Back to Client Corner

Excluded and Special Authorization

Date modified:  October 2020

 

DIN Name Status
2046733 PULMOZYME 2.5mL AMP. Excluded
1985205 CREON-25 CAP Excluded
2200104 CREON 10 CAP Excluded
2239007 CREON - 5 CAP * Excluded
2239008 CREON- 20 CAP * Excluded
591548 PANCREASE 4000/20000/25000 USP ENT CAP Excluded
443239 VIOKASE TABLET-BEEF ROBIN Excluded
443247 VIOKASE POWDER-BEEF ROBIN Excluded
2239630 TOBI 300MG/5ML INH SOLN Excluded
745626 HUMATROPE INJ 1mg/mL 5mL Excluded
2243077 HUMATROPE 6.7MG INJ Excluded
2243078 HUMATROPE 12MG INJ Excluded
2243079 HUMATROPE 24MG INJ Excluded
2325055 OMNITROPE 5.8MG/VIAL INJ. Excluded
2325063 OMNITROPE 5MG/1.5ML CARTRIDGE Excluded
2325071 OMNITROPE 10MG/1.5ML CARTRIDGE Excluded
2216183 NUTROPIN 5mg INJ Excluded
2216191 NUTROPIN 10mg INJ Excluded
2229722 NUTROPIN AQ 5MG/ML Excluded
2248002 NUTROPIN AQ PEN 5MG/ML Excluded
2249002 NUTROPIN AQ PEN 5MG/ML Excluded
2215136 SAIZEN 3.3mg INJ Excluded
2237971 SAIZEN VIAL 5MG Excluded
2272083 SAIZEN 8.8MG Excluded
2239046 SEROSTIM 5MG INJ Excluded
2239047 SEROSTIM 6MG INJ Excluded
2192683 3TC 150mg Tab (lamivudine) Excluded
2247825 3TC 300MG Excluded
2192691 3TC Oral Soln 10mg/mL (lamivudine)* Excluded
1946323 APO-ZIDOVUDINE 100mg CAP Excluded
2273322 APTIVUS 250MG CAP (SECOND LINE THERAPY) Excluded
2300699 ATRIPLA TAB Excluded
2299852 CELSENTRI 300MG TAB Excluded
2239213 Combivir Tab * Excluded
2229161 Crixivan 200mg Tab Excluded
2229196 Crixivan 400mg Tab Excluded
2162695 CYTOVENE 500MG INJ Excluded
2247725 FUZEON INJ (SECOND LINE THERAPY) Excluded
2239193 HEPTOVIR 100 MG TAB* Excluded
2306778 INTELENCE 100 MG TAB (SECOND LINE THER) Excluded
2216965 Invirase 200mg Cap Excluded
2279320 INVIRASE 500MG TAB Excluded
2301881 ISENTRESS 400MG TAB Excluded
2312301 KALETRA 100MG/25MG Excluded
2285533 KALETRA 200/50MG TAB Excluded
2243644 Kaletra Soln 80/20mg Excluded
2269341 KIVEXA Excluded
2229137 NORVIR 100MG CAP * Excluded
2229145 Norvir 80mg/ml o/l Excluded
2241480 Norvir SEC 100mg Cap Excluded
2324016 PREZISTA 400MG Excluded
2324024 PREZISTA TAB Excluded
2238348 Rescriptor 100mg Tab Excluded
1902660 RETROVIR 100MG CAP Excluded
1902644 RETROVIR INJ. 10MG/ML Excluded
1902652 RETROVIR SYR 10MG Excluded
2248610 REYATAZ 150MG CAP Excluded
2248611 REYATAZ 200MG CAP Excluded
2294176 REYATAZ 300MG CAPS Excluded
2288389 SEBIVO 600MG TAB Excluded
2239887 Sustiva 100mg Cap (DISC FEV 29) Excluded
2239888 Sustiva 200mg Cap Excluded
2239886 Sustiva 50mg Cap Excluded
2246045 SUSTIVA 600MG Excluded
2261553 TELZIR 50mg/ml Excluded
2261545 TELZIR 700MG TAB Excluded
2244757 TRIZIVIR COMBO TAB Excluded
2274906 TRUVADA TABLET Excluded
2245777 Valcyte 450mg Tab (DISC DEC.04) Excluded
1940538 VIDEX 50MG TAB Excluded
2244596 VIDEX EC 125MG  CAPS Excluded
2244597 VIDEX EC 200MG CAPS Excluded
2244598 VIDEX EC 250MG CAPS Excluded
2244599 VIDEX EC 400 MG CAPS Excluded
2238617 Viracept 250mg Tab Excluded
2238618 Viracept 50mg/g Oral Pwd.(DISC MAR/06) Excluded
2248761 VIRACEPT 625MG TAB Excluded
2238748 Viramune 200mg Tab Excluded
2247128 VIREAD  (NEW HIV MED) Excluded
2216086 Zerit 15mg Cap Excluded
2216094 Zerit 20mg Cap Excluded
2216108 Zerit 30mg Cap Excluded
2216116 Zerit 40mg Cap Excluded
2240358 Ziagen 20mg/ml O/L Excluded
2240357 Ziagen 300mg Tab Excluded
2269201 AVONEX PS 30MCG/0.5ML PRE-FILLED SYR Excluded
2237318 REBIF 44MCG LYOPHILIZED PWD INJ Excluded
2237319 REBIF 22MCG INJ.(MAX QTY/SYR) Excluded
2237320 REBIF 44MCG INJ(MAX QTY/SYR) Excluded
2281708 REBIF INITIATION PACK (6x22 + 6x8.8) Excluded
2308261 REBIF INITIATION PACK Excluded
2318253 REBIF MULTI-DOSE CART. 22GD/DOSE Excluded
2318261 REBIF MULTI-DOSE CART. 44PG/DOSE Excluded
2318288 REBIF MULTI-DOSE CART. INI. PCK Excluded
2169649 BETASERON  1ML INJ Excluded
2233014 COPAXONE 20MG INJ (DISC 10/04) Excluded
2245619 COPAXONE 20MG/ML PRE FILLED SYRINGE Excluded
2286386 TYSABRI 300MG/15ML Excluded
2337819 Extavia Excluded
593257 SANDIMMUNE IV             Excluded
950792 NEORAL 10MG CAP Excluded
950793 NEORAL 25mg CAP Excluded
950807 NEORAL 50mg CAP Excluded
950815 NEORAL 100MG CAP Excluded
950823 NEORAL 100mg/ml SYRUP Excluded
2041731 CYCLOSPASMOL 400mg TAB Excluded
2175983 PROGRAF 5MG CAP Excluded
2175991 PROGRAF 1MG CAP (Tacholimus, FK506) Excluded
2176009 PROGRAF 5mg/ml AMP Excluded
2192748 CELLCEPT CAP 250 mg                Excluded
2237484 CELLCEPT 500 MG CAP* Excluded
2237671 NEORAL 10MG CAP Excluded
2240347 CELLCEPT I.V.             Excluded
2242145 CELLCEPT 200MG/ML Excluded
2242815 SIMULECT 20MG/ML IV Excluded
2242821 SANDOZ-CYCLOSPORINE 100MG CAPS Excluded
2243144 PROGRAF CAMP .5MG Excluded
2243237 RAPAMUNE 1MG/ML ORAL SOLUTION Excluded
2244324 APO-CYCLOSPORINE 100MG/ML SYR Excluded
2247073 SANDOZ-CYCLOSPORINE 25MG Excluded
2247074 SANDOZ-CYCLOSPORINE 50MG Excluded
2247111 RAPAMUNE 1MG TAB Excluded
2264560 MYFORTIC 180MG TAB Excluded
2264579 MYFORTIC 360MG TAB Excluded
2296462 ADVAGRAF 0.5 MG CAP Excluded
2296470 ADVAGRAF 1 MG CAP Excluded
2296489 ADVAGRAF 5 MG CAP Excluded
2304104 TORISEL 25MG/ML INJ Excluded
22470740 SANDOZ-CYCLOSPORINE50MG Excluded
99004372 RAPAMUNE 1MG/ML ORAL SOLN (1ML) Excluded
99004380 RAPAMUNE 1MG/ML ORAL SOLN (2ML) Excluded
99004399 RAPAMUNE 1MG/ML ORAL SOLN (5ML) Excluded
2283395 SOMATULINE AUTOGEL 60mg/0.3mL SYRINGE Special Authorization
2283409 SOMATULINE AUTOGEL 90mg/0.3mL SYRINGE Special Authorization
2283417 SOMATULINE AUTOGEL 120mg/0.3mL SYRINGE Special Authorization
705896 INTRON A 3 Mill. IU/6 x 3mL              Special Authorization
705918 INTRON A 5 Mill. IU/6 x 5mL              Special Authorization
705926 INTRON A 10 Mill. IU/6 x 10mL            Special Authorization
839191 SANDOSTATIN Special Authorization
839205 SANDOSTATIN Special Authorization
839213 SANDOSTATIN Special Authorization
875880 EPREX INJ 4000u/mL 1mL VIAL              Special Authorization
875899 EPREX INJ 10,000u/mL 1mL VIAL            Special Authorization
889067 INTRON A PD INJ 5Meg 2&5mL               Special Authorization
913898 ARANESP 30MCG PREF SYR                   Special Authorization
999001 NEUPOGEN 300MCG/ML 1.6ML PK              Special Authorization
1959263 PROTROPIN 5MG INJ                        Special Authorization
1968017 NEUPOGEN 300MCG/ML PK 1ML                Special Authorization
1981501 BOTOX OCCULINUM 100U INJ                 Special Authorization
2049392 SANDOSTATIN Special Authorization
2204576 PROTROPIN 10MG/ML INJ                    Special Authorization
2204584 PROTROPIN 5MG/ML INJ                     Special Authorization
2206072 EPREX INJ 20,000u/mL 1mL VIAL            Special Authorization
2223406 INTRON A I.U. INJ.                       Special Authorization
2231583 EPREX 1000IU/.5ML PRE-FILLED SYR         Special Authorization
2231584 EPREX 2000IU/.5ML PRE-FILLED SYR         Special Authorization
2231585 EPREX 3000IU/ML PRE-FILLED INJ           Special Authorization
2231586 EPREX 4000IU/ML PRE-FILLED INJ           Special Authorization
2231587 EPREX 10000IU/ML PRE-FILLED SYR          Special Authorization
2231651 INTRON A 18 MILL. INJ                    Special Authorization
2238453 XELODA 150MG TAB*                        Special Authorization
2238454 XELODA 500MG TAB*                        Special Authorization
2238674 INTRON A 3ML VIAL INJ PK                 Special Authorization
2238675 INTRON A 5MU/VIAL INJ 0.5ML PK           Special Authorization
2239323 SANDOSTATIN Special Authorization
2239324 SANDOSTATIN Special Authorization
2239325 SANDOSTATIN Special Authorization
2239832 INFERGEN 0.03MG/ML INJ                   Special Authorization
2240693 INTRON A 15X 10IU/ML PREFILL SYR         Special Authorization
2240694 INTRON A 25X10IU/ML PREFILLED SYR        Special Authorization
2240695 INTRON A 50X10IU/ML PREFILLED SYR        Special Authorization
2240722 EPREX INJ 40,000U/ML 1ML VIAL            Special Authorization
2241093 TEMODAL 5MG CAP                          Special Authorization
2241094 TEMODAL 20MG CAP*                        Special Authorization
2241095 TEMODAL 100MG CAP                        Special Authorization
2241096 TEMODAL 250MG CAP                        Special Authorization
2242367 VISUDYNE 2MG/ML INJ                      Special Authorization
2242903 ENBREL 25MG INJ                          Special Authorization
2242966 UNITRON-PEG INJ 74UG/VIAL                Special Authorization
2242967 UNITRON-PEG INJ 118.4UG/VIAL             Special Authorization
2242968 UNITRON-PEG INJ 177.6UG/VIAL             Special Authorization
2242969 UNITRON-PEG INJ 222UG/VIAL               Special Authorization
2243239 EPREX 20,000 IU/0.5ML PRE-FILLED SYR     Special Authorization
2243400 EPREX 5000U/0.5ML INJ                    Special Authorization
2243401 EPREX 6000IU/0.6ML PREFILLED SYR         Special Authorization
2243403 EPREX PREFILLED SYR 6/8000IU .8ML        Special Authorization
2244016 REMICADE 100MG 20ML VIAL INJ             Special Authorization
2244725 GLEEVEC 100MG CAP                        Special Authorization
2244981 TRACLEER 62.5MG FILM COATED TAB          Special Authorization
2244982 TRACLEER 125MG FILM COATED TAB           Special Authorization
2245913 KINERET 100MG/0.67ML PREFILLED SYR       Special Authorization
2246016 THYROGEN INJ. 09MG/ML 2 VIAL KIT        Special Authorization
2246026 PEGETRON 50MCG/800MG COMBO               Special Authorization
2246027 PEGETRON 80MCG/800MG COMBO               Special Authorization
2246028 PEGETRON 100MCG/1000MG COMBO             Special Authorization
2246029 PEGETRON 120MCG/1000MG COMBO             Special Authorization
2246030 PEGETRON 150MCG/1200MG COMBO             Special Authorization
2246226 FLUDARA 10MG TAB                         Special Authorization
2246355 ARANESP 20MCG PREF SYR                   Special Authorization
2246357 ARANESP 30MCG PREF SYR                   Special Authorization
2246358 ARANESP 60MCG PREF SYR                   Special Authorization
2246360 ARANESP 150MCG PREF SYR                  Special Authorization
2247823 HEPSERA 10MG TAB                         Special Authorization
2248077 PEGASYS 180MCG/0.5ML VIAL INJ            Special Authorization
2248078 PEGASYS 180MCG/1.0ML VIAL INJ            Special Authorization
2248624 FASLODEX 250MG/5ML                       Special Authorization
2248639 SANDOSTATIN Special Authorization
2248640 SANDOSTATIN Special Authorization
2248641 SANDOSTATIN Special Authorization
2248642 SANDOSTATIN Special Authorization
2248676 IRESSA 250MG TAB                         Special Authorization
2249790 NEULASTA 6MG 10MG/ML                     Special Authorization
2253275 GLEEVEC 100MG TAB                        Special Authorization
2253283 GLEEVEC 400 MG TAB                       Special Authorization
2253410 PEGASYS RBV 180MCG/ML                    Special Authorization
2253429 PEGASYS RBV 180MCG/0.5ML                 Special Authorization
2254573 REDIPEN 50MCG/0.5ML INJ                  Special Authorization
2254581 REDIPEN 80MCG/0.5ML INJ                  Special Authorization
2254603 REDIPEN 100MCG/0.5ML INJ                 Special Authorization
2254638 REDIPEN 120MCG/0.5ML INJ                 Special Authorization
2254646 REDIPEN 150MCG/0.5ML INJ                 Special Authorization
2254689 FORTEO 250 MCG/ML                        Special Authorization
2256460 VFEND 50MG TAB                           Special Authorization
2256479 VFEND 200MG TAB                          Special Authorization
2257130 SENSIPAR 30MG TAB                        Special Authorization
2257149 SENSIPAR 60 MG TAB                       Special Authorization
2257157 SENSIPAR 90MG TAB                        Special Authorization
2258595 HUMIRA 40MG/0.8ML                        Special Authorization
2258986 AMEVIVE 7.5MG/0.5ML INJ                  Special Authorization
2259052 AMEVIVE 15MG/0.5ML                       Special Authorization
2260565 XOLAIR 150MG VIAL                        Special Authorization
2266121 SATIVEX BUCCAL SPRAY                     Special Authorization
2267225 MACUGEN 0.3MG PRE-FILLED SYRINGE         Special Authorization
2269015 TARCEVA 100MG                            Special Authorization
2269023 TARCEVA 150MG                            Special Authorization
2272199 SOMAVERT 10MG/VIAL INJ                   Special Authorization
2272202 SOMAVERT 15MG/VIAL                       Special Authorization
2272210 SOMAVERT 20MG/VIAL INJ                   Special Authorization
2274728 ENBREL 50 MG PRE-FILLED SYRINGE          Special Authorization
2280795 SUTENT  12.5 MG CAPSULE                  Special Authorization
2280809 SUTENT  25 MG CAPSULE                    Special Authorization
2280817 SUTENT  50 MG CAPSULE                    Special Authorization
2282097 ORENCIA                                  Special Authorization
2282224 BARACLUDE 0.5 MG TABLET                  Special Authorization
2282232 BARACLUDE 0.05MG/ML ORAL SOL.            Special Authorization
2284227 NEXAVAR 200 MG TABLET                    Special Authorization
9853464 NEUPOGEN 300MCG/ML 1.6ML PK              Special Authorization
9854053 INTRON A 25MU/VIAL INJ 2.5ML PK          Special Authorization
99003155 REBETRON (84) 200MG-6MILLION UI/MLQUEBEC Special Authorization
99003457 REBETRON (84)200MG-15MILLIONUI/MLQUEBEC  Special Authorization
99004917 ARANESP 40MCG PREF SYR                   Special Authorization
99004925 ARANESP 50MCG PREF SYR                   Special Authorization
99100172 PEGASYS RBV 180MCG/ML (35)               Special Authorization
99100173 PEGASYS RBV 180MCG/0.5ML (42)            Special Authorization
99100174 PEGASYS RBV 180MCG/ML (42)               Special Authorization
99100209 ARANESP 200MCG/0.4ML                     Special Authorization
99100210 ARANESP 300MCG                           Special Authorization
99100211 ARANESP 500MCG/1.0ML                     Special Authorization
99900011 ARANESP 40MCG PREF SYR                   Special Authorization
99900012 ARANESP 50MCG PREF SYR                   Special Authorization
99900013 ARANESP 80MCG PREF SYR                   Special Authorization
99900014 ARANESP 100MCG PREF SYR                  Special Authorization
2269007 TARCEVA 25mg tablet Special Authorization
2293129 SPRYCEL 20mg tablet Special Authorization
2293137 SPRYCEL 50mg tablet Special Authorization
2293145 SPRYCEL 70mg tablet Special Authorization
2268272 XYREM 500mg/mL ORAL SOLUTION Special Authorization
2293404 SPRIAFIL ORAL SUSPENSION Special Authorization
2292165 DUODOPA INTESTINAL GEL Special Authorization
2296810 LUCENTIS 10mg/mL INJ. Special Authorization
2299844 CELSENTRI 150MG Tablet Special Authorization
2307065 Volibris tablet 5mg Special Authorization
2307073 Volibris tablet 10mg Special Authorization
99100385 Humira 40mg Pen Special Authorization
2242763 Rilutek Special Authorization
2279401 Revatio Special Authorization
2308215 Relistor injection Special Authorization
2306085 VALCYTE 50mg/mL POWDER FOR ORAL SOLUTION Excluded
2315874 TASIGNA 200MG TAB Special Authorization
2288680 EPREX 30000UNIT/ 0.75ML Special Authorization
2320673 STELARA Special Authorization
2324032 XEOMIN Special Authorization
2326442 Tykerb Special Authorization
2320193 Sprycel 100mg tablets Special Authorization
2324776 Simponi pre-filled syringes Special Authorization
2324784 Simponi autoinjector Special Authorization
2331675 Cimzia 200mg pre-filled syringes Special Authorization
2327619 Zolinza 100 mg Special Authorization
2336707 Vidaza Special Authorization
2338327 Adcirca 20 mg                                      Special Authorization
2329840 Cayston Special Authorization
2339528 Afinitor 10mg Special Authorization
2338432 Prezista 75mg Special Authorization
2339501 Afinitor 5 mg Special Authorization
2344939 Ilaris 150 mg Special Authorization
99020672 Stelara 45 mg prefilled syringes Special Authorization
908436 NEUPOGEN 1.6MCG/ML INJ Special Authorization
2246354 ARANESP 10MCG PREF SYR Special Authorization
99001454 NEUPOGEN 300MG/ML PK 1.6ML Special Authorization
2350580 Kuvan 100 mg Special Authorization
2350092 Actemra 80 mg/4 ml Special Authorization
2350106 Actemra 200 mg/10 ml Special Authorization
2350114 Actemra 400 mg/20 ml Special Authorization
2312816 Temodal 180 mg Special Authorization
2312794 Temodal 140 mg Special Authorization
2350122 Saizen 6 mg Special Authorization
2350130 Saizen 12 mg Special Authorization
2350149 Saizen 20 mg Special Authorization
2317699 Revlimid 15 mg Special Authorization
2317710 Revlimid 25 mg Special Authorization
2304899 Revlimid 5 mg Special Authorization
2304902 Revlimid 10 mg Special Authorization
2319500 RATIO-SILDENAFIL R 20mg Special Authorization
2355191 Thalomid 50mg Special Authorization
2337649 Toctino 30mg Special Authorization
2352303 Votrient 200mg Special Authorization
2357593 Norvir  Excluded
2360829 Sprycel 140mg Special Authorization
2365480 Gilenya Excluded
2361825 Revolade 25mg Special Authorization
2361833 Revolade 50mg Special Authorization
9857386 BOTOX OCCULINUM 50u/vial - ODB Pseudo DIN Special Authorization
9857387 BOTOX OCCULINUM 200u/vial - ODB Pseudo DIN Special Authorization
99100763 Avonex - Quebec Pseudo Din Excluded
2337630 Toctino 10mg Special Authorization
2370816 Victrelis Special Authorization
2306980 Retisert Special Authorization
2365154 TOBI PODHALER Excluded
2371065 Zytiga 250mg Special Authorization
2368250 Tasigna 150mg Special Authorization
2371448 Victrelis Triple (combo with Pegetron Redipen 80mcg + 56 caps) Special Authorization
2371456 Victrelis Triple (combo with Pegetron Redipen 100mcg + 56 caps) Special Authorization
2371464 Victrelis Triple (combo with Pegetron Redipen 120mcg + 70 caps) Special Authorization
2371472 Victrelis Triple (combo with Pegetron Redipen 150mcg + 84 or 98 caps) Special Authorization
2370050 Benlysta 120mg/5ml Special Authorization
2370069 Benlysta 400mg/20ml Special Authorization
2369257 AFINITOR 2.5MG Special Authorization
2374129 COMPLERA Excluded
2371553 INCIVEK Special Authorization
2370603 EDURANT Excluded
2241927 RITUXAN Special Authorization
9857187 ARANESP 500MCG/1ML Special Authorization
9857186 ARANESP 300MCG/0.6ML Special Authorization
9857185 ARANESP 200MCG/0.4ML Special Authorization
2355205 Thalomid 100mg Special Authorization
2355221 Thalomid 200mg Special Authorization
2378582 Caprelsa 100mg Special Authorization
2378590 Caprelsa 300mg Special Authorization
2379910 Fampyra 10mg Excluded
2375931 Intelence 200mg (second-Line therapy) Excluded
2386275 Sandoz-Bosentan 62.5mg Special Authorization
2386283 Sandoz-Bosentan 125MG Special Authorization
2383497 Mylan-Bosentan 62.5mg Special Authorization
2383500 Mylan-Bosentan 125mg Special Authorization
2386194 Co-Bosentan 62.5mg Special Authorization
2386208 Co-Bosentan 125mg Special Authorization
2383012 Pms-Bosentan 62.5mg Special Authorization
2383020 Pms-Bosentan 125mg Special Authorization
2376393 Nutropin AQ NuSpin Excluded
2360810 Sprycel 80mg Special Authorization
2377225 Mozobil Special Authorization
99100373 ENBREL 50 MG PRE-FILLED SYRINGE          Special Authorization
2389630 Inlyta 1mg Special Authorization
2389649 Inlyta 5mg Special Authorization
2388006 Jakavi 5mg Special Authorization
2388014 Jakavi 15mg Special Authorization
2388022 Jakavi 20mg Special Authorization
2389819 Ahi-Temozolomide 20mg Special Authorization
2389827 Ahi-Temozolomide 100mg Special Authorization
2389835 Ahi-Temozolomide 140mg Special Authorization
2389843 Ahi-Temozolomide 180mg Special Authorization
2389851 Ahi-Temozolomide 250mg Special Authorization
2369753 Prezista 150mg Excluded
2380242 Zelboraf Special Authorization
2393050 Prezista 800 mg  Excluded
2397137 Stribild Excluded
2396955 APO-ENTECAVIR Special Authorization
2393751 ESBRIET Special Authorization
2320681 STELARA 90MG Special Authorization
2371081 Xeomin 50 Special Authorization
2403390 Stivarga 40mg Special Authorization
2392429 Isentress 25mg Excluded
2392437 Isentress 25mg Excluded
2355337 Apo-Imatinib 100mg Special Authorization
2399806 Teva-Imatinib 100mg Special Authorization
2355345 Apo-Imatinib 400mg Special Authorization
2399814 Teva-Imatinib 400mg Special Authorization
2404508 Tecfidera Excluded
2407329 Xtandi Special Authorization
2388316 Xiaflex Special Authorization
2402475 Orencia SC Injection Special Authorization
2409267 Erivedge Special Authorization
2393824 Apo-Valganciclovir 450mg Excluded
2395274 CO-TEMOZOLOMIDE 20MG CAP Special Authorization
2395282 CO-TEMOZOLOMIDE 100MG CAP Special Authorization
2395290 CO-TEMOZOLOMIDE 140MG CAP Special Authorization
2395312 CO-TEMOZOLOMIDE 250MG CAP Special Authorization
2409623 Mekinist 0.5mg Special Authorization
2409658 Mekinist 2mg Special Authorization
2409607 Tafinlar 50mg Special Authorization
2409615 Tafinlar 75mg Special Authorization
9857394 Enbrel (Pseudo DIN for Ontario) Special Authorization
2412764 Adempas 0.5mg Special Authorization
2412772 Adempas 1mg Special Authorization
2412799 Adempas 1.5mg Special Authorization
2412802 Adempas 2mg Special Authorization
2412810 Adempas 2.5mg Special Authorization
2381524 MYLAN-EFAVIRENZ 600MG TAB Excluded
2416441 Galexos 150mg  Special Authorization
2414945 Tivicay 50mg  Excluded
2400022 TEVA-CAPECITABINE 150MG TAB Special Authorization
2400030 TEVA-CAPECITABINE 500 MG TAB Special Authorization
2389762 TEVA-EFAVIRENZ 600MG TAB Excluded
2416328 Aubagio 14MG Excluded
2417472 Simponi IV 50MG/4.0ML Special Authorization
2410702 Zaxine 550MG Special Authorization
2401703 GENOTROPIN-GOQUICK PREFILLED PEN 5.3MG Excluded
2401789 GENOTROPIN-MINIQUICKPREFILLED SYRINGE 1.0MG Excluded
2401711 GENOTROPIN-GOQUICK PREFILLED PEN 12MG Excluded
2401762 GENOTROPIN-MINIQUICK PREFILLED SYR. 0.6MG Excluded
2401770 GENOTROPIN-MINIQUICK PREFILLED SYR. 0.8MG Excluded
2401797 GENOTROPIN-MIMIQUICK PREFILLED SYR.1.2MG Excluded
2401800 GENOTROPIN-MINIQUICK PREFILLED SYR. 1.4MG Excluded
2401819 GENOTROPIN-MINIQUICK PREFILLED SYR. 1.6MG Excluded
2401827 GENOTROPIN-MINIQUICK PREFILLED SYR. 1.8MG Excluded
2401835 GENOTROPIN-MINIQUICK PREFILLED SYR. 2.0MG Excluded
2413175 SIMPONI PREFILLED SYR. 100MG/1.0ML Special Authorization
2413183 SIMPONI AUTOINJECTOR 100MG/1.0ML Special Authorization
99100982 GLEEVEC 400MG TAB Special Authorization
99100983 GLEEVEC 100MG TAB Special Authorization
2391821 ARANESP 300MCG/0.6ML SINGLEJECT Special Authorization
2415992 Eylea 40mg/mL Special Authorization
2398958 Diacomit 250mg (Capsule) Special Authorization
2398974 Diacomit 250mg (Suspension) Special Authorization
2398966 Diacomit 500mg (Capsule) Special Authorization
2398982 Diacomit 500mg (Suspension) Special Authorization
2415690 Opsumit 10mg Special Authorization
2418355 Sovaldi 400mg Special Authorization
2413299 Signifor 300mcg Special Authorization
2413302 Signifor 600mcg Special Authorization
2413310 Signifor 900mcg Special Authorization
2415666 Giotrif 20mg Special Authorization
2415674 Giotrif 30mg Special Authorization
2415682 Giotrif 40mg Special Authorization
2391740 ARANESP 40MCG/0.4ML SINGLEJECT Special Authorization
2419580 Pomalyst 1mg Special Authorization
2419599 Pomalyst 2mg Special Authorization
2419602 Pomalyst 3mg Special Authorization
2419610 Pomalyst 4mg Special Authorization
2420201 Tecfidera 240mg Excluded
2391767 ARANESP 80mcl/0.4ml SINGLEJECT Special Authorization
2418118 APO-SILDENAFIL R 20MG TAB Special Authorization
2391783 ARANESP 130MCL/.65ML SINGLEJECT Special Authorization
2409674 Apo-Voriconazole 50MG  Special Authorization
2409682 Apo-Voriconazole 200MG  Special Authorization
2418320 Lemtrada 12MG/1.2ML Excluded
2392321 ARANESP 20MCG/0.5ML SINGLEJECT Special Authorization
2392348 ARANESP 20MCG/0.3ML SINGLEJECT Special Authorization
2392364 ARANESP 500MCG/1ML SINGLEJECT Special Authorization
2398400 TEVA-BOSENTAN 6.25 MG TAB Special Authorization
2398419 TEVA-BOSENTAN 125 MG TAB Special Authorization
2416824 SANDOZ TACROLIMUS 1MG CAP Excluded
2416832 SANDOZ TACROLIMUS 5MG CAP Excluded
2424770 Actemra SC Special Authorization
2424622 Posanol Delayed Release Tablet Special Authorization
2391775 ARANESP 100MCG/0.5ML SINGLEJECT Special Authorization
2392356 ARANESP 60MCG/0.3ML SINGLEJECT Special Authorization
2391791 ARANESP 150MCG/0.3ML SINGLEJECT  Special Authorization
2396866 TEVA-VORICONAZOLE 50MG TAB Special Authorization
2396874 TEVA-VORICONAZOLE 200MG TAB Special Authorization
2391759 ARANESP 50MCL/0.5ML SINGLEJECT Special Authorization
2391805 ARANESP 200MCL.0.4ML SINGLEJECT Special Authorization
2397285 CO IMATINIB 100MG TAB Special Authorization
2397293 CO IMATINIB 400MG TAB Special Authorization
2399245 SANDOZ VORICONAZOLE 50MG TAB Special Authorization
2399253 SANDOZ VORICONAZOLE 200MG TAB Special Authorization
2413191 OCPHYL 50MCL/ML Special Authorization
2413205 OCPHYL 100MCL/ML Special Authorization
2413213 OCPHYL 500MCL/ML Special Authorization
92099988 GLEEVEC 100MG TAB Special Authorization
92099987 GLEEVEC 400MG TAB Special Authorization
9857447 GLEEVEC 100MG TAB Special Authorization
9857448 GLEEVEC 400MG TAB Special Authorization
2419149 BOSULIF 100MG TAB Special Authorization
2419157 BOSULIF 500MG TAB Special Authorization
2423898 Xeljanz  Special Authorization
2372746 APO-MYCOPHENOLIC ACID 360MG TAB Excluded
2372738 APO-MYCOPHENOLIC ACID 180MG TAB Excluded
2418428 AURO-EFAVIRENZ 600MG TAB Excluded
2410567 AURO-LAMIVUDINE 300MG TAB Excluded
2410575 AURO-LAMIVUDINE 150MG TAB Excluded
2414414 AURO-LAMIVUDINE/ZIDOVUDINE 150MG/300MG TAB Excluded
2420333 Apo-Adefovir 10mg Special Authorization
2425890 Ibavyr 400mg Special Authorization
2425904 Ibavyr 600mg Special Authorization
2399091 NUTROPIN AQ NUSPIN 5 2ML Excluded
2399083 NUTROPIN AQ NUSPIN 20 2ML Excluded
2430576 PMS-ENTECAVIR 0.5MG TAB Special Authorization
9857294 HUMIRA 40MG/0.8ML Special Authorization
2432226 HARVONI 90MG/400MG TAB Special Authorization
2426501 PREZCOBIX Excluded
2430932 TRIUMEQ Excluded
2434407 IMBRUVICA 140MG CAP Special Authorization
2434334 OTEZLA 30MG TAB Special Authorization
2421917 SANDOZ CAPECITABINE 150MG TAB Special Authorization
2421925 SANDOZ CAPECITABINE 500MG TAB Special Authorization
2413825 TEVA-VALGANCICLOVIR 450MG TAB  Excluded
2416816 SANDOZ-TACROLIMUS 0.5MG CAP Excluded
2426757 ACH-CAPECITABINE 150MG TAB Special Authorization
2426765 ACH-CAPECITABINE 500MG TAB Special Authorization
2377691 TEVA-ERLOTINIB 25MG TAB Special Authorization
2377705 TEVA-ERLOTINIB 100MG TAB Special Authorization
2377713 TEVA-ERLOTINIB 150MG TAB Special Authorization
2425661 AFINITOR DISPERZ 5MG TAB Special Authorization
2425653 AFINITOR DISPERZ 3MG TAB Special Authorization
2425645 AFINITOR DISPERZ 2MG TAB Special Authorization
2436027 HOLKIRA PAK Special Authorization
2419475 INFLECTRA IV Special Authorization
2412179 PMS-SILDENAFIL R 20MG TAB Special Authorization
2425629 LUCENTIS 10MG/ML SYRINGE 0.05ML Special Authorization
2436841 ENTYVIO Special Authorization
2434814 JAKAVI 10mg Special Authorization
2438798 ZYDELIG 100mg Special Authorization
2438801 ZYDELIG 150mg Special Authorization
2439212 IBAVYR 200mg Special Authorization
2438070 COSENTYX Special Authorization
2334852 NORDITROPIN NORDIFLEX 5MG Excluded
2334860 NORDITROPIN NORDIFLEX 10MG Excluded
2334879 NORDITROPIN NORDIFLEX 15MG Excluded
02437503 JINARC 45MG/15MG COMBO PACK Special Authorization
02437538 JINARC 90MG/30MG COMBO PACK Special Authorization
02437511 JINARC 60MG/30MG COMBO PACK Special Authorization
2431114 PMS-IMATINIB 100MG TAB Special Authorization
2431122 PMS-IMATINIB 400MG TAB Special Authorization
2443074 OFEV 150MG Special Authorization
2443066 OFEV 100MG Special Authorization
2399202 APO-BOSENTAN 62.5MG TAB Special Authorization
2399210 APO-BOSENTAN 125MG TAB Special Authorization
2437333 ICLUSIG 15MG TAB Special Authorization
243341 ICLUSIG 45MG TAB Special Authorization
2444372 PLEGRIDY 63MCG Excluded
2444380 PLEGRIDY 94 MCG Excluded
2444399 PLEGRIDY 125MCG Excluded
2444402 PLEGRIDY 63MCG AND 94 MCG Excluded
2437252 SIGNIFOR LAR 20MG Special Authorization
2437260 SIGNIFOR LAR 40MG Special Authorization
2437279 SIGNIFOR LAR 60MG Special Authorization
2446057 REPATHA 140MG/ML Special Authorization
2444755 DAKLINZA 60MG Special Authorization
2444747 DAKLINZA 30MG Special Authorization
2447711 TECHNIVIE TABLETS Special Authorization
2421933 APO-TADALAFIL PAH 20MG TAB Special Authorization
2435179 AURO-VALGANCICLOVIR 450MG TAB Excluded
2443481 TARO-TEMOZOLOMIDE 20 MG CAP Special Authorization
2443538 TARO-TEMOZOLOMIDE 140 MG CAP Special Authorization
2443473 TARO-TEMOZOLOMIDE 5 MG CAP Special Authorization
2441160 ACT TEMOZOLOMIDE 5 MG CAP  Special Authorization
2443554 TARO-TEMOZOLOMIDES 250 MG CAP Special Authorization
2443511 TARO-TEMOZOLOMIDES 100 MG CAP Special Authorization
2420104 NEUPOGEN PRE-FILLED SYRINGE 0.5 ML Special Authorization
2420112 NEUPOGEN PRE-FILLED SYRINGE 0.8 ML Special Authorization
2449498 GENVOYA Excluded
2416255 APO-ABACAVIR-LIMIVUDINE-ZIDOVUDINE 300MG/150MG/300MG Excluded
2441489 GRASTOFIL 0.5 ML PREFILLED SYRINGE Special Authorization
2443368 SANDOZ-TOBRAMYCIN INH. SOL. 5 ML Excluded
2449781 NUCALA 10 ML VIAL Special Authorization
2389622 TEVA-TOBRAMYCIN 5 ML AMPOULES Excluded
2440601 REVLIMID 20 MG CAP Special Authorization
2399539 APO-ABACAVIR-LAMIVUDINE 600/300 MG TAB Excluded
2416662 TEVA- ABACAVIR/LAMIVUDINE 600/300MG TAB Excluded
2450682 MYLAN-ABACAVIR/LAMIVUDINE 600/300 MG TAB Excluded
2396769 APO-ABACAVIR 300 MG TAB Excluded
2452693 APO-CINACALCET 30 MG TAB Special Authorization
2452707 APO-CINACALCET 60 MG TAB Special Authorization
2452715 APO-CINACALCET 90 MG TAB Special Authorization
2450321 LENVIMA 10 MG Special Authorization
2450313 LENVIMA 14 MG Special Authorization
2450305 LENVIMA 20 MG Special Authorization
2450291 LENVIMA 24 MG Special Authorization
2451158 UPTRAVI 200 MCG Special Authorization
2451166 UPTRAVI 400 MCG Special Authorization
2451174 UPTRAVI 600 MCG Special Authorization
2451182 UPTRAVI 800 MCG Special Authorization
2451190 UPTRAVI 1000 MCG Special Authorization
2451204 UPTRAVI 1200 MCG Special Authorization
2451212 UPTRAVI 1400 MCG Special Authorization
2451220 UPTRAVI 1600 MCG Special Authorization
2453819 PRALUENT 75 ML SINGLE USE PEN Special Authorization
2453835 PRALUENT 150 MG/ML SINGLE USE PEN Special Authorization
2453754 PRALUENT 75 ML PRE-FILLED PEN Special Authorization
2453762 PRALUENT 150 ML PRE-FILLED PEN Special Authorization
2454386 PMS-ERLOTINIB 100 MG TAB Special Authorization
2454394 PMS-ERLOTINIB 150 MG TAB Special Authorization
2432625 VAN-MYCOPHENOLATE 500MG TAB Excluded
2433680 VAN-MYCOPHENOLATE 250 MG CAP Excluded
2456370 EPCLUSA 400/100 MG TAB Special Authorization
2452219 JADENU 90 MG TAB Special Authorization
2452227 JADENU 180 MG TAB Special Authorization
2452235 JADENU 360 MG TAB Special Authorization
2451131 ZEPATIER 50MG/100MG Special Authorization
2442302 QUINSAIR Excluded
99101167 REMICADE 100MG/VIAL Special Authorization
2450267 AFINITOR 7.5 MG TAB Special Authorization
2448777 AURO-ENTECAVIR 0.5mg tab Special Authorization
2456915 COPAXONE 40 ML PRE-FILLED SYRINGE Excluded
2454416 DESCOVY 200/10 MG TAB Excluded
2454424 DESCOVY 200/25 MG TAB Excluded
2455323 BRENZYS PRE-FILLED SYRINGE 50MG/ML Special Authorization
2455331 BRENZYS PRE-FILLED AUTO INJECTOR 50MG/ML Special Authorization
2455110 TALTZ 80 ML SINGLE DOSE PREFILLED SYR. Special Authorization
2455102 TALTZ 80 ML  PREFILLED AUTOINJECTOR Special Authorization
2458381 PMS-ABACAVIR-LAMIVUDINE 600MG Excluded
2457369 SANIS-MYCOPHENOLATE MOFETIL 250 MG  Excluded
2457377 SANIS-MYCOPHENOLATE MOFETIL 500 MG  Excluded
2457113 ZYTIGA 500MG TAB Special Authorization
2454548 GRASTOFIL SINGLE USE PREFILLED SYRINGE 0.8ML Special Authorization
2441624 TEVA-CINACALCET 30 MG  Special Authorization
2441632 TEVA- CINACALCET 60MG Special Authorization
2441640 TEVA-CINACALCET 90MG Special Authorization
2438119 ACH-TEMOZOLOMIDE 5MG CAP Special Authorization
2456419 CINQAIR 100 MG VIAL Special Authorization
2436663 PHEBURANE 174 G BOTTLE Special Authorization
02454513 AURO-ABACAVIR/LAMIVUDINE 600/300MG TAB Excluded
02458349 HUMIRA PREFILLED SYRINGE0.4ML Special Authorization
02458357 HUMIRA PREFILLED PEN 0.4ML Special Authorization
02459418 REVLIMID 2.5 MG CAP Special Authorization
2452340 COTELLIC 20 MG Special Authorization
2453150 IBRANCE 75 MG Special Authorization
2453169 IBRANCE 100 MG Special Authorization
2453117 IBRANCE 125 MG Special Authorization
2287439 EXJADE TAB 250 MG Special Authorization
2287447 EXJADE TAB 500 MG Special Authorization
2287420 EXJADE 125 MG TAB Special Authorization
2434547 MYLAN-CINACALCET 60MG TAB Special Authorization
2434555 MYLAN-CINACALCET 90MG TAB Special Authorization
2445158 CREON MINIMICROSPHERES GRANULES 100 MG Excluded
2443791 TEVA-ATAZANAVIR 150MG CAP Excluded
2443813 TEVA-ATAZANAVIR 200MG CAP Excluded
2460521 KEVZARA PREFILLED SYRINGE 150MG/1.14ml Special Authorization
2460548 KEVZARA PRE FILLED SYRINGE 250MG/1.14ml Special Authorization
2456877 MYLAN-ATAZANAVIR 150MG CAP Excluded
2456885 MYLAN-ATAZANAVIR 200MG CAP Excluded
2456893 MYLAN-ATAZANAVIR 300MG CAP Excluded
2456117 DYSPORT THERAPEUTIC 500 UNIT VIAL Special Authorization
2460203 DYSPORT THERAPEUTIC 300 UNIT VIAL Special Authorization
2461463 ODEFSEY 200MG TAB Excluded
2462850 ERELZI 50MG/ML PREFILLED SYRINGE Special Authorization
2462869 ERELZI 50MG/ML PREFILLED AUTO INJ Special Authorization
2462877 ERELZI 0.5ML/25MGMLPREFILLED SYRINGE Special Authorization
2460661 GLATECT PRE-FILLED SYRINGE 20MG/ML Excluded
2459647 OMNITROPE 15MG/1.5ML SOL Excluded
2459779 REPATHA 3.5ML AUTOMATED MIN-DOSER Special Authorization
2464241 VEMLIDY 25MG TAB Special Authorization
2443821 TEVA ATAZANAVIR 300MG CAP Excluded
2461544 APO-DEFERASIROX 125MG TAB Special Authorization
2461552 APO-DEFERASIROX 250MG TAB Special Authorization
2461560 APO-DEFERASIROX 500MG TAB Special Authorization
2459620 ZINBRYTA PRE-FILLED SYRINGE 150MG/ML Excluded
2459639 ZINBRYTA PRE-FILLED PEN 150MG/ML Excluded
2461218 TIVICAY 10MG TAB Excluded
2461226 TIVICAY 25MG TAB Excluded
2463520 TARO-DEFERASIROX 125MG TAB Special Authorization
2463539 TARO-DEFERASIROX 250MG TAB Special Authorization
2463547 TARO-DEFERASIROX 500MG TAB Special Authorization
2407957 TEVA-DEFERASIROX 125MG TAB Special Authorization
2407965 TEVA-DEFERASIROX 250MG TAB Special Authorization
2407973 TEVA-DEFERASIROX 500MG TAB Special Authorization
2451980 APO-TENOFOVIR 300MG TAB Excluded
2399059 TEVA-EMTRICITABINE/TENOFOVIR 200/300MG TAB Excluded
2452006 APO-EMTRICITABINE-TENOFOVIR 200/300MG Excluded
99101215 COSENTYX 150ML PRE-FILLED PENS Special Authorization
2467224 OCREVUS SINGLE USE VIAL 30MG/ML Special Authorization
2467550 MAVIRET 100/40MG TAB 28 DAILY DOSE PK Special Authorization
2393549 TEVA-EFAVIRENZ/EMTRICITABINE/TENOFOVIR 600/200/300MG TAB Excluded
2461412 MYLAN-EFAVIRENZ/EMTRICITABINE/TENOFOVIR DISOPROXIL FUMARATE 600/200/300MG TAB Excluded
2460173 AURO-TENOFOVIR 300MG TAB Excluded
2403889 TEVA-TENOFOVIR 300MG TAB Excluded
2452634 MYLAN-TENOFONIR DISOPROXIL 300MG TAB Excluded
2443902 MYLAN-EMTRICITABINE/TENOFOVIR DISOPROXIL 200/300MG TAB Excluded
2464489 ESBRIET 267MG TABLET Special Authorization
2459787 XOLAIR PREFILLED SYRINGE 0.5 ML Special Authorization
2459795 XOLAIR PREFILLED SYRINGE 1 ML Special Authorization
2457490 TARO-CAPECITABINE 150MG TAB Special Authorization
2457504 TARO-CAPECITABINE 500MG TAB Special Authorization
2464454 SANDOZ DEFERASIROX 125MG TAB Special Authorization
2464462 SANDOZ DEFERASIROX 250MG TAB Special Authorization
2464470 SANDOZ DEFERASIROX 500MG TAB Special Authorization
2461889 APO-ERLOTINIB 150MG TAB Special Authorization
2461870 APO-ERLOTINIB 100MG TAB Special Authorization
2461862 APO-ERLOTINIB 25MG TAB Special Authorization
2464500 ESBRIET 801 MG TAB Special Authorization
2465337 ISENTRESS HD 600MG TAB Excluded
2465574 CIMZIA SINGLE USE AUTO INJ 200MG  2 PER CTN Special Authorization
2468050 APO- GEFITINIB 250 MG TAB Special Authorization
2467542 VOSEVI Special Authorization
2463121 OCALIVA 5MG TAB Special Authorization
2463148 OCALIVA 10MG TAB Special Authorization
97799171 FreeStyle Libre Sensor Special Authorization
2466538 BIO-BOSENTAN 62.5 MG TAB Special Authorization
2466546 BIO-BOSENTAN 125MG TAB Special Authorization
2463199 REDDY-AZACITIDINE 100MG VIAL SINGLE USE Special Authorization
999001 NEUPOGEN 1.6ML PIN FOR NB Special Authorization
2470365 DUPIXENT 150MG/ML SOL. Special Authorization
2469758 TREMFYA 1ML PRE-FILLED SYRINGE Special Authorization
2470179 MAVENCLAD 10MG TAB Special Authorization
2470489 BENLYSTA AUTO INJ SINGLE DOSE Special Authorization
2434512 APO-CAPECITABINE 500MG TAB Special Authorization
2472988 KEVZARA 1.14ML/200ML PREFILLED PEN  Special Authorization
2472961 KEVZARA 1.14ML/150ML PREFILLED PEN 2PER CTN Special Authorization
2470470 BENLYSTA PREFILL SYR SINGLE DS 200MG/1ML Special Authorization
2472104 LONSURF 15MG/6.14MG TAB Special Authorization
2472112 LONSURF 20MG/8.19MG TAB Special Authorization
2470608 XELJANZ XR 11MG TAB Special Authorization
2473720 SYMTUZA 800/150MG TAB Excluded
2473976 RITUXAN SC SINGLE DOSE VIAL 20ML Special Authorization
2459132 MOVAPO 30MG/3ML PREFILLED PEN Special Authorization
2470373 RENFLEXIS SINGLE USE 20ML VIAL Special Authorization
2467232 JAMP-ENTECAVIR 0.5MG TAB Special Authorization
2473569 KISQALI 200MG TAB Special Authorization
2473623 SILIQ 210MG/1.5 ML SINGLE USE PREFILL SY Special Authorization
2473232 FASENRA 30MG/ML SINGLE DS PREFILLED SYR Special Authorization
2469375 PREVYMIS 240MG TAB Special Authorization
2469383 PREVYMIS 480MG TAB Special Authorization
2475774 JULUCA 25/50MG TAB Excluded
2478579 BIKTARVY 50/200/25 TABLET Excluded
2466236 RYDAPT 25MG CAP Special Authorization
2480018 OLUMIANT 2MG TABLET Special Authorization
99108894 RENFLEXIS SINGLE USE 20ML VIAL Special Authorization
99109093 RENFLEXIS SINGLE USE 20ML VIAL Special Authorization
99108493 REMICADE 100MG/10ML VIAL INJ. Special Authorization
99108693 REMICADE 100MG/10ML VIAL INJ. Special Authorization
99108893 INFLECTRA 100MG /VAIL Special Authorization
2467984 NAT-BOSENTAN 62.5 MG TAB Special Authorization
2467992 NAT-BOSENTAN 125 MG TAB Special Authorization
2481987 M-CINACALCET 30MG TAB Special Authorization
2481995 M-CINACALCET 60MG TAB Special Authorization
2482002 M-CINACALCET 90MG TAB Special Authorization
2478900 AURO-CINACALCET 30 MG TAB Special Authorization
2478919 AURO-CINACALCET 60 MG TAB Special Authorization
2478943 AURO-CINACALCET 90 MG TAB Special Authorization
2483610 FULVESTRANT 250MG/5ML INJ Special Authorization
2460130 TEVA-FULVESTRANT 250MG/5ML X2 Special Authorization
2482533 GILENYA 0.25 MG CAP BLISTER PK Special Authorization
2480786 XELJANZ 10MG TAB Special Authorization
2448858 SOMAVERT 30MG/VIAL (1ML) Special Authorization
2448831 SOMAVERT 25MG/VIAL (1ML) Special Authorization
2487454 SKYRIZI 75MG PREFILLED SYRINGE Special Authorization
2487314 TREMFYA ONE-PRESS 1ML INJECTOR Special Authorization
2478374 ERLEADA 60MG TAB Special Authorization
2486024 Vizimpro Tablet 15mg Special Authorization
2486032 Vizimpro Tablet 30mg Special Authorization
2486040 Vizimpro Tablet 45mg Special Authorization
2483939 NAT-ERLOTINIB 150MG TAB Special Authorization
2483920 NAT-ERLOTINIB 10MG TAB Special Authorization
2483912 NAT-ERLOTINIB 25 MG Special Authorization
2474565 LAPELGA 6MG/0.6ML SINGLEUSE PREILLED SYR Special Authorization
2485265 APO-DEFERASIROX (TYPE J) 90MG TAB Special Authorization
2485273 APO-DEFERASIROX (TYPE J) 180MG TAB Special Authorization
2485281 APO-DEFERASIROX (TYPE J) 360MG TAB Special Authorization
2487748 SDZ-GEFITINIB 250MG TAB Special Authorization
2468220 LENVIMA 8MG DOSE 5 DAY BLISTER PK Special Authorization
2468239 LENVIMA 18MG DOSE 5 DAY BLISTER PK Special Authorization
2484056 LENVIMA 4MG 5 DAY BLISTER PK Special Authorization
2484129 LENVIMA 12MG 5 DAY BLISTER PK Special Authorization
2487098 VERZENIO 50MG TAB Special Authorization
2487101 VERZENIO 100MG TAB Special Authorization
2487128 VERZENIO 150MG TAB Special Authorization
2487136 VERZENIO 200MG TAB Special Authorization
99101399 FREESTYLE LIBRE Special Authorization
9857632 FREESTYLE LIBRE 14-DAY SENSOR Special Authorization
2483327 Actemra ACTpen Special Authorization
2489597 Evenity Special Authorization
2485877 ENVARSUS PA 0.75MG Excluded
2485885 ENVARSUS PA 1MG Excluded
2485893 ENVARSUS PA 4MG Excluded
2348675 TEVA-MYCOPHENOLATE 500MG/TAB Excluded
2331667 ADVAGRAF 3MG Excluded
2469936 APO-FINGOLIMOD 0.5MG TAB BLS Excluded
2469715 MYLAN-FINGOLIMOD 0.5 TAB BLS Excluded
2492989 NUCALA PREFILLED AUTO -INJ 1ML Special Authorization
2492997 NUCALA PREFILLED SYR. 1ML Special Authorization
2483971 Cresemba Capsules Special Authorization
2491753 Dovato                   Excluded
2469782 PMS FINGOLIMOD 0.5MG CAP Excluded
2461110 PMS-EMTRICITABINE-TENOFOVIR 200/300mg Excluded
2469332 CUVPOSA 473ML (16oz) ORAL SOLUTION Special Authorization
2491087 EMGALITY PREFILLED PEN 1ML Special Authorization
2491060 EMGALITY PREFILLED SYR, 1ML Special Authorization
2484676 SDZ-EFAVIRENZ/EMTRICITABINE/TENOFOVIR 600/200/300MG TAB Excluded
2469561 TEVA-FINGOLIMOD 0.5 MG CAP Excluded
2482606 SDZ-FINGOLIMOD 0.5MG CAP Excluded
2463229 TEVA-EVEROLIMUS 2.5MG TAB Special Authorization
2463237 TEVA-EVEROLIMUS 5MG TAB Special Authorization
2463253 TEVA-EVEROLIMUS 10MG TAB Special Authorization
2474743 MAR-FINGOLIMOD 0.5MG CAP Excluded
2487772 JAMP FINGOLIMOD 0.5MG CAP Excluded
2469618 TARO-FINGOLIMOD 0.5MG CAP Excluded
2485907 MINT-ENTECAVIR 0.5MG TAB Special Authorization
2470705 APO-DASATINIB 20MG TAB Special Authorization
2470713 APO-DASATINIB 50MG TAB  Special Authorization
2481499 APO-DASATINIB 70MG TAB  Special Authorization
2481502 APO-DASATINIB 80MG TAB  Special Authorization
2470721 APO-DASATINIB 100MG TAB  Special Authorization
2495155 RINVOQ 15MG TAB (ER) Special Authorization
2487241 APO-DARUNAVIR 600MG TAB Excluded
2462826 REDDY-AZACITIDINE FOR INJ 100MG VIAL Special Authorization
2474263 HUMIRA PREFILLED SYRINGE 20mg/0.2ml Special Authorization
2482215 KUVAN 500MG /SACHET Special Authorization
2482207 KUVAN 100MG /SACHET Special Authorization
2478382 TRUXIMA 100MG/10ML Special Authorization
2478390 TRUXIMA 500MG/50ML VIAL Special Authorization
2487268 APO-DARUNAVIR 800MG TAB Excluded
2491575 JINARC 15/15MG TAB COMBO PACK Special Authorization
2491583 JINARC 15/30MG TAB COMBO PACK  Special Authorization
2483149 TARO-BOSENTAN  125MG TAB Special Authorization
2483130 TARO-BOSENTAN 62.5MG TAB Special Authorization
2495457 MINT-VALGANCICLOVIR Excluded
2486121 AURO-DARUNAVIR 600MG TAB Excluded
2486148 AURO-DARUNAVIR 800MG TAB Excluded
2484153 FULPHILA 10MG/ML PREFILLED SYRINGE Special Authorization
463221 LYSODREN TAB 500MG Special Authorization
2496348 NUBEQA 300MG TAB Special Authorization