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Prior Authorization/Medical Necessity Determination medicine list

Horizon Blue Cross Blue Shield of New Jersey Pharmacy is committed to providing our members with access to safe and effective medicines. Below you will find a list of medicines requiring Prior Authorization/Medical Necessity Determination. This means that your doctor must give us information to show the use of the medicine meets specific criteria. The criteria follow U.S. Food and Drug Administration (FDA)-approved product labeling and generally accepted treatment guidelines to ensure safe and proper use.

It is important that your doctor submit a request with the information to Horizon Pharmacy to prevent any delay in getting your medicine. If you have any questions, talk with your doctor or call Pharmacy Member Services at 1-800-370-5088.

This list is subject to change and will be updated periodically. The listing below contains the brand name medicines only. The generic versions of these brand name medicines may also be subject to Prior Authorization/Medical Necessity Determination.

You can also look up details about your pharmacy benefits, including if a generic or brand name medicine requires Medical Necessity Determination, by visiting Member Online Services:

  1. Visit HorizonBlue.com/pharmacyservices.
  2. Sign in to Member Online Services with your user name and password.
  • 7T LIDO GEL
  • ABILIFY
  • ABILIFY ASIMTUFII
  • ABILIFY MAINTENA
  • ABILIFY MYCITE
  • ABILIFY MYCITE MAINTENANCE KIT
  • ABILIFY MYCITE STARTER KIT
  • ABIRATERONE ACETATE
  • ABSORICA
  • ABSORICA LD
  • ACANYA
  • ACCOLATE
  • ACCRUFER
  • ACCUPRIL
  • ACCURETIC
  • ACCUTANE
  • ACIPHEX
  • ACIPHEX SPRINKLE
  • ACTEMRA
  • ACTEMRA ACTPEN
  • ACTICLATE
  • ACTIMMUNE
  • ACTIQ
  • ACTIVELLA
  • ACTONEL
  • ACTOPLUS MET
  • ACTOS
  • ACULAR
  • ACULAR LS
  • ACYCLOVIR
  • ACZONE
  • ADAPALENE
  • ADAPALENE AND BENZOYL PEROXIDE
  • ADAPALENE AND BENZOYL PEROXIDE TOPICAL GEL
  • ADAPALENE PUMP
  • ADBRY
  • ADCIRCA
  • ADDERALL
  • ADDERALL XR
  • ADDYI
  • ADEMPAS
  • ADHANSIA XR
  • ADIPEX-P
  • ADLARITY
  • ADLYXIN
  • ADLYXIN STARTER PACK
  • ADMELOG
  • ADMELOG SOLOSTAR
  • ADZENYS ER
  • ADZENYS XR-ODT
  • AFINITOR
  • AFINITOR DISPERZ
  • AFREZZA
  • AGRYLIN
  • AIMOVIG
  • AIRDUO DIGIHALER 113/14
  • AIRDUO DIGIHALER 232/14
  • AIRDUO DIGIHALER 55/14
  • AIRDUO RESPICLICK 113/14
  • AIRDUO RESPICLICK 55/14
  • AJOVY
  • AKLIEF
  • ALA SCALP
  • ALDACTAZIDE
  • ALDACTONE
  • ALDARA
  • ALECENSA
  • ALENDRONATE SODIUM
  • ALINIA
  • ALKERAN
  • ALKINDI SPRINKLE
  • ALLZITAL
  • ALMOTRIPTAN
  • ALMOTRIPTAN MALATE
  • ALOCRIL
  • ALOGLIPTIN
  • ALOGLIPTIN/METFORM HCL
  • ALOGLIPTIN/METFORM
    HYDROCHLORIDE
  • ALOGLIPTIN/PIOGLITAZONE
  • ALORA
  • ALOSETRON HYDROCHLORIDE
  • ALPHAGAN P
  • ALTACE
  • ALTOPREV
  • ALTRENO
  • ALUNBRIG
  • ALYQ
  • AMARYL
  • AMBIEN
  • AMBIEN CR
  • AMBRISENTAN
  • AMCINONIDE
  • AMERGE
  • AMICAR
  • AMIODARONE HCL
  • AMIODARONE HYDROCHLORIDE
  • AMITIZA
  • AMJEVITA
  • AMNESTEEM
  • AMPHETAMINE ER
  • AMPYRA
  • AMRIX
  • AMZEEQ
  • ANADROL-50
  • ANAFRANIL
  • ANALPRAM HC
  • ANALPRAM HC SINGLES
  • ANAPROX DS
  • ANASPAZ
  • ANASTROZOLE
  • ANCOBON
  • ANDRODERM
  • ANDROGEL
  • ANDROGEL PUMP
  • ANTARA
  • ANUSOL-HC
  • APEXICON E
  • APIDRA
  • APIDRA SOLOSTAR
  • APLENZIN
  • APOKYN
  • APOMORPHINE HYDROCHLORIDE
  • APRACLONIDINE
  • APRISO
  • APTENSIO XR
  • ARANESP ALBUMIN FREE
  • ARAVA
  • ARAZLO
  • ARCALYST
  • ARICEPT
  • ARIKAYCE
  • ARIMIDEX
  • ARISTADA
  • ARISTADA INITIO
  • ARIXTRA
  • ARMONAIR DIGIHALER
  • AROMASIN
  • ARTHROTEC 50
  • ARTHROTEC 75
  • ASACOL HD
  • ASPIRIN/OMEPRAZOLE
  • ASPRUZYO SPRINKLE
  • ATACAND
  • ATACAND HCT
  • ATELVIA
  • ATIVAN
  • ATRALIN
  • AUBAGIO
  • AUGMENTIN
  • AUGMENTIN ES-600
  • AURYXIA
  • AUSTEDO
  • AUSTEDO XR
  • AUVELITY
  • AUVI-Q
  • AVALIDE
  • AVAPRO
  • AVAR LS CLEANSER
  • AVAR-E LS
  • AVITA
  • AVODART
  • AVONEX
  • AVONEX PEN
  • AYGESTIN
  • AYVAKIT
  • AZELEX
  • AZILECT
  • AZOPT
  • AZOR
  • AZSTARYS
  • AZULFIDINE
  • AZULFIDINE EN TABS
  • BACLOFEN
  • BACTRIM
  • BACTRIM DS
  • BAFIERTAM
  • BALVERSA
  • BANZEL
  • BARACLUDE
  • BECONASE AQ
  • BELBUCA
  • BELSOMRA
  • BENICAR
  • BENICAR HCT
  • BENLYSTA
  • BENZACLIN
  • BENZACLIN PUMP
  • BENZAMYCIN
  • BENZEPRO
  • BENZONATATE
  • BENZPHETAMINE HCL
  • BEPREVE
  • BESER
  • BESREMI
  • BETAMETHASONE DIPROPIONATE AUGMENTED
  • BETAMETHASONE VALERATE
  • BETAPACE
  • BETAPACE AF
  • BETASERON
  • BETHKIS
  • BEXAROTENE
  • BEYAZ
  • BIDIL
  • BILTRICIDE
  • BIMATOPROST
  • BINOSTO
  • BISMUTH SUBCITRATE POT/
    METRONIDAZOLE/TETRACYCLINE
    HYDROCHOL
  • BLEPH-10
  • BONIVA
  • BONJESTA
  • BOSENTAN
  • BOSULIF
  • BP CLEANSING WASH
  • BRAFTOVI
  • BREXAFEMME
  • BREZTRI AEROSPHERE
  • BRISDELLE
  • BRIVIACT
  • BRUKINSA
  • BRYHALI
  • BUDESONIDE ER
  • BUDESONIDE/FORMOTEROL FUMARATE DIHYDRATE
  • BUMEX
  • BUPAP
  • BUPHENYL
  • BUPRENORPHINE
  • BUPRIPION HYDROCHOLRIDE ER (XL)
  • BUTALBITAL/ACETAMINOPHEN
  • BUTALBITAL/ACETAMINOPHEN/ CAFFEINE
  • BUTRANS
  • BYDUREON BCISE
  • BYETTA
  • BYLVAY
  • BYLVAY (PELLETS)
  • BYSTOLIC
  • CABLIVI
  • CABOMETYX
  • CADUET
  • CAFERGOT
  • CALAN SR
  • CALCIPOTRIENE
  • CALCIPOTRIENE/BETAMETHASONE DIPROPIONATE
  • CALCITONIN SALMON
  • CALQUENCE
  • CAMBIA
  • CAMZYOS
  • CAPECITABINE
  • CAPEX
  • CAPLYTA
  • CAPRELSA
  • CARAC
  • CARAFATE
  • CARBAGLU
  • CARBATROL
  • CARBINOXAMINE MALEATE
  • CARDIZEM
  • CARDIZEM CD
  • CARDIZEM LA
  • CARDURA
  • CARGLUMIC ACID
  • CARISOPRODOL
  • CARNITOR
  • CARNITOR SF
  • CAROSPIR
  • CASODEX
  • CATAPRES-TTS-1
  • CATAPRES-TTS-2
  • CATAPRES-TTS-3
  • CAYSTON
  • CELEBREX
  • CELEXA
  • CELLCEPT
  • CEPHALEXIN
  • CEQUA
  • CERDELGA
  • CETRORELIX ACETATE
  • CETROTIDE
  • CHENODAL
  • CHLORZOXAZONE
  • CHOLBAM
  • CHORIONIC GONADOTROPIN
  • CIALIS
  • CIBINQO
  • CILOXAN
  • CIMETIDINE HCL
  • CIMETIDINE HYDROCHLORIDE
  • CIMZIA
  • CIMZIA STARTER KIT
  • CINACALCET HYDROCHLORIDE
  • CIPRO
  • CIPRODEX
  • CITALOPRAM HYDROBROMIDE
  • CLARAVIS
  • CLARINEX
  • CLEMASTINE FUMARATE
  • CLENPIQ
  • CLEOCIN
  • CLEOCIN PEDIATRIC GRANULES
  • CLEOCIN-T
  • CLIMARA
  • CLINDAGEL
  • CLINDAMYCIN PHOSPHATE/ TRETINOIN
  • CLOBETASOL PROPIONATE
  • CLOBETASOL PROPIONATE EMOLLIENT
  • CLOBEX
  • CLOCORTOLONE PIVALATE
  • CLODAN
  • CLODERM
  • CLOVIQUE
  • CLOZAPINE ODT
  • CLOZARIL
  • COLAZAL
  • COLCHICINE
  • COLCRYS
  • COLESTID
  • COLESTID FLAVORED
  • COMBIGAN
  • COMBIVIR
  • COMETRIQ
  • COMPOUNDED PRESCRIPTION COSTING $150 OR GREATER
  • COMTAN
  • CONCERTA
  • CONDYLOX
  • CONJUPRI
  • CONSENSI
  • CONTRAVE
  • CONZIP
  • COPAXONE
  • COPIKTRA
  • CORDRAN
  • COREG
  • COREG CR
  • COREMINO
  • CORGARD
  • CORTEF
  • CORTENEMA
  • CORTISONE ACETATE
  • CORVITE 150
  • COSENTYX
  • COSENTYX SENSOREADY PEN
  • COSOPT
  • COSOPT PF
  • COTELLIC
  • COTEMPLA XR-ODT
  • COZAAR
  • CRESEMBA
  • CRESTOR
  • CRINONE
  • CUPRIMINE
  • CUTIVATE
  • CUVPOSA
  • CYCLOBENSAPRINE HYDROCHLORIDE
  • CYCLOBENZAPRINE HYDROCHLORIDE ER
  • CYCLOGYL
  • CYCLOPHOSPHAMIDE
  • CYCLOSPORINE IN KLARITY
  • CYMBALTA
  • CYSTADANE
  • CYSTADROPS
  • CYSTARAN
  • CYTOMEL
  • CYTOTEC
  • D.H.E. 45
  • DALFAMPRIDINE ER
  • DALIRESP
  • DANAZOL
  • DANTRIUM
  • DARAPRIM
  • DARTISLA ODT
  • DAURISMO
  • DAYBUE
  • DAYPRO
  • DAYTRANA
  • DAYVIGO
  • DDAVP
  • DEFERASIROX
  • DEFERIPRONE
  • DELESTROGEN
  • DELZICOL
  • DEMECLOCYLCINE HCL
  • DEMOCLOCYCLINE HYDROCHLORIDE
  • DEMSER
  • DENAVIR
  • DEPAKOTE
  • DEPAKOTE ER
  • DEPAKOTE SPRINKLES
  • DEPO-TESTOSTERONE
  • DERMA-SMOOTH /FS BODY
  • DERMA-SMOOTH /FS SCALP
  • DERMOTIC
  • DESCOVY
  • DESONATE
  • DESONIDE
  • DESOWEN
  • DESOXIMETASONE
  • DESOXYN
  • DESRX
  • DESVENLAFAXINE ER
  • DETROL
  • DETROL LA
  • DEXCHLORPHENIRAMINE MALEATE
  • DEXCOM G6 RECEIVER
  • DEXCOM G6 SENSOR
  • DEXCOM G6 TRANSMITTER
  • DEXCOM G7 RECEIVER
  • DEXCOM G7 SENSOR
  • DEXEDRINE
  • DEXILANT
  • DHIVY
  • DIBENZYLINE
  • DICHLORPHENAMIDE
  • DICLEGIS
  • DICLOFENAC
  • DICLOFENAC EPOLAMINE
  • DICLOFENAC POTASSIUM
  • DICLOFENAC SODIUM
  • DIETHYLPROPION HCL
  • DIETHYLPROPION HCL ER
  • DIETHYLPROPION HYDROCHLORIDE
  • DIETHYLPROPION HYDROCHLORIDE ER
  • DIFFERIN
  • DIFICID
  • DIFLORASONE DIACETATE
  • DIFLUCAN
  • DIGOXIN
  • DIHYDROERGOTAMINE MESYLATE
  • DIOVAN
  • DIOVAN HCT
  • DIPROLENE
  • DIPROLENE AF
  • DITROPAN XL
  • DIURIL
  • DIVIGEL
  • DOJOLVI
  • DOPTELET
  • DORYX
  • DORYX MPC
  • DORZOLAMIDE HCL
  • DORZOLAMIDE HCL/TIMOLOL MALEATE
  • DOVONEX
  • DOXEPIN HYDROCHLORIDE
  • DOXYCYCLINE
  • DOXYCYCLINE HYCLATE DR
  • doxycycline monohydrate
  • DOXYLAMINE SUCCINATE/PYRIDOXINE HYDROCHLORIDE
  • DRISDOL
  • DRIZALMA SPRINKLE
  • DROXIA
  • DROXIDOPA
  • DUAKLIR PRESSAIR
  • DUETACT
  • DUEXIS
  • DUOBRII
  • DUPIXENT
  • DURAGESIC
  • DUREZOL
  • DYANAVEL XR
  • DYMISTA
  • DYRENIUM
  • E.E.S. GRANULES
  • EC-NAPROSYN
  • ECOZA
  • EDARBI
  • EDARBYCLOR
  • EDECRIN
  • EDLUAR
  • EFAVIRENZ
  • EFFEXOR XR
  • EFFIENT
  • EFUDEX
  • EGRIFTA SV
  • ELEPSIA XR
  • ELETRIPTAN HYDROBROMIDE
  • ELIDEL
  • ELIMITE
  • ELMIRON
  • ELURYNG
  • ELYXYB
  • EMFLAZA
  • EMGALITY
  • EMPAVELI
  • ENABLEX
  • ENALAPRIL MALEATE
  • ENBREL
  • ENBREL MINI
  • ENBREL SURECLICK
  • ENDARI
  • ENDOMETRIN
  • ENSPRYNG
  • ENSTILAR
  • ENTADFI
  • ENTEREG
  • ENTOCORT EC
  • EPANED
  • EPCLUSA
  • EPIDIOLEX
  • EPIDUO
  • EPIDUO FORTE
  • EPINEPHRINE
  • EPIPEN 2-PAK
  • EPIPEN-JR 2-PAK
  • EPIVIR
  • EPIVIR HBV
  • EPOGEN
  • EPRONTIA
  • EPSOLAY
  • EPZICOM
  • ERGOMAR
  • ERGOTAMINE TARTRATE/CAFFEINE
  • ERIVEDGE
  • ERLEADA
  • ERLOTINIB HYDROCHLORIDE
  • ERMEZA
  • ERTACZO
  • ERY
  • ERYGEL
  • ERYPED 200
  • ERYPED 400
  • ESBRIET
  • ESOMEPRAZOLE STRONTIUM
  • ESTRACE
  • ESTROSTEP FE
  • ETODOLAC ER
  • ETONGESTREL/ETHINYL ESTRADIOL
  • ETOPOSIDE
  • EUCRISA
  • EVEKEO
  • EVEKEO ODT
  • EVEROLIMUS
  • EVOCLIN
  • EVOXAC
  • EVRYSDI
  • EXELDERM
  • EXELON
  • EXEMESTANE
  • EXFORGE
  • EXFORGE HCT
  • EXJADE
  • EXKIVITY
  • EXSERVAN
  • EXTAVIA
  • EXTINA
  • EYSUVIS
  • EZALLOR SPRINKLE
  • EZETIMIBE/ATORVASTATIN
  • EZETIMIBE/ROSUVASTATIN
  • FABIOR
  • FAMOTIDINE
  • FANAPT
  • FANAPT TITRATION PAK
  • FARXIGA
  • FARYDAK
  • FASENRA PEN
  • FEBUXOSTAT
  • FELBATOL
  • FELDENE
  • FEMARA
  • FEMHRT
  • FENOFIBRATE
  • FENOFIBRATE MICRONIZED
  • FENOFIBRIC ACID
  • FENOGLIDE
  • FENOPROFEN CALCIUM
  • FENORTHO
  • FENTANYL
  • FENTANYL CITRATE
  • FENTANYL CITRATE ORAL TRANSMUCOSAL
  • FENTORA
  • FERRIPROX
  • FERRIPROX TWICE-A-DAY
  • FETZIMA
  • FETZIMA TITRATION PACK
  • FEXMID
  • FIBRICOR
  • FILSPARI
  • FINACEA
  • FINTEPLA
  • FIORICET
  • FIRAZYR
  • FIRDAPSE
  • FLAGYL
  • FLECTOR
  • FLEQSUVY
  • FLOLIPID
  • FLOMAX
  • FLUORIDEX SENSITIVITY RELIEF
  • FLUORIDEX SENSITIVITY RELIEF/ SLS FREE
  • FLUORIMAX 5000 SENSITIVE
  • FLUOROPLEX
  • FLUOROURACIL
  • FLUOXETINE DR
  • FLUOXETINE HYDROCHLORIDE
  • FLURANDRENOLIDE
  • FLUTICASONE PROPRIONATE
  • FLUTICASONE PROPRIONATE/ SALMETEROL
  • FLUTICASONE PROPRIONATE/ SALMETEROL DISKUS
  • FLUVASTATIN
  • FLUVASTATIN SODIUM ER
  • FML LIQUIFILM
  • FOCALIN
  • FOCALIN XR
  • FOLGARD RX
  • FOLLISTIM AQ
  • FORFIVO XL
  • FORTAMET
  • FORTEO
  • FORTESTA
  • FOSAMAX
  • FOSRENOL
  • FOTIVDA
  • FROVA
  • FROVATRIPTAN SUCCINATE
  • FULPHILA
  • FUROSCIX
  • FUROSEMIDE
  • FYCOMPA
  • FYLNETRA
  • FYREMADEL
  • GABITRIL
  • GALAFOLD
  • GANIRELIX ACETATE
  • GASTROCROM
  • GATTEX
  • GAVRETO
  • GELNIQUE
  • GEMTESA
  • GENERESS FE
  • GENOTROPIN
  • GENOTROPIN MINIQUICK
  • GEODON
  • GILENYA
  • GILOTRIF
  • GIMOTI
  • GLATOPA
  • GLEEVEC
  • GLUCOSE TEST STRIPS**
  • GLUCOTROL
  • GLUCOTROL XL
  • GLUMETZA
  • GLYCATE
  • GLYCOPYRROLATE
  • GLYDO
  • GLYNASE
  • GLYXAMBI
  • GOCOVRI
  • GONAL-F
  • GONAL-F RFF
  • GONAL-F RFF REDIJECT
  • GRALISE
  • GRANIX
  • GRASTEK
  • HAEGARDA
  • HALCINONIDE
  • HALCION
  • HALDOL
  • HALDOL DECANOATE 100
  • HALDOL DECANOATE 50
  • HALOBETASOL PROPIONATE
  • HALOETTE
  • HALOG
  • HARVONI
  • HELIDAC THERAPY
  • HEMADY
  • HEPSERA
  • HETLIOZ
  • HETLIOZ LQ
  • HIPREX
  • HORIZANT
  • HUMALOG
  • HUMALOG JUNIOR KWIKPEN
  • HUMALOG KWIKPEN
  • HUMALOG MIX 50/50
  • HUMALOG MIX 50/50 KWIKPEN
  • HUMALOG MIX 75/25
  • HUMALOG MIX 75/25 KWIKPEN
  • HUMALOG TEMPO PEN
  • HUMATROPE
  • HUMIRA
  • HUMIRA PEDIATRIC CROHNS DISEASE STARTER PACK
  • HUMIRA PEN
  • HUMIRA PEN-CD/UC/HS STARTER
  • HUMIRA PEN-PEDIATRIC UC STARTER PACK
  • HUMIRA PEN-PS/UV STARTER
  • HYCAMTIN
  • HYDREA
  • HYDROCODONE BITARTRATE ER
  • HYDROCORTISONE BUTYRATE
  • HYDROMORPHONE HCL ER
  • HYDROMORPHONE HYDROCHLORIDE ER
  • HYFTOR
  • HYSINGLA ER
  • HYZAAR
  • IBRANCE
  • ISBRELA
  • IBUPROFEN/FAMOTIDINE
  • ICAR-C PLUS
  • ICATIBANT ACETATE
  • ICLUSIG
  • ICOSAPENT ETHYL
  • IDHIFA
  • IMBRUVICA
  • IMCIVREE
  • IMIQUIMOD
  • IMIQUIMOD PUMP
  • IMITREX
  • IMITREX STATDOSE REFILL
  • IMITREX STATDOSE SYSTEM
  • IMPEKLO
  • IMPOYZ
  • IMURAN
  • IMVEXXY MAINTENANCE PACK
  • IMVEXXY STARTER PACK
  • INBRIJA
  • INCRELEX
  • INDERAL LA
  • INDOCIN
  • INDOMETHACIN
  • INGREZZA
  • INLYTA
  • INPEFA
  • INQOVI
  • INREBIC
  • INSPRA
  • INSULIN DEGLUDEC
  • INSULIN DEGLUDEC FLEXTOUCH
  • INSULIN GLARGINE
  • INSULIN GLARGINE SOLOSTAR
  • INSULIN LISPRO
  • INSULIN LISPRO JUNIOR KWIKPEN
  • INSULIN LISPRO KWIKPEN
  • INSULIN LISPRO PROTAMINE/INSULIN LISPRO KWIKPEN
  • INTELENCE
  • INTRAROSA
  • INTRON A
  • INTUNIV
  • INVEGA
  • INVEGA HAFYERA
  • INVEGA SUSTENNA
  • INVEGA TRINZA
  • INVOKAMET
  • INVOKAMET XR
  • INVOKANA
  • IRESSA
  • ISOPTO CARPINE
  • ISORDIL TITRADOSE
  • ISOSORBIDE DINITRATE
  • ISOTRETINOIN
  • ISTALOL
  • ISTURISA
  • ITRACONAZOLE
  • IVERMECTIN
  • JADENU
  • JADENU SPRINKLE
  • JAKAFI
  • JALYN
  • JANUMET
  • JANUMET XR
  • JANUVIA
  • JARDIANCE
  • JATENZO
  • JAVYGTOR
  • JAYPIRCA
  • JENTADUETO
  • JENTADUETO XR
  • JOENJA
  • JORNAY PM
  • JUBLIA
  • JUXTAPID
  • JYNARQUE
  • KALETRA
  • KALYDECO
  • KAPVAY
  • KARBINAL ER
  • KATERZIA
  • KAZANO
  • KEFLEX
  • KENALOG
  • KEPPRA
  • KEPPRA XR
  • KERENDIA
  • KERYDIN
  • KESIMPTA
  • KETOCONAZOLE
  • KETODAN
  • KETOPROFEN
  • KETOPROFEN ER
  • KETOROLAC TROMETHAMINE
  • KEVEYIS
  • KEVZARA
  • KINERET
  • KISQALI
  • KISQALI FEMARA 200 DOSE
  • KISQALI FEMARA 400 DOSE
  • KISQALI FEMARA 600 DOSE
  • KITABIS PAK
  • KLARON
  • KLISYRI
  • KLONOPIN
  • KOMBIGLYZE XR
  • KONVOMEP
  • KORLYM
  • KOSELUGO
  • K-PHOS
  • K-PHOS NEUTRAL
  • KRAZATI
  • K-TAB
  • KUVAN
  • KYNMOBI
  • KYZATREX
  • LACOSAMIDE
  • LACRISERT
  • LACTULOSE
  • LAMICTAL
  • LAMICTAL CHEWABLE DISPERSIBLE
  • LAMICTAL ODT
  • LAMICTAL STARTER/NOT TAKING CARBAMAZEPINE
  • LAMICTAL STARTER/TAKING CARBAMAZAPINE/NOT TAKING VALPROATE
  • LAMICTAL STARTER/TAKING VALPROATE
  • LAMICTAL XR
  • LANOXIN
  • LANSOPRAZOLE/AMOXICILLIN/ CLARITHROMYCIN
  • LANTHANUM CARBONATE
  • LANTUS
  • LANTUS SOLOSTAR
  • LAPATINIB DITOSYLATE
  • LASIX
  • LASTACAFT
  • LATANOPROST
  • LATISSE
  • LATUDA
  • LAZANDA
  • LEDIPASVIR/SOFOSBUVIR
  • LENALIDOMIDE
  • LENVIMA 10 MG DAILY DOSE
  • LENVIMA 12 MG DAILY DOSE
  • LENVIMA 14 MG DAILY DOSE
  • LENVIMA 18 MG DAILY DOSE
  • LENVIMA 20 MG DAILY DOSE
  • LENVIMA 24 MG DAILY DOSE
  • LENVIMA 4 MG DAILY DOSE
  • LENVIMA 8 MG DAILY DOSE
  • LESCOL XL
  • LETAIRIS
  • LETROZOLE
  • LEUKINE
  • LEVAMLODIPINE
  • LEVBID
  • LEVORPHANOL TARTRATE
  • LEVOTHYROXINE SODIUM
  • LEVSIN
  • LEVSIN/SL
  • LEXAPRO
  • LEXETTE
  • LIALDA
  • LIBRAX
  • LICART
  • LIDOCAINE
  • LIDOCAINE AND TETRACAINE CREAM
  • LIDOCAINE HCL
  • LIDOCAINE HCL JELLY
  • LIDOCAINE HYDROCHLORIDE
  • LIDOCAINE PATCH 5%
  • LIDOCAINE/PRILOCAINE
  • LIDOCAINE/TETRACAINE
  • LIDODERM
  • LINZESS
  • LIPITOR
  • LIPOFEN
  • LIQREV
  • LIVALO
  • LIVMARLI
  • LIVTENCITY
  • LOCOID
  • LOCOID LIPOCREAM
  • LODINE
  • LODOSYN
  • LOFENA
  • LOKELMA
  • LOMAIRA
  • LOMOTIL
  • LONHALA MAGNAIR REFILL KIT
  • LONHALA MAGNAIR STARTER KIT
  • LONSURF
  • LOPID
  • LOPRESSOR
  • LOPROX
  • LOPROX SHAMPOO
  • LORBRENA
  • LOREEV XR
  • LORZONE
  • LOSEASONIQUE
  • LOTEMAX
  • LOTENSIN
  • LOTENSIN HCT
  • LOTEPREDNOL ETABONATE
  • LOTREL
  • LOTRONEX
  • LOVAZA
  • LOVENOX
  • LUBIPROSTONE
  • LULICONAZOLE
  • LUMAKRAS
  • LUMIGAN
  • LUMRYZ
  • LUNESTA
  • LUPKYNIS
  • LUXIQ
  • LUZU
  • LYBALVI
  • LYNPARZA
  • LYRICA
  • LYRICA CR
  • LYSODREN
  • LYSTEDA
  • LYTGOBI
  • LYUMJEV
  • LYUMJEV KWIKPEN
  • LYUMJEV TEMPO PEN
  • LYVISPAH
  • MACROBID
  • MACRODANTIN
  • MALARONE
  • MAPROTILINE HCL
  • MARINOL
  • MATULANE
  • MAVENCLAD
  • MAVYRET
  • MAXALT
  • MAXALT-MLT
  • MAXITROL
  • MAXZIDE
  • MAXZIDE-25
  • MAYZENT
  • MAYZENT STARTER PACK
  • MECLOFENEMATE SODIUM
  • MEDROL
  • MEDROL DOSEPAK
  • MEKINIST
  • MEKTOVI
  • MELOXICAM
  • MEMANTINE HYDROCHLORIDE
  • MENOPUR
  • MEPHYTON
  • MEPRON
  • MESALAMINE DR
  • MESTINON
  • MESTINON TIMESPAN
  • METAXALONE
  • METFORMIN HYDROCHLORIDE
  • METFORMIN HYDROCHLORIDE ER
  • METHITEST
  • METHOCARBAMOL
  • METHOXSALEN
  • METHYLIN
  • METHYLPHENIDATE HYDROCHLORIDE ER
  • METHYLTESTOSTERONE
  • METROCREAM
  • METROGEL
  • METROLOTION
  • MIACALCIN
  • MICARDIS
  • MICARDIS HCT
  • MICONAZOLE NITRATE/ZINC OXIDE/ WHITE PETROLATUM
  • MIFEPREX
  • MIGERGOT
  • MIGLUSTAT
  • MIGRANAL
  • MINASTRIN 24 FE
  • MINIPRESS
  • MINIVELLE
  • MINOCYCLINE HYDROCHOLORIDE ER
  • MINOLIRA
  • MIRAPEX
  • MIRAPEX ER
  • MIRCERA
  • MIRCETTE
  • MITIGARE
  • MOBIC
  • MONDOXYNE NL
  • MORPHINE SULFATE ER
  • MOTEGRITY
  • MOTOFEN
  • MOUNJARO
  • MOVANTIK
  • MOVIPREP
  • MOXEZA
  • MOXIFLOXACIN HYDROCHLORIDE
  • MS CONTIN
  • MULPLETA
  • MUPIROCIN
  • MYALEPT
  • MYAMBUTOL
  • MYCAPSSA
  • MYCOBUTIN
  • MYDAYIS
  • MYDRIACYL
  • MYFEMBREE
  • MYFORTIC
  • MYORISAN
  • MYRBETRIQ
  • MYSOLINE
  • NAFTIFINE HCL
  • NAFTIFINE HYDROCHLORIDE
  • NAFTIN
  • NALFON
  • NAMENDA XR
  • NAMENDA XR TITRATION PAK
  • NAMZARIC
  • NAPRELAN
  • NAPROSYN
  • NAPROXEN SODIUM
  • NAPROXEN SODIUM CR
  • NAPROXEN SODIUM ER
  • naproxen/esomeprazole MAGNESIUM
  • NARDIL
  • NASCOBAL
  • NASONEX
  • NATESTO
  • NATPARA
  • NAYZILAM
  • NEOMYCIN/POLYMYXIN/GRAMICIDIN
  • NEPHRO-VITE RX
  • NERLYNX
  • NESINA
  • NEULASTA
  • NEULASTA ONPRO KIT
  • NEUPOGEN
  • NEURONTIN
  • NEXAVAR
  • NEXIUM
  • NEXLETOL
  • NEXLIZET
  • NIASPAN
  • NILANDRON
  • NINLARO
  • NITISINONE
  • NITRO-DUR
  • NITROFURANTOIN
  • NITROLINGUAL PUMP SPRAY
  • NITROSTAT
  • NITYR
  • NIVESTYM
  • NIZATIDINE
  • NOCDURNA
  • NOLIX
  • NORDITROPIN FLEXPRO
  • NORGESIC FORTE
  • NORITATE
  • NORLIQVA
  • NORPRAMIN
  • NORTHERA
  • NORVASC
  • NORVIR
  • NOURIANZ
  • NOVAREL
  • NOXAFIL
  • NUBEQA
  • NUCALA
  • NUCORT
  • NUCYNTA ER
  • NUEDEXTA
  • NUPLAZID
  • NURTEC
  • NUTROPIN AQ NUSPIN 10
  • NUTROPIN AQ NUSPIN 20
  • NUTROPIN AQ NUSPIN 5
  • NUVESSA
  • NUVIGIL
  • NUZYRA
  • NYMALIZE
  • NYVEPRIA
  • OCALIVA
  • OCTREOTIDE ACETATE
  • OCUFLOX
  • ODACTRA
  • ODOMZO
  • OFEV
  • OLPRUVA
  • OLUMIANT
  • OLUX
  • OLUX-E
  • OMECLAMOX-PAK
  • OMEPRAZONE/SODIUM BICARBONATE
  • OMNARIS
  • OMNIPOD 5 INTRO KIT (GEN 5)
  • OMNIPOD 5 G6 PODS (GEN 5)
  • OMNIPOD CLASSIC PODS (GEN 3)
  • OMNIPOD DASH INTRO KIT (GEN 4)
  • OMNIPOD DASH PDM KIT (GEN 4)
  • OMNIPOD DASH PODS (GEN 4)
  • OMNITROPE
  • ONEXTON
  • ONFI
  • ONGENTYS
  • ONGLYZA
  • ONUREG
  • ONZETRA XSAIL
  • OPSUMIT
  • OPZELURA
  • ORACEA
  • ORALAIR
  • ORALAIR ADULT STARTER PACK
  • ORALAIR CHILDREN/ADOLESCENTS STARTER PACK
  • ORAPRED ODT
  • ORENCIA
  • ORENCIA CLICKJECT
  • ORENITRAM
  • ORENITRAM TITRATION KIT MONTH 1
  • ORENITRAM TITRATION KIT MONTH 2
  • ORENITRAM TITRATION KIT MONTH 3
  • ORFADIN
  • ORGOVYX
  • ORIAHNN
  • ORILISSA
  • ORKAMBI
  • ORLADEYO
  • ORLISTAT
  • ORPHENADRINE CITRATE/ASPIRIN/ CAFFEINE
  • ORPHENGESIC FORTE
  • ORSERDU
  • ORTHO MICRONOR
  • ORTIKOS
  • OSENI
  • OSMOLEX ER
  • OSMOPREP
  • OSPHENA
  • OTEZLA
  • OTREXUP
  • OVACE PLUS
  • OVACE PLUS WASH
  • OVACE WASH
  • OVIDE
  • OVIDREL
  • OXANDROLONE
  • OXBRYTA
  • OXERVATE
  • OXICONAZOLE NITRATE
  • OXISTAT
  • OXSORALEN-ULTRA
  • OXYBUTYNIN CHLORIDE
  • OXYCODONE HCL ER
  • OXYCODONE HYDROCHLORIDE ER
  • OXYCODONE HYDROCHLORIDE/ ACETAMINOPHEN
  • OXYCONTIN
  • OXYMORPHONE HYDROCHLORIDE ER
  • OZEMPIC
  • OZOBAX
  • PACERONE
  • PALFORZIA INITIAL DOSE ESCALATION
  • PALFORZIA LEVEL 1
  • PALFORZIA LEVEL 10
  • PALFORZIA LEVEL 11 (MAINTENANCE)
  • PALFORZIA LEVEL 11 (TITRATION)
  • PALFORZIA LEVEL 2
  • PALFORZIA LEVEL 3
  • PALFORZIA LEVEL 4
  • PALFORZIA LEVEL 5
  • PALFORZIA LEVEL 6
  • PALFORZIA LEVEL 7
  • PALFORZIA LEVEL 8
  • PALFORZIA LEVEL 9
  • PALYNZIQ
  • PAMELOR
  • PANDEL
  • PARLODEL
  • PARNATE
  • PATANASE
  • PAXIL
  • PAXIL CR
  • PEDIAPRED
  • PEGASYS
  • PEG-INTRON
  • PEMAZYRE
  • PENICILLAMINE
  • PENNSAID
  • PENTASA
  • PEPCID
  • PERCOCET
  • PERIDEX
  • PERSERIS
  • PEXEVA
  • PHEBURANE
  • PHENDIMETRAZINE TARTRATE
  • PHENDIMETRAZINE TARTRATE ER
  • PHENELZINE SULFATE
  • PHENTERMINE HCL
  • PHENTERMINE HYDROCHLORIDE
  • PIMECROLIMUS
  • PIQRAY 200MG DAILY DOSE
  • PIQRAY 250MG DAILY DOSE
  • PIQRAY 300MG DAILY DOSE
  • PIRFENIDONE
  • PLAQUENIL
  • PLAVIX
  • PLEGRIDY
  • PLEGRIDY STARTER PACK
  • PLEXION
  • PLEXION CLEANSER
  • PLEXION CLEANSING CLOTHS
  • PLIAGLIS
  • POLYTRIM
  • POMALYST
  • PONVORY
  • PONVORY 14-DAY STARTER PACK
  • POSACONAZOLE
  • POSACONAZOLE DR
  • PRADAXA
  • PRALUENT
  • PRAMOSONE
  • PRAVACHOL
  • PRECOSE
  • PRED FORTE
  • PREDNICARBATE
  • PREDNISOLONE ACETATE
  • PREDNISOLONE ACETATE P-F
  • PREDNISOLONE SODIUM PHOSPHATE ODT
  • PREGABALIN ER
  • PREGNYL W/DILUENT BENZYL ALCOHOL/NACL
  • PREMIUM LIDOCAINE
  • PREVACID
  • PREVACID SOLUTAB
  • PREVIDENT 5000 ENAMEL PROTECT
  • PREVIDENT 5000 SENSITIVE
  • PRILOSEC
  • PRIMIDONE
  • PRINIVIL
  • PRISTIQ
  • PROAIR DIGIHALER
  • PROAIR HFA
  • PROCARDIA
  • PROCARDIA XL
  • PROCRIT
  • PROCTOCORT
  • PROCYSBI
  • PROGLYCEM
  • PROLATE
  • PROMACTA
  • PROMETRIUM
  • PROPECIA
  • PROPRANOLOL HCL
  • PROSCAR
  • PROTONIX
  • PROTOPIC
  • PROVENTIL HFA
  • PROVERA
  • PROVIGIL
  • PROXIVOL
  • PROZAC
  • PRUDOXIN
  • PULMICORT
  • PULMICORT FLEXHALER
  • PYLERA
  • PYRIDIUM
  • PYRUKYND
  • PYRUKYND TAPER PACK
  • QBRELIS
  • QBREXA
  • QDOLO
  • QELBREE
  • QINLOCK
  • QMIIZ ODT
  • QNASL
  • QNASL CHILDRENS
  • QSYMIA
  • QTERN
  • QUALAQUIN
  • QUARTETTE
  • QUDEXY XR
  • QUESTRAN
  • QUESTRAN LIGHT
  • QUETIAPINE FUMARATE
  • QUILLICHEW ER
  • QUILLIVANT XR
  • QUINAPRIL/HYDROCHLOROTHIAZIDE
  • QULIPTA
  • QUVIVIQ
  • RABEPRAZOLE SODIUM DR SPRINKLE
  • RADICAVA ORS
  • RADICAVA ORS STARTER KIT
  • RAGWITEK
  • RAMELTEON
  • RAPAFLO
  • RAPAMUNE
  • RASUVO
  • RAVICTI
  • RAYALDEE
  • RAYOS
  • RAZADYNE ER
  • REBIF
  • REBIF REBIDOSE
  • REBIF REBIDOSE TITRATION PACK
  • REBIF TITRATION PACK
  • RECORLEV
  • REDITREX
  • REGLAN
  • REGRANEX
  • RELAFEN DS
  • RELEUKO
  • RELEXXII
  • RELISTOR
  • RELPAX
  • RELTONE
  • RELYVRIO
  • REMERON
  • REMERON SOLTAB
  • RENAGEL
  • RENVELA
  • REPATHA
  • REPATHA PUSHTRONEX SYSTEM
  • REPATHA SURECLICK
  • RESTASIS
  • RESTASIS MULTIDOSE
  • RESTORIL
  • RETACRIT
  • RETEVMO
  • RETIN-A
  • RETIN-A MICRO
  • RETIN-A MICRO PUMP
  • RETROVIR
  • REVATIO
  • REVCOVI
  • REVLIMID
  • REXULTI
  • REYVOW
  • REZLIDHIA
  • REZUROCK
  • REZVOGLAR KWIKPEN
  • RHOPRESSA
  • RILUTEK
  • RINVOQ
  • RIOMET
  • RISPERDAL
  • RISPERDAL CONSTA
  • RISPERIDONE ODT
  • RITALIN
  • RITALIN LA
  • ROBINUL
  • ROBINUL FORTE
  • ROCALTROL
  • ROCKLATAN
  • ROSADAN KIT
  • ROSZET
  • ROWASA
  • ROXYBOND
  • ROZEREM
  • ROZLYTREK
  • RUBRACA
  • RUFINAMIDE
  • RUZURGI
  • RYALTRIS
  • RYBELSUS
  • RYCLORA
  • RYDAPT
  • RYTARY
  • RYTHMOL SR
  • RYVENT
  • SABRIL
  • SAFYRAL
  • SAIZEN
  • SAIZEN PREP RECONSTRUCTION KIT
  • SAJAZIR
  • SALAGEN
  • SALEX
  • SAMSCA
  • SANCUSO
  • SANDOSTATIN
  • SAPHRIS
  • SAPROPTERIN DIHYDROCHLORIDE
  • SAXENDA
  • SCEMBLIX
  • SEASONIQUE
  • SECUADO
  • SEGLENTIS
  • SEGLUROMET
  • SELZENTRY
  • SENSIPAR
  • SERNIVO
  • SEROQUEL
  • SEROQUEL XR
  • SEROSTIM
  • SERTRALINE HYDROCHLORIDE
  • SEVELAMER HYDROCHLORIDE
  • SEYSARA
  • SIGNIFOR
  • SIKLOS
  • SILDENAFIL
  • SILDENAFIL CITRATE
  • SILENOR
  • SILIQ
  • SILVADENE
  • SIMPONI
  • SINEMET
  • SINGULAIR
  • SITAVIG
  • SKELAXIN
  • SKYCLARYS
  • SKLICE
  • SKYRIZI
  • SKYRIZI PEN
  • SKYTROFA
  • SLYND
  • SOAANZ
  • SODIUM OXYBATE
  • SODIUM PHENYLBUTYRATE
  • SODIUM SULFACETAMIDE/SULFUR
  • SODIUM SULFACETAMIDE/SULFUR CLEANSER IN UREA
  • SOFOSBUVIR/VELPATASVIR
  • SOGROYA
  • SOLIQUA 100/33
  • SOLODYN
  • SOLOSEC
  • SOLTAMOX
  • SOMA
  • SOMAVERT
  • SOOLANTRA
  • SORAFENIB
  • SORAFENIB TOSYLATE
  • SORIATANE
  • SORILUX
  • SOTYKTU
  • SOTYLIZE
  • SOVALDI
  • SPORANOX
  • SPORANOX PULSEPAK
  • SPRIX
  • SPRYCEL
  • SSS 10-5
  • STARLIX
  • STAVUDINE
  • STEGLATRO
  • STEGLUJAN
  • STELARA
  • STIMUFEND
  • STIVARGA
  • STRATTERA
  • STRENSIQ
  • STRIANT
  • STROMECTOL
  • SUBSYS
  • SUCRAID
  • SUCRALFATE
  • SULAR
  • SULCONAZOLE NITRATE
  • SULFAMYLON
  • SUMADAN WASH
  • SUMADAN XLT
  • SUMATRIPTAN SUCCINATE
  • SUMATRIPTAN SUCCINATE REFILL
  • SUMATRIPTAN /NAPROXEN SODIUM
  • SUMAXIN
  • SUMAXIN WASH
  • SUNITINIB MALATE
  • SUNLENCA
  • SUNOSI
  • SUPRAX
  • SUPREP BOWEL PREP KIT
  • SUSTIVA
  • SUTAB
  • SUTENT
  • SYMBYAX
  • SYMDEKO
  • SYMPROIC
  • SYNALAR
  • SYNDROS
  • SYNERA
  • SYNJARDY
  • SYNJARDY XR
  • SYPRINE
  • TABRECTA
  • TACLONEX
  • TACROLIMUS
  • TADALAFIL
  • TADLIQ
  • TAFINLAR
  • TAFLUPROST
  • TAGRISSO
  • TAKHZYRO
  • TALICIA
  • TALTZ
  • TALZENNA
  • TARCEVA
  • TARGRETIN
  • TARPEYO
  • TASCENSO ODT
  • TASIGNA
  • TASIMELTEON
  • TASMAR
  • TAVABOROLE
  • TAVALISSE
  • TAVNEOS
  • TAYTULLA
  • TAZAROTENE
  • TAZORAC
  • TAZVERIK
  • TECFIDERA
  • TECFIDERA STARTER PACK
  • TEGSEDI
  • TEKTURNA
  • TEKTURNA HCT
  • TELMISARTAN/AMLODIPINE
  • TEMODAR
  • TEMOVATE
  • TEMOZOLOMIDE
  • TEMPO WELCOME
  • TENORETIC 100
  • TENORETIC 50
  • TENORMIN
  • TEPMETKO
  • TERIPARATIDE
  • TESSALON PERLES
  • TESTIM
  • TESTOSTERONE
  • TESTOSTERONE CYPIONATE
  • TESTOSTERONE ENANTHATE
  • TESTOSTERONE PUMP
  • TESTOSTERONE TOPICAL SOLUTION
  • TETRABENAZINE
  • tetracycline hydrochloride
  • TEXACORT
  • TEZSPIRE
  • THALOMID
  • THIOLA
  • THYQUIDITY
  • TIAZAC
  • TIBSOVO
  • TIGLUTIK
  • TIKOSYN
  • TIMOPTIC
  • TIMOPTIC OCUDOSE
  • TIMOPTIC-XE
  • TINIDAZOLE
  • TIROSINT
  • TIROSINT-SOL
  • TIVORBEX
  • TIZANIDINE HCL
  • TIZANIDINE HYDROCHLORIDE
  • TLANDO
  • TOBI
  • TOBI PODHALER
  • TOBRADEX
  • TOBRAMYCIN
  • TOBREX
  • TOLMETIN SODIUM
  • TOLSURA
  • TOLVAPTAN
  • TOPAMAX
  • TOPAMAX SPRINKLE
  • TOPICORT
  • TOPIRAMATE ER
  • TOPROL XL
  • TOSYMRA
  • TOVET
  • TOVIAZ
  • TRACLEER
  • TRADJENTA
  • TRAMADOL HCL ER
  • TRAMADOL HYDROCHLORIDE
  • TRANXENE T
  • TRAVATAN Z
  • TRAVOPROST
  • TREMFYA
  • TRETINOIN
  • TRETINOIN MICROSPHERE
  • TRETINOIN MICROSPHERE PUMP
  • TREXALL
  • TREXIMET
  • TRIAMCINOLONE ACETONIDE
  • TRIAMCINOLONE ACETONIDE IN ABSORBASE
  • TRIANEX
  • TIBENZOR
  • TRICOR
  • TRIDESILON
  • TRIENTINE HYDROCHLORIDE
  • TRIFLURIDINE
  • TRIJARDY XR
  • TRIKAFTA
  • TRILEPTAL
  • TRILIPIX
  • TRIMETHOPRIM
  • TRINTELLIX
  • TRITOCIN
  • TROKENDI XR
  • TRUDHESA
  • TRULANCE
  • TRULICITY
  • TRUSELTIQ
  • TRUSOPT
  • TRUVADA
  • TUDORZA PRESSAIR
  • TUKYSA
  • TURALIO
  • TWYNEO
  • TWYNSTA
  • TYKERB
  • TYMLOS
  • TYRVAYA
  • TYVASO DPI MAINTENANCE KIT
  • TYVASO DPI TITRATION KIT
  • UBRELVY
  • UCERIS
  • UDENYCA
  • ULORIC
  • ULTRAVATE
  • UPTRAVI
  • UPTRAVI TITRATION PACK
  • UROCIT-K 10
  • UROCIT-K 15
  • UROCIT-K 5
  • UROGESIC-BLUE
  • UROXATRAL
  • URSO 250
  • URSO FORTE
  • URSODIOL
  • UZEDY
  • VAGIFEM
  • VALCYTE
  • VALIUM
  • VALSARTAN
  • VALTOCO 10 MG DOSE
  • VALTOCO 15 MG DOSE
  • VALTOCO 20 MG DOSE
  • VALTOCO 5 MG DOSE
  • VALTREX
  • VANCOCIN
  • VANOS
  • VASCEPA
  • VASERETIC
  • VASOTEC
  • VELPHORO
  • VELTASSA
  • VELTIN
  • VENCLEXTA
  • VENCLEXTA STARTING PACK
  • VENLAFAXINE BESYLATE ER
  • VERDESO
  • VEREGEN
  • VERELAN
  • VERKAZIA
  • VERQUVO
  • VERSACLOZ
  • VERZENIO
  • VESICARE
  • VESICARE LS
  • VFEND
  • VIBERZI
  • VIBRAMYCIN
  • VICTOZA
  • VIEKIRA PAK
  • VIGAMOX
  • VIIBRYD
  • VIIBRYD STARTER PACK
  • VIJOICE
  • VIMOVO
  • VIMPAT
  • VIRAMUNE XR
  • VIRAZOLE
  • VIREAD
  • VISTARIL
  • VITRAKVI
  • VIVELLE DOT
  • VIVJOA
  • VIVLODEX
  • VIZIMPRO
  • VOGELXO
  • VOGELXO PUMP
  • VONJO
  • VOQUEZNA DUAL PAK
  • VOQUEZNA TRIPLE PAK
  • VORICONAZOLE
  • VOSEVI
  • VOTRIENT
  • VOXZOGO
  • VRAYLAR
  • VTAMA
  • VTOL LQ
  • VUMERITY
  • VUSION
  • VYLEESI
  • VYNDAMAX
  • VYNDAQEL
  • VYTORIN
  • VYVANSE
  • VYZULTA
  • WAKIX
  • WEGOVY
  • WELCHOL
  • WELIREG
  • WELLBUTRIN SR
  • WELLBUTRIN XL
  • WINLEVI
  • WIXELA INHUB
  • WYNZORA
  • XACIATO
  • XADAGO
  • XALATAN
  • XALKORI
  • XANAX
  • XANAX XR
  • XATMEP
  • XCOPRI
  • XELJANZ
  • XELJANZ XR
  • XELODA
  • XELPROS
  • XELSTRYM
  • XENAZINE
  • XENICAL
  • XENLETA
  • XEPI
  • XERESE
  • XERMELO
  • XHANCE
  • XIFAXAN
  • XIGDUO XR
  • XIIDRA
  • XIMINO
  • XOLAIR
  • XOLEGEL
  • XOPENEX
  • XOPENEX CONCENTRATE
  • XOSPATA
  • XPOVIO
  • XPOVIO 100 MG ONCE WEEKLY
  • XPOVIO 40 MG ONCE WEEKLY
  • XPOVIO 40 MG TWICE WEEKLY
  • XPOVIO 60 MG ONCE WEEKLY
  • XPOVIO 60 MG TWICE WEEKLY
  • XPOVIO 80 MG ONCE WEEKLY
  • XPOVIO 80 MG TWICE WEEKLY
  • XTAMPZA ER
  • XTANDI
  • XULTOPHY 100/3.6
  • XYOSTED
  • XYREM
  • XYWAV
  • YASMIN 28
  • YAZ
  • YONSA
  • YOSPRALA
  • YUPELRI
  • ZANAFLEX
  • ZARXIO
  • ZAVESCA
  • ZEGERID
  • ZEJULA
  • ZELBORAF
  • ZELNORM
  • ZEMBRACE SYMTOUCH
  • ZEMPLAR
  • ZENATANE
  • ZENZEDI
  • ZEPATIER
  • ZEPOSIA
  • ZEPOSIA 7-DAY STARTER PACK
  • ZEPOSIA STARTER KIT
  • ZERVIATE
  • ZESTORETIC
  • ZESTRIL
  • ZETIA
  • ZETONNA
  • ZIAC
  • ZIAGEN
  • ZIANA
  • ZIEXTENZO
  • ZILXI
  • ZIOPTAN
  • ZIPSOR
  • ZITHROMAX
  • ZITHROMAX TRI-PAK
  • ZITHROMAX Z-PAK
  • ZOCOR
  • ZOFRAN
  • ZOHYDRO ER
  • ZOKINVY
  • ZOLINZA
  • ZOLMITRIPTAN
  • ZOLMITRIPTAN ODT
  • ZOLOFT
  • ZOLPIDEM TARTRATE
  • ZOLPIMIST
  • ZOMACTON
  • ZOMIG
  • ZOMIG ZMT
  • ZONALON
  • ZONEGRAN
  • ZONISADE
  • ZORBTIVE
  • ZORVOLEX
  • ZORYVE
  • ZOVIRAX
  • ZTALMY
  • ZTLIDO
  • ZUPLENZ
  • ZYCLARA
  • ZYCLARA PUMP
  • ZYDELIG
  • ZYKADIA
  • ZYLOPRIM
  • ZYMAXID
  • ZYPITAMAG
  • ZYPREXA
  • ZYPREXA RELPREVV
  • ZYPREXA ZYDIS
  • ZYTIGA
  • ZYVOX

(Revised July 1, 2023)

**Lifescan and Ascensia products are preferred. All other test strips are non-preferred and are subjected to prior authorization/medical necessity determination.

This document contains brand name products that are registered marks or registered trademarks of brand manufacturers not affiliated with either Horizon Blue Cross Blue Shield of New Jersey or the Blue Cross and Blue Shield Association.

This listing of prescription drugs that are subject to Prior Authorization/Medical Necessity review under your prescription coverage is complete as of the date indicated. Please note that new medicines are coming to market with increasing frequency and as a result, this listing is subject to revision on a regular basis.

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey.

© 2023 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105.