12 DRUG NAME(S) PREFERRED OPTION(S) hydrochlorothiazide, valsartan, valsartan-hydrochlorothiazide ATIVAN alprazolam, clonazepam, diazepam, lorazepam, oxazepam AVENOVA Talk to your doctor AZASITE ciprofloxacin, erythromycin, gentamicin, levofloxacin, moxifloxacin, ofloxacin, sulfacetamide, tobramycin, BESIVANCE AZELEX adapalene (except adapalene pad), benzoyl peroxide, clindamycin gel (except NDC 68682046275), clindamycin solution, clindamycin-benzoyl peroxide, dapsone, erythromycin solution, erythromycin-benzoyl peroxide, tazarotene, tretinoin, AKLIEF, EPIDUO, TWYNEO, WINLEVI AZESCO generic prenatal vitamins AZOR amlodipine-olmesartan, amlodipine-telmisartan, amlodipine-valsartan BALCOLTRA ethinyl estradiol-drospirenone, ethinyl estradiol-drospirenone- levomefolate, ethinyl estradiol- levonorgestrel, ethinyl estradiol- levonorgestrel-iron, ethinyl estradiol-norethindrone acetate, ethinyl estradiol- norethindrone acetate-iron, ethinyl estradiol-norgestimate, LO LOESTRIN FE, NATAZIA BANZEL clobazam, clonazepam, lamotrigine, rufinamide, topiramate, topiramate ext-rel BASAGLAR INSULIN GLARGINE-YFGN, LANTUS BENICAR, BENICAR HCT candesartan, candesartan- hydrochlorothiazide, irbesartan, irbesartan-hydrochlorothiazide, losartan, losartan- hydrochlorothiazide, olmesartan, olmesartan-hydrochlorothiazide, telmisartan, telmisartan- hydrochlorothiazide, valsartan, valsartan-hydrochlorothiazide BENSAL HP desonide (except desonide gel), hydrocortisone benzonatate (NDCs 69336012615, 69499032915 only) benzonatate (except NDCs 69336012615, 69499032915) BEPREVE azelastine, bepotastine, cromolyn sodium, loteprednol, DRUG NAME(S) PREFERRED OPTION(S) olopatadine BETAMETHASONE ACETATE- BETAMETHASONE SODIUM PHOSPHATE dexamethasone, hydrocortisone, methylprednisolone, prednisolone solution (except prednisolone solution 10 mg/5 mL, 20 mg/5 mL), prednisone betamethasone dipropionate ointment 0.05% desoximetasone (except desoximetasone ointment 0.05%), fluocinonide (except fluocinonide cream 0.1%), BRYHALI BETAPACE, BETAPACE AF sotalol BETIMOL timolol maleate solution, BETOPTIC S BEVESPI AEROSPHERE ANORO ELLIPTA, STIOLTO RESPIMAT BEYAZ ethinyl estradiol-drospirenone, ethinyl estradiol-drospirenone- levomefolate, ethinyl estradiol- levonorgestrel, ethinyl estradiol- levonorgestrel-iron, ethinyl estradiol-norethindrone acetate, ethinyl estradiol-norethindrone acetate-iron, ethinyl estradiol- norgestimate, LO LOESTRIN FE, NATAZIA BREEZE 2 STRIPS AND KITS ACCU-CHEK AVIVA PLUS STRIPS AND KITS, ACCU-CHEK GUIDE STRIPS AND KITS, ACCU- CHEK SMARTVIEW STRIPS AND KITS, TRUE METRIX STRIPS AND KITS BROMSITE bromfenac, diclofenac, ketorolac, ILEVRO budesonide ext-rel tablet balsalazide, mesalamine delayed- rel, mesalamine ext-rel, sulfasalazine, sulfasalazine delayed-rel bupropion ext-rel tablet 450 mg bupropion, bupropion ext-rel (except bupropion ext-rel tablet 450 mg) butalbital-acetaminophen capsule, butalbital- acetaminophen tablet 25-325 mg, butalbital-acetaminophen tablet 50-300 mg, BUTALBITAL- ACETAMINOPHEN (NDC 69499034230 only) diclofenac sodium, ibuprofen, naproxen (except naproxen CR or naproxen suspension) butalbital-acetaminophen- caffeine capsule diclofenac sodium, ibuprofen, naproxen (except naproxen CR or naproxen suspension) BUTRANS buprenorphine transdermal, BELBUCA BYDUREON BCISE liraglutide, MOUNJARO,