Specialty Pharmacy Drug List
Specialty Pharmacy Drug List Specialty medicines are usually prescribed by doctors who treat chronic and complex disease. These medications usually require a higher degree of management, are high in cost and are generally not stocked at retail pharmacies. Most specialty medications can be filled at: Fairview Specialty Pharmacy for UCare Choices and Fairview UCare Choices members: • Phone: 612-672-5260 • Fax: 866-347-4939 This list applies to UCare Choices and Fairview UCare Choices only and is updated regularly. Drugs with a Non-Formulary status may be covered under your medical benefit. Please go to ucare.org to review coverage criteria. F = Formulary, NF = Non-Formulary DRUG ABRAXANE 100 MG VIAL
FORMULARY STATUS NF
ACTEMRA 162 MG/0.9 ML SYRINGE ACTEMRA 200 MG/10 ML VIAL
F NF
ACTEMRA 400 MG/20 ML VIAL
NF
ACTEMRA 80 MG/4 ML VIAL
NF
ACTIMMUNE 100 MCG/0.5 ML VIAL ADCETRIS 50 MG VIAL
F NF
ADCIRCA 20 MG TABLET
F
ADEFOVIR DIPIVOXIL 10 MG TAB ADVATE 1,201-1,800 UNIT VIAL
F NF
ADVATE 1,801-2,400 UNIT VIAL
NF
ADVATE 2,401-3,600 UNIT VIAL
NF
ADVATE 200-400 UNIT VIAL
NF
ADVATE 3,601-4,800 UNIT VIAL
NF
ADVATE 401-800 UNIT VIAL
NF
ADVATE 801-1,200 UNIT VIAL
NF
AFINITOR 10 MG TABLET
F
AFINITOR 2.5 MG TABLET
F
UC FVC_042018 IA (04202018) Updated 04/2018
AFINITOR 5 MG TABLET
F
AFINITOR 7.5 MG TABLET
F
AFINITOR DISPERZ 2 MG TABLET AFINITOR DISPERZ 3 MG TABLET AFINITOR DISPERZ 5 MG TABLET AFSTYLA 1,000 UNIT VIAL
NF
AFSTYLA 1,500 UNIT RANGE VIAL AFSTYLA 2,000 UNIT VIAL
NF
AFSTYLA 2,500 UNIT RANGE VIAL AFSTYLA 250 UNIT VIAL
NF
AFSTYLA 3,000 UNIT VIAL
NF
AFSTYLA 500 UNIT VIAL
NF
NF NF NF
NF
NF
ALDURAZYME 2.9 MG/5 ML VIAL ALECENSA 150 MG CAPSULE
F
ALFERON N 5 MILLION UNITS VIAL ALIMTA 100 MG VIAL
NF
ALIMTA 500 MG VIAL
F
F F
U7486 (04/18)
ALKERAN 2 MG TABLET
NF
ARIXTRA 2.5 MG/0.5 ML SYRINGE ARIXTRA 5 MG/0.4 ML SYRINGE
NF
ALKERAN 50 MG VIAL
NF
ALPHANATE 1,000-400 UNIT VIAL ALPHANATE 1,500-600 UNIT VIAL ALPHANATE 2,000-800 UNIT VIAL ALPHANATE 250-100 UNIT VIAL
NF
NF
NF
ARIXTRA 7.5 MG/0.6 ML SYRINGE ARRANON 250 MG/50 ML VIAL
NF
ARZERRA 1,000 MG/50 ML VIAL
NF
ARZERRA 100 MG/5 ML VIAL
NF
ALPHANATE 500-200 UNIT VIAL
NF
ASTAGRAF XL 0.5 MG CAPSULE
NF
ALPHANINE SD 1,000 UNIT VIAL
NF
ASTAGRAF XL 1 MG CAPSULE
NF
ALPHANINE SD 1,500 UNIT VIAL
NF
ASTAGRAF XL 5 MG CAPSULE
NF
ALPHANINE SD 500 UNIT VIAL
NF
ARALAST NP 1,000 MG VIAL
NF
NF
NF
NF
ATGAM 50 MG/ML AMPUL
F
AVASTIN 100 MG/4 ML VIAL
F
AVASTIN 400 MG/16 ML VIAL
F
AVONEX 30 MCG VIAL KIT
F
AVONEX PEN 30 MCG/0.5 ML KIT AVONEX PREFILLED SYR 30 MCG AVONEX PREFILLED SYR 30 MCG KT BARACLUDE 0.05 MG/ML SOLUTION BARACLUDE 0.5 MG TABLET
F
NF
BARACLUDE 1 MG TABLET
NF NF
ARALAST NP 500 MG VIAL
F
ARANESP 10 MCG/0.4 ML SYRINGE ARANESP 100 MCG/0.5 ML SYRINGE ARANESP 100 MCG/ML VIAL
F
ARANESP 150 MCG/0.3 ML SYRINGE ARANESP 150 MCG/0.75 ML VIAL ARANESP 200 MCG/0.4 ML SYRINGE ARANESP 200 MCG/ML VIAL
F
F
BCG (TICE STRAIN) VIAL
ARANESP 25 MCG/0.42 ML SYRING ARANESP 25 MCG/ML VIAL
F F
BCG VACCINE (TICE STRAIN) VIAL BEBULIN 200-1,200 UNITS VIAL
NF
ARANESP 300 MCG/0.6 ML SYRINGE ARANESP 300 MCG/ML VIAL
F
BENEFIX 1,000 UNIT RANGE
NF
BENEFIX 2,000 UNIT RANGE
NF
ARANESP 40 MCG/0.4 ML SYRINGE ARANESP 40 MCG/ML VIAL
F
BENEFIX 250 UNIT RANGE
NF
BENEFIX 3,000 UNIT RANGE
NF
BENEFIX 500 UNIT RANGE
NF
ARANESP 500 MCG/1 ML SYRINGE ARANESP 60 MCG/0.3 ML SYRINGE ARANESP 60 MCG/ML VIAL
F
ARIXTRA 10 MG/0.8 ML SYRINGE
F F
F F
F
F
F F NF
F F F
F
BENLYSTA 120 MG VIAL
F
BENLYSTA 200 MG/ML AUTOINJECT BENLYSTA 200 MG/ML SYRINGE BENLYSTA 400 MG VIAL
NF
BERINERT 500 UNIT KIT
NF
NF F
BETASERON 0.3 MG KIT
F
BETHKIS 300 MG/4 ML AMPULE
NF
BICNU 100 MG VIAL
NF
BIVIGAM LIQUID 10% VIAL
NF
COSENTYX 300 MG DOSE-2 PENS COSENTYX 300 MG DOSE-2 SYRINGE COSMEGEN 0.5 MG VIAL
BOTOX 100 UNITS VIAL
NF
CYTOGAM 2.5 GM/50 ML VIAL
NF
BOTOX 200 UNITS VIAL
NF
DACOGEN 50 MG VIAL
NF
BOTOX COSMETIC 100 UNITS VIAL BOTOX COSMETIC 50 UNITS VIAL BRAVELLE 75 UNIT VIAL
NF
DAKLINZA 30 MG TABLET
NF
DAKLINZA 60 MG TABLET
NF
DAKLINZA 90 MG TABLET
NF NF
BUSULFEX 60 MG/10 ML VIAL
NF
CALCIUM FOLINATE POWDER
NF
DAUNOXOME 50 MG (2 MG/ML) VIAL DDAVP 0.01% NASAL SPRAY
CAMPTOSAR 100 MG/5 ML VIAL
NF
DDAVP 0.1 MG TABLET
NF
CAMPTOSAR 300 MG/15 ML VIAL CAMPTOSAR 40 MG/2 ML VIAL
NF
DDAVP 0.2 MG TABLET
NF NF
CAPECITABINE 150 MG TABLET
F
DDAVP 10 MCG/0.1 ML SOLUTION DDAVP 4 MCG/ML AMPUL
CAPECITABINE 500 MG TABLET
F
DDAVP 4 MCG/ML VIAL
NF
CARIMUNE NF 12 GM VIAL
F
DEPOCYT 50 MG/5 ML VIAL
NF
CARIMUNE NF 6 GM VIAL
F
DESFERAL 2 GRAM VIAL
NF
DESFERAL MESYLATE 500 MG VL DOCEFREZ 20 MG VIAL
NF
DOCEFREZ 80 MG VIAL
NF
DOXIL 2 MG/ML VIAL
NF
NF NF
NF
CELLCEPT 200 MG/ML ORAL SUSP CELLCEPT 250 MG CAPSULE
NF
CELLCEPT 500 MG TABLET
NF
CELLCEPT 500 MG VIAL
NF
NF
F F NF
NF
NF
NF
CETROTIDE 0.25 MG KIT
NF
DUPIXENT 300 MG/2 ML SAFE SYRG DYSPORT 300 UNIT VIAL
CIMZIA 200 MG VIAL KIT
NF
DYSPORT 500 UNITS VIAL
F
CIMZIA 200 MG/ML STARTER KIT CIMZIA 200 MG/ML SYRINGE KIT CLOLAR 20 MG/20 ML VIAL
NF
ELAPRASE 6 MG/3 ML VIAL
F
CEREZYME 400 UNITS VIAL
F
F F
ELIGARD 22.5 MG SYRINGE KIT
NF
ELIGARD 30 MG SYRINGE KIT
NF
NF
ELIGARD 45 MG SYRINGE KIT
NF
COPAXONE 20 MG/ML SYRINGE
NF
ELIGARD 7.5 MG SYRINGE KIT
NF
COPAXONE 40 MG/ML SYRINGE
NF
ELITEK 1.5 MG VIAL
F
COPEGUS 200 MG TABLET
NF
ELITEK 7.5 MG VIAL
F
COSENTYX 150 MG/ML PEN INJECT COSENTYX 150 MG/ML SYRINGE
NF
F
ELLENCE 2 MG/ML VIAL
NF
F
ELOCTATE 1,000 UNIT NOMINAL
NF
ELOCTATE 1,500 UNIT NOMINAL ELOCTATE 2,000 UNIT NOMINAL ELOCTATE 250 UNIT NOMINAL
NF NF
ERBITUX 100 MG/50 ML VIAL
NF
ERBITUX 200 MG/100 ML VIAL
NF
ESBRIET 267 MG CAPSULE
F
NF
ESBRIET 267 MG TABLET
F
ELOCTATE 3,000 UNIT NOMINAL ELOCTATE 4,000 UNIT NOMINAL ELOCTATE 5,000 UNIT NOMINAL ELOCTATE 500 UNIT NOMINAL
NF
ESBRIET 801 MG TABLET
F
ETOPOPHOS 100 MG VIAL
NF
EUFLEXXA 20 MG/2 ML SYRINGE EVOMELA 50 MG VIAL
NF
EXJADE 125 MG TABLET
F
ELOCTATE 6,000 UNIT NOMINAL ELOCTATE 750 UNIT NOMINAL
NF
EXJADE 250 MG TABLET
F
EXJADE 500 MG TABLET
F
NF
EXTAVIA 0.3 MG KIT
F
ELOXATIN 100 MG/20 ML VIAL
NF
EXTAVIA 0.3 MG VIAL
F
ELOXATIN 50 MG/10 ML VIAL
NF
FABRAZYME 35 MG VIAL
F
ELSPAR 10,000 UNITS VIAL
NF
FABRAZYME 5 MG VIAL
F
FASLODEX 250 MG/5 ML SYRINGE FEIBA NF 1,000 UNIT (NOMINAL) FEIBA NF 2,500 UNIT (NOMINAL) FEIBA NF 500 UNIT (NOMINAL)
F
NF NF NF
ENBREL 25 MG KIT
F
ENBREL 25 MG/0.5 ML SYRINGE
F
ENBREL 50 MG/ML MINI CARTRIDGE ENBREL 50 MG/ML SURECLICK SYR ENBREL 50 MG/ML SYRINGE
F
ENTECAVIR 0.5 MG TABLET
F
ENTECAVIR 1 MG TABLET
F
F F
FIRAZYR 30 MG/3 ML SYRINGE
NF
NF NF NF F
FIRMAGON 2 X 120 MG KIT
NF
FIRMAGON 2 X 120 MG VIALS
NF
FIRMAGON 80 MG KIT
NF
FIRMAGON 80 MG VIAL
NF
FLEBOGAMMA DIF 10% VIAL
NF
FLEBOGAMMA DIF 5% VIAL
NF
ENTYVIO 300 MG VIAL
NF
ENVARSUS XR 0.75 MG TABLET
NF
ENVARSUS XR 1 MG TABLET
NF
ENVARSUS XR 4 MG TABLET
NF
EPCLUSA 400 MG-100 MG TABLET EPIVIR HBV 100 MG TABLET
F
FLOXURIDINE 500 MG VIAL
NF
NF
FLOXURIDINE POWDER
NF
EPIVIR HBV 25 MG/5 ML SOLN
NF
FOLLISTIM AQ 150 UNIT VIAL
NF
EPOGEN 10,000 UNITS/ML VIAL
F F
EPOGEN 20,000 UNITS/2 ML VIAL EPOGEN 20,000 UNITS/ML VIAL
F
FOLLISTIM AQ 300 UNIT CARTRIDG FOLLISTIM AQ 600 UNIT CARTRIDG FOLLISTIM AQ 75 UNIT VIAL
NF
EPOGEN 2,000 UNITS/ML VIAL
EPOGEN 3,000 UNITS/ML VIAL
F
NF
EPOGEN 4,000 UNITS/ML VIAL
F
FOLLISTIM AQ 900 UNIT CARTRIDG
F
NF NF
FOLOTYN 20 MG/ML VIAL
NF
FOLOTYN 40 MG/2 ML VIAL
NF
FORTEO 600 MCG/2.4 ML PEN INJ FRAGMIN 10,000 UNITS/ML SYRING FRAGMIN 12,500 UNITS/0.5 ML
F
FRAGMIN 15,000 UNITS/0.6 ML
F
FRAGMIN 18,000 UNITS/0.72 ML
F
FRAGMIN 2,500 UNITS/0.2 ML SYR FRAGMIN 5,000 UNITS/0.2 ML SYR FRAGMIN 7,500 UNITS/0.3 ML SYR FRAGMIN 95,000 UNITS/3.8 ML VL FUZEON 90 MG VIAL
F
F F
F F F NF
GAMASTAN S-D VIAL
F
GAMMAGARD LIQUID 10% VIAL GAMMAGARD S-D 10 G (IGA
FORMULARY STATUS NF
ACTEMRA 162 MG/0.9 ML SYRINGE ACTEMRA 200 MG/10 ML VIAL
F NF
ACTEMRA 400 MG/20 ML VIAL
NF
ACTEMRA 80 MG/4 ML VIAL
NF
ACTIMMUNE 100 MCG/0.5 ML VIAL ADCETRIS 50 MG VIAL
F NF
ADCIRCA 20 MG TABLET
F
ADEFOVIR DIPIVOXIL 10 MG TAB ADVATE 1,201-1,800 UNIT VIAL
F NF
ADVATE 1,801-2,400 UNIT VIAL
NF
ADVATE 2,401-3,600 UNIT VIAL
NF
ADVATE 200-400 UNIT VIAL
NF
ADVATE 3,601-4,800 UNIT VIAL
NF
ADVATE 401-800 UNIT VIAL
NF
ADVATE 801-1,200 UNIT VIAL
NF
AFINITOR 10 MG TABLET
F
AFINITOR 2.5 MG TABLET
F
UC FVC_042018 IA (04202018) Updated 04/2018
AFINITOR 5 MG TABLET
F
AFINITOR 7.5 MG TABLET
F
AFINITOR DISPERZ 2 MG TABLET AFINITOR DISPERZ 3 MG TABLET AFINITOR DISPERZ 5 MG TABLET AFSTYLA 1,000 UNIT VIAL
NF
AFSTYLA 1,500 UNIT RANGE VIAL AFSTYLA 2,000 UNIT VIAL
NF
AFSTYLA 2,500 UNIT RANGE VIAL AFSTYLA 250 UNIT VIAL
NF
AFSTYLA 3,000 UNIT VIAL
NF
AFSTYLA 500 UNIT VIAL
NF
NF NF NF
NF
NF
ALDURAZYME 2.9 MG/5 ML VIAL ALECENSA 150 MG CAPSULE
F
ALFERON N 5 MILLION UNITS VIAL ALIMTA 100 MG VIAL
NF
ALIMTA 500 MG VIAL
F
F F
U7486 (04/18)
ALKERAN 2 MG TABLET
NF
ARIXTRA 2.5 MG/0.5 ML SYRINGE ARIXTRA 5 MG/0.4 ML SYRINGE
NF
ALKERAN 50 MG VIAL
NF
ALPHANATE 1,000-400 UNIT VIAL ALPHANATE 1,500-600 UNIT VIAL ALPHANATE 2,000-800 UNIT VIAL ALPHANATE 250-100 UNIT VIAL
NF
NF
NF
ARIXTRA 7.5 MG/0.6 ML SYRINGE ARRANON 250 MG/50 ML VIAL
NF
ARZERRA 1,000 MG/50 ML VIAL
NF
ARZERRA 100 MG/5 ML VIAL
NF
ALPHANATE 500-200 UNIT VIAL
NF
ASTAGRAF XL 0.5 MG CAPSULE
NF
ALPHANINE SD 1,000 UNIT VIAL
NF
ASTAGRAF XL 1 MG CAPSULE
NF
ALPHANINE SD 1,500 UNIT VIAL
NF
ASTAGRAF XL 5 MG CAPSULE
NF
ALPHANINE SD 500 UNIT VIAL
NF
ARALAST NP 1,000 MG VIAL
NF
NF
NF
NF
ATGAM 50 MG/ML AMPUL
F
AVASTIN 100 MG/4 ML VIAL
F
AVASTIN 400 MG/16 ML VIAL
F
AVONEX 30 MCG VIAL KIT
F
AVONEX PEN 30 MCG/0.5 ML KIT AVONEX PREFILLED SYR 30 MCG AVONEX PREFILLED SYR 30 MCG KT BARACLUDE 0.05 MG/ML SOLUTION BARACLUDE 0.5 MG TABLET
F
NF
BARACLUDE 1 MG TABLET
NF NF
ARALAST NP 500 MG VIAL
F
ARANESP 10 MCG/0.4 ML SYRINGE ARANESP 100 MCG/0.5 ML SYRINGE ARANESP 100 MCG/ML VIAL
F
ARANESP 150 MCG/0.3 ML SYRINGE ARANESP 150 MCG/0.75 ML VIAL ARANESP 200 MCG/0.4 ML SYRINGE ARANESP 200 MCG/ML VIAL
F
F
BCG (TICE STRAIN) VIAL
ARANESP 25 MCG/0.42 ML SYRING ARANESP 25 MCG/ML VIAL
F F
BCG VACCINE (TICE STRAIN) VIAL BEBULIN 200-1,200 UNITS VIAL
NF
ARANESP 300 MCG/0.6 ML SYRINGE ARANESP 300 MCG/ML VIAL
F
BENEFIX 1,000 UNIT RANGE
NF
BENEFIX 2,000 UNIT RANGE
NF
ARANESP 40 MCG/0.4 ML SYRINGE ARANESP 40 MCG/ML VIAL
F
BENEFIX 250 UNIT RANGE
NF
BENEFIX 3,000 UNIT RANGE
NF
BENEFIX 500 UNIT RANGE
NF
ARANESP 500 MCG/1 ML SYRINGE ARANESP 60 MCG/0.3 ML SYRINGE ARANESP 60 MCG/ML VIAL
F
ARIXTRA 10 MG/0.8 ML SYRINGE
F F
F F
F
F
F F NF
F F F
F
BENLYSTA 120 MG VIAL
F
BENLYSTA 200 MG/ML AUTOINJECT BENLYSTA 200 MG/ML SYRINGE BENLYSTA 400 MG VIAL
NF
BERINERT 500 UNIT KIT
NF
NF F
BETASERON 0.3 MG KIT
F
BETHKIS 300 MG/4 ML AMPULE
NF
BICNU 100 MG VIAL
NF
BIVIGAM LIQUID 10% VIAL
NF
COSENTYX 300 MG DOSE-2 PENS COSENTYX 300 MG DOSE-2 SYRINGE COSMEGEN 0.5 MG VIAL
BOTOX 100 UNITS VIAL
NF
CYTOGAM 2.5 GM/50 ML VIAL
NF
BOTOX 200 UNITS VIAL
NF
DACOGEN 50 MG VIAL
NF
BOTOX COSMETIC 100 UNITS VIAL BOTOX COSMETIC 50 UNITS VIAL BRAVELLE 75 UNIT VIAL
NF
DAKLINZA 30 MG TABLET
NF
DAKLINZA 60 MG TABLET
NF
DAKLINZA 90 MG TABLET
NF NF
BUSULFEX 60 MG/10 ML VIAL
NF
CALCIUM FOLINATE POWDER
NF
DAUNOXOME 50 MG (2 MG/ML) VIAL DDAVP 0.01% NASAL SPRAY
CAMPTOSAR 100 MG/5 ML VIAL
NF
DDAVP 0.1 MG TABLET
NF
CAMPTOSAR 300 MG/15 ML VIAL CAMPTOSAR 40 MG/2 ML VIAL
NF
DDAVP 0.2 MG TABLET
NF NF
CAPECITABINE 150 MG TABLET
F
DDAVP 10 MCG/0.1 ML SOLUTION DDAVP 4 MCG/ML AMPUL
CAPECITABINE 500 MG TABLET
F
DDAVP 4 MCG/ML VIAL
NF
CARIMUNE NF 12 GM VIAL
F
DEPOCYT 50 MG/5 ML VIAL
NF
CARIMUNE NF 6 GM VIAL
F
DESFERAL 2 GRAM VIAL
NF
DESFERAL MESYLATE 500 MG VL DOCEFREZ 20 MG VIAL
NF
DOCEFREZ 80 MG VIAL
NF
DOXIL 2 MG/ML VIAL
NF
NF NF
NF
CELLCEPT 200 MG/ML ORAL SUSP CELLCEPT 250 MG CAPSULE
NF
CELLCEPT 500 MG TABLET
NF
CELLCEPT 500 MG VIAL
NF
NF
F F NF
NF
NF
NF
CETROTIDE 0.25 MG KIT
NF
DUPIXENT 300 MG/2 ML SAFE SYRG DYSPORT 300 UNIT VIAL
CIMZIA 200 MG VIAL KIT
NF
DYSPORT 500 UNITS VIAL
F
CIMZIA 200 MG/ML STARTER KIT CIMZIA 200 MG/ML SYRINGE KIT CLOLAR 20 MG/20 ML VIAL
NF
ELAPRASE 6 MG/3 ML VIAL
F
CEREZYME 400 UNITS VIAL
F
F F
ELIGARD 22.5 MG SYRINGE KIT
NF
ELIGARD 30 MG SYRINGE KIT
NF
NF
ELIGARD 45 MG SYRINGE KIT
NF
COPAXONE 20 MG/ML SYRINGE
NF
ELIGARD 7.5 MG SYRINGE KIT
NF
COPAXONE 40 MG/ML SYRINGE
NF
ELITEK 1.5 MG VIAL
F
COPEGUS 200 MG TABLET
NF
ELITEK 7.5 MG VIAL
F
COSENTYX 150 MG/ML PEN INJECT COSENTYX 150 MG/ML SYRINGE
NF
F
ELLENCE 2 MG/ML VIAL
NF
F
ELOCTATE 1,000 UNIT NOMINAL
NF
ELOCTATE 1,500 UNIT NOMINAL ELOCTATE 2,000 UNIT NOMINAL ELOCTATE 250 UNIT NOMINAL
NF NF
ERBITUX 100 MG/50 ML VIAL
NF
ERBITUX 200 MG/100 ML VIAL
NF
ESBRIET 267 MG CAPSULE
F
NF
ESBRIET 267 MG TABLET
F
ELOCTATE 3,000 UNIT NOMINAL ELOCTATE 4,000 UNIT NOMINAL ELOCTATE 5,000 UNIT NOMINAL ELOCTATE 500 UNIT NOMINAL
NF
ESBRIET 801 MG TABLET
F
ETOPOPHOS 100 MG VIAL
NF
EUFLEXXA 20 MG/2 ML SYRINGE EVOMELA 50 MG VIAL
NF
EXJADE 125 MG TABLET
F
ELOCTATE 6,000 UNIT NOMINAL ELOCTATE 750 UNIT NOMINAL
NF
EXJADE 250 MG TABLET
F
EXJADE 500 MG TABLET
F
NF
EXTAVIA 0.3 MG KIT
F
ELOXATIN 100 MG/20 ML VIAL
NF
EXTAVIA 0.3 MG VIAL
F
ELOXATIN 50 MG/10 ML VIAL
NF
FABRAZYME 35 MG VIAL
F
ELSPAR 10,000 UNITS VIAL
NF
FABRAZYME 5 MG VIAL
F
FASLODEX 250 MG/5 ML SYRINGE FEIBA NF 1,000 UNIT (NOMINAL) FEIBA NF 2,500 UNIT (NOMINAL) FEIBA NF 500 UNIT (NOMINAL)
F
NF NF NF
ENBREL 25 MG KIT
F
ENBREL 25 MG/0.5 ML SYRINGE
F
ENBREL 50 MG/ML MINI CARTRIDGE ENBREL 50 MG/ML SURECLICK SYR ENBREL 50 MG/ML SYRINGE
F
ENTECAVIR 0.5 MG TABLET
F
ENTECAVIR 1 MG TABLET
F
F F
FIRAZYR 30 MG/3 ML SYRINGE
NF
NF NF NF F
FIRMAGON 2 X 120 MG KIT
NF
FIRMAGON 2 X 120 MG VIALS
NF
FIRMAGON 80 MG KIT
NF
FIRMAGON 80 MG VIAL
NF
FLEBOGAMMA DIF 10% VIAL
NF
FLEBOGAMMA DIF 5% VIAL
NF
ENTYVIO 300 MG VIAL
NF
ENVARSUS XR 0.75 MG TABLET
NF
ENVARSUS XR 1 MG TABLET
NF
ENVARSUS XR 4 MG TABLET
NF
EPCLUSA 400 MG-100 MG TABLET EPIVIR HBV 100 MG TABLET
F
FLOXURIDINE 500 MG VIAL
NF
NF
FLOXURIDINE POWDER
NF
EPIVIR HBV 25 MG/5 ML SOLN
NF
FOLLISTIM AQ 150 UNIT VIAL
NF
EPOGEN 10,000 UNITS/ML VIAL
F F
EPOGEN 20,000 UNITS/2 ML VIAL EPOGEN 20,000 UNITS/ML VIAL
F
FOLLISTIM AQ 300 UNIT CARTRIDG FOLLISTIM AQ 600 UNIT CARTRIDG FOLLISTIM AQ 75 UNIT VIAL
NF
EPOGEN 2,000 UNITS/ML VIAL
EPOGEN 3,000 UNITS/ML VIAL
F
NF
EPOGEN 4,000 UNITS/ML VIAL
F
FOLLISTIM AQ 900 UNIT CARTRIDG
F
NF NF
FOLOTYN 20 MG/ML VIAL
NF
FOLOTYN 40 MG/2 ML VIAL
NF
FORTEO 600 MCG/2.4 ML PEN INJ FRAGMIN 10,000 UNITS/ML SYRING FRAGMIN 12,500 UNITS/0.5 ML
F
FRAGMIN 15,000 UNITS/0.6 ML
F
FRAGMIN 18,000 UNITS/0.72 ML
F
FRAGMIN 2,500 UNITS/0.2 ML SYR FRAGMIN 5,000 UNITS/0.2 ML SYR FRAGMIN 7,500 UNITS/0.3 ML SYR FRAGMIN 95,000 UNITS/3.8 ML VL FUZEON 90 MG VIAL
F
F F
F F F NF
GAMASTAN S-D VIAL
F
GAMMAGARD LIQUID 10% VIAL GAMMAGARD S-D 10 G (IGA
