 
6                           02407590    APO-TETRABENAZINE         APX 0042686 F 
6                           02199270    NITOMAN                   BAU 0086430 F 
41                          TILDRAKIZUMAB                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          100MG/ML INJECTION PRE-FILLED SYRINGE (MG)          
61                          02516098    ILUMYA (EDS)              SUN 0493500 E 
42                          100MG/ML INJECTION PRE-FILLED PEN (MG)              
61                          02558904    ILUMYA (EDS)              SUN 0493500 E 
41                          TOCILIZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?20MG/ML SOL FOR IV INFUSION (4ML VIAL)              
61                          02552450    TYENNE (EDS)              FCL 1247610 E 
61                          02562022    AVTOZMA (EDS)             CEL 1247610 E 
42                         ?20MG/ML SOL FOR IV INFUSION (10ML VIAL)             
61                          02552469    TYENNE (EDS)              FCL 3119025 E 
61                          02562030    AVTOZMA (EDS)             CEL 3119025 E 
42                         ?20MG/ML SOL FOR IV INFUSION (20ML VIAL)             
61                          02552477    TYENNE (EDS)              FCL 6238050 E 
61                          02562049    AVTOZMA (EDS)             CEL 6238050 E 
42                         ?162MG/0.9ML AUTOINJECTOR                            
61                          02552485    TYENNE (EDS)              FCL 2422875 E 
61                          02562065    AVTOZMA (EDS)             CEL 2422875 E 
42                         ?162MG/0.9ML PREFILLED SYRINGE                       
61                          02552493    TYENNE (EDS)              FCL 2449525 E 
61                          02562057    AVTOZMA (EDS)             CEL 2449525 E 
41                          TOFACITINIB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG TABLET                                          
61                          02511304    TARO-TOFACITINIB (EDS)    TAR 0059897 E 
61                          02522799    PMS-TOFACITINIB (EDS)     PMS 0059897 E 
61                          02522896    JAMP TOFACITINIB (EDS)    JPC 0059897 E 
61                          02530007    AURO-TOFACITINIB (EDS)    API 0059897 E 
61                          02551691    SANDOZ TOFACITINIB (EDS)  SDZ 0059897 E 
61                          02423898    XELJANZ (EDS)             PFI 0247733 E 
42                         *10MG TABLET                                         
61                          02511312    TARO-TOFACITINIB (EDS)    TAR 0105859 E 
61                          02530015    AURO-TOFACITINIB (EDS)    API 0105859 E 
61                          02551705    SANDOZ TOFACITINIB (EDS)  SDZ 0105859 E 
61                          02480786    XELJANZ (EDS)             PFI 0437833 E 
42                         *11MG EXTENDED RELEASE TABLET                        
61                          02553988    TARO-TOFACITINIB XR (EDS) TAR 0272507 E 
61                          02470608    XELJANZ XR (EDS)          PFI 0495467 E 
41                          TRIENTINE HCL                                       
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         ?250MG CAPSULE                                       
61                          02504855    MAR-TRIENTINE (EDS)       MPI 0200000 E 
61                          02515067    WAYMADE-TRIENTINE (EDS)   WAY 0200000 E 
41                          TRIMEPRAZINE TARTRATE                               
42                          2.5MG TABLET                                        
6                           01926306    PANECTYL                  SLP 0004730 F 
42                          5MG TABLET                                          
6                           01926292    PANECTYL                  SLP 0005675 F 
41                          UPADACITINIB                                        
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          15MG EXTENDED RELEASE TABLET                        
61                          02495155    RINVOQ (EDS)              ABV 0516810 E 
42                          30MG EXTENDED RELEASE TABLET                        
61                          02520893    RINVOQ (EDS)              ABV 0785762 E 
42                          45MG EXTENDED RELEASE TABLET                        
61                          02539721    RINVOQ (EDS)              ABV 1039480 E 
41                          USTEKINUMAB                                         
51                          WHEN BILLING, SUBMIT QUANTITY IN TERMS OF           
52                          MILLIGRAMS.                                         
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          45MG/0.5ML SOL FOR SC INJ (PFP) (MG)                
61                          02553317    WEZLANA (EDS)             AMG 0612419 E 
42                         ?45MG/0.5ML SOL FOR SC INJ (PFS) (MG)                
61                          02544180    WEZLANA (EDS)             AMG 0612419 E 
61                          02550245    STEQEYMA (EDS)            CEL 0612419 E 
61                          02550539    PYZCHIVA (EDS)            ORG 0612419 E 
61                          02554283    OTULFI (EDS)              FCL 0612419 E 
42                          45MG/0.5ML SOL FOR SC INJ (PFS/VIAL) (MG)           
61                          02543036    JAMTEKI (EDS)             JPC 0612419 E 
42                          45MG/0.5ML SOL FOR SC INJ (VIAL) (MG)               
61                          02544202    WEZLANA (EDS)             AMG 0612419 E 
42                         ?90MG/1.0ML SOL FOR SC INJ (PFS) (MG)                
61                          02543044    JAMTEKI (EDS)             JPC 0306210 E 
61                          02544199    WEZLANA (EDS)             AMG 0306210 E 
61                          02550253    STEQEYMA (EDS)            CEL 0306210 E 
61                          02550547    PYZCHIVA (EDS)            ORG 0306210 E 
61                          02554291    OTULFI (EDS)              FCL 0306210 E 
42                          90MG/1.0ML SOL FOR SC INJ (PFP) (MG)                
61                          02553309    WEZLANA (EDS)             AMG 0306210 E 
42                         ?130MG/26ML SOL FOR IV INFUSION (VIAL) (MG)          
61                          02544210    WEZLANA I.V. (EDS)        AMG 0096000 E 
61                          02550261    STEQEYMA I.V. (EDS)       CEL 0096000 E 
61                          02550520    PYZCHIVA I.V. (EDS)       ORG 0096000 E 
61                          02554305    OTULFI I.V. (EDS)         FCL 0096000 E 
41                          VEDOLIZUMAB                                         
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          300MG/VIAL SOLUTION FOR INFUSION (MG)               
61                          02436841    ENTYVIO (EDS)             TAK 0126059 E 
42                          108MG/0.68ML PRE-FILLED PEN (MG)                    
61                          02497867    ENTYVIO (EDS)             TAK 0087540 E 
42                          108MG/0.68ML PRE-FILLED SYRINGE (MG)                
61                          02497875    ENTYVIO (EDS)             TAK 0087540 E 
41                          VERICIGUAT                                          
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          2.5MG TABLET                                        
61                          02537044    VERQUVO (EDS)             BAY 0048300 E 
42                          5MG TABLET                                          
61                          02537052    VERQUVO (EDS)             BAY 0048300 E 
42                          10MG TABLET                                         
61                          02537060    VERQUVO (EDS)             BAY 0048300 E 
41                          VUTRISIRAN                                          
51                          PLEASE CONTACT THE DRUG PLAN FOR BILLING            
52                          INFORMATION.SUBMIT QUANTITY PER 100MCG              
53                          SEE APPENDIX A FOR EDS CRITERIA                     
42                          25MG/0.5ML PRE-FILLED SYRINGE (100MCG)              
61                          02542420    AMVUTTRA (EDS)            ALN 5721640 E 
41                          ZOLEDRONIC ACID                                     
51                          SEE APPENDIX A FOR EDS CRITERIA                     
42                         *5MG/100ML INJECTION SOLUTION (VIAL)                 
61                          02422433    ZOLEDRONIC ACID INJ (EDS) DLC 3916110 E 
61                          02269198    ACLASTA (EDS)             SDZ 8274400 E 
2         COMPLEMENT INHIBITORS                                                 
41                          ZILUCOPLAN (ZILUCOPLAN SODIUM)                      
51                          SEE APPENDIX A FOR EDS CRITERIA                     
52                          SUBMIT QUANTITY PER 100MCG                          
42                          16.6MG/0.416ML PRE-FILLED SYRINGE (100MCG)          
61                          02549220    ZILBRYSQ (EDS)            UCB 0039173 E 
42                          23MG/0.574ML PRE-FILLED SYRINGE (100MCG)            
61                          02549239    ZILBRYSQ (EDS)            UCB 0039173 E 
42                          32.4MG/0.81ML PRE-FILLED SYRINGE (100MCG)           
61                          02549247    ZILBRYSQ (EDS)            UCB 0039173 E 
1         SUPPLIES FOR DIABETES MANAGEMENT                                      
2         SUPPLIES FOR DIABETES MANAGEMENT                                      
31        NOTE:  SOME OF THE IDENTIFICATION NUMBERS LISTED IN THIS              
32        SECTION HAVE BEEN GENERATED BY THE PRESCRIPTION DRUG PLAN             
33        FOR BILLING PURPOSES ONLY.                                            
41                          ISOPROPYL ALCOHOL                                   
42                         ?70% SWAB                                            
6                           80002455    ALCOHOL SWAB              LIF 0000122 F 
6                           00795232    WEBCOL ALCOHOL PREP       TYC 0000099 F 
6                           02240759    EMBECTA ALCOHOL SWABS     EMB 0000245 F 
41                          LANCET                                              
42                         ?LANCET                                              
6                           97799807    MPD ULTRA THIN            MPD 0000387 F 
6                           97799810    MPD THIN                  MPD 0000387 F 
6                           97799480    BIONIME RIGHTEST LANCETS  BNM 0000397 F 
6                           00950913    EQUATE THIN               MPD 0000546 F 
6                           00950914    EQUATE ULTRATHIN          MPD 0000598 F 
6                           97799232    DROPLET LANCET 28G        HTL 0000600 F 
6                           97799233    DROPLET LANCET 30G        HTL 0000600 F 
6                           97799234    DROPLET LANCET 33G        HTL 0000600 F 
6                           00906239    MICROLET                  ADC 0000636 F 
6                           00901359    ONE TOUCH ULTRA SOFT      LSN 0000650 F 
6                           97799540    EZ HEALTH ORACLE          THI 0000688 F 
6                           97799139    ONETOUCH DELICA PLUS 33G  LSN 0000720 F 
6                           97799140    ONETOUCH DELICA PLUS 30G  LSN 0000720 F 
6                           00906190    ABBOTT THIN               ABC 0000800 F 
6                           99401063    FREESTYLE                 ABC 0000800 F 
6                           00000165    SOFTCLIX                  RDC 0000826 F 
6                           97799494    ACCU-CHEK FASTCLIX MOBILE RDC 0000999 F 
6                           97799255    FIRST CNDN HEALTH 33G     ARA 0001118 F 
6                           97799348    ULTILET CLASSIC LANCETS   SKM 0001200 F 
41                          NEEDLE                                              
42                         ?29G NEEDLE                                          
6                           00964344    UNIFINE 12MM              ACM 0002200 F 
6                           97799280    SURECOMFORT 12.7MM        ALM 0002541 F 
6                           97799543    ULTICARE PEN 29G 12MM     ULT 0002805 F 
6                           97799235    DROPLET PEN NEEDLE 12MM   HTL 0002850 F 
6                           97799238    DROPLET PEN NEEDLE 10MM   HTL 0002850 F 
42                         ?30G NEEDLE                                          
6                           97799269    SURECOMFORT 8MM           ALM 0002541 F 
6                           97799567    INSUPEN 8MM               DRX 0002600 F 
6                           00908169    NOVOFINE 8MM              NOO 0003789 F 
42                         ?31G NEEDLE                                          
6                           00964220    UNIFINE 8MM               ACM 0002200 F 
6                           00964271    UNIFINE 6MM               ACM 0002200 F 
6                           97799426    UNIFINE PENTIPS 5MM       ACM 0002200 F 
6                           97799441    LIFE BRAND PEN NEEDLE 8MM SPP 0002518 F 
6                           97799442    LIFE BRAND PEN NEEDLE 6MM SPP 0002518 F 
6                           97799066    GENTLE TOUCH NEEDLE 8MM   SOS 0002540 F 
6                           97799067    GENTLE TOUCH NEEDLE 6MM   SOS 0002540 F 
6                           97799068    GENTLE TOUCH NEEDLE 4MM   SOS 0002540 F 
6                           97799069    GENTLE TOUCH NEEDLE 5MM   SOS 0002540 F 
6                           97799268    SURECOMFORT 8MM           ALM 0002541 F 
6                           97799279    SURECOMFORT 5MM           ALM 0002541 F 
6                           97799176    INSUPEN 5MM               DRX 0002600 F 
6                           97799568    INSUPEN 8MM               DRX 0002600 F 
6                           97799569    INSUPEN 6MM               DRX 0002600 F 
6                           97799148    ULTICARE PEN NEEDLE 8MM   ULT 0002805 F 
6                           97799149    ULTICARE PEN NEEDLE 5MM   ULT 0002805 F 
6                           97799544    ULTICARE PEN 31G 8MM      ULT 0002805 F 
6                           97799545    ULTICARE PEN 31G 6MM      ULT 0002805 F 
6                           97799236    DROPLET PEN NEEDLE 8MM    HTL 0002850 F 
6                           97799237    DROPLET PEN NEEDLE 6MM    HTL 0002850 F 
6                           97799239    DROPLET PEN NEEDLE 5MM    HTL 0002850 F 
6                           97799084    CLICKFINE 31G 5MM         HTL 0003100 F 
6                           97799038    NANOFINE PLUS 6MM         PPL 0003500 F 
6                           90109614    NUVAPOINT PLUS 6MM        FAM 0003599 F 
6                           00951673    ULTRA-FINE 5MM 3BEVEL TW  EMB 0003819 F 
6                           00977011    ULTRA-FINE 8MM 3BEVEL TW  EMB 0003819 F 
42                         ?32G NEEDLE                                          
6                           09770017    EZ HEALTH ORACLE 4MM      THI 0001999 F 
6                           00951193    UNIFINE PENTIPS 4MM       ACM 0002480 F 
6                           97799063    GENTLE TOUCH NEEDLE 6MM   SOS 0002540 F 
6                           97799064    GENTLE TOUCH NEEDLE 5MM   SOS 0002540 F 
6                           97799065    GENTLE TOUCH NEEDLE 4MM   SOS 0002540 F 
6                           97799267    SURECOMFORT 4MM           ALM 0002541 F 
6                           97799278    SURECOMFORT 6MM           ALM 0002541 F 
6                           97799399    INSUPEN 4MM               DRX 0002800 F 
6                           97799570    INSUPEN 8MM               DRX 0002800 F 
6                           97799571    INSUPEN 6MM               DRX 0002800 F 
6                           97799147    ULTICARE PEN NEEDLE 4MM   ULT 0002805 F 
6                           97799150    ULTICARE PEN NEEDLE 6MM   ULT 0002805 F 
6                           97799440    ULTICARE PEN NEEDLE       ULT 0002805 F 
6                           97799240    DROPLET PEN NEEDLE 8MM    HTL 0002850 F 
6                           97799241    DROPLET PEN NEEDLE 6MM    HTL 0002850 F 
6                           97799242    DROPLET PEN NEEDLE 5MM    HTL 0002850 F 
6                           97799243    DROPLET PEN NEEDLE 4MM    HTL 0002850 F 
6                           97799085    CLICKFINE 32G 4MM         HTL 0003100 F 
6                           97799037    NANOFINE PLUS 4MM         PPL 0003500 F 
6                           97799039    NANOFINE PLUS 5MM         PPL 0003500 F 
6                           90109612    NUVAPOINT PLUS 4MM        FAM 0003599 F 
6                           90109613    NUVAPOINT PLUS 5MM        FAM 0003599 F 
6                           97799337    SITESMART PEN NEEDLE 4MM  MMI 0003630 F 
6                           97799386    NOVOFINE PLUS 32G 4MM     NOO 0003703 F 
6                           00951438    NANO PRO 4MM 5BEVEL UTW   EMB 0003819 F 
6                           97799468    NOVOTWIST TIP NEEDLE      NOO 0003905 F 
6                           97799764    NOVOFINE ETW 32G          NOO 0003905 F 
42                         ?33G NEEDLE                                          
6                           00951450    UNIFINE PENTIPS 4MM       ACM 0002680 F 
6                           97799062    GENTLE TOUCH NEEDLE 4MM   SOS 0002740 F 
6                           97799383    INSUPEN 4MM               DRX 0002990 F 
42                          34G NEEDLE                                          
6                           90108841    DROPLET MICRON 34G 3.5MM  HTL 0003250 F 
41                          SYRINGE                                             
42                         ?0.3CC SYRINGE                                       
6                           97799260    SURECOMFORT 29G 1/2       ALM 0001285 F 
6                           97799261    SURECOMFORT 30G 5/16      ALM 0001418 F 
6                           97799264    SURECOMFORT 30G 1/2       ALM 0001418 F 
6                           97799273    SURECOMFORT 31G 5/16,(HM) ALM 0001485 F 
6                           97799274    SURECOMFORT 31G 5/16      ALM 0001485 F 
6                           97799516    ULTICARE 30G 1/2          ULT 0002144 F 
6                           97799513    ULTICARE 31G 5/16         ULT 0002171 F 
6                           00977951    MONOJECT ULTRACOMFORT 29G TYC 0002199 F 
6                           99254011    MONOJECT ULTRACOMFORT 30G TYC 0002199 F 
6                           97799509    ULTICARE 29G 1/2          ULT 0002810 F 
6                           97799506    ULTICARE 30G 5/16         ULT 0002924 F 
6                           00950959    ULTRA-FINE 8MM 31G 1/2U   EMB 0004462 F 
6                           97799425    ULTRA-FINE 6MM 31G 1/2U   EMB 0004462 F 
42                         ?0.5CC SYRINGE                                       
6                           97799257    SURECOMFORT 28G 1/2       ALM 0001285 F 
6                           97799259    SURECOMFORT 29G 1/2       ALM 0001285 F 
6                           97799270    SURECOMFORT 30G 1/2       ALM 0001418 F 
6                           97799272    SURECOMFORT 30G 5/16      ALM 0001418 F 
6                           97799263    SURECOMFORT 31G 5/16      ALM 0001485 F 
6                           97799518    ULTICARE 28G 1/2          ULT 0001950 F 
6                           97799515    ULTICARE 30G 1/2          ULT 0002144 F 
6                           97799512    ULTICARE 31G 5/16         ULT 0002171 F 
6                           00920355    MONOJECT ULTRACOMFORT 30G TYC 0002199 F 
6                           99432799    MONOJECT ULTRACOMFORT 29G TYC 0002682 F 
6                           97799508    ULTICARE 29G 1/2          ULT 0002810 F 
6                           97799505    ULTICARE 30G 5/16         ULT 0002924 F 
6                           97799385    ULTRA-FINE 6MM 31G        EMB 0004462 F 
6                           97799885    ULTRA-FINE 8MM 30G        EMB 0004462 F 
42                         ?1CC SYRINGE                                         
6                           97799258    SURECOMFORT 29G 1/2       ALM 0001285 F 
6                           97799275    SURECOMFORT 28G 1/2       ALM 0001285 F 
6                           97799265    SURECOMFORT 30G 5/16      ALM 0001418 F 
6                           97799271    SURECOMFORT 30G 1/2       ALM 0001418 F 
6                           97799262    SURECOMFORT 31G 5/16      ALM 0001485 F 
6                           97799517    ULTICARE 28G/1/2          ULT 0001950 F 
6                           97799514    ULTICARE 30G/1/2          ULT 0002144 F 
6                           97799511    ULTICARE 31G 5/16         ULT 0002171 F 
6                           00920045    MONOJECT ULTRACOMFORT 30G TYC 0002199 F 
6                           99433383    MONOJECT ULTRACOMFORT 29G TYC 0002199 F 
6                           97799507    ULTICARE 29G 1/2          ULT 0002810 F 
6                           97799504    ULTICARE 30G 5/16         ULT 0002924 F 
6                           00909238    ULTRA-FINE 8MM 30G        EMB 0004462 F 
6                           97799384    ULTRA-FINE 6MM 31G        EMB 0004462 F 
2         SUPPLIES FOR INSULIN PUMPS                                            
31        NOTE:  THE IDENTIFICATION NUMBERS LISTED IN THIS SECTION              
32        HAVE BEEN GENERATED BY THE PRESCRIPTION DRUG PLAN FOR BILLING         
33        PURPOSES ONLY.                                                        
41                          CARTRIDGE/RESERVOIR                                 
42                          1.8ML SYRINGE RESERVOIR                             
61                          97799707    MINIMED RESERVOIR (EDS)   MOC 0043500 E 
42                         ?3.0ML RESERVOIR/CARTRIDGE                           
61                          97799706    MINIMED RESERVOIR (EDS)   MOC 0043500 E 
61                          00951417    T SLIM X2 CARTRIDGE (EDS) TDC 0049950 E 
42                          3.15ML PLASTIC CARTRIDGE                            
61                          00950971    ACCU-CHEK SPIRIT (EDS)    DIS 0028280 E 
42                          OMNIPOD DASH DELIVERY DEVICE                        
61                          00951513    OMNIPOD DASH DEVICE (EDS) INS 0300000 E 
42                          OMNIPOD 5 AUTOMATED DELIVERY DEVICE                 
61                          00951694    OMNIPOD 5 DEVICE(EDS)     INS 0360000 E 
41                          INFUSION SET                                        
42                         ?6MM CANNULA/18" TUBING                              
61                          97799101    MINIMED SURE-T (EDS)      MOC 0168000 E 
61                          97799093    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
42                         ?6MM CANNULA/23" TUBING                              
61                          97799100    MINIMED SURE-T (EDS)      MOC 0168000 E 
61                          00951418    AUTOSOFT 90 (EDS)         TDC 0195950 E 
61                          00951419    TRUSTEEL CLEAR (EDS)      TDC 0195950 E 
61                          97799089    MINIMED QUICK SET (EDS)   MOC 0205000 E 
61                          97799166    MINIMED MIO ADVANCE (EDS) MOC 0235000 E 
42                          6MM CANNULA/24" TUBING                              
61                          00950973    ACCU-CHEK RAPID D (EDS)   DIS 0084500 E 
42                          6MM CANNULA/31" TUBING                              
61                          00950974    ACCU-CHEK RAPID D (EDS)   DIS 0084500 E 
42                         ?6MM CANNULA/32" TUBING                              
61                          97799099    MINIMED SURE-T (EDS)      MOC 0168000 E 
61                          00951421    TRUSTEEL CLEAR (EDS)      TDC 0195950 E 
61                          97799094    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
42                         ?6MM CANNULA/43" TUBING                              
61                          00951422    AUTOSOFT 90 (EDS)         TDC 0195950 E 
61                          97799090    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
42                         ?8MM CANNULA/23" TUBING                              
61                          97799098    MINIMED SURE-T (EDS)      MOC 0168000 E 
61                          00951424    TRUSTEEL CLEAR (EDS)      TDC 0195950 E 
42                          8MM CANNULA/24" TUBING                              
61                          00950982    ACCU-CHEK ULTRAFLEX 1(EDS DIS 0126750 E 
42                          8MM CANNULA/31" TUBING                              
61                          00950984    ACCU-CHEK ULTRAFLEX 1(EDS DIS 0126750 E 
42                          8MM CANNULA/32" TUBING                              
61                          00951435    TRUSTEEL CLEAR (EDS)      TDC 0195950 E 
42                          8MM CANNULA/43" TUBING                              
61                          00950987    ACCU-CHEK ULTRAFLEX 2(EDS DIS 0063375 E 
42                         ?9MM CANNULA/23" TUBING                              
61                          00951425    AUTOSOFT 90 (EDS)         TDC 0195950 E 
61                          97799091    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
61                          97799061    MINIMED MIO ADVANCE (EDS) MOC 0235000 E 
42                          9MM CANNULA/32" TUBING                              
61                          97799095    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
42                         ?9MM CANNULA/43" TUBING                              
61                          00951427    AUTOSOFT 90 (EDS)         TDC 0195950 E 
61                          97799092    MINIMED QUICK-SET (EDS)   MOC 0205000 E 
61                          97799060    MINIMED MIO ADVANCE (EDS) MOC 0235000 E 
42                          10MM CANNULA/24" TUBING                             
61                          00950988    ACCU-CHEK ULTRAFLEX 1(EDS DIS 0126750 E 
42                          10MM CANNULA/31" TUBING                             
61                          00950990    ACCU-CHEK ULTRAFLEX 1(EDS DIS 0126750 E 
42                          13MM CANNULA/18" TUBING                             
61                          97799114    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
42                         ?13MM CANNULA/23" TUBING                             
61                          97799649    ACCU-CHECK TENDER-1 (EDS) DIS 0120250 E 
61                          00951047    COMFORT SHORT ANGLED(EDS) MOC 0191300 E 
61                          00951429    AUTOSOFT 30 (EDS)         TDC 0195950 E 
61                          00951430    VARISOFT CLEAR (EDS)      TDC 0195950 E 
61                          97799111    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
42                          13MM CANNULA/32" TUBING                             
61                          00951436    VARISOFT CLEAR (EDS)      TDC 0195950 E 
42                         ?13MM CANNULA/43" TUBING                             
61                          00951431    AUTOSOFT 30 (EDS)         TDC 0195950 E 
61                          97799110    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
42                         ?17MM CANNULA/23" TUBING                             
61                          00951433    VARISOFT CLEAR (EDS)      TDC 0195950 E 
61                          97799112    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
61                          97799718    MINIMED SIL. FULL (EDS)   MOC 0205000 E 
42                          17MM CANNULA/32" TUBING                             
61                          97799108    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
42                         ?17MM CANNULA/43" TUBING                             
61                          00951434    VARISOFT CLEAR (EDS)      TDC 0195950 E 
61                          97799113    MINIMED SILHOUETTE (EDS)  MOC 0205000 E 
61                          97799719    MINIMED SIL. FULL (EDS)   MOC 0205000 E 
41                          INSERTION DEVICE                                    
42                          INSERTER                                            
61                          00951007    MINIMED QUICK-SERTER(EDS  MOC 0367500 E 
41                          SKIN PREPARATION                                    
42                         ?SKIN PREPARATION                                    
61                          00951072    IV SKIN PREPARATION (EDS) MOC 0003798 E 
61                          00951011    IV SKIN PREPARATION (EDS) ACM 0004198 E 
61                          00951041    SKIN TAC WIPES (EDS)      MOC 0005214 E