Formulario. H4740_2015 Formulary_IT_Accepted

Transcript

1 Formulario Questo formulario è aggiornato al 1 o agosto Per qualsiasi chiarimento telefonare allʹarchcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. Per gli utenti TTY il numero è 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito H4740_2015 Formulary_IT_Accepted Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 1

2 ArchCare Community Advantage FIDA Plan Elenco dei farmaci dispensabili 2015 (Formulario) Questo è un elenco di farmaci dispensabili agli Assistiti aderenti al piano ArchCare Community Advantage FIDA Plan (Piano Medicare-Medicaid). L'ArchCare Community Advantage FIDA Plan è un piano assicurativo sanitario che si interfaccia con Medicare e il Dipartimento della Salute dello Stato di New York (Medicaid) per erogare agli Assistiti le prestazioni previste da entrambi i programmi di assistenza sanitaria attraverso la Fully Integrated Duals Advantage (FIDA) Demonstration. Le prestazioni, l'elenco dei farmaci dispensabili e le informazioni sulle farmacie e sui servizi convenzionati possono cambiare nel corso dell'anno e al primo gennaio di ogni anno. È sempre possibile consultare online l'elenco aggiornato dei farmaci dispensabili dall'archcare Community Advantage FIDA Plan sul sito o telefonando agli ArchCare Community Advantage FIDA Plan Participant Services al numero , 24/24 ore, 7/7 giorni, numero per utenti TTY 711. La chiamata è gratuita. Possono trovare applicazione limitazioni e restrizioni. Per ulteriori informazioni telefonare agli ArchCare Community Advantage FIDA Plan Participant Services o leggere la documentazione contenuta nel manuale (ArchCare Community Advantage FIDA Plan Participant Handbook). Per i farmaci dispensabili non sono previste quote a degli assistiti. Queste informazioni sono disponibili gratuitamente anche in altri formati, come Braille o stampa a caratteri grandi. Telefonare al numero TTY 711. La chiamata è gratuita. Queste informazioni sono disponibili gratuitamente anche in altre lingue. Telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Usted puede obtener esta información de forma gratuita en otros idiomas. Llame Advantage ArchCare Comunidad al las 24 horas del día, 7 días a la semana. TTY 711. La llamada es gratuita. Вы можете получить эту информацию бесплатно и на других языках. Позвоните ArchCare Community преимущество в часа в сутки, 7 дней в неделю. Телетайп 711. Звонок бесплатный. 你 可 以 在 其 他 语 言 中 这 些 信 息 是 免 费 的 呼 叫 ArchCare 社 区 优 势 在 一 个 星 期 每 天 小 时,7 天 TTY711 该 电 话 是 免 费 的 Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 2

3 Ou ka jwenn enfòmasyon sa a pou gratis nan lòt lang yo. Rele Advantage ArchCare Kominotè nan èdtan nan yon jou, 7 jou yon semèn. TTY 711. Rele a se gratis. È possibile ottenere queste informazioni gratuitamente in altre lingue. Chiama Advantage ArchCare Comunità a ore al giorno, 7 giorni alla settimana. TTY 711. La chiamata è gratuita. 당신은 다른 언어로 무료로이 정보를 얻을 수 있습니다 하루 24 시간, 주 7 일에 ArchCare 커뮤니티의 장점을 호출합니다. TTY 711. 통화는 무료입니다. Lo Stato di New York ha istituito l'ufficio del difensore civico (ombudsman) denominato Independent Consumer Advocacy Network (ICAN) che offre assistenza gratuita e riservata sulle prestazioni erogate dall'archcare Community Advantage FIDA Plan. Per contattare ICAN chiamare il numero verde oppure consultare il sito icannys.org. Quesiti ricorrenti (FAQ) Qui è possibile trovare le risposte alle domande di chiarimenti sull'elenco dei farmaci dispensabili. È possibile leggere tutti i quesiti e solo quelli di interesse specifico. Quali sono i farmaci dispensabili su ricetta presenti nell'elenco dei farmaci dispensabili? (Nel prosieguo, per brevità, l'elenco dei farmaci dispensabili verrà chiamato semplicemente "Elenco dei farmaci" o "Elenco"). I farmaci riportati nell'elenco che inizia a p. 12 sono quelli dispensabili dall'archcare Community Advantage FIDA Plan. I farmaci sono disponibili nelle farmacie convenzionate. Le farmacie convenzionate sono quelle con le quali abbiamo stipulato accordi per l'erogazione delle prestazioni ai nostri assistiti. Indichiamo queste farmacie come "farmacie convenzionate". L'ArchCare Community Advantage FIDA Plan dispensa tutti i farmaci in Elenco purché: il medico di famiglia o un altro operatore sanitario convenzionato dichiarino che gli stessi servono per migliorare o mantenere la salute, il farmaco sia necessario per lo stato di salute e la ricetta venga utilizzata in una farmacia convenzionata con l'archcare Community Advantage FIDA Plan. L'ArchCare Community Advantage FIDA Plan può prevedere altre formalità per erogare determinati farmaci all'assistito (vedere quesito n. 5). In alcuni casi può essere necessario dover soddisfare qualche requisito per ottenere un determinato farmaco, ad esempio provarne un altro. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 3

4 L'assistito può anche consultare un Elenco aggiornato dei farmaci dispensabili sul sito o telefonando ai Participant Services al numero L'Elenco dei farmaci cambia nel tempo? Sì. Nel corso dell'anno possono essere aggiunti o eliminati dei farmaci dall'archcare Community Advantage FIDA Plan. In genere l'elenco dei farmaci cambia solamente quando: viene immesso in commercio un nuovo farmaco che funziona altrettanto bene come uno in elenco, oppure si viene a sapere che un farmaco non è sicuro. È anche possibile che vengano cambiate le regole sui farmaci. Ad esempio è possibile: Decidere se richiedere o meno l'autorizzazione preventiva di un farmaco (intendendosi come approvazione preventiva l'autorizzazione da parte dell'archcare Community Advantage FIDA Plan o dell'interdisciplinary Team (IDT) competente all'uso di un determinato farmaco). Aumentare o variare il dosaggio di un farmaco che l'assistito già assume (i cosiddetti limiti di dosaggio ). Aumentare o variare le limitazioni di una terapia graduale relativamente ad un farmaco (intendendosi con terapia graduale che l'assistito deve provare un determinato farmaco prima che gliene venga dispensato un altro). (Per ulteriori informazioni su queste regole vedere pag. 5). Comunicheremo agli assistiti quando un farmaco da essi assunto viene tolto dall'elenco. Inoltre comunicheremo loro quando vengono cambiate le regole sull'erogazione di un determinato farmaco. I quesiti 3, 4 e 7 riguardano più specificatamente le modalità di cambiamento dell'elenco dei farmaci. Gli assistiti possono sempre consultare l'elenco aggiornato dei farmaci dispensabili dall'archcare Community Advantage FIDA Plan online sul sito Per informazioni sull'elenco dei farmaci aggiornato è anche possibile telefonare ai Participant Services al numero Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 4

5 Che cosa succede se si rende disponibile un farmaco meno caro che funziona altrettanto bene come uno presente in Elenco? Se si rende disponibile un farmaco meno caro che funziona altrettanto bene come uno presente in Elenco: Il farmacista può dare il prodotto meno caro alla successiva presentazione della ricetta da parte. Se l'assistito e il medico ritengono che il farmaco meno caro non sia adatto, il medico può dire al farmacista di continuare a dare il farmaco utilizzato in precedenza. L'ArchCare Community Advantage FIDA Plan può decidere di togliere il farmaco più costoso dall'elenco dei farmaci. Se l'assistito sta assumendo un farmaco che è stato tolto dall'elenco perché si è reso disponibile un farmaco meno costoso che funziona altrettanto bene, lo comunicheremo all'assistito almeno 60 giorni prima di toglierlo dall'elenco o al momento della presentazione della successiva ricetta. Dopodiché l'assistito otterrà il farmaco precedente per 60 giorni prima che diventi operativo il cambiamento dell'elenco. Se un farmaco viene tolto dall'elenco lo comunicheremo all'assistito per posta. Che cosa succede se si scopre che un farmaco non è sicuro? Nel caso in cui la Food and Drug Administration (FDA) affermi che un farmaco assunto dall'assistito non è sicuro, lo toglieremo dall'elenco. In tal caso invieremo una lettera all'assistito segnalandogli la cancellazione del farmaco dall'elenco. Alla ricezione della lettera, l'assistito dovrà contattare il medico che gli ha prescritto il farmaco in questione. Oppure telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Esistono restrizioni o limitazioni relative alla copertura dei farmaci? Oppure sono previsti passi particolari per ottenere determinati farmaci? Sì, per alcuni farmaci esistono regole riguardanti la copertura o limitazioni in merito alla quantità assumibile. In alcuni casi, per poter assumere il farmaco, l'assistito deve fare alcuni passi. Ad esempio: Approvazione preventiva (o autorizzazione preventiva): Per alcuni farmaci, l'assistito o il medico che lo segue o altro operatore sanitario devono ottenere l'approvazione dell'archcare Community Advantage FIDA Plan o dell'interdisciplinary Team (IDT) competente prima di compilare la prescrizione. In assenza di tale approvazione, il farmaco potrebbe non essere coperto dall'archcare Community Advantage FIDA Plan. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 5

6 Limiti di dosaggio: In alcuni casi l'archcare Community Advantage FIDA Plan limita il dosaggio di farmaco assumibile. Terapia graduale: In alcuni casi l'archcare Community Advantage FIDA Plan richiede all'assistito di assumere una terapia graduale. Pertanto, l'assistito dovrà provare dei farmaci in un determinato ordine per la patologia che lo riguarda. Potrebbe essere necessario provare un determinato farmaco prima di poter ottenere l'autorizzazione al farmaco in questione. Se il medico ritiene che il primo farmaco non sia adatto al suo paziente, provvederemo ad autorizzare il secondo. Per verificare se il farmaco di interesse è soggetto ad ulteriori requisiti o limitazioni, vedere le tabelle che iniziano a pag. 12. Per ulteriori informazioni visitare il nostro sito web Abbiamo pubblicato online documenti che spiegano le limitazioni in merito all'autorizzazione preventiva ed alla terapia graduale. Inoltre, l'assistito può richiedercene una copia. L'assistito può richiedere una deroga a tali limitazioni. Per ulteriori informazioni in merito vedere il quesito 12. In caso di assistiti ospitati presso case di cura o altre strutture a lunga permanenza, che debbano assumere un farmaco non in Elenco o abbiano difficoltà a reperire un farmaco, siamo pronti ad intervenire. Metteremo a disposizione una scorta del farmaco in questione sufficiente per 31 giorni (salvo prescrizione per un periodo di tempo minore), indipendentemente dal fatto che si tratti o meno di un nuovo assistito dell'archcare Community Advantage FIDA Plan. Così facendo, l'assistito avrà la possibilità di contattare il medico o altro operatore sanitario, che potranno consigliarlo in merito all'idoneità di un farmaco analogo presente in Elenco o alla necessità di chiedere una deroga. Per ulteriori informazioni sulle eccezioni vedere il quesito 11. Come si fa a sapere se il farmaco prevede delle limitazioni o se sono necessari dei passi particolari per ottenerlo? Nell'Elenco dei farmaci dispensabili a pag. 12 c'è una colonna intitolata di dosaggio o. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 6

7 Che cosa succede nel caso in cui vengano modificate le regole riguardanti l'erogazione di determinati farmaci? Ad esempio, nel caso in cui vengano inserite l'autorizzazione (o l'approvazione) preventiva, limiti di dosaggio e/o restrizioni riguardanti la terapia graduale per un farmaco. Informeremo l'assistito in caso di inserimento di approvazione preventiva, limiti di dosaggio e/o restrizioni riguardanti la terapia graduale per un farmaco. Tali informazioni verranno comunicate almeno 60 giorni prima dell'entrata in vigore della restrizione o del momento in cui viene fatta la successiva richiesta di rifornimento. Quindi, l'assistito potrà contare su una scorta di 60 giorni prima che venga modificato l'elenco. In questo modo, l'assistito avrà la possibilità di contattare il medico o altro operatore sanitario, facendosi consigliare in merito. Come si fa a trovare un farmaco nell'elenco? Si può procedere in due modi: Si può fare una ricerca in ordine alfabetico (se si conosce il nome del farmaco), oppure Si può cercare il farmaco in base alla patologia. Per cercare il farmaco in ordine alfabetico, andare all'elenco alfabetico a pag. 92. Quindi cercare il nome del farmaco. Per cercare il farmaco in base alla patologia, andare alla sezione intitolata Elenco di farmaci in base alla patologia" a pag. 12. Quindi cercare la patologia di interesse. Ad esempio, se l'assistito è affetto da cardiopatia, deve cercare il farmaco in questa categoria, dove sono presenti tutti i farmaci che trattano problematiche di tipo cardiaco. Che cosa succede se il farmaco di interesse non è in Elenco? Se il farmaco di interesse non è in Elenco, telefonare ai Participant Services al numero chiedendo informazioni in merito. Se si viene a sapere che l'archcare Community Advantage FIDA Plan non copre il farmaco è possibile fare quanto segue: Chiedere ai Participant Services un elenco dei farmaci simili a quello che si desidera assumere. Mostrare l'elenco al medico o altro operatore autorizzato alle prescrizioni, i quali provvederanno a prescrivere un farmaco presente in Elenco simile a quello che si deve assumere. Oppure È possibile chiedere all'interdisciplinary Team (IDT) competente di fare una deroga e autorizzare la prescrizione del farmaco. Per ulteriori informazioni sulle eccezioni vedere il quesito 11. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 7

8 Che cosa deve fare un neo-assistito dell'archcare Community Advantage FIDA Plan che non trova il suo farmaco abituale nell'elenco dei farmaci o ha problemi a procurarselo? Possiamo pensarci noi. Siamo obbligati, in caso di necessità, a fornire il farmaco per i primi 90 giorni di copertura di un nuovo assistito dell'archcare Community Advantage FIDA Plan. Così facendo, l'assistito avrà la possibilità di contattare il medico o altro operatore sanitario, che potranno consigliarlo in merito all'idoneità di un farmaco analogo presente in Elenco o alla necessità di chiedere una deroga. Forniremo il farmaco per i primi 90 giorni di copertura temporanea se: l'assistito assume un farmaco che non è presente nell'elenco dei farmaci, oppure il piano sanitario stabilisce che l'assistito non può assumere la dose prescrittagli, oppure il farmaco dev'essere approvato preventivamente dall'archcare Community Advantage FIDA Plan o dall'interdisciplinary Team (IDT) competente, oppure l'assistito assume un farmaco nell'ambito di una limitazione ad una terapia graduale. Se è ospite di una casa di cura o altra struttura a lunga permanenza, l'assistito può farsi prescrivere il farmaco per 91 giorni, periodo durante il quale può farselo prescrivere più volte. In questo modo viene lasciato il tempo necessario al medico per cambiare la prescrizione, scegliendo un farmaco presente nell'elenco, o per chiedere un'eccezione. In caso di assistiti ospitati presso case di cura o altre strutture a lunga permanenza, che debbano assumere un farmaco non in Elenco o abbiano difficoltà a reperire un farmaco, siamo pronti ad intervenire. Metteremo a disposizione una scorta del farmaco in questione sufficiente per 31 giorni (salvo prescrizione per un periodo di tempo minore), indipendentemente dal fatto che si tratti o meno di un nuovo assistito dell'archcare Community Advantage FIDA Plan. Così facendo, l'assistito avrà la possibilità di contattare il medico o altro operatore sanitario, che potranno consigliarlo in merito all'idoneità di un farmaco analogo presente in Elenco o alla necessità di chiedere una deroga. Per ulteriori informazioni sulle eccezioni vedere il quesito 11. È possibile chiedere una deroga per continuare ad usare un determinato farmaco? Sì. L'assistito può chiedere all'archcare Community Advantage FIDA Plan o all'interdisciplinary Team (IDT) competente di fare una deroga per continuare a prescrivere un farmaco non presente nell'elenco. L'assistito può anche richiedere all'archcare Community Advantage FIDA Plan o all'idt di modificare le regole relative al farmaco. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 8

9 Ad esempio, l'archcare Community Advantage FIDA Plan può limitare il dosaggio del farmaco dispensato. Se il farmaco che assume è soggetto a limitazioni, l'assistito ha diritto a chiedere a noi o all'idt di cambiare la limitazione per aumentare il dosaggio. Altri esempi: L'assistito può chiedere a noi o all'idt di eliminare le limitazioni alla terapia graduale o l'autorizzazione preventiva. Quanto tempo ci vuole per ottenere una deroga? Prima di tutto, l'archcare Community Advantage FIDA Plan o l'interdisciplinary Team (IDT) competente devono ricevere una dichiarazione da parte del medico a conferma della richiesta di deroga. Dopo aver ricevuto la dichiarazione, comunicheremo la nostra decisione all'assistito entro 72 ore. Se l'assistito o il medico ritengono che le condizioni di salute possano peggiorare nell'arco delle 72 ore, è possibile richiedere una decisione in tempi più rapidi. Si tratta di un iter più spedito. Se il medico conferma la richiesta, la decisione verrà comunicata entro 24 ore. Come si fa per chiedere una deroga? Per chiedere una deroga rivolgersi al proprio Care Manager, il quale consiglierà all'assistito e al medico come chiedere la deroga. Che cosa sono i farmaci generici? I farmaci generici contengono lo stesso principio attivo di quelli di marca. Normalmente costano meno di questi ultimi e vengono distribuiti con nomi meno famosi. I farmaci generici sono approvati dalla Food and Drug Administration (FDA). L'ArchCare Community Advantage FIDA Plan dispensa sia farmaci di marca sia generici. Che cosa sono i farmaci da banco? I farmaci da banco sono quelli per i quali non è necessaria la prescrizione medica. L'ArchCare Community Advantage FIDA Plan dispensa alcuni farmaci da banco dietro presentazione di ricetta medica. Per sapere quali sono i farmaci da banco dispensati dall'archcare Community Advantage FIDA Plan consultare l'elenco dei farmaci. Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 9

10 L'ArchCare Community Advantage FIDA Plan dispensa anche prodotti da banco oltre ai farmaci? Oltre ai farmaci, l'archcare Community Advantage FIDA Plan dispensa alcuni prodotti da banco dietro presentazione di ricetta medica. Tra i prodotti prescrivibili figurano: tamponi imbevuti di alcool, garze (5x5 cm), aghi per penne da insulina, aghi di sicurezza per insulina e siringhe per insulina. Per sapere quali sono i prodotti da banco, oltre ai farmaci, dispensati dall'archcare Community Advantage FIDA Plan consultare l'elenco dei farmaci. In che cosa consiste la quota a? Per i prodotti inseriti nell'elenco dei farmaci l'assistito non è tenuto a pagare alcuna quota. Che cosa sono le fasce di farmaci? I farmaci sono suddivisi in tre categorie, denominate fasce. Fascia 1: Farmaci generici Medicare Part D Fascia 2: Farmaci di marca Medicare Part D Fascia 3: Farmaci da banco e non Medicare su ricetta Per nessuna fascia è prevista la quota a. Elenco dei farmaci dispensati L'elenco dei farmaci dispensati sotto riportato contiene le informazioni relative ai farmaci dispensati dall'archcare Community Advantage FIDA Plan. In caso di problemi ad individuare un farmaco in elenco, consultare l'indice a partire da pag. 92. La prima colonna della tabella contiene il nome del farmaco. I farmaci di marca sono scritti in lettere maiuscole (es., COUMADIN), quelli generici in lettere minuscole (es., warfarin). Le informazioni riportate nella colonna si riferiscono ad eventuali regole specifiche previste dall'archcare Community Advantage FIDA Plan per quel farmaco. Nota: L'asterisco ( * ) accanto al farmaco indica che non si tratta di un farmaco Part D. Per questi farmaci valgono altre regole per i reclami. Con reclamo s'intende una procedura formale per chiedere la revisione o la modifica di una decisione circa l'erogazione di un farmaco se si ritiene che Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 10

11 la stessa sia errata. Ad esempio, l'archcare Community Advantage FIDA Plan o l'interdisciplinary Team (IDT) competente possono decidere che un farmaco richiesto dall'assistito non è o non è più coperto da Medicare o Medicaid. Se l'assistito o il suo medico o un altro operatore autorizzato alla prescrizione non sono d'accordo con questa decisione, l'assistito può presentare un reclamo. Per conoscere le modalità di presentazione dei reclami telefonare ai Participant Services al numero o all'independent Consumer Advocacy Network (ICAN) al numero L'assistito può anche consultare il Participant Handbook per informarsi sulla procedura di reclamo. Guida ai codici dell'elenco dei farmaci PA È richiesta l'autorizzazione preventiva: Per alcuni farmaci, l'assistito o il medico che lo segue o altro operatore sanitario devono ottenere l'approvazione dell'archcare Community Advantage FIDA Plan o dell'interdisciplinary Team (IDT) competente prima di compilare la prescrizione. In assenza di tale approvazione, il farmaco potrebbe non essere coperto dall'archcare Community Advantage FIDA Plan. QL Limiti di dosaggio: In alcuni casi l'archcare Community Advantage FIDA Plan limita il dosaggio di farmaco assumibile. ST Terapia graduale: In alcuni casi l'archcare Community Advantage FIDA Plan richiede all'assistito di assumere una terapia graduale. Pertanto, l'assistito dovrà provare dei farmaci in un determinato ordine per la patologia che lo riguarda. Potrebbe essere necessario provare un determinato farmaco prima di poter ottenere l'autorizzazione al farmaco in questione. Se il medico ritiene che il primo farmaco non sia adatto al suo paziente, provvederemo ad autorizzare il secondo. B/D Il piano stabilirà se questo farmaco verrà dispensato da Medicare Part B o Part D sulla base del motivo per il quale il medico lo ha prescritto. LA Disponibilità limitata: Il farmaco è disponibile soltanto in un limitato numero di farmacie specializzate. NM Non disponibile per la vendita per corrispondenza. Non tutti i farmaci possono essere ordinati per corrispondenza; per chiarimenti rivolgersi al servizio assistenza clienti. 11

12 ArchCare Community Advantage FIDA Plan In vigore dal 1 agosto 2015 Denominazione del farmaco ANALGESICI - FARMACI ANTIDOLORIFICI E ANTINFIAMMATORI GOTTA - FARMACI PER IL TRATTAMENTO DELLA GOTTA allopurinol tab 1 $0 colchicine w/ probenecid 1 $0 COLCRYS 2 $0 QL (120 compresse / 30 probenecid 1 $0 ULORIC 2 $0 ST VARI acetaminophen CHEW; ELIX; 3 $0 NM; * LIQD; SOLN; SUSP; TABS; TBCR; TBDP ACETAMINOPHEN SUPP 3 $0 NM; * ACETAMINOPHEN 8 HOUR 3 $0 NM; * ADULT ASPIRIN LOW STRENGT 3 $0 NM; * APAP $0 NM; * ASCRIPTIN 3 $0 NM; * aspirin CHEW 3 $0 NM; * ASPIRIN SUPP 60mg, 120mg, 3 $0 NM; * 200mg aspirin SUPP 300mg, 600mg 3 $0 NM; * aspirin TABS 3 $0 NM; * aspirin TBEC 325mg, 500mg, 3 $0 NM; * 650mg ASPIRIN TBEC 650mg 3 $0 NM; * aspirin buffered (cal carb-mag 3 $0 NM; * carb-mag oxide) aspirin effervescent 3 $0 NM; * BUFFERIN EXTRA STRENGTH 3 $0 NM; * BUFFERIN LOW DOSE 3 $0 NM; * CHILDRENS MOTRIN CHEW 3 $0 NM; * ELIXSURE FEVER/PAIN 3 $0 NM; * FEBROL 3 $0 NM; * FEVERALL INFANTS 3 $0 NM; * ibuprofen CAPS 3 $0 NM; * ibuprofen CHEW 3 $0 NM; * ibuprofen SUSP 50mg/1.25ml, 3 $0 NM; * 100mg/5ml IBUPROFEN TABS 100mg 3 $0 NM; * ibuprofen TABS 200mg 3 $0 NM; * 12

13 magnesium salicylate tetrahydrate 3 $0 NM; * NAPROXEN SODIUM CAPS 3 $0 NM; * naproxen sodium TABS 220mg 3 $0 NM; * NON-ASPIRIN EXTRA STRENGT 3 $0 NM; * TBDP ST JOSEPH ADULT ANALGESIC 3 $0 NM; * STANBACK ASPIRIN FREE 3 $0 NM; * TRIAMINIC FEVER REDUCER P 3 $0 NM; * FANS - FARMACI ANTIDOLORIFICI E ANTINFIAMMATORI celecoxib CAPS 1 $0 QL (60 capsule / 30 diclofenac potassium 1 $0 diclofenac sodium TB24 1 $0 diclofenac sodium TBEC 1 $0 diflunisal 1 $0 etodolac 1 $0 etodolac er 1 $0 flurbiprofen TABS 1 $0 ibuprofen SUSP 100mg/5ml 1 $0 ibuprofen TABS 400mg, 600mg 1 $0 ibuprofen tab 800 mg 1 $0 ketoprofen CAPS 1 $0 MELOXICAM SUSP 1 $0 meloxicam TABS 1 $0 nabumetone TABS 1 $0 naproxen SUSP; TABS; TBEC 1 $0 naproxen sodium TABS 275mg, 1 $0 550mg piroxicam CAPS 1 $0 sulindac TABS 1 $0 OPPIACEI ANALGESICI - FARMACI ANTIDOLORIFICI acetaminophen w/ codeine SOLN 1 $0 QL (5000 ml / 30 acetaminophen w/ codeine TABS 1 $0 QL (400 compresse / 30 butorphanol tartrate SOLN 1 $0 1mg/ml, 2mg/ml hydroco/apap tab 5-325mg 1 $0 QL (360 compresse / 30 hydroco/apap tab $0 QL (360 compresse / 30 hydroco/apap tab mg 1 $0 QL (360 compresse / 30 13

14 hydrocodone-acetaminophen mg/15ml 1 $0 QL (5400 ml / 30 1 $0 QL (150 compresse / 30 hydrocodone-ibuprofen tab mg lorcet hd tab mg 1 $0 QL (360 compresse / 30 lorcet plus tab $0 QL (360 compresse / 30 lorcet tab 5-325mg 1 $0 QL (360 compresse / 30 lortab tab 5-325mg 1 $0 QL (360 compresse / 30 lortab tab $0 QL (360 compresse / 30 lortab tab mg 1 $0 QL (360 compresse / 30 tramadol hcl TABS 1 $0 QL (240 compresse / 30 tramadol-acetaminophen 1 $0 QL (240 compresse / 30 OPPIACEI ANALGESICI, CII - FARMACI ANTIDOLORIFICI DURAMORPH 1 $0 B/D endocet 1 $0 QL (360 compresse / 30 fentanyl 12mcg/hr, 25mcg/hr 1 $0 QL (10 cerotti / 30 fentanyl 50mcg/hr, 75mcg/hr, 100mcg/hr 1 $0 QL (10 cerotti / 30, PA fentanyl citrate LPOP 2 $0 QL (120 pastiglie / 30, PA FENTORA 2 $0 QL (120 compresse / 30, PA hydromorphon inj 10mg/ml 1 $0 B/D hydromorphone hcl LIQD 1 $0 hydromorphone hcl TABS 1 $0 QL (270 compresse / 30 LAZANDA SPR 100MCG 2 $0 QL (30 flaconi / 30, PA LAZANDA SPR 400MCG 2 $0 QL (30 flaconi / 30, PA methadone hcl CONC 1 $0 QL (120 ml / 30 methadone hcl SOLN 5mg/5ml, 1 $0 QL (600 ml / 30 10mg/5ml methadone hcl TABS 1 $0 QL (240 compresse / 30 14

15 morphine ext-rel tab 15mg, 30mg, 60mg, 100mg 1 $0 QL (90 compresse / 30 morphine ext-rel tab 200mg 1 $0 QL (60 compresse / 30 MORPHINE SUL INJ 1mg/ml, 1 $0 B/D 4mg/ml, 10mg/ml, 15mg/ml morphine sul inj.5mg/ml, 1mg/ml 1 $0 B/D morphine sulfate CP24 10mg, 20mg, 30mg, 50mg, 60mg 1 $0 QL (60 capsule / 30 morphine sulfate CP24 80mg 2 $0 QL (60 capsule / 30 MORPHINE SULFATE SOLN 1 $0 B/D 2mg/ml, 8mg/ml MORPHINE SULFATE TABS 1 $0 QL (180 compresse / 30 morphine sulfate beads 1 $0 QL (60 capsule / 30 morphine sulfate cap 100mg er 2 $0 QL (60 capsule / 30 MORPHINE SULFATE ORAL SOL 1 $0 oxycodone hcl CAPS 1 $0 QL (180 capsule / 30 OXYCODONE HCL CONC 1 $0 oxycodone hcl SOLN 1 $0 oxycodone hcl TABS 1 $0 QL (180 compresse / 30 oxycodone hcl tab 5 mg 1 $0 QL (180 compresse / 30 oxycodone w/ acetaminophen $0 QL (360 compresse / 325mg 30 oxycodone w/ acetaminophen 5-325mg 1 $0 QL (360 compresse / 30 oxycodone w/ acetaminophen $0 QL (360 compresse / 325mg 30 oxycodone w/ acetaminophen mg 1 $0 QL (360 compresse / 30 roxicet soln 2 $0 QL (1800 ml / 30 giorni sol.) roxicet tabs 1 $0 QL (360 compresse / 30 ANESTETICI - ANESTETICI LOCALI ANESTETICI LOCALI lidocaine hcl (local anesth.) 1 $0 B/D lidocaine inj 0.5% 1 $0 B/D lidocaine inj 1% 1 $0 B/D 15

16 lidocaine inj 1.5% 1 $0 B/D lidocaine inj 2% 1 $0 B/D ANTINFETTIVI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI ANTIBATTERICI - VARI amikacin sulfate SOLN 1 $0 gentamicin in saline 1 $0 gentamicin sulfate SOLN 1 $0 neomycin sulfate TABS 1 $0 paromomycin sulfate CAPS 1 $0 streptomycin sulfate SOLR 1 $0 sulfadiazine TABS 2 $0 tobramycin NEBU 2 $0 B/D, NM tobramycin sulfate SOLN; SOLR 1 $0 tobramycin sulfate in saline 2 $0 ANTINFETTIVI - VARI ALBENZA 2 $0 ALINIA 2 $0 atovaquone SUSP 2 $0 AZACTAM 2 $0 AZACTAM/DEX INJ 1GM 2 $0 AZACTAM/DEX INJ 2GM 2 $0 aztreonam 1 $0 BILTRICIDE 2 $0 CAYSTON 2 $0 NM, LA, PA clindamycin cap 75mg 1 $0 clindamycin cap 300mg 1 $0 clindamycin hcl cap 150 mg 1 $0 clindamycin phosphate inj 1 $0 clindamycin sol 75mg/5ml 1 $0 colistimethate sodium SOLR 1 $0 CUBICIN 2 $0 dapsone TABS 1 $0 DARAPRIM 2 $0 imipenem-cilastatin 1 $0 INVANZ 2 $0 ivermectin TABS 1 $0 linezolid SOLN 2 $0 meropenem 1 $0 methenamine hippurate 1 $0 metronidazole TABS 1 $0 metronidazole in nacl 1 $0 NEBUPENT 2 $0 B/D 16

17 nitrofurantoin macrocrystal 2 $0 PA; limite di 90 giorni se >64 anni nitrofurantoin monohyd macro 2 $0 PA; limite di 90 giorni se >64 anni PENTAM $0 SIVEXTRO 2 $0 sulfamethoxazole-trimethoprim 1 $0 sulfamethoxazole-trimethoprim inj 1 $0 SYNERCID 2 $0 trimethoprim TABS 1 $0 TYGACIL 2 $0 vancomycin hcl CAPS 2 $0 vancomycin hcl SOLR 1 $0 ZYVOX SUSR; TABS 2 $0 ANTIFUNGINI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI FUNGINE ABELCET 2 $0 B/D AMBISOME 2 $0 B/D amphotericin b SOLR 1 $0 B/D CANCIDAS 2 $0 ERAXIS 2 $0 fluconazole SUSR; TABS 1 $0 fluconazole in dextrose 1 $0 fluconazole in nacl 1 $0 flucytosine CAPS 2 $0 griseofulvin microsize 1 $0 griseofulvin ultramicrosize 1 $0 itraconazole CAPS 1 $0 PA ketoconazole TABS 1 $0 PA MYCAMINE 2 $0 NOXAFIL SUSP; TBEC 2 $0 nystatin TABS 1 $0 terbinafine hcl TABS 1 $0 QL (90 compresse / 365 voriconazole SOLR 1 $0 voriconazole SUSR; TABS 2 $0 ANTIMALARICI - FARMACI PER IL TRATTAMENTO DELLA MALARIA atovaquone-proguanil hcl 1 $0 chloroquine phosphate TABS 1 $0 COARTEM 2 $0 mefloquine hcl 1 $0 PRIMAQUINE PHOSPHATE 2 $0 quinine sulfate CAPS 1 $0 PA 17

18 ANTIRETROVIRALI - FARMACI PER ELIMINARE L'INFEZIONE DA HIV/AIDS abacavir sulfate 1 $0 APTIVUS 2 $0 CRIXIVAN 2 $0 didanosine 1 $0 EDURANT 2 $0 EMTRIVA 2 $0 EPIVIR SOLN 2 $0 FUZEON 2 $0 NM INTELENCE 2 $0 INVIRASE 2 $0 ISENTRESS CHEW; TABS 2 $0 ISENTRESS PACK 1 $0 lamivudine 1 $0 LEXIVA 2 $0 NEVIRAPINE SUSP 1 $0 nevirapine TABS; TB24 1 $0 NORVIR 2 $0 PREZISTA 2 $0 RESCRIPTOR 2 $0 RETROVIR IV INFUSION 2 $0 REYATAZ 2 $0 SELZENTRY 2 $0 stavudine 1 $0 SUSTIVA 2 $0 TIVICAY 2 $0 TYBOST 2 $0 VIDEX PEDIATRIC 2 $0 VIRACEPT 2 $0 VIRAMUNE XR 100mg 2 $0 VIREAD 2 $0 VITEKTA 2 $0 ZIAGEN SOLN 2 $0 zidovudine 1 $0 ANTIRETROVIRALI DI COMBINAZIONE - FARMACI PER ELIMINARE L'INFEZIONE DA HIV/AIDS abacavir sulfate-lamivudinezidovudine 2 $0 ATRIPLA 2 $0 COMPLERA 2 $0 EPZICOM 2 $0 EVOTAZ 2 $0 18

19 KALETRA SOL 2 $0 KALETRA TAB MG 2 $0 KALETRA TAB MG 2 $0 lamivudine-zidovudine 2 $0 PREZCOBIX 2 $0 STRIBILD 2 $0 TRIUMEQ 2 $0 TRUVADA 2 $0 QL (30 compresse / 30 ANTITUBERCOLARI - FARMACI PER IL TRATTAMENTO DELLA TUBERCOLOSI CAPASTAT SULFATE 2 $0 cycloserine CAPS 1 $0 ethambutol hcl TABS 1 $0 isoniazid TABS 1 $0 isoniazid inj 100 mg/ml 1 $0 isoniazid syp 50mg/5ml 1 $0 paser d/r 2 $0 PRIFTIN 2 $0 pyrazinamide 1 $0 rifabutin 1 $0 rifampin CAPS; SOLR 1 $0 RIFATER 2 $0 SIRTURO 2 $0 LA, PA TRECATOR 2 $0 ANTIVIRALI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI VIRALI acyclovir CAPS; SUSP; TABS 1 $0 acyclovir sodium 1 $0 B/D adefovir dipivoxil 2 $0 BARACLUDE SOLN 2 $0 entecavir 2 $0 EPIVIR HBV SOLN 2 $0 famciclovir TABS 1 $0 foscarnet sodium 1 $0 ganciclovir inj 500mg 1 $0 B/D HARVONI 2 $0 NM, PA lamivudine (hbv) 1 $0 moderiba 800 dose pack 2 $0 NM, PA moderiba pak 600/day 2 $0 NM, PA moderiba pak 1000/day 2 $0 NM, PA moderiba pak 1200/day 2 $0 NM, PA moderiba tab 200mg 1 $0 NM, PA 19

20 OLYSIO 2 $0 NM, PA REBETOL SOLN 2 $0 NM, PA RELENZA DISKHALER 2 $0 ribapak mis 600/day 2 $0 NM, PA ribasphere CAPS 1 $0 NM, PA ribasphere TABS 200mg, 400mg 1 $0 NM, PA ribasphere TABS 600mg 2 $0 NM, PA ribasphere ribapak $0 NM, PA ribasphere ribapak $0 NM, PA ribasphere ribapak $0 NM, PA ribavirin 200mg 1 $0 NM, PA rimantadine hydrochloride 1 $0 SOVALDI 2 $0 NM, PA TAMIFLU 2 $0 TYZEKA 2 $0 valacyclovir hcl TABS 1 $0 VALCYTE SOLR 2 $0 valganciclovir hcl 2 $0 VICTRELIS 2 $0 NM, PA CEFALOSPORINE - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI cefaclor 1 $0 cefaclor monohydrate er 2 $0 cefadroxil 1 $0 cefazolin in d5w 2 $0 cefazolin inj 1 $0 cefazolin sodium 1gm, 20gm 1 $0 cefdinir 1 $0 cefepime hcl 1 $0 cefixime 1 $0 cefotaxime sodium 1gm, 2gm, 1 $0 500mg cefoxitin sodium 1 $0 cefpodoxime proxetil 1 $0 cefprozil 1 $0 ceftazidime 1gm, 2gm, 6gm 1 $0 CEFTAZIDIME/DEXTROSE 2 $0 ceftriaxone sodium SOLR 1gm, 1 $0 2gm, 10gm, 250mg, 500mg cefuroxime axetil 1 $0 cefuroxime sodium 1.5gm, 7.5gm, 1 $0 750mg cephalexin CAPS 250mg, 500mg 1 $0 20

21 cephalexin SUSR 1 $0 SUPRAX CAPS 2 $0 suprax CHEW 2 $0 suprax SUSR 100mg/5ml, 2 $0 200mg/5ml SUPRAX SUSR 500mg/5ml 2 $0 tazicef SOLR 1 $0 tazicef vial 1 $0 TEFLARO 2 $0 ERITROMICINE/MACROLIDI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI AZITHROMYCIN PACK 1 $0 azithromycin SOLR 500mg 1 $0 azithromycin SUSR 1 $0 azithromycin TABS 1 $0 clarithromycin TABS 1 $0 clarithromycin er 1 $0 clarithromycin for susp 1 $0 DIFICID 2 $0 e.e.s. 1 $0 e.e.s $0 E.E.S. GRANULES 2 $0 ery-tab 2 $0 ERYPED $0 ERYPED $0 erythrocin lactobionate 500mg 2 $0 erythrocin stearate 1 $0 erythromycin base 1 $0 erythromycin cap 250mg ec 1 $0 ZMAX 2 $0 FLUOROCHINOLONI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI ciprofloxacin SUSR 1 $0 ciprofloxacin er 1 $0 ciprofloxacin hcl tab 1 $0 ciprofloxacin in d5w 1 $0 ciprofloxacin inj 1 $0 levofloxacin TABS 1 $0 levofloxacin in d5w 1 $0 levofloxacin inj 25mg/ml 1 $0 levofloxacin oral soln 25 mg/ml 1 $0 PENICILLINE - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI amoxicillin 1 $0 21

22 amoxicillin & pot clavulanate 1 $0 ampicillin & sulbactam sodium 1 $0 ampicillin cap 250 mg 1 $0 ampicillin cap 500 mg 1 $0 ampicillin for susp 125 mg/5ml 1 $0 ampicillin for susp 250 mg/5ml 1 $0 ampicillin inj 1 $0 ampicillin sodium 1 $0 BICILLIN L-A 2 $0 dicloxacillin sodium 1 $0 nafcillin sodium 1gm 1 $0 nafcillin sodium 2gm, 10gm 2 $0 oxacillin sodium 1gm, 2gm 1 $0 oxacillin sodium 10gm 2 $0 PENICILLIN G POT IN DEXTROSE 2 $0 penicillin g potassium 1 $0 penicillin g procaine 2 $0 penicillin g sodium 1 $0 penicillin v potassium 1 $0 penicilln gk inj 5mu 1 $0 piperacillin sodium-tazobactam 1 $0 sodium TETRACICLINE - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI doxy inj 1 $0 doxycycline (monohydrate) CAPS 1 $0 50mg, 100mg doxycycline (monohydrate) TABS 1 $0 doxycycline hyclate CAPS; SOLR; 1 $0 TABS minocycline hcl CAPS 1 $0 VIBRAMYCIN SYRP 2 $0 ANTINEOPLASTICI - FARMACI PER LA CURA DEL CANCRO AGENTI ALCHILANTI BICNU 2 $0 B/D BUSULFEX 2 $0 B/D CYCLOPHOSPHAMIDE CAPS 2 $0 B/D cyclophosphamide SOLR 1 $0 B/D dacarbazine 200mg 1 $0 B/D EMCYT 2 $0 HEXALEN 2 $0 IFEX 3gm 2 $0 B/D ifosfamide inj 1gm 1 $0 B/D ifosfamide inj 1gm/20ml 1 $0 B/D 22

23 IFOSFAMIDE INJ 3GM 2 $0 B/D ifosfamide inj 3gm/60ml 1 $0 B/D LEUKERAN 2 $0 LOMUSTINE 1 $0 melphalan hcl 2 $0 B/D MUSTARGEN 2 $0 B/D TREANDA 2 $0 B/D, NM ANTRACICLINE adriamycin 1 $0 B/D daunorubicin hcl 1 $0 B/D doxorubicin hcl for inj 50 mg 1 $0 B/D doxorubicin hcl liposomal inj 2 $0 B/D 2mg/ml doxorubicin inj 50mg 1 $0 B/D epirubicin hcl 1 $0 B/D idarubicin hcl 2 $0 B/D ANTIBIOTICI bleomycin sulfate 1 $0 B/D mitomycin SOLR 1 $0 B/D ANTIMETABOLITI adrucil 1 $0 B/D ALIMTA 2 $0 B/D azacitidine 2 $0 B/D, NM cladribine 2 $0 B/D cytarabine 20mg/ml 1 $0 B/D fludarabine phosphate 1 $0 B/D fluorouracil SOLN 1 $0 B/D GEMCITABINE HCL SOLN 2 $0 B/D gemcitabine hcl SOLR 2 $0 B/D mercaptopurine TABS 1 $0 methotrexate sodium inj 1 $0 B/D NIPENT 2 $0 B/D PURIXAN 2 $0 TABLOID 2 $0 ANTIMITOTICI, TAXOIDI DOCETAXEL CONC 20mg/ml, 2 $0 B/D 80mg/4ml docetaxel CONC 140mg/7ml 2 $0 B/D DOCETAXEL SOLN 80mg/8ml, 2 $0 B/D 200mg/20ml paclitaxel 1 $0 B/D ANTIMITOTICI, ALCALOIDI DELLA VINCA vinblastine sulfate 2 $0 B/D 23

24 vincasar 1 $0 B/D vincristine sulfate 1 $0 B/D vinorelbine tartrate 1 $0 B/D MODIFICATORI DELLA RISPOSTA BIOLOGICA AVASTIN 2 $0 B/D, NM ERIVEDGE 2 $0 NM, LA, PA FARYDAK 2 $0 NM, LA, PA HERCEPTIN 2 $0 B/D, NM IBRANCE 2 $0 NM, LA, PA ISTODAX 2 $0 B/D, NM KADCYLA 2 $0 B/D, NM LYNPARZA 2 $0 NM, PA PROLEUKIN 2 $0 B/D, NM RITUXAN 2 $0 NM, PA VELCADE 2 $0 B/D, NM ZOLINZA 2 $0 NM, PA AGENTI ANTINEOPLASTICI ORMONALI anastrozole TABS 1 $0 bicalutamide 1 $0 DEPO-PROVERA INJ 400/ML 2 $0 B/D exemestane 1 $0 FARESTON 2 $0 FASLODEX 2 $0 B/D flutamide 1 $0 letrozole TABS 1 $0 leuprolide acetate KIT 1 $0 NM, PA LUPR DEP-PED INJ 30MG (3-2 $0 NM, PA MONTH) LUPRON DEPOT 3.75mg 2 $0 NM, PA LUPRON DEPOT INJ MG 2 $0 NM, PA LUPRON DEPOT-PED 2 $0 NM, PA LYSODREN 2 $0 MEGACE ES 2 $0 PA megestrol acetate SUSP; TABS 2 $0 PA NILANDRON 2 $0 SOLTAMOX 2 $0 tamoxifen citrate TABS 1 $0 TRELSTAR DEP INJ 3.75MG 2 $0 NM, PA TRELSTAR LA INJ 11.25MG 2 $0 NM, PA XTANDI 2 $0 NM, LA, PA ZYTIGA 2 $0 NM, PA INIBITORI DELLA CHINASI AFINITOR 2 $0 NM, PA 24

25 AFINITOR DISPERZ 2 $0 NM, PA BOSULIF 2 $0 NM, PA CAPRELSA 2 $0 NM, LA, PA COMETRIQ 2 $0 NM, PA GILOTRIF TAB 20MG 2 $0 NM, LA, PA GILOTRIF TAB 30MG 2 $0 NM, LA, PA GILOTRIF TAB 40MG 2 $0 NM, LA, PA GLEEVEC 2 $0 NM, PA ICLUSIG 2 $0 NM, LA, PA IMBRUVICA CAP 140MG 2 $0 NM, LA, PA INLYTA 2 $0 NM, LA, PA JAKAFI 2 $0 NM, LA, PA LENVIMA 10MG DAILY DOSE 2 $0 NM, LA, PA LENVIMA 14MG DAILY DOSE 2 $0 NM, LA, PA LENVIMA 20MG DAILY DOSE 2 $0 NM, LA, PA LENVIMA 24MG DAILY DOSE 2 $0 NM, LA, PA MEKINIST 2 $0 NM, PA NEXAVAR 2 $0 NM, LA, PA SPRYCEL 2 $0 NM, PA STIVARGA 2 $0 NM, LA, PA SUTENT 2 $0 NM, PA TAFINLAR 2 $0 NM, PA TARCEVA 2 $0 NM, PA TASIGNA 2 $0 NM, PA TYKERB 2 $0 NM, LA, PA VOTRIENT 2 $0 NM, PA XALKORI 2 $0 NM, LA, PA ZELBORAF 2 $0 NM, LA, PA ZYDELIG 2 $0 NM, LA, PA ZYKADIA 1 $0 NM, LA, PA VARI DROXIA 2 $0 hydroxyurea CAPS 1 $0 MATULANE 2 $0 mitoxantrone hcl 1 $0 B/D, NM POMALYST CAP 1MG 2 $0 NM, LA, PA POMALYST CAP 2MG 2 $0 NM, LA, PA POMALYST CAP 3MG 2 $0 NM, LA, PA POMALYST CAP 4MG 2 $0 NM, LA, PA SYLATRON KIT 296MCG 2 $0 NM, PA SYLATRON KIT 444MCG 2 $0 NM, PA SYLATRON KIT 888MCG 2 $0 NM, PA TARGRETIN CAPS 2 $0 NM, PA 25

26 tretinoin (chemotherapy) 2 $0 TRISENOX 2 $0 B/D AGENTI A BASE DI PLATINO carboplatin 1 $0 B/D cisplatin 1 $0 B/D oxaliplatin 2 $0 B/D AGENTI PROTETTIVI amifostine crystalline 2 $0 B/D dexrazoxane 250mg 2 $0 B/D ELITEK 2 $0 B/D leucovorin calcium SOLR 1 $0 B/D leucovorin calcium TABS 1 $0 leucovorin calcium for inj 500 mg 1 $0 B/D mesna 1 $0 B/D MESNEX TABS 2 $0 INIBITORI DELLA TOPOISOMERASI etoposide SOLN 500mg/25ml 1 $0 B/D irinotecan hcl 2 $0 B/D toposar 1gm/50ml 1 $0 B/D topotecan hcl SOLR 2 $0 B/D APPARATO CARDIOVASCOLARE - FARMACI PER IL TRATTAMENTO DELLE PATOLOGIE CARDIACHE E CIRCOLATORIE COMBINAZIONI DI ACE INIBITORI - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE amlodipine--benazepril hcl cap 10-1 $0 QL (30 capsule / mg amlodipine-benazepril hcl cap mg 1 $0 QL (30 capsule / 30 amlodipine-benazepril hcl cap $0 QL (30 capsule / 30 mg amlodipine-benazepril hcl cap $0 QL (30 capsule / 30 mg amlodipine-benazepril hcl cap $0 QL (30 capsule / 30 mg amlodipine-benazepril hcl cap 10-1 $0 40mg benazepril & hydrochlorothiazide 1 $0 captopril & hydrochlorothiazide 1 $0 enalapril maleate & 1 $0 hydrochlorothiazide fosinopril sodium & 1 $0 hydrochlorothiazide lisinopril & hydrochlorothiazide 1 $0 26

27 moexipril-hydrochlorothiazide 1 $0 quinapril-hydrochlorothiazide 1 $0 ACE INIBITORI - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE benazepril hcl TABS 1 $0 captopril TABS 1 $0 enalapril maleate TABS 1 $0 fosinopril sodium 1 $0 lisinopril TABS 1 $0 moexipril hcl 1 $0 perindopril erbumine 1 $0 quinapril hcl 1 $0 ramipril 1 $0 trandolapril 1 $0 ANTAGONISTI DEI RECETTORI DELL'ALDOSTERONE - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE eplerenone 1 $0 spironolactone TABS 1 $0 ALFABLOCCANTI - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE doxazosin mesylate 1mg, 2mg, 4mg 1 $0 QL (30 compresse / 30 doxazosin mesylate 8mg 1 $0 prazosin hcl 1 $0 terazosin hcl 1 $0 COMBINAZIONI DI ANTAGONISTI DEI RECETTORI DELL'ANGIOTENSINA II - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE amlodipine besylate-valsartan tab mg 1 $0 QL (30 compresse / 30 amlodipine besylate-valsartan tab mg 1 $0 QL (30 compresse / 30 amlodipine besylate-valsartan tab mg 1 $0 QL (30 compresse / 30 amlodipine besylate-valsartan tab 1 $ mg amlodipine-valsartanhydrochlorothiazide mg 1 $0 QL (30 compresse / 30 amlodipine-valsartanhydrochlorothiazide mg 1 $0 QL (60 compresse / 30 amlodipine-valsartanhydrochlorothiazide mg 1 $0 QL (30 compresse / 30 27

28 amlodipine-valsartanhydrochlorothiazide mg 1 $0 QL (30 compresse / 30 amlodipine-valsartanhydrochlorothiazide 1 $ mg AZOR 10-40MG 2 $0 AZOR TAB 5-20MG 2 $0 QL (30 compresse / 30 AZOR TAB 5-40MG 2 $0 QL (30 compresse / 30 AZOR TAB 10-20MG 2 $0 QL (30 compresse / 30 BENICAR HCT 40-25MG 2 $0 BENICAR HCT TAB MG 2 $0 QL (30 compresse / 30 BENICAR HCT TAB MG 2 $0 QL (30 compresse / 30 losartan-hctz mg 1 $0 QL (30 compresse / 30 losartan-hctz mg 1 $0 QL (30 compresse / 30 losartan-hctz mg 1 $0 TRIBENZOR40- TAB 10-25MG 2 $0 TRIBENZOR TAB MG 2 $0 QL (30 compresse / 30 TRIBENZOR TAB MG 2 $0 QL (30 compresse / 30 TRIBENZOR TAB MG 2 $0 QL (30 compresse / 30 TRIBENZOR TAB $0 QL (30 compresse / 30 valsartan & hctz tab mg 1 $0 QL (30 compresse / 30 valsartan & hctz tab mg 1 $0 QL (30 compresse / 30 valsartan & hctz tab mg 1 $0 QL (30 compresse / 30 valsartan & hctz tab mg 1 $0 valsartan & hctz tab mg 1 $0 ANTAGONISTI DEI RECETTORI DELL'ANGIOTENSINA II - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE BENICAR 5mg 2 $0 QL (60 compresse / 30 BENICAR 20mg 2 $0 QL (30 compresse / 30 BENICAR 40mg 2 $0 28

29 losartan potassium 25mg, 50mg 1 $0 QL (60 compresse / 30 losartan potassium 100mg 1 $0 valsartan 40mg, 80mg, 160mg 1 $0 QL (60 compresse / 30 valsartan 320mg 1 $0 ANTIARITMICI - FARMACI PER IL CONTROLLO DEL RITMO CARDIACO amiodarone hcl 1 $0 disopyramide phosphate 2 $0 PA flecainide acetate 1 $0 mexiletine hcl 1 $0 MULTAQ 2 $0 NORPACE CR 2 $0 PA pacerone 1 $0 propafenone hcl 1 $0 quinidine gluconate TBCR 1 $0 quinidine sulfate TABS 1 $0 sorine 1 $0 sotalol hcl 1 $0 sotalol hcl (afib/afl) 1 $0 TIKOSYN 2 $0 NM ANTILIPEMICI, INIBITORI DELLA HMG-CoA REDUTTASI - FARMACI PER IL TRATTAMENTO DEL COLESTEROLO atorvastatin calcium TABS 1 $0 QL (30 compresse / 30 CRESTOR 2 $0 QL (30 compresse / 30 lovastatin 10mg 1 $0 QL (30 compresse / 30 lovastatin 20mg 1 $0 QL (120 compresse / 30 lovastatin 40mg 1 $0 QL (60 compresse / 30 pravastatin sodium 1 $0 QL (30 compresse / 30 simvastatin TABS 1 $0 QL (30 compresse / 30 ANTILIPEMICI, VARI - FARMACI PER IL TRATTAMENTO DEL COLESTEROLO cholestyramine 1 $0 cholestyramine light 1 $0 choline fenofibrate 1 $0 29

30 colestipol hcl 1 $0 fenofibrate TABS 48mg, 54mg, 1 $0 145mg, 160mg fenofibrate micronized 1 $0 fenofibrate micronized cap 1 $0 gemfibrozil TABS 1 $0 niacin (antihyperlipidemic) 500mg 1 $0 QL (90 compresse / 30 niacin (antihyperlipidemic) 1 $0 750mg, 1000mg niacor 1 $0 omega-3-acid ethyl esters 1 $0 prevalite 1 $0 VASCEPA 2 $0 WELCHOL 2 $0 ZETIA TAB 10MG 2 $0 BETABLOCCANTI/DIURETICI - FARMACI PER IL TRATTAMENTO DI IPERTENSIONE E CARDIOPATIE atenolol & chlorthalidone 1 $0 bisoprolol & hydrochlorothiazide 1 $0 metoprolol & hctz tab 50-25mg 1 $0 metoprolol & hctz tab mg 1 $0 metoprolol & hctz tab mg 1 $0 propranolol & hydrochlorothiazide 1 $0 BETABLOCCANTI - FARMACI PER IL TRATTAMENTO DI IPERTENSIONE E CARDIOPATIE acebutolol hcl CAPS 1 $0 atenolol TABS 1 $0 bisoprolol fumarate 1 $0 BYSTOLIC 2 $0 carvedilol 1 $0 labetalol hcl TABS 1 $0 metoprolol succinate 25mg, 50mg 1 $0 QL (60 compresse / 30 metoprolol succinate 100mg 1 $0 QL (45 compresse / 30 metoprolol succinate 200mg 1 $0 metoprolol tartrate SOLN; TABS 1 $0 nadolol TABS 1 $0 pindolol 1 $0 propranolol cap er 1 $0 propranolol hcl SOLN; TABS 1 $0 timolol maleate TABS 1 $0 30

31 BLOCCANTI DEL CANALE DEL CALCIO - FARMACI PER IL TRATTAMENTO DI IPERTENSIONE E CARDIOPATIE afeditab cr 30mg 1 $0 QL (60 compresse / 30 afeditab cr 60mg 1 $0 amlodipine besylate TABS 2.5mg, 1 $0 QL (45 compresse / 30 5mg amlodipine besylate TABS 10mg 1 $0 cartia xt cap 120/24hr 1 $0 cartia xt cap 180/24hr 1 $0 cartia xt cap 240/24hr 1 $0 cartia xt cap 300/24hr 1 $0 dilt-cd cap 1 $0 dilt-xr cap 1 $0 diltiazem cap 1 $0 diltiazem cap 120mg/24hr 1 $0 diltiazem cap er/12hr 1 $0 diltiazem hcl SOLN; TABS 1 $0 diltiazem hcl coated beads cp24 1 $0 120mg diltiazem hcl coated beads cp24 1 $0 180mg diltiazem hcl coated beads cp24 1 $0 240mg diltiazem hcl coated beads cp24 1 $0 300mg diltiazem hcl coated beads cp24 1 $0 360mg diltzac 1 $0 felodipine 2.5mg 1 $0 QL (30 compresse / 30 felodipine 5mg 1 $0 QL (60 compresse / 30 felodipine 10mg 1 $0 isradipine 1 $0 nicardipine hcl CAPS 1 $0 nifedical 30mg 1 $0 QL (30 compresse / 30 nifedical 60mg 1 $0 nifedipine TB24 30mg 1 $0 QL (60 compresse / 30 nifedipine TB24 60mg, 90mg 1 $0 nifedipine er 30mg 1 $0 QL (30 compresse / 30 31

32 nifedipine er 60mg, 90mg 1 $0 nimodipine CAPS 1 $0 NYMALIZE 2 $0 taztia 1 $0 verapamil cap er 100mg, 120mg, 1 $0 180mg, 200mg, 240mg, 300mg VERAPAMIL CAP ER 360mg 1 $0 verapamil hcl SOLN; TABS 1 $0 verapamil tab er 1 $0 GLICOSIDI DIGITALICI - FARMACI PER IL TRATTAMENTO DI CARDIOPATIE digitek.25mg 1 $0 PA digitek.125mg 1 $0 QL (30 compresse / 30 digoxin SOLN 1 $0 digoxin TABS 125mcg 1 $0 QL (30 compresse / 30 digoxin TABS 250mcg 1 $0 PA DIGOXIN SOL 50MCG/ML 1 $0 PA LANOXIN TABS 125mcg 2 $0 QL (30 compresse / 30 LANOXIN TABS 250mcg 2 $0 PA INIBITORI DIRETTI DELLA RENINA/COMBINAZIONI - FARMACI PER IL TRATTAMENTO DI CARDIOPATIE TEKAMLO MG 2 $0 TEKAMLO TAB 150-5MG 2 $0 QL (30 compresse / 30 TEKAMLO TAB MG 2 $0 QL (30 compresse / 30 TEKAMLO TAB 300-5MG 2 $0 QL (30 compresse / 30 TEKTURNA 150mg 2 $0 QL (30 compresse / 30 TEKTURNA 300mg 2 $0 TEKTURNA HCT TAB MG 2 $0 QL (30 compresse / 30 TEKTURNA HCT TAB MG 2 $0 QL (60 compresse / 30 TEKTURNA HCT TAB MG 2 $0 QL (30 compresse / 30 TEKTURNA HCT TAB MG 2 $0 DIURETICI - FARMACI PER IL TRATTAMENTO DI CARDIOPATIE acetazolamide CP12; TABS 1 $0 amiloride & hydrochlorothiazide 1 $0 32

33 amiloride hcl 1 $0 bumetanide 1 $0 chlorothiazide 1 $0 chlorthalidone 25mg, 50mg 1 $0 DIURIL SUS 250/5ML 2 $0 DYRENIUM 2 $0 EDECRIN 2 $0 furosemide SOLN; TABS 1 $0 furosemide inj 1 $0 hydrochlorothiazide CAPS; TABS 1 $0 indapamide 1 $0 methazolamide TABS 1 $0 methyclothiazide 1 $0 metolazone 1 $0 spironolactone & 1 $0 hydrochlorothiazide torsemide inj 20mg/2ml 1 $0 torsemide inj 50mg/5ml 1 $0 torsemide tabs 1 $0 triamterene & hydrochlorothiazide 1 $0 TABS triamterene & hydrochlorothiazide 1 $0 cap mg VARI clonidine hcl PTWK; TABS 1 $0 DEMSER 2 $0 hydralazine hcl SOLN; TABS 1 $0 midodrine hcl 1 $0 minoxidil TABS 1 $0 RANEXA 2 $0 NITRATI - FARMACI PER IL TRATTAMENTO DI CARDIOPATIE isosorb mononitrate tab 1 $0 isosorbide dinitrate 1 $0 isosorbide mononitrate er tab 1 $0 minitran 1 $0 nitro-bid 2 $0 NITRO-DUR DIS 0.3MG/HR 2 $0 NITRO-DUR DIS 0.8MG/HR 2 $0 nitroglycerin PT24 1 $0 NITROLINGUAL PUMPSPRAY 2 $0 NITROSTAT 2 $0 IPERTENSIONE ARTERIOSA POLMONARE - FARMACI PER IL TRATTAMENTO DELL'IPERTENSIONE POLMONARE 33

34 ADCIRCA 2 $0 QL (60 compresse / 30, NM, PA ADEMPAS 2 $0 QL (90 compresse / 30, NM, PA LETAIRIS 2 $0 QL (30 compresse / 30, NM, LA, PA REMODULIN 2 $0 B/D, NM, LA REVATIO SUSR 2 $0 QL (2 flaconi / 30, NM, PA sildenafil citrate (pulmonary hypertension) 2 $0 QL (90 compresse / 30, NM, PA TRACLEER 62.5mg 2 $0 QL (120 compresse / 30, NM, LA, PA TRACLEER 125mg 2 $0 QL (60 compresse / 30, NM, LA, PA SISTEMA NERVOSO CENTRALE - FARMACI PER IL TRATTAMENTO DI DISTURBI DEL SISTEMA NERVOSO ANSIOLITICI - FARMACI PER IL TRATTAMENTO DELL'ANSIA alprazolam CONC 1 $0 QL (300 ml / 30 alprazolam tab 0.5mg 1 $0 QL (240 compresse / 30 alprazolam tab 0.25mg 1 $0 QL (480 compresse / 30 alprazolam tab 1mg 1 $0 QL (120 compresse / 30 alprazolam tab 2mg 1 $0 QL (150 compresse / 30 buspirone hcl TABS 1 $0 fluvoxamine maleate TABS 25mg, 1 $0 QL (45 compresse / 30 50mg fluvoxamine maleate TABS 100mg 1 $0 lorazepam CONC 1 $0 QL (150 ml / 30 lorazepam SOLN 1 $0 lorazepam TABS 1 $0 QL (150 compresse / 30 ANTICONVULSANTI - FARMACI PER IL TRATTAMENTO DELL'EPILESSIA APTIOM 200mg 2 $0 QL (180 compresse / 30 APTIOM 400mg 2 $0 QL (90 compresse / 30 APTIOM 600mg 2 $0 QL (60 compresse / 30 34

35 APTIOM 800mg 2 $0 QL (30 compresse / 30 BANZEL SUS 40MG/ML 2 $0 PA BANZEL TAB 200MG 2 $0 PA BANZEL TAB 400MG 2 $0 PA carbamazepine CHEW; CP12; 1 $0 SUSP; TABS; TB12 CELONTIN 2 $0 clonazepam TABS 1mg 1 $0 QL (600 compresse / 30 clonazepam TABS 2mg 1 $0 QL (300 compresse / 30 clonazepam TABS.5mg 1 $0 QL (1200 compresse / 30 clonazepam TBDP 1mg 1 $0 QL (600 compresse / 30 clonazepam TBDP 2mg 1 $0 QL (300 compresse / 30 clonazepam TBDP.5mg 1 $0 QL (1200 compresse / 30 clonazepam TBDP.25mg 1 $0 QL (2400 compresse / 30 clonazepam TBDP.125mg 1 $0 QL (4800 compresse / 30 clorazepate dipotassium 3.75mg, 7.5mg 1 $0 QL (120 compresse / 30, PA clorazepate dipotassium 15mg 1 $0 QL (180 compresse / 30, PA diazepam CONC 1 $0 QL (240 ml / 30, PA diazepam SOLN 1 $0 QL (1200 ml / 30, PA diazepam TABS 1 $0 QL (120 compresse / 30, PA DIAZEPAM GEL 1 $0 diazepam inj 1 $0 dilantin 2 $0 DILANTIN-125 SUS 125/5ML 2 $0 divalproex sodium 1 $0 epitol 1 $0 ethosuximide CAPS; SOLN 1 $0 felbamate SUSP 2 $0 felbamate TABS 400mg 1 $0 felbamate TABS 600mg 2 $0 35

36 FYCOMPA 2mg 2 $0 QL (180 compresse / 30, PA FYCOMPA 4mg 2 $0 QL (90 compresse / 30, PA FYCOMPA 6mg 2 $0 QL (60 compresse / 30, PA FYCOMPA 8mg, 10mg, 12mg 2 $0 QL (30 compresse / 30, PA gabapentin CAPS 100mg 1 $0 QL (1080 capsule / 30 gabapentin CAPS 300mg 1 $0 QL (360 capsule / 30 gabapentin CAPS 400mg 1 $0 QL (270 capsule / 30 gabapentin SOLN 1 $0 QL (2160 ml / 30 gabapentin TABS 600mg 1 $0 QL (180 compresse / 30 gabapentin TABS 800mg 1 $0 QL (120 compresse / 30 GABITRIL 12mg, 16mg 2 $0 lamotrigine CHEW; TABS; TB24 1 $0 levetiracetam SOLN; TABS; TB24 1 $0 LEVETIRACETAM IN NACL 2 $0 levetiracetam inj 500/5ml 1 $0 LYRICA CAPS 25mg, 50mg, 75mg, 2 $0 QL (120 capsule / mg, 150mg LYRICA CAPS 200mg 2 $0 QL (90 capsule / 30 LYRICA CAPS 225mg, 300mg 2 $0 QL (60 capsule / 30 LYRICA SOLN 2 $0 QL (946 ml / 30 ONFI 2 $0 PA oxcarbazepine 1 $0 PEGANONE 2 $0 phenobarbital ELIX; TABS 2 $0 PA PHENOBARBITAL SODIUM 2 $0 PA 65mg/ml phenobarbital sodium 130mg/ml 2 $0 PA phenytek 2 $0 phenytoin CHEW; SUSP 1 $0 phenytoin sodium SOLN 1 $0 phenytoin sodium extended 1 $0 POTIGA 50mg 2 $0 36

37 POTIGA 200mg 2 $0 QL (180 compresse / 30 POTIGA 300mg, 400mg 2 $0 QL (90 compresse / 30 primidone TABS 1 $0 SABRIL PACK 2 $0 QL (180 pacchetti / 30, NM, LA, PA SABRIL TABS 2 $0 QL (180 compresse / 30, NM, LA, PA TEGRETOL 2 $0 TEGRETOL-XR 2 $0 tiagabine hcl 1 $0 topiramate CPSP; TABS 1 $0 valproate sodium SOLN; SYRP 1 $0 valproic acid CAPS 1 $0 VIMPAT SOLN 10mg/ml 2 $0 QL (1200 ml / 30 VIMPAT SOLN 200mg/20ml 2 $0 VIMPAT TABS 50mg 2 $0 QL (180 compresse / 30 VIMPAT TABS 100mg, 150mg, 200mg 2 $0 QL (60 compresse / 30 zonisamide CAPS 1 $0 ANTIDEMENZA - FARMACI PER IL TRATTAMENTO DELLA DEMENZA E DELLA PERDITA DI MEMORIA donepezil hydrochloride TABS 5mg 1 $0 QL (30 compresse / 30 donepezil hydrochloride TABS 1 $0 10mg, 23mg donepezil hydrochloride TBDP 5mg 1 $0 QL (30 compresse / 30 donepezil hydrochloride TBDP 1 $0 10mg EXELON PATCHES 2 $0 QL (30 cerotti / 30 galantamine hydrobromide CP24 8mg, 16mg 1 $0 QL (30 capsule / 30 galantamine hydrobromide CP24 1 $0 24mg galantamine hydrobromide SOLN 1 $0 galantamine hydrobromide TABS 4mg 1 $0 QL (180 compresse / 30 galantamine hydrobromide TABS 8mg 1 $0 QL (90 compresse / 30 37

38 galantamine hydrobromide TABS 1 $0 12mg NAMENDA SOL 10MG/5ML 2 $0 PA; PA se <30 anni NAMENDA TAB 2 $0 PA; PA se <30 anni NAMENDA XR 2 $0 PA; PA se <30 anni NAMENDA XR TITRATION PACK 2 $0 PA; PA se <30 anni rivastigmine tartrate 1 $0 ANTIDEPRESSIVI - FARMACI PER IL TRATTAMENTO DELLA DEPRESSIONE amitriptyline hcl TABS 2 $0 PA amoxapine tab 25mg 1 $0 amoxapine tab 50mg 1 $0 amoxapine tab 100mg 1 $0 amoxapine tab 150mg 1 $0 BRINTELLIX 5mg 2 $0 QL (120 compresse / 30 BRINTELLIX 10mg 2 $0 QL (60 compresse / 30 BRINTELLIX 20mg 2 $0 QL (30 compresse / 30 bupropion hcl TABS 1 $0 bupropion hcl TB12 1 $0 bupropion hcl TB24 150mg 1 $0 QL (90 compresse / 30 bupropion hcl TB24 300mg 1 $0 QL (30 compresse / 30 citalopram hydrobromide SOLN 1 $0 citalopram hydrobromide TABS 10mg, 20mg 1 $0 QL (45 compresse / 30 citalopram hydrobromide TABS 40mg 1 $0 QL (30 compresse / 30 clomipramine hcl CAPS 2 $0 PA desipramine hcl TABS 1 $0 doxepin hcl CAPS; CONC 2 $0 PA duloxetine hcl CPEP 20mg, 30mg, 1 $0 QL (60 capsule / 30 60mg EMSAM 2 $0 QL (30 cerotti / 30, PA escitalopram oxalate SOLN 1 $0 QL (600 ml / 30 escitalopram oxalate TABS 5mg, 10mg 1 $0 QL (45 compresse / 30 escitalopram oxalate TABS 20mg 1 $0 QL (60 compresse / 30 38

39 FETZIMA 20mg 2 $0 QL (180 capsule / 30 FETZIMA 40mg 2 $0 QL (90 capsule / 30 FETZIMA 80mg, 120mg 2 $0 QL (30 capsule / 30 FETZIMA TITRATION PACK 2 $0 fluoxetine hcl CAPS 10mg 1 $0 QL (30 capsule / 30 fluoxetine hcl CAPS 20mg 1 $0 QL (120 capsule / 30 fluoxetine hcl CAPS 40mg 1 $0 fluoxetine hcl SOLN 1 $0 fluoxetine hcl TABS 10mg 1 $0 QL (45 compresse / 30 fluoxetine hcl TABS 20mg 1 $0 imipramine hcl TABS 2 $0 PA maprotiline hcl 1 $0 MARPLAN TAB 10MG 2 $0 QL (180 compresse / 30 mirtazapine TABS 7.5mg, 15mg 1 $0 QL (45 compresse / 30 mirtazapine TABS 30mg, 45mg 1 $0 mirtazapine TBDP 15mg 1 $0 QL (30 compresse / 30 mirtazapine TBDP 30mg, 45mg 1 $0 nefazodone hcl 1 $0 nortriptyline hcl CAPS; SOLN 1 $0 paroxetine hcl TABS 10mg, 20mg, 1 $0 QL (45 compresse / 30 40mg paroxetine hcl TABS 30mg 1 $0 QL (60 compresse / 30 PAXIL SUSP 2 $0 QL (900 ml / 30 phenelzine sulfate TABS 1 $0 PRISTIQ 2 $0 QL (30 compresse / 30 protriptyline hcl 1 $0 sertraline hcl CONC 1 $0 sertraline hcl TABS 25mg, 50mg 1 $0 QL (45 compresse / 30 sertraline hcl TABS 100mg 1 $0 SURMONTIL CAP 25MG 2 $0 QL (240 capsule / 30, PA SURMONTIL CAP 50MG 2 $0 QL (120 capsule / 30, PA 39

40 SURMONTIL CAP 100MG 2 $0 QL (60 capsule / 30, PA tranylcypromine sulfate 1 $0 trazodone hcl TABS 50mg, 1 $0 100mg, 150mg venlafaxine hcl CP mg, 75mg 1 $0 QL (30 capsule / 30 venlafaxine hcl CP24 150mg 1 $0 QL (60 capsule / 30 venlafaxine hcl TABS 1 $0 VIIBRYD KIT 2 $0 VIIBRYD TABS 2 $0 QL (30 compresse / 30 AGENTI ANTIPARKINSONIANI - FARMACI PER IL TRATTAMENTO DELLA MALATTIA DI PARKINSON amantadine hcl CAPS; SYRP; TABS 1 $0 APOKYN 2 $0 NM, LA, PA AZILECT 2 $0 benztropine mesylate SOLN 1 $0 benztropine mesylate TABS 2 $0 PA bromocriptine mesylate CAPS; 1 $0 TABS carbidopa-levodopa 1 $0 CARBIDOPA/LEVODOPA/ENTACAPO1 $0 NE entacapone 1 $0 NEUPRO 2 $0 pramipexole dihydrochloride TABS 1 $0 ropinirole hydrochloride TABS 1 $0 selegiline hcl CAPS; TABS 1 $0 trihexyphenidyl hcl 2 $0 PA ANTIPSICOTICI - FARMACI PER IL TRATTAMENTO DELLE PSICOSI ABILIFY DISCMELT 2 $0 QL (60 compresse / 30 ABILIFY INJ 9.75MG 2 $0 QL (4 ml / 1 giorno) ABILIFY MAIN INJ 300MG 2 $0 QL (1 fiala / 28 ABILIFY MAIN INJ 400MG 2 $0 QL (1 fiala / 28 ABILIFY MAINTENA 2 $0 QL (1 siringa / 28 ABILIFY TABS 2 $0 QL (30 compresse / 30 aripiprazole 2 $0 QL (30 compresse / 30 chlorpromazine hcl SOLN 2 $0 40

41 chlorpromazine hcl TABS 1 $0 clozapine 25mg, 50mg 1 $0 clozapine 100mg 1 $0 QL (270 compresse / 30 clozapine 200mg 1 $0 QL (135 compresse / 30 CLOZAPINE ODT 12.5mg, 25mg 1 $0 PA CLOZAPINE ODT 100mg 1 $0 QL (270 compresse / 30, PA CLOZAPINE ODT 150MG 1 $0 QL (180 compresse / 30, PA CLOZAPINE ODT 200MG 1 $0 QL (135 compresse / 30, PA FANAPT 2 $0 QL (60 compresse / 30, ST FANAPT TITRATION PACK 2 $0 ST FAZACLO TAB 12.5/ODT 2 $0 PA FAZACLO TAB 25MG ODT 2 $0 PA FAZACLO TAB 100/ODT 2 $0 QL (270 compresse / 30, PA FAZACLO TAB 150MG 2 $0 QL (180 compresse / 30, PA FAZACLO TAB 200MG 2 $0 QL (135 compresse / 30, PA fluphenazine decanoate SOLN 1 $0 fluphenazine hcl 1 $0 GEODON SOLR 2 $0 QL (6 ml / 3 haloperidol TABS 1 $0 haloperidol decanoate SOLN 1 $0 haloperidol lactate 1 $0 haloperidol lactate oral conc 2 1 $0 mg/ml INVEGA 1.5mg, 3mg, 9mg 2 $0 QL (30 compresse / 30 INVEGA 6mg 2 $0 QL (60 compresse / 30 INVEGA SUST INJ 39 MG/0.25 ML 2 $0 QL (1 iniezione / 28 INVEGA SUST INJ 78 MG/0.5 ML 2 $0 QL (1 iniezione / 28 INVEGA SUST INJ 117 MG/0.75 ML 2 $0 QL (1 iniezione / 28 INVEGA SUST INJ 156MG/ML 2 $0 QL (1 iniezione / 28 41

42 INVEGA SUST INJ 234 MG/1.5 ML 2 $0 QL (1 iniezione / 28 LATUDA 20mg 2 $0 QL (240 compresse / 30 LATUDA 40mg, 120mg 2 $0 QL (30 compresse / 30 LATUDA 60mg, 80mg 2 $0 QL (60 compresse / 30 loxapine succinate 1 $0 olanzapine SOLR 1 $0 QL (3 fiale / 1 giorno) olanzapine TABS 2.5mg, 5mg, 7.5mg 1 $0 QL (30 compresse / 30 olanzapine TABS 10mg, 15mg, 20mg 1 $0 QL (60 compresse / 30 olanzapine TBDP 5mg 1 $0 QL (30 compresse / 30 olanzapine TBDP 10mg, 15mg 1 $0 QL (60 compresse / 30 olanzapine TBDP 20mg 2 $0 QL (60 compresse / 30 ORAP 2 $0 perphenazine TABS 1 $0 quetiapine fumarate 1 $0 QL (90 compresse / 30 RISPERDAL INJ 12.5MG 2 $0 QL (2 fiale / 28 RISPERDAL INJ 25MG 2 $0 QL (2 fiale / 28 RISPERDAL INJ 37.5MG 2 $0 QL (2 fiale / 28 RISPERDAL INJ 50MG 2 $0 QL (2 fiale / 28 risperidone SOLN 1 $0 QL (240 ml / 30 risperidone TABS 1mg, 2mg, 3mg 1 $0 QL (60 compresse / 30 risperidone TABS 4mg 1 $0 QL (120 compresse / 30 risperidone TABS.25mg,.5mg 1 $0 QL (90 compresse / 30 risperidone TBDP 1mg, 2mg, 3mg 1 $0 QL (60 compresse / 30 risperidone TBDP 4mg 1 $0 QL (120 compresse / 30 risperidone TBDP.25mg,.5mg 1 $0 QL (90 compresse / 30 SAPHRIS 2.5mg 2 $0 QL (240 compresse / 30 SAPHRIS 5mg 2 $0 QL (120 compresse / 30 42

43 SAPHRIS 10mg 2 $0 QL (60 compresse / 30 SEROQUEL XR 50mg 2 $0 QL (120 compresse / 30 SEROQUEL XR 150mg, 200mg 2 $0 QL (30 compresse / 30 SEROQUEL XR 300mg, 400mg 2 $0 QL (60 compresse / 30 thioridazine hcl TABS 2 $0 PA thiothixene 1 $0 trifluoperazine hcl 1 $0 VERSACLOZ 2 $0 QL (600 ml / 30, PA ziprasidone hcl 20mg, 40mg 1 $0 QL (60 capsule / 30 ziprasidone hcl 60mg, 80mg 1 $0 QL (90 capsule / 30 ZYPREXA RELPREVV 2 $0 B/D DISTURBO DI IPERATTIVITÀ DA DEFICIT DI ATTENZIONE - FARMACI PER IL TRATTAMENTO DELL'ADHD amphetamine-dextroamphetamine 1 $0 QL (90 capsule / 30 cap sr 24hr 5 mg amphetamine-dextroamphetamine 1 $0 QL (90 capsule / 30 cap sr 24hr 10 mg amphetamine-dextroamphetamine 1 $0 QL (30 capsule / 30 cap sr 24hr 15 mg amphetamine-dextroamphetamine 1 $0 QL (30 capsule / 30 cap sr 24hr 20 mg amphetamine-dextroamphetamine 1 $0 QL (30 capsule / 30 cap sr 24hr 25 mg amphetamine-dextroamphetamine 1 $0 QL (30 capsule / 30 cap sr 24hr 30 mg amphetamine-dextroamphetamine 1 $0 QL (360 compresse / tab 5 mg 30 amphetamine-dextroamphetamine 1 $0 QL (240 compresse / tab 7.5 mg 30 amphetamine-dextroamphetamine 1 $0 QL (180 compresse / tab 10 mg 30 amphetamine-dextroamphetamine 1 $0 QL (144 compresse / tab 12.5 mg 30 amphetamine-dextroamphetamine 1 $0 QL (120 compresse / tab 15 mg 30 amphetamine-dextroamphetamine tab 20 mg 1 $0 QL (90 compresse / 30 43

44 amphetamine-dextroamphetamine 1 $0 QL (60 compresse / 30 tab 30 mg guanfacine hcl (adhd) 2 $0 metadate tab 20mg er 1 $0 QL (90 compresse / 30 methylphenidate hcl TABS 5mg, 10mg 1 $0 QL (180 compresse / 30 methylphenidate hcl TABS 20mg 1 $0 QL (90 compresse / 30 methylphenidate hcl TBCR 10mg, 1 $0 QL (90 compresse / 30 20mg methylphenidate hcl oral soln 5mg/5ml 1 $0 QL (1800 ml / 30 methylphenidate hcl oral soln 1 $0 QL (900 ml / 30 10mg/5ml STRATTERA 10mg, 18mg, 25mg 2 $0 QL (120 capsule / 30 STRATTERA 40mg 2 $0 QL (60 capsule / 30 STRATTERA 60mg, 80mg, 100mg 2 $0 QL (30 capsule / 30 IPNOTICI - FARMACI PER IL TRATTAMENTO DELL'INSONNIA ROZEREM 2 $0 QL (30 compresse / 30 SILENOR 3mg 2 $0 QL (60 compresse / 30 SILENOR 6mg 2 $0 QL (30 compresse / 30 temazepam 7.5mg 1 $0 QL (30 capsule / 30, PA; limite di 90 giorni se >64 anni temazepam 15mg 1 $0 QL (60 capsule / 30, PA; limite di 90 giorni se >64 anni zolpidem tartrate TABS 2 $0 QL (30 compresse / 30, PA; limite di 90 giorni se >64 anni EMICRANIA - FARMACI PER IL TRATTAMENTO DI CEFALEE GRAVI cafergot 2 $0 dihydroergotamine mesylate 1 $0 1mg/ml naratriptan hcl 1 $0 QL (9 compresse / 30 RELPAX 2 $0 QL (12 compresse / 30 44

45 rizatriptan benzoate 1 $0 QL (18 compresse / 30 SUMATRIPTAN SOLN 5mg/act 1 $0 QL (24 inalatori / 30 SUMATRIPTAN SOLN 20mg/act 1 $0 QL (12 inalatori / 30 SUMATRIPTAN SUCCINATE SOCT 1 $0 QL (6 ml / 30 sumatriptan succinate SOSY 1 $0 QL (6 ml / 30 sumatriptan succinate TABS 1 $0 QL (9 compresse / 30 SUMATRIPTAN SUCCINATE INJ 1 $0 QL (6 ml / 30 SOAJ 4mg/0.5ml sumatriptan succinate inj SOAJ 1 $0 QL (6 ml / 30 6mg/0.5ml SUMATRIPTAN SUCCINATE INJ 1 $0 QL (6 ml / 30 SOCT sumatriptan succinate inj SOLN 1 $0 QL (6 ml / 30 zolmitriptan TABS 1 $0 QL (12 compresse / 30 zolmitriptan odt 1 $0 QL (12 compresse / 30 VARI LITHIUM 2 $0 lithium carbonate CAPS; TABS 1 $0 lithium carbonate er 1 $0 NUEDEXTA 2 $0 PA pyridostigmine bromide TABS 1 $0 riluzole 1 $0 XENAZINE 12.5mg 2 $0 QL (240 compresse / 30, NM, LA, PA XENAZINE 25mg 2 $0 QL (120 compresse / 30, NM, LA, PA SCLEROSI MULTIPLA - FARMACI PER IL TRATTAMENTO DELLA SCLEROSI MULTIPLA BETASERON 2 $0 QL (14 siringhe / 28, NM, PA COPAXONE INJ 40MG/ML 2 $0 QL (12 siringhe / 28, NM, PA COPAXONE KIT 20MG/ML 2 $0 QL (30 siringhe / 30, NM, PA GILENYA CAP 0.5MG 2 $0 QL (28 capsule / 28, NM, PA TYSABRI 2 $0 NM, LA, PA 45

46 TERAPIA MUSCOLOSCHELETRICA - FARMACI PER IL TRATTAMENTO DEGLI SPASMI MUSCOLARI baclofen TABS 1 $0 cyclobenzaprine hcl TABS 5mg, 1 $0 PA 10mg dantrolene sodium CAPS 1 $0 tizanidine hcl TABS 1 $0 NARCOLESSIA /CATAPLESSIA - FARMACI PER I DISTURBI DEL SONNO NUVIGIL 50mg 2 $0 QL (150 compresse / 30, PA NUVIGIL 150mg 2 $0 QL (60 compresse / 30, PA NUVIGIL 200mg, 250mg 2 $0 QL (30 compresse / 30, PA XYREM 2 $0 QL (540 ml / 30, LA, PA PSICOFARMACI-VARI acamprosate calcium 1 $0 buprenorphine hcl SUBL 1 $0 PA buprenorphine hcl-naloxone hcl sl 1 $0 QL (120 compresse / 30, PA buproban 1 $0 CHANTIX 2 $0 PA CHANTIX CONTINUING MONTH 2 $0 PA CHANTIX STARTER PACK 2 $0 PA diphenhydramine hcl (sleep) 3 $0 NM; * diphenhydramine-acetaminophen 3 $0 NM; * (sleep) disulfiram TABS 1 $0 doxylamine succinate (sleep) 3 $0 NM; * ibuprofen-diphenhydramine citrate 3 $0 NM; * naloxone hcl SOLN 1 $0 naltrexone hcl TABS 1 $0 nicotine 3 $0 NM; * nicotine polacrilex GUM 3 $0 NM; * nicotine polacrilex LOZG 2mg, 3 $0 NM; * 4mg NICOTINE POLACRILEX LOZG 3 $0 NM; * 2mg, 4mg NICOTINE TRANSDERMAL SYST 3 $0 NM; * NICOTROL INHALER 2 $0 NICOTROL NS 2 $0 46

47 SUBOXONE MIS 2-0.5MG 2 $0 QL (4 scatole / 30, PA SUBOXONE MIS 4-1MG 2 $0 QL (4 scatole / 30, PA SUBOXONE MIS 8-2MG 2 $0 QL (4 scatole / 30, PA SUBOXONE MIS 12-3MG 2 $0 QL (2 scatole / 30, PA SISTEMA ENDOCRINO E METABOLISMO - FARMACI PER IL TRATTAMENTO DEL DIABETE E PER LA REGOLAZIONE ORMONALE ANDROGENI - FARMACI PER LA REGOLAZIONE DEGLI ORMONI MASCHILI ANDRODERM 2 $0 QL (30 cerotti / 30, PA oxandrolone TABS 1 $0 PA TESTIM 2 $0 QL (300 grammi / 30, PA testosterone cypionate SOLN 1 $0 testosterone enanthate SOLN 1 $0 ANTIDIABETICI, INIETTABILI - FARMACI PER IL TRATTAMENTO DEL DIABETE ALCOHOL SWABS 2 $0 * GAUZE PADS 2" X 2" 2 $0 * HUMULIN R INJ U $0 B/D INSULIN PEN NEEDLE 2 $0 * INSULIN SAFETY NEEDLES 2 $0 * INSULIN SYRINGE 2 $0 * LANTUS 2 $0 LANTUS SOLOSTAR 2 $0 LEVEMIR 2 $0 LEVEMIR FLEXTOUCH 2 $0 NOVOLIN 70/30 2 $0 RELION non coperto NOVOLIN N 2 $0 RELION non coperto NOVOLIN R 2 $0 RELION non coperto NOVOLOG 2 $0 NOVOLOG FLEXPEN 2 $0 NOVOLOG MIX 70/30 2 $0 NOVOLOG MIX 70/30 PREFILL 2 $0 NOVOLOG PENFILL 2 $0 SYMLINPEN 60 2 $0 QL (8 penne / 30, PA SYMLINPEN $0 QL (4 penne / 30, PA 47

48 TOUJEO SOLOSTAR 2 $0 VICTOZA 2 $0 QL (3 penne / 30 ANTIDIABETICI, ORALI - FARMACI PER IL TRATTAMENTO DEL DIABETE acarbose 1 $0 glimepiride 1mg 1 $0 QL (240 compresse / 30 glimepiride 2mg 1 $0 QL (120 compresse / 30 glimepiride 4mg 1 $0 QL (60 compresse / 30 glip/metform tab 5-500mg 1 $0 QL (120 compresse / 30 glipizide TABS 5mg 1 $0 QL (240 compresse / 30 glipizide TABS 10mg 1 $0 QL (120 compresse / 30 glipizide TB24 2.5mg 1 $0 QL (240 compresse / 30 glipizide TB24 5mg 1 $0 QL (120 compresse / 30 glipizide TB24 10mg 1 $0 QL (60 compresse / 30 glipizide-metformin hcl tab $0 QL (240 compresse / mg 30 glipizide-metformin hcl tab $0 QL (120 compresse / mg 30 INVOKAMET TAB MG 2 $0 QL (120 compresse / 30 INVOKAMET TAB $0 QL (60 compresse / 30 INVOKAMET TAB $0 QL (60 compresse / 30 INVOKAMET TAB $0 QL (60 compresse / 30 INVOKANA 100mg 2 $0 QL (90 compresse / 30 INVOKANA 300mg 2 $0 QL (30 compresse / 30 JANUMET 2 $0 QL (60 compresse / 30 JANUMET XR TAB MG 2 $0 QL (60 compresse / 30 48

49 JANUMET XR TAB $0 QL (60 compresse / 30 JANUMET XR TAB $0 QL (30 compresse / 30 JANUVIA 2 $0 QL (30 compresse / 30 JENTADUETO 2 $0 QL (60 compresse / 30 metformin hcl TABS 500mg 1 $0 QL (150 compresse / 30 metformin hcl TABS 850mg 1 $0 QL (90 compresse / 30 metformin hcl TABS 1000mg 1 $0 QL (75 compresse / 30 metformin hcl TB24 500mg 1 $0 QL (120 compresse / 30 metformin hcl TB24 750mg 1 $0 QL (60 compresse / 30 nateglinide 1 $0 QL (90 compresse / 30 pioglitazone hcl 1 $0 QL (30 compresse / 30 repaglinide 2mg 1 $0 QL (240 compresse / 30 repaglinide.5mg, 1mg 1 $0 QL (120 compresse / 30 RIOMET 2 $0 QL (946 ml / 30 TRADJENTA 2 $0 QL (30 compresse / 30 BIFOSFONATI - FARMACI PER IL TRATTAMENTO DELL'OSTEOPOROSI alendronate sodium TABS 5mg, 1 $0 10mg, 40mg alendronate sodium TABS 35mg, 70mg 1 $0 QL (4 compresse / 28 ibandronate sodium TABS 1 $0 B/D, QL (1 compressa / 30 pamidronate disodium SOLN 1 $0 B/D zoledronic inj 4mg/5ml 2 $0 B/D, NM ZOMETA SOLN 2 $0 B/D, NM CALCIO-AGONISTI SENSIPAR 30mg, 90mg 2 $0 QL (120 compresse / 30, NM SENSIPAR 60mg 2 $0 QL (60 compresse / 30, NM AGENTI CHELANTI 49

50 CHEMET 2 $0 DEPEN TITRATABS 2 $0 EXJADE 2 $0 NM, LA, PA kionex 1 $0 sodium polystyrene sulfonate 1 $0 sps susp 15gm/60ml 1 $0 SYPRINE 2 $0 CONTRACCETTIVI - FARMACI PER IL CONTROLLO DELLE NASCITE altavera 1 $0 apri 28 day 1 $0 aranelle 28 1 $0 aubra 28 day 1 $0 aviane 28 1 $0 balziva 28 day 1 $0 briellyn 28 day 1 $0 camila 28 day 1 $0 cryselle 28 1 $0 cyclafem 1/35 28 day 1 $0 cyclafem 7/7/7 28 day 1 $0 deblitane 28 day 1 $0 delyla 28 day 1 $0 desogestrel-ethinyl estradiol 1 $0 (biphasic) drospirenone-ethinyl estradiol 1 $0 ELLA 2 $0 emoquette 1 $0 enpresse 28 day 1 $0 errin 28 day 1 $0 falmina 28 day 1 $0 GIANVI 1 $0 gildagia 1 $0 gildess 1.5/30 21 day 1 $0 heather 1 $0 introvale 91 day 1 $0 JOLESSA TAB MG 1 $0 JOLIVETTE 1 $0 junel 1.5/30 21 day 1 $0 junel 1/20 21 day 1 $0 junel fe 1.5/30 28 day 1 $0 junel fe 1/20 28 day 1 $0 kariva 28 day 1 $0 kimidess tab 1 $0 larin 1.5/30 1 $0 50

51 larin 1/20 1 $0 larin fe 1.5/30 1 $0 larin fe 1/20 1 $0 LEENA 1 $0 lessina 28 day 1 $0 levonest 28 day 1 $0 levonorgestrel & eth estradiol 1 $0 levonorgestrel (emergency oc) 1.5mg levonorgestrel (emergency oc) 1 $0.75mg, 1.5mg levonorgestrel-ethinyl estradiol 1 $0 (91-giorno) levora 0.15/30 28 day 1 $0 loryna 28 day 1 $0 low-ogestrel 28 day 1 $0 lutera 28 day 1 $0 lyza 1 $0 marlissa 28 day 1 $0 medroxyprogesterone acetate $0 mg/ml microgestin 1.5/30 21 day 1 $0 microgestin 1/20 21 day 1 $0 microgestin fe 1.5/30 28 day 1 $0 microgestin fe 1/20 28 day 1 $0 MONONESSA 1 $0 my way 1 $0 myzilra 1 $0 necon 0.5/35 28 day 1 $0 necon 1/35 28 day 1 $0 NECON 7/7/7 1 $0 necon 10/11 28 day 2 $0 NECON TAB 1/ $0 next choice one dose 1 $0 nikki 28 day 1 $0 NORA-BE TAB 1 $0 norethindrone (contraceptive) 1 $0 norgestimate-ethinyl estradiol 1 $0 (triphasic) norlyroc 28 day 1 $0 nortrel 0.5/35 28 day 1 $0 nortrel 1/35 21 day 1 $0 nortrel 1/35 28 day 1 $0 nortrel 7/7/7 28 day 1 $0 3 $0 NM; * 51

52 NUVARING 2 $0 OCELLA TAB MG 1 $0 orsythia 28 day 1 $0 philith 1 $0 pimtrea pack 1 $0 pirmella 1/35 28 day 1 $0 portia 28 day 1 $0 previfem 28 day 1 $0 quasense 91 day 1 $0 reclipsen 28 day 1 $0 sharobel 28 day 1 $0 SOLIA 1 $0 sprintec 28 day 1 $0 sronyx 1 $0 tarina fe tab 1/20 1 $0 tri-legest 28 day 1 $0 tri-previfem 28 day 1 $0 tri-sprintec 28 day 1 $0 TRINESSA 1 $0 trivora 28 day 1 $0 velivet 28 day 1 $0 vestura 1 $0 viorele 1 $0 vyfemia 28 day 1 $0 xulane 1 $0 zarah 1 $0 zenchent 28 day 1 $0 ENDOMETRIOSI danazol CAPS 1 $0 SYNAREL 2 $0 SOSTITUZIONE ENZIMATICA - FARMACI PER IL TRATTAMENTO DELLE DEFICIENZE ENZIMATICHE ADAGEN 2 $0 NM, LA, PA ALDURAZYME 2 $0 NM, LA, PA CARBAGLU 2 $0 NM, LA, PA CERDELGA 2 $0 NM, PA CEREZYME 2 $0 NM, PA CYSTADANE 2 $0 NM CYSTAGON 2 $0 NM, PA FABRAZYME 2 $0 NM, PA KUVAN 2 $0 NM, PA levocarnitine (metabolic modifiers) 1 $0 B/D LUMIZYME 2 $0 NM, PA 52

53 MYOZYME 2 $0 NM, PA NAGLAZYME 2 $0 NM, LA, PA ORFADIN 2 $0 NM, PA sodium phenylbutyrate 2 $0 NM ZAVESCA 2 $0 NM, LA, PA ESTROGENI - FARMACI PER LA REGOLAZIONE DEGLI ORMONI FEMMINILI COMBIPATCH 2 $0 PA estradiol PTWK 2 $0 PA estradiol TABS 2 $0 PA ESTRADIOL VALERATE OIL 1 $0 10mg/ml, 40mg/ml estradiol valerate OIL 20mg/ml 1 $0 PREMARIN CREAM 2 $0 VAGIFEM 2 $0 GLUCOCORTICOIDI - FARMACI PER IL TRATTAMENTO DELLA RISPOSTA IMMUNITARIA a-hydrocort 1 $0 cortisone acetate TABS 1 $0 dexamethasone CONC; ELIX; 1 $0 SOLN; TABS dexamethasone sodium phosphate 1 $0 fludrocortisone acetate TABS 1 $0 hydrocortisone TABS 1 $0 methylpr ace inj 40mg/ml 1 $0 B/D methylpr ace inj 80mg/ml 1 $0 B/D methylpr ss inj 1gm 1 $0 B/D methylpr ss inj 40mg 1 $0 B/D methylpr ss inj 125mg 1 $0 B/D methylpred pak 4mg 1 $0 B/D methylpred tab 4mg 1 $0 B/D methylpred tab 8mg 1 $0 B/D methylpred tab 16mg 1 $0 B/D methylpred tab 32mg 1 $0 B/D pred sod pho sol 5mg/5ml 1 $0 B/D prednisolone sol 15mg/5ml 1 $0 B/D prednisolone sol 25mg/5ml 1 $0 B/D prednisolone syp 15mg/5ml 1 $0 B/D prednisone con 5mg/ml 2 $0 B/D prednisone pak 5mg 1 $0 B/D prednisone pak 10mg 1 $0 B/D prednisone sol 5mg/5ml 1 $0 B/D prednisone tab 1mg 1 $0 B/D 53

54 prednisone tab 2.5mg 1 $0 B/D prednisone tab 5mg 1 $0 B/D prednisone tab 10mg 1 $0 B/D prednisone tab 20mg 1 $0 B/D prednisone tab 50mg 1 $0 B/D SOLU-CORTEF 250mg 2 $0 IPERGLICEMIZZANTI - FARMACI PER IL TRATTAMENTO DELL'IPOGLICEMIA GLUCAGEN HYPOKIT 2 $0 GLUCAGON EMERGENCY KIT 2 $0 PROGLYCEM 2 $0 ORMONI UMANI DELLA CRESCITA - FARMACI PER LA REGOLAZIONE DEGLI ORMONI PITUITARI NORDITROPIN FLEXPRO 2 $0 NM, PA NORDITROPIN NORDIFLEX PEN 2 $0 NM, PA TEV-TROPIN 2 $0 NM, PA VARI cabergoline 1 $0 calcitonin (salmon) 1 $0 FORTICAL 2 $0 INCRELEX 2 $0 NM, LA, PA methylergonovine maleate TABS 1 $0 MIACALCIN 200unit/ml 2 $0 B/D octreotide acetate 50mcg/ml, 1 $0 NM, PA 100mcg/ml, 200mcg/ml octreotide acetate 500mcg/ml, 2 $0 NM, PA 1000mcg/ml PROLIA 2 $0 QL (1 siringa / 180, NM raloxifene hcl 1 $0 SANDOSTATIN LAR DEPOT 2 $0 NM, PA SOMATULINE DEPOT 2 $0 NM, PA SOMAVERT 2 $0 NM, LA, PA XGEVA 2 $0 NM, PA ORMONI PARATIROIDEI - FARMACI PER LA REGOLAZIONE DEI LIVELLI PARATIROIDEI FORTEO 2 $0 QL (1 penna / 28, NM, PA LEGANTI DI FOSFATO - FARMACI PER LA REGOLAZIONE DEI LIVELLI DI CALCIO E FOSFORO calcium acetate (phosphate binder) 1 $0 FOSRENOL CHEW 2 $0 54

55 PHOSLYRA 2 $0 RENVELA PAK 0.8GM 2 $0 RENVELA PAK 2.4GM 2 $0 RENVELA TAB 800MG 2 $0 PROGESTINE - FARMACI PER LA REGOLAZIONE DEGLI ORMONI FEMMINILI medroxyprogesterone acetate tab 1 $0 norethindrone acetate TABS 1 $0 AGENTI TIROIDEI - FARMACI PER LA REGOLAZIONE DEI LIVELLI TIROIDEI levothyroxine sodium TABS 1 $0 LEVOXYL 1 $0 liothyronine sodium TABS 1 $0 methimazole TABS 1 $0 propylthiouracil TABS 1 $0 SYNTHROID 2 $0 UNITHROID 1 $0 VASOPRESSINE - FARMACI PER LA REGOLAZIONE DEGLI ORMONI PITUITARI desmopressin acetate spray 1 $0 desmopressin acetate spray 1 $0 refrigerated desmopressin acetate tabs 1 $0 desmopressin inj 4mcg/ml 1 $0 DESMOPRESSIN SOL 0.01% 1 $0 APPARATO GASTROINTESTINALE - FARMACI PER IL TRATTAMENTO DEI DISTURBI GASTRICI E INTESTINALI ANTIACIDO alum & mag hydrox-simethicone 3 $0 NM; * ALUMINUM HYDROXIDE 3 $0 NM; * aluminum hydroxide gel 3 $0 NM; * aluminum hydroxide-mag carb 3 $0 NM; * aluminum hydroxide-mag trisil 3 $0 NM; * CALCIUM CARBONATE TABS 3 $0 NM; * 648mg calcium carbonate (antacid) 3 $0 NM; * calcium carbonate-mag hydrox 3 $0 NM; * calcium carbonate-simethicone 3 $0 NM; * GAVISCON CHEW 3 $0 NM; * GAVISCON EXTRA STRENGTH R 3 $0 NM; * MAALOX TC 3 $0 NM; * MAG-AL 3 $0 NM; * 55

56 MAGNESIUM OXIDE CAPS 3 $0 NM; * magnesium oxide TABS 3 $0 NM; * SODIUM BICARBONATE POWD 3 $0 NM; * sodium bicarbonate (antacid) 3 $0 NM; * URO-MAG 3 $0 NM; * ANTIDIARROICI bismuth subsalicylate CHEW; 3 $0 NM; * SUSP; TABS FLORASTOR KIDS 3 $0 NM; * lactobacillus 3 $0 NM; * lactobacillus rhamnosus (gg) 3 $0 NM; * loperamide hcl LIQD; SUSP; TABS 3 $0 NM; * PROBIOTIC FORMULA 3 $0 NM; * RISA-BID PROBIOTIC 3 $0 NM; * saccharomyces boulardii 3 $0 NM; * ANTIEMETICI - FARMACI PER LA NAUSEA E IL VOMITO compro 1 $0 dimenhydrinate TABS 3 $0 NM; * dronabinol 2.5mg, 5mg 1 $0 B/D, QL (60 capsule / 30 dronabinol 10mg 2 $0 B/D, QL (60 capsule / 30 EMEND CAP 40MG 1 $0 B/D EMEND CAP 80MG 2 $0 B/D EMEND CAP 125MG 2 $0 B/D EMEND PAK 80 & $0 B/D granisetron hcl SOLN 1 $0 granisetron hcl TABS 1 $0 B/D meclizine hcl CHEW 3 $0 NM; * meclizine hcl TABS 12.5mg, 25mg 1 $0 meclizine hcl TABS 25mg, 32mg 3 $0 NM; * metoclopramide hcl SOLN; TABS 1 $0 metoclopramide inj 1 $0 ondansetron hcl SOLN 1 $0 ondansetron hcl TABS 1 $0 B/D ondansetron hcl inj 1 $0 ondansetron hcl oral soln 1 $0 B/D ondansetron odt 1 $0 B/D prochlorperazine inj 1 $0 prochlorperazine maleate TABS 1 $0 prochlorperazine supp 1 $0 promethazine hcl SOLN 25mg/ml, 2 $0 PA 50mg/ml 56

57 TRANSDERM-SCOP 2 $0 QL (10 cerotti / 30, PA ANTISPASMODICI - FARMACI PER GLI SPASMI GASTRICI CUVPOSA 2 $0 dicyclomine hcl 1 $0 glycopyrrolate TABS 1 $0 glycopyrrolate inj 1 $0 ANTAGONISTI DEI RECETTORI H2 - FARMACI PER ULCERE E ACIDITÀ DI STOMACO AXID AR 3 $0 NM; * cimetidine TABS 200mg 3 $0 NM; * famotidine SOLN 40mg/4ml, 1 $0 200mg/20ml famotidine SUSR 1 $0 famotidine TABS 10mg, 20mg 3 $0 NM; * famotidine TABS 20mg, 40mg 1 $0 famotidine inj 1 $0 PEPCID AC CHEW 3 $0 NM; * ranitidine hcl SOLN 1 $0 ranitidine hcl TABS 75mg, 150mg 3 $0 NM; * ranitidine hcl TABS 150mg, 300mg 1 $0 ranitidine hcl inj 1 $0 ranitidine syrup 1 $0 MALATTIE INFIAMMATORIE CRONICHE INTESTINALI APRISO 2 $0 ASACOL HD 2 $0 balsalazide disodium 1 $0 budesonide ec 2 $0 CANASA 2 $0 colocort enema 100mg 1 $0 DELZICOL 2 $0 DIPENTUM 2 $0 HYDROCORTISONE 1 $0 (INTRARECTAL) LIALDA 2 $0 mesalamine enema 1 $0 mesalamine w/ cleanser 1 $0 PENTASA 2 $0 sulfasalazine TABS 1 $0 sulfasalazine ec 1 $0 UCERIS TB24 2 $0 LASSATIVI BENEFIBER CHEW; POWD 3 $0 NM; * 57

58 benzocaine-docusate sodium 3 $0 NM; * bisacodyl SUPP; TBEC 3 $0 NM; * BLACK DRAUGHT 3 $0 NM; * calcium polycarbophil 3 $0 NM; * COATS ALOE VERA JUICE DRI 3 $0 NM; * constulose 1 $0 corn dextrin 3 $0 NM; * docusate calcium 3 $0 NM; * docusate sodium CAPS; ENEM; 3 $0 NM; * LIQD; SYRP; TABS DULCOLAX BOWEL PREP KIT 3 $0 NM; * enulose 1 $0 EQL NATURAL FIBER 3 $0 NM; * EQUALACTIN 3 $0 NM; * fiber CHEW 3 $0 NM; * FIBER CHEW 3 $0 NM; * fiber POWD 3 $0 NM; * FIBER POWD 3 $0 NM; * FLEET BISACODYL 3 $0 NM; * gaviltye-g 1 $0 gavilyte-c 1 $0 gavilyte-h 1 $0 gavilyte-n 1 $0 generlac 1 $0 GOLYTELY 2 $0 HYDROCIL INSTANT PACK 3 $0 NM; * KONSYL PACK 28.3%, 100% 3 $0 NM; * KONSYL POWD 60.3%, 71.67% 3 $0 NM; * KONSYL-D 3 $0 NM; * lactulose 1 $0 lactulose (encephalopathy) 1 $0 magnesium citrate SOLN 3 $0 NM; * magnesium hydroxide SUSP 3 $0 NM; * magnesium oxide (laxative) 3 $0 NM; * magnesium sulfate (laxative) 3 $0 NM; * METAMUCIL WAFR 3 $0 NM; * METAMUCIL MULTIHEALTH FIB 3 $0 NM; * POWD 63% METAMUCIL SMOOTH TEXTURE 3 $0 NM; * methylcellulose (laxative) 3 $0 NM; * MILK OF MAGNESIA CONCENTR 3 $0 NM; * mineral oil ENEM 3 $0 NM; * MINERAL OIL OIL 3 $0 NM; * 58

59 MOVIPREP 2 $0 NULYTELY/FLAVOR PACKS 2 $0 NUTRISOURCE FIBER PACK 3 $0 NM; * PEDIA-LAX LIQD 3 $0 NM; * peg 3350-kcl-sod bicarb-sod 1 $0 chloride-sod sulfate peg 3350-potassium chloride-sod 1 $0 bicarbonate-sod chloride PEG 3350/ELECTROLYTES 1 $0 PHILLIPS MILK OF MAGNESIA 3 $0 NM; * polyethylene glycol 3350 PACK; 1 $0 POWD psyllium CAPS 3 $0 NM; * psyllium POWD 28.3%, 30%, 3 $0 NM; * 30.9%, 33%, 48.57%, 58.6%, 68%, 95%, 100% PSYLLIUM POWD 49% 3 $0 NM; * RELISTOR 2 $0 PA SENNA SYRP 3 $0 NM; * senna TABS 3 $0 NM; * SENNA PROMPT 3 $0 NM; * sennosides CAPS 3 $0 NM; * sennosides CHEW 3 $0 NM; * sennosides SYRP 3 $0 NM; * SENNOSIDES TABS 8.6mg 3 $0 NM; * sennosides TABS 8.6mg, 15mg, 3 $0 NM; * 17.2mg, 25mg sennosides-docusate sodium 3 $0 NM; * sodium phosphates 3 $0 NM; * SUPREP BOWEL PREP 2 $0 trilyte 1 $0 wheat dextrin 3 $0 NM; * wheat dextrin-calcium 3 $0 NM; * VARI alosetron hcl 2 $0 PA AMITIZA CAP 8MCG 2 $0 QL (60 capsule / 30 AMITIZA CAP 24MCG 2 $0 QL (60 capsule / 30 cromolyn sodium (mastocytosis) 2 $0 diphenoxylate w/ atropine 1 $0 LINZESS CAP 145MCG 2 $0 QL (60 capsule / 30 59

60 LINZESS CAP 290MCG 2 $0 QL (30 capsule / 30 loperamide hcl CAPS 1 $0 LOTRONEX 2 $0 PA misoprostol TABS 1 $0 MOVANTIK 12.5mg 2 $0 QL (60 compresse / 30 MOVANTIK 25mg 2 $0 QL (30 compresse / 30 SUCRAID 2 $0 sucralfate TABS 1 $0 ursodiol CAPS; TABS 1 $0 XIFAXAN 550mg 2 $0 PA ENZIMI PANCREATICI CREON 2 $0 ZENPEP 2 $0 INIBITORI DELLA POMPA PROTONICA - FARMACI PER ULCERE E ACIDITÀ DI STOMACO DEXILANT 2 $0 QL (30 capsule / 30 esomeprazole sodium inj 1 $0 famotidine-calcium carbonatemagnesium 3 $0 NM; * hydroxide lansoprazole CPDR 15mg 3 $0 NM; * NEXIUM CAP 20MG 2 $0 QL (30 capsule / 30 NEXIUM CAP 40MG 2 $0 QL (30 capsule / 30 NEXIUM GRA 2.5MG DR 2 $0 NEXIUM GRA 5MG DR 2 $0 NEXIUM GRA 10MG DR 2 $0 QL (30 pacchetti / 30 NEXIUM GRA 20MG DR 2 $0 QL (30 pacchetti / 30 NEXIUM GRA 40MG DR 2 $0 QL (30 pacchetti / 30 omeprazole CPDR 10mg, 40mg 1 $0 QL (30 capsule / 30 omeprazole CPDR 20mg 1 $0 QL (60 capsule / 30 OMEPRAZOLE TBEC 3 $0 NM; * omeprazole magnesium 3 $0 NM; * omeprazole-sodium bicarbonate 3 $0 NM; * 60

61 pantoprazole sodium tbec 1 $0 QL (30 compresse / 30 PRILOSEC OTC 3 $0 NM; * APPARATO GENITOURINARIO - FARMACI PER IL TRATTAMENTO DI PATOLOGIE DEGLI ORGANI GENITALI E DEL TRATTO URINARIO IPERPLASIA PROSTATICA BENIGNA - FARMACI PER IL TRATTAMENTO DELL'INGROSSAMENTO PROSTATICO alfuzosin hcl 1 $0 QL (30 compresse / 30 AVODART 2 $0 QL (30 capsule / 30 finasteride TABS 5mg 1 $0 JALYN 2 $0 QL (30 capsule / 30 tamsulosin hcl 1 $0 QL (60 capsule / 30 VARI bethanechol chloride TABS 1 $0 ELMIRON 2 $0 POTASSIUM CITRATE 1 $0 (ALKALINIZER) 540mg, 1080mg ANTISPASMODICI URINARI - FARMACI PER IL TRATTAMENTO DELL'INCONTINENZA URINARIA MYRBETRIQ 25mg 2 $0 QL (60 compresse / 30 MYRBETRIQ 50mg 2 $0 QL (30 compresse / 30 oxybutynin chloride SYRP 1 $0 oxybutynin chloride TABS 1 $0 oxybutynin chloride TB24 5mg 1 $0 QL (30 compresse / 30 oxybutynin chloride TB24 10mg, 15mg 1 $0 QL (60 compresse / 30 TOLTERODINE TARTRATE CAP ER 1 $0 QL (30 capsule / 30 tolterodine tartrate tabs 1 $0 TOVIAZ 2 $0 QL (30 compresse / 30 trospium chloride TABS 1 $0 QL (60 compresse / 30 VESICARE 2 $0 QL (30 compresse / 30 FARMACI PER IL TRATTAMENTO DELLE INFEZIONI VAGINALI clindamycin phosphate vaginal 1 $0 61

62 clotrimazole vaginal 3 $0 NM; * metronidazole vaginal 1 $0 miconazole nitrate vaginal CREA 3 $0 NM; * miconazole nitrate vaginal KIT 3 $0 NM; * miconazole nitrate vaginal SUPP 3 $0 NM; * 100mg povidone-iodine vaginal 3 $0 NM; * terconazole vaginal 1 $0 tioconazole vaginal 3 $0 NM; * VANDAZOLE 1 $0 zazole.4% 1 $0 ZAZOLE.8% 1 $0 EMATOLOGIA - FARMACI PER IL TRATTAMENTO DEI DISTURBI EMATICI ANTICOAGULANTI - FLUIDIFICANTI DEL SANGUE COUMADIN 2 $0 ELIQUIS 2 $0 enoxaparin sodium 30mg/0.3ml, 1 $0 40mg/0.4ml, 60mg/0.6ml, 80mg/0.8ml, 300mg/3ml enoxaparin sodium 100mg/ml, 2 $0 120mg/0.8ml, 150mg/ml fondaparinux sodium 2.5mg/0.5ml 1 $0 fondaparinux sodium 5mg/0.4ml, 2 $0 7.5mg/0.6ml, 10mg/0.8ml heparin sod inj 1000/ml 1 $0 B/D HEPARIN SOD INJ 2000/ML 2 $0 B/D HEPARIN SOD INJ 2500/ML 2 $0 B/D heparin sod inj 5000/ml 1 $0 B/D heparin sod inj 10000/ml 1 $0 B/D heparin sod inj 20000/ml 1 $0 B/D HEPARIN SODIUM/D5W 2 $0 HEPARIN SODIUM/NACL 0.45% 2 $0 jantoven 1 $0 PRADAXA 2 $0 warfarin sodium 1 $0 XARELTO 2 $0 XARELTO STARTER PACK 2 $0 FATTORI DI CRESCITA EMOPOIETICA GRANIX 2 $0 NM, PA LEUKINE 2 $0 NM, PA MOZOBIL 2 $0 NM, PA NEUMEGA 2 $0 NM 62

63 NEUPOGEN 2 $0 NM, PA PROCRIT 2 $0 NM, PA FERRO BIFERA 3 $0 NM; * carbonyl iron 3 $0 NM; * CVS SLOW RELEASE IRON 3 $0 NM; * FEOSOL 45mg 3 $0 NM; * FERRETTS IPS 3 $0 NM; * FERRIMIN $0 NM; * FERROUS FUMARATE TABS 29mg, 3 $0 NM; * 90mg ferrous fumarate TABS 325mg 3 $0 NM; * FERROUS GLUCONATE 225mg, 3 $0 NM; * 324mg ferrous gluconate 240mg, 324mg, 3 $0 NM; * 325mg ferrous sulfate ELIX 3 $0 NM; * FERROUS SULFATE LIQD 3 $0 NM; * ferrous sulfate SOLN 3 $0 NM; * FERROUS SULFATE SYRP 3 $0 NM; * ferrous sulfate TABS 3 $0 NM; * ferrous sulfate TBCR 45mg, 3 $0 NM; * 47.5mg, 50mg FERROUS SULFATE TBCR 140mg 3 $0 NM; * FERROUS SULFATE TBEC 324mg 3 $0 NM; * ferrous sulfate TBEC 325mg 3 $0 NM; * ferrous sulfate dried 3 $0 NM; * FOLGARD 3 $0 NM; * folic acid-vitamin b6-vitamin b12 3 $0 NM; * FOLITAB $0 NM; * INTEGRA 3 $0 NM; * IRON TABS 28mg, 90mg 3 $0 NM; * iron TABS 256mg 3 $0 NM; * IRON TBCR 3 $0 NM; * iron chews pediatric 3 $0 NM; * IRON DEXTRAN 3 $0 NM; * IRON UP 3 $0 NM; * iron-vitamin c 3 $0 NM; * iron-vitamin c-vitamin b12-folic 3 $0 NM; * acid MYKIDZ IRON 10 3 $0 NM; * NOVAFERRUM $0 NM; * NOVAFERRUM PEDIATRIC DROP 3 $0 NM; * polysaccharide iron complex 3 $0 NM; * 63

64 PROFE 3 $0 NM; * SLOW RELEASE IRON 3 $0 NM; * SM SLOW RELEASE IRON 3 $0 NM; * VITAMIN B12/FOLIC ACID 3 $0 NM; * VARI anagrelide hcl 1 $0 cilostazol 1 $0 CINRYZE 2 $0 NM, LA, PA FIRAZYR 2 $0 NM, PA pentoxifylline TBCR 1 $0 PROMACTA 12.5mg 2 $0 QL (360 compresse / 30, NM, LA, PA PROMACTA 25mg 2 $0 QL (180 compresse / 30, NM, LA, PA PROMACTA 50mg 2 $0 QL (90 compresse / 30, NM, LA, PA PROMACTA 75mg 2 $0 QL (60 compresse / 30, NM, LA, PA tranexamic acid SOLN; TABS 1 $0 INIBITORI DELL'AGGREGAZIONE PIASTRINICA AGGRENOX 2 $0 BRILINTA 2 $0 clopidogrel bisulfate 75mg 1 $0 QL (30 compresse / 30 EFFIENT 2 $0 ZONTIVITY 2 $0 AGENTI IMMUNOLOGICI - FARMACI PER IL TRATTAMENTO DEI DISTURBI DEL SISTEMA IMMUNITARIO FARMACI ANTIREUMATICI MODIFICANTI LA MALATTIA (DMARD) - FARMACI PER IL TRATTAMENTO DELL'ARTRITE REUMATOIDE CIMZIA 2 $0 NM, PA CIMZIA STARTER KIT 2 $0 NM, PA HUMIRA 2 $0 NM, PA HUMIRA KIT 40MG/0.8 1 $0 NM, PA HUMIRA PEN 2 $0 NM, PA HUMIRA PEN-CROHNS DISEASE 2 $0 NM, PA HUMIRA PEN-PSORIASIS STAR 2 $0 NM, PA hydroxychloroquine sulfate 1 $0 leflunomide TABS 1 $0 methotrexate sodium tabs 1 $0 REMICADE 2 $0 NM, PA IMMUNOGLOBULINE BIVIGAM 2 $0 NM, PA 64

65 CARIMUNE NANOFILTERED 2 $0 NM, PA FLEBOGAMMA 2 $0 NM, PA FLEBOGAMMA DIF 2 $0 NM, PA GAMASTAN S/D 2 $0 B/D, NM GAMMAGARD LIQUID 2 $0 NM, PA GAMMAGARD S/D 2 $0 NM, PA GAMMAKED 2 $0 NM, PA GAMMAPLEX 2.5gm/50ml, 2 $0 NM, PA 5gm/100ml, 10gm/200ml GAMUNEX-C 2 $0 NM, PA GAMUNEX-C 1GM/10ML 2 $0 NM, PA OCTAGAM 1gm/20ml, 2gm/20ml, 2 $0 NM, PA 2.5gm/50ml, 5gm/100ml, 10gm/200ml, 25gm/500ml PRIVIGEN 2 $0 NM, PA IMMUNOMODULATORI ACTIMMUNE 2 $0 NM, LA, PA ARCALYST 2 $0 NM, PA INTRON-A INJ 10MU 2 $0 B/D, NM INTRON-A INJ 18MU 2 $0 B/D, NM INTRON-A INJ 25MU 2 $0 B/D, NM INTRON-A INJ 50MU 2 $0 B/D, NM PEG-INTRON 2 $0 NM, PA PEG-INTRON REDIPEN 2 $0 NM, PA REVLIMID 2 $0 NM, LA, PA THALOMID 2 $0 NM, PA IMMUNOSUPPRESSORI azathioprine TABS 1 $0 B/D cyclosporine CAPS; SOLN 1 $0 B/D cyclosporine modified (for 1 $0 B/D microemulsion) gengraf 1 $0 B/D mycophenolate mofetil CAPS; 1 $0 B/D TABS mycophenolate mofetil SUSR 2 $0 B/D mycophenolate sodium 180mg 1 $0 B/D mycophenolate sodium 360mg 2 $0 B/D NEORAL 2 $0 B/D NULOJIX 2 $0 B/D PROGRAF CAPS 2 $0 B/D RAPAMUNE SOLN 2 $0 B/D SANDIMMUNE CAPS 2 $0 B/D SANDIMMUNE SOLN 100mg/ml 2 $0 B/D 65

66 SIROLIMUS TABS 1mg 1 $0 B/D SIROLIMUS TABS 2mg 2 $0 B/D sirolimus TABS.5mg 1 $0 B/D tacrolimus CAPS 5mg 2 $0 B/D tacrolimus CAPS.5mg, 1mg 1 $0 B/D ZORTRESS 2 $0 B/D ZORTRESS TAB 0.5MG 2 $0 B/D ZORTRESS TAB 0.75MG 2 $0 B/D VACCINI ACTHIB 2 $0 ADACEL 2 $0 BCG VACCINE 2 $0 BEXSERO 2 $0 BOOSTRIX 2 $0 CERVARIX 2 $0 COMVAX 2 $0 DAPTACEL 2 $0 DIPHTHERIA/TETANUS TOXOID 2 $0 B/D ENGERIX-B SUSP 2 $0 B/D GARDASIL 2 $0 GARDASIL 9 2 $0 HAVRIX 2 $0 HIBERIX 2 $0 IMOVAX RABIES (H.D.C.V.) 2 $0 INFANRIX 2 $0 IPOL INACTIVATED IPV 2 $0 IXIARO 2 $0 M-M-R II W/DILUENT 10 DOS 2 $0 MENACTRA 2 $0 MENOMUNE-A/C/Y/W $0 MENVEO 2 $0 PEDVAX HIB 2 $0 PROQUAD 2 $0 RABAVERT 2 $0 RECOMBIVAX HB 2 $0 B/D ROTARIX 2 $0 ROTATEQ 2 $0 SYNAGIS 2 $0 NM TENIVAC 2 $0 B/D TETANUS TOXOID ADSORBED 2 $0 B/D TETANUS/DIPHTHERIA TOXOID 2 $0 B/D TRUMENBA 2 $0 TWINRIX INJ 2 $0 66

67 TYPHIM VI 2 $0 VAQTA 2 $0 VARIVAX 2 $0 YF-VAX 2 $0 ZOSTAVAX 2 $0 QL (1 fiala una tantum) NUTRIENTI/INTEGRATORI - VITAMINE E INTEGRATORI ELETTROLITI KLOR-CON 8 1 $0 KLOR-CON 10 1 $0 klor-con m15 1 $0 klor-con m20 1 $0 klor-con pow 20meq 1 $0 MAGNESIUM SULFATE SOLN 2 $0 40mg/ml, 80mg/ml magnesium sulfate SOLN 50% 1 $0 MAGNESIUM SULFATE SOLN 50% 1 $0 MAGNESIUM SULFATE IN D5W 2 $0 oral electrolytes SOLN 3 $0 NM; * potassium chloride CPCR 1 $0 potassium chloride LIQD 1 $0 potassium chloride TBCR 8meq 1 $0 POTASSIUM CHLORIDE TBCR 1 $0 20meq POTASSIUM CHLORIDE ER 1 $0 potassium chloride 1 $0 microencapsulated crystals cr SODIUM CHLORIDE SOLN 1 $0 2.5meq/ml SODIUM FLUORIDE CHEW; TAB; 1 $0 1.1 (0.5 F) MG/ML SOLN TPN ELECTROLYTES 2 $0 B/D NUTRIZIONE PARENTERALE AMINOSYN 2 $0 B/D AMINOSYN 7%/ELECTROLYTES 2 $0 B/D AMINOSYN 8.5%/ELECTROLYTE 2 $0 B/D AMINOSYN II 2 $0 B/D AMINOSYN II 8.5%/ELECTROL 2 $0 B/D AMINOSYN M 2 $0 B/D AMINOSYN-HBC 2 $0 B/D AMINOSYN-PF 2 $0 B/D AMINOSYN-PF 7% 2 $0 B/D AMINOSYN-RF 2 $0 B/D CLINIMIX 2.75%/DEXTROSE 5% 2 $0 B/D 67

68 CLINIMIX 4.25%/DEXTROSE 5% 2 $0 B/D CLINIMIX 4.25%/DEXTROSE 25% 2 $0 B/D CLINIMIX 5%/DEXTROSE 15% 2 $0 B/D CLINIMIX 5%/DEXTROSE 20% 2 $0 B/D CLINIMIX 5%/DEXTROSE 25% 2 $0 B/D CLINIMIX INJ 4.25/D10 2 $0 B/D CLINIMIX INJ 4.25/D20 2 $0 B/D FREAMINE HBC 6.9% 2 $0 B/D FREAMINE III 2 $0 B/D HEPATAMINE 2 $0 B/D INTRALIPID INJ 20% 2 $0 B/D INTRALIPID INJ 30% 2 $0 B/D NEPHRAMINE 2 $0 B/D NUTRILIPID EMU 20% 2 $0 B/D premasol sol 6% 1 $0 B/D premasol sol 10% 2 $0 B/D PROCALAMINE 2 $0 B/D PROSOL 2 $0 B/D travasol 10 2 $0 B/D TROPHAMINE INJ 10% 2 $0 B/D SOLUZIONI PER REIDRATAZIONE PARENTERALE DEXTROSE 2.5%/NACL 0.45% 1 $0 DEXTROSE 5% 1 $0 DEXTROSE 5% /ELECTROLYTE 2 $0 DEXTROSE 5%/LACTATED RING 1 $0 DEXTROSE 5%/NACL 0.2% 1 $0 DEXTROSE 5%/NACL 0.3% 1 $0 DEXTROSE 5%/NACL 0.9% 1 $0 DEXTROSE 5%/NACL 0.33% 1 $0 DEXTROSE 5%/NACL 0.45% 1 $0 DEXTROSE 5%/NACL 0.225% 1 $0 DEXTROSE 5%/POTASSIUM CHL 1 $0 DEXTROSE 10% FLEX CONTAIN 1 $0 DEXTROSE 10%/NACL 0.2% 2 $0 DEXTROSE 10%/NACL 0.45% 1 $0 DEXTROSE 50% 1 $0 dextrose inj 70% 1 $0 IONOSOL-B/DEXTROSE 5% 2 $0 IONOSOL-MB/DEXTROSE 5% 2 $0 ISOLYTE P 2 $0 isolyte s 2 $0 KCL0.15%/D5W/NACL0.2% 1 $0 KCL0.15%/D5W/NACL0.225% 2 $0 68

69 KCL 0.3%/D5W/NACL 0.9% 1 $0 KCL 0.3%/D5W/NACL 0.45% 1 $0 KCL 0.15%/D5W/NACL 0.9% 1 $0 KCL 0.075%/D5W/NACL 0.45% 1 $0 KCL IN NACL INJ $0 KCL/D5W INJ 0.3% 1 $0 KCL/D5W/NACL INJ.15/.33% 1 $0 KCL/D5W/NACL INJ.15/.45% 1 $0 KCL/NACL INJ $0 LACTATED RINGER'S INJ 1 $0 normosol-m 1 $0 NORMOSOL-R 2 $0 NORMOSOL-R IN D5W 2 $0 PLASMA-LYTE A 2 $0 PLASMA-LYTE-56/D5W 2 $0 PLASMA-LYTE $0 POTASSIUM CHLORIDE SOLN 1 $0 10meq/100ml, 20meq/100ml potassium chloride SOLN 1 $0.4meq/ml, 2meq/ml, 10meq/50ml, 40meq/100ml POTASSIUM CHLORIDE 0.15% 1 $0 POTASSIUM CHLORIDE 0.22% 1 $0 potassium chloride in nacl 1 $0 RINGER'S 1 $0 SODIUM CHLORIDE SOLN 3%, 5% 1 $0 SODIUM CHLORIDE 0.45% VIA 1 $0 SODIUM CHLORIDE INJ 0.9% 1 $0 MINERALI ADVANCED CALCIUM FORMULA 3 $0 NM; * BEELITH 3 $0 NM; * BONE DENSITY 3 $0 NM; * bone meal w/ vitamin d 3 $0 NM; * CAL-CITRATE PLUS VITAMIN 3 $0 NM; * CAL-GLU 3 $0 NM; * CAL-QUICK 3 $0 NM; * CAL/MAG 3 $0 NM; * CALCET CREAMY BITES 3 $0 NM; * CALCET PETITES 3 $0 NM; * CALCI-MIX 3 $0 NM; * CALCIONATE 3 $0 NM; * calcium TABS 3 $0 NM; * CALCIUM $0 NM; * 69

70 CALCIUM D 3 $0 NM; * CALCIUM & MAGNESIUM 3 $0 NM; * calcium & phosphorus w/ vitamin d 3 $0 NM; * CALCIUM CARBONATE CHEW 3 $0 NM; * CALCIUM CARBONATE POWD 3 $0 NM; * calcium carbonate SUSP 3 $0 NM; * calcium carbonate TABS 600mg, 3 $0 NM; * 1250mg, 1500mg calcium carbonate-cholecalciferol 3 $0 NM; * CAPS calcium carbonate-cholecalciferol 3 $0 NM; * CHEW CALCIUM CARBONATE- 3 $0 NM; * CHOLECALCIFEROL CHEW calcium carbonate-cholecalciferol 3 $0 NM; * TABS calcium carbonate-ergocalciferol 3 $0 NM; * calcium carbonate-vitamin d 3 $0 NM; * calcium carbonate-vitamin d w/ 3 $0 NM; * minerals CALCIUM CITRATE GRAN 3 $0 NM; * CALCIUM CITRATE TABS 250mg 3 $0 NM; * calcium citrate TABS 950mg 3 $0 NM; * CALCIUM CITRATE MALATE/VI 3 $0 NM; * CALCIUM CITRATE W/D 3 $0 NM; * calcium citrate-vitamin d 3 $0 NM; * CALCIUM GLUCONATE TABS 3 $0 NM; * 50mg, 500mg calcium gluconate TABS 500mg 3 $0 NM; * CALCIUM GUMMIES 3 $0 NM; * CALCIUM LACTATE 100mg, 648mg 3 $0 NM; * calcium lactate 650mg 3 $0 NM; * calcium w/ magnesium 3 $0 NM; * calcium w/ vitamin d 3 $0 NM; * calcium w/ vitamins d & k 3 $0 NM; * calcium-magnesium w/ vitamin d 3 $0 NM; * calcium-magnesium-zinc 3 $0 NM; * CALCIUM/C/D 3 $0 NM; * CALCIUM/MAGNESIUM 3 $0 NM; * CALCIUM/MAGNESIUM/VITAMIN 3 $0 NM; * CALCIUM/MAGNESIUM/ZINC 3 $0 NM; * CALMAG THINS 3 $0 NM; * CALTRATE 600+D PLUS MINER CHEW 3 $0 NM; * 70

71 caltrate 600+d soft chews 3 $0 NM; * CHELATED CALCIUM 3 $0 NM; * CITRACAL CALCIUM GUMMIES 3 $0 NM; * CITRACAL PLUS HEART HEALT 3 $0 NM; * CORAL CALCIUM CAPS 3 $0 NM; * CORAL CALCIUM PLUS 3 $0 NM; * coral calcium-magnesium w/ 3 $0 NM; * vitamin d CVS CALCIUM CITRATE 3 $0 NM; * EQL CALCIUM/VITAMIN D 3 $0 NM; * EQL CHILDRENS CALCIUM GUM 3 $0 NM; * GNP CALCIUM 500 +D3 3 $0 NM; * LIQUID CALCIUM WITH D3 MA 3 $0 NM; * LOCALNESIUM 3 $0 NM; * LOCALNESIUM-C 3 $0 NM; * MAG $0 NM; * MAG-TAB SR 3 $0 NM; * MAGINEX 3 $0 NM; * MAGNEBIND $0 NM; * MAGNEBIND $0 NM; * magnesium CAPS 100mg 3 $0 NM; * MAGNESIUM CAPS 400mg 3 $0 NM; * magnesium TABS 100mg, 200mg, 3 $0 NM; * 250mg magnesium chloride TBCR 3 $0 NM; * magnesium chloride-calcium 3 $0 NM; * MAGNESIUM CITRATE TABS 3 $0 NM; * MAGNESIUM ELEMENTAL 3 $0 NM; * MAGNESIUM GLUCONATE TABS 3 $0 NM; * 250mg, 550mg magnesium oxide (mg supplement) 3 $0 NM; * MAGNESIUM SULFATE CAPS 3 $0 NM; * oral electrolytes TABS 3 $0 NM; * OSTEO-PORETICAL 3 $0 NM; * oyster shell 3 $0 NM; * PARVA-CAL 3 $0 NM; * PARVA-CAL $0 NM; * PHOS-NAK POWDER CONCENTRA 3 $0 NM; * RA CALCIUM/BORON 3 $0 NM; * RA OYSTER SHELL CALCIUM/V 3 $0 NM; * selenium TABS 100mcg 3 $0 NM; * SELENIUM TBCR 3 $0 NM; * SLOW-MAG 3 $0 NM; * 71

72 SM CORAL CALCIUM 3 $0 NM; * UPCAL D 3 $0 NM; * VITAMINE A-25 3 $0 NM; * ACEROLA C $0 NM; * ANTIOXIDANT FORMULA SG 3 $0 NM; * APATATE 3 $0 NM; * AQUA-E 3 $0 NM; * ascorbic acid CHEW; CPCR; LOZG; 3 $0 NM; * SYRP; TABS; TBCR ASCORBIC ACID POWD 3 $0 NM; * b complex w/ c 3 $0 NM; * B-1 3 $0 NM; * B-12 TABS 3 $0 NM; * B-12 DOTS 3 $0 NM; * B-12 QUICK DISSOLVE 3 $0 NM; * b-complex vitamins 3 $0 NM; * b-complex w/ c & calcium 3 $0 NM; * b-complex w/ c & e + zn 3 $0 NM; * b-complex w/ c & folic acid 3 $0 NM; * b-complex w/ folic acid 3 $0 NM; * b-complex w/ minerals 3 $0 NM; * b-complex w/biotin & folic acid 3 $0 NM; * B-NATAL 3 $0 NM; * beta carotene CAPS 15mg, 3 $0 NM; * 25000unit biotin CAPS 5mg 3 $0 NM; * biotin TABS 2.5mg, 300mcg 3 $0 NM; * brewers yeast TABS 3 $0 NM; * calcitriol CAPS 1 $0 B/D calcitriol inj 1 $0 B/D calcitriol oral soln 1 mcg/ml 1 $0 B/D calcium ascorbate TABS 3 $0 NM; * calcium pantothenate TABS 3 $0 NM; * 500mg CALNA 3 $0 NM; * CENTRUM SILVER CHEW 3 $0 NM; * CHOLECALCIFEROL CAPS 400unit 3 $0 NM; * cholecalciferol CAPS 1000unit, 3 $0 NM; * 2000unit, 5000unit, 10000unit, 50000unit cholecalciferol CHEW 3 $0 NM; * cholecalciferol LIQD 3 $0 NM; * 72

73 cholecalciferol TABS 3 $0 NM; * CLASSIC PRENATAL 3 $0 NM; * cod liver oil CAPS 3 $0 NM; * COD LIVER OIL OIL 3 $0 NM; * CVS VITAMIN C 3 $0 NM; * cyanocobalamin LIQD; SOLN; 3 $0 NM; * SUBL; TABS; TBCR; TBDP CYTO B2 3 $0 NM; * D3 DOTS 3 $0 NM; * DECARA 25000unit 3 $0 NM; * DIALYVITE 800/ZINC 15 3 $0 NM; * DIALYVITE VITAMIN D3 MAX 3 $0 NM; * ELDERTONIC 3 $0 NM; * EQL CHILDRENS MULTIVITAMI 3 $0 NM; * ergocalciferol CAPS; SOLN 3 $0 NM; * EZFE FORTE 3 $0 NM; * FA-8 3 $0 NM; * FOLIC ACID CAPS 3 $0 NM; * folic acid SOLN 3 $0 NM; * FOLIC ACID TABS 1mg 3 $0 NM; * folic acid TABS 1mg, 400mcg, 3 $0 NM; * 800mcg GERIATRIC VITAMIN 3 $0 NM; * GNP DAILY PRENATAL 3 $0 NM; * HONEY BEARS 3 $0 NM; * HONEY BEARS W/IRON AND ZI 3 $0 NM; * hydroxocobalamin SOLN 3 $0 NM; * ICAPS LUTEIN/ZEAXANTHIN F 3 $0 NM; * iron w/ vitamins 3 $0 NM; * KPN PRENATAL 3 $0 NM; * LUMITENE 3 $0 NM; * MEPHYTON 3 $0 NM; * MISSION PRENATAL 3 $0 NM; * MISSION PRENATAL HP 3 $0 NM; * MULTI-DELYN/IRON 3 $0 NM; * multiple vitamin 3 $0 NM; * multiple vitamins w/ iron 3 $0 NM; * multiple vitamins w/ minerals 3 $0 NM; * MYKIDZ IRON 3 $0 NM; * NASCOBAL 3 $0 NM; * NEPHRONEX LIQD 3 $0 NM; * niacin CPCR; TABS; TBCR 3 $0 NM; * NIACIN TR 3 $0 NM; * 73

74 niacinamide TABS 3 $0 NM; * NUTRICION PORVIDA 3 $0 NM; * pantothenic acid 3 $0 NM; * paricalcitol CAPS 1 $0 B/D pediatric multiple vitamin w/ c 3 $0 NM; * pediatric multiple vitamin w/ c & fa 3 $0 NM; * pediatric multiple vitamin w/ extra 3 $0 NM; * c & fa pediatric multiple vitamin w/ 3 $0 NM; * minerals & c pediatric multiple vitamins 3 $0 NM; * pediatric multiple vitamins w/ iron 3 $0 NM; * pediatric vitamins adc 3 $0 NM; * PERRY PRENATAL 3 $0 NM; * phytonadione SOLN; TABS 3 $0 NM; * PRENATAL 3 $0 NM; * PRENATAL VITAMIN/FOLIC ACID > 1 $0 0.8 MG (GENERIC) PROTEXIN 3 $0 NM; * pyridoxine hcl SOLN; TABS; TBCR 3 $0 NM; * riboflavin TABS 25mg, 50mg, 3 $0 NM; * 100mg ROCALTROL 2 $0 B/D SCOOBY-DOO ONE A DAY 3 $0 NM; * SM VITAMIN D3 MAXIMUM STR 3 $0 NM; * specialty vitamins products 3 $0 NM; * STUART PRENATAL + DHA 3 $0 NM; * SUPER NU-THERA 3 $0 NM; * TAB-A-VITE WOMENS 3 $0 NM; * THERA-D $0 NM; * THERA/BETA-CAROTENE 3 $0 NM; * THERANATAL CORE NUTRITION 3 $0 NM; * thiamine hcl SOLN; TABS 3 $0 NM; * thiamine mononitrate 3 $0 NM; * TRI-VI-SOL 3 $0 NM; * TRI-VI-SOL/IRON 3 $0 NM; * VITA-MAG 3 $0 NM; * VITALETS 3 $0 NM; * vitamin a CAPS 8000unit, 3 $0 NM; * 10000unit VITAMIN A TABS 3 $0 NM; * vitamin a TABS 10000unit 3 $0 NM; * VITAMIN A PALMITATE TABS 3 $0 NM; * VITAMIN C SOLR 3 $0 NM; * 74

75 VITAMIN D2 3 $0 NM; * VITAMIN D3 LIQD 1200unit/15ml 3 $0 NM; * VITAMIN D3 TABS 3 $0 NM; * vitamin e CAPS 3 $0 NM; * VITAMIN E CHEW 3 $0 NM; * vitamin e LIQD 400unit/15ml 3 $0 NM; * vitamin e OIL 3 $0 NM; * vitamin e SOLN 3 $0 NM; * VITAMIN E TABS 100unit, 200unit 3 $0 NM; * vitamin e TABS 400unit 3 $0 NM; * VITAMIN K 3 $0 NM; * vitamin mixture 3 $0 NM; * vitamins a & d CAPS 3 $0 NM; * vitamins c & e 3 $0 NM; * ZOO FRIENDS COMPLETE 3 $0 NM; * OFTALMOLOGIA - FARMACI PER IL TRATTAMENTO DELLE PATOLOGIE OCULARI ANTINFETTIVI /ANTINFIAMMATORI - FARMACI PER IL TRATTAMENTO DI INFEZIONI E INFIAMMAZIONI bacitracin-poly-neomycin-hc 1 $0 blephamide OINT 2 $0 neomycin-polymy-dexameth 1 $0 neomycin-polymyxin-hc (ophth) 1 $0 sulfacetamide sod-prednisolone 1 $0 TOBRADEX OINT 2 $0 TOBRADEX ST 2 $0 tobramycin-dexamethasone 1 $0 ZYLET 2 $0 ANTINFETTIVI - FARMACI PER IL TRATTAMENTO DELLE INFEZIONI bacitracin (ophthalmic) 1 $0 bacitracin-polymyxin b (ophth) 1 $0 BESIVANCE 2 $0 CILOXAN OINT 2 $0 ciprofloxacin hcl (ophth) 1 $0 erythromycin (ophth) 1 $0 gatifloxacin (ophth) 1 $0 gentak 1 $0 gentamicin sulfate (ophth) 1 $0 ilotycin 1 $0 MOXEZA 2 $0 NATACYN 2 $0 neomycin-bacitracin zn-polymyxin 1 $0 neomycin-polymyxin-gramicidin 1 $0 75

76 ofloxacin (ophth) 1 $0 polymyxin b-trimethoprim 1 $0 sulfacetamide sodium (ophth) 1 $0 tobramycin (ophth) 1 $0 TOBREX OINT 2 $0 trifluridine SOLN 1 $0 VIGAMOX 2 $0 ANTINFIAMMATORI - FARMACI PER IL TRATTAMENTO DELLE INFIAMMAZIONI ALREX 2 $0 bromfenac sodium (ophth) 1 $0 BROMFENAC SODIUM 1 $0 (OPHTH)(ONCE-DAILY) dexamethasone sodium phosphate 1 $0 (ophth) diclofenac sodium (ophth) 1 $0 DUREZOL 2 $0 FLUOROMETHOLONE 1 $0 flurbiprofen sodium 1 $0 ILEVRO 2 $0 ketorolac tromethamine (ophth) 1 $0 LOTEMAX 2 $0 MAXIDEX 2 $0 NEVANAC 2 $0 PREDNISOLONE ACETATE (OPHTH) 1 $0 prednisolone sodium phosphate 2 $0 (ophth) ANTIALLERGICI - FARMACI PER IL TRATTAMENTO DELLE ALLERGIE azelastine drop 0.05% 1 $0 BEPREVE 2 $0 cromolyn sodium (ophth) 1 $0 ketotifen fumarate (ophth) 3 $0 NM; * LASTACAFT 2 $0 naphazoline w/ pheniramine 3 $0 NM; * NAPHAZOLINE W/ PHENIRAMINE 3 $0 NM; * PATADAY 2 $0 PATANOL 2 $0 PAZEO 2 $0 phenylephrine hcl (ophth) 3 $0 NM; * tetrahydrozoline hcl (ophth) 3 $0 NM; * tetrahydrozoline w/ zinc sulfate 3 $0 NM; * VASOCLEAR A 3 $0 NM; * VISINE-LR 3 $0 NM; * 76

77 ANTIGLAUCOMA - FARMACI PER IL TRATTAMENTO DEL GLAUCOMA ALPHAGAN P SOL 0.1% 2 $0 AZOPT 2 $0 betaxolol hcl (ophth) 1 $0 BETOPTIC-S 2 $0 brimonidine sol 0.2% 1 $0 BRIMONIDINE SOL 0.15% 1 $0 carteolol hcl (ophth) 1 $0 COMBIGAN 2 $0 dorzolamide hcl 1 $0 dorzolamide hcl-timolol maleate 1 $0 ISTALOL 2 $0 latanoprost SOLN 1 $0 levobunolol hcl.5% 1 $0 LEVOBUNOLOL HCL.25% 1 $0 LUMIGAN 2 $0 metipranolol 1 $0 PHOSPHOLINE IODIDE 2 $0 PILOCARPINE HCL SOLN 1 $0 SIMBRINZA 2 $0 timolol maleate (ophth) 1 $0 TIMOLOL MALEATE GEL 1 $0 TRAVATAN Z 2 $0 VARI artificial tear ointment 3 $0 NM; * artificial tear solution 3 $0 NM; * BLINK TEARS LUBRICATING E 3 $0 NM; * carboxymethylcellulose sodium 3 $0 NM; * (ophth) carboxymethylcellulose-glycerin 3 $0 NM; * CLEAR EYES FOR DRY EYES 3 $0 NM; * COMPUTER EYE DROPS 3 $0 NM; * ENUCLENE 3 $0 NM; * FRESHKOTE 3 $0 NM; * GENTEAL 3 $0 NM; * GENTEAL MILD 3 $0 NM; * glycerin-hypromellosepolyethylene 3 $0 NM; * glycol 400 GONIOVISC 3 $0 NM; * HYPOTEARS 3 $0 NM; * hypromellose (gonioscopic) 3 $0 NM; * hypromellose (ophth) 3 $0 NM; * ISOPTO TEARS 3 $0 NM; * 77

78 MURO 128 SOLN 2% 3 $0 NM; * naphazoline 0.1% 1 $0 NUTRATEAR 3 $0 NM; * ophthalmic irrigation solution 3 $0 NM; * polyethylene glycol-propylene 3 $0 NM; * glycol (ophth) polyvinyl alcohol SOLN 3 $0 NM; * polyvinyl alcohol-povidone (ophth) 3 $0 NM; * PROLENSA 2 $0 proparacaine hcl SOLN 1 $0 propylene glycol-glycerin 3 $0 NM; * REFRESH CELLUVISC 3 $0 NM; * REFRESH OPTIVE ADVANCED 3 $0 NM; * RESTASIS 2 $0 QL (64 fiale / 30 RETAINE MGD 3 $0 NM; * sodium chloride hypertonic 3 $0 NM; * SOOTHE 3 $0 NM; * STERILE LUBRICANT DROPS 3 $0 NM; * SYSTANE BALANCE RESTORATI 3 $0 NM; * SYSTANE LIQUID GEL 3 $0 NM; * SYSTANE OVERNIGHT THERAPY 3 $0 NM; * TEARS AGAIN NIGHT & DAY 3 $0 NM; * THERATEARS SOLN 3 $0 NM; * VIVA DROPS 3 $0 NM; * white petrolatum-mineral oil 3 $0 NM; * APPARATO RESPIRATORIO - FARMACI PER IL TRATTAMENTO DEI DISTURBI RESPIRATORI ANTICOLINERGICI /BETA AGONISTI - FARMACI PER IL TRATTAMENTO DELLA BRONCOPNEUMOPATIA CRONICA OSTRUTTIVA (BPCO) ANORO ELLIPTA 2 $0 QL (1 inalatore / 30 COMBIVENT RESPIMAT 2 $0 QL (2 inalatori / 30 ipratropium-albuterol nebu 1 $0 B/D ANTICOLINERGICI - FARMACI PER IL TRATTAMENTO DELLA BRONCOPNEUMOPATIA CRONICA OSTRUTTIVA (BPCO) ATROVENT HFA 2 $0 QL (2 inalatori / 30 ipratropium bromide SOLN 1 $0 B/D ipratropium bromide (nasal) 1 $0 SPIRIVA HANDIHALER 2 $0 QL (30 capsule / 30 78

79 SPIRIVA RESPIMAT 2 $0 QL (1 inalatore / 30 TUDORZA PRESSAIR 2 $0 QL (1 inalatore / 30 TUDORZA PRESSAIR (INSTITUTIONAL PACK) 400MCG/ACT 2 $0 QL (2 inalatori / 30 ANTISTAMINICI - FARMACI PER IL TRATTAMENTO DELLE ALLERGIE ALA-HIST IR 3 $0 NM; * ALDEX AN 3 $0 NM; * ALLEGRA ALLERGY CHILDRENS 3 $0 NM; * SUSP; TABS ASTEPRO 2 $0 azelastine hcl SOLN 1 $0 azelastine spr 0.1% 1 $0 cetirizine hcl 3 $0 NM; * cetirizine syrup 1 $0 chlorpheniramine maleate SYRP; 3 $0 NM; * TABS; TBCR CLARITIN CAPS; CHEW 3 $0 NM; * CLARITIN REDITABS 5mg 3 $0 NM; * clemastine fumarate TABS 1.34mg 3 $0 NM; * diphenhydramine hcl CAPS; 3 $0 NM; * CHEW; ELIX; LIQD; TABS; TBDP diphenhydramine inj 1 $0 ED CHLORPED 3 $0 NM; * fexofenadine hcl TABS 3 $0 NM; * hydroxyzine hcl SOLN; TABS 2 $0 PA hydroxyzine hcl inj 2 $0 PA hydroxyzine pamoate CAPS 2 $0 PA J-TAN PD 3 $0 NM; * levocetirizine dihydrochloride 1 $0 loratadine SYRP; TABS; TBDP 3 $0 NM; * olopatadine hcl (nasal) 1 $0 TRIAMINIC COUGH & RUNNY N 3 $0 NM; * STRP AGONISTI BETA - FARMACI PER IL TRATTAMENTO DELL'ASMA E DELLA BRONCOPNEUMOPATIA CRONICA OSTRUTTIVA (COPD) albuterol sulfate NEBU 1 $0 B/D albuterol sulfate SYRP; TABS; 1 $0 TB12 FORADIL AEROLIZER 2 $0 QL (60 capsule / 30 levalbuterol conc 1.25mg/0.5ml 1 $0 B/D 79

80 PERFOROMIST 2 $0 B/D PROAIR HFA 2 $0 QL (2 inalatori / 30 SEREVENT DISKUS 2 $0 QL (1 inalatore / 30 terbutaline sulfate SOLN; TABS 1 $0 XOPENEX HFA 2 $0 QL (2 inalatori / 30 TOSSE E RAFFREDDORE acetaminophen w/ dm 3 $0 NM; * acetaminophen-guaifenesin 3 $0 NM; * ADVIL ALLERGY & CONGESTIO 3 $0 NM; * ADVIL ALLERGY SINUS 3 $0 NM; * ADVIL COLD & SINUS CAPS 3 $0 NM; * AFRIN MENTHOL 3 $0 NM; * ALA-HIST PE 3 $0 NM; * ALDEX GS 3 $0 NM; * ALDEX GS DM 3 $0 NM; * ALDEX-CT 3 $0 NM; * AYR NASAL DROPS 3 $0 NM; * benzonatate 100mg, 200mg 3 $0 NM; * BICLORA 3 $0 NM; * BIOSPEC DMX 3 $0 NM; * BROHIST D 3 $0 NM; * brompheniramine & phenyleph 3 $0 NM; * brompheniramine & pseudoeph 3 $0 NM; * BROVEX PSB 3 $0 NM; * BROVEX PSB DM 3 $0 NM; * CAPCOF 3 $0 NM; * CAPMIST DM 3 $0 NM; * cetirizine-pseudoephedrine 3 $0 NM; * CHLO TUSS EX 3 $0 NM; * chlorpheniramine & phenylephrine 3 $0 NM; * chlorpheniramine & pseudoeph 3 $0 NM; * chlorpheniramine-dm 3 $0 NM; * chlorpheniramine-phenylephrineacetaminophen 3 $0 NM; * chlorpheniraminepseudoephedrine-acetaminophen 3 $0 NM; * CLOFERA 3 $0 NM; * CODAR AR 3 $0 NM; * CODAR D 3 $0 NM; * CODAR GF 3 $0 NM; * CODITUSS DM 3 $0 NM; * 80

81 COMPLETE SINUS RELIEF 3 $0 NM; * CONEX COLD/ALLERGY 3 $0 NM; * CONTAC COLD/FLU DAY & NIG 3 $0 NM; * CONTAC COLD/FLU MAXIMUM S 3 $0 NM; * COUGH SYRUP D 3 $0 NM; * cromolyn sodium (nasal) 3 $0 NM; * cvs nasal mist.9% 3 $0 NM; * DALLERGY SYRP 3 $0 NM; * DECON-A LIQD 3 $0 NM; * DELTUSS DP 3 $0 NM; * DEX-TUSS 3 $0 NM; * DEXATREX D NASAL 3 $0 NM; * dextromethorphan hbr CAPS; 3 $0 NM; * LIQD; SYRP dextromethorphan polistirex 3 $0 NM; * dextromethorphan-doxylamineacetaminophen 3 $0 NM; * dextromethorphan-guaifenesin 3 $0 NM; * dextromethorphan-phenylephrineacetaminophen 3 $0 NM; * DIABETIC TUSSIN COLD/FLU 3 $0 NM; * DICEL CD 3 $0 NM; * DIMETAPP LONG ACTING COUG 3 $0 NM; * diphenhydramine-acetaminophen 3 $0 NM; * diphenhydramine-phenylephrine 3 $0 NM; * diphenhydramine-phenylephrineacetaminophen 3 $0 NM; * LIQD DIPHENHYDRAMINE- 3 $0 NM; * PHENYLEPHRINE-ACETAMINOPHEN LIQD diphenhydramine-phenylephrineacetaminophen 3 $0 NM; * PACK diphenhydramine-phenylephrineacetaminophen 3 $0 NM; * SUSP diphenhydramine-phenylephrineacetaminophen 3 $0 NM; * TABS DONATUSSIN 3 $0 NM; * doxylamine-dm 3 $0 NM; * doxylamine-phenylephrineacetaminophen 3 $0 NM; * DRYMAX AF 3 $0 NM; * DURAFLU 3 $0 NM; * ED CHLORPED D 3 $0 NM; * ENTSOL NASAL GEL 3 $0 NM; * 81

82 ephedrine-guaifenesin 3 $0 NM; * fexofenadine-pseudoephedrine 3 $0 NM; * guaifenesin LIQD; SYRP; TABS; 3 $0 NM; * TB12 guaifenesin-codeine 3 $0 NM; * J-MAX 3 $0 NM; * J-TAN D PD 3 $0 NM; * LITTLE NOSES DECONGESTANT 3 $0 NM; * LODRANE D 3 $0 NM; * LOHIST-D 3 $0 NM; * loratadine & pseudoephedrine 3 $0 NM; * LORTUSS DM 3 $0 NM; * LORTUSS EX 3 $0 NM; * LORTUSS LQ 3 $0 NM; * LUSAIR 3 $0 NM; * M-END DMX 3 $0 NM; * M-END MAX D 3 $0 NM; * M-END PE 3 $0 NM; * MAR-COF BP 3 $0 NM; * MEDI-GRAINE 3 $0 NM; * MUCINEX COUGH FOR KIDS 3 $0 NM; * MUCINEX D 3 $0 NM; * MUCINEX FOR KIDS 3 $0 NM; * MUCINEX MAXIMUM STRENGTH 3 $0 NM; * NASAL DECONGESTANT 3 $0 NM; * NASOHIST DM 3 $0 NM; * NASOPEN PE 3 $0 NM; * NEO-SYNEPHRINE.5% 3 $0 NM; * neutrahist 3 $0 NM; * NOREL AD 3 $0 NM; * NOREL CS 3 $0 NM; * ONSET FORTE 3 $0 NM; * oxymetazoline hcl SOLN 3 $0 NM; * PHENAGIL 3 $0 NM; * phenylephrine hcl SOLN.25%, 1% 3 $0 NM; * phenylephrine hcl (oral) 3 $0 NM; * phenylephrine w/ acetaminophen 3 $0 NM; * phenylephrine w/ dm-gg 3 $0 NM; * phenylephrine-acetaminophenguaifenesin 3 $0 NM; * phenylephrine-brompheniraminedm 3 $0 NM; * phenylephrine-chlorphen-dm 3 $0 NM; * 82

83 phenylephrine-chlorpheniraminedm w/ apap 3 $0 NM; * phenylephrine-dm 3 $0 NM; * phenylephrine-dm-gg w/ apap 3 $0 NM; * phenylephrine-doxylaminedextromethorphan-acetaminophen 3 $0 NM; * phenylephrine-guaifenesin 3 $0 NM; * PHENYLHISTINE DH 3 $0 NM; * POLY-TUSSIN 3 $0 NM; * POLY-TUSSIN AC 3 $0 NM; * POLY-TUSSIN D 3 $0 NM; * PRETZ 3 $0 NM; * PRO-CHLO 3 $0 NM; * PRO-CLEAR AC 3 $0 NM; * pseudoephed-bromphen-dm 3 $0 NM; * pseudoephed-doxyl-dm w/apap 3 $0 NM; * pseudoephedrine hcl LIQD; SYRP; 3 $0 NM; * TABA; TABS; TB12 pseudoephedrine w/ codeine-gg 3 $0 NM; * pseudoephedrine w/ dm-gg 3 $0 NM; * pseudoephedrine-acetaminophen 3 $0 NM; * pseudoephedrinebrompheniramine-codeine 3 $0 NM; * pseudoephedrine-chlorphen-dm 3 $0 NM; * pseudoephedrinedexchlorpheniramine-chlophedianol 3 $0 NM; * pseudoephedrine-guaifenesin 3 $0 NM; * PSEUDOEPHEDRINE-IBUPROFEN 3 $0 NM; * SUSP pseudoephedrine-ibuprofen TABS 3 $0 NM; * PYRIL DM 3 $0 NM; * pyrilamine maleate-phenylephrine 3 $0 NM; * hcl tannate RESCON 3 $0 NM; * RESCON DM 3 $0 NM; * RESPAIRE-30 3 $0 NM; * RHINARIS 3 $0 NM; * ROBITUSSIN CHILDRENS COUG 3 $0 NM; * RU-HIST-D 3 $0 NM; * RYMED 3 $0 NM; * SALINE GEL 3 $0 NM; * saline SOLN 3 $0 NM; * SCOT-TUSSIN 3 $0 NM; * SCOT-TUSSIN SENIOR 3 $0 NM; * 83

84 STAHIST AD 3 $0 NM; * STATUSS GREEN 3 $0 NM; * SUDAFED 24 HOUR 3 $0 NM; * THERAFLU FLU & SORE THROA 3 $0 NM; * THERAFLU MAX-D SEVERE COL 3 $0 NM; * THERAFLU SINUS & COLD 3 $0 NM; * TRIAMINIC CHEST & NASAL C 3 $0 NM; * TRIAMINIC COLD & ALLERGY 3 $0 NM; * TRIAMINIC COLD & COUGH DA 3 $0 NM; * SOLN TRIAMINIC COLD/COUGH NIGH 3 $0 NM; * TRIAMINIC MULTI-SYMPTOM F 3 $0 NM; * TRIAMINIC NIGHT TIME COLD 3 $0 NM; * TRICODE AR 3 $0 NM; * TRICODE GF 3 $0 NM; * triprolidine & pseudoephedrine 3 $0 NM; * TUSNEL LIQD 3 $0 NM; * TUSNEL PEDIATRIC 3 $0 NM; * TUSNEL-DM PEDIATRIC 3 $0 NM; * VICKS VAPORUB 3 $0 NM; * Z-TUSS AC 3 $0 NM; * Z-TUSS E 3 $0 NM; * ZODRYL AC 25 3 $0 NM; * ZODRYL AC 30 3 $0 NM; * ZODRYL AC 35 3 $0 NM; * ZODRYL AC 40 3 $0 NM; * ZODRYL DAC 25 3 $0 NM; * ZODRYL DAC 30 3 $0 NM; * ZODRYL DAC 35 3 $0 NM; * ZODRYL DAC 40 3 $0 NM; * ZODRYL DEC 25 3 $0 NM; * ZODRYL DEC 30 3 $0 NM; * ZODRYL DEC 35 3 $0 NM; * ZODRYL DEC 40 3 $0 NM; * zonatuss 3 $0 NM; * ANTAGONISTI RECETTORIALI DEI LEUCOTRIENI - FARMACI PER IL TRATTAMENTO DELL'ASMA E DELLE ALLERGIE montelukast sodium CHEW; PACK; 1 $0 TABS zafirlukast 1 $0 STABILIZZATORI DI MASTOCITI - FARMACI PER IL TRATTAMENTO DELLE ALLERGIE cromolyn sodium nebu 1 $0 B/D 84

85 VARI acetylcysteine SOLN 10%, 20% 1 $0 B/D ARALAST NP 2 $0 NM, LA, PA AUVI-Q 2 $0 DALIRESP 2 $0 EPIPEN 2-PAK 2 $0 EPIPEN-JR 2-PAK 2 $0 PROLASTIN-C 2 $0 NM, LA, PA PULMOZYME 2 $0 B/D, NM SODIUM CHLORIDE NEBU.45% 3 $0 NM; * XOLAIR 2 $0 NM, LA, PA ZEMAIRA 2 $0 NM, LA, PA STEROIDI NASALI - FARMACI PER IL TRATTAMENTO DELLE ALLERGIE flunisolide (nasal) 1 $0 QL (2 flaconi / 30 fluticasone propionate (nasal) 1 $0 QL (1 flacone / 30 NASONEX 2 $0 QL (2 flaconi / 30 STEROIDI INALATORI - FARMACI PER IL TRATTAMENTO DELL'ASMA ASMANEX TWISTHALER 14 MET 2 $0 QL (2 inalatori / 30 ASMANEX TWISTHALER 30 MET 2 $0 QL (2 inalatori / 30 ASMANEX TWISTHALER 60 MET 2 $0 QL (2 inalatori / 30 ASMANEX TWISTHALER 120 ME 2 $0 QL (2 inalatori / 30 budesonide (inhalation) 1 $0 B/D FLOVENT DISKUS 50mcg/blist, 100mcg/blist 2 $0 QL (2 inalatori / 30 FLOVENT DISKUS 250mcg/blist 2 $0 QL (4 inalatori / 30 FLOVENT HFA 2 $0 QL (2 inalatori / 30 QVAR 40mcg/act 2 $0 QL (1 inalatore / 30 QVAR 80mcg/act 2 $0 QL (2 inalatori / 30 STEROIDI / BETA-AGONISTI - FARMACI PER IL TRATTAMENTO DELL'ASMA E DELLA BRONCOPNEUMOPATIA CRONICA OSTRUTTIVA (BPCO) 85

86 ADVAIR DISKUS 2 $0 QL (1 inalatore / 30 ADVAIR HFA 2 $0 QL (1 inalatore / 30 BREO ELLIPTA 2 $0 QL (1 inalatore / 30 DULERA 2 $0 QL (1 inalatore / 30 SYMBICORT 2 $0 QL (1 inalatore / 30 XANTINE - FARMACI PER IL TRATTAMENTO DELLA BRONCOPNEUMOPATIA CRONICA OSTRUTTIVA (BPCO) aminophylline inj 1 $0 elixophyllin 2 $0 theo-24 2 $0 theophylline 1 $0 TOPICI - FARMACI PER IL TRATTAMENTO DELLE OTITI E DELLE DERMATITI DERMATOLOGIA, ACNE adapalene CREA 1 $0 adapalene GEL.1% 1 $0 amnesteem 1 $0 AVITA 1 $0 benzoyl peroxide-erythromycin 1 $0 claravis 1 $0 clindamax 1 $0 clindamycin phosphate (topical) 1 $0 GEL; LOTN; SOLN; SWAB ery pad 2% 1 $0 erythromycin (acne aid) 1 $0 myorisan 1 $0 sulfacetamide sodium (acne) 1 $0 tretinoin CREA; GEL 1 $0 zenatane 1 $0 DERMATOLOGIA, ANTIBIOTICI ACNE MEDICATION 3 $0 NM; * ACNE MEDICATION 5 3 $0 NM; * bacitracin (topical) 3 $0 NM; * bacitracin zinc OINT 3 $0 NM; * bacitracin-polymyxin b 3 $0 NM; * BENZOYL PEROXIDE BAR 3 $0 NM; * benzoyl peroxide CREA 3 $0 NM; * BENZOYL PEROXIDE GEL 2.5% 3 $0 NM; * 86

87 benzoyl peroxide GEL 5%, 10% 3 $0 NM; * benzoyl peroxide LIQD 3 $0 NM; * benzoyl peroxide LOTN 3 $0 NM; * BP CLEANSING LOTION 3 $0 NM; * gentamicin sulfate (topical) 1 $0 mupirocin OINT 1 $0 neomycin-bacitracin-polymyxin 3 $0 NM; * neomycin-bacitracin-polymyxin w/ 3 $0 NM; * lidocaine neomycin-bacitracin-polymyxinpramoxine 3 $0 NM; * neomycin-polymyxin w/ pramoxine 3 $0 NM; * PANOXYL-4 CREAMY WASH 3 $0 NM; * PANOXYL-8 CREAMY WASH 3 $0 NM; * SILVER SULFADIAZINE CREA 1 $0 SSD 1 $0 SULFAMYLON CREA 2 $0 DERMATOLOGIA, ANTIFUNGINI castellani paint 3 $0 NM; * ciclopirox CREA; GEL; SUSP 1 $0 ciclopirox shampoo 1% 1 $0 clotrimazole (topical) CREA 1% 1 $0 clotrimazole (topical) CREA 1% 3 $0 NM; * clotrimazole (topical) SOLN 1% 1 $0 clotrimazole (topical) SOLN 1% 3 $0 NM; * econazole nitrate CREA 1 $0 FUNGOID TINCTURE 3 $0 NM; * GENTIAN VIOLET SOLN 3 $0 NM; * ketoconazole cream 1 $0 LAMISIL ADVANCED 3 $0 NM; * LAMISIL AT SPRAY 3 $0 NM; * LOTRIMIN ULTRA 3 $0 NM; * miconazole nitrate (topical) 3 $0 NM; * NIZORAL A-D 3 $0 NM; * nyamyc 1 $0 nystatin (topical) 1 $0 nystop 1 $0 terbinafine hcl (topical) 3 $0 NM; * tolnaftate 3 $0 NM; * DERMATOLOGIA, ANTIPRURITO procto-pak 1 $0 proctosol hc cre 2.5% 1 $0 proctozone hc 1 $0 87

88 PRUDOXIN CRE 5% 1 $0 DERMATOLOGIA, ANTIPSORIASICI acitretin 2 $0 PA calcipotriene CREA; OINT; SOLN 1 $0 calcitrene oin 0.005% 1 $0 8-MOP 2 $0 TAZORAC CREA 2 $0 PA DERMATOLOGIA, ANTISEBORROICI ketoconazole shampoo 1 $0 selenium sulfide LOTN 1 $0 DERMATOLOGIA, ANTIVIRALI acyclovir topical 1 $0 DENAVIR 2 $0 DERMATOLOGIA, CORTICOSTEROIDI ala-cort 1 $0 alclometasone dipropionate 1 $0 amcinonide CREA; LOTN 1 $0 amcinonide OINT 2 $0 apexicon 1 $0 betamethasone dipropionate 1 $0 (topical) betamethasone dipropionate 1 $0 augmented betamethasone valerate CREA; 1 $0 LOTN; OINT clobetasol propionate CREA 1 $0 clobetasol propionate GEL 1 $0 clobetasol propionate OINT 1 $0 clobetasol propionate SOLN 1 $0 cormax 1 $0 CVS HDYROCORTISONE ACETAT 3 $0 NM; * DESONIDE CREA 1 $0 desonide LOTN; OINT 1 $0 desoximetasone CREA 1 $0 desoximetasone GEL 1 $0 DESOXIMETASONE OINT.05% 1 $0 desoximetasone OINT.25% 1 $0 diflorasone diacetate 1 $0 fluocinolone acetonide CREA; OIL; 1 $0 OINT; SOLN fluocinolone acetonide body oil 1 $0 fluocinonide CREA.05% 1 $0 fluocinonide GEL 1 $0 88

89 fluocinonide OINT 1 $0 fluocinonide SOLN 1 $0 fluocinonide emulsified base 1 $0 fluticasone propionate CREA 1 $0 fluticasone propionate OINT 1 $0 halobetasol propionate 1 $0 hydrocortisone (topical) CREA 1%, 1 $0 2.5% hydrocortisone (topical) CREA.5%, 1% 3 $0 NM; * hydrocortisone (topical) GEL 3 $0 NM; * hydrocortisone (topical) LOTN 1% 3 $0 NM; * hydrocortisone (topical) LOTN 1 $0 2.5% hydrocortisone (topical) OINT 1%, 1 $0 2.5% hydrocortisone (topical) OINT 3 $0 NM; *.5%, 1% hydrocortisone (topical) SOLN 3 $0 NM; * hydrocortisone acetate (topical) 3 $0 NM; * hydrocortisone acetate-aloe vera 3 $0 NM; * hydrocortisone butyrate 1 $0 hydrocortisone valerate 1 $0 hydrocortisone-aloe vera 3 $0 NM; * HYDROCORTISONE/ALOE 3 $0 NM; * LOKARA LOTN 0.05% 1 $0 mometasone furoate CREA; OINT; 1 $0 SOLN texacort soln 2.5% 2 $0 triamcinolone acetonide (topical) 1 $0 CREA; LOTN; OINT triderm 1 $0 TUCKS ANTI-ITCH 3 $0 NM; * DERMATOLOGIA, ANESTETICI LOCALI lidocaine PTCH 1 $0 QL (3 cerotti / 1 giorno), PA lidocaine hcl GEL 1 $0 lidocaine hcl SOLN 4% 1 $0 lidocaine oint 5% 1 $0 lidocaine-prilocaine 1 $0 B/D DERMATOLOGIA, PELLE E MUCOSE ABREVA 3 $0 NM; * ammonium lactate CREA; LOTN 1 $0 BOUDREAUXS BUTT PASTE 3 $0 NM; * 89

90 DESITIN CREA 3 $0 NM; * ELIDEL 2 $0 PA fluorouracil (topical) CREA 5% 1 $0 fluorouracil (topical) SOLN 1 $0 imiquimod CREA 1 $0 laclotion lotn 12% 1 $0 metronidazole (topical) CREA; 1 $0 LOTN metronidazole gel 0.75% 1 $0 MEXSANA 3 $0 NM; * PANRETIN 2 $0 podofilox SOLN 1 $0 RA CALAMINE LOTN 3 $0 NM; * risamine 3 $0 NM; * rosadan cre 0.75% 1 $0 SECURA EXTRA PROTECTIVE 3 $0 NM; * SENSI-CARE PROTECTIVE BAR 3 $0 NM; * TARGRETIN GEL 2 $0 NM, PA TRIPLE PASTE 3 $0 NM; * VALCHLOR 2 $0 NM, LA, PA VOLTAREN 2 $0 ZINC OXIDE PSTE 3 $0 NM; * zinc oxide (topical) 3 $0 NM; * DERMATOLOGIA, SCABICIDI E PEDICULICIDI A-200 GEL 3 $0 NM; * BARC 3 $0 NM; * EURAX 2 $0 LICIDE TREATMENT KIT 3 $0 NM; * malathion 1 $0 permethrin AERO; LIQD; LOTN 3 $0 NM; * permethrin CREA 1 $0 permethrin & pyrethrins-piperonyl 3 $0 NM; * butoxide PRONTO 3 $0 NM; * PYRETHINS/PIPERONYL BUTO 3 $0 NM; * pyrethrins-piperonyl butoxide 3 $0 NM; * pyrethrins-piperonyl butoxidepermethrin-nit 3 $0 NM; * remover rid essential lice elimin 3 $0 NM; * SCHOOLTIME SHAMPOO 3 $0 NM; * DERMATOLOGIA, CICATRIZZANTI acetic acid.25% 1 $0 REGRANEX 2 $0 PA 90

91 SANTYL 2 $0 SODIUM CHLORIDE 0.9% 1 $0 STERILE WATER IRRIGATION 1 $0 IGIENE ORALE / COLLUTTORI cevimeline hcl 1 $0 chlorhexidine gluconate (mouththroat) 1 $0 clotrimazole TROC 1 $0 lidocaine hcl (mouth-throat) 1 $0 nystatin (mouth-throat) 1 $0 periogard 1 $0 pilocarpine hcl (oral) 1 $0 triamcinolone acetonide (mouth) 1 $0 OTOLOGICI - FARMACI PER IL TRATTAMENTO DELLE PATOLOGIE AURICOLARI acetic acid (otic) 1 $0 acetic acid-aluminum acetate 1 $0 CIPRODEX 2 $0 fluocinolone acetonide (otic) 1 $0 neomycin-polymyxin-hc (otic) 1 $0 ofloxacin (otic) 1 $0 91

92 Indice 8 8-MOP A A A abacavir sulfate abacavir sulfate-lamivudine-zidovudine ABELCET ABILIFY DISCMELT ABILIFY INJ 9.75MG ABILIFY MAIN INJ 300MG ABILIFY MAIN INJ 400MG ABILIFY MAINTENA ABILIFY TABS ABREVA acamprosate calcium acarbose acebutolol hcl ACEROLA C acetaminophen ACETAMINOPHEN ACETAMINOPHEN 8 HOUR acetaminophen w/ codeine acetaminophen w/ dm acetaminophen-guaifenesin acetazolamide acetic acid acetic acid (otic) acetic acid-aluminum acetate acetylcysteine acitretin ACNE MEDICATION ACNE MEDICATION ACTHIB ACTIMMUNE acyclovir acyclovir sodium acyclovir topical ADACEL ADAGEN adapalene ADCIRCA adefovir dipivoxil ADEMPAS adriamycin adrucil ADULT ASPIRIN LOW STRENGT ADVAIR DISKUS ADVAIR HFA ADVANCED CALCIUM FORMULA ADVIL ALLERGY & CONGESTIO ADVIL ALLERGY SINUS ADVIL COLD & SINUS afeditab cr AFINITOR AFINITOR DISPERZ AFRIN MENTHOL AGGRENOX a-hydrocort ala-cort ALA-HIST IR ALA-HIST PE ALBENZA albuterol sulfate alclometasone dipropionate ALCOHOL SWABS ALDEX AN ALDEX GS ALDEX GS DM ALDEX-CT ALDURAZYME alendronate sodium alfuzosin hcl ALIMTA ALINIA ALLEGRA ALLERGY CHILDRENS allopurinol tab alosetron hcl ALPHAGAN P SOL 0.1% alprazolam alprazolam tab 0.25mg alprazolam tab 0.5mg alprazolam tab 1mg alprazolam tab 2mg ALREX altavera alum & mag hydrox-simethicone ALUMINUM HYDROXIDE aluminum hydroxide gel aluminum hydroxide-mag carb aluminum hydroxide-mag trisil Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 92

93 amantadine hcl AMBISOME amcinonide amifostine crystalline amikacin sulfate amiloride & hydrochlorothiazide amiloride hcl aminophylline inj AMINOSYN AMINOSYN 7%/ELECTROLYTES AMINOSYN 8.5%/ELECTROLYTE AMINOSYN II AMINOSYN II 8.5%/ELECTROL AMINOSYN M AMINOSYN-HBC AMINOSYN-PF AMINOSYN-PF 7% AMINOSYN-RF amiodarone hcl AMITIZA CAP 24MCG AMITIZA CAP 8MCG amitriptyline hcl amlodipine besylate amlodipine besylate-valsartan tab mg.. 27 amlodipine besylate-valsartan tab mg.. 27 amlodipine besylate-valsartan tab mg amlodipine besylate-valsartan tab mg amlodipine--benazepril hcl cap mg amlodipine-benazepril hcl cap 10-40mg amlodipine-benazepril hcl cap mg amlodipine-benazepril hcl cap 5-10 mg amlodipine-benazepril hcl cap 5-20 mg amlodipine-benazepril hcl cap 5-40 mg amlodipine-valsartan-hydrochlorothiazide mg amlodipine-valsartan-hydrochlorothiazide mg amlodipine-valsartan-hydrochlorothiazide mg amlodipine-valsartan-hydrochlorothiazide mg amlodipine-valsartan-hydrochlorothiazide mg ammonium lactate amnesteem amoxapine tab 100mg amoxapine tab 150mg amoxapine tab 25mg amoxapine tab 50mg amoxicillin amoxicillin & pot clavulanate amphetamine-dextroamphetamine cap sr 24hr 10 mg amphetamine-dextroamphetamine cap sr 24hr 15 mg amphetamine-dextroamphetamine cap sr 24hr 20 mg amphetamine-dextroamphetamine cap sr 24hr 25 mg amphetamine-dextroamphetamine cap sr 24hr 30 mg amphetamine-dextroamphetamine cap sr 24hr 5 mg amphetamine-dextroamphetamine tab 10 mg amphetamine-dextroamphetamine tab 12.5 mg amphetamine-dextroamphetamine tab 15 mg amphetamine-dextroamphetamine tab 20 mg amphetamine-dextroamphetamine tab 30 mg amphetamine-dextroamphetamine tab 5 mg amphetamine-dextroamphetamine tab 7.5 mg. 43 amphotericin b ampicillin & sulbactam sodium ampicillin cap 250 mg ampicillin cap 500 mg ampicillin for susp 125 mg/5ml ampicillin for susp 250 mg/5ml ampicillin inj ampicillin sodium anagrelide hcl anastrozole ANDRODERM ANORO ELLIPTA ANTIOXIDANT FORMULA SG APAP APATATE apexicon APOKYN apri 28 day APRISO APTIOM... 34, 35 APTIVUS AQUA-E ARALAST NP aranelle ARCALYST Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 93

94 aripiprazole artificial tear ointment artificial tear solution ASACOL HD ascorbic acid ASCORBIC ACID ASCRIPTIN ASMANEX TWISTHALER 120 ME ASMANEX TWISTHALER 14 MET ASMANEX TWISTHALER 30 MET ASMANEX TWISTHALER 60 MET aspirin ASPIRIN aspirin buffered (cal carb-mag carb-mag oxide)12 aspirin effervescent ASTEPRO atenolol atenolol & chlorthalidone atorvastatin calcium atovaquone atovaquone-proguanil hcl ATRIPLA ATROVENT HFA aubra 28 day AUVI-Q AVASTIN aviane AVITA AVODART AXID AR AYR NASAL DROPS azacitidine AZACTAM AZACTAM/DEX INJ 1GM AZACTAM/DEX INJ 2GM azathioprine azelastine drop 0.05% azelastine hcl azelastine spr 0.1% AZILECT azithromycin AZITHROMYCIN AZOPT AZOR 10-40MG BESIVANCE AZOR TAB 10-20MG beta carotene AZOR TAB 5-20MG betamethasone dipropionate (topical) AZOR TAB 5-40MG betamethasone dipropionate augmented aztreonam Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito B b complex w/ c B B B-12 DOTS B-12 QUICK DISSOLVE bacitracin (ophthalmic) bacitracin (topical) bacitracin zinc bacitracin-polymyxin b bacitracin-polymyxin b (ophth) bacitracin-poly-neomycin-hc baclofen balsalazide disodium balziva 28 day BANZEL SUS 40MG/ML BANZEL TAB 200MG BANZEL TAB 400MG BARACLUDE BARC BCG VACCINE b-complex vitamins b-complex w/ c & calcium b-complex w/ c & e + zn b-complex w/ c & folic acid b-complex w/ folic acid b-complex w/ minerals b-complex w/biotin & folic acid BEELITH benazepril & hydrochlorothiazide benazepril hcl BENEFIBER BENICAR BENICAR HCT 40-25MG BENICAR HCT TAB MG BENICAR HCT TAB MG benzocaine-docusate sodium benzonatate benzoyl peroxide... 86, 87 BENZOYL PEROXIDE benzoyl peroxide-erythromycin benztropine mesylate BEPREVE... 76

95 betamethasone valerate BETASERON betaxolol hcl (ophth) bethanechol chloride BETOPTIC-S BEXSERO bicalutamide BICILLIN L-A BICLORA BICNU BIFERA BILTRICIDE BIOSPEC DMX biotin bisacodyl bismuth subsalicylate bisoprolol & hydrochlorothiazide bisoprolol fumarate BIVIGAM BLACK DRAUGHT bleomycin sulfate blephamide BLINK TEARS LUBRICATING E B-NATAL BONE DENSITY bone meal w/ vitamin d BOOSTRIX BOSULIF BOUDREAUXS BUTT PASTE BP CLEANSING LOTION BREO ELLIPTA brewers yeast briellyn 28 day BRILINTA BRIMONIDINE SOL 0.15% brimonidine sol 0.2% BRINTELLIX BROHIST D bromfenac sodium (ophth) BROMFENAC SODIUM (OPHTH)(ONCE-DAILY).. 76 bromocriptine mesylate brompheniramine & phenyleph brompheniramine & pseudoeph BROVEX PSB BUFFERIN LOW DOSE bumetanide buprenorphine hcl buprenorphine hcl-naloxone hcl sl buproban bupropion hcl buspirone hcl BUSULFEX butorphanol tartrate BYSTOLIC BROVEX PSB DM CALCIUM CITRATE budesonide (inhalation) CALCIUM CITRATE MALATE/VI budesonide ec CALCIUM CITRATE W/D BUFFERIN EXTRA STRENGTH calcium citrate-vitamin d Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 95 visitare il sito C cabergoline cafergot CAL/MAG CALCET CREAMY BITES CALCET PETITES CALCI-MIX CALCIONATE calcipotriene calcitonin (salmon) CAL-CITRATE PLUS VITAMIN calcitrene oin 0.005% calcitriol calcitriol inj calcitriol oral soln 1 mcg/ml calcium CALCIUM & MAGNESIUM calcium & phosphorus w/ vitamin d CALCIUM D CALCIUM calcium acetate (phosphate binder) calcium ascorbate calcium carbonate CALCIUM CARBONATE... 55, 70 calcium carbonate (antacid) calcium carbonate-cholecalciferol CALCIUM CARBONATE-CHOLECALCIFEROL calcium carbonate-ergocalciferol calcium carbonate-mag hydrox calcium carbonate-simethicone calcium carbonate-vitamin d calcium carbonate-vitamin d w/ minerals calcium citrate... 70

96 calcium gluconate CALCIUM GLUCONATE CALCIUM GUMMIES calcium lactate CALCIUM LACTATE calcium pantothenate calcium polycarbophil calcium w/ magnesium calcium w/ vitamin d calcium w/ vitamins d & k CALCIUM/C/D CALCIUM/MAGNESIUM CALCIUM/MAGNESIUM/VITAMIN CALCIUM/MAGNESIUM/ZINC calcium-magnesium w/ vitamin d calcium-magnesium-zinc CAL-GLU CALMAG THINS CALNA CAL-QUICK CALTRATE 600+D PLUS MINER caltrate 600+d soft chews camila 28 day CANASA CANCIDAS CAPASTAT SULFATE CAPCOF CAPMIST DM CAPRELSA captopril captopril & hydrochlorothiazide CARBAGLU carbamazepine CARBIDOPA/LEVODOPA/ENTACAPONE carbidopa-levodopa carbonyl iron carboplatin carboxymethylcellulose sodium (ophth) carboxymethylcellulose-glycerin CARIMUNE NANOFILTERED carteolol hcl (ophth) cartia xt cap 120/24hr cartia xt cap 180/24hr cartia xt cap 240/24hr cartia xt cap 300/24hr carvedilol castellani paint CAYSTON cefaclor cefaclor monohydrate er cefadroxil cefazolin in d5w cefazolin inj cefazolin sodium cefdinir cefepime hcl cefixime cefotaxime sodium cefoxitin sodium cefpodoxime proxetil cefprozil ceftazidime CEFTAZIDIME/DEXTROSE ceftriaxone sodium cefuroxime axetil cefuroxime sodium celecoxib CELONTIN CENTRUM SILVER cephalexin... 20, 21 CERDELGA CEREZYME CERVARIX cetirizine hcl cetirizine syrup cetirizine-pseudoephedrine cevimeline hcl CHANTIX CHANTIX CONTINUING MONTH CHANTIX STARTER PACK CHELATED CALCIUM CHEMET CHILDRENS MOTRIN CHLO TUSS EX chlorhexidine gluconate (mouth-throat) chloroquine phosphate chlorothiazide chlorpheniramine & phenylephrine chlorpheniramine & pseudoeph chlorpheniramine maleate chlorpheniramine-dm chlorpheniramine-phenylephrine-acetaminophen chlorpheniramine-pseudoephedrineacetaminophen chlorpromazine hcl... 40, 41 Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 96

97 chlorthalidone cholecalciferol... 72, 73 CHOLECALCIFEROL cholestyramine cholestyramine light choline fenofibrate ciclopirox ciclopirox shampoo 1% cilostazol CILOXAN cimetidine CIMZIA CIMZIA STARTER KIT CINRYZE CIPRODEX ciprofloxacin ciprofloxacin er ciprofloxacin hcl (ophth) ciprofloxacin hcl tab ciprofloxacin in d5w ciprofloxacin inj cisplatin citalopram hydrobromide CITRACAL CALCIUM GUMMIES CITRACAL PLUS HEART HEALT cladribine claravis clarithromycin clarithromycin er clarithromycin for susp CLARITIN CLARITIN REDITABS CLASSIC PRENATAL CLEAR EYES FOR DRY EYES clemastine fumarate clindamax clindamycin cap 300mg clindamycin cap 75mg clindamycin hcl cap 150 mg clindamycin phosphate (topical) clindamycin phosphate inj clindamycin phosphate vaginal clindamycin sol 75mg/5ml CLINIMIX 2.75%/DEXTROSE 5% CLINIMIX 4.25%/DEXTROSE 25% CLINIMIX 4.25%/DEXTROSE 5% CLINIMIX 5%/DEXTROSE 15% CLINIMIX 5%/DEXTROSE 20% CLINIMIX 5%/DEXTROSE 25% CLINIMIX INJ 4.25/D CLINIMIX INJ 4.25/D clobetasol propionate CLOFERA clomipramine hcl clonazepam clonidine hcl clopidogrel bisulfate clorazepate dipotassium clotrimazole clotrimazole (topical) clotrimazole vaginal clozapine CLOZAPINE ODT CLOZAPINE ODT 150MG CLOZAPINE ODT 200MG COARTEM COATS ALOE VERA JUICE DRI cod liver oil COD LIVER OIL CODAR AR CODAR D CODAR GF CODITUSS DM colchicine w/ probenecid COLCRYS colestipol hcl colistimethate sodium colocort enema 100mg COMBIGAN COMBIPATCH COMBIVENT RESPIMAT COMETRIQ COMPLERA COMPLETE SINUS RELIEF compro COMPUTER EYE DROPS COMVAX CONEX COLD/ALLERGY constulose CONTAC COLD/FLU DAY & NIG CONTAC COLD/FLU MAXIMUM S COPAXONE INJ 40MG/ML COPAXONE KIT 20MG/ML CORAL CALCIUM CORAL CALCIUM PLUS coral calcium-magnesium w/ vitamin d Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 97

98 cormax corn dextrin cortisone acetate COUGH SYRUP D COUMADIN CREON CRESTOR CRIXIVAN cromolyn sodium (mastocytosis) cromolyn sodium (nasal) cromolyn sodium (ophth) cromolyn sodium nebu cryselle CUBICIN CUVPOSA CVS CALCIUM CITRATE CVS HDYROCORTISONE ACETAT cvs nasal mist CVS SLOW RELEASE IRON CVS VITAMIN C cyanocobalamin cyclafem 1/35 28 day cyclafem 7/7/7 28 day cyclobenzaprine hcl cyclophosphamide CYCLOPHOSPHAMIDE cycloserine cyclosporine cyclosporine modified (for microemulsion) CYSTADANE CYSTAGON cytarabine CYTO B D D3 DOTS dacarbazine DALIRESP DALLERGY danazol dantrolene sodium dapsone DAPTACEL DARAPRIM DELTUSS DP delyla 28 day DELZICOL DEMSER DENAVIR DEPEN TITRATABS DEPO-PROVERA INJ 400/ML desipramine hcl DESITIN desmopressin acetate spray desmopressin acetate spray refrigerated desmopressin acetate tabs desmopressin inj 4mcg/ml DESMOPRESSIN SOL 0.01% desogestrel-ethinyl estradiol (biphasic) desonide DESONIDE desoximetasone DESOXIMETASONE dexamethasone dexamethasone sodium phosphate dexamethasone sodium phosphate (ophth) DEXATREX D NASAL DEXILANT dexrazoxane dextromethorphan hbr dextromethorphan polistirex dextromethorphan-doxylamine-acetaminophen 81 dextromethorphan-guaifenesin dextromethorphan-phenylephrineacetaminophen DEXTROSE 10% FLEX CONTAIN DEXTROSE 10%/NACL 0.2% DEXTROSE 10%/NACL 0.45% DEXTROSE 2.5%/NACL 0.45% DEXTROSE 5% DEXTROSE 5% /ELECTROLYTE DEXTROSE 5%/LACTATED RING DEXTROSE 5%/NACL 0.2% DEXTROSE 5%/NACL 0.225% DEXTROSE 5%/NACL 0.3% DEXTROSE 5%/NACL 0.33% DEXTROSE 5%/NACL 0.45% DEXTROSE 5%/NACL 0.9% daunorubicin hcl DEXTROSE 5%/POTASSIUM CHL deblitane 28 day DEXTROSE 50% DECARA dextrose inj 70% DECON-A DEX-TUSS Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 98 visitare il sito

99 DIABETIC TUSSIN COLD/FLU DIALYVITE 800/ZINC DIALYVITE VITAMIN D3 MAX diazepam DIAZEPAM GEL diazepam inj DICEL CD diclofenac potassium diclofenac sodium diclofenac sodium (ophth) dicloxacillin sodium dicyclomine hcl didanosine DIFICID diflorasone diacetate diflunisal digitek digoxin DIGOXIN SOL 50MCG/ML dihydroergotamine mesylate dilantin DILANTIN-125 SUS 125/5ML dilt-cd cap diltiazem cap diltiazem cap 120mg/24hr diltiazem cap er/12hr diltiazem hcl diltiazem hcl coated beads cp24 120mg diltiazem hcl coated beads cp24 180mg diltiazem hcl coated beads cp24 240mg diltiazem hcl coated beads cp24 300mg diltiazem hcl coated beads cp24 360mg dilt-xr cap diltzac dimenhydrinate DIMETAPP LONG ACTING COUG DIPENTUM diphenhydramine hcl diphenhydramine hcl (sleep) diphenhydramine inj diphenhydramine-acetaminophen diphenhydramine-acetaminophen (sleep) diphenhydramine-phenylephrine diphenhydramine-phenylephrine-acetaminophen DIPHENHYDRAMINE-PHENYLEPHRINE- ACETAMINOPHEN diphenoxylate w/ atropine DIPHTHERIA/TETANUS TOXOID disopyramide phosphate disulfiram DIURIL SUS 250/5ML divalproex sodium docetaxel DOCETAXEL docusate calcium docusate sodium DONATUSSIN donepezil hydrochloride dorzolamide hcl dorzolamide hcl-timolol maleate doxazosin mesylate doxepin hcl doxorubicin hcl for inj 50 mg doxorubicin hcl liposomal inj 2mg/ml doxorubicin inj 50mg doxy inj doxycycline (monohydrate) doxycycline hyclate doxylamine succinate (sleep) doxylamine-dm doxylamine-phenylephrine-acetaminophen dronabinol drospirenone-ethinyl estradiol DROXIA DRYMAX AF DULCOLAX BOWEL PREP KIT DULERA duloxetine hcl DURAFLU DURAMORPH DUREZOL DYRENIUM Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito E e.e.s e.e.s E.E.S. GRANULES econazole nitrate ED CHLORPED ED CHLORPED D EDECRIN EDURANT EFFIENT ELDERTONIC ELIDEL

100 ELIQUIS ELITEK elixophyllin ELIXSURE FEVER/PAIN ELLA ELMIRON EMCYT EMEND CAP 125MG EMEND CAP 40MG EMEND CAP 80MG EMEND PAK 80 & emoquette EMSAM EMTRIVA enalapril maleate enalapril maleate & hydrochlorothiazide endocet ENGERIX-B enoxaparin sodium enpresse 28 day entacapone entecavir ENTSOL NASAL GEL ENUCLENE enulose ephedrine-guaifenesin EPIPEN 2-PAK EPIPEN-JR 2-PAK epirubicin hcl epitol EPIVIR EPIVIR HBV eplerenone EPZICOM EQL CALCIUM/VITAMIN D EQL CHILDRENS CALCIUM GUM EQL CHILDRENS MULTIVITAMI EQL NATURAL FIBER EQUALACTIN ERAXIS ergocalciferol ERIVEDGE errin 28 day ery pad 2% erythrocin stearate erythromycin (acne aid) erythromycin (ophth) erythromycin base erythromycin cap 250mg ec escitalopram oxalate esomeprazole sodium inj estradiol estradiol valerate ESTRADIOL VALERATE ethambutol hcl ethosuximide etodolac etodolac er etoposide EURAX EVOTAZ EXELON PATCHES exemestane EXJADE EZFE FORTE ERYPED fenofibrate ERYPED fenofibrate micronized ery-tab fenofibrate micronized cap erythrocin lactobionate fentanyl Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 100 visitare il sito F FA FABRAZYME falmina 28 day famciclovir famotidine famotidine inj famotidine-calcium carbonate-magnesium hydroxide FANAPT FANAPT TITRATION PACK FARESTON FARYDAK FASLODEX FAZACLO TAB 100/ODT FAZACLO TAB 12.5/ODT FAZACLO TAB 150MG FAZACLO TAB 200MG FAZACLO TAB 25MG ODT FEBROL felbamate felodipine... 31

101 fentanyl citrate FENTORA FEOSOL FERRETTS IPS FERRIMIN ferrous fumarate FERROUS FUMARATE ferrous gluconate FERROUS GLUCONATE ferrous sulfate FERROUS SULFATE ferrous sulfate dried FETZIMA FETZIMA TITRATION PACK FEVERALL INFANTS fexofenadine hcl fexofenadine-pseudoephedrine fiber FIBER finasteride FIRAZYR FLEBOGAMMA FLEBOGAMMA DIF flecainide acetate FLEET BISACODYL FLORASTOR KIDS FLOVENT DISKUS FLOVENT HFA fluconazole fluconazole in dextrose fluconazole in nacl flucytosine fludarabine phosphate fludrocortisone acetate flunisolide (nasal) fluocinolone acetonide fluocinolone acetonide (otic) fluocinolone acetonide body oil fluocinonide... 88, 89 fluocinonide emulsified base FLUOROMETHOLONE fluorouracil fluorouracil (topical) fluoxetine hcl flutamide fluticasone propionate fluticasone propionate (nasal) fluvoxamine maleate FOLGARD folic acid FOLIC ACID folic acid-vitamin b6-vitamin b FOLITAB fondaparinux sodium FORADIL AEROLIZER FORTEO FORTICAL foscarnet sodium fosinopril sodium fosinopril sodium & hydrochlorothiazide FOSRENOL FREAMINE HBC 6.9% FREAMINE III FRESHKOTE FUNGOID TINCTURE furosemide furosemide inj FUZEON FYCOMPA fluphenazine decanoate gavilyte-h fluphenazine hcl gavilyte-n flurbiprofen GAVISCON flurbiprofen sodium GAVISCON EXTRA STRENGTH R Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 101 visitare il sito G gabapentin GABITRIL galantamine hydrobromide... 37, 38 GAMASTAN S/D GAMMAGARD LIQUID GAMMAGARD S/D GAMMAKED GAMMAPLEX GAMUNEX-C GAMUNEX-C 1GM/10ML ganciclovir inj 500mg GARDASIL GARDASIL gatifloxacin (ophth) GAUZE PADS 2" X 2" gaviltye-g gavilyte-c... 58

102 gemcitabine hcl GEMCITABINE HCL gemfibrozil generlac gengraf gentak gentamicin in saline gentamicin sulfate gentamicin sulfate (ophth) gentamicin sulfate (topical) GENTEAL GENTEAL MILD GENTIAN VIOLET GEODON GERIATRIC VITAMIN GIANVI gildagia gildess 1.5/30 21 day GILENYA CAP 0.5MG GILOTRIF TAB 20MG GILOTRIF TAB 30MG GILOTRIF TAB 40MG GLEEVEC glimepiride glip/metform tab 5-500mg glipizide glipizide-metformin hcl tab mg glipizide-metformin hcl tab mg GLUCAGEN HYPOKIT GLUCAGON EMERGENCY KIT glycerin-hypromellose-polyethylene glycol glycopyrrolate glycopyrrolate inj GNP CALCIUM 500 +D GNP DAILY PRENATAL GOLYTELY GONIOVISC granisetron hcl GRANIX griseofulvin microsize griseofulvin ultramicrosize guaifenesin guaifenesin-codeine guanfacine hcl (adhd) haloperidol decanoate haloperidol lactate haloperidol lactate oral conc 2 mg/ml HARVONI HAVRIX heather heparin sod inj 1000/ml heparin sod inj 10000/ml HEPARIN SOD INJ 2000/ML heparin sod inj 20000/ml HEPARIN SOD INJ 2500/ML heparin sod inj 5000/ml HEPARIN SODIUM/D5W HEPARIN SODIUM/NACL 0.45% HEPATAMINE HERCEPTIN HEXALEN HIBERIX HONEY BEARS HONEY BEARS W/IRON AND ZI HUMIRA HUMIRA KIT 40MG/ HUMIRA PEN HUMIRA PEN-CROHNS DISEASE HUMIRA PEN-PSORIASIS STAR HUMULIN R INJ U hydralazine hcl hydrochlorothiazide HYDROCIL INSTANT hydroco/apap tab mg hydroco/apap tab 5-325mg hydroco/apap tab hydrocodone-acetaminophen mg/15ml 14 hydrocodone-ibuprofen tab mg hydrocortisone HYDROCORTISONE (INTRARECTAL) hydrocortisone (topical) hydrocortisone acetate (topical) hydrocortisone acetate-aloe vera hydrocortisone butyrate hydrocortisone valerate HYDROCORTISONE/ALOE hydrocortisone-aloe vera hydromorphon inj 10mg/ml hydromorphone hcl H hydroxocobalamin halobetasol propionate hydroxychloroquine sulfate haloperidol hydroxyurea Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito

103 hydroxyzine hcl hydroxyzine hcl inj hydroxyzine pamoate HYPOTEARS hypromellose (gonioscopic) hypromellose (ophth) I ibandronate sodium IBRANCE ibuprofen... 12, 13 IBUPROFEN ibuprofen tab 800 mg ibuprofen-diphenhydramine citrate ICAPS LUTEIN/ZEAXANTHIN F ICLUSIG idarubicin hcl IFEX ifosfamide inj 1gm ifosfamide inj 1gm/20ml IFOSFAMIDE INJ 3GM ifosfamide inj 3gm/60ml ILEVRO ilotycin IMBRUVICA CAP 140MG imipenem-cilastatin imipramine hcl imiquimod IMOVAX RABIES (H.D.C.V.) INCRELEX indapamide INFANRIX INLYTA INSULIN PEN NEEDLE INSULIN SAFETY NEEDLES INSULIN SYRINGE INTEGRA INTELENCE INTRALIPID INJ 20% INTRALIPID INJ 30% INTRON-A INJ 10MU INTRON-A INJ 18MU INTRON-A INJ 25MU INTRON-A INJ 50MU introvale 91 day INVANZ INVEGA INVEGA SUST INJ 117 MG/0.75 ML INVEGA SUST INJ 156MG/ML INVEGA SUST INJ 234 MG/1.5 ML INVEGA SUST INJ 39 MG/0.25 ML INVEGA SUST INJ 78 MG/0.5 ML INVIRASE INVOKAMET TAB INVOKAMET TAB INVOKAMET TAB INVOKAMET TAB MG INVOKANA IONOSOL-B/DEXTROSE 5% IONOSOL-MB/DEXTROSE 5% IPOL INACTIVATED IPV ipratropium bromide ipratropium bromide (nasal) ipratropium-albuterol nebu irinotecan hcl iron IRON iron chews pediatric IRON DEXTRAN IRON UP iron w/ vitamins iron-vitamin c iron-vitamin c-vitamin b12-folic acid ISENTRESS ISOLYTE P isolyte s isoniazid isoniazid inj 100 mg/ml isoniazid syp 50mg/5ml ISOPTO TEARS isosorb mononitrate tab isosorbide dinitrate isosorbide mononitrate er tab isradipine ISTALOL ISTODAX itraconazole ivermectin IXIARO Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito J JAKAFI JALYN jantoven JANUMET JANUMET XR TAB

104 JANUMET XR TAB JANUMET XR TAB MG JANUVIA JENTADUETO J-MAX JOLESSA TAB MG JOLIVETTE J-TAN D PD J-TAN PD junel 1.5/30 21 day junel 1/20 21 day junel fe 1.5/30 28 day junel fe 1/20 28 day K KADCYLA KALETRA SOL KALETRA TAB MG KALETRA TAB MG kariva 28 day KCL 0.075%/D5W/NACL 0.45% KCL 0.15%/D5W/NACL 0.9% KCL 0.3%/D5W/NACL 0.45% KCL 0.3%/D5W/NACL 0.9% KCL IN NACL INJ KCL/D5W INJ 0.3% KCL/D5W/NACL INJ.15/.33% KCL/D5W/NACL INJ.15/.45% KCL/NACL INJ KCL0.15%/D5W/NACL0.2% KCL0.15%/D5W/NACL0.225% ketoconazole ketoconazole cream ketoconazole shampoo ketoprofen ketorolac tromethamine (ophth) ketotifen fumarate (ophth) kimidess tab kionex KLOR-CON KLOR-CON klor-con m klor-con m klor-con pow 20meq KONSYL KONSYL-D KPN PRENATAL KUVAN Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito L labetalol hcl laclotion lotn 12% LACTATED RINGER'S INJ lactobacillus lactobacillus rhamnosus (gg) lactulose lactulose (encephalopathy) LAMISIL ADVANCED LAMISIL AT SPRAY lamivudine lamivudine (hbv) lamivudine-zidovudine lamotrigine LANOXIN lansoprazole LANTUS LANTUS SOLOSTAR larin 1.5/ larin 1/ larin fe 1.5/ larin fe 1/ LASTACAFT latanoprost LATUDA LAZANDA SPR 100MCG LAZANDA SPR 400MCG LEENA leflunomide LENVIMA 10MG DAILY DOSE LENVIMA 14MG DAILY DOSE LENVIMA 20MG DAILY DOSE LENVIMA 24MG DAILY DOSE lessina 28 day LETAIRIS letrozole leucovorin calcium leucovorin calcium for inj 500 mg LEUKERAN LEUKINE leuprolide acetate levalbuterol conc 1.25mg/0.5ml LEVEMIR LEVEMIR FLEXTOUCH levetiracetam LEVETIRACETAM IN NACL levetiracetam inj 500/5ml

105 levobunolol hcl LEVOBUNOLOL HCL levocarnitine (metabolic modifiers) levocetirizine dihydrochloride levofloxacin levofloxacin in d5w levofloxacin inj 25mg/ml levofloxacin oral soln 25 mg/ml levonest 28 day levonorgestrel & eth estradiol levonorgestrel (emergency oc) levonorgestrel-ethinyl estradiol (91-day) levora 0.15/30 28 day levothyroxine sodium LEVOXYL LEXIVA LIALDA LICIDE TREATMENT KIT lidocaine lidocaine hcl lidocaine hcl (local anesth.) lidocaine hcl (mouth-throat) lidocaine inj 0.5% lidocaine inj 1% lidocaine inj 1.5% lidocaine inj 2% lidocaine oint 5% lidocaine-prilocaine linezolid LINZESS CAP 145MCG LINZESS CAP 290MCG liothyronine sodium LIQUID CALCIUM WITH D3 MA lisinopril lisinopril & hydrochlorothiazide LITHIUM lithium carbonate lithium carbonate er LITTLE NOSES DECONGESTANT LOCALNESIUM LOCALNESIUM-C LODRANE D LOHIST-D LOKARA LOTN 0.05% lorazepam lorcet hd tab mg lorcet plus tab lorcet tab 5-325mg lortab tab mg lortab tab 5-325mg lortab tab LORTUSS DM LORTUSS EX LORTUSS LQ loryna 28 day losartan potassium losartan-hctz mg losartan-hctz mg losartan-hctz mg LOTEMAX LOTRIMIN ULTRA LOTRONEX lovastatin low-ogestrel 28 day loxapine succinate LUMIGAN LUMITENE LUMIZYME LUPR DEP-PED INJ 30MG (3-MONTH) LUPRON DEPOT LUPRON DEPOT INJ MG LUPRON DEPOT-PED LUSAIR lutera 28 day LYNPARZA LYRICA LYSODREN lyza LOMUSTINE magnesium chloride loperamide hcl... 56, 60 magnesium chloride-calcium loratadine magnesium citrate loratadine & pseudoephedrine MAGNESIUM CITRATE Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 105 visitare il sito M MAALOX TC MAG MAG-AL MAGINEX MAGNEBIND MAGNEBIND magnesium MAGNESIUM... 71

106 MAGNESIUM ELEMENTAL MAGNESIUM GLUCONATE magnesium hydroxide magnesium oxide MAGNESIUM OXIDE magnesium oxide (laxative) magnesium oxide (mg supplement) magnesium salicylate tetrahydrate magnesium sulfate MAGNESIUM SULFATE... 67, 71 magnesium sulfate (laxative) MAGNESIUM SULFATE IN D5W MAG-TAB SR malathion maprotiline hcl MAR-COF BP marlissa 28 day MARPLAN TAB 10MG MATULANE MAXIDEX meclizine hcl MEDI-GRAINE medroxyprogesterone acetate 150 mg/ml medroxyprogesterone acetate tab mefloquine hcl MEGACE ES megestrol acetate MEKINIST meloxicam MELOXICAM melphalan hcl MENACTRA M-END DMX M-END MAX D M-END PE MENOMUNE-A/C/Y/W MENVEO MEPHYTON mercaptopurine meropenem mesalamine enema mesalamine w/ cleanser mesna MESNEX metadate tab 20mg er METAMUCIL METAMUCIL MULTIHEALTH FIB METAMUCIL SMOOTH TEXTURE metformin hcl methadone hcl methazolamide methenamine hippurate methimazole methotrexate sodium inj methotrexate sodium tabs methyclothiazide methylcellulose (laxative) methylergonovine maleate methylphenidate hcl methylphenidate hcl oral soln methylpr ace inj 40mg/ml methylpr ace inj 80mg/ml methylpr ss inj 125mg methylpr ss inj 1gm methylpr ss inj 40mg methylpred pak 4mg methylpred tab 16mg methylpred tab 32mg methylpred tab 4mg methylpred tab 8mg metipranolol metoclopramide hcl metoclopramide inj metolazone metoprolol & hctz tab mg metoprolol & hctz tab mg metoprolol & hctz tab 50-25mg metoprolol succinate metoprolol tartrate metronidazole metronidazole (topical) metronidazole gel 0.75% metronidazole in nacl metronidazole vaginal mexiletine hcl MEXSANA MIACALCIN miconazole nitrate (topical) miconazole nitrate vaginal microgestin 1.5/30 21 day microgestin 1/20 21 day microgestin fe 1.5/30 28 day microgestin fe 1/20 28 day midodrine hcl MILK OF MAGNESIA CONCENTR mineral oil Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 106

107 MINERAL OIL minitran minocycline hcl minoxidil mirtazapine misoprostol MISSION PRENATAL MISSION PRENATAL HP mitomycin mitoxantrone hcl M-M-R II W/DILUENT 10 DOS moderiba 800 dose pack moderiba pak 1000/day moderiba pak 1200/day moderiba pak 600/day moderiba tab 200mg moexipril hcl moexipril-hydrochlorothiazide mometasone furoate MONONESSA montelukast sodium morphine ext-rel tab morphine sul inj MORPHINE SUL INJ morphine sulfate MORPHINE SULFATE morphine sulfate beads morphine sulfate cap 100mg er MORPHINE SULFATE ORAL SOL MOVANTIK MOVIPREP MOXEZA MOZOBIL MUCINEX COUGH FOR KIDS MUCINEX D MUCINEX FOR KIDS MUCINEX MAXIMUM STRENGTH MULTAQ MULTI-DELYN/IRON multiple vitamin multiple vitamins w/ iron multiple vitamins w/ minerals mupirocin MURO mycophenolate sodium MYKIDZ IRON MYKIDZ IRON myorisan MYOZYME MYRBETRIQ myzilra MUSTARGEN neomycin-bacitracin-polymyxin-pramoxine my way neomycin-polymy-dexameth MYCAMINE neomycin-polymyxin w/ pramoxine mycophenolate mofetil neomycin-polymyxin-gramicidin Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 107 visitare il sito N nabumetone nadolol nafcillin sodium NAGLAZYME naloxone hcl naltrexone hcl NAMENDA SOL 10MG/5ML NAMENDA TAB NAMENDA XR NAMENDA XR TITRATION PACK naphazoline 0.1% naphazoline w/ pheniramine NAPHAZOLINE W/ PHENIRAMINE naproxen naproxen sodium NAPROXEN SODIUM naratriptan hcl NASAL DECONGESTANT NASCOBAL NASOHIST DM NASONEX NASOPEN PE NATACYN nateglinide NEBUPENT necon 0.5/35 28 day necon 1/35 28 day necon 10/11 28 day NECON 7/7/ NECON TAB 1/ nefazodone hcl neomycin sulfate neomycin-bacitracin zn-polymyxin neomycin-bacitracin-polymyxin neomycin-bacitracin-polymyxin w/ lidocaine... 87

108 neomycin-polymyxin-hc (ophth) neomycin-polymyxin-hc (otic) NEORAL NEO-SYNEPHRINE NEPHRAMINE NEPHRONEX NEUMEGA NEUPOGEN NEUPRO neutrahist NEVANAC nevirapine NEVIRAPINE NEXAVAR NEXIUM CAP 20MG NEXIUM CAP 40MG NEXIUM GRA 10MG DR NEXIUM GRA 2.5MG DR NEXIUM GRA 20MG DR NEXIUM GRA 40MG DR NEXIUM GRA 5MG DR next choice one dose niacin niacin (antihyperlipidemic) NIACIN TR niacinamide niacor nicardipine hcl nicotine nicotine polacrilex NICOTINE POLACRILEX NICOTINE TRANSDERMAL SYST NICOTROL INHALER NICOTROL NS nifedical nifedipine nifedipine er... 31, 32 nikki 28 day NILANDRON nimodipine NIPENT nitro-bid NITRO-DUR DIS 0.3MG/HR NITRO-DUR DIS 0.8MG/HR nitrofurantoin macrocrystal nitrofurantoin monohyd macro nitroglycerin NITROLINGUAL PUMPSPRAY NITROSTAT NIZORAL A-D NON-ASPIRIN EXTRA STRENGT NORA-BE TAB NORDITROPIN FLEXPRO NORDITROPIN NORDIFLEX PEN NOREL AD NOREL CS norethindrone (contraceptive) norethindrone acetate norgestimate-ethinyl estradiol (triphasic) norlyroc 28 day normosol-m NORMOSOL-R NORMOSOL-R IN D5W NORPACE CR nortrel 0.5/35 28 day nortrel 1/35 21 day nortrel 1/35 28 day nortrel 7/7/7 28 day nortriptyline hcl NORVIR NOVAFERRUM NOVAFERRUM PEDIATRIC DROP NOVOLIN 70/ NOVOLIN N NOVOLIN R NOVOLOG NOVOLOG FLEXPEN NOVOLOG MIX 70/ NOVOLOG MIX 70/30 PREFILL NOVOLOG PENFILL NOXAFIL NUEDEXTA NULOJIX NULYTELY/FLAVOR PACKS NUTRATEAR NUTRICION PORVIDA NUTRILIPID EMU 20% NUTRISOURCE FIBER NUVARING NUVIGIL nyamyc NYMALIZE nystatin nystatin (mouth-throat) nystatin (topical) nystop Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 108

109 O OCELLA TAB MG OCTAGAM octreotide acetate ofloxacin (ophth) ofloxacin (otic) olanzapine olopatadine hcl (nasal) OLYSIO omega-3-acid ethyl esters omeprazole OMEPRAZOLE omeprazole magnesium omeprazole-sodium bicarbonate ondansetron hcl ondansetron hcl inj ondansetron hcl oral soln ondansetron odt ONFI ONSET FORTE ophthalmic irrigation solution oral electrolytes... 67, 71 ORAP ORFADIN orsythia 28 day OSTEO-PORETICAL oxacillin sodium oxaliplatin oxandrolone oxcarbazepine oxybutynin chloride oxycodone hcl OXYCODONE HCL oxycodone hcl tab 5 mg oxycodone w/ acetaminophen mg oxycodone w/ acetaminophen mg oxycodone w/ acetaminophen 5-325mg oxycodone w/ acetaminophen mg oxymetazoline hcl oyster shell P pacerone paclitaxel pamidronate disodium PANOXYL-4 CREAMY WASH PANOXYL-8 CREAMY WASH PANRETIN pantoprazole sodium tbec pantothenic acid paricalcitol paromomycin sulfate paroxetine hcl PARVA-CAL PARVA-CAL paser d/r PATADAY PATANOL PAXIL PAZEO PEDIA-LAX pediatric multiple vitamin w/ c pediatric multiple vitamin w/ c & fa pediatric multiple vitamin w/ extra c & fa pediatric multiple vitamin w/ minerals & c pediatric multiple vitamins pediatric multiple vitamins w/ iron pediatric vitamins adc PEDVAX HIB PEG 3350/ELECTROLYTES peg 3350-kcl-sod bicarb-sod chloride-sod sulfate peg 3350-potassium chloride-sod bicarbonatesod chloride PEGANONE PEG-INTRON PEG-INTRON REDIPEN PENICILLIN G POT IN DEXTROSE penicillin g potassium penicillin g procaine penicillin g sodium penicillin v potassium penicilln gk inj 5mu PENTAM PENTASA pentoxifylline PEPCID AC PERFOROMIST perindopril erbumine periogard permethrin permethrin & pyrethrins-piperonyl butoxide perphenazine PERRY PRENATAL PHENAGIL Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 109

110 phenelzine sulfate phenobarbital phenobarbital sodium PHENOBARBITAL SODIUM phenylephrine hcl phenylephrine hcl (ophth) phenylephrine hcl (oral) phenylephrine w/ acetaminophen phenylephrine w/ dm-gg phenylephrine-acetaminophen-guaifenesin phenylephrine-brompheniramine-dm phenylephrine-chlorphen-dm phenylephrine-chlorpheniramine-dm w/ apap phenylephrine-dm phenylephrine-dm-gg w/ apap phenylephrine-doxylamine-dextromethorphanacetaminophen phenylephrine-guaifenesin PHENYLHISTINE DH phenytek phenytoin phenytoin sodium phenytoin sodium extended philith PHILLIPS MILK OF MAGNESIA PHOSLYRA PHOS-NAK POWDER CONCENTRA PHOSPHOLINE IODIDE phytonadione PILOCARPINE HCL pilocarpine hcl (oral) pimtrea pack pindolol pioglitazone hcl piperacillin sodium-tazobactam sodium pirmella 1/35 28 day piroxicam PLASMA-LYTE A PLASMA-LYTE PLASMA-LYTE-56/D5W podofilox polyethylene glycol polyethylene glycol-propylene glycol (ophth) polymyxin b-trimethoprim polyvinyl alcohol polyvinyl alcohol-povidone (ophth) POMALYST CAP 1MG POMALYST CAP 2MG POMALYST CAP 3MG POMALYST CAP 4MG portia 28 day potassium chloride... 67, 69 POTASSIUM CHLORIDE... 67, 69 POTASSIUM CHLORIDE 0.15% POTASSIUM CHLORIDE 0.22% POTASSIUM CHLORIDE ER potassium chloride in nacl potassium chloride microencapsulated crystals cr POTASSIUM CITRATE (ALKALINIZER) POTIGA... 36, 37 povidone-iodine vaginal PRADAXA pramipexole dihydrochloride pravastatin sodium prazosin hcl pred sod pho sol 5mg/5ml PREDNISOLONE ACETATE (OPHTH) prednisolone sodium phosphate (ophth) prednisolone sol 15mg/5ml prednisolone sol 25mg/5ml prednisolone syp 15mg/5ml prednisone con 5mg/ml prednisone pak 10mg prednisone pak 5mg prednisone sol 5mg/5ml prednisone tab 10mg prednisone tab 1mg prednisone tab 2.5mg prednisone tab 20mg prednisone tab 50mg prednisone tab 5mg PREMARIN CREAM premasol sol 10% premasol sol 6% PRENATAL PRENATAL VITAMIN/FOLIC ACID > 0.8 MG (GENERIC) polysaccharide iron complex PRETZ POLY-TUSSIN prevalite POLY-TUSSIN AC previfem 28 day POLY-TUSSIN D PREZCOBIX Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 110 visitare il sito

111 PREZISTA PRIFTIN PRILOSEC OTC PRIMAQUINE PHOSPHATE primidone PRISTIQ PRIVIGEN PROAIR HFA probenecid PROBIOTIC FORMULA PROCALAMINE PRO-CHLO prochlorperazine inj prochlorperazine maleate prochlorperazine supp PRO-CLEAR AC PROCRIT procto-pak proctosol hc cre 2.5% proctozone hc PROFE PROGLYCEM PROGRAF PROLASTIN-C PROLENSA PROLEUKIN PROLIA PROMACTA promethazine hcl PRONTO propafenone hcl proparacaine hcl propranolol & hydrochlorothiazide propranolol cap er propranolol hcl propylene glycol-glycerin propylthiouracil PROQUAD PROSOL PROTEXIN protriptyline hcl PRUDOXIN CRE 5% pseudoephed-bromphen-dm pseudoephed-doxyl-dm w/apap pseudoephedrine hcl pseudoephedrine w/ codeine-gg pseudoephedrine w/ dm-gg pseudoephedrine-acetaminophen pseudoephedrine-brompheniramine-codeine pseudoephedrine-chlorphen-dm pseudoephedrine-dexchlorpheniraminechlophedianol pseudoephedrine-guaifenesin pseudoephedrine-ibuprofen PSEUDOEPHEDRINE-IBUPROFEN psyllium PSYLLIUM PULMOZYME PURIXAN pyrazinamide PYRETHINS/PIPERONYL BUTO pyrethrins-piperonyl butoxide pyrethrins-piperonyl butoxide-permethrin-nit remover pyridostigmine bromide pyridoxine hcl PYRIL DM pyrilamine maleate-phenylephrine hcl tannate.. 83 Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito Q quasense 91 day quetiapine fumarate quinapril hcl quinapril-hydrochlorothiazide quinidine gluconate quinidine sulfate quinine sulfate QVAR R RA CALAMINE RA CALCIUM/BORON RA OYSTER SHELL CALCIUM/V RABAVERT raloxifene hcl ramipril RANEXA ranitidine hcl ranitidine hcl inj ranitidine syrup RAPAMUNE REBETOL SOLN reclipsen 28 day RECOMBIVAX HB REFRESH CELLUVISC REFRESH OPTIVE ADVANCED

112 REGRANEX RELENZA DISKHALER RELISTOR RELPAX REMICADE REMODULIN RENVELA PAK 0.8GM RENVELA PAK 2.4GM RENVELA TAB 800MG repaglinide RESCON RESCON DM RESCRIPTOR RESPAIRE RESTASIS RETAINE MGD RETROVIR IV INFUSION REVATIO REVLIMID REYATAZ RHINARIS ribapak mis 600/day ribasphere ribasphere ribapak ribasphere ribapak ribasphere ribapak ribavirin 200mg riboflavin rid essential lice elimin rifabutin rifampin RIFATER riluzole rimantadine hydrochloride RINGER'S RIOMET RISA-BID PROBIOTIC risamine RISPERDAL INJ 12.5MG RISPERDAL INJ 25MG RISPERDAL INJ 37.5MG RISPERDAL INJ 50MG risperidone RITUXAN ropinirole hydrochloride rosadan cre 0.75% ROTARIX ROTATEQ roxicet soln roxicet tabs ROZEREM RU-HIST-D RYMED rivastigmine tartrate SIMBRINZA rizatriptan benzoate simvastatin ROBITUSSIN CHILDRENS COUG sirolimus ROCALTROL SIROLIMUS Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 112 visitare il sito S SABRIL saccharomyces boulardii saline SALINE SANDIMMUNE SANDOSTATIN LAR DEPOT SANTYL SAPHRIS... 42, 43 SCHOOLTIME SHAMPOO SCOOBY-DOO ONE A DAY SCOT-TUSSIN SCOT-TUSSIN SENIOR SECURA EXTRA PROTECTIVE selegiline hcl selenium SELENIUM selenium sulfide SELZENTRY senna SENNA SENNA PROMPT sennosides SENNOSIDES sennosides-docusate sodium SENSI-CARE PROTECTIVE BAR SENSIPAR SEREVENT DISKUS SEROQUEL XR sertraline hcl sharobel 28 day sildenafil citrate (pulmonary hypertension) SILENOR SILVER SULFADIAZINE... 87

113 SIRTURO SIVEXTRO SLOW RELEASE IRON SLOW-MAG SM CORAL CALCIUM SM SLOW RELEASE IRON SM VITAMIN D3 MAXIMUM STR SODIUM BICARBONATE sodium bicarbonate (antacid) SODIUM CHLORIDE... 67, 69, 85 SODIUM CHLORIDE 0.45% VIA SODIUM CHLORIDE 0.9% sodium chloride hypertonic SODIUM CHLORIDE INJ 0.9% SODIUM FLUORIDE CHEW; TAB; 1.1 (0.5 F) MG/ML SOLN sodium phenylbutyrate sodium phosphates sodium polystyrene sulfonate SOLIA SOLTAMOX SOLU-CORTEF SOMATULINE DEPOT SOMAVERT SOOTHE sorine sotalol hcl sotalol hcl (afib/afl) SOVALDI specialty vitamins products SPIRIVA HANDIHALER SPIRIVA RESPIMAT spironolactone spironolactone & hydrochlorothiazide sprintec 28 day SPRYCEL sps susp 15gm/60ml sronyx SSD ST JOSEPH ADULT ANALGESIC STAHIST AD STANBACK ASPIRIN FREE streptomycin sulfate STRIBILD STUART PRENATAL + DHA SUBOXONE MIS 12-3MG SUBOXONE MIS 2-0.5MG SUBOXONE MIS 4-1MG SUBOXONE MIS 8-2MG SUCRAID sucralfate SUDAFED 24 HOUR sulfacetamide sodium (acne) sulfacetamide sodium (ophth) sulfacetamide sod-prednisolone sulfadiazine sulfamethoxazole-trimethoprim sulfamethoxazole-trimethoprim inj SULFAMYLON sulfasalazine sulfasalazine ec sulindac SUMATRIPTAN sumatriptan succinate SUMATRIPTAN SUCCINATE sumatriptan succinate inj SUMATRIPTAN SUCCINATE INJ SUPER NU-THERA suprax SUPRAX SUPREP BOWEL PREP SURMONTIL CAP 100MG SURMONTIL CAP 25MG SURMONTIL CAP 50MG SUSTIVA SUTENT SYLATRON KIT 296MCG SYLATRON KIT 444MCG SYLATRON KIT 888MCG SYMBICORT SYMLINPEN SYMLINPEN SYNAGIS SYNAREL STATUSS GREEN SYNERCID stavudine SYNTHROID STERILE LUBRICANT DROPS SYPRINE STERILE WATER IRRIGATION SYSTANE BALANCE RESTORATI STIVARGA SYSTANE LIQUID GEL STRATTERA SYSTANE OVERNIGHT THERAPY Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni 113 visitare il sito

114 T TAB-A-VITE WOMENS TABLOID tacrolimus TAFINLAR TAMIFLU tamoxifen citrate tamsulosin hcl TARCEVA TARGRETIN... 25, 90 tarina fe tab 1/ TASIGNA tazicef tazicef vial TAZORAC taztia TEARS AGAIN NIGHT & DAY TEFLARO TEGRETOL TEGRETOL-XR TEKAMLO MG TEKAMLO TAB MG TEKAMLO TAB 150-5MG TEKAMLO TAB 300-5MG TEKTURNA TEKTURNA HCT TAB MG TEKTURNA HCT TAB MG TEKTURNA HCT TAB MG TEKTURNA HCT TAB MG temazepam TENIVAC terazosin hcl terbinafine hcl terbinafine hcl (topical) terbutaline sulfate terconazole vaginal TESTIM testosterone cypionate testosterone enanthate TETANUS TOXOID ADSORBED TETANUS/DIPHTHERIA TOXOID tetrahydrozoline hcl (ophth) tetrahydrozoline w/ zinc sulfate theophylline THERA/BETA-CAROTENE THERA-D THERAFLU FLU & SORE THROA THERAFLU MAX-D SEVERE COL THERAFLU SINUS & COLD THERANATAL CORE NUTRITION THERATEARS thiamine hcl thiamine mononitrate thioridazine hcl thiothixene tiagabine hcl TIKOSYN timolol maleate timolol maleate (ophth) TIMOLOL MALEATE GEL tioconazole vaginal TIVICAY tizanidine hcl TOBRADEX TOBRADEX ST tobramycin tobramycin (ophth) tobramycin sulfate tobramycin sulfate in saline tobramycin-dexamethasone TOBREX tolnaftate TOLTERODINE TARTRATE CAP ER tolterodine tartrate tabs topiramate toposar topotecan hcl torsemide inj 20mg/2ml torsemide inj 50mg/5ml torsemide tabs TOUJEO SOLOSTAR TOVIAZ TPN ELECTROLYTES TRACLEER TRADJENTA tramadol hcl tramadol-acetaminophen TEV-TROPIN trandolapril texacort soln 2.5% tranexamic acid THALOMID TRANSDERM-SCOP theo tranylcypromine sulfate Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito

115 travasol TRAVATAN Z trazodone hcl TREANDA TRECATOR TRELSTAR DEP INJ 3.75MG TRELSTAR LA INJ 11.25MG tretinoin tretinoin (chemotherapy) triamcinolone acetonide (mouth) triamcinolone acetonide (topical) TRIAMINIC CHEST & NASAL C TRIAMINIC COLD & ALLERGY TRIAMINIC COLD & COUGH DA TRIAMINIC COLD/COUGH NIGH TRIAMINIC COUGH & RUNNY N TRIAMINIC FEVER REDUCER P TRIAMINIC MULTI-SYMPTOM F TRIAMINIC NIGHT TIME COLD triamterene & hydrochlorothiazide triamterene & hydrochlorothiazide cap mg TRIBENZOR TAB MG TRIBENZOR TAB TRIBENZOR TAB MG TRIBENZOR TAB MG TRIBENZOR40- TAB 10-25MG TRICODE AR TRICODE GF triderm trifluoperazine hcl trifluridine trihexyphenidyl hcl tri-legest 28 day trilyte trimethoprim TRINESSA TRIPLE PASTE tri-previfem 28 day triprolidine & pseudoephedrine TRISENOX tri-sprintec 28 day TRIUMEQ TRI-VI-SOL TRI-VI-SOL/IRON trivora 28 day TRUMENBA TRUVADA TUCKS ANTI-ITCH TUDORZA PRESSAIR TUDORZA PRESSAIR (INSTITUTIONAL PACK) 400MCG/ACT TUSNEL TUSNEL PEDIATRIC TUSNEL-DM PEDIATRIC TWINRIX INJ TYBOST TYGACIL TYKERB TYPHIM VI TYSABRI TYZEKA velivet 28 day TROPHAMINE INJ 10% venlafaxine hcl trospium chloride Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito U UCERIS ULORIC UNITHROID UPCAL D URO-MAG ursodiol V VAGIFEM valacyclovir hcl VALCHLOR VALCYTE valganciclovir hcl valproate sodium valproic acid valsartan valsartan & hctz tab mg valsartan & hctz tab mg valsartan & hctz tab mg valsartan & hctz tab mg valsartan & hctz tab mg vancomycin hcl VANDAZOLE VAQTA VARIVAX VASCEPA VASOCLEAR A VELCADE... 24

116 verapamil cap er VERAPAMIL CAP ER verapamil hcl verapamil tab er VERSACLOZ VESICARE vestura VIBRAMYCIN VICKS VAPORUB VICTOZA VICTRELIS VIDEX PEDIATRIC VIGAMOX VIIBRYD VIMPAT vinblastine sulfate vincasar vincristine sulfate vinorelbine tartrate viorele VIRACEPT VIRAMUNE XR VIREAD VISINE-LR VITALETS VITA-MAG vitamin a VITAMIN A VITAMIN A PALMITATE VITAMIN B12/FOLIC ACID VITAMIN C VITAMIN D VITAMIN D vitamin e VITAMIN E VITAMIN K vitamin mixture vitamins a & d vitamins c & e VITEKTA VIVA DROPS VOLTAREN voriconazole VOTRIENT vyfemia 28 day W warfarin sodium WELCHOL wheat dextrin wheat dextrin-calcium white petrolatum-mineral oil Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito X XALKORI XARELTO XARELTO STARTER PACK XENAZINE XGEVA XIFAXAN XOLAIR XOPENEX HFA XTANDI xulane XYREM Y YF-VAX Z zafirlukast zarah ZAVESCA zazole ZAZOLE ZELBORAF ZEMAIRA zenatane zenchent 28 day ZENPEP ZETIA TAB 10MG ZIAGEN zidovudine ZINC OXIDE zinc oxide (topical) ziprasidone hcl ZMAX ZODRYL AC ZODRYL AC ZODRYL AC ZODRYL AC ZODRYL DAC ZODRYL DAC ZODRYL DAC ZODRYL DAC ZODRYL DEC

117 ZODRYL DEC ZODRYL DEC ZODRYL DEC zoledronic inj 4mg/5ml ZOLINZA zolmitriptan zolmitriptan odt zolpidem tartrate ZOMETA zonatuss zonisamide ZONTIVITY ZOO FRIENDS COMPLETE ZORTRESS ZORTRESS TAB 0.5MG ZORTRESS TAB 0.75MG ZOSTAVAX Z-TUSS AC Z-TUSS E ZYDELIG ZYKADIA ZYLET ZYPREXA RELPREVV ZYTIGA ZYVOX Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 117

118 Questo formulario è stato aggiornato il 1 o agosto Per qualsiasi chiarimento telefonare agli ArchCare Community Advantage FIDA Plan Participant Services al numero , 24/24 ore, 7/7 giorni. Per gli utenti TTY il numero è 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito Per qualsiasi chiarimento telefonare all'archcare Community Advantage FIDA Plan al numero , 24/24 ore, 7/7 giorni. TTY 711. La chiamata è gratuita. Per ulteriori informazioni visitare il sito 118