ABBVIE US LLC ANDROGEL GEL PACKET (TRANSDERM.) ANDROGENIC AGENTS ABBVIE US LLC ANDROGEL GEL PUMP (TRANSDERM) ANDROGENIC AGENTS ABBVIE US LLC CREON (ORAL) PANCREATIC ENZYMES ACTAVIS DELZICOL (ORAL) ULCERATIVE COLITIS AGENTS ACTAVIS ZENPEP (ORAL) PANCREATIC ENZYMES ACTIENT PHARMAC SEMPREX-D (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING AKORN INC. ZIOPTAN (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. ALOMIDE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. CILOXAN OINTMENT (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. CIPRO HC (OTIC) OTIC ANTIBIOTICS ALCON LABS. CIPRODEX (OTIC) OTIC ANTIBIOTICS ALCON LABS. DUREZOL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. EMADINE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. ILEVRO (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. MOXEZA (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALCON LABS. NEVANAC (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALCON LABS. PATADAY (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. PATANASE (NASAL) INTRANASAL RHINITIS AGENTS ALCON LABS. PATANOL (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALCON LABS. TRAVATAN Z 2.5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. TRAVATAN Z 5 ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALCON LABS. VIGAMOX (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS ALLEGIS PHARMAC DURAVENT DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ALLEGIS PHARMAC DURAVENT PE TABLET OTC (ORAL) COUGH AND COLD, COLD ALLEGIS PHARMAC ENDACON LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ALLEGIS PHARMAC HISTEX-DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC ALLEGIS PHARMAC HISTEX-PE LIQUID OTC (ORAL) COUGH AND COLD, COLD ALLERGAN INC. ACUVAIL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES ALLERGAN INC. ALOCRIL (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. LASTACAFT (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS ALLERGAN INC. LUMIGAN 2.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. LUMIGAN 7.5ML (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS ALLERGAN INC. TAZORAC CREAM (TOPICAL) ACNE AGENTS, TOPICAL ALLERGAN INC. TAZORAC GEL (TOPICAL) ACNE AGENTS, TOPICAL ANACOR PHARMACE KERYDIN (TOPICAL) ANTIFUNGALS, TOPICAL APTALIS PHARMA CANASA (RECTAL) ULCERATIVE COLITIS AGENTS APTALIS PHARMA ULTRESA (ORAL) PANCREATIC ENZYMES APTALIS PHARMA VIOKACE (ORAL) PANCREATIC ENZYMES ARBOR PHARMACEU PEDIADERM AF (TOPICAL) ANTIFUNGALS, TOPICAL ARBOR PHARMACEU PEDIADERM HC (TOPICAL) STEROIDS, TOPICAL LOW ARBOR PHARMACEU PEDIADERM TA (TOPICAL) STEROIDS, TOPICAL LOW ASTELLAS PHARMA PROTOPIC (TOPICAL) IMMUNOMODULATORS, ATOPIC DERMATITIS ASTRAZENECA PULMICORT FLEXHALER (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA RHINOCORT AQUA (NASAL) INTRANASAL RHINITIS AGENTS ASTRAZENECA SYMBICORT (INHALATION) GLUCOCORTICOIDS, INHALED ASTRAZENECA XIGDUO XR (ORAL) HYPOGLYCEMICS, SGLT2 AUXILIUM PHARM TESTIM (TRANSDERM.) ANDROGENIC AGENTS B.F ASCHER & CO BENZEDREX INHALER OTC (NASAL) COUGH AND COLD, COLD BAUSCH & LOMB ALREX (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB BEPREVE (OPHTHALMIC) OPHTHALMICS FOR ALLERGIC CONJUNCTIVITIS BAUSCH & LOMB BESIVANCE (OPHTHALMIC) OPHTHALMIC ANTIBIOTICS BAUSCH & LOMB LOTEMAX DROPS (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB LOTEMAX GEL (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB LOTEMAX OINTMENT (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAUSCH & LOMB PROLENSA (OPHTHALMIC) OPHTHALMICS, ANTI-INFLAMMATORIES BAYER,PHARM DIV DESONATE GEL (TOPICAL) STEROIDS, TOPICAL LOW BIOGEN-IDEC PLEGRIDY (SUBCUTANE.) MULTIPLE SCLEROSIS AGENTS BOEHRINGER ING. ATROVENT HFA (INHALATION) COPD AGENTS BOEHRINGER ING. COMBIVENT RESPIMAT (INHALATION) COPD AGENTS BOEHRINGER ING. SPIRIVA (INHALATION) COPD AGENTS BOEHRINGER ING. SPIRIVA RESPIMAT (INHALATION) COPD AGENTS BOEHRINGER ING. STRIVERDI RESPIMAT (INHALATION) BRONCHODILATORS, BETA AGONIST CAPELLON LIQUITUSS GG LIQUID OTC (ORAL) COUGH AND COLD, COLD CAPELLON RESCON TABLET OTC (ORAL) COUGH AND COLD, COLD CAPELLON RESCON-DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC ALEVAZOL OTC (TOPICAL) ANTIFUNGALS, TOPICAL CAPITAL PHARMAC AQUANAZ OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC CAPCOF LIQUID (ORAL) COUGH AND COLD, NARCOTIC CAPITAL PHARMAC CAPMIST DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CAPITAL PHARMAC CAPRON DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS NINJACOF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS NINJACOF-A LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS NINJACOF-XG LIQUID OTC (ORAL) COUGH AND COLD, NARCOTIC CENTURION LABS TRYMINE CD LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC CENTURION LABS TRYMINE D SYRUP OTC (ORAL) COUGH AND COLD, COLD CHIESI BETHKIS (INHALATION) ANTIBIOTICS, INHALED CHIESI ZYFLO (ORAL) LEUKOTRIENE MODIFIERS /Provider Synergies, L.L.C. Page 1 of 5
CHIESI ZYFLO CR (ORAL) LEUKOTRIENE MODIFIERS DIGESTIVE CARE PERTZYE (ORAL) PANCREATIC ENZYMES ECR PHARM. LODRANE D CAPSULE OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC ED A-HIST LIQUID OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST PSE TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED A-HIST TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED BRON GP LIQUID OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED CHLORPED D DROPS OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC ED-A-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC MUCAPHED TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYMED TABLET OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYNEX DM SOLUTION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC EDWARDS PHARMAC RYNEX PE SOLUTION OTC (ORAL) COUGH AND COLD, COLD EDWARDS PHARMAC RYNEX PSE LIQUID OTC (ORAL) COUGH AND COLD, COLD EISAI INC. AKYNZEO (ORAL) ANTIEMETIC/ANTIVERTIGO AGENTS ELI LILLY & CO. AXIRON (TRANSDERM) ANDROGENIC AGENTS ELI LILLY & CO. TRULICITY (SUBCUTANE.) HYPOGLYCEMICS, INCRETIN MIMETICS/ENHANCERS ENDO PHARM INC. FORTESTA (TRANSDERM) ANDROGENIC AGENTS FOREST PHARMACE DALIRESP (ORAL) COPD AGENTS FOREST PHARMACE TUDORZA PRESSAIR (INHALATION) COPD AGENTS G.M. PHARM NASOPEN PE LIQUID OTC (ORAL) COUGH AND COLD, COLD G.M. PHARM VANACOF DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC G.M. PHARM VANACOF-8 LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC GALDERMA LABORA CAPEX SHAMPOO (TOPICAL) STEROIDS, TOPICAL LOW GALDERMA LABORA CLOBEX SPRAY (TOPICAL) STEROIDS, TOPICAL VERY HIGH GALDERMA LABORA DIFFERIN CREAM (TOPICAL) ACNE AGENTS, TOPICAL GALDERMA LABORA DIFFERIN GEL (TOPICAL) ACNE AGENTS, TOPICAL GALDERMA LABORA DIFFERIN GEL PUMP (TOPICAL) ACNE AGENTS, TOPICAL GALDERMA LABORA DIFFERIN LOTION (TOPICAL) ACNE AGENTS, TOPICAL GALDERMA LABORA EPIDUO (TOPICAL) ACNE AGENTS, TOPICAL GILEAD SCIENCES CAYSTON (INHALATION) ANTIBIOTICS, INHALED GLAXOSMITHKLINE ABREVA OTC (TOPICAL) ANTIVIRALS, TOPICAL GLAXOSMITHKLINE ADVAIR DISKUS (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE ADVAIR HFA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE ANORO ELLIPTA (INHALATION) COPD AGENTS GLAXOSMITHKLINE ARNUITY ELLIPTA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE BECONASE AQ (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE BREO ELLIPTA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE FLONASE OTC (NASAL) INTRANASAL RHINITIS AGENTS GLAXOSMITHKLINE FLOVENT DISKUS (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE FLOVENT HFA (INHALATION) GLUCOCORTICOIDS, INHALED GLAXOSMITHKLINE INCRUSE ELLIPTA (INHALATION) COPD AGENTS GLAXOSMITHKLINE SEREVENT (INHALATION) BRONCHODILATORS, BETA AGONIST GLAXOSMITHKLINE SORILUX (TOPICAL) ANTIPSORIATICS, TOPICAL GLAXOSMITHKLINE VENTOLIN HFA (INHALATION) BRONCHODILATORS, BETA AGONIST GLAXOSMITHKLINE VERAMYST (NASAL) INTRANASAL RHINITIS AGENTS HAWTHORN PHARM REZIRA SOLUTION (ORAL) COUGH AND COLD, NARCOTIC HAWTHORN PHARM VITUZ SOLUTION (ORAL) COUGH AND COLD, NARCOTIC HAWTHORN PHARM ZUTRIPRO SOLUTION (ORAL) COUGH AND COLD, NARCOTIC HILL DERM DERMA-SMOOTHE-FS (TOPICAL) STEROIDS, TOPICAL LOW INNOCUTIS HOLDI CNL 8 KIT (TOPICAL) ANTIFUNGALS, TOPICAL INNOCUTIS HOLDI SITAVIG (BUCCAL) ANTIVIRALS, ORAL JANSSEN PHARM. PANCREAZE (ORAL) PANCREATIC ENZYMES JANSSEN PHARM. SPORANOX SOLUTION (ORAL) ANTIFUNGALS, ORAL JANSSEN PHARM. XARELTO DOSE PACK (ORAL) ANTICOAGULANTS JAYMAC PHARMA J-MAX SYRUP OTC (ORAL) COUGH AND COLD, COLD JAYMAC PHARMA J-TAN D PD DROPS OTC (ORAL) COUGH AND COLD, COLD KENWOOD LAB. TYZINE SPRAY (NASAL) COUGH AND COLD, COLD LARKEN LABS LOHIST PEB DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS LOHIST-D LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS LOHIST-DM LIQUID (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS LOHIST-PEB LIQUID OTC (ORAL) COUGH AND COLD, COLD LARKEN LABS NOHIST-DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LARKEN LABS NOHIST-LQ LIQUID OTC (ORAL) COUGH AND COLD, COLD LASER DALLERGY DROPS OTC (ORAL) COUGH AND COLD, COLD LASER DALLERGY LIQUID OTC (ORAL) COUGH AND COLD, COLD LASER DALLERGY TABLET OTC (ORAL) COUGH AND COLD, COLD LASER DONATUSSIN LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LASER RESPAIRE-30 CAPSULE OTC (ORAL) COUGH AND COLD, COLD LEADER MUCUS DM MAX TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LEO PHARMA INC. TACLONEX OINTMENT (TOPICAL) ANTIPSORIATICS, TOPICAL LEO PHARMA INC. TACLONEX SCALP (TOPICAL) ANTIPSORIATICS, TOPICAL LLORENS PHARM CONEX SOLUTION OTC (ORAL) COUGH AND COLD, COLD LLORENS PHARM CONEX TABLET OTC (ORAL) COUGH AND COLD, COLD LLORENS PHARM TUSNEL C SYRUP OTC (ORAL) COUGH AND COLD, NARCOTIC LLORENS PHARM TUSNEL PEDIATRIC DROPS OTC (ORAL) COUGH AND COLD, COLD /Provider Synergies, L.L.C. Page 2 of 5
LLORENS PHARM TUSNEL PEDIATRIC LIQUID (ORAL) COUGH AND COLD, NON-NARCOTIC LLORENS PHARM TUSNEL PEDIATRIC LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LLORENS PHARM TUSNEL SOLUTION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LLORENS PHARM TUSNEL TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC LLORENS PHARM TUSNEL-DM PEDIATRIC DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC BP 8 COUGH ORAL SUSPENSION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC BPM/PSE/DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC BROM-PSE-DM SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MACOVEN PHARMAC TRIP-PSE LIQUID OTC (ORAL) COUGH AND COLD, COLD MAGNA PHARM STAHIST AD LIQUID OTC (ORAL) COUGH AND COLD, COLD MAGNA PHARM STAHIST AD TABLET OTC (ORAL) COUGH AND COLD, COLD MAGNA PHARM Z-TUSS AC OTC (ORAL) COUGH AND COLD, NARCOTIC MARNEL PHARM. MAR-COF BP LIQUID (ORAL) COUGH AND COLD, NARCOTIC MCR/AMERICAN PH ALLFEN DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MCR/AMERICAN PH MAXIPHEN DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC MCR/AMERICAN PH MAXIPHEN TABLET OTC (ORAL) COUGH AND COLD, COLD MEDA PHARMACEUT AEROSPAN (INHALATION) GLUCOCORTICOIDS, INHALED MEDA PHARMACEUT ASTEPRO (NASAL) INTRANASAL RHINITIS AGENTS MEDA PHARMACEUT DIPENTUM (ORAL) ULCERATIVE COLITIS AGENTS MEDA PHARMACEUT DYMISTA (NASAL) INTRANASAL RHINITIS AGENTS MEDA PHARMACEUT ROWASA (RECTAL) ULCERATIVE COLITIS AGENTS MEDA PHARMACEUT SFROWASA (RECTAL) ULCERATIVE COLITIS AGENTS MEDICIS DERM VANOS (TOPICAL) STEROIDS, TOPICAL HIGH MEDICIS DERM ZIANA (TOPICAL) ACNE AGENTS, TOPICAL MEDIMETRIKS PHA CLODAN KIT (TOPICAL) STEROIDS, TOPICAL VERY HIGH MEDIMETRIKS PHA KETODAN FOAM KIT (TOPICAL) ANTIFUNGALS, TOPICAL MEDIMETRIKS PHA NEUAC (TOPICAL) ACNE AGENTS, TOPICAL MEDIMETRIKS PHA NEUAC KIT (TOPICAL) ACNE AGENTS, TOPICAL MEDIMETRIKS PHA SYNALAR CREAM KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR OINTMENT KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MEDIMETRIKS PHA SYNALAR TS KIT (TOPICAL) STEROIDS, TOPICAL MEDIUM MERCK SHARP & D ASMANEX (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D ASMANEX HFA (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D CLARINEX SYRUP (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING MERCK SHARP & D CLARINEX-D 12 HOUR (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING MERCK SHARP & D DULERA (INHALATION) GLUCOCORTICOIDS, INHALED MERCK SHARP & D FORADIL (INHALATION) BRONCHODILATORS, BETA AGONIST MERCK SHARP & D NASONEX (NASAL) INTRANASAL RHINITIS AGENTS MERCK SHARP & D PROVENTIL HFA (INHALATION) BRONCHODILATORS, BETA AGONIST MERZ AQUA GLYCOLIC HC (TOPICAL) STEROIDS, TOPICAL LOW MERZ NAFTIN CREAM (TOPICAL) ANTIFUNGALS, TOPICAL MERZ NAFTIN GEL (TOPICAL) ANTIFUNGALS, TOPICAL MERZ ONMEL (ORAL) ANTIFUNGALS, ORAL MISSION PHARM. TEXACORT (TOPICAL) STEROIDS, TOPICAL LOW MORTON GROVE PH BROMFED DM SYRUP (ORAL) COUGH AND COLD, NON-NARCOTIC MYLAN MENTAX (TOPICAL) ANTIFUNGALS, TOPICAL MYLAN SPECIALTY EPIPEN (INTRAMUSC) EPINEPHRINE, SELF-INJECTED MYLAN SPECIALTY EPIPEN JR (INTRAMUSC) EPINEPHRINE, SELF-INJECTED MYLAN SPECIALTY PERFOROMIST (INHALATION) BRONCHODILATORS, BETA AGONIST NOVARTIS ARCAPTA NEOHALER (INHALATION) BRONCHODILATORS, BETA AGONIST NOVARTIS CHILD TRIAMINIC COUGH-CONGEST SYRUP OTC (ORAL) COUGH AND COLD, NON-NARCOTIC NOVARTIS LAMISIL AT GEL OTC (TOPICAL) ANTIFUNGALS, TOPICAL NOVARTIS LAMISIL GRANULES (ORAL) ANTIFUNGALS, ORAL NOVARTIS LAMISIL SPRAY OTC (TOPICAL) ANTIFUNGALS, TOPICAL NOVARTIS THERAFLU PACKET OTC (C) (ORAL) COUGH AND COLD, COLD NOVARTIS TOBI (INHALATION) ANTIBIOTICS, INHALED NOVARTIS TOBI PODHALER (INHALATION) ANTIBIOTICS, INHALED PARAPRO LLC NATROBA (TOPICAL) ANTIPARASITICS, TOPICAL PERNIX THERAPEU ALDEX GS DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PERNIX THERAPEU ALDEX GS TABLET OTC (ORAL) COUGH AND COLD, COLD PERNIX THERAPEU PEDIATEX TDM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PHARMADERM PANDEL (TOPICAL) STEROIDS, TOPICAL MEDIUM POLY PHARM. ALA-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. ALA-HIST IR TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. ALA-HIST PE TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. DECONEX DMX TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. DECONEX IR TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. DURAFLU TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY HIST FORTE TABLET OTC (ORAL) COUGH AND COLD, COLD POLY PHARM. POLY-HIST DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-HIST PD DROPS OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-TUSSIN AC LIQUID OTC (ORAL) COUGH AND COLD, NARCOTIC POLY PHARM. POLY-TUSSIN D LIQUID OTC (ORAL) COUGH AND COLD, NARCOTIC POLY PHARM. POLY-TUSSIN LIQUID OTC (ORAL) COUGH AND COLD, NARCOTIC POLY PHARM. POLY-VENT DM TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC POLY PHARM. POLY-VENT IR TABLET OTC (ORAL) COUGH AND COLD, COLD PRESTIUM PHARMA DENAVIR (TOPICAL) ANTIVIRALS, TOPICAL PRESTIUM PHARMA LUXIQ (TOPICAL) STEROIDS, TOPICAL MEDIUM /Provider Synergies, L.L.C. Page 3 of 5
PRESTIUM PHARMA VUSION (TOPICAL) ANTIFUNGALS, TOPICAL PROCTER&GAMBLE VICKS CHILDREN'S NYQUIL LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PROCTER&GAMBLE VICKS NATURE FUSION LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PROCTER&GAMBLE VICKS NYQUIL SEVERE COLD-FLU TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PROMIUS PHARMA CLODERM (TOPICAL) STEROIDS, TOPICAL MEDIUM PRO-PHARMA LLC PRO-CHLO LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC PRO-PHARMA LLC PRO-CLEAR AC LIQUID OTC (ORAL) COUGH AND COLD, NARCOTIC PRO-PHARMA LLC PRO-RED AC LIQUID (ORAL) COUGH AND COLD, NARCOTIC QUALITEST CODITUSS DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. CHLO HIST SOLUTION OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. CHLO TUSS EX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. CHLO TUSS LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. M-CLEAR WC LIQUID (ORAL) COUGH AND COLD, NARCOTIC R.A.MC NEIL CO. M-END DMX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC R.A.MC NEIL CO. M-END MAX D LIQUID (ORAL) COUGH AND COLD, NARCOTIC R.A.MC NEIL CO. M-END PE LIQUID (ORAL) COUGH AND COLD, NARCOTIC RANBAXY LABORAT EURAX CREAM (TOPICAL) ANTIPARASITICS, TOPICAL RANBAXY LABORAT EURAX LOTION (TOPICAL) ANTIPARASITICS, TOPICAL RANBAXY LABORAT EXELDERM CREAM (TOPICAL) ANTIFUNGALS, TOPICAL RANBAXY LABORAT EXELDERM SOLUTION (TOPICAL) ANTIFUNGALS, TOPICAL RANBAXY LABORAT HALOG CREAM (TOPICAL) STEROIDS, TOPICAL HIGH RANBAXY LABORAT HALOG OINTMENT (TOPICAL) STEROIDS, TOPICAL HIGH RANBAXY LABORAT KENALOG AEROSOL (TOPICAL) STEROIDS, TOPICAL HIGH RANBAXY LABORAT ULTRAVATE X PAC CREAM (TOPICAL) STEROIDS, TOPICAL VERY HIGH RANBAXY LABORAT ULTRAVATE X PAC OINTMENT (TOPICAL) STEROIDS, TOPICAL VERY HIGH RECKITT BENCKIS CHILD DELSYM COUGH+COLD LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS CHILDREN'S MUCINEX LIQUID OTC (C) (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS CHILDREN'S MUCINEX LIQUID OTC (NN) (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM COUGH & COLD LIQUID OTC (C) (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS DELSYM COUGH & COLD LIQUID OTC (NN) (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM COUGH RELIEF PLUS LOZENGE OTC (MUCOUS MEMBRANE) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS DELSYM SUSPENSION ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX COLD & SINUS LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX COLD-FLU & SORE THROAT LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX COUGH GRAN PACK OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX D TABLET ER 12H OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX DM TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX DM TABLET ER 12H OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX ER TABLET OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX COLD-FLU TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX COLD-SINUS TABLET OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX CONGEST-COLD TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX CONGEST-COUGH TABLET OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX DM MAX LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX FAST-MAX NITE COLD-FLU LIQUID OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX FAST-MAX SEVERE COLD LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX GRAN PACK OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SEVERE CONGEST-COUGH LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC RECKITT BENCKIS MUCINEX SINUS-MAX SPRAY OTC (NASAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX DAY-NIGHT TABLET SEQUELS OTC (ORAL) COUGH AND COLD, COLD RECKITT BENCKIS MUCINEX SINUS-MAX TABLET OTC (ORAL) COUGH AND COLD, COLD SALIX PHARMACEU APRISO (ORAL) ULCERATIVE COLITIS AGENTS SALIX PHARMACEU GIAZO (ORAL) ULCERATIVE COLITIS AGENTS SALIX PHARMACEU UCERIS (RECTAL) ULCERATIVE COLITIS AGENTS SALLUS LABORATO LORTUSS DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC SALLUS LABORATO LORTUSS LQ LIQUID OTC (ORAL) COUGH AND COLD, COLD SANDOZ APEXICON E (TOPICAL) STEROIDS, TOPICAL VERY HIGH SANDOZ OXISTAT CREAM (TOPICAL) ANTIFUNGALS, TOPICAL SANDOZ OXISTAT LOTION (TOPICAL) ANTIFUNGALS, TOPICAL SANOFI-AVENTIS AUVI-Q (INTRAMUSC) EPINEPHRINE, SELF-INJECTED SANOFI-PASTEUR SKLICE (TOPICAL) ANTIPARASITICS, TOPICAL SANTARUS INC. UCERIS (ORAL) ULCERATIVE COLITIS AGENTS SEVEN OAKS BENSAL HP (TOPICAL) ANTIFUNGALS, TOPICAL SHIRE US INC. LIALDA (ORAL) ULCERATIVE COLITIS AGENTS SHIRE US INC. PENTASA (ORAL) ULCERATIVE COLITIS AGENTS STIEFEL LABS. FABIOR (TOPICAL) ACNE AGENTS, TOPICAL STIEFEL LABS. VELTIN (TOPICAL) ACNE AGENTS, TOPICAL SUCAMPO PHARMA RESCULA (OPHTHALMIC) OPHTHALMICS, GLAUCOMA AGENTS SUNOVION PHARMA ALVESCO (INHALATION) GLUCOCORTICOIDS, INHALED SUNOVION PHARMA BROVANA (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA OMNARIS (NASAL) INTRANASAL RHINITIS AGENTS SUNOVION PHARMA XOPENEX HFA (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA XOPENEX NEB SOLN (INHALATION) BRONCHODILATORS, BETA AGONIST SUNOVION PHARMA ZETONNA (NASAL) INTRANASAL RHINITIS AGENTS TARO PHARM USA TOPICORT SPRAY (TOPICAL) STEROIDS, TOPICAL HIGH TEVA SPECIALTY PROAIR HFA (INHALATION) BRONCHODILATORS, BETA AGONIST TEVA SPECIALTY QNASL (NASAL) INTRANASAL RHINITIS AGENTS TEVA SPECIALTY QVAR (INHALATION) GLUCOCORTICOIDS, INHALED /Provider Synergies, L.L.C. Page 4 of 5
UCB PHARMA XYZAL SOLUTION (ORAL) ANTIHISTAMINES, MINIMALLY SEDATING UPSHER SMITH VOGELXO GEL (TRANSDERM) ANDROGENIC AGENTS UPSHER SMITH VOGELXO GEL PACKET (TRANSDERM) ANDROGENIC AGENTS UPSHER SMITH VOGELXO GEL PUMP (TRANSDERM) ANDROGENIC AGENTS US PHARMACEUTIC NOREL AD TABLET OTC (ORAL) COUGH AND COLD, COLD US PHARMACEUTIC NOREL CS LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC VALEANT ACANYA W/PUMP (TOPICAL) ACNE AGENTS, TOPICAL VALEANT ATRALIN (TOPICAL) ACNE AGENTS, TOPICAL VALEANT BENZACLIN (TOPICAL) ACNE AGENTS, TOPICAL VALEANT BENZACLIN W/PUMP (TOPICAL) ACNE AGENTS, TOPICAL VALEANT ELIDEL (TOPICAL) IMMUNOMODULATORS, ATOPIC DERMATITIS VALEANT ERTACZO (TOPICAL) ANTIFUNGALS, TOPICAL VALEANT FUNGOID KIT OTC (TOPICAL) ANTIFUNGALS, TOPICAL VALEANT GRIFULVIN V TABLETS (ORAL) ANTIFUNGALS, ORAL VALEANT GRIS-PEG (ORAL) ANTIFUNGALS, ORAL VALEANT JUBLIA (TOPICAL) ANTIFUNGALS, TOPICAL VALEANT LUZU (TOPICAL) ANTIFUNGALS, TOPICAL VALEANT ONEXTON W/PUMP (TOPICAL) ACNE AGENTS, TOPICAL VALEANT RETIN-A MICRO 0.04%, 0.1% (TOPICAL) ACNE AGENTS, TOPICAL VALEANT RETIN-A MICRO 0.04%, 0.1% PUMP (TOPICAL) ACNE AGENTS, TOPICAL VALEANT RETIN-A MICRO 0.08% PUMP (TOPICAL) ACNE AGENTS, TOPICAL VALEANT TUSSICAPS CAPSULE ER 12H (ORAL) COUGH AND COLD, NARCOTIC VALEANT XERESE (TOPICAL) ANTIVIRALS, TOPICAL VALEANT ZOVIRAX CREAM (TOPICAL) ANTIVIRALS, TOPICAL VALEANT ZOVIRAX OINTMENT (TOPICAL) ANTIVIRALS, TOPICAL VERTICAL PHARM ZONATUSS CAPSULE (ORAL) COUGH AND COLD, NON-NARCOTIC WATSON PHARMA ANDRODERM (TRANSDERM) ANDROGENIC AGENTS WATSON PHARMA CORDRAN TAPE (TOPICAL) STEROIDS, TOPICAL MEDIUM WC PROF PRODS ASACOL HD (ORAL) ULCERATIVE COLITIS AGENTS WYETH CONSUMER ADT ROBITUSSIN COUGH-COLD-FLU LIQUID OTC (ORAL) COUGH AND COLD, COLD WYETH CONSUMER ADVIL COLD & SINUS CAPSULE OTC (ORAL) COUGH AND COLD, COLD WYETH CONSUMER ADVIL CONGESTION RELIEF TABLET OTC (ORAL) COUGH AND COLD, COLD WYETH CONSUMER DIMETAPP LONG-ACTING LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC WYETH CONSUMER ROBITUSSIN COUGH & COLD CF LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC WYETH CONSUMER ROBITUSSIN LONG-ACTING LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC WYETH CONSUMER ROBITUSSIN NIGHTTIME COUGH DM LIQUID OTC (ORAL) COUGH AND COLD, NON-NARCOTIC X-GEN PHARMACEU PANCRELIPASE (AG) (ORAL) PANCREATIC ENZYMES ZYLERA ULESFIA (TOPICAL) ANTIPARASITICS, TOPICAL /Provider Synergies, L.L.C. Page 5 of 5